Public Health Commons^™

Utilization Patterns Of Telehealth: New Realities In Post-Covid Children's Behavioral Health Care In Louisiana, Evidence To Practice, Cep Briefs, Sonita Singh, Brian Bumbarger, Willandra Whiting, Stephen Phillippi

Policy & Position Papers

No abstract provided.

Face-To-Face With Scorching Wildfire: Potential Toxicant Exposure And The Health Risks Of Smoke For Wildland Firefighters At The Wildland-Urban Interface, Jooyeon Hwang, Ngee-Sing Chong, Mengliang Zhang, Robert J Agnew, Chao Xu, Zhuangjie Li, Xin Xu

Faculty, Staff and Student Publications

As wildfire risks have elevated due to climate change, the health risks that toxicants from fire smoke pose to wildland firefighters have been exacerbated. Recently, the International Agency for Research on Cancer (IARC) has reclassified wildland firefighters' occupational exposure as carcinogenic to humans (Group 1). Wildfire smoke contributes to an increased risk of cancer and cardiovascular disease, yet wildland firefighters have inadequate respiratory protection. The economic cost of wildland fires has risen concurrently, as illustrated by the appropriation of $45 billion for wildfire management over FYs 2011-2020 by the U.S. Congress. Occupational epidemiological studies of wildland firefighters are crucial for …

Predictors Of Hiv Molecular Cluster Membership And Implications For Partner Services, Camden J Hallmark, Charles Luswata, Natascha Del Vecchio, Christina Hayford, Ricardo Mora, Michelle Carr, Marlene Mcneese, Nanette Benbow, John A Schneider, Joel O Wertheim, Kayo Fujimoto

Faculty, Staff and Student Publications

Public health surveillance data used in HIV molecular cluster analyses lack contextual information that is available from partner services (PS) data. Integrating these data sources in retrospective analyses can enrich understanding of the risk profile of people in clusters. In this study, HIV molecular clusters were identified and matched to information on partners and other information gleaned at the time of diagnosis, including coinfection with syphilis. We aimed to produce a more complete understanding of molecular cluster membership in Houston, Texas, a city ranking ninth nationally in rate of new HIV diagnoses that may benefit from retrospective matched analyses between …

Investigation Of Teratogenic Concerns In The Covid-19 Era, Emily Daykin

Dissertations and Theses (Open Access)

In the United States, Coronavirus disease 19 (COVID-19) has disproportionately impacted vulnerable populations, including pregnant people, who were shown to be at higher risk of severe illness from COVID-19 infection and pregnancy complications. Research on the teratogenicity of COVID-19 is still ongoing, but overall neither COVID-19 infection nor vaccination appear to increase the risk of birth defects. Numerous studies have investigated healthcare providers’ opinions on whether and when pregnant people should get vaccinated, as well as pregnant people’s perceptions of COVID-19 vaccines and psychosocial impacts of the pandemic. However, more research is needed to identify the most common concerns regarding …

Treatment Planning Automation For Rectal Cancer Radiotherapy, Kai Huang

Dissertations and Theses (Open Access)

Background

Rectal cancer is a common type of cancer. There is an acute health disparity across the globe where a significant population of the world lack adequate access to radiotherapy treatments which is a part of the standard of care for rectal cancers. Safe radiotherapy treatments require specialized planning expertise and are time-consuming and labor-intensive to produce.

Purpose:

To alleviate the health disparity and promote the safe and quality use of radiotherapy in treating rectal cancers, the entire treatment planning process needs to be automated. The purpose of this project is to develop automated solutions for the treatment planning process …

Impact Of Recent Abortion Legislation On Patient Trust In Healthcare Providers, Jasmine Tyson Ms

Dissertations and Theses (Open Access)

Trust is a key aspect of any patient-provider relationship as patients must rely on their healthcare providers (HCPs) to provide appropriate care and guidance, maintain confidentiality, and act in their best interests. Studies suggest that recent changes to abortion legislation have resulted in a loss of the patient-physician relationship, with individuals describing feelings of isolation and fear regarding safety and confidentiality, and many seeking information outside of the medical community. An anonymous survey was distributed among members of abortion support groups and advocacy organizations in the United States to assess how recent changes to abortion legislation may impact patient trust …

The Need For Racial And Ethnic Health Disparity Curriculum In Genetic Counseling Programs, Yusra Aziz

Dissertations and Theses (Open Access)

Racial and ethnic health disparities (REHD) exist across all organized medicine, including the spectrum of genetic counseling, particularly in genomic testing and access to care. While cultural competency and health disparities have been included as a part of the Standards of Accreditation for Genetic Counseling, there have not been previous efforts to define what topics related to REHD are most important to include in graduate program curriculum. Therefore, this study aimed to determine what topics related to REHD should be taught in genetic counseling program curriculum by assessing what topics genetic counselors (GCs) learned about and in what settings, …

Turnaround Time And Efficiency Of Pediatric Outpatient Brain Magnetic Resonance Imaging: A Multi-Institutional Cross-Sectional Study, Shireen E Hayatghaibi, Cecilia G Cazaban, Sherwin S Chan, Jonathan R Dillman, Xianglin L Du, Yu-Ting Huang, Ramesh S Iyer, Osama I Mikhail, John M Swint

Faculty, Staff and Student Publications

BACKGROUND: Aside from single-center reports, few data exist across pediatric institutions that examine overall MRI turnaround time (TAT) and the determinants of variability.

OBJECTIVE: to determine average duration and determinants of a brain MRI examination at academic pediatric institutions and compare the duration to those used in practice expense relative value units (RVUs).

MATERIALS AND METHODS: This multi-institutional cross-sectional investigation comprised four academic pediatric hospitals. We included children ages 0 to < 18 years who underwent an outpatient MRI of the brain without contrast agent in 2019. Our outcome of interest was the overall MRI TAT derived by time stamps. We estimated determinants of overall TAT using an adjusted log-transformed multivariable linear regression model with robust standard errors.

RESULTS: The average overall TAT significantly varied among the four hospitals. A sedated brain MRI ranged from 158 min to 224 min, a non-sedated MRI from 70 min to …

Reliability Estimates For Assessing Meal Timing Derived From Longitudinal Repeated 24-Hour Dietary Recalls, Lacie Peterson, Hyejung Lee, Inge Huybrechts, Carine Biessy, Marian L Neuhouser, Benjamin Haaland, Benjamin Krick, Marc Gunter, Matthias B Schulze, Franziska Jannasch, Adriana M Coletta, Sheetal Hardikar, Amandine Chaix, Cici X Bauer, Qian Xiao, Mary C Playdon

Faculty, Staff and Student Publications

BACKGROUND: Regulating meal timing may have efficacy for improving metabolic health for preventing or managing chronic disease. However, the reliability of measuring meal timing with commonly used dietary assessment tools needs characterization prior to investigating meal timing and health outcomes in epidemiologic studies.

OBJECTIVES: to evaluate the reliability of estimating meal timing parameters, including overnight fasting duration, the midpoint of overnight fasting time, the number of daily eating episodes, the period with the largest percentage of daily caloric intake, and late last eating episode (> 09:00 pm) from repeated 24-h dietary recalls (24HRs).

METHODS: Intraclass correlation coefficients (ICC), Light's Kappa …

Updated Analysis To Reject The Laboratory-Engineering Hypothesis Of Sars-Cov-2, Fuqing Wu

Faculty, Staff and Student Publications

A clear understanding of the origin of SARS-CoV-2 is important for future pandemic preparedness. Here, I provided an updated analysis of the type IIS endonuclease maps in genomes of alphacoronavirus, betacoronavirus, and SARS-CoV-2. Scenarios to engineer SARS-CoV-2 in the laboratory and the associated workload was also discussed. The analysis clearly shows that the endonuclease fingerprint does not indicate a synthetic origin of SARS-CoV-2 and engineering a SARS-CoV-2 virus in the laboratory is extremely challenging both scientifically and financially. On the contrary, current scientific evidence does support the animal origin of SARS-CoV-2.

Opioid-Related Mortality: Dynamic Temporal And Spatial Trends By Drug Type And Demographic Subpopulations, Massachusetts, 2005–2021, Thomas J Stopka, Marc R Larochelle, Xiaona Li, Dana Bernson, Wenjun Li, Leland K Ackerson, Ric Bayly, Olaf Dammann, Cici Bauer

Faculty, Staff and Student Publications

BACKGROUND: Fatal opioid-related overdoses (OOD) present significant public health challenges. Intuitive and replicable analytical approaches are needed to inform targeted public health responses.

METHODS: We obtained fatal OOD data for 2005-2021 from the Massachusetts Registry of Vital Records and Statistics. We conducted heatmap analyses to assess trends in fatal OOD rates per 100,000 residents, visualizing rates by death year and decedent age at one-year intervals, stratifying by race/ethnicity, sex, rurality, and involved substances. We calculated Getis-Ord Gi* statistics to identify spatial clusters of OOD rates.

RESULTS: Among 20,774 fatal OODs, rates were higher among males, and highly variable by race/ethnicity, …

Perceived Negative Political Climate Among Hispanic/Latino Adolescents Before And After The 2020 Us Presidential Election: Associations With Internalizing Symptoms And Substance Use, Pablo Montero-Zamora, Saskia R Vos, Jennifer B Unger, Ingrid Zeledon, Ryan Lee, Daniel W Soto, Eric C Brown, Maria Duque, Maria Fernanda Garcia, Carolina Scaramutti, Beyhan Ertanir, Seth J Schwartz

Faculty, Staff and Student Publications

The political climate often changes following the installment of a new president. This volatility presents opportunities for examining how elections might affect vulnerable subgroups such as Hispanic/Latino (HL) adolescents. The present study explored the perception of negative political climate among HL adolescents before and after the 2020 U.S. presidential election and its association with internalizing symptoms and substance use. We conducted the study in Los Angeles and Miami between 2020-2021, with a sample of 304 HL adolescents (Females = 60.8%), aged 15.3 years on average. Participants completed measures of negative political climate (pre- post-election) and measures of depressive symptoms, anxiety, …

Identifying Predictors Of Eventual Rural Practice Among Female Osteopathic Medical Students, Dana Kahl

Graduate Theses and Dissertations

The United States is facing a growing physician shortage that threatens the ability of our healthcare system to provide needed services. This shortage will be more acutely felt in rural and underserved areas. Osteopathic medical education, with its priority of primary care specialties, plays a significant role in meeting the healthcare needs of rural communities in America. The fastest-growing demographic of osteopathic physicians is women under the age of 45 (American Osteopathic Association, 2021). Additionally, for the first time in history, women outnumber men in medical schools, accounting for 51% of current medical students (Boyle, 2019). Who is admitted to …

Social Reproduction And Covid-19, Caroline I. Donovan

Dartmouth College Master’s Theses

As Covid-19 rips across the world we are collectively asked to examine the structures of society to see what is working and what we can change. What can we learn from the roughly 6.9 million deaths (and counting) worldwide? How can we prevent something like this from happening again? This paper follows the course of Covid-19 from its birth in Wuhan, China, to the present day of mid-April 2023. By looking at the ways in which we have reacted to the pandemic, we are able to look forward and imagine new ways of tackling future pandemics and other pressing problems …

Integrating Human Papillomavirus Testing As A Point-Of Care Service Using Genexpert Platforms: Findings And Lessons From A Kenyan Pilot Study (2019–2020), Valerian Mwenda, Joan-Paula Bor, Mary Nyangasi, James Njeru, Sharon Olwande, Patricia Njiri, Marc Arbyn, Philippe Tummers, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Globally, cervical cancer is a major public health problem, with about 604,000 new cases and over 340,000 deaths in 2020. In Kenya, it is the leading cause of cancer deaths, with over 3,000 women dying in 2020 alone. Both the Kenyan cancer screening guidelines and the World Health Organization’s Global Cervical Cancer Elimination Strategy recommend human papillomavirus (HPV) testing as the primary screening test. However, HPV testing is not widely available in the public healthcare system in Kenya. We conducted a pilot study using a point of care (POC) HPV test to inform national roll-out.

Methods: The …

Postpartum Detection Of Diastolic Dysfunction And Nondipping Blood Pressure Profile In Women With Preeclampsia, Marwa Sayed, Mariam Rashed, Ahmed M Abbas, Amr Youssef, Mohamed Abdel Ghany

The Texas Heart Institute Journal

BACKGROUND: Left ventricular diastolic dysfunction and nocturnal "nondipping" of blood pressure detected via ambulatory blood pressure monitoring are predictors of increased cardiovascular morbidity.

METHODS: A prospective cohort study including normotensive women with a history of preeclampsia in their current pregnancy was conducted. All cases were subjected to 24-hour ambulatory blood pressure monitoring and 2-dimensional transthoracic echocardiography 3 months after delivery.

RESULTS: This study included 128 women with a mean (SD) age of 28.6 (5.1) years and a mean (SD) basal blood pressure of 123.1 (6.4)/74.6 (5.9) mm Hg. Among the participants, 90 (70.3%) exhibited an ambulatory blood pressure monitoring profile …

The Social Vulnerability Index As A Risk Stratification Tool For Health Disparity Research In Cancer Patients: A Scoping Review, Tiffaney Tran, Morgan A Rousseau, David P Farris, Cici Bauer, Kelly C Nelson, Hung Q Doan

Faculty, Staff and Student Publications

PURPOSE: The social vulnerability index (SVI), developed by the Centers for Disease Control and Prevention, is a novel composite measure encompassing multiple variables that correspond to key social determinants of health. The objective of this review was to investigate innovative applications of the SVI to oncology research and to employ the framework of the cancer care continuum to elucidate further research opportunities.

METHODS: A systematic search for relevant articles was performed in five databases from inception to 13 May 2022. Included studies applied the SVI to analyze outcomes in cancer patients. Study characteristics, patent populations, data sources, and outcomes were …

Dna Methylation Analysis Is Used To Identify Novel Genetic Loci Associated With Circulating Fibrinogen Levels In Blood, Julie Hahn, Jan Bressler, Arce Domingo-Relloso, Ming-Huei Chen, Daniel L Mccartney, Alexander Teumer, Jenny Van Dongen, Marcus E Kleber, Dylan Aïssi, Brenton R Swenson, Jie Yao, Wei Zhao, Jian Huang, Yujing Xia, Michael R Brown, Ricardo Costeira, Eco J C De Geus, Graciela E Delgado, Dre'von A Dobson, Paul Elliott, Hans J Grabe, Xiuqing Guo, Sarah E Harris, Jennifer E Huffman, Sharon L R Kardia, Yongmei Liu, Stefan Lorkowski, Riccardo E Marioni, Matthias Nauck, Scott M Ratliff, Maria Sabater-Lleal, Tim D Spector, Pierre Suchon, Kent D Taylor, Florian Thibord, David-Alexandre Trégouët, Kerri L Wiggins, Gonneke Willemsen, Jordana T Bell, Dorret I Boomsma, Shelley A Cole, Simon R Cox, Abbas Dehghan, Andreas Greinacher, Karin Haack, Winfried März, Pierre-Emmanuel Morange, Jerome I Rotter, Nona Sotoodehnia, Maria Tellez-Plaza, Ana Navas-Acien, Jennifer A Smith, Andrew D Johnson, Myriam Fornage, Nicholas L Smith, Alisa S Wolberg, Alanna C Morrison, Paul S De Vries

Faculty, Staff and Student Publications

Background:

Fibrinogen plays an essential role in blood coagulation and inflammation. Circulating fibrinogen levels may be determined by inter-individual differences in DNA methylation at CpG sites, and vice versa.

Methods:

We performed an epigenome-wide association study (EWAS) of circulating fibrinogen levels in 18,037 White, Black, American Indian, and Hispanic participants representing 14 studies from the CHARGE consortium. Circulating leukocyte DNA methylation was measured in 12,904 participants using the Illumina 450K array, and in 5,133 participants using the EPIC array. Each study performed an EWAS of fibrinogen using linear mixed models adjusted for potential confounders. Study-specific results were combined using array-specific …

Chronic Overlapping Pain Conditions And Long-Term Opioid Treatment, Maria Ukhanova, Robert W Voss, Miguel Marino, Nathalie Huguet, Steffani R Bailey, Daniel M Hartung, Jean O'Malley, Irina Chamine, John Muench

Faculty, Staff and Student Publications

OBJECTIVES: One in 5 people in the United States lives with chronic pain. Many patients with chronic pain experience a subset of specific co-occurring pain conditions that may share a common pain mechanism and that have been designated as chronic overlapping pain conditions (COPCs). Little is known about chronic opioid prescribing patterns among patients with COPCs in primary care settings, especially among socioeconomically vulnerable patients. This study aims to evaluate opioid prescribing among patients with COPCs in US community health centers and to identify individual COPCs and their combinations that are associated with long-term opioid treatment (LOT).

STUDY DESIGN: Retrospective …

Exploring Sexual And Reproductive Health Care In Central Appalachia Through The Experiences Of Transgender And Gender Non-Binary People, Chase Harless

Electronic Theses and Dissertations

Background: Transgender or nonbinary (TNB) individuals in the United States experience higher rates of sexual and reproductive health disparities when compared to their cisgender counterparts, along with lower access to care. TNB people in the south experience higher rates of disparities. Societal, interpersonal, and individual barriers contribute to these disparities in the TNB population. However, there is a paucity of research examining the sexual and reproductive health experiences of TNB people living in Central Appalachia.

Methods: An interpretive phenomenological analysis (IPA) research design was used to collect and analyze semi-structured interviews with TNB individuals living in central Appalachia regarding their …

Influences On Pregnancy: An Exploration Of Maternal Discrimination, An Alternative Model Of Prenatal Care And Health Information Online, Emily Doherty

All Dissertations

In the United States metrics of perinatal health lag far behind peer countries and is characterized by stark disparities. The studies that make up this dissertation seek to elucidate factors influencing perinatal health.

The first and second chapters provide an introduction and extensive review of the literature of factors contributing to perinatal health with specific focus on discrimination and perinatal health; group prenatal care and digital pregnancy health information. The third chapter introduces the methodology to be used by each of the following studies. Subsequent chapters are formatted as individual manuscripts, each presenting background, methodology, results, and discussion.

The fourth …

Diagnosis Of Urinary Tract Infections And Rapid Molecular Characterization Of Antibiotic Resistance, Mohammed Harris

All Dissertations

Urinary tract infections (UTIs) are one of the most common infectious clinical entities in both community and hospital settings. They have a broad range of clinical severity yet inflict large epidemiological burden of morbidity and mortality on patients and the healthcare system with billions of dollars in cost of treatment. Understanding what methods are optimal for diagnosing UTIs are critical to mitigate the marked impact and cost of these infections.

Chapter 1 and 2 in this work surveys the broad array of diagnostic modalities for UTIs and highlights their advantages and limitations in the context of the current standard of …

Opioid Prescribing Practice & Policy – A Study Of Medicaid Pediatric Population In South Carolina, Laksika Sivaraj

All Dissertations

Opioids are widely used as analgesics in different clinical settings, but they are also highly criticized for their downsides. Among the adult population, the addictive nature of opioids continues to be the main concern, while among young children, there are other adverse health outcomes that opioids can cause. These concerns have led the US Food and Drug Administration (FDA) and other professional bodies to discourage opioid prescribing for children. Nevertheless, opioids continue to be prescribed for children for contraindicated health conditions. The goal of this research is to assess opioid prescribing practices for the pediatric population in South Carolina (SC). …

Electronic Monitoring Of Mom's Schedule (Emomstm): Recruitment Of Pregnant Populations With Elevated Bmi In A Feasibility Randomized Controlled Trial, Lisette T. Jacobson, Michael Wolfe, Rosey Zackula, Hayrettin Okut, Faith E. Hampton, David A. Grainger, Adrianne K. Griebel-Thompson, Kai Ling Kong, Christie Befort

Manuscripts, Articles, Book Chapters and Other Papers

Underrepresentation of pregnant populations in randomized controlled trials of lifestyle change interventions is concerning due to high attrition and providers' limited clinical time. The purpose of this evaluative study was to assess intervention uptake of pregnant individuals enrolled in a three-arm feasibility randomized controlled trial, electronic Monitoring Of Mom's Schedule (eMOMSTM), examining lifestyle changes and lactation support alone, and in combination. Measures included: (1) participation and completion rates, and characteristics of intervention completers versus other eligible participants; and (2) provider experiences with screening and enrolling pregnant participants. Pregnant people with a pre-pregnancy body mass index ≥ 25 and < 35 kg/m2 were enrolled into the eMOMSTM trial between September 2019 - December 2020. Of the 44 consented participants, 35 were randomized, at a participation rate of 35%, and 26 completed the intervention, resulting in a completion rate of 74%. Intervention completers were slightly older and entered the study earlier in pregnancy compared to non-completers. Completers were more likely to be first-time mothers, resided in urban areas, had higher educational attainment, and were slightly more racially and ethnically diverse. A majority of providers reported willingness to participate, believed the study aligned with their organization's mission, and were satisfied with using iPads for screening. Lessons learned to guide recruitment success include use of: (1) designated research staff in combination with physician support; and (2) user-friendly technology to help mitigate time burden on physicians and their staff. Future work should focus on successful strategies to recruit/retain pregnant populations in clinical trials.

A Twin Study Of Genetic Heritage And Environmental Influences On Tobacco Susceptibility And Initiation On Early Age, Yadi Liu

Capstone Experience: Master of Public Health

Purpose: Tobacco product susceptibility is defined as the interest a person has to start smoking. Tobacco product initiation refers to whether a person has ever used tobacco products. We aim to understand and explain how genetic and environmental factors affect tobacco products' susceptibility and initiation in children. Methods: The classical twin model estimates three sources of variance: additive genetic (A), shared environmental (C), and unique environments (E). Each source of variance is latent and is calculated from the similarity in the correlations of twin pairs on a phenotype. The magnitude of difference in the correlation of a particular …

Utilization Of Routine And Recommended Preventive Care Among Individuals With Disabilities In Nebraska, Snehal Jadhav

Capstone Experience: Master of Public Health

Background: Healthcare access disparities exist among individuals with and without disabilities (IWD, IWoD). There is a scarcity of studies focused on Nebraskans living with disabilities.

Methods: Access to Care Nebraska surveyed adults (age 19+) in Oct 2020-Mar 2021. We used Andersen’s model of healthcare utilization to group risk factors for non-compliance with routine care and recommended cancer screening. A multivariate log-binomial regression compared the non-compliance between IWD and IWoD to compute adjusted prevalence ratios (aPR) for risk factors.

Results: Of the 1101 participants,96(8.7%) were IWD. IWD had a higher proportion of non-compliance to routine preventive care (61.7% vs 54.1%) and …

A Systematic Literature Review On Long-Term Care Quality Improvement Initiatives In The United States, Daisy D. Pang

Capstone Experience: Master of Public Health

As the number of people 65 and older increases due to the baby boomer population, there will be a greater demand for long-term care (LTC) services. Quality improvement in LTC is essential to ensure positive health outcomes, patient satisfaction, and reduction in healthcare costs. The purpose of this systematic literature review is to identify the current quality initiatives for LTC in the United States and evaluate the outcomes, effects, and values of each quality initiative identified to support the claim that current the quality initiatives have a limited effect on quality improvement in LTC settings. The Preferred Reporting Items for …

Cultivating A Robust Safety Culture Through Identifying And Overcoming Barriers Within Organizations, Morgan Shradar

Capstone Experience: Master of Public Health

The hierarchical power structure within healthcare and response teams may impede communication about safety risks and violations. In developing or enhancing the safety culture within the emergency response to infectious disease events in healthcare organizations, the hierarchy of controls can be utilized to evaluate successful transmission prevention or further harm to responding teams. Within the tool, administrative controls focus on policies, procedures, and practices that minimize the risk of exposure/transmission. The idea of a safe culture emerged following the Chernobyl Disaster, in which a combination of human and system failures led to this emergency. Safety culture has been integrated into …

Reducing Burnout Using Emergency Planning: A Literature Review, Taylor Vaughn

Capstone Experience: Master of Public Health

Objective

The objective of this capstone is to gain knowledge on what burnout is, what causes it, what can be done to prevent it, and what can be added to public health emergency plans to reduce burnout in local emergency preparedness workforces.

Methodology

A literature review was completed through peer-reviewed articles, and documents from professional and governmental organizations. The results were used to search current plans to determine whether burnout-related recommendations were present.

Results

Burnout prevention at the personal level includes a good diet, routine exercise, and mindfulness activities. At the organizational level it should include providing emotional support, emphasizing …

Comprehensive Literature Review: Assessing The Impact Of Covid-19 Policies, School Closures And Social Distancing, On The Mental Health Of School Age Children, Fatuma A. Hassan

Capstone Experience: Master of Public Health

Mental health is vital to the well-being of all individuals, especially children. COVID-19 unveiled a significant public health issue with poor mental health during the pandemic. There is limited literature about the mental health implications of COVID-19 policies for children and adolescents and preventive strategies for future pandemics. This comprehensive literature review seeks to further investigate the mental health impacts of school shutdowns and social distancing, which were nonpharmaceutical strategies, on school-aged children, 5-18 years old, and propose recommendations for public health officials to mitigate the mental health impacts for future pandemics. Additionally, the review aims to highlight the potential …