Public Health Commons^™

Structural Barriers To Health Care Access And Ipv Disclosure In First-Generation Latina Immigrants, Donna L. Schminkey, Deborah Elkins, Karen Jagiello, Sandra Annan, Jamie Robinson, Erika Metzler Sawin

Virginia Journal of Public Health

Background: This study aimed to describe the unique structural barriers faced by Latina women in rural areas of Virginia as they attempt to access the health care system, and, once they have gained access, to identify barriers to intimate partner violence (IPV) disclosure.

Methods: Semi-structured in-depth individual interviews with first-generation Latina immigrants were conducted after initial purposeful convenience sampling and concomitant snowball recruiting. A thematic content analysis using a phenomenological approach was employed to interpret participants' experiences. Initial findings were validated through additional interviews.

Results: The overarching theme expressed by these women was their search for dignity. Emergent sub-themes related …

Vaccine Uptake In The Era Of Covid-19: Associations Between Willingness To Receive The Influenza And Covid-19 Vaccines, Mutaz Alkalbani, Ritsa Frousios, Matilda Francis, Yousef Beidas, Jennifer Ryal, Brynn Sheehan

Virginia Journal of Public Health

Background/purpose. Despite efforts to increase flu vaccine uptake, the rate of vaccination remains below target. Additionally, many Virginians remain unvaccinated or have not maintained a booster schedule in line with recommendations. The current study investigated willingness to receive the flu and COVID-19 vaccines during the COVID-19 pandemic, associations between the likelihood of receiving the two vaccines, and differences in uptake by racial group and insurance status. Methods. Participants were adult patients seen for appointments at an ambulatory clinic in Southeast, VA. Participants completed a questionnaire assessing vaccination history and future vaccination intentions. Results. Results revealed significant associations between having received …

Policy Forum: The Tobacco Surcharge & Sugar-Sweetened Beverage Taxes: Reconciling Equity And Targeted Public Health Interventions, Ben Barber

Virginia Journal of Public Health

Virginia is poised to repeal the tobacco surcharge, an ineffective policy that disproportionately harms low- and middle-income Virginians. (Small, 2023) The Patient Protection and Affordable Care Act (ACA), which otherwise strengthened health care access and equity, allows health insurers in the individual and small-group markets to charge smokers up to 50 percent higher premiums relative to nonsmokers. (ACA, 2010) The law’s financial assistance does not apply to this surcharge, forcing enrollees to bear the entire cost of the penalty. This provision was a compromise between the ACA’s drafters, most of whom opposed the surcharge, and the health insurance industry, which …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

Development And Validation Protocol For An Instrument To Measure Household Water Insecurity Across Cultures And Ecologies: The Household Water Insecurity Experiences (Hwise) Scale, Sera L. Young, Shalean M. Collins, Godfred O. Boateng, Torsten B. Neilands, Zeina Jamaluddine, Joshua D. Miller, Alexander A. Brewis, Edward A. Frongillo Jr., Wendy E. Jepson, Hugo Melgar-Quiñonez, Roseanna C. Schuster, Justin B. Stoler, Amber Wuitch, Hwise Research Coordination Network

Faculty Publications

Introduction A wide range of water-related problems contribute to the global burden of disease. Despite the many plausible consequences for health and well-being, there is no validated tool to measure individual- or household-level water insecurity equivalently across varying cultural and ecological settings. Accordingly, we are developing the Household Water Insecurity Experiences (HWISE) Scale to measure household-level water insecurity in multiple contexts.

Methods and analysis After domain specification and item development, items were assessed for both content and face validity. Retained items are being asked in surveys in 28 sites globally in which water-related problems have been reported (eg, shortages, excess …

An Examination Of Dyadic Diabetes Self-Management Education For Patients And Care Partners: A Scoping Review, Jessica L. Tucker

Honors Theses

Diabetes self-management education and support (DSMES) programs are crucial in equipping individuals with the necessary knowledge and skills. Involving care partners in diabetes management acknowledges that it is a collaborative effort within a social context, emphasizing the importance of integrating care partners into educational interventions. This approach offers benefits like emotional and practical support, shared responsibility in managing diabetes, enhanced treatment adherence, and improved communication.

To understand this concept better, this review's objectives are defining dyadic relationships, exploring implementation logistics, and assessing program outcomes and limitations to inform future research and program development.

This study revealed inconsistent terminology and definitions …

Ethical Considerations Of Clinical Research In Emergency Care Settings: A Review, Adith Velavan

Honors Scholar Theses

Emergency and acute care settings are some of the most volatile and high intensity areas of any healthcare operation. Better understanding of systems and treatments in these spaces are critical to improving outcomes for the high risk patients that are treated there. Clinical research serves as a cornerstone of modern medical research, and is critical to the further improvement of clinical care in these settings. This thesis serves to explore the ethicality of such research given the constraints of emergency medicine settings. Not only does this thesis provide a strong foundation regarding the history and current practices of clinical research, …

Medical Interpreters' Work Impact On Their Lives: Understanding Medical Interpreters' Work Experience, Nicholas M. Herrarte Smith

Senior Honors Projects, 2020-current

Medical interpreters in the US are crucial health workers that specialize in facilitating communication between non-English-speaking patients and English medical professionals. Although much research has been done regarding the positive impact of professional medical interpreters on LEP (limited English proficient) patients' health, it is less known how medical interpreters’ lives are impacted in this line of work. Thus, this study was aimed at gaining a better understanding on the impact that this line of work has on the lives of medical interpreters. For this study, a survey was created with questions regarding demographics, interpretation’s certification process, interpreter’s satisfaction/experience, and mental …

Case Study: Lead Contamination In Soil And Plants Of A Metro Atlanta Home, Jaci Carithers, Samantha Gowen, Farmaan Judge, Brian Matayoshi

Research Day

INTRODUCTION: Lead contamination in housing developments of the Metro Atlanta Area has prompted the US Environmental Protection Agency (EPA) to establish the Westside Lead Superfund Site for soil and plant remediation efforts. As a result, affected residents have to review their own health and wellness in a different perspective due to the possibility of having lead contamination. No quantity of lead is considered safe in the human body, especially since it is known to compete with the functionality of calcium in many vital biological processes. Manufacturing and disposal procedures in lead-based industries have contributed to lead contamination of soil and …

The Impact Of The Deinstitutionalization Policies On Homelessness, Henrique Krigner

Helm's School of Government Conference - 2021-2024

Homelessness is a growing issue in America. In 2019 there were 567,715 homeless individuals in the United States, distributed in emergency shelters (63%) or residing unsheltered on streets (27%). In 2021, even though specialists argue that the Covid-19 restrictions greatly harmed an accurate counting, the total number of unsheltered homeless in America increased in 20%. Such increase became a central discussion not only to regular citizens and neighborhood associations, but it also became a great concern within the federal government which has been appropriating billions of dollars each year to “end homeless”.

Specialists point out that the growth of the …

Drug Ideologies Of The United States, Macy Montgomery

Helm's School of Government Conference - 2021-2024

The United States has been increasingly creating lenient drug policies. Seventeen states and Washington, the District of Columbia, legalized marijuana, and Oregon decriminalized certain drugs, including methamphetamine, heroin, and cocaine. The medical community has proven that drugs, including marijuana, have myriad adverse health side effects. This leads to two questions: Why does the United States government continue to create lenient drug policies, and what reasons do citizens give for legalizing drugs when the medical community has proven them harmful? The paper hypothesizes that the disadvantages of drug legalization outweigh its benefits because of the numerous harms it causes, such as …

Possible Role Of Caffeine In Nicotine Use Onset Among Early Adolescents: Evidence From The Young Mountaineer Health Study Cohort, Alfgeir L. Kristjansson, Steven M. Kogan, Michael J. Mann, Megan L. Smith, Christa L. Lilly, Jack E. James

Public and Population Health Faculty Publications and Presentations

Background

Preventing nicotine use onset among children and youth is an important public health goal. One possible contributor that has received little empirical investigation is caffeine use. The goal of this study was to examine the possible contribution of caffeine to nicotine onset during early adolescence.

Methods

We used data from the Young Mountaineer Health Study Cohort. Survey data were collected from 1,349 (response rate: 80.7%) 6^th grade students (mean age at baseline 11.5 years) in 20 middle schools in West Virginia during the fall of 2020 and spring of 2021. We limited our analyses to students reporting never …

Human Trafficking And Nutrition: Assessing The Effects Of U.S. Public Policy On Food Security And The Malnourishment Of Refugees, Moxie R. Mccandless

Honors Projects

This research paper aims to assess the challenges associated with human trafficking within the lived experience of refugees, specifically focusing on food security, and the resulting system shaped by existing United States policies and programs. By examining this complex relationship, the study seeks to shed light on the influence of power dynamics on fulfilling basic human needs and to propose more effective strategies for improving food security among marginalized populations.

A comprehensive literature review is conducted, and a community nutrition needs assessment is performed in King County, Washington. Qualitative interviews are conducted with human trafficked organizations, government officials, and experts …

Enhancing Rural Capacity For Contraceptive Provision Through Training, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Resources

No abstract provided.

Health Professional Well-Being And Preparedness During The Covid-19 Pandemic In Trinidad And Tobago: An Online Survey, Loren De Freitas, Darren Dookeeram, Shastri Motilal

Journal of Wellness

Introduction: Poor well-being impacts mental health and subsequently affects personal lives, leads to absenteeism, poor productivity, and compromised patient safety. Frontline healthcare workers are highly vulnerable to COVID-19 pandemic-related mental health strain. This study assessed the well-being and preparedness of frontline healthcare workers in Trinidad and Tobago during the pandemic.

Methods: An online cross-sectional survey was sent to doctors, nurses, and prehospital providers from public and private healthcare sectors. Data was collected from May to June 2020 utilizing a self- administered online platform. The WHO Five Well-being Index (WHO-5) was used to assess well-being. Raw scores less than 13 indicated …

Developing A Management And Finance Training For Future Public Health Leaders, Kristy T. Hayes, Harry J. Heiman, Peggy A. Honoré

School of Public Health Faculty Publications

Public health leaders are increasingly being asked to address adaptive challenges in the context of finite and often limited resources. Budgets and their associated resources create the financial framework within which public health agencies and organizations must operate. Yet, many public health professionals expected to undertake roles requiring this foundational knowledge and skills are not trained in the fundamentals of public finance and are ill-equipped for managing and monitoring funds. Graduate courses in schools of public health most often are focused on health care management and finance or private sector finance. To meet the needs of future public health leaders, …

Factors Affecting Initiation And Retention Of Medication-Assisted Recovery (Mar) Within A Pilot Pharmacist-Involved Practice Model At A Federally Qualified Healthcare Center (Fqhc) During The Covid-19 Pandemic, Tiffany Nguyen, Thomas Craig Cheetham, Souhiela Fawaz, Richard Beuttler, Sharon Xavioer

Pharmacy Faculty Articles and Research

Background: During the COVID-19 pandemic, opioid-related overdose deaths increased. Although Medication-Assisted Treatment or Recovery (MAT or MAR) is available, initiation and retention rates vary. The goal of this study was to evaluate clinical, demographic, and Social Determinant of Health factors affecting MAR initiation, on-time initiation of medications, and successful retention in the program. The secondary goal was to evaluate the impact of a novel interprofessional practice model incorporating pharmacists. Methods: A retrospective analysis was conducted using electronic health record data from a pilot MAR Program initiated within a California Federally Qualified Healthcare Center. Results: From September 2019 to August 2020, …

Co-Clinical Imaging Metadata Information (Cimi) For Cancer Research To Promote Open Science, Standardization, And Reproducibility In Preclinical Imaging, Stephen M Moore, James D Quirk, Andrew W Lassiter, Richard Laforest, Gregory D Ayers, Cristian T Badea, Andriy Y Fedorov, Paul E Kinahan, Matthew Holbrook, Peder E Z Larson, Renuka Sriram, Thomas L Chenevert, Dariya Malyarenko, John Kurhanewicz, A Mcgarry Houghton, Brian D Ross, Stephen Pickup, James C Gee, Rong Zhou, Seth T Gammon, Henry Charles Manning, Raheleh Roudi, Heike E Daldrup-Link, Michael T Lewis, Daniel L Rubin, Thomas E Yankeelov, Kooresh I Shoghi

Faculty, Staff and Students Publications

Preclinical imaging is a critical component in translational research with significant complexities in workflow and site differences in deployment. Importantly, the National Cancer Institute's (NCI) precision medicine initiative emphasizes the use of translational co-clinical oncology models to address the biological and molecular bases of cancer prevention and treatment. The use of oncology models, such as patient-derived tumor xenografts (PDX) and genetically engineered mouse models (GEMMs), has ushered in an era of co-clinical trials by which preclinical studies can inform clinical trials and protocols, thus bridging the translational divide in cancer research. Similarly, preclinical imaging fills a translational gap as an …

Home Oxygen And Monitoring For Covid-19 Patients: A Multidisciplinary Team Approach, Mahta Salehi, Shehrose Chaudry, Rebecca B. Newman, Josette Hartnett, Suzanne J. Rose, Forugh Homayounrooz

Journal of Community Hospital Internal Medicine Perspectives

Introduction: During the initial COVID-19 pandemic peak, Stamford Hospital implemented a home oxygen program (HOP) to create a comprehensive, multi-disciplinary outpatient initiative without sacrificing a safe discharge. Primary care physicians monitored program participants, whose only indication for remaining admitted was an oxygen requirement. We retrospectively examined participant co-morbidities and outcomes, including death and readmission rates to evaluate HOP safety.

Methods: A retrospective analysis of program participants discharged between April 2020-Janurary 2021 was performed. Variables included demographics, oxygen requirement, days enrolled in the HOP, and major comorbidities such as cardiovascular disease (CVD), diabetes (DM), hypertension (HTN), obesity, chronic kidney disease, malignancies …

How Medical Cannabis Took Root In Mississippi, Loral Winn

Honors Theses

How Medical Cannabis Took Root in Mississippi

(Under the direction of Dr. Iveta Imre)

How Medical Cannabis Took Root in Mississippi is a multimedia journalism piece that follows the timeline of medical cannabis’ legalization in Mississippi through the lives and lenses of characters from each sector of the medical marijuana industry. Written in a journalistic style with hints of narrative methods, the article tells the story of medical cannabis advocates, current patients, state registered practitioners, dispensary owners and employees, and a family-owned cultivation facility while also providing concrete evidence and facts about the legislation and regulations included in the state’s …

Physician Views On The Provision Of Information On Immune Checkpoint Inhibitor Therapy To Patients With Cancer And Pre-Existing Autoimmune Disease: A Qualitative Study, Maria A Lopez-Olivo, Gabrielle F Duhon, Juan I Ruiz, Mehmet Altan, Hussein Tawbi, Adi Diab, Clifton O Bingham, Cassandra Calabrese, Natalia I Heredia, Robert J Volk, Maria E Suarez-Almazor

Faculty, Staff and Student Publications

Immune checkpoint inhibitors (ICIs) have improved cancer outcomes but can cause severe immune-related adverse events (irAEs) and flares of autoimmune conditions in cancer patients with pre-existing autoimmune disease. The objective of this study was to identify the information physicians perceived as most useful for these patients when discussing treatment initiation with ICIs. Twenty physicians at a cancer institution with experience in the treatment of irAEs were interviewed. Qualitative thematic analysis was performed to organize and interpret data. The physicians were 11 medical oncologists and 9 non-oncology specialists. The following themes were identified: (1) current methods used by physicians to provide …

Balancing Functional Tradeoffs Between Protein Stability And Ace2 Binding In The Sars-Cov-2 Omicron Ba.2, Ba.2.75 And Xbb Lineages: Dynamics-Based Network Models Reveal Epistatic Effects Modulating Compensatory Dynamic And Energetic Changes, Gennady M. Verkhivker, Mohammed Alshahrani, Grace Gupta

Mathematics, Physics, and Computer Science Faculty Articles and Research

Evolutionary and functional studies suggested that the emergence of the Omicron variants can be determined by multiple fitness trade-offs including the immune escape, binding affinity for ACE2, conformational plasticity, protein stability and allosteric modulation. In this study, we systematically characterize conformational dynamics, structural stability and binding affinities of the SARS-CoV-2 Spike Omicron complexes with the host receptor ACE2 for BA.2, BA.2.75, XBB.1 and XBB.1.5 variants. We combined multiscale molecular simulations and dynamic analysis of allosteric interactions together with the ensemble-based mutational scanning of the protein residues and network modeling of epistatic interactions. This multifaceted computational study characterized molecular mechanisms and …

Calculating Risk: A Scoping Review Of Ncaa D1 Football Players’ Motivations To Play And The Correlation To Demographic Characteristics And Injury Experiences, Kathleen D. Walsh

Honors Theses

The purpose of this research was to investigate the motivations of National Collegiate Athletic Association (NCAA) Division 1 (D1) football players for playing the game and how these motivations are associated with their socioeconomic status (SES). Further, the research aimed to investigate how the uncovered motivations were linked to injury experiences. The original project was designed as a survey-based mixed methods study on a national scale. However, issues with participant recruitment led to sidelining of that primary research. The research presented is a scoping review of the available literature pertaining to the research question: What is known from existing literature …

The Impact Of Minority Physician Representation On Minority Patient Health, Nicholas Bohannon, Emeka Ikeakanam, Evan Curry, D'Angelo Stokes, Jordan Howard, Terrence Mchugh, Jason Walker

Research Day

Background:

Before the COVID-19 pandemic, the medical profession underwent a physician burnout crisis. Post pandemic, physician burnout transformed into an epidemic that has contributed to the inability of physician supply to meet patient demand in the USA. Recent studies by the American Medical Association predict by 2034, a widespread physician shortage across both primary care and non-primary care specialties (AAMC, 2021). As a result, medical institutions have implemented programs to address this shortage. While this shortage is concerning and needs to be addressed, it isn’t the only shortage at hand. Minorities are deeply underrepresented in the medical field with respect …

Opioid Overdose: Rural Georgia Vs. Urban Georgia - Who's Winning The Battle?, Zizah-Wosseni Blair, Justice Dove, Didem Aydin, Stacie Fairley

Research Day

INTRODUCTION: The opioid crisis is a major public health issue affecting communities across the United States, including Georgia. The widespread misuse of prescription and illicit opioids has led to a significant increase in opioid-related overdoses and deaths. The impact on Georgia communities has been devastating, affecting individuals from all walks of life and causing significant harm to families and communities. The Georgia Department of Public Health reported that the number of drug overdose deaths in the state rose by 61.9% from 2019 to 2021. Rural and Urban communities in Georgia face unique challenges in addressing this epidemic. Rural communities often …

Rural And Urban Caregiver Experiences Of Financial Strain And Food Insecurity During Pediatric Hospitalizations, Rachel E. Granberg

Research Days

Background: Stress is common among caregivers of hospitalized children. In addition to stress related to their child’s illness, caregivers experience stress related to financial strain and food insecurity during their child’s hospitalization. The burden of financial strain and food insecurity related to pediatric hospitalizations may vary between rural and urban populations.

Objectives/Goal: To identify financial strain and food insecurity experienced by caregivers of hospitalized children and to describe differences between rural and urban populations.

Methods/Design: A prospective cross-sectional survey enrolled a random sample of caregivers of hospitalized children between 8/31/2021 and 12/2/2022 at a single children’s hospital. Demographic information was …

Understanding Home Visitor Attendance At Well Child Checks: A Mixed Methods Study, Rachel Segal, Sommer Rose, Marcia Dutcher, Tyler Myroniuk, Mary Moffatt, James Anderst

Research Days

Background: Early childhood home visiting programs have variable outcomes on child health across models and studies. Given this variability, novel approaches are needed to foster consistent positive outcomes. One approach is attendance of a home visitor (HV) at medical provider well child checks (WCCs) to provide a stronger link between home visiting and the medical home. This process may be assessed in an exploratory study evaluating the qualitative perceptions and initial quantitative effects of the intervention.

Objectives/Goal: Qualitatively explore perspectives of HVs attending WCCs and quantitatively evaluate effects of the practice on (1) family compliance with American Academy of Pediatrics …

Nothing About Youth Without Youth: Involving Youth In Participatory Action Research Conducted With Health Departments, Vivian Cortes

Dissertations and Theses

Background: Health departments are vital to community-partnered public health efforts and research and are positioned to influence community or policy level systems that impact population health. However, while some health departments partner with community members in their programming, not much is known about health departments partnering with community youth. From 2018-2019 the New York City Department of Health & Mental Hygiene (NYC DOHMH) implemented a youth participatory action research (YPAR) project to develop a public awareness campaign in partnership with youth and adult community stakeholders for a federally funded program. It was the first participatory research conducted by the agency …

Small Community Water Systems Have The Highest Prevalence Of Mn In Drinking Water In California, Usa, Miranda Aiken, Samantha C. Ying

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Manganese (Mn) is currently regulated as a secondary contaminant in California, USA; however, recent revisions of the World Health Organization drinking water guidelines have increased regulatory attention of Mn in drinking water due to increasing reports of neurotoxic effects in infants and children. In this study, Mn concentrations reported to California’s Safe Drinking Water Information System were used to estimate the potentially exposed population within California based on system size. We estimate that between 2011 and 2021, over 525,000 users in areas with reported Mn data are potentially exposed to Mn concentrations exceeding the WHO health-based guideline (80 μg L …

The Black Progress Index In Mountain West Metropolitan Statistical Areas (Msas), Zachary Billot, Caitlin J. Saladino, William E. Brown Jr.

Demography

This fact sheet examines data from the Brookings Institution report, “Black Progress Index: Examining Social Factors That Influence Black Well-Being” authored by Andre Perry and Jonathan Rothwell in September 2022. The Black Progress Index (BPI) score is constructed using data and social factors that impact life expectancy for Black Americans. This fact sheet compares the BPI with the actual life expectancy of Black people in Mountain West metropolitan statistical areas (MSAs). This fact sheet also examines each of the 13 variables included in the original report to present the BPI in the Las Vegas-Henderson-Paradise, NV MSA.