Community Health and Preventive Medicine Commons^™

The Effects Of Night Shift Work On Heart, Gut, And Reproductive Health, A Systematic Review, Courtney Grayson, Preeti Oza

Pacific Journal of Health

Night shift work, a commonplace in today’s society, creates a variety of health-related challenges for individuals who participate in it. Often, the only adverse health effects discussed in relation to night shift work are sleep dysfunction and mental health issues. This systematic review examined the cardiovascular, gastrointestinal, and fertility health effects that plague individuals working night shift. The goal of this work is to illuminate these lesser known, but equally important, health effects in an effort to bring awareness to the issues. By educating night shift workers and health care providers of the acute risks associated with this type of …

Predictors Of Lung Cancer Screening Recommendation In Virginia Using The Community Health Assessment Survey, Aashish Batheja, Carrie Miller, Sunny Jung Kim, Bernard Fuemmeler F., Rajsh Balkrishnan

Virginia Journal of Public Health

Purpose: The purpose of this analysis was to determine the factors that may influence the probability of being recommended a lung cancer screening by a health professional in Virginia.

Methods: Data were obtained from the Community Health Assessment Survey conducted by the University of Virginia (UVA) Health System and Cancer System in collaboration with Virginia Commonwealth University (VCU) Cancer Center. SAS software was used to conduct a logistic regression with the following variables: age, sex, race, current smoking status, cancer history, education level, income level, insurance, and rurality.

Results: Statistically significant positive predictors included being a current smoker (OR: 3.504, …

Promoting Community Health Research Partnerships Through A Small Grants Program: Processes And Lessons Learned, Sophie G. Wenzel, Amanda J. Nguyen, Kristin Miller, Leigh Guarinello, Allison Mckell, Kathryn Hosig

Virginia Journal of Public Health

While there are multiple ways to engage communities in health research, one approach is through partnership-based research in which community representatives are involved as intentional partners in the research process, from conceptualization and co-creation to implementation, analysis, interpretation, and dissemination. However, there remain numerous challenges to supporting and sustaining such partnerships.

Since its launch in 2019, the integrated Translational Health Research Institute of Virginia (iTHRIV) has sought to foster community engaged health research among its four research/clinical institutions through a community partnership-based grant program. Over five funding cycles, iTHRIV has awarded 14 one-year research grants addressing topics such as opioid …

Empowering Community Health Workers In Guatemala, Oswald M. Attin, Gineska Castillo, Grace Sibert, Andrea Harper

Virginia Journal of Public Health

Introduction:

Community health workers (CHW) have been integral in helping middle- and low-income countries. This research paper discusses the benefits of the involvement of CHWs in health screenings.

Methods:

Health screenings were performed for three rural communities in Guatemala, in 2021, alongside a church in Zacapa, to identify community wide health risks. The screenings included a detailed questionnaire that collected demographic data, height and weight, a blood glucose check, a hemoglobin check, and a blood pressure reading. Additional nutritional data was collected to understand diet patterns and habits. In-depth educational sessions were done with the CHWs, emphasizing preventative care, and …

The Evaluation Of Collaborative Disease Prevention And Control Measures For Border Health Between Thailand And Myanmar, Laos, And Cambodia, Orathai Srithongtham, Aomthip Polbupha, Taweewun Srisookkum, Orathai Katkhaw, Thossaphong Buraman

Journal of Health Research

Background: Collaborative disease prevention and control measures for border health between Thailand and three neighboring countries (Myanmar; Lao People’s Democratic Republic (PDR), also known as Laos; Cambodia) were implemented in 2016 - 2017.

Methods: Summative evaluation and a mixed-method design aimed to evaluate the measures for border health between Thailand and three neighboring countries. The participants were public health personnel from provincial, district, and sub-district levels. Data were collected by questionnaire and interview guide. Quantitative data were analyzed by descriptive statistics; and qualitative data were analyzed through content analysis.

Results: The overall collaboration for border health of Thailand …

The Effects Of Cigarette Price Incentive And Regulatory Policies In Taiwan, Che-Ning Yang, Yi-Fan Lin

Journal of Health Research

Background: Price affects the demand for cigarettes, but its direct impact on smoking behaviors remains unclear. This study evaluated the effects of cigarette price increases and non-pricing tobacco control policies on adult smoking behaviors in Taiwan, using data from national annual survey during 2004~2015 with 166,325 valid respondents.

Methods: We established mixed-effects models of logistic regression for each of the three dependent variables, “smoking,” “quit attempts,” and “cessation maintenance,” to characterize smoking behaviors. Socioeconomic and sociodemographic factors were also included in the models.

Results: Non-pricing tobacco control policies had no significant effects on smoking behaviors. Conversely, cigarette price …

What We Know About School-Based Health Centers: Literature On Outcomes, Cost Impact, Implementation, And Sustainability, Michelle R. Coble, Valerie F. Mcdaniel

Pacific Journal of Health

Many children lack access to adequate healthcare in the United States. School Based Health Centers (SBHC) are a useful resource for accessing those needed services. The purpose of this study is to evaluate the available research for the strengths of SBHCs with improving health outcomes and health equity, cost impact of SBHCs, and best practices for implementing and sustaining an SBHC. The focus of this study was on reviewing the current literature on the impact of SBHCs on improving health equity, health outcomes, cost impact, and to establish best practices for implementing and sustaining an SBHC. Although the current literature …

From Life To Life: Transitioning To Freedom After 45 Years Of Incarceration- A Single Subject Case Study, James O. Mackey, Lindsay Gietzen

Pacific Journal of Health

This case study delves into the complex process of reintegrating an elderly parolee who recently emerged from a 45-year-long incarceration within California's state prisons. The research explores this unique individual's reentry experiences and compares them with those of parolees of average age and sentence length. Factors such as family support, educational background, criminal history, health, social support, employment, access to age-appropriate resources, and recidivism rates are meticulously examined to provide valuable insights into the successful reintegration of elderly individuals back into society.

The Effect Of Pesticide Spray Season And Residential Proximity To Agriculture On Glyphosate Exposure Among Pregnant People In Southern Idaho, 2021, Cynthia L. Curl, Carly Hyland, Meredith Spivak, Lianne Sheppard, Bruce Lanphear, Michael N. Antoniou, Maria Ospina, Antonia M. Calafat

Public and Population Health Faculty Publications and Presentations

Background: Glyphosate is one of the most heavily used pesticides in the world, but little is known about sources of glyphosate exposure in pregnant people living in agricultural regions.

Objective: Our objective was to evaluate glyphosate exposure during pregnancy in relation to residential proximity to agriculture as well as agricultural spray season.

Methods: We quantified glyphosate concentrations in 453 urine samples collected biweekly from a cohort of 40 pregnant people in southern Idaho from February through December 2021. We estimated each participant’s glyphosate exposure as the geometric mean (GM) of glyphosate concentrations measured in all samples (average n = 11 …

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

Planners Vs. Non-Planners: Do Preterm Births Impact Future Contraceptive Use?, Jessie Moore

NYMC Student Theses and Dissertations

Background: In the United States, 45% of all pregnancies are unintended and occur when contraception is not used or is used inconsistently. Among those pregnancies, 1 in 10 women will experience a preterm birth, which is defined as a birth occurring before 37 weeks gestation. Women who have delivered preterm are at an increased risk for preterm birth in future pregnancies and are encouraged to wait at least 18 months between giving birth and getting pregnant again. Among women who have experienced a preterm birth, the desire to delay future pregnancy or avoiding it all together often becomes a necessity …

Spotlight On Mental Health On A Healthcare Campus: An Assessment Of Psychological Trauma Awareness, Training, And Treatment In The University Of Nebraska Medical Center College Of Public Health Community, Jenny E. Mueller

Capstone Experience: Master of Public Health

Background: Psychological trauma has been recognized as a public health concern of epidemic proportions globally. Public health community awareness of and education in trauma is likely to be integral to preparing future public health professionals to work effectively and safely in the field. Currently, the extent of trauma awareness, training, and treatment on the University of Nebraska Medical Center College of Public Health (UNMC COPH) campus is not known.

Aims: The aims of this project are to investigate and assess the level of psychological trauma awareness, training, and treatment on the UNMC COPH campus; and to provide recommendations for actions …

Strategies To Encourage Recall And Prevent Relapse After Full Mouth Rehabilitation Under General Anesthesia In Children, Claire Koukol

Capstone Experience: Master of Public Health

Background: Dental caries are preventable. Dentists utilize many prevention strategies in the office and provide at-home education to families. However, once a child develops Early Childhood Caries (ECC), especially in more severe cases, they may need general anesthesia (GA) to complete treatment. While this is an effective way to achieve full mouth dental rehabilitation (FMDR), this burdens the healthcare systems and families and does not come without risk to the patient. Patients with high caries experience remain at high risk of caries relapse after FMDR under GA, sometimes necessitating additional FMDR under GA. While there has been a significant amount …

Associations Between Self-Reported Cognitive Decline And Chronic Diseases: A Cross-Sectional Analysis Of Behavioral Risk Factor Surveillance System (Brfss) 2022, Hailey Child

Capstone Experience: Master of Public Health

Objective: This study seeks to capture how self-reports measure cognitive decline. The association between chronic conditions and cognition with age consideration in individuals aged 45 and older is investigated.

Methods: Univariate analysis generates frequencies and weighted percentages of 2022 BRFSS data. Chi-square tests and polytomous regressions generate odds ratios for bivariate analyses. A weighted multiple logistic regression model stratified by age group analyzes self-reported cognitive decline.

Results: Respondents ages 45 to 54 with three or more chronic diseases have the highest odds (OR = 6.81; 95% CI = 4.42, 10.48) of cognitive decline. Respondents 75 and older …

Morphological And Metabolic Criteria Of Covid-19 Vaccine Associated Axillary Nodes On 18-Fluorodeouxyglucose Pet/Ct Imaging In Breast Cancer Patients, Nosheen Fatima, Unaiza Zaman, Areeba Zaman, Sidra Zaman, Rabia Tehseen, Maseeh Uz Zaman

Department of Radiology

Background: In the current era vaccine-associated lymphadenopathy (VAL) is not an uncommon presentation on 18F-FDG PET/CT examinations in patients inoculated with Coronavirus disease 2019 (COVID-19) vaccination. In this study, we are presenting data of VAL on 18F-FDG PET/CT regarding its prevalence, temporal response to vaccination and imaging characteristics of VAL.
Methods: Seventy-eight (78) consecutive vaccinated breast cancer (BC) patients who had 18FDG PET/CT were retrospectively analyzed. All patients had COVID-19 vaccine shots in contralateral arms and none in breast cancer site axilla (BSA). In 35 patients 18FDG avid nodes were found in vaccine site axilla (VSA). In 25 patients 18FDG …

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

Providing Optimal Resident Sleep Hygiene In Assisted Living Communities; Opportunities For Design And Operation Teams To Collaborate And Share Their Unique Knowledge, Beverly B. J. Miller

Architecture Masters of Science Program: Theses

Research is emerging relating sleep hygiene to disease pathogenesis including Parkinson's, dementia, Alzheimer’s disease and increased cardiovascular risk. The application of circadian science as it relates to human wellness has intensified as a result. The quality of sleep significantly impacts the wellness of residents living in long term care, however sleep hygiene research is lacking in assisted living (AL) communities.

The thesis question inquires; How can operation and design teams collaborate to optimize sleep health for residents in assisted living communities? The research methodology utilized a two-phase process. Phase I identified three AL communities as test sites, providing case studies …

Addressing Cervical Cancer Disparities In Texas: Expansion Of A Community-Based Prevention Initiative For Medically Underserved Populations, Samantha H Batman, Melissa L Varon, Maria Daheri, Tony Ogburn, Saul D Rivas, Laura Guerra, Paul A Toscano, Monica Gasca, Lori Campos, Savanah Foster, Melissa Martin, Marian Yvette Williams-Brown, Yvette Poindexter, Belinda Reininger, Mila P Salcedo, Andrea Milbourne, Bryan Fellman, Maria E Fernandez, Ellen Baker, Rose Gowen, Susan Fisher-Hoch, Ana M Rodriguez, Jessica Milan, Monica Pippin, Ernest Hawk, Kathleen M Schmeler

Faculty, Staff and Student Publications

Although cervical cancer is preventable, significant disparities exist in access to screening and prevention services. In medically underserved areas (MUAs) of Texas, these rates are 55% higher compared to the remainder of the US. In 2019, we expanded a multicomponent, comprehensive program to improve cervical cancer prevention in partnership with 13 clinics and mobile vans in MUAs of Texas. Our multicomponent intervention program consists of community education and patient navigation coupled with a training/mentoring program for local medical providers to perform diagnostic procedures and treatment for patients with abnormal screening results. Hands-on training courses to learn these skills are coupled …

A Practical Method For Integrating Community Priorities In Planning And Implementing Cancer Control Programs, Emily Bilenduke, Andrea J Dwyer, Elsa S Staples, Kristin Kilbourn, Patricia A Valverde, Maria E Fernández, Betsy C Risendal

Faculty, Staff and Student Publications

PURPOSE: Community engagement is essential in effective public health programs. This paper illustrates the methods used to engage community in the development of a multi-level implementation intervention to address cancer disparities related to hereditary cancer syndromes.

METHODS: Implementation Mapping (IM), was used to guide the co-creation of an intervention. Key partners were recruited to a 13-member statewide community advisory board (CAB) representing healthcare and community-based organizations. As part of a needs assessment, a 3-round modified Delphi method with the CAB was used to identify implementation outcomes to use in later steps of IM. An anonymous online survey of a validated …

The State Of Integrated Disease Surveillance In Seven Countries: A Synthesis Report, A C K Lee, B G Iversen, S Lynes, A Rahman-Shepherd, N A Erondu, Mishal S. Khan, A Tegnell, M Yelewa, T M Arnesen, E S Gudo

Community Health Sciences

Objectives: Integrated disease surveillance (IDS) offers the potential for better use of surveillance data to guide responses to public health threats. However, the extent of IDS implementation worldwide is unknown. This study sought to understand how IDS is operationalized, identify implementation challenges and barriers, and identify opportunities for development.
Study design: Synthesis of qualitative studies undertaken in seven countries.
Methods: Thirty-four focus group discussions and 48 key informant interviews were undertaken in Pakistan, Mozambique, Malawi, Uganda, Sweden, Canada, and England, with data collection led by the respective national public health institutes. Data were thematically analysed using a conceptual framework that …

A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon

Electronic Theses and Dissertations

Abstract

Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature …

A Case Report Of Myocardial Infarction In A Young Transgender Man With Testosterone Therapy: Raising Awareness On Healthcare Issues In The Transgender Community And A Call For Further Research, Paul J Connelly, Joanna Osmanska, Matthew M Y Lee, Christian Delles, Margaret B Mcentegart, John Byrne

Faculty, Staff and Student Publications

BACKGROUND: People who are transgender may utilize masculinizing or feminizing gender-affirming hormonal therapy. Testosterone and oestrogen receptors are expressed throughout the cardiovascular system, yet the effects of these therapies on cardiovascular risk and outcomes are largely unknown. We report the case of a young transgender man with no discernible cardiovascular risk factors presenting with an acute coronary syndrome.

CASE SUMMARY: A 31-year-old transgender man utilizing intramuscular testosterone masculinizing gender-affirming hormonal therapy presented with central chest pain radiating to the left arm. He had no past medical history of hypertension, dyslipidaemia, diabetes, or smoking. Electrocardiography demonstrated infero-septal ST depression, and high-sensitivity …

Empowering The Community: An Explanatory Mixed Methods Study Exploring The Social Mechanisms Of Community Health Worker-Primary Care Integration Using A Team Science Approach, Alexandria Blacker

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Expanding primary care (PC) has emerged as a national priority to transform health care delivery (Pittman et al., 2015). This requires that PC teams become highly functioning interprofessional teams. Community Health Workers (CHWs), frontline health care workers who are seen as trusted members of their community, act as links between the community and care teams, providing a crucial means to increase access to health services, reduce health care costs and address social determinants of health (SDH) (American Public Health Association, 2021). CHWs are increasingly becoming part of PC teams (Franklin et al., 2015; Herman, 2011). Despite decades of research …

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 …

Vaccination Status, Views, And Opinions On The Covid-19 Vaccine, Zuri Dale

COVID Research

The Spring 2023 Tigers Care Vaccination Status and Views/Opinion Survey sought to capture perspectives on COVID-19 vaccination within the Texas Southern University community during spring festivities, engaging 126 respondents. Findings revealed that 86.29% were fully vaccinated, predominantly with the Pfizer vaccine. Among respondents, 78% had received a booster, and 42% expressed willingness to get a new booster in 2023.

Hesitancy was reported by 40% of participants, driven by concerns about long-term effects and vaccine safety. Factors like medical consultations and research helped change minds among hesitant individuals. A small segment (9.68%) remained unvaccinated, largely citing personal choice or distrust in …

Impact Of A Provider Flagging System On Increasing Ezetimibe Utilization In High-Cardiac Risk Adults, Janessa Creado

Student Scholarly Projects

Practice Problem: Cardiovascular disease continues to be the leading cause of mortality globally. Often, healthcare providers fail to follow evidence-based guidelines in their practice.

PICOT: In high cardiac-risk, adult patients with low-density lipoprotein cholesterol (LDL-C) levels greater than 70 milligram/deciliter (mg/dl) despite being on a maximum tolerated dose of statin (P), what was the effect of a provider flagging system to initiate ezetimibe (I) compared to standard care (C) on increasing the utilization of ezetimibe according to the 2018 American Heart Association (AHA) guidelines (O) within 8 weeks (T)?

Evidence: An extensive evidence literature review …

A Quality Improvement Initiative For Hiv Prevention In Underserved Communities, Meredith E. Clement, Angie D. Settle, Claudia T. Martorell, Jeffrey D. Carter, Melissa Rodriguez, Chelsie Anderson Chadha, Bonnie Douglas, Laura Simone, Leah Molloy

School of Medicine Faculty Publications

Infectious Diseases Week, IDWeek 2023, October 11 - 15, 2023, Boston, MA

Pulmonary Specialist-Supported Health Coaching Delivered By Lay Personnel Improves Receipt Of Quality Care For Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial, Rachel Willard-Grace, Danielle Hessler, Beatrice Huang, Denise Devore, Chris Chirinos, Jessica Wolf, Devon Low, Chris Garvey, Doranne Donesky, Stephanie Tsao, David H. Thom, George Su

Journal of Patient-Centered Research and Reviews

Purpose: Half of people living with chronic obstructive pulmonary disease (COPD) do not receive high-quality, evidenced-based care as described in international guidelines. We conducted secondary data analysis of a previously published study to assess the ability of a model of lay health coaching to improve provision of guideline-based care in a primary care setting.

Methods: As part of a randomized controlled trial, we recruited English- and Spanish-speaking patients with moderate to severe COPD from primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive usual care or 9 months of health coaching from primary care …

Point Of Care Testing: Best Practice Toolkit For Improving Access To Point Of Care Testing In Mobile Medicine, Michaela Gist

Student Scholarly Projects

Practice Problem: Healthcare for persons experiencing homelessness (PEH) is a complex issue. Chronic and communicable diseases are disproportionately represented within this population. Healthcare spending is 2.5 times more costly in comparison to those who have not experienced homelessness. Although mobile health clinics aim to reduce the concerns with access to care, they do not eliminate barriers if the appropriate tests are not immediately available.

PICO: In the homeless population treated in mobile medicine (P), what is the effect of point of care testing (I) on turnaround time (O) compared with outside laboratory testing (C)?

Evidence: Critical analysis of the literature …