Public Health Commons^™

A Technology-Based, Mixed Methods Approach To Examining The Psychosocial Determinants Of Maternal Health Disparities, Hannah M. Ming

Theses and Dissertations

Background: Exposure to racism and discrimination in the U.S. increases Black women’s risk for experiencing maternal health disparities. Additionally, racism and discrimination affect maternal psychosocial well-being, creating evidence for a biopsychosocial relationship between racism and maternal health outcomes. However, current research does not define the psychosocial Black maternal self well. Given the dynamic relationship between racism, psychosocial well-being, and Black maternal health outcomes, research must comprehensively examine the Black maternal self. The operationalization of a comprehensive construct for Black maternal psychosocial well-being can improve understanding of the relationship between racism, psychosocial well-being, and Black maternal health outcomes.

Purpose: …

Disability In An American Indian Community : Prevalence, Distribution, And The Role Of Polychlorinated Biphenyls, Thoin Farzana Begum

Legacy Theses & Dissertations (2009 - 2024)

The Akwesasne reservation along the St. Lawrence River has experienced significant exposure to several persistent organic pollutants due to rapid industrialization. The Aluminum Company of America, General Motors, and Reynolds Metals operated aluminum foundries that used polychlorinated biphenyls (PCBs) as hydraulic fluids, which contaminated the community environment, the soil, air and water, and community food sources with PCBs. We administered the World Health Organization Disability Assessment Schedule II (WHODAS II) to 119 Akwesasne Mohawk adults residing along the St. Lawrence River in New York. We used exploratory factor analysis to summarize the 36- items comprising the WHODAS II. The 7 …

Association Between Antiretroviral Therapy And Severe Covid-19 Outcomes Among Hospitalized Hiv Positive People With Sars-Cov-2 In Nys, Aizhan Kyzayeva

Legacy Theses & Dissertations (2009 - 2024)

IMPORTANCE The role of antiretroviral therapy (ART) type in people living with HIV (PLWDH) co-infected with acute respiratory syndrome coronavirus 2 (SARS-Cov-2) remains unclear. There is evidence that certain classes of ART may mute the risk of severe COVID-19 outcomes.

Radical Trachelectomy For Invasive Cervical Cancer : A Pathway To Fertility For Some, But Not Without Repercussions, Erica Jamro-Comer

Legacy Theses & Dissertations (2009 - 2024)

BackgroundRadical trachelectomy (RT) is a surgical procedure that offers a substantial benefit to women diagnosed with invasive cervical cancer: fertility preservation. However, as a newer surgical option, there are still many unknowns about the characteristics and outcomes of women who undergo this procedure after a cervical cancer diagnosis. Initial research in this area indicates that some disparities exist in who has the surgery versus the standard radical hysterectomy procedure; however, these are not fully understood and characterized. Furthermore, little is known about how women plan their families and how their high-risk pregnancies are managed in the absence of a standard …

Trace Elements In Nails And Anemia In Children Living Along The Interoceanic Highway, Madre De Dios, Peru / Narrative Competence And Cognitive Mapping As A Culturally Sustaining Pedagogy In The Education Of Emergent Bilinguals, Tia Marks

Legacy Theses & Dissertations (2009 - 2024)

Anthropogenic changes in the Peruvian Amazon, including deforestation, highway development, agriculture, and artisanal and small-scale gold mining (ASGM), have increased community concern about potential exposures toxic trace elements (TTE) including arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb). Such exposures can lead to detrimental health effects in children, such as developmental delays and anemia. The overarching goal of my dissertation was to understand exposure to both toxic and essential (manganese (Mn), selenium (Se), and zinc (Zn)) trace elements, anemia prevalence, and the associations between hemoglobin (Hb) levels and trace elements. To do this, I leveraged existing data from a …

Disability In An American Indian Community : Prevalence, Distribution, And The Role Of Polychlorinated Biphenyls, Thoin F. Begum

Legacy Theses & Dissertations (2009 - 2024)

Phthalates have been implicated as reproductive toxicants in animal models and in human populations. This study examined associations between potential exposure sources and urinary phthalate concentrations among couples undergoing infertility treatment. Women (n=56) and their male partners (n=43) undergoing in vitro fertilization (IVF) were enrolled in a prospective cohort investigation of environmental chemicals and IVF outcomes at an academic medical center. On the day of oocyte retrieval, participants provided urine samples and completed questionnaires detailing use of personal care products (PCPs), and consumption of medications, foods, and beverages in the preceding 24-hours. Urine was analyzed for MEP, MBP, MPP, MHxP, …

Effects Of Metal And Polychlorinated Biphenyls Exposures And Fish Consumption On Cognitive Function In Adults, Nozomi Sasaki

Legacy Theses & Dissertations (2009 - 2024)

Cognitive decline often occurs with aging, independent of development of neurodegenerative diseases. Little is known about how to prevent cognitive decline or what cofactors, hereditary or environmental, may accelerate or protect against it. In young people, metals, including lead, cadmium, arsenic, methylmercury, and some organic compounds such as polychlorinated biphenyls (PCBs), are known to decrease cognitive function. Consumption of fish is a route of exposure to methylmercury and PCBs, but fish also contain omega-3 fatty acids that are reported to enhance infant neurodevelopment and postnatal cognitive performance. Yet, a recent systematic review concluded that there was inconclusive evidence the omega-3 …

Food Environment, Food Acquisition Behavior, And Fruit And Vegetable Consumption Among Burmese Immigrants And Refugees : A Socio-Ecological Study, Hnin Wai Lwin Myo

Legacy Theses & Dissertations (2009 - 2024)

Background: Using the framework of the Socio-Ecological Model, the current study aimed to investigate the associations between nutritional knowledge, food environment, food acquisition behavior, and daily recommended fruit and vegetable consumption (≥5 cups of fruits and vegetables) among Burmese refugees and immigrants in the Capital Region, New York. Methods: During July - November 2018, a cross-sectional survey with face-to-face interviews was conducted among Burmese refugees and immigrants aged 18 years and older living in Albany and Rensselaer counties (n=173, 52.0% female, mean age = 42.8). Daily recommended fruit and vegetable consumption was determined as ≥5 cups of fruit and vegetable …

Maternal Antifungal Use During Pregnancy : A Study Of Prevalence Of Use And The Risk Of Birth Defects, Eleni A. Papadopoulos

Legacy Theses & Dissertations (2009 - 2024)

Fungal infections, especially vulvovaginal candidiasis (VVC), are common among pregnant women. Therefore, it is important to study the effect that antifungal medications may have on the developing fetus. Recent studies have suggested there are positive associations between birth defects and specific oral antifungals. In this dissertation, maternal antifungal use during pregnancy was examined using data from the National Birth Defects Prevention Study (NBDPS). The NBDPS was multi-site, population-based, case-control study and included women with estimated delivery dates during October 1997 through December 2011. It was designed to investigate risk factors associated with more than 30 categories of major birth defects. …

Genomic Epidemiology Of Clinical Salmonella Enterica In New Hampshire, 2017-2020, Madison R. Turcotte

Legacy Theses & Dissertations (2009 - 2024)

Antimicrobial resistance in Salmonella enterica remains a challenging public health threat. We aim to characterize the population structure and evolutionary history of 394 genomes of S. enterica isolates recovered from human clinical cases in New Hampshire, USA from 2017 to 2020. The population is phylogenetically diverse, consisting of 78 STs and 67 serotypes. We detected 61 genes associated with resistance to14 different antimicrobial classes. Rather than a single multidrug resistant clone expanding in the state, we found multiple lineages carrying different combinations of independently acquired resistance determinants. New or emerging lineages can therefore rapidly spread over relatively short timeframes. In …

Examining The Impact Of The Covid-19 Pandemic On Birth Outcomes In Onondaga County, New York, Simone A. Seward

Legacy Theses & Dissertations (2009 - 2024)

Background: Preterm birth (PTB), defined as births that occur prior to 37 completed weeks of gestation, and low birth weight (LBW), defined as an infant born with a birthweight of < 5.5 lbs or 2,500 grams, have been identified as significant contributors to the high infant morbidity and mortality rate in the United States (U.S.). The etiology of PTB and LBW is complex, and multifaceted. Linkages have been made to several categorical risk factors related to socio-demographics, medical, behavioral, psychosocial, and environmental pathways. Given the known risk factors, the current COVID-19 pandemic has raised concerns from public health officials and clinicians about the short-and long-term impact on the health and well-being of pregnant women and their birth outcomes. Study Purpose: The purpose of the study was to: 1) examine the impact of the COVID-19 pandemic on preterm birth (PTB) and low birthweight (LBW) in Onondaga County, NY; and 2) determine the potential impact of psychosocial factors, particularly maternal depression and social support, on PTB and LBW. Guided by the Integrated Socio-Environmental Model of Health and Well-being (ISEM), The Life Course Perspective (LCP), concepts of allostatic load and the weathering hypothesis, the study recognizes the numerous factors, over the life course, that co-occur and can synergistically contribute to or moderate the impact of the COVID-19 pandemic on birth outcomes. Methodology: The study utilized a mixed methods approach to answer the four research questions. For the quantitative component, the study utilized relevant data elements obtained from the Statewide Perinatal Data System (SPDS) during February 1, 2019 through March 31, 2021 for secondary data analysis. For the qualitative component, 20 key informant interviews were conducted to investigate and describe the health care and social support experiences of individuals who delivered in Onondaga County, NY before and during the COVID-19 pandemic. Results: Results from the bivariate analysis indicated a statistically significant association between lack of prenatal care, lack of social support, maternal depression and both PTB and LBW (all p <.0001). Exposure to the COVID-19 pandemic was not significantly associated with either LBW or PTB (p=0.2289 and p=0.2932, respectively). The analysis yielded no statistically significant difference in the rates of LBW (p= 0.2289) or PTB (p=0.2932) between the two cohorts. The major themes that emerged from the interviews related to prenatal care experience were: Preparing for Pregnancy, Feeling Supported by their Health Care Provider, Restrictive COVID-19 Policies, Dealing with the Unknown, and Self-Advocacy. The major themes related to social support experience were: Personal Relationships during Pregnancy, Forms of Social Support during pregnancy, and Pandemic Impact on Social Support. Overlapping themes were identified between the two cohorts. Study Significance: The findings from this study have implications for public health and clinical practice, public health policy, and future research. The findings from this study emphasize the need for a range of accessible, affordable options for pregnancy-related care and social support, especially during stressful life events, like a pandemic. This study contributes to the growing literature on the COVID-19 pandemic by providing an analysis of the factors (risk and protective) which could moderate or mediate the effects of a public health crisis on birth outcomes. The strength of the study lies in the triangulation of data to research a persistent public health issue and health disparity during a widespread public health crisis.

Anticipating Iqos Market Expansion In The United States, Lorien Abroms, Hagai Levine, Katelyn Romm, Christina Wysota, David Broniatowski, Yael Bar-Zeev, Carla Berg

GW Authored Works

IQOS is sold globally in over 60 countries and entered the US market in 2019 and by 17 May 2021, it was sold in four states: Georgia (Atlanta, Buford), Virginia (Richmond, Tysons), North Carolina (Charlotte, Raleigh), and South Carolina (Charleston, Myrtle Beach), and had 52 specialty stores and 400 retail outlets. While US sales stopped on 29 November 2021 due to a patent lawsuit, they may resume in the near future. As IQOS distribution will likely expand in the future throughout the US, surveillance systems are needed to inform local and national regulatory efforts. Key decision-driving factors for IQOS expansion …

The Impact Of Tobacco Use On Covid-19 Outcomes: A Systematic Review, Jessica Baker, Nandita Krishnan, Lorien C. Abroms, Carla J. Berg

GW Authored Works

Introduction. Tobacco use increases risks for numerous diseases, including respiratory illnesses. We examined the literature to determine whether a history of tobacco use increases risks for adverse outcomes among COVID-19 patients. Methods. We conducted a systematic search of PubMed, LitCovid, Scopus, and Europe PMC (for preprints) using COVID-19 and tobacco-related terms. We included studies of human subjects with lab-confirmed COVID-19 infections that examined tobacco use history as an exposure and used multivariable analyses. The data was collected between March 31st, 2020, and February 20th, 2021. Outcomes included mortality, hospitalization, ICU admission, mechanical ventilation, and illness severity. Results. Among the 39 …

Implementation Of Client-Centered Care Coordination For Hiv Prevention With Black Men Who Have Sex With Men: Activities, Personnel Costs, And Outcomes—Hptn 073, Darren L. Whitfield, La Ron E. Nelson, Arnošt Komárek, De Anne Turner, Zhao Ni, Donte T. Boyd, Tamara Taggart, S. Raquel Ramos, Leo Wilton, Geetha G. Beauchamp, Lisa Hightow-Weidman, Steven J. Shoptaw, Manya Magnus, Kenneth H. Mayer, Sheldon D. Fields, Darrell P. Wheeler

GW Authored Works

Background: Black men who have sex with men (MSM) experience disproportionate rates of HIV infection in the USA, despite being no more likely to engage in sexual risk behaviors than other MSM racial/ethnic groups. HIV pre-exposure prophylaxis (PrEP) has been shown to reduce risk of HIV acquisition; however, rates of PrEP use among Black MSM remain low. Clinical, psychosocial, and structural factors have been shown to impact PrEP use and adherence among Black MSM. Care coordination of HIV prevention services has the potential to improve PrEP use and adherence for Black MSM, as it has been shown to improve HIV-related …

Assessing Sexual Assault And Harassment At Montclair State University: Research Abstracts, Amanda Birnbaum, Eva Goldfarb, Lisa Lieberman, Stephanie A. Navarro Silvera

Department of Public Health Scholarship and Creative Works

No abstract provided.

Public Health Implications Of Cannabis Legalization: An Exploration Of Adolescent Use And Evidence-Based Interventions, Joseph Donnelly, Michael Young, Brenda Marshall, Michael L. Hecht, Elena Saldutti

Department of Public Health Scholarship and Creative Works

Abstract: This article examines the relaxation of state marijuana laws, changes in adolescent use of marijuana, and implications for drug education. Under federal law, use of marijuana remains illegal. In spite of this federal legislation, as of 1 June 2021, 36 states, four territories and the District of Columbia have enacted medical marijuana laws. There are 17 states, two territories and the District of Columbia that have also passed recreational marijuana laws. One of the concerns regarding the enactment of legislation that has increased access to marijuana is the possibility of increased adolescent use of marijuana. While there are documented …

Don’T Forget To Wash! Water, Sanitation, And Hygiene Among Zambian Students, Katie Schmitz

NUTR/GLST 498b: Global Research Experiences in Nutrition and Health

Introduction: Water, sanitation, and hygiene practices in sub-Saharan Africa, including Zambia, have not met the Millennium Development Goals (MDGs) and remain inadequate to improve the overall health and wellbeing of most populations.

Methods: Survey research, interviews, WASH observations, and anthropometric assessment were conducted between May-June 2022 on 6-7th grade students within 6 Zambian schools.

Results: While hygiene knowledge was prominent, and handwashing stations and pit latrines were available, schools rarely supplied soap or toilet paper. Diarrheal and respiratory diseases were common and water shortages remain problematic with some students traveling long distances to reach a water source.

Discussion: As in …

Dental Decay In Zambian School Children In Eastern And Southern Provinces, Elizabeth Graham

NUTR/GLST 498b: Global Research Experiences in Nutrition and Health

Introduction: Dental caries is the most prevalent and infectious disease worldwide. Zambia has a high rate of vitamin A deficiency, and this deficiency is associated with dental caries.

Methods: Visual dental checks, interviewing, and anthropometric assessments were done on 781 Zambian primary school children.

Results: Caries rates are 20% among sample populations, males have more decay than females, first molars are the most decayed, a majority use toothbrushes to clean their teeth, and children who eat vitamin A rich foods are less likely to have dental caries.

Discussion: Caries’ rates in the Southern and Eastern provinces are higher than in …

The Impact Of Expanded Tele-Mental Health On Quality-Of-Care Indicators: A Three-Pronged Regression Analysis At Los Angeles County’S Department Of Mental Health, Ami Bhatt

CGU Theses & Dissertations

Background: The use of Tele-Mental Health (TMH) skyrocketed after the COVID-19 pandemic led to the announcement of a public health emergency in March 2020. This rise coincided with soaring rates of mental health issues and increasing demand for accessible and sustainable treatment, all while meeting physical distancing requirements. TMH use is theorized to improve timely access to care and provide opportunities to improve quality of care indicators in individuals and at the health systems level. Research Question: How has the widespread adoption of Tele-Mental Health changed quality of care (QoC) indicators among patients of LA County Department of Mental Health’s …

The Influence Of Race And Ethnicity On The Prevalence Of Social Stigma For People With Type 1 Diabetes Mellitus, Donielle Hyde

Walden Dissertations and Doctoral Studies

Various studies attempting to evaluate the prevalence of health-related social stigma in people with type 1 diabetes mellitus (T1DM) identified themes that coincide with increased prevalence including anxiety, low self-esteem, depression, fear of judgement, anger, and feeling ashamed. This phenomenon is believed to be due to the lack of knowledge and understanding about the differences between the diagnosis, treatment, and prevention strategies for T1DM and type 2 diabetes mellitus (T2DM). The Resilient, Empowered, Active Living intervention dataset (n=115) was utilized to further examine this phenomenon by determining whether race and ethnicity influence the prevalence of the following health-related social stigma …

Healing Through Mother Earth, Taylor A. Russell

Dance (MFA) Theses

This thesis deals with mental health, with a focus on Black women. Historically, Black women are often so compromised, being constant caregivers and helping everyone else, that they forget to help themselves, not having the time and financial means to do so. If we go back in the time of slavery, many Black women were taking care of slave owners' children and suckling the white women’s babies instead of their own. By the time they got home and after diligently caring for other people’s children they were focused on their own children, who they had been away from for hours …

The Interaction Of Children Living In Single-Parent Households With Healthcare In Tennessee, Molly Balcer

Scholarship in Medicine - All Papers

The objective of this paper is to examine how a child living in a single-parent home is able to interact with healthcare in the state of Tennessee in 2020. Family structure in the United States trends away from the nuclear family, with 32% of households containing children headed by single-parents in 2018 as recorded by the United States Census Bureau. Given the knowledge that children in single-parent families are at higher risk for unmet healthcare needs, it is prudent to determine whether these trends are mirrored in Tennessee. Tests of statistical analysis were conducted on publicly available data collected from …

Factors Affecting The Rates Of Childhood Poverty In Tennessee, Aleeya F. Shareef

Scholarship in Medicine - All Papers

Objective: The goal of this investigation is to analyze data to determine the factors that influence childhood poverty in Tennessee. Specifically, I am examining how child poverty has changed over the past years, as well as determining its associations with residential segregation (Black/white), food insecurity, teen births, low birthweights, child and infant mortalities, drug overdose deaths, access to healthy foods, premature deaths, and uninsured children. Data was used from the County Health Rankings website. Their data has been collected from surveys. Paired t-tests, unpaired t-tests, Pearson correlations, and stepwise linear regressions were performed. Results indicated that Tennessee has had decreased …

Relationship Between Poverty And Ed Visit Rate (Per 10,000) With Primary Diagnosis Of Asthma Amongst Ohio Counties, Emily Schneider

Scholarship in Medicine - All Papers

Objective: Previous literature have found mixed results regarding poverty as a risk factor for asthma prevalence. More recently, national data obtained from Medicaid has shown that there is no association between poverty and asthma prevalence but has shown an association with asthma-related Emergency Department (ED) visits and hospitalizations. The objective of this study is to determine if this relationship is evident amongst the 88 counties in Ohio. Methods: Pearson correlations were conducted with the following variables: percent in poverty under age 18 and the ED visit rate with a primary diagnosis of asthma amongst children in each Ohio county. This …

Association Of Health Literacy And Provider Education With Knowledge Of Breast And Cervical Cancer Screening In An Underserved Female Population, Mallory Gandy, Karly A. Meyer, Jennifer Liu, Jenenne Geske

EMET Projects

No abstract provided.

The Impact Of Covid-19 On Collaboration And Turnover Among State Health Leadership, Kaylee Gouge

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background/Objectives: State Health Officials (SHOs), the physician-leaders of state public health departments in the US, have long been indicated as potential peacemakers between the fields of medicine and public health. However, the average term length of SHOs has declined in recent years. Meanwhile, the COVID-19 pandemic has increased public visibility of state public health departments and their leadership. Some have hypothesized that the political strain of the pandemic has further accelerated SHO turnover, compromising their leadership efficacy. Contrarily, others have suggested that the pandemic would force public health and organized medicine into closer collaborative alignment through a common enemy. …

Fully Automated Life Support Training Effects On Inpatient, Cardiac Arrest Survival Rates, Adessa D. Goss

Walden Dissertations and Doctoral Studies

In the United States, more than 200,000 adult patients die annually from inpatient cardiac arrest with survival rates stagnated at 22%–25% nationally. Recently, the adoption of fully automated life support training modalities by health care organizations has become widespread with limited literature available showing the effects on inpatient, cardiac arrest survival. The purpose of this quantitative study was to investigate the effects of fully automated life support training on inpatient, cardiac arrest survival. Applying Bloom’s mastery learning theory, the impact of the Resuscitation Quality Improvement (RQI) quarterly training and hospital unit compliance on inpatient cardiac arrest return of spontaneous circulation …

Social Distance Compliance And Perceived Importance Of Online Youtube Diabetes Prevention Programs, Bettyann Rogers

Walden Dissertations and Doctoral Studies

This quantitative, nonexperimental survey was designed using a five-point Likert scale to measure the differences in the perceived importance scores for enrollment practices into nationally accredited YouTube diabetes prevention programs, or YouTube DPP, among online U.S. adult participants during the COVID-19 pandemic based on the social cognitive framework and was validated with Cronbach’s alpha. G* Power analysis for alpha level = 0.05, standard power = 0.08, and the effect size = 0.25 was calculated for a target population of over 100,000. Responses (i.e., N = 258) from the COVID-19 Blood Sugar Wellness Survey were uploaded from SurveyMonkey. The perceived important …

Factors Associated With Nonmedical Prescription Opioid Use And Prescription Opioid Misuse Among Rural Americans, Brittany Cox

Walden Dissertations and Doctoral Studies

Opioid misuse is a rapidly evolving health epidemic in the United States, leading to opioid use disorders, overdose deaths, and disparities in treatment. The rural population may be more susceptible given socioeconomic status, less educational attainment, and lower income. The impact on specific populations is not well understood. The purpose of this study was to identify the association of nonmedical prescription opioid use (NPOU), prescription opioid misuse (POM), and treatment-seeking with race, age, sex, education, and insurance status among rural Americans. The social-ecological model (SEM) served as the theoretical framework. The SEM described the interplay between individual, relationship, community, and …

Five-Year Cervical Cancer Survival Rates By Stage At Diagnosis, Race, And Place Of Residence In Georgia, Usa, Layal Mansour

Walden Dissertations and Doctoral Studies

Despite breakthroughs and improvement in cervical cancer (cercancer) management strategies over the years, racial and geographical disparities on 5-year relative survival rates (RSRs) persist. Studies showed black women have higher mortality rates than white women with the majority of deaths occurring among women above age 45. The aim of this cross-sectional study was to investigate the predicting abilities of race and residence on 5-year RSRs by stage at diagnosis and the potential effect on survival probability in the early stage of cercancer for women above 45 years living in Georgia. Anderson's behavioral model for inequalities in healthcare was the theoretical …