Public Health Commons^™

The Plant-Based And Soul-Full Study (Pass): Examining How Owners Of Local Vegan Soul Food Restaurants Promote The Consumption Of Vegan Foods In The African American Community, Anthony Crimarco

Theses and Dissertations

Background: Obesity remains a prevalent public health epidemic and African American (AA) adults are disproportionately affected by obesity more than any other ethnic group. There are also disparities in obesity by location, with the South having the highest rates compared to other geographic regions in the United States. Addressing poor dietary habits is important for improving obesity rates among AAs, but there has been limited research that has focused on specifically developing culturally-tailored interventions. With a recent number of soul food restaurants serving exclusively vegan meals opening up across the country to appeal to AAs and others interested in eating …

Prenatal Opioid Maintenance In The U.S. And Its Effect On Neo-Natal Abstinence Syndrome: The Case Of West Virginia's Opioid Epidemic, Morgan Ruley, Alberto Coustasse

Management Faculty Research

In 2017, West Virginia’s opioid epidemic was the cause of about 1000 deaths. Opioid abuse has become an issue among pregnant mothers and has increased the effects of Neonatal Abstinence Syndrome (NAS) in infants. The purpose of this study was to evaluate the participation of prenatal opioid maintenance to determine if it has decreased the amount of treatment needed for NAS in infants in West Virginia. The methodology utilized a literature review complemented with a semi-structured interview. Thirty-six sources were referenced for this literature review. It was found that Buprenorphine Maintenance Therapy had the most positive effect on NAS after …

Photo Elicitation Study 2018-2019, Lisa Armstrong, Kaela Edwards, Violetta Feshchenko, Kimberly Kullmann, Alexandre Martinez, Rebecca Mercier, Nicole Murray, Pamela Myers, Priyanka Prasad, Victoria Ramos, Nicholas Salter, Madalene Zale, Amy Henderson Riley, Drph, Rosemary Frasso, Phd, Adrea Cope, Nataki Duncan, Rachel Ewalt, Catherine Freeland, Nichole Holmes, Laura Slifer, April Smith, Sabina Spigner, Simal Thind, Eliza Whiteman Kinsey, Phd

JCPH at APHA 2019

Photographer and researcher John Collier first named photo elicitation in a paper published in 1957. Photo elicitation involves a qualitative interview stimulated and guided by participant photographs. This method can help break down barriers between researchers and participants and can promote rich and collaborative discussions (Harper, 1994).

Student Perspectives on Work-Life Balance: A Photo Elicitation Study

Each student in Qualitative Research Methods (PBH 512, Summer 2018) recruited a study participant (n=12) from across the colleges of Thomas Jefferson University. Students trained participants in the appropriate and ethical use of this method. Study participants were asked to define and explore the …

Advocacy-Related Occupations Among People With Disabilities: Assessing Program Outcomes Of An Advocacy Workshop, Audrey Tarbutton, Stefanie Austin, Rachel Bendewald, Hayley Monforte

Community Based

An emerging area of occupational therapy (OT) practice includes program development for persons with disabilities (PWD). These programs are designed to train PWD how to identify issues and advocate for inclusion and accessibility (Umeda et al., 2017). Among the available literature on community-based advocacy programs, results show positive social outcomes including increased self-advocacy knowledge and related behaviors (i.e. Kramer, 2015; Mishna et al., 2011). Regarding the present study, an advocacy training program titled “Community Organizing Advocacy Skills Training” (COAST) was developed using the Midwest Academy Training Manual for the Advocate. The purpose of this study was to pilot a tool …

Global Occupational Therapists’ Health And Wellness Interventions With Community-Dwelling Older Adults, Catherine Keegin, Lyndsey Lehman, Hannah Meier, Megan Weinberg

Older Adult

Rationale: The profession of occupational therapy (OT) has an opportunity to positively impact health and wellness for community-dwelling older adults with the approaching global increase of the aging population (He, Goodkind, & Kowal, 2016). Objective: The purpose of this study was to explore occupational therapists’ use of health promotion and wellness approaches to facilitate healthy aging with community-dwelling older adults in a global context. Results: Four qualitative themes were uncovered: perceptions of older adults, safety, the role of OT, and preventive versus reactive care. Participants with 10 or more years of experience addressed spirituality in practice more often than those …

The Benefits And Accessibility Of Integrative Exercise In Geriatric Populations, Elizabeth Nisper

Honors Projects

There are many physical and mental benefits of conventional exercise and they have been well-studied. However, integrative exercise practices aim to encompass more than physical fitness. There is also a spiritual/ethical component when taking into account aspects such as meditation and mindfulness. By examining a number of different health domains, we can study whether the benefits of yoga and tai chi extend beyond the benefits of exercise more broadly. While the short-term physical fitness benefits of other cardio and strength training may exceed those of integrative practices, yoga and tai chi appear to be equally as beneficial in the long …

Cooking And Meal Planning As Predictors Of Fruit And Vegetable Intake And Bmi In First-Year College Students, Andrea Hanson, Kendra K. Kattelmann, Lacey A. Mccormack, Wenjun Zhou, Onika N. Brown, Tanya M. Horacek, Karla P. Shelnutt, Tandalayo Kidd, Audrey Opoku-Acheampong, Lisa Franzen-Castle, Melissa D. Olfert, Sarah E. Colby

Health and Nutritional Sciences Faculty Publications

The objective was to determine if cooking skills and meal planning behaviors are associated with greater fruit and vegetable intake and lower body mass index (BMI) in first-year college students who are at risk for excessive weight gain. A cross-sectional analysis was conducted using baseline data from a multi-state research project aimed at preventing weight gain in first-year college students. Cooking type, frequency and confidence, self-instruction for healthful mealtime behavior intention, self-regulation of healthful mealtime behavior, and cup equivalents of fruits and vegetables (FV) were measured using validated surveys. BMI was calculated from measured height and weight. First-year students (n …

Behavioral And Neural Correlates Of Aging Effects On Temporal Predictive Mechanisms During Speech Production And Limb Movement, Karim Joharikhatoonabad

Theses and Dissertations

Existing evidence suggests that the brain facilitates motor responses to temporally predictable sensory inputs by generating more robust predictions about the timing of incoming stimuli to better estimate the next state of movement. In this context, previous studies have shown that motor responses are generated with faster reaction time in response to sensory stimuli with predictable compared to those with unpredictable temporal dynamics. However, our understanding of the underlying behavioral and neural mechanisms of temporal predictive mechanisms during movement production has remained limited by several factors. First, studies regarding temporal predictive mechanisms have mainly examined limb movement as a target …

Association Between Snps In The Vitamin D Binding Protein, Vitamin D Status, And Aggressive Prostate Cancer By Race, Diana Diaz

Theses and Dissertations

Prostate cancer incidence and mortality have been decreasing in recent years, but it remains the most commonly diagnosed cancer among men. Racial disparities exist in prostate cancer with African Americans (AAs) having notably higher rates of incidence and mortality, lower survival rates, and are more likely to be diagnosed with a highergrade cancer compared to European Americans (EAs). Genome-wide association studies have revealed several single nucleotide polymorphisms (SNPs) within the vitamin Drelated GC gene that may be associated with prostate cancer aggressiveness. In addition to SNPs, previous research has suggested that low levels of 25-hydroxyvitamin D (25(OH)D) may be related …

The Association Of Rural Hospital Closures With In-Hospital And 30-Day Post Hospital Discharge Mortality From Emergency Care Sensitive Conditions, Melinda A. Merrell

Theses and Dissertations

Purpose

Over 100 rural hospitals have closed in the U.S. since 2010. Continuous pressures on the rural health care delivery system suggest that the trajectory of closures will continue in at least the short-term. While the causes of rural hospital closures have been described in the literature, the effects on the health outcomes of populations that experience these closures are still poorly understood. The purpose of this study was to determine associations between rural hospital closures and in-hospital and 30-day post hospital discharge mortality rates for affected residents experiencing time-sensitive emergencies in two U.S. states.

Methods

Rural hospital closures were …

Pre-Exposure Prophylaxis (Prep) For Hiv Prevention: A Mixed-Methods Study Of Sexual Risks And Knowledge, Perceptions, And Willingness Of Prep Use Among African American Women In The South, Jamie Troutman

Theses and Dissertations

There are approximately 1.1 million people living with HIV in United States, with nearly 40,000 new diagnoses annually. Significant regional and racial disparities are associated with HIV diagnoses — with the South experiencing the greatest burden of HIV and African American women accounting for 60% of new diagnoses among women. Pre-exposure prophylaxis (PrEP) has been designated as an effective tool to prevent HIV transmission among individuals who may be at risk of HIV infection. Earlier PrEP research has focused mainly on at-risk groups such as men who have sex with men (MSM). Previous PrEP research involving African American women included …

Disparities In Non-Small Cell Lung Cancer In The United States: An Examination Of Treatment, Survival, And Access To Care, Cassie Lewis Odahowski

Theses and Dissertations

Lung cancer is the leading cause of cancer-related deaths in the United States with a 5-year survival rate of only 18%. Differences in access to care and treatment utilization may play a role in observed survival disparities among rural patient populations. This dissertation aimed to examine rural disparities in all-cause and lung-cancer specific survival, time to treatment initiation, and utilization of surgical treatment among non-small cell lung cancer cases.

We utilized comprehensive cancer registry data from the Surveillance, Epidemiology, and End Results program linked with Medicare billing claims (SEER-Medicare) for non-small cell lung cancer (NSCLC) patients diagnosed between 2003-2011. We …

Use Of The Who Access, Watch, And Reserve Classification To Define Patterns Of Hospital Antibiotic Use (Aware): An Analysis Of Paediatric Survey Data From 56 Countries., Yingfen Hsia, Brian R. Lee, Ann Versporten, Yonghong Yang, Julia Bielicki, Charlotte Jackson, Jason Newland, Herman Goossens, Nicola Magrini, Mike Sharland, Garpec And Global-Pps Networks

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions.

METHODS: 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and …

Depression Among Expectant And New Mothers: A Multi-Study Investigation Of Rates, Correlates, And Training For Healthcare Providers, Molly M. Long

Health Services Research Dissertations

Perinatal depression (PD) is a common concern among women. PD has been shown to have negative effects on the mother, child, and mother-child relationship. Screening for PD is inconsistent and low among healthcare providers. However, several governing organizations (e.g., The American College of Obstetricians and Gynecologists, The American Academy of Pediatrics) have provided guidelines for screening and treating PD, indicating the importance and utility of screening and treating PD by a variety of healthcare providers. Few studies, with low methodological rigor, have attempted to improve PD screening, treatment, and referral practices. Therefore, it is important to implement and assess additional …

Effect Of Heart Rate Variability Biofeedback On Sleep, Joshua Mercadel

Theses and Dissertations

Healthy amounts of sleep is vital for normal human functions such as daily learning, memory, emotional state and cardiovascular function. Studies conducted previously have shown sleep deprivation to be associated with increases in sympathetic activity contributing to autonomic nervous system (ANS) dysregulation. HRV biofeedback (HRVB) training induces HRV coherence, a condition that maximizes HRV and facilitates autonomic and cardiorespiratory homeostasis. This randomized, controlled, intervention trial will test the hypothesis that HRVB can improve HRV coherence and increase overall sleep quality. Patients are randomized to previously established HRVB or sham protocols (n=40 each, total planned enrollment N=80). Each participant completes a …

Experience Of Persistent Pain Among Military Service Members Participating In An Interdisciplinary Intensive Outpatient Program, Barbara Katarzyna Bujak

Theses and Dissertations

Persistent pain is one of today’s most complex issues in healthcare. In the U.S. military, persistent pain affects close to half of the service members who have deployed overseas and up to 73.2% of service members and veterans experiencing persistent pain. Interdisciplinary pain management, considered one of the most effective ways to manage persistent pain, utilizes the biopsychosocial model that illustrates the dynamic interaction between the physiological, psychological and social factors involved in the experience of persistent pain. Effective interdisciplinary programs address all components of the model and result in better coping skills to self-manage persistent pain, decreased fear of …

Dissociation Between The Growing Opioid Demands And Drug Policy Directions Among The U.S. Older Adults With Degenerative Joint Diseases, Pearl Kim Phd, Takashi Yamashita Phd, Mph, Ma, Jay J. Shen Phd, Seong-Min Park Phd, Sung-Youn Chun Phd, Sun Jung Kim Phd, Mhsa, Jinwook Hwang Md, Phd, Se Won Lee Md, Georgia Dounis Dds, Ms, Hee-Taik Kang Md, Phd, Yong-Jae Lee Md, Phd, Dong-Hun Han Dds, Phd, Ji Eun Kim Phd, Hyeyoung Yeom Md, David Byun Do, Tsigab Bahta Md, Ji Won Yoo Md

School of Public Health Faculty Research

We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others. As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation. A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45–64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital …

Effect Of Pre-Exam Absenteeism On Academic Performance Among First Year Bds Students, Sai Silesh Kumar Goothy, Srinivasa Bharath Mr, Susmitha Paladugu Ms, Avinash Prasad Yamalapalli Mr

Manipal Journal of Nursing and Health Sciences

Being away from college without a valid reason is called absenteeism. Absenteeism refers to a student’s intentional or habitual absence from work. Pre-exam absenteeism is being absent just before the examinations. Most of the students bunk classes a day prior to the examinations to cover the portion at the last minute. The present study was undertaken to observe the impact of pre-exam absenteeism on academic performance among first year BDS students. Hundred and one first-year BDS students were recruited in the present study. The students who were absent a day prior to the examination were grouped as absentees. Their internal …

Risk And Resilience Pertaining To Mental Health Of Youth Attending A College In Kathmandu Who Were Exposed To The 2015 Earthquakes During Their Adolescence: A Mixed Method Study, Vinita Sharma

USF Tampa Graduate Theses and Dissertations

Background: Adverse mental health outcomes have been previously reported among survivors of natural disasters. Available studies mostly focus on risk factors and not resilience. In 2015, a series of earthquakes caused massive loss of lives and livelihood in Nepal. Epidemiological data pertaining to youth mental health in Nepal is limited. Information about the post-earthquake mental health of youth who were exposed to earthquakes during their adolescence in Nepal is scarce.

Purpose: The purpose of this study was to address risk and resilience factors related to mental health among college-attending Nepali youth (18-20 years) exposed to the 2015 earthquake during their …

The Association Of Cardiorespiratory Fitness With Advancing Age Among Those With And Without Type Ii Diabetes, Amber Kathlyn Watson

Theses and Dissertations

OBJECTIVE: This study examined the relationship between cardiorespiratory fitness (CRF) and age to determine if the decrease in CRF associated with advancing age is greater among those with type 2 diabetes mellitus (T2DM) as compared to those without T2DM. This study also assessed if differences in CRF between persons with T2DM and those without are consistent across CRF percentiles.

METHODS: Data from the Aerobics Center Longitudinal Study (ACLS, Dallas, Texas, 1970-2006) were utilized in the current study. CRF was measured by maximal treadmill exercise testing using the Balke protocol and T2DM status was determined by self-report of previous diagnosis by …

Disparities In Colorectal Cancer: Measuring Spatial Accessibility, Screening, And Surveillance Outcomes In South Carolina, Michele J. Josey

Theses and Dissertations

The purpose of this dissertation project is to add to the growing literature about the multi-faceted aspects of colorectal cancer (CRC) prevention and related disparities. We focused on the spatial distribution of facilities performing screening services to identify areas that underutilize colonoscopy screening. Next, we examined how the food and physical activity environment affects precursors of CRC by considering plausible pathways. Finally, we explored if access to health insurance reduced the racial disparity of receiving a timely surveillance colonoscopy after a CRC diagnosis.

We utilized the SC Ambulatory Surgery Discharge Database, an all-payer, population-based outpatient dataset with colonoscopy records from …

Social Networks, Social Support, And Contextual Factors That Affect Blood Glucose Control Among Individuals With Type 2 Diabetes Mellitus In Urban Ghana, Marian O. Botchway

Theses and Dissertations

This study used primary data from Kumasi, Ghana, to examine whether social networks, social support, diabetes-related stigma, religion, and traditional medicine affected blood glucose (HbA1c) control among adults with type 2 diabetes mellitus (T2DM). First, the study evaluated whether three social network characteristics (kin composition, household composition, and network density) were directly or indirectly (via social support) associated with HbA1c. Kin composition and household composition were significantly associated with social support. Neither network characteristics nor social support were associated with HbA1c, which suggests that social network characteristics may operate through mechanisms other than social support to affect HbA1c among study …

Role Of Heart Rate Variability Biofeedback In Cognitive Performance, Chronic Pain, And Related Symptoms, James P. Winstead

Theses and Dissertations

Over-modulation of the sympathetic nervous system and reduced heart rate variability (HRV) are commonly overlooked components of pain, poor cognition (decreased attention, recall, and cognitive processing), depression, stress, and fatigue. HRV Biofeedback (HRVB) training induces HRV coherence to balance the autonomic system. Paced breathing (~6 breaths/minute) increases HRV coherence. This randomized, controlled intervention trial tested the hypothesis that HRVB would improve HRV coherence, pain (severity, interference, and catastrophizing), cognitive performance, and reduce depressive, stress, and fatigue symptoms and pain medication use in veterans. Participants were randomized to previously established HRVB or control protocols. Each participant completed a Baseline Assessment, 6 …

Sociocultural Factors Influencing Cervical Cancer Prevention And Control Behaviors In Cusco, Peru, Venice Elizabeth Haynes

Theses and Dissertations

Cervical cancer is one of the most preventable types of cancer; however, it continues to pose significant health challenges for women in low and middle-income countries (LMICs), particularly in Peru. Studies previously conducted in Peru have examined factors associated with cervical cancer screening, screening access, availability, and geographical determinants on cervical cancer incidence and mortality. These studies have suggested the need to explore sociocultural factors and the roles of men and women in screening decisions associated with excessive cervical cancer burden and low rates of screening among Peruvian women. The goal of the dissertation research was to explore influences of …

Prevalence Trends Of Victimization Among High School Students By Race, Ethnicity, And Gender – Yrbss 2009-2017, Carlos Avalos

Theses and Dissertations

Introduction: Students who are victimized at school are more likely to report mental health, behavioral, and academic problems. Bullying and electronic bullying are types of victimization that are prevalent in US schools, with prevalence varying by race and ethnicity, gender, and age. Additionally, due to increases in bias-based harassment (such as being targeted due to race, ethnicity, or religious beliefs) in the country over the last few years, it is of interest to see how victimization behaviors in schools may have changed from 2015 to 2017.

Objective: To analyze trends of overall bullying, school bullying, electronic bullying, and other forms …

Evaluating Impacts Of A Multilevel Resilience-Based Psychosocial Intervention On Mental Health Of Children Affected By Parental Hiv In China, Yanping Jiang

Theses and Dissertations

Background: Children affected by parental HIV are commonly exposed to multiple risk factors, including parental illness and death, other traumatic life events, HIV stigma, and poverty, all of which in turn put them at elevated risk of experiencing poor mental health outcomes. Previous research has suggested the promise of psychosocial interventions in improving mental health for children affected by parental HIV through an integrated and multilevel resilience-based approach. However, there are few multilevel resilience-based interventions for this group, and the efficacy of such interventions on mental health outcomes has not been fully examined. Furthermore, very few studies have examined whether …

Exploring Breast Cancer Care Variation In Coc-Accredited Facilities, Sarah Grace Barron

Theses and Dissertations

INTRODUCTION: While improvements have been made in reducing breast cancer incidence and mortality over the past twenty years, disparities in breast cancer mortality remain. Understanding systematic differences in breast cancer treatment and quality of care remain at the epicenter of understanding breast cancer disparities. Needle biopsy is a less invasive and less expensive diagnostic test for breast cancer (as compared to excisional biopsy) and permits diagnosis while avoiding unnecessary surgery. This study was conducted to 1) examine how the National Quality Forum (NQF)-endorsed needle biopsy utilization measure varies geographically (i.e. state and region) and 2) determine the patient- and/or health …

Statin Prescription For Patients With Atherosclerotic Cardiovascular Disease From National Survey Data, Kristina Vatcheva, Vicente Aparicio, Ayesha Araya, Eduardo Gonzalez, Susan T. Laing

School of Mathematical & Statistical Sciences Faculty Publications

Despite strong evidence for the use of statins for patients with atherosclerotic cardiovascular disease (ASCVD), statin prescription is still suboptimal. We aimed to determine the rates and factors that influence statin prescription using national survey data. This is a cross-sectional retrospective study on 8,468 patients with clinical ASCVD who were drawn from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey from years 2011 to 2015. Survey-weighted analysis was conducted to estimate weighted prevalence and odds ratios for statin prescription. There was a significant increase in statin prescription from the years 2011 to 2015. Nevertheless, …

Increasing Actual And Perceived Burden Of Tick-Borne Disease In Maine, Robert P. Smith Md Mph, Carol A. Mccarthy Md, Susan P. Elias Phd

Journal of Maine Medical Center

Introduction: The burden of tick-borne disease (TBD) in Maine has steadily increased since the first case of Lyme disease was reported in the late 1980s. The emergence of five different agents of TBD in Maine has been challenging and confusing for clinicians and the public.

Methods: We reviewed the ecology of emerging of tick -borne disease, then reviewed risk factors for tick bites and tick-borne disease in Maine. We then compared the burden of TBD versus community-acquired comparison infections in terms of hospitalizations, deaths, and media attention.

Results and Discussion: In Maine, risk of exposure to bites from the vector …

Using Physician Champions To Extend The Reach Of The Let’S Go! 5-2-1-0 Obesity Prevention Program In Clinical Practice, Michael Dedekian, Jackie Vine, Jonathan Fanburg, Naomi Anderson Schucker, Victoria Rogers

Journal of Maine Medical Center

ABSTRACT

Introduction: There is limited evidence for large scale interventions to address childhood obesity. Let’s Go! is a Maine-based obesity prevention program that deploys a consistent message across multiple community settings to encourage children and families to make healthy choices. This report describes implementation of Let's Go! in primary care offices.

Methods: Consideration for physician champion recruitment included previous involvement with Let’s Go! and ensuring statewide geographic coverage. Champions received standardized training and became local leaders in obesity prevention and treatment. 13 champions engaged 99 practices at baseline; 71 practices were engaged all 4 years (2012-2015). Data were analyzed on …