Public Health Commons^™

Impact In Action: Your Michigan Dental Association Foundation, Anne Berquist

The Journal of the Michigan Dental Association

The Michigan Dental Association (MDA) Foundation, a 501(c)3 non-profit, works to promote better dental health and support the future dental workforce through educational scholarships. The Foundation’s impact is increasing yearly, evidenced by a 42% increase in scholarship awards in 2024, providing $44,000 to 15 recipients. It also provides grants to statewide organizations delivering dental care to uninsured, impoverished, and underserved populations, awarding $141,500 in 2025. A high-profile program is the biannual Michigan Mission of Mercy (MOM), which provided over $1.1 million in donated care in Flint in 2024. Support is generated through various fundraisers, including the Year-End Fundraising Campaign.

Enhancing Crna's Knowledge Of Radiation Safety Through Online Education, Angela Iledan, Madeline Pousson

Doctoral Projects

Although ionizing radiation is frequently used in anesthesia-related procedures, many CRNAs receive minimal training in radiation safety principles and protective measures. This knowledge gap increases the risk of cumulative radiation exposure for providers and patients. To address the issue, this doctoral project developed and implemented an online educational intervention designed to enhance CRNAs’ understanding of radiation safety, ultimately promoting safer practices in radiation-prone environments.

The doctoral project follows a QI and EBP approach that incorporated diverse adult learning styles to enhance engagement and knowledge retention of CRNAs. The online educational module was designed and delivered to CRNAs that currently practice …

A Feasibility Study Of Sexual Organ-Dose Sparing Volumetric Modulated Arc Therapy In Female Low Rectal Cancer Patients Treated With Three-Dimensional Conformal Radiation Therapy, Margaret Downes, Victoria Olsen, Andre Williams, Rendi Sheu, Maria Thor, Lucy Greenwald, Vishruta Dumane, Kristin Hsieh, Ayesha Ali, Orly Morgan, Michael Buckstein, Deborah Marshall

Department of Radiation Oncology Faculty Papers

BACKGROUND: Sexual dysfunction is a significant toxicity of pelvic radiation therapy (RT) for female rectal cancer patients and may be more common with intensity-modulated techniques compared to three-dimensional conformal radiation therapy (3D-CRT). However, limited research has evaluated dose sparing of female sexual organs at risk (OARs), particularly erectile tissues that are critical for sexual function.

PURPOSE: This feasibility study aimed to demonstrate the practicality of contouring and sparing female sexual OARs in rectal cancer RT by generating sexual organ-sparing volumetric modulated arc therapy (SO-VMAT) plans from a small 3D-CRT cohort and comparing dose distributions to guide future planning.

METHODS: Nine …

Drought, Worry, And Preparing For The Future: The Ethnopsychology Of Climate Distress In Kilifi County, Kenya, Edna Bosire, Syed Wahid, Linda Khakali, Benjamin Oestericher, Felix Agoi, Anthony Ngugi, Rosebella Iseme, Jasmit Shah, Zul Merali, Lukoye Atwoli

Brain and Mind Institute

The impacts of climate change in sub-Saharan Africa (SSA) presents a chronic and intensifying disaster, with drought, flooding, and extreme heat, presenting unique challenges and profound disruptions. Growing evidence links such events to ecological grief, ecological anxiety, and solastalgia – negative affective states that reflects responses to climate change related destruction of nature, species, culturally significant or sacred spaces, and other ways of life. While this literature is expanding in the Global North, little is known about how communities in SSA perceive and respond to deteriorating or depleting natural ecosystems. This article explores the ethnopsychology of distress precipitated by environmental …

Community Perspectives On Factors Contributing To Resilience For Healthy Aging In Kenya, Linda Khakali, Everline Onchari, Maureen Ondire, Catherine Onyancha, Chinedu Momoh, Edna Bosire

Brain and Mind Institute

Background: The global elderly population is increasing and expected to double in thenext decade. Aging increases the likelihood of adversities, with resilience becomingan important aspect of healthy aging. Understanding how individuals conceptualizeresilience offers an opportunity to create contextually relevant interventions forpromoting healthy aging. This study aimed to explore adults’ perspectives on factorsinfluencing resilience in Kenya.

Method: Using qualitative methods, 36 adults aged 35 years and above werepurposively recruited from various communities in Nairobi County to participate ininterviews. We asked questions about their understanding of aging, adversity andresiliency. We also provided them with case scenarios of two individuals respondingdifferently to the …

Reassessing Dementia Risk: Expanding The 2024 Lancet Commission Report For A More Accurate Global Understanding, Cyprian Mostert

Brain and Mind Institute

Background: The 2024 Lancet Commission Report analyzes 14 risk factors thataccount for 45 percent of global dementia cases. However, it overlooks four criticalrisk factors: poverty, wealth shocks, income inequality, and viral infections. This isparticularly concerning given that 57 percent of the identified risk factors in theLancet report are more prevalent in men, even though dementia predominantly affectswomen worldwide.

Method: In this policy paper, we used the recent global review studies and argue that itis essential to recalibrate and expand the 2024 Lancet Commission’s list of risk factorsto include poverty, wealth shocks, income inequality, and viral infections. Our analysissuggests that these …

Understanding And Willingness To Participate In Dementia Clinical Trials In Kenya: An Ethnographic Study, Edna Bosire, Lucy Kamau, Chinedu Momoh, Jasmit Shah, Karen Blackmon, Caroline Kiio, Irene Meier, Vaibhav Narayan, Olivera Nesic Taylor,, Zul Merali

Brain and Mind Institute

Background: Advancements in dementia research are in part contingent on participation in clinical research. Clinical trials can help researchers determine if new drugs, devices, or diagnostic procedures for dementia are safe and effective. However, little is known about clinical trials for dementia in resource constrained settings such as Kenya. The aim of our research was to explore people’s understanding of dementia clinical trials, their attitudes and perceptions towards dementia clinical trials and what can be done to enhance enrollments on such clinical trials.

Method: This was an ethnographic study involving 8 focused group discussions (FGDs; age and gender stratified; n=81) …

Perceptions And Attitudes On Biospecimen Sample Collection For Dementia Research In Kenya, Lucy Kamau, Chinedu Momoh, Karen Blackmon, Caroline Kiio, Jasmit Shah, Vaibhav Narayan, Irene Meier, Olivera Nesic Taylor,, Zul Merali, Edna Bosire

Brain and Mind Institute

Background: Biospecimen sample collection is crucial in dementia diagnosis and evaluation. Limited research exists from African Countries including Kenya on people's perception on biospecimen sample collection for dementia- a disease that is largely unknown. Our aim was to understand the public perceptions towards collection of biospecimen samples for dementia research in Kenya.

Method: We conducted 8 focused group discussions (FGDs; age and gender stratified) in Nairobi to understand people's perceptions about different biospecimens (urine, saliva, blood, tears, hair, cerebrospinal fluid (CSF) and the brain samples). An open-ended FGD guide was used for the discussions, each lasting about 90 minutes.

Result: …

Tricounty Vaccine Improvement Program (Tc-Vip): Enhancing Vaccine Confidence And Uptake In Rural Utah, Aaron Hunt, Yvette Rea, Annalyz Castro

Outcomes and Impact Quarterly

The Utah State University Extension TriCounty Vaccine Improvement Program addressed low rural vaccination rates across a three-county area through bilingual social media campaigns, health fairs, training in motivational interviewing, and neuromarketing. Evaluation results showed improved skills, broad community reach, and positive participant feedback, demonstrating a replicable model to reduce vaccine hesitancy and strengthen rural health systems.

Influence Of Rec-Connect On Youth Physical Activity: A Multi-Year Look At Behavior Change, Cailyn A. Van Camp, Bree Bode, Jocelyn Hayward, Lauryn Lin, Nicole Jess, Marci Scott

Michigan Journal of Public Health

Background: Physical activity (PA) engagement in youth is associated with numerous health benefits. However, youth PA behaviors are influenced by a complex set of factors including school and community environments and broader societal influences. Rec-Connect^TM is a community-based intervention that aims to impact PA behavior in youth. Purpose: To assess changes in youth PA behavior across multiple years of Rec-Connect^TM implementation. Methods: SNAP-eligible youth [aged 8 to 17 (n=261, matched)] who participated in Rec-Connect^TM completed a pre and post survey to assess PA knowledge and behavior change. Educators completed implementation fidelity logs. Descriptives were conducted to examine …

Determinants Of Utilization Of Skilled Birth Attendant Among Women Of Reproductive Age In Habeswein Ward, Wajir County, Kenya, Suada Hassan

MSc in Advanced Practice Midwifery

Background: Maternal care provided by a skilled birth attendant (SBA) during pregnancy, at delivery, childbirth, and the postpartum period is vital for reducing maternal and neonatal mortality. In sub-Saharan Africa, the overall prevalence of usage of SBA in a 2021 study was 63%. Tanzania recorded the lowest rate at 13.8%, while Kenya registered 89.3% in 2023. However, disparities exist within Kenyan counties, for instance, in Wajir County only 57% of births were assisted by skilled health providers, a disparity that could be due to socio-cultural differences.

Aim: This study aimed to determine the factors influencing the utilization of skilled …

Cultural Adaptation Of An Innovative Reproductive Health Assessment Tool For Dementia Research In Africa: Insights From The Fember-Africa Study, Alice Moraa Ondieki, Anne Njogu, Cynthia I Sabel Smith, Edna Bosire, Karen Blackmon, Harrison Kaleli, Jasmit Shah, Rachel Maina, Sheila Waa, Chinedu Momoh

Brain and Mind Institute

Background: Dementia research accounts for only 0.1% of all research in Africa,making it the lowest among all low- and middle-income country (LMIC) regions. Thedevelopment and adaptation of biological and psychosocial measures in ethnicallyand culturally diverse populations remain limited but are essential for culturallyinformed research. This is particularly critical for examining sex- and gender-basedvulnerabilities to Alzheimer’s disease and related dementias (ADRD), including factorssuch as reproductive health and fertility.

Method: We conducted a thorough review of our clinical and health questionnaires forcultural relevance and sensitivity through a series (n = 3) of focus groups discussions.These focus groups included a diverse range of …

Vitality Tracking In Kenyan Adults Using Wearable Devices And Ecological Momentary Assessments, Karen Blackmon, Benard Alaka, Catherine Onyancha, Litha Musili, Raechel Kamau, Cyprian Mostert, Mansoor Saleh, Zul Merali, Chinedu Momoh, Thomas Thesen

Brain and Mind Institute

Background: Vitality is essential to healthy aging but is elusive to define and measure.Dynamic capture of fluctuations in vitality can uncover abnormal trajectories thatcould be a harbinger of frailty in older adults. Yet, these fluctuations are missed bystatic and/or sparse sampling strategies. To address the need for dynamic and high-density capture of vitality in older adults, we developed a passive sensing and activeprobing digital platform using wearable devices and smartphones. We deployed thisparadigm in older Kenyan adults and evaluated its potential for use in research on thedynamics of accelerated aging.

Method: Cognitively unimpaired (CU) Kenyan adults ≥ 35 years of …

Predicting Accelerated And Delayed Aging In Global Settings: Biobehavioral Age Gaps And The Role Of Global Exposomes, Hernan Hernandez, Hernando Santamaria-Garcia, Sebastian Moguilne, Agustina Legaz, Pavel Prado, Jhosmary Cuadros, Liset Gonzalez, Cyprian Mostert, Chinedu Momoh, Zul Merali

Brain and Mind Institute

Background: Global health challenges like aging and dementia are shaped bysocioeconomic disparities, environmental factors, and social determinants of health.We developed a behavioral age gap (BAG), measuring the difference between expectedbehavioral age and chronological age

Method: We utilized a cross-sectional sample (n = 161,981) comprising countriesfrom Latin America, Europe, Asia, and Africa. Behavioral age was estimated usinga Gradient Boosting Regressor with 10-fold cross-validation, incorporating multiplerisk factors (hypertension, diabetes, heart disease, female sex, visual impairment andhearing impairment) and protective factors (cognition, functional ability, education)associated with healthy aging. BAG was calculated as the difference between predictedand chronological age, and adjusted gaps were derived …

Barriers To Mental Health Access Among Immigrant Populations In The U.S., Cecilia Menzinger

Capstones

No abstract provided.

Title Page Only: Nuts, Seeds, And Specific Cardiometabolic Diseases: The Adventist Health Study 2, Montry Se-Lin Suprono

Loma Linda University Electronic Theses, Dissertations & Projects

No abstract provided.

A Randomized Controlled Trial Combining House Screening And Insecticide-Treated Nets Reduces Malaria Transmission In Northwestern Ethiopia, Aklilu K. Belay, Abebe Asale, Catherine L. Sole, Abdullahi A. Yusuf, Baldwyn Torto, Zewdu Abro, Menale Kassie, Clifford M. Mutero, David P. Tchouassi

All Peer-Reviewed Publications

House screening (HS) of doors, eaves, and windows using wire-mesh has demonstrated potential in the integrated vector management of malaria. However, limited epidemiological data are available to guide its implementation across different ecological settings. In a 16-month randomized controlled trial (follow-up period) conducted across three agroecological areas (dry mountain, plateau highland, and semi-arid) in Jabi Tehnan district, northwestern Ethiopia, treatment houses were equipped with HS combined with insecticide-treated nets (ITNs), while control houses received ITNs only. The intervention led to a significant 2.3-fold reduction in indoor malaria vector density, the primary entomologic outcome, largely influenced by An. gambiae s.l. mosquitoes. …

Title Page And Front Matter

Michigan Journal of Public Health

No abstract provided.

Preparing For “Disease X”: Lessons From Tax And Non-Tax Policy Responses To The Covid-19 Pandemic In Singapore And Australia, Vincent Ooi

Research Collection Yong Pung How School Of Law

During the Covid-19 pandemic, a lack of pre-pandemic planning resulted in sub-optimal policy outcomes. Crucial lessons can be drawn from the experience of Singapore and Australia in the pandemic in implementing various tax and non-tax economic measures; lessons that can help in preparing for the next pandemic (“Disease X”). This article analyses and critically evaluates three main categories of economic measures: direct payments, tax measures and non-tax “other” measures. It finds that direct payment measures such as jobs support had a very significant impact on preserving jobs and supporting the economy. However, eligibility conditions have to be carefully designed for …

Exploring And Validating Associations Between Six Systemic Inflammatory Indices And Ischemic Stroke In A Middle-Aged And Old Chinese Population, Yulu Zheng, Zheng Guo, Jingzheng Wang, Zhiyuan Wu, Xiaolin Chen, Yahong Zhu, Guangle Shan, Haifeng Hou, Xingang Li

Research outputs 2022 to 2026

Background: Inflammation and maladaptive immune mechanisms have been substantiated as integral components in the critical pathological processes of the injury cascade in ischemic stroke (IS). This study aimed to explore the associations between six systemic inflammatory indices and IS in a Chinese population. Methods: This was a case-control study based on the retrospective review of electronic medical records from two hospitals in Shandong Province, China. Systemic inflammatory indices, including the systemic inflammation response index (SIRI), systemic immune inflammation index (SII), pan-immune-inflammation value (PIV), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and lymphocyte monocyte ratio (LMR), were calculated. Logistic regression …

Large-Scale Experimental Study On The Impact Of Air Cleaning & Ventilation On Indoor Air Quality And Student Illness-Related Absenteeism, Daud Nosham

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

This large-scale randomized experimental field study investigated the effect of portable air purifiers (PAPs) on classroom’s air quality and student’s illness related absenteeism. PAPs were installed in 317 classrooms from various school districts located in Eastern Nebraska. The classrooms were randomly assigned into four conditions: three treatment conditions (T1, T2 & T3) and one control condition (device without any filter). T1 was equipped with HEPA filters, T2 added Activated Carbon (AC) layer to HEPA, and T3 further integrated Germicidal Ultraviolet (GUV) alongside HEPA and AC filters. The measured variables were carbon dioxide (CO2), fine particles (PN2.5) and coarse particles (PNcoarse), …

Evaluation And Identification Of Risk Factors For Stress Among Maquiladora Workers Based On The Mexican Official Standard 035 Survey Tool, Andrea Baca Melendez

Open Access Theses & Dissertations

Background and significance: Occupational psychosocial risk factors are workplace conditions that can trigger physiological, emotional, cognitive, and behavioral changes. They are strongly associated with mental health issues such as anxiety and depression, as well as non-mental health conditions like myocardial infarction, stroke, and occupational injuries. Analyzing these risks from a sociodemographic perspective provides valuable insights for improving work environments and workers’ well-being. Purpose: This study aimed to identify and determine the levels of occupational psychosocial risk factors among workers in a manufacturing company in Cd. Juárez, Chihuahua, and to examine their relationship with sociodemographic variables to inform future interventions in …

Exploring Intersectional Risks Of Substance Use Disorder, Mental Health, Hiv/Aids, And Hepatitis C Among Hispanic Adults On The Tx-Mx Border: A Mixed-Methods Study, Md Mohsin

Open Access Theses & Dissertations

Purpose: The purpose of this study was to explore intersectional risks of substance use disorders, mental health, HIV/AIDS, and HCV among Mexican-origin Hispanic adults on the Texas-Mexico border. Methods: The study employed an exploratory sequential mixed-methods approach, which involved collecting and analyzing qualitative data first, followed by quantitative data collection. Selected purposively, 15 in-depth interviews were conducted among the target population. Using convenient sampling, 106 cross-sectional surveys were conducted. Qualitative interview data were analyzed manually using thematic analysis. Quantitative data analyses included univariate descriptive analysis, bivariate, and multivariable penalized logistic regression, negative binomial, and zero-inflated negative binomial regression. Results: The …

Relationships Between Social Determinants Of Health And Pain Outcome Changes After Exercise In Adults With Knee Osteoarthritis, Klarissa Siebert

Open Access Theses & Dissertations

Background: Knee osteoarthritis (KOA) is a common musculoskeletal disease with pain as the primary symptom. KOA pain is a major contributor to disability and reduced quality of life and has been associated with social determinants of health (SDOH) variables. As for treatments of KOA pain, exercise such as stationary cycling is a first-line and recommended treatment. However, limited research has examined how SDOH influence pain outcomes following such interventions. Objective: This study investigated whether income level, education level, employment status, acculturative stress, and perceived ethnic discrimination are associated with changes in pain following a standardized cycling ergometer exercise in adults …

Net Effects Of Correlated Determinants Of Health Among U.S. Older Adults, Haomiao Jia, E I. Lubetkin

Publications and Research

Background

The health effect produced by a contributing factor alone may be different from the effect when other interacting factors are present. The effects of a set of contributors, estimated by regression coefficients, may be invalid or inappropriate if some of the predictors are correlated or the model has interaction and nonlinear terms. The net effect (NE) of a given contributing factor is the effect produced by the factor alone, not by other factors due to their correlations with the factor of interest. This study estimated NE of selected determinants of health for U.S. older adults.

Methods

Participants, aged ≥ …

Public Health Trade-Offs During A Pandemic: Mobility Decline And Hypertension Risk In India, Arpita Khanna, Tomoki Fujii

Research Collection School Of Economics

The Covid pandemic dramatically altered patterns of daily life, particularly through widespread declines in mobility due to lockdowns and social distancing measures. While the economic and epidemiological effects of these restrictions have been widely studied, their broader health implications remain underexplored. This paper investigates the relationship between mobility decline during the Covid pandemic and hypertension outcomes in India. Leveraging district-level variation in mobility from Google Community Mobility Reports and health data from the 2019–2021 Indian Demographic and Health Survey (DHS), we find that a 1 percentage point reduction in mobility over the 30 days prior to interview is associated with …

Presenteeism Among Health Care Personnel With Covid-19, James C. Crosby, Eliezer Santos Leon, Brian Chinnock, Karisa K. Harland, Anusha Krishnadasan, Nicholas M. Mohr, Ian D. Plumb, Melissa Briggs Hagen, Kelli Wallace, David A. Talan, Anne Zepeski, Tracy Young, Howard A. Smithline, Lilly C. Lee, Stephen C. Lim, Gregory J. Moran, Mark T. Steele, David G. Beiser, John P. Haran, Peter C. Hou, Brett Faine, Utsav Nandi, Walter A. Schrading, Anne Chipman, Frank Lovecchio, Alysia Powers, Lisandra Uribe, Kavitha Pathmarajah, Dean M. Hashimoto, Chloe Namias, Efrat Kean, Elizabeth Krebs, Amy Stubbs, Sara Roy, Lucia Solis, Mary Mulrow, Nathan Graff, Jillian M Tozloski, William Mower, Jacqueline Caldera, Michelle Huber, Jacob Hampton, Abigail Lopes, Katherine Elkort, Stephanie A. Eucker, Carla Kingsbury, Jonathan Femling, Silas Bussmann, Jane Yee, Joseph Stuppy, Richard E. Rothman, Gaby Dashler, Marcel E. Curlin, Mastura Wahedi, Laurie Kemble

Department of Medicine Faculty Papers

IMPORTANCE: Presenteeism-defined as continuing to work during an illness-poses a public health risk in the workplace and is especially hazardous within health care institutions where vulnerable patients may be exposed to nosocomial infections. Understanding the frequency and characteristics of health care personnel (HCP) who report presenteeism while ill with COVID-19 may help mitigate SARS-CoV-2 spread in hospitals and other health care institutions.

OBJECTIVES: To determine the frequency of presenteeism among HCP with symptomatic COVID-19, and to evaluate the demographic, occupational, and clinical factors associated with it.

DESIGN, SETTING, AND PARTICIPANTS: This is an observational cohort study that uses data from …

Association Of Epigenetic Age Acceleration And Mitochondrial Dna-Based Aging Metrics Provides Insights Into Mechanisms Of Aging-Related Diseases, Mengyao Wang, Yinan Zheng, Meng Lai, Emmanuel Saake, Xue Liu, Xiuqing Guo, Kent D Taylor, Tianxiao Huan, Roby Joehanes, Drew R Nannini, Kai Zhang, Nicole J Lake, Christina A Castellani, Stephen S Rich, Jerome I Rotter, Yongmei Liu, Laura M Raffield, April P Carson, Myriam Fornage, Jiantao Ma, Dan E Arking, Lifang Hou, Daniel Levy, Chunyu Liu

Faculty, Staff and Student Publications

Investigating the interplay between mitochondrial DNA (mtDNA) variations and epigenetic aging metrics may elucidate biological mechanisms associated with age-related diseases. We estimated epigenetic age acceleration (EAA) metrics from DNA methylation data and derived mtDNA metrics, including heteroplasmic variants and mtDNA copy number (mtDNA CN) from whole genome sequencing. Linear regressions and meta-analyses were conducted to assess associations between EAA and mtDNA metrics, adjusting for chronological age, self-identified sex, and other covariates in 6,316 participants (58% female, 41% non-White Americans). Mediation analysis was conducted to examine whether EAA mediated the relationship between mtDNA CN and metabolic traits. A higher burden of …

Adaptive Compulsion, Amanda A. Santos

Electronic Theses, Projects, and Dissertations

Adaptive

Adjective

Adap.tive ( ə-ˈdap-tiv)

of, relating to, or being a heritable trait that serves a specific function and improves an organism's fitness or survival

Compulsion

Noun

Com.pul.sion (kəm-ˈpəl-shən)

a repetitive behavior or mental act that a person feels driven to perform to alleviate the anxiety and distress caused by an unwanted thought or urge, known as an obsession.

For years we have lived in unprecedented times. From the worldwide quarantine in 2020 resulting from the pandemic, to our current US political crisis. The constant barrage of events is overwhelming and demoralizing.

The work in this gallery is a display …

Assessing Post-Pandemic Engagement In The Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Northeast Tennessee, Christen Minnick

Electronic Theses and Dissertations

Since 1974, the federal Supplemental Nutrition Program for Women, Infants, and Children (WIC) has provided healthy food resources, nutrition education, and provider referrals for families at risk for poor nutrition. Public health professionals have consistently presented evidence that WIC engagement reduces premature births and infant mortality, improves child health and development, and increases specialized care access for participants. While average monthly participation in WIC has increased since the program’s inception, trends indicate that only around half of eligible families have consistently engaged with the program since 2011. Research has linked declining WIC participation to administrative burden, citing learning, psychological, compliance, …