Community Health and Preventive Medicine Commons^™

Does What Happens In Vegas Increase Pedestrian Safety? A Longitudinal Study On The Effectiveness Of Pedestrian Bridges, Jalen Paulos, Joaquin Miguel Del Mundo, Brock Wentz, Janel Pietryga

Department of Orthopaedics Faculty Research

Urban populations continue to rise and the frequency that pedestrians are exposed to vehicular traffic continues to increase. The result is an increase in automobile versus pedestrian collisions. This study aims to determine the efficacy of pedestrian bridges in reducing the rates of automobile‒pedestrian collisions. Data for all automobile versus pedestrian collisions and injuries from July 1997 through December 2023 at four distinct intersections along Las Vegas Boulevard were retrieved from the Nevada Department of Transportation. These sites were chosen because of their historically high rates of automobile versus pedestrian incidents and the construction of pedestrian bridges at three of …

Caregiver Training: Improving Social Determinants Of Health, Patient Safety, Empowerment Through Improving Elder Care Education And Skills, Kathleen Thimsen

Nursing Faculty Research

Caregiver training (CaGi TRaining) is a time-tested intervention aimed at improving safety in elders living and aging in place in the community. While elder abuse and maltreatment was the intial purpose of the project, with over 3500 Caregivers graduated from this program since 2009, the course has addresses social determinants of health, and improved workforce pipelines by providing stable employment, improved self-efficacy, and confidence demonstrated by self-reports at graduation and in follow up surveys. Previously learners without a high school diploma retruned to school to obtain a GED (40%), with an additional return to school for bacalaureate and degrees (27%) …

It Is Not Clear How Well Physical Activity Promotion Materials Are Understood: Findings From A Rapid Literature Review, Jafra D. Thomas, Jasmine C. Wong, Regina F. Hockert, Yi Sheng Wu, Winston Kennedy

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 6: Issue 1, Article 6, 2025. Efforts to promote physical activity and other health-related behaviors are more effective when resource materials are understood by a wide and diverse audience. Before our lab’s previous investigations (Thomas et al., 2024), only one study seemed to use the cloze procedure to directly test the comprehension (i.e., readability) of physical activity promotion material (Cardinal & Seidler, 1995). Thus, this rapid literature review sought to (a) determine the extent the cloze procedure has been used to study physical activity promotion material comprehension in lay adults and (b) collate …

A Winning Strategy: Sports For Advancing Health In Underserved Communities, Chia-Liang Dai

Community Engagement Expo Research Posters

Prevailing disparities in health outcomes underscore the urgent need for targeted interventions tailored to the unique needs of underserved students. An after-school sports program plays a vital role in promoting comprehensive school health by offering structured team sports alongside social-emotional lessons and academic support.

Injury Inequity Among Nevada Pedestrians: Assessment Using Measurements Of Community Needs, Merika Charupoom, Nicole Bacani, Emily Carter, Emily Strickler, Laura K. Gryder, Kavita Batra, Deborah A. Kuhls Md, Facs

Undergraduate Research Symposium Posters

In 2020, the National Highway Traffic Safety Administration (NHTSA) reported that Nevada was the 10th highest ranking in pedestrian fatality rates. According to a report by Zero Fatalities, in 2021, there were 84 pedestrian deaths. Underserved communities, the elderly, and low income individuals are more likely to use walking, biking, or public transportation as a primary means of transportation due to vehicle expenses. Older adults, racial/ethnic minorities and those with lower socioeconomic statuses (SES) may bear a disproportionate burden of auto-pedestrian crashes.

Covid-19 Severity Among American Indians And Alaska Natives In 16 States - January 1, 2020, To March 31, 2021, Jessica Arrazola, Scott Erickson, Chiao Wen Lan, Adrian Dominguez, Sujata Joshi, Andria Apostolou, Ashley Busacker, David Casey, Christiana Coyle, Kathryn Helfrich, Jennifer Kraszewski, Thomas Kim, Genelle Lamont, Richard Leman, Pamela Lemaster, Nick Lehnertz, Mike Mannell, Dakota Matson, Alex Merrill, Tracy Miller, Benjamin Schram, Ozair Naqvi, Samantha Rice, Samantha Hyde-Rolland, Alyssa Rowell, Dean Seneca, Victoria Warren-Mears, Laura Williamson

Journal of Health Disparities Research and Practice

Objective: To compare rates and risk factors of severe COVID-19-related outcomes between American Indian/Alaska Native (AI/AN) and non-Hispanic White people (NHW).

Methods: Aggregate Social Vulnerability Index (SVI), COVID-19-related risk factor, hospitalization, and mortality data were obtained from 16 states for January 1, 2020-March 31, 2021. Generalized estimating equation Poisson regression models calculated age-adjusted cumulative incidences, incidence ratios (IR), and 95% confidence intervals (CI) comparing AI/AN and NHW persons by age, sex, and county-level SVI status.

Results: Race data were missing for 42.7% of COVID-19 cases, 24.7% of hospitalizations, and 10.1% of deaths. Risk of AI/AN COVID-19 mortality …

Pili Pono Practice: A Qualitative Study On Reimagining Native Hawaiian Food Sovereignty Through Malama Backyard Aquaponics, Pahonu Coleman, Samantha Keaulana, J Kahaulahilahi Vegas, Phoebe W. Hwang, Leshay Keliiholokai, Jane J. Chung-Do, Ikaika Rogerson, Ilima Ho-Lastimosa

Journal of Health Disparities Research and Practice

Living in one of the most remote island chains in the world, Native Hawaiians developed sophisticated food cultivation systems that sustained a thriving and robust population for centuries. These systems were disrupted by colonization, which has contributed to the health disparities that Native Hawaiians face today. MALAMA, a culturally-grounded backyard aquaponics program, was developed to promote food sovereignty among Native Hawaiians. This study utilized participant interview and focus group data to identify how participating in the MALAMA program impacts the wellbeing. The findings demonstrate that MALAMA enhanced the participants’ pilina (relationship, connection) to traditional foods, land, cultural identity, family, and …

Food Insecurity And Risky Sexual Behaviors Among College Students During The Covid-19 Pandemic, Bertille Assoumou, Jennifer Pharr, Courtney Coughenour

Environmental & Global Health Faculty Research

Background

Sexually transmitted infections (STIs) and food insecurity are public health concerns in the United States (US) due to their growing prevalence and incidence among young people, and particularly in college students. Studies have reported that college students are at higher risk of STIs due to the high rates of risky sexual behavior (RSB). Most studies report a food insecurity prevalence of more than 30% among college students, which was more than twice the overall national food insecurity rate of 10.5% in 2020. This study aims to assess the relationship between food insecurity and RSB among college students during the …

Does Using Sofa Score For Ventilator Triage Among Covid 19 Patients Result In Suboptimal Allocation Of Medical Ventilators For The Bipoc Population?, Alexandrea Mp Masocco, Elisabeth Michel, Ebbin Dotson

Journal of Health Disparities Research and Practice

Introduction: Since the COVID-19 pandemic in the United States, Black, and Latinx populations have been disproportionately affected by the COVID-19 pandemic. It can be inferred with high confidence that those most vulnerable are the least likely to receive essential care. Kidney transplant allocation and COVID-19 triage protocols share commonalities in that both protocols involve using multivariate scored criteria with objective and subjective inputs. As such, the similar conclusion in outcomes is concerning. It is worth questioning whether the racial inequalities demonstrated in the COVID-19 pandemic related to access to life-saving ventilators were associated with triage protocols.

Methodology: Using an exploratory …

Perspectives On Flu Vaccination Advertisement Messaging In The Era Of Covid-19: Thematic Analysis Centering Adult Black Voices, Krissy Moehling Geffel, Stephanie N. Christian, Andrea D. Casas, Harika P. Dyer, Tiffany L. Gary-Webb, Hannah E. Hardy, Roderick Harris, Dara D. Mendez

Journal of Health Disparities Research and Practice

Influenza (flu) is an infectious, respiratory disease that causes substantial burden and mortality, and Non-Hispanic Black people experience profound disparities in flu disease burden in the United States. One contributor to flu disease disparities is lower flu vaccination rates among Black populations. This qualitative study was conducted during the COVID-19 pandemic and used the Public Health Critical Race Praxis framework to center and elicit Black adults’ perspectives of desired flu vaccine messaging. This work builds upon efforts to increase access to flu vaccinations and recommendations are provided to aid in tailoring flu vaccine messaging via a health equity lens. Recommendations …

Diabetes Self-Management Support Program In Predominantly Hispanic Faith Community Settings: A Pilot Study, Leah Carrillo, Summer R. Wilmoth, Raymundo Mendoza, Ashton Balarin, Meixia Pan, Elena Martinez,, Erica T. Sosa, Zenong Yin, Sarah Ullevig, Meizi He

Journal of Health Disparities Research and Practice

Objectives: This study aimed to assess the feasibility, facilitators, barriers, and impact of adopting the Self-Management Resource Center Diabetes Self-Management Program (SMRC DSMP) on diabetes-related outcomes.

Methods: The SMRC DSMP was implemented in five churches in San Antonio, Texas. A single group pre-post-test design was used to evaluate program effect on improving T2D outcomes. The primary outcome was glycohemoglobin (HbA1c) and secondary outcomes included Self-Efficacy for Diabetes, health-related quality of life (HRQOL), and patterns of eating and physical activity. Program feasibility, facilitators, and barriers were assessed through documentation and in-person interviews with participants.

Results: A total of 96 participants were …

Associated Factors With Colorectal Cancer (Crc) Screening Awareness In The Black Belt Region Of Alabama: A Comparison Among Three Types Of Crc Screening, Hee Yun Lee, Yan Luo, Chiahung Chou, Mi Hwa Lee, Marion Bennett

Journal of Health Disparities Research and Practice

Objective: The present study aims to assess the levels of awareness of three types of CRC screening tests (FIT or FBOT, sigmoidoscopy, and colonoscopy) among African Americans living in the Black Belt area, and examine the factors associated with awareness of CRC screening tests among this population.

Methods: The current study utilized a survey research design. Univariate analysis was used to assess the awareness of three types of colorectal cancer screening: FIT or FOBT, sigmoidoscopy, and colonoscopy. Three sets of logistic regression analyses were conducted to examine the factors associated with the awareness level of each of the three colorectal …

Assessing The Testability Of The Multi-Theory Model (Mtm) In Predicting Vaping Quitting Behavior Among Young Adults In The United States: A Cross-Sectional Survey, Manoj Sharma, Kavita Batra, Ravi Batra, Chia-Liang Dai, Traci Hayes, Melinda J. Ickes, Tejinder Pal Singh

Social and Behavioral Health Faculty Research

Purpose: Given the increased exposure to e-cigarettes and nicotine among young adults, difficulty in quitting vaping is likely, which supports the need for effective behavioral interventions. Therefore, this cross-sectional study aims to assess the testability of the contemporary multi-theory model of health behavior change in predicting the vaping quitting behavior among young adults in the United States. Methods: A nationally representative sample of 619 young adults engaged in vaping behavior and aged 18–24 years was recruited to complete a 49-item web-based survey. A structural equation model was used to test relationships between MTM constructs. Hierarchical multiple regression was utilized to …

When Keeping It Real Is Required: Challenging The Pandemic Of Racism In Lactation Land, Tameka Jackson-Dyer

Journal of Health Disparities Research and Practice

Human milk is the optimal source of nutrition for infants, but few are able to provide their milk to their babies for the minimum twelve months recommended by health experts. This is especially true for Black women. Due to structural racism embedded in medical care, implicit bias of healthcare providers and generational traumas that began during American chattel slavery, Black women are less likely than every other ethnic group to initiate breastfeeding. Those that do are often sabotaged by unsupportive systems and lack of access to clinically-skilled, culturally respectful lactation consultants. Calling out the racism that exists in Lactation Land …

Narrative Review Of Covid-19 Vaccine Hesitancy: Evidence In Late 2021, Ambree Papa Schoetker, Manoj Sharma

Spectra Undergraduate Research Journal

The coronavirus disease, COVID-19, has changed daily life dramatically since early 2020. Although COVID-19 vaccines are available in the United States, many express distrust in this primary prevention measure and doubt both the seriousness of COVID-19 and its associated morbidity and mortality. Vaccine hesitancy, also described as the reluctance or refusal of vaccines despite availability, exists on a continuum and was a known public health threat prior to the coronavirus pandemic. This narrative review examines studies related to the determinants of COVID-19 vaccine hesitancy among adults in the United States. Also explored are the factors related to COVID-19 vaccine risk …

Addressing Racial Disparities In Maternal Health: The Case For An Equity Birth Plan, Alice Trye, Damali Campbell Oparaji, Natalie Roche, Lisa Gittens Williams

Journal of Health Disparities Research and Practice

Birth equity can be defined as “The assurance of the conditions of optimal births for all people with a willingness to address racial and social inequities in a sustained effort.” (Birth Equity |California Maternal Quality Care Collaborative, n.d.). Complex explanations exist for adverse maternal outcomes, but unequal health care, socioeconomic and racial inequalities pose risks to women and their babies (“Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” 2003). The data is clear: Maternal death rates have increased and are 3 to 4 times higher for black women than white women (Zaharatos et al., 2018). These …

Editor's Notes, Nekeshia Jones, Sharla Smith, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

These Editors' Notes introduce the first special issue of the Journal of Health Disparities Research and Practice based on the work the National Maternal Health Research Network.

Assessing Covid-19 Booster Hesitancy And Its Correlates: An Early Evidence From India, Geetanjali C. Achrekar, Kavita Batra, Yashashri Urankar, Ravi Batra, Naved Iqbal, Sabiha A. Choudhury, Deepti Hooda, Roohi Khan, Suraj Arora, Aditi Singh, Francesco Chirico, Manoj Sharma

School of Medicine Faculty Research

The emergence of SARS-CoV-2 mutants, waning immunity, and breakthrough infections prompted the use of booster doses of the COVID-19 vaccine to fight against the pandemic. India started booster doses in January 2022 and it is critical to determine the intention of booster dose uptake and its correlates. Therefore, the current cross-sectional study aimed to investigate booster dose acceptability and associated predictors among the Indian population. A convenience sampling technique was utilized to recruit a sample of 687 Indian residents. A 55-item psychometric validated survey tool was used to assess booster dose acceptability, vaccine literacy and vaccine confidence. Univariate, bivariate, and …

2019 Statewide Child Death Report, Nevada Institute For Children’S Research And Policy, Dawn L. Davidson, Elizabeth Holka

Nevada Institute for Children's Research and Policy Reports

The purpose of this report is to provide comprehensive information regarding the circumstances by which children die in Nevada in order to prevent future child deaths and improve the health and safety of children in the state.

Covid-19 Booster Vaccination Hesitancy In The United States: A Multi-Theory-Model (Mtm) Based National Assessment, Kavita Batra, Manoj Sharma, Chia-Liang Dai, Jagdish Khubchandani

School of Medicine Faculty Research

Background: Despite the availability of COVID-19 vaccines and the proven benefits of vaccinations outweighing the potential risks, hesitancy to accept vaccines and additional doses remains a persistent problem. Therefore, the purpose of the study was to investigate hesitancy, confidence, literacy, and the role of the multi-theory model (MTM) constructs in COVID-19 booster uptake. Methods: This cross-sectional study utilized a 52-item psychometric valid web-based survey conducted during the month of October 2021 to recruit a nationally representative sample of U.S. adults. Univariate, bivariate, and multivariate statistical tests were used to analyze the data. Results: Among the booster hesitant group (n = …

Mental Disorder Symptoms During The Covid-19 Pandemic In Latin America – A Systematic Review And Meta-Analysis, Stephen X. Zhang, Kavita Batra, Wen Xu, Tao Liu, Rebecca Kechen Dong, Allen Yin, Andrew Yilong Delios, Bryan Z. Chen, Richard Z. Chen, Saylor Miller, Xue Wan, Wenping Ye, Jiyao Chen

School of Medicine Faculty Research

Aims There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America. Methods Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv, were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. …

Knowledge Or Awareness Of Non-Communicable Diseases And Their Associated Risk Factors Among University Students In Fiji: A Cross-Sectional Study, Awadhesh Kumar Shirotriya, Kavita Batra

School of Medicine Faculty Research

Introduction: Chronic diseases (aka Non-communicable diseases, NCDs) contribute to the global burden of morbidity and mortality, with a significant share of premature deaths among low-and middle-income countries (LMICs), including Fiji. The early exposure to the risk factors of NCDs affects the entire life course; knowledge or awareness of adolescents towards NCDs and associated risk factors is critical for health promotion. This study aims to investigate the knowledge or awareness level of chronic conditions and their risk factors among Fijian students. Methods: In this cross-sectional study, a sample of 338 university students was recruited using the paper as well as web-based …

Online Teaching Of Program Planning & Evaluation, Manoj Sharma

UNLV Best Teaching Practices Expo

Program Planning & Evaluation (PBH 440-1001) offered by the School of Public Health at University of Nevada, Las Vegas was taught asynchronously online by Manoj Sharma to undergraduate students (primarily from public health) in Spring 2021 (n=34). This course is designed to equip students with the knowledge and skills necessary to systematically develop, implement, and evaluate health-related programs, services, and interventions. The specific teaching techniques that were used in teaching this course were organizing the entire course in Canvas and making it available from day 1, recording all lectures beforehand in Panopto, utilizing cases studies in modules, embedding journal articles …

Understanding Disparities In Clinical Trials For Native Hawaiian Men, Gabriela A. Layi, Kevin Cassel, Maile Taualii, Jeffrey L. Berenberg, Erin O. Bantum

Journal of Health Disparities Research and Practice

Understanding low rates of participation by minority populations in clinical trials is critical for reducing and eliminating disparities. We examined beliefs and attitudes of Native Hawaiian men related to illness and cancer to better understand their rates of participation in clinical trials. We conducted face-to-face interviews with Native Hawaiian key informants throughout the State of Hawai‘i using quota sampling methods to obtain a range of perspectives about attitudes towards health care seeking to provide insight into low clinical trials participation. Interviews were audio-taped, transcribed, and independently coded by researchers. Thematic analysis guided the extraction of relevant data from the discussions. …

Testing Multi-Theory Model (Mtm) In Explaining Sunscreen Use Among Florida Residents: An Integrative Approach For Sun Protection, Manoj Sharma, Matthew Asare, Erin Largo-Wight, Julie Merten, Mike Binder, Ram Lakhan, Kavita Batra

Environmental & Global Health Faculty Research

Florida residents have the second highest incidence of skin cancer in the nation. Sunscreen usage was found to be the one of the most effective integrative health approaches for reducing risk of skin cancer. Given the limited information on the likelihood of adopting and continuing sunscreen usage behavior, this cross-sectional study aimed to examine the correlates of initiating and sustaining sunscreen usage behavior among Florida dwellers, using the fourth-generation, multi-theory model (MTM) of behavior change. A web-based survey containing 51 questions was emailed to Florida residents aged 18 years or above, who were randomly selected from the state voter file. …

Protective Factors That Foster Resilience To Hiv/Aids: Insights And Lived Experiences Of Older Gay, Bisexual, And Other Men Who Have Sex With Men, Renato M. Liboro, Tammy C. Yates, Sherry Bell, Brandon Ranuschio, George Da Silva, Charles Fehr, Francisco Ibañez-Carrasco, Paul A. Shuper

Psychology Faculty Research

Since the beginning of the HIV/AIDS epidemic, gay, bisexual, and other men who have sex with men (gbMSM) have been disproportionately impacted by HIV/AIDS health disparities. Research showed that resilience to HIV/AIDS is associated with increased use of relevant health services, lower sexual health risks, and improved mental health outcomes among racially and ethnically diverse gbMSM. As the subpopulation that has historically been impacted by HIV/AIDS the longest, older gbMSM living with HIV/AIDS have inarguably exhibited resilience to HIV/AIDS the most. The qualitative study described in this paper sought to identify and examine protective factors that fostered resilience to HIV/AIDS …

Association Between Insurance Status And Hospital Outcomes Among Acute Kidney Failure Patients, Khoa Truong, Thuan Thai, Lingling Zhang, Lu Shi, C. Jason Wang

Journal of Health Disparities Research and Practice

Objectives: To investigate the relationship between insurance status and the risk of acute kidney failure (AKF) and consequential hospitalization outcomes.

Methods: A cross-sectional regression analysis was conducted for inpatients ages 18-64 in South Carolina 2012–2013. One dichotomous dependent variable - diagnosed with AKF at hospital admission, and two continuous dependent variables of hospital outcomes - total charge and length of stay, were examined. The key explanatory variable was the patient’s insurance status. Other covariates included patient’s age, gender, and race as well as AKF risk factors - Type 2 diabetic mellitus (T2DM), chronic kidney disease (CKD), hypertension, and proteinuria.

Results: …

Postsecondary Educational Attainment And Health Among Younger U.S. Adults In The “College-For-All” Era, Anna Zajacova, Elizabeth Lawrence

Sociology Faculty Research

Population-health research has neglected differentiation within postsecondary educational attainments. This gap is critical to understanding health inequality because college experience with no degree, vocational/technical certificates, and associate degrees may affect health differently. We examine health across detailed postsecondary attainment levels. We analyze data on 14,750 respondents in Waves I and IV of the nationally representative Add Health panel spanning adolescence to ages 26 to 34. Multivariate regression and counterfactual approaches to minimize the impact of confounders estimate multiple health outcomes across postsecondary attainment levels. Compared to high school diplomas, we find significant returns to bachelor’s degrees for most health outcomes …

Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson

Environmental & Occupational Health Faculty Presentations

Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change. Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing …

Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson

Environmental & Global Health Faculty Research

Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change. Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing …