Public Health Commons^™

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 …

Effects Of Β-Carotene Intake On The Risk Of Fracture: A Bayesian Meta-Analysis, Tesfaye Getachew Charkos, Yawen Liu, Kemal Sherefa Oumer, Ann M. Vuong, Shuman Yang

School of Public Health Faculty Research

Background: Epidemiological studies examining the association between β-carotene intake and risk of fracture have reported inconsistent findings. We conducted a meta-analysis to investigate the association between β-carotene intake and risk of fracture. Methods: We systematically searched PubMed, EMBASE and Cochrane library databases for relevant articles that were published until December 2019. We also identified studies from reference lists of articles identified from the clinical databases. The frequentist and Bayesian random-effects model was used to synthesize data. Results: Nine studies with a total of 190,545 men and women, with an average age of 59.8 years, were included in this meta-analysis. For …

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

School of Public Health Faculty Research

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 Research

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 & Global Health Faculty Research

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% …

Changes In Preventive Care Utilisation And Its Influencing Factors Among Chinese Adults Before And After The Healthcare Reform: Cross-Sectional Evidence From The China Health And Nutrition Survey In 2004-2015, Tingting Wu, Wei Wei Liu, Mao Zou, Xun Lei, Qiang Yang, Manoj Sharma, Yong Zhao, Zu Min Shi

Environmental & Global Health Faculty Research

Objective China launched its health reform in 2009. This study aimed to assess changes in preventive care utilisation (PCU) and its relationship with the healthcare reform. Design A cross-sectional study using demographic characteristics, socioeconomic status, environmental factors, and lifestyle and health status data of adults from five waves (2004–2015) of the China Health and Nutrition Survey (CHNS) was conducted. Multilevel mixed-effects logistic regression models were used. Setting Data were derived from urban and rural communities of nine provinces in China. Participants Data were obtained from five waves of the CHNS, with 9960 participants in 2004, 9888 in 2006, 10 286 …

The Association Between Depressive Symptoms And Accumulation Of Stress Among Black Men In The Health And Retirement Study, Roland J. Thorpe Jr., Phd, Ryon Cobb Phd, Keyonna King Drph, Marino A. Bruce Phd, Msrc, Mdiv, Paul Archibald Drph, Lcsw, Harlan P. Jones Phd, Keith C. Norris Phd, Keith E. Whitfield Phd, Darrell Hudson Phd, Mph

Office of the President Faculty Publications

Background and Objectives: Among the multiple factors posited to drive the health inequities that black men experience, the fundamental role of stress in the production of poor health is a key component. Allostatic load (AL) is considered to be a byproduct of stressors related to cumulative disadvantage. Exposure to chronic stress is associated with poorer mental health including depressive symptoms. Few studies have investigated how AL contributes to depressive symptoms among black men. The purpose of the cross-sectional study was to examine the association between AL and depressive symptoms among middle- to old age black men. Research Design and Methods: …

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

Environmental & Global Health Faculty Research

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 Research

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

School of Public Health Faculty Research

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

School of Public Health Faculty Research

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 …

Strategies For Increasing Impact, Engagement, And Accessibility In Hiv Prevention Programs: Suggestions From Women In Urban High Hiv Burden Counties In The Eastern United States (Hptn 064), Jasmine A. Abrams, Michelle Odlum, Emily Tillett, Danielle Haley, Jessica Justman, Sally Hodder, Linda Vo, Ann O’Leary, Paula M. Frew

School of Public Health Faculty Research

Background: Merely having the tools to end HIV is insufficient. Effectively ending the epidemic necessitates addressing barriers that impede engagement in biomedical and behavioral prevention and wide scale implementation and utilization of existing interventions. This qualitative study identifies suggestions for increasing access to, engagement in, and impact of HIV prevention among women living in cities in high HIV burden counties in the eastern US. Methods: Data analyzed for the current study were collected via a qualitative sub-study within the HIV Prevention Trials Network Study 064 (HPTN 064), a multisite observational cohort study designed to estimate HIV incidence among women residing …

Dietary Behaviours Among Han, Tujia And Miao Primary School Students: A Cross-Sectional Survey In Chongqing, China, Zhengjie Cai, Jinli Xian, Xianglong Xu, Ziwei Zhang, Camila Araujo, Manoj Sharma, Yong Zhao

School of Public Health Faculty Research

Background and Purpose: Exploring the differences of children’s dietary behaviours from different nationalities could provide a reference for targeted nutritional interventions. This study aims to assess the dietary behaviours among Han, Tujia and Miao primary school students and the differences among the ethnic groups. Materials and Methods: This cross-sectional survey included 556 primary school students (249 Han, 76 Tujia and 231 Miao students) aged 6– 13 years from the representative minority areas of Chongqing, China. Data were collected with a self-administered or one-on-one interview-based questionnaire encompassing questions on sociodemographics, eating habits and dietary intake. Eating habits and dietary intake 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.

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 …

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. …

Individual Differences In Infants' Temperament Affect Face Processing, Jennifer L. Rennels, Andrea J. Kayl, Kirsty M. Kulhanek

Psychology Faculty Research

Infants show an advantage in processing female and familiar race faces, but the effect sizes are often small, suggesting individual differences in their discrimination abilities. This research assessed whether differences in 6–10-month-olds’ temperament (surgency and orienting) predicted how they scanned individual faces varying in race and gender during familiarization and whether and how long it took them to locate the face during a visual search task. This study also examined whether infants viewing faces posing pleasant relative to neutral expressions would facilitate their discrimination of male and unfamiliar race faces. Results showed that infants’ surgency on its own or in …

Correction To: Temporal Trend Of Research Related To Gun Violence From 1981 To 2018 In The United States: A Bibliometric Analysis, Lung-Chang Chien, Maxim Gakh, Courtney Coughenour, Ro-Ting Lin

School of Public Health Faculty Research

No abstract provided.

Readability And Suitability Assessment Of Educational Materials In Promoting The Quality Of Life For Postmenopausal Women, Mohammad Ali Morowatisharifabad, Nooshin Yoshany, Manoj Sharma, Narjes Bahri, Sara Jambarsang

Environmental & Global Health Faculty Research

Introduction: Educational materials are frequently used by health providers to inform postmenopausal women about menopause acceptance behavior. However, little attention has been paid to the readability and suitability of these educational materials. The study aimed to determine the readability and suitability of educational materials in promoting the quality of life for postmenopausal women. Material and methods: Multiple instructional materials and books were used for the design and preparation of educational materials and were then tailored to the target group. Readability was measured by using the readability assessment of materials (RAM); and suitability was determined by the suitability assessment of materials …

Efficacy Testing Of The Savor (Sisters Adding Fruits And Vegetables For Optimal Results) Intervention Among African American Women: A Randomized Controlled Trial, Lavonne Brown, Manoj Sharma, Sophia Leggett, Jung H. Sung, Russell L. Bennett, Mario Azevedo

Environmental & Global Health Faculty Research

Background: In the United States, only about 15% of individuals meet daily fruit intake recommendations of 2 cups per day and only 10% meet the vegetable intake recommendations of 3 cups per day. African American women are a high-risk group. In this study, a fourth-generation multi-theory model (MTM) of health behavior change was used to design and evaluate a Sisters Adding Fruits and Vegetables for Optimal Results (SAVOR) intervention for AA women. Methods: The study utilized a randomized controlled trial (RCT) with measurements taken at pretest, posttest (after the three-week intervention) and follow-up (at the end of eight weeks). SAVOR …

Using Multi Theory Model (Mtm) Of Health Behavior Change To Explain Intention For Initiation And Sustenance Of The Consumption Of Fruits And Vegetables Among African American Men From Barbershops In Mississippi, Jaelrbreiret L. Williams, Manoj Sharma, Vincent L. Mendy, Sophia Leggett, Luma Akil, Samuel Perkins

Environmental & Global Health Faculty Research

Background: African American men have poorer health outcomes compared to their white counterparts despite medical advancements and early detection of diseases. The purpose of this study was to determine to what extent the constructs of the multi theory model (MTM) explain the intention for initiation and sustenance of the consumption of fruits and vegetables among African American adult men in Mississippi. Methods: Using a cross-sectional design a valid and reliable paper survey was administered during November and December of 2019. The target population for the study consisted of African American adult men (18 or older) that had not consumed recommended …

Sociodemographic Determinants Of Physical Activity And Sport Participation Among Women In The United States, Jennifer R. Pharr, Nancy L. Lough, Angela M. Terencio

School of Public Health Faculty Research

Regular physical activity and sport participation have been shown to improve women’s health; however, research has found that better health is associated with sport participation. Little is known about the sociodemographic determinants of physical activity among women, especially among the different subcategories of physical activity (sport, conditioning exercise, recreation, and household tasks). Because of the added health benefits associated with sport participation, the purpose of this study was to examine the sociodemographic determinants among subcategories of physically active women in the United States by analyzing Behavioral Risk Factor Surveillance System (BRFSS) data. We used data from the 2017 national BRFSS …

Behavior Change Following Pain Neuroscience Education In Middle Schools: A Public Health Trial, Adriaan Louw, Regina Landrus, Jessie Podolak, Patricia Benz, Jen Delorenzo, Christine Davis, Alison Rogers, Kathy Cooper, Colleen Louw, Kory Zimney, Emilio J. Puentedura, Merrill R. Landers

Integrated Health Sciences Faculty Research

Chronic pain and the opioid epidemic need early, upstream interventions to aim at meaningful downstream behavioral changes. A recent pain neuroscience education (PNE) program was developed and tested for middle-school students to increase pain knowledge and promote healthier beliefs regarding pain. In this study, 668 seventh-grade middle-school students either received a PNE lecture (n = 220); usual curriculum school pain education (UC) (n = 198) or PNE followed by two booster (PNEBoost) sessions (n = 250). Prior to, immediately after and at six-month follow-up, pain knowledge and fear of physical activity was measured. Six months after the initial intervention school, …

Opioid Use Disorders And Hospital Palliative Care Among Patients With Gastrointestinal Cancers: Ten-Year Trend And Associated Factors In The U.S. From 2005 To 2014, Jinwook Hwang, Jay J. Shen, Sun Jung Kim, Sung-Youn Chun, Pearl C. Kim, Se Won Lee, David Byun, Ji Won Yoo

School of Public Health Faculty Research

This study aimed to analyze the trends of opioid use disorders, cannabis use disorders, and palliative care among hospitalized patients with gastrointestinal cancer and to identify their associated factors. We analyzed the National Inpatient Sample data from 2005 to 2014 and included hospitalized patients with gastrointestinal cancers. The trends of hospital palliative care and opioid or cannabis use disorders were analyzed using the compound annual growth rates (CAGR) with Rao-Scott correction for χ2 tests. Multivariate logistic regression analyses were performed to identify the associated factors. From 2005 to 2014, among 4,364,416 hospitalizations of patients with gastrointestinal cancer, the average annual …

Covid-19 Vulnerability Among People Who Use Drugs: Recommendations For Global Public Health Programmes And Policies, Ian W. Holloway, Anne C. Spaulding, Ayako Miyashita Ochoa, Laura A. Randall, Adrian R. King, The Hbou Study Team, Paula M. Frew

School of Public Health Faculty Research

No abstract provided.