Community Health and Preventive Medicine Commons^™

The Diabetes Prevention Program And Its Outcomes Study: Niddk's Journey Into The Prevention Of Type 2 Diabetes And Its Public Health Impact, Jill P Crandall, Dana Dabelea, William C Knowler, David M Nathan, Marinella Temprosa, Dpp Research Group

Children’s Nutrition Research Center Staff Publications

The current-day epidemic of type 2 diabetes, largely driven by increased adiposity and reduced physical activity in the setting of genetic susceptibility, is a major public health challenge. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) presciently proposed the Diabetes Prevention Program (DPP), a multicenter randomized clinical trial, designed by investigators in conjunction with NIDDK staff and initiated in 1996. The primary goal of DPP was to determine whether an intensive lifestyle intervention (ILS) or metformin in comparison with placebo would reduce the development of diabetes in a high-risk population with prediabetes. After mean 2.8 years, ILS …

The Sun Shines Beyond The Mountains: The Creation Of A Suicidality Needs Assessment For Lesotho, Layhla Currier

Theses/Capstones/Creative Projects

The country of Lesotho has the highest suicide mortality rate in the world. Although this is true, there has seldom been research into the cause of this astronomical rate, and even less evaluating how to address the issue. This study focused on the analysis of available data to better understand the possible causes of the high suicide rate in Lesotho. Additionally, a suicidality needs assessment was created to collect data regarding mental health, social support, risk factors, and previous suicidality from Basotho (moniker for residents of Lesotho) in a non-stigmatizing way. Two varying suicidality assessments were used to create this …

Evaluating The Impact Of Community Gardens On Social Equity And Public Health: A Case Study Of Caramel Connections Foundation's (Ccf) Seeds Of Joy Community Garden, Elizabeth Pinder

Electronic Theses, Projects, and Dissertations

Community gardens have been increasingly recognized as effective public health interventions that address food insecurity, foster social cohesion, and promote environmental sustainability. This evaluation examines the impact of the Caramel Connections Foundation (CCF) Seeds of Joy Community Garden in Ontario, California, by assessing its effectiveness in advancing social equity, improving public health outcomes, and fostering community engagement. Using an evaluation framework, this study measures key program outcomes, including improvements in community well-being, inclusivity, and access to green spaces.

A mixed-methods evaluation design was applied, incorporating process and impact evaluation methodologies. Secondary data collected from CCF’s existing program records, survey responses, …

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 …

A Qualitative Approach To Identifying Obstacles To Mental Healthcare In The Rio Grande Valley From The Perspective Of Mental Healthcare Professionals., Shania M. Linder, Cristian Botello, Raquel Villarreal, Nelda Rodriguez, Mario Gil, Dayana Zamora

Research Symposium

Background: There are many factors that prevent members of the Hispanic/Latino community from accessing mental health resources. This is important to investigate because there is a lack of knowledge on why residents of the Rio Grande Valley, an underserved region of South Texas, are unable to access and/or utilize mental health resources.

Methods: A focus group session was held at a mental health counseling clinic in Cameron County, Texas on February 1, 2024. The participants consisted of mental health professionals, such as two mental health clinicians, a clinical counselor, two school counselors, a licensed professional counselor supervisor, and a …

From Fields To Fast Foods: Food Culture, Identity, And Health In Puerto Rico Under The U.S. Empire, Ivanna Morales Mercado

CMC Senior Theses

Operation Bootstrap, launched in 1947, fundamentally altered Puerto Rico’s economy, just as much as its food culture. Prioritizing manufacturing over agriculture led to the collapse of the island’s farming sector, increasing reliance on food imports and leading to a rise in diet-related diseases such as obesity, type 2 diabetes, and cardiovascular issues. This thesis examines the legacies of Operation Bootstrap on Puerto Rico’s food system, health outcomes, and cultural identity by emphasizing the need to value intergenerational knowledge. The oral history research in this study highlights the importance of intergenerational knowledge in reclaiming sustainable agricultural practices and healthy, culturally significant …

Food Security And Its Impact On Hypertension In Urban Communities, Lauren M. Nobriga

Master's Projects and Capstones

The Quality Improvement Team proposed an intervention to increase enrollment in the Food Security Program, a six-month initiative that provides vouchers redeemable for fruits and vegetables. Long-term impacts of this Program include an improved food economy and enhanced patient disease management autonomy. This project aimed to increase the percentage of eligible adult medicine clinic patients enrolled in the Food Security Program by 25%, or 11 patients per month, based on the mean enrollment for the first four months of the Program (May to August) of nine patients. The intervention was based on bi-monthly performance reports, making the goal include enrolling …

The Moderating Effect Of Socioeconomic Status And Walkability On The Efficacy Of Physical Activity Interventions, Analisa Vavoso, Vincent Berardi, Marc A. Adams

Student Scholar Symposium Abstracts and Posters

To enable physical activity (PA) interventions to better tailor procedures to participant characteristics, we investigated the role of neighborhood socioeconomic status (SES) and walkability on the differential effectiveness of adaptive versus static activity goals (AG vs. SG) and immediate versus delayed (IR vs. DR) reinforcement in a PA trial.

Data was collected as a part of the WalkIT Arizona study, where healthy, inactive adults (n = 512) were instructed to wear an accelerometer daily for one year and were provided with daily goals for moderate-to-vigorous PA (MVPA). The intersection of goal types (adaptive and static) as well as reinforcement types …

Medications For Opioid Use Disorder & Implications For Mobile Methadone Units, Sarah Boeke, Samantha Singer, Stella Resko

Substance Use Research Team

Research has shown the urgent need for updates to guidelines regulating opioid treatment programs (OTPs), especially as the COVID-19 pandemic exacerbated overdose rates and the drug supply became increasingly contaminated with fentanyl, synthetic opioids, and xylazine (Moghtaderi et al., 2023)(DEA, 2022). Part 8 of Title 42 of the Code of Federal Regulations (CFR), originally enacted in 2001, includes regulations that guide OTPs. The 42 CFR Part 8 final rule, issued by SAMHSA, updates these federal regulations. It is the first major revision since 2001, aimed at expanding access to care, improving patient outcomes, and integrating lessons learned from the COVID-19 …

A Case Study In Program Evaluation, Sydney Wilcoxson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Evaluation is a critical component of a successful evidence-based health promotion program or intervention. In public health, evaluations ensure that interventions are achieving their intended objectives, provide feedback on program strengths and weaknesses, and serve as a mechanism of accountability and transparency to stakeholders so that they know their invested resources are being utilized in the most efficient manner. Without evaluation, it would be much more difficult to understand how well the intervention is working, and communication between stakeholders would be significantly affected.

A recently confirmed Methicillin-resistant staphylococcus aureus (MRSA) outbreak on a Fayette County Public Schools (FCPS) high school …

Understanding Guardian Perceptions Of Whole-Foods Plant-Based Diets As Interventions In Pediatric Medicine, Vijay R. Luthra

Honors Undergraduate Theses

The obesity epidemic is widespread in American society, often affecting children who bear its consequences innocently. Due to a lack of nutrition knowledge, children rely on caregivers to meet their nutritional needs and instill healthy habits. This study examines parents' attitudes, knowledge, and behaviors, as well as perceived barriers to adopting a whole-foods plant-based diet (WFPD) for their children. Using a modified survey instrument by Morton et al., this study focused on parents and children regarding dietary choices. Participants were recruited from the waiting area of a pediatric clinic at the Medical College of Georgia between April and May 2023. …

Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry

Theses and Dissertations

COVID-19 presented unique challenges for rural Mississippi communities including impacts on the mental health of rural individuals. This research study aimed to identify opportunities for mental health interventions to provide health promotion professionals with quantitative data on the accessibility and the likelihood of engagement with mental health-fostering behaviors. A secondary objective of this research was to categorize these behaviors within the constructs of the Social Ecological Model. Demographics for rural Mississippi communities were collected and displayed, and using multivariate analyses including Spearman’s correlation and a Mann-Whitney U test the correlation between mental health fostering behaviors and demographic factors was obtained. …

Associations Between Avocado Intake And Measures Of Glucose And Insulin Homeostasis In Hispanic Individuals With And Without Type 2 Diabetes: Results From The Hispanic Community Health Study/Study Of Latinos (Hchs/Sol), Mackenzie K Senn, Mark O Goodarzi, Gautam Ramesh, Matthew A Allison, Mariaelisa Graff, Kristin L Young, Gregory A Talavera, Amanda C Mcclain, Tanya P Garcia, Jerome I Rotter, Alexis C Wood

Faculty, Staff and Students Publications

BACKGROUND AND AIMS: To investigate associations between avocado intake and glycemia in adults with Hispanic/Latino ancestry.

METHODS AND RESULTS: The associations of avocado intake with measures of insulin and glucose homeostasis were evaluated in a cross-sectional analysis of up to 14,591 Hispanic/Latino adults, using measures of: average glucose levels (hemoglobin A1c; HbA1c), fasting glucose and insulin, glucose and insulin levels after an oral glucose tolerance test (OGTT), and calculated measures of insulin resistance (HOMA-IR, and HOMA-%β), and insulinogenic index. Associations were assessed using multivariable linear regression models, which controlled for sociodemographic factors and health behaviors, and which were stratified by …

A Comparative Analysis Of Adolescent Pregnancy Patient Outcomes In The United States And United Kingdom Healthcare Systems, Liza Hopper

Senior Theses

Individuals all across the world should have equal access to healthcare. However, one’s ability to receive and afford quality care differs between countries. Comparing the differences in healthcare structures in both the UK and the US provides great insight into how certain welfare models affect patient outcomes. In this project, I discuss the functionality of the healthcare systems in the UK and the US. Then, by delving into how they relate to adolescent pregnancy patient outcomes, one can compare how the healthcare policies relate to the patient outcomes of a vulnerable population group. In both countries, adolescent mothers, those who …

Expanding Health Professional Education In The Rio Grande Valley During The Covid-19 Pandemic, Sabrina R. Orta, Samantha G. Alvarado, Shuchita Jhaveri

Research Symposium

Purpose: The COVID-19 Pandemic has prompted innovation in health professional education, such that learners are able to recognize and mitigate healthcare disparities in the outcomes of vulnerable populations. The objective of our project was to increase education on preventing, preparing for, and responding to COVID-19 and other locally prevalent infectious diseases that disproportionately affect RGV communities.

Description: This project had 3 goals: (1) provide learners with virtual patient-interaction simulations (2) provide interactive training modules on the identification, prevention, and treatment of infectious diseases affecting South TX and strategies to increase child vaccinations, and (3) provide learners an opportunity to coordinate …

Perspectives On Non-Prescription Antibiotic Use Among Hispanic Patients In The Houston Metroplex, Lindsey Laytner, Patricia Chen, Susan Nash, Michael K Paasche-Orlow, Richard Street, Roger Zoorob, Barbara Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

BACKGROUND: Non-prescription antibiotic use includes taking an antibiotic without medical guidance (e.g., leftovers, from friends/relatives, or purchased without a prescription). Non-prescription use contributes to antimicrobial resistance, adverse drug reactions, interactions, superinfection, and microbiome imbalance. Qualitative studies exploring perspectives regarding non-prescription use among Hispanic patients are lacking. We used the Kilbourne Framework for Advancing Health Disparities Research to identify factors influencing patients' non-prescription use and organize our findings.

METHODS: Our study includes Hispanic primary care clinic patients with different types of health insurance coverage in the Houston metroplex who endorsed non-prescription use in a previous survey. Semistructured interviews explored the factors …

What More Can Be Done? Childhood Obesity In Glassboro, Nj, N. Mirmanesh, Seth Spicer, Stephen Acheampong, Mary K. Duggan

Rowan-Virtua Research Day

Childhood obesity is a growing public health concern in the United States, with an estimated 20% of American children being obese. In New Jersey (NJ), 9% of high school students are obese, and there are disparities in obesity rates based on gender, sexual identity, and race/ethnicity. In Gloucester County, NJ, limited data is available on childhood obesity rates, but 36.4% of adults are obese, and lower SES is related to higher rates of obesity in youth. To address this issue, this research poster proposes a partnership with the Boys and Girls Club of Glassboro to provide nutritional resources and create …

The Effects Of Obesity And Diabetes On The Pediatric Population, Keyur Patel, Vrushank Shah, Zachary Harris, Kanad Mukherjee

Rowan-Virtua Research Day

The World Health Organization has declared diabetes (DM) and Obesity to be epidemics due to their rising prevalence. Obesity plays a role in the aetiopathogenesis of type 2 diabetes, the most common type of diabetes in the world, as well as the development of its complications. Obesity and overweight play a growing role in type 1 diabetes. Weight gain is often thought of as a side effect of insulin therapy, but it also has a significant pathophysiological impact at different stages of the disease. (1) In the United States and other nations across the world, childhood obesity has become a …

Communicating Health: Misinformation And Mistrust In The Age Of Coronavirus, Chris Anstead

Undergraduate Theses

With one of the most advanced medical systems in the world, the Untied States still experienced an exceedingly high COVID-19 death rate per capita. Because biomedical therapies for COVID-19 were available, the focus of this review is on the social aspects of the COVID-19 response. By observing how Americans reacted to vaccination, masking, and social distancing guidelines, as well as how those guidelines were communicated to the general population from the public and private sectors, this thesis argues that the social and political aspects of the COVID-19 pandemic played a significant role in the outcome of the pandemic response. Additionally, …

Brief Report: Out Of Sight Out Of Mind - Preventable Childhood Kidney Disease In The Far North, Johanna Neville, Allison Hempenstall, Caroline Taunton, Valmay Fisher, Malcolm Mcdonald

Journal of the Australian Indigenous HealthInfoNet

APSGN is an immune-mediated kidney disease that occurs after a Streptococcus pyogenes skin or throat infection in children and contributes to chronic kidney disease later in life. It is a disease of poverty and regrettably common in Aboriginal and Torres Strait Islander children. There have been seven documented APSGN outbreaks across Far North Queensland in the last nine years. Despite this disease being notifiable in both Western Australia and the Northern Territory, Queensland is yet to acknowledge the importance of early notification in the management of APSGN. Notification-driven publication of APSGN incidence should help raise its profile and stimulate better …

Ending The Hiv Epidemic: Identifying Barriers And Facilitators To Implement Molecular Hiv Surveillance To Develop Real-Time Cluster Detection And Response Interventions For Local Communities, Moctezuma Garcia, Samantha Devlin, Jared Kerman, Kayo Fujimoto, Lisa R Hirschhorn, Gregory Phillips, John Schneider, Moira C Mcnulty

Faculty, Staff and Student Publications

The rapid implementation of molecular HIV surveillance (MHS) has resulted in significant challenges for local health departments to develop real-time cluster detection and response (CDR) interventions for priority populations impacted by HIV. This study is among the first to explore professionals' strategies to implement MHS and develop CDR interventions in real-world public health settings. Methods: Semi-structured qualitative interviews were completed by 21 public health stakeholders in the United States' southern and midwestern regions throughout 2020-2022 to identify themes related to the implementation and development of MHS and CDR. Results for the thematic analysis revealed (1) strengths and limitations in utilizing …

Socioecological Factors Linked With Pharmaceutical Incentive-Driven Prescribing In Pakistan, Muhammad Naveed Noor, Afifah Rahman-Shepherd, Amna Rehana Siddiqui, Wafa Aftab, Sadia Shakoor, Rumina Hasan, Mishal Khan

Department of Pathology and Laboratory Medicine

Pharmaceutical marketing through financial incentivisation to general practitioners (GPs) is a poorly studied health system problem in Pakistan. Pharmaceutical incentivisation is seen to be distorting GPs prescribing behaviour that can compromise the health and well-being of patients. We draw on a conceptual framework outlined in the ecological system theory to identify multiple factors linked with pharmaceutical incentivisation to GPs in Pakistan. We conducted qualitative interviews with 28 policy actors to seek their views on the health system dynamics, how they sustain pharmaceutical incentivisation and their effect on the quality of care. Our analysis revealed four interlinked factors operating at different …

Public Health Measures And Sars-Cov-2 Cases In The Juvenile Justice System: Implications For Pandemic Response In The Detention Setting, Asha Davidson, Shelley Aggarwal, Mona Eissa, Laura Benjamins, John Will, Rebecca Beyda

Faculty, Staff and Student Publications

OBJECTIVE: The purpose of this study was to examine severe acute respiratory syndrome-coronavirus-2 case positivity in juvenile justice facilities of two different states alongside institutional, local, and state public health policies during the first 6 months of the coronavirus disease 2019 pandemic.

METHODS: This retrospective chart review examined two large, urban juvenile justice centers in California and Texas. Positive intake or day 12 tests were considered suggestive of community-acquired severe acute respiratory syndrome-coronavirus-2 infection. Researchers examined state and county restrictions, closings, and openings. The study included all of the youths 10 to 18 years residing in the facilities between March …

The Impact Of Universal Free Meals During Covid-19 On Family Life And Perspective Of School Meals In Central Washington State, Charlotte Green

All Master's Theses

This study explored the impact of the USDA COVID-19 Universal Free Meal (UFM) waivers on family life, school meal participation, and child eating habits from parents with children in Central Washington state (WA) schools. n = 119 parents/caregivers with students who were in K-12^th grade in Central WA from August 2019-February 2023 completed a 10 question electronic, and descriptive survey. The survey measured changes in participation in school lunch/breakfast pre to post COVID-19 waiver, which provided free meals for all children, and whether UFM were beneficial to families, impacted perception of school food, child’s sense of community at school …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

Impact Of The Covid Pandemic On Mental Health And Training Opportunities Of Public Health Residents From 4 European Countries: A Cross-Sectional Study, Giovanna Failla, Marta Caminiti, José Chen-Xu, Giuseppina Lo Moro, Nausicaa Berselli, Madalena Cabral Ferreira, Filipa Malcata, David Peyre-Costa, Roberto Croci, Giorgia Soldà, Angelo Capodici, Caterina Morcavallo, Francesco Traglia, Fabrizio Cedrone, Ilaria Storti, Alfonso Alonso Jaquete, Martina Antinozzi, Anca Vasiliu

Faculty, Staff and Students Publications

OBJECTIVES: There is little evidence on the impact of the COVID-19 pandemic on Public Health Residents' (PHR) mental health (MH). This study aims at assessing prevalence and risk factors for depression, anxiety and stress in European PHR during the COVID-19 pandemic.

METHODS: Between March and April 2021, an online survey was administered to PHR from France, Italy, Portugal and Spain. The survey assessed COVID-19 related changes in working conditions, training opportunities and evaluated MH outcomes using the Depression Anxiety Stress Scales-21. Multivariable logistic regressions were applied to identify risk factors.

RESULTS: Among the 443 respondents, many showed symptoms of depression …

Glyphosate And Dopaminergic Neurotoxicity: Herbicide Impacts On Parkinson's Disease Development, Lojy Hozyen

Undergraduate Research Posters

Nearly one million individuals in the United States are living with Parkinson’s disease (PD). In the past two decades, the death rate from PD has risen by about 63 percent in the United States. Major findings have been made in the past five years about the potential impact of glyphosate (N-(phosphonomethyl) glycine) exposure on the onset of PD symptoms. The purpose of this meta-analysis is to provide a compiled update on the chemical and biological alterations that glyphosate imposes on the human brain. A meta-analysis was conducted to create a quantitative estimate of the connection between PD and glyphosate. Findings …

Public Health Burden Of Secondhand Smoking: Case Reports Of Lung Cancer And A Literature Review, Ladislav Štěpánek, Jarmila Ševčíková, Dagmar Horáková, Mihir Sanjay Patel, Radka Durďáková

Faculty, Staff and Student Publications

Secondhand smoke (SHS), composed of mainstream and sidestream smoke, is a known human carcinogen. It contains a variety of harmful substances at even higher concentrations than mainstream smoke itself, which is inhaled during firsthand smoking. Exposure to SHS, affecting more than a third of the worldwide population, increases the likelihood of lung cancer by roughly 30%, with specific contributions depending on the histological type of cancer. This study aimed to present the harmful potential of SHS through case reports and describe the burden of SHS via a literature review. From a collection of lung cancer case reports occurring in never …

Find Your Flow: A Menstrual Health Social Media Campaign, Sarah Hamp-Adams

Kinesiology and Public Health

In many cultures, menstruation is surrounded by silence and shame instead of being celebrated as a sign of health and vitality. Globally, challenges, including stigma surrounding menstruation, create barriers for menstruators (White, 2013; Crawford, 2014; Garg, 2015). It proves to be difficult for young menstruators to navigate menarche due to the taboos and socio-cultural restrictions surrounding menstruation (Sharma,2015). Encouraging women to have open conversations about their periods is necessary to combat these challenges.

To understand how to address the stigmas around menstruation, the researchers first conducted a literature review, revealing that education messages via the Internet, posters, storytelling, and peer …

The Opioid Epidemic & Narcan® Education: Current State Of Narcan® Use, Alicia Podwojniak, Fatimah Seyed-Ali, Akhil Abraham, Archana Salek

Rowan-Virtua Research Day

Objectives:

• Investigate the need for increased naloxone awareness and availability in communities across the state [New Jersey]
• Assess the current advantages and disadvantages of Narcan® use
• Identify the barriers preventing naloxone from becoming a socially accepted treatment
• Develop an education plan to effectively teach target communities about Narcan® training and related resources/centers in that area.