Community Health and Preventive Medicine Commons^™

Use Of Advance Directives In Us Veterans And Non-Veterans: Findings From The Decedents Of The Health And Retirement Study 1992–2014, Ho-Jui Tung, Ming-Chin Yeh

Health Policy & Community Health: Faculty Publications

Evidence shows that older patients with advance directives such as a living will, or durable power of attorney for healthcare, are more likely to receive care consistent with their preferences at the end of life. Less is known about the use of advance directives between veteran and non-veteran older Americans. Using data from the decedents of a longitudinal survey, we explore whether there is a difference in having an established advance directive between the veteran and non-veteran decedents. Data were taken from the Harmonized End of Life data sets, a linked collection of variables derived from the Health and Retirement …

Assessing The Correlation Between The Socioeconomic Level And Cognitive Function Among Older Adults In Egypt, Macy Abougabal

Theses and Dissertations

The number of older adults is increasing worldwide at an unprecedented rate. Some countries began to understand the challenges of aging, while others are still at the stage of comprehending the true dimensions of the situation. There is a global focus on aging research to appropriately mitigate the negative impact of aging and cognitive decline. Not only that dementia add economic pressure on governments, it also increase the psychological and physical burden of the caregivers. Scholars have previously studied socioeconomic level in three variables, namely work, education, and income, and their relationship with cognitive function. It was concluded that the …

Humanity In Trauma, Alyssa K. Thompson

University Honors Theses

The main objective of the literature review is to use the trauma-informed care paradigm to argue that the current implementation of trauma-informed care reinforces hierarchies of harm, leading to feelings of moral obligation and moral injury while perpetuating othering. This literature review criticizes trauma-informed care, emphasizing lived experiences against the characteristics trauma-informed care aspires to reflect. The review centers on the broad themes of understanding, universality, and acceptance of the present trauma-informed care paradigm. The critique comes from the silently excluded group of healthcare workers, with a personal perspective from a professional who worked in an urban hospital emergency department …

Evaluation Of Feasibility And Acceptability Of A Web-Based Diabetes Prevention Program (Dpp) For Diabetes Risk Reduction In Chinese Americans In New York City, Ming-Chin Yeh, Wincy Lau, Claire Anselmo Keady, Margrethe Horlyck-Romanovsky, Ho-Jui Tung, Lu Hu, Grace X. Ma, Judith Wylie-Rosett

Health Policy & Community Health: Faculty Publications

Introduction: Intensive lifestyle intervention remains an effective modality to reduce diabetes incidence and delay the progression to type 2 diabetes. The primary aim of this study was to pilot-test the feasibility and acceptability of a culturally and linguistically tailored web-based DPP intervention among Chinese Americans with prediabetes living in New York City.

Methods: Thirteen Chinese American participants with prediabetes were recruited to complete a 1-year web-based Diabetes Prevention Program (DPP) lifestyle intervention. Quantitative and qualitative measures such as retention rate and data collected from web-based questionnaires and focus groups were collected and analyzed to assess study feasibility and …

Evaluating The Use Of Blood Pressure Polygenic Risk Scores Across Race/Ethnic Background Groups, Nuzulul Kurniansyah, Matthew O Goodman, Alyna T Khan, Jiongming Wang, Elena Feofanova, Kerri L Wiggins, Tanika Kelly, Tali Elfassy, Xiuqing Guo, Walter Palmas, Henry J Lin, Shih-Jen Hwang, Yan Gao, Kendra Young, Gregory L Kinney, Jennifer A Smith, Bing Yu, Simin Liu, Sylvia Wassertheil-Smoller, Joann E Manson, Xiaofeng Zhu, Yii-Der Ida Chen, I-Te Lee, C Charles Gu, Donald M Lloyd-Jones, Sebastian Zöllner, Myriam Fornage, Charles Kooperberg, Adolfo Correa, Bruce M Psaty, Donna K Arnett, Carmen R Isasi, Stephen S Rich, Robert C Kaplan, Susan Redline, Braxton D Mitchell, Nora Franceschini, Daniel Levy, Jerome I Rotter, Alanna C Morrison, Tamar Sofer

Faculty, Staff and Student Publications

We assess performance and limitations of polygenic risk scores (PRSs) for multiple blood pressure (BP) phenotypes in diverse population groups. We compare "clumping-and-thresholding" (PRSice2) and LD-based (LDPred2) methods to construct PRSs from each of multiple GWAS, as well as multi-PRS approaches that sum PRSs with and without weights, including PRS-CSx. We use datasets from the MGB Biobank, TOPMed study, UK biobank, and from All of Us to train, assess, and validate PRSs in groups defined by self-reported race/ethnic background (Asian, Black, Hispanic/Latino, and White). For both SBP and DBP, the PRS-CSx based PRS, constructed as a weighted sum of PRSs …

Building Up Cal Poly Global Brigades Student Group: Reflections On Designing And Implementing One Undergraduate-Led Community Info Session, Caroline Nicole Smith, Jafra D. Thomas

Kinesiology and Public Health

Intro: Global Brigades, an international non-profit organization, trains college students and other pre-professionals in community-based health promotion by mobilizing community service trips around the world, which are taught and led by local community groups. Cal Poly’s Global Brigades student group was founded in 2018, and thus far, they have carried out three annual, medically-focused brigades to Honduras (two in-person, one virtual).

Purpose: The aim of this report is to present the findings of one experiential senior project to promote Cal Poly’s Global Brigades student group^[1] (conducted January to March 2023).

Methods: The student designed material for …

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

Piloting The Sexual And Gender Minority Cancer Curricular Advances For Research And Education (Sgm Cancer Care) Workshop: Research Training In The Service Of Sgm Cancer Health Equity, Miria Kano, Irene Tamí-Maury, Mandi L Pratt-Chapman, Shine Chang, Mikaela Kosich, Tonia Poteat, Ronit Elk, Ulrike Boehmer, Julian Sanchez, Charles Kamen, Nelson F Sanchez

Faculty, Staff and Student Publications

The purpose of this study is to describe the context, curriculum design, and pilot evaluation of the educational program "Sexual and Gender Minority Cancer Curricular Advances for Research and Education" (SGM Cancer CARE), a workshop for early-career researchers and healthcare providers interested in gaining knowledge and skills in sexual and gender minority (SGM) cancer research and healthcare advocacy. A needs assessment of a sample of clinicians and researchers (n = 104) and feedback from an Advisory Board informed the curriculum design of the SGM Cancer CARE workshop. Four SGM-tailored modules, focusing on epidemiology, clinical research, behavioral science and interventions, and …

Investigating And Mitigating The Harmful Impact Of Precarious Employment On The Health And Well-Being Of New York City Food Workers, Emilia F. Vignola

Dissertations and Theses

Much of the United States (US) food chain – from production to processing, wholesale, retail, and services – is characterized by precarious employment, defined as work with little employment security, inadequate income, and limited rights and protections. Studies show that precarious employment is associated with adverse mental and physical health and well-being outcomes. Separate research indicates numerous health issues in certain segments of the food workforce; little scholarly work has explored the contribution of precarious employment as an upstream driver of these health issues. Gaps remain in our understanding of 1) the health needs and status of workers across the …

Retrospective Assessment Of A Collaborative Digital Asthma Program For Medicaid-Enrolled Children In Southwest Detroit: Reductions In Short-Acting Beta-Agonist (Saba) Medication Use, Meredith Barrett, Rahul Gondalia, Vy Vuong, Leanne Kaye, Alex B. Hill, Elliot Attisha, Teresa Holtrop

Urban Studies and Planning Faculty Research Publications

Background
Real-world evidence for digitally-supported asthma programs among Medicaid-enrolled children remains limited. Using data from a collaborative quality improvement program, we evaluated the impact of a digital intervention on asthma inhaler use among children in southwest Detroit.

Methods
Children (6–13 years) enrolled with Kids Health Connection (KHC), a program involving home visits with an asthma educator, were invited to participate in a digital self-management asthma program (Propeller Health). Patients were provided with a sensor to capture short-acting beta-agonist (SABA) medication use, and given access to a paired mobile app to track usage. Patients’ healthcare providers and caregivers (“followers”) were invited …

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

Building Sustainable Environmental Activism Programs For Youth, Aminah Habib

Master's Projects and Capstones

As the negative impacts of climate change become more and more common across the United States, many youth are experiencing eco-anxiety or other negative mental health impacts due to the state of the environment. Engaging with activism has been named as a potential mitigator of the negative impacts of climate change among youth, but the relationship between activism and youth well-being is an emerging area of research. To explore this relationship, this scoping review explored and synthesized available literature to inform the next steps. In addition to the community-level and society-level contributions that come from youth activism, there are also …

The Use Of Therapeutic Gardening In Addiction Recovery, Sophia Agne

Master's Projects and Capstones

Problem: Numerous recent studies have emerged detailing the benefits of horticultural therapy on mental health and wellness. Despite this, substance use disorder treatment facilities rarely include an outdoor component in their programming. The project seeks to examine the advantages of incorporating therapeutic gardening as a complementary part of addiction treatment.

Context: The microsystem where the study was conducted was at a 32-bed residential substance abuse treatment facility for adult men who have previously been involved in the criminal justice system. The treatment approach employed at the facility aligns with the Integrated Dual Disorder Treatment (IDDT) curriculum, which emphasizes mental health-informed …

Health Disparities: Ranking Horry County's Most Disadvantaged Communities, Stephen Borders, Jacob Bradley, Mackenzie Cannon, William Hall

Public Health

Horry County is a rapidly growing region in South Carolina, with a diverse population of over 300,000 residents. Despite this growth, the county faces significant health challenges, including high rates of chronic diseases, such as diabetes and obesity, and a shortage of healthcare providers in certain areas. These challenges are exacerbated by the county's socio-economic disparities, with many low-income residents lacking access to basic health services. Our approach is to address these challenges by identifying the areas within the county with the greatest unmet needs, also known as disadvantaged communities. By identifying the needs of Horry County’s most disadvantaged communities, …

Calculating Risk: A Scoping Review Of Ncaa D1 Football Players’ Motivations To Play And The Correlation To Demographic Characteristics And Injury Experiences, Kathleen D. Walsh

Honors Theses

The purpose of this research was to investigate the motivations of National Collegiate Athletic Association (NCAA) Division 1 (D1) football players for playing the game and how these motivations are associated with their socioeconomic status (SES). Further, the research aimed to investigate how the uncovered motivations were linked to injury experiences. The original project was designed as a survey-based mixed methods study on a national scale. However, issues with participant recruitment led to sidelining of that primary research. The research presented is a scoping review of the available literature pertaining to the research question: What is known from existing literature …

Healthcare Disparities In The Lgbtqia+ Community: A Scoping Review Of Community Vs Provider Experiences, Uttara Hardikar, Alisha Vincent, Venkateswar Venkataman, Millicent Channell

Rowan-Virtua Research Day

Background: It is well-established that healthcare disparities exist in the LGBTQIA+ community. The divide is a growing concern exacerbated by recent changes in the healthcare and sociopolitical climate. To eliminate this divide and find ways to deliver better outcomes to the LGBTQIA+ is a dire need. This report analyzes the possible reasons from the community as well as the providers perspective, with a goal to find best practices that could be implemented in both components.

Methods: A scoping literature review was carried out as described below to collect perspectives from both sides: patients as well as providers.

Results: From patient …

Food Insecurity And Dietary Restrictions, Courtney Williams, Savana Rodriguez, Tiffany Guerrero, Stephen Acheampong, Vanesa Pizutelli

Rowan-Virtua Research Day

According to the USDA Food Insecurity affects around 10.2 percent of the US population as of 2021. For families that have members with certain dietary restriction such as, but not limited to diabetes, hypertension, gluten intolerance, lactose intolerance, and food allergies, the challenge of securing food becomes an even greater burden with having to navigate food banks or discount stores that may not offer food items that meet their dietary requirements. Families with dietary restrictions often face greater food insecurity and less access to food. More research is needed to understand the challenges families with dietary restrictions face regarding food …

Immigration Status And Household Income As Predictors Of Childhood Obesity, Bhaumik Patel, Jeffery Powers

Rowan-Virtua Research Day

Childhood obesity rates have been on a remarkably steep rise in recent years. According to recent literature, the rate in the United States alone has more than doubled compared to other regions in the world such as Australia, Canada and Europe1,2 . Especially in the African immigrant community, there has been speculation of a higher prevalence of childhood obesity in the United States3 . This warranted further investigation into demographic factors impacting childhood obesity rates and their subsequent consequences with other clinical diseases such as diabetes and heart disease. The CDC reports that in 2011-2014, among individuals ages 2 to …

Barriers To Colorectal Cancer Screening For Low-Income Hispanic Men In Urban Areas Between 50-75, Alex Vega

Rowan-Virtua Research Day

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Although CRC screening rates have improved in non-Hispanic whites (NHW), Hispanic adult males (HAM) aged 50-75 in urban areas continue to experience low screening rates and higher CRC morbidity and mortality. This review aims to identify the barriers to CRC screening among HAM and propose targeted interventions to increase screening rates. A comprehensive literature review was conducted using databases such as PubMed, Scopus, and Google Scholar. Key search terms included "colorectal cancer", "screening", "Hispanic adult males", "urban", "barriers", and "interventions". Factors identified include poverty, language …

Cardiovascular Disease Prediction Modelling: A Machine Learning Approach, Usmaan Al-Shehab, Maduka Gunasinghe, Yousuf Elkhoga, Nimay Patel, Juliana Yang

Rowan-Virtua Research Day

The objective of this project is to utilize the UCI Heart Disease dataset to identify physiological biomarkers that are highly correlated with heart disease incidence. A predictive model can then be developed using these biomarkers to estimate the likelihood of someone having or developing a heart-related condition. This study compares the efficacy of predicting cardiovascular disease as an outcome using three machine learning algorithms: Support Vector Machine, Gaussian Naive Bayes, and logistic regression. Support Vector Machine works by creating hyperplanes between data points to conduct classification. Gaussian Naive Bayes works by using the conditional probabilities of events to classify the …

Cultural Food Accomodations In South New Jersey, Anahit Stepanyan, Resty Mercado, David Jiang

Rowan-Virtua Research Day

NJ is a melting pot of different cultures and ethnicities, each bringing their own unique customs and traditions. Of these traditions, diet and food are one of the most renowned distinctions and some of the most celebrated.

In response, several Public School districts have made halal and kosher food reforms to accommodate the rise in the Muslim and Jewish student body.

These menu accommodations were made in response to concerns about a lack of halal food options, which negatively impacted Muslim and Jewish students' health and mental well-being and can be recognized as a health disparity disadvantaging Muslim American student …

Health Equity Module: The Latino Paradox, Noel A. Tufts, Jackie V. Carman, Laura Barbas Rhoden

Community Based Research

This project aims to educate participants about health inequities and the Latinx community, particularly first and second generation immigrants. Participants may be students who plan careers in health care or professionals and community experts new to working with Latinx community members. The module equips participants with foundational knowledge; shares resources for continued learning; and invites participants to reflect critically about their own intersectional identities and how different intersectional identities impact health care experiences.

Early Childhood Support Specialist Evaluation Report, Emilie Swenson Msw, Rachel Gallo Mph

Children, Youth, & Families

The Early Childhood Support Specialist (ECSS) at MaineHealth builds relationships with families who have children aged birth to three, a timeframe when infants and toddlers are rapidly developing, learning, and benefiting from family and community connections. The ECSS assesses a family’s strengths and needs to understand how that family can be supported and connected. The ECSS connects families to resources, provides referrals, coaches families on children’s social and emotional development, and generally serves as a point of contact to assist families with social, emotional, and medical needs. Ultimately, the intended outcome of this model is to increase family connections, decrease …

Our Story, Our Song: Assessing And Addressing Black Women's Healthcare Experiences., Jason Deakings

Electronic Theses and Dissertations

Despite advancements in medicine and health sciences, health disparities and declining life expectancy persists among Black women in the United States. Researchers and non-traditional healthcare providers suggest alternative healing (e.g., music and Sister Circles) and research methodologies to achieve a culturally conscious, traumainformed, quality, and holistic care and practice. The intersecting identities and cultural responsibility of Black women highly influences the barriers and facilitators on the uptake of healthcare services. Utilizing a community engaged research approach, this qualitative study assessed the healthcare experiences, as well as the role of music in the lived and retold experiences of Black women navigating …

Exploring Sexual And Reproductive Health Care In Central Appalachia Through The Experiences Of Transgender And Gender Non-Binary People, Chase Harless

Electronic Theses and Dissertations

Background: Transgender or nonbinary (TNB) individuals in the United States experience higher rates of sexual and reproductive health disparities when compared to their cisgender counterparts, along with lower access to care. TNB people in the south experience higher rates of disparities. Societal, interpersonal, and individual barriers contribute to these disparities in the TNB population. However, there is a paucity of research examining the sexual and reproductive health experiences of TNB people living in Central Appalachia.

Methods: An interpretive phenomenological analysis (IPA) research design was used to collect and analyze semi-structured interviews with TNB individuals living in central Appalachia regarding their …

National Cancer Control Plan Of The Korea: Current Status And The Fourth Plan (2021-2025), Kyu-Tae Han, Jae Kwan Jun, Jeong-Soo Im

Faculty, Staff and Student Publications

Cancer management has become a major policy goal for the government of the Korea. As such, the government introduced the National Cancer Control Plan (NCCP) to reduce the individual and social burdens caused by cancer and to promote national health. During the past 25 years, 3 phases of the NCCP have been completed. During this time, the NCCP has changed significantly in all aspects of cancer control from prevention to survival. The targets for cancer control are increasing, and although some blind spots remain, new demands are emerging. The government initiated the fourth NCCP in March 2021, with the vision …

The Effects Of Multiple Micronutrient Fortified Beverage And Responsive Caregiving Interventions On Early Childhood Development, Hemoglobin, And Ferritin Among Infants In Rural Guatemala, Alysse J. Kowalski, Victor Alfonso Mayen, Silvia De Ponce, Kaley B. Lambden, Nick Tilton, Lisa M. Villanueva, Ana M. Palacios, Greg A. Reinhart, Kristen M. Hurley, Maureen M. Black

Health Policy & Community Health: Faculty Publications

Undernutrition and a lack of learning opportunities can jeopardize long-term growth and development among infants in low- and middle-income countries. We conducted a 6-month 2 × 2 cluster-randomized trial to assess the effects of multiple micronutrient-fortified beverages and responsive caregiving interventions among infants 6–18 months in 72 community sectors in southwest Guatemala. We administered baseline and endline assessments of childhood development (Bayley Scales of Infant and Toddler Development) and socioemotional development (Brief Infant Toddler Socio-Emotional Assessment) and measured ferritin and hemoglobin on a subsample. The trial was analyzed using linear mixed models. At the baseline, the mean age (SD) was …

Comparing Levels Of Situational Empathy Based On Medium Of Exposure To Covid-19 Mortality Information And Proximity To Others, Beth Durkin

Honors Projects

In response to the COVID-19 pandemic, many people expressed a lax attitude to the policies put in place to keep the public safe despite the high risk of infection and its devastating effects on health across the United States. It is possible that this response may be partially due to a “numbness to numbers,” a phenomenon that describes diminished empathy for a large group of people experiencing a negative event (eg. COVID-19). The present study explored the relationship between levels of situational empathy and the medium of exposure to COVID-19 mortality information (eg. personal story or fact sheet) in an …

Reviewer Acknowledgments, Randy Wykoff Md, Mph & Tm, Rachel E. Dixon Mphil

Journal of Appalachian Health

As we reach our fifth year, we are particularly thankful for the contributions of our peer reviewers. The knowledge, expertise, and guidance offered by the people listed below have ensured that we can continue to share timely research to effect health and well-being across Appalachia.

We Welcome Findings From Further Afield, Randy Wykoff Md, Mph & Tm, Rachel E. Dixon Mphil

Journal of Appalachian Health

For the past five years, the Journal of Appalachian Health has published timely, high-quality research from within Appalachia. We also welcome submissions from those working outside of Appalachia who produce quality research of direct relevance to our region.