Community Health and Preventive Medicine Commons^™

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

A Program Evaluation Case Study, Madelyne G. Culbertson

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

This case study presents a program evaluation of a physical activity intervention implemented in Bourbon County, Kentucky, guided by the Centers for Disease Control and Prevention’s Framework for Program Evaluation in Public Health.

A Case Study In Program Evaluation Evaluation Of A Physical Inactivity Program In Bourbon County, Kentucky, Carine N. Malekera

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

This paper evaluates a physical activity program by the Bourbon County Health Department aimed at increasing physical activity among local residents. Using the CDC’s Framework for Program Evaluation, the study includes both process and outcome evaluations to assess program implementation and impact on health outcomes. Key findings indicate success in urban areas but challenges in rural regions due to limited access to resources. Recommendations include improving access to exercise opportunities in rural areas and offering virtual classes. This evaluation emphasizes the importance of continuous assessment for effective public health interventions.

Exploring Dominican University Nursing Student’S Perceptions Of Economic Barriers To Accessing Essential Women’S Health Products, Annabelle E. Burke

Nursing | Student Research Posters

Access to essential feminine hygiene products, including menstrual supplies and hygiene items, is a growing economic and public health issue. Rising product prices and reliance on costly disposable products contribute to financial strain for many women. Period poverty is the lack of access to menstrual products, education, and hygiene facilities due to financial constraints, and it negatively affects women’s physical and mental health, particularly among students and low-income populations. Research shows that limited access to menstrual products affects dignity, sanitation, and emotional well-being and is compounded by social stigma and cultural silence surrounding menstruation (Brinkley & Niebuhr, 2023). Findings from …

The Impacts Of Dietary And Educational Intervention In Addressing Adult Obesity In The Mexican Population, Matthew C. Servin

CMC Senior Theses

Mexico’s obesity epidemic has been an ongoing issue for the past few decades, with multiple studies attributing this to the disparities in accessing healthy food and health education. Designing a solution to Mexico’s adult obesity crisis will focus on studying the effects of an intervention plan that addresses these obesogenic factors. This proposed study will assess how a token system and health education sessions may impact the risk of obesity in the adult Mexican population. This study also will consider any limitations that arise when only one of the two intervention methods are used. As these interventions are implemented over …

Reducing Stress Related To Injection Therapy: A Zen Bundle Approach, Valoree Bowen

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Needle fear and stress are common barriers preventing adults from seeking necessary medical treatments, including intramuscular (IM) injection therapy. Research highlights the need for evidence-based interventions to mitigate this fear and improve patient experience.

Objective: This evidence-based pilot project included a Zen Bundle—an intervention incorporating shared decision-making, aromatherapy, and distraction—to evaluate the impact on stress reduction and patient satisfaction in a retail vitamin shop in North Texas.

Methods: The project utilized a pre-and post-intervention design over eight weeks. Participants completed pre-surveys assessing stress levels using a Visual Analog Scale before choosing an intervention (aromatherapy, distraction, or both) during IM …

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …

Researching Dementia Indicators Among Rural Populations, Justin S. Yount

Theses and Dissertations--Community & Leadership Development

The study explored potential dementia indicators and risk factors among older adults residing in rural areas who are actively engaged in farming operations. Data was collected in three components a questionnaire, an audiogram test, and a memory impairment screening. 104 people responded to the questionnaire, 133 participants took the audiogram test, and 94 participated in the memory impairment screening. The findings revealed that 80.9% of participants showed no sign of cognitive impairment while 19.1% showed signs of possible impairment. Participants reported moderate levels of physical and social activity, but common risk factors such as elevated BMI, diabetes, hearing loss, and …

Understanding The Impact Of Language Barriers And Visit Duration On Caregiver Satisfaction In Pediatric Primary Care, Gavin Miller, Liz Vazquez, Joyce Ho, Emma Maynor, Emily L. Allen, Marley F. Fradley, Julian Ruiz, Ana J. Bridges

2025 Honors Symposium

Abstract:

Problem. Children from households that speak languages other than English (LOE) face significant challenges in accessing healthcare, which can lead to poorer health outcomes and inadequate medical care (Flores et al., 2005). Language barriers contribute to these disparities, often resulting in diminished communication between healthcare providers and families (Ramirez et al., 2023). In pediatric primary care, visit duration—defined as the amount of time between when a patient is checked into and out of the clinic—may play a crucial role in facilitating effective communication and improving patient satisfaction (Tsiga et al., 2013). Physicians experience significant time pressure and productivity expectations, …

Addressing Barriers To Preventive Healthcare Access Through Community Outreach In Underserved Populations, Deneisha Sparks

Theses and Dissertations

Access to preventive healthcare is a significant public health challenge, particularly for underserved populations in Muscogee County, Georgia. This project addresses systemic barriers such as transportation, limited health education, and economic constraints, which contribute to health disparities and reliance on emergency room services. Guided by the Social Determinants of Health (SDOH) framework and the Health Belief Model (HBM), the project aims to enhance access to preventive care, improve health literacy and identify barriers to healthcare access.

This program evaluation report examined a community-based initiative that utilized a mobile health unit to improve access to preventive healthcare in underserved areas of …

Attacking Diabetes One Day At A Time, Kyla Duncan

Theses and Dissertations

The "Attacking Diabetes One Day at a Time" initiative targets the growing concern of public health, type 2 diabetes, among under-reserved communities. This comprehensive care program emphasizes the importance of prevention through education, improving lifestyles, and access to care. Based on insights from the Self-Care Management Theory, this initiative seeks to provide individuals with sound, culturally tailored strategies that reduce disease risk and help them manage healthy lifestyles. Major components include educational workshops, and resource navigation. The success of this program, from community engagement through evaluation on a phased implementation plan, is guaranteed. The expected outcomes of this work will …

Influence Of Perceived Health Provider Communication, Diabetes Duration And Age At Diagnosis With Confidence In Diabetes Self-Care, Courtney L. Ortz, Meredith S. Duncan, Oluwatosin Leshi, William B. Burrows, Brittany L. Smalls

Family and Community Medicine Faculty Publications

Introduction: Several factors influence individuals’ confidence to perform diabetes-related self-care activities, including perceived patient-provider communication, diabetes duration and age at diagnosis. It has been well-documented that patient-provider communication is essential when managing chronic diseases such as diabetes; however, the impact of this communication with diabetes duration and age at diabetes diagnosis on confidence in performing self-care behaviors is obscure.

Research design and methods: We utilized data from the 2021 Household Component of the Medical Expenditure Survey among participants 18 years or older who had completed the Diabetes Care Survey. Ordinal logistic regression models were utilized to assess the association between …

An Analysis Of Covid-19 Vaccine Hesitancy In The U.S., Hieu Trung Bui, Sandra Eksioglu, Ruben Proano, Sarah Nurre Pinkley

Industrial Engineering Faculty Publications and Presentations

Reluctance or refusal to get vaccinated, commonly known as Vaccine Hesitancy (VH), poses a significant challenge to COVID-19 vaccination campaigns. Understanding the factors contributing to VH is essential for shaping effective public health strategies. This study proposes a novel framework for combining machine learning with publicly available data to generate a proxy metric that evaluates the dynamics of VH faster than the currently used survey methods. The metric is input to descriptive classification models that analyze a wide array of data, aiming to identify key factors associated with VH at the county level in the U.S. during the COVID-19 pandemic …

Structural And Interpersonal Determinants Of Covid-19 Vaccine Uptake In Vulnerable Populations Of The United States, Alyea Wood

Capstone Showcase

Since its introduction in late 2020, the uptake of the COVID-19 vaccine has had the lowest rates in marginalized populations like minorities, elderly, and those of low socioeconomic status. Decreased rates of vaccination uptake in these groups has resulted in increased burden of disease and subsequently higher rates of hospitalization and death. Many inequities in poor COVID-19 health outcomes can be explained by examining common predictive factors that determine vaccination rates in these United States populations. This special article research aims to explore these various predictive factors with the goal to provide targeted strategies to boost COVID-19 vaccination rates, especially …

Beyond The First Trimester: Social Determinants Of Delayed Prenatal Care At A Community Health Center Using The Prapare Tool, Abbie Page, Rebecca Ford Mccann, Sarah Maness, Maya Merriweather, Page D. Dobbs

Health, Human Performance and Recreation Faculty Publications and Presentations

Social determinants of health have been used to explore associations with pregnancy outcomes and the birth weight of infants; however, research employing individually based social risk measures has not examined associations among underserved populations, including pregnant persons at community health centers. Data were collected from a sample (n = 345) of pregnant persons who sought care at a community health center between January 2019 and December 2020. Social risks of pregnant patients were measured using the PRAPARE tool. First, associations between patients’ social risks and trimester in which they initiated care were assessed using ANOVAs, grouping social risk by …

Comparison Of Dynamic Mode Decomposition With Other Data-Driven Models For Lung Cancer Incidence Rate Prediction, L. Raymond Guo, Jifu Tan, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

Introduction: Public health data analysis is critical to understanding disease trends. Existing analysis methods struggle with the complexity of public health data, which includes both location and time factors. Machine learning offers powerful tools but can be computationally expensive and require specialized knowledge. Dynamic mode decomposition (DMD) is an alternative that offers efficient analysis with fewer resources. This study explores applying DMD in public health using lung cancer data and compares it with other machine learning models.

Methods: We analyzed lung cancer incidence data (2000–2021) from 1,013 US counties. Machine learning models (random forest, gradient boosting machine, support vector machine) …

Facility-Based Uptake Of Colorectal Cancer Screening In 45-49-Year-Olds After U.S. Guideline Changes, Alyssa H. Harris, Hannah Murphy, Madeleine Mcdowell, Margaret E. Wright, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

No abstract provided.

Understanding The Impact Of The Care Connect Washington Program, Hannah Cohen-Cline, Dan Fish, Taylor Doren, Abby Bush

Articles, Abstracts, and Reports

No abstract provided.

The Role Of Social Isolation In Shaping Health Outcomes In Older Adults: A Regional Analysis, Vince Falco, Lynn Wiles, Jonathan Romero, Leorey Saligan

Ellmer School of Nursing Faculty Publications

Social isolation is a critical public health concern in older adults and is linked to a range of adverse health outcomes across diverse sociodemographic groups. This study investigated the associations between social isolation with physical and mental health of older adults residing in Hampton Roads, a racially diverse region in Southeastern Virginia, home to a large population of senior military veterans. Secondarily, the study explored how social determinants of health (SDoH) and comorbid medical conditions influenced the relationship of social isolation with physical and mental health of these seniors. Physical and mental health were measured using the Patient-Reported Outcomes Measurement …

Addressing Barriers In The Primary Prevention Of Hypertension In Black People, Makalah Pierre Rn Bsn

Honors Undergraduate Theses

Hypertension is a significant health concern among minority groups, and the black population is most at risk (Abrahamowicz et al., 2023). The black population experience higher prevalence rates of hypertension compared to other racial groups and are more likely to experience hypertension-related problems, including cardiovascular disease (CVD) and chronic kidney disease (CKD).  This literature review explores various nursing interventions aimed at preventing hypertension within this population. In this review, the term “black people or persons” is a broad term used to describe both African Americans and people of Afro-Caribbean decent. This includes various backgrounds such as Haitian, Jamaican, or otherwise …

Using Ai To Improve Study Skills, Lesley L. Rennis

Open Educational Resources

This module consists of three lesson plans designed to teach students to use AI tools responsibly and ethically to create outlines, refine research questions, and use APA referencing. By integrating AI into study practices, students enhance their organizational, analytical, and citation skills, while maintaining academic integrity. The lessons emphasize using AI as a tool to improve study skills so that more time can be spent on deep learning and critically thinking about class material.

At The Crossroads: Initial Findings And Lessons Learned From A Medicaid Housing Benefit Pilot, Cat Livingston, Megan Holtorf, Benjamin Gronowski, Alyssa Cragie

Articles, Abstracts, and Reports

No abstract provided.

Mda Foundation: Great Things Are Ahead For The Mda Foundation In 2025, Anne Berquist

The Journal of the Michigan Dental Association

The MDA Foundation expresses heartfelt gratitude to donors and volunteers who contributed to improving oral health care access and education in 2024. Efforts included funding free and reduced-cost clinics, awarding scholarships, and hosting the Mission of Mercy (MOM) free clinic in Flint. For 2025, plans include the Sparkling Smiles fundraising event during the MDA Annual Session in Detroit and laying the groundwork for next year’s MOM in Kalamazoo. The Foundation encourages applications for grants (deadline: May 1) and scholarships (applications open Aug. 1), continuing its commitment to supporting Michigan communities and dental students.

Examining Healthcare Access Disparities: Social Determinants And Patient Experiences At Valley Healthcare, Mikaila Larmond

Theses and Dissertations

Persistent disparities in healthcare access continued to affect low-income, rural, and underserved populations across the United States. This capstone project explored these disparities within Valley HealthCare, a regional provider in Columbus, Georgia, by examining how social determinants such as income, education, geography, and transportation shaped healthcare engagement among adult patients. A mixed-methods case study design was used to analyze survey data, patient satisfaction feedback, and organizational reports from a sample of 80 adult patients between January and March 2025.

The results showed that patients residing in lower-income or geographically isolated areas reported significantly higher rates of missed appointments. Individuals with …

Use Of Digital Health Interventions For Cancer Prevention Among People Living With Disabilities In The United States: A Scoping Review, Chinenye Lynette Ejezie, Lea Sacca, Sylvia Ayieko, Sara Burgoa, Yasmine Zerrouki, Diana Lobaina, Goodness Okwaraji, Christine Markham

Faculty, Staff and Student Publications

BACKGROUND: The use of digital health strategies for cancer care increased dramatically in the United States over the past 4 years. However, a dearth of knowledge remains about the use of digital health for cancer prevention for some populations with heath disparities. Therefore, the purpose of the present scoping review was to identify digital health interventions for cancer prevention designed for people with disabilities.

METHODS: This scoping review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and the Arksey and O'Malley methodological framework. The Embase, PubMed, Ovid MEDLINE, and CINAHL/EBSCO databases were …

Prevalence Of Depression And Its Coping Strategies Among Rural And Urban Geriatric Population, Mohit Negi, Smitha M C

Digital Journal of Clinical Medicine

Background: Aging is a natural process, and older age is a period in which most aspects of life require support from others. Globally, Depression is a serious public health concern among elderly populations. The aim of this study was to estimate the prevalence of depression and its coping strategies among geriatric population and to evaluate the association between socio-demographic factors and level of depression.

Methods: A cross-sectional study was conducted among 410 study participants in both rural and urban areas. Geriatric Depression Scale (GDS-15) was used to measure the depression and brief-COPE (28-items) scale was used to measure the coping …

A Systematic Review And Narrative Synthesis Of Factors Affecting Pre-Exposure Prophylaxis Willingness Among Black Women For Hiv Prevention, Alexis Sims Haynes, Christine Markham, Vanessa Schick, Robert Suchting, Nivedhitha Parthasarathy, Sumaita Choudhury, Mandy J Hill

Faculty, Staff and Student Publications

Pre-exposure prophylaxis (PrEP) can significantly reduce human immunodeficiency virus (HIV) transmission among Black women in the United States (U.S.), a group disproportionately affected by HIV. However, PrEP uptake in this HIV-vulnerable population is low. This review analyzes the factors influencing Black women's PrEP willingness using the Behavioral Model for Vulnerable Populations (BMVP). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Population, Intervention, Comparison, Outcome, Study Design (PICOS) framework, we conducted a systematic literature search and selected 24 peer-reviewed studies on PrEP willingness. Narrative synthesis revealed a heterogeneous landscape of the determinants affecting PrEP willingness …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

All About Over-The-Counters: The Use Of Public Health Principles In Health Education, Himanshu Gandhi

Honors Program: Senior Projects (Public)

The transition from high school to college can be extremely tough on students. There is a massive restructuring in schedules, academics, social lives, and even health. While many students come to college prepared to tackle their respective majors and courses, many of them aren’t prepared to handle the challenges of independent living. One of these challenges is self-healing and preventative care. As part of the University Honors Program, I have had the privilege of taking the first step of many in tackling this challenge. My project consisted of researching several common over-the-counter medications, utilizing my pharmaceutical and biochemical background to …

Willingness To Use Long-Acting Injectable Pre-Exposure Prophylaxis (Lai-Prep) Among Black Cisgender Women In The Southern United States, Sylvia Shangani, Jaquetta M. Reeves, Kristin Heron, Jessica M. Sales, Kenneth K. Mugwanya

Psychology Faculty Publications

Background

Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) for HIV prevention may improve adherence for those with concerns with daily pills. Limited data exist on LAI-PrEP acceptability among Black women in the U.S., a population vulnerable to HIV. We assessed willingness to use LAI-PrEP among Black women eligible for PrEP in the Southern U.S.

Methods

We conducted a cross-sectional online survey of HIV-negative Black women from March to June 2022 in the U.S. South. Participants provided information on sociodemographic characteristics, HIV knowledge, PrEP awareness, and use, stigma, risk perception, medical mistrust, and healthcare access. Multivariate logistic regression models determined factors associated with …