Public Health Commons^™

Community-Level Factors Influencing The Duration Of Buprenorphine Treatment In Individuals With Opioid Use Disorder: A Cohort Study Using Us Longitudinal Claims Data, Paula A Jaimes-Buitron, Kehe Zhang, Yanmin Gong, Yuanxiong Guo, Cici Bauer, Carolina Vivas-Valencia

Faculty, Staff and Student Publications

Introduction: Buprenorphine is effective in reducing opioid-related morbidity and mortality; however, many patients discontinue treatment prematurely. While previous research has focused on individual-level predictors of retention, the influence of community context remains underexplored. This study aims to examine how community-level factors, such as social vulnerability, availability of buprenorphine-waivered providers and access to behavioural health services, affect the duration of buprenorphine treatment episodes for individuals with opioid use disorder (OUD).

Methods: We conducted a retrospective cohort study using longitudinal claims data from 2006 to 2022. Adults aged 18 and older who initiated buprenorphine treatment for OUD and maintained continuous enrolment were …

Feasibility Of Conducting A Pilot Randomized Trial Of A Mindfulness-Based Intervention Among Sheltered Young Adults Experiencing Homelessness, Diane Santa Maria, Paula Cuccaro, Erica Sibinga, Kimberly Bender, Ethel Jacko, Widumini Liyanage, Jennifer Jones, Stanley Cron

Faculty, Staff and Student Publications

Purpose: Youth experiencing homelessness (YEH) are an underserved and difficult-to-reach population that experiences a disproportionate burden of trauma and stress compared to their housed peers. Prolonged trauma and stress can impact the development of negative emotions, reactive stress responses, and impulsive decision-making, which can lead to risk-taking behaviors. Growing research shows that Mindfulness-Based interventions (MBIs) can improve coping, impulsivity, emotion regulation, and executive function although no MBIs tailored for YEH have been tested.

Methods: We conducted a pilot attention-control randomized trial to test the feasibility and acceptability of an adapted MBI, .b4me (pronounced dot be for me), for …

Large-Vessel Occlusion Stroke Knowledge And Training For Stroke Severity Assessment Among Emergency Medical Services Personnel In The United States, Kaiz S Asif, Robin Novakovic, Thanh N Nguyen, Santiago Ortega-Gutierrez, Youngran Kim, Amanda Jagolino-Cole, Sushanth Aroor, Alicia Castonguay, Prateek Kumar, Ashutosh P Jhadav, Dileep Yavagal, May Nour, Gabor Toth, Maxim Mokin, Sunil A Sheth, Mouhammad A Jumaa, Alhamza Al-Bayati, Mohamed Teleb, Ossama Y Mansour, Shashvat M Desai, Joshua Hartman, David S Liebeskind, Ameer E Hassan, Brijesh P Mehta, Svin Education And Speed Committees

Faculty, Staff and Student Publications

Background: Prehospital identification of large-vessel occlusion (LVO) stroke facilitates the development of a regional triage protocol that could lead to an improvement in intrahospital and interhospital workflows. This requires stroke education of emergency medical services (EMS) personnel to improve stroke recognition, severity assessment, and prenotification. However, the current state of EMS personnel's knowledge of LVO stroke, their training for stroke severity assessment, and their preferences for educational methods are unknown. We conducted a nationwide EMS survey across the United States to glean insights that can inform and customize future EMS educational efforts.

Methods: The Society of Vascular and Interventional Neurology, …

Community Engagement Studios To Improve Racial Diversity And Health Equity In Parkinson’S, Eunyoung Kang, Dominique Woodhouse, Kandace Davis, Jane Q Yap, Peter S Myers, Meghan C Campbell, Yvonne D Hughes, Joyce E Balls-Berry, Erin R Foster

Faculty, Staff and Student Publications

Background: Black or African Americans (AA) with Parkinson's disease (PD) are underrepresented in both care and research and experience significant health disparities. The existing literature provides limited guidance on how to enhance the engagement of AA individuals in PD care and research, particularly from the perspectives of AA patients, care partners, and healthcare providers. This project aimed to (1) describe the use of Community Engagement (CE) Studios as a community-engaged research approach to inform culturally appropriate and inclusive research and (2) examine factors influencing AA engagement in PD-related activities.

Methods: We conducted three CE Studios: one with AA with PD …

Community Consultation For Exception From Informed Consent Studies: Are Market Research Surveys Representative Of The Target Community Populations?, Shannon W Stephens, Russell L Griffin, Christy Carroll-Ledbetter, Sarah Duckert, Margaret Nelson, Joel Rodgers, Adam Mcclintock, Sara F Goldkind, Luke Gelinas, Amanda E Higley, Stacia Desantis, Claudia Pedroza, Luis Leon-Novelo, James Stubbs, Marissa B Marques, Henry Wang, John B Holcomb, Jan O Jansen, Troop Trial Investigators

Faculty, Staff and Student Publications

Background: 'Exception from informed consent' research requires community consultation to ensure that the views of the local population have been considered. Using market research companies to distribute surveys across local populations is attractive because it ensures adequate response rates. It is not known whether individuals who respond to surveys are typical of the targeted communities. The purpose of this study is to compare the demographics of the survey respondents with that of the general population in the same area.

Methods: This is an analysis of data collected as part of the 'Trauma Resuscitation with Group O Whole Blood or Products' …

A Directed Content Analysis For Greatest Problems Among People With And Without Traumatic Brain Injury, Emily Dudek, Michael W Williams, Chung Lin Novelle Kew, Annalyn Demello, Brittany Wright, Alexandra B Holland, Alyssa Day-Gorman, Alexa S Gonzalez, Luis Leon Novelo, Xiangyi Liu, Shannon B Juengst

Faculty, Staff and Student Publications

Objective: To characterize the greatest problem or need among individuals with a history of traumatic brain injury (TBI), as compared with individuals with a history of other neurologic conditions, mental health conditions, and no history of neurologic or mental health conditions.

Design: A directed content analysis of open-text responses to a single online survey question using a framework guided by the Mayo-Portland Adaptability Inventory-4.

Setting: Community.

Participants: A total of 2861 community-dwelling adults (n=274 with TBI; n=289 with other neurologic conditions besides TBI; n=454 with mental health conditions but no neurologic conditions; and n=1844 controls).

Interventions: Not applicable.

Main outcome …

The Impact Of State-Mandated Certification Of Surgical Technologists On Surgical Site Infection Rates: Evaluating Policy, Practice, And Patient Outcomes, Katherine E. Geiger

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Chairperson: Matthew Schertz, Ph.D.

Committee Member: Morgen J Alwell, Ph.D.

Committee Member: Jill Davis, M.Ed.

As a surgical technology instructor, I have witnessed firsthand the impact that certified surgical technologists (CSTs) have on patient safety, particularly in the prevention of surgical site infections (SSIs). This professional paper investigates the relationship between state-mandated certification of surgical technologists and SSI rates, with a focus on how standardized education and credentialing influence clinical outcomes. SSIs remain a significant concern in surgical environments, contributing to increased morbidity, longer hospital stays, and greater healthcare costs. The research presented here examines certification requirements across various …

Risk And Prognosis Of Hepatocellular Carcinoma In Mexican Americans With Type 2 Diabetes Mellitus, Rikita I Hatia, Lu-Yu Hwang, Ruosha Li, Catherine Troisi, Prasun K Jalal, Christopher I Amos, Henry F Gomez, Yun Shin Chun, Asif Rashid, Ahmed O Kaseb, Paul A Scheet, Manal M Hassan

Faculty, Staff and Student Publications

INTRODUCTION: Hepatocellular carcinoma (HCC) disproportionately affects Hispanic persons with higher age-specific incidence and increased mortality rates compared to non-Hispanic Whites. These high rates of incidence and mortality may be explained by the variation in risk factors. Given the high prevalence of type 2 diabetes mellitus (DM) among the Hispanic population, we aimed to assess the risk and prognosis of HCC in Mexican Americans with type 2 DM with consideration of treatment for DM.

METHODS: A case-control study of 241 Mexican American HCC patients and 500 healthy controls in Texas was conducted. Multivariable logistic regression analysis was performed to determine the …

A Systematic Review And Narrative Synthesis Of Factors Affecting Pre-Exposure Prophylaxis Willingness Among Black Women For Hiv Prevention, Alexis Sims Haynes, Christine Markham, Vanessa Schick, Robert Suchting, Nivedhitha Parthasarathy, Sumaita Choudhury, Mandy J Hill

Faculty, Staff and Student Publications

Pre-exposure prophylaxis (PrEP) can significantly reduce human immunodeficiency virus (HIV) transmission among Black women in the United States (U.S.), a group disproportionately affected by HIV. However, PrEP uptake in this HIV-vulnerable population is low. This review analyzes the factors influencing Black women's PrEP willingness using the Behavioral Model for Vulnerable Populations (BMVP). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Population, Intervention, Comparison, Outcome, Study Design (PICOS) framework, we conducted a systematic literature search and selected 24 peer-reviewed studies on PrEP willingness. Narrative synthesis revealed a heterogeneous landscape of the determinants affecting PrEP willingness …

Association Between Trust In The Incumbent President And Covid-19 Preventive Behaviors During The Pandemic In Four Latin American Countries, Juliana Mejía-Grueso, Gloria Isabel Niño-Cruz, Javiera Alarcón-Aguilar, Pablo Roa-Urrutia, Sergio Mauricio Moreno-López, Adriano Akira Ferreira Hino, Alexandre Augusto De Paula Da Silva, Fernando López, Deborah Salvo, Rodrigo Siqueira Reis, Guillermo Rosas, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

The COVID-19 pandemic revealed disparities in policy responses in Latin America. We examined the association between trust in the president and COVID-19 preventive behaviors in Brazil, Chile, Colombia, and Mexico. We used data from the Collaborative COVID-19 Response Survey by the McDonnell Academy at Washington University in St. Louis (United States), from September 2020 to March 2021. Nonprobabilistic sampling included adult citizens from the four countries. Multivariate negative binomial regression models were applied. The study included 8,125 participants, with Brazil showing the lowest adherence to preventive behaviors (65.5%). Increased adoption of preventive behaviors was linked with ages 18-26 (aIRR = …

A Comparison Of Floating Catchment Area Parameters With Applications To A Dataset Of Clinics Enrolled In A Statewide Child And Adolescent Psychiatric Consultation Program, Jocelyn Hunyadi, Lara S Savas, Kehe Zhang, Jeanette E Deason, Ryan Ramphul, Melissa F Peskin, Erica L Frost, Cici Bauer

Faculty, Staff and Student Publications

INTRODUCTION: Healthcare resources are often crucial but limited, requiring careful consideration and informed allocation based on population needs and potential healthcare access. In resource allocation settings, availability and accessibility of resources should be examined simultaneously. The two-step floating catchment area (2SFCA) method has been previously used to evaluate spatial accessibility to healthcare resources and services, and to address health-related disparities. The 2SFCA methods have regained significant popularity during the COVID-19 pandemic, as their application proved crucial in addressing priority public health data analysis, modeling, and accessibility challenges. However, comprehensive comparisons of the 2SFCA method input parameters in the context of …

Untargeted Metabolome Atlas For Sleep-Related Phenotypes In The Hispanic Community Health Study/Study Of Latinos, Ying Zhang, Brian W Spitzer, Yu Zhang, Danielle A Wallace, Bing Yu, Qibin Qi, Maria Argos, M Larissa Avilés-Santa, Eric Boerwinkle, Martha L Daviglus, Robert Kaplan, Jianwen Cai, Susan Redline, Tamar Sofer

Faculty, Staff and Student Publications

BACKGROUND: Sleep is essential to maintaining health and wellbeing of individuals, influencing a variety of outcomes from mental health to cardiometabolic disease. This study aims to assess the relationships between various sleep-related phenotypes and blood metabolites.

METHODS: Utilising data from the Hispanic Community Health Study/Study of Latinos, we performed association analyses between 40 sleep-related phenotypes, grouped in several domains (sleep disordered breathing (SDB), sleep duration, sleep timing, self-reported insomnia symptoms, excessive daytime sleepiness (EDS), and heart rate during sleep), and 768 metabolites measured via untargeted metabolomics profiling. Network analysis was employed to visualise and interpret the associations between sleep phenotypes …

Challenges And Opportunities Of Universal Health Coverage In Africa: A Scoping Review, Evaline Chepchirchir Langat, Paul Ward, Hailay Gesesew, Lillian Mwanri

Centre of Excellence in Women and Child Health

Background: Universal health coverage (UHC) is a global priority, with the goal of ensuring that everyone has access to high-quality healthcare without suffering financial hardship. In Africa, most governments have prioritized UHC over the last two decades. Despite this, the transition to UHC in Africa is seen to be sluggish, with certain countries facing inertia. This study sought to examine the progress of UHC-focused health reform implementation in Africa, investigating the approaches utilized, the challenges faced, and potential solutions.

Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we scoped the literature …

Providing Healthcare Access For The African Population Using An International Care Coordination System: A Case Study Of Nigeria And Ghana, Aminat B. Nwaonumah

College of Graduate Studies: Theses & Dissertations

Introduction: Healthcare access is a major population health challenge among underserved populations in many parts of the world, and the situation in Africa is no exception. Foreign aid, a significant component of healthcare financing in Africa, has played a crucial role in mitigating communicable diseases. However, there is a lacuna in care for non-communicable diseases, such as chronic illnesses, especially among the elderly. This study explored an innovative approach to expanding healthcare access in Nigeria and Ghana through care coordination sponsored by migrant family members residing in the United States. Beyond foreign aid, this research elucidates how the International Care …

Co-Creating A Social, Emotional, And Mental Health Well-Being Group For College Students With Disabilities And/Or Chronic Health Conditions And Are Registered With Disability Support Services, Consuelo A. Click Copeland

All ETDs from UAB

ABSTRACT Nearly one in four adults in the United States report living with a disability (Centers for Disease Control and Prevention, 2024). According to the National Center for Educational Statistics (2023), approximately 21 percent of undergraduate students and 11 percent of postbaccalaureate students report having a disability. Students with disabilities in college encounter considerable obstacles that can adversely affect their mental health, academic performance, and general well-being. These obstacles encompass social isolation, stigma, and insufficient personalized support services, resulting in increased levels of anxiety, depression, and dropout rates compared to students without disabilities. Despite the critical need, there is a …

Effect Of Pre-Treatment Lab-Based Comorbidities On Treatment Related Outcomes Among Patients With Cancer, Jeffrey Alan Franks

All ETDs from UAB

Cancer is one of the leading causes of mortality and morbidity in the United States. In addition to their cancer, nearly 50% of individuals have a comorbid condition. This adds complexity to the treatment of these patients as it may delay cancer diagnosis or treatment or prevent treatment all together. Lab-values are an important tool to measure comorbidities and end-organ damage as they are routinely captured as part of standard of care and the basis of clinician decision making. However, despite the widespread multimorbidity and how crucial they are to decision making, few studies assess the association of lab abnormalities …

Occupational Exposure To Cooking Emissions And Evaluation Of Ventilation System In Restaurant Kitchens, Matthew Kaleb Hanvey

All ETDs from UAB

Background: In the restaurant environment, there are many harmful contaminants generated during the cooking process that kitchen workers are potentially exposed to. The purposes of this study were to evaluate the potential exposure to aldehydes and respirable particles among restaurant kitchen workers and to examine the ventilation performance of the kitchen exhaust hoods. Methods: There were three restaurants recruited for this study and they cooked seafood/poultry (Restaurant 1), farm style foods (Restaurant 2), and finger foods (Restaurant 3). The three restaurants had wall-mounted canopy hoods. Restaurant 1 had two hoods, Restaurant 2 had two hoods, and Restaurant 3 had one …

The Impact Of Transportation Insecurity On No-Show Appointments And Acute Care Utilization In Pediatric Sickle Cell Patients, Seabrook Hannah Jeffcoat

All ETDs from UAB

Sickle cell disease (SCD) patients experience high levels of transportation insecurity. Missed or delayed medical care due to transportation barriers can result in worsened clinical outcomes and increased hospital admissions and emergency department (ED) visits. We hypothesized that the relationship between transportation insecurity and acute care utilization is partially mediated by no-show appointments. This retrospective cohort study included 101 SCD patients aged ≤ 21 treated through the Pediatric Sickle Cell Clinic at Children’s of Alabama (COA) hospital from 2023 to 2024 and completed a social determinants of health (SDoH) questionnaire. Negative binomial or Poisson regression was used to model ED …

"The Association Between Serious Psychological Distress And Life Satisfaction Among U.S Adults With Hypertension", Kellen Michael Lenz

All ETDs from UAB

Purpose: Given the observed link between psychosocial and physical health outcomes, this study investigates the association between serious psychological distress and life satisfaction among U.S adults with hypertension. Methods: A cross-sectional study using 2021 National Health Interview Survey data among U.S adults was conducted to investigate the association between serious psychological distress and hypertension and assess the role of life satisfaction in modifying this relationship. Hypertension (diagnosed, undiagnosed), serious psychological distress (≥ 13 on the Kessler 6 nonspecific distress scale), and life satisfaction (Very satisfied, Satisfied, Dissatisfied, Very dissatisfied) were self-reported by participants. Ordinal logistic regression was used to investigate …

Exploring The Impact Of Returning To Office Work Post-Pandemic On The Mental Health Of Workers: A Cross-Sectional Analysis, Jasmine M. Nelson

All ETDs from UAB

This study examines the association between work settings and mental health outcomes among Black working-aged women, with a focus on racial disparities and the role of self-care. Using data from the U.S. Census Bureau's 2024 Household Pulse Survey, this cross-sectional analysis includes responses from 196,293 employed women aged 18–65. Mental health outcomes, including anxiety, worry, lack of interest, and depressive symptoms—were assessed through self-reported measures. Work settings were categorized as telework (hybrid/remote) or in-office, and logistic regression models were used to assess associations between work setting and mental health outcomes, adjusting for demographic and socioeconomic factors. Findings indicate that Black …

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …

Post-Migration Living Distress And Suicidal Behavior In Refugee Populations Resettled In Vermont, Phoebe K. Lewis

Antioch University Dissertations & Theses

The study of refugee psychology and suicidal distress is a comparatively nascent field when compared with the body of research concerning non-refugee populations. Over the past fifty years, however, the post-migration refugee experience has been the subject of growing clinical interest. In particular, the construct of post-migration living distress (PMLD) has been identified as a salient factor contributing to psychological distress in refugee populations. This dissertation explores the relationship between PMLD and suicidality in a sample of refugees resettled in a New England city. Guided by the Interpersonal Theory of Suicide (IPTS), this dissertation considers how elements of the post-migration …

Clarification Of Public Health Pathways Toward Clinical Careers: A Pilot Study Describing A Benchmark Analysis Project, Elizabeth A. Brown, Melissa Feliciano, Daniel Martinez

Health Behavior, Policy & Management Faculty Publications

Introduction: Undergraduate public health programs have adapted the required basic sciences based on medical and technological advances and the needs of the public health workforce. We aim to demonstrate how a benchmark analysis project was used to improve curriculum and develop a model where basic sciences in public health can be used to build pathways to clinical graduate programs like medicine, pharmacy, physician assistant, etc.

Methods: Authors conducted a benchmark analysis of Bachelor of Science in Public Health (BSPH) Degrees (or public health-related degrees) in the southern region of the United States (US) to explore required basic sciences. Authors searched …

Impact Of Volume-Based Procurement Policy On Coronary Stent Use In Tianjin: Interrupted Time Series Analysis, Zhao Yang, Liangyu Ni, Wei Zhao, Yuxi Li, Yongyi Wu, Qiyun Zhu, Linlin Da, Weijia Liu, Qi Zhang, Jianping Li, Bin Jiang

Health Behavior, Policy & Management Faculty Publications

Objectives

This study aimed to analyze the impact of China’s centralized volume-based procurement policy on the procurement and utilization of coronary stents in Tianjin from 2019 to 2021.

Methods

An interrupted time-series design was used to assess monthly procurement data of coronary stents and balloons in Tianjin from January 2019 to December 2021.

Results

The volume-based procurement policy significantly reduced coronary stents prices, with an average price reduction of 92.67% for ten selected stents, and the lowest price dropped to 469 CNY. Following policy implementation, annual procurement in Tianjin increased by 59.55%, and tertiary hospitals demonstrated a significant monthly level …

Élaboration Et Faisabilité D'Application D'Une Méthode D'Évaluation Biomécanique De L'Exposition Physique Lors Du Port D'Exosquelettes En Milieu De Travail, Xavier Robert-Lachaine, Hakim Mecheri, Denys Denis, Christian Larivière

Rapports de recherche scientifique

La prévalence des troubles musculosquelettiques (TMS) liés au travail physique reste prédominante selon les données épidémiologiques. Les récentes avancées technologiques des exosquelettes représentent une opportunité pour la prévention des TMS. Des études ont montré que les exosquelettes peuvent réduire l'activité musculaire pendant des tâches spécifiques en laboratoire. Cependant, très peu d'études ont évalué les exosquelettes directement sur le lieu de travail.

L'objectif est d’élaborer une méthode d’évaluation de l'efficacité des exosquelettes à réduire l'exposition physique des travailleuses et travailleurs et de vérifier sa polyvalence. La méthode indique la posture et l'activité musculaire des régions du dos et des épaules à …

Harmonizing Healing: Integrating Traditional/Cultural Remedies And Western Medicine For Chronic Pain Management In Immigrant Populations, Doreen Ugwu, Samuel T. Opoku

Eagles Talking About the Public’s Health

No abstract provided.

Healthy Homes, Healthy Lives: An Essential Call To Action For Public Health, Samuel Mbadu, Santino Oifoh, Katie M. Mercer, Atin Adhikari

Eagles Talking About the Public’s Health

No abstract provided.

Enhancing Malaria Prevention: Barriers To Expanding Vaccine Access In Sub-Saharan Africa, Nenrot Gopep, Patra Chisom Ezeamii, Ho-Jui Tung

Eagles Talking About the Public’s Health

No abstract provided.

Breaking The Cycle: Public Health Solutions For Homeless Youth And Foster Care Survivors, Alysia D. Williams, Bettye Apenteng

Eagles Talking About the Public’s Health

No abstract provided.

Buyer Be Aware: An Underutilized Tool In The Public Health Protection Toolkit, Padde Musa, Jacob Gakpo, Samuel T. Opoku, Bettye A. Apenteng

Eagles Talking About the Public’s Health

No abstract provided.