Public Health Commons^™

Exploring Mediated Psychosocial Effects On Dating Violence Perpetration And Victimization In The Me & You Building Healthy Relationships Program For Middle School Students, Mike Henson-Garcia, Elizabeth R Baumler, Christine M Markham, Robert C Addy, Ross Shegog, Belinda Hernandez, Paula Cuccaro, Jeffery Temple, Susan Tortolero Emery, Melissa F Peskin

Faculty, Staff and Student Publications

Teen dating violence (TDV) is a prevalent and injurious public health threat affecting adolescent populations across the globe. In response, a plethora of interventions have been developed and implemented with various effects emerging from evaluation studies of these prevention initiatives. The purpose of this study was to investigate whether attitudes toward sexting, gender-based norms toward violence, and constructive conflict resolution skills mediate the main effects of a TDV intervention. Specifically, this study leverages data from the original efficacy trial of the

Healthy Living As A Critical Part Of Emergency Preparedness, Callahan K. Ward, April Litchford

All Current Publications

This resource presents practical, health-focused actions that individuals and caregivers can take to strengthen resilience before, during, and after emergencies. By integrating long-term wellness habits and short-term readiness strategies, it supports a more comprehensive and inclusive approach to disaster preparedness, enhancing not only personal outcomes but also community-wide response capacity.

Epidemiology, Presentation, And Diagnosis Of Type 2 Diabetes Mellitus In Children And Adolescents, Bisher Alsabbagh, Whard Alsabbagh

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents has increased substantially over recent decades, paralleling rising rates of pediatric obesity and metabolic risk. Youth-onset T2DM is characterized by significant insulin resistance accompanied by an inadequate compensatory insulin response, resulting in progressive hyperglycemia and early beta-cell dysfunction. Incidence varies widely among racial and ethnic groups, with the highest rates observed in non-Hispanic Black, Hispanic, Native American, Asian American, and Pacific Islander youth. Risk factors include obesity, family history, high-risk ethnicity, pubertal insulin resistance, prenatal metabolic exposures, and comorbid conditions such as polycystic ovary syndrome. Clinical presentation ranges …

Improving Communication To Enhance Health Literacy And Self-Management Of Heart Failure: Protocol For A Multimethod Study, Neda Karimi, Francesco De Toni, Walter Abhayaratna, Blake Askelin, Philip Currie, Karol Edge, Christopher Etherton-Beer, Elizabeth Fewster, Liza Goncharov, Nisha Jijo, Susy Macqueen, Nilufeur Mckay, Suzanne Raine, Amineh Rashidi, Christopher Rouen, Rosemary Saunders, Peter Schulz, Rhea Tecson, Diana Slade

Research outputs 2022 to 2026

Introduction Self-care plays a pivotal role in the management of heart failure (HF). Health literacy and empowerment are considered the prerequisites of effective self-care. This project aims to improve self-management in people with HF by describing, analysing and enhancing the communication practices of clinicians and patients to support people with HF to increase their health literacy skills and participate in shared decision-making. Methods and analysis A multimethod research design incorporating an interview component, a concurrent mixed-methods component and a pilot intervention study is used. The study is currently being conducted at two Australian hospitals in metropolitan areas (one public and …

Proteome-Wide Association Study Of Prostate Cancer Risk Across Populations, Hua Zhong, Jingjing Zhu, Shuai Liu, Chong Wu, Liang Wang, Seamus P. Whelton, Catherine H. Marshall, Michael J. Blaha, Peter Durda, Xiuqing Guo, Craig W. Johnson, Henry J. Lin, Kent D. Taylor, Russell P. Tracy, Ronit I. Yarden, Ani W. Manichaikul, Stephen S. Rich, Jerome I. Rotter, Rajat Deo, Ruth F. Dubin, Peter Ganz, Lang Wu

School of Graduate Studies Faculty Publications

There is insufficient understanding of the molecular basis of prostate cancer (PCa) across different populations. We perform a large-scale proteome-wide association study (PWAS) to identify proteins with genetically regulated expression in plasma to be associated with PCa risk across populations. We develop genetic prediction models for expression of 1578, 1993, 1218, and 1390 proteins for African (n = 450), European (n = 758), Asian (n = 289), and Hispanic/Latino (n = 474) males, respectively, and evaluate associations of genetically regulated protein expression with PCa risk in 19,391 PCa cases and 61,608 controls of African population, 122,188 cases and 604,640 controls …

Development And Evaluation Of The Sex Positivity Inventory For Counselors, M. Ashley Burks, Jennifer Gerlach, Joshua C. Watson

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

The purpose of the study was to clarify the definition of sex positivity and identify sex-positive attitudes, knowledge, and skills through the development and evaluation of the Sex Positivity Inventory for Counselors (SPI-C). The exploratory factor analysis supported a six-factor, 34-item scale, accounting for 32.9% of the variance within the study. The SPI-C had an excellent internal consistency of 0.96 and consisted of the following factors: 1) Procedural Sex Positivity, 2) Comfortability with Sexuality, 3) Perceived Sex Positivity, 4) Fundamental Sex Education, 5) Sexological Worldview, and 6) Unconditional Positive Sexual Regard. Implications for practice, counselor education, and supervision are discussed.

Pregnancy Intention And Maternal Morbidity In Oklahoma And Mississippi: A Moderation Analysis Of Abortion Restriction Policies, Vicki Johnson

Walden Dissertations and Doctoral Studies

More than half of all pregnancies are unintended (mistimed or unwanted), and women with unplanned pregnancies may face economic hardships for families and additional health consequences if they have pre-existing medical conditions. This quantitative study was conducted to examine the relationship between pregnancy intention levels and severe acute maternal morbidity, specifically chorioamnionitis, among women who gave birth in Oklahoma and Mississippi in 2022. Using secondary data (N=1939) from the Pregnancy Risk Assessment Monitoring System Automated Research Files and state-level abortion policy data from the Guttmacher Institute, this study employed Bronfenbrenner’s social ecological model framework to investigate the relationship between pregnancy …

Behçet's Disease Unraveled: Insights Into Clinical Manifestations, Diagnosis, And Management, Mansour Alghamdi, Stephen Lindsey

School of Medicine Faculty Publications

Behçet's disease is a rare and recurrent multisystem inflammatory disorder, primarily distinguished by systemic vasculitis that affects veins and arteries of various sizes. Clinically, Behçet's disease is characterized by the presence of recurrent oral and genital ulcers, skin lesions, and uveitis. The prevalence of this condition is significantly elevated along the historical Silk Road, particularly in Turkey; however, epidemiological data indicate variations across different regions and ethnic groups. The diagnosis of Behçet's disease is typically established during the third decade of life, with a more severe prognosis noted when the onset occurs before the age of 25. This review aims …

Asian College Students' Well-Being During A Period Of Rising Anti-Asian Sentiment, Kyuhan Choi, Ying Shi, Maria Zhu

Center for Policy Research

We use a large survey of students in U.S. colleges to study the distinct ways in which the COVID-19 pandemic and accompanying anti-Asian rhetoric shaped the experiences of Asian and Pacific Islanders (APIs). Using a difference-in-differences approach, we find that the pandemic led to Asian students experiencing more discrimination, feeling less safe during the day, and using fewer mental health services compared to White peers. The increase in discrimination and the perceived lower safety are concentrated among East and Southeast Asians, while South Asians were not affected. Despite these effects, we detect no relative deterioration in severe psychological distress or …

Universal School Meal Policies And Perceived Stigma: Quantitative Evidence From Eight Us States, Dania Orta-Aleman, Monica D. Zuercher, Leah Chapman, Marlene B. Schwartz, Caitlin D. French, Anisha I. Patel, Lorrene D. Ritchie, Juliana Cohen, Wendi Gosliner

Health Sciences Faculty Publications

Background

Universal school meals (USMs) policies, which provide free meals to all students regardless of income, have the potential to improve child nutrition and reduce stigma. Quantitative evidence on the association between USM and stigma is limited.

Methods

Leveraging a natural policy variation in state‐level USM implementation, we surveyed 1066 middle and high school students from eight US states (four with USM, four without) during the 2022–2023 school year. Stigma was measured as self‐reported embarrassment about eating school lunch. We used generalized estimating equations to examine the associations between USM, embarrassment, and lunch participation.

Results

Overall about one in nine …

Prevalence And Factors Associated With Alcohol And Illicit Drug Use Among Brazilian Youth: A Multicenter Cross-Sectional Study, Emerson Brito, Marina Bessel, Natalia Luiza Kops, Lucas Albrechet-Souza, Flavia Moreno, Alexis Koskan, Thayane Martins Dornelles, Ben Hur Graboski Pinheiro, Suelen Basgalupp, Eliana Wendland

School of Medicine Faculty Publications

This study examined alcohol and illicit drug use among Brazilian youth aged 16 to 25 during the transition to adulthood. A multicenter, cross-sectional survey was conducted between Sep-2016 and Dec-2017 across all 26 Brazilian state capitals and the Federal District. A total of 8,581 participants completed structured interviews on substance use and sociodemographic characteristics. Lifetime prevalence was 71.6% for alcohol and 30% for illicit drugs. Frequent alcohol use was more common among males, while the most used illicit substances were cannabis (27.4%) and cocaine (9.9%). Participants without a partner had higher rates of alcohol and hallucinogen use, while those with …

Primary Care Provider Communication Barriers With College-Aged Students, Mckenna Mahakian, Sharon Schaeffer, Rachel Immel

Honors Projects

As both a researcher and a college student, I’ve noticed that my peers and I share a common negative sentiment toward scheduling and attending routine doctor’s appointments. There are unique barriers in place for the age demographic; college students encountering the medical system and Primary Care Providers (PCPs) seem to have unique challenges in communication. I released a qualitative, anonymous survey to Bowling Green State University students to gauge opinionated responses on sentiments regarding how they felt about the level of communication between themselves and their provider, how the pediatric switch to a regular doctor impacted their inpatient care, how …

Historical Review: More Than Two Decades Understanding The Genetic Architecture Of Hemostasis And Thrombosis, Maria Sabater-Lleal, Florian Thibord, Paul S De Vries, Jennifer Huffman, Alisa S Wolberg, Charles J Lowenstein, Alanna C Morrison, Andrew D Johnson, Nicholas L Smith

Faculty, Staff and Student Publications

From the beginning of the millennium and the development of genome-wide analyses, the technical advances and remarkable increase in research sample sizes have led to an escalating number of discoveries revealing genetic determinants of levels of the main factors regulating hemostasis and thrombosis and demonstrating a clear polygenic complex regulation of most coagulation factors. These discoveries have been useful to understand the biology underlying hemostasis regulation and to understand risk of associated thrombotic disease, such as venous thromboembolism, coronary artery disease, and ischemic stroke. In this historical review, we outline the main discoveries in genetic studies of coagulation factors (fibrinogen …

Through The Eyes Of Time, Shaneece Prince, Steven Indelicato

Publications and Research

Frames have been a staple throughout history, however in recent times, a trend of having multiple pairs of glasses opposed to one, life lasting pair, has emerged. As a result, frames have piled up in landfills contributing to the polluting of our environment. Through the analysis of previously recorded studies and statistics, conclusions of the eyewear industry's growing impact on society and the planet were formed.

Millions of frames are in constant circulation, studies show that up to 31% of spectacle wearers out of a group of 375, disposed of their eyewear in the trash. The lifespan of popular eyewear …

The Effect Of Community-Based Exercise For Individuals With Pre-Existing Health Conditions, Amy M. Stahl

Doctoral Dissertations and Projects

Physical inactivity is a growing problem for the health and wellbeing of the world’s population. Increases in physical activity may help to improve health outcomes for the general population of the United States. This study is two-fold and seeks to determine if community-based exercise groups are successful in improving the health of people with preexisting conditions and encouraging community members to adhere to an exercise program. A quasi-experimental 12-week comparison study consists of a control group of standard care and an intervention group that participates in a three-day a week community walking group. The purpose of the group is to …

Healthcare Disparities Related To Income In South Carolina, Rebekka Byrd

Doctoral Dissertations and Projects

Low-income individuals and families in South Carolina face significant barriers to accessing healthcare, despite the presence of public health programs like Medicaid. Many fall into the healthcare coverage gap, earning too much to qualify for Medicaid but too little to afford private insurance. This study explored the consequences of the healthcare coverage gap by examining the relationships between income, healthcare access, and the ability to afford healthcare services among 500 adults aged 19–64 who participated in the National Health Interview Survey between 2018 and 2023. Utilizing a retrospective quantitative analysis of secondary data from the National Health Interview Survey (NHIS) …

The Impact Of Education And Awareness In Influencing Lifestyle Behaviors That Prevent And Treat Sarcopenia In Older Adults: A Mixed-Methods Cross-Sectional Research Study, Alan Lynn Jones

Doctoral Dissertations and Projects

This mixed-methods, cross-sectional study assessed the current level of knowledge and awareness among people aged 50 and older about sarcopenia, as well as their willingness to adopt lifestyle changes that could prevent or reverse the condition as they age. The study aimed to determine whether a lack of awareness and knowledge is linked to current lifestyle behaviors that contribute to or protect against the development of the disease. The population included men and women 50 and older, living independently in the community with no prior diagnosis of sarcopenia. The study used a custom-designed questionnaire and semi-structured interviews. A total of …

Cardiovascular Disease And Pregnancy: Clinical Outcomes From A Tertiary Center Experience In Saudi Arabia, Nouf Alanazi, Sara Abou Al-Saud, Wareef Almousa, Ghada Alshalan, Jumana Alqahtani, Munira Alsharif, Abrar Alshahrani, Hessah Alothman

Journal of the Saudi Heart Association

Cardiovascular disease complicates pregnancy and elevates maternal and fetal risks. Local data in Saudi Arabia is scarce. This study examines pregnancy outcomes in women with cardiovascular disease at a tertiary center. A retrospective cohort study of 103 cardio-obstetric patients (2015-2023) at King Khalid University Hospital. Multivariable logistic regression identified risk factors for adverse maternal and neonatal outcomes, with significance at p

Travel Time To Treating Facility And Mortality In Men With Prostate Cancer, Stephan M. Korn, Filippo Dagnino, Danesha Daniels, Zhiyu Qian, Hanna Zurl, Klara K. Pohl, Mei Chin Hsieh, Brenda Y. Hernandez, Andrea Piccolini, Alexander P. Cole, Amanda J. Reich, Joel S. Weissman, Quoc Dien Trinh, Hari S. Iyer

School of Public Health Faculty Publications

IMPORTANCE Geographic access to prostate cancer care may influence outcomes but is often measured using straight-line distance, which may not accurately capture the travel burden experienced by patients. OBJECTIVE To evaluate the association between estimated travel time from patients’ residence to treatment facilities and all-cause and prostate cancer–specific mortality. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used data from the Multilevel Epidemiologic Tumor Registry for Oncology, a nationally representative, investigatorinitiated, population-based cancer registry that integrates geomasked residential and treatment facility information from multiple US state cancer registries. The study included patients aged 40 to 99 years from Hawaii, Louisiana, …

Social And Contextual Factors Influencing Hypertension Among Latino Men Living In California, Leslie Ivett Ortega

Walden Dissertations and Doctoral Studies

Hypertension remains a critical and often silent public health issue that disproportionately affects Latino men in California. This quantitative, retrospective cross-sectional study explored the social and contextual factors influencing hypertension among this vulnerable population. Using the 2019 Behavioral Risk Factor Surveillance System dataset, which included a sample size of 2,060 participants, the study examined the relationship between hypertension and key variables including primary care utilization, health insurance, smoking, physical activity, mental health, and marital status, while controlling for age, education, and income. Guided by the health belief model, binary logistic regression analyses found health insurance and primary care utilization significantly …

Influence And Excess: A Study Of Alcohol’S Governmental, Societal, Biochemical, And Enzymatic Impact In The U.S And Other Countries Around The World, Thomas W. Snider

Senior Honors Theses

The conduct of the thesis is to explore the intricacies of alcohol consumption. The thesis will outline the history of alcohol and the societal pressures and conduct of drinking with relation to the government. After the history of alcohol has been defined, the thesis will move into the chemistry portion, delineating the absorption, digestion, metabolism, and excretion of alcohol. This is the portion of the thesis that will contain the quantitative data and source material as much research has already been conducted regarding these components of alcohol consumption. The condition of the research is that the data will be collected …

Medicaid Funding And Health-Related Social Needs: A Policy Analysis, Passion Ilea

Dissertations and Theses

The U.S. has disproportionately high health care spending compared to other high-income nations and comparatively poor health outcomes. The Centers for Medicare and Medicaid Services (CMS) have recently increased emphasis on addressing Medicaid member social needs. CMS believes addressing health-related social needs (HRSN) may reduce costs and improve health outcomes for Medicaid members. CMS has begun to test theories regarding the impact of member HRSN on health care by designing federal mechanisms to address HRSN, such as in lieu of services and settings-funded services, and by encouraging state Medicaid programs to develop their own approaches, such as Flexible Services. Information …

Cost-Benefit Analysis Program Percontohan Pengendalian Rabies Berbasis One Health Di Wilayah Sanur, Denpasar Selatan, Marheni Ni Wayan, Sutarsa I Nyoman, Made Subrata

Jurnal Ekonomi Kesehatan Indonesia

Rabies continues to pose a significant public health challenge in Bali Province, Indonesia. The Dharma Program, a rabies control initiative based on the One Health approach, has been implemented in multiple areas of the province. Sustaining and expanding this program requires an economic evaluation that compares the cost burden of rabies under scenarios with and without program implementation. This study was conducted in two pilot villages: Sanur Kaja (SKJ) and Sanur Kauh (SKH). Cost data were obtained from activity reports, published literature, and structured interviews with program managers. Benefit values were estimated using scenario modeling, which included treatment costs, post-exposure …

Analisis Perbedaan Biaya Satuan Sectio Caesarea Tanpa Penyulit Dengan Tarif Ina-Cbgs Di Rumah Sakit Swasta Tipe D (X) Di Ternate Tahun 2022, Ummu Hani Mars, Prastuti Soewondo

Jurnal Ekonomi Kesehatan Indonesia

Cesarean section unit cost is an important component for hospital’s management to implement strategic efficiency steps in the future, especially for Rumah Sakit X which 90% of patients are Jaminan Kesehatan Nasional’s participant. Geographically, this hospital is one of hospitals which serve delivery and labor services in Ternate Island that can accommodate references from nearby islands. This resulting in high caesarean section rate, 55 % of all deliveries. The low JKN rate for caesarean section forced management to know the detailed cost component, so the efficiency strategies and the continuity of hospital services could be more increased. This research through …

Analisis Perbandingan Biaya Dan Penggunaan Obat Antara Pasien Bpjs Kesehatan Dan Non-Bpjs Kesehatan Periode Januari-Desember 2022 Di Klinik Pratama X Kota Bandung, Phebe Ariella Wilis, Tjokorde Istri Armina Padmasawitri, Syifa Fitrah Qanaah

Jurnal Ekonomi Kesehatan Indonesia

Primary healthcare facilities may have two sources of drug funding: capitation funds for drugs prescribed to patients under the Social Security Administering Agency (BPJS Kesehatan), and out-of-pocket payments from non-BPJS Kesehatan patients. Analyzing drug utilization patterns and financing is essential to ensure the efficient use of these funding sources. This study aims to analyze drug costs and utilization among BPJS Kesehatan patients compared to non-BPJS Kesehatan patients at Primary Clinic X in Bandung City from January to December 2022.This study used a retrospective cross-sectional design with data collected from electronic medical records and pharmacy transactions. Descriptive analysis was employed to …

More Girls In The Classroom Improves Adolescent Mental Health, Monica Deza, Maria Zhu

Population Health Research Brief Series

Mental health challenges are common among adolescents in the United States. This brief summarizes findings from a study using data from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative survey of middle and high school students conducted in 1994-1995. The analysis included over 17,000 students from 133 schools across the United States. The authors find that the mix of boys and girls in a classroom affects adolescent mental health and school satisfaction. When classes have more girls, both boys and girls experience better mental health outcomes. Boys in classes with more female peers are 10% less …

Examining The Association Between User Fee Exemptions And Maternal Healthcare Utilization In Northern Ghana, Martina Hilton-Ansah

Walden Dissertations and Doctoral Studies

Abstract In Ghana, the user fee exemption policy, implemented in 2008, provides free maternal health services, which are a key component of the National Health Insurance Scheme (NHIS). Grounded in the Health Access Livelihood Framework, the purpose of this study was to determine the association between the user fee exemption policy and the utilization of antenatal care, facility-based delivery, and postnatal care in Northern Ghana, while controlling for sociodemographic factors. A quantitative approach was employed using secondary data from the Ghana Demographic and Health Surveys, encompassing women of reproductive age (15–49 years; N = 6,948). Logistic regression was used to …

Epigenome-Wide Association Study Of Nuclear Dna Methylation In Relation To Mitochondrial Heteroplasmy, Meng Lai, Kyeezu Kim, Yinan Zheng, Christina A Castellani, Scott M Ratliff, Mengyao Wang, Xue Liu, Jeffrey Haessler, Tianxiao Huan, Kwadwo Bonsu, Charles Newcomb, Kyler Mckessy, Lawrence F Bielak, Wei Zhao, Roby Joehanes, Jiantao Ma, Xiuqing Guo, Joann E Manson, Megan L Grove, Jan Bressler, Kent D Taylor, Tuuli Lappalainen, Silva Kasela, Thomas W Blackwell, Nicole J Lake, Jessica D Faul, Kendra R Ferrier, Stephen C Ekker, Lifang Hou, Charles Kooperberg, Alexander P Reiner, Kai Zhang, Patricia A Peyser, Myriam Fornage, Eric Boerwinkle, Laura M Raffield, April P Carson, Stephen S Rich, Yongmei Liu, Daniel Levy, Jerome I Rotter, Jennifer A Smith, Dan E Arking, Chunyu Liu

Faculty, Staff and Student Publications

We analyze 10,986 participants (mean age 77; 63% women; 54% non-White) across seven U.S. cohorts to study the relationship between mitochondrial DNA (mtDNA) heteroplasmy and nuclear DNA methylation. We identify 597 CpGs associated with heteroplasmy burden, generally showing lower methylation. These CpGs are enriched in dynamically regulated island shores and depleted in CpG islands, indicating involvement in context-specific rather than constitutive gene regulation. In HEK293T cells, we introduce a truncating mtDNA mutation (MT-COX3, mt.9979) and observe a positive correlation between variant allele fraction and methylation at cg04569152, supporting a direct mtDNA-nDNA epigenetic link. Many heteroplasmy-associated CpGs overlap with known methylation-trait …

Engaging Ukrainian Tf-Cbt Therapists In A Practice Skills Course To Support Their Wellbeing, Elisabeth Pollio, Esther Deblinger, Beth Cooper, Maike Garbade, Julie P Harrison, Elisa Pfeiffer

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background: Burnout and secondary traumatic stress (STS) are common among therapists working with trauma-exposed clients, which can negatively impact them professionally and personally. The shared trauma of war exposure may put therapists at greater risk. To help support their wellbeing, an eight-session course was offered to Ukrainian therapists following training in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). This course involves therapists personally utilizing the PRACTICE skills taught to clients in TF-CBT for professional and personal benefit.

Objective: The objective was to gather preliminary evidence on the potential impact of implementing the course with Ukrainian therapists providing TF-CBT during a period of …

An Evaluation Of Virtual Supervision Effectiveness Within Department Of Veterans Affairs (Va) Health Professionals Training Programs, Linda M. Kawentel, John P. Donnelly, Kaylee W. Burgan, Gezan M. Yahya, Joanna S. Doredla, Jessica L. Johnson, Kimberly Falco, Marjorie A. Bowman, John Byrne, Nicholas W. Bowersox

Population and Public Health Sciences Faculty Publications

Background Limited information exists on whether virtual training is equivalent to traditional in-person training in supporting the development of clinical providers. Methods A multi-site evaluation using survey methods was conducted with a multidisciplinary group of health professions trainees and supervisors within the Veterans Health Administration to assess the equivalence of two supervision modalities – exclusively in-person supervision and supervision incorporating at least some virtual supervision – on trainee clinical competency development, trainee preparedness to respond to patient emergencies, and effective trainee/supervisor working relationships. Results Trainees who experienced some virtual supervision rated their clinical competency levels as higher than trainees with …