Health Services Administration Commons^™

Addressing Breast Health Disparities Among Recent, Established African-Born Immigrant Women And Second-Generation Americans In Prince George County, Maryland, Omolola Okunromade

College of Graduate Studies: Theses & Dissertations

Background: Breast health disparities and underutilization of screening methods are major concerns in the United States (US), particularly affecting Black women who experience lower survival rates and advanced diagnoses. Despite the rapid growth of the African-born immigrant population, breast health among this group in the US is notably under-examined. This study aims to investigate the breast health knowledge and practices of first-generation African-born immigrants and second-generation immigrant women of African descent, aiming to understand the distinctive attributes of this group and the impact of acculturation on this public health issue.

Methods: Interviews were conducted among First Generation African immigrants and …

Lessons Learned: Covid-19 In Post-Corrections Secured Behavioral Rehabilitation, Jennifer G. Jones, Maria Devalpine, Erica J. Lewis

Virginia Journal of Public Health

Background: The COVID-19 case rate on June 5, 2020, for prisoners in the United States (US) was 5.5 times higher than the US population case rate (Saloner et al., 2020). Secure facilities were challenged to mitigate the spread of COVID-19. One secure behavioral rehabilitation facility made many changes to facility and program protocols to meet this challenge.

Methods: The purpose of this program evaluation was to assess newly implemented infection control measures at a secure behavioral rehabilitation facility and to inform policy and procedure recommendations for the mitigation of COVID-19 transmission in congregate living facilities in the future. Case rates, …

The Experiences And Challenges Of Community Health Volunteers As Agents For Behaviour Change Programming In Africa: A Scoping Review, Mary Ndu, Ellena Andoniou, Sorcha Mcnally, Francisco Olea Popelka, Marisa Tippet, Elysee Nouvet

Health Studies Publications

ommunity health volunteers are considered a vital part of the community health structure in Africa. Despite this vital role in African health systems, very little is known about the community health volunteers’ day-to-day lived experiences providing services in communities and supporting other health workers. This scoping review aims to advance understanding of the day-to-day experiences of community health volunteers in Africa. In doing so, this review draws attention to these under-considered actors in African health systems and identifies critical factors and conditions that represent challenges to community health volunteers’ work in this context. Ultimately, our goal is to provide a …

Time-To-Event Modeling For Hospital Length Of Stay Prediction For Covid-19 Patients, Yuxin Wen, Md. Fashiar Rahman, Yan Zhuang, Michael Pokojovy, Honglun Xu, Peter Mccaffrey, Alexander Vo, Eric Walser, Scott Moen, Tzu-Liang Bill Tseng

Engineering Faculty Articles and Research

Providing timely patient care while maintaining optimal resource utilization is one of the central operational challenges hospitals have been facing throughout the pandemic. Hospital length of stay (LOS) is an important indicator of hospital efficiency, quality of patient care, and operational resilience. Numerous researchers have developed regression or classification models to predict LOS. However, conventional models suffer from the lack of capability to make use of typically censored clinical data. We propose to use time-to-event modeling techniques, also known as survival analysis, to predict the LOS for patients based on individualized information collected from multiple sources. The performance of six …

Covid-19 In Tennessee: Lessons Learned And A Tool For The Future, Allen Archer, Randy Wykoff, Megan Quinn

Undergraduate Honors Theses

Background: In late 2019, the SARS-CoV-2 virus was identified in Wuhan, China. Within a matter of weeks, the virus spread to the United States and many other countries around the world. By March 5, 2020, the first case of COVID-19 (the disease caused by the SARS-CoV-2 virus) was identified in the state of Tennessee, and the first known COVID-19 associated death in the state followed on March 20, 2020. In 2020 alone, there were 514,922 confirmed cases and 6,760 COVID-19 attributed deaths in the state of Tennessee. It is important to understand, however, that confirmed COVID-19 deaths do not accurately …

Citizenship Matters: Non-Citizen Covid-19 Mortality Disparities In New York And Los Angeles, Jason A. Douglas, Georgiana Bostean, Angel Miles Nash, Emmanuel B. John, Lawrence M. Brown, Andrew M. Subica

Health Sciences and Kinesiology Faculty Articles

U.S. non-citizen residents are burdened by inequitable access to socioeconomic resources, potentially placing them at heightened risk of COVID-19-related disparities. However, COVID-19 impacts on non-citizens are not well understood. Accordingly, the current study investigated COVID-19 mortality disparities within New York (NYC) and Los Angeles (LAC) to test our hypothesis that areas with large proportions of non-citizens will have disproportionately high COVID-19 mortality rates. We examined ecological associations between March 2020–January 2021 COVID-19 mortality rates (per 100,000 residents) and percent non-citizens (using ZIP Code Tabulation Areas (ZCTA) for NYC and City/Community units of analysis for LAC) while controlling for sociodemographic factors. …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

The Yearly Financing Need Of Providing Paid Maternity Leave In The Informal Sector In Indonesia, Adiatma Y. M. Siregar, Pipit Pitriyan, Donny Hardiawan, Paul Zambrano, Mireya Vilar-Compte, Graciela Ma Teruel Belismelis, Meztli Moncada, David Tamayo, Grace Carroll, Rafael Perez-Escamilla, Roger Mathisen

Department of Public Health Scholarship and Creative Works

Background: The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15–49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia. Method: The costing methodology …

Breastfeeding Media Coverage And Beliefs During The Covid-19 Pandemic In Mexico: Implications For Breastfeeding Equity, Mireya Vilar-Compte, P. Gaitán‐Rossi, E. C. Rhodes, V. Cruz‐Villalba, R. Pérez‐Escamilla

Department of Public Health Scholarship and Creative Works

Background: Because breastfeeding offers short- and long- term health benefits to mothers and children, breastfeeding promotion and support is a public health priority. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are thought to be contained in breastmilk of mothers with history of COVID-19 infection or vaccination. WHO recommends direct breastfeeding as the preferred infant feeding option during the COVID-19 pandemic, even among women with COVID-19; but conflicting practices have been adopted, which could widen existing inequities in breastfeeding. This study aims to describe how information about breastfeeding was communicated in Mexican …

Responding To The Pandemic: A Multicountry Study On Social-Political Factors And Health Outcomes Of Covid-19, Lan Yao

Theses and Dissertations (ETD)

Introduction. Coronavirus Disease 2019 (COVID-19) poses a major global threat to human beings, which has caused devastating consequences of population health, political, and economic crises in many countries. This dissertation was composed of three research activities to study the following aims: (1) review the existing literature focusing on political factors and health outcomes of COVID-19; (2) assess the relationship between democracy and case fatality rate of COVID-19 by controlling for the effect of age, comorbidity, health expenditure, healthcare workforce, and population density; and (3) identify the trajectory pattern cases peak days, deaths peak days, and peak periods.

Methods. We accessed …

Impact Of The Covid-19 Pandemic On Loneliness And Social Isolation: A Multi-Country Study, Roger O’Sullivan, Annette Burns, Gerard Leavey, Iracema Leroi, Vanessa Burholt, James Lubben, Julianne Holt-Lunstad, Christina Victor, Brian Lawlor, Mireya Vilar-Compte, Carla M. Perissinotto, Mark A. Tully, Mary Pat Sullivan, Michael Rosato, Joanna Mchugh Power, Elisa Tiilikainen, Thomas R. Prohaska

Department of Public Health Scholarship and Creative Works

The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during …

La Migración Como Determinante De La Obesidad Infantil En Estados Unidos Y Latinoamérica, Mireya Vilar-Compte, Arturo V. Bustamante, Nancy López-Olmedo, Pablo Gaitán-Ross, Jaqueline Torres, Karen E. Peterson, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

La migración internacional tiene consecuencias económicas y en la salud. El proceso de aculturación en el país de acogida puede estar relacionado con la obesidad infan-til. Utilizamos el marco conceptual del balance energético comunitario (CEB, por sus siglas en inglés) para analizar la relación entre migración y obesidad infantil en los hogares mexicanos con migrantes internacionales. Utilizando datos longitudinales de la Encuesta Nacional de Niveles de Vida de los Hogares de México (ENNViH), exami-namos cómo influyen las redes de migrantes sobre la obesidad infantil en las comuni-dades de origen. También revisamos programas de salud binacionales que podrían ser eficaces para …

Living Environment Considerations On Obesity Prevention Behaviors And Self-Efficacy Among Chinese Americans, Doreen Liou, Jessica A. Karasik

Department of Nutrition and Food Studies Scholarship and Creative Works

The aim of this study is to ascertain if the living environment (type of residential neighborhood and number of household members) will elucidate differences in obesity risk reduction behaviors and self-efficacy in Chinese Americans. A cross-sectional survey design was used to recruit participants from Los Angeles County and New York City metropolitan areas. A total of 650 adults were recruited from diverse socioeconomic backgrounds. Descriptive statistics were measured for 19 behaviors reflecting food intake and portion size control and items measuring self-efficacy and attitudes. T-tests were applied for the two categories of living environment. The mean age of the sample …

The Association Of Demographics, Social And Personal/Family Characteristics With Treatment Utilization Among Young Adults With Opioid Use Disorder In The United States, Marva L. Frederick

Dissertations, Theses, and Capstone Projects

Background

Opioid use disorder is a life-threatening medical condition and an ongoing public health problem in the United States. Treatment is necessary to combat opioid use disorder and to minimize the health-associated problems. Opioid use disorder is treatable with life-extending medications. Studies that examined treatment utilization among young adults with opioid use disorder in the United States was scarce. This study investigated the characteristics posited in the Andersen Behavioral Model of health utilization which may be associated with treatment utilization, among young adults with opioid use disorder in the United States. The urgency posed by the continuing opioid crisis in …

Migration As A Determinant Of Childhood Obesity In The United States And Latin America, Mireya Vilar-Compte, Arturo V. Bustamante, Nancy López-Olmedo, Pablo Gaitán-Rossi, Jaqueline Torres, Karen E. Peterson, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

International migration has economic and health implications. The acculturation process to the host country may be linked to childhood obesity. We use the Community Energy Balance (CEB) framework to analyze the relationship between migration and childhood obesity in Mexican households with international migrants. Using longitudinal data from the Mexican Family Life Survey (MxFLS), we examine how migrant networks affect childhood obesity in origin communities. We also review binational health programs that could be effective at tackling childhood obesity in migrant households from Mexico. Children embedded in migrant networks are at greater risk of developing overweight or obesity, suggesting a significant …

Implementation Of Childhood Obesity Prevention And Control Policies In The United States And Latin America: Lessons For Cross-Border Research And Practice, Rafael Perez-Escamilla, Mireya Vilar-Compte, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Progress has been made in the development and widespread implementation of effective interventions to address childhood obesity, yet important challenges remain. To understand how the United States and Latin American countries achieved success in implementing obesity policies and programs (PAPs) and identify improvement opportunities using implementation science principles. We identified three comparative case studies: (1) front-of-food package labeling (Mexico and Chile); (2) Open Streets/play streets (Colombia and the United States); and (3) the Baby-Friendly Hospital Initiative (Brazil and the United States). Information from multiple sources (e.g., scientific and gray literature and key informant interviews) was synthesized to describe barriers, facilitators, …

Fire Service Covid-19 Infection Prevention And Control Policy Comparison, Saaddedine Dichari

Theses & Dissertations

To date, there have been over 2.7 million deaths and more than 126 million cases attributed to the COVID-19 pandemic (JHU, 2021). This pandemic has affected nearly every aspect of daily life. Among those impacted are U.S. firefighters, as they provide many services beyond simply extinguishing structure fires and are frequently dual certified as emergency medical technicians. Many of the victims of this pandemic have relied on first responders to provide them with emergency medical care and hospital transport. When caring for these infected patients, firefighters have an increased risk of exposure and must be provided with adequate …

Covid-19 Resources For Speakers Of Other Languages (Covid Resol), Ali Harb, Irvin Santiago-Bautista, Sulleymarie Sanchez

Rowan-Virtua Research Day

Objectives

• identify barriers to COVID 19 testing and vaccination in NJ Hispanics with limited English proficiency (LEP)
• develop resources targeted towards vaccination for Hispanic NJ residents and communities in Atlantic, Camden, and Cumberland counties
• share evidence based information regarding the COVID 19 pandemic and disease spread prevention

Conclusions

• Barriers to equitable COVID 19 care for NJ Hispanics with LEP may include but is not limited to resource availability in Spanish, misinformation about COVID 19, a lack of understanding about where and how to get tested and/or vaccinated, and transportation accessibility
• Increased efforts for providing equitable access to vaccination and testing …

County-Level Factors That Influenced The Trajectory Of Covid-19 Incidence In The New York City Area, Ashley Wendell Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

More than a century of research has shown that sociodemographic conditions affect infectious disease transmission. In the late spring and early summer of 2020, reports of the effects of sociodemographic variables on the spread of COVID- 19 were used in the media with minimal scientific proof attached. With new cases of COVID-19 surging in the United States at that time, it became essential to better understand how the spread of COVID-19 was varying across all segments of the population. We used hierarchical exponential growth curve modeling techniques to examine whether community socioeconomic characteristics uniquely influence the incidence of reported COVID-19 …

The Financing Need For Expanding Paid Maternity Leave To Support Breastfeeding In The Informal Sector In The Philippines, Valerie Gilbert Ulep, Paul Zambrano, Janice Datu-Sanguyo, Mireya Vilar-Compte, Graciela Materuel Belismelis, Rafael Pérez-Escamilla, Grace J. Carrol, Roger Mathisen

Department of Public Health Scholarship and Creative Works

In low- and middle-income countries, almost three-fourths of women in the labour force lack maternity protection. In the Philippines, current laws do not guarantee paid maternity leave to workers in the informal economy. A non-contributory maternity cash transfer to informal sector workers could be used to promote social equity and economic productivity and could provide health benefits by helping mothers meet their breastfeeding goals. The objective of the study is to provide a realistic cost estimate and to assess the financial feasibility of implementing a publicly financed, non-contributory maternity cash transfer programme to the informal sector in the Philippines. Using …

Food Insecurity Measurement And Prevalence Estimates During The Covid-19 Pandemic In A Repeated Cross-Sectional Survey In Mexico, Pablo Gaitán-Rossi, Mireya Vilar-Compte, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Objective: To validate the telephone modality of the Latin American and Caribbean Food Security Scale (ELCSA) included in three waves of a phone survey to estimate the monthly household food insecurity prevalence during the COVID-19 pandemic in Mexico. Design: We examined the reliability and internal validity of the ELCSA scale in three repeated waves of cross-sectional surveys with Rasch models. We estimated the monthly prevalence of food insecurity in the general population and in households with and without children and compared them with a national 2018 survey. We tested concurrent validity by testing associations of food insecurity with socio-economic status …

Implementación De Políticas De Prevención Y Control De La Obesidad Infantil En Estados Unidos Y Latinoamérica: Lecciones Para La Investigación Y La Práctica Transfronterizas, Mireya Vilar-Compte, Rafael Perez-Escamilla, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Aunque se han hecho avances en el desarrollo y aplicación a gran escala de inter-venciones eficaces contra la obesidad infantil, los retos siguen siendo importantes. Nuestro objetivo era comprender las causas del éxito de Estados Unidos y los países latinoamericanos en la implementación de políticas y programas (PYP) contra la obe-sidad e identificar oportunidades de mejora aplicando los principios de la ciencia de la implementación. Seleccionamos tres estudios de comparación de casos: (1) el etique-tado frontal en los envases de alimentos (México y Chile), (2) los programas de calles abiertas y calles para el juego (Colombia y Estados Unidos) y …

The Impact Of The Hospital Value-Based Purchasing Program On Healthy Days, Health Inequity, And Hospital Community Benefit Spending, Samhita Kadiyala

Scripps Senior Theses

The Hospital Value-Based Purchasing Program (HVBP) is a Centers for Medicare and Medicaid Services (CMS) program implemented in 2012 to reward acute-care hospitals with incentive payments for the quality of care provided to Medicare patients in inpatient settings. Under this policy, payment adjustments are made based on a variety of factors including clinical quality, patient experience, and cost reductions. This paper uses state-level variation in the implementation of HVBP to ascertain whether the policy led to improvements in Healthy Days (a CDC-designed composite measure of individuals’ self-reported number of physically and mentally “healthy” days per month), health disparities, and community …

From The Legal Literature: Covid And The Criminal Law, Francesca Laguardia

Department of Justice Studies Faculty Scholarship and Creative Works

No abstract provided.

Covid-19 Viral Testing Disparities In Los Angeles City, Laura Cyphers

Student Scholar Symposium Abstracts and Posters

Hispanic and Black communities have been disproportionately impacted by COVID-19-related morbidity and mortality (California Department of Public Health, 2020). Inequitable access to viral testing resources may have exacerbated these COVID-19-related racial and ethnic health disparities. For example, reports from the Los Angeles Department of Public Health revealed glaring viral testing disparities in April 2020 (early pandemic), with predominantly White communities in Los Angeles County receiving 65% more tests than Hispanic and Black communities. In response, California statewide testing was expanded for communities of color (Vann et al., 2020). To investigate access to viral testing in Los Angeles City, the current …

Three Decades Of Research: The Case For Comprehensive Sex Education, Eva Goldfarb, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Purpose

School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education.

Methods

Researchers searched the ERIC, PsycINFO, and MEDLINE. The research team identified papers meeting the systematic literature review criteria. Of 8,058 relevant articles, 218 met specific review criteria. More than 80% focused solely on pregnancy and disease prevention and were excluded, leaving …

Coh-2000 - Community Health Interventions, Jose Nanin

Open Educational Resources

This syllabus includes OER materials and college policies for a fully online course that exposes students to a range of health promotion and disease prevention and management strategies used by health specialists to address community health challenges. Through readings and videos, as well as online course assignments and discussions, students learn about planning and designing interventions to improve the health of specific priority populations and communities-at-large.

Factors Associated With Binge Drinking During The Transition Into Adulthood: Exploring Associations Within Two Distinct Young Adult Age Ranges, Tamara Leech, Sarah Jacobs, Denis Watson

Department of Public Health Scholarship and Creative Works

Background:

Binge drinking among young adults aged 18-21 years has declined over the past decade, but binge drinking rates among people 22-25 years old have remained largely the same. This steady trend in later years represents a departure from the traditional course of maturing out of risky alcohol use, perhaps because young adults are delaying the transition into adulthood.

Aims:

This paper explores the relationship between binge drinking and aspects of the transition into adulthood that could inform interventions targeting these two distinct groups of young adults.

Methods:

We use survey data on 1,081 young adults aged 18-25 living in …

Housing Stability And Diabetes Among People Living In New York City Public Housing, Sungwoo Lim, Sze Yan Liu, Melanie H. Jacobson, Eugenie Poirot, Aldo Crossa, Sean Locke, Jennifer Brite, Elizabeth Hamby, Zinzi Bailey, Stephanie Farquhar

Department of Public Health Scholarship and Creative Works

Public housing provides affordable housing and, potentially, housing stability for low-income families. Housing stability may be associated with lower incidence or prevalence and better management of a range of health conditions through many mechanisms. We aimed to test the hypotheses that public housing residency is associated with both housing stability and reduced risk of diabetes incidence, and the relationship between public housing and diabetes risk varies by levels of housing stability. Using 2004-16 World Trade Center Health Registry data, we compared outcomes (housing stability measured by sequence analysis of addresses, self-reported diabetes diagnoses) between 730 New York City public housing …

How Much Can Mexican Healthcare Providers Learn About Breastfeeding Through A Semi-Virtual Training? A Propensity Score Matching Analysis, Mireya Vilar-Compte, Rafael Pérez-Escamilla, Meztli Moncada, Diana Flores

Department of Public Health Scholarship and Creative Works

Background: Mexico has shown a worrisome decrease in breastfeeding indicators, especially in the lowest socioeconomic level. Improving breastfeeding protection, promotion, and support services through workforce development is a key area of intervention. The objective of this study is to assess the influence on breastfeeding knowledge and abilities of a semi-virtual training for primary healthcare providers assisting beneficiaries of PROSPERA in Mexico, which is one of the largest conditional cash-transfer programs in the world. Methods: Two independent cross-sectional samples of healthcare providers were drawn at baseline and post-intervention in three states of Mexico. Baseline data were collected among primary physicians, registered …