Public Health Commons^™

Effectiveness Among Community Health Center Governing Boards: An Assessment Of The Different Governing Board Members’ Perspectives, Brandi L. Wright

Theses and Dissertations

Governing boards of Community Health Centers were created with the anticipation that majority of its members be patients (users) of the Community Health Center they served. This study assessed South Carolina Community Health Center governing board members’ perception and understanding of what they believe their roles and responsibilities are, and their perceived overall effectiveness. It provides a framework for understanding the governance structure of Community Health Centers, based on examining three characteristic areas (Board Function, Board Performance and Board Development) of Community Health Centers located in South Carolina.

This study invited 234 governing board members to obtain members perceptions. Key …

Examining The Organizational Capacity Of Public Libraries That Offer Obesity Prevention Programs, Olivia Whitt

Theses and Dissertations

Supplemental Nutrition Assistance Program Education (SNAP-Ed) is a federally funded grant program that helps SNAP-eligible populations make healthy choices, like those outlined by the Dietary Guidelines for Americans and the Physical Activity Guidelines for Americans. Together with implementation agencies (IAs) and local sites, SNAP-Ed provides direct nutrition education and facilitates policy, systems, and environmental strategies (PSEs) such as farmers markets and community gardens. This qualitative research investigated two specific aims: 1.) Understand the elements of organization capacity that influence a public library’s ability to implement obesity prevention programs and 2.) Evaluate the need for library staff public health knowledge …

Nutrient Timing: A Garage Door Of Opportunity?, Shawn M. Arent, Harry P. Cintineo, Bridget A. Mcfadden, Alexa Jenny Chandler, Michelle Angelique Arent

Faculty Publications

Nutrient timing involves manipulation of nutrient consumption at specific times in and around exercise bouts in an effort to improve performance, recovery, and adaptation. Its historical perspective centered on ingestion during exercise and grew to include pre- and post-training periods. As research continued, translational focus remained primarily on the impact and outcomes related to nutrient consumption during one specific time period to the exclusion of all others. Additionally, there seemed to be increasing emphasis on outcomes related to hypertrophy and strength at the expense of other potentially more impactful performance measures. As consumption of nutrients does not occur at only …

Living Arrangements And Food Security Of A Sample Of Older Palestinian Refugees In Lebanon, Nadine R. Sahyoun, Anniebelle Sassine, Anna Vaudin, Fayrouz Sakr-Ashour, Hala Ghattas Ph.D.

Faculty Publications

Background

Although we know of the relationship between food insecurity, poor dietary intake and health outcomes, there are limited studies examining the determinants of food insecurity in older adults in developing countries. This study describes the living arrangement and characteristics of protracted Palestinian refugees in Lebanon aged 60 years and older and, the status and determinants of household food insecurity.

Methods

Two surveys, representative of Palestinian refugees in Lebanon (2010 and 2015), were appended and used to examine living arrangement of older adults and household food security. Our final pooled sample included 5412 households and 24,540 individuals. Of these individuals, …

Linking Activity, Nutrition, And Child Health (Launch): Protocol For A Longitudinal Cohort Study Of Children As They Develop From Infancy To Preschool Age, Russell R. Pate, Edward A. Frongillo Jr., Kerry Cordan, Marsha Dowda, Alexander C. Mclain, Myriam E. Torres, William H. Brown, Agnes Bucko, Emily R. Shull

Faculty Publications

Background

Physical activity is known to provide important health benefits in children ages 3 years and above, but little is known about the effects of physical activity on health in very young children under age 3. LAUNCH (Linking Activity, Nutrition, and Child Health) is a study designed to expand the body of knowledge on development of physical activity behavior and associations between physical activity and other health characteristics as children transition from infancy to preschool age.

Methods

Physical activity and sedentary behavior will be measured objectively in young children over a period of 30 months. Each child will complete a …

The Cascade Of Care In Managing Hypertension In The Arab World: A Systematic Assessment Of The Evidence On Awareness, Treatment And Control, Christelle Akl, Chaza Akik, Hala Ghattas Ph.D., Carla Makhlouf Obermeyer

Faculty Publications

Background:

Hypertension is a leading risk factor for mortality and morbidity globally and in the Arab world. We summarize the evidence on awareness, treatment, and control of hypertension, to assess the extent of gaps in the hypertension continuum of care. We also assess the influence of gender and other social determinants at each level of the cascade of care.

Methods:

We searched MEDLINE and SSCI databases for studies published between 2000 and 2017, reporting the rates of awareness, treatment or control of hypertension and/or their determinants in the Arab region. We included sources on both general populations and on clinical …

Differential Relationships Between Waist Circumference And Cardiorespiratory Fitness Among People With And Without Type 2 Diabetes, Andrew Ortaglia, Samantha M. Mcdonald, Christina Supino, Michael D. Wirth, Xuem Sui, Matteo Bottai

Faculty Publications

Adults with type 2 diabetes mellitus tend to exhibit an increased level of central adiposity, augmenting their risk of further non-communicable diseases (NCDs). Importantly, consistent evidence demonstrates a significant, negative association between cardiorespiratory fitness (CRF) and waist circumference (WC). However, no previous studies have investigated differences in these CRF-related reductions in WC between adults with and without diabetes.

This study used data from the Aerobic Center for Longitudinal Studies, conducted between 1970 and 2006 among predominately Non-Hispanic White, middle-to-upper class adults in Texas. Quantile regression models were used to estimate CRF-related differences in WC between persons with and without diabetes. …

Responding To Health Needs Of Women, Children And Adolescents Within Syria During Conflict: Intervention Coverage, Challenges And Adaptations, Chaza Akik, Aline Semaan, Linda Shaker-Berbari, Zeina Jamaluddine, Ghada E. Saad, Katherine Lopes, Joanne Constantin, Abdulkarim Ekzayez, Neha S. Singh, Karl Blanchet, Jocelyn Dejong, Hala Ghattas Ph.D.

Faculty Publications

Background:

Women and children suffer disproportionately in armed-conflicts. Since 2011, the protracted Syrian crisis has fragmented the pre-existing healthcare system. Despite the massive health needs of women and children, the delivery of key reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) interventions, and its underlying factors are not well-understood in Syria. Our objective was to document intervention coverage indicators and their implementation challenges inside Syria during conflict.

Methods:

We conducted 1) a desk review to extract RMNCAH&N intervention coverage indicators inside Syria during the conflict; and 2) qualitative interviews with decision makers and health program implementers to …

Effect Of Differences In Month And Location Of Measurement In Estimating Prevalence And Trend Of Wasting And Stunting In India In 2005-2006 And 2015-2016, Emily M. Madan, Edward A. Frongillo Jr., Sayeed Unisa, Laxmikant Dwivedi, Robert Johnston, Abner Daniel, Praween K. Agrawal, Sila Deb, Ajay Khera, Purnima Menon, Phuong H. Nguyen

Faculty Publications

Background: Child undernutrition in India remains widespread. Data from the National Family Health Survey 3 and 4 (NFHS-3 and NFHS-4) suggest that wasting prevalence has increased while stunting prevalence has declined. Objective: The objectives of this study were to do the following: ) describe wasting and stunting by month of measurement in India in children surveys, and ) test whether differences in the timing of anthropometric data collection and in states between survey years introduced bias in the comparison of estimates of wasting and stunting between NFHS-3 and NFHS-4. Methods: Data on wasting and stunting for 42,608 and 232,744 children …

Objective Church Environment Audits And Attendee Perceptions Of Healthy Eating And Physical Activity Supports Within The Church Setting, Marilyn E. Wende, Andrew T. Kaczynski, John A. Bernhart, Caroline G. Dunn, Sarah Wilcox

Faculty Publications

Interventions in faith-based settings are increasingly popular, due to their effectiveness for improving attendee health outcomes and behaviors. Little past research has examined the important role of the church environment in individual-level outcomes using objective environmental audits. This study examined associations between the objectively measured physical church environment and attendees’ perceptions of physical activity (PA) and healthy eating (HE) supports within the church environment, self-efficacy for PA and HE, and self-reported PA and HE behaviors. Data were collected via church audits and church attendee surveys in 54 churches in a rural, medically underserved county in South Carolina. Multi-level regression was …

Association Of Multisetting Community Programs And Policies With Child Body Mass Index: The Healthy Communities Study, Vicki L. Collie-Akers, Stephen B. Fawcett, Jerry A. Schultz, Kandace K. Fleming, Rebecca E. Swinburne Romine, Lorrene D. Ritchie, Edward A. Frongillo Jr., S Sonia Arteaga

Faculty Publications

INTRODUCTION:

Expert opinion suggests that efforts to address childhood obesity should seek to transform the environments in which children operate. The objective of this study was to describe the extent to which multisetting programs and policies interact with community and child predictors and are associated with child body mass index (BMI) in the 130 US communities participating in the Healthy Communities Study.

METHODS:

For 2 years beginning in fall 2013, we collected data through key informant interviews on community programs and policies related to healthy weight among children that occurred in the 10 years before the interview. We characterized community …

Associations Between Food Insecurity And Psychotropic Medication Use Among Women Living With Hiv In The United States, Henry J. Whittle, William R. Wolfe, Lila A. Sheira, Edward A. Frongillo Jr., Kartika Palar, Daniel Merenstein, Tracey E. Wilson, Adebola Adedimeji, Mardge H. Cohen, Eryka L. Wentz, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

AIMS: Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. METHODS: We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary …

Social Networks, The Local Food Environment, And Maternal Food Choice For Children Ages 1 To 5 Years Old In Rural Mexico, Ligia Ivette Reyes

Theses and Dissertations

Children’s nutrition is largely determined by the food choices their primary caregivers make. Food choice for children has important implications for nutrition, development, and the dietary habits and preferences that are formed during early life food exposure. Little is known about the food environments in which food choices are made and the role of social networks in maternal food choice during habit- and preference-forming years in contexts undergoing nutrition transitions and facing the double burden of malnutrition. The overall objective of this study was to gain an indepth understanding about how mothers, as primary caregivers, make food choices for their …

Vaccine Confidence, Coverage, And Hesitancy Worldwide: A Literature Analysis Of Vaccine Hesitancy And Potential Causes Worldwide, Jordan Hammond

Senior Theses

Vaccines are one of the world’s most impactful medical therapies. They are cost-effective, successfully proven, and one of the quickest treatment options available today (Clark et al., 2016). They save millions of lives every year and have eliminated certain diseases on a national and international level. However, millions of people worldwide still remain unvaccinated. In developed nations, mainly The United States (U.S.) and the European countries, many of the unvaccinated are a result of rising vaccine hesitancy of parents in conjunction with the anti-vaccination movement. Vaccine hesitancy is defined as “a delay in acceptance or refusal of vaccines despite availability” …

The Role Of A Community-Driven, Structured Exercise Program On Children's And Adolescent's Quality Of Life, Padgett Singley Powe

Senior Theses

Childhood obesity is a long-standing epidemic in the United States as of 2020, and the problem is continuing to worsen. Childhood obesity has been shown to have many unhealthy effects, such as increasing prevalence of cardiovascular disease, depression, and social anxiety, which all can contribute to a worsened quality of life. Research suggests that summer is the most critical time period to combat childhood obesity is because children’s lives are less structured over the summer, which can lead to increased unhealthy behaviors, obesity, and a decrease in quality of life. The current study, the Skybrook Swim Team Study, aimed to …

Associations Between County-Level Socioeconomic Status And Opioid Overdose Rates In Northern New England, Samuel Godfrey

Theses and Dissertations

Background – The opioid epidemic persists as a significant concern to public health as the proliferation of fentanyl presents additional risks for illicit opioid users. States such as Maine and New Hampshire experience far greater opioid overdose rates compared to the overall US opioid overdose rate. Many studies on the opioid epidemic use socioeconomic and macroeconomic factors individually but few use a composite index of multiple of these measures. Limited attention has been paid to the need for a composite index of socioeconomic status at the small area (county) level designed to quantify the impact of socioeconomic status on the …

Is Vaping Related To Other Health Risk Behaviors Among Adolescents?, Alvina Emran

Senior Theses

Vaping (smoking a vaporized liquid with an active ingredient) has had an upward trend in high school populations (ages 13-18) within the last decade, mainly due to misinformation and targeting from companies that sell e-cigarettes (142, 7). The most common substances that are vaped in teens are nicotine and tetrahydrocannabinol (THC, the active ingredient in marijuana) (147). Nicotine and THC bind to NAchR and CB1 receptors that affect certain parts of the dopamine reward pathway, such as the prefrontal cortex, the ventral tegmental area, and the ventral striatum in the brain (44,106). Dysfunction within these pathways have been associated with …

Relation Of Flt-1 And Endothelial Function In Women Soon After Delivery: Effect Of Physical Activity And Sedentary Behavior, Chloe W. Caudell

Senior Theses

Adverse pregnancy outcomes (APOs) are believed to be caused by poor placental formation. APOs can be characterized by elevated levels of a circulating Fms-like tyrosine kinase biomarker called Flt-1, produced by the placenta when its blood vessels are shallow or inadequately formed. Flt-1 acts directly on the maternal endothelium to impair vascular function during pregnancy and contributes to maternal features of APOs. This study aimed to evaluate the relation of Flt-1 and endothelial function in women soon after delivery. This study also aimed to evaluate the relation of Flt-1 and physical activity and sedentary behavior in women during and soon …

Differences In Food Spending On Groceries And Eating Out Between Two Dietary Groups: The New Soul Study, Carly Fassler

Senior Theses

Background: Heart disease is now the leading cause of death for both men and women in the United States. Obesity, high blood pressure, and high cholesterol are all risk factors for heart disease. Research has shown that increasing consumption of plant-based foods may be effective in reducing risk factors for chronic disease, especially heart disease. A plant-based diet consists of nutrient-dense plant foods and minimizes the consumption of processed animal products. High costs of eating a healthier diet are a commonly cited barrier that prevents individuals from making dietary changes that could potentially decrease their chronic disease risk.

Objective: To …

Surveying Tuberculosis Screening Practices Of South Carolina Hospital Employees, Tamara T. Carree

Theses and Dissertations

BACKGROUND: Every year tuberculosis (TB) causes over 10 millions of people globally and in recent years has caused over 9,000 cases annually in the United States. TB can be transmitted in hospital settings, and South Carolina hospitals, like hospitals elsewhere in the country maintain a responsibility to test their employees for this disease. Nosocomial infections of active TB among patients and healthcare workers can be burdensome on hospital resources. Testing healthcare workers and implementing prevention strategies are examples of administrative controls provided in the 2005 guidelines by the Centers for Disease Control and Prevention (CDC). Implementation of administrative controls are …

Perspectives Of Health Professionals And Associations On The Use Of Electronic Cigarettes For Smoking Cessation, Rowdy Fitzpatrick

Senior Theses

In an effort to deduce the current perspective of health professionals and health associations on electronic cigarettes, this project reviews position statements and policy guidelines, as well as studies regarding physician practices and knowledge, and primary data collected from focus groups. This data is analyzed in regard to beliefs on the risks and benefits of using electronic cigarettes as harm reduction or cessation tools. The multi-pronged approach attempts to clearly demonstrate the atmosphere of the healthcare community regarding electronic cigarettes.

An Examination Between Neighborhood Characteristics And Alzheimer’S Disease And Related Dementias And Caregiver Mental Health In South Carolina, Dana Mahmoud Alhasan

Theses and Dissertations

Research has examined the relationship between neighborhood environments and cognitive decline, yet few have investigated the role of neighborhood characteristics specifically on incident Alzheimer’s disease and related dementias (ADRD), on severity of Alzheimer’s disease (AD) including neuropsychiatric symptoms (NPS), and on caregiver mental health including depressive symptoms. This dissertation aimed to 1) ecologically examine the geographic distribution of ADRD and investigate ecologic associations between census-tract neighborhood characteristics and diagnosed ADRD case incidence from 2010-2014 in the South Carolina (SC) Alzheimer’s Disease Registry; 2) estimate the cross-sectional association between neighborhood characteristics and NPS among those with AD in 2010 in SC; …

Contraceptive Education In South Carolina Women's Jails, Sarah B. Johnson

Senior Theses

Women in jail, which is currently a growing population, are at risk of unplanned pregnancy due to their potential exposure to alcohol and drug use, history of living in an abusive environment, and potential practice of prostitution(Clarke et al., 2012; Clarke et al., 2006; Kelly, 2012). The majority of female inmates are between the ages of 17-30, the peak reproductive age, which increases the importance of jails providing education to improve inmates’ reproductive health (Hale et al., 2009). Many females arrested will be released from jail back into society, making jails an opportune place to provide information to improve the …

The Impact Of Financial Incentives On Urban-Rural Disparities In Dental Supply: Evidence From Thailand, Rakchanok Noochpoung

Theses and Dissertations

Financial incentive is one of the common strategies used to attract healthcare workers in rural and remote areas. Both high-income and low-income countries extensively use financial strategy to tackle the disparity distribution of healthcare workers. However, most studies were conducted in developed countries and assessed positive incentives programs. Previous studies showed the effectiveness of financial incentives on recruitment and retention of healthcare workers. Current studies show that most of the financial incentives supported for education such as scholarships and loan repayment programs are effective. A few studies assessed the effectiveness of direct payment incentive programs, especially in low-middle income countries. …

The Impact Of Psychosocial, Clinical, And Neighborhood Factors On Inflammatory Outcomes Among African American Women, Malcolm Seth Bevel

Theses and Dissertations

Inflammatory-related chronic diseases are disparagingly prevalent among African Americans in the United States, particularly in the Southeastern region. Access to community gardens shows promise in mitigating chronic disease outcomes, despite multiple barriers to physical activity and diet among underserved populations. We seek to determine if psychosocial or clinical factors mediate the association between the treatment effect of a healthy lifestyle intervention and inflammatory biomarker levels among African American women, respectively. We also seek to analyze the relationship between residing in a food desert/swamp and inflammatory biomarker levels, while gaining a qualitative perspective about community garden access among African American women. …

Circulating Calcium, Phosphorus, And Parathyroid Hormone And Aggressive Prostate Cancer In The North Carolina-Louisiana Prostate Cancer Project, Brittany Crawford

Theses and Dissertations

Prostate cancer is the most commonly diagnosed cancer among men in the United States. Despite improvements in screening, diagnostic methods, and treatment, African-American men have an increased risk of total and aggressive prostate cancer. In recent years, a growing body of evidence linking biomarkers of calcium and parathyroid hormone (PTH) to prostate cancer development has emerged. Circulating calcium, phosphorus, and PTH are homeostatically related. Prior studies linking prostate cancer and circulating calcium and PTH have produced inconclusive results, and no studies have examined the association between serum phosphorus and prostate cancer. The present study examined the relationship between circulating calcium, …

The Interaction Between Caffeine Consumption, Alcohol Use, And Amount Of Sleep On Bone Health, Haley Davis-Martin

Theses and Dissertations

Using cross-sectional data from the 2009-2010 and 2013-2014 NHANES surveys we examined potential interaction between caffeine consumption, alcohol use, and sleep and its relation to bone health, measured using bone mineral density (BMD). The study population consisted of 2,405 individuals at least 40 years old who were not taking any medications or hormones that would affect bone mineral density. Several factors such as smoking status, exercise, dietary intake of calcium, dietary intake of vitamin D, dietary intake of phosphorus, presence of arthritis, age, gender and race were considered in this project. We found a statistically significant negative linear relationships between …

Influenza Vaccination Coverage In Pediatric Patients With Inflammatory Bowel Disease, Kelly Brown

Senior Theses

Background: Children with chronic health conditions, including inflammatory bowel disease (IBD), are at especially high risk for influenza infection and complications. The Crohn’s & Colitis Foundation and American College of Gastroenterology recommend that IBD patients should receive annual influenza vaccination. The aims of this study were to evaluate influenza vaccination coverage over time and identify predictors of flu vaccination in pediatric IBD and non-IBD patients.

Methods: We utilized longitudinal data (2000 to 2016) from South Carolina Medicaid to conduct a matched cohort study. The primary exposure of interest was IBD diagnosis based upon ICD-9/10 diagnosis codes. Children with IBD were …

First Aid And Emergency Preparedness: Improving Health Outcomes Among Aging Adults, Anna J. Kulangara

Senior Theses

As the United States population demographic shifts and the baby boomer population enters seniority, the health sector must adjust and prepare to provide efficient and adequate healthcare to the people. The Silver Tsunami, a metaphor for the expected wave of aging adults, will inevitably strain healthcare professionals and can be partly relieved by promoting risk-minimizing behavior in baby boomers before severe conditions develop. Through this effort, a health education course, titled First Aid and Emergency Preparedness, was developed and taught twice at a local senior center to target senior citizens and promote proactivity and healthy behaviors. Course development founded largely …

Treatment Of Chronic Pain In U.S. Veterans: The Effectiveness Of Interdisciplinary Programs, Morgan L. Compton

Senior Theses

Chronic pain is a prevalent issue amongst US veterans. Experts suggest that interdisciplinary pain treatment is the most effective method of treating chronic pain, specifically due to targeting functioning and quality of life. These programs combine cognitive behavioral therapy and physical therapy by utilizing a variety of exercise and education regimens. The pain department at Columbia VA Health Care System offers both a comprehensive interdisciplinary treatment, Outpatient Interdisciplinary Pain Program (OIPP), and a flexible, multidisciplinary option (OIPP-Lite) for veterans suffering from chronic pain. The goal of this program is to improve knowledge for coping with chronic pain and to create …