Investigating Black Emerging Adult Health And Model Of Care Choices, Alexandra Wynn

Theses and Dissertations

This mixed methods study aimed to analyze the health profiles of Black emerging adults (who do not seek medical care for chronic condition management) college students to identify factors influencing their use of preventive services and their choices in healthcare plans. The study revealed distinct profiles of Black emerging adults based on patterns of factors related to their engagement with healthcare, such as barriers to care, insurance access, usual source of care, self-rated health, intention to seek care, discrimination, trust in physician, medical mistrust, and sex-assigned at birth. Interviews were conducted to investigate the similarities and differences among all participants …

Transforming Children's Oral Health: The Impact Of Oral Healthcare Policies On Virginia Medicaid Dental Health Outcomes., Anita M. Kumar

Theses and Dissertations

Abstract: Transforming Children's Oral Health: The Impact of Oral Healthcare Policies on Virginia Medicaid Dental Health Outcomes.

Objectives: This dissertation uses Department of Medical Assistance Services (DMAS) administrative files at the individual and provider level from fiscal years (FY) 2011 to 2021 to systematically study the effect of recently implemented oral health policies (EBD guidelines on sealants, CMS updated quality measures, expansion of Medicaid oral healthcare for qualifying pregnant women) on oral health outcomes of Virginia Medicaid-enrolled children.

Methods: The studies employ a difference in differences regression methods (negative binomial, Poisson, and logistic) to examine the effects of oral health …

Longitudinal Analysis Of Maternal Depression, Physical Work Demand, And Working Hours Before, During, And After Pregnancy On Offspring Blood Pressure Trajectories, Medhin Tsegaye Haile

Theses and Dissertations

Overall Abstract

Background: Pediatric high blood pressure (BP) is a growing global concern, with 1 in 7 adolescents in the U.S. experiencing elevated BP or hypertension. Maternal lifestyle factors, including depressive symptoms, physically demanding work, and work hours during pregnancy, may influence offspring BP trajectories. However, prior studies often focus on single time points or specific age groups, limiting understanding of long-term effects. This study investigates the associations between maternal depressive symptoms, physically demanding work-related factors, and work hours before, during, and after pregnancy with offspring systolic blood pressure (SBP) trajectories from early childhood to adolescence.

Methods: We utilized …

The Genetic Architecture Of Cervical Change During Pregnancy: From Modeling To Mechanism — Does The Cervix Mediate Maternal Risk For Spontaneous Preterm Birth?, Hope M. Wolf

Theses and Dissertations

This project leverages clinical data and biospecimens from a prospective longitudinal cohort of pregnant women to study the genetic and phenotypic relationships between cervical shortening and the duration of pregnancy. Sonographic cervical length (CL) was measured throughout pregnancy in a cohort of 5,160 Black/African American women in Detroit, Michigan. Maternal DNA samples were sequenced with a next-generation low-pass whole genome platform. The heritability of cervical change during pregnancy and its genetic correlation with gestational age at delivery (GAD) were estimated using Genome-Wide Complex Trait Analysis. These estimates suggest that cervical change is heritable (h²CL = 51%) and highly polygenic trait. …

Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry

Theses and Dissertations

COVID-19 presented unique challenges for rural Mississippi communities including impacts on the mental health of rural individuals. This research study aimed to identify opportunities for mental health interventions to provide health promotion professionals with quantitative data on the accessibility and the likelihood of engagement with mental health-fostering behaviors. A secondary objective of this research was to categorize these behaviors within the constructs of the Social Ecological Model. Demographics for rural Mississippi communities were collected and displayed, and using multivariate analyses including Spearman’s correlation and a Mann-Whitney U test the correlation between mental health fostering behaviors and demographic factors was obtained. …

The Relationship Between Parental Trauma History And Perceptions Regarding Their Child’S Healthcare And Utilization Of Healthcare Services, Krishna Patel

Theses and Dissertations

Abstract

TITLE: The Relationship Between Parental Trauma History and Perceptions Regarding Their Child’s Healthcare and Utilization of Healthcare Services

Adverse child events (ACEs) have been associated with a number of physical and mental health problems and have also been linked to increased health care utilization. While parents who have an ACE history may tend to seek healthcare services for themselves, limited studies have examined the impact of their trauma history on seeking healthcare services for their child. Healthcare utilization may also depend on the parents’ level of health anxiety, as well as their anxiety about their child’s health status. This …

Can Physical Activity Help Fight Diabetes Incidence And What Is The Association Between Socioeconomic Status, Demographics, And Diabetes Mellitus In Arkansas In 2019?, Rahima Kerimovna Bay

Theses and Dissertations

One of the most prevalent health challenges among people of all ages in the United States is Diabetes Mellitus that affects 9.3% of the total population. In 2019 Arkansas entered the top 5 states with the highest diabetes death rates (1,144 deaths). Many researchers state that a sedentary lifestyle is considered one of the major risk factors for T2DM and its complications. Regular physical activity is an effective primary and secondary prevention strategy for at least 25 chronic diseases, including type 2 diabetes. Our study showed that the variable for physical activity is statistically significant and associated with the incidence …

Dietary Inflammatory Index During Pregnancy And Changes Over Time: Associations With Post-Partum Sleep Duration And Quality And Depressive Symptoms., Nowrin Tamanna

Theses and Dissertations

STUDY OBJECTIVES: Sleep and mental health are two important factors for a new mother, as adequate sleep and a healthy mind help her prioritize self-care, seek support when needed, and create a nurturing environment for both her and her baby. Among various plausible theories exploring the etiology of sleep disturbances and depression, the concept of inflammation is gaining attention. This study examined the hypothesis that more pro-inflammatory diets during pregnancy are associated with a decrease in sleep quality and duration, abnormal sleep timing and higher Edinburg Postnatal depression score (EPDS) scores 6 months and 12 months post-partum.

METHODS: A secondary …

No More Loosies: A Mixed-Methods Study On The Implementation And Enforcement Of The Loose Cigarette And Bidi Sale Ban In India, Mayank Sakhuja

Theses and Dissertations

Background: Sale of loose cigarettes and bidis (loosies) is widely accepted as a key factor in promoting the tobacco epidemic in India. This mixed-methods study aimed to broaden understanding around the sale and purchase of loosies addressed three aims: 1) To determine the prevalence and correlates of loosies purchase in India; 2) To examine the association between purchase behavior and health warning labels (HWLs) exposure and responses, and 3) To conduct a stakeholder analysis regarding the ban on the sale of loosies in India. Methods: Data from the 2018-19 Tobacco Control Policy (TCP) India survey (643 current cigarette users and …

The Intersectionality Of Rurality And Race On Covid-19 Vaccination Among Adults In The United States, Shiba Simon Bailey

Theses and Dissertations

Background Vaccination remains a cornerstone of public health, significantly contributing to the prevention and control of infectious diseases. During the COVID-19 pandemic, vaccine development was critical to prevent new SARS-Cov-2 infections. However, COVID-19 vaccination uptake among racial and ethnic minority populations and rural residents in the United States (US) lags behind their urban non-Hispanic White counterparts. Underlying causes of these disparities are unclear, but vaccine hesitancy, access to care barriers, and structural racism may be to blame. Such barriers may vary by residential urbanicity, leading to different racial/ethnic disparities in rural and urban America. Understanding the variations in vaccine uptake …

Adverse Childhood Experiences And Social Determinants Of Health In Relation To Cigarette Smoking And E-Cigarette Use Among Adults, Kankana Sengupta

Theses and Dissertations

Cigarette smoking is the leading cause of preventable morbidity and premature mortality in the U.S. and other high-income nations. E-cigarette use or vaping is an addictive behavior. During the past 5 years, the prevalence of e-cigarette use has increased markedly in U.S. adolescents and young adults. The public health implications of this increased prevalence are unclear. Adverse childhood experiences (ACEs) are associated with cigarette smoking in adulthood. However, the pathway from experiencing ACEs in childhood to smoking cigarettes or using e-cigarettes in adulthood is not clearly understood. Additional factors experienced between childhood and adulthood might either increase or decrease the …

Social Network Attributes Associated With Conversations About Smoking And Cessation And Differences By Socioeconomic Status, Victoria Catherine Lambert

Theses and Dissertations

Conversations about smoking and cessation in response to cessation messages appear to encourage quit attempts, yet there is some evidence that smokers with lower income and education have these conversations less often than their counterparts with higher income and education. No research has investigated the social network characteristics that encourage smokers to have these conversations or the mechanisms for SES differences in these conversations. Because social factors play a role in SES disparities in smoking and cessation as well as other health behaviors and outcomes, social network characteristics likely explain some SES differences in conversations about smoking and cessation. The …

The Genetic Associations Of Circadian Rhythm And Sleep Disorder Traits With Risk Of Monoclonal Gammopathy Of Undetermined Significance And Multiple Myeloma, Brittany Crawford

Theses and Dissertations

Background: Circadian rhythm disruption and sleep have been widely studied for their roles in immunity and cancer development. Evidence for an association of circadian rhythm and sleep traits with multiple myeloma (MM) risk is inconclusive. No studies have investigated these traits in relation to monoclonal gammopathy of undetermined significance (MGUS). Given that MGUS precedes almost all MM cases, investigating sleep and circadian rhythm in relation to both MM and MGUS is necessary. The purpose of this dissertation was to explore the genetic influences of circadian rhythm and sleep traits on the risk of MGUS and MM. Methods: Data were leveraged …

Correlates Of Immunization Timeliness In Three South Asian Countries: Secondary Analysis Of Demographic And Health Surveys, Tanzir Ahmed Shuvo

Theses and Dissertations

Despite the availability of effective vaccines, 1.5 million children under the age of 5 years die every year because of vaccine preventable diseases. Improvements in vaccine delivery infrastructure have resulted in relatively high coverage of vaccines, but many children are not receiving their vaccines on a timely basis. Timely administration of routine vaccines recommended by the Expanded Programme on Immunization (EPI) ensures maximum efficacy. It is vital to explore rates of vaccination timeliness and the correlates of timely vaccination among children to design targeted interventions for improving both coverage and timeliness. We conducted a secondary data analysis of the Demographic …

The Utility Of Bayesian Predictive Models To Forecast Arboviruses In The United States Of America And Territories, Maggie Suzanne Jennave Mccarter

Theses and Dissertations

Statistical models have been utilized to understand and forecast infectious diseases across the globe. However, these models have historically been difficult to access and interpret for non-specialist audiences. This dissertation focuses on one computationally efficient model fitting method, the integrated nested LaPlace approximation approach, to forecast three arboviruses in hopes of encouraging accessibility to statistical modelling. Such accessibility could provide areas who simultaneously are most susceptible to infection, and have the least resources, an invaluable tool for informing policy and prevention decisions. The resulting models included biological, land cover, and environmental factors and produced accurate forecasts of neuroinvasive West Nile …

Establishing Validity And Preliminary Clinical Utility Of A Behavioral Economic Measure Of Social Risk Discounting For Health Behaviors, Connor A. Burrows

Theses and Dissertations

The COVID-19 pandemic has been the most profound public health emergency of the past several decades and the United States has faced numerous challenges with the timely adoption of mitigating health behaviors. Sustained ambivalence surrounding perceptions of public health recommendations of social distancing, mask wearing, and timely vaccination remain a barrier to slowing the spread of the virus years after its initial onset. Behavior analysis and behavioral economics offer compelling theoretical and quantitative models for framing the relationship between behaviors that are aversive in the short term but beneficial for individual and public good in the long term. The present …

Prenatal Depression And Breastfeeding Practices Healthy Start Participants, 2019-2022, Peyton Ashleigh Mosher

Theses and Dissertations

Background: Breastfeeding has health benefits for both mother and child, but breastfeeding practices among Black and lower-income women are the poorest in the United States. Few studies have examined the associations between maternal prenatal depression and breastfeeding duration, even fewer among a predominantly low-income Black population. Objective: To explore the association between prenatal depression and breastfeeding practices among low-income Black women during the COVID-19 pandemic.

Methods: Prospective cohort data from Midlands Healthy Start (MHS) was analyzed to examine women’s depression symptoms during pregnancy and their breastfeeding initiation and duration through two and six months. Perinatal depressive symptoms were identified using …

Exploration Of The Association Between Obesogenic Environments And Childhood Overweight/Obesity Rates In Rural Counties In The United States, Kara Lea Ferguson Davis

Theses and Dissertations

Rising obesity rates, particularly among children, pose a significant public health concern. Of particular concern is the prevalence of childhood obesity in rural communities, with up to 38% of rural children classified as overweight or obese, compared to 30% of urban children. Rural communities often lack the typical built environment characteristics associated with increased physical activity rates and healthy eating behaviors. Further, research on obesogenic environments within rural areas is limited. This study aimed to address this research gap by examining the association between obesogenic environment features and childhood overweight/obesity rates across the urban-rural continuum.

Simple and multiple linear regression …

Insurance Status And Cancer Staging, Time To Treatment, And Mortality: Examining Cancers Of The Breast, Colon, And Lung, Gabriel A. Benavidez

Theses and Dissertations

Introduction: When examining cancer outcomes, timely detection and treatment are critical factors for favorable prognoses. Previous studies have shown that individuals with public health insurance, specifically Medicaid, have worse cancer outcomes than those with private insurance. While differences in socioeconomic status may account for this disparity, one potential area for further investigation is the effect of Medicaid enrollment timing on cancer outcomes. In some states, individuals may not be eligible for Medicaid until after their cancer diagnosis, potentially nullifying health insurance benefits. This analysis examines the impact of Medicaid enrollment timing on cancer outcomes by comparing patients not enrolled in …

Babe (Body Appreciation And Better Eating), Just Add A Dash Of Self-Compassion: A Randomized Controlled Pilot Study For Black/African American Teenage Girls, Nkechi Bianca Okpara

Theses and Dissertations

Introduction

Body dissatisfaction contributes to disproportionately high rates of disordered eating behaviors observed in Black teenagers. Given that self-compassion is found to buffer against eating pathology and body dissatisfaction and is linked to reduced incidences of binge eating and disordered eating behavior. Incorporating the self-compassion construct, specifically centering on nutrition, with a program that combats negative body image, like the Body Project, may further help decrease body dissatisfaction and improve overall nutrition.

Purpose

The aim of this dissertation was to test (1) the acceptability and feasibility of a novel program, Body Appreciation and Better Eating, add self-compassion (BABE+SC), and to …

Beyond Vaccination Coverage: A Critical Look At Zero-Dose Children In Sub-Saharan Africa, Chamberline Ekene Ozigbu

Theses and Dissertations

Background: Despite continuous efforts to enhance childhood vaccination coverage, a considerable number of children in sub-Saharan Africa (SSA) remain unvaccinated (zero-dose). Recent estimates indicate that approximately 17 million zero-dose children reside mainly in 10 Low- and Middle-Income Countries (LMICs) in SSA. The Immunization Agenda 2030 (IA2030) aims to reduce the number of zero-dose children by half, necessitating research to identify populations and groups at higher risk of being unvaccinated.

Objectives: This research sought to (1) examine individual and contextual factors associated with zero-dose status in SSA, (2) assess the geographical clustering of zero-dose children aged 12-59 months in SSA and …

Phoneme Stability In Speech Production Of Cognate And Non-Cognate Nouns In A Bilingual With Aphasia, Katherine Vlach

Theses and Dissertations

With the growing bilingual population in the world comes a greater incidence of bilingual aphasia, a communication disorder characterized by expressive or receptive language impairment in one or both of a bilingual speaker’s languages. The cognate facilitation effect, which has greatly been explored in healthy bilingual studies, has shown that cognates are named faster and more accurately than non-cognates; as the cognate facilitation effect is also retained in bilingual speakers with aphasia, it is thought that cognates could potentially be used as a treatment tool to facilitate lexical access, particularly when a bilingual speaker with aphasia presents with one of …

Bayesian Spatial And Spatio-Temporal Models For Complex Data Sets, Rongjie Huang

Theses and Dissertations

The cost of testing for infectious diseases can be high, and analyzing large amounts of historical data to forecast disease prevalence can be a time-consuming process. Group testing techniques offer a way to decrease the expenses associated with testing, but this comes at the cost of increased complexity of the data structure due to grouping and imperfect testing when compared to individual-level testing. In this dissertation research, we propose two Bayesian mixed effects spatial group testing regression models: one for areal data and the other for point process data. The former model utilizes a conditional autoregressive (CAR) prior for areal …

Examining The Associations Of The Kidney Allocation System With Patient Sensitivity, Wait Time To Transplant, And Donor Distance, Shamika Danielle Jones

Theses and Dissertations

Background

The Kidney Allocation System (KAS) was created in 2014 to address long wait times for a kidney transplant, inappropriately matched kidneys, and high re-transplantation rates. This research examines the associations of the KAS with the percentage of sensitized patients receiving a kidney transplant, wait time to transplant and the distance between donor and recipient hospitals.

Methods

Data from the Scientific Registry of Transplant Recipients (SRTR) was used for this research. The study population included adults over 18 in the United States who received a kidney transplant between December 4, 2009, and December 4, 2018. Patients simultaneously waitlisted for other …

Complementary And Integrative Health (Cih) And Opioid Use Among Adults With Chronic Noncancer Pain In The Us, Yi-Wen Shih

Theses and Dissertations

Chronic noncancer pain (CNCP) is defined as persistent pain lasting for more than three months due to conditions other than malignancy. This condition affects one in five American adults annually. The prescribing of opioids to individuals experiencing CNCP has been recognized as a critical contributor to the ongoing opioid crisis. In 2016, the Centers for Disease Control and Prevention (CDC) recommended Complementary and Integrative Health (CIH) as a nonpharmacologic treatment to be used among adults with CNCP. Despite the potential benefits of CIH for pain relief, there may be a discrepancy between individuals with CNCP and their insurance coverage for …

Patient Experiences And Disparities In Telehealth Hiv Care During The Covid-19 Pandemic: Study Results From The Southern United States, Valerie Yelverton

Theses and Dissertations

Background: To maintain HIV care continuity during the COVID-19 pandemic, most HIV care facilities in the United States adopted telehealth. However, not everyone was participating in telehealth equally. This dissertation seeks to understand experiences with and the use of telehealth in HIV care, and decision processes guiding the selection of visit type during the COVID-19 pandemic.

Methods: Qualitative interviews explored people living with HIV’s (PWH) and HIV care provider’s experiences with telehealth HIV care and visit type decision processes. Quantitative analyses of electronic health record (EHR) data characterized patterns of and disparities in telehealth HIV care during the COVID-19 pandemic. …

Differential Levels Of Nutrients And Heavy Metals In Tilapia Collected From Drains In Egypt, Emily Burch

Theses and Dissertations

Tilapia is one of the most widely cultivated and consumed fish globally. In terms of human health, tilapia is an excellent source of protein, polyunsaturated fatty acids, and micronutrients. Tilapia and other aquatic species have become increasingly susceptible to contamination, as anthropogenic activities have been increasing around the world. Anthropogenetic activities often introduce high levels of contaminants, including heavy metals, into the marine environment. These contaminants often do not biodegrade, and they are absorbed by aquatic species. Contaminants can bioaccumulate and proceed in biomagnification up the fish food chain putting consumers at an increased risk of exposure. Heavy metals can …

Global Health Governance And Its Role In Health Equity: The Case Of Covid-19, Wafa Abu El Kheir-Mataria

Theses and Dissertations

In the globalized world, we are living in, health became the joint responsibility of individuals, their governments, and the global health governance system. Moreover, based on the right to health, health equity is increasingly in demand, and adopting it to a global level has become an even more complex task to realize. This thesis is focuses on health equity at a global level. The main research questions addressed are: Is health equity present at an intercountry /global level? how is it related to Global Health Governance (GHG)? Is GHG performing well in achieving health equity? what are the reasons behind …

Inoculation For Neutralizing Misinformation: Replication Of An Experiment On The Effect Of The Fake Experts’ Strategy In Climate Change Communication’S Context, Joseph Abdalla

Theses and Dissertations

Low acceptance of climate change and low support for its mitigation efforts can be due to public misconceptions towards climate change. Climate skeptics use a communication strategy of fake experts to spread misinformation through spokespersons who are not experts in the field. Inoculation can be a protective approach for tackling the misinformation’s effect. Previous research was conducted in the United States and Germany and was never conducted in Africa. This study aimed to complement the previous research findings with results for Egypt by replication an experiment by Cook et al. with a 2 × 2 between-subjects design. A total of …

Assessing The Correlation Between The Socioeconomic Level And Cognitive Function Among Older Adults In Egypt, Macy Abougabal

Theses and Dissertations

The number of older adults is increasing worldwide at an unprecedented rate. Some countries began to understand the challenges of aging, while others are still at the stage of comprehending the true dimensions of the situation. There is a global focus on aging research to appropriately mitigate the negative impact of aging and cognitive decline. Not only that dementia add economic pressure on governments, it also increase the psychological and physical burden of the caregivers. Scholars have previously studied socioeconomic level in three variables, namely work, education, and income, and their relationship with cognitive function. It was concluded that the …