Public Health Commons^™

Patient Experience Study: Healthy Birth Initiatives & Providence, Monique Gill, Ritu Ghosal, Maggie M Hodges, Lindsay Dickey, Roberta Hunte

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No abstract provided.

Inequalities And Impacts On Poverty Incidence Of Tobacco, Alcohol, And Health Out-Of-Pocket Expenditures In The Philippines, 2012–2018, Nel Jason Haw

Health Sciences Faculty Publications

The Philippines increased taxes for tobacco and alcohol products and expanded population coverage under the national social health insurance scheme from 2012 to 2018. This paper examines inequalities in tobacco, alcohol, and health out-of-pocket (OOP) expenditures in the Philippines using the Family Income and Expenditure Survey 2012, 2015, and 2018. Fewer households reported spending on tobacco and alcohol, and the amount decreased among poor households over time, resulting in a decrease in impoverishment. Tobacco and alcohol spending was regressive, with the magnitude of regressivity decreasing between 2015 and 2018. Health OOP expenditures decreased between 2015 and 2018, with the magnitude …

Demographic Factors In Adult Low-Grade Glioma Survival: A Seer Study, Mathew Krick

Public Health Theses

PURPOSE: It is unclear what role sociodemographic predictors have on the subtype-specific survival patterns of patients with low-grade gliomas. Understanding these effects may help guide and improve public health intervention strategies for patients with this relatively rare, understudied condition. METHODS: Using the Surveillance, Epidemiology, and End Results Program, we identified adult cases (aged 20-79 years) diagnosed with a World Health Organization Central Nervous System grade II supratentorial astrocytoma, oligodendroglioma, or mixed glioma between 1975-2019. Kaplan-Meier estimates and multivariable Cox models were utilized to assess factors associated with survival. RESULTS: The final cohort included 4,684 adult grade II glioma cases with …

What Impact Does The Ability To Access Healthcare Have On Maternal Outcomes In Africa?, Helena Harris

Nursing | Senior Theses

Background: Maternal mortality rates reflect health inequities in access to obstetric care in some parts of the world including many African countries. Geographical barriers and limited number of skilled human resources have put women in rural areas at a significantly higher risk of maternal mortality.

Research Question: What impact does the ability to access healthcare have on maternal outcomes in African rural areas compared to urban cities?

Methods: A literature review was performed of credible databases. Six articles were reviewed extensively highlighting the purpose, strengths, and limitations of each study. Refer to Appendix A for the literature review table.

Findings: …

Assessment Of Appropriate Antibiotic Usage After Intervention To Increase Antibiotic Stewardship In A Rural Health Care Setting, Mayci Mccloud Speights

Doctoral Projects

Antibiotics are a powerful and useful tool prescribed by healthcare providers to treat bacterial infections in patients. However, when antibiotics are unnecessarily prescribed or improperly consumed or not consumed by patients, antimicrobial resistance (AMR) can ensue. Antibiotic resistance (ABR) is an urgent public health threat and is, unfortunately, the root cause of many deaths in the United States every year. According to the Centers for Disease Control (CDC), in the United States, more than 2.8 million antimicrobial-resistant infections occur each year, and more than 35,000 people die as a result (Centers for Disease Control [CDC], 2022a). Even further, when infections …

Studying The Impact Of Hyperlipidemia Monitoring Tools On Referral Rates In Patients Taking Antipsychotics, Jasmyn S. Allen

Doctoral Projects

The purpose of this DNP project is to determine how well an evaluation tool may be used to track hyperlipidemia in patients using antipsychotic medicines who are between the ages of 20 and 50. Elevated lipid contents in the bloodstream, or hyperlipidemia, increase the danger of heart-related illnesses. Antipsychotic drugs, frequently administered for mental health disorders and dyslipidemia, have been connected. The goal is to ascertain whether utilizing an evaluation tool raises the three-month referral rates for hyperlipidemia to primary care (Dayabandara et al., 2017). The foundation of the research is found in several articles collected from different websites. According …

Identifying Barriers To Dental Care Among Hispanics In Southwest Minnesota, Lissette Garza

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to assess the different barriers for dental health care among the Hispanic population in a rural, southwestern community in Minnesota. To collect data, an adaptation of the survey written by Vazquez and Swan (2003) was distributed to Hispanic individuals at an agricultural facility, religious organization, and an early childhood organization. The findings for the research question are presented in the cross-sectional study utilizing descriptive statistics in the form of frequencies and percentages. The results of this study indicate that not having a dental provider of the same cultural background, having a language barrier, and …

Validation Of The Occupational Depression Inventory In Sweden, Markus Jansson-Fröjmark, Farzaneh Badinlou, Tobias Lundgren, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Background The Occupational Depression Inventory (ODI) was recently devised to assess depressive symptoms that individuals specifically attribute to their work. One purpose of the ODI is to overcome limitations in current assessments of job-related distress. This study aimed to validate the Swedish version of the ODI.

Methods The study involved 365 individuals employed in Sweden. In addition to the ODI, the study included the Satisfaction with Life Scale, the Effort-Reward Imbalance Questionnaire, the Demand-Control-Support Questionnaire, the GAD-2, and the PHQ-9. We inquired into the factorial validity, dimensionality, scalability, test-score reliability, criterion validity, convergent validity, discriminant validity, and measurement invariance of …

Contraception And Healthcare Utilization By Reproductive-Age Women Who Use Drugs In Rural Communities: A Cross-Sectional Survey., Ximena A. Levander, Canyon A. Foot, Sara L. Magnusson, Ryan R. Cook, Jerel M. Ezell, Judith Feinberg, Vivian F. Go, Kathryn E. Lancaster, Elizabeth Salisbury-Afshar, Gordon S. Smith, Ryan P. Westergaard, April M. Young, Judith I. Tsui, P. Todd Korthuis

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: Women who use drugs (WWUD) have low rates of contraceptive use and high rates of unintended pregnancy. Drug use is common among women in rural U.S. communities, with limited data on how they utilize reproductive, substance use disorder (SUD), and healthcare services.

OBJECTIVE: We determined contraceptive use prevalence among WWUD in rural communities then compared estimates to women from similar rural areas. We investigated characteristics of those using contraceptives, and associations between contraceptive use and SUD treatment, healthcare utilization, and substance use.

DESIGN: Rural Opioids Initiative (ROI) - cross-sectional survey using respondent-driven sampling (RDS) involving eight rural U.S. regions …

Who’S Hangry?: Food Insecurity And Psychosocial Adjustment In D.C. Teens, Robert Price, Andrea Murillo, David Whittington, Jelani Garrett, Jordan Ray

DC Health and Academic Prep Program (DC HAPP)

About 19,430 children in Washington D.C. experience food insecurity every day (Oliver, 2022). This is equivalent to 1 in 7 children in the area. According to WUSA, a news channel; food insecurity has been proven to lead to grave behavioral and emotional issues that can impair mental health and make it difficult for students to adjust to social situations (WUSA, 2017).We are excited to announce a new program that will help tackle food insecurity in public high schools in wards 7 & 8. The program’s name is DC Creating Overall Optimism in Kids (DC COOKs). The goal is to provide …

Mind Match: A Holistic App-Based Intervention For Post-Pandemic Adolescent Mental Health, Irene Xinyuan Hu, Hoyt King, Samara Lynch, Nyla Thomas

DC Health and Academic Prep Program (DC HAPP)

The global COVID-19 pandemic and subsequent quarantine measures had profound implications for the mental well-being of adolescents. Studies have shown that adolescents who received MRIs post-pandemic demonstrated more severe mental health problems (Gotlib et al, 2021). As of 2021, more than 36% of DC youth who have depression did not receive any mental health care (NAMI, 2021). These statistics underscore the urgent need to address the mental health challenges faced by teenagers, particularly those from underrepresented backgrounds with limited access to mental health services (Mental health disparities: Diverse populations, 2017). In response to the downstream effects of COVID-19 on underrepresented …

Field Days Against Flu Days: Decreasing Missed School Days In The D.C. Metropolitan Area Due To Influenza, Elyana Belete, Evan Bowie, Maria - Carmen Miko, Raymond Weeden

DC Health and Academic Prep Program (DC HAPP)

The World Health Organization (WHO) estimates that about 290,000 to 650,000 people worldwide are affected annually by the flu (WHO, 2023). Children ages 0–17 are more prone to contracting the flu due to increased contact with other individuals in daycare and grade school as they are more likely to put their hands in their mouths and less likely to practice proper hygiene. Additionally, they have less developed immune systems to fight off infections (CDC, 2020). This leads to an increased likelihood of catching an illness that can spread from person to person compared to adults. According to the Morbidity and …

Bugged By Bugs: A Comprehensive Guide To Pest Control, Brandon Runyon

Department of Entomology: Distance Master of Science Projects

This book aims to create a user-friendly guide tocommercial pest control practices covering German cockroaches, bed bugs, odorous house ants, pavement ants, brown recluse spiders, wolf spiders, house flies, and fruit flies. We will address these pests in the following locations: hotels, restaurants, apartments, and offices.

Growing And Sustaining Community Health Workers In Missouri, Jennifer Trott, Jacqueline Baños, Marsha Regenstein

Health Policy and Management Issue Briefs

With funding from the Missouri Foundation for Health, in August 2022 The George Washington University Milken Institute School of Public Health began a 12-month study to assess the Community Health Worker field in Missouri. The resulting report, Growing and Sustaining Community Health Workers in Missouri, provides a landscape of current CHW workforce activity in the state, reviews recent milestones in the development of the profession, and profiles innovative training and practice models being employed in Missouri. The report draws on perspectives about the profession from interviews with 40 individuals from the field, including CHWs and others who supervise or …

Sisyphean Frustrations: The Impetus For Improving Harm Reduction Strategies In Minneapolis, Mn, Jordan Baker

Theses and Graduate Projects

Background: The last decade has seen an alarming rise in deaths attributed to opioid use. Considering the ever-increasing mortality rate contributable to opiate use disorder, it is important to identify and utilize more efficacious public health interventions.

Purpose: The focus of this paper is identifying the current harm reduction strategies being implemented in Minneapolis MN, the history of harm reduction in the US, and opportunities to improve existing systems to better engage current conditions.

Methods: The primary research method for this community assessment was volunteer work with Southside Harm Reduction in Minneapolis, MN. Through community clean-ups the researcher was able …

A Unique Hiv Harm Reduction Perspective From Costa Rica: Hogar De La Esperanza An Ethnographic Case Study And Comparative Examination Of Approach To Hiv Treatment Between The United States And Costa Rica, Kim Marie Day

Theses and Graduate Projects

This case study presents a real, currently operational scenario of harm reduction in action in Costa Rica, focusing on its success and the challenges faced by healthcare professionals, the experiences of those who live at Hogar de la Esperanza, and the implications for healthcare policies and interventions in the United States. By examining this specific case of a Costa Rican community-based HIV treatment model, the aim of this ethnographic report is to shed light on the complexities and factors contributing to the success or failure of harm reduction treatment strategies within the United States and what can be learned by …

Growing Pains: A Needs-Based Assessment Of Aging In Place In The Twin Cities, Emma Burt

Theses and Graduate Projects

Background: As they age, older adults are often forced to change their living environments to accommodate their growing medical and personal needs. However, alternative living options are often less desired and present other challenges. Aging in place is the ability for individuals to choose where they live as they age, prioritizing the aging person’s choice and providing resources to support it. Purpose: The Twin Cities metropolitan area of Minnesota currently has a population of nearly 472,000 older individuals, and it is only continuing to rise. Although infrastructure exists that supports aging in place, not all older individuals get adequate services …

A Systematic Review Of Sodium Intake And Its Impact On Cardiovascular Health: Insights From Costa Rican Studies, Benjamin M. Hillebrand

Theses and Graduate Projects

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide, with dietary sodium intake identified as a critical risk factor. This systematic review comprehensively examines the existing literature on sodium intake and its impact on cardiovascular health in Costa Rica. Fifteen relevant studies were analyzed, revealing concerning patterns of sodium consumption, particularly among youngsters and adolescents, with processed and fast foods being major contributors. High sodium intake was consistently associated with elevated blood pressure, a well-established CVD risk factor. The review also assessed sodium reduction initiatives and strategies, demonstrating the potential benefits of interventions in reducing cardiovascular risk. …

Better Nature: How Nature Improves Our Health And How We Can Use Nature To Do Better, Alyssa K. Snyder

Theses and Graduate Projects

This research paper outlines the salubrious effects of exposure to green spaces and explores how healthcare providers in urban areas can leverage the benefits of green spaces to combat poor health outcomes from the chronic stress of urbanicity, particularly in disadvantaged populations. Focusing on the metropolitan area of Minnesota, this study acknowledges existing barriers and constraints of populations experiencing health inequities while analyzing data on green space accessibility and seeking solutions for those communities, particularly BIPOC and low-income. This paper synthesizes evidence from various studies that establish the positive associations between health and exposure to green spaces, which can also …

Barriers To Hpv Screening And Prevention In Latin America: A Systematic Review, Lauren Rutten

Theses and Graduate Projects

In Latin America, cervical cancer is the second most common female cancer and the fourth most leading cancer of women around the world, with an estimated 342,000 deaths in 2020.1 This systematic review of literature gives insight into Latin Americas barriers to Human Papillomavirus Virus (HPV) screening and prevention. A comprehensive literature review was conducted using google scholar, the WHO, and the CDC. Search terms included: barriers to HPV screening, cervical cancer, Latin America, Central America, Costa Rica, Prevention of HPV, and Human Papillomavirus. Three main barriers to HPV screening and prevention were found including, fear, lack of education, and …

The Benefits And Limitations Of A Clinician Lead Sexual Education Program In Wisconsin Public Schools, Margaret Freiermuth

Theses and Graduate Projects

Background: Abstinence-based sexual education is the primary method of sexual education in public schools.4 The majority of public schools use teachers who may or not have proper training to teach the course. Comprehensive sexual education taught by clinicians could potentially decrease sexual risky behavior in the youth population.

Purpose: Identify potential benefits or limitations to a clinician-led sexual education program in Wisconsin public schools. Methods: Articles 2017 or newer were reviewed utilizing search engines such as PubMed, Google Scholar, and NIH. A Google Forum with 18 questions was sent out to 420 Wisconsin public school administrators. It was open for …

Safety First: Assessing First Aid Educational Needs Of Outdoor Education Participants, Melissa Niemiec

Theses and Graduate Projects

Background: Much of the general population has a lack of first aid knowledge, despite engaging in activities that might end in needing some level of medical care. Even when first aid education is gained, sometimes it is subpar or less relevant to wilderness excursions. In order to create a high quality wilderness first aid course, it should be interactive and take place in a wilderness setting. Having basic first aid skills increases confidence and reduces anxiety of participants, possibly reducing the rate of injury.

Purpose: This needs assessment sets out to determine the first aid needs and concerns held by …

Improving Minnesota’S Access To Opioid Use Disorder Treatment And Naloxone, Annasha Doane-Ramkhalawon

Theses and Graduate Projects

Background: In 2020, Minnesota recorded 4,920 admissions with associated opioid use for adults 18 years of age and older.1 2021 put Minnesota's Opioid-related overdose mortality number at 1,017 individuals.2 Methadone and Buprenorphine as MOUD is the first line treatment for Opioid Use Disorder and long-time management as the standard of care.3 Naloxone is the drug of choice for opioid reversal and overdose prevention.3

Purpose: This study aims to investigate the barriers that OUD feel when attempting to receive treatment for OUD and access Naloxone. The indication is the number of OUD- related admissions and OUD-related overdose fatalities. In addition, the …

What Do People Affected By Amyotrophic Lateral Sclerosis Want From Health Communications? Evidence From The Als Talk Project, Shelagh K. Genuis, Westerly Luth, Tania M. Bubela, Wendy S. Johnston

Office of the Provost

Introduction/aims: Health communication is central to effective, supportive amyotrophic lateral sclerosis (ALS) clinical care. Guidance for ALS communication is limited, focuses on diagnosis disclosure, and frequently relies on expert consensus and/or reviews. Patient-based evidence is needed to guide ALS health communication. We investigated how the experiences of ALS patients and family caregivers can inform effective communication practices from diagnosis to end-of-life.
Methods: Data were drawn from the ALS Talk Project, an asynchronous, online focus group study. Seven focus groups and five interviews (105 participants) were conducted. Data were qualitatively analyzed using directed content analysis and the constant-comparative approach.
Results: We …

Researching Medical Treatment Assessments From United States Military Veterans Diagnosed With Substance Use Disorder, And Determining Interest In The Matrix Model Of Treatment For Potential Application In Their Treatment Programs, Christopher R. Strunk

Dissertations and Theses

The purpose of this research study is to learn the beliefs and thoughts on the current state of medical treatment provided to United States (US) military Veterans diagnosed with substance use disorder (SUD), and gauge Veterans’ levels of interest and support in the potential application of the Matrix Model of Treatment (MMT) in their healthcare programs. This proposal focused on verifying the Veterans’ interest in the MMT model since the US Department of Veterans Affairs (DVA) does not currently implement this full-spectrum, 16-week treatment system. It is believed interest will be strong enough to merit supporting its consideration with approving …

Hearing Aid Loan Program For Hearing Loss At The End Of Life, M. Courtney Hughes, Diane Schecklong, King Chung

Faculty Articles, Papers, and Other Scholarship

This article describes a hearing aid loan program to provide free amplification devices for patients at the end of life to help them communicate more effectively at this critical time. It includes steps for establishing such a program, addressing challenges, and the role of the informal caregiver throughout the intervention. Healthcare professionals and social workers are encouraged to develop similar programs and use the information here as helpful suggestions to consider for their programs.

Does The Health Literacy Of Spanish Speakers Impact Their Vaccination Decisions?: A Literature Review Of Related Research, Kelly Tran

Honors Undergraduate Theses

Background: The Hispanic community has historically faced high rates of vaccine hesitancy when compared to their non-Hispanic white counterparts. This not only poses a threat to their individual health, but also to their community. In a population that is disproportionately affected by COVID-19 infections, it is critical to address vaccine uptake concerns to control the pandemic and prevent future spread of infections.

Objective: This study aims to explore Spanish speakers' vaccination decisions and to explore whether improving health literacy would be an effective approach in increasing vaccination rates. The secondary objective is to describe the role of physicians in decreasing …

Improving Group B Streptococcus Susceptibility Testing, Sofia Sarduy, Michelle Ozcan

North Florida Division GME Research Day 2023

No abstract provided.

Incrasing The Rate Of Pneumococcal Vaccination In Patients Over 65, Ubaldo Gonzalez Morales, Muna Alhusban, Chelsea Guan, Natalia Cavin, Humeyra Dogan, Liliana Franco Moreira, Ashwini Komarla, Allison Ferrara

North Florida Division GME Research Day 2023

No abstract provided.

The Impact Of Demographic Factors And Language On Stroke Metrics Within The Hca Healthcare System, Henry Yelkin, Glenn Goodwin, Jonghoon Chang, Mchenry Mauger, Erin Marra

East Florida Division GME Research Day 2023

Background: Effective evaluation of stroke symptoms necessitates a comprehensive clinical assessment, influencing the timely administration of tissue plasminogen activator (tPA). This study examines the relationship between patients’ preferred language as well demographic factors and stroke care metrics within the framework of the HCA Healthcare System.

Methods: A retrospective study design was used to examine the national HCA database for all patients admitted to an HCA hospital with a diagnosis of stroke and with a recorded NIH stroke scale (NIHSS) between the years of 2017 and 2022. 37,956 patient visits from 170 HCA hospitals were analyzed to compare stroke metrics including …