Public Health Commons^™

Perceptions Of Implicit Bias In New York City Healthcare System During Covid-19, Kiesha Jackson

Walden Dissertations and Doctoral Studies

Implicit bias has been identified as a significant problem that hinders effective healthcare delivery. The purpose of this qualitative exploratory phenomenological study was to examine whether implicit bias influenced healthcare services for African Americans with comorbidities aged 30 and over living in New York City during the COVID-19 pandemic. Current studies show healthcare disparities, revealing barriers with healthcare delivery; however, they do not disclose a patient’s lived experience qualitatively, which constituted a gap in the literature. The frameworks of the behavioral model of health services use, and social construction and policy design guided this study. Research questions addressed (a) whether …

Attitudes Of State Public Health Laboratory Directors Towards Iso/Iec 17025 Accreditation, Christine Kilonzo

Walden Dissertations and Doctoral Studies

The impact of ISO/IEC 17025 accreditation in state public health laboratories (SPHLs) is understudied. There is a scarcity of research on SPHLs involving behavioral intent regarding ISO/IEC 17025 accreditation. The theory of planned behavior (TPB) was utilized to evaluate SPHL directors’ attitudes towards and intent to seek or maintain ISO/IEC 17025 accreditation. To test the questions of whether the three constructs of the TPB, attitude, subjective norms and perceived behavioral control are significant predictors of intent to seek or maintain ISO/IEC 17025 accreditation, and whether there are significant differences in these constructs towards the accreditation between SPHL directors based on …

Impact Of Covid-19 On The Mental Health Of Resettled Refugee Children, Joseph Lawsel Williams

Public Health Theses

Background: Mental health difficulties disproportionately impact resettled refugee children (RRC). Little is known regarding the impact between COVID-19 and RRC mental health. A mixed-methods retrospective pilot study was conducted to examine the impact of COVID-19 on RRC mental health.

Methods: Families were recruited in partnership with Elena’s Light, a refugee resettlement community-stakeholder. Participants included 20 RRC (N=11 ages 4-11; N=9 ages 11-15; equal gender distribution) from 10 families (N=6 Afghanistan; N=1 Turkey; N=1 Syria; N=2 non-disclosed) resettled to New Haven, CT before March 2019. Pre-Covid (PC) and During-Covid (DC) maternal responses for three Strength and Difficulties Questionnaire (SDQ) dimensions (Emotional, …

Differential Gene Expression In Cord Blood Of Infants Diagnosed With Cerebral Palsy: A Pilot Analysis Of The Beam Cohort, Maria L V Dizon, Raye-Ann O Deregnier, Steven J Weiner, Michael W Varner, Dwight J Rouse, Maged M Costantine, Ronald J Wapner, John M Thorp, Sean C Blackwell, Nina K Ayala, Antonio F Saad, Steve N Caritis, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal-Fetal Medicine Units Network

Faculty, Staff and Student Publications

The Beneficial Effects of Antenatal Magnesium clinical trial was conducted between 1997 and 2007, and demonstrated a significant reduction in cerebral palsy (CP) in preterm infants who were exposed to peripartum magnesium sulfate (MgSO4). However, the mechanism by which MgSO4 confers neuroprotection remains incompletely understood. Cord blood samples from this study were interrogated during an era when next-generation sequencing was not widely accessible and few gene expression differences or biomarkers were identified between treatment groups. Our goal was to use bulk RNA deep sequencing to identify differentially expressed genes comparing the following four groups: newborns who ultimately developed CP treated …

Stress Coping Responses Of Undergraduate University Students Prior To & Since The Onset Of The Covid-19 Pandemic, Kaylee Diefenderfer

All Graduate Theses, Dissertations, and Other Capstone Projects

The stress coping mechanisms used by undergraduate university students affects their psychological well-being, stress level, and mental health outcomes. Increasing students’ use of positive coping mechanisms may increase academic outcomes, and overall health and well-being. This study evaluated the stress coping mechanisms used by undergraduate university students prior to and since the COVID-19 pandemic began. The Brief COPE inventory was used to measure stress coping responses. The results of this research indicated a significant change in 9 out of the 14 main coping mechanisms used by undergraduate university students prior to since the pandemic began. The top two stress coping …

A Technology-Based, Mixed Methods Approach To Examining The Psychosocial Determinants Of Maternal Health Disparities, Hannah M. Ming

Theses and Dissertations

Background: Exposure to racism and discrimination in the U.S. increases Black women’s risk for experiencing maternal health disparities. Additionally, racism and discrimination affect maternal psychosocial well-being, creating evidence for a biopsychosocial relationship between racism and maternal health outcomes. However, current research does not define the psychosocial Black maternal self well. Given the dynamic relationship between racism, psychosocial well-being, and Black maternal health outcomes, research must comprehensively examine the Black maternal self. The operationalization of a comprehensive construct for Black maternal psychosocial well-being can improve understanding of the relationship between racism, psychosocial well-being, and Black maternal health outcomes.

Purpose: …

Disability In An American Indian Community : Prevalence, Distribution, And The Role Of Polychlorinated Biphenyls, Thoin Farzana Begum

Legacy Theses & Dissertations (2009 - 2024)

The Akwesasne reservation along the St. Lawrence River has experienced significant exposure to several persistent organic pollutants due to rapid industrialization. The Aluminum Company of America, General Motors, and Reynolds Metals operated aluminum foundries that used polychlorinated biphenyls (PCBs) as hydraulic fluids, which contaminated the community environment, the soil, air and water, and community food sources with PCBs. We administered the World Health Organization Disability Assessment Schedule II (WHODAS II) to 119 Akwesasne Mohawk adults residing along the St. Lawrence River in New York. We used exploratory factor analysis to summarize the 36- items comprising the WHODAS II. The 7 …

Association Between Antiretroviral Therapy And Severe Covid-19 Outcomes Among Hospitalized Hiv Positive People With Sars-Cov-2 In Nys, Aizhan Kyzayeva

Legacy Theses & Dissertations (2009 - 2024)

IMPORTANCE The role of antiretroviral therapy (ART) type in people living with HIV (PLWDH) co-infected with acute respiratory syndrome coronavirus 2 (SARS-Cov-2) remains unclear. There is evidence that certain classes of ART may mute the risk of severe COVID-19 outcomes.

Radical Trachelectomy For Invasive Cervical Cancer : A Pathway To Fertility For Some, But Not Without Repercussions, Erica Jamro-Comer

Legacy Theses & Dissertations (2009 - 2024)

BackgroundRadical trachelectomy (RT) is a surgical procedure that offers a substantial benefit to women diagnosed with invasive cervical cancer: fertility preservation. However, as a newer surgical option, there are still many unknowns about the characteristics and outcomes of women who undergo this procedure after a cervical cancer diagnosis. Initial research in this area indicates that some disparities exist in who has the surgery versus the standard radical hysterectomy procedure; however, these are not fully understood and characterized. Furthermore, little is known about how women plan their families and how their high-risk pregnancies are managed in the absence of a standard …

Trace Elements In Nails And Anemia In Children Living Along The Interoceanic Highway, Madre De Dios, Peru / Narrative Competence And Cognitive Mapping As A Culturally Sustaining Pedagogy In The Education Of Emergent Bilinguals, Tia Marks

Legacy Theses & Dissertations (2009 - 2024)

Anthropogenic changes in the Peruvian Amazon, including deforestation, highway development, agriculture, and artisanal and small-scale gold mining (ASGM), have increased community concern about potential exposures toxic trace elements (TTE) including arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb). Such exposures can lead to detrimental health effects in children, such as developmental delays and anemia. The overarching goal of my dissertation was to understand exposure to both toxic and essential (manganese (Mn), selenium (Se), and zinc (Zn)) trace elements, anemia prevalence, and the associations between hemoglobin (Hb) levels and trace elements. To do this, I leveraged existing data from a …

Disability In An American Indian Community : Prevalence, Distribution, And The Role Of Polychlorinated Biphenyls, Thoin F. Begum

Legacy Theses & Dissertations (2009 - 2024)

Phthalates have been implicated as reproductive toxicants in animal models and in human populations. This study examined associations between potential exposure sources and urinary phthalate concentrations among couples undergoing infertility treatment. Women (n=56) and their male partners (n=43) undergoing in vitro fertilization (IVF) were enrolled in a prospective cohort investigation of environmental chemicals and IVF outcomes at an academic medical center. On the day of oocyte retrieval, participants provided urine samples and completed questionnaires detailing use of personal care products (PCPs), and consumption of medications, foods, and beverages in the preceding 24-hours. Urine was analyzed for MEP, MBP, MPP, MHxP, …

Effects Of Metal And Polychlorinated Biphenyls Exposures And Fish Consumption On Cognitive Function In Adults, Nozomi Sasaki

Legacy Theses & Dissertations (2009 - 2024)

Cognitive decline often occurs with aging, independent of development of neurodegenerative diseases. Little is known about how to prevent cognitive decline or what cofactors, hereditary or environmental, may accelerate or protect against it. In young people, metals, including lead, cadmium, arsenic, methylmercury, and some organic compounds such as polychlorinated biphenyls (PCBs), are known to decrease cognitive function. Consumption of fish is a route of exposure to methylmercury and PCBs, but fish also contain omega-3 fatty acids that are reported to enhance infant neurodevelopment and postnatal cognitive performance. Yet, a recent systematic review concluded that there was inconclusive evidence the omega-3 …

Food Environment, Food Acquisition Behavior, And Fruit And Vegetable Consumption Among Burmese Immigrants And Refugees : A Socio-Ecological Study, Hnin Wai Lwin Myo

Legacy Theses & Dissertations (2009 - 2024)

Background: Using the framework of the Socio-Ecological Model, the current study aimed to investigate the associations between nutritional knowledge, food environment, food acquisition behavior, and daily recommended fruit and vegetable consumption (≥5 cups of fruits and vegetables) among Burmese refugees and immigrants in the Capital Region, New York. Methods: During July - November 2018, a cross-sectional survey with face-to-face interviews was conducted among Burmese refugees and immigrants aged 18 years and older living in Albany and Rensselaer counties (n=173, 52.0% female, mean age = 42.8). Daily recommended fruit and vegetable consumption was determined as ≥5 cups of fruit and vegetable …

Maternal Antifungal Use During Pregnancy : A Study Of Prevalence Of Use And The Risk Of Birth Defects, Eleni A. Papadopoulos

Legacy Theses & Dissertations (2009 - 2024)

Fungal infections, especially vulvovaginal candidiasis (VVC), are common among pregnant women. Therefore, it is important to study the effect that antifungal medications may have on the developing fetus. Recent studies have suggested there are positive associations between birth defects and specific oral antifungals. In this dissertation, maternal antifungal use during pregnancy was examined using data from the National Birth Defects Prevention Study (NBDPS). The NBDPS was multi-site, population-based, case-control study and included women with estimated delivery dates during October 1997 through December 2011. It was designed to investigate risk factors associated with more than 30 categories of major birth defects. …

Genomic Epidemiology Of Clinical Salmonella Enterica In New Hampshire, 2017-2020, Madison R. Turcotte

Legacy Theses & Dissertations (2009 - 2024)

Antimicrobial resistance in Salmonella enterica remains a challenging public health threat. We aim to characterize the population structure and evolutionary history of 394 genomes of S. enterica isolates recovered from human clinical cases in New Hampshire, USA from 2017 to 2020. The population is phylogenetically diverse, consisting of 78 STs and 67 serotypes. We detected 61 genes associated with resistance to14 different antimicrobial classes. Rather than a single multidrug resistant clone expanding in the state, we found multiple lineages carrying different combinations of independently acquired resistance determinants. New or emerging lineages can therefore rapidly spread over relatively short timeframes. In …

Examining The Impact Of The Covid-19 Pandemic On Birth Outcomes In Onondaga County, New York, Simone A. Seward

Legacy Theses & Dissertations (2009 - 2024)

Background: Preterm birth (PTB), defined as births that occur prior to 37 completed weeks of gestation, and low birth weight (LBW), defined as an infant born with a birthweight of < 5.5 lbs or 2,500 grams, have been identified as significant contributors to the high infant morbidity and mortality rate in the United States (U.S.). The etiology of PTB and LBW is complex, and multifaceted. Linkages have been made to several categorical risk factors related to socio-demographics, medical, behavioral, psychosocial, and environmental pathways. Given the known risk factors, the current COVID-19 pandemic has raised concerns from public health officials and clinicians about the short-and long-term impact on the health and well-being of pregnant women and their birth outcomes. Study Purpose: The purpose of the study was to: 1) examine the impact of the COVID-19 pandemic on preterm birth (PTB) and low birthweight (LBW) in Onondaga County, NY; and 2) determine the potential impact of psychosocial factors, particularly maternal depression and social support, on PTB and LBW. Guided by the Integrated Socio-Environmental Model of Health and Well-being (ISEM), The Life Course Perspective (LCP), concepts of allostatic load and the weathering hypothesis, the study recognizes the numerous factors, over the life course, that co-occur and can synergistically contribute to or moderate the impact of the COVID-19 pandemic on birth outcomes. Methodology: The study utilized a mixed methods approach to answer the four research questions. For the quantitative component, the study utilized relevant data elements obtained from the Statewide Perinatal Data System (SPDS) during February 1, 2019 through March 31, 2021 for secondary data analysis. For the qualitative component, 20 key informant interviews were conducted to investigate and describe the health care and social support experiences of individuals who delivered in Onondaga County, NY before and during the COVID-19 pandemic. Results: Results from the bivariate analysis indicated a statistically significant association between lack of prenatal care, lack of social support, maternal depression and both PTB and LBW (all p <.0001). Exposure to the COVID-19 pandemic was not significantly associated with either LBW or PTB (p=0.2289 and p=0.2932, respectively). The analysis yielded no statistically significant difference in the rates of LBW (p= 0.2289) or PTB (p=0.2932) between the two cohorts. The major themes that emerged from the interviews related to prenatal care experience were: Preparing for Pregnancy, Feeling Supported by their Health Care Provider, Restrictive COVID-19 Policies, Dealing with the Unknown, and Self-Advocacy. The major themes related to social support experience were: Personal Relationships during Pregnancy, Forms of Social Support during pregnancy, and Pandemic Impact on Social Support. Overlapping themes were identified between the two cohorts. Study Significance: The findings from this study have implications for public health and clinical practice, public health policy, and future research. The findings from this study emphasize the need for a range of accessible, affordable options for pregnancy-related care and social support, especially during stressful life events, like a pandemic. This study contributes to the growing literature on the COVID-19 pandemic by providing an analysis of the factors (risk and protective) which could moderate or mediate the effects of a public health crisis on birth outcomes. The strength of the study lies in the triangulation of data to research a persistent public health issue and health disparity during a widespread public health crisis.

Assessing Sexual Assault And Harassment At Montclair State University: Research Abstracts, Amanda Birnbaum, Eva Goldfarb, Lisa Lieberman, Stephanie A. Navarro Silvera

Department of Public Health Scholarship and Creative Works

No abstract provided.

Public Health Implications Of Cannabis Legalization: An Exploration Of Adolescent Use And Evidence-Based Interventions, Joseph Donnelly, Michael Young, Brenda Marshall, Michael L. Hecht, Elena Saldutti

Department of Public Health Scholarship and Creative Works

Abstract: This article examines the relaxation of state marijuana laws, changes in adolescent use of marijuana, and implications for drug education. Under federal law, use of marijuana remains illegal. In spite of this federal legislation, as of 1 June 2021, 36 states, four territories and the District of Columbia have enacted medical marijuana laws. There are 17 states, two territories and the District of Columbia that have also passed recreational marijuana laws. One of the concerns regarding the enactment of legislation that has increased access to marijuana is the possibility of increased adolescent use of marijuana. While there are documented …

Implementation Of Client-Centered Care Coordination For Hiv Prevention With Black Men Who Have Sex With Men: Activities, Personnel Costs, And Outcomes—Hptn 073, Darren L. Whitfield, La Ron E. Nelson, Arnošt Komárek, De Anne Turner, Zhao Ni, Donte T. Boyd, Tamara Taggart, S. Raquel Ramos, Leo Wilton, Geetha G. Beauchamp, Lisa Hightow-Weidman, Steven J. Shoptaw, Manya Magnus, Kenneth H. Mayer, Sheldon D. Fields, Darrell P. Wheeler

GW Authored Works

Background: Black men who have sex with men (MSM) experience disproportionate rates of HIV infection in the USA, despite being no more likely to engage in sexual risk behaviors than other MSM racial/ethnic groups. HIV pre-exposure prophylaxis (PrEP) has been shown to reduce risk of HIV acquisition; however, rates of PrEP use among Black MSM remain low. Clinical, psychosocial, and structural factors have been shown to impact PrEP use and adherence among Black MSM. Care coordination of HIV prevention services has the potential to improve PrEP use and adherence for Black MSM, as it has been shown to improve HIV-related …

Australian Teachers’ Perceptions And Experiences Of Food And Nutrition Education In Primary Schools: A Qualitative Study, Gozde Aydin, Claire Margerison, Anthony Worsley, Alison Booth

Australian Journal of Teacher Education

Teacher delivered food and nutrition education (FNE) can be effective in improving children’s food literacy and eating habits. However, teachers are known to face some barriers to the delivery of FNE globally. To obtain a deeper understanding of Australian primary school teachers’ experiences and views, 17 teachers were interviewed. The results of the thematic analysis showed that teachers acknowledged the importance of FNE and were willing to include more FNE content into their teaching. We also identified the FNE topics taught, resources used, their teaching partners, and barriers encountered. The discussion presents strategies to overcome these barriers.

Don’T Forget To Wash! Water, Sanitation, And Hygiene Among Zambian Students, Katie Schmitz

NUTR/GLST 498b: Global Research Experiences in Nutrition and Health

Introduction: Water, sanitation, and hygiene practices in sub-Saharan Africa, including Zambia, have not met the Millennium Development Goals (MDGs) and remain inadequate to improve the overall health and wellbeing of most populations.

Methods: Survey research, interviews, WASH observations, and anthropometric assessment were conducted between May-June 2022 on 6-7th grade students within 6 Zambian schools.

Results: While hygiene knowledge was prominent, and handwashing stations and pit latrines were available, schools rarely supplied soap or toilet paper. Diarrheal and respiratory diseases were common and water shortages remain problematic with some students traveling long distances to reach a water source.

Discussion: As in …

Dental Decay In Zambian School Children In Eastern And Southern Provinces, Elizabeth Graham

NUTR/GLST 498b: Global Research Experiences in Nutrition and Health

Introduction: Dental caries is the most prevalent and infectious disease worldwide. Zambia has a high rate of vitamin A deficiency, and this deficiency is associated with dental caries.

Methods: Visual dental checks, interviewing, and anthropometric assessments were done on 781 Zambian primary school children.

Results: Caries rates are 20% among sample populations, males have more decay than females, first molars are the most decayed, a majority use toothbrushes to clean their teeth, and children who eat vitamin A rich foods are less likely to have dental caries.

Discussion: Caries’ rates in the Southern and Eastern provinces are higher than in …

The Impact Of Expanded Tele-Mental Health On Quality-Of-Care Indicators: A Three-Pronged Regression Analysis At Los Angeles County’S Department Of Mental Health, Ami Bhatt

CGU Theses & Dissertations

Background: The use of Tele-Mental Health (TMH) skyrocketed after the COVID-19 pandemic led to the announcement of a public health emergency in March 2020. This rise coincided with soaring rates of mental health issues and increasing demand for accessible and sustainable treatment, all while meeting physical distancing requirements. TMH use is theorized to improve timely access to care and provide opportunities to improve quality of care indicators in individuals and at the health systems level. Research Question: How has the widespread adoption of Tele-Mental Health changed quality of care (QoC) indicators among patients of LA County Department of Mental Health’s …

The Influence Of Race And Ethnicity On The Prevalence Of Social Stigma For People With Type 1 Diabetes Mellitus, Donielle Hyde

Walden Dissertations and Doctoral Studies

Various studies attempting to evaluate the prevalence of health-related social stigma in people with type 1 diabetes mellitus (T1DM) identified themes that coincide with increased prevalence including anxiety, low self-esteem, depression, fear of judgement, anger, and feeling ashamed. This phenomenon is believed to be due to the lack of knowledge and understanding about the differences between the diagnosis, treatment, and prevention strategies for T1DM and type 2 diabetes mellitus (T2DM). The Resilient, Empowered, Active Living intervention dataset (n=115) was utilized to further examine this phenomenon by determining whether race and ethnicity influence the prevalence of the following health-related social stigma …

Healing Through Mother Earth, Taylor A. Russell

Dance (MFA) Theses

This thesis deals with mental health, with a focus on Black women. Historically, Black women are often so compromised, being constant caregivers and helping everyone else, that they forget to help themselves, not having the time and financial means to do so. If we go back in the time of slavery, many Black women were taking care of slave owners' children and suckling the white women’s babies instead of their own. By the time they got home and after diligently caring for other people’s children they were focused on their own children, who they had been away from for hours …

Telehealth Delivery Of Acceptance And Commitment Therapy And Recreational Therapy: Supporting People With Chronic Pain During The Covid-19 Pandemic, Grace L. Roy

Honors Theses and Capstones

Chronic pain is a significant public health problem that requires person-centered and comprehensive care to address the many socioecological factors that contribute to pain. Within the context of the COVID-19 pandemic, telehealth options for chronic pain management can help more people access the care that they need. The purpose of the current pilot study was to investigate the efficacy and feasibility of delivering a 6-week Acceptance and Commitment Therapy (ACT) and recreational therapy intervention via telehealth for a group of seven participants with chronic pain. It was found that TeleACT-RT was associated with positive behavioral outcomes including increased psychological flexibility, …

College Of Health And Human Service Faculty’S Confidence And Inclusion Of Lgbtq+ Health Content In Curriculum, Carley S. Kanter

Honors Theses and Capstones

In the health care system, those who identify as lesbian, gay, bisexual, transgender, queer, (LGBTQ+) face discrimination and health disparities. Students who are better prepared in higher education to provide care for this population have higher levels of confidence in LGBTQ+ health content than those who have less exposure. Therefore, faculty who teach curriculum related to health and wellness have an opportunity to prepare students to provide high quality, patient centered care by teaching culturally competent care that is inclusive of LGBTQ+ populations. The aim of the study is to determine whether the degree of confidence in teaching LGBTQ+ health …

Review Of Age-Related Trends Of Infection Among People Hospitalized Hospitalized For Infection With Concurrent Substance Use, Julia Catherine Lucia Gregorio

Honors Theses and Capstones

Background: Opioids and related injections are the most common drug associated with infection (Capizzi et al., 2020). Overall, data overwhelmingly shows infection and overdose rates on the rise in recent years (Kaiser Family Foundation, 2019).

Methods: The aim of this study was to identify trends between age and concurrent infection rates related to substance use from 2012 to 2019. This quantitative study utilized data from the NH Hospital Discharge Summaries (Office of Health Statistics, 2021). Specifically, trends among three age groups (young adults (18-34), middle-aged (35-54), and older adults (55+)) who were admitted to an inpatient unit or the emergency …

Review Of Age-Related Trends Of Infection Among People Hospitalized For Infection With Concurrent Substance Use, Julia Catherine Lucia Gregorio

Honors Theses and Capstones

Abstract

Background: Opioids and related injections are the most common drug associated with infection (Capizzi et al., 2020). Overall, data overwhelmingly shows infection and overdose rates on the rise in recent years (Kaiser Family Foundation, 2019).

Methods: The aim of this study was to identify trends between age and concurrent infection rates related to substance use from 2012 to 2019. This quantitative study utilized data from the NH Hospital Discharge Summaries (Office of Health Statistics, 2021). Specifically, trends among three age groups (young adults (18-34), middle-aged (35-54), and older adults (55+)) who were admitted to an inpatient unit or the …

Prevalence Of Vaping And The Association With Cardiometabolic Risk In College Students, Brittney Rose Nalesnik

Honors Theses and Capstones

Vaping is a growing public health concern; however, most reported prevalence rates have only focused on youth. The purpose of this study was to investigate prevalence rates among undergraduates (18–24 years old) and examine differences in cardiometabolic parameters between vapers and non-vapers. Students (n= 267) were recruited from an introductory nutrition course during Fall 2021 to participate in the College Health and Nutrition Assessment Survey. Prevalence data were collected through a self-reported wellness survey. More than half (55.1%) reported ever vaping. During the past 3 months, 7.9% reported zero use, 18.4% 1x/2x, 3.4% monthly, 10.5% weekly, and 15.0% daily/almost daily; …