Community Health and Preventive Medicine Commons^™

Variation In Treatment Recommendations For Low-Risk Prostate Cancer: A Focus On Active Surveillance Across Physician Specialties, Sinyu Yang B.S., Tiffany Chu B.S., Cathryn Bock Ph.D, Jinping Xu M.D.

Medical Student Research Symposium

Prostate cancer (PC) is the second leading cause of cancer-related death in men globally, with 1 in 8 men in the US diagnosed during their lifetime. For Low-Risk Prostate Cancer (LRPC), management options include Watchful Waiting (WW), Active Surveillance (AS), or curative treatments such as prostatectomy or radiation. While curative treatments can have significant long-term side effects like urinary incontinence and sexual dysfunction, AS is less invasive and preferred due to fewer adverse effects. However, variations in physician training may lead to differing recommendations, potentially causing confusion or frustration for patients consulting multiple specialists. This study investigates whether treatment recommendations—AS, …

Understanding Barriers To Fresh Produce Consumption In Detroit, Riley Ann Macdonald, Kalyyanee Ganesh Nanaaware, Jeff Lu, Derek Zahnleuter, Heather Sun, Sara Naessig, Aminah Bharadia, Eric A. Mcgrath

Medical Student Research Symposium

Title: Understanding Barriers to Fresh Produce Consumption in Detroit

Abstract:

Background Information:

Detroit has barriers to fresh produce consumption and poor health outcomes related to diet, which necessitate further study. We aim to investigate these barriers by understanding current consumption practices of fresh produce, and provide evidence for future solutions to combat these barriers.

Methods:

Surveys were distributed at two urban garden locations (Wayne State University School of Medicine Medical Student Garden and Wayne Pediatrics Garden) in Midtown, Detroit, to patrons (n=34) receiving fresh produce between March-October 2024. Surveys screened for demographics, transportation, what produce patrons took, if they …

Stopping The Cirrhosis: An International Review Of Hep C Screening In Prisons And Jails From 2004-2023, Anastasia Sahu Bs, Jack Spurlock Ba, Mhs, Eliza Beal Md

Medical Student Research Symposium

Background: As of 2023, HCV prevalence in state prisons in the United States was 9 times higher than the general population¹. Without treatment, 20% of people with HCV will develop cirrhosis, and some estimate that 70% of hepatocellular carcinoma (HCC) cases arise from cirrhosis or advanced fibrosis². Despite the high prevalence in prisons, the US does not have nationally standardized Hep C screening in correctional facilities. The goal of this study is to investigate different models of existing programs in prisons internationally. Understanding these models will inform Hep C screening in US prisons on a state …

Low, Current, And Persistent Poverty Area Residence And Social Risks Among Black Cancer Survivors, Leane S. Kuo, Theresa A. Hastert

Medical Student Research Symposium

Background: Persistent area-level poverty may contribute to long-term social and economic disinvestment and fewer health promoting resources even compared with current area-level poverty. This may contribute to unmet social needs, which are associated with adverse health outcomes. This study examines associations between living in persistent (vs. current and low) poverty areas and prevalence of social needs among African American cancer survivors.

Methods: We utilized data from 3,650 participants in the Detroit Research on Cancer Survivors (ROCS) cohort. African American adults were invited to participate if they were ages 20-79 at diagnosis with breast, colorectal, lung, prostate, or endometrial cancer (ages …

Sexual And Reproductive Healthcare Perceptions Among Arab-American Women: Implications For Gynecological Health Outcomes, Munna Hazime, Kaitlyn Zablock, Whitney Bowyer, Natalie Ahmad Mateju, Andrew Markowitz

Medical Student Research Symposium

This literature review analyzes the sexual and reproductive healthcare perceptions of Arab-American (AA) women living in the United States and how this impacts the prevalence of gynecological diseases. Sexual health is viewed promiscuously within the AA population and is generally reduced to the physical act of intercourse. It is considered either an agent of sexual desire or a means to reproduce. This dichotomy overlooks aspects of gynecological health within a broader framework. This attitude is evident in the minimal utilization of preventative screenings and increased rates of sexually transmitted infections (STIs) and gynecological cancers. Consequently, this narrow view of sexual …

The Role Of Churches In Enhancing Cancer Screening Adherence: A Focus On Faith-Based Health Literacy Among African American Women, Miranda I. Goodson, Genevieve Murray

Medical Student Research Symposium

Background: It is estimated that cancer is the second leading cause of death for African American women in the United States. One study revealed that Black women have a 1 in 3 chance of developing cancer with a 1 in 6 chance of mortality. Research has shown a lower breast cancer screening adherence among women in cultural minorities and faith-based communities. The importance of spirituality and religion as an influential factor on Black community members’ beliefs about health and medicine must be considered as churches are pillars of social support within Black American communities.

Methods: A search for studies about …

Summary Of: Financial Impacts Of The Covid-19 Pandemic On Immigrant Communities In Portland, Maine: A Qualitative Study, Eilish W. Carpenter, Claude Rwaganje, Michael Kohut, Elizabeth A. Jacobs, Kathleen Fairfield, Gloria Sclar

Northern New England Clinical & Translational Research

The COVID-19 pandemic not only disproportionately impacted the health of immigrants in the US, but it led to financial disparities as well.

Study found @ "Financial impacts of the COVID-19 pandemic on immigrant communities in" by Eilish W. Carpenter

Addressing Informal Caregiver Burnout In The United States: Policies, Interventions, And Recommendations, Michael Blampye

Master's Projects and Capstones

Informal caregiver burnout has been and will continue to be a significant public health concern in the United States, necessitating a comprehensive analysis of initiatives and policies to reduce its negative impacts. This paper provides an overview of existing approaches to address caregiver burnout at the individual, community, and national level, identifying critical gaps in policies and programs. By highlighting successful approaches in other developed countries, this paper presents comprehensive program and policy recommendations to strengthen informal caregiver support systems in the United States. Prioritizing these proposals can guide policymakers in creating a more supportive environment that values the crucial …

Physiotherapy In Community-Based Rehabilitation In Middle And Low-Income Countries: A Scoping Review, Er D. Petil Jr., Napoleon R. Caballero

Philippine Journal of Physical Therapy

Introduction: Community-based rehabilitation (CBR) is a widely recognized approach to address the rehabilitation needs of individuals with disabilities in low- and middle-income countries (LMICs). Physical therapy (PT) plays a crucial role within CBR programs. This study aimed to synthesize the current state of literature regarding the integration of PT in CBR programs in LMICs across Asia, Africa, and Latin America, examining key characteristics, reported outcomes, and challenges to implementation.

Methods: A comprehensive review of literature was conducted, focusing on studies published in the past decade. Data were extracted and synthesized in matrix format to compare and contrast findings across the …

Association Between Use Of Services To Address Adverse Social Determinants Of Health And Documented Suicide Attempt Among Patients In The Veterans Health Administration, John R. Blosnich, Aerin Derussy, Joshua S. Richman, Melissa E. Dichter, Gala True, Ann Elizabeth Montgomery

School of Medicine Faculty Publications

Suicide prevention is a top priority for the US Department of Veterans Affairs (VA), and suicide is often associated with adverse social factors (e.g., financial, legal, and housing problems). The VA provides social services integrated with healthcare services, which may increase the opportunities to detect and document suicide attempt in EHR records. Using VA administrative data, we examined three cohorts of all patients from 2014 to 2018 who had housing instability (n = 659,987), justice involvement (n = 200,487), and unemployment (n = 346,556). Administrative records were used to determine ordinal indicators of receipt of VA social services (no services, …

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

V.O.T.S. Virus Outbreak Tracking System, Izak O. De La Cruz, Elias Ciudad Leon, Van Nguyen, Amy Torres, Enzo Jaques

Posters - 2025

In a post-pandemic world, the need for real-time, accessible disease tracking has never been more critical. While global COVID-19 heat maps were widely utilized during the pandemic, local virus tracking tools have since diminished, leaving a gap in public health awareness.

V.O.T.S. is an interactive application that visualizes real time disease outbreaks through an interactive heatmap, enabling users to track virus trends by county, severity, and timeframe. The system integrates public health data from trusted sources such as the CDC, empowering individuals and healthcare professionals to make informed decisions. In addition, V.O.T.S. enhances accessibility with multilingual support, symptoms assessment, and …

Cultural And Religious Perspectives On Suicide And Healing, Arielle Friedman

be Still

This essay is built off of a paper I wrote in a college global health course on culture and mental illness. I have always been fascinated by cultural interpretations of illness & believe that as a future physician, it is my responsibility to educate myself and others on the complex interplay between religious ideologies & recognition/management of biological disease in order to provide appropriate patient-centered care.

Hbv Transmission Knowledge Among Korean-American Chronic Hepatitis B Patients In The United States, Giyoung Lee, Hee-Soon Juon, Eunji Kim, Katherine C Smith, Hie-Won Hann, Mimi Chang, Ann C. Klassen

Division of Gastroenterology and Hepatology Faculty Papers

Chronic hepatitis B (CHB) is a condition that disproportionately affects Asian Americans in the United States. Knowledge of transmission is crucial for CHB patients to practice prevention methods to limit the spread of the hepatitis B virus (HBV), but also live their lives free from unwarranted fears or restrictions. Among Asian CHB patients, several misperceptions about HBV transmission have been identified. This analysis aims to assess the current state of HBV knowledge among a cohort of Korean-American CHB patients. This mixed-methods study includes 363 respondents who completed a survey in either Korean (N = 298) or English (N = 65) …

An Application Of Minimization For Ensuring Balanced Study Arms In A Group-Randomized Covid-19 Educational Intervention Trial, Xu Zhang, Mohammad H Rahbar, Amirali Tahanan, Cici Bauer, Marcia C De Oliveira Otto, Alanna C Morrison, Belinda Reininger, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Our institution carried out a multi-center, group-randomized controlled trial to evaluate the effectiveness of two community-based interventions on promoting the uptake of COVID-19 testing and vaccination in three regions with high levels of health disparities in Texas. We selected Census Block Groups (CBGs) with high disparity for randomization. In each study region, selected CBGs were randomized into two intervention groups and one control group. An important goal was to ensure balanced distributions of two continuous covariates, the disparity index and population size, across study arms. In this paper, we describe a novel minimization method used to ensure balanced study …

Advancing Pandemic Response: Integrated Strategies For Testing, Prediction, And Bias Mitigation, Tianshu Gu

Theses and Dissertations (ETD)

The COVID-19 pandemic, along with prior outbreaks such as SARS and Ebola, has revealed critical gaps in global pandemic preparedness, emphasizing the need for integrated approaches to infectious disease management. This dissertation addresses three key areas of pandemic response: developing scalable screening strategies, constructing reliable predictive models, and mitigating demographic biases in artificial intelligence (AI) models used for healthcare decision-making.

The first study introduces a global screening strategy designed to optimize resource use and increase testing capacity, particularly in low- and middle-income countries (LMICs) where resources are limited. This study leverages pooled testing methods, where multiple samples are combined into …

Examining Racial Disparities In Cancer Incidence And Mortality Across South Carolina Regions, William Stokes, Swann Arp Adams, Kara M Montgomery

Senior Theses

Purpose: To provide updated cancer mortality-to-incidence ratio (MIR) data across South Carolina (SC).

Methods: State and national incidence and mortality data were collected from the South Carolina Central Cancer Registry (SCCCR) and the National Cancer Institute’s Surveillance Epidemiology and End Results Program (SEER). MIRs (mortality rate/incidence rate) were calculated for all cancer sites, cervical, colon, female breast, lung and bronchus, oral cancers, and prostate cancers from the years 2016-2021, excluding 2020.

Results: Major racial disparities in MIR were found in SC, with the largest discrepancies seen in cervical, colon, and prostate cancers. Of note, each SC region had white cervical …

Estimation Of Therapeutic Threshold For Tuberculosis Using Adapted Nominal Group Technique And Clinical Vignettes In Clinical And Community Settings In Southern Africa, Alfred Kipyegon Keter, Alastair Van Heerden, Tom Decroo, Tom Boyles, Shannon Bosman, Thandanani Madonsela, Lindani Innocent Msimango, Lenika Naiken, Carlos Kiyan, Mashaete Kamele

Population Health, East Africa

Background: When confronted with diagnostic uncertainty and a decision on whether to start treatment or not, clinicians consider the potential harm and benefit of offering versus withholding treatment. Treatment can be offered if the probability of tuberculosis (TB) in the patient is above the “therapeutic threshold” (ThT): the probability of disease at which the expected utility of treating and not treating is the same. We estimated ThT for TB in clinical and community settings in Southern Africa using two methods: an adapted nominal group technique (aNGT), and decisions made based on clinical vignettes (CVs).

Methods: We enrolled health …

Shifting Healthcare In Rural South Carolina: A Study Of Media Coverage Of The Effects Of Hospital Closures, Morgan Harper

Senior Theses

Rural hospital closures have become an increasingly urgent issue in healthcare across the United States. These closures have impacted access to healthcare, the job market, and general community health. Most hospitals have been forced to close due to low patient volumes, financial struggles, and corporate ownership. Immediate implications of closures include the displacement of healthcare workers, community concern about lacking a central healthcare facility, and increased travel times to access care.

This thesis examines South Carolina’s healthcare landscape in areas with hospital closures since 2012 and explores the effects of and responses to these closures as discussed in newspapers and …

Impacts On College-Aged Asian American Mental Health, Zahra Soherwardy

Senior Theses

This study explores the relationship between different forms of racial harassment and mental health issues in Asian American college students. Asian American mental health is a growing concern in the field of public health. Asian Americans have the lowest treatment rates and some of the highest stigma levels of any demographic. They are also impacted by the model minority myth and discrimination, further alienating them from getting help. The topics of subtle racism, blatant racism, and current racial discrimination were compared to depressive symptoms, anxiety, self-esteem, and four domains of aggression using survey data. Subtle racism was found to be …

#Discreetshipping: Selling E-Cigarettes On Tiktok, Page D. Dobbs, Eric D. Schisler, Charlotte Mccormick

Health, Human Performance and Recreation Faculty Publications and Presentations

Introduction

Youth and young adult use of e-cigarette products continues to remain high despite regulatory approaches to reduce youth access. This study sought to examine TikTok content regarding the sale and distribution of e-cigarettes.

Aims and Methods

TikTok videos (n = 475) and metadata posted between June 2022 and August 2023 were scraped using a TikTok application programming interface and popular hashtags used to sell vaping products (ie, #discreetshipping [40.8 million], #puffbundle [14.8 million], #hiddennic [1.0 million]). After watching the 25 most viewed videos (39 600–868 800 views), a codebook was developed. All metadata were annotated using 11 unique …

Mothers’ Characteristics And Children's Diarrhea Between 2010-2020 In Rwanda, Amans Ntakarutimana Dr., Patrick A. Tschida Dr.

Journal of Social, Behavioral, and Health Sciences

Mothers’ characteristics influence children’s health and development. We conducted a cross-sectional study to assess the influence of mothers’ education level, employment status, and exposure to domestic violence on diarrhea among children under 5 years old using secondary data from 2010, 2015, and 2020 Rwanda Demographic Health Surveys. We used stratified descriptive statistics, pairwise comparisons, and logistic regression designs to assess (a) the prevalence of mothers per education level, employment status, and exposure to domestic violence; (b) their variation over time; and (c) their influence on diarrhea among children under 5 years old between 2010 and 2020 in Rwanda. According to …

Poor Cancer Prevention And Detection In Zimbabwe, Kenyon C. Chipman

Journal of Nonprofit Innovation

Abstract

In the aftermath of the HIV/AIDS epidemic, Sub-Saharan Africa, particularly Zimbabwe, has witnessed a surge in noncommunicable diseases such as cancer. Despite the decline in HIV/AIDS and other cancer-associated illnesses like HPV, these diseases have set the stage for a growing cancer epidemic. Key contributing factors to this rise include a lack of knowledge about cancer among both patients and health professionals, the prevalence of cancer-associated communicable diseases, and limited accessibility to early detection and prevention services and resources. These factors have led to late diagnoses, increased burden on the healthcare system, and adverse effects on individuals and families. …

Defining Sexual Assault, Consent, And Resources To Empower Students: A Dnp Project, Sarah Powers

SACAD: Scholarly Activities

Abstract

Sexual assault (SA) remains a pervasive issue on college campuses in the United States, often compounded by underreporting and a lack of knowledge about available resources. This Doctor of Nursing Practice (DNP) project aims to educate first-year college students about SA, sexual consent, and available resources to empower students in preventing assaults and seeking help when needed. The intervention, which was integrated into mandatory freshman seminars at a four-year university, was guided by Knowles' Adult Learning Theory. A presentation provided critical information, and knowledge gains were assessed through pre- and post-presentation surveys. Initial findings indicated significant increases in understanding …

Exploring The Causes Of Plwha Non-Adherence With Antiretroviral Therapy: Implications For Practice In The Post-Covid-19 Era, A Phenomenological Study, Adriani Suwito, Evi Hasnita, Nurhayati -. Nurhayati, Oktavianis -. Oktavianis

The Qualitative Report

One of the goals of HIV/AIDS health services is to combat patients’ non-adherence with medication. This is the key to providing effective care for these patients. If a patient is rebellious or undisciplined in following his treatment regimen, the consequences can include decreased production, increased morbidity, and even death. However, in the post-COVID-19 period, where health protocol adherence remains strong, there are concerns regarding the potential spread of HIV/AIDS. The purpose of this qualitative phenomenon study is to investigate the factors that contribute to non-adherence to medicine in HIV/AIDS patients during the post-COVID-19 condition to remove barriers to patient treatment. …

Value-Based Healthcare Reimagined: A Mixed-Methods Study On Behavioral Health Clinicians' Perspectives, Amanda L. Strickland

Electronic Theses and Dissertations

This study explores how behavioral health clinicians perceive Value-Based Healthcare (VBHC), a model designed by Porter and Teisberg (2006) to improve outcomes relative to costs. While widely promoted in healthcare reform, VBHC poses unique challenges when applied to behavioral health settings. Using an explanatory mixed-methods design, this study first assessed clinicians’ awareness of VBHC through a survey of 23 licensed clinicians at a Community Mental Health Center (CMHC) in Colorado. Quantitative findings revealed that one-third of participants were aware of VBHC with awareness differing by role prompting further exploration in a qualitative phase. Semi-structured interviews with eight clinicians provided deeper …

Healthy Here Active Living Year 1 Summary, Camille R. Velarde, Courtney A. Fitzgerald, Theresa H. Cruz

Reports & Documents

No abstract provided.

Healthy Here Healthy Eating Year 1 Summary, Camille R. Velarde, Courtney A. Fitzgerald, Theresa H. Cruz

Reports & Documents

No abstract provided.

Healthy Here Immunization Year 1 Summary, Camille R. Velarde, Courtney A. Fitzgerald, Theresa H. Cruz

Reports & Documents

No abstract provided.

Dengue Cases In Hanoi, Vietnam: Unseasonal Surge Foreshadows Increased Incidence That Demands Organized Preventive Action, Andrew W. Taylor-Robinson

Chulalongkorn Medical Journal

Letter to the Editor - Abstract not required.