Public Health Commons^™

Comorbidities, Therapy And Health System Factors Associated With Treatment Interruption Among Males With Tuberculosis In Nairobi County, Kenya, Lorraine Nkirote Mugambi-Nyaboga

Walden Dissertations and Doctoral Studies

While males are recognized as key drivers of tuberculosis (TB) transmission, the association between comorbidities (i.e., diabetes and malnutrition), adverse drug reactions (ADRs), and health system factors (i.e., frequency of drug refills) with TB treatment interruption, remains unclear. I aimed to determine the association between these factors and TB treatment interruption among males diagnosed with TB in Nairobi County, Kenya controlling for age, sub-county of residence, alcohol use, HIV co-infection, type of TB and presence of treatment supporter. Guided by WHO’s framework on adherence to long-term therapies, a quantitative, case-control study was conducted using secondary analysis of Kenya’s TB surveillance …

Intersectional Analysis Of Vaccination Inequity Among Individuals With Disabilities In The United States During The Covid-19 Pandemic, Philip Ndoki, Heba M. Athar, David O. Anderson

Journal of Social, Behavioral, and Health Sciences

We investigated how disability status, types, sociodemographic indicators, and reasons for not receiving vaccinations influenced COVID-19 vaccination rates among individuals with disabilities in the United States. Despite efforts, vaccination disparities persisted, necessitating a nuanced understanding of the barriers to vaccination. Using intersectionality theory and the social determinants of health framework, we examined the impact of marginalized identities and structural inequalities. Key questions included the association between disability status and vaccination uptake, differences among disability types moderated by sociodemographic factors, and the interaction between disability status and reasons for not vaccinating. We used Household Pulse Survey data from the U.S. Census …

A Multi-Level Gene-Diet Interaction Analysis Of Fish Oil And 14 Polyunsaturated Fatty Acid Traits Identifies The Fads And Gpr12 Loci, Susan Adanna Ihejirika, Alexandra Huong Chiang, Aryaman Singh, Eunice Stephen, Han Chen, Kaixiong Ye

Faculty, Staff and Student Publications

Fish oil supplements (FOS) are known to alter circulating levels of polyunsaturated fatty acids (PUFAs) but in a heterogeneous manner across individuals. These varied responses may result from unidentified gene-FOS interactions. To identify genetic factors that interact with FOS to alter the circulating levels of PUFAs, we performed a multi-level genome-wide interaction study (GWIS) of FOS on 14 plasma measurements in 200,060 unrelated European-ancestry individuals from the UK Biobank. From our single-variant tests, we identified genome-wide significant interacting SNPs (p < 5 × 10-8) in the FADS1-FADS2 gene cluster for total omega-3, omega-3%, docosapentaenoic acid (DHA), DHA%, and the omega-6 to omega-3 ratio. Among the interaction signals for omega-3%, the lead SNP, rs35473591 (C>CT, CT allele frequency = 0.34), had a lower association effect size in the FOS-taking group (β = 0.35 for …

A Review Of Mirvetuximab Soravtansine-Gynx In Folate Receptor Alpha-Expressing Platinum-Resistant Ovarian Cancer, Judith A Smith, Patrick Medina, Mary Miao, Kathleen N Moore

Faculty, Staff and Student Publications

Purpose: To evaluate the pharmacology, efficacy, safety, and dosing and administration considerations (including adjusted ideal body weight [AIBW] dosing) for mirvetuximab soravtansine-gynx, a first-in-class folate receptor alpha (FRα)-directed antibody-drug conjugate for platinum-resistant ovarian cancer (PROC).

Summary: A literature search was conducted in PubMed using the terms "ovarian cancer" and "mirvetuximab soravtansine" of articles published from inception to April 16, 2024. Relevant publications, abstracts, and clinical trials were reviewed. Mirvetuximab soravtansine-gynx is dosed at 6 mg/kg AIBW every 3 weeks and comprises an FRα-binding antibody, a hydrophilic disulfide linker, and a maytansinoid DM4 payload. Mirvetuximab soravtansine-gynx binds to FRα, which induces …

Strengthening Occupational Health And Safety (Ohs) In Schools To Minimize Risks For Students, Teachers, And Visitors: Policy Recommendation, Wiwik Eko Pertiwi, Hanifa Maher Denny, Yuliani Setyaningsih, Agung Dwi Laksono

Journal of Indonesian Health Policy and Administration

Vocational schools equip students with practical skills and expose them to industry-related hazards, making Occupational Health and Safety (OHS) a crucial aspect of the school environment. This study aims to identify key factors behind the weak implementation of OHS in vocational schools. A literature review used articles published between 2017–2024 from national and international journals. The review found poor OHS implementation stems from lack of awareness, inadequate policies, insufficient infrastructure, weak safety culture, and negligence in accident prevention. To address these issues, the study recommends OHS education and training, improvement of school infrastructure, curriculum integration, formation of safety teams, and …

Staff Expectancies In Conducting Ship Hygiene And Sanitation Inspections: A Qualitative Study At Banten Class I Port Health Quarantine Office, Lukman Waris, Budiman Budiman, Hany Puspita Aryani

Journal of Indonesian Health Policy and Administration

Sea transport plays a vital role in the movement of goods and passengers, yet it simultaneously poses a potential risk for the transmission of infectious diseases, both nationally and internationally. Ship hygiene and sanitation inspection (HSI) is a strategic measure to control such risks, and the outcomes of these inspections are influenced by the expectations of the implementing officers. This study explores how staff expectancy at the Banten Class I Port Health Quarantine Office affects the quality of HSI. A qualitative study using the Rapid Assessment Procedure (RAP) was conducted with 80 staff members across five work units. Data were …

Reproductive Health In America: A System Ran By Sexism And Male Control, Hailey Mccool

Merge

No abstract provided.

2024 Health Equity Impact Report, Children's Health, Stormee Williams

Publications

The Health Equity Impact Report from Children’s Health outlines the organization’s strategy and progress in advancing equitable pediatric care. The report highlights efforts to identify and address social determinants of health—such as food insecurity, housing instability, and access to transportation—through systemwide screening and targeted interventions.

Evaluation Of Knowledge, Attitudes And Vaccine Hesitancy Towards Mmr Vaccine Among Parents In The United Arab Emirates, Kamel A. Samara, Hiba Jawdat Barqawi, Deema M. Alhayali, Samah Mohamed Kannas, Rim M. Elmorsy, Eman Abu-Gharbieh

Abington Jefferson Health Papers

BACKGROUND: The Measles, Mumps, and Rubella (MMR) vaccine is highly effective, but vaccine hesitancy (VH) is a key barrier to achieving herd immunity. This study aims to assess the general attitudes and knowledge of UAE parents regarding measles and the MMR vaccine while identifying determinants of VH.

METHODOLOGY: A cross-sectional study was done from 15th April 2024 and 5th June 2024. This study recruited 462 parents residing in the UAE using convenience sampling. Recruitment occurred through various social media platforms including WhatsApp, X, and Instagram, as well as in public by approaching parents in parks and malls. Information collected included …

Rethinking Congenital Cytomegalovirus: A Narrative Review Of The Clinical, Public Health, And Ethical Challenges Of A Preventable Cause Of Childhood Hearing Loss, M. Peyton Simons, Gauri Mankekar

School of Medicine Faculty Publications

Congenital cytomegalovirus (cCMV) is the most common non-genetic cause of pediatric sensorineural hearing loss, affecting approximately tens of thousands of infants annually in the United States. While cCMV may present symptomatically at birth, many infants are asymptomatic initially and later develop progressive or fluctuating hearing loss, which is often undiagnosed without early screening. Despite advances in diagnostic methods such as polymerase chain reaction (PCR) testing, the absence of a national screening policy in the U.S. results in significant variability in early detection and follow-up care. This narrative review provides an overview of the clinical manifestations, diagnostic strategies, and treatment options …

Dietary Intake Of Protein By Food Source And Incident Hypertension Among Diverse Us Adults: The Mesa Study, Ji Yun Tark, Ruosha Li, Bing Yu, Alexis C Wood, Nikhil S Padhye, Marcia C De Oliveira Otto

Faculty, Staff and Student Publications

Background: Dietary guidelines recommend adequate protein intake from diverse sources for optimal blood pressure; however, its role in hypertension risk remains unclear. We examined prospective associations of protein intake and diversity, overall and by source, with hypertension risk in the MESA (Multi-Ethnic Study of Atherosclerosis) study.

Methods and results: Among 2294 participants aged 45 to 84 years without hypertension at baseline, total, animal, and plant protein intake was assessed using a 120-item food frequency questionnaire. Protein diversity was evaluated using count and the dissimilarity index. Over a 9-year median follow-up, 1356 hypertension cases were identified through blood pressure measurements and …

Adhd Diagnosis And Treatment Within Ethnic Minority Groups, Dianthe Hoang

Undergraduate Honors Theses

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is commonly diagnosed in childhood, and the National Survey of Children’s Health reported that ADHD had a prevalence of around 6.1 million children aged 2-17 years old (NSCH, 2016). This review discusses the cultural and socioeconomic barriers that contribute to the underdiagnosis and treatment in members of ethnic minority communities. Black, Hispanic, Native American, and Asian adults received less mental health care compared to White Americans. Previous findings indicated that cultural factors, such as misinterpretation of symptoms from families and teachers and cultural perceptions of mental health, contributed to disparities …

The Impact Of Functional Disabilities On The Quality Of Life Of Older U.S. Adults, Bernadette Lavender

Walden Dissertations and Doctoral Studies

Among older U.S. adults, functional disabilities are critical determinants of quality of life (QoL), influencing mobility, social engagement, and independence. Despite growing evidence of these impacts, limited research examines how healthcare access, social support, and socioeconomic factors moderate this relationship. This quantitative study explored the effects of functional disabilities on QoL, operationalized through self-reported health, while examining the moderating roles of key social determinants. Using a cross-sectional design, secondary data from the Health and Retirement Study (HRS) were analyzed. The sample included 42,405 participants aged 60 years and above from all 50 states. Multiple regression analyses and ANOVA were employed …

Food Insecurity, Myplate Utilization, And Hba1c In United States Adults With Prediabetes, Lindley R. Sharp

Walden Dissertations and Doctoral Studies

The rising prevalence of prediabetes in the United States presents a significant public health challenge, particularly due to its progression into Type 2 diabetes. Despite national dietary guidelines, disparities in dietary adherence persist, especially among food-insecure adults. This quantitative study examined the impact of food insecurity and MyPlate utilization on HbA1C levels in prediabetic U.S. adults, while accounting for structural and intermediary determinants of health. Guided by the Commission on Social Determinants of Health framework, this cross-sectional study utilized secondary data from the 2015–March 2020 National Health and Nutrition Examination Survey including a sample size of 1,417 noninstitutionalized male and …

Sociodemographic And Psychosocial Characteristics Of E-Cigarette Ever-Use: U.S. Hints 6 Survey, Lilianna Phan, Kuang-Yi Wen, Hee Jun Kim, Julie A. Barta, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

Objective

Methods

Results

A Comparative, Quantitative Analysis Of Birth Outcomes Among Women With Intellectual Or Developmental Disabilities, Jocelyn T. Reddix

MUSC Theses and Dissertations

Women who are pregnant or planning to give birth deserve equitable resources, respect, and assurances to ensure a healthy and safe pregnancy, including women of childbearing age who are diagnosed with intellectual or developmental disabilities (IDD). These women are more likely to experience negative perinatal, delivery, and postpartum health outcomes (Tarasoff et al., 2020). Healthcare providers, clinicians, and the family and friends of those with IDD must understand the impact and implications of the prenatal and postpartum journey for this group of women. This comparative research examined 2021 birth outcomes of women in the United States with IDD compared to …

Addressing Socioeconomic Disparities In The Treatment Of Antimicrobial-Resistant Infections: The Role Of Pharmacists In Mitigating Barriers, Arin Wade, Danielle Egbujor, Anna Spalvieri, Owen Fox, Marisa Petrunich, Joshua Honaker, Samantha Mccord, Kasie Landin

Pharmacy and Wellness Review

Antimicrobial resistance is an escalating global threat driven by inappropriate antibiotic use and shaped by socioeconomic disparities. Social determinants of health, including limited healthcare access, poverty, low health literacy, and environmental conditions, contribute to higher rates of resistant infections and poorer treatment outcomes in underserved populations. Barriers such as pharmacy deserts, self-medication, and inadequate stewardship infrastructure amplify these risks. Pharmacists, as accessible and highly trained healthcare professionals, play a critical role in combating antimicrobial resistance by optimizing antibiotic use, delivering culturally competent education, and leading antimicrobial stewardship programs across settings. Community and clinical pharmacists are especially well positioned to bridge …

Guidelines For The Creation And Implementation Of A School-Based Vision Program For The Greater Seattle Area, Suzanna P. Gill

Honors Projects

Proper vision care contributes to a child’s ability to perform academically as well as their overall health and wellbeing. Pediatric vision care begins with vision screening, which occurs in public schools in Washington state. These vision screenings allow for possible vision issues to be identified in children. They are not, however, a replacement for eye examinations that help determine what is causing the problem and provide treatment. A substantial proportion of children that are recommended to receive the exams will not, partially because Washington does not require parents to take their children to eye care professionals. These children are more …

Rural And Urban Disparities In Access To Glp-1 Agonists For Patients With Obesity, Christine J. Hackler-Moorman

MUSC Theses and Dissertations

The increasing interest in glucagon-like peptide-1 (GLP-1) agonists, such as semaglutide, which are often prescribed as a first-line treatment for managing Type II diabetes, as well as for non-diabetic purposes—such as weight management and improving metabolic health—highlights their potential in preventive care. This promise inspires hope for a future where preventive healthcare is more effective and accessible to a wider audience. Nonetheless, significant geographic disparities in access to healthcare, especially between rural and urban areas, create obstacles that prevent numerous patients from reaping the benefits of these essential medications. In rural communities, challenges like cost, availability, and awareness are often …

Endophenotype-Informed Association Analyses For Liver Fat Accumulation And Metabolic Dysfunction In The Fels Longitudinal Study, Ariana L. Garza, John Blangero, Miryoung Lee, Cici X. Bauer, Stefan A. Czerwinski, Audrey Choh

School of Medicine Publications

The identification of causal genomic regions for liver fat accumulation in the context of metabolic dysfunction remains a challenging goal. This study aimed to identify potential endophenotypes for liver fat content and employ them in bivariate linkage searches for pleiotropic genetic regions where targeted association analysis is more likely to reveal significant variants. Multiple metabolic risk and adiposity distribution traits were assessed using the endophenotype ranking value. The top-ranked endophenotypes were then used in a bivariate linkage analysis, paired with liver fat content. Quantitative trait loci (QTLs) identified as significant or suggestive were targeted for measured genotype association analyses. The …

E-Cigarette Or Vaping Product Use-Associated Lung Injury: A Comprehensive Review, Mohammad Asim Amjad, Daniel Ocazionez Trujillo, Rosa M Estrada-Y-Martin, Sujith V Cherian

Faculty, Staff and Student Publications

E-cigarette or vaping product use-associated lung injury (EVALI) is a critical and potentially fatal form of lung injury that gained considerable public health concern in 2019. The use of e-cigarettes and vaping products is causally associated with EVALI, a condition characterized by a constellation of respiratory symptoms, such as coughing, shortness of breath, and chest pain. This comprehensive narrative literature review explores the complexities of EVALI, including its association with the structure and composition of e-cigarettes and its epidemiology, pathogenesis, clinical and radiological manifestations, management strategies, and public health implications. Moreover, it uncovers the long-term repercussions of EVALI and underscores …

Shifting To A Culture Of Inclusion By Design: Applying A Mixed-Methods Approach To Advance Accessibility Of Public Health Emergency Information & Communication Technology, Jessica L. Franks, Erin Vinoski Thomas

Developmental Disabilities Network Journal

Adults with intellectual and developmental disabilities (IDD) experience inequities in access to timely, accurate, and understandable information and communication technology (ICT), which increases risk for public health emergency (PHE)-related health disparities and impedes opportunities to achieve optimal health. This study assessed federal COVID-19 webpage accessibility levels and explored existing knowledge of and experience with filing accessibility complaints for federal ICT among adults with IDD. Through a mixed-methods approach, we evaluated compliance with accessibility standards for 18 federal agencies’ COVID-19 webpages (study 1) and interviewed 16 adults with IDD about experiences accessing federal webpages and filing accessibility complaints (study 2). We …

Generative Ai For Thematic Analysis In A Maternal Health Study: Coding Semistructured Interviews Using Large Language Models, Shan Qiao, Xingyu Fang, Junbo Wang, Ran Zhang, Xiaoming Li, Yuhao Kang

Faculty Publications

Study Objectives: The coding of semistructured interview transcripts is a critical step for thematic analysis of qualitative data. However, the coding process is often labor-intensive and time-consuming. The emergence of generative artificial intelligence (GenAI) presents new opportunities to enhance the efficiency of qualitative coding. This study proposed a computational pipeline using GenAI to automatically extract themes from interview transcripts. Methods: Using transcripts from interviews conducted with maternity care providers in South Carolina, we leveraged ChatGPT for inductive coding to generate codes from interview transcripts without a predetermined coding scheme. Structured prompts were designed to instruct ChatGPT to generate and summarize …

Assessing One-Year Health Impacts From Wildfires In Rural Communities: Roles For Extension In Promoting Wildfire Preparedness And Recovery, Marc T. Braverman, Sandi Cleveland Phibbs, Emily Jane Davis, Amanda Rau, Elijah Penner

Journal of Extension

Wildfires can produce health impacts that persist for years in affected communities. This article describes an Extension-led study of health impacts in rural Oregon communities one year after a destructive wildfire. Data collection included key informant interviews (n=36), an online survey (n=80), and three focus group interviews with survivors (n=23). Mental health, exposure to contaminants, physical stress, food insecurity, and other issues were frequently identified health concerns. Survivors’ difficulties in dealing with housing displacement significantly exacerbated health challenges. We describe potential roles for Extension in addressing wildfire risk and mitigating health impacts, including a description of the Oregon Fire Program.

Reaching Tomorrow’S Extension Customer: A Food And Health Needs Assessment, Morgan Szczepaniak, Sarah L. Francis, Ruth Litchfield, Ulrike Genschel, Shannon Coleman, Anirudh Naig

Journal of Extension

The food and health needs and preferences of Iowans (n=452) were examined. The leading food and health information sources were online platforms, social media, and print media. Program topics with high participation likelihood were cooking, food preservation, food safety, and gardening. Short, low-cost, online programs were preferred. Extension use was more likely among those who identified as persons of color, Hispanic/Latino, or were food insecure (p < 0.030). Those with less education and chronic disease were less likely to be interested in Extension programming (p < 0.040). These results provide valuable information regarding future directions for Extension programming.

Emergency Medicine Residency Website Wellness Pages: A Content Analysis, Alexandra Sappington, Brian Milman

School of Medicine Faculty Publications

Introduction: The COVID-19 pandemic impacted the way medical students seek residency positions. In 2020, the Accreditation Council for Graduate Medical Education advocated for virtual interviews. Most emergency medicine (EM) interviews in 2023 remained virtual, and this format will persist for the foreseeable future. Since students are not evaluating programs in person in most cases, residency websites are crucial for prospective residents. Resident wellness is critical for resident training and important to prospective residents; it follows that programs must be transparent about resident wellness on websites. In this study we aimed to quantify the number of EM programs with wellness pages …

Science Tikkun: A Bioscience Pandemic Framework In A Hebrew Tradition Of Global Repair, Peter Hotez

Center for Medical Ethics and Health Policy Staff Publications

Over the past decade we have seen a steady increase in dangerous pandemic threats. They include two major Ebola epidemics and cholera in Africa; dengue, Zika, yellow fever in the Americas; a COVID-19 pandemic; and H5N1 in Texas. This is happening because of a confluence of modern forces including urbanization, deforestation, and climate change. Yet as pandemics emerge on a crowded and warming planet, anti-science disinformation and antisemitism impede our response. Science tikkun is an overarching framework for repair and redress. It honors the legacy of Maimonides, Teilhard de Chardin, and others who have sought reconciliation between science and religion.

Climate Change Impacts On Drinking Water Security: A Comparative Study In Australia’S Remote Central Australia And Torres Strait Islands, Nina Lansbury, Julia Bradford, Sandra J. Creamer, Geoffrey Evans

Journal of the Australian Indigenous HealthInfoNet

Aboriginal and Torres Strait Islander communities are well adapted to the many different environments in which they have lived for thousands of years. However, their environments and communities are highly vulnerable to impacts of anthropogenic climate change, including increasing threats to the security of drinking water supplies. Climate change is intensifying the significant social and economic disadvantage Australia’s Aboriginal and Torres Strait Islander communities face from poverty, poor housing, and poor health including high exposure to infectious and other diseases. Lack of sufficient safe, clean, drinking water could force Aboriginal and Torres Strait Islander people to leave their homelands, adding …

Centralising Local Aboriginal Language And Culture In Healthy Skin Books On The See Treat Prevent (Stop) Trial In The Kimberley Region Of Western Australia: A Process And Impact Inquiry, Tracy Mcrae, Kelli Mcintosh, Hannah Mm Thomas, Stephanie Enkel, Abbey Ford, John Jacky, Slade Sibosado, Marianne Mullane, Alexandra Whelan, Rebecca Dalton, Juli Coffin, Jonathan R. Carapetis, Roz Walker, Asha C Bowen

Journal of the Australian Indigenous HealthInfoNet

Language is significant for communicating knowledge across cultures and generations and has the power to attribute meanings and alter our worldviews. More than 250 Aboriginal and Torres Strait Islanders languages were spoken in 1788. This number has diminished to approximately 110 languages spoken in 2016, of which 90% were considered endangered in 2019. Language custodians and speakers across Australia are working to preserve and ensure languages are strongly spoken into the future. Language revitalisation initiatives can facilitate (re)connection to Country, cultures and communities and be recognised as acts of reconciliation for Aboriginal and Torres Strait Islander peoples. In a health …

Observed And Reported Outcomes Following Experiential Cultural Capability And Clinical Yarning Training For Clinicians Treating Aboriginal And Torres Strait Islander People With Persistent Pain, Stuart Ekberg, Renata F. I Meuter, Ivan Lin, Roslyn Rowen, Angela Kinnell, Eva Malacova, Tania Waring, Kushla Houkamau, Marayah Taylor, Matthew Bryant, Jermaine Isua, Andrew Claus, Paul Gray, Joseph Kluver, Christina M. Bernardes, Greg Pratt

Journal of the Australian Indigenous HealthInfoNet

Communication is recognised as crucial to culturally safe healthcare, and poor communication remains a major reason that Aboriginal and Torres Strait Islander people do not access healthcare. This pragmatic, pre-post comparison study employed mixed methods to evaluate cultural capability and clinical yarning training delivered to 57 clinicians supporting Aboriginal and Torres Strait Islander people at three persistent pain management services in Queensland, Australia. Observable outcomes of the training were evaluated by video recording clinicians’ training experiences and seven consultations with patients that occurred either pre- or post-training. Reported outcomes were evaluated by using a modified Cultural Safety Survey (CSS), which …