Public Health Commons^™

The Dynamic Risk Factors Of Cardiovascular Disease Among People Living With Hiv: A Real-World Data Study, Ziang Liu, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Haoyuan Gao, Shujie Chen, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: This study aims to investigate the incidence and dynamic risk factors for cardiovascular diseases (CVD) among people living with HIV (PLWH).

Methods: In this population-based statewide cohort study, we utilized integrated electronic health records data to identify adult (age ≥ 18) who were diagnosed with HIV between 2006 and 2019 and were CVD event-free at the HIV diagnosis in South Carolina. The associations of HIV-related factors and traditional risk factors with the CVD incidence were investigated during the overall study period, and by different follow-up periods (i.e., 0-5yrs, 6-10yrs 11-15yrs) using multivariable logistic regression models.

Results: Among 9,082 eligible …

Chronic Β3-Ar Stimulation Activates Distinct Thermogenic Mechanisms In Brown And White Adipose Tissue And Improves Systemic Metabolism In Aged Mice, Duraipandy Natarajan, Bhuvana Plakkot, Kritika Tiwari, Shoba Ekambaram, Weidong Wang, Michael Rudolph, Mahmoud A Mohammad, Shaji K Chacko, Madhan Subramanian, Stefano Tarantini, Andriy Yabluchanskiy, Zoltan Ungvari, Anna Csiszar, Priya Balasubramanian

Faculty, Staff and Students Publications

Adipose thermogenesis has been actively investigated as a therapeutic target for improving metabolic dysfunction in obesity. However, its applicability to middle-aged and older populations, which bear the highest obesity prevalence in the United States (approximately 40%), remains uncertain due to age-related decline in thermogenic responses. In this study, we investigated the effects of chronic thermogenic stimulation using the β3-adrenergic (AR) agonist CL316,243 (CL) on systemic metabolism and adipose function in aged (18-month-old) C57BL/6JN mice. Sustained β3-AR treatment resulted in reduced fat mass, increased energy expenditure, increased fatty acid oxidation and mitochondrial activity in adipose depots, improved glucose homeostasis, and a …

Genomic Analysis Of The Sars-Cov-2 Variants Circulated In The Philippines, 2020–2024, Arnie Dimaano, Kiana Dominique Carreon, Giselle Sophia Camaya, Irvin Rondolo, Jarel Elgin Tolentino

Biology Faculty Publications

Purpose

Genomic sequencing has been an invaluable tool to determine the evolution of SARS-CoV-2. In the present study, we provided a comprehensive description of the SARS-CoV-2 variants circulated in the Philippines.

Methods

The dataset from the human COVID-19 infections was acquired by downloading the sequences and their associated metadata spanning from March 2020 to April 2024. Then, we executed several filtering criteria to acquire the final dataset for the Philippine samples and performed spatial distribution analysis and phylogenetic tree construction of the reported SARS-CoV-2 sequences.

Results

A total of 16,679,203 SARS-CoV sequences were obtained, of which 17,393 (0.10 %) were …

Patient, Provider, And Health System Characteristics Leading To The Delivery Of Low Value Health Care Services And Outcomes Of An Intervention For Mitigating Low Value Care., Philip Ray Rohrer

Electronic Theses and Dissertations

The United States spends more on health care than any other country, and Medicare accounted for nearly one-quarter of total personal health care spending in 2019. Waste within the health care system in the United States is estimated to represent approximately 25% of total U.S. health care expenditures. Low value care includes health care services that provide little or no benefit to patients, have potential to cause harm, incur unnecessary costs to patients, or waste limited healthcare resources. Low value care is estimated to represent roughly 10% of total health care waste, or between $75.7 billion and $101.2 billion dollars …

Understanding Carceral Pathways And Outcomes Of Marginalized Adults Who Use Drugs., Carmen Renee Mitchell

Electronic Theses and Dissertations

This dissertation is an examination of outcomes among substance users at various stages of the incarceration process divided among five chapters. Chapter One provides an overview of substance use disorder (SUD), incarceration, and wider justice system-involvement, and explores how the political economy of health theoretical framework can be applied to examine how the criminal justice system creates and perpetuates inequality among marginalized people who use substances. Chapter Two examines post-release health outcomes among the population of incarcerated people who use substances using a scoping review and finds that people in reentry with SUD have poorer overall outcomes that without transitional …

Understanding The Association Between Neighborhoods And Adolescent Sleep: Evidence From Add Health, Sam J Neally, Breanna J P Rogers, Yangyang Deng, Mohammad Moniruzzaman, Qian Xiao, Kosuke Tamura

Faculty, Staff and Student Publications

INTRODUCTION: Research suggests that perceived neighborhood social environments (PNSE) may contribute to gender and race/ethnicity-based sleep disparities. Our study aimed to examine associations between PNSE factors and adolescents' sleep patterns. As a secondary aim, we examined how gender and race/ethnic groups might moderate these associations.

METHOD: Data came from the National Longitudinal Study of Adolescent to Adult Health (n=5158; mean age=15.34 years). Four self-reported sleep outcomes were created: 1) sleep duration (hours/night), 2) short sleep (≥8 hours [reference] vs <8 >hours), 3) parental set bedtime (10:00 PM/earlier [reference] among girls vs by 11:00PM vs by/after 12:00AM), and 4) sleep satisfaction (enough …

Genetic Architecture Of Cerebrospinal Fluid And Brain Metabolite Levels And The Genetic Colocalization Of Metabolites With Human Traits, Ciyang Wang, Chengran Yang, Daniel Western, Muhammad Ali, Yueyao Wang, Chia-Ling Phuah, John Budde, Lihua Wang, Priyanka Gorijala, Jigyasha Timsina, Agustin Ruiz, Pau Pastor, Maria Victoria Fernandez, Dominantly Inherited Alzheimer Network (Dian), Alzheimer’S Disease Neuroimaging Initiative (Adni), Daniel J Panyard, Corinne D Engelman, Yuetiva Deming, Merce Boada, Amanda Cano, Pablo Garcia-Gonzalez, Neill R Graff-Radford, Hiroshi Mori, Jae-Hong Lee, Richard J Perrin, Laura Ibanez, Yun Ju Sung, Carlos Cruchaga

Faculty, Staff and Student Publications

Brain metabolism perturbation can contribute to traits and diseases. We conducted a genome-wide association study for cerebrospinal fluid (CSF) and brain metabolite levels, identifying 205 independent associations (47.3% new signals, containing 11 new loci) for 139 CSF metabolites, and 32 independent associations (43.8% new signals, containing 4 new loci) for 31 brain metabolites. Of these, 96.9% (CSF) and 71.4% (brain) of the new signals belonged to previously analyzed metabolites in blood or urine. We integrated the metabolite quantitative trait loci (MQTLs) with 23 neurological, psychiatric and common human traits and diseases through colocalization to identify metabolites and biological processes implicated …

Navigating Physical Activity Promotion And Policy In The Post-Covid-19-Pandemic Era, Justin Richards, Katja Siefken, Michael Pratt, Adrian Bauman, Juliana Mejía-Grueso, Catherine B Woods, Wanda Wendel-Vos, Erica Hinckson, Deborah Salvo, Pedro C Hallal, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Background: There is limited evidence on the priorities and opportunities associated with promoting population physical activity (PA) participation for the post-COVID-19-pandemic future.

Purpose: This study assessed government-led PA promotion efforts before and during the COVID-19 pandemic, along with post-COVID-19-pandemic priorities and recommendations.

Methods: Two separate cross-sectional surveys conducted in 2023. Survey 1 was targeted at the Global Observatory for Physical Activity (GoPA!) Country Contacts. Survey 2 also included key international informants representing influential stakeholders in PA policy implementation.

Results: There were 68 respondents to Survey 1, collectively representing 61 countries. An additional 37 people, including representatives from 14 key international …

Continuous Vital Sign Monitoring On Surgical Wards: The Cosmos Pilot, Nikola Anusic, Alper Gulluoglu, Elyad Ekrami, Edward J Mascha, Shuyi Li, René Coffeng, Alparslan Turan, Amber Clemens, Christine Perez, John W Beard, Daniel I Sessler

Faculty, Staff and Student Publications

Study objectives: Alerts for vital sign abnormalities seek to identify meaningful patient instability while limiting alarm fatigue. Optimal vital sign alarm settings for postoperative patients remain unknown, as is whether alerts lead to effective clinical responses reducing vital sign disturbances. We conducted a 2-phase pilot study to identify thresholds and delays and test the hypothesis that alerts from continuous monitoring reduce the duration of vital sign abnormalities.

Design: Two-phase pilot.

Patients: 250 adults having major non-cardiac surgery.

Setting: Surgical wards.

Intervention: All patients had routine vital sign monitoring by nurses at 4-h intervals. We initially continuously recorded clinician-blinded saturation, heart …

Prediagnostic Amino Acid Metabolites And Risk Of Gout, Accounting For Serum Urate: Prospective Cohort Study And Mendelian Randomization, Natalie Mccormick, Amit D Joshi, Chio Yokose, Bing Yu, Adrienne Tin, Robert Terkeltaub, Tony R Merriman, Oana Zeleznik, A Heather Eliassen, Gary C Curhan, Hang-Korng Ea, Matthew Nayor, Laura M Raffield, Hyon K Choi

Faculty, Staff and Student Publications

Objective: Our objective was to prospectively investigate prediagnostic population-based metabolome for risk of hospitalized gout (ie, most accurate, severe, and costly cases), accounting for serum urate.

Methods: We conducted prediagnostic metabolome-wide analyses among 249,677 UK Biobank participants with nuclear magnetic resonance metabolomic profiling (N = 168 metabolites, including eight amino acids) from baseline blood samples (2006-2010) without a history of gout. We calculated multivariable hazard ratios (HRs) for hospitalized incident gout, before and after adjusting for serum urate levels; we included patients with nonhospitalized incident gout in a sensitivity analysis. Potential causal effects were evaluated with two-sample Mendelian randomization.

Results: …

Whole-Of-School Physical Activity Promotion: Findings From Elementary Schools In The United States, Derek W Craig, Christopher D Pfledderer, Natalia I Heredia, Kevin Lanza, Kempson Onadeko, Andjelka Pavlovic, Jizyah Injil, Laura F Defina, Timothy J Walker

Faculty, Staff and Student Publications

INTRODUCTION: Schools can support students' participation in physical activity by offering opportunities consistent with a Whole-of-School (WOS) approach; however, the extent to which physical activity opportunities are provided and how school-level characteristics associate with their use remains unclear. This study examined how elementary schools' use a WOS approach to promote physical activity, as well as associations between school-level characteristics and physical activity opportunities provided.

METHODS: Survey data was collected from 162 elementary schools participating in the NFL PLAY 60 FitnessGram Project during the 2022-2023 school year. A WOS index (ranging from 0 to 12) was created from responses by school …

Economic Disadvantage During Childhood, Obesity, And Diabetes Across Three Birth Cohorts Of Older Mexicans, Jesús-Daniel Zazueta-Borboa, Rafael Samper-Ternent, Rebeca Wong, Neil Mehta

Faculty, Staff and Student Publications

OBJECTIVES: Diabetes prevalence has increased markedly in Mexico. We examined the individual and joint contributions of economic disadvantage during childhood (EDDC) and elevated body weight on diabetes prevalence in 3 cohorts of Mexican adults.

METHODS: Data on those 60-69 years old from the 1930-1939, 1940-1949, and 1950-1959 birth cohorts in Waves 1 (2001), 3 (2012), and 5 (2018) of the Mexican Health and Aging Study were used. EDDC was defined as the absence of a toilet in the household before age 10. Body mass status was defined using self-reported perceived body image at age 50. Diabetes was based on respondent …

Hpv Vaccine-Related Articles Shared On Facebook From 2019 To 2021: Did Covid Make A Difference?, L Aubree Shay, Ashley Mckenzie, Elaine Avshman, Lara S Savas, Ross Shegog

Faculty, Staff and Student Publications

OBJECTIVE: HPV vaccination is recommended for children beginning at age 9 to prevent several types of cancer. Many parents turn to Facebook for health information. This study describes changes in HPV vaccine-related articles shared on Facebook amidst the COVID-19 pandemic.

METHODS: HPV-related articles shared on Facebook (2019-2021) were collected using Buzzsumo, a social media analytics tool and analyzed using content analysis. Articles were categorized by valence, misinformation, evidence types, persuasive tactics, and framing. We quantified these data and tested for difference by article year.

RESULTS: Of the 138 included articles, 51% had positive valence towards the vaccine and 36% had …

Covid-19 Risk Assessment Among Vulnerable Small Business Owners In El Paso County, Texas, Sadie H Conway, Denise Vasquez, Kristina D Mena, Louis D Brown, Soyoung Kwon, Janelle Rios

Faculty, Staff and Student Publications

Background: Our objective was to deliver actionable, worksite-specific COVID-19 risk assessments and mitigation strategies tailored to vulnerable workers in one of the highest-risk areas in the US.

Methods: Four trained, bilingual (English/Spanish) community health workers (CHWs) recruited small businesses (ie, ≤20 employees) across various industries and executed novel on-site infectious disease risk assessment surveys of at least one employer and one employee.

Results: Of 102 participating businesses (95% Hispanic-owned), 96% were characterized as "high risk" or "very high risk" for disease transmission. All businesses reported implementing at least one practice to reduce disease transmission; however, almost half of businesses lacked …

Bivariate Genome-Wide Association Study Of Circulating Fibrinogen And C-Reactive Protein Levels, Julie Hahn, Gerard Temprano-Sagrera, Natalie R Hasbani, Symen Ligthart, Abbas Dehghan, Alisa S Wolberg, Nicholas L Smith, Maria Sabater-Lleal, Alanna C Morrison, Paul S De Vries

Faculty, Staff and Student Publications

Background: Fibrinogen and C-reactive protein (CRP) play an important role in inflammatory pathways and share multiple genetic loci reported in previously published genome-wide association studies (GWAS), highlighting their common genetic background. Leveraging the shared biology may identify further loci pleiotropically associated with both fibrinogen and CRP.

Objectives: To identify novel genetic variants that are pleiotropic and associated with both fibrinogen and CRP, by integrating both phenotypes in a bivariate GWAS by using a multitrait GWAS.

Methods: We performed a bivariate GWAS to identify further pleiotropic genetic loci, using summary statistics of previously published GWAS on fibrinogen (n = 120 246) …

The Association Between Care Integration And Care Quality, Micah B Aaron, Michaela Kerrissey, Zhanna Novikov, Maike V Tietschert, Adam Scherling, Hassina Bahadurzada, Russell S Phillips, Anna D Sinaiko, Sara J Singer

Faculty, Staff and Student Publications

Objective: The study aims to analyze the relationship between care integration and care quality, and to examine if the relationship varies by patient risk.

Data sources and study setting: The key independent variables used validated measures derived from a provider survey of functional (i.e., administrative and clinical systems) and social (i.e., patient integration, professional cooperation, professional coordination) integration. Survey responses represented data from a stratified sample of 59 practice sites from 17 health systems. Dependent variables included three quality measures constructed from patient-level Medicare data: colorectal cancer screening among patients at risk, patient-level 30-day readmission, and a practice-level Healthcare Effectiveness …

Identification Of Proteins Associated With Type 2 Diabetes Risk In Diverse Racial And Ethnic Populations, Shuai Liu, Jingjing Zhu, Hua Zhong, Chong Wu, Haoran Xue, Burcu F Darst, Xiuqing Guo, Peter Durda, Russell P Tracy, Yongmei Liu, W Craig Johnson, Kent D Taylor, Ani W Manichaikul, Mark O Goodarzi, Robert E Gerszten, Clary B Clish, Yii-Der Ida Chen, Heather Highland, Christopher A Haiman, Christopher R Gignoux, Leslie Lange, David V Conti, Laura M Raffield, Lynne Wilkens, Loïc Le Marchand, Kari E North, Kristin L Young, Ruth J Loos, Steve Buyske, Tara Matise, Ulrike Peters, Charles Kooperberg, Alexander P Reiner, Bing Yu, Eric Boerwinkle, Quan Sun, Mary R Rooney, Justin B Echouffo-Tcheugui, Martha L Daviglus, Qibin Qi, Nicholas Mancuso, Changwei Li, Youping Deng, Alisa Manning, James B Meigs, Stephen S Rich, Jerome I Rotter, Lang Wu

Faculty, Staff and Student Publications

Aims/hypothesis: Several studies have reported associations between specific proteins and type 2 diabetes risk in European populations. To better understand the role played by proteins in type 2 diabetes aetiology across diverse populations, we conducted a large proteome-wide association study using genetic instruments across four racial and ethnic groups: African; Asian; Hispanic/Latino; and European.

Methods: Genome and plasma proteome data from the Multi-Ethnic Study of Atherosclerosis (MESA) study involving 182 African, 69 Asian, 284 Hispanic/Latino and 409 European individuals residing in the USA were used to establish protein prediction models by using potentially associated cis- and trans-SNPs. The models were …

Designing A Blockchain Technology Platform For Enhancing The Pre-Exposure Prophylaxis Care Continuum, Anjum Khurshid, Daniel Toshio Harrell, Dennis Li, Camden Hallmark, Ladd Hanson, Nishi Viswanathan, Michelle Carr, Armand Brown, Marlene Mcneese, Kayo Fujimoto

Faculty, Staff and Student Publications

OBJECTIVES: Pre-exposure prophylaxis (PrEP) is a key biomedical intervention for ending the HIV epidemic in the United States, but its uptake is impeded by systemic barriers, including fragmented workflows and ineffective data coordination. This study aims to design PrEPLinker, a blockchain-based, client-centered platform to enhance care to address these challenges by improving care coordination and enabling clients to securely manage their identity and PrEP-related data.

MATERIALS AND METHODS: Using Houston, Texas, as a use case, we conducted a needs assessment with PrEP collaborators to evaluate existing workflows and identify barriers in the PrEP care continuum. Based on these findings, we …

Association Of Common And Rare Variants With Alzheimer’S Disease In More Than 13,000 Diverse Individuals With Whole-Genome Sequencing From The Alzheimer’S Disease Sequencing Project, Wan-Ping Lee, Seung Hoan Choi, Margaret G Shea, Po-Liang Cheng, Beth A Dombroski, Achilleas N Pitsillides, Nancy L Heard-Costa, Hui Wang, Katia Bulekova, Amanda B Kuzma, Yuk Yee Leung, John J Farrell, Honghuang Lin, Brian W Kunkle, Adam Naj, Elizabeth E Blue, Frederick Nusetor, Dongyu Wang, Eric Boerwinkle, William S Bush, Xiaoling Zhang, Philip L De Jager, Josée Dupuis, Lindsay A Farrer, Myriam Fornage, Eden Martin, Margaret Pericak-Vance, Sudha Seshadri, Ellen M Wijsman, Li-San Wang, Alzheimer's Disease Sequencing Project;, Gerard D Schellenberg, Anita L Destefano, Jonathan L Haines, Gina M Peloso

Faculty, Staff and Student Publications

INTRODUCTION: Alzheimer's disease (AD) is a common disorder of the elderly that is both highly heritable and genetically heterogeneous.

METHODS: We investigated the association of AD with both common variants and aggregates of rare coding and non-coding variants in 13,371 individuals of diverse ancestry with whole genome sequencing (WGS) data.

RESULTS: Pooled-population analyses of all individuals identified genetic variants at apolipoprotein E (APOE) and BIN1 associated with AD (p < 5 × 10

DISCUSSION: We observed that complementary pooled-population and subgroup-specific analyses offered unique insights into the genetic architecture of AD.

HIGHLIGHTS: We determine the association of genetic variants with Alzheimer's disease (AD) using …

Effectiveness Of Enhanced Care For Treatment Of Acute Or Persistent Diarrhea In Malnourished Children Aged 0 Months To 10 Years: A Systematic Review, Ridwa Alam, Khadija Vadsaria, Ahmad Khan, Uswa Jiwani, Aqsa Ishaq, Anmol Minaz, Ashraf Sharif, Jai K. Das, Sajid Bashir Soofi, Shabina Ariff

Centre of Excellence in Women and Child Health

Background: Diarrhea poses a significant public health challenge, particularly affecting children under five. The link between malnutrition and diarrhea is well established, with diarrhea being a primary cause of malnutrition in young children and malnutrition exacerbating the severity of diarrhea. While the World Health Organization (WHO) recommends a comprehensive approach to both diarrhea and malnutrition management, including oral rehydration, continuous feeding, zinc supplementation, and antibiotics for specific strains, it does not adequately address the complex needs of malnourished children with diarrhea who may benefit from enhanced care in the form of follow-up and monitoring beyond initial treatment. We aimed to …

Associations Of Metabolic Changes And Polygenic Risk Scores With Cardiovascular Outcomes And All-Cause Mortality Across Bmi Categories: A Prospective Cohort Study, Cancan Li, Xiaoni Meng, Jie Zhang, Haotian Wang, Huimin Lu, Meiling Cao, Shengzhi Sun, Youxin Wang

Research outputs 2022 to 2026

Background: Associations between metabolic status and metabolic changes with the risk of cardiovascular outcomes have been reported. However, the role of genetic susceptibility underlying these associations remains unexplored. We aimed to examine how metabolic status, metabolic transitions, and genetic susceptibility collectively impact cardiovascular outcomes and all-cause mortality across diverse body mass index (BMI) categories. Methods: In our analysis of the UK Biobank, we included a total of 481,576 participants (mean age: 56.55; male: 45.9%) at baseline. Metabolically healthy (MH) status was defined by the presence of < 3 abnormal components (waist circumstance, blood pressure, blood glucose, triglycerides, and high-density lipoprotein cholesterol). Normal weight, overweight, and obesity were defined as 18.5 ≤ BMI < 25 kg/m2, 25 ≤ BMI < 30 kg/m2, and BMI ≥ 30 kg/m2, respectively. Genetic predisposition was estimated using the polygenic risk score (PRS). Cox regressions were performed to evaluate the associations of metabolic status, metabolic transitions, and PRS with cardiovascular outcomes and all-cause mortality across BMI categories. Results: During a median follow-up of 14.38 years, 31,883 (7.3%) all-cause deaths, 8133 (1.8%) cardiovascular disease (CVD) deaths, and 67,260 (14.8%) CVD cases were documented. Among those with a high PRS, individuals classified as metabolically healthy overweight had the lowest risk of all-cause mortality (hazard ratios [HR] 0.70; 95% confidence interval [CI] 0.65, 0.76) and CVD mortality (HR 0.57; 95% CI 0.50, 0.64) compared to those who were metabolically unhealthy obesity, with the beneficial associations appearing to be greater in the moderate and low PRS groups. Individuals who were metabolically healthy normal weight had the lowest risk of CVD morbidity (HR 0.54; 95% CI 0.51, 0.57). Furthermore, the inverse associations of metabolic status and PRS with cardiovascular outcomes and all-cause mortality across BMI categories were more pronounced among individuals younger than 65 years (Pinteraction < 0.05). Additionally, the combined protective effects of metabolic transitions and PRS on these outcomes among BMI categories were observed. Conclusions: MH status and a low PRS are associated with a lower risk of adverse cardiovascular outcomes and all-cause mortality across all BMI categories. This protective effect is particularly pronounced in individuals younger than 65 years. Further research is required to confirm these findings in diverse populations and to investigate the underlying mechanisms involved. Graphical abstract: (Figure presented.)

Dual-Trajectory Of Tyg Levels And Lifestyle Scores And Their Associations With Ischemic Stroke In A Non-Diabetic Population: A Cohort Study, Hui Zhou, Xiong Ding, Yulong Lan, Wei Fang, Xiaojie Yuan, Yan Tian, Shuohua Chen, Shouling Wu, Dan Wu

Research outputs 2022 to 2026

Background: The Triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has been implicated in the risk of ischemic stroke. However, the interplay between TyG levels, lifestyle factors, and their collective impact on stroke risk in non-diabetic populations remains inadequately explored. This study aims to evaluate the association of ischemic stroke with the joint development of the TyG index and lifestyle in the non-diabetic population. Methods: In this prospective cohort study, data was collected across three consecutive biennial surveys of the Kailuan Study from 2006 to 2011. The dual-trajectory model was used to determine the temporal development of TyG levels …

A Replication Study — Suicidal Thoughts And Behaviors Among High School Students — Youth Risk Behavior Survey, United States, 2021, Mallory Hays

Capstone Experience: Master of Public Health

Suicidal thoughts and behaviors among adolescents are critical public health concerns in the United States, with suicide being the third leading cause of death among high school-aged youths (14-18 years). This study replicates and extends the findings of the 2021 Youth Risk Behavior Survey (YRBS) conducted by Gaylor et al., which analyzed data from 13,677 students in 2019 and 17,232 students in 2021. The original study revealed alarming increases in suicidal ideation and behaviors, particularly among female students, and highlighted disparities across demographic groups. Using raw YRBS datasets, this replication involved a pure replication of the original findings, followed by …

Promoting Adolescent Mental And Physical Health: Initiatives Focused On Connecting Public Health And Social Services To The Health Sector In Nebraska, Theresa Nguyen

Capstone Experience: Master of Public Health

This capstone focuses on the second recommendation of improving access to comprehensive, coordinated health services from the National Academies of Sciences, Engineering, and Medicine report The Promise of Adolescence: Realizing Opportunity for All Youth (2019). This proposal uses secondary data from the research project, Moving Evidence-Based Recommendations to Practice to Strengthen the Health Care System in Nebraska. Key stakeholders (n=28) were interviewed from the health care, public health, social services, and policy sectors. Each subject was asked to participate in a semi-structured interview by a trained interviewer. The interview was 1 hour long and conducted via phone call or Zoom. …

The Association Between Systolic Blood Pressure And Coronary Heart Disease In The Framingham Heart Study: A Long-Term Prospective Cohort Study, Alexandrea M. Welch

Capstone Experience: Master of Public Health

Coronary heart disease (CHD) is a leading cause of morbidity and mortality worldwide, with systolic blood pressure (SBP) as a critical risk factor. This study utilized data from the Framingham Heart Study to assess the association between SBP and CHD among participants. Univariate, bivariate, and multivariable logistic regression was used to explore this association as well as the association with other key covariates. We found a significant positive association between elevated SBP and the risk of CHD (adjusted OR: 1.69, 95% CI: 1.41-2.01, p < 0.0001). Age, sex, current blood pressure medication use, and body mass index (BMI) were significantly associated with CHD. Our findings support the need for blood pressure management to prevent cardiac events and reduce CHD burden.

Closing Gaps To Address Lifespan Health: Considerations For Developing A Preconception Healthcare Training For Community Health Workers, Jaclyn R. Vancamp

Capstone Experience: Master of Public Health

Community health workers (CHWs) are frontline public health workers who are embedded in their own communities and as linkages to care, decreasing health disparities for underserved individuals. The goal of this capstone project was to identify Michigan CHWs' knowledge gaps in the area of preconception healthcare. Through administering a training needs assessment to a sample of community health workers, the goal was to characterize knowledge gaps and make recommendations about what type of training would be most useful to them. The results of this needs assessment showed that the general state of self-reported knowledge about preconcept health among Michigan community …

Dietary And Physical Activity Behaviors In 2021 And Changes From 2019 To 2021 Among High School Students: A Replication Study, Jamila Nasir

Capstone Experience: Master of Public Health

Shannon L. Michael et al. conducted the study “Dietary and Physical Activity Behaviors in 2021 and Changes from 2019 to 2021 Among High School Students” to compare the prevalences of specific dietary and exercise behaviors among high-school students between 2019 and 2021, in order to examine how the COVID-19 pandemic affected these behaviors and to identify disparities in these effects.

This replication of the study focuses on exercise behaviors. The study data, drawn from the CDC’s YRBS in 2019 and 2021, had been selected using a three-stage cluster sampling method in which the clusters in the third stage were selected …

Association Between Cigarette Smoking And Angina Pectoris Among Middle-Aged Adults: Findings From The Framingham Cohort Study, Lauren M. Hron

Capstone Experience: Master of Public Health

Objectives: This study investigates the relationship between current cigarette smoking at baseline and the occurrence of angina pectoris during follow-up among middle-aged adults (30-70 years), adjusting for age, sex, BMI, diabetes status, education, and number of cigarettes smoked per day.

Methods: Using the Framingham Heart Study cohort (N=4,434), logistic regression analyses were performed. A backward selection approach identified confounders and explored effect modification.

Results: Angina prevalence was 16.4%, with higher odds observed in males, older individuals, and those with obesity or diabetes. Smoking status showed a non-significant association with angina in multivariable models (aOR:0.86, 95% CI: 0.73-1.01). However, age and …

Cybersecurity Vulnerabilities And Considerations In U.S. Healthcare Facilities: A Scoping Review, Rebecca J. Campbell

Capstone Experience: Master of Public Health

Robust cybersecurity measures are essential for business continuity of U.S. healthcare institutions which is to maintain care standards for all patients. Hackers seek to disrupt healthcare delivery for financial and political means, to disrupt services in retaliation, or simply for malicious intent (Wasserman & Wasserman, 2022). The COVID-19 pandemic further accelerated innovation and digitization in healthcare, including wearable and implanted medical devices, telehealth care delivery options, artificial intelligence, and cloud-based data management (Kioskli, Fotis, & Mouratidis, 2021). This progress in innovation continues today but also brings new vulnerabilities and challenges to stay ahead of cybersecurity threats.

Given that cyberattacks have …

Knowledge, Attitudes, And Behaviors Regarding Water Quality, Nitrate Contamination, And Related Health Issues Among Nebraska Healthcare Professionals, Jessenia Hincapie

Capstone Experience: Master of Public Health

Background: Nitrate contamination in drinking water is a public health concern, particularly in agricultural regions. Healthcare professionals often address water quality issues but may lack sufficient knowledge regarding the health effects of nitrate contamination. This study evaluates whether Nebraska healthcare professionals' knowledge and attitudes about nitrate contamination predict their behaviors in addressing this issue.

Methods: A survey was administered to healthcare professionals across Nebraska to assess their knowledge, attitudes, and behaviors regarding nitrate contamination in drinking water. A total of 462 respondents participated. Generalized linear regression analysis was employed to assess the impact of knowledge and attitudes regarding nitrate contamination …