Public Health Commons^™

Associations Between Cardiovascular Disease And Utilization Of Dental Preventive And Periodontic Services, Amirhossein Fakhre Yaseri

Theses and Dissertations

Cardiovascular disease (CVD), including coronary artery disease, heart failure, myocardial infarction, and stroke, remains a leading cause of global mortality, with approximately 20.5 million deaths in 2021. Despite advancements in medical science, CVD prevalence continues to rise, underscoring the need for preventive approaches and increased awareness. CVD is closely associated with oral diseases, and poor oral health is linked to worse cardiovascular outcomes. This study investigates the association between CVD and the utilization of dental preventive and periodontal services using data from the Dental Experience and Research Exchange (DERE) database, which aggregates clinical data from dental practices across the U.S. …

Shifting Healthcare In Rural South Carolina: A Study Of Media Coverage Of The Effects Of Hospital Closures, Morgan Harper

Senior Theses

Rural hospital closures have become an increasingly urgent issue in healthcare across the United States. These closures have impacted access to healthcare, the job market, and general community health. Most hospitals have been forced to close due to low patient volumes, financial struggles, and corporate ownership. Immediate implications of closures include the displacement of healthcare workers, community concern about lacking a central healthcare facility, and increased travel times to access care.

This thesis examines South Carolina’s healthcare landscape in areas with hospital closures since 2012 and explores the effects of and responses to these closures as discussed in newspapers and …

From Pregnancy To Postpartum: A Longitudinal Analysis Of Maternal Depressive Symptoms And Hemoglobin Concentration In Uttar Pradesh, India, Abdullah Nurus Salam Khan

Theses and Dissertations

Background: Perinatal depression and maternal anemia impact maternal health, pregnancy outcomes, and infant growth in low- and middle-income countries. This study examines the prevalence and risk factors of these conditions during pregnancy and postpartum in rural Uttar Pradesh, India. Methods: A prospective cohort study was conducted among 475 pregnant women recruited during early pregnancy (≤20 weeks gestation) and followed through late pregnancy (≥27 weeks) and postpartum (< 42 days of childbirth). The outcome variables were, i) depressive symptoms, assessed using the Edinburgh Postnatal Depression Scale (EPDS), and ii) hemoglobin concentrations, measured using HemoCue Hb 301 analyzer from capillary blood. Multivariable linear regression examined associations of the outcome variables with sociodemographic, obstetric, nutritional, interpersonal, and perinatal factors. Path analysis evaluated direct and indirect paths influencing postpartum hemoglobin. Results: Prevalence of probable depression (EPDS score≥13) peaked in early pregnancy (24%) and declined in late pregnancy (17%) and postpartum (4%). Mean hemoglobin declined from early (10.5 g/dL) to late pregnancy (9.7 g/dL), and partially recovering in postpartum (10.4 g/dL). Household food insecurity was associated with higher depressive symptoms during pregnancy and postpartum (early pregnancy:β=2.61, p=0.011; late pregnancy:β=2.84, p< 0.001; postpartum:β=1.40, p=0.023). Psychological intimate partner violence was associated with greater depressive symptoms in early pregnancy (β=3.19, p=0.001). Receiving more antenatal visits was associated with decrease in depressive symptoms in late pregnancy (β=-0.46, p=0.001) and hemoglobin at postpartum (β=-0.11, p=0.070). Consumption of more food groups was associated with increase in depressive symptoms (β=0.63, p=0.004) and hemoglobin in late pregnancy (β=0.10, p=0.026). Iron folic acid (IFA) consumption was associated with increase in hemoglobin in late pregnancy (β=0.01, p< 0.001) and postpartum (β=0.004, p=0.031). Experiencing postpartum health complications was associated with increase in depressive symptoms (β=0.41, p=0.013) and decrease in hemoglobin concentrations (β=-0.18, p=0.036). Antenatal hemoglobin concentrations mediated the associations of IFA supplementation and dietary diversity with postpartum concentrations. Conclusion: Perinatal depression was associated with socioeconomic vulnerabilities, food insecurity, and intimate partner violence, while hemoglobin concentrations were associated with maternal nutrition and perinatal care. Integrating mental health services and comprehensive nutrition interventions into antenatal and postpartum care can improve psychological and physical well-being of mothers during and after pregnancy.

Examining Racial Disparities In Cancer Incidence And Mortality Across South Carolina Regions, William Stokes, Swann Arp Adams, Kara M Montgomery

Senior Theses

Purpose: To provide updated cancer mortality-to-incidence ratio (MIR) data across South Carolina (SC).

Methods: State and national incidence and mortality data were collected from the South Carolina Central Cancer Registry (SCCCR) and the National Cancer Institute’s Surveillance Epidemiology and End Results Program (SEER). MIRs (mortality rate/incidence rate) were calculated for all cancer sites, cervical, colon, female breast, lung and bronchus, oral cancers, and prostate cancers from the years 2016-2021, excluding 2020.

Results: Major racial disparities in MIR were found in SC, with the largest discrepancies seen in cervical, colon, and prostate cancers. Of note, each SC region had white cervical …

Addressing Gaps In Access: Examining Language Barrier Accommodations In Medicaid Member Handbooks, 2015-2019, Sanskruti Patel

Senior Theses

Objective: This study examines the linguistic accessibility of Medicaid Managed Care Organization (MCO) handbooks from 2015 to 2019 by analyzing the instructions provided to access interpreter and written translation services. Trends were compared over time, considering state and plan-level factors that impact equitable healthcare access for Limited English Proficiency (LEP) enrollees.

Methods: A systematic search using manual efforts and FOIA requests located all publicly available Medicaid handbooks from 2015-2019 (N=657) across 39 states with comprehensive MCO plans. These handbooks were coded by independent reviewers to assess the study outcome variables. Random mixed-effects logistic and linear regression models were conducted to …

The Impact Of Discretion On Human Service Workers Supporting The Health Of Unaccompanied Minors In Foster Care, Diana M. Clark

Senior Theses

Unaccompanied children (UCs) are a vulnerable population that enters government custody and accesses healthcare via the Office of Refugee Resettlement (ORR)'s system of care. While prior research has focused on generating policy recommendations to improve healthcare services available to UCs both in ORR custody and following release from custody, this thesis will instead expand upon the experiences of staff members working at ORR-contracted agencies. These workers make decisions that have short- and long-term implications on the health and wellbeing of UCs. Drawing from 65 in-depth interviews with human service workers in ORR-contracted voluntary agencies, this thesis uses street-level bureaucracy framework …

Impacts On College-Aged Asian American Mental Health, Zahra Soherwardy

Senior Theses

This study explores the relationship between different forms of racial harassment and mental health issues in Asian American college students. Asian American mental health is a growing concern in the field of public health. Asian Americans have the lowest treatment rates and some of the highest stigma levels of any demographic. They are also impacted by the model minority myth and discrimination, further alienating them from getting help. The topics of subtle racism, blatant racism, and current racial discrimination were compared to depressive symptoms, anxiety, self-esteem, and four domains of aggression using survey data. Subtle racism was found to be …

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

Role Of Race And Ethnicity In The Development, Diagnosis, And Treatment Of Gestational Diabetes Mellitus, Gabrielle D. Shupard

Senior Theses

Gestational diabetes mellitus (GDM) is the most common metabolic disorder of pregnancy, and rates of this disease have been steadily increasing over the past ten years. GDM disproportionately impacts racial and ethnic minorities at higher rates than their Caucasian counterparts. In this study, the PRECEDE model framework was employed during a literature review to gain a greater understanding of the complex risk factors contributing to differences in the development, diagnosis, and treatment of GDM among these population subgroups. The second part of this study concentrated on reviewing the extent to which current literature evaluates the role of race and ethnicity …

Racial And Ethnic Inequalities In Actual Vs Nearest Delivery Hospitals, Nansi S. Boghossian, Lucy T. Greenberg, Jeffrey S. Buzas, Joshua Radack, Molly Passarella, Jeannette Rogowski, George R. Saade, Ciaran S. Phibbs, Scott A. Lorch

Faculty Publications

IMPORTANCE Minoritized racial and ethnic groups, such as American Indian and Black individuals, often receive lower quality health care compared with White individuals. There is limited understanding of how these disparities extend to obstetric care, particularly when comparing the quality of care at the actual delivery hospital vs the nearest obstetric hospital based on the birthing individual’s residence. OBJECTIVE To examine inequality in care based on the actual delivery hospital and the closest delivery hospital to the birthing individual’s residential zip code centroid. DESIGN, SETTING, AND PARTICIPANTS This population-based retrospective cohort study used data from 5 states (2008 to 2020 …

Alcohol Use Disorder Medication Coverage And Utilization Management In Medicaid Managed Care Plans, Maureen T. Stewart, Sage R. Feltus, Christina Andrews Ph.D., Andrea Acevedo, Cindy Parks Thomas, Jeffrey Bratberg, Constance M. Horgan, Dominic Hodgkin, Rachel Sayko Adams

Faculty Publications

IMPORTANCE Evidence-based, patient-centered treatment for alcohol use disorder (AUD) can include pharmacotherapy with naltrexone, acamprosate, or disulfiram; however, these medications are rarely used. Medicaid managed care plans (MCPs) manage health services for nearly 80% of Medicaid enrollees and are the largest payer for addiction treatment services. Little is known about Medicaid MCP policies for AUD medications.

OBJECTIVES To describe Medicaid MCPs’ coverage and management of acamprosate, naltrexone, and disulfiram for AUD and examine associations of plan characteristics and state policies with medication coverage.

DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, a content analysis was performed of 2021 insurance benefit …

Does Travel Time Matter?: Predictors Of Transportation Vulnerability And Access To Hiv Care Among People Living With Hiv In South Carolina, Sayward Elizabeth Harrison, Peiyin Hung, Katherine Green, Sarah J. Miller, Mariajosé Patron, Divya Ahuja, Sharon Weissman, Caroline Rudisill, Tammeka Evans

Faculty Publications

Background

People living with HIV (PLHIV) in the southern United States (US) are at high risk for poor outcomes across the HIV care continuum leading to low rates of viral suppression. Understanding structural barriers to care—including transportation vulnerability—is critical to improve HIV outcomes. This study investigated relationships between travel time to HIV care, transportation vulnerability, and HIV care disruptions to inform future transportation interventions for PLHIV residing in South Carolina and other southern US states.

Methods

A total of 160 PLHIV (N = 160) were recruited from a large immunology center in South Carolina. Participants reported on transportation experiences, transportation …

Pre-Exposure Prophylaxis Uptake Among Black/African American Men Who Have Sex With Other Men In Midwestern, United States: A Systematic Review, Oluwafemi Adeagbo, Oluwaseun Abdulganiyu Badru, Prince Addo, Amber Hawkins, Monique J. Brown Ph.D., Mph, Xiaoming Li, Rima Afifi

Faculty Publications

Introduction: Black/African American men who have sex with other men (BMSM) are disproportionately affected by HIV, experience significant disparities in HIV incidence, and face significant barriers to accessing HIV treatment and care services, including pre-exposure prophylaxis (PrEP). Despite evidence of individual and structural barriers to PrEP use in the Midwest, no review has synthesized this finding to have a holistic view of PrEP uptake and barriers. This review examines patterns of, barriers to, and facilitators of PrEP uptake among BMSM in the Midwest, United States (US).

Methods: Five databases (CINAHL Plus, PUBMED, PsycINFO, SCOPUS, and Web of Science) were searched …

Alcohol Use Disorder Medication Coverage And Utilization Management In Medicaid Managed Care Plans, Maureen T. Stewart, Sage R. Feltus, Christina M. Andrews Ph.D., Andrea Acevedo, Cindy Parks Thomas, Jeffrey Bratberg, Constance M. Horgan, Dominic Hodgkin, Rachel Sayko Adams

Faculty Publications

Importance: Evidence-based, patient-centered treatment for alcohol use disorder (AUD) can include pharmacotherapy with naltrexone, acamprosate, or disulfiram; however, these medications are rarely used. Medicaid managed care plans (MCPs) manage health services for nearly 80% of Medicaid enrollees and are the largest payer for addiction treatment services. Little is known about Medicaid MCP policies for AUD medications. Objectives: To describe Medicaid MCPs' coverage and management of acamprosate, naltrexone, and disulfiram for AUD and examine associations of plan characteristics and state policies with medication coverage. Design, Setting, and Participants: In this cross-sectional study, a content analysis was performed of 2021 insurance benefit …

Church Leaders’ Health Behaviors And Program Implementation In The Faith, Activity, And Nutrition Program In The United States, Kelsey R. Day, Sara Wilcox Phd, Lindsay Decker, John Bernhart Ph.D., Mph, Ches, Meghan Baruth, Andrew T. Kaczynski Ph.D., Christine A. Pellegrini Ph.D.

Faculty Publications

Objectives: Church leaders are important to the success of faith-based health promotion interventions through the role modeling of health behaviors. However, clergy may be at a higher risk of chronic disease than their congregants and their health is understudied. This study examined church leaders’ health-related behaviors, differences in health behaviors by socio-demographic characteristics, and associations between health behaviors and church-level implementation of an ecological intervention. Methods: Pastors (n = 93) and church coordinators (n = 92) reported body mass index (BMI), self-rated health, fruit and vegetable consumption (F&V), and physical activity (PA) at baseline and 12 months post-training in the …

Rural–Urban Differences In Substance Use During Pregnancy, Emma Kathryn Boswell, Olivia M. Hinds, Cassie Odahowski Phd, Mph, Elizabeth L. Crouch, Peiyin Hung Ph.D, Christina M. Andrews Ph.D.

Faculty Publications

Purpose: Drug overdoses are now a leading cause of pregnancy-related deaths in the United States. Despite evidence of rural–urban disparities in substance use, there has not yet been a nationally representative examination of rural–urban differences in perinatal substance use. This study provides a comprehensive examination of rural–urban disparities in perinatal substance use. Methods: This study uses cross-sectional data to examine 3499 pregnant women from the 2015–2019 National Survey on Drug Use and Health (NSDUH). Rural (nonmetro)–urban (metro) differences in past-month tobacco use, alcohol use, binge drinking, illicit drug use, and marijuana use were examined using Rao–Scott chi-square tests and multivariable …

Modifiable And Non-Modifiable Risk Factors For Dementia Among Non-Hispanic White And Black Populations Aged 50-64 In The United States, 2006-2016, Jingkai Wei, Matthew C. Lohman Ph.D., Monique J. Brown, James W. Hardin, Chih-Hsiang Yang, Anwar T. Nerchant, Daniela B. Friedman

Faculty Publications

Background and Objectives

Research Design and Methods

Adverse Childhood Experiences, Resilience, And Syringe Services Program Attendance Among Persons Who Inject Drugs In Northeast Georgia, Usa: A Mediation Analysis, Mohammad Rifat Haider, Samantha Clinton, Monique J. Brown, Nathan B. Hansen

Faculty Publications

Background: Syringe services programs (SSP) are evidence-based venues offering harm reduction services to persons who inject drugs (PWID), such as sterile syringes, STI/HIV testing, and linkage to care to decrease drug use-related morbidities and mortalities. Adverse childhood experiences (ACEs) have been linked with reduced resilience, while increased resilience can help PWID attend SSPs. This study examined the potential mediating role of resilience between ACEs and SSP attendance among PWID.

Methods: Data were collected from adult HIV-negative PWID in northeast Georgia, between February-December 2023 (N = 173). Data were collected on SSP attendance (Yes vs. No), resilience, and ACEs. Covariates included …

Geographic Disparities In Unpaid Caregiving, Emma Kathryn Boswell, Monique J. Brown Ph.D., Mph, Lorie Donelle Phd, Rn, Fcan, Nicholas Yell, Taryn Farrell, Peiyin Hung Ph.D., Elizabeth Crouch Ph.D.

Faculty Publications

Purpose: An updated, nationally representative examination of rural–urban differences in the experiences, health, and well-being of caregivers is needed; previous research on this topic uses older data or has limited generalizability. This study examines rural–urban differences in the characteristics, experiences, and health of caregivers. Methods: The 2021–2022 Behavioral Risk Factor Surveillance System (n = 44,274 unpaid caregivers) was used, with rurality defined according to the 2013 National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme. Chi-square tests compared rural–urban differences in these caregivers’ characteristics, including demographic factors, caregiving intensity (e.g., weekly hours spent caregiving, reason for caregiving, past-month ADL/IADL assistance), …

Legal Residency Status And Its Relationship With Health Indicators Among Syrian Refugees In Lebanon: A Nested Cross-Sectional Study, Marie-Elizabeth Ragi, Hala Ghattas Ph.D., Berthe Abi Zeid, Hazar Shamas, Noura Joseph El Salibi, Sawsan Abdulrahim, Jocelyn Dejong, Stephen J. Mccall, The Caep Study Group

Faculty Publications

Background Failure to possess or renew legal residency permits increases the burden on a vulnerable refugee population. It risks detention or deportation, and hinders access to basic services including healthcare. This study aimed to examine the association between legal residency status and health of Syrian refugees living in Lebanon.

Methods Data were from two independent nested cross-sectional studies collected in 2022 through telephone surveys. In the first study, all Syrian refugees aged 50 years or older from households that received humanitarian assistance were invited to participate. The second included all adult Syrian refugees residing in a suburb of Beirut. The …

Integrating Postnatal Care Into The Redesign Of Group Care Beyond Birth, Ashley Gresh, Astrid Van Damme, Deborah Lynn Billings Phd, Sharon Schindler Rising, Shaimaa Ibrahim, Abiola Ajibola, Ellen Chirwa, Jennyfer Don-Aki, Nastassia Donoho, Manodj Hindori, Nafisa Jiddawi, Emeka Kanebi, Esnath Kapito, Catherine Kay, Tara Kinra, Vlorian Milliqaj, Bolanle Oyeledun, Marlies E.B. Rijnders, Octavia Wiseman, Ghutai Sadeq Yaqubi, Crystal L. Patil

Faculty Publications

Background

Globally, alarmingly high rates of maternal and infant mortality and morbidity persist. A constellation of health system and social factors contribute to this, including poor quality and barriers to accessing health care, including preventive services. As such, there have been calls for a redesign of maternal and child health (MCH) services. Although group care has primarily been tested in antenatal settings, it offers a promising redesign that optimizes maternal and child health care, survival, and well-being. The purpose of this study was to produce a blueprint of an adapted group care model that integrates postnatal maternal care, well-child care, …

Post-Term Births As A Risk Factor For Small For Gestational Age Births And Infant Mortality In Brazil, Mexico, And Palestinian Refugees: An Analysis Of Electronic Birth Records, Zeina Jamaluddine, Lorena Suarez Idueta, Enny S. Paixao, Julia M. Pescarini, Hala Ghattas Ph.D., Miho Sato, Akihiro Seita, Luis A. Martinez-Juarez, Mauricio L. Barreto, Eric O. Ohuma, Louise T. Day, Oona M.R. Campbell, Hannah Blencowe

Faculty Publications

Background:

Post-term pregnancy, defined as reaching or exceeding 42 + 0 weeks of gestation, is known to be associated with unfavourable birth outcomes. High-income countries have responded to this risk by widely adopting labour induction protocols in late-term, but many low- and middle-income countries have not. However, understanding underlying mechanisms linking post-term births to adverse newborn and infant outcomes remains limited.

Objective:

To investigate the (a) prevalence of post-term, (b) the risk factors associated with post-term (c) the association between post-term births and the risk of small-for-gestational-age (SGA) neonates and of infant mortality in middle-income settings.

Methods:

We used existing …

The Built Environment And Place Attachment: Insights From Japanese Cities, Juiling Li, Mohammed Javad Koohsari, Andrew T. Kaczynski, Ryo Tanimoto, Reo Watanabe, Tomoki Nakaya, Yufeng Luo, Jing Zhao, Akitomo Yasunaga, Koichiro Oka, Tomoya Hanibuchi

Faculty Publications

Objective

Methods

Results

Association Of Racial Residential Segregation And Other Social Determinants Of Health With Hiv Late Presentation, Fanghui Shi, Jiajia Zhang Ph.D., Shujie Chen, Xueying Yang Ph.D., Zhenlong Li, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Understanding social determinants of HIV late presentation with advanced disease (LPWA) beyond individual-level factors could help decrease LPWA and improve population-level HIV outcomes. This study aimed to examine county-level social determinants of health (SDOH) with HIV late presentation. We aggregated datasets for analysis by linking statewide HIV diagnosis data from the South Carolina (SC) Enhanced HIV/AIDS Reporting System and multiple social contextual datasets (e.g., the American Community Survey). All adult (18 years and older) people with HIV diagnosed from 2014 to 2019 in SC were included. Linear mixed models with forward selection were employed to explore the association of county-level …

Childhood Sexual Trauma, Substance Use, And Antiretroviral Therapy Adherence Among Older Adults Living With Hiv: A Mediational Analysis, Monique J. Brown, Josie Zhang, Prince Nii Ossah Addo, Amandeep Kaur, Daniel Amoatika, Elizabeth L. Crouch Ph.D., Steven A. Cohen

Faculty Publications

Childhood sexual abuse (CSA) is linked to substance use and lower antiretroviral therapy (ART) adherence. However, studies examining the mediational role of substance use between CSA and ART adherence are lacking. Therefore, the aim of this study was to determine the potential mediational role of substance use between CSA and ART adherence among older adults living with HIV (OALH) (n = 91). Mediation analyses assessed the direct and indirect relationships between CSA, substance use, and ART adherence. Statistically significant differences existed in substance use by gender (male vs. female: 12.3 vs. 9.97) and ART adherence by race (Black vs. …

Perceived Healthiness Of Sugary Drinks And Related Social Norms Among Adults In Five Countries: Evidence From The International Food Policy Study, Virginie Drolet-Labelle

Faculty Publications

Background

A better understanding of correlates of sugary drink consumption is essential to inform public health interventions. This study examined differences in perceived healthiness of sugary drinks and related social norms between countries, over time, and sociodemographic groups and associations with sugary drink intake.

Methods

This study used annual cross-sectional data from the International Food Policy Study from 2018 to 2021 in Australia, Canada, the United Kingdom, the United States, and Mexico. Analyses examined perceived healthiness of eight beverage types and two types of perceived social norms (descriptive, injunctive) that discourage sugary drink consumption. The 24-item Beverage Frequency Questionnaire was …

An Investigation Of Travel Distance And Timeliness Of Breast Cancer Treatment Among A Diverse Cohort In The United States, Swann Arp Adams, Oluwole Adeyemi Babatunde, Whitney Zahnd, Peiyin Hung, Karen E. Wickersham, Nathaniel Bell Ph.D., Jan M. Eberth Ph.D.

Publications

Travel to and from distant cancer treatment facilities can place a significant burden on cancer patients, particularly rural and minority survivors. Thus, the purpose of our investigation was to examine the association between patient travel distance and delays in types of treatment for breast cancer (surgery, radiation, chemotherapy, and hormonal therapy) and treatment delays. Using a novel linkage between the state cancer registry and administrative data from Medicaid and a private insurance plan, 2155 BC patients were successfully linked to create the cohort. ArcGIS was used to geocode all case residences and treatment facility addresses and calculate network distance between …

Associations Between Social Determinants Of Health And Mental Health Disorders Among U.S. Population: A Cross-Sectional Study, S. Tanarsuwongkul

Faculty Publications

Aims

The impact of social determinants of health (SDOH) on mental health is increasingly realized. A comprehensive study examining the associations of SDOH with mental health disorders has yet to be accomplished. This study evaluated the associations between five domains of SDOH and the SDOH summary score and mental health disorders in the United States.

Methods

We analyzed data from a diverse group of participants enrolled in the All of Us research programme, a research programme to gather data from one million people living in the United States, in a cross-sectional design. The primary exposure was SDOH based on Healthy …

Organizational Readiness For Implementation: A Qualitative Assessment To Explain Survey Responses, Maria Mcclam, Lauren Workman, Timothy J. Walker, Emanuelle M. Dias, Derek W. Craig, Joe R. Padila, Andrea E. Lamont, Abraham Wandersman, Maria E. Fernandez

Faculty Publications

Background

One factor considered essential to successful implementation is organizational readiness. The purpose of this study was to explore ways to improve the measurement of organizational readiness, and in particular to refine a preliminary measure based on the Readiness = Motivation x innovation Specific Capacity x General Capacity (R = MC2) heuristic. We assessed the experiences of staff in Federally Qualified Health Centers (FQHC) implementing evidence-based interventions (EBIs) designed to increase colorectal cancer screening (CRCS) who previously completed the survey and aimed to understand their perspectives on why our data were positively skewed.

Methods

We conducted a series of qualitative …

Preliminary Evaluation Of A Brief Intervention To Enhance Trauma-Informed Attitudes Among Educators And School Mental Health Counselors, Cheri Shapiro, Kara Lee, Courtnie Collins, Tristan Collier, Carl Sorensen

Publications

Professional development training designed to advance knowledge of the impacts of trauma and trauma-responsive practices for educators and counselors in schools and mental health settings have become common. Given the popularity of these training approaches, it is important to understand the potential impact on trauma-informed attitudes and beliefs. This descriptive, exploratory study examined changes in traumainformed care attitudes as a function of participating in a novel intervention designed to support trauma-informed practices in a sample of elementary school educators, administrators, and school mental health counselors (n=194) from one state in the Southeastern US. Positive changes in trauma-informed attitudes from pre …