Public Health Commons^™

Incidence Of Neonatal Abstinence Syndrome Epidemic And Associated Predictors In Nevada: A Statewide Audit, 2016–2018, Kavita Batra, Patricia Cruz, Chad L. Cross, Neeraj Bhandari, Farooq Abdulla, Jennifer R. Pharr, Mark P. Buttner

Environmental & Occupational Health Faculty Publications

Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome among neonates born to mothers with drug dependence disorders. NAS poses a significant public health challenge nationally, with a six-fold increase in incidence (1.2 to 6.7 per 1000 hospital births/year) from 2000–2016. Besides national data, it is critical to quantify NAS at the state-level to identify target areas for prevention. The objectives of this study were to ascertain statewide burden, including county and regional distribution of NAS in Nevada during 2016–2018, and to investigate potential factors associated with NAS. This study utilized hospital administrative data, and a total of 100,845 inpatient …

Individual- And Country-Level Correlates Of Female Permanent Contraception Use In Sub-Saharan Africa, Babayemi O. Olakunde, Jennifer R. Pharr, Lung-Chang Chien, Rebecca D. Benfield, Francisco S. Sy

Environmental & Occupational Health Faculty Publications

Background: Female permanent contraception is a cost-effective contraceptive method that can help clients with the desire to limit childbearing achieve their reproductive intention. However, despite its benefits, the use of FPC remains low in sub-Saharan Africa (SSA), and limited studies have examined the correlates of its uptake. In this study, we assessed the individual- and country-level factors associated with the use of FPC among married or in-union women using modern contraceptive methods to limit childbearing in SSA. Methods: This study was a secondary data analysis of individual- and country-level data obtained from the Demographic and Health Surveys (DHS) Program and …

Perceptions Of The Built Environment Among Older Adults Who Live In Age-Restricted Communities Compared To Those Who Do Not In Southern Nevada, Sandra Annan

UNLV Theses, Dissertations, Professional Papers, and Capstones

As Americans are living longer, there has been exponential growth in the number of older adults. Growth in the aging population has created unique challenges. As seniors age, they face many changes in their health, financial stability, and lifestyle, making it challenging to remain independent. The inability to remain independent can be a stressful and depressing experience for older adults. Studies show that most seniors prefer to stay in their current living environment as they age, or age in place, rather than move into senior housing or other available housing options designed for aging. This study investigates how perceptions about …

How Does Stress And Coping Impact Undergraduate Students' Mental Health On A Racially Diverse Campus?, Kristina Ricker-Boles

UNLV Theses, Dissertations, Professional Papers, and Capstones

The study focuses on how subjective stress and mastery skills impact physical and mental wellbeing among UNLV undergraduate college students. Bovier, Chamot, and Perneger’s (2004) study was repeated within a racially diverse campus setting. The Transactional Model of Stress and Coping provided the foundation of this study with an emphasis on primary and secondary appraisal among racial and ethnic groups. The study utilized the Pearlin Coping Questionnaire, the Short Form-12 (SF-12), the Brief Encounter Psychosocial Instrument (BEPSI), and Duke-UNC Functional Social Support Questionnaire to assess subjective stress, mastery skills, and the moderator of social support while comparing the results among …

Gardasil Vaccine Trends Within Nevada, California, And The U.S.: A Comparative Study, Karen S. Gutierrez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite decreasing incidence in cervical cancer in the U.S., there continues to be an increase in public health concern for cervical cancer worldwide. Recent studies report that individuals are disproportionately affected based on region, sex, and race. Additionally, the human papillomavirus (HPV) attributable cancers may be reduced between 70% and 90% through the universal use of HPV-vaccines. In order to expand current knowledge and implement intervention programs in Nevada, it is critical to examine the associations among the Gardasil vaccine, cervical cancer screening, and adverse events following immunization as well as to understand the different socio-demographic subgroups affected. To our …

The Relationship Among Sociocultural Assimilation, Dietary Behavior, And Physical Activity In Adult Latinxs In The U.S., Erick Lopez

UNLV Theses, Dissertations, Professional Papers, and Capstones

This dissertation examines the relationship between sociocultural assimilation and health behaviors among adult Latinxs in the United States to address whether different assimilation models promote or hinder Latinx health. Existing research on assimilation and health behaviors among Latinxs relies heavily on the use of proxy measures of assimilation such as length of time in the U.S., nativity, age of arrival, and language preferences for surveys. These studies tend to show that greater assimilation to mainstream U.S. culture among Latinxs is associated with the adoption of poor health behaviors and the erosion of the immigrant health advantage. Research that uses sociocultural …

An Exploratory Study Of The Likelihood Of Adopting Genetic Counseling And Testing For Lynch Syndrome-Related Colorectal Cancer Among Primary Care Physicians In Florida, Vanessa B. Crowther, Sandra G. Suther, Jullet A. Weaver, Clement K. Gwede, Matthew Dutton, Dongming Cui, Ivette A. Lopez

Journal of Health Disparities Research and Practice

Genetic counseling and testing for inherited cancer syndromes have the potential to save lives and may be an avenue for addressing health care disparities among African Americans newly diagnosed with colorectal cancer (CRC); and their close relatives. African Americans are more likely to be diagnosed with CRC at younger ages (under age 50 years), and diagnosed at later stages when cancer is more aggressive and difficult to treat, which are factors associated with hereditary cancers such as Lynch syndrome-related CRC. Considering the benefits of genetic testing for hereditary cancer syndromes - risk stratification, preventive surveillance, targeted treatment, and subsequent reduction …

Relationship Between Psychosocial-Cultural Factors And African American Women Obesity., Francoise Knox-Kazimierczuk

Journal of Health Disparities Research and Practice

Objective: To determine associations between African American female obesity and SEM variables.

Design: Data from the National Survey of American Life Self-Administered Questionnaire (NSAL-SAQ), a 2001–2003 nationally representative cross-sectional survey was used to extract data for African American women.

Participants: African American females at a BMI of 18.5 kg/m2 or greater were included in the final sample (n = 2,100) for analysis.

Main Outcome Measure(s): BMI

Analysis: Measures for socioecological model (SEM) were analyzed using a regression model in SPSS.

Results: Intrapersonal and community/institutional levels were found to be significantly associated with BMI. Two multiple regression analyses models were developed …

Generational Impacts Of 1930s Housing Discrimination And The Imperative Need For The Healthy Start Initiative To Address Structural Racism, Brittney Butler, Michael Outrich, Jessica Roach, Arthur James

Journal of Health Disparities Research and Practice

For nearly three decades, Healthy Start Initiative(HSI) has served communities with high rates of adverse pregnancy outcomes--with the goal to lower them by 50%. Despite a large focus on social determinants of health, HSI has narrowly addressed racism. The effects of legal housing discrimination continue to be felt and have profound implications for pregnancy. To understand the historical context of racism in these communities, we geospatially evaluated the relationship between HSI service areas and Home-Owners Loan Corporation(HOLC) graded maps. Using data from John Snow Inc, National Healthy Start Association, and Mapping Inequality we found that 73 of 100 communities served …

The Early Impact Of The Affordable Care Act Upon Colorectal Cancer Screening Utilization In Florida, Aldenise P. Ewing, Laura Baum, Rosalyn Roker, Marlene Joannie Bewa, Tali Schneider, Claudia F. Parvanta, Clement K. Gwede, Cathy D. Meade, Dinorah Martinez Tyson

Journal of Health Disparities Research and Practice

Background: Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Although preventable and curable through screening, early detection and treatment, a lack of health insurance is a major obstacle to receiving colorectal cancer screening (CRCS). Despite the Affordable Care Act (ACA) increasing access to health insurance by mandating coverage of CRCS, disparities in utilization rates continue. Therefore, researchers sought to better understand ACA related facilitators and impediments that affect the utilization of CRCS and collect specific recommendations from healthcare professionals to increase screening utilization rates in Florida.

Methods: Researchers conducted in-depth interviews with …

Employing Position Generators To Assess Social Capital And Health: A Scoping Review Of The Literature And Recommendations For Measurement In Future Population-Based Surveillance, Steven Meanley, Candice Biernesser, Teagen O'Malley, Todd Bear, Jeanette Trauth

Journal of Health Disparities Research and Practice

Beneficial social connections are critical to individual-level health because they can be used to avoid or minimize the risks and consequences associated with diseases. How to best measure beneficial social connections to inform social network-level health interventions remains poorly understood. A scoping review of health surveillance studies was conducted to highlight the utility of employing position generators to assess how access to beneficial social connections was associated with population health and disparities. Our review yielded 39 articles conducted across 14 predominantly high-income countries. Most studies (77%) with composite measures for beneficial social connections exhibited health-protective associations. Of the remaining articles, …

Internet All Nation Breath Of Life (I-Anbl) A Tribal College Student Engaged Development Of An Internet-Based Smoking Cessation Intervention, Joseph A. Pacheco, Charley Lewis, Christina M. Pacheco, Jason W. Hale, Jessica A. R. Williams, Sean M. Daley, Christine M. Daley, Won S. Choi

Journal of Health Disparities Research and Practice

Background: Compared to non-Hispanic white college students, American Indian (AI) tribal college students have the highest smoking prevalence in the U.S. (~34%). Culturally-tailored smoking cessation programs have proven to be successful in reducing smoking rates but may require new methods to reach college students. Currently, there is little documentation on the development and success of Internet-based smoking interventions for AI tribal college students.

Objectives: To develop an Internet-based smoking cessation program (Internet-All Nations Breath of Life or I-ANBL) with tribal college students.

Methods: We conducted six focus groups (n=41) at a tribal college. Focus groups included tribal college students who …

Child Food Insecurity In Nevada Counties, 2018, Ally Beckwith, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet synthesizes data on the child hunger discrepancies in Nevada counties from the Feeding America 2018 Map the Meal Gap Study. The information focuses on food insecurity experienced by children, and the food budget shortfall in Nevada.

Flame Retardants And Neurodevelopment: An Updated Review Of Epidemiological Literature, Ann M. Vuong, Kimberly Yolton, Kim M. Cecil, Joseph M. Braun, Bruce P. Lanphear, Aimin Chen

Public Health Faculty Publications

Purpose of Review: Flame retardant (FR) compounds can adversely impact neurodevelopment. This updated literature review summarizes epidemiological studies of FRs and neurotoxicity published since 2015, covering historical (polybrominated biphenyls [PBBs], polychlorinated biphenyls [PCBs]), contemporary (polybrominated diphenyl ethers [PBDEs], hexabromocyclododecane [HBCD], and tetrabromobisphenol A [TBBPA]), and current-use organophosphate FRs (OPFRs) and brominated FRs (2-ethylhexyl 2,3,4,5-tetrabromobezoate [EH-TBB] TBB), bis(2-ethylhexyl) tetrabromophthalate [BEH-TEBP]), focusing on prenatal and postnatal periods of exposure. Recent Findings: Continuing studies on PCBs still reveal adverse associations with child cognition and behavior. Recent studies indicate PBDEs are neurotoxic, particularly for gestational exposures with decreased cognition and increased externalizing behaviors. Findings …

The Rural-Urban Divide In Tanzania: Residential Context And Socioeconomic Inequalities In Maternal Health Care Utilization, Neema Langa, Tirth Bhatta

Sociology Faculty Research

Background Existing studies in Tanzania, based mostly on rural samples, have primarily focused on individual behaviors responsible for the lower utilization of maternal health care. Relatively less attention had been paid to inequalities in structural circumstances that contribute to reduced utilization of maternal health care. More importantly, scholarship concerning the impact of the rural-urban divide on socioeconomic disparities in the utilization of maternal health care is virtually nonexistent in Tanzania. Methods Drawing from the Demographic Health Survey (2015-2016) conducted in Tanzania, our study includes a total of 3,595 women aged between 15-49 years old, who had given birth in five …

College Students' Health Insurance: A Focus On Foreign-Born Students' Healthcare, Phuong Le

Undergraduate Research Symposium Podium Presentations

This research is to explore the uninsured rates of foreign-born students from the age of 18 to 24, including those who study abroad in the United States from foreign countries, immigrants of the U.S. who are green-card holders, and residents/citizens who were not born in the U.S. It is found that there is no significant difference between Asian foreign-born students and other racial groups of foreign-born students, suggesting that there may not be a big cultural difference in perceiving health insurance among foreign-born students. In general, foreign-born students are 19.34 percentage points more likely to be uninsured. Statistical analysis has …

Improving Healthcare Quality In The United States Healthcare System: A Scientific Management Approach, Soumya Upadhyay, William Opoku-Agyeman

Public Health Faculty Publications

The US healthcare system has been facing pressures from stakeholders to reduce costs and improve quality. The purpose of this paper is to develop a conceptual model to illustrate the approaches used in healthcare quality management (Continuous Quality Improvement/Total Quality Management, Lean, and Six Sigma) weaved into the underlying framework of scientific management theory. This paper employs scientific management theory to explain the healthcare quality tenets that influence the quality of care in our healthcare organizations. The father of scientific management, Frederick Taylor, and other key contributors collectively created scientific management principles, which are widely used for quality improvement purposes …

Intergenerational Associations Of Adverse Birth Outcomes: A Surveillance Report, Dong Liu, Ge Lin, Dejun Su, James M. Alexender, Xiaoting Sun, Ming Qu

School of Medicine Faculty Publications

Nebraska births between 1995 and 2005 were followed until 2018 to look for intergenerational associations of low birth weight (LBW) and preterm birth (PTB). Results from generalized estimating equations revealed that mothers born LBW preterm were more likely to deliver LBW (adjusted OR 1.94, 95% CI 1.39–2.71) or preterm (adjusted OR 1.65, 95% CI 1.20–2.27) than mothers born with normal weight or at term. In addition, mothers who had an LBW sibling were 44% more likely to have an LBW infant (OR 1.44, 95% CI 1.04–2.00). A consistent finding was also observed for mothers who had a PTB sibling (OR …

A National Study On The Physical And Mental Health Of Intersex Adults In The U.S., Amy Rosenwohl-Mack, Suegee Tamar-Mattis, Arlene B. Baratz, Katharine B. Dalke, Alesdair Ittelson, Kimberly Zieselman, Jason D. Flatt

Environmental & Occupational Health Faculty Publications

Objectives: To describe the health of intersex adults (people with differences of sex development) in the U.S. using community-based research methods. Methods: In July–September 2018, we conducted a national health study of intersex adults aged 18 and older in the U.S., using a survey hosted on Qualtrics. The study describes the physical and mental health experiences of intersex adults, including differences by age (18 to 39 vs. 40 and older). Questions were derived from national (Behavioral Risk Factor Surveillance System) and intersex-related health studies. Results: A non-probability sample of 198 intersex adults completed the survey over three months. Over 43% …

Covid-19 And Social Isolation Endangering Psychological Health Of Older Adults: Implications For Telepsychiatry, Kavita Batra, Amanda Elizabeth Morgan, Manoj Sharma

Environmental & Occupational Health Faculty Publications

Coronavirus disease-19 (COVID-19) has created a public health emergency and had claimed 911,877 lives at the time of writing this manuscript (September 12, 2020). While everybody is at the risk of acquiring infection following the exposure to SARS-CoV-2, older adults are significantly more likely to experience severe illness, life-threatening complications, hospitalizations, and deaths. As the pandemic evolved, social distancing or shielding efforts as primary prevention were instituted to protect the physical health status of the vulnerable population, with no or limited consideration to the psychological health of the older population. Social isolation and loneliness are the long-standing public health concerns …

Reporting The Spanish Influenza Epidemic In Nevada, Peter Michel

Library Faculty Publications

The last great global pandemic before COVID 19 was the Spanish Influenza of 1918-20 which killed by some estimates over 30,000,000 people, 675,000 of those in the United States, ten-times the number of Americans who died in World War I. In another historical comparison, more people died of the Spanish Influenza in one year than died in four years of the Black Death of 1347-1351 in which a third of Europe’s population perished. In the early days of mass communication by telegraph and newspapers, compared to our own age of instant, constant streaming information, how did people know what was …

Covid-19 And Mental Well-Being: Guidance On The Application Of Behavioral And Positive Well-Being Strategies, Amar Kanekar, Manoj Sharma

Public Health Faculty Publications

The raging COVID-19 pandemic has been a great source of anxiety, distress, and stress among the population. Along with mandates for social distancing and infection control measures, the growing importance of managing and cultivating good mental well-being practices cannot be disregarded. The purpose of this commentary is to outline and discuss some research-proven positive well-being and stress reduction strategies to instill healthy coping mechanisms among individuals and community members. The authors anticipate that usage of these strategies at the individual and the community level should greatly benefit the mental well-being not only in the current COVID-19 pandemic but also in …

Prevalence Of Depression, Anxiety, And Stress During Covid-19 Pandemic, Ram Lakhan, Amit Agrawal, Manoj Sharma

Public Health Faculty Publications

The coronavirus disease 2019 (COVID-19) crisis has greatly affected human lives across the world. Uncertainty and quarantine have been affecting people’s mental health. Estimations of mental health problems are needed immediately for the better planning and management of these concerns at a global level. A rapid scoping review was conducted to get the estimation of mental health problems in the COVID-19 pandemic during the first 7 months. Peer-reviewed, data-based journal articles published in the English language were searched in the PubMed, Medline, and Google Scholar electronic databases from December 2019 to June 2020. Papers that met the inclusion criteria were …

Barriers For Cervical Cancer Screening In Women Living With Hiv: A Systematic Review, Vimala Ganta Md, Mph, Sheniz Moonie Phd, Brian Labus Phd, Karen Gutierrez Bs, Xan Y. Goodman Mlis, Ahip

Journal of Health Disparities Research and Practice

Cervical cancer is a prominent cancer in U.S. women caused primarily by the human papilloma virus and its incidence and mortality rates have decreased through screening programs. Certain barriers are perceived to be affecting the rates of cervical cancer screening among women living with HIV (WLWH). A systematic review was conducted to identify and summarize these barriers among WLWH nationwide. There is a need to increase awareness and education among WLWH. Public health programs and community-based interventions should target women of low SES and minority status while assessing the barriers among this population to improve cervical cancer screening rates.

Disparities In Health Behavior Risks Among Employed And Unemployed Black And White Older Adults, M. Courtney Hughes, Tamara A. Baker, Hansol Kim

Journal of Health Disparities Research and Practice

Objective: Examine health behavior risk rates and disparities in health behavior risks related to race and employment among older adults. Methods: A cross-sectional analysis of a representative sample of noninstitutionalized adults aged 65 and older (150,669 in 2015 and 168,011 in 2016) from the Behavioral Risk Factor Surveillance System. Self-reported health behavior risks were measured as well as multiple logistic regression analyses assessing the independent effects of demographic variables on health behavior risks. Results: Employed older adults have greater health behavior risks than unemployed older adults. Black employed older adults have greater health behavior risks than Black unemployed older adults …

A Lung Cancer Screening Personalized Decision-Aid Improves Knowledge And Reduces Decisional Conflict Among A Diverse Population Of Smokers At An Urban Academic Medical Center, Madeline Kaufman, Nilan Schnure, Andrea Nicholson, Frank Leone, Carmen Guerra

Journal of Health Disparities Research and Practice

Introduction: Few lung cancer screening decision aids have been tested in diverse populations. The study objective was to determine whether the online decision aid www.shouldiscreen.com impacts knowledge of and decisional conflict around lung cancer screening in a diverse population.

Methods: Eligible patients had significant smoking histories, were at increased risk for lung cancer (ages 45-80, >20 pack-years, smoking within last 15 years) and had no history of prior lung cancer or screening. Data was collected and analyzed in 2017.

Results: 40 patients were enrolled: 80% were female, 62.5% black, 33% white, and 48% had a high school …

Sex Differences In Risk Factors For Oral And Pharyngeal Cancer Among Puerto Rican Adults, Maira A. Castaneda-Avila, Cynthia Perez, Jose Vivaldi, Elba C. Díaz, Hilmaris Centeno, Ana P. Ortiz

Journal of Health Disparities Research and Practice

Background: Oral and pharyngeal cancer (OPC) is a frequent type of cancer in Puerto Rico, with the risk being higher in men relative to women. We assessed differences in OPC risk factors implicated in these sex disparities.

Methods: We analyzed data of 740 adult participants (40-65 years) from the San Juan Overweight Adults Longitudinal Study (SOALS). A comprehensive questionnaire was administered to collect information on sociodemographic characteristics, cigarette smoking, binge drinking, oral high-risk HPV infection, fruit and vegetable consumption, sexual behavior, and oral hygiene practices. A full-mouth periodontal examination was also performed. Sixteen OPC known and potential risk factors were …

Assessment Of Real-World Use Of Behavioral Health Mobile Applications By A Novel Stickiness Metric, Andrew D. Carlo, Reza H. Ghomi Md, Mse, Brenna N. Renn Phd, Michael A. Strong Md, Patricia A. Areán Phd

Psychology Faculty Research

Digital health treatments for individuals with behavioral health problems are increasing rapidly in number.1,2 Studies to date have demonstrated that longitudinal patient engagement is challenging,3,4 making it unlikely for most applications (hereafter, apps) to effect real-world change. In this cross-sectional study, we describe usage patterns of popular mobile behavioral health apps and identify characteristics of those that are most continually accessed (also known as the stickiest),5 with the aim of informing future research on behavioral health app engagement.

The Prevalence And Predictors Of Complementary And Alternative Medicine (Cam) Use Among Racially/Ethnically Diverse College Students, Hermella Misiker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: National data on complementary and alternative medicine (CAM) use, available through the National Health Interview Survey (NHIS), convey higher prevalence of CAM use among college students compared to the general U.S population. NHIS findings also highlight non-vitamin non- mineral (NVNM) products are the most widely used form of CAM in the U.S. The purpose of this study was to identify the socio-cognitive and demographic predictors of CAM and NVNM use among a racially/ethnically diverse college student body.

Methods: An online survey was used to collect data from 392 University of Nevada, Las Vegas (UNLV) undergraduate, graduate, and professional students. …

Sexually Transmitted Infections And The 65 And Older Population: Knowledge And Perceived Risk, Alexus Miranda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sexually transmitted infections (STI) can impact all persons. Since 2000, the number of STIs has steadily increased among persons aged 50 years and older in the United States (Purpora, 2012). Persons over the age of 60 accounted for the biggest increase of in-office treatments of STIs between 2014 and 2017 (Howley, 2018). The purpose of this study was to use the Sexual Health Model to examine the relationship between various predictors and these persons’ perceived risk of STIs, their STI knowledge, and other barriers that impact the sexual health of persons 65 years of age and older. This study used …