Public Health Commons^™

Mediation Analysis Using Marginalized Zero-Inflated Poisson Model, Andrew Sims

All ETDs from UAB

Mediation analysis has become exponentially more popular over the last decade as researchers are interested in establishing mechanistic pathways for intervention. Standard statistical methods emphasize quantifying and testing whether a specific exposure impacts a particular health outcome. Mediation analysis addresses the question ‘How is the exposure causing the outcome?’ by examining the extent to which an intermediate variable, called a mediator, influences the relationship between an exposure and an outcome. While multiple mediation strategies exist, the counterfactual approach to mediation allows for mediation effects to be estimated directly with nonlinearities and interactions. The counterfactual approach allows for the effect of …

The Costly Performance Of Strength: An Exploration Of Mental Health Treatment Utilization Among Black Women In The Deep South, Amber N. Martin

All ETDs from UAB

Introduction: Strength is indoctrinated into the cultural tapestry of Black women, dating back to slavery, and passed down through intergenerational socialization. The incessant need for Black women to be strong diminishes their psychological health leading to poorer quality of life. Further, historical injustices and unethical practices in mental healthcare continue to perpetuate the need for Black women to perform in strength. The performance of strength is one explanation for the grave mental health disparities among Black women offering an opportunity to better understand their mental health needs. This project aims to center Black women within the cultural contextualization of the …

Impact Of Malaria Rapid Diagnostic Test On The Receipt Of Antimalarials Among Children Aged 6-59 Months In Nigeria From 2010 To 2021, Sandra Chibuzor Olisakwe

All ETDs from UAB

Background: Nigeria has the highest malaria burden globally, and antimalarials have been commonly used to treat malaria without parasitological confirmation. In 2012, Nigeria implemented RDTs to reduce use of antimalarials for those without malaria and to increase the use of artemisinin-combination therapies (ACTs) for malaria treatment. In this study, we examined trends in antimalarial receipt among children aged 6-59 months during a 12-year period of increasing RDT availability. Methods: We conducted a cross-sectional analysis using nationally representative Nigeria Malaria Indicator Survey (NMIS) data from 2010 (before RDT implementation), 2015, and 2021. NMIS surveys used histidine-rich protein 2 (HRP2)- based RDTs …

Social Determinants Of Health And Blood Pressure Control In Black And White Us Adults, Oluwasegun Philip Akinyelure

All ETDs from UAB

Black adults in the US have 2 to 3 times higher rates of cardiovascular disease (CVD) mortality compared to White adults. Most of the excess CVD mortality in Black adults has been attributed to their higher prevalence of hypertension and uncontrolled blood pressure (BP). In October 2020, the US Surgeon General published a Call-to-Action to improve hypertension control and identified social determinants of health (SDOH) as a major contributor to Black:White disparities in hypertension control. Prior research has showed that SDOH are associated with excess hypertension risk among Black compared with White adults, but data on their association with BP …

Acute Placental Inflammation And Growth Outcomes In Preterm Infants, Emily Gunawan

All ETDs from UAB

Background. Acute placental inflammation (API) has been associated with various adverse outcomes in preterm infants. However, little is known about how API affects their body composition and growth outcomes. This study aims to examine the association between API and growth outcomes in preterm infants. Methods. We conducted a retrospective cohort study of mother-infant dyads born < 326/7 weeks of gestation with fat mass (FM) accretion measured using air displacement plethysmography at term-equivalent age. API severity including maternal inflammatory response (MIR) and fetal inflammatory response (FIR) was staged according to criteria by Society for Pediatric Pathology based on placental pathology reports. We examined the differences in characteristics of mother-infant dyads by API severity using ANOVA or the Kruskall-Wallis test. The association between API severity and growth outcomes was analyzed using linear regression models and adjusted for statistically significant confounders. Mediation analyses were used to study the direct and indirect association of API and growth outcomes via gestational age. Results. Among 375 mother-infant dyads analyzed, 104 (28%) dyads had MIR. FIR was found in 82% of dyads with MIR. Adjusted models indicated that API severity progression was positively associated with FM accretion. Gestational age partially (49%) iv mediated the association between API severity and FM z score (indirect effect: b=0.12, 95% CI: 0.05-0.19; direct effect: b=0.12, 95% CI: 0.01-0.25). Conclusions. API severity is associated with growth outcomes and helps to accurately predict body composition in preterm infants.

Social Vulnerability And Racial Disparities In Overall Survival Among Endometrial Cancer Patients, Alfonsus Adrian Hadikusumo Harsono

All ETDs from UAB

Introduction. Social vulnerability (SV) refers to potential negative effects on communities caused by external stresses on human health. The CDC/ATSDR Social Vulnerability Index (SVI) scores communities on 15 social indicators in 4 themes: (1) socioeconomic status (SES), (2) household composition and disability, (3) minority status and language, and (4) housing type and transportation. An overall score ranging from 0 (least vulnerable) to 1 (most vulnerable) is calculated to estimate vulnerability. We investigated whether SV as measured by the SVI can explain why black endometrial cancer (EC) patients survive less well than do white EC patients. Methods. We studied the survival …

Temporal Trends In Tularemia Incidence In The United States From 2010 To 2020. Are Age And Sex Associated With These Changing Trends?, Carla V. Brooks

All ETDs from UAB

Background: Tularemia or Rabbit Fever was discovered in 1911 in a plague-like outbreak among rodents in Tulare County, California. Tularemia in the US has expanded from rural to more metropolitan areas, which may be potentially correlated with the escalating exposure of humans to animal vectors. There has not been a recent study evaluating trends in Tularemia, especially one that has evaluated if the trends in Tularemia over time differ by demographic characteristics. Methods: This is an ecological study to evaluate the temporal trends and if trends Tularemia incidence over time differs by age and sex in the United States from …

Understanding How Multi-Level Factors Influence Cancer Clinical Trial Enrollment Decisions By Patients Living In Higher Disadvantaged Areas, Nicole Caston

All ETDs from UAB

Cancer clinical trials offer current patients with cancer new treatment and novel interventions to treat their cancer, while advancing the care of future patients. Clinical trials test new drugs against the standard of care to determine drug efficacy and safety. There are many groups of patients who are either unrepresented or underrepresented in cancer clinical trials and there is a plethora of reasons they are not represented. One underrepresented population of interest is patients with cancer who live in highly disadvantaged neighborhoods. Previous research found that when compared to patients who live in areas of lower disadvantage, patients living in …

Socioeconomic Challenges Of Long Covid, Justin Catt

All ETDs from UAB

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection or PASC, is a condition resulting from a SARS-CoV-2 infection characterized by continuing or novel symptoms across multiple organ systems occurring at least four weeks after infection. Symptoms of Long COVID can include cognitive impairment, memory loss, and fatigue. Although associations between COVID-19 and social determinants of health have been studied, noting that disadvantaged socioeconomic or racial groups have higher incidence and mortality rates from COVID-19, the associations between Long COVID and social determinants of health have not been robustly examined. Using data from the Household Pulse Survey in Summer …

Antimicrobial Resistance In Type Ii Diabetic Patients In Southeastern U.S., Onyebuchi Angela Elegede

All ETDs from UAB

Background: In the Southern and Appalachian regions of the United States, antibiotic prescription rates surpass the national average, coinciding with a higher prevalence of Type II diabetes (DM2). Although international research has previously described the correlation between DM2 and increased risk of antimicrobial-resistant (AMR) infections, comprehensive studies on this relationship are lacking in the U.S. The objective of this study was to investigate the association between AMR infections and DM2 and examine the association in two DM2 positive racial groups. This study also examined the differences in the prevalence of clindamycin resistance of methicillinresistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus …

Parenting Through A Pandemic: A Mixed Methods Analysis Of Covid-19’S Impact On Stress, Coping, Resiliency, And Mental Health Among University Student-Parents, Jordin Ann Lane

All ETDs from UAB

The COVID-19 pandemic has taken a toll on the mental health of university students and continues to have a profound impact to this day. The transition from in-person traditional courses to online courses and campus closures, coupled with feelings of isolation, fear of contracting COVID-19, and uncertainty of the future has further intensified the mental health of college students. The effects of federal and state regulations, such as stay-at-home orders, influenced the mental health and general well-being of many Americans, specifically those who take on a dual role as a student and a parent. Unfortunately, literature pertaining to the effects …

Identifying The Factors Influencing Hiv Testing And Safe Sex Practices: An Ecological Approach, Shekwonya Evelyn Samuel

All ETDs from UAB

Introduction: HIV (Human Immunodeficiency Virus) is a sexually transmitted infection (STI) that is still a major health issue in the United States and the world. Emerging adults are more likely to engage in risky sexual behaviors such as multiple sexual partners and unprotected sex. HIV testing contributes to ending the HIV epidemic by identifying at-risk individuals and promoting early diagnosis.Methods: Secondary data analyses of the City Health II dataset were conducted to 1) identify the association between HIV testing and risky sexual behaviors among Black/African American emerging adults ages 18-25 years living in Birmingham metro area, 2) use social network …

Social Vulnerability And Trust Associated With African American Secondary Syphilis Cases Reported In Alabama, United States, 2020-2022, Givanta Tribit

All ETDs from UAB

Introduction: Syphilis is a sexually transmitted infection (STI) that can cause serious health problems, including neurological disorders, blindness, and fetal abnormalities. Routine STI screenings can help prevent its spread. Despite effective treatments, syphilis cases have risen sharply in the last decade, particularly among marginalized communities. Understanding the ecological and contextual factors contributing to syphilis incidence could inform prevention efforts and improve healthcare outcomes for all. Methods: Retrospective secondary data analyses, at the county level, from 2020 to 2022, were conducted to assess for mean differences among social vulnerability index (SVI) scores, SVI scores by four primary categories, Black Belt regional …

Neighborhood Disadvantage, Sleep Quality, And Shift Work: The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Rebecca Williams

All ETDs from UAB

The first study used data (n=14,609) from the REasons for Geographic and Racial Differences in Stroke (REGARDS) to test the associations among Area Deprivation Index (ADI) and self-reported total sleep time (TST), sleep efficiency (SE), and number of restless nights within the last week. The second study (n=12,496) tested the associations among ADI, shift work status, and restlessness.Regression models were fit to examine associations between ADI and SE or TST or restlessness, as well as assess the relation between ADI and SE in clinically meaningful categories. Moderation analyses indicated whether sex or race impact the association between ADI and sleep. …

Soft X-Ray And Susceptibility Based Magnetic Resonance Imaging To Map Iron Distribution In Apples: Initial Results To Model Iron Storage In Water-Deficient Or Dehydrated Biological Tissue, Subhendra N. Sarkar, Eric Lobel, Evans Lespinasse, Zoya Vinokur, Analia Basilicata, Sonia Orellana, Maria Orellana, Aaliyah Salmon, Joanna Syska, Aravis Mcbroom, Jian Wang, Anam Riaz, Jodi-Ann Douglas

Publications and Research

Radiology departments have contributed significantly to greenhouse gases including release of toxic imaging contrast media to environment. We feel Radiology also has several spectroscopy and imaging tools that may apply to monitor and support cleaner environmental goals. The current manuscript is one of the firsts to prompt Radiology to move in that direction by non invasive imaging of bio metals that are less abundant in biological tissues but play key roles as co-factors in tissue structure and function. Conventional analytical tools are mostly invasive and cannot characterize the native oxidation states of bio metals. We chose carbohydrate matrix of metal-rich …

Validation Of An Emg Submaximal Method To Calibrate A Novel Dynamic Emg-Driven Musculoskeletal Model Of The Trunk: Effects On Model Estimates, Amir H. Eskandari, Farshid Ghezelbash, Aboulfazl Shirazi-Adl, Denis Gagnon, Hakim Mecheri, Christian Larivière

Études primaires

Background

Multijoint EMG-assisted optimization models are reliable tools to predict muscle forces as they account for inter- and intra-individual variations in activation. However, the conventional method of normalizing EMG signals using maximum voluntary contractions (MVCs) is problematic and introduces major limitations. The sub-maximal voluntary contraction (SVC) approaches have been proposed as a remedy, but their performance against the MVC approach needs further validation particularly during dynamic tasks.

Methods

To compare model outcomes between MVC and SVC approaches, nineteen healthy subjects performed a dynamic lifting task with two loading conditions.

Results

Results demonstrated that these two approaches produced highly correlated results …

Improving Cervical Cancer Screening In Sub-Saharan Africa, Nigeria: Reaching Levels Of Cervical Cancer Prevention In Developed Countries, Chigozie Alexandra Ogwara, Biyi-Olutunde Olusegun, Yelena Tarasenko

Eagles Talking About the Public’s Health

No abstract provided.

Addressing Racial Disparities In Maternal Health Through Policy, Alexandria Alford, Alisha Riggins, Joanne Chopak-Foss, Sarah Sejoro, Tobi Oloyede, Mambwe Mutiti

Eagles Talking About the Public’s Health

No abstract provided.

Accessibility And Comprehension Of United States Health Insurance Among International Students: A Gray Area, Queeneth C. Edwards, Stacy Smallwood

Eagles Talking About the Public’s Health

No abstract provided.

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

College of Graduate Studies: Theses & Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

My Baby, My Move+: Feasibility Of A Community Prenatal Wellbeing Intervention, Jenn A. Leiferman, Rachael Lacy, Jessica Walls, Charlotte V. Farewell, Mary K. Dinger, Danielle Symons Downs, Sarah S. Farrabi, Jennifer L. Huberty, James F. Paulson

Psychology Faculty Publications

Background

Excessive gestational weight gain (EGWG), insufficient prenatal physical activity and sleep, and poor psychological wellbeing independently increase risks for adverse maternal and infant outcomes. A novel approach to mitigate these risks is utilizing peer support in a community-based prenatal intervention. This study assessed the feasibility (acceptability, demand, implementation, and practicality) of a remotely delivered prenatal physical activity intervention called My Baby, My Move + (MBMM +) that aims to increase prenatal physical activity, enhance mood and sleep hygiene, and reduce EGWG.

Methods

Participants were recruited through community organizations, local clinics, and social media platforms in the Fall of 2020 …

The Potential And Peculiarities Of Perma: A Meta-Analysis Of Two Well-Being Measures With Working Samples, William P. Jimenez, Xiaoxiao Hu, Rebecca Garden, Asiye Zeytonli

Psychology Faculty Publications

In the first meta-analysis of the PERMA well-being framework (i.e., positive emotions, engagement, positive relationships, meaning, accomplishment), we cumulated 692 effect sizes (k = 33 independent samples, N = 10,050 workers). Average reliability did not meet the conventional ɑ = .70 threshold for engagement measured with the PERMA-Profiler or the Workplace PERMA Profiler or for negative emotions measured with the former. Overall, PERMA dimensions were strongly intercorrelated, and model comparisons suggested multidimensionality. We also summarized PERMA’s relationships with some conceptual antecedents (conscientiousness, loneliness); correlates (happiness, negative emotions); and outcomes (physical health, depressive symptoms, overall …

The Effect Of High-Speed Power Training On Physical Frailty In Older Adults: Effect Of A Visual-Guided Exercise Program In South Korean Rural Areas, Dong H. Yoon, Jin-Soo Kim, Su S. Hwang, Dong W. Lee, Wook Song

Research outputs 2022 to 2026

Objective. Exercise has been shown to be an effective intervention; the difficulty still lies in providing exercise programs to the older adults in rural areas. Therefore, this study aimed to examine the effects of a 12-week exercise program provided with visual guidelines (prerecorded video) on frailty among older adults in rural areas. Methods. Fifty participants (71.7 ± 4.9 years) from 5 different rural areas were recruited and divided into two groups: the exercise group (EX, n = 24 (male: 8, female: 18)) and the control group (CON, n = 26 (male: 7, female: 17)). With the commencement of the exercise …

Unrecognized Hypertension Among A General Adult Ghanaian Population: An Urban Community-Based Cross-Sectional Study Of Prevalence And Putative Risk Factors Of Lifestyle And Obesity Indices, Enoch O. Anto, Wina I. O. Boadu, Emmanuel E. Korsah, Ezkiel Ansah, Eric Adua, Joseph Frimpong, Patience Nyarkoa, Valentine C. K. T. Tamakloe, Emmanuel Acheampong, Evans A. Asamoah, Stephen Opoku, Ebenezer Afrifa-Yamoah, Max E. Annani-Akollor, Christian Obirikorang

Research outputs 2022 to 2026

Hypertension (HTN) is the leading cause of cardiovascular diseases. Nevertheless, most individuals in developing countries are unaware of their blood pressure status. We determined the prevalence of unrecognized hypertension and its association with lifestyle factors and new obesity indices among the adult population. This community-based study was conducted among 1288 apparently healthy adults aged 18–80 years in the Ablekuma North Municipality, Ghana. Sociodemographic, lifestyle characteristics, blood pressure and anthropometric indices were obtained. The prevalence of unrecognized HTN was 18.4% (237 / 1288). The age groups 45–54 years [aOR = 2.29, 95% CI (1.33–3.95), p = 0.003] and 55–79 years [aOR …

Diagnostic Accuracy Of Autoverification And Guidance System For Covid-19 Rt-Pcr Results, Yingmu Cai, Mengyu Liu, Zhiyuan Wu, Cuihong Tian, Song Qiu, Zhen Li, Feng Xu, Wei Li, Yan Zheng, Aijuan Xu, Longxu Xie, Xuerui Tan

Research outputs 2022 to 2026

Background:

To date, most countries worldwide have declared that the pandemic of COVID-19 is over, while the WHO has not officially ended the COVID-19 pandemic, and China still insists on the personalized dynamic COVID-free policy. Large-scale nucleic acid testing in Chinese communities and the manual interpretation for SARS-CoV-2 nucleic acid detection results pose a huge challenge for labour, quality and turnaround time (TAT) requirements. To solve this specific issue while increase the efficiency and accuracy of interpretation, we created an autoverification and guidance system (AGS) that can automatically interpret and report the COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) results relaying …

Assessing Children To Identify Developmental Coordination Disorder: A Survey Of Occupational Therapists In Australia, Jacqui Hunt, Jill Zwicker, Erin Godecke, Annette Raynor

Research outputs 2022 to 2026

Background: Developmental coordination disorder (DCD), a prevalent neurodevelopmental disorder with motor and psychosocial consequences, can significantly impact children's quality of life. In Australia, most children with diagnosed/suspected DCD have received occupational therapy services, more so than any other health service. As such, occupational therapists are key in identification and treatment and require a sound knowledge of diagnostic criteria and the best evidence for practice. This study explored current occupational therapy services for children with DCD. Areas for development are identified to improve the identification of, and subsequent intervention for, children with DCD. Methods: In this cross-sectional study, an online survey …

Barriers And Enablers Associated With Participation In A Home-Based Pragmatic Exercise Snacking Program In Older Adults Delivered And Monitored By Amazon Alexa: A Qualitative Study, Paul Jansons, Jackson J. Fyfe, Jack Dalla Via, Robin M. Daly, David Scott

Research outputs 2022 to 2026

Background: ‘Exercise snacking’, which is characterised by shorter and more frequent exercise bouts compared with traditional exercise guidelines, may be an acceptable strategy for increasing physical activity and reducing sedentary behaviour in older adults. Aim: The aim of this study was to evaluate the enablers and barriers for older adults associated with participation in a home-based exercise snacking program delivered and monitored using an Amazon Echo Show 5 device (Alexa). Methods: This study used an interpretive description qualitative design to conduct semi-structured interviews following a 12-week pilot study in 15 adults aged 60–89 years with at least one chronic condition. …

The Definition Of A Community Paramedic: An International Consensus, Brendan Shannon, Sasch Baldry, Peter O'Meara, Nicole Foster, Angela Martin, Matthew Cook, Karen Stewart, Alecka Miles

Research outputs 2022 to 2026

Community paramedicine is a globally evolving model of care where paramedics provide community-based, preventative and primary healthcare services. With increased global interest and adaptation of the community paramedicine model, there is a lack of a clear definition of the role of a community paramedic. This study sought to come to an international consensus on the definition of a community paramedic. A four-phase Delphi methodology was utilised to achieve a global consensus on the definition of a community paramedic. A systematic approach to expert identification was performed and reported in line with the Conducting and REporting of DElphi Studies standard. A …

Editorial: Computational Predictions, Dynamic Tracking, And Evolutionary Analysis Of Antibiotic Resistance Through The Mining Of Microbial Genomes And Metagenomic Data, Volume Ii, Qi Zhao, Jian Li, Alfred Tay, Liang Wang

Research outputs 2022 to 2026

Antibiotic resistance has emerged as a critical global health challenge, posing a significant threat to human and animal health. The rapid development of antibiotic resistance among pathogens has reduced the efficacy of existing treatments, leading to an urgent need for novel therapeutic strategies. One promising avenue of research involves mining microbial genomes and metagenomic data to uncover novel antimicrobial agents and a better understanding of the resistance mechanism.

Hand Hygiene Knowledge And Demonstrated Technique Among Malawian Kindergarten Children: A Quasi-Experimental Study, Balwani Chingatichifwe Mbakaya, Maggie Zgambo, Fatch Welcome Kalembo

Research outputs 2022 to 2026

Aim: To evaluate hand hygiene knowledge and demonstrated technique before and after implementation of the hand hygiene programme and its sustainability among Malawian kindergarten students. Design: Quasi-experimental design, utilizing a repeated measure at three points, namely, before intervention (T0), soon after intervention (T1) and follow-up (T2). Methods: The hand hygiene programme consisted of integrating hand hygiene protocol into the school health curriculum, setting up proper handwashing facilities, training school teachers, health talks and developing reminders on hand hygiene. Fifty-three kindergarten children aged 3–6 years were enrolled in the programme. Data were collected at 3 months' intervals (T0, T1, and T2). …