Public Health Commons^™

Report: Evaluation Of Seal!Nd: School Year 2021-2022: North Dakota Department Of Health Oral Health Program’S School-Based Dental Sealant Program, Shawnda Schroeder, Tonya Connor

Indigenous Health Faculty Publications

The North Dakota Department of Health (DoH)a Oral Health Program (OHP)b has established a school-based dental sealant program, (SEAL!ND)c , which has been providing dental sealants, fluoride varnish applications, oral health education and dental screenings and referrals for students throughout North Dakota dating back to 2012. All services occur in the school during school hours. School-based sealant programs are a highly effective way to deliver preventive oral health services and dental sealants to children less likely to receive private dental care. The SEAL!ND program prioritizes providing preventive oral health care to low-income and underserved students by targeting schools with 45% …

Aligning Investments To Improve Population Health: A Statewide Strategy To Address The Social Determinants Of Health, Michael E. Swack, Sarah Boege, Kevin Barnett

Carsey Publications

In this report, authors Michael Swack, Sarah Boege, and Kevin Barnett discuss the initiative to develop a statewide strategy to address the social determinants of health in New Hampshire. Launched in 2020, this project is a collaboration between the Center for Impact Finance at the Carsey School of Public Policy at UNH, the Center to Advance Community Health and Equity (CACHE) at the Public Health Institute, the Institute for Health Policy and Practice at UNH, and the New Hampshire Hospital Association/Foundation for Healthy Communities. Michael Swack, director of the Center for Impact Finance at the Carsey School, serves as the …

Rural Mental Health Care During A Global Health Pandemic: Addressing And Supporting The Rapid Transition To Tele-Mental Health, Shawnda Schroeder, Holly Roberts, Thomasine Heitkamp, Brandy Clarke, Heather J. Gotham, Erika Franta

Indigenous Health Faculty Publications

The adoption of tele-mental health by mental health professionals has been slow, especially in rural areas. Prior to 2020, less than half of mental health agencies offered tele-mental health for patients. In response to the global health pandemic in March of 2020, mental health therapists across the U.S. were challenged to make the rapid shift to tele-mental health to provide patient care. Given the lack of adoption of tele-mental health previously, immediate training in tele-mental health was needed. This article describes collaborative efforts between two mental health technology transfer centers and one addiction technology transfer center in rural regions of …

Developing Tools For The Implementation And Evaluation Of Participatory Worker Health Promotion Interventions, Ryan J. Walsh

WUSM Theses and Dissertations – All Programs

The chronic disease burden among American workers leads to substantial expenditures on healthcare, lost productivity at work, and reduced quality of life. Workers from communities of lower socioeconomic status (SES) shoulder a disproportionate burden of chronic diseases and costs. A promising strategy for addressing this population health burden is to develop and implement participatory worker health promotion interventions in workplaces. Part of this effort to develop and implement these programs entails improving the quality of evaluation tools and approaches. Thus, we completed a series of secondary analyses of a large participatory worker health promotion program trial called Working For You. …

Birthing Reimagined: Perceptions Of Safety And Autonomy In Birth Experiences Among Postpartum Individuals During Covid-19, Beldina Orinda

Senior Honors Papers / Undergraduate Theses

Background: Safety during childbirth is a priority for care providers, but patients' perceptions of safety may differ from those of providers, especially in biomedical settings.1–4 This can influence health outcomes and satisfaction with the birth experience.5–7 We hypothesize that autonomy, defined as the ability to make decisions about care during childbirth, may enhance feelings of safety and positive mental health outcomes.9,15

Methods: Surveys via REDCap v11.1.29 captured the experiences and Edinburgh Postnatal Depression Scale (EPDS) scores of pregnant and postpartum women. Participants (n=49) included 15 pregnant and 34 postpartum individuals, aged 18 and older, who had given …

The Role Of Rural And Urban Geography And Gender In Community Stigma Around Mental Illness, Shawnda Schroeder, Chih Ming Tan, Brian Urlacher, Thomasine Heitkamp

Indigenous Health Faculty Publications

Empirical evidence describes the negative outcomes people with mental health disorders experience due to societal stigma. The aim of this study was to examine the role of gender and rural/urban living in perceptions about mental illness. Participants completed the Day’s Mental Illness Stigma Scale, a nationally validated instrument for measuring stigma. Directors of Chambers of Commerce in North Dakota distributed the electronic survey to their members. Additionally, distribution occurred through use of social media and other snowball sampling approaches. Analysis of data gathered from 749 participants occurred through examination of the difference in perceptions based on geography and gender. The …

Anxiety And Depression And Associated Factors Among A Sample Of Semi-Rural High School Students In Georgia, Raul Perez Zarate, Yi-Ting Hana Lee, Jean A. Welsh, Julie A. Gazmararian

Journal of the Georgia Public Health Association

Background: Anxiety and depression can affect adolescents’ health and current literature lacks studies of youths living in non-urban settings.

Methods: We used chi-square and t-tests on data collected from self-administered online surveys, completed by 9^th-grade students (n=222) attending a large, semi-rural public high school in the state of Georgia, to assess the prevalence of symptoms of anxiety and depression and associated factors.

Results: Almost half of the students self-reported anxiety (43%) or depression (55%) and students who self-reported either condition were more likely to report poorer sleep hygiene, sleepiness, race-related mistreatment, and higher stress.

Conclusions: Our findings suggest …

Improving Healthcare Experiences For Transgender And Intersex Populations, Destiny S. J. Lee, Joanne Chopak-Foss

Journal of the Georgia Public Health Association

Intersex is an umbrella term for individuals who are born with sex characteristics that do not typically fall into male or female categories. Individuals who are intersex make up about 1.7% of the United States population today and are identified within the lesbian, gay, bisexual, transgender, and intersex (LGBTQIA+) community. Many people who are intersex identify as transgender, which relates to the social process of gender change, as they develop into adults. In Georgia, approximately 4% of the population identify as LGBTQIA+. The purpose of this paper is to increase awareness of the perceived discrimination from healthcare providers, non-inclusive organizational …

Health Disparities: Ranking Horry County's Most Disadvantaged Communities, Stephen Borders, Jacob Bradley, Mackenzie Cannon, William Hall

Public Health

Horry County is a rapidly growing region in South Carolina, with a diverse population of over 300,000 residents. Despite this growth, the county faces significant health challenges, including high rates of chronic diseases, such as diabetes and obesity, and a shortage of healthcare providers in certain areas. These challenges are exacerbated by the county's socio-economic disparities, with many low-income residents lacking access to basic health services. Our approach is to address these challenges by identifying the areas within the county with the greatest unmet needs, also known as disadvantaged communities. By identifying the needs of Horry County’s most disadvantaged communities, …

The Relationship Between Adverse Childhood Experiences And Risky Health Behaviors: Avenues For Prevention In New Mexico, Arianna Trott

Individual, Family, and Community Education ETDs

This study was designed to assess if adverse childhood experiences (ACES) predict risky health behaviors in New Mexico. The purpose was to determine if any factors support improved outcomes for people who have experienced ACES in New Mexico. Lastly, the study aimed to identify if urban-rural status impacted outcomes of risky health behaviors related to ACES. This study used data from the 2019 New Mexico Community Survey across twelve counties (N = 853). Multiple logistic regression and hierarchical linear modeling were used to analyze the data. The findings concluded ACES could predict risky health behaviors. Overall, there was a gradated …

The Rising Use Of Fire As A Weapon, Jason Woods, Jeffrey Carter, Kathe Conlon, Carl Flores, Randy Kearns

School of Medicine Faculty Publications

55th Annual Meeting of the American Burn Association, ABA 2023, May 16 - 19, 2023, Dallas, TX

Characteristics Of Verified And Designated Burn Centers, Jeffrey Carter, Randy Kearns, Elle Lovick, Erica Murata, Bart Phillips

School of Medicine Faculty Publications

55th Annual Meeting of the American Burn Association, ABA 2023, May 16 - 19, 2023, Dallas, TX

Mental Health Among D1 Female College Athletes: Prevalance And Links To Athletic And Academic Performance, Mary Goebel

Honors Theses

Background. NCAA Division I female student-athletes are underrepresented in mental health research; existing research among female athletes tends to focus only on disordered eating and body appearance. This study aims to 1) describe the prevalence of mental health issues (i.e., anxiety, depression, and stress) among female Division I college athletes, and 2) assess the association between mental health issues and the student-athlete experience (i.e., athletic and academic performance).

Methods. This was a quantitative, cross-sectional study that used a self-administered online survey. The participants were NCAA Division I female student-athletes, mainly from the University of Mississippi. Demographics and sample characteristics were …

Comparing Particulate Matter Exposures During Two Work Shifts In A Large University Dining Commons Kitchen, Shalom Emmanuel, Atin Adhikari

Journal of the Georgia Public Health Association

Objective: Cooking emits a huge concentration of indoor air pollutants, including particulate matter (PM). Exposure to PM can lead to long-term adverse respiratory effects among workers engaged in cooking. Only a few studies have measured cooking-related air pollutants in large school cafeterias where young student workers are frequently employed. The objective of this research was to compare stationary exposures to PM from cooking during two work shifts at a very large university dining commons kitchen.

Methods: Number concentrations of PM of varying aerodynamic sizes (1, 2.5, 5, and 10 µm) were measured at the back kitchen, DC grill, and …

Protocol For Developing A Personalised Prediction Model For Viral Suppression Among Under-Represented Populations In The Context Of The Covid-19 Pandemic, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Bankole Olatosi Ph.D.

Faculty Publications

Introduction Sustained viral suppression, an indicator of long-term treatment success and mortality reduction, is one of four strategic areas of the 'Ending the HIV Epidemic' federal campaign launched in 2019. Under-represented populations, like racial or ethnic minority populations, sexual and gender minority groups, and socioeconomically disadvantaged populations, are disproportionately affected by HIV and experience a more striking virological failure. The COVID-19 pandemic might magnify the risk of incomplete viral suppression among under-represented people living with HIV (PLWH) due to interruptions in healthcare access and other worsened socioeconomic and environmental conditions. However, biomedical research rarely includes under-represented populations, resulting in biased …

Determinants Of Quality Contraceptive Counselling Information Among Young Women In Sierra Leone: Insights From The 2019 Sierra Leone Demographic Health Survey, Quraish Sserwanja, Lilian Nuwabaine, Kassim Kamara, Milton W. Musaba

School of Nursing & Midwifery, East Africa

Background

The quality of contraceptive counseling information received by prospective clients of family planning services can greatly influence both the uptake and continued use of contraceptives. Therefore, an understanding of the level and determinants of quality contraception information among young women in Sierra Leon could inform family programs, with the aim of reducing the high unmet need in the country.

Methods

We analyzed secondary data from the 2019 Sierra Leone Demographic Health Survey (SLDHS). Participants were young women aged 15–24 years, who were using a family planning method (n = 1,506). Good quality family planning counselling was defined …

An Exploratory Study On Strategies Adopted By Parents Who Use E-Cigarettes To Negotiate Risk Perceptions Of Their Children's Secondhand Exposure And Parental Role Modeling, Joon Kyung Nam, Jesse P Zatloff, Su-Wei Wong, Hsien-Chang Lin, Wei-Chung Su, Anne Buu

Faculty, Staff and Student Publications

Existing health messages mainly targeted youth susceptible to vaping or parents who do not have much knowledge about e-cigarettes. This study makes a unique contribution by conducting the first in-depth investigation of e-cigarette-using parents' risk perceptions and parental role modeling and how these two factors affect their vaping behaviors at home or implementation of any strategies to reduce their children's risk. Fifteen parents who used e-cigarettes participated in a semi-structured interview. Interview transcripts were coded and analyzed through a deductive approach of thematic analysis. This study demonstrates the need to develop and disseminate future health messages for e-cigarette-using parents who …

Oral Health Literacy: A Tool To Reduce Oral Health Disparities Among Californians, Rubina Bukhari

Master's Projects and Capstones

Oral health is the health of the mouth, cheeks, teeth, and their supporting structure within the oral cavity. It helps in performing day-to-day routine functions such as swallowing, tasting, chewing, talking, and making a wide array of complex facial expressions. Apart from performing everyday functions, oral health is a crucial contributor to the overall state of well-being and good quality of life. It is measured by oral conditions such as tooth decay, gum disease (Periodontal), and oral cancers. Tooth decay and cavity formations are the most prevalent oral health conditions which affect people of all age groups. However, children are …

Clinically Stable Covid-19 Patients Presenting To Acute Unscheduled Episodic Care Venues Have Increased Risk Of Hospitalization: Secondary Analysis Of A Randomized Control Trial, Joseph Bledsoe, Scott C Woller, Maria Brooks, Frank C Sciurba, Jerry A Krishnan, Deborah Martin, Peter Hou, Janet Y Lin, Andrei Kindzelski, Eileen Handberg, Bridget-Anne Kirwan, Elaine Zaharris, Lauren Castro, Nancy L Shapiro, Carl J Pepine, Sarah Majercik, Zhuxuan Fu, Yongqi Zhong, Vidya Venugopal, Yu-Hsuan Lai, Paul M Ridker, Jean M Connors

Faculty, Staff and Student Publications

BACKGROUND: Assessment for risks associated with acute stable COVID-19 is important to optimize clinical trial enrollment and target patients for scarce therapeutics. To assess whether healthcare system engagement location is an independent predictor of outcomes we performed a secondary analysis of the ACTIV-4B Outpatient Thrombosis Prevention trial.

METHODS: A secondary analysis of the ACTIV-4B trial that was conducted at 52 US sites between September 2020 and August 2021. Participants were enrolled through acute unscheduled episodic care (AUEC) enrollment location (emergency department, or urgent care clinic visit) compared to minimal contact (MC) enrollment (electronic contact from test center lists of positive …

Access To Burn Care: A 10 Year Perspective Of Burn Centers In The U.S, Elle Lovick, Jeffrey Carter, Herbert Phelan, Randy Kearns, Bart Phillips, William Hickerson

School of Medicine Faculty Publications

55th Annual Meeting of the American Burn Association, ABA 2023, May 16 - 19, 2023, Dallas, TX

Injury To Intervention: Is There Another Opportunity To Improve Burn Care?, William L. Hickerson, Jeffrey E. Carter, John Friedstat, James H. Holmes, James Hwang, Steven A. Kahn, Herbert A. Phelan, Alisa Savetamal

School of Medicine Faculty Publications

55th Annual Meeting of the American Burn Association, ABA 2023, May 16 - 19, 2023, Dallas, TX

Implementation Of A Decision Aid To Increase The Rate Of Routine Breast Cancer Screening Among Women Between 50 To 74 Years Old At A Federally Qualified Health Center, Dana Mars

Doctor of Nursing Practice Scholarly Projects

Background: Breast cancer is the most prevalent form of cancer in the U.S. Cancer screenings can result in prompt treatments and positive health outcomes. Disparities in screening rates are prevalent among vulnerable populations. At a Federally Qualified Health Center (FQHC), where the project occurred, the rate of breast cancer screening in 2021 (64%) was lower than the target set by the Healthy People 2030 (77%). This quality improvement project aimed to increase the rate of routine breast cancer screening among women aged 50-74 years old in the FQHC.

Methods: Previous studies have reported that decision aids on breast cancer screening …

Predictors Of Future Physician Practice Location, Allegra Latimer

Honors Theses

Healthcare disparities exist throughout the United States. While Mississippi does not stand alone in the maldistribution of physicians and medical practices across the state, it does exist as a state that has been historically medically underserved. According to data collected by The County Health Rankings Model developed by the University of Wisconsin Population Health Institute, in 2019, the ratio of population to primary care physicians in Mississippi was 1860:1. This is nearly 30% higher in disparity than the national average. It is also important to note that of Mississippi’s 82 counties, 79.3% are considered rural with the majority of physicians …

A Systematic Literature Review Of Telehealth For Health Equity In Pediatric And Women's Health Care: Promise Vs Reality, Sharanya Chandu

Honors Scholar Theses

Background: Telehealth interventions can transform the healthcare system to improve accessibility, quality of care, and outcomes for women’s obstetric health.

Objective: This literature review seeks to summarize current research to understand the effect of telehealth on women’s obstetrics and gynecology outcomes.

Methods: A literature review was conducted following the PRISMA methodology to identify a set of papers containing information related to obstetrics and maternal health. The search terms used identified telehealth or telemedicine interventions used for obstetric, maternal, or prenatal care from the period 2013-2023. 19 articles were identified and reviewed.

Results: The literature review considered three primary aspects from …

Medical Marijuana In Mississippi: A Journalistic View Of Physician Opinions And Patient Education, Michael Pitts

Honors Theses

Medical Marijuana in Mississippi: A Journalistic View of Physician Opinions and Patient Education is an in-depth investigative journalism project examining aspects of the Mississippi Medical Cannabis Program. Specific areas of interest were Mississippi physician opinions on the use medical marijuana and their views on the application of the state’s program as well as an examination into how patients are receiving education on medical marijuana. This project involved interviews of healthcare providers, dispensary staff, and patients, in addition to background research that was used to formulate interview questions, determine areas of interest and add necessary context. This project occurred during the …

A Study Of First-Generation College Students At The University Of Mississippi, Brady Suttles

Honors Theses

First-generation college students (FGCS) are a distinct sub-population within higher education. In comparison to their peers, FGCS report increased levels of anxiety, depression, and stress along with lower levels of social support and academic attainment. Considering the unique context and history of the University of Mississippi (UM), it is crucial to understand the specific needs of FGCS enrolled at UM. The aims of this study were to: 1) assess the associations between FGCS status and mental health and academic achievement, and 2) determine whether sense of belonging moderates these associations.

First-generation college students had higher mean levels of depression symptoms …

Structural Barriers To Health Care Access And Ipv Disclosure In First-Generation Latina Immigrants, Donna L. Schminkey, Deborah Elkins, Karen Jagiello, Sandra Annan, Jamie Robinson, Erika Metzler Sawin

Virginia Journal of Public Health

Background: This study aimed to describe the unique structural barriers faced by Latina women in rural areas of Virginia as they attempt to access the health care system, and, once they have gained access, to identify barriers to intimate partner violence (IPV) disclosure.

Methods: Semi-structured in-depth individual interviews with first-generation Latina immigrants were conducted after initial purposeful convenience sampling and concomitant snowball recruiting. A thematic content analysis using a phenomenological approach was employed to interpret participants' experiences. Initial findings were validated through additional interviews.

Results: The overarching theme expressed by these women was their search for dignity. Emergent sub-themes related …

Vaccine Uptake In The Era Of Covid-19: Associations Between Willingness To Receive The Influenza And Covid-19 Vaccines, Mutaz Alkalbani, Ritsa Frousios, Matilda Francis, Yousef Beidas, Jennifer Ryal, Brynn Sheehan

Virginia Journal of Public Health

Background/purpose. Despite efforts to increase flu vaccine uptake, the rate of vaccination remains below target. Additionally, many Virginians remain unvaccinated or have not maintained a booster schedule in line with recommendations. The current study investigated willingness to receive the flu and COVID-19 vaccines during the COVID-19 pandemic, associations between the likelihood of receiving the two vaccines, and differences in uptake by racial group and insurance status. Methods. Participants were adult patients seen for appointments at an ambulatory clinic in Southeast, VA. Participants completed a questionnaire assessing vaccination history and future vaccination intentions. Results. Results revealed significant associations between having received …

Policy Forum: The Tobacco Surcharge & Sugar-Sweetened Beverage Taxes: Reconciling Equity And Targeted Public Health Interventions, Ben Barber

Virginia Journal of Public Health

Virginia is poised to repeal the tobacco surcharge, an ineffective policy that disproportionately harms low- and middle-income Virginians. (Small, 2023) The Patient Protection and Affordable Care Act (ACA), which otherwise strengthened health care access and equity, allows health insurers in the individual and small-group markets to charge smokers up to 50 percent higher premiums relative to nonsmokers. (ACA, 2010) The law’s financial assistance does not apply to this surcharge, forcing enrollees to bear the entire cost of the penalty. This provision was a compromise between the ACA’s drafters, most of whom opposed the surcharge, and the health insurance industry, which …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …