Public Health Commons^™

Hidden Heroes: Tales From Caregivers, Part 4, Singapore Management University

Social Space

As the COVID-19 pandemic continues to unleash its effects on a global scale, most of us are glued to the news and social media for updates, and bracing ourselves for the impact of the coronavirus on our countries, communities and families. In the face of such uncertainty, it's only normal to feel anxious and afraid. However, if you're holed up at home letting your worries and fears get the better of you, it may be time to slow down and steer yourself into a calmer headspace.

Fluoridation: Our History, Our Legacy, James Wieland Dds

The Journal of the Michigan Dental Association

2020 marks the 75th anniversary of one of the world’s most dramatic public health initiatives, a public health project that dramatically improved the oral health of millions of people, not only in the United States but throughout the world. On Jan. 25, 1945, the Grand Rapids Study was launched and the Furniture City became the world’s first to adjust the fluoride level of its public water supply.

This landmark trial established the use of fluoridation as a safe, effective, and economical public health measure to prevent tooth decay.

How the Grand Rapids Study began is a fascinating story. Even though …

Celebrate! The Legacy Of Community Water Fluoridation Continues In Grand Rapids, James Wieland Dds

The Journal of the Michigan Dental Association

Michigan dentistry continues to tell the world about the great advance in public health that began in Grand Rapids 75 years ago. This article looks back at past commemorations, and a tribute to those who worked so hard to make a permanent monument to community water fluoridation.

Shedding Light On Endometriosis: Patient And Provider Perspectives On A Challenging Disease, Madalene Zale, Emily Lambert, Marianna Lanoue, Amy E. Leader

College of Nursing Faculty Papers & Presentations

Background: Endometriosis is a serious yet understudied medical condition impacting millions of women worldwide.

Methods: This mixed methods study aimed to understand health care provider perceptions and patient experiences with endometriosis in the United States. Providers were surveyed to assess their understanding of disease prevalence. A subset of providers also participated in short, open-ended interviews about treating patients who have or are suspected to have endometriosis. Interviews were also conducted with women diagnosed with endometriosis to understand their experiences with the disease. Means and frequencies were calculated for survey data; interviews were transcribed and separately analyzed by two coders using …

Woodi Health Hub: Promoting Health Information Literacy To Students In The Atlanta University Center, Rosaline Y. Odom

Georgia International Conference on Information Literacy

“Health Literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” National initiatives call for improved health literacy as a means of addressing ongoing health disparities in the U.S. Low health literacy is linked to a poorer overall health status and higher risk of death among at-risk populations. Vulnerable populations include older adults, immigrant populations, minority populations and low income populations. College years are a time when young adults transition from parental control to independence and face new challenges, stressors and messages …

Public Health: Social Justice And Advocacy Ghc 102g, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Developing An Indicator System For A Healthy City: Taking An Urban Area As A Pilot, Tingting Li, Yong Fang, Dewei Zeng, Zumin Shi, Manoj Sharma, Huan Zeng, Yong Zhao

Environmental & Global Health Faculty Research

Purpose: The Healthy Cities Project is an important strategy for global health. This study aimed to develop a scientific and appropriate indicator system for the evaluation of a Healthy City in Chongqing, China. Methods: Data were collected via a review of government documents, focus group discussions, and in-depth interviews. A total of 34 government documents were reviewed to build the indicator database based on our previous studies. The first round of focus group discussions, which involved eight health-related experts, was conducted to form the indicator system framework. In-depth interviews with 15 experts from government departments were conducted to design the …

A Public Health Approach To Uncovering The Health-Related Needs Of Teen Library Patrons, Jennifer R. Banas, Michelle J. Oh, Robin Willard, Jeremy Dunn

Health Sciences and Physical Education Faculty Publications

Widespread problems with health literacy significantly limit effective dissemination and understanding of health information, particularly among vulnerable populations. As libraries are re-envisioned as community centers and resource providers, librarians are well positioned to help patrons overcome health literacy challenges by helping them to search for and use health information. Librarians often have not had health reference training, and some are unsure of the appropriateness of their role in patrons’ health. This study presents the results of a health needs assessment done in collaboration between the Teen Services Department of a major urban library and faculty from a state university. Using …

Covid-19’S Effects On New York City’S Food System: Lessons For Public Health Responses, Nevin Cohen, Nicholas Freudenberg

Publications and Research

The COVID-19 pandemic disrupted food availability and affordability and changed the daily food practices of New Yorkers. Eleven surveys of samples of 1,000 New York City adults from March 13 through June 28 illustrate three effects on food access and food insecurity: (1) closing restaurants, schools, and other sources of prepared foods reduced access and changed shopping patterns, food expenditures, and diets; (2) economic disruption exacerbated food insecurity and increased demand for food assistance; and (3) altered food practices affected diets and health. These impacts were disproportionately borne by vulnerable populations. This paper reports survey responses illustrating the effects of …

Associations Between Oncogenic Risk Markers And Clinical Outcomes Among Black And White Colorectal Cancer Patients, Victoria B. Starks, Edith P. Mitchell, Md, Facp

Phase 1

Introduction: Blacks have a 25% higher incidence of colorectal cancer compared to their white societal counterparts. Additionally, the overall mortality rate among black colorectal cancer patients is 50% higher than that of whites. However, little is known about the biomarkers prevalent among blacks and their possible correlation to treatment response and patient outcomes.

Objective: The objective of this study is to explore disease trends that may unveil a correlation between molecular markers and poor clinical outcomes among black colorectal cancer patients.

Methods: De-identified patient data was obtained from The Oncology Data Services Department (Cancer Registry) of TJUH. The population cohort …

Medical Student Knowledge Of Narcolepsy, Alyssa Sinko, Karl Doghramji, Md

Phase 1

Background: Narcolepsy is a sleep disorder, whose main symptoms include daytime sleepiness, cataplexy, sleep paralysis, disturbed sleep, and hypnagogic hallucinations. The disorder is poorly identified in medical settings. We hypothesized that lack of knowledge of narcolepsy and its hallmark symptoms are a cause for the low levels of identification of this disorder. This was a pilot study into medical student knowledge of narcolepsy at Sidney Kimmel Medical College of Thomas Jefferson University (SKMC).

Methods: Two groups of SKMC students, years 1 and 2 (before sleep medicine education) and years 3 and 4 (after sleep medicine education) were the subjects of …

Examining Israeli Emergency Medical Preparedness In The Context Of Jefferson And Affiliates Practices, Jamie D. Garden, Amit S. Padaki

Phase 1

Introduction: Recent domestic disasters have demonstrated the challenges and vulnerabilities in the US health care disaster preparedness framework, challenges that extend to Thomas Jefferson University Hospital System (TJUH), in Philadelphia, PA. As Israel serves as a global leader in civilian defense and disaster preparedness, this study examines best practices in response to a mass casualty event at Hadassah Hospital in Jerusalem, Israel, and compares them with existing protocol at TJUH. The list of best practices generated from this research allows for a greater understanding of standards that are feasibly employable at TJUH.

Methods: This study examined hospital staff response practices …

Systems Analysis Of The Community Elder Caregiver Program At The Spirit Lake Nation, Morgan Ferrell, Robert Motley, Md, Mhcds, Christine Burd, Phd, Rn

Phase 1

Native Americans (NA) disproportionately reside in areas with significantly more social, economic, and health disparities than any other population, and have the lowest employment rates nationally. Additionally, the NA Baby Boomer generation is aging, with senior citizen services largely unavailable on reservations. The Community Elder Caregiver (CEC) Program at Spirit Lake was developed with two aims: 1) to meet the needs of unemployed natives and 2) to develop a competent workforce to help elders safely “age in place”. In the initial pilot, seventeen individuals started the initial (NECC) training, with three completing the Qualified Service Provider (QSP) training. We analyzed …

Assessing Access To Healthcare For Limited English Proficient Patients, Hannah Bergamini

Mahurin Honors College Capstone Experience/Thesis Projects

Patients with limited English skills often face additional struggles when accessing medical care. These patients, referred to as limited English proficient (LEP) patients, are unable to communicate directly with their physician. This lack of direct communication typically results in unique challenges for the patient and provider. Due to these challenges, LEP patients often have poorer health statuses and experience poorer health outcomes. However, when provided with access to qualified medical interpreters, many of these challenges facing LEP patients can be ameliorated. Therefore, using qualified interpreters is an important component in improving the access to healthcare for LEP patients. To determine …

Understanding The Attitudes And Perceptions Towards Lung Cancer Screening Amongst United States Veterans: A Qualitative Study, Shannon Nugent, Kristine Pham, Mph, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: Lung cancer is the leading cause of cancer mortality in the United States, with this rate disproportionately affecting the veteran population. Despite USPSTF recommendations, screening rates are low and underutilized. The purpose of this study is to understand veterans’ knowledge, attitudes and beliefs surrounding lung cancer and lung cancer screening to better address barriers to screening.

Methods: Five interviews were conducted with veteran community members, and three were conducted with key informants for a current total of eight interviews. Key informants included Philadelphia community leaders who work with veterans. Interviews explored lung cancer screening knowledge, motivating factors and barriers …

Medication Adherence In A Housing First Model, Lily Segal, Sharon Lyles

Phase 1

Introduction: Mental illness and chronic medical conditions are prevalent among those experiencing homelessness. Medication adherence has been very poor due to a variety of barriers, one of those being housing. For those who have previously experienced homelessness, does a Housing First model have a positive impact on medication adherence?

Methods: The target population was individuals on Team 1 at Pathways to Housing, PA. Medication adherence was measured through the use of blister packs, which contained 1 weeks’ worth of medication, therefore at the end of the month 4-empty blister packs should have been returned. Medication adherence, specifically for …

The Utility Of Performing Cervical Length Follow-Up In Lower Risk Singleton, Varsha Kripalu, Rupsa Boelig, Md

Phase 1

Introduction: Short cervical length (<25 mm) during pregnancy is known to be an increased risk factor for preterm birth (<37 weeks). While interventions exist for women who have had prior preterm births, it is important to investigate the cost effectiveness of screening low risk women with an intermediate cervical length (26-29 mm).

Objective: To quantify the association between change in cervical length on follow up and the incidence of preterm birth in otherwise low risk women with an initial intermediate cervical length.

Methods: A retrospective cohort study was conducted, reviewing 108 charts of women who had an initial screening between 26 and 29 mm. Charts were reviewed for whether or not a follow-up ultrasound was recommended, whether or not the follow-up was performed, and the outcome of their deliveries.

Results: 93.5% (N=101) of women were recommended to get a follow-up ultrasound and 84% (N=85) completed their follow-up. …

The Experience Of Intimate Partner Violence Among Pregnant Women Seeking Treatment For Opioid Use Disorder, Julia Dewey, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Intimate partner violence (IPV) is a major health issue among those with substance use disorder. A history of partner violence is associated with increased health problems and less improvement in treatment. The perinatal period is a time of increased risk of IPV for women, as well as a key opportunity for opioid use disorder treatment intervention. The purpose of this study is to characterize the experience of partner violence and evaluate the typology of sequelae associated with it in a population of pregnant women seeking medication assisted treatment for opioid use disorder.

Methods: The population of interest in this …

Lgbt Elder Initiative Thrivers Program Evaluation, Darcy Curtis, David Griffiths

Phase 1

Introduction: Aging with HIV is a critical area of study, especially as the generation that was initially affected by the disease grows older. The LGBT Elder Initiative (LGBT EI) is an organization in Philadelphia that supports and advocates for older members in the LGBT community. The LGBT EI Thrivers program is a community group that meets monthly to discuss what it means to “thrive” with HIV. The purpose of this study is to evaluate the LGBT EI’s Thrivers program and determine what motivates older individual with HIV to become involved in this program and identify the impact of the program. …

Medical Utilization In The Context Of Culture: Analyzing The Concepts, Benefits And Drawbacks Of Sri Lankan Biomedical And Ayurvedic Healthcare, Miriah Rajaguru

All Graduate Theses, Dissertations, and Other Capstone Projects

Sri Lanka is an island inhabited by a culture more than 5,000 years old. The primary medicine utilized by this culture in precolonial times is known as Ayurveda. During colonization, Sri Lanka was introduced to biomedicine and forced to negate Ayurvedic medicine. Throughout the years, rather than abandoning their indigenous medical practice, Sri Lanka incorporated biomedicine and Ayurvedic medicine into their medically plural society. Today, Sri Lankans utilized both medicines for different ailments, concerns and conditions. Utilizing a variety of anthropological methods and theories, this study gathered qualitative information from 39 Sri Lankan informants. These informants were recruited to find …

Anemia And It's Associated Factors Among Adolescents In Kuwait, Lemia Shaban, Abdullah Al-Taiar, Abdur Rahman, Reem Al-Sabah, Olusegun Mojiminiyi

Community & Environmental Health Faculty Publications

We estimated the prevalence of anemia among school children and investigated factors associated with this problem in Kuwait. A cross-sectional study was conducted on 1415 adolescents randomly selected from middle schools in Kuwait. Hemoglobin, iron, ferritin, folate and vitamin B-12, in addition to many other laboratory indicators, were measured in a venous blood sample. Data on risk factors for anemia were collected from parents and adolescents. Multiple logistic regression was used to investigate factors associated with anemia. The prevalence of anemia was 8.06% (95% CI: 6.69-9.60%), which was significantly higher among females compared to males (10.96% vs. 5.04%; p < 0.001). Mean (SD) Hb level was 133.7 (9.89) g/L and 130.00 (10.48) g/L among males and females, respectively (p < 0.001). The prevalence of mild, moderate and severe anemia was 5.94%, 1.91% and 0.21%, respectively. Gender, age, iron concentration and ferritin were associated with anemia in multivariable analysis. These data indicate that anemia among school children in Kuwait is of mild public health significance. Further reduction in anemia in school girls should focus on correcting iron deficiency. Surveillance systems for anemia may consider using a cut-off point that is specific for the method of blood sampling and the method of Hb measurement.

Reviving Focused Scrutiny In The Constitutional Review Of Public Health Measures, Robert Gatter

All Faculty Scholarship

This article re-examines the "focused scrutiny" standard proposed by Prof. Scott Burris in 1989 and argues for its application particularly during an infectious disease emergency such as the COVID-19 pandemic. Focused scrutiny seeks to tie judicial review of the constitutionality of public health measures closely to the facts of the particular disease and to evidence of the efficacy of each governmental action to prevent the spread of that disease, even when courts adopt rational basis testing.

Traffic And Our Health, Atteh Akoto

Scholarship in Medicine - All Papers

Objective: The intent of this study is to find a correlation between long commute times, physical health, and mental health. Methods: Data was collected from a publicly available dataset on countyhealthrecords.org. Results: Increased percentage of lone drivers with long commutes and obese adults, positive correlation between long commuters and access to exercise opportunities, and negative correlation between long commuters and poor mental health days.

Growing Green Minds: Implementation Of A School Garden & Nutrition Program For The Freedom Area School District In Rural Wisconsin, Marissa Schuh

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

Most children in the U.S. consume too few fruits and vegetables which is putting them at risk to develop obesity and other lifestyle diseases. The 2015-2020 Dietary Guidelines for Americans recommends that individuals should increase the amount and variety of fruits and vegetables consumed in order to prevent weight gain and other chronic diseases. Research shows that garden-based educational programs can increase children’s fruit and vegetable intake as well as change their preferences and attitudes towards eating and trying new fruits and vegetables. Incorporating a garden and nutrition curriculum into a school setting is an ideal opportunity to improve children’s …

Effect Of Sustained Attention On Early Start Denver Model Outcomes, Katherine Mcleod, Giacomo Vivanti, Phd

Phase 1

Introduction: There is very little research on the use of sustained attention as an outcome predictor for the Early Start Denver Model (ESDM). We hypothesized that a child’s level of sustained attention prior to therapy will correlate with positive ESDM outcomes.

Methods: 10 pre-preschool age children with a diagnosis of autism spectrum disorder received one year of ESDM therapy. A novel coding scheme was developed to evaluate each child’s pre-treatment level of sustained attention. Mullen Scales of Early Learning were evaluated prior to and after one year of ESDM. Pre-treatment levels of sustained attention were compared to pre-and post-treatment Mullen …

Obesity And Cardiovascular Health Differences Between Urban And Suburban Philadelphia High School Athletes, Peri Levey, Kyle Prochno, Prashant Rao, Md, David Shipon, Md, Facc, Facp, Jeremy Close, Md

Phase 1

Introduction: The strongest risk factor for primary hypertension in children is obesity, and concern for pediatric hypertension rises with the rising prevalence of obesity in American children. Specifically, in urban Philadelphia schools from 2009 to 2012, preparticipation physical evaluations (PPEs) demonstrated a positive correlation between blood pressure measurements demonstrating stage 1 or 2 hypertension and elevated body mass index (P < 0.00001).

Objective: The purpose was to identify potential differences in cardiovascular health and prevalence of obesity between adolescents in the urban and suburban Philadelphia areas.

Methods: Data from PPEs administered to urban Philadelphia high school athletes in 2018 by the Athlete …

Health Concerns In The Juvenile Justice System In Philadelphia: An Analysis, Sarah Humrich

Phase 1

Introduction: There are more than 40,000 minors nationwide that are incarcerated, and yet there remains to be no standardized way to offer this population health care. Time spent in prison offers a unique opportunity that could allow healthcare workers to intervene, providing needed health care to an otherwise neglected population. This research seeks to better understand the healthcare offered to youth in juvenile detention centers in Philadelphia and to determine the unique health concerns of this population.

Methods: The target population of this study is the incarcerated youth in the juvenile detention centers of Philadelphia. I intend to collect data …

Survey Of Hie Leaders: Assessment Of Hie Research Participation And Perceptions, Brittany Macdonald, Kristin Rising, Md, Ms

Phase 1

Introduction: Health information exchanges (HIEs) allow for healthcare providers to effectively and securely access patient information from various healthcare networks. Some HIEs have acknowledged the important role they can play in research, however, this is not standard practice despite recognition that availability of research and outcomes data is a main limitation to evidence-based practice.

Methods: We created an electronic survey in collaboration with Health Share Exchange (an HIE in Philadelphia) with the aim of assessing HIE leader perceptions regarding the importance of and barriers to participation in research. The survey was disseminated via a Strategic Health Information Exchange Collaborative (the …

Predictors Of Negative Outcomes And Causes Of Loss To Follow Up Among Breast Cancer Patients In Port-Au-Prince, Haiti, A. Johnson, R. R. Henderson, G. Jones, Y. Fujii, P. Haley, J. Bernard, V. Degennaro

Phase 1

Objective: To determine predictors of negative outcomes and causes of loss to follow-up (LTFU) in patients with breast cancer in Haiti.

Design and Methods: Patients seen by Innovating Health International’s (IHI) cancer program were designated as LTFU after at least six months of non-contact (n=606). A cohort of LTFU breast cancer patients (n=101) was compared to the larger population of breast cancer patients (n=939), and a regression model constructed in order to identify risks for death and LTFU. Multiple calls were made to contact LTFU patients, and reasons for LTFU were recorded.

Results: Death and LTFU status were associated with …

Veteran Employment: A Study Into Barriers In Healthcare Industry Positions, Javier Saldana, Debby Derricks

Phase 1

Introduction: While there are many challenges veterans face while making the transition to the civilian lifestyle, undoubtedly one of the more frustrating factors is finding employment. While the veteran unemployment rate has dropped in recent years, it currently sits at ~3.4%. Therefore, an estimated 323, 000 veterans are currently unemployed. Given these statistics, what are the common barriers veterans face when seeking employment, specifically in healthcare industry positions?

Methods: Two (30 minute) interviews will be conducted with individuals heavily involved in veteran employment at Jefferson Hospitals. The questions asked the interviewee’s opinions on factors that make veterans successful in gaining …