Public Health Commons^™

The Economic Sustainability Of Culture In Hawai’I: Tourists’ Willingness To Pay For Hawaiian Cultural Experiences, Gabriella Andrade, Holly Itoga, Catherine Linnes, Jerome Agrusa, Joseph Lema

Hospitality Faculty Research

Given the current travel restrictions with the COVID-19 pandemic, there is an unprecedented opportunity for Hawai’i to reexamine its current tourism offerings and establish a new approach to support a more authentic, cultural, and sustainable tourism for the U.S. domestic tourist market. As tourists from the continental U.S. are the largest source market for visitors to Hawai’i, the purpose of this study is to examine the trend towards an “authentic cultural” tourism experience and evaluate whether U.S. visitors will be willing to pay for a deeper integration and representation of Hawaiian culture in tourism offerings. The contingent valuation method (CVM) …

Skilled Maneuvering: Evaluation Of A Young Driver Advanced Training Program, Samantha A. Slinkard-Barnum, Laura K. Gryder-Culver, Kavita Batra, Paul J. Chestovich, Deborah A. Kuhls

Department of Surgery Faculty Research

BACKGROUND: Young drivers (YDs) are disproportionately injured and killed in motor vehicle crashes throughout the United States. Nationally, YDs aged 16 to 20 years constituted nearly 9% of all traffic-related fatalities in 2018. A Nevada Advanced Driver Training (ADT) program for YDs aims to reduce YD traffic injuries and fatalities through four modules taught by professional drivers. The program modules include classroom-based didactic lessons and hands-on driving exercises intended to improve safe driving knowledge and behaviors. The overarching purpose of this study was to determine if theNevada ADT programachieved its objectives for improving safe driving knowledge and behaviors based on …

Dietary Blueberry And Soluble Fiber Improve Serum Antioxidant And Adipokine Biomarkers And Lipid Peroxidation In Pregnant Women With Obesity And At Risk For Gestational Diabetes, Arpita Basu, Jeannette Crew, Jeffrey L. Ebersole, Jefferson W. Kinney, Arnold M. Salazar, Petar Planinic, James M. Alexander

Kinesiology and Nutrition Sciences Faculty Research

Pregnancies affected by obesity are at high risk for developing metabolic complications with oxidative stress and adipocyte dysfunction contributing to the underlying pathologies. Few studies have examined the role of dietary interventions, especially those involving antioxidants including polyphenolic flavonoids found in fruits and vegetables on these pathologies in high-risk pregnant women. We conducted an 18 gestation-week randomized controlled trial to examine the effects of a dietary intervention comprising of whole blueberries and soluble fiber vs. control (standard prenatal care) on biomarkers of oxidative stress/antioxidant status and adipocyte and hormonal functions in pregnant women with obesity (n = 34). Serum samples …

Protective Factors That Foster Resilience To Hiv/Aids: Insights And Lived Experiences Of Older Gay, Bisexual, And Other Men Who Have Sex With Men, Renato M. Liboro, Tammy C. Yates, Sherry Bell, Brandon Ranuschio, George Da Silva, Charles Fehr, Francisco Ibañez-Carrasco, Paul A. Shuper

Psychology Faculty Research

Since the beginning of the HIV/AIDS epidemic, gay, bisexual, and other men who have sex with men (gbMSM) have been disproportionately impacted by HIV/AIDS health disparities. Research showed that resilience to HIV/AIDS is associated with increased use of relevant health services, lower sexual health risks, and improved mental health outcomes among racially and ethnically diverse gbMSM. As the subpopulation that has historically been impacted by HIV/AIDS the longest, older gbMSM living with HIV/AIDS have inarguably exhibited resilience to HIV/AIDS the most. The qualitative study described in this paper sought to identify and examine protective factors that fostered resilience to HIV/AIDS …

Measuring Routine Childhood Vaccination Coverage In 204 Countries And Territories, 1980–2019: A Systematic Analysis For The Global Burden Of Disease Study 2020, Release 1, Natalie C. Galles, Patrick Y. Liu, Rachel I. Updike, Stephen S. Lim, Jonathan F. Mosser, Asma Tahir Awan, Gbd 2020, Release 1, Vaccine Coverage Collaborators

Environmental & Global Health Faculty Research

Background: Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods: For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific …

Syndemic Of Opioid Crisis And Covid-19 Pandemic: A Call To Invest In Solutions, Manoj Sharma, Kavita Batra

Social and Behavioral Health Faculty Research

Preliminary data by the Centers for Disease Control and Prevention [CDC, 2020] indicated a significant surge in the number of opioid involved deaths amidst COVID-19 pandemic and these trends are concerning, which warrant a collective investment in finding the solutions (Baumgartner & Radley, 2021; Becker & Fiellin, 2020). [...]this editorial aims to reflect on the interaction of the COVID-19 pandemic with the existing opioid crisis and its role in widening the gap of the pre-existing disparities, and discusses implications of practice to protect the health of vulnerable drug-users. Recently, the Substance Abuse and Mental Health Services Administration (SAMHSA) allowed take-home …

Are Gaming And Gambling Disorders Related? Examining The Roles Of Money, Relative Deprivation, And Upward Mobility, Anthony J. King

UNLV Theses, Dissertations, Professional Papers, and Capstones

Few studies have examined the financial motives and risks involved in modern video games, as well as the psychosocial factors contributing to this type of gaming involvement. Previous research on gambling has shown financial motives alone to be a major risk factor for the development of gambling disorder, with higher levels of personal relative deprivation (PRD) identified as a main contributor to this relationship. Therefore, the present study investigated whether this association applied to US adult video gamers, and if it would predict their problematic gaming behaviors. We hypothesized PRD and gaming disorder severity would have a positive association, with …

Barriers And Facilitators To Promoting Resilience To Hiv/Aids: A Qualitative Study On The Lived Experiences Of Hiv-Positive, Racial And Ethnic Minority, Middle-Aged And Older Men Who Have Sex With Men From Ontario, Canada, Renato M. Liboro, Sherry Bell, Brandon Ranuschio, Lianne Barnes, Jenna Despres, Aruna Sedere, Trinity Puno, Paul A. Shuper

Psychology Faculty Research

Evidence-based research has highlighted the need for exploring factors that support the mental health of men who have sex with men living with HIV/AIDS (MSMLWH), and environmental influences that promote their resilience to HIV/AIDS. This exploratory study utilized a community-based participatory research approach to investigate barriers and facilitators to promoting resilience to HIV/AIDS, specifically among racial and ethnic minority, middle-aged and older MSMLWH, a population that continues to be significantly impacted by HIV/AIDS today. This collaborative, qualitative study recruited participants who identified as racial or ethnic minority MSMLWH, were aged 40 or older, and resided in Ontario, Canada. Participants (n …

Surveillance Of The Incidence And Mortality Of Oral And Pharyngeal, Esophageal, And Lung Cancer In Nevada: Potential Implications Of The Nevada Indoor Clean Air Act, Kevin Foote, David Foote, Karl Kingsley

Dental Medicine Faculty Research

Reviews of national and state-specific cancer registries have revealed differences in rates of oral, esophageal, and lung cancer incidence and mortality that have implications for public health research and policy. Many significant associations between these types of cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans—including the Nevada Clean Indoor Air Act (NCIAA) of 2006 (and subsequent modification in 2011). Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of …

Prevalence Trend And Disparities In Rheumatoid Arthritis Among Us Adults, 2005–2018, Yingke Xu, Qing Wu

School of Public Health Faculty Research

Rheumatoid arthritis (RA) trends among US adults and disparities in RA patients in recent years have not been well described. We aimed to examine the trend of RA prevalence and disparities among US adults. Data from the National Health and Nutrition Examination Survey (NHANES) of the years 2005–2018 were analyzed to examine the self-reported RA prevalence trend. Age-adjusted RA prevalence stratified by race/ethnicity and socioeconomic status (SES), as well as associated linear trends, were calculated for both genders. The multivariable adjustment was used to evaluate the association between race, SES, and RA. During 2005–2018, there was no significant linear trend …

Concordance And Patient-Centered Care In Medicaid Enrollees’ Care Experience With Providers, Iwimbong Kum Ghabowen, Neeraj Bhandari

Healthcare Administration and Policy Faculty Research

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, …

Using The Multi-Theory Model (Mtm) Of Health Behavior Change To Explain The Correlates Of Mammography Screening Among Asian American Women, Manoj Sharma, Chia-Liang Dai, Kavita Batra, Ching-Chen Chen, Jennifer R. Pharr, Courtney Coughenour, Asma Awan, Hannah Catalano

Environmental & Global Health Faculty Research

Globally, breast cancer is the most common malignancy affecting women. The incidence of breast cancer has been growing among Asian American women. Mammography is a screening procedure that provides early diagnosis for the timely treatment to reduce premature mortality due to breast cancer. However, there are no national data available that summarize the rates of mammography screening among Asian American women. Some small-scale studies have reported low rates of mammography uptake among Asian American women. This cross-sectional study utilized the fourth-generation, multi-theory model (MTM) of health behavior change to explain the correlates of mammography screening among Asian American women between …

A Systematic Review Of The Rationale For Vaccine Hesitancy Among American Parents, Jordan Luttrell-Freeman, Timothy J. Bungum, Jennifer R. Pharr

Environmental & Global Health Faculty Research

Vaccines are one of the most successful interventions in the history of public health. They are largely responsible for the near eradication of several diseases. However, some people are vaccination averse which can lead to vaccine hesitancy. Vaccine hesitant parents are those that refuse or delay getting their children vaccinated despite the availability of vaccination services. This phenomenon often occurs despite parent’s belief that vaccines are effective. The purpose of this review was to exam available literature to identify predictors of vaccine hesitancy among parents and parental rationale for vaccine hesitancy

Sociodemographic Inequities In Nurturing Care For Early Childhood Development Across Brazilian Municipalities, Gabriela Buccini, Stefanie Eugênia Dos Anjos Coelho Kubo, Jéssica Pedroso, Juracy Bertoldo, Alberto Sironi, Marcos Ennes Barreto, Rafael Pérez-Escamilla, Sonia Isoyama Venancio, Muriel Bauermann Gubert

Environmental & Global Health Faculty Research

Providing an enabling nurturing care environment for early childhood development (ECD) that cuts across the five domains of the Nurturing Care Framework (i.e., good health, adequate nutrition, opportunities for early learning, security and safety and responsive caregiving) has become a global priority. Brazil is home to approximately 18.5 million children under 5 years of age, of which 13% are at risk of poor development due to socio-economic inequalities. We explored whether the Early Childhood Friendly Municipal Index (IMAPI) can detect inequities in nurturing care ECD environments across the 5570 Brazilian municipalities. We examined the validity of the IMAPI scores and …

The Intersection Of Hiv, Covid-19 And Systemic Racism, Gary F. Spinner

Journal of Health Disparities Research and Practice

ABSTRACT

The Human Immunodeficiency Virus (HIV) pandemic has taken the greatest toll on racial and ethnic minorities in the United States. Blacks and Latinxs suffer greater disease incidence, prevalence, morbidity and mortality from HIV as compared with Whites. Similarly, the Covid-19 pandemic caused by SARS-CoV-2 has disproportionately affected Blacks, Latinxs, and Native Americans causing higher rates of infection, more severe disease, and higher rates of mortality as compared with Whites. The pandemic of racism is as ubiquitous as the pandemics of HIV and Covid-19. Its sustaining forces drive wealth inequality, poverty, racially segregated and overcrowded housing, unequal employment opportunities, unequal …

Can Community Gardens With Workshops Increase Gardening Behavior? A Navajo Wellness Collaboration, Kevin A. Lombard Phd, India J. Ornelas Phd, Desiree Deschenie, Felix Nez, Sonia Bishop, Katie Osterbauer Ms, Eileen Rillamas-Sun Phd, Shirley A.A. Beresford Phd

Journal of Health Disparities Research and Practice

This paper seeks to evaluate the potential efficacy of a community gardening intervention on the Navajo Nation to increase gardening and healthy eating behaviors, which are potentially important in preventing obesity and related health conditions. Rates of obesity are high among American Indians, including those living on Navajo Nation land. Eating fresh fruits and vegetables is part of healthy eating. However, availability and access to fresh fruits and vegetables are severely limited on the Navajo Nation, due to distance and cost. One way to increase both availability and consumption of fresh fruits and vegetables is through community gardening, yet …

Health Disparities And Covid-19 Pandemic: Increasing Clinical Research Participation Among African Americans, Kashica J. Webber-Ritchey, Abbi D. Lane-Cordova

Journal of Health Disparities Research and Practice

Health disparities in African Americans is a persistent issue. Higher rates and severity of the novel coronavirus-19 [COVID-19] among African Americans only widens health disparities. Effective COVID-19 treatment options are imperative, requiring representation of African Americans in clinical research. However, low participation and under-representation of African Americans is complex in nature. This article describes health disparities, the impact of COVID-19, and participation in clinical research among African Americans. We offer strategies for researchers to enhance the inclusion of African Americans. We also offer strategies in conducting clinical research during COVID-19.

Lessons From The Health Care Innovation Awards: Productively Engaging Vulnerable Populations To Address Social Determinants Of Health, Maysoun Freij, Megan Skillman, Caitlin Cross-Barnet, Rachel Friedman Singer, Christina Rotondo, Michelle Dougherty, Sarah Ruiz, Adil Moiduddin, Lynne Page Snyder

Journal of Health Disparities Research and Practice

Objectives: This paper examines productive interactions—a cornerstone of the Chronic Care Model—between health care providers and vulnerable populations with chronic illnesses and/or disabilities. Methods: We conducted qualitative analysis of 16 focus groups and 29 interviews with patients and/or caregivers and 195 interviews with program leadership and providers across 15 Health Care Innovation Awards that targeted vulnerable populations. We analyzed how awardees addressed health concerns and social determinants of health (SDOH), and identified key components of productive interactions. Results: Providers achieved productive interactions through four primary strategies: establishing trust and showing respect; solving problems; building accuracy in health …

Association Between Insurance Status And Hospital Outcomes Among Acute Kidney Failure Patients, Khoa Truong, Thuan Thai, Lingling Zhang, Lu Shi, C. Jason Wang

Journal of Health Disparities Research and Practice

Objectives: To investigate the relationship between insurance status and the risk of acute kidney failure (AKF) and consequential hospitalization outcomes.

Methods: A cross-sectional regression analysis was conducted for inpatients ages 18-64 in South Carolina 2012–2013. One dichotomous dependent variable - diagnosed with AKF at hospital admission, and two continuous dependent variables of hospital outcomes - total charge and length of stay, were examined. The key explanatory variable was the patient’s insurance status. Other covariates included patient’s age, gender, and race as well as AKF risk factors - Type 2 diabetic mellitus (T2DM), chronic kidney disease (CKD), hypertension, and proteinuria.

Results: …

Lagged Meteorological Impacts On Covid-19 Incidence Among High-Risk Counties In The United States—A Spatiotemporal Analysis, Lung-Chang Chien, Lung-Wen Antony Chen, Ro-Ting Lin

School of Public Health Faculty Research

Background: The associations between meteorological factors and coronavirus disease 2019 (COVID-19) have been discussed globally; however, because of short study periods, the lack of considering lagged effects, and different study areas, results from the literature were diverse and even contradictory. Objective: The primary purpose of this study is to conduct more reliable research to evaluate the lagged meteorological impacts on COVID-19 incidence by considering a relatively long study period and diversified high-risk areas in the United States. Methods: This study adopted the distributed lagged nonlinear model with a spatial function to analyze COVID-19 incidence predicted by multiple meteorological measures from …

Testing The Multi-Theory Model (Mtm) To Predict The Use Of New Technology For Social Connectedness In The Covid-19 Pandemic, Manoj Sharma, Kavita Batra, Jason Flatt

Environmental & Global Health Faculty Research

Loneliness or social isolation, recently described as a “behavioral epidemic,” remains a long-standing public health issue, which has worsened during the COVID-19 pandemic. The use of technology has been suggested to enhance social connectedness and to decrease the negative health outcomes associated with social isolation. However, till today, no theory-based studies were performed to examine the determinants of technology use. Therefore, the current study aims to test theory-based determinants in explaining the adoption of new technology in a nationally representative sample during the COVID-19 pandemic (n = 382). A psychometrically reliable and valid instrument based on the multi-theory model (MTM) …

Helping Mothers Survive: Program Evaluation And Early Outcomes Of Maternal Care Training In The Dominican Republic, Meghan Smith, Alexandra Leader, Wanny Roa, Ericka Jaramillo, Davina Lazala, Jose Flores, Claudia Cadet, Ruraj Vazifedan, Suzanne Bentley, Lloyd Jensen

School of Medicine Faculty Research

Introduction: In 2017, approximately 295,000 women died during and immediately following pregnancy and childbirth worldwide, with 94% of these deaths occurring in low-resource settings. The Dominican Republic (DR) exhibits one of the highest maternal mortality ratios in the region of Latin America and the Caribbean despite the fact that 99% of registered births in the country are reportedly attended by a skilled birth attendant. This paradox implies that programs to support healthcare worker knowledge and skills improvement are vital to improving maternal health outcomes in the DR. Helping Mothers Survive (HMS) is a provider training program developed by Jhpiego and …

Factors That Determine Comprehensive Categorical Classification Of Ehr Implementation Levels, Soumya Upadhyay, William Opoku-Agyeman

Healthcare Administration and Policy Faculty Research

Electronic Health Records (EHRs) have the potential to alleviate patient safety mistakes. Of the various levels of EHR, advanced or higher-level functionalities of EHR are designed to improve patient safety. Certain organizational and environmental factors may pose as barriers toward implementing all of the functionalities, leaving certain hospitals intermediate between basic and comprehensive levels of implementation. This study identifies a comprehensive categorical classification that includes hospitals that have functionalities between basic and comprehensive levels of EHR and determines the organizational and environmental factors that may influence hospitals to implement one or more combinations of these categories. A longitudinal panel design …

Influence Of The Request And Purchase Of Television Advertised Foods On Dietary Intake And Obesity Among Children In China, Jinli Xian, Mao Zeng, Zhengjie Cai, Changxiao Xie, Yuqian Xie, Manoj Sharma, Yong Zhao, Zumin Shi

Environmental & Global Health Faculty Research

Background: This study aims to examine the effects of the request and purchase of Television (TV) advertised foods on children’s dietary intake, overweight and obesity in China. Methods: Data from 1417 children (aged 6–17 years) in the 2011 China Health and Nutrition Survey were analysed. The request and purchase of TV advertised foods were assessed through the frequency of children’s requests to purchase TV advertised foods and the frequency of parents’ purchases of these advertised foods, as well as the frequency of children’s purchases of TV advertised foods. The height and weight of children were measured. Logistic regression models were …

Impact Of Nutrition-Based Interventions On Athletic Performance During Menstrual Cycle Phases: A Review, Macy M. Helm, Graham R. Mcginnis, Arpita Basu

Kinesiology and Nutrition Sciences Faculty Research

Despite the steady increase in female participation in sport over the last two decades, comprehensive research on interventions attenuating the influence of female menstrual physiology on performance remains scarce. Studies involving eumenorrheic women often only test in one menstrual phase to limit sex hormone variance, which may restrict the application of these findings to the rest of the menstrual cycle. The impacts of nutrition-based interventions on athletic performance throughout the menstrual cycle have not been fully elucidated. We addressed this gap by conducting a focused critical review of clinical studies that reported athletic outcomes as well as menstrual status for …

Postsecondary Educational Attainment And Health Among Younger U.S. Adults In The “College-For-All” Era, Anna Zajacova, Elizabeth Lawrence

Sociology Faculty Research

Population-health research has neglected differentiation within postsecondary educational attainments. This gap is critical to understanding health inequality because college experience with no degree, vocational/technical certificates, and associate degrees may affect health differently. We examine health across detailed postsecondary attainment levels. We analyze data on 14,750 respondents in Waves I and IV of the nationally representative Add Health panel spanning adolescence to ages 26 to 34. Multivariate regression and counterfactual approaches to minimize the impact of confounders estimate multiple health outcomes across postsecondary attainment levels. Compared to high school diplomas, we find significant returns to bachelor’s degrees for most health outcomes …

Propensity Score Analysis Assessing The Burden Of Non-Communicable Diseases Among The Transgender Population In The United States Using The Behavioral Risk Factor Surveillance System (2017–2019), Jennifer R. Pharr, Kavita Batra

Environmental & Global Health Faculty Research

Research to assess the burden of non-communicable diseases (NCDs) among the transgender population needs to be prioritized given the high prevalence of chronic conditions and associated risk factors in this group. Previous cross-sectional studies utilized unmatched samples with a significant covariate imbalance resulting in a selection bias. Therefore, this cross-sectional study attempts to assess and compare the burden of NCDs among propensity score-matched transgender and cisgender population groups. This study analyzed Behavioral Risk Factor Surveillance System data (2017–2019) using complex weighting procedures to generate nationally representative samples. Logistic regression was fit to estimate propensity scores. Transgender and cisgender groups were …

American Association For The Surgery Of Trauma Prevention Committee Review: Family Justice Centers-A Not-So-Novel, But Unknown Gem, Thomas K. Duncan, Ronald Stewart, Kimberly Joseph, Deborah A. Kuhls, Tracey Dechert, Sharven Taghavi, Stephanie Bonne, Kazuhide Matsushima

School of Medicine Faculty Research

The American College of Surgeons Committee on Trauma requires that trauma centers demonstrate adequate financial support for an injury prevention program as part of the verification process. With the ongoing challenges that arise with important social determinants of health, trauma centers have the important task of navigating a patient through the complex process of obtaining services and tools for success. This summary from the American Association for the Surgery of Trauma Prevention Committee focuses on a model that has been present for several years, but has not been brought to full awareness in the trauma world. It highlights the importance …

Scaling Up Information Sharing On Hiv-Associated Neurocognitive Disorder: Raising Awareness And Knowledge Among Key Stakeholders, Renato M. Liboro, Paul A. Shuper, Lori E. Ross

Psychology Faculty Research

Although the majority of specialists and researchers in the field of HIV/AIDS are aware and knowledgeable about HIV-associated neurocognitive disorder (HAND) as a condition that affects as much as 50% of people living with HIV/AIDS (PLWH), research has documented that many health care and service providers who work directly with PLWH are either unaware of HAND or believe they do not know enough information about HAND to effectively support their clients experiencing neurocognitive challenges. Based on the findings of a qualitative study that interviewed 33 health care and service providers in HIV/AIDS services to identify and examine their awareness and …

Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson

Environmental & Occupational Health Faculty Presentations

Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change. Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing …