Public Health Commons^™

Mpox Insights: From Structure To Human Cell Interaction, Md. S. Zaman, Robert C. Sizemore, Draven Rodriguez, Emilio Lopez, S. M. Golam Alam, Suleyman Tufa, Juan C Lopez Alvarenga, Nuraly S. Akimbekov, Mohammed S. Razzaque

School of Medicine Publications

Mpox, a zoonotic viral disease, has emerged as a global concern due to outbreaks in both endemic and non-endemic regions in 2022. Rodents, including African squirrels and Gambian pouched rats, are suspected key reservoirs, with human infections occurring through direct contact with infected animals or bushmeat consumption. Previously confined to rural Africa, mpox has spread via international travel and the exotic pet trade. Human-to-human transmission occurs mainly via respiratory droplets and direct contact with bodily fluids or lesions. The virus has a double-stranded DNA genome within a lipid envelope. Despite lower mutation rates in DNA viruses, mpox has developed mutations, …

Pediatric Firearm Injuries In A Major Urban Louisiana City: A Deadly Public Health Issue, Morgan Brown, Jenny Stevens, Jose Cruz Ayala, Claudia Leonardi, Alison Smith, Fabienne Gray

Journal of the Louisiana Public Health Association

Background: In 2019, firearm injuries surpassed motor vehicle collisions as the leading cause of pediatric death in the US. In Louisiana, firearm injuries represent the leading cause of pediatric death since 2013. A more comprehensive understanding of risk factors associated with pediatric firearm injury is needed to improve outcomes. Methods: A retrospective review from 2016-2023 of pediatric trauma patients presenting to a Level I Adult Trauma Center & Level II Pediatric Trauma Center in a major urban Louisiana city was performed. Demographics, mechanism of injury, and injury intent were evaluated. Results: Among 8,832 patients, 1,116 (12.6%) sustained firearm injuries. Among …

Band-Aids And Backroads: Surviving Rural Healthcare In South-Central Mississippi, Cambry L. Craft

Honors Theses

Health is more than the absence of disease—it is the product of opportunity, trust, and access. Yet for millions living in rural areas of the United States, equitable healthcare remains out of reach. This thesis seeks to amplify the voices of rural residents in Mississippi and uncover how their experiences, beliefs, and cultural values shape their perception of their local hospital and the care that is provided there. This qualitative research study examines the experiences and opinions of a rural community in south-central Mississippi regarding their local hospital, as well as their perceptions of the most effective approach to prevent …

Assessment Of Microbial Contamination On High-Touch Public Surfaces And Its Implications For Community Health: A Cross-Sectional Study From Urban South India, Muhammed Suhail S

Journal Of Indian Physician Associates

Objectives High-contact public surfaces, such as bus seatbacks, mall escalator belts, and theater armrests, may act as reservoirs of opportunistic and antimicrobial-resistant microorganisms, posing a significant but underreported risk to community health. In urban environments like Coimbatore, Tamil Nadu, surface-level microbial surveillance remains poorly characterized. This study aimed to assess the magnitude, composition, and density of microbial contaminants on commonly touched surfaces across transit and commercial hubs.

Methods A total of 30 surface swab samples were collected from five public locations, including intra-city TNSTC buses, inter-state SETC coaches, Brookfields Mall escalator handrails, multiplex theaters and local bus seat-grips. Standardized 25 …

Social Determinants Of Self-Reported Health In Vulnerable Populations During A Polycrisis In Lebanon, Rindala Fayyad, Marie Elizabeth Ragi, Hala Ghattas Ph.D., Stephen J. Mccall

Faculty Publications

Importance: In the context of a polycrisis, which is characterized by multiple interconnected and mutually reinforcing crises, humanitarian and health needs increase. It is therefore crucial to identify social determinants impacting health and well-being of vulnerable populations to better inform appropriate interventions.

Objective: To assess the association between social determinants and pain frequency, self-rated health, and depression over time among vulnerable populations during a polycrisis in Lebanon.

Design, Setting, and Participants: In this population-based longitudinal cohort study, data were collected in Sin-El-Fil, a suburb of Beirut, Lebanon, in 4 waves: June 28 to October 26, 2022; September 8 to December …

Enhancing Methods For Research On Cannabis: A Workshop Report, Jonathan Samet, Jessica Barrington-Trimis, Lisa Bero, Ashley Brooks-Russell, Meghan Buran, Julia Dilley, Darin Erickson, Marilyn Huestis, Kent Hutchison, Thomas Jeanne, Michael Kosnett, David Kroll, Stephen Lankenau, Richard Miech, Rosalie Liccardo Pacula, Paula Riggs, Neeloofar Soleimanpour, Steven Teutsch, Gregory Tung, George Sam Wang

College of Health Professions Faculty Papers

AIMS: Progressive legalization of medical and recreational cannabis markets at the state-level has led to rapid growth of medical and recreational cannabis markets and to product diversification with emerging products having high concentrations of delta-9-tetrahydrocannabinol. Research on these products is still limited and the evidence available for policy formulation is diminished by methodological limitations.

METHODS: As a step towards addressing these limitations, the Colorado School of Public Health convened a multidisciplinary workshop that addressed four areas of cannabis research: epidemiological, clinical, surveillance, and policy. Workshop participants provided recommendations in each area to advance research on cannabis to make it more …

Identifying Barriers And Place-Based Solutions To Physical Activity For Older Adults In East Tennessee, Lydia Hoskins, Jodi Southerland

Journal of Appalachian Health

Introduction: Older adults in East Tennessee (TN), the fastest growing demographic, face significant health challenges, with 44% reporting four or more chronic conditions. The state ranks 45th in physical inactivity among older adults, exacerbating chronic disease risks, fall-related injuries, and mental health issues. Urban-rural disparities in East TN further complicate efforts to promote active living, particularly for rural residents.

Purpose: This qualitative study explored socioecological barriers and solutions to increase physical activity (PA).

Methods: In April 2024, two focus group were conducted in East TN, with a total of 11 participants composed of six community partners and five older adults. …

Outcomes Of Bio-Psycho-Social-Spiritual Communitybased Drug Rehabilitation Program For Voluntary Vs. Court-Mandated Clients In The Philippines, Maria Regina M. Hechanova, Trixie Anne Co, Fessa R. Egusquiza

Psychology Department Faculty Publications

This study sought to evaluate the outcomes of a community- based rehabilitation program for voluntary and court-mandated drug users in the Philippines. Participants went through a bio-psycho-social-spiritual group-based program that aimed to develop their recovery skills and life skills. The program also included family modules to enhance their knowledge of drug use, its effects, and the role of family in recovery. A cohort design was used with pre- and posttest surveys administered before and immediately after the program. The sample consisted of 105 voluntary clients and 118 court-mandated clients who underwent screening or drug dependency evaluation and were recommended for …

Nursing Students’ Sociodemographic Characteristics And Consumer Preferences’ Prediction Level Of Perceived Food Literacy, Sinan Duru

Makara Journal of Health Research

Background: Food literacy, which is a critical competency for nursing students, plays a pivotal role in promoting evidence-based nutrition behaviors and contributes effectively to public health. This study aimed to determine the level of perceived food literacy among nursing students.

Methods: This cross-sectional study involved 488 nursing students from two universities in the south of Turkey. The research data were collected face to face via the Personal Information Form, the Consumer Preferences Form, and Self Perceived Food Literacy. The data was analyzed using the Independent Sample t Test, One Way ANOVA, and multiple linear regression.

Results: The …

Understanding And Predicting Flossing Behavior In A Rural Appalachian Community Using The Multi-Theory Model, Rahib K. Islam, Manoj Sharma, Amanda H. Wilkerson, Bradford Layman, Clyde Dunn, Shamima A. Somi, Ratnesh Sharma, Karen Gruszynski, Syed S. Quadri, Vinayak K. Nahar, Robert E. Davis

School of Medicine Faculty Publications

Effective flossing is essential for preventing periodontal disease. However, in a rural Appalachian community, adherence to flossing routines remains low, contributing to significant oral health disparities. The purpose of this study was to conceptualize intention of initiation and sustenance of flossing behaviors using the multi-theory model (MTM) of health behavior change. A cross-sectional survey was administered to individuals recruited from a shopping mall in rural Appalachia. The MTM constructs were measured and data were analyzed using multiple linear regression models. Of the 228 participants, 55% did not floss daily. Behavioral confidence (β = 0.571, p < 0.001) was a significant predictor for the intention of initiation of flossing among non-daily flossers, while emotional transformation (β = 0.377, p = 0.836) significantly explained sustenance among non-daily flossers. For daily flossers, changes in the physical environment (β = 0.432, p = 0.003) significantly predicted the intention of initiation of flossing, whereas emotional transformation (β = 0.344, p = 0.008) and practice for change (β = 0.594, p < 0.001) significantly predicted sustenance of flossing behavior. The MTM appears to be a robust framework for understanding and predicting flossing behaviors in rural Appalachian populations. Interventions designed to enhance behavioral confidence, physical environment changes, emotional transformation, and practice for change could improve flossing adherence. Further research should explore these constructs to develop targeted public health strategies.

Analyzing Food Access: An Investigation Of Food Insecurity Amongst Latinos In Rural Nebraska, Natalia Santos

Theses & Dissertations

Background: Food insecurity is a public health issue in the United States, with disproportionately higher rates among Latino/Hispanic households. Rural communities face unique geographical, socioeconomic, and systemic barriers that often exacerbate food access disparities. Despite the growing Latino population in rural areas, particularly in Midwestern states like Nebraska, there remains a critical gap in comprehensive research that integrates both objective and subjective understandings of their food environments. Understanding these multifaceted influences is crucial for developing effective, culturally sensitive interventions.

Problem Statement: This dissertation aims to answer the central question: How does food access and food insecurity manifest amongst Latinos in …

Dietary, Behavioral, And Psychosocial Factors Related To Cardiovascular Disease Risk Among South Asian Americans: A Scoping Review, Lakshmi Meyyappan, Peggy A. Ursuy, Olivia S. Anderson

Internet Journal of Allied Health Sciences and Practice

Purpose: South Asian Americans disproportionately represent the world’s prevalence of cardiovascular disease. This scoping review assessed the dietary and psychosocial factors associated with cardiovascular disease risk that South Asian Americans encounter and concluded with considerations for health professionals who encounter this population in practice. Method: Inclusion criteria included studies with the primary population as South Asian Americans and investigated diet or psychosocial factors as variables and cardiovascular disease as an outcome variable. Results: Thirteen studies were included. Analysis of nutritional factors showed that South Asian Americans have high dietary quality yet eating non-vegetarian diets and high alcohol consumption is associated …

Restricting Outdoor Advertising Of Unhealthy Food: Can Australia's Food Category-Based Classification System Be Applied Consistently?, Clare Whitton, Frith Klug, Alexia Bivoltsis, Georgina S.A. Trapp, Claire E. Pulker

Research outputs 2022 to 2026

Most outdoor food advertising (e.g. billboards and bus stops) features foods that are considered unhealthy. The most important technical challenge when designing policies to restrict unhealthy outdoor food advertising is defining 'unhealthy food'. To date, most restriction policies have used nutrient profiling models (i.e. foods are classified according to their nutritional composition) to determine which foods and beverages may be advertised. In Australia, state governments have endorsed a food category-based classification system, with no prescribed nutrient limits, which may create ambiguity when multiple users are identifying food advertisements to be restricted. This study aimed to assess the consistency of decisions …

A Global Movement Takes Shape – Physical Activity, Health, And The New Era Of Responsibility: “Global Alliance For Promotion Of Physical Activity”, J. M. Steinacker, W. Van Mechelen, C. Joisten, S. Zanuso, C. A. Jaworski, Y. P. Pitsiladis

Research outputs 2022 to 2026

No abstract provided.

Medical Surveillance In Custodial Jsas: Preventing Bloodborne Pathogen Exposure, Kiara Gadea

Electronic Theses, Projects, and Dissertations

Custodians play an important role in maintaining our surroundings safe and sanitary. However, in doing so, they are their exposure to health hazards that put them at risk, yet these exposures are often overlooked. One major risk they face is contact with bloodborne pathogens, which put custodial staff at risk for infections such as hepatitis B. While Job Safety Analyses (JSA’s) outline various protective measures, many fail to incorporate medical surveillance as part of their risk management program. Overlooking this important detail leaves custodians vulnerable to health risks that can be prevented.

Adding a medical surveillance section to custodial JSA’s, …

If Alcohol Consumption Were Eliminated, Which Us Counties Would Still Experience High Rates Of Breast Cancer Among Women?, Hina Javed

Boise State University Theses and Dissertations

Background

Breast cancer is the most prevalent cancer among women in the United States, accounting for roughly one-third of all newly diagnosed female cancers (American Cancer Society, 2024). The risk factors for breast cancer include both non-modifiable and modifiable factors. Non-modifiable factors include age at menarche, early menstrual cycles and late menopause. Modifiable factors include smoking, diabetes, obesity and environmental factors such as air pollution. The interplay between lifestyle factors and environmental exposures in cancer development has long been debated. While alcohol consumption is widely recognized as a major breast cancer risk factor, the role of environmental exposure such as …

Chance Or Strategy? Assessing The Unanticipated Policy Window For Active Transportation During The Covid-19 Pandemic: A Systematic Review, Katja Siefken, Michael Pratt, Juliana Mejía-Grueso, Adrian Bauman, Deborah Salvo, Catherine B Woods, Wanda Wendel-Vos, Justin Richards, J Jaime Miranda, Pedro C Hallal, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Physical activity (PA) policy is essential for promoting population-level PA by coordinating efforts across various sectors. Global crises like the COVID-19 pandemic can open policy windows, enabling rapid implementation of innovative policies. This study examined how policy windows shaped active transportation (AT) policies during the pandemic, resulting in infrastructural changes.

Methods: A systematic review using PubMed, Scopus, ProQuest-Coronavirus Research Database, Web of Science, WHO COVID-19 Research Database, PsycInfo, and SPORTDiscus conducted to characterize AT policy during the pandemic (2020-2023). Descriptive analyses were conducted in Stata. PROSPERO registration number: CRD42025644930.

Results: The search retrieved 3879 articles; 1162 were duplicates, leaving 2716 …

Investigating Environmental And Socioeconomic Contributors To Adult Obesity In The Rio Grande Valley, John Nicholas Cauba, Jihoo Woo, Russel Wiggins, Shizue Mito

School of Medicine Publications

Obesity in the Rio Grande Valley (RGV) of Texas remains a critical public health concern, with rates (46.9%) significantly exceeding those of Texas (36%) and the U.S. (34%) (p < 0.001). This study used 2024 County Health Rankings data to analyze environmental and socioeconomic contributors to obesity across 240 Texas counties, with a population-weighted focus on Hidalgo, Cameron, Starr, and Willacy counties. The RGV exhibited markedly poorer access to exercise, higher rates of physical inactivity, lower Food Environment Index scores (FEI = 4.3 vs. 5.7 in Texas), higher rates of uninsurance, worse patient-to–primary care physician (PCP) ratios (2152:1 vs. Texas 1660:1), and increased preventable hospitalizations. Multiple linear regression identified physical inactivity (β = 0.6, p = 0.01) and access to exercise (β = −0.02, p = 0.02) as significant predictors of obesity. Notably, higher uninsured rates were associated with lower reported obesity, likely due to underdiagnosis in the absence of routine care. These findings emphasize the need for targeted interventions addressing food access, environmental and recreational infrastructure, along with healthcare infrastructure in the RGV, where socioeconomic disadvantage and structural barriers magnify the impact of national obesity trends on the regional level.

Author Reply: Investment Case For Mental Health, Cyprian Mostert

Population Health, East Africa

No abstract provided.

Bibliometric Analysis Of Congenital Toxoplasmosis: A Ten-Year (2013-2023) Review Of Research Publications, Festus Mulakoli, Horatius Musembi, Ann Kimani

School of Nursing & Midwifery, East Africa

Background:Toxoplasma gondii, an obligate intracellular protozoan, infects more than one-third of the global population and causes toxoplasmosis, which can lead to severe fetal complications in pregnant women. The global prevalence of latent toxoplasmosis in pregnant women is 33.8%, with regional variations and risk factors, including the consumption of undercooked meat, exposure to cat feces, and consumption of contaminated water. Pregnant women lack sufficient awareness of these risk factors, necessitating enhanced education, regular screening, and counseling during antenatal care for early detection and management.

Aim: This study performed a comprehensive bibliometric analysis of research on congenital toxoplasmosis published between 2013 …

The Social Standing Versus The Mind Standing Of Older Adults In Egypt: Cross-Sectional Analysis Of The Relationship Between Social Capital And Cognitive Functions, Shaza H. Shinaishen Dr

Theses and Dissertations

Introduction: Egypt's population, much like that of other countries, is expected to age considerably over the course of the coming decades. Although biological and socioeconomic predictors of cognitive function have been studied widely, personal level social capital remains unexplored, especially in LMICs.

Purpose: This study primarily investigates the relationship between individual social capital and cognitive functioning among older adults aged 65 years and older in Egypt using the structural and cognitive components of social capital, including group membership, civic engagements, and caregiving roles.

Methods: A cross-sectional survey on 363 older individuals in different geographical and demographic segments of Egypt using …

Covid-19 & Healthcare (Re)Privatization? A Comparative Analysis Of High And Medium Per Capita Gdp Countries, Kristina Donders, Kaitlyn Matthews, Brittany Reyes, Frank. H. Rizzo

Working Papers Series

This paper examines whether the COVID-19 pandemic accelerated healthcare privatization in high- and medium-GDP countries. Drawing on political economy theories of path dependence and privatization, we analyze changes in public and private healthcare expenditures in eight countries: Canada, Chile, Denmark, Georgia, Luxembourg, Norway, the Philippines, and South Korea—comparing data from 2019 and 2022. Using World Bank indicators on healthcare financing, GDP, aging populations, and food insecurity, we find that although healthcare expenditures generally increased during the pandemic, this increase was primarily in public, not private, spending. Case studies of Georgia and South Korea reveal that local economic and demographic pressures, …

Influences And Implications Of Medical Mistrust On Healthcare Behaviors In A Low Health Outcomes County In The State Of New Jersey, Dale Johnson, Adeena Javed, Nathaniel J Byrnes, Anne C Jones, Kristin N Bertsch

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Medical mistrust is an ongoing concern in the United States, with patient confidence in both individual practitioners and institutions decreasing sharply in recent years. Atlantic County, New Jersey has some of the worst health outcomes in the state and is below the national average. This study sought to investigate medical mistrust by recruiting participants to complete a survey and/or health screening at 12 food pantry distribution events throughout Atlantic County (N = 124). The mean score for the Medical Mistrust Index was 19.06 (SD = 5.6) for participants who reported receiving the annual influenza vaccine and 16.05 (SD = 4.7) …

Investigating Social Network Peer Effects On Hiv Care Engagement Using A Fuzzy-Like Matching Approach: Cross-Sectional Secondary Analysis Of The N2 Cohort Study, Cho-Hee Shrader, Dustin T Duncan, Redd Driver, Juan G Arroyo-Flores, Makella S Coudray, Raymond Moody, Yen-Tyng Chen, Britt Skaathun, Lindsay Young, Natascha Del Vecchio, Kayo Fujimoto, Justin R Knox, Mariano Kanamori, John A Schneider

Faculty, Staff and Student Publications

BACKGROUND: Social network data are essential and informative for public health research and implementation as they provide details on individuals and their social context. For example, health information and behaviors, such as HIV-related prevention and care, may disseminate within a network or across society. By harmonizing egocentric and digital networks, researchers may construct a sociocentric-like "fuzzy" network based on a subgroup of the population.

OBJECTIVE: We aimed to generate a more complete sociocentric-like "fuzzy" network by harmonizing alternative sources of egocentric and digital network data to examine relationships between participants in the Neighborhoods and Networks (N2) cohort study. Further, we …

The Interaction Between Physical Activity And Fruit And Vegetable Intake On Body Composition, Om S. Ghetia

Honors Scholar Theses

Objective: Fruit and Vegetable (FV) intake and Physical Activity (PA) are important lifestyle factors associated with body composition. This study assessed the combined impact of meeting FV intake and PA recommendations on body composition measures including body mass index (BMI), percent body fat (PBF), and waist circumference (WC) in adults aged 20–64 years from diverse backgrounds.

Design: A cross-sectional study conducted in Northeastern Connecticut.

Methods: A total of 124 participants completed a one-week dietary and PA record followed by anthropometric assessments. Participants were categorized into groups based on FV intake (≥400 g/day vs. < 400 g/day) and PA levels (≥600 MET-minutes/week vs. < 600 MET-minutes/week). Independent t-tests and chi-square tests were used to compare dietary intake, PA levels, and body composition outcomes across groups.

Results: Participants meeting FV recommendations had significantly …

Conflict, Human Development, And Neonatal Health: A Regional Analysis Of The Eastern Mediterranean, Zynub A. Al-Sherri

Honors Theses

Background. The effects of war and conflict on a population are direct and indirect in nature. One of the most devastating consequences is the destruction of healthcare infrastructure, which severely disrupts access to essential services and impedes long-term socioeconomic development. Among those most affected are newborns, as the neonatal period represents the most vulnerable stage of a child’s life and serves as a sensitive indicator of a society’s overall health and socioeconomic conditions. Given the persistent instability in the Eastern Mediterranean Region (EMR), this study aimed to explore how conflict and human development are associated with neonatal health outcomes …

Frontier Healthscapes: Competing Narratives Of Disease, Environment, And Wellbeing In Early Minnesota, Aidan Reynolds

Geography Honors Projects

Across settler societies, health narratives were shaped by evolving tensions between lay and expert knowledge, frameworks of disease causation, and perceptions of the environment as both a source of health and a threat. In the decades following Euro-American settlement (1860-1900), Minnesota became a focal point for these debates, with its landscape fostering complex and competing narratives on health, wellbeing, and disease. This paper explores how public health discourse developed in Minnesota through the perspectives of institutions, the public, and economic interests. Combining environmental history with critical discourse analysis of archival materials, this study examines shifts within the Minnesota State Board …

“It's Easier To Deal With The Vaccines You Know Than The Ones You Don't Know”: A Qualitative Study On Healthcare Workers' Vaccine Confidence In Nigeria, Ayobami A. Bakare, Elisa Gobbo, Kofoworola O. Akinsola, Carina King, Julius Salako, Damola Bakare, Halima Usman, Claudia Hanson, Adegoke G. Falade, Sibylle Herzig Van Wees

Centre of Excellence in Women and Child Health

Vaccination is a cost-effective public health intervention that has saved many lives and improved well-being [1]. Between 2011 and 2020, over 20 million deaths were believed to have been averted due to vaccinations in GAVI supported countries [2]. Moreover, globally, Carter et al. estimated additional 51 million deaths are expected to be prevented from vaccines between 2021 and 2030 [3]. Yet, despite the importance of vaccines, there have been concerns about low uptake of vaccines globally [4,5]. This concern was accentuated during the COVID-19 pandemic. Waning vaccine confidence has been recognized as a leading threat to global health [[6], [4], …

Knowledge, Attitudes, And Practices Regarding Antimicrobial Resistance And Antimicrobial Stewardship Among Healthcare Workers In Outpatient Medical Centers In Kenya: A Qualitative Study, Mary Kaniu, Wahu Gitakah, Rupali Jain, Ann Munyare, Rodney Adam, Aliza Monroe Wise

Paediatrics and Child Health, East Africa

Objective: Antimicrobial resistance (AMR) is a major global health threat with a projected 10 million deaths globally by 2050. Antimicrobial stewardship (AMS) programs are coordinated efforts involving doctors, nurses, pharmacists, and other healthcare providers. Understanding knowledge, attitudes, and practices of health providers is pivotal for implementing strategies to curb the spread of AMR. The aim of this study was to evaluate knowledge, attitudes, and practices surrounding AMR and AMS among healthcare workers in Kenya.

Design: A qualitative study using in-depth semi-structured interviews

Setting: 12 private outpatient clinics in Kenya.

Participants: Healthcare workers including administrators and clinicians. …

Social Media Use In Health Education: National Children's Dental Health Month Social Media Toolkit, Jazmin Pelayo

Electronic Theses, Projects, and Dissertations

National Children's Dental Health Month (NCDHM) was created by the American Dental Association and is celebrated annually by local oral health programs all around the country. The celebration began as a one-day event on February 8, 1949, expanded to a week-long observance in 1955, and was later extended to a month-long celebration in 1981. Today local oral health programs celebrate NCDHM in a variety of ways but the one I will be focusing on is a social media tool kit. A social media tool kit consists of videos or posts that are posted on different platforms such as the www.smilesbc.org …