Public Health Commons^™

The Syndemic Landscape: A New Paradigm For Montana Suicide Prevention Grounded In Agricultural Renewal, Emory Chandler Padgett

Graduate Student Theses, Dissertations, & Professional Papers

Montana has had one of the highest suicide rates in the nation for half a century, and since 2000, it has risen almost 50%. Despite suicide’s alarming persistence in the state, there has been minimal academic study of suicide or mental health specifically in Montana, so this thesis attempts to answer a few questions: Why does Montana have such a high suicide rate? Is there something culturally, historically, or socially unique about Montana that contributes to suicide? Are current prevention efforts helpful, harmful, or lacking? Could a consideration of culture and land benefit an understanding of suicide in Montana? What …

Assessing Effectiveness Of A Person-Centered Group Anc-Pnc Model Among First-Time Young Mothers And Their Partners For Improving Quality And Use Of Mnch-Fp Services, Sharif M.I. Hossain, Shongkour Roy, Sigma Ainul, Abdullah Al Mahmud Shohag, A.T.M. Rezaul Karim, Ubaidur Rob

Sexual and Reproductive Health, Rights, and Choices

This baseline report is part of an operations research project “Healthy Women, Healthy Families (HWHF): Shustha Ma, Shustha Poribar” led by Management Sciences for Health (MSH) in partnership with BRAC, SCOPE, and the Population Council. The project aims to improve quality and increase utilization of maternal, newborn, and child health (MNCH) and family planning (FP) services and information for young mothers-to-be, first-time mothers (FTMs) aged 15-24, and their partners in the urban municipality of Tongi, Gazipur District, Bangladesh, through a group antenatal care ANC-PNC approach. The objectives of this study are to establish baseline values of selected HWHF project …

Normative Values Of College-Aged Men And Women For The 1.5-Mile Run Test On A Treadmill For Cardiorespiratory Fitness, Eli Baginski

Cal Poly Humboldt theses and projects

Physical activity has been shown to positively affect both mental and physical health. A means of determining an individual’s physical fitness is a necessary tool in developing and maintaining a healthy exercise routine. The 1.5-mile run test provides an accurate and reliable estimate of VO₂ max and can be used to routinely assess cardiorespiratory fitness. The aim of this study is to develop normative data for the 1.5 mile run test for both college-aged women and men. We examine how the calculated normative data presented produced by the Cooper Institute compares to our measured values, as well as compare …

Selective Participation In Syphilis Partner Services And Implications For Control Efforts, Fulton County, Georgia, 2013-2015, Sarah Hamid, Udodirim N. Onwubiko, David P. Holland, Allison T. Chamberlain

Journal of the Georgia Public Health Association

Background. Partner services is an important component of syphilis control, but not all persons with syphilis participate, limiting the strategy’s potential effectiveness and possibly introducing selection biases into analyses of risk factors for reinfection. This study aimed to describe demographic and clinical differences between partner-services participants and non-participants in Fulton County, Georgia, and to assess the association between participation and syphilis re-diagnosis.

Methods. Using surveillance data, we identified primary and secondary syphilis cases in Fulton County with a first diagnosis in 2013-2015. We compared the distributions of demographic and clinical characteristics between participants and non-participants using chi-squared tests. …

Barriers And Facilitators To Implementation Of The Accountable Health Communities (Ahc) Model: Findings From A Between-Site Qualitative Assessment Of Implementation Strategies, Linda Highfield, Gayla M Ferguson, Jennifer Holcomb

Faculty, Staff and Student Publications

INTRODUCTION: A multitude of HRSN interventions are undergoing testing in the U.S., with the CMS Accountable Health Communities (AHC) Model as the largest. HRSN interventions typically include screening for social needs, referral to community resources, and patient navigation to ensure needs are met. There is currently a paucity of evidence on implementation of HRSN interventions. The Consolidated Framework for Implementation Research (CFIR) is a determinant framework widely used to plan and assess implementation. to the authors knowledge, there are no published studies assessing CFIR constructs for HRSN intervention implementation in the U.S. In the Assessment step of the Strengthening Peer …

A Pilot Study Of Total Personal Exposure To Volatile Organic Compounds Among Hispanic Female Domestic Cleaners, Kelly Oyer-Peterson, David Gimeno Ruiz De Porras, Inkyu Han, George L Delclos, Edward G Brooks, Masoud Afshar, Kristina W Whitworth

Faculty, Staff and Student Publications

Cleaners have an elevated risk for the development or exacerbation of asthma and other respiratory conditions, possibly due to exposure to cleaning products containing volatile organic compounds (VOCs) leading to inflammation and oxidative stress. This pilot study aimed to quantify total personal exposure to VOCs and to assess biomarkers of inflammation and pulmonary oxidative stress in 15 predominantly Hispanic women working as domestic cleaners in San Antonio, Texas, between November 2019 and July 2020. In partnership with a community organization, Domésticas Unidas, recruited women were invited to attend a training session where they were provided 3M 3500 passive organic vapor …

Racial Disparities In Treatments And Mortality Among A Large Population-Based Cohort Of Older Men And Women With Colorectal Cancer, Xianglin L Du, Lulu Song

Faculty, Staff and Student Publications

BACKGROUND: There were racial disparities in treatment and mortality among patients with colorectal cancer, but few studies incorporated information on hypertension and diabetes and their treatment status.

PATIENTS AND METHODS: The study identified 101,250 patients from Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database in the United States who were diagnosed with colorectal cancer at age ≥65 years between 2007 and 2015 with follow-up to December 2016.

RESULTS: There were substantial racial and ethnic disparities in the prevalence of hypertension and diabetes in patients with colorectal cancer, in receiving chemotherapy and radiation therapy, and in receiving antihypertensive and antidiabetic treatment. …

Risk Of Developing Alzheimer's Disease And Related Dementias In Allhat Trial Participants Receiving Diuretic, Ace-Inhibitor, Or Calcium-Channel Blocker With 18 Years Of Follow-Up, Xianglin L Du, Lara M Simpson, Mikala C Osani, Jose-Miguel Yama, Barry R Davis

Faculty, Staff and Student Publications

BACKGROUND: There is no any large randomized clinical trial of antihypertensive drug treatment with 18-year passive follow-up to examine the risk of Alzheimer's Disease (AD) or Related Dementias (ADRD).

METHODS: Post-trial passive follow-up study of Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) participants in 1994-1998 by linking with their Medicare claims data through 2017 among 17,158 subjects in 567 U.S. centers who were free of ADRD at baseline on January 1, 1999. Main outcome was the occurrence of ADRD over 18 years of follow-up.

RESULTS: The 18-year cumulative incidence rates were 30.9% for AD, 59.2% for non-AD …

Comorbidities, Health-Related Quality Of Life, Health-Care Utilization In Older Persons With Hemophilia-Hematology Utilization Group Study Part Vii (Hugs Vii), Randall Curtis, Marilyn Manco-Johnson, Barbara A Konkle, Roshni Kulkarni, Joanne Wu, Judith R Baker, Megan Ullman, Duc Quang Tran, Michael B Nichol

Faculty, Staff and Student Publications

PURPOSE: We compare the impact of hemophilia on comorbidities, joint problems, health-related quality of life (HRQoL) and health-care utilization between two age groups: 40-49 years and ≥50 years.

PATIENTS AND METHODS: The HUGS VII study recruited persons with hemophilia A or B age ≥40 years. Participants completed surveys to collect data on sociodemographic and clinical characteristics, hemophilia treatment regimen, pain, joint problems, comorbidities, HRQoL, depression and anxiety, at baseline and 6-months later. Clinical chart reviews documented hemophilic severity and treatment.

RESULTS: The sample includes 69 males, 65.2% aged ≥50 years, 75.4% with hemophilia A. Individuals ≥50 years were more likely …

Associations Between Physical Activity And Alcohol Consumption In Rural Cancer Survivors, Scherezade K Mama, Natalia I Heredia, Hannah Johnston, David E Conroy

Faculty, Staff and Student Publications

PURPOSE: Rural adults and cancer survivors are more likely to be physically inactive and exceed recommendations for alcohol use. Physical activity and alcohol use are positively associated in adults and cancer survivors but associations between physical activity and alcohol use in rural cancer survivors is unknown. This cross-sectional study explored associations between physical activity, sitting time, and alcohol use in rural cancer survivors.

METHODS: Cancer survivors residing in central Pennsylvania were recruited to the Partnering to Prevent and Control Cancer (PPCC) study and completed mailed questionnaires assessing physical activity (low, moderate, high), sitting time (≥6 hours/day), and alcohol use (0 …

Trends And Correlates Of Breakthrough Infections With Sars-Cov-2, Jose-Miguel Yamal, Savitri Appana, Mengxi Wang, Luis Leon-Novelo, Eric Bakota, Yuanqing Ye, Shreela Sharma, Alanna C Morrison, Dritana Marko, Stephen H Linder, Alison Rector, Katelyn K Jetelina, Eric Boerwinkle, Marcia De Oliveira Otto

Faculty, Staff and Student Publications

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant has been hypothesized to decrease the efficacy of COVID-19 vaccines. Factors associated with infections with SARS-CoV-2 after vaccination are unknown. In this observational cohort study, we examined two groups in Harris County, Texas: (1) individuals with positive Nucleic Acid Amplification test between 12/14/2020 and 9/30/2021 and (2) the subset of individuals fully vaccinated in the same time period. Infected individuals were classified as a breakthrough if their infection occurred 14 days after their vaccination had been completed. Among fully vaccinated individuals, demographic and vaccine factors associated with breakthrough infections were …

Blood Metabolites Predicting Mild Cognitive Impairment In The Study Of Latinos-Investigation Of Neurocognitive Aging (Hchs/So), Shan He, Einat Granot-Hershkovitz, Ying Zhang, Jan Bressler, Wassim Tarraf, Bing Yu, Tianyi Huang, Donglin Zeng, Sylvia Wassertheil-Smoller, Melissa Lamar, Martha Daviglus, Maria J Marquine, Jianwen Cai, Thomas Mosley, Robert Kaplan, Eric Boerwinkle, Myriam Fornage, Charles Decarli, Bruce Kristal, Hector M Gonzalez, Tamar Sofer

Faculty, Staff and Student Publications

INTRODUCTION: Blood metabolomics-based biomarkers may be useful to predict measures of neurocognitive aging.

METHODS: We tested the association between 707 blood metabolites measured in 1451 participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), with mild cognitive impairment (MCI) and global cognitive change assessed 7 years later. We further used Lasso penalized regression to construct a metabolomics risk score (MRS) that predicts MCI, potentially identifying a different set of metabolites than those discovered in individual-metabolite analysis.

RESULTS: We identified 20 metabolites predicting prevalent MCI and/or global cognitive change. Six of them were novel and 14 were previously reported as …

Using Implementation Mapping For The Adoption And Implementation Of Target:Bp In Community Health Centers, Melissa A Valerio-Shewmaker, Natalia I Heredia, Catherine Pulicken, Patenne D Mathews, Roshanda Chenier, Tracy L Swoboda, Ella R Garza, Fernanda Velasco-Huerta, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Despite the availability of multilevel evidence-based interventions for blood pressure management, poor hypertension control is common among community health center patient populations across the state of Texas and the United States.

METHODS: We used Implementation Mapping (IM) to identify barriers and facilitators influencing the adoption and implementation of the

RESULTS: As part of the needs and capacity assessment, we collected data through interviews with CHC staff, examining gaps in needs and services (e.g., what do clinics need to implement

DISCUSSION: This paper provides an example of using Implementation Mapping to develop strategies to increase the adoption and implementation of …

Incidence Rate Of Psychiatric Disorders In 2020: The Pivotal Role Played By Sars-Cov-2 Infection, Antonio L Teixeira, Regina M Hansen, Joseph S Wozny, Caroline M Schaefer, Rodrigo Machado-Vieira, Lokesh Shahani, Scott D Lane, Jair C Soares, Trudy M Krause

Faculty, Staff and Student Publications

IMPORTANCE: The Coronavirus Disease (COVID-19) pandemic has significantly impacted mental health outcomes. While the frequency of anxiety and depressive symptoms has increased in the whole population, the relationship between COVID-19 and new psychiatric diagnoses remains unclear.

OBJECTIVE: to compare the population incidence rate of emergence of de novo psychiatric disorders in 2020 compared to the previous years, and to compare the incidence rate of new psychiatric disorder diagnoses between people with vs without COVID-19.

DESIGN, SETTING, AND PARTICIPANTS: This study utilized administrative claims data from the Clinformatics® Data Mart database, licensed from Optum®. The study is a cross-sectional analysis that …

Population-Based Correlates Of Covid-19 Infection: An Analysis From The Dfw Covid-19 Prevalence Study, Amit G Singal, Andrew Masica, Kate Esselink, Caitlin C Murphy, Jill A Dever, Annika Reczek, Matthew Bensen, Nicole Mack, Ellen Stutts, Jamie L Ridenhour, Evan Galt, Jordan Brainerd, Noa Kopplin, Sruthi Yekkaluri, Chris Rubio, Shelby Anderson, Kathryn Jan, Natalie Whitworth, Jacqueline Wagner, Stephen Allen, Alagar R Muthukumar, Jasmin Tiro

Faculty, Staff and Student Publications

BACKGROUND: COVID-19 has resulted in over 1 million deaths in the U.S. as of June 2022, with continued surges after vaccine availability. Information on related attitudes and behaviors are needed to inform public health strategies. We aimed to estimate the prevalence of COVID-19, risk factors of infection, and related attitudes and behaviors in a racially, ethnically, and socioeconomically diverse urban population.

METHODS: The DFW COVID-19 Prevalence Study Protocol 1 was conducted from July 2020 to March 2021 on a randomly selected sample of adults aged 18-89 years, living in Dallas or Tarrant Counties, Texas. Participants were asked to complete a …

Strategies For Preventing And Mitigating Counterfeit Medication From Entering The U.S. Supply Chain, Denise Blais

Walden Dissertations and Doctoral Studies

Some pharmaceutical brand protection managers lack strategies to mitigate financial losses from counterfeit prescription drugs. A multilayered approach involving guiding principles, supply chain security, investigations, enforcement, advocacy, and awareness can help mitigate potential financial losses and keep patients safe. Guided by the Six Sigma define, measure, analyze, improve, and control (DMAIC) model and the fraud triangle conceptual framework, the purpose of this multiple case study was to explore strategies brand protection managers use to mitigate financial losses from counterfeit prescription drugs. Data collection included three semi-structured interviews using Zoom. Analyzing data entailed transcribing and coding themes within data and relating …

Assessing Online Faculty Likelihood To Refer Students To University Mental Health Services, Karin Evans

Walden Dissertations and Doctoral Studies

The negative impact of mental health concerns experienced by college students has prompted faculty teaching in-person to become gatekeepers, assisting students in accessing mental health services. COVID-19 has changed the learning environment and presented a need to explore the role online faculty play as gatekeepers. The purpose of this study was to investigate online faculty’s willingness to refer students to university mental health services by applying factors shown to influence in-person faculty in context of the health belief model. Using a quantitative, non-experimental, cross-sectional study design, 182 online faculty completed an online survey assessing the likelihood of making a referral …

Factors That Predict Prescription Opioid Misuse By Type Of Healthcare Insurance Coverage, Keon Green

Walden Dissertations and Doctoral Studies

The opioid epidemic remains one of the leading causes of unintended deaths in the United States and is still one of the focal points of the public health field. Previous research has increased awareness of the opioid crisis and has focused on sociodemographic factors that may cause or predict prescription opioid misuse. The purpose of this study was to investigate sociodemographic factors that may predict prescription opioid misuse while controlling for healthcare insurance. The theoretical foundation for this secondary data analysis project was the socioecological model using the 2019 National Survey on Drug Use and Health. The population was 56,136 …

Predictors Of Health Literacy Scores In The Adolescent Oncologic Population, Amber N. Jenkins

Walden Dissertations and Doctoral Studies

Recent research showed a relationship between low health literacy in adult oncology patients, poor communication with providers, misconceptions about disease and treatment options, and the inability to adhere to treatment plans. Comparative literature addressing adolescent health literacy contained insufficient evidence of these relationships. The purpose of this exploratory cross-sectional quantitative study, based on the health literacy skills framework, was to assess the health literacy of adolescents treated in the oncology department at an academic children’s hospital in Missouri to determine whether there was a significant relationship between individual health literacy scores of this population based on age, sex, number of …

Sociodemographic Factors As Predictors Of Low Influenza Vaccination In Chicago, Illinois, Ingrid L. Jeske

Walden Dissertations and Doctoral Studies

Outbursts of seasonal influenza contribute to morbidity and mortality in the United States. Influenza is a contagious disease caused by influenza viruses. The main subtypes of the influenza virus are Type A and Type B. Influenza vaccines are among the most effective methods in preventing the spread of the influenza virus because they offer the best immune defense. However, health care providers face significant challenges due to low patient compliance with current vaccine recommendations and misinformation. Scholars have yet to expand and further explore the reasons for the gap in influenza vaccination between White individuals and minorities, such as the …

Primary Care Physicians’ Knowledge, Attitudes, And Practices Regarding Lyme Disease In High- Versus Low-Incidence Lyme Disease Midwestern States, Alexander Karnga

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this quantitative cross-sectional study, guided by the barriers to physician behavior change (BPBC) framework, was to address the gaps in the Lyme disease empirical literature by examining whether there were significant differences in Lyme disease knowledge, attitude, and practices between primary care physicians in Wisconsin, a high-incidence Midwestern Lyme disease state, and Michigan, a low-incidence Lyme disease Midwestern state. The study was conducted with 65 physicians (53.8% male and 46.2% female). The study hypotheses were tested by conducting a one-way multivariate analysis of covariance (MANCOVA), controlling for physicians’ years of practice (the number of patients seen per …

Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan

Walden Dissertations and Doctoral Studies

Approximately 21 million individuals suffer from typhoid fever (TF) globally, and most outbreaks occur in Southeast Asia. The incidence of TF is high in Pakistan, particularly in low socioeconomic areas, and a new drug-resistant strain makes it difficult to control the spread of TF. There is a pressing need for up-to-date and accurate data regarding the attitudes, beliefs, and habits leading to the spread of TF infection among individuals living in low socioeconomic areas of Pakistan. This qualitative, phenomenological study was grounded in the health belief model and explored factors that influence the spread of TF among women of childbearing …

Gender And Risk Behaviors Association With Hepatitis-B Infections Among Liberia Military Personnel, Joseph B N Kowo Jr

Walden Dissertations and Doctoral Studies

The increasing number of hepatitis B-related deaths in the Armed Forces of Liberia was due to the lack of understanding of the associated risks with the disease. Gender, substance use, and condom use have been researched as related risk factors for hepatitis B virus infection (HBV). The goal of this study was to determine if gender (male or female) and risk factors (substance use, alcohol abuse, and condom use) predicted hepatitis B infections after adjusting for age, marital status, education, and military rank among Liberia military population. The theory that grounded this study was Bronfenbrenner’s socio-ecological model (SEM) which posits …

Improving Nurses' Knowledge Of Patient Self-Management Of Sickle Cell Disease, Angel Amaura Mccullough

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a chronic illness affecting over 100,000 Americans annually. SCD causes severe pain, which may require frequent hospital admissions for pain control. A high level of patient self-care knowledge is needed to prevent readmissions. Patients usually receive self-care education at hospital discharge from nurses, who may not know about self-care in SCD. Inadequate patient education on self-management of SCD at hospital discharge can lead to hospital readmissions. There was a gap in knowledge among RNs regarding SCD self-care at the local facility. This doctoral project was intended to educate nurses about SCD self-management to increase their …

The Relationship Between Team Engagement And Physician Engagement, Lynne Miles

Walden Dissertations and Doctoral Studies

AbstractWhile physician engagement has previously been shown to be related to both turnover and burnout, there are no studies that focus primarily on the relationship between the physician and team. The purpose of this quantitative study was to examine the relationship between team engagement and physician engagement. The theoretical framework used to guide this research study is the neoclassical organizational theory. The secondary data source was from an engagement survey taken by employed team members and physicians. The independent variable is team engagement. The dependent variable is physician engagement. The instrument for the study is valid and reliable and was …

Overeating As A Coping Response To Workplace Gender Discrimination: The Role Of Resilience And Social Support, Rosemarie Charmain Mitchell

Walden Dissertations and Doctoral Studies

Gender discrimination in the workplace continues to be a persistent source of stress for women even after 5 decades of antidiscrimination legislation in the United States. Women are more likely than men to cope with stress by overeating, which is a risk factor for chronic illnesses and obesity. Much less is known about the protective factors that could weaken the association between perceived stress and overeating. The purpose of this quantitative study was to address this gap in the literature by examining whether resilience and social support are moderators of the overeating response for women who have experienced gender discrimination …

School Lunch Timing And Student Body Mass Index, Megan Monteith

Walden Dissertations and Doctoral Studies

Obesity continues to be a leading public health issue in the United States. Many chronic diseases are associated with obesity, including hypertension, diabetes, and several forms of cancer. There are multiple known contributing factors to obesity; however, historically, there has been little research focusing on time of day eating as a possible risk factor for obesity, especially childhood obesity. Childhood obesity is a significant risk factor for adult obesity. Obese children and adolescents are five times more likely to be obese in adulthood. The theoretical foundation for this study was the social ecological model. In this secondary correlational analysis using …

Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar

Walden Dissertations and Doctoral Studies

Nurse Practitioners (NPs) across Canada continue to endure the escalating demands of increasing patient workloads, the deficiency of inadequate resources, and the paucity of leadership support. The ongoing exposure to these and other challenges often contributes to a complex work environment that may result in compassion fatigue (CF). CF can be operationally defined as a state of exhaustion and dysfunction because of prolonged exposure to compassion stress and all that it evokes. The need for education and prevention of CF is critical as the prevalence of CF is on the rise. Guided by Watson’s Theory of Human Caring and Benner’s …

Perceptions Of Hiv Testing Among African-Born Immigrants In Washington State, Phoebe Kirigo Mugo

Walden Dissertations and Doctoral Studies

African born immigrants (ABIs) face challenges associated with HIV testing. As a result, many ABIs are not tested for HIV, and this population is among some of the most diagnosed at late stages of HIV/AIDS. The purpose of this qualitative phenomenological study was to explore and seek to understand the lived experiences of ABI adults ages 25 to 49 living in Washington State. I gathered data to gain their perceptions of HIV testing through in-depth interviews. The study was informed by the health belief model, which helped to understand the complex nature of healthcare-seeking behaviors among this population and how …

Exploring Vaccination Hesitancy Among Nonmandated Nurses And Health Care Workers, Germaine Lazett Nelson

Walden Dissertations and Doctoral Studies

COVID-19 vaccinations have been mandated for most healthcare professionals providing direct patient care, but there are a group of nonmandated healthcare professionals who have been hesitant to receive the vaccine. Given prolonged hesitancy among key health professionals charged with providing direct patient care, it is crucial to understand why they are hesitant; their apprehension may impact the pool of professionals available to provide direct patient care. This is a cross-sectional quantitative study that included an online survey. The health belief model served as the theoretical framework. The research questions addressed whether there is an association between type of patient care …