Public Health Commons^™

A Discrete Choice Experiment Investigating Hiv Testing Preferences In South Africa, P. Chiwire, A. C. Muhlbacher, S. M. Evers, H. Mahomed, Jan Ostermann Ph.D., M. Hiligsmann

Faculty Publications

Background

South Africa (SA) has the world’s highest burden of HIV infection, with an estimated 13.7% of the population living with HIV (PLWH/Persons Living With HIV). The early identification of PLWH and rapid engagement of them in HIV treatment are indispensable tools in the fight against HIV transmission. Understanding client preferences for HIV testing may help improve uptake. This study aimed to elicit client preferences for key characteristics of HIV testing options.

Methods

A discrete-choice experiment (DCE) was conducted among individuals presenting for HIV testing at two public primary healthcare facilities in Cape Town, South Africa. Participants were asked to …

Dietetic Intervention In Psoriatic Arthritis: The Dieta Trial, Beatriz F. Leite, Melissa A. Morimoto, Carina M. F. Gomes, Barbara N.C. Klemz, Patrícia S. Genaro, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Nágila R.T. Damasceno, Marcelo M. Pinheiro

Faculty Publications

Aim To evaluate whether dietary pattern changes, antioxidant supplementation or 5-10% weight loss could improve disease activity (skin and joint) in patients with psoriatic arthritis (PsA). Methods A total of 97 PsA patients were enrolled in this 12-week randomized, double-blinded, placebo-controlled trial. Patients were randomized into three groups: Diet-placebo (hypocaloric diet + placebo supplementation); Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; and Placebo. Food intake (3-day registry, Healthy Eating Index (HEI), and the Dietary Inflammatory Index (DII)), body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) …

Exposure To Negative News Stories About Vaping, And Harm Perceptions Of Vaping, Among Youth In England, Canada, And The United States Before And After The Outbreak Of E-Cigarette Or Vaping-Associated Lung Injury (‘Evali’), Katherine East, Jessica L. Reid, Robin Burkhalter, Olivia A. Wackowski, Jim Thrasher Ph.D., Ma, Ms, Harry Tattan-Birch, Christian Boudreau, Maansi Bansal-Travers, Alex C. Liber, Ann Mcneill, David Hammond

Faculty Publications

Introduction

Little is known about the international impact of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’) on youth perceptions of vaping harms. Methods

Repeat cross-sectional online surveys of youth aged 16–19 years in England, Canada, and the United States before (2017, 2018), during (2019 August/September), and after (2020 February/March, 2020 August) the ‘EVALI’ outbreak (N = 63380). Logistic regressions assessed trends, country differences, and associations between exposure to negative news stories about vaping and vaping harm perceptions. Results

Exposure to negative news stories increased between 2017 and February–March 2020 in England (12.6% to 34.2%), Canada (16.7% to 56.9%), and the United …

Healthcare Safety-Net In The United States: Patient Satisfaction Across Rural And Urban Hospitals, Vivian Ho

Senior Theses

Objective. To examine rurality and other hospital characteristics associated with patient satisfaction across hospitals in the United States.

Data. Nationwide hospital data from the 2019 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and the 2020 Centers for Medicare & Medicaid Services (CMS) Provider of Services (POS) file.

Study Design. Hospital ZIP-codes were categorized into urban, rural micropolitan, or small/isolated rural based on Rural-Urban Commuting Area (RUCA) codes. Patient satisfaction measures from the HCAHPS survey were linked to the CMS POS data for hospital characteristics, yielding 2,357 urban, 749 rural micropolitan, and 1,343 small/isolated rural hospitals. ANOVA and …

Associations Among Plant-Based Dietary Indexes, The Dietary Inflammatory Index, And Inflammatory Potential In Female College Students In Saudi Arabia: A Cross-Sectional Study, Ghadeer S. Aljuraiban, Rachel Gibson, Leenah Al-Freeh, Sara Al-Musharaf, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert, Linda M. Oude, Queenie Chan

Faculty Publications

Background Saudi Arabian diets are transitioning to more Western dietary patterns that have been associated with higher levels of inflammation. Emerging evidence suggests plant-based diets are related to lower levels of inflammation; however, the definition of plant-based diets varies. Objective The purpose of this study was to identify the extent to which an overall Plant-Based Diet Index (PDI), Healthy-PDI (hPDI), and Unhealthy-PDI (uPDI) vs Energy-Adjusted Dietary Inflammatory Index correlate with high-sensitivity C-reactive protein (hs-CRP) level. Design This was a cross-sectional study carried out at King Saud University. Data on dietary intake, anthropometrics, and hs-CRP were collected. Participants/setting Female students aged …

Exploration Of The Role Of Neighborhood Residential Segregation By Race And Ethnicity In Obesity Risk Among School-Aged, Melissa L. Fair

Theses and Dissertations

Youth obesity prevalence remains high, despite decades of intervention. Grounded in the social ecological model, neighborhoods and schools are important settings in addressing the complex systems that influence obesity. Contributing to disparities, by race/ethnicity, Black and Hispanic youth are more likely to live in segregated neighborhoods and attend segregated schools, which are also more likely to have high rates of poverty and are less likely to have high quality nutrition and built environments. Leveraging data from local school district (district and state department of education) and national datasets (ACS, Childhood Opportunity Index 2.0), this study examined the associations between school …

Feasibility Of A Primary Care Patient Decision Aid For Smoking Cessation With Information About E-Cigarettes, Jennifer H. Lelaurin, Jim F. Thrasher Ph.D., Ma, Ms, Scott M. Strayer, John Malaty, Christy Kollath-Cattano, Maribeth Williams, Oliver T. Nguyen, Allie M. Kellner, James M. Smith, Ramzi G. Salloum

Faculty Publications

Decision aids can promote shared decision making and behavior change and may be effective in helping patients quit smoking. Patients are increasingly using e-cigarettes for smoking cessation; however, little is known about the impact of including e-cigarette information in smoking cessation decision aids. Our objective was to assess the feasibility and acceptability of a smoking cessation decision aid including e-cigarette information. This study was conducted at one family medicine clinic in the United States. We used a pre-post design. In Phase I, the decision aid presented information about approved cessation methods. In Phase II, current e-cigarette users and patients with …

Homestead Vegetable And Poultry Production And Related Practices: An Assessment In Nepal, Shiva Bhandari

Theses and Dissertations

Consumption of nutrients-rich foods like diverse vegetables, eggs, and meat throughout a year remains a challenge in low- and middle-income countries due to poor availability, accessibility, and affordability. One important way to overcome the challenge is to promote households’ own production of these foods and encourage individuals to consume. Improving household production of the foods necessitates understanding whether active participation and performance of frontline workers in the communities and performing improved production-related practices can translate into improved production of nutrients-rich foods. This study had two specific aims. The first aim was to examine demographic, socio-economic, and programmatic determinants of active …

Bright Light Treatment Of Combat-Related Ptsd: A Randomized Controlled Trial, Shawn D. Youngstedt, Christopher E. Kline, Alexandria Reynolds, Shannon K. Crowley, James B. Burch Ph.D., Nidha Khan, Seungyong Han

Faculty Publications

Introduction

Post-traumatic stress disorder (PTSD) is a prevalent consequence of combat with significant associated morbidity. Available treatments for PTSD have had limitations, suggesting a need to explore alternative or adjuvant treatments. Numerous rationales for bright light treatment of PTSD include its benefits for common PTSD comorbidities of depression, anxiety, and circadian misalignment and its relative ease of use with few side effects. The primary aims of this research were to examine the effects of bright light treatment for combat-related PTSD and associated morbidity. Materials and Methods

A randomized controlled trial was performed in N = 69 veterans with PTSD attributable …

Application Of The Precede-Proceed Planning Model In Designing An Infant Mortality Mitigation Strategy, Alexandria Hawkinson

Senior Theses

In this paper, I present a clinical intervention strategy aimed at mitigating infant mortality rates through application of the PRECEDE-PROCEED planning model. These steps involve analyzing the social implications of infant mortality among non-Hispanic black women in the state of South Carolina and identifying contributing factors of preterm birth via a thorough literature review. After concluding that adverse childhood experiences are linked to preterm birth and its contributing factors, I utilize the Health Belief Model to develop a health promotion program titled Empowered Mothers of South Carolina. This program works towards increasing acknowledgment of adverse childhood experiences and implementation of …

Wastewater Surveillance Of Sars-Cov-2 On American University Campuses: A Comparison Of Responses To The Covid-19 Pandemic, Emily Gosnell

Senior Theses

Wastewater surveillance has been used for a variety of purposes but, in recent years, has most notably been utilized during the COVID-19 pandemic. Many universities in the United States used it as a means of monitoring levels of the SARS-CoV-2 virus on their campuses. The University of South Carolina, University of Arizona, and University of North Carolina- Charlotte were three such schools. An analysis of data published by these three schools has been used to synthesize a proposed list of best methods to be used by other universities during the reemergence of SARS-CoV-2 or during the outbreak of a new …

The Effect Of Provider-Patient Racial Concordance On Student Health Services, Sophia B. Gilliam

Senior Theses

Objective: This research aimed to evaluate the effect of provider-patient racial concordance on perceived care received by University of South Carolina students at Student Health Services.

Methods: A total of 173 students at the University of South Carolina Columbia campus who have received care from Student Health Services within the past 2 years participated in the study. Participants were questioned about their experience with Student Health Services using an adaptation of the CAHPS® Clinician & Group Survey Version 3.0. Independent samples t-tests and descriptive analyses were used for comparisons between the 25 non-white respondents and a randomly selected proportionate group …

“Pandemias Políticas: The Effects Of Political And Social Instability On Infectious Disease Epidemiology In Latin America"”, Sarah H. Noonan

Senior Theses

This paper seeks to analyze the relationship between political and social unrest and conflict and infectious disease epidemiology in Latin America. An analysis of published literature regarding epidemiological, biomedical, political, and historical content was conducted to highlight potential connections between infectious disease epidemics and sociopolitical conflict in the region. Specific analyses of Smallpox, Venezuelan Equine Encephalitis, Chagas disease, Cholera, Dengue, and COVID-19 were conducted, in an effort to uncover potential causations and context of epidemics of these conditions. Results of this analysis depict a necessity for further research into public health and disease control mechanisms during times of conflict and …

Perspectives About Food Safety In Diverse Low- And Middle-Income Countries, Sejla Isanovic

Theses and Dissertations

Concerns about unsafe food influence food choice, and consumption of unsafe foods increases morbidity and mortality, particularly in low- and middle-income countries. Actions to ensure safety of food are dominated by mitigation of biological and chemical hazards through supply-side risk management, disregarding individuals’ experiences and perspectives of food safety. We aimed to identify and categorize perspectives about food safety in five countries. Five Drivers of Food Choice projects provided transcripts from 17 focus groups discussions and 303 interviews in Kenya, Ghana, India, Guinea, and Vietnam. We analyzed transcripts using a priori and emergent codes. Individuals constructed meaning about food safety …

Gonorrhea: Core Areas And State Policies, Jessica Purser

Theses and Dissertations

This research looked at gonorrhea rates both from a community perspective and at the state level. Using hot spot analysis, means differences, and quantile regression, we found that education, specifically the percent of people over the age of 25 with less than a high school education, was the dominant factor at the state level while core areas of gonorrhea exist in the PeeDee and western Lowcountry regions of South Carolina in 2017 and 2018. Risky sexual behaviors are well-defined in the literature for individual persons, but this shows that looking at societal and community factors is important.

This is a …

The Impact Of Cannabis And Alcohol Use On The Management Of Type 1 Diabetes Mellitus, Joshua Eric Sellner

Theses and Dissertations

This dissertation sought to contribute to the evidence-base of diabetes management and acute complications associated with alcohol and cannabis use among individuals with Type 1 Diabetes (T1DM). Three interconnected studies were initiated to complete this goal. First, existing literature surrounding the potential consequences of cannabis consumption among individuals with T1DM were summarized within a systematic review. Study results were combined to provide a single measure of association through a meta-analysis. Second, identified associations were further investigated through a cross-sectional study using the SEARCH for Diabetes in Youth data on alcohol and cannabis use on diabetes management and acute complications including …

Associations Of The Fto Gene And Risk Of Acute Myeloid Leukemia, Avery Ulrich

Theses and Dissertations

Background Acute Myeloid Leukemia (AML) is a blood cancer that affects ~70,000 people each year in the US. The Fat Mass and Obesity (FTO) gene on chromosome 16 has been reported to be associated with obesity, solid tumor cancers (lung, renal, breast, prostate, pancreatic, endometrial), and more recently with hematologic malignancies, like AML. In this thesis, we test the hypothesis that inherited variants within the FTO gene are associated with an increased risk of AML. Methods Using the DISCOVeRY-BMT (Determining the Influence of Susceptibility COnveying Variants Related to one-Year mortality after Blood and Marrow Transplantation), a well-powered genome-wide association study …

Determinants Of Hiv Treatment Disparities In The Latino Population Of South Carolina, Elizabeth G. Caulk

Senior Theses

The Latino population in the United States faces a heightened risk in terms of contracting HIV/AIDS and experiencing negative health outcomes from said infection. HIV/AIDS continues to disproportionately impact ethnic/racial minorities, and the Latino population exemplifies this unfortunate trend, with Latino Americans making up around 18.4% of the national population, but nearly 30% of the HIV/AIDS infections (US Office of Minority Health, 2021). More enduring changes to the current resources available to this population will need to be made in order to address this disparity. Thus, the current study examined social determinants, how they increase risk of infection, and how …

The Age Of E-Cigarette Initiation And Association With Frequency Of Use And Risk Of Combustible Tobacco Cigarette Smoking Initiation, Andy Hu

Senior Theses

Background - Studies have shown that electronic nicotine delivery systems (ENDS) are unsafe for consumption. However, the prevalence of e-cigarette use among adolescents and young adults continues to increase, which is being addressed by research. Little attention has been paid to the effects of earlier age of ENDS initiation.

Purpose - This paper examined published research studies on the topic of the age of initiation of e-cigarette use in relation to 1) frequency of e-cigarette use and 2) risk of combustible tobacco cigarette smoking initiation. This research tested the hypothesis that an earlier age of e-cigarette initiation was associated with …

Superfund And Society Benumbed: An In-Depth Look At Environmental Justice In South Carolina, Sydney A. Hampton

Senior Theses

This thesis investigates the relationship between superfund sites in minority communities and their public health through the lens of social vulnerability. Various demographic parameters were used to assess the risk associated with minority communities and exposure to hazardous waste. After investigating the history of the Environmental Justice movement, three superfund sites of interest in South Carolina, and demographic and public health data; each community was analyzed to determine association between exposure to hazardous waste and minority status. Each examined community exhibited characteristics contributing to heightened social vulnerability, potentially causing increased susceptibility to negative health outcomes from exposure to hazardous waste.

Assessing Satisfaction With Bi-Weekly Produce Deliveries As A Means To Reduce Food Insecurity On College Campuses, Sophie Crosby

Senior Theses

Background: As food insecurity disproportionately affects college students and students are often unable to receive government nutritional assistance, more lasting, sustainable interventions are needed to decrease food insecurity on college campuses. The purpose of this study was to measure the satisfaction of the FoodShare program, a low-cost, biweekly fresh produce delivery, at the University of South Carolina. The purpose of this study was to pilot FoodShare’s program with adaptations to the University of South Carolina and examine participants’ experience with the program. Methods: Forty-three students, faculty, and staff purchased boxes over a three-month period. FoodShare boxes were purchased and delivered …

Longitudinal Relation Of Dietary Quality And Hemoglobin A1c In Youth And Young Adults With Diabetes, Hope Bercaw

Theses and Dissertations

Background Hemoglobin A1c (HbA1c) is a clinical measure of glycemic control among people with diabetes and is associated with health outcomes such as cardiovascular disease. It is possible to decrease HbA1c by improving diet, but it is largely unknown which dietary components are most important in targeting glycemic control.

Objective This study aims to examine whether changes in diet quality across diabetes duration, assessed with the 2015-Healthy Eating Index (HEI), are associated with HbA1c in youth and young adults (YYA) with type 1 (T1D) and type 2 diabetes (T2D). Additionally, we aim to assess whether these relationships differ when dietary …

A Resilience-Based Intervention To Mitigate The Effect Of Hiv-Related Stigma: Protocol For A Stepped Wedge Cluster Randomized Trial, Xiaoming Li Ph.D., Shan Qiao Ph.D., Xueying Yang, Sayward E. Harrison, Cheuk Chi Tam, Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Background: Despite decades of global efforts to tackle HIV-related stigma, previous interventions designed to reduce stigma have had limited effects that were typically in the small- to-moderate range. The knowledge gaps and challenges for combating HIV-related stigma are rooted both in the complexity of the stigma and in the limitations of current conceptualizations of stigma reduction efforts. Recent research has shown the promise of resilience-based approaches that focus on the development of strengths, competencies, resources, and capacities of people living with HIV (PLWH) and their key supporting systems (e.g., family members and healthcare providers) to prevent, reduce, and mitigate the …

Correlational Networking Guides The Discovery Of Unclustered Lanthipeptide Protease-Encoding Genes, Dan Xue, Ethan Older, Zheng Zhong, Zhou Shang, Nanzhu Chen, Nolan Dittenhauser, Lukuan Hou, Peiyan Cai, Michael D. Walla, Shi-Hui Dong, Xiaoyu Tang, Hexin Chen, Prakash Nagarkatti, Mitzi Nagarkatti, Yong-Xin Li, Jie Li

Faculty Publications

Bacterial natural product biosynthetic genes, canonically clustered, have been increasingly found to rely on hidden enzymes encoded elsewhere in the genome for completion of biosynthesis. The study and application of lanthipeptides are frequently hindered by unclustered protease genes required for final maturation. Here, we establish a global correlation network bridging the gap between lanthipeptide precursors and hidden proteases. Applying our analysis to 161,954 bacterial genomes, we establish 5209 correlations between precursors and hidden proteases, with 91 prioritized. We use network predictions and co-expression analysis to reveal a previously missing protease for the maturation of class I lanthipeptide paenilan. We further …

Hiv-Related Stigma, Sexual Identity, And Depressive Symptoms Among Msm Living With Hiv: A Moderated Mediation Modeling Analysis, Tianyue Mi, Guanghua Lan, Xueying Yang Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Depression is one of the biggest health issues among men who have sex with men (MSM) living with HIV, where sexual identity might play an intricate role. Yet, findings of the relationship between sexual identity and depression were mixed and few studies explored its underlying mechanisms. This study aimed to examine the association between sexual identity and depression, and the potential mediating role of HIV-related stigma and moderating role of age. A cross-sectional survey was conducted among 203 MSM living with HIV in Guangxi, China. Participants provided information on sexual identity, depression, HIV-related stigma, and background information. Descriptive statistics, bivariate …

Translation Of Policy For Reducing Undernutrition From National To Sub-National Levels In Rwanda, Elyse Iruhiriye, Deanna K. Olney, Edward A. Frongillo, Emmanuel Niyongira, Simeon Nanama, Eugene Rwibasira, Paul Mbonyi, Christine E. Blake

Faculty Publications

Understanding how countries improve children’s nutrition can inform policies and contribute to further improvements. We examined the relationship between improvements in nutrition in Rwanda (1992–2017) and political commitment to- and policy coherence in- nutrition. We reviewed nutrition-relevant Rwandan policies and programs (2000–2018) and conducted 90 semi-structured interviews with national (n = 32), mid-level (n = 38), and community (n = 20) nutrition stakeholders and 40 community-level focus group discussions (FGDs). FGDs and sub-national interviews were conducted in ten purposefully selected districts, five each in which stunting decreased (reduced) and increased or stagnated (non-reduced) between the 2010 and 2014/15 Rwanda Demographic …

The Relationship Of Hair Glucocorticoid Levels To Immunological And Virological Outcomes In A Large Cohort Of Combination Antiretroviral Therapy Treated People Living With Hiv, Quan Zhang, Xiaoming Li Ph.D., Shan Qiao Ph.D., Shuaifeng Liu, Yuejiao Zhou, Zhiyong Shen

Faculty Publications

Background

Existing literature mostly investigated the relationship of acute or short-term glucocorticoid exposure to HIV disease progression using cortisol levels in serum, saliva, or urine. Data are limited on the relationship of long-term glucocorticoid exposure to HIV disease progression. This study examined whether hair glucocorticoid levels, novel retrospective indicators of long-term glucocorticoid exposure, are associated with two common indicators of HIV disease progression (CD4 count and HIV viral load) among a large cohort of combination antiretroviral therapy treated Chinese people living with HIV (PLHIV).

Methods

A total of 1198 treated PLHIV provided hair samples for glucocorticoid (cortisol and cortisone) assay …

Increased Risk Of Major Depressive Disorder Following Tinnitus: A Population-Based Study, Herng-Ching Lin, Sudha Xirasagar Mbbs, Ph.D., Chia-Hui Wang, Yen-Fu Cheng, Tzong-Hann Yang

Faculty Publications

Background and Purpose: In this study, we aimed to evaluate the relationship between tinnitus and a subsequent diagnosis of major depressive disorder (MDD) by studying the incidence of both entities.

Design: A retrospective cohort study.

Methods: Data for this observational follow-up study were retrieved from the Taiwan's National Health Insurance Dataset. A total of 375,272 patients with newly diagnosed tinnitus (study group) were retrieved. The date of first diagnosis of tinnitus was assigned as their index date. Comparison patients were selected by propensity score matching (one per case, n = 375,272 controls) from the same dataset, with their index date …

Television Viewing Time And All-Cause Mortality: Interactions With Bmi, Physical Activity, Smoking, And Dietary Factors, Christopher T. Swain, Julie K. Bassett, Allison M. Hodge, David W. Dunstan, Neville Owen, Yi Yang, Harindra Jayasekara, James R. Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Robert J. Macinnis, Roger L. Milne, Dallas R. English, Brigid M. Lynch

Faculty Publications

Background Higher levels of time spent sitting (sedentary behavior) contribute to adverse health outcomes, including earlier death. This effect may be modified by other lifestyle factors. We examined the association of television viewing (TV), a common leisure-time sedentary behavior, with all-cause mortality, and whether this is modified by body mass index (BMI), physical activity, smoking, alcohol intake, soft drink consumption, or diet-associated inflammation. Methods Using data from participants in the Melbourne Collaborative Cohort Study, flexible parametric survival models assessed the time-dependent association of self-reported TV time (three categories: < 2 h/day, 2-3 h/day, > 3 h/day) with all-cause mortality. Interaction terms were fitted to test whether …

Evaluation Of A Community-Based Performance Arts Programme For People Who Have Experienced Stroke In The Uk: Protocol For The Shaper-Stroke Odysseys Study, Carolina Estevao, Maria Baldellou Lopez, Rachel E. Davis, Lucinda Jarret, Tayana Soukup, Ioannis Bakolis, Andy Healey, Jean Harrington, Anthony Woods, Nikki Crane, Fiona Jones, Carmine Pariante, Daisy Fancourt, Nick Sevdalis

Faculty Publications

INTRODUCTION: Stroke survivors, once in the community, face challenges with their long-term rehabilitation care and present higher levels of loneliness, depression and anxiety than the rest of the population. A community-based performance arts programme, Stroke Odysseys (SO), has been devised to tackle the challenges of living with stroke in the UK. In this study, we aim to evaluate the implementation, impact and experiences of SO for stroke survivors. METHODS AND ANALYSIS: Scaling-up Health Arts Programmes: Implementation and Effectiveness Research (SHAPER)-SO aims to scale-up SO to 75 participants and 47 stakeholders, while simultaneously evaluating the effectiveness and implementation of the programme. …