Community Health and Preventive Medicine Commons^™

Neighborhood Environment And Poor Maternal Glycemic Control-Associated Complications Of Gestational Diabetes Mellitus, Leela V. Thomas, Claudine T. Jurkovitz, Zugui Zhang, Mitchell R. Fawcett, M. James Lenhard

Department of Medicine Faculty Papers

INTRODUCTION: Risk of complications due to gestational diabetes mellitus is increasing in the U.S., particularly among individuals from racial minorities. Research has focused largely on clinical interventions to prevent complications, rarely on individuals' residential environments. This retrospective cohort study aims to examine the association between individuals' neighborhoods and complications of gestational diabetes mellitus.

METHODS: Demographic and clinical data were extracted from electronic health records and linked to American Community Survey data from the U.S. Census Bureau for 2,047 individuals who had 2,164 deliveries in 2014-2018. Data were analyzed in 2021-2022 using Wilcoxon rank sum test and chi-square test for bivariate …

Determining Bystander Motivations And Hesitations To Intervene During An Opioid Overdose Event, John Wahlstedt, Alana Platukus, Eric Fei, Yasmine Eichbaum, Noah Streitfeld, Robert S. Pugliese, Kelly Kehm

Alpha Omega Alpha Research Symposium Posters

Background

Harm reduction initiatives have been shown to improve morbidity and mortality of overdose; however, the rate of death due to opioid overdose continues to rise in Philadelphia. One aspect of the overdose scenario that requires more focus is the response of witnesses to overdose.

The Philadelphia Lung Cancer Learning Community: A Multi-Health-System, Citywide Approach To Lung Cancer Screening, Julie A. Barta, Cherie P. Erkmen, Christine S. Shusted, Ronald E. Myers, Chelsea Saia, Sarah Cohen, Jocelyn Wainwright, Charnita Zeigler-Johnson, Farouk Dako, Richard Wender, Gregory C. Kane, Anil Vachani, Katharine A. Rendle

Division of Pulmonary and Critical Care Medicine Faculty Papers

Background

Lung cancer screening uptake for individuals at high risk is generally low across the United States, and reporting of lung cancer screening practices and outcomes is often limited to single hospitals or institutions. We describe a citywide, multicenter analysis of individuals receiving lung cancer screening integrated with geospatial analyses of neighborhood-level lung cancer risk factors. Methods

The Philadelphia Lung Cancer Learning Community consists of lung cancer screening clinicians and researchers at the 3 largest health systems in the city. This multidisciplinary, multi-institutional team identified a Philadelphia Lung Cancer Learning Community study cohort that included 11 222 Philadelphia residents who …

Differentials And Predictors Of Food Insecurity Among Federally Qualified Health Center Target Populations In Philadelphia: A Cross-Sectional Study, Galicano Kai Inguito, Brandon Joa, James Gardner, Eric N Fung, Laura Layer, Karen Fritz

Department of Medicine Faculty Papers

BACKGROUND: Over the past decade, the prevalence of food insecurity declined in the United States but curiously climbed in Philadelphia, Pennsylvania, a sizable metropolitan area where many households experience food insecurity and are dependent on programs like SNAP. Therefore, we aimed to determine the burden of food insecurity among populations near Philadelphia Federally Qualified Health Center (FQHC) clinic sites.

METHODS: This cross-sectional study was conducted in North Philadelphia, a populous and impoverished section of Philadelphia with many zip codes reporting 30-45% or more of the population below the federal poverty line. Students and clinicians affiliated with a local FQHC conducted …

The Prescription Drug Monitoring Program In A Multifactorial Approach To The Opioid Crisis: Pdmp Data, Pennsylvania, 2016–2020, Jenna R. Adalbert, Amit Syal, Karan Varshney, Brandon George, Jeffrey Hom, Asif M. Ilyas

College of Population Health Faculty Papers

Background: Prescription opioids remain an important contributor to the United States opioid crisis and to the development of opioid use disorder for opioid-naïve individuals. Recent legislative actions, such as the implementation of state prescription drug monitoring programs (PDMPs), aim to reduce opioid morbidity and mortality through enhanced tracking and reporting of prescription data. The primary objective of our study was to describe the opioid prescribing trends in the state of Pennsylvania (PA) as recorded by the PA PDMP following legislative changes in reporting guidelines, and discuss the PDMP's role in a multifactorial approach to opioid harm reduction.

Methods: State-level opioid …

Parental Perceptions Of The Hpv Vaccine For Prevention Of Anogenital And Oropharyngeal Cancers, Beth I. Schwartz, Merissa Maccani, Shalini Bansal, Meghan Gannon

Department of Obstetrics and Gynecology Faculty Papers

Background and Objectives

Human papillomavirus (HPV) is implicated in the development of both anogenital and oropharyngeal cancers. Although HPV vaccination prevents the majority of anogenital and head and neck cancers (HNC), vaccination rates remain low, especially among males. Known barriers to vaccination are knowledge gaps and vaccine acceptability. The objective of this study is to explore parental knowledge, perceptions, and decision-making processes about HPV and HPV vaccination for both anogenital and HNC.

Methods

This qualitative study recruited parents of children and adolescents aged 8–18 to participate in semi-structured telephone interviews. Data were analyzed using thematic analyses, informed by an inductive …

I Don't Believe A Person Has To Die When Trying To Get High: Overdose Prevention And Response Strategies In Rural Illinois, Suzan M. Walters, Marisa Felsher, David Frank, Jessica Jaiswal, Tarlise Townsend, Brandon Muncan, Alex S. Bennett, Samuel R. Friedman, Wiley Jenkins, Mai T. Pho, Scott Fletcher, Danielle C. Ompad

College of Population Health Faculty Papers

BACKGROUND: Overdose is a leading cause of morbidity and mortality among people who inject drugs. Illicitly manufactured fentanyl is now a major driver of opioid overdose deaths.

METHODS: Semi-structured interviews were conducted with 23 participants (19 persons who inject drugs and 4 service providers) from rural southern Illinois. Data were analyzed using constant comparison and theoretical sampling methods.

RESULTS: Participants were concerned about the growing presence of fentanyl in both opioids and stimulants, and many disclosed overdose experiences. Strategies participants reported using to lower overdose risk included purchasing drugs from trusted sellers and modifying drug use practices by partially injecting …

Assessing The Effect Of Four Types Of Direct Mail Messages To Promote The Uptake Of Residential Lead Remediation Funds, H. Okatch, B. Nkala, J. Beltrami, E. Poy, D. Parmer, J. Nkala, F. Olawole

College of Population Health Faculty Papers

Objective

To examine the efficacy of direct mailing using four types of messaging on promoting the uptake of residential lead remediation (RLR) funds in Lancaster, PA, USA.

Study design

We designed a quasi-experiment to assess the effect of 4 RLR messages sent to households in Lancaster, PA by direct mail between September and December 2020: a brief flyer (F); a detailed brochure + the flyer (BF); a health infographic + the flyer (IF); and an application form + the flyer (AFF).

Methods

Mailers were sent to addresses in four census tracts; each census tract received a different message. Both English …

Implementation And Outcomes Of A Remote Hepatitis B Screening Program Designed To Overcome Covid-19 Pandemic-Related Disruptions To Community-Based Screenings For Asians In Greater Philadelphia: A Descriptive Study, Yoonhee P Ha, Yusha Sun, Jack Wilkinson, Sonia Wang, Lillian Chien, Marisa Wu, Evangeline Wang, Catherine Freeland

College of Population Health Faculty Papers

No abstract provided.

Looking Upstream: Promoting Health Equity In Philadelphia Through Novel Partnership Strategies, Adrea Cope, David B. Nash, Sandra E Brooks, David Platt

College of Population Health Faculty Papers

No abstract provided.

A Mixed Methods Case Study Of Food Shopping In A Community With High Infant Mortality, Sarah Evenosky, Eleanor Lewis, Katherine Isselmann Disantis

College of Population Health Faculty Papers

In the U.S., preterm birth disproportionately impacts certain racial/ethnic groups, with Black women experiencing preterm birth at a rate 50% higher than other groups. Among the numerous factors that likely contribute to these increased rates are neighborhood characteristics, such as food environment. In this mixed-methods case study, we evaluated how pregnant women living in a predominately minority, lower income community with high preterm birth rates navigate and perceive their food environment. Qualitative interviews were performed to assess perceptions of food environment (n = 7) along with geographic and observational assessments of their food environment. Participants traveled an average of 2.10 …

Virtual Community Health Workers: Outreach Calls During Covid-19, Geoffrey Hayden, Md, Paula Ostroff, Rn, Ms, Emily Romano, Bs, Imani Gray-Taylor, Carl Johnson, Bs, Angelique Miller, Sharla Thomas, Ba, Gina Mccoy, Bs, Deborah Ziring, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

The “Clinical Experience” program at the Sidney Kimmel Medical College, established in 2017, provides pre-clerkship students with an opportunity to identify and address patients’ needs for social determinants of health (SDoH). The COVID-19 pandemic led to a suspension of the student program in the clinical environment, but the CHWs continued to address patients’ social needs from a remote setting. In the absence of established best practices regarding patient outreach calls from a remote setting, we sought to develop an effective workflow that would mask the CHWs’ personal cell phones while leading to fewer “unable to reach” scenarios and improved case …

Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Ellen Solomon, Oluwatoni Okuboyejo, Shandon Coffman, Brandon Joa, Bon Ku, Md, Mpp

Phase 1

Background: Designing South Philadelphia’s first permanent healthcare facility dedicated to refugee health presents a unique opportunity to integrate cultural sensitivity with principles of community health. Design thinking (human-centered design) is a promising strategy to address health and social justice concerns through the development of innovative products and services that prioritize population needs. This project utilized design thinking to inform suggestions to the design of Hansjörg Wyss Wellness Center that promote a culturally sensitive and welcoming environment in order to improve healthcare outcomes for the refugee population in Philadelphia.

Methods: Standard qualitative data gathering methods were used to gather insight into …

A Photovoice Project With Latino Youth In Easten North Philadelphia, Maria F. Arisi, Vincent Pepe, John Mckeegan, Caleb Dafilou, Mph, Rickie Brawer, Mph, Phd

Phase 1

Introduction: Eastern North Philadelphia is home to both the highest density Latino population in Philadelphia and some of the poorest health measures of the city. This Latino population is known to face a multitude of barriers to health, such as high rates of poverty, low educational attainment, and language barriers. There is little data showing what the self-identified priority needs of these Latino populations are, and even less showing the needs of Latino youth. Understanding how youth perceive the impact of their social and built environments can bring attention to the issues that the community needs addressed.

Methods: We conducted …

Applying Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Brandon Joa, Ellen Solomon, Oluwatoni Okuboyejo, Shandon Coffman, Bon Ku, Md, Mpp

Phase 1

Purpose: This case study demonstrates the application of design thinking to the process of building a culturally sensitive health center for refugees and immigrants.

Background: Refugee communities present a growing underserved population. Designing South Philadelphia’s first permanent healthcare facility dedicated to immigrant and refugee health presents a unique opportunity to integrate cultural sensitivity with principles of community health. Design thinking is a promising yet underutilized strategy for addressing health and social justice concerns in an efficient way that improves both provider and patient satisfaction. A project was conducted to utilize design thinking to make suggestions to the design of Hansjörg …

Applying Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Oluwatoni Okuboyejo, Ellen Solomon, Shandon Coffman, Brandon Joa, Bon Ku, Md, Mpp

Phase 1

Background: Designing South Philadelphia’s first permanent healthcare facility dedicated to immigrant and refugee health presents a unique opportunity to integrate cultural sensitivity with principles of community health. Philadelphia is a city saturated with many medical institutions and hospitals, yet there are large health disparities within miles of each other. Bringing together healthcare providers with a common goal of improving community health needs from a cultural standpoint can be tasking, even when all are on the same page. Design thinking is an underexplored perspective that has the potential to address these concerns in an efficient way that improves both provider and …

Identifying The Health Needs Of The East North Philadelphia Latino Youth Via Photovoice, Vincent Pepe, Maria F. Arisi, John Mckeegan, Caleb Dafilou, Mph, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: The East North Philadelphia community contains the city’s largest Latino population, most of whom are of Puerto Rican and Dominican descent. This community in particular has unique health needs compared to the rest of the city of Philadelphia, with rates of diabetes (22.9%), asthma (28.6%), and poverty (45.5%) exceeding the national and city averages. Documenting the perceived needs of the children living here regarding their built environment will provide insight into the problems onto which the community at large needs to focus. This study aims to determine the priority needs of the community and to empower the youth …

Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Shandon Coffman, Oluwatoni Okuboyejo, Ellen Solomon, Brandon Joa, Bon Ku, Md, Mpp

Phase 1

Background: South Philadelphia has a growing immigrant and refugee population, increasing the need for a healthcare facility dedicated to refugee health that integrates cultural sensitivity with principles of community health. Design thinking (human-centered design) is a promising strategy to address health and social justice concerns through the development of innovative products and services that prioritize population needs. This project utilized design thinking to inform suggestions to the design of Hansjörg Wyss Wellness Center that promote a culturally sensitive and welcoming environment in order to improve healthcare outcomes for the refugee population in Philadelphia.

Methods: Standard qualitative data gathering methods were …

Do Employees From Less-Healthy Communities Use More Care And Cost More? Seeking To Establish A Business Case For Investment In Community Health., Russell K. Mcintire, Martha C. Romney, Greg Alonzo, Jill Hutt, Lauren Bartolome, Greg Wood, Gary Klein, Neil I. Goldfarb

College of Population Health Faculty Papers

INTRODUCTION: Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities.

METHODS: We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel …

Health Literacy: Cancer Prevention Strategies For Early Adults., Robert Simmons, Susan C. Cosgrove, Martha C. Romney, James D. Plumb, Rickie O. Brawer, Evelyn T. Gonzalez, Linda G. Fleisher, Bradley S Moore

College of Population Health Faculty Papers

Health literacy, the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make health decisions, is an essential element for early adults (aged 18-44 years) to make informed decisions about cancer. Low health literacy is one of the social determinants of health associated with cancer-related disparities. Over the past several years, a nonprofit organization, a university, and a cancer center in a major urban environment have developed and implemented health literacy programs within healthcare systems and in the community. Health system personnel received extensive health literacy training to reduce medical jargon …

Effects Of Evidence-Based Fall Reduction Programing On The Functional Wellness Of Older Adults In A Senior Living Community: A Clinical Case Study., Andrew Harnish, William Dieter, Albert G. Crawford, Tiffany E E. Shubert

College of Population Health Faculty Papers

BACKGROUND: Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care.

OBJECTIVES: The purpose of this study was …

An Evaluation Of A Sexual Health Education Program For Adolescents In A Residential Treatment Program In The Philadelphia Area, Rachel Powell (Student), P. Smith, Amy Leader

College of Population Health Posters

BACKGROUND

The US is currently experiencing an epidemic; millions of American adolescents are affected by sexually transmitted diseases (STDs), teen pregnancy and intimate partner violence (IPV), costing the country both socially and economically:

• Adolescents 15-24 years of age account for 50% of the 20 million new STD cases each year
• US birth rates are significantly higher than countries in Europe
  • 6.8 times higher than teens living in the UK
  • 13.9 times higher than teens living the EU
• In 2010 18.7% of adolescents ages 11-17 experienced IPV for the first time
• Adolescents who are diagnosed with an STD, are teen parents …

Evaluating The Decision Making Process Of Pediatricians' Recommendations For First Complementary Foods In Infants, Gretchen Schmoyer

Master of Public Health Capstone Presentations

The purpose of this research study was to document the feeding guidelines from medical associations, understand what pediatricians are recommending to new mothers, and to capture the response from mothers regarding their understanding and personal practices in feeding. Previous studies have found that mothers were not following feeding recommendations by the American Academy of Pediatrics (AAP). Furthermore, the role of infant rice cereal as an early first food is currently under debate. Qualitative research was conducted through interviews with five mothers of children under 2 years, five healthcare providers in pediatric settings, and three policy experts. The Theory of Reasoned …

Smoking It Out; Vaping Is In. The Rise Of E-Cigarettes Amoung U.S. Youth, Russell K. Mcintire Phd, Mph, Brianna Ludwig

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Prevalence Of Health-Related Quality Of Life (Hrqol) In Asian Americans, Hee-Soon Juon, Phd, Frederic Kim, Ms, Seon Yoon Chung, Msn, Sunmin Lee, Scd

Department of Medical Oncology Posters

Objectives

To report the prevalence of Health Related Quality of Life (HRQOL) in foreign-born Asian Americans (AA) and to compare this with the general AA from 2010 BRFSS data.

To examine the influential factors associated with HRQOL-4 including English proficiency, perceived racial discrimination, smoking, alcohol use, and sociodemographics.

Background

Quality of life (QOL) represents individuals’ subjective perception of multidimensional aspects of life including physical, psychological, social and spiritual aspects.

HRQOL represents the physical and mental health domain of QOL.

Centers for Disease Control and Prevention (CDC) has been measuring HRQOL to capture people’s overall perceptions about their health; HRQOL has …

Healthy Corner Store Network "Heart Smarts" Program, Nyssa Entrekin, Sandra Sherman, Edd, Rickie Brawer, Mph, Phd, Mches, James D. Plumb, Md, Mph

College of Population Health Lectures, Presentations, Workshops

Objectives:

1. Identify corner stores for nutrition education and health screenings based on criteria presented.

2. Identify education strategies appropriate for a corner store setting when integrating health screenings, nutrition education and food access.

3. List at least two store owner training topics for use in a corner store setting that reinforce nutrition education and disease prevention in the store.

4. Understand methods for evaluating outcomes of an integrated educational effort.

Presented at APHA in Chicago, Illinois.

Purchase Of Loose Cigarettes By Adult Smokers In Philadelphia: Individual-Level Correlates And Neighborhood Characteristics, Russell K. Mcintire, Phd, Mph

College of Population Health Posters

Background

• Philadelphia has the highest adult smoking rate1 and the highest rate of tobacco retailers2 among the 10 largest U.S. cities.

• Governmental reports have identified high rates of illegal sale of cigarettes in Philadelphia2.

• Studies have found that a main source of cigarette use in low income communities is single (loose) cigarettes purchased at tobacco retailers or from unregulated street vendors3,4.

• While studies have shown that loose cigarette use is a problem among urban youth who reside in disadvantaged neighborhoods, less research has been performed among adults on this topic5,6, and no studies focus on Philadelphia. …

Communication Skills Training For Patients And Healthcare Providers: A Proposed Blend Of Performance Studies, Theatre, And Communication Strategies, Rachel Thomas Mph, Pamela Zubow Poe Phd

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The 24th Annual Dr. Raymond C. Grandon Lecture: Building A Culture Of Health In America

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Stephen Klein Wellness Center As A Community-Centered Health Home - A Partnership Between Jefferson And Project Home, James D. Plumb Md, Mph, Lara Weinstein Md, Mph, Monica Mccurdy Pa-C, Mhs

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.