Public Health Commons^™

Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene

Walden Dissertations and Doctoral Studies

Policies mandating HIV status disclosure to decrease incidence create ethical challenges for physicians on whether to breach or maintain infected patients' confidentiality. In Sub-Saharan Africa where HIV incidence is high, there is a need for clear guidelines/policies on making confidentiality decisions. The purpose of this quantitative quasi experiment was to determine whether the gender, gender orientation, and sexual relationship of an infected patient and physicians' demographics predicted physicians' decisions to breach confidentiality. In Plateau State, Nigeria, 222 physicians were given vignette questionnaires containing 6 different descriptions of gender, gender orientation, and sexual relationships of a hypothetical patient. Each physician decided …

The Impacts Of Race, Residence, And Prenatal Care On Infant Mortality, Mary Christine Dorley

Walden Dissertations and Doctoral Studies

Tennessee ranks high for infant mortality (IM) in the United States. Despite public health efforts, the IM rate for Blacks is twice that of Whites mimicking what is observed nationally. Several risk factors for IM have been identified; however, it was still unclear how places of residence and prenatal care (PNC) affect IM for Tennesseans. The purpose of this study was to assess the relationship between places of residence (conceptualized by rurality and racial concentration), PNC, and IM among racial groups across Tennessee and to determine if race modified these associations. This was a cross-sectional study using data from the …

Clinic-Based Delivery Of The Young Men’S Health Project (Ymhp) Targeting Hiv Risk Reduction And Substance Use Among Young Men Who Have Sex With Men: Protocol For A Type 2, Hybrid Implementation-Effectiveness Trial, Jeffrey T. Parsons, Tyrel Starks, Sitaji Gurung, Demetria Cain, Jonathan Marmo, Sylvie Naar

Publications and Research

Background: Young men who have sex with men (YMSM) are disproportionately at risk for HIV and sexually transmitted infections. Adapting and testing the effectiveness of the Young Men’s Health Project (YMHP), an efficacious intervention designed to reduce substance use and condomless anal sex (CAS) among YMSM, at clinics in Miami, Detroit, and Philadelphia has the potential to reduce HIV and STI disparities among urban YMSM.

Objective: This study (Adolescent Medicine Trials Network for HIV/AIDS Interventions [ATN] 145 YMHP) aims to adapt YMHP for clinic and remote delivery by existing clinic staff and compare their effectiveness in real-world adolescent HIV clinics. …

A Review Of Rat Lungworm Infection And Recent Data On Its Definitive Hosts In Hawaii, Chris N. Niebuhr, Susan I. Jarvi, Shane R. Siers

Human–Wildlife Interactions

Rat lungworm (Angiostrongylus cantonensis) is a zoonotic nematode that causes rat lungworm disease (angiostrongyliasis), a potentially debilitating form of meningitis, in humans worldwide. The definitive hosts for rat lungworm are primarily members of the genus Rattus, with gastropods as intermediate hosts. This parasite has emerged as an important public health concern in the United States, especially in Hawaii, where the number of human cases has increased in the last decade. Here we discuss the current knowledge of the rat lungworm, including information on the life cycle and host species, as well as updates on known infection levels. Three …

Training As An Intervention To Decrease Medical Record Abstraction Errors Multicenter Studies., Meredith Nahm Zozus, Leslie W. Young, Alan E. Simon, Maryam Garza, Lora Lawrence, Songthip T. Ounpraseuth, Megan Bledsoe, Sarah Newman-Norlund, J Dean Jarvis, Mary Mcnally, Kimberly R. Harris, Russell Mcculloh, Rachel Aikman, Sara Cox, Lacy Malloch, Anita Walden, Jessica Snowden, Irene Mangan Chedjieu, Chester A. Wicker, Lauren Atkins, Lori A. Devlin

Manuscripts, Articles, Book Chapters and Other Papers

Studies often rely on medical record abstraction as a major source of data. However, data quality from medical record abstraction has long been questioned. Electronic Health Records (EHRs) potentially add variability to the abstraction process due to the complexity of navigating and locating study data within these systems. We report training for and initial quality assessment of medical record abstraction for a clinical study conducted by the IDeA States Pediatric Clinical Trials Network (ISPCTN) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN) using medical record abstraction as the primary data …

Does Widowhood Affect Cognitive Function Among Chinese Older Adults?, Zhenmei Zhang, Lydia W. Li, Hongwei Xu, Jinyu Liu

Publications and Research

There is growing evidence from Western countries that widowhood may affect cognitive health in later life. However, little is known about whether widowhood isassociated with cognitive health in Eastern Asian countries such as China and what factors may explain the association between widowhood and cognitive health. Weadd to this line of research by investigating the effect of widowhood on 2-year change in cognitive function among Chinese adults ages 55 and older from 2011 to2013, using data from the China Health and Retirement Longitudinal Study. Cognitive function was measured by episodic memory and mental intactness (i.e.,attention and time orientation). Our results …

The Impact Of Shift Work On Health And Wellbeing, Stephanie M. Gagelin

Physician Assistant Scholarly Project Posters

• Many of today’s industries require workers to perform shift work (typically during 1600-0700). If workers are awake during this time period, circadian misalignment occurs. This scholarly project uses research studies and meta- analyses to provide information about increased health risks associated with circadian misalignment, focusing on the categories of glucose metabolism, cardiovascular system, carcinogenesis, and mental health and acuity.

• Shift work has been found to increase BMI and waist circumference of employees, as well as increase blood glucose levels to “prediabetic” levels in previously euglycemic individuals.

• Shift work has been proven to increase high-sensitivity C-reactive protein (hs-CRP), …

Reducing The Health Care Burden Caused By Undocumented Immigrants, Juan Carlos Garcia Ramirez

Physician Assistant Scholarly Project Posters

• Uncompensated health care and Emergency Department (ED) overcrowding are a national crisis in the United States, and uninsured patients are a major contributor. Undocumented Immigrants (UIs) are a large component of the uninsured patient population.

• The purpose of this study is to evaluate for efficacy and taxpayer value two large-scale potential solutions: Federally Qualified Health Centers (FQHCs), and expanded Medicaid.

• The method of research included a variety of key terms in electronic search databases such as CINAHL Complete, PubMed, and Google Scholar, and only articles published between 2014 and 2018 by peer- reviewed journals or gray literature …

Program Evaluation Of The Employee Health And Wellbeing Program, Alicia Carmen Marlena Perez

Walden Dissertations and Doctoral Studies

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive …

Accessibility Of Innovative Services In Radiation Oncology, Patricia Sansourekidou

Walden Dissertations and Doctoral Studies

The field of radiation oncology (RO) involves the use of highly advanced techniques to treat cancer and safely spare healthy organs. The discipline has experienced rapid growth in the past 25 years, with technological advancement as the driving force. Available data and an instrument to effectively measure the accessibility of innovation in the field were lacking. The purpose of this study was to investigate the accessibility of innovative services in RO in the United States and assess possible diffusion patterns. Two hundred and forty medical physicists practicing in RO in the United States completed a custom Internet-based survey. The diffusion …

Oromo Ethiopians Perceptions Of The Prevalence, Causes, Treatment And Prevention Of Trachoma, Linda L. Gross

Walden Dissertations and Doctoral Studies

In Ethiopia, one of the primary contributors to blindness is trachoma, which is an infectious ocular disease. There is no record of any prevention programs in rural Ethiopian villages of Oromia, where the prevalence of trachoma is high. The original purpose of this phenomenological study was to explore the perceptions of rural Oromo villagers in Ethiopia on the causes, treatment, and prevention of trachoma, using the health belief model and the social-ecological model as a theoretical framework. Due to a security situation in Ethiopia, final interviews were conducted with immigrant Ethiopians in the US, all of them from the trachoma-endemic …

Parental Perception Of Physician Cultural Sensitivity And Adherence To Asthma Treatment, Narue Jaynelle Wright-Jegede

Walden Dissertations and Doctoral Studies

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in …

Equity In Starting Salaries: A Tangible Effort To Achieve Gender Equity In Medicine, Esther Choo, David R. Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Letter to the Editor.

In 2017, for the first time, more women than men enrolled in medical school, marking a pivotal moment for setting and achieving reasonable goals for gender equity in medicine.

Inequity in compensation is a key target: The gender pay gap begins upon first hire, is not explained by part-time work or choice of specialty, and compounds over time. In a 2016 Wall Street Journal analysis, female physicians earned only 64.5% of what male physicians earned, the largest disparity amongst the 446 occupations examined. In its 2018 compensation report, Doximity reported an average physician gender gap of …

Cardiovascular Risk Factors Associated With Venous Thromboembolism, John Gregson, Stephen Kaptoge, Thomas Bolton, Lisa Pennells, Peter Willeit, Carlos J. Crespo, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Importance It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE).

Objective To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism.

Design, Setting, and Participants This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731 728 participants; 75 cohorts; years of baseline surveys, February 1960 to June 2008; latest date of follow-up, December 2015) and the UK Biobank (421 537 participants; years of baseline surveys, March 2006 to September 2010; latest date of follow-up, February …

Geospatial-Temporal, Demographic, And Programmatic Adoption Characteristics Of A Large-Scale Water Filter And Improved Cookstove Intervention In Western Province, Rwanda, Katie Fankhauser, Corey L. Nagel, Christina Barstow, Miles Kirby, Evan A. Thomas

OHSU-PSU School of Public Health Faculty Publications and Presentations

Lowering the global disease burden of preventable disease has been addressed in part by the distribution of health products and behavior change campaigns in low-income countries. Realizing a health impact requires adoption by participants, and the topic of program uptake and sustained adoption has been studied extensively, although an ecological context is largely missing from existing work. This study characterizes self-reported and observed adoption of improved cookstoves and point-of-use water filters among nearly 80,000 households in Rwanda using demographic and programmatic variables from implementer surveys and integration of geospatial and temporal data based on differentiated recipient location. The odds of …

Shared Medical Appointments And Patient-Centered Experience: A Mixed-Methods Systematic Review, Kim H. Wadsworth, Trevor G. Archibald, Allison E. Payne, Anita K. Cleary, Byron L. Haney, Adam S. Hoverman

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Shared medical appointments (SMAs), or group visits, are a healthcare delivery method with the potential to improve chronic disease management and preventive care. In this review, we sought to better understand opportunities, barriers, and limitations to SMAs based on patient experience in the primary care context.

Methods: An experienced biomedical librarian conducted literature searches of PubMed, Cochrane Library, PsycINFO, CINAHL, Web of Science, ClinicalTrials.gov, and SSRN for peer-reviewed publications published 1997 or after. We searched grey literature, nonempirical reports, social science publications, and citations from published systematic reviews. The search yielded 1359 papers, including qualitative, quantitative, …

Internet Addiction, Smartphone Addiction, And Hikikomori Trait In Japanese Young Adult: Social Isolation And Social Network, Masaru Tateno, Alan R. Teo, Wataru Ukai, Junichiro Kanazawa, Ryoko Katsuki, Hiroaki Kubo, Takahiro A. Kato

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: As the number of internet users increases, problems related to internet overuse are becoming more and more serious. Adolescents and youth may be particularly attracted to and preoccupied with various online activities. In this study, we investigated the relationship of internet addiction, smartphone addiction, and the risk of hikikomori, severe social withdrawal, in Japanese young adult.

Methods: The subjects were 478 college/university students in Japan. They were requested to complete the study questionnaire, which consisted of questions about demographics, internet use, the Internet Addiction Test (IAT), the Smartphone Addiction Scale (SAS)–Short Version (SV), the 25-item Hikikomori Questionnaire …

Exploring The Extent Of The Hikikomori Phenomenon On Twitter: Mixed Methods Study Of Western Language Tweets, Pereira-Sanchez, Miguel Angel Alvarez-Mon, Angel Asunsolo Del Barco, Melchor Alvarez-Mon, Alan R. Teo

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Hikikomori is a severe form of social withdrawal, originally described in Japan but recently reported in other countries. Debate exists as to what extent hikikomori is viewed as a problem outside of the Japanese context. Objective: We aimed to explore perceptions about hikikomori outside Japan by analyzing Western language content from the popular social media platform, Twitter. Methods: We conducted a mixed methods analysis of all publicly available tweets using the hashtag #hikikomori between February 1 and August 16, 2018, in 5 Western languages (Catalan, English, French, Italian, and Spanish). Tweets were first classified as to whether they described …

Use Of Single Irbs For Multi-Site Studies: A Case Report And Commentary From A National Drug Abuse Treatment Clinical Trials Network Study, Ceilidh Nichols, Lynn E. Kunkel, Robin Baker, Eve Jelstrom, Megan Addis, Kim Hoffman, Dennis Mccarty, P. Todd Korthuis

OHSU-PSU School of Public Health Faculty Publications and Presentations

Recent NIH policy stipulates that multi-site studies must use a single or IRB (Institutional Review Board) in order to streamline the review process while maintaining standards for human subjects protection. The Western States Node of the Clinical Trials Network (CTN) used a single IRB for protocol CTN-0067, a clinical trial testing the use of an opioid antagonist (extended-release naltrexone) versus opioid agonists (buprenorphine or methadone) for opioid use disorders among individuals living with HIV. This case study discusses the processes and challenges associated with use of a single IRB. These lessons are also informed by other single IRB experiences within …

Making The Business Case For An Addiction Medicine Consult Service: A Qualitative Analysis, Kelsey C. Priest, Dennis Mccarty

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

As the drug poisoning crisis worsens in North America and opioid use disorder (OUD)-related hospital admissions increase, policymakers and hospital administrators are beginning to recognize the important role of hospitals in the OUD care continuum. This study explores and describes how U.S. addiction medicine physicians created and presented business propositions to hospital administrators to support the development of addiction medicine consult (AMC) services.

Methods

Fifteen qualitative interviews were completed with board-certified or board-eligible addiction medicine physicians from 14 U.S. hospitals. The interviews occurred as part of a broader mixed methods study exploring hospital service delivery for patients admitted with …

Alternative Payment Models And Hospital Engagement In Health Information Exchange, Sunny C. Lin, John M. Hollingsworth, Julia Adler-Milstein

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives:

To assess whether hospital participation in alternative payment models (APMs) is associated with greater engagement in health information exchange (HIE) along 4 dimensions: volume of patients for whom information is exchanged, diversity of information types, breadth of partner types, and depth of technical approach.

Study Design:

Pooled, cross-sectional analysis of data on US hospitals from 2014–2015.

Methods:

APM participation came from Leavitt Partners data, Medicare public use files, and the American Hospital Association (AHA) Annual Survey. We used Medicare data to measure HIE volume for 798 hospitals attesting to stage 2 Meaningful Use and the AHA Information Technology Supplement …

Learners With Disabilities Can Contribute To Waste Management, Arvie S. Andal, Maria Corazon C. Colendrino, Monaliza U. Guce-Vinas

Angelo King Institute for Economic and Business Studies (AKI)

Encouraging the community to shift into a more environmentally friendly practice would entail a consideration of several factors, more so if it includes the participation of individuals with disabilities. The result of the study highlights several actions needed to maximize the potential of the program: 1) the continuous training of learners with disabilities to build capacity and capability; and continuous funding for such; 2) the continuous improvement of product quality to meet specific market needs; and 3) the development of programs to increase the community’s awareness, understanding, and appreciation of the benefits of recycling.

Kangaroo Mother Care And Traditional Care, Arianna Smola, Kirsten Lawson

Williams Honors College, Honors Research Projects

Prematurity and low birth weight are leading causes of infant death. Throughout recent years care methods for this population have evolved from incubator care to Kangaroo Mother Care (KMC). The purpose of this systematic review was to answer the following PICO question: in the case of preterm and low birth weight (LBW) infants, how does the technique of Kangaroo Mother Care (KMC) compare to traditional incubator use, regarding long and short-term outcomes of preterm and LBW infant recovery. Methods of this study included the selection of twenty peer-reviewed articles that studied the effect of incubators and KMC on premature and …

Understanding Access To Menstrual Hygiene Products In The Akron Area, Corinne Plas

Williams Honors College, Honors Research Projects

Abstract

The purpose of this project is to contribute to the understanding of the nature of access to menstrual hygiene products in the Akron area. Questions being researched are “Do Akron area residents need better access to menstrual hygiene products?”, “What is the nature of current access to products in the Akron area?”, “What influences a lack of access to products, if anything?”, and “What kinds of products are preferred and actually used?” The project consists of a 30-question survey, which was taken online by 51 participants. Completed analyses were cross tabulation analyses using Qualtrics and IBM SPSS programs and …

Females, Perceptions, And Strength Training, Victoria Kanel, Alexandria Rellinger

Williams Honors College, Honors Research Projects

Performing a regular strength training routine leads to a plethora of beneficial physiological and psychological changes. A gender disparity exists with participation rates of strength training. There is a possible discrepancy in knowledge and education provided to males and females based on their physical activity and exercise backgrounds. The design of this study is an effort to better understand potential barriers females may experience and serve as a needs-assessment tool to identify females’ views of strength training participation. This study sought to explore views of strength training among females and to determine if consensus exists and how views may aid …

Advanced Practice Nursing In Nigerian Healthcare: Prospects And Challenges, Raymond O. Chimezie, Sally N. Ibe

Journal of Sustainable Social Impact

This study explored the prospects and challenges of introducing advanced practice nursing (APN) in the Nigerian health system. It sought to address the following: career pathways for registered nurses and midwives, advanced duties performed by them and the circumstances, their views and willingness for autonomous practice, and doctors’ degree of acceptance. Research population composed of registered nurses, midwives and medical doctors in primary healthcare. The conceptual framework for this study was based on the scope of practice, standards and competencies of the APN established by the International Council of Nurses (2008). A 12-item checklist of typical duties of APN from …

The Role Of Food Processing In The Inflammatory Potential Of Diet During Pregnancy, Carolina Assis Silva, Izabela Da Silva Santos, Nitin Shivappa, James R. Hebert, Livia Castro Crivellenti, Daniela Saes Sartorelli

Faculty Publications

The aim was to investigate the relationship between the energy contribution (E%) of foods according to the degree of industrial processing and the energy-adjusted dietary inflammatory index (E-DII) in pregnancy. Two 24-hour dietary recalls were obtained from each of the 784 pregnant women. Adjusted linear regression models allowed observing an inverse association between E-DII scores and E% from minimally processed foods β = -0.049 (95%CI -0.055– -0.042) and a direct association with the E% of ultra-processed foods β = 0.052 (95%CI 0.045–0.058), indicating a relationship between the dietary inflammatory potential and the degree of industrial processing of foods.

The Influence Of Food Insecurity, Low-Income, And Race On Diabetes Self-Management Practices Among Women With Diabetes, Jill La Capria

Walden Dissertations and Doctoral Studies

Diabetes is a chronic condition affecting more than 30 million adults living in the United States. Diabetes self-management (DSM) can prevent or delay the complications of diabetes and improve clinical outcomes; however, data show that low-income, food insecurity, female gender, and race contribute to challenges performing effective DSM. The health belief model was the theoretical framework for this cross-sectional study, which examined how food insecurity, low-income, and race affect DSM activities in women with diabetes. The sample population from the 2017 Behavioral Risk Factor Surveillance System survey consisted of 1,842 women with diabetes who were 18 years of age or …

Use Of Medical Care And Suicide Among Veterans, Wyatt Edward Meriwether

Walden Dissertations and Doctoral Studies

Due to rising veteran suicide rates, the veteran population has become a focus of practitioners, research scientists, and policymakers. Although researchers have studied the relationship between suicidality and the environment, more research is required to evaluate how suicidal behavior, suicidal ideation, and suicide risk are associated with a veteran's use of medical care services within the Veterans Health Administration (VHA). Therefore, this study focused on environmental variables (medical care usage and rurality), and their relationship with suicidal behavior (Manuscript 1), suicidal ideation (Manuscript 2), and suicide risk (Manuscript 3). The social ecological model was used to better understand the interaction …

Association Between Substandard Housing And Asthma In African-American Children, Sharmanita Davis

Walden Dissertations and Doctoral Studies

An improved understanding of the role of housing in asthma prevalence among African-American children is essential to addressing the issues associated with asthma and housing that perpetuate racial and ethnic health disparities. This study was conducted to examine the influence of substandard housing on the odds of asthma among low-income African-American children. The social ecological model was used as the theoretical framework for this study, that allowed consideration of the housing environment where African-American children live as an influential determinant of respiratory health. A cross-sectional research design using data obtained from the 2012 National Health Interview Survey and Comprehensive Housing …