Public Health Commons^™

Long-Term Cancer Survivors' Use Of Healthcare Providers, Madeleine Tessier-Kay

Public Health Theses

Abstract

Introduction: The number of long-term (>5 years post-diagnosis) cancer survivors in the United States is growing, making it critical to understand how they utilize healthcare for their past cancer diagnosis. There are limited data on patient characteristics associated with care utilization patterns. Methods: Data are reported from the 9-year post-diagnosis follow-up of the Connecticut participants (n=399) in the American Cancer Society’s Study of Cancer Survivors-I. We assessed characteristics associated with long-term primary cancer care provider (cancer specialist vs. primary care physician (PCP), shared care vs. PCP) and number of PCP visits in the past year via multinomial logistic …

Genetic Determinants For Cancer Risks With Racial Differences And Asthma, Yinqiao Wang

Public Health Theses

Over the past decade, many studies have found disproportionally higher prostate cancer among men of African ancestry, and testicular cancer incidences among men of European ancestry, compared with men from other ethnicity/race groups. However, genetic determinants that could potentially explain this observation are unclear. This study collected single nucleotide polymorphisms (SNPs) related to the two cancer types and compared the frequencies of each risk allele of SNPs among men of African or European ancestry from several genetic databases. When comparing the frequencies of risk alleles that are associated with prostate and testicular cancers, significant differences were found between those of …

The Impact Of The Accuracy Of Hiv Risk Perception On Hiv Risk Behavior Changes Among Women With Substance Use Disorders In Treatment., Yiwen Ye

Public Health Theses

Studies involving women or women with SUDs for PrEP are limited even though in many areas of the world women remain at high-risk for HIV acquisition. This study is to evaluate the impact of accuracy of HIV risk perception on HIV risk behaviors changes over time among women with substance use disorders in treatment, including sexual and injecting risk behaviors. This is a secondary analysis based on a preference controlled un-blinded study. This study enrolled 165 cis- or trans-female volunteers ≥18 years old who were self-reported HIV-uninfected, had diagnosed SUDs, and were presenting for or currently enrolled in drug treatment. …

Identification Of Genetic Factors For Metabolically Healthy Obese And Metabolically Obese Normal-Weight, Junli Zhu

Public Health Theses

Though obesity is typically associated with metabolic dysfunction and cardiometabolic diseases, there are both obese individuals who have favorable metabolic profiles (metabolically healthy obese; MHO) and individuals who present obesity alterations despite their normal weight (metabolically obese normal weight; MONW). Genetic studies suggest that there is a genetic component underlying these phenotypes. However, previous research has been restricted by the use of the candidate gene approach, limited choice of metabolic indicators, and low statistical power. A genome-wide association (GWA) study that examines both MHO and MONW in a single large-scale population cohort is necessary to uncover the genetic determinants of …

Covid-19 Student Mental Health Check, Dianna Blankenship, Irma S. Jones

Criminal Justice Faculty Publications

The COVID-19 pandemic has produced many changes in the lives of our students and families. In this article, the responses of students in criminal justice classes at a Hispanic serving institution in south Texas were collected and synthesized. The 252 responses were divided into seven frequently observed and repeated themes: jobs and job related, school and courses, graduation, routine, family, positivity, and groceries/shopping. Findings for this time period matched what much of what the national and international news and reports have all reported. It indicates that, as teaching professionals, we must be mindful to provide the added support to assist …

Medical Knowledge As A Recalcitrant Epistemological System: An Application Of Standpoint Epistemology In The Analysis Of Marginalization Within U.S Healthcare, Abby Deshazo

CMC Senior Theses

Research on healthcare disparities outside the field of epistemology tend to miss the true origins of oppressions imposed on marginalized individuals by the U.S healthcare system. This happens because of the false belief that these oppressions are reducible to social or political oppressions. By employing the perspective of a standpoint epistemologist, we can better identify the origins of these oppressions and subsequently consider more appropriate solutions. The standpoint epistemologist’s perspective (1) provides an intuitive case for the role individuals’ schemas play in the evaluation of what healthcare professionals know; (2) situates medical knowledge within epistemology, leading us to …

Postpartum Depression Rates In Latine Birthing Parents During The Covid-19 Pandemic: A Closer Look At Cultural Protective Factors And Acculturation, Perla Barajas

CMC Senior Theses

In the Latine community, the prioritization of social or familial support (familism) serves as a cultural protective factor that has typically guarded against unfavorable health outcomes. However, during the COVID-19 pandemic, social interactions and familial support were substantially limited. A vulnerable population during this pandemic was Latine birthing parents because previous studies have shown that perception of social support directly impacts postpartum depression (PPD) in this group. This study will use data from the Pregnancy Risk Assessment Monitoring System to compare PPD rates for Latine birthing parents from before the COVID-19 pandemic to the PPD rates during the pandemic. Moreover, …

More Than A Myth: The Benefits Of Incorporating Holistic Healing Methods From Native American And Mexican Cultures To Approach Opioid Use Disorder (Oud) Treatment, Juliana Favela

CMC Senior Theses

Opioid Use Disorder (OUD) is a substance use disorder that characterizes a dependence on and an addiction to opioids. Opioids attack the prefrontal cortex, the dopaminergic reward system, and the hypothalamic-pituitary-adrenal (HPA) axis which is responsible for the body’s stress response. Opioids constantly shift one’s “set point” to the point where normal actions that cause joy and excitement no longer cause those feelings, resulting in craving and dependence. The opioid epidemic is currently ravaging the United States and has disproportionately affected Native American populations specifically in the rural areas (Tipps, et.al, 2018). The current methods for addressing OUD include medicine …

Long-Term Assessment Of The Effects Of Covid-19 And Isolation Care On Survivor Disability And Anxiety, David Brett-Major, David S. Cates, James V. Lawler, Chad Vokoun, Angela L. Hewlett, Daniel W. Johnson, Elizabeth R. Schnaubelt, Michael C. Wadman, Christopher J. Kratochvil, M. Jana Broadhurst

Journal Articles: Epidemiology

We conducted an assessment of disability, anxiety, and other life impacts of COVID-19 and isolation care in a unique cohort of individuals. These included both community admissions to a university hospital as well as some of the earliest international aeromedical evacuees. Among an initial 16 COVID-19 survivors that were interviewed 6-12 months following their admission into isolation care, perception of their isolation care experience was related to their reporting of long-term consequences. However, anxiety and disability assessed with standard scores had no relationship with each other. Both capture of the isolation care experience and caution relying on single scoring systems …

Multiplex Qpcr Discriminates Variants Of Concern To Enhance Global Surveillance Of Sars-Cov-2, Chantal B. F. Vogels, Mallery I. Breban, Isabel M. Ott, Tara Alpert, Mary E. Petrone, Anne E. Watkins, Chaney C. Kalinich, Rebecca Earnest, Jessica E. Rothman, Jaqueline Goes De Jesus, Ingra Morales Claro, Giulia Magalhães Ferreira, Myuki A. E. Crispim, Brazil-Uk Cadde Genomic Network, Lavanya Singh, Houriiyah Tegally, Ugochukwu J. Anyaneji, Network For Genomic Surveillance In South Africa, Emma B. Hodcroft, Christopher E. Mason, Gaurav Khullar, Jessica Metti, Joel T. Dudley, Matthew J. Mackay, Megan Nash, Jianhui Wang, Chen Liu, Pei Hui, Steven Murphy, Caleb Neal, Eva Laszlo, Marie L. Landry, Anthony Muyombwe, Randy Downing, Jafar Razeq, Tulio De Oliveira, Nuno R. Faria, Ester C. Sabino, Richard A. Neher, Joseph R. Fauver, Nathan D. Grubaugh

Journal Articles: Epidemiology

With the emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants that may increase transmissibility and/or cause escape from immune responses, there is an urgent need for the targeted surveillance of circulating lineages. It was found that the B.1.1.7 (also 501Y.V1) variant, first detected in the United Kingdom, could be serendipitously detected by the Thermo Fisher TaqPath COVID-19 PCR assay because a key deletion in these viruses, spike Δ69-70, would cause a "spike gene target failure" (SGTF) result. However, a SGTF result is not definitive for B.1.1.7, and this assay cannot detect other variants of concern (VOC) that lack …

Perceptions Of Local Board Of Health Effectiveness In Georgia, Amber Erickson

College of Graduate Studies: Theses & Dissertations

Objective: The purpose of this study is to examine the perceptions of the local board of health chairpersons in Georgia on their engagement in six governance functions and examining the challenges faced and facilitators perceived by local boards of health in performing the governance functions properly. Methods: For this descriptive mixed method study design, a survey was administered to all local board of health chairpersons and key informant interviews were conducted with a small selection of board of health chairpersons. Descriptive statistics were produced for recoded survey data variables and themes from qualitative data collected through the surveys and interviews …

The Association Of Demographic Characteristics And Social Vulnerability With Covid-19 Outcomes, Gloria D. Boone

College of Graduate Studies: Theses & Dissertations

The Association of Demographic Characteristics and Social Vulnerability With COVID-19 Outcomes

by

Gloria Boone

(Under the Direction of Gulzar Shah)

ABSTRACT

This research explored 102 Illinois counties' COVID-19 data to determine whether demographic characteristics and social vulnerability are associated with increased vulnerability to COVID-19 infections and deaths. COVID-19 is disproportionately impacting vulnerable groups and has been deadlier for African American and Hispanic people. The findings of this research will contribute to the knowledge base regarding social vulnerability and assist public health officials in targeting resources and designing interventions. This study used a retrospective cross-sectional design to assess demographic characteristics of …

Qualitative Study Of Factors Contributing To Fertility Service Use Among Cancer Survivors Of Reproductive Age In The Us, Angela Rodgers Moore

College of Graduate Studies: Theses & Dissertations

Cancer remains the second leading cause of death in the United States; however, there has been a decline in incidence and mortality due to advances in screening and treatment. Currently 16.9 million survivors are thriving within the United States, and the population of cancer survivors has been projected to grow to 22.2 million by 2030. Although cancer survivors report an increased surge of vitality and vigor, they often face physical, mental, psychosocial, or financial challenges that threaten their quality of life. A late treatment effect of particular concern for cancer survivors of reproductive age that has both physical and psychosocial …

Effects Of Trained Providers And Naloxone Distribution On Prescription Opioid Use Disorder, Samuel Sarpong

Walden Dissertations and Doctoral Studies

AbstractOpioid abuse and overdose are associated with substantial morbidity and mortality rates, as well as social and economic costs. The purpose of this study was to evaluate the independent and interactive effects of state-sponsored prescription drug monitoring program (PDMP) trained healthcare providers and community-based naloxone distribution program related factors in the states of Florida and Georgia for the prevention and reduction of prescription opioid use disorder, overdose, and deaths. The research theory adopted was the socio-ecological model with an emphasis on risk factors such as age. The study used secondary data from 2014 to 2018 from the Florida and Georgia …

Social Determinants Of Health And Type 2 Diabetes Among Enrollees Of California Children’S Services Program In Fresno County, California, Daniela Marie Aghadjanian

Walden Dissertations and Doctoral Studies

Despite extensive study in adults, Type 2 diabetes (T2D) has been the subject of little research concerning young adults or children. Doctors believed T2D to develop only in a person’s later years until health care providers found younger individuals developing this disease. The purpose of this cross-sectional quantitative analysis was to determine correlations between T2D and social determinants of health in Fresno County, California, based on children and adolescents. The 2017-19 data came from the Fresno County Department of Public Health. The theoretical foundation for the study was the socio-ecological framework focusing on individuals’ traits having a bidirectional impact on …

Understanding How Religious Practices Influence Self-Care In Black Churchgoers Diagnosed With Hypertension, Taquina C. Davis

Walden Dissertations and Doctoral Studies

Religion plays an essential role in managing health; however, there is limited research on religious practices among Black churchgoers diagnosed with hypertension. This research aims to understand how religious practices influence self-care in Black churchgoers diagnosed with hypertension. The sample consisted of 21 Black men and women, ages 29 to 70 years, with a clinical diagnosis of hypertension. Participants were recruited from two local, predominately Black churches in South Carolina and administered semistructured interviews to participants. A grounded theory design was used, and the data analysis consisted of constant comparison. Two core concepts were identified. One core concept identified was …

The Influence Of Community-Based Interventions On Behaviors Of Hiv+ Persons In Congo-Kinshasa, Max Ebengho Bokelo

Walden Dissertations and Doctoral Studies

AbstractSub-Saharan African communities bear the highest burden of HIV/AIDS in the world. Because of identifiable cultural links and local beliefs, people are more likely to engage in sexual mores that could negatively impact their lives. Starting in early 2000, Congolese HIV+ patients have undergone a variety of inputs designed to decrease HIV risk behaviors among people. The purpose of this inquiry was to understand the impact of those actions within the community. Data grounded on the socioecological model were collected regarding any changes in (1) behavioral rejection of condoms, (2) Kintwidi phenomenon, (3) levirate and (4) sororate marriage, (5) sexual …

Developing A Clinical Practice Guideline For Colorectal Cancer Screening In Primary Care, Michelle Janise Berkley-Brown

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States for both men and women combined. CRC screening is an effective way to reduce mortality and morbidity related to the disease. Practitioners within primary care practices can play an essential role in encouraging people to be screened. Yet, CRC screening rates remain low in primary care practices. Evidence-based strategies are available to help practitioners improve CRC screening activities and improve screening rates. The lack of a clinical practice guideline (CPG) with strategies to help improve CRC screening interventions was identified as a practice gap for …

The Power Of Exogenous Variables In Predicting West Nile Virus In South Carolina, Christopher Lee Glaze

Walden Dissertations and Doctoral Studies

Despite the availability of medical data, environmental surveillance tools, and heightened public awareness, West Nile Virus (WNv) remains a global health hazard. Reliable methods for predicting WNv outbreaks remain elusive, and environmental health managers must take preventive actions without the benefit of simple predictive tools. The purpose of this ex post facto research was to examine the accuracy and timeliness of exogenous data in predicting outbreaks of WNv in South Carolina. Decision theory, the CYNEFIN construct, and systems theory provided the theoretical framework for this study, allowing the researcher to broaden traditional decision theory concepts with powerful system-level precepts. Using …

Patient Perceptions Of Access To Chronic Pain Medications, Lauren Amy Durham

Walden Dissertations and Doctoral Studies

AbstractThe 2014 Drug Enforcement Administration’s reclassification of hydrocodone combination products caused significant unintentional consequences to patients with chronic pain. Although a few researchers have looked at the problems that resulted immediately following the reclassification, none have as yet repeated their studies, creating a knowledge gap. Additionally, previous researchers have shown that most of the current opioid restricting policies in place today were not created using a strong evidence-based or ethically inclusive approach. The purpose of this study was to assess whether common factors identified as issues impacting care for these patients immediately following the reclassification continue to affect care standards. …

Haitian Immigrant Parents’ Perceptions On Acculturation And High-Risk Behaviors Among Their Children, Weiselande Cesar

Walden Dissertations and Doctoral Studies

Immigrant Haitian parents experience acculturative stress when adjusting to the norms and expectations of a new country. Acculturative stress may be exacerbated if their adolescent children display unfamiliar behaviors, which may result in a greater need for psychological assessments and education programs to mitigate the instances of family breakdown. Following Haiti’s 2010 earthquake, there has been an increase in high-risk behaviors among Haitian adolescents. To date, there is limited research on acculturative stress in immigrant Haitian parents and how this stress may relate to their actions and perceptions of high-risk behaviors in their adolescent children. In this case study date …

Change Fatigue, Job Satisfaction, And Organizational Commitment Among Nurses, Melissa Kapping

Walden Dissertations and Doctoral Studies

The healthcare environment is complex and ever-changing, which has a direct impact on the nurse. The effects of the constant change to the nurse may result in the development of change fatigue, which causes the loss of trust in the organization, a feeling of resentment, and a sense of apprehension while depleting the individual’s reserves. The purpose of this correlational study guided by Lazarus and Folkman’s stress and coping theory was to determine if there is a relationship between (a) job satisfaction and change fatigue and (b) organizational commitment and change fatigue in nurses who work in an outpatient clinical …

Perceived Health And Preventative Care In The Transgender Population, Gregory Page Carpenter

Walden Dissertations and Doctoral Studies

Historically, the transgender community has been treated and studied myopically, using the lens of psychological illness. As treatment and research efforts have expanded in the past decade, the transgender population is becoming better understood. The purpose of the study was to examine the relationship between perceived health and preventative care in the transgender community. The health belief model was the theoretical framework for this cross-sectional study, which included data from the 2014–2018 Behavioral Risk Factor Surveillance System Survey. Chi-square tests and binomial logistic regressions were performed to investigate associations between perceived health and preventative care in the transgender community. The …

Current Effects Of U.S. Preventive Care Quality Narratives On Preventive Health Services, James Fisher

Walden Dissertations and Doctoral Studies

In the interest of improving patient outcomes, significant investments in operationalized quality of care within the Medicare space have promulgated a low-resolution narrative predicated on conflation of higher quality scores with improved population health. Concomitant financial incentivization of Medicare Advantage plans through aligned Star Measures places contracts as the fundamental unit of most care quality analyses, but no studies have considered how present incentivization schema have impacted physician use and associated quality scores over time for breast cancer screening (BCS), colorectal cancer screening (CCS), and annual flu vaccination (AFV) at a county level. Guided by the Evidence Based Model framework, …

Hospital Emergency Room Visits For Heavy Menstrual Bleeding, Henry John Mead

Walden Dissertations and Doctoral Studies

Heavy menstrual bleeding (HMB) is a well-recognized health issue among women of reproductive age. The characteristics and demographics of women in the community with HMB who present at the emergency department (ED) are not well described. This research aimed to describe the cohort of women who seek treatment at the ED. The Healthcare Cost and Utilization Project 2016 National Emergency Department Sample was examined. The theory of reasoned action predicts that women who present at the ED are exhibiting health seeking behavior. From 32 million records, the inception cohort identified N = 111,555 cases. Using national estimation weights, this translates …

Comparison Of The Therapeutic Efficacy Of Rheumatoid Arthritis Treatments, Kacy Smith Davis

Walden Dissertations and Doctoral Studies

Rheumatoid arthritis (RA) is an autoimmune condition that causes chronic joint pain and destruction. The current standard regimen of monotherapy disease modifying anti-rheumatic drug (DMARD) treatments may not be as effective as that of combination therapy of a DMARD and a biologic agent in treating RA. The purpose of this study was to answer the question, is there a difference in the therapeutic efficacy of combination DMARD treatments with a biologic, compared to monotherapy DMARDs without a biologic, in U.S. Caucasian women between the ages of 30 and 60 that have been diagnosed with RA? Guided by the theoretical framework …

Chronic Obstructive Pulmonary Disease Readmissions And Mortality In Veterans Administration Hospitals, Carolyne S. Davis

Walden Dissertations and Doctoral Studies

AbstractRates for chronic obstructive pulmonary disease (COPD) have continued to increase, resulting in readmission tracking by the Centers for Medicare and Medicaid for community hospitals and Veterans Health Administration (VHA) hospitals. By using the Andersen healthcare utilization model as the theoretical framework, the purpose of this quantitative correlational research was to examine differences in 4,879 COPD readmission and mortality rates in VHA hospitals for the four Veteran Administration (VA) regional districts—Northeast, Southeast, Continental, and Pacific—as well as and between rural and urban VA hospitals. Secondary data was acquired from an open website through the Centers for Medicare & Medicaid Services. …

Association Between Modifiable Risk Factors And Stroke Among Hispanics, Shanice Williams

Walden Dissertations and Doctoral Studies

Stroke is a significant public health issue that impacts the health of Hispanic adults. Understanding the multiple risk factors of stroke is an essential strategy to control the disease among this population. The purpose of this study was to examine the association between modifiable risk factors and stroke among Hispanics. The public health prevention framework guided this study. The research questions were designed to determine whether an association exists between modifiable risk factors for stroke among Hispanics. A quantitative, cross-sectional research design was used to conduct secondary analysis of the pooled 2017–2019 Behavioral Risk Factor Surveillance System annual surveys. The …

The Determinants Of Endometrial Cancer Survival Disparities In The United States, Evelyn Anegbe

Walden Dissertations and Doctoral Studies

Endometrial cancer is the most common gynecologic cancer in the United States with recent trends showing a continued increase in incidence and mortality. Prognosis is influenced by cancer stage at diagnosis and differs by race/ethnicity. Researchers have documented poorer survival among Blacks than Whites diagnosed with endometrial cancer. The 5-year survival rates for women with endometrial cancer is 81%; while survival for White and Black women are 84% and 62%, respectively. There is a gap in literature examining the widening disparity in incidence and survival of women diagnosed with advanced stage disease among population subgroups across the United States. The …

Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark

Walden Dissertations and Doctoral Studies

The increased number of older adults living longer parallels with the growth of public health concerns regarding the impact of sociodemographic and psychosocial factors (e.g., loneliness and social isolation) on older adults' wellbeing. The purpose of this quantitative study was to examine the association between loneliness, social isolation, the combined model of loneliness, and social isolation on wellbeing among older adults when accounting for age, gender, ethnicity, and social support. The socioecological model (SEM) was used to evaluate the multiple levels of environmental determinants for loneliness, social isolation, and wellbeing. The target population included older adults 65 years and older …