Public Health Commons^™

Examining Nationwide Disparities In Managing Critical Limb Threatening Ischemia Among Individuals With Diabetes Mellitus Or End-Stage Kidney Disease By Race And Ethnicity, Daniel Dominguez, Waseem Wahood

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with tables.

Introduction: Critical Limb Threatening Ischemia (CLTI) presents a significant challenge, particularly for individuals with diabetes mellitus (DM) or End-Stage Kidney Disease (ESKD). Healthcare disparities related to race and ethnicity are a pressing concern. This study aims to examine a 16-year trend to assess whether the disparities in managing critical limb-threatening ischemia (CLTI) are diminishing among individuals with diabetes mellitus (DM) or End-Stage Kidney Disease (ESKD).

Methods: The analysis involved an examination of the National Inpatient Sample data from 2005 to 2020, with a focus on hospitalizations related to CLI. Identification of …

Clinical Characteristics Of Covid-19 Waves In The Southeastern United States: A Retrospective Study, Omar Kandah, Robert Sherertz, Richard Duff, Erica Junqueira

South Atlantic Division GME Research Day 2023

No abstract provided.

Illicit Drug Use Patterns In Myrtle Beach, S.C. From 2017-2022, Michelle Fowler, Mark Plexousakis, Meg Riley, Blaine Rourke, Erin Artigiani, Amy Billing, Margaret Hsu, Ebonie Massey, Eric Wish

South Atlantic Division GME Research Day 2023

No abstract provided.

Understanding The Relationship Between Undergraduate Students’ On-Campus Employment Status And Their Reported Sense Of Belonging To The Campus Community Post The Covid-19 Pandemic, Samantha Martinez

CGU Theses & Dissertations

Belonging has been studied for decades with many researchers concluding that humans have an inherent need to belong. Although each person’s level of need to belong differs, it is a deeply rooted human motivation that impacts a person’s feelings, thoughts, and behaviors. Individuals develop a sense of belonging when they feel connected to others. The postsecondary journey allows for unique experiences and opportunities that foster a sense of belonging, which can assist college students to flourish in many aspects of their lives. Research has shown that belonging significantly impacts student well-being and academic achievement, making the topic imperative to continue …

Saftey Of Covid-19 Vaccines In Real World Studies, Khawla Amar Mohamed Gammudi

CGU Theses & Dissertations

Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been present since its outbreak in 2019. Despite global efforts to fully halt its spread, new strains are emerging daily. Various efforts have been undertaken to slow down the infection's spread by implementing different restrictive measures and policies, such as lockdowns, social distancing, and mask-wearing. However, the most effective approach to controlling this disease is through vaccinations (Chen, 2021). Substantial efforts have been dedicated to encouraging people in the United States to receive COVID-19 vaccines and booster doses. As of December 7, 2022, approximately 68.5% of the world's …

Utilizing Translational Research To Identify And Develop Effective Strategies For Operationalizing And Implementing A National Board Health And Wellness Coaching (Nbhwc) Certification Program Within The Non-Profit, Living Your Truth Empowered (Lyte), Rielly Keyser

CGU Theses & Dissertations

Introduction: This dissertation presents a comprehensive study that employs a combined formative and translational research design, alongside a mixed methods approach, to identify and develop strategies for operationalizing and implementing a National Board of Health and Wellness Coaching (NBHWC) certification program within the nonprofit organization Living Your Truth Empowered (LYTE). The research involves evidence-based strategies identification, analysis, and strategic planning to enhance the program's launch and effectiveness, with a particular focus on serving the diverse breast cancer community.

Methods: The study begins with an extensive literature review and the examination of 32 similar programs to identify OPR and IMP strategies. …

Recent Advances In Research And Management Of Human Monkeypox Virus: An Emerging Global Health Threat, Parveen Kumar, Benu Chaudhary, Nishant Yadav, Sushma Devi, Ashutosh Pareek, Sujatha Alla, Fnu Kajal, Behdin Nowrouzi-Kia, Vijay Kumar Chattu, Madan Mohan Gupta

Engineering Management & Systems Engineering Faculty Publications

In 2003, the United States saw an epidemic of monkeypox that was later traced back to rodents of West Africa infected with the monkeypox virus (MPXV). Disease in the United States seemed less severe than the smallpox-like disease in the Democratic Republic of the Congo (DRC). In this study, researchers analyzed data from Central Africa: two distinct MPXV clades were confirmed by sequencing the genomes of MPXV isolates from Western Africa, the United States, and Central Africa. By comparing open reading frames across MPXV clades, scientists can infer which virus proteins might account for the observed variation in pathogenicity in …

Adaptive Evaluation For Systems In Rapid Change Or Sustained Transition: Innovations And Applications Generated From A Community-Based Diabetes Prevention Program During The Covid-19 Pandemic, Amy Kuhn

CGU Theses & Dissertations

Program evaluation is a key part of the life cycle of public health and prevention science projects. But in complex environments or evolving situations, existing evaluation theory faces challenges in successful practical application. Process evaluation can track changes as a program runs, but when a program operates outside of its original design, questions can arise related to fidelity of implementation and interpretation of results. Outcome evaluation often requires a closed system without changes to determine actual effects of a program, but in times of complicated change that isolation can be difficult to achieve or to work around. In practice, systems …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Using Multi-Theory Model To Explain Hiv Screening Behaviors Among College-Aged People, Joshua David Kamimoto

Walden Dissertations and Doctoral Studies

There is a need to examine novel approaches that explain the association between the initiation and sustenance of HIV screening behavior. This quantitative, cross-sectional study was used to examine if the components of the multi-theory model (MTM) of health behavior change can explain the initiation and sustenance of HIV screening behavior among college-aged people. A convenience sample of 151 consenting college-aged people between the ages of 18 and 34 in a western US state completed a self-administered 44-item instrument. Multiple regression analysis was used to assess the correlation between the constructs of the multi-theory model of health behavior change (independent …

Perioperative Nurse Education For Undiagnosed Obstructive Sleep Apnea Screening, Juanita Turnipseed

Walden Dissertations and Doctoral Studies

AbstractApproximately one third of surgical patients have undiagnosed obstructive sleep apnea (OSA), the most common form of sleep disordered breathing, which presents a risk in the perioperative setting. OSA is underdiagnosed and undertreated in the adult population and has an economic impact on limited healthcare resources. The need existed for nurses in the perioperative setting to be educated on OSA, including the introduction of the STOP-BANG screening questionnaire. The analysis, design, development, implementation, and evaluation model of instructional design informed this project. The purpose of this Doctor of Nursing Practice project was to plan, implement, and evaluate a perioperative nurse …

Predictive Effects Of Length Of Treatment And Type Of Dialysis On African Americans’ Quality Of Life, Latoya Benjamin

Walden Dissertations and Doctoral Studies

Individuals on dialysis often face challenges with the management of their health, resulting in low health-related quality of life (HRQOL), but the extent of this impact has not been fully examined. The purpose of this quantitative cross-sectional study was, having accounted for relevant demographic variables such as age, gender, family history, employment status, to examine the effects of length of time for treatment and type of dialysis on HRQOL in African American end-stage renal disease (ESRD) patients. This study was guided by the socioecological model. Secondary data from 2016 to 2021 was obtained from the Chronic Renal Insufficiency Cohort (CRIC) …

Help Seeking Behavior For Mental Health Issues Among College Students At A Southern University, Amanda Brooke Espinoza

Walden Dissertations and Doctoral Studies

The mental health of college students continues to decline, leading to increased suicide rates among young adults. College campuses provide mental health resources; however, many college students do not effectively utilize the resources. This quantitative research study allowed for a deeper understanding of why college students are not using mental health resources on their campus. A non-probability convenience sample was used. This sample of convenience was comprised of students who volunteered to complete the study survey sent via a university email. The survey was created for the purposes of this study using social cognitive theory constructs. The instrument contained four …

Internal Population Displacement And Vaccination Completion, Malnutrition, And Respiratory Infections Among Children In The Central African Republic, Francois Xavier Batalingaya

Walden Dissertations and Doctoral Studies

Forced displacement in fragile and conflict-affected countries has the potential to disrupt access to basic primary healthcare services such as immunization. The purpose of this study was to assess the association between internal population displacement and vaccination completion, malnutrition, and acute respiratory infections (ARIs) while controlling for maternal characteristics of wealth index, education level, and residence status in the Central African Republic. The socioecological model underpinned this cross-sectional study that used a secondary dataset collected in 2018 – 2019 and maintained by UNICEF. Descriptive statistics and logistic regression tests were used to analyze the data. The findings of this study …

Association Between Dietary Phytoestrogen Intake And Xenoestrogen Exposure And Estrogen-Dependent Cancers, Pisita Bolsue

Walden Dissertations and Doctoral Studies

The role of circulating estrogens and the impact of lifetime exposure to multiple sources of exogenous estrogens as factors in carcinogenesis were not well understood. Research showed conflicting results when dietary phytoestrogen (PE) intake and xenoestrogen (XE) exposure occurred independently and when co-exposed. The purpose of this quantitative cross-sectional study was to investigate the association between dietary PE intake and XE exposure and the development of estrogen-dependent cancers in an epidemiological context. The advanced model of the epidemiology triangle was the theoretical framework for the current study in which binary logistic regression was employed on secondary data from the 2003–2006 …

Relationship Between Childhood Trauma, ,Adverse Childhood Experiences, And Self-Management Of Type 1 And Type 2 Diabetes, Deserie J. Otoole

Walden Dissertations and Doctoral Studies

AbstractPoorly controlled diabetes is the result of lack of self-care, which contributes to complications, ill quality in life, the rise in health care costs, and early death. The purpose of this quantitative, nonexperimental study was to examine the extent to which diabetes type (Type 1 and Type 2), childhood trauma, and adverse childhood experiences predict diabetes self-management (glucose management, dietary control, physical activity, health care use, total self-management). Contemporary trauma theory suggests that early childhood trauma results in negative health-related consequences in adulthood. Standard multiple regression analyses showed that (a) higher levels of physical neglect and emotional abuse predicted poorer …

Providing Diabetes Education To Improve Staff Nurses' Knowledge, Marcia A. Patterson

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a chronic metabolic disease that affects over 34.2 million or 10.5% of the U.S. population and ranks as the seventh leading cause of death. Tennessee's diabetes prevalence rate is ranked 45th overall in the nation, with 14.9% of the population affected, and in the local area for this project, the rate is greater than 15%, creating a public health concern. Despite its prevalence, there is still a wide gap in knowledge among nurses on diabetes management. The practice-focused question for this project addressed whether a staff education program would improve nurses' knowledge regarding diabetes. The significant gap …

The Relationship Between Chlamydia, Gonorrhea, Syphilis And Race, Gender, And Age, Johnny James Mcgrew

Walden Dissertations and Doctoral Studies

The purpose of this quantitative correlational design using secondary data from Colorado Department of Public Health and Environment was to examine the relationship between different types of sexually transmitted infections (STIs), specifically, chlamydia, gonorrhea, and syphilis, and race, gender, and age in the United States. This study is significant because it could assist medical personnel to focus on more personally-based STI treatments. This study could also lead to a call for more research regarding sexual health programs across the nation, individuals’ willingness to share personal information regarding STIs, and how sexual health programs could increase testing for STIs. The study …

Pancreatic Cancer: Quantitative Study Investigating The Regional Risk Factors In North Carolina, Holly Marie Myers

Walden Dissertations and Doctoral Studies

Pancreatic cancer is the fourth-leading cause of cancer-related deaths in the United States, killing more than 90% of individuals diagnosed within 5 years. Due to the lack of signs and symptoms, 82% of all pancreatic cancer cases are diagnosed in terminal stages. As such, the most powerful method to reducing the morbidity and mortality of pancreatic cancer is to further investigate the risk factors. According to the theoretical framework of the ecosocial theory, long-term exposure to exposures to unfavorable socioecological and environmental factors serve as a “web of causation” for adverse health outcomes. Using data from the North Carolina Department …

Education To Increase Nurse Knowledge And Compliance With Social Determinants Of Health Screening, Bonnie Rieger

Walden Dissertations and Doctoral Studies

To provide holistic care and ensure positive patient health outcomes, the social determinants of health (SDOH) must be addressed. Research demonstrates that while medical care is a contributor to wellness, the SDOH serve an influential role in patient health outcomes. There is limited literature describing how to best educate practicing nurses about SDOH concepts. The purpose of this DNP project was to provide an educational intervention to increase inpatient staff nursing knowledge of the SDOH. Sources of evidence used to create the education module included scholarly literature describing the SDOH concepts and their application to patient, community, and population health. …

Exploring Barriers And Promoters Of Crc Screening Use Among Agricultural Operators: A Pilot Study Of An Application Of Concept Mapping, Cheryl Beseler, Jungyoon Kim, Roma Subramanian, Susan Harris, Karen Funkenbusch, Aaron Yoder, Tamara Robinson, Jason M. Foster, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

INTRODUCTION: The purpose of the study was to identify barriers and facilitators of colorectal cancer (CRC) screening use among agricultural operators in Nebraska, US.

METHODS: The concept mapping approach was used to engage participants and enhance the generation of ideas and opinions regarding CRC screening. Two focus groups (seven women and seven men) were conducted.

RESULTS: Among women, the cost domain was most agreed upon as important, followed by experiencing symptoms, awareness, and family. Among men, the important concepts related to CRC screening were family and friend support, feeling too young to get CRC, family or personal history of CRC, …

How The Commonwealth Of The Northern Mariana Islands Stalled Covid-19 For 22 Months And Managed Its First Significant Community Transmission, Dwayne Davis, Stephanie Kern-Allely, Lily Muldoon, John M. Tudela, Jesse Tudela, Renea Raho, Heather S. Pangelinan, Halina Palacios, John Tabaguel, Alan Hinson, Guillermo Lifoifoi, Warren Villagomez, Joseph R. Fauver, Haley L. Cash, Esther Muña, Sean T. Casey, Ali S. Khan

Journal Articles: Epidemiology

OBJECTIVE: The Commonwealth of the Northern Mariana Islands (CNMI) is a remote Pacific island territory with a population of 47 329 that successfully prevented the significant introduction of coronavirus disease (COVID-19) until late 2021. This study documents how the response to the introduction of COVID-19 in CNMI in 2021 was conducted with limited resources without overwhelming local clinical capacity or compromising health service delivery for the population.

METHODS: Data from COVID-19 case investigations, contact tracing, the Commonwealth's immunization registry and whole genome sequencing were collated and analysed as part of this study.

RESULTS: Between 26 March 2020 and 31 December …

Maternal Occupation And Pediatric Brain Cancer In Kentucky, Mary Begley

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

Pediatric brain cancer is a rare and potentially deadly diagnosis that affects children in Kentucky at a higher incidence than those nationally. Limited exposures in children early in life to warrant the development and progression of brain cancer point to the role parental exposures experienced in the period prior to conception and throughout pregnancy may play in its development. Many of these exposures may be experienced through occupation. Data on a subset of pediatric brain cancer cases in Kentucky was compared to all cases diagnosed in the state from 1995 to 2019. Survey data of the study sample was collected …

Cardinal's Blues: Implementation Of A School-Based Cognitive Behavioral Therapy Program For Jefferson County Public Schools In Louisville, Kentucky, Loui Chang

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

With the increasing rate of adolescent depression and anxiety1 2, developing mental health interventions is necessary. Many adolescents’ times spent in schools increased compared to 20 years ago5, which makes school-based intervention programs suitable for reaching adolescent population effectively. Though there are numerous treatment providers available in Jefferson County, Kentucky, the school-based prevention programs addressing adolescent’s negative mental health outcomes have never been implemented. The Blueprints for Healthy Youth Development developed a program called the Blues Program24. The Blues Program provides an adapted version of group Cognitive Behavioral Therapy sessions to train and educate adolescents coping skills and cognitive restructuring24. …

Cross-Tailoring Integrative Alcohol And Risky Sexual Behavior Feedback For College Students: Protocol For A Hybrid Type 1 Effectiveness-Implementation Trial, Anne E. Ray, Eun-Young Mun, Melissa A. Lewis, Dana M. Litt, Jerod L. Stapleton, Lin Tan, David B. Buller, Zhengyang Zhou, Heather M. Bush, Seth Himelhoch

UK CARES Faculty Publications

Background: Underage drinking and related risky sexual behavior (RSB) are major public health concerns on United States college campuses. Although technology-delivered personalized feedback interventions (PFIs) are considered a best practice for individual-level campus alcohol prevention, there is room for improving the effectiveness of this approach with regard to alcohol-related RSB.

Objective: The aims of this study are to (1) evaluate the impact of a brief PFI that integrates content on alcohol use and RSB and is adapted to include a novel cross-tailored dynamic feedback (CDF) component for at-risk first-year college students and (2) identify implementation factors critical to the CDF’s …

Massachusetts Prevalence Of Opioid Use Disorder Estimation Revisited: Comparing A Bayesian Approach To Standard Capture-Recapture Methods, Jianing Wang, Nathan Doogan, Katherine L. Thompson, Dana Bernson, Daniel Feaster, Jennifer Villani, Redonna Chandler, Laura F. White, David Kline, Joshua A. Barocas

Statistics Faculty Publications

Background: The National Survey on Drug Use and Health (NSDUH) estimated the prevalence of opioid use disorder (OUD) among the civilian, noninstitutionalized people aged 12 years or older in Massachusetts as 1.2% between 2015 and 2017. Accurate estimation of the prevalence of OUD is critical to the success of treatment and resource planning. Various indirect estimation approaches have been used but are subject to data availability and infrastructure-related issues.

Methods: We used 2015 data from the Massachusetts Public Health Data Warehouse (PHD) to compare the results of two approaches to estimating OUD prevalence in the Massachusetts population. First, we used …

Food Insecurity On College Campuses: Addressing The Issue Through A Student-Centered Perspective, Thomas Ard

Theses and Dissertations--Kinesiology and Health Promotion

Research indicates food insecurity (FI) has become a consistent challenge for college students. However, more is needed regarding the students' lived experiences of food insecurity following the COVID-19 pandemic. Universities play a vital role in assisting students with food insecurity through food assistance programs, on-campus resources, and financial help, which impacts their physiological needs and academic performance. A better understanding of what influences students' perceptions and decisions about whether to engage in these resources is essential.

This dissertation's purpose was to explore how college students living with food insecurity experience engaging in food assistance programs (FAP). The study used a …

Integrating Spiritual Tools And Practices In Mental Health Care: A Scoping Review Of Spiritual Healing From The African Continent, Meron Girma

Public Health Theses

Western medicine typically describes traditional and spiritual healing as a homogenous healing system independent, and in many ways antagonistic to “science.” However, Western medicine fails to acknowledge the global influence of traditional and spiritual practices and its potential to strengthen current mental wellness care. For centuries, traditional and spiritual healing has served as a foundational system in many African nations, utilized to overcome challenges, pain and trauma. It is rooted in harmonious monism which reconciles the duality between mind and matter and conceptualizes the universe as interconnected and interdependent. African spiritual practices unite individuals to a community of shared values, …

Wildfires And Their Impacts On Immigrant Farmworker Women Of Childbearing Age, Rosa Gonzalez Juarez

Public Health Theses

Wildfires have been increasing in recent years due to the climate change that has been affecting the nation and across the globe. The Western part of the United States has been greatly affected, especially California. In 2022 there were 68,988 wildfires reported which consumed 7,577,183 acres nationwide, this was strikingly higher than the 10-year average (National Interagency Coordination Center Wildland Fire Summary and Statistics Annual Report 2022, 2022). The California Wildfires have been detrimental to its residents; however, they have specifically disproportionately affected the Latino population either due to the location of their homes, citizenship status or socioeconomic status (Rosenthal …

For “Them”, Not Us: A Qualitative Study Of Asian American Pacific Islander Perceptions Of Substance Use And Harm Reduction, Winnie Ho

Public Health Theses

Background: Asian American Pacific Islander (AAPI) substance use data is typically aggregated in a way that not only produces overly generalized results, but also potentially perpetuates stereotypes created by the Model Minority Myth (MMM). This has mutually reinforced a lack of representation and understanding of AAPI substance use experiences and needs. This presents a public health concern that is both excluding them from consideration by the field of harm reduction, but also themselves from considering harm reduction. Disaggregated data shows rising rates of substance use and associated harms that are often hidden or not taken as seriously as a public …