Public Health Commons^™

A Unique Hiv Harm Reduction Perspective From Costa Rica: Hogar De La Esperanza An Ethnographic Case Study And Comparative Examination Of Approach To Hiv Treatment Between The United States And Costa Rica, Kim Marie Day

Theses and Graduate Projects

This case study presents a real, currently operational scenario of harm reduction in action in Costa Rica, focusing on its success and the challenges faced by healthcare professionals, the experiences of those who live at Hogar de la Esperanza, and the implications for healthcare policies and interventions in the United States. By examining this specific case of a Costa Rican community-based HIV treatment model, the aim of this ethnographic report is to shed light on the complexities and factors contributing to the success or failure of harm reduction treatment strategies within the United States and what can be learned by …

Growing Pains: A Needs-Based Assessment Of Aging In Place In The Twin Cities, Emma Burt

Theses and Graduate Projects

Background: As they age, older adults are often forced to change their living environments to accommodate their growing medical and personal needs. However, alternative living options are often less desired and present other challenges. Aging in place is the ability for individuals to choose where they live as they age, prioritizing the aging person’s choice and providing resources to support it. Purpose: The Twin Cities metropolitan area of Minnesota currently has a population of nearly 472,000 older individuals, and it is only continuing to rise. Although infrastructure exists that supports aging in place, not all older individuals get adequate services …

A Systematic Review Of Sodium Intake And Its Impact On Cardiovascular Health: Insights From Costa Rican Studies, Benjamin M. Hillebrand

Theses and Graduate Projects

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide, with dietary sodium intake identified as a critical risk factor. This systematic review comprehensively examines the existing literature on sodium intake and its impact on cardiovascular health in Costa Rica. Fifteen relevant studies were analyzed, revealing concerning patterns of sodium consumption, particularly among youngsters and adolescents, with processed and fast foods being major contributors. High sodium intake was consistently associated with elevated blood pressure, a well-established CVD risk factor. The review also assessed sodium reduction initiatives and strategies, demonstrating the potential benefits of interventions in reducing cardiovascular risk. …

Better Nature: How Nature Improves Our Health And How We Can Use Nature To Do Better, Alyssa K. Snyder

Theses and Graduate Projects

This research paper outlines the salubrious effects of exposure to green spaces and explores how healthcare providers in urban areas can leverage the benefits of green spaces to combat poor health outcomes from the chronic stress of urbanicity, particularly in disadvantaged populations. Focusing on the metropolitan area of Minnesota, this study acknowledges existing barriers and constraints of populations experiencing health inequities while analyzing data on green space accessibility and seeking solutions for those communities, particularly BIPOC and low-income. This paper synthesizes evidence from various studies that establish the positive associations between health and exposure to green spaces, which can also …

Barriers To Hpv Screening And Prevention In Latin America: A Systematic Review, Lauren Rutten

Theses and Graduate Projects

In Latin America, cervical cancer is the second most common female cancer and the fourth most leading cancer of women around the world, with an estimated 342,000 deaths in 2020.1 This systematic review of literature gives insight into Latin Americas barriers to Human Papillomavirus Virus (HPV) screening and prevention. A comprehensive literature review was conducted using google scholar, the WHO, and the CDC. Search terms included: barriers to HPV screening, cervical cancer, Latin America, Central America, Costa Rica, Prevention of HPV, and Human Papillomavirus. Three main barriers to HPV screening and prevention were found including, fear, lack of education, and …

The Benefits And Limitations Of A Clinician Lead Sexual Education Program In Wisconsin Public Schools, Margaret Freiermuth

Theses and Graduate Projects

Background: Abstinence-based sexual education is the primary method of sexual education in public schools.4 The majority of public schools use teachers who may or not have proper training to teach the course. Comprehensive sexual education taught by clinicians could potentially decrease sexual risky behavior in the youth population.

Purpose: Identify potential benefits or limitations to a clinician-led sexual education program in Wisconsin public schools. Methods: Articles 2017 or newer were reviewed utilizing search engines such as PubMed, Google Scholar, and NIH. A Google Forum with 18 questions was sent out to 420 Wisconsin public school administrators. It was open for …

Safety First: Assessing First Aid Educational Needs Of Outdoor Education Participants, Melissa Niemiec

Theses and Graduate Projects

Background: Much of the general population has a lack of first aid knowledge, despite engaging in activities that might end in needing some level of medical care. Even when first aid education is gained, sometimes it is subpar or less relevant to wilderness excursions. In order to create a high quality wilderness first aid course, it should be interactive and take place in a wilderness setting. Having basic first aid skills increases confidence and reduces anxiety of participants, possibly reducing the rate of injury.

Purpose: This needs assessment sets out to determine the first aid needs and concerns held by …

Improving Minnesota’S Access To Opioid Use Disorder Treatment And Naloxone, Annasha Doane-Ramkhalawon

Theses and Graduate Projects

Background: In 2020, Minnesota recorded 4,920 admissions with associated opioid use for adults 18 years of age and older.1 2021 put Minnesota's Opioid-related overdose mortality number at 1,017 individuals.2 Methadone and Buprenorphine as MOUD is the first line treatment for Opioid Use Disorder and long-time management as the standard of care.3 Naloxone is the drug of choice for opioid reversal and overdose prevention.3

Purpose: This study aims to investigate the barriers that OUD feel when attempting to receive treatment for OUD and access Naloxone. The indication is the number of OUD- related admissions and OUD-related overdose fatalities. In addition, the …

What Do People Affected By Amyotrophic Lateral Sclerosis Want From Health Communications? Evidence From The Als Talk Project, Shelagh K. Genuis, Westerly Luth, Tania M. Bubela, Wendy S. Johnston

Office of the Provost

Introduction/aims: Health communication is central to effective, supportive amyotrophic lateral sclerosis (ALS) clinical care. Guidance for ALS communication is limited, focuses on diagnosis disclosure, and frequently relies on expert consensus and/or reviews. Patient-based evidence is needed to guide ALS health communication. We investigated how the experiences of ALS patients and family caregivers can inform effective communication practices from diagnosis to end-of-life.
Methods: Data were drawn from the ALS Talk Project, an asynchronous, online focus group study. Seven focus groups and five interviews (105 participants) were conducted. Data were qualitatively analyzed using directed content analysis and the constant-comparative approach.
Results: We …

Researching Medical Treatment Assessments From United States Military Veterans Diagnosed With Substance Use Disorder, And Determining Interest In The Matrix Model Of Treatment For Potential Application In Their Treatment Programs, Christopher R. Strunk

Dissertations and Theses

The purpose of this research study is to learn the beliefs and thoughts on the current state of medical treatment provided to United States (US) military Veterans diagnosed with substance use disorder (SUD), and gauge Veterans’ levels of interest and support in the potential application of the Matrix Model of Treatment (MMT) in their healthcare programs. This proposal focused on verifying the Veterans’ interest in the MMT model since the US Department of Veterans Affairs (DVA) does not currently implement this full-spectrum, 16-week treatment system. It is believed interest will be strong enough to merit supporting its consideration with approving …

Hearing Aid Loan Program For Hearing Loss At The End Of Life, M. Courtney Hughes, Diane Schecklong, King Chung

Faculty Articles, Papers, and Other Scholarship

This article describes a hearing aid loan program to provide free amplification devices for patients at the end of life to help them communicate more effectively at this critical time. It includes steps for establishing such a program, addressing challenges, and the role of the informal caregiver throughout the intervention. Healthcare professionals and social workers are encouraged to develop similar programs and use the information here as helpful suggestions to consider for their programs.

Does The Health Literacy Of Spanish Speakers Impact Their Vaccination Decisions?: A Literature Review Of Related Research, Kelly Tran

Honors Undergraduate Theses

Background: The Hispanic community has historically faced high rates of vaccine hesitancy when compared to their non-Hispanic white counterparts. This not only poses a threat to their individual health, but also to their community. In a population that is disproportionately affected by COVID-19 infections, it is critical to address vaccine uptake concerns to control the pandemic and prevent future spread of infections.

Objective: This study aims to explore Spanish speakers' vaccination decisions and to explore whether improving health literacy would be an effective approach in increasing vaccination rates. The secondary objective is to describe the role of physicians in decreasing …

Improving Group B Streptococcus Susceptibility Testing, Sofia Sarduy, Michelle Ozcan

North Florida Division GME Research Day 2023

No abstract provided.

Incrasing The Rate Of Pneumococcal Vaccination In Patients Over 65, Ubaldo Gonzalez Morales, Muna Alhusban, Chelsea Guan, Natalia Cavin, Humeyra Dogan, Liliana Franco Moreira, Ashwini Komarla, Allison Ferrara

North Florida Division GME Research Day 2023

No abstract provided.

The Impact Of Demographic Factors And Language On Stroke Metrics Within The Hca Healthcare System, Henry Yelkin, Glenn Goodwin, Jonghoon Chang, Mchenry Mauger, Erin Marra

East Florida Division GME Research Day 2023

Background: Effective evaluation of stroke symptoms necessitates a comprehensive clinical assessment, influencing the timely administration of tissue plasminogen activator (tPA). This study examines the relationship between patients’ preferred language as well demographic factors and stroke care metrics within the framework of the HCA Healthcare System.

Methods: A retrospective study design was used to examine the national HCA database for all patients admitted to an HCA hospital with a diagnosis of stroke and with a recorded NIH stroke scale (NIHSS) between the years of 2017 and 2022. 37,956 patient visits from 170 HCA hospitals were analyzed to compare stroke metrics including …

Examining Nationwide Disparities In Managing Critical Limb Threatening Ischemia Among Individuals With Diabetes Mellitus Or End-Stage Kidney Disease By Race And Ethnicity, Daniel Dominguez, Waseem Wahood

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with tables.

Introduction: Critical Limb Threatening Ischemia (CLTI) presents a significant challenge, particularly for individuals with diabetes mellitus (DM) or End-Stage Kidney Disease (ESKD). Healthcare disparities related to race and ethnicity are a pressing concern. This study aims to examine a 16-year trend to assess whether the disparities in managing critical limb-threatening ischemia (CLTI) are diminishing among individuals with diabetes mellitus (DM) or End-Stage Kidney Disease (ESKD).

Methods: The analysis involved an examination of the National Inpatient Sample data from 2005 to 2020, with a focus on hospitalizations related to CLI. Identification of …

Clinical Characteristics Of Covid-19 Waves In The Southeastern United States: A Retrospective Study, Omar Kandah, Robert Sherertz, Richard Duff, Erica Junqueira

South Atlantic Division GME Research Day 2023

No abstract provided.

Illicit Drug Use Patterns In Myrtle Beach, S.C. From 2017-2022, Michelle Fowler, Mark Plexousakis, Meg Riley, Blaine Rourke, Erin Artigiani, Amy Billing, Margaret Hsu, Ebonie Massey, Eric Wish

South Atlantic Division GME Research Day 2023

No abstract provided.

Understanding The Relationship Between Undergraduate Students’ On-Campus Employment Status And Their Reported Sense Of Belonging To The Campus Community Post The Covid-19 Pandemic, Samantha Martinez

CGU Theses & Dissertations

Belonging has been studied for decades with many researchers concluding that humans have an inherent need to belong. Although each person’s level of need to belong differs, it is a deeply rooted human motivation that impacts a person’s feelings, thoughts, and behaviors. Individuals develop a sense of belonging when they feel connected to others. The postsecondary journey allows for unique experiences and opportunities that foster a sense of belonging, which can assist college students to flourish in many aspects of their lives. Research has shown that belonging significantly impacts student well-being and academic achievement, making the topic imperative to continue …

Saftey Of Covid-19 Vaccines In Real World Studies, Khawla Amar Mohamed Gammudi

CGU Theses & Dissertations

Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been present since its outbreak in 2019. Despite global efforts to fully halt its spread, new strains are emerging daily. Various efforts have been undertaken to slow down the infection's spread by implementing different restrictive measures and policies, such as lockdowns, social distancing, and mask-wearing. However, the most effective approach to controlling this disease is through vaccinations (Chen, 2021). Substantial efforts have been dedicated to encouraging people in the United States to receive COVID-19 vaccines and booster doses. As of December 7, 2022, approximately 68.5% of the world's …

Utilizing Translational Research To Identify And Develop Effective Strategies For Operationalizing And Implementing A National Board Health And Wellness Coaching (Nbhwc) Certification Program Within The Non-Profit, Living Your Truth Empowered (Lyte), Rielly Keyser

CGU Theses & Dissertations

Introduction: This dissertation presents a comprehensive study that employs a combined formative and translational research design, alongside a mixed methods approach, to identify and develop strategies for operationalizing and implementing a National Board of Health and Wellness Coaching (NBHWC) certification program within the nonprofit organization Living Your Truth Empowered (LYTE). The research involves evidence-based strategies identification, analysis, and strategic planning to enhance the program's launch and effectiveness, with a particular focus on serving the diverse breast cancer community.

Methods: The study begins with an extensive literature review and the examination of 32 similar programs to identify OPR and IMP strategies. …

Recent Advances In Research And Management Of Human Monkeypox Virus: An Emerging Global Health Threat, Parveen Kumar, Benu Chaudhary, Nishant Yadav, Sushma Devi, Ashutosh Pareek, Sujatha Alla, Fnu Kajal, Behdin Nowrouzi-Kia, Vijay Kumar Chattu, Madan Mohan Gupta

Engineering Management & Systems Engineering Faculty Publications

In 2003, the United States saw an epidemic of monkeypox that was later traced back to rodents of West Africa infected with the monkeypox virus (MPXV). Disease in the United States seemed less severe than the smallpox-like disease in the Democratic Republic of the Congo (DRC). In this study, researchers analyzed data from Central Africa: two distinct MPXV clades were confirmed by sequencing the genomes of MPXV isolates from Western Africa, the United States, and Central Africa. By comparing open reading frames across MPXV clades, scientists can infer which virus proteins might account for the observed variation in pathogenicity in …

Adaptive Evaluation For Systems In Rapid Change Or Sustained Transition: Innovations And Applications Generated From A Community-Based Diabetes Prevention Program During The Covid-19 Pandemic, Amy Kuhn

CGU Theses & Dissertations

Program evaluation is a key part of the life cycle of public health and prevention science projects. But in complex environments or evolving situations, existing evaluation theory faces challenges in successful practical application. Process evaluation can track changes as a program runs, but when a program operates outside of its original design, questions can arise related to fidelity of implementation and interpretation of results. Outcome evaluation often requires a closed system without changes to determine actual effects of a program, but in times of complicated change that isolation can be difficult to achieve or to work around. In practice, systems …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Using Multi-Theory Model To Explain Hiv Screening Behaviors Among College-Aged People, Joshua David Kamimoto

Walden Dissertations and Doctoral Studies

There is a need to examine novel approaches that explain the association between the initiation and sustenance of HIV screening behavior. This quantitative, cross-sectional study was used to examine if the components of the multi-theory model (MTM) of health behavior change can explain the initiation and sustenance of HIV screening behavior among college-aged people. A convenience sample of 151 consenting college-aged people between the ages of 18 and 34 in a western US state completed a self-administered 44-item instrument. Multiple regression analysis was used to assess the correlation between the constructs of the multi-theory model of health behavior change (independent …

Perioperative Nurse Education For Undiagnosed Obstructive Sleep Apnea Screening, Juanita Turnipseed

Walden Dissertations and Doctoral Studies

AbstractApproximately one third of surgical patients have undiagnosed obstructive sleep apnea (OSA), the most common form of sleep disordered breathing, which presents a risk in the perioperative setting. OSA is underdiagnosed and undertreated in the adult population and has an economic impact on limited healthcare resources. The need existed for nurses in the perioperative setting to be educated on OSA, including the introduction of the STOP-BANG screening questionnaire. The analysis, design, development, implementation, and evaluation model of instructional design informed this project. The purpose of this Doctor of Nursing Practice project was to plan, implement, and evaluate a perioperative nurse …

Predictive Effects Of Length Of Treatment And Type Of Dialysis On African Americans’ Quality Of Life, Latoya Benjamin

Walden Dissertations and Doctoral Studies

Individuals on dialysis often face challenges with the management of their health, resulting in low health-related quality of life (HRQOL), but the extent of this impact has not been fully examined. The purpose of this quantitative cross-sectional study was, having accounted for relevant demographic variables such as age, gender, family history, employment status, to examine the effects of length of time for treatment and type of dialysis on HRQOL in African American end-stage renal disease (ESRD) patients. This study was guided by the socioecological model. Secondary data from 2016 to 2021 was obtained from the Chronic Renal Insufficiency Cohort (CRIC) …

Help Seeking Behavior For Mental Health Issues Among College Students At A Southern University, Amanda Brooke Espinoza

Walden Dissertations and Doctoral Studies

The mental health of college students continues to decline, leading to increased suicide rates among young adults. College campuses provide mental health resources; however, many college students do not effectively utilize the resources. This quantitative research study allowed for a deeper understanding of why college students are not using mental health resources on their campus. A non-probability convenience sample was used. This sample of convenience was comprised of students who volunteered to complete the study survey sent via a university email. The survey was created for the purposes of this study using social cognitive theory constructs. The instrument contained four …

Internal Population Displacement And Vaccination Completion, Malnutrition, And Respiratory Infections Among Children In The Central African Republic, Francois Xavier Batalingaya

Walden Dissertations and Doctoral Studies

Forced displacement in fragile and conflict-affected countries has the potential to disrupt access to basic primary healthcare services such as immunization. The purpose of this study was to assess the association between internal population displacement and vaccination completion, malnutrition, and acute respiratory infections (ARIs) while controlling for maternal characteristics of wealth index, education level, and residence status in the Central African Republic. The socioecological model underpinned this cross-sectional study that used a secondary dataset collected in 2018 – 2019 and maintained by UNICEF. Descriptive statistics and logistic regression tests were used to analyze the data. The findings of this study …

Association Between Dietary Phytoestrogen Intake And Xenoestrogen Exposure And Estrogen-Dependent Cancers, Pisita Bolsue

Walden Dissertations and Doctoral Studies

The role of circulating estrogens and the impact of lifetime exposure to multiple sources of exogenous estrogens as factors in carcinogenesis were not well understood. Research showed conflicting results when dietary phytoestrogen (PE) intake and xenoestrogen (XE) exposure occurred independently and when co-exposed. The purpose of this quantitative cross-sectional study was to investigate the association between dietary PE intake and XE exposure and the development of estrogen-dependent cancers in an epidemiological context. The advanced model of the epidemiology triangle was the theoretical framework for the current study in which binary logistic regression was employed on secondary data from the 2003–2006 …