Public Health Commons^™

Identifying Micrornas Panel Associated With Hepatocellular Carcinoma In Serum Of Chronic Hepatitis C Patients, Areeg Dabbish

Theses and Dissertations

Introduction: early detection of hepatocellular carcinoma (HCC) will reduce morbidity and mortality rates of this poorly diagnosed widely-spread disease. Dysregulation in microRNA (miRNAs) expression is associated with HCC progression. Objective: Is to identify a panel of differentially expressed miRNAs (DE-miRNAs) to enhance HCC early prediction in hepatitis C virus (HCV) infected patients. Methodology: Candidate miRNAs were selected using bioinformatic analysis of microarray and RNA-sequencing datasets, resulting in nine DE- miRNAs (miR-142, miR-150, miR-183, miR-199a, miR-215, miR-217, miR-224, miR-424 and miR-3607). Their expressions were validated in the serum of 44 healthy individuals, 62 non-cirrhotic HCV patients, 67 cirrhotic-HCV and 72 HCV-associated …

Feasibility Of Delivering Fall Prevention Intervention For People With Intellectual Disability In Group-Homes, Poram Choi

Theses and Dissertations

Adults with intellectual disability (ID) have a higher rate of falls than the general population, and changing health behaviors through exercise program could enhance health and reduce falls in this population. However, the feasibility study of fall prevention based on the theoretical framework for adults with ID has not been explored to date. This study examined the feasibility of a home-based exercise intervention for people with ID living in a residential setting. We provided an 8 week intervention consisting of a training workshop for support workers and sessions for adults with ID devoted to behavior reward, education about fall prevention …

Examining The Need For Parental Satisfaction With The Msu Extension Equine Assisted Therapy Program, Ashlyn Ann Kiker

Theses and Dissertations

Animal assisted interventions are becoming more prevalent in our society. Animal interventions have become a popular therapy technique that exist to aid a variety of disabilities. Equine therapeutic riding has become one of the most popular forms of animal assisted therapy for both children and adults. While research shows the importance and benefits of animal assisted therapy for children, there is a lack of research concerning parental satisfaction within therapeutic riding programs.

This study tested a newly developed instrument for measuring parental satisfaction for therapeutic riding programs. The Parent/Caregiver Evaluation Tool (Kerr, 2021) was administered to parents/caregivers whose children participated …

Effects Of Provider Support And Psychosocial Stressors On Maternal Health-Promoting Behaviors, Mary Catherine Jessen

Theses and Dissertations

ABSTRACTEFFECTS OF PROVIDER SUPPORT AND PSYCHOSOCIAL STRESSORS ON MATERNAL HEALTH-PROMOTING BEHAVIORS

Despite technological and structural advances in the organization and delivery of health care services to pregnant women and infants, the U.S. ranks low on perinatal outcomes with profound disparities. Engagement in health-promoting behaviors during pregnancy is critical in improving birth outcomes. Women, particularly women of color, continue to experience unmet needs for emotional support with providers. Women of color experience being treated differently based on their race. The purpose of this study was to 1) examine the relationships between stress, provider support, and specific maternal health promoting behaviors (MHPB) …

Factors Influencing Intent To Take A Covid-19 Test In The United States, Sheila Rutto

Theses and Dissertations

In 2020, COVID-19 became the first pandemic in the world’s history that brought the entire world to an abrupt and unexpected halt. Since the first reported case of the disease to date, the novel coronavirus has been able to wreak havoc in literary every corner of the globe and left an ever-growing number of unprecedented fatalities. The normal way of life has been disrupted, and the level of uncertainty about the end of this pandemic continues to manifest to many. Due to the urgency to bring this pandemic under control, medical officers have been able to recommend actions that people …

A Statistical Comparison Of Covid-19 In The United States Across Political Affiliations And Census Regions, Margarito Torres

Theses and Dissertations

In mid-January 2020, the United States reported their first cases of the coronavirus disease (COVID-19) from a passenger returning from Wuhan, China. Initially, the situation wasn’t very alarming as in China and European countries, but the situation began to worsen in March 2020 when the number of cases began to multiply. Then, in a matter of a few months, the United States became the number one country in terms of total cases and total deaths from COVID-19. We have been closely observing the United States and the world since July 2020. Our study aims to compare the political affiliations and …

Pre-Exposure Prophylaxis (Prep) Knowledge, Willingness To Use & Uptake Among Black Heterosexual Men, Akeen Lowell Hamilton

Theses and Dissertations

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP …

Utilization Of Remote Sensing To Analyze Aedes Mosquito Egg Abundance With Combined Weather Variables In Two Southeastern Coastal Cities, Danielle M. Johnson

Theses and Dissertations

Several vector-borne diseases have recently resurfaced, and many have suddenly spread to new areas in the United States (U.S.) due to climate change and tropicalization. Two vectors of public health importance are Aedes aegyptiand Aedes albopictus. The Southeastern region of the U.S. appears to be a preferential ecological niche for both Aedes species. Aedes aegyptiand Aedes albopictus are highly susceptible to environmental conditions, such as humidity, precipitation, temperature. Remote sensing technology has proven to be useful for estimating vector populations. Miami-Dade County is an established hotspot for disease transmission. Charleston County is newly vulnerable due to similar …

Hear My Voice: Qualitative Studies To Explore What Empowers Patients To Talk With Their Doctor And Participate In Making Health Care Decisions, Alicia Marie Oostdyk

Theses and Dissertations

Patients with fibromyalgia are faced with many decisions throughout the process of seeking and obtaining health care. For patients to feel empowered to take action, it is essential they feel as if they can play a role in making decisions up to their desired level of participation. However, it is unclear what constitutes empowerment in shared decision making between patients and providers. For patients with fibromyalgia, who deal with complex symptomology and individualized treatment choice, it is important to know what makes them feel empowered to participate in care. The objective of this dissertation is to create a patient-centered definition …

Evaluating The Health Impact Of Centeringpregnancy Program Versus Traditional Prenatal Care In Midland Obstetric Clinics And Validating Selected Item On Birth Certificate, Oluwatosin A. Momodu

Theses and Dissertations

The primary focus of this dissertation is to evaluate the health impact of the CenteringPregnancy (CP) program versus traditional prenatal care (TPNC) on important maternal outcomes of pregnancy. This is looked at in two outcomes-gestational weight gain (GWG) and pregnancy induced hypertension (PIH). The specific aims are to examine the: (1) effects of CenteringPregnancy program versus traditional prenatal care on gestational weight gain (GWG); (2) effects of CenteringPregnancy program versus traditional prenatal care on pregnancy induced hypertension (PIH).

Birth certificate (BC) data were linked to hospital discharge records of women who delivered in midland’s obstetric clinics of South Carolina between …

Food Choice Decision-Making Among School-Going Adolescents Amidst The Nutrition Transition In Urban Accra, Ghana, Krystal Krsna Rampalli

Theses and Dissertations

Like many countries of the world, Ghana is experiencing a nutrition transition and rising non-communicable diseases. Adolescents are susceptible to diet-related health risks as they experience significant physical and psychological changes, which are happening in tandem with food environment changes, including widespread proliferation of large portion and package sizes of energy-dense, nutrient-poor foods. Both local and multinational food and beverage companies have encouraged consumption of their products through various marketing tactics targeted directly to adolescents. Some of these tactics include the use of characters or celebrity endorsement, promotional discounts, and appeal to sociocultural values, including messages about body size preferences. …

The Impact Of Structural Determinants On Pregnancy Intention And Reproductive Decision Making Among African American Women, Jill Strickland Denson

Theses and Dissertations

ABSTRACTTHE IMPACT OF STRUCTURAL DETERMINANTS ON PREGNANCY INTENTION AND REPRODUCTIVE DECISION MAKING AMONG AFRICAN AMERICAN WOMEN

BACKGROUND: Nearly half of U.S. pregnancies are unintended with African American women having the highest rates of unintended pregnancies and many of the poorest pregnancy-related health outcomes. Intersectional approaches are needed to better understand how intersecting oppressions effect pregnancy intentions in African American women’s lives. This study examined African American women’s intersectional identities related to pregnancy intention, experiences accessing reproductive care, and making reproductive decisions. METHODS: This mixed-methods participatory study used Group Concept Mapping (GCM) along with four questionnaires (reproductive history, Adverse Childhood Experiences, …

Household Food Security, Lifestyle Factors, And Glycemic Control Among Youth And Young Adults With Diabetes, Lauren A. Reid

Theses and Dissertations

The purpose of this study was to assess the associations between household food insecurity (HFI) and glycemic control, physical activity, and diet quality in youth and young adults (YYA) with type 1 diabetes (T1D) and type 2 diabetes (T2D). Among older adults, HFI has been shown to complicate diabetes management due to the essential role of diet in diabetes management and the financial stress associated with HFI. Although HFI is more prevalent among YYA with diabetes than the general population, there are only a handful of studies that have focused on this population and, studies that include YYA with T2D …

Intersection Of Maternal Disability Status, Prescription Opioid Use Before And During Pregnancy, And Adverse Birth Outcomes, Chelsea Lynes Richard

Theses and Dissertations

Nationally, individuals with disability, like those with chronic health conditions, have higher rates of opioid use and misuse and are prescribed higher dosages than those without disability. Because opioid agonists and antagonists can cross the placenta rapidly, there is biological plausibility that they may have an impact on birth outcomes. Therefore, monitoring prescription opioid use, particularly among pregnant women, is of great public health importance. While evidence for the impact of opioid use on preterm birth and low birthweight are conflicting; findings are consistent that opioid use during pregnancy is associated with a higher risk of small for gestational age, …

Applying Health Stigma Framework To Examine The Mechanisms Of Hiv-Related Stigma On Clinical Outcomes, Chengbo Zeng

Theses and Dissertations

Background: HIV clinical outcomes including CD4 count, viral suppression, and health-related quality of life (HRQoL), are important indicators reflecting immunologic functioning, treatment efficacy, and overall health quality. However, due, in part, to HIV-related stigma, many people living with HIV (PLWH) experience suboptimal clinical outcomes. The Health Stigma Framework introduced the potentially distinct mechanisms underlying internalized, anticipated, enacted stigma and health outcomes through psycho-behavioral pathways. Based on this framework, this dissertation investigated the impacts and mechanisms of HIV-related stigma on clinical outcomes among PLWH in Guangxi, China from a longitudinal perspective. Methods: Data at baseline, 6-, 12-, 18- month follow-ups …

Dysbiosis-Related Medications And The Association With Cognitive Decline, Cognitive Impairment, And Dementia, Nicholas Victor Resciniti

Theses and Dissertations

The main objectives of this dissertation were to quantitatively assess whether there is an association between medications (e.g., antibiotics, PPIs, antipsychotics) and cognitive performance over time, conduct a causal mediation analysis to evaluate the role of inflammation (C-reactive protein) in the association between medications and subsequent cognitive decline, and examine if dysbiosis-related medications (DRM) are associated with a greater risk of dementia for participants that were cognitively normal and had MCI at baseline.

The Health and Retirement Study (HRS) was used to conduct a secondary data analysis that used longitudinal data from 2004 to 2016. The HRS is an ongoing, …

A Cost Effectiveness Analysis Of The Nutritious Eating With Soul Study, Mary Jones Wilson

Theses and Dissertations

PURPOSE Historically, African Americans (AA) have been underrepresented in nutritionrelated behavioral research despite their disproportionate higher risk of cardiovascular disease (CVD). The Nutritious Eating with Soul (NEW Soul) Study is one of the first of its kind to recruit an AA only study group to examine CVD prevention via a clinical trial to examine changes in CVD risk factors across two cohorts who are randomly assigned to a plant-based, soul food vegan diet or low-fat omnivorous (omni) diet. The purpose of cost effectiveness analysis (CEA) is to inform clinical and policy decisions and the costs of interventions that society is …

Neighborhood Socioeconomic Status, Green Space, And Walkability And Risk For Falls And Fracture Among Postmenopausal Women: The Women’S Health Initiative, Marilyn Elizabeth Wende

Theses and Dissertations

The purpose of this study was to assess whether neighborhood socioeconomic status (SES), walkability, and green space impacts fall and fracture incidence among postmenopausal women, and to assess important modifiers for these relationships, such as fall history, physical activity, physical impairment, race/ethnicity, and rurality. Data from the Women’s Health Initiative study from 1993 to 2012 (N=161,808) was used.

SES had a significant relationship with falling after adjustment (intermediate vs low SES OR=0.99, p=0.0309; high vs low SES OR=0.99, p=0.1192). Study arm participation and fall frequency at baseline significantly modified this relationship. Walkability had a significant relationship with falling incidence after …

A Contextual Evaluation Of The Fresh Fruit And Vegetable Program In South Carolina And Related Child Health Behaviors, Kathryn Irene Hoy

Theses and Dissertations

Children in vulnerable communities are at increased risk for poor diet.1,2 The Fresh Fruit and Vegetable Program (FFVP) is a United States Department of Agriculture (USDA) child nutrition program that increases vulnerable children’s access to and consumption of fruits and vegetables.3,4 FFVP is inherently flexible,5 has few regulations, and helps identify and develop best practices for individual schools to increase fruit and vegetable consumption among low-resource children.6 Flexibility built into the FFVP at the federal level naturally results in a variation of program adoption and implementation at both the state and school-levels.7 These variations affect outcomes in complex health promotion …

Examining The Cost And Quality Relationship In Medicare, Alexandria Fleming Delage

Theses and Dissertations

Purpose.

The purpose of this study is to evaluate the cost and quality of care dynamic among physicians billing under Medicare Fee for Service in 2018 to examine the relationship between quality and total cost of care at the physician level. Examining this relationship will advance scientific knowledge regarding the impact of increasing high value service use on healthcare costs and will provide insight in terms of expected cost outcomes of quality programs for healthcare policymakers (Salmond and Echevarria 2017; Williams, Brown, and Healy 2018).

Methods.

The study used publicly available data sets provided by the Center for Medicare and …

Diabetes, Anti-Diabetic Medication Use, And The Risk Of Ovarian Cancer, Chantaezia Joseph

Theses and Dissertations

Background- Although ovarian cancer is a rare disease, it is the 5th leading cause of cancer-related deaths among women in the United States. Diabetes is a serious chronic disease that plagues over 436 million adults worldwide and was ranked 7th in causes of death in the US in 2017. Epidemiologic evidence suggests that diabetes may lead to an increased risk of ovarian cancer due to shared risk factors such as sedentary behaviors, smoking and poor diet or through biological mechanisms related to hyperglycemia and obesity, but the epidemiologic evidence yields mixed results. Certain anti-diabetic medications may increase the risk …

Factors That Influence The Health Seeking Behavior And Degree Of Health Service Utilization Of Ethiopian Immigrants Living In One Of The Midwest Cities Of The United States: A Mixed Methods, Sisay Bekele Mersha

Theses and Dissertations

ABSTRACTFACTORS THAT INFLUENCE THE HEALTH SEEKING BEHAVIOR AND DEGREE OF HEALTH SERVICE UTILIZATION OF ETHIOPIAN IMMIGRANTS LIVING IN ONE OF THE MIDWEST CITIES OF THE UNITED STATES: A MIXED METHODS

Immigrants have a significantly higher prevalence of chronic diseases, such as diabetes, hypertension, heart disease, and worse health outcomes than native-born individuals in the United States. The disproportionate adverse outcomes have been associated with structural, systemic, and socioeconomic inequalities and individuals’ Health-Seeking Behavior (HSB) and patters of Health Service Utilization (HSU). The purpose of this study was twofold. First, the survey explored (a) factors influencing the HSB of Ethiopian immigrants …

Two Essays On Leveraging Analytics To Improve Healthcare, Deepika Gopukumar

Theses and Dissertations

The healthcare cost has continued to increase over the past few years despite various policies, efforts, and initiatives taken by the government. It is still projected to grow over the next few years by the Centers for Medicare and Medicaid Services (CMS). Readmissions have been a major contributor to the increase in costs and have always been a contributing factor. To get a perspective, considering the fact that at least 9% of individuals who had COVID-19 were likely to get readmitted shortly, according to a study by the Centers for Disease Control and Prevention (CDC) COVID-19 response team, along with …

Inoculation Of Juvenile Monodelphis Domestica With Zika Virus Using Various Routes Of Infection, Juan Garcia Jr.

Theses and Dissertations

Monodelphis domestica is a small marsupial from South America that has been previously been used in human metabolism research. However, their suitability as models for Zika virus (ZIKV) research, is currently unknown. Preliminary studies have shown M. domestica susceptible to ZIKV through the intracerebral route. We utilized immunohistochemistry, and analyzation of serological responses to show that juvenile Monodelphis domestica can be infected with ZIKV by using various routes of infection that include subcutaneous, intraperitoneal, and intramuscular. ELISAs performed on sera confirmed that juveniles injected with ZIKV by all three routes generated anti-ZIKV antibodies. Additionally, ZIKV nonstructural protein 1 was detected …

The Current State Of Health Care Facility Preparedness, Health Care Utilization, And Covid-19 Knowledge Amidst The Covid-19 Pandemic In The Malaria-Endemic Setting Of Manicaland Province, Zimbabwe, Julia Grace Scott

Theses and Dissertations

The impact of the coronavirus disease 2019 (COVID-19) pandemic has been felt worldwide, especially in Sub-Saharan Africa (SSA). With fractured health systems, disrupted supply chains, limited resources, and continued fighting of endemic diseases such as malaria, SSA is at risk for greater impact. Manicaland Province has the highest incidence rate of malaria in Zimbabwe, and a higher malaria mortality rate than the national average. Manicaland also has the third highest number of COVID-19 cases and deaths in Zimbabwe. In this study, health care facilities and households throughout Makoni, Mutare, and Buhera districts in Manicaland Province were administered cross-sectional surveys. We …

The Inflammatory Potential Of Diet And Its Relationship With Metabolic, Mental, And Cardiovascular Health Among Childhood Cancer Survivors: The St. Jude Lifetime Cohort Study (Sjlife), Christian Ricardo Alvarado

Theses and Dissertations

Background: Diet is now known to play an important role in the process of inflammation and subsequent chronic health events, such as cancer, metabolic syndrome (MetS), anxiety, depression, and cardiovascular disease (CVD). The Dietary Inflammatory Index (DII®) and energy-adjusted DII (E-DIITM) are tools that can estimate the inflammatory potential of diet of individuals. Previous research has focused predominantly on diet-associated inflammation and adverse health effects in populations that were not composed of cancer survivors. As of the time of this dissertation, none have focused on childhood cancer survivors. Childhood cancer survivors are at an elevated risk of suffering from an …

Association Of Nsaids And Acetaminophen Prescriptions During Pregnancy With Autism Spectrum Disorders In The Child, Mohiuddin Ahsanul Kabir Chowdhury

Theses and Dissertations

Neurodevelopmental disorders in children including Autism Spectrum Disorders (ASD) and Intellectual disability (ID) are the topics of growing concern and recently many studies looked for the risk factors of these disorders. Although antidepressants and antiepileptics consumption during pregnancy have been reported to be associated with ASD, the effect of NSAID or acetaminophen, two most common drugs used during pregnancy, have been under researched. We conducted a prospective cohort study linking data from Medicaid, Department of Education, and Department of Disabilities and Special Needs with birth certificate data from mothers and children between 2010-2017. Beside exposure variables, NSAID and acetaminophen, and …

A Multilevel And Spatial Analysis Of Oral And Pharyngeal Cancer In South Carolina, Deborah M. Hurley

Theses and Dissertations

Objective: Disparities in the distribution of oral and pharyngeal cancer exist worldwide. This is also true in the United States and in South Carolina. Differences exist in oral and pharyngeal cancer stage and survival by race and sex, with higher incidence rates for Whites but higher proportions of late-stage cancer and lower survival for Blacks. This study was conducted to evaluate whether any differences exist in the spatial distribution of oral and pharyngeal cancer stage at diagnosis and survival, and to evaluate the association of income inequality, material deprivation and other measures of social determinants of health (contextual risk factors) …

Evaluation Of A Clinic-Based Peer Navigation Program (Pnp) For African Americans Living With Hiv In South Carolina, Kimberly Butler Willis

Theses and Dissertations

Peer navigation programs have been identified as a potential motivator in care engagement and retention for patients living with HIV, although the data is inconsistent. HIV management requires important disease management considerations and innovative approaches for patient care. Medication advancements and technology have drastically improved care for most patients living with this chronic disease; yet African Americans contract, live with, and die because of HIV-related complications at disproportionately higher rates compared to their White peers.The purpose of this exploratory mixed-methods outcome evaluation is to: (1) determine if peer navigation is a viable intervention to improve three key HIV care metrics: …

Perceptions Of Residents Living In A Food Desert On The Impact Of A Community-Supported Agriculture Pilot Program, Jessica Thome

Theses and Dissertations

Objective: The purpose of the study was to examine perspectives on food access among a low-income, food desert community through participation in a grant funded CSA program.Design: Healthy Eating Program is a pilot program assessing the effect of a CSA intervention on health among residents living in a food desert. Participants were surveyed through an initial survey and final survey with questions regarding perceived health status and daily food stressors. Data was collected through Qualtrics and analyzed using SPSS. Setting: Low-income, food desert community residing in the Westside of Bloomington, Illinois. Participants: Forty participants 18 years or older, low-income and …