Community Health and Preventive Medicine Commons^™

Migrants Sans Papiers: The Impact Of Cantonal Program And Policy Discrepancies On Undocumented Migrant Healthcare Utilization In Switzerland, Denise Peng

Independent Study Project (ISP) Collection

While Switzerland houses what is generally considered one of the best healthcare systems globally, regional policy discrepancies leave undocumented migrants (UDM) in precarious conditions that threaten the nation’s claim to universal health coverage. Critical analyses of existing UDM-catering structures in different cantons, the Swiss Confederation member states, reveal that local discrepancies in healthcare utilization are functional gradients of cantonal support and public endorsement. Relationships with these authorities are instrumental in steering health outcomes not only with program funding and outreach but also management of studies to better understand UDM health determinants and inform future preventative measures.

UDM services and initiatives …

Fixing The System: A Comparative Review Of The United Kingdom, Germany, And United States’ Healthcare Systems And Lessons Learned For Potential Improvements In The United States, Jessica Goddard

Senior Theses

In an effort to provide recommendations to the United States’ considerations of a universal healthcare system, this thesis analyzes the United States healthcare system alongside the sophisticated systems of the United Kingdom and Germany. Literature review and an analysis of 10 health outcomes and indicators guided the framework for a set of interview questions to be asked of healthcare professionals in all three countries. The interview response data was then organized and used to guide the suggested recommendations to the United States in its path towards universal healthcare. While a limited number of solutions could be provided given the time …

Costumbre Y Carnavales; El Rol De Alcohol En La Comunidad Aymara De Putre, Billy White

Independent Study Project (ISP) Collection

Esta investigación tuvo como objetivo evaluar el impacto del alcohol en la comunidad aymara de Putre, localidad rural del norte de Chile. Se realizaron 17 entrevistas semiformales en Putre y sus alrededores con profesionales de la salud de la comunidad, pacientes adultos del CESFAM local, curanderos tradicionales aymaras y líderes comunitarios. El estudio encontró que el consumo de alcohol en Putre está intrínsecamente relacionado con las costumbres y la cultura aymara, ya que su perspectiva sobre el alcohol informa su consumo. El alcohol tiene un papel importante en la religión aymara, la medicina y las fiestas locales. Los hábitos de …

Medicina Tradicional En La Urbe: El Funcionamiento Del Sistema De Salud Mapuche En Santiago, Mariko Yatsuhashi

Independent Study Project (ISP) Collection

En Santiago, Chile, una ciudad con más de 5 millones de personas, el pueblo originario Mapuche ha logrado la reconstrucción de su sistema tradicional de salud para servir la comunidad urbana de la comunidad mapuche. Hoy en día, la mayoría de gente mapuche viven en ambientes urbanos debido a una migración masiva desde su territorio ancestral en el sur, que creó una población distinta de gente mapuche llamada warriache, o gente de la ciudad. Después de una expansión nacional de los derechos básicos de pueblos originarios en los años ‘90, el pueblo originario Mapuche, junto con otros pueblos originarios, podía …

A Dentist's Role In The Delivery Of Culturally Competent Oral Health Care To Transgender Patients, Laura Rhein Dds, Benjamin Solomowitz Dmd, Michael Mand Dds

The New York State Dental Journal

The importance of delivering patient-centered care is understood by professionals across all healthcare fields. But to deliver such patient-centered care involves understanding various patient populations, especially marginalized populations. Rendering non-biased, non-prejudicial care to marginalized populations is irrefutably critical. To do so, it requires understanding the specific needs of these at-risk populations to deliver high quality patient-centered care. The transgender community is one marginalized population that faces inequities in healthcare. This article seeks to examine current literature to reveal such inequities that the transgender population encounters in dental care and to explore the dentist’s role in the delivery of culturally competent …

Lessons Learned From Covid-19, Donald Tucker Dds

The New York State Dental Journal

Dentistry and society, in general, must seek out accurate information regarding the virus and follow scientifically established guidelines to mitigate serious outcomes.

Oral Health Considerations For Aging Patients Living With Hiv/Aids, Madeleine Daily Dds, Susan Liu Dds, Yuna Park Dds, Mph, Ms, Emily Byington Msw, Ivette Estrada Ma, Mphil, Sunil Wadhwa Dds, Carol Kunzel Phd

The New York State Dental Journal

People living with HIV/AIDS (PLWH) have an increased life expectancy due to advances in antiretroviral therapy. In 1996, the life expectancy for a 20-year old living with HIV was 39-years old; today, it is >70-years old. As life expectancy increases, PLWH are burdened with age-associated comorbidities. This paper reviews the interaction between aging and HIV and how it affects social, physical, and oral health issues. The shift in demographics presents new challenges for clinicians in how to identify, address, and manage these complex manifestations. This review summarizes how to approach HIV-related changes when providing care as a dental clinician.

Differences In American Adolescent Sport Participation During The Covid-19 Pandemic By Learning Mode: A National Survey

Faculty, Staff and Student Publications

This study aimed to examine the relation between learning mode with sport participation and compare participation prevalence in different settings by learning mode among United States adolescents during the COVID-19 pandemic. A cross-sectional, national survey was conducted by a market research company (December 2021-January 2022) among parents whose child participated in sports pre-pandemic. Parents were asked about their child's learning mode (in-person, online, hybrid); sports participation (yes/no) during the pandemic; and participation setting (school, community, club/elite). Weighted logistic regression models examined the relation between learning mode with sport participation. Weighted prevalence estimates of participation setting were compared by learning mode. …

Are Human Papillomavirus Knowledge And Vaccine Uptake Associated With Hiv Status And Social Determinants Of Health In Young Sexual Minority Men?, Jacky Kuo, Kayo Fujimoto

Faculty, Staff and Student Publications

This brief report examines the relationship, if any, between human immunodeficiency virus (HIV) status, and individual-level and socio-sexual partner-level factors of social determinants of health (SDOH) that are associated with human papillomavirus (HPV) knowledge and vaccine uptake in young sexual minority men (YSMM). We used data from 126 YSMM recruited by network-based sampling during 2015-2016 in Houston, Texas. Descriptive statistics and regression analyses were conducted to test the association between HIV status, SDOH, and HPV knowledge and vaccine uptake. Those living with HIV had lower odds of knowledge of HPV-associated anal cancer (OR: 0.43, 95% CI: 0.18-0.97) and knowledge of …

“Community Members Have More Impact On Their Neighbors Than Celebrities”: Leveraging Community Partnerships To Build Covid-19 Vaccine Confidence, Maria Tjilos Mph, Autumn L. Tamlyn, Elizabeth J. Ragan Mph, Sabrina A. Assoumou Md, Mph, Katherine Gergen Barnett Md, Petrina Martin Mba, Rebecca Perkins Md, Msc, Benjamin P. Linas Md, Mph, Mari-Lynn Drainoni Phd, Med

Medical Student Research Symposium

Vaccines are a strong public health tool to protect against severe disease, hospitalization, and death from COVID-19. Still, inequities in COVID-19 vaccination rates and health outcomes continue to exist among Black and Latino populations. Boston Medical Center (BMC) has played a significant role in vaccinating medically underserved populations, and organized a series of community-engaged conversations to better understand community concerns regarding the COVID-19 vaccine. We accessed and analyzed nine publicly available recordings of the community-engaged conversations which were held between Mar 2021-Sep 2021 (n=8-122 attendees). We employed a Consolidated Framework for Implementation Research-driven codebook to code our data and utilized …

The Role Of Vigorous And High Intensity Interval Training Physical Activity Counseling In Prenatal Care, Emily Lau, Brendan T. Lynch, Sonia Hassan

Medical Student Research Symposium

Background: Physical activity is becoming a more common component of preventative medicine and patient counseling; however, the prevalence of physical activity counseling and specific social determinants of health have prevented women, namely prenatal patients, from receiving this counseling from their providers¹. Physical activity, including high intensity interval training (HIIT), has been shown to be feasible for implementation in patient counseling³ and shown to be safe for pregnant women, even into the third trimester². We hypothesize that the current percentage of patients, including prenatal patients, being counseled on physical activity is lacking. In addition, we hypothesize …

Editorial: Assessing And Addressing Health Inequities And Disparities: The Role Of Health Informatics, Gulzar H. Shah, Anjum Khurshid, Joanne Chopak-Foss

Health Policy & Community Health: Faculty Publications

No abstract provided.

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Radical Youth Work: A Community Based Approach To Working With Youth, Young Adults And Families, Weston J. Robins

National Youth Advocacy & Resilience Conference

Eternal Strength Center for Radical Youth Work is a blended community center with customizable mental health therapeutic support for youth, young adults and families. Providing humanistic and person centered psychotherapy and counseling, alongside experiential therapies and community engagement we support families and youth struggling with anxiety, depression, substance abuse, self harm, suicidality and other challenges on their developmental growth journey.

A Nationwide Study Of The “July Effect” Concerning Postpartum Hemorrhage And Its Risk Factors At Teaching Hospitals Across The United States, Zahra Shahin, Gulzar H. Shah, Bettye Apenteng, Kristie Cason Waterfield, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

Objective To assess the “July effect” and the risk of postpartum hemorrhage (PPH) and its risk factors across the U.S. teaching hospitals. Method This study used the 2018 Nationwide Inpatient Sample (NIS) and included 2,056,359 of 2,879,924 single live-birth hospitalizations with low-risk pregnancies across the U.S. teaching hospitals. The International Classification of Diseases, Tenth Revision (ICD-10) from the American Academy of Professional Coders (AAPC) medical coding was used to identify PPH and other study variables. Multivariable logistic regression models were used to compare the adjusted odds of PPH risk in the first and second quarters of the academic year vs. …

Determinants Of Child Stunting, Wasting, And Underweight: Evidence From 2017 To 2018 Pakistan Demographic And Health Survey, Maryam Siddiqa, Gulzar H. Shah, Tilicia Mayo-Gamble, Amber Zubair

Health Policy & Community Health: Faculty Publications

Child malnutrition persists in low-resource countries such as Pakistan, indicating an urgent need for interventions and policies aimed to address this critical population health issue. The World Health Organization Global Target 2025 includes the reduction of malnourishment in the form of stunting, wasting, and low weight. This study aims to examine the prevalence of factors associated with three measures of child malnutrition, i.e., stunting, wasting, and low weight in Pakistan. This study uses a secondary data analysis design based on data from Pakistan Demographic and Health Survey (2017-18) that used a two-stage cluster sampling approach. National level data covering urban …

Affective Depression Mediates Ptsd To Suicide In A Sample Of Treatment-Seeking First Responders, James Whitworth, Jeanine Galusha, Jose Carbajal, Warren Ponder, Donna Schuman

Faculty Publications

Objective: The aim of this study was to examine the associations of comorbid

posttraumatic stress disorder (PTSD), affective or somatic depression, and

suicide among first responders (FRs). Method: We used baseline data from

FRs (N = 232) who sought services at a nonprofit mental health agency specializing

in treating trauma exposed FRs. We conducted two PROCESS simple

mediation models with PTSD as the predictor, affective depression and somatic

depression as the mediators, and suicidality as the dependent variable.

Results: Affective depression significantly mediated the relationship between

PTSD and suicidality, whereas somatic depression did not. The direct effect …

Family Caregivers Of Older Adults With Physical Disabilities In Rural Thailand, Denis Tuttle, Jiranan Griffiths, Anuchart Kaunnil

The Qualitative Report

Thailand is one of many countries experiencing changes in the demographics of its population. People are living longer and having fewer children resulting in an increasing percentage of older adults in the general population. This presents a challenge in providing care for older adults, especially in countries where there is a culture of family caregiving. This study aims to investigate the experience of family caregivers, exploring the problems of caring for older people with physical disabilities and the needs of family caregivers. This is done to better understand ways to support caregivers. Using a descriptive qualitative approach, 15 family caregivers …

Portrait De La Santé Et De La Sécurité Agricole Au Québec : Le Cas Des Éleveurs De Porcs, Nancy Beauregard, Alain Marchand, Philippe Fravalo, Marie Archambault, Pascal Thériault, Philippe Roy, Heather Burnett, Pierre Durand

Rapports de recherche scientifique

Pourquoi l’étude Éleveurs de porcs en santé ?

Le secteur agricole au Canada possède un bilan préoccupant en matière de santé et de sécurité du travail. Bien qu’une réduction importante des décès liés à l’agriculture ait été observée ces dernières années, la preuve empirique cumulée montre que ce secteur d’activités demeure à risque eut égard à d’autres indicateurs d’intérêt (p. ex. : santé physique, santé mentale, pratiques de travail sécuritaires). Or, peu d’études en contexte canadien ont cherché à examiner une pluralité de déterminants individuels et environnementaux (c.-à-d. environnement immédiat de travail et son interface avec la famille, contexte lié …

The Current State Of Underrepresented Osteopathic Minorities In Competitive Specialties, Emmanuel Oyalabu, Steve Guzman, Dashon Eure, Ezenna Obilor

Annual Research Symposium

It is well documented that barriers exist for underrepresented minorities to enter the field of medicine and even more competitive residencies. As defined by the NRMP, competitive specialties include but are not limited to Interventional Radiology, Orthopedic Surgery, Plastic Surgery, Radiation Oncology, Vascular Surgery, Neurosurgery, Dermatology, and Otornylogy (NRMP-AMA). A large number of osteopathic medical school graduates have a history of going into primary care specialties because many osteopathic medical schools have a primary care focus (Primary Care- Osteopathic Medicine). The emphasis on primary care, whether intentional or not, can foster a less-than-advantageous environment for underrepresented minority students (URM), pursuing …

The Silent Suffering Of Survivors: The Covid-19 Pandemic's Impact On Domestic Violence Resources, Osoniya I. Wodi

XULAneXUS

Increased reports of domestic violence has coincided with the eruptions and growth of the COVID-19 pandemic. Previous research has shown a positive correlation between domestic violence and the occurrence of humanitarian crises. Recently published research about domestic violence police reports in the COVID-19 pandemic has also supported this correlation. We used data from the National Network To End Domestic Violence (NNEDV) to analyze the number of survivors served by domestic violence programs in the United States, type of resources available, and unmet request from 2019-2021, one year pre-pandemic and the first two years of the pandemic. Findings from this study …

Socioecological Factors Linked With Pharmaceutical Incentive-Driven Prescribing In Pakistan, Muhammad Naveed Noor, Afifah Rahman-Shepherd, Amna Rehana Siddiqui, Wafa Aftab, Sadia Shakoor, Rumina Hasan, Mishal Khan

Department of Pathology and Laboratory Medicine

Pharmaceutical marketing through financial incentivisation to general practitioners (GPs) is a poorly studied health system problem in Pakistan. Pharmaceutical incentivisation is seen to be distorting GPs prescribing behaviour that can compromise the health and well-being of patients. We draw on a conceptual framework outlined in the ecological system theory to identify multiple factors linked with pharmaceutical incentivisation to GPs in Pakistan. We conducted qualitative interviews with 28 policy actors to seek their views on the health system dynamics, how they sustain pharmaceutical incentivisation and their effect on the quality of care. Our analysis revealed four interlinked factors operating at different …

A Focused Review Of Multidimensional Well-Being Assessments, Samantha Schonhardt, Stephanie Sullivan, Rebecca Shisler Marshall

Journal of Wellness

Introduction: Interest in the topic of well-being continues to grow and has resulted in the creation of a variety of well-being assessments. However, each assessment often brings its own terminology, theories, definitions, and dimensions. This creates a muddled research base that produces inconsistencies in the field of well-being. Therefore, the aim of this review was to identify assessments that measure multiple dimensions of well-being, catalogue and group the dimensions into categories, and develop definitions for the categories based on the conceptualizations in the literature. In doing so, the dimensionality of well-being portrayed in the literature can be better understood. …

Age And Racial Disparities In The Utilization Of Anticancer, Antihypertension, And Anti-Diabetes Therapies, And In Mortality In A Large Population-Based Cohort Of Older Women With Breast Cancer

Faculty, Staff and Student Publications

OBJECTIVE: This study examined the receipt of therapies for cancer, hypertension, and diabetes in association with age and racial disparities in mortality among women with breast cancer.

METHODS: This study identified 92,829 women diagnosed with breast cancer at age ≥ 65 years in 2007-2015 with follow-up to 2016 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database.

RESULTS: There were substantial age and racial disparities in the prevalence of hypertension and diabetes, which was higher in women ≥ 75 (86.3% and 32.0%) than younger women 65-74 (72.8% and 29.3%), and the highest in Black women (91.1% and 49.1%), followed …

Association Between E-Cigarette Use Behaviors And Perceived Harmfulness Of E-Cigarettes And Anxiety/Depression Symptoms Among Black/African American Adults, J Michael Wilkerson

Faculty, Staff and Student Publications

Black/African American adults are at greater risk of experiencing negative health outcomes stemming from tobacco use, yet little research has examined e-cigarette use behavior in the Black/African American adult-only population. We examined the association between e-cigarette use behaviors (never, former, and current use) and perceived harmfulness of e-cigarette use and anxiety/depression symptoms among Black/African American adults. This cross-sectional study was a secondary analysis of nationally representative data from the 2011-2020 Health Information National Trends Survey (n = 6,268). Multinomial logit models were used to examine differences in e-cigarette use behaviors (reference group = never used e-cigarettes), given the risk factors …

Sit Less, Move More: A National Study Of Physical-Activity Behavior And Cancer, Stella O. Nwogugu

Dissertations, Theses, and Capstone Projects

Background: Physical activity is associated with lower risks of cancer, the second leading cause of death among Americans. Yet, sedentary behavior is the prevailing lifestyle for about 80% of American adults. Additionally, cancer survivors remain significantly inactive, even though physical activity has been shown to decrease risk of cancer and cancer recurrence, improve tolerance of cancer therapy, and reduce mortality. This research explores the relative impact of personal agency, social support, and key demographic variables on physical-activity behavior for a national sample of adults as well as how these relationships differ for cancer survivors and their counterparts.

Methods: Using the …

Race, Gender, Physical Activity, And Cancer: A Quantitative Investigation, Shawna A. Townsend

Dissertations, Theses, and Capstone Projects

Black women are more likely to die from cancer than any other population in the United States. Physical activity is known to be associated with preventing and reducing cancer burden. However, Black women are less physically active than their White counterparts and have a higher prevalence of diseases related to lack of physical activity than any other female group. To better understand these issues, this study employed the self-and-family management framework and intersectionality as theoretical frameworks through a secondary analysis of the Health Information National Trends Survey (HINTS) dataset and hierarchical regression modeling to examine the relative impact of (a.) …

Effectiveness Of Telemedicine In Diabetes Management: A Retrospective Study In An Urban Medically Underserved Population Area (Umupa), Lisa Ariellah Ward, Gulzar H. Shah, Jeffery A. Jones, Linda Kimsey, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

This paper examines the efficacy of telemedicine (TM) technology compared to traditional face-to-face (F2F) visits as an alternative healthcare delivery service for managing diabetes in populations residing in urban medically underserved areas (UMUPAs). Retrospective electronic patient health records (ePHR) with type 2 diabetes mellitus (T2DM) were examined from 1 January 2019 to 30 June 2021. Multiple linear regression models indicated that T2DM patients with uncontrolled diabetes utilizing TM were similar to traditional visits in lowering hemoglobin (HbA1c) levels. The healthcare service type significantly predicted HbA1c % values, as the regression coefficient for TM (vs. F2F) showed a significant negative association …

Factors In Primary Care Use Among Young Adult Refugees From Burma And Bhutan In Early Resettlement: Findings From Colorado, Sarah Brewer, Jini Puma

Journal of Refugee & Global Health

Background: Young adult refugees have suboptimal primary care use in early resettlement—domains of integration influence primary care engagement during this time.

Methods: Adjusted logistic regression models were used to estimate odds of (1) having a primary care exam and (2) identification of a primary care provider (PCP) as predicted by domains of integration among young adult refugees (n=154) from Burma and Bhutan across four years following resettlement.

Results: Overall integration and predisposing factors, such as language and cultural knowledge, were lower odds of having a primary care provider. Enabling factors such as having insurance and knowing how to make an …

Review Of Alcohol And Drug Treatment For Aboriginal And Torres Strait Islander Peoples, Marguerite Tracy, Bradley Freeburn, Kylie Lee, Julie Woods, Kate Conigrave

Journal of the Australian Indigenous HealthInfoNet

This review provides an overview of treatments for problem alcohol and other drug (AOD) use for Aboriginal and Torres Strait Islander people. It includes information on the available research and discusses core principles for providing treatment. The review outlines how effective mainstream treatment approaches can be adapted to be more suitable for Aboriginal and Torres Strait Islander ways of being or worldview. It also highlights that services, such as those offered by Aboriginal community controlled health organisations are in a unique position to offer culturally secure treatment approaches. The barriers to accessing treatment are discussed as well as recommendations for …