Conspiracy Theories Are Not Religions: Scrutinizing Religious Exemptions To The Covid-19 Vaccine, Shirley B. Luk

University of San Francisco Law Review

No abstract provided.

Observational Study Of The Clinical Performance Of A Public-Private Partnership National Referral Hospital Network In Lesotho: Do Improvements Last Over Time?, Nancy A. Scott, Jeanette L. Kaiser, Brian W. Jack, Elizabeth L. Nkholongo, Allison Juntunen, Tshema Nash, Mayowa Alade, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Public-private partnerships (PPP) may increase healthcare quality but lack longitudinal evidence for success. The Queen ‘Mamohato Memorial Hospital (QMMH) in Lesotho is one of Africa’s first healthcare PPPs. We compare data from 2012 and 2018 on capacity, utilization, quality, and outcomes to understand if early documented successes have been sustained using the same measures over time. In this observational study using administrative and clinical data, we assessed beds, admissions, average length of stay (ALOS), outpatient visits, and patient outcomes. We measured triage time and crash cart stock through direct observation in 2013 and 2020. Operational hospital beds increased from 390 …

Covid-19 Youth Ambassador Corp, A Community-Based Program To Address Vaccine Hesitancy, Atoosa Azarang

Master's Projects and Capstones

With over one million confirmed deaths from COVID-19, the United States (U.S.) continues to battle the public health crisis arising from the spread of the SARS-CoV-2 virus. The COVID-19 pandemic has had a devastating impact on our economic, social, and health systems. Social distancing efforts and other precautionary measures such as mask-wearing have not sufficiently reduced morbidity and mortality from COVID-19; thus, COVID-19 vaccinations are an important tool for substantially alleviating the effects of the pandemic. Although COVID-19 vaccines are available to all Americans aged six months and older, many individuals are hesitant to receive vaccines. The two most common …

Tobacco Policy Reform: Ending The Youth And Young Adult Tobacco Epidemic, Rocio Arjon

Master's Projects and Capstones

Tobacco has been accessible to communities all over the world since 6,000 BC. Overtime, the tobacco industry adapted its products to become more modern and look like technology or taste like common foods and candy. In 1989 the California Department of Public Health organized the California Control Tobacco Program (CTCP) which funds many local jurisdictions in California to provide tobacco education to community members and pass local ordinance to protect the health of their community. This paper is examining the existing policies in Hollister to protect our children and young adults, end the tobacco epidemic, advocate for more comprehensive tobacco …

Interventions To Support Teen Mothers In California And Reduce The Disparities Related To The Effects Of Teen Pregnancy, Shanelle Christine Sanchez

Master's Projects and Capstones

The US teen birth rate has slowly been declining; however, teenage pregnancy is still prevalent. In 2018 the US teen birth rate was 17.4 births per 1,000 girls aged 15-19 years, totaling 179,871 births (National Vital Statistic Report). California’s most recent birth rate was 13.6 births per 1,000 girls aged 15-19 years in 2020 (CDC, 2020). Few studies focus on teen mothers’ health, life needs, and outcomes as a result of adolescent pregnancy and subsequently, adolescent parenting. Additionally, few studies have looked at the cultural differences and views of adolescent pregnancy and parenting within the Hispanic population, which are greatly …

Reframing Culturally Competent Care To Improve Mental Health Outcomes Among African Americans, Jaelen Kennedy-Valdez

Master's Projects and Capstones

African Americans are continuously disadvantaged when it comes to interacting with mental health services which has been evident in the utilization of services, treatment engagement, and quality of services compared to their White counterparts (Alang, 2019). Many researchers and providers have called for culturally competent care and tailored treatment for African Americans to address barriers to access and quality of health care (Alang, 2019). In this paper, a systematic review will be conducted to assess several models that have been integrated in the U.S. healthcare settings and services. In addition, we will define the components of culturally competent care and …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Reducing The Digital Divide: Why Culturally Relevant Ehealth Interventions Can Reduce Latino Health Disparities, Blanca Flor Garcia-Silva

Master's Projects and Capstones

Objectives: This paper systematically reviews the recent literature on incorporating culturally relevant material in electronic health (eHealth) tools for Latinos. Latinos are a fast-growing ethnic population set to reach 119 million individuals by 2060 (Velasco-Mondragon et al., 2016). Latinos are also disproportionately affected by comorbidities and other poor health outcomes. Developing a culturally sensitive eHealth tool can lead to positive health outcomes among Latinos. Methods: Peer-reviewed articles and analyses were extracted to identify whether eHealth was associated with positive health outcomes among Latino adults. Four literature databases were used to extract English-language articles published from 2001 to 2022. …

Sexual And Reproductive Health Care For Undocumented Californians: Universal Health Care & Reproductive Justice, Josephine Emily Roberts

Master's Theses

Universal Health Care can hardly be achieved if the Sexual Reproductive Health needs of a population are not met. In other words, Sexual and Reproductive Health and Universal Health Care are mutually reinforcing, and the state of California should consider this when implementing Medi-Cal health care for all Undocumented Californians. In 2016, California implemented an extension of Medi-Cal treatment to undocumented children up to 26 years of age. Comparable to the United States Federal Medicaid program aimed to help cut health care costs for low-income and vulnerable populations, Medi-Cal offers some coverage for emergency medical services to undocumented individuals of …

How Environmental Change Will Impact Mosquito-Borne Diseases, Arsal Khan

Master's Projects and Capstones

Mosquitos, the most lethal species throughout human history, are the most prevalent source of vector-borne diseases and therefore a major global health burden. Mosquito-borne disease incidence is expected to shift with environmental change. These changes can be predicted using species distribution models. With the wide variety of methods used for models, consensus for improving accuracy and comparability is needed. A comparative analysis of three recent modeling approaches revealed that integrating modeling techniques compensates for trade-offs associated with a singular approach. An area that represents a critical gap in our ability to predict mosquito behavior in response to changing climate factors, …

Integrating Culturally Tailored Interventions To Increase Cervical Cancer Screening: A Quality Improvement Initiative In A Primary Care Clinic, Marife Centeno Solomon

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: While the incidence of cervical cancer in the US has significantly decreased due to the utilization of vaccination and screening tests, Asian, Native Hawaiian, and other Pacific Islander women consistently have the lowest rate of cervical cancer screening, making them at risk for undetected cervical cancer disease.

Problem: The low cervical cancer screening uptake can be attributed to a knowledge deficit about cervical cancer and its screening and the importance of early detection. Being an immigrant and with limited English proficiency can hinder women of Asian, Native Hawaiian, and other Pacific Islander from getting screened for cervical …

What Should Ethical And Strategic Employers Do About Covid-19 Vaccines?, Dale B. Thompson, Susan A. Suspina, Katherina G. Pattit, Dawn R. Swink

University of San Francisco Law Review

No abstract provided.

Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …

Guiding Change: A Multidisciplinary Framework For Interventions Addressing Systemic Racism In Healthcare, Lavette D. King

Master's Projects and Capstones

The relationship between systemic and institutional racism in the U.S., and health outcomes in people of the African Diaspora have been well documented (Bailey et al., 2017). Distrust in the healthcare system is the result of generational trauma compounded by an ongoing issue that has yet to be fully addressed (Scharff et al., 2015). For decades people of African descent have expressed concern about negative experiences with the U.S. healthcare system. Often the encounters leave them feeling, mistreated, unheard and or criminalized. These feelings result in trepidation over using the healthcare system which often further compounds health issues (Washington, 2008). …

Strategies For Addressing Vaccination Disparities And Rates In The U.S Among Racial/Ethnic Minority Adults, Harpreet Kaur

Master's Projects and Capstones

As new and emerging infectious diseases surface, public health officials are working harder to close the immunization gap. Every year, thousands of adults in the U.S suffer adverse health outcomes and die from vaccine-preventable diseases. The COVID-19 pandemic has reminded us of the power of vaccines as they have been able to eradicate diseases, save lives, and create healthier communities. A literature review was conducted to identify the gaps in research as it relates to vaccine disparities among racial/ethnic adult populations.

The literature indicates that ethnic/racial minorities are at disproportionate risk for vaccine-preventable diseases and data has shown increasingly high …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

California's Master Plan For Aging, Health Reimagined: A Case For Seniors To Age-In-Place, Remonia A. Bowie

Master's Projects and Capstones

Abstract

In 2021 Worldwide, communities face a singular yet common challenge; and this is the significant aging of their senior adult populations. Current evidence from the literature suggests that older adults prefer to stay in their homes as they age. However, the facilitators and challenges older people encounter in realizing their aging goals have been inadequately addressed by the current body of literature given the projected increase in the number of older people in the United States preferring to age from their homes. Aging adults are vulnerable to daily frustration, which could negatively impact their aging process. However, knowledge of …

Mental Health Outcomes Of Various Types Of Fear Among University Students Who Have An Undocumented Legal Status During The Donald Trump Presidency, Liliana Campos

Doctoral Dissertations

Having an undocumented legal status is a risk factor for mental health conditions such as depression and anxiety among university students. Much of the literature on the experiences of university students who hold an undocumented legal status has primarily focused on better understanding the educational, social, financial, and legal challenges among undergraduate students. The literature has addressed how some of these difficulties impact components of their social and mental health wellness. Yet, there is still a dearth of research focused on further understanding the experiences of students who hold an undocumented legal status from a psychological perspective, and specifically, with …

Improving Vaccination Uptake In The Latinx Community Through Standardized Outreach, Vanessa M. Arteaga

Master's Projects and Capstones

Vaccine hesitancy during the COVID-19 pandemic has been an issue in the Latinx and Black community since the initial discussions of the emergency use of the experimental Moderna and Pfizer vaccines. The aim of this project is to standardize the patient outreach process to increase COVID-19 vaccine uptake. Patients at a community clinic in Oakland have expressed hesitance of the COVID-19 vaccine. They also exhibited increased frustration with the staff who are contacting them to schedule vaccine appointments and provide information. This resulted in refusal of the vaccine and less than desirable number of vaccine appointments. The objective of this …

Understanding The Significance Of Virtual Support During Global Pandemic In Young Adults Diagnosed With Hepatitis C, Veronika Arkhipova

Master's Projects and Capstones

Hepatitis C is a viral infection that attacks the liver and leads to inflammation. In recent years, the prevalence of hepatitis C infections among 20 and 30 years of age has increased by 300 percent, and between 30 and 39 years by 400 percent. Due to the global coronavirus pandemic, people diagnosed with Hepatitis C have lost access to mental health services and resources, including in-person meetings with support groups. Since most states enforced stay-at-home order, many community centers, non-profit organizations that work with Hepatitis C patients and the affected population provide limited to no access to support group meetings …

Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek

DNP Qualifying Manuscripts

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.

Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …

Identifying And Structuring Long-Term Community Engagement Platforms For San Francisco's Ending The Hiv/Hcv/Sti Epidemics Initiative, Adam Landeros

Master's Projects and Capstones

Purpose: The primary objective for this project was to develop recommendations for a long-term community engagement structure and process for the ten-year implementation of the San Francisco Department of Public Health’s Ending the HIV/HCV/STI Epidemics initiative.

Background: Community engagement offers public health practitioners, researchers, and policymakers the opportunity for open, respectful dialogue with community members in pursuit of a common goal. This project was designed to explore different community engagement coordinators’ experiences with undertaking such initiatives, in order to inform a large-scale funding proposal being pursued by the San Francisco Department of Public Health (SFDPH).

Methods: Phase 1 of the …

Con Confianza: Using Community-Based Participatory Research Principles To Inform Community-Academic Partnership Practices And Build Trust In Hispanic Communities, Sharon Tafolla

Master's Projects and Capstones

Hispanic communities are at disproportionate risk for chronic diseases and researchers have cited the need for further community and culturally informed studies to improve research outcomes to either make treatments and interventions more generalizable or modify them to the needs of Hispanic communities. However, many of the same linguistic and cultural barriers to health care access and utilization also impact the ability for Hispanic groups to participate in research studies. Community Academic Partnerships (CAPs) are positioned to conduct culturally and linguistically competent research in Hispanic communities. For research in Hispanic communities to be effective, CAPs must prioritize practices that build …

Promoting Community Engagement Through Basic User Tutorial Of Epa Geospatial Screening Tools, Jonas Nguyen

Master's Projects and Capstones

Social inequalities are riddled with health disparities and outcomes leading toward lower life expectancy. Communities of color, low income, and rural neighborhoods lack the voice and resources to effectively oppose industrial settlement which would likely lead to the release of toxic wastes into the water, air and ground ultimately affecting residential health. Empowering members through community engagement is a relatively new strategic process where researchers are finding mutual benefits in design, implementation, and results. This study aims to identify and promote tools for community engagement within the scope of environmental justice by working with EPA geospatial screening tools and designing …

A Qualitative Exploration Of Community Ownership Of A Maternity Waiting Home Model In Rural Zambia, Constance P. Fontanet Mph, Rachel M. Fong, Jeanette L. Kaiser, Misheck Bwalya, Thandiwe Ngoma, Taryn Vian, Godfrey Biemba, Nancy A. Scott

Nursing and Health Professions Faculty Research and Publications

Context

Ownership is an important construct of sustainability for community-based health programming, though it is often not clearly defined or measured. We implemented and evaluated a community-driven maternity waiting home (MWH) model in rural Zambia. We engaged stakeholders at all levels and provided intensive mentorship to an MWH governance committee comprised of community-selected members. We then examined how different stakeholders perceive community ownership of the MWH.

Methods

We conducted 42 focus group discussions with community stakeholders (pregnant women, fathers, elders, and community health volunteers) and 161 in-depth interviews with MWH stakeholders (health facility staff, district health officials, and MWH governance …

Plant-Powered: A Digital Plant-Based Nutrition Intervention For Low-Income Patients With Type Ii Diabetes, Ellen Pelos

Master's Projects and Capstones

Purpose: This project aimed to measure the acceptability and feasibility of plant-based diets among low-income individuals with type II diabetes at the Samaritan House Food Pharmacy and to create a user-centered pilot program to encourage the adoption of a plant-based diet.

Background: Plant-based diets are effective for preventing, treating, and reversing type II diabetes, but there is not much evidence about the acceptability and feasibility of these diets.

Methods: Focus groups were used to gather qualitative data about the acceptability and feasibility of plant-based diets in the target population. The researcher conducted interviews with Food Pharmacy program leaders to learn …

Black Pregnancy Matters: Racial Reproductive Bias In African American Maternal Mortality, Juhi Khemani

Master's Projects and Capstones

This semester-long research project uncovers how racial biases demonstrated in the reproductive health field, and specifically before, during, and after childbirth, affect the rate of maternal mortality and morbidity for African American mothers in the United States. The rate of maternal mortality for this specific racial group is four times greater as compared to Caucasian women and this discrepancy will be investigated and analyzed throughout this capstone thesis. Interviews were conducted with key figures in the obstetric and gynecological field as well as with Black mothers themselves in an effort to uncover what factors, aside from medical anomalies, are leading …

The Expansion And Evaluation Of Medication Assisted Treatment Services For An Underserved Rural Northern California Community, Carolyn Perrotti

DNP Qualifying Manuscripts

Problem: Widespread opioid misuse has led to the opioid epidemic that claims 130 deaths per day due to an opioid overdose (CDC, 2018). The opioid epidemic has plagued the United States for three decades and has been considered a public health emergency since 2017 (HHS, 2017). Rural communities are disproportionately affected by this problem and in 2014, the rate of opioid overdose deaths was 45% higher in rural communities (SAMHSA, 2018).

Context: Medication-assisted treatment (MAT) is considered the most effective treatment for opioid dependence because it incorporates medication management and biopsychosocial supports (Jones et al., 2018). Retention in a MAT …

Initiating Prep In Primary Care: Addressing The Adolescent And Young Adult High Risk Populations, Igor G. Mocorro

Doctor of Nursing Practice (DNP) Projects

Problem: Adolescents and young adults (AYA) ages 13 to 24 comprise a quarter of the new HIV diagnoses in the United States. Lack of access to HIV-preventive therapies such as pre-exposure prophylaxis (PrEP) reduces opportunities to prevent HIV infection in this population. Initiating PrEP in AYA significantly reduces the negative health outcomes of HIV, but it is evident that many clinicians are still reluctant to initiate PrEP in AYA patients based on perceived threats and barriers.

Context: Primary care clinics, including school-based clinics, have an opportunity to offer HIV prevention services including PrEP. This project, the Adolescent and Young Adult …

Evaluating Implementation Effectiveness And Sustainability Of A Maternity Waiting Homes Intervention To Improve Access To Safe Delivery In Rural Zambia: A Mixed-Methods Protocol, Elizabeth G. Henry, Thandiwe Ngoma, Jeanette L. Kaiser, Rachel M. Fong, Taryn Vian, Davidson H. Hamer, Peter C. Rockers, Godfrey Biemba, Nancy A. Scott

Nursing and Health Professions Faculty Research and Publications

Background: In low-income countries such as Zambia, where maternal mortality rates are persistently high, maternity waiting homes (MWHs) represent one potential strategy to improve access to safe delivery, especially for women living in remote areas. The Maternity Homes Access in Zambia project (MAHMAZ) is evaluating the impact of a MWH model on women’s access to safe delivery in rural Zambia. There is a growing need to understand not only the effectiveness of interventions but also the effectiveness of their implementation in order to appropriately interpret outcomes. There is little evidence to guide effective implementation of MWH for both immediate uptake …