Community Health and Preventive Medicine Commons^™

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 …

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 …

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 …

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 …

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 …

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.

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.

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 …

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 …

Differences In American Adolescent Sport Participation During The Covid-19 Pandemic By Learning Mode: A National Survey, Ashleigh M Johnson, Gregory Knell, Timothy J Walker, Emily Kroshus

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?, Trisha L Amboree, Alan G Nyitray, John Schneider, Nick Gargurevich, Jacky Kuo, Elizabeth Y Chiao, Lu-Yu Hwang, 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 …

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.

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 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 …

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, Xianglin L Du, Lulu Song

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, David Adzrago, Kayo Fujimoto, Melissa B Harrell, Antwan Jones, 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 …

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.) …

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 …

Community Facing Athletic Trainer, Eric Post

2022 Fall Reports (Marshall, IL)

In an initial planning meeting with Marshall Mayor John Hasten, the mayor identified the potential need for an athletic trainer to serve as a community-facing health professional within the Marshall community in order to provide access to highquality injury prevention, evaluation, and care. The agreed-upon objectives for this project were to: ● Perform a needs assessment to determine the potential costs and resources necessary to provide a community-facing athletic trainer within the Marshall community. ● Share perspectives on how athletic trainers can provide services to serve the health needs in the Marshall community. ● Determine the best strategies for providing …

Health Behavior And Outlooks In An Altered Microbial Diversity: Changes In Parental Attitudes On ‘Building Immunity’ Throughout The Covid-19 Pandemic, Jennifer Vidal

Pitzer Senior Theses

The Covid-19 Pandemic in a short amount of time put into action disease control measures. Current literature has sought to address the long-term effects of sanitization efforts and social isolation on the diversity of the microbiome and the future of infectious diseases. Microbes – microorganisms such as bacteria, protozoa, algae, fungi, and viruses – inhabit the natural environment and human microbiome with our immune system, playing an essential role in immune regulation. The interplay between humans and microbes forms early immune development that has impacted parents’ attitudes toward microbes shown through their participation in Covid-19 preventative health practices. Using the …

Expanding Medicaid To Reduce Human Immunodeficiency Virus Transmission In Houston, Texas: Insights From A Modeling Study, Francis Lee, Aditya S Khanna, Camden J Hallmark, Richa Lavingia, Marlene Mcneese, Jing Zhao, Melanie L Mcneese, Salma Khuwaja, Babak M Ardestani, Nicholson Collier, Jonathan Ozik, Anna L Hotton, Nina T Harawa, John A Schneider, Kayo Fujimoto

Faculty, Staff and Student Publications

CONTEXT: Medicaid expansion has been nationally shown to improve engagement in the human immunodeficiency virus (HIV) treatment and prevention continua, which are vital steps to stopping the HIV epidemic. New HIV infections in the United States are disproportionately concentrated among young Black men who have sex with men (YBMSM). Houston, TX, is the most populous city in the Southern United States with a racially/ethnically diverse population that is located in 1 of 11 US states that have not yet expanded Medicaid coverage as of 2021.

METHODS: An agent-based model that incorporated the sexual networks of YBMSM was used to simulate …

Genetic Associations Between Sleep Traits And Cognitive Ageing Outcomes In The Hispanic Community Health Study/Study Of Latinos, Yuan Zhang, Michael Elgart, Einat Granot-Hershkovitz, Heming Wang, Wassim Tarraf, Alberto R Ramos, Ariana M Stickel, Donglin Zeng, Tanya P Garcia, Fernando D Testai, Sylvia Wassertheil-Smoller, Carmen R Isasi, Martha L Daviglus, Robert Kaplan, Myriam Fornage, Charles Decarli, Susan Redline, Hector M González, Tamar Sofer

Faculty, Staff and Student Publications

BACKGROUND: Sleep phenotypes have been reported to be associated with cognitive ageing outcomes. However, there is limited research using genetic variants as proxies for sleep traits to study their associations. We estimated associations between Polygenic Risk Scores (PRSs) for sleep duration, insomnia, daytime sleepiness, and obstructive sleep apnoea (OSA) and measures of cogntive ageing in Hispanic/Latino adults.

METHODS: We used summary statistics from published genome-wide association studies to construct PRSs representing the genetic basis of each sleep trait, then we studied the association of the PRSs of the sleep phenotypes with cognitive outcomes in the Hispanic Community Healthy Study/Study of …

Crime, Illness, & Abolition: An Exploration Through The Connective Tissue Within The Pic/Mic Matrix, Laila Kent

Scripps Senior Theses

This two part zine illuminates the shared mechanisms that construct and respond to ‘crime’, also define and treat illness in the US. Part 1 uncovers the status quo of our prison and health care system via the emergence of the The Prison-Industrial Complex (PIC), and The Medical-Industrial Complex (MIC). Through an exploration of the respective and overlapping histories, logics, and realities underlying the function of these systems, the mechanisms of individualism, objectification, and profiteering become strikingly clear. Part 2 breaks free of the status quo outlined in Part 1 by introducing abolition as the vision and strategy to heal from …

Still, We Thrive: Understanding How Gay, Bisexual, Transgender, And Other Men Who Have Sex With Men (Gbtmsm) Experience Structural Barriers & Facilitators To Wellness, Lucas Gergyek

Theses and Dissertations (Comprehensive)

Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, …