Community Health and Preventive Medicine Commons^™

Interdisciplinary Integrated Primary And Behavioral Healthcare (I2pbh) Initiative, John Ronnau, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz

Research Symposium

Purpose: The Interdisciplinary Integrated Primary and Behavioral Healthcare (I²PBH) initiative will train University of Texas Rio Grande Valley (UTRGV) mental health graduates to deliver high quality, evidence-based Integrated Behavioral Health (IBH) services in the Rio Grande Valley (RGV) – a high-need, high-demand, medically underserved Hispanic region along the US-Mexico border. Specifically, the I²PBH initiative will train 24 UTRGV mental health graduates annually to deliver high-quality Integrated Behavioral Health (IBH) clinical services through the evidence based Primary Care Behavioral Health (PCBH) model. With a training emphasis on basic/advanced theory and clinical skills in the PCBH model, students …

Clinical Characteristics And Risk Factors For Mortality During The 'First Wave' Of Covid-19 In Reynosa, Tamaulipas, Luis G. Vargas Garcia, Francisco E. Díaz Cisneros, Antonio Gutiérrez Sierra, Juan Rosales Martínez, Manlio F. Lara Duck, Netzahualcoyotl Mayek Pérez

Research Symposium

Background: The COVID-19 pandemic has impacted public health in Mexico. As of February 2020, there have been at least four "waves" of contagion that resulted in 5.82 million positive cases and more than 325 thousand deaths. At the beginning of the COVID-19 pandemic, hospital and population-based information was available, frequently with non-specific symptoms. Little was known about the risk factors for mortality in specific conditions. We described the clinical characteristics of patients with COVID-19 in Reynosa, Tamaulipas during 2020 and identified the risk factors for mortality.

Methods: The COVID-19 cases registered from March to November 2020 in Reynosa were divided …

Comparing Stroke Symptom Recognition And Intervention Times In The Rio Grande Valley, Joshua M. Ninan, Kelsey Baker

Research Symposium

This is a retrospective study that aims to evaluate the duration from onset of stroke-like symptoms to presentation to medical facilities for aid in the Rio Grande Valley. The main goal of the study is to understand the extent of pre-hospital delays with regards to the treatment of stroke in the RGV.

Utrgv Student Run Clinic: The Past, The Present, And The Future, Jessica Flores, Elizabeth Althaus, Uchechi Ehiemua, Elio Garcia Sosa, Lucinda Hinojosa, Andrew Kolodziej, Dikachi Osaji, Asma Syed, Chelsea Chang

Research Symposium

Purpose: The UTRGV SOM Student Run Clinic (SRC) is a student- led organization that provides free primary care and promotes health equity in the Rio Grande Valley. Through the SRC, barriers of access to healthcare and health promotion are targeted, especially by emphasizing health literacy and patient advocacy. The SRC benefits not only our patients but medical students who work in the clinic, learning about the unique needs and culture of the underserved community while gaining clinical experience.

Description: The SRC brings teams of volunteer medical students and physicians to Peñitas, TX to provide free primary healthcare to vulnerable populations, …

Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (Pcbh Paths), Kristan Diaz-Rios, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii

Research Symposium

Purpose: Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (PCBH PATHS) is a workforce development pipeline project aimed at permanently augmenting UTRGV’s institutional capacity to address shortage of an Integrated Behavioral Health (IBH) competent workforce locally, regionally and nationally. Our initiative, aligned with UTRGV strategic priorities and key initiatives, will integrate basic(model specific strategy and operational elements), mid-level (role identity and profession specific behavioral competencies specific to each health profession), and advanced (behavioral medicine clinical skills) applications of the evidence based PCBH model of delivery. A PCBH focused delivery system (clinical and educational), in which primary care providers …

Obesity Management In Primary Care Medicine: A Review Of Obesity Perception And Barriers To Weight Loss, Asma Syed, Saima Siddiqui

Research Symposium

Background: This project addresses the obesity epidemic in America. According to the CDC, in 2018, the US obesity prevalence was 42.4%. Obesity is linked to many conditions including heart disease, stroke, type 2 diabetes, and certain types of cancer. Successfully treating obesity can decrease these leading causes of preventable and premature deaths. A proper understanding of the successes and failures of current obesity management in primary care medicine with the help of qualitative research through patient and provider interviews can elucidate the best practices to reduce the burden of disease in America.

Methods: A review of literature was conducted …

Mixed Method Approach Towards The Life Of University Students During The Covid-19 Pandemic, Raihan Khan, Andrew White, Tony Jehi

Department of Health Sciences - Faculty Scholarship

Background

The COVID-19 pandemic negatively impacted the higher education system. This mixed-methods study aimed to assess COVID-19 fear, anxiety, and stress among Shenandoah Valley college students.

Methods

An online survey was fielded and completed by n=680 students. Qualitative semi-structured interviews were conducted with 20 students.

Results

The mean participant age was 22.14±5.48 years, and primarily White (81.9%), women (80.4%), and undergraduate (78.0%) students. Approximately 41% were enrolled in health-related majors (41.4%). Women students had significantly higher anxiety, depression, and fear of contracting COVID-19 than men. Undergraduate students had significantly higher depression than graduate students. Qualitative analysis revealed several major themes: …

Building On The Health Policy Analysis Triangle: Elucidation Of The Elements, Aysha Zahidie, Saima Asif, Meesha Iqbal

Community Health Sciences

The health policy triangle first presented in the 20th century by Walt and Gilson has been extensively used at local, national, regional, and international levels to assess health policies related to communicable and non-communicable diseases, physical and mental health, antenatal and postnatal care, and human resources, services, and systems. However, the framework lacks intricate details for the four pillars in the triangle viz: 'content,' 'context', 'actors', and 'processes. We propose a checklist of elements to be considered for each pillar; to ease and enhance the process of policy analyses for researchers and policymakers across the globe, including low- and middle-income …

Exploring Opportunities To Expand And Improve Prep Uptake In Vulnerable Us Communities., Pedro B. Carneiro

Dissertations and Theses

The implementation of preexposure prophylaxis (PrEP) in the United States has fallen short of meeting both 2020 and projected 2030 milestones, with less than one-third of those who would benefit most from PrEP choosing to initiate it. High discontinuation rates and persistently elevated HIV incidence underscore the need for improvement. However, opportunities exist to enhance PrEP uptake, supported by a growing pipeline of PrEP innovations. To achieve this, effective implementation of available tools to combat HIV and the inclusion of all communities as stakeholders are essential. One such tool is event-driven (ED) PrEP, also known as PrEP 2-1-1, which is …

From Awareness To Action: Understanding And Addressing Health Disparities, Aamira Shah

The Cardinal Edge

In the United States, marginalized groups consistently face barriers to healthcare services necessary for maintaining quality of life and achieving positive health outcomes. Health disparities can be defined as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by populations that have been disadvantaged by their social or economic status, geographic location, or environment” (CDC, 2008). With input from insightful interviews, this article seeks to investigate specific challenges faced by marginalized groups in the healthcare setting and provide potential solutions to reduce health disparities.

Influence Of Apathy And Grit On Exercise Adherence For Persons With Parkinson’S Disease: A Cohort Study, Erica J. Kiernan, Evan M. Pucillo, Christopher M. Wiedman

Internet Journal of Allied Health Sciences and Practice

Purpose: Parkinson’s disease (PD) is the second most common neurodegenerative disease in the United States. A preponderance of evidence supports exercise and physical activity as an effective intervention to slow the progression of motor symptoms in persons with PD. However, less study has been given to the influence of non-motor symptoms of PD, such as apathy and grit, on adherence to therapeutic exercise programs. The primary aim of this study was to characterize levels of apathy and grit in individuals with PD and explore any relationship to adherence in a community exercise program. Due to the importance of caregiver interaction, …

Association Between Alcohol Consumption And Ectopic Fat In The Multi-Ethnic Study Of Atherosclerosis, Richard Kazibwe, Parag A Chevli, Joni K Evans, Matthew Allison, Erin D Michos, Alexis C Wood, Jingzhong Ding, Michael D Shapiro, Morgana Mongraw-Chaffin

Faculty, Staff and Students Publications

Background The relationship between alcohol consumption and ectopic fat distribution, both known factors for cardiovascular disease, remains understudied. Therefore, we aimed to examine the association between alcohol consumption and ectopic adiposity in adults at risk for cardiovascular disease. Methods and Results In this cross-sectional analysis, we categorized alcohol intake among participants in MESA (Multi-Ethnic Study of Atherosclerosis) as follows (drinks/day): <1 >(light drinking), 1 to 2 (moderate drinking), >2 (heavy drinking), former drinking, and lifetime abstention. Binge drinking was defined as consuming ≥5 drinks on 1 occasion in the past month. Visceral, subcutaneous, and intermuscular fat area, pericardial fat volume, and …

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, Allergy, 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 …

The Effect Of Long Covid Syndrome On Physical Activity, Patrisha Hanna Villarmea

Master of Science in Kinesiology

Long covid syndrome is a condition where individuals experience persistent symptoms and functional limitations that can last about three months to two years after the initial Covid-19 infection. While long-term health consequences of Covid-19 have garnered significant attention,the impact of long covid syndrome symptoms is poorly understood. The purpose of the study is to explore the effect of long covid syndrome symptoms to an individual’s physical activity. Furthermore, this research aims to provide an overview of the existing literature on the effect of long covid syndrome symptoms on physical activity. The research would invite participants to answer two surveys that …

Sars-Cov-2 Niches In Human Placenta Revealed By Spatial Transcriptomics, Enrico R Barrozo, Maxim D Seferovic, Eumenia C C Castro, Angela M Major, David N Moorshead, Michael D Jochum, Ricardo Ferral Rojas, Cynthia D Shope, Kjersti M Aagaard

Faculty, Staff and Students Publications

BACKGROUND: Functional placental niches are presumed to spatially separate maternal-fetal antigens and restrict the vertical transmission of pathogens. We hypothesized a high-resolution map of placental transcription could provide direct evidence for niche microenvironments with unique functions and transcription profiles.

METHODS: We utilized Visium Spatial Transcriptomics paired with H&E staining to generate 17,927 spatial transcriptomes. By integrating these spatial transcriptomes with 273,944 placental single-cell and single-nuclei transcriptomes, we generated an atlas composed of at least 22 subpopulations in the maternal decidua, fetal chorionic villi, and chorioamniotic membranes.

FINDINGS: Comparisons of placentae from uninfected healthy controls (n = 4) with COVID-19 asymptomatic …

An Evolutionary Pathway For Coping With Emerging Infectious Disease, Scott Lyell Gardner, Daniel R. Brooks, Walter A. Boeger, Eric P. Hoberg

Zea E-Books Collection

Emerging infectious disease (EID) represents an existential threat to humanity. EIDs are increasing in frequency and impact because of climate change and other human activities. We are losing the battle against EIDs because of improper assessment of the risk of EID. This stems from adherence to a failed paradigm of pathogen-host associations that suggests EIDs ought to be both unpredictable and rare. That, in turn, leads to policies suggesting that crisis response is the best we can do. Real-time and phylogenetic assessments show EIDs to be neither rare nor unpredictable—this is the parasite paradox that shows the failures of the …

Critical Issues In Community Health Course At Kingsborough Cc (Coh 1200) - Fall 2023, Jose Nanin

Open Educational Resources

This syllabus includes OER materials and college policies for a fully online course that exposes students to a range of topics and methods that health specialists use to research health disparities in affected communities. Through readings and videos, as well as online course assignments and discussions, students learn about library/database research methods, credibility of health information, and the health disparities most commonly occurring in modern society.

Needle Exchange Programs And Their Impact On Hiv Incidence In West Virginia: Is It Working?, Amber Graves, Katie Duty, Thomas Norton, Alberto Coustasse

Management Faculty Research

The opioid epidemic has had a strong impact on West Virginia, due to various social, economic, cultural, and environmental hardships. To aid users, Needle Exchange Programs (NEPs) were created to exchange used needles for new sterile ones and provide awareness of treatment and rehabilitation options. This study aimed to assess the effectiveness of NEPs in reducing HIV and Hepatitis C infections in West Virginia, and the subsequent decrease in healthcare costs. In 2018 and 2019, there was an HIV outbreak in Cabell County, with 85 cases requiring CDC intervention in 2019. This occurred after the county-run needle exchange was reduced. …

Evaluating The Knowledge, Attitudes, And Practices Of Healthcare Workers Regarding High-Risk Nosocomial Infections: A Global Cross-Sectional Study, Elham M Khatrawi, Priyadarshi Prajjwal, Muhammad Farhan, Pugazhendi Inban, Shraddha Gurha, Saud M S Al-Ezzi, Mohammed D M Marsool, Prerna Ahuja, Mohammed A Mateen, Felix O Aina, Omniat A Hussin

Faculty, Staff and Student Publications

BACKGROUND: Healthcare workers (HCWs) play a vital role in delivering care and are frequently exposed to the risk of acquiring infections within the hospital setting. Around 15% of hospitalized patients suffer from these infections globally. However, the role and awareness of HCWs in the transmission of hospital-acquired infections (HAIs) or nosocomial infections is still unclear. This study aimed to evaluate the knowledge, attitude, and practices (KAP) toward high-risk microbial infections among HCWs on a global scale to identify measures to address this problem.

METHOD: A cross-sectional descriptive study was conducted between 2022 and 2023, with HCWs selected as the study …

Meta Echo: Using All-Payers Claims Data Analysis As Part Of A Multi-Layered Approach To Plan An Evaluate Echo Programs, Marcy Doyle, Erica Plante

Faculty Publications

No abstract provided.

An Examination Of The Relationships Between The Neighborhood Social Environment, Adiposity, And Cardiometabolic Disease Risk In Adolescence: A Cross-Sectional Study, Kara D. Denstel, Robbie A. Beyl, Denise M. Danos, Maura M. Kepper, Amanda E. Staiano, Katherine T. Theall, Tung Sung Tseng, Stephanie T. Broyles

School of Public Health Faculty Publications

Background: Disadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 years. Methods: This cross-sectional study utilized baseline data from the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) study. Adolescent data were obtained using self-reported questionnaires (demographics and perceived neighborhood disorder), anthropometry, body imaging, and a blood draw while objective neighborhood data for the concentrated disadvantage index were acquired from the 2016 American Community Survey …

Lymphocytic Choriomeningitis Virus In Person Living With Hiv, Connecticut, Usa, 2021, Jonathan Dyal, Shiv Gandhi, Caitlin M Cossaboom, Austin Leach, Ketan Patel, Marjorie Golden, Joseph Canterino, Marie-Louise Landry, Debi Cannon, Mary Choi, Inna Krapiunaya, John D Klena, Trevor Shoemaker

Faculty, Staff and Student Publications

Lymphocytic choriomeningitis virus is an underreported cause of miscarriage and neurologic disease. Surveillance remains challenging because of nonspecific symptomatology, inconsistent case reporting, and difficulties with diagnostic testing. We describe a case of acute lymphocytic choriomeningitis virus disease in a person living with HIV in Connecticut, USA, identified by using quantitative reverse transcription PCR.

Patient-Reported Outcomes In Older Breast Cancer Survivors With And Without Prior Chemotherapy Treatment, Taiwo Adesoye, Kai-Ping Liao, Susan Peterson, Liang Li, Daria Zorzi, Holly M Holmes, Mariana Chavez-Macgregor, Sharon H Giordano

Faculty, Staff and Student Publications

BACKGROUND: Little is known about long-term treatment-related symptoms in older breast cancer survivors. We characterized long-term patient-reported symptoms and examined factors associated with the presence and severity of symptoms, and symptom interference with daily activities.

METHODS: Texas Cancer Registry (TCR) Medicare linkage data was used to identify breast cancer patients age 65 and older with local/regional stage disease diagnosed between 2012-2013. Symptom burden was assessed using breast-specific items from the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE™). Demographic and clinical data also were collected. Logistic regression models were used to assess the association between symptom …

Who Left The Hospital Against Medical Advice During The Early Covid-19 Pandemic?, Bryan Werner, Se Won Lee

HCA Healthcare Journal of Medicine

Background

Patients leaving against medical advice (AMA) presents a challenge to hospitals as they try to manage costs and improve patient outcomes in an ever-increasing competitive market. Investigating AMA discharges that occurred during the early COVID-19 pandemic presents a unique opportunity to better understand this phenomenon and be better prepared for the future.

Methods

This retrospective analysis of 34 379 patients from a nationwide private healthcare system across 20 states analyzed patients during the early stages of the pandemic who chose to leave against medical advice (AMA) after being admitted with COVID-19 infection and identified several patient characteristics associated with …

Impact Of Interprofessional Student Teams At A Remote Area Medical Event In Rural Appalachia, Emily K. Flores, Karilynn Dowling, Caroline Abercrombie Md, Rick L. Wallace

Journal of Appalachian Health

Introduction: Education in interprofessional collaboration is vital to expand healthcare access, especially in areas of higher disparity. To address this need, interprofessional faculty collaborators incorporated undergraduate and graduate health profession students into teams at an annual Remote Area Medical event in rural Appalachia between 2017 and 2020.

Purpose: This article evaluates the impact of an interprofessional student teams model on both patient care experience and students’ interprofessional collaboration attitudes and behaviors.

Methods: Student volunteers completed pre- and post-event surveys containing questions about demographics, open-ended questions, and questions from two instruments: the Student Perceptions of Interprofessional Clinical Education-Revised Instrument, Version 2 …

Association Between Insurer Connectivity In Appalachian Population Health Networks And Preventable Hospitalizations: Evidence From Kentucky, Rachel Hogg-Graham, Kelsey R. Gatton, Rick Ingram, Glen P. Mays

Journal of Appalachian Health

Introduction: Addressing complex health and social needs requires cross-sector collaboration to deliver medical, social, and population health services at the community level. Capacity in community health and social services networks may be constrained in regions like Appalachia due to the combined effects of rurality and persistently poor health and social outcomes. One way that cross-sector networks serving low-resource communities can expand their capacity is by engaging partners, like health insurers, who can leverage resources from outside the local area.

Purpose: This study examines insurer connectivity in cross-sector networks across Kentucky’s geographic regions and the association between connectivity and the probability …

The Ninth Myth Of Appalachia, Randolph Wykoff

Journal of Appalachian Health

Many stereotypes afflict our much-maligned region, and the Jonesborough­­–Washington County History Museum displays eight of these "myths of Appalachia." Here, our Editor-in-Chief suggests a ninth—that the people of Appalachia "do not care" about their health—and argues that regional health disparities result not from apathy but from a confluence of socioeconomic factors.

Self-Reported Consumption Of Bottled Water V. Tap Water In Appalachian And Non-Appalachian Kentucky, Jason W. Marion

Journal of Appalachian Health

Introduction: Quantitative studies on drinking water perceptions in Appalachia are limited. High-profile water infrastructure failures in the U.S. and Eastern Kentucky, coupled with human-made and natural disasters in the Appalachian Region, have likely impacted opinions regarding tap water.

Purpose: To use existing unexplored data to describe baseline tap water v. bottled water consumption in Kentucky.

Methods: Telephone-based cross-sectional data were obtained from the 2013 Kentucky Health Issues Poll (KHIP) directed by the Foundation for a Healthy Kentucky. Among many items in KHIP, self-reported consumption of bottled water over tap water, reasons for bottled water use, and demographic data were obtained. …

Prediction Of Factors For Patients With Hypertension And Dyslipidemia Using Multilayer Feedforward Neural Networks And Ordered Logistic Regression Analysis: A Robust Hybrid Methodology, Wan Muhamad Amir W Ahmad, Mohamad Nasarudin Bin Adnan, Norhayati Yusop, Hazik Bin Shahzad, Farah Muna Mohamad Ghazali, Nor Azlida Aleng, Nor Farid Mohd Noor

Makara Journal of Health Research

Background: Hypertension is characterized by abnormally high arterial blood pressure and is a public health problem with a high prevalence of 20%–30% worldwide. This research combined multiple logistic regression (MLR) and multilayer feedforward neural networks to construct and validate a model for evaluating the factors linked with hypertension in patients with dyslipidemia.

Methods: A total of 1000 data entries from Hospital Universiti Sains Malaysia and advanced computational statistical modeling methodologies were used to evaluate seven traits associated with hypertension. R-Studio software was utilized. Each sample's statistics were calculated using a hybrid model that included bootstrapping.

Results: Variable …

Stratification Of Pediatric Covid-19 Cases Using Inflammatory Biomarker Profiling And Machine Learning., Devika Subramanian, Aadith Vittala, Xinpu Chen, Christopher Julien, Sebastian Acosta, Craig Rusin, Carl Allen, Nicholas Rider, Zbigniew Starosolski, Ananth Annapragada, Sridevi Devaraj

Faculty, Staff and Students Publications

While pediatric COVID-19 is rarely severe, a small fraction of children infected with SARS-CoV-2 go on to develop multisystem inflammatory syndrome (MIS-C), with substantial morbidity. An objective method with high specificity and high sensitivity to identify current or imminent MIS-C in children infected with SARS-CoV-2 is highly desirable. The aim was to learn about an interpretable novel cytokine/chemokine assay panel providing such an objective classification. This retrospective study was conducted on four groups of pediatric patients seen at multiple sites of Texas Children's Hospital, Houston, TX who consented to provide blood samples to our COVID-19 Biorepository. Standard laboratory markers of …