Other Public Health Commons^™

Determinants Of Multimorbidity Among Stroke Patients For Epidemiological Management In Indonesia's Agro-Coastal Communities, Krish Naufal Anugrah Robby, Isa Ma'rufi, Farida Wahyu Ningtyias, Latifatul Izzah, Nurjazuli Nurjazuli, Suhartono Suhartono, Muchlis Achsan Udji Sofro, Ida Srisurani Wiji Astuti, Olivia Listiowati Prawoto, Dedek Sutinbuk, Taufik Kurrohman, Elhoussin Ouassou

Kesmas

Multimorbidity remains a major public health challenge among stroke patients, particularly in agro-coastal communities characterized by socioeconomic vulnerability, limited healthcare access, and lifestyle changes. This study aimed to analyze the determinants of multimorbidity among stroke patients in agro-coastal communities. A quantitative observational analytical design was employed, involving 45 stroke patients selected through total sampling in Jember District, Indonesia. Data were collected through structured interviews, anthropometric measurements, and secondary health records. The model included biological, socioeconomic, healthcare access, and lifestyle as exogenous variables, with multimorbidity as the endogenous variable. Data were analyzed using PLS-SEM, including evaluation of measurement and structural models …

Assessing Hpv And Hpv Vaccine Awareness And Perception Amongst Undergraduate Students, Maura Hawkins

Honors Theses

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections in the United States. Vaccination rates remain low among college-aged students despite an effective vaccine being available. This study investigates HPV and HPV vaccination-related knowledge, beliefs, and perceptions among undergraduate students to inform targeted intervention strategies. Participants included undergraduate students (n = 19) who attended one of three focus groups conducted in April 2025 at the University of South Alabama. Structured interview guides explored HPV knowledge, perceived risk and severity, attitudes towards vaccination, autonomy in health decision-making, trust in health information sources, and preferred educational strategies. Discussions were …

Refining Of An Online Rotator Cuff Related Pain Screening Tool (Orcs): A Mixed Methods Refinement Study, Andrew J. Smythe, Rhiannon Whale, Melanie Farlie, Peter Malliaras

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study is to refine an online rotator cuff related shoulder pain screening tool. Method: A mixed methods item-refinement study was used. The original tool was designed through expert opinion and informal literature review. In this study the original tool was refined over three rounds of cognitive interviews totalling 39 participants. The screening tool consisted of two sections, red flag screening followed by rotator cuff related shoulder pain differential diagnostic items. Results from each round of interviews were summarised and informed a nominal group research panel review process to modify items and develop a finalised version …

Five Corridors: A Community Health Needs Assessment Of Horry County, Stephen Borders, Hayley Bilko, Molly Craig, Olivia Guthrie, Ashley Mcconnell, Emily Mcgowan, Anna Quick, Abigail Rike, Makayla Wilson

Public Health

This report presents a Community Health Needs Assessment (CHNA) of Horry County, South Carolina. Its central analytical contribution is a five-corridor framework derived from k-means cluster analysis of the county's 76 residential census tracts, drawing on social and economic indicators from the American Community Survey and health estimates from the CDC PLACES program. The analysis organizes the county into five distinct community types — Affluent Coastal Retirement, Moderate Coastal Retirement, Inland Rural/Suburban Transitional, Concentrated Disadvantage, and Hispanic Hospitality Worker — each with a characteristic profile of social and health conditions.

Within this framework, the assessment examines a range of social …

Spatial Distribution Patterns Of Determinants Of Hypertension In West Java In 2023, Meirina Nur Asih Susanti, Wahyu Septiono

Preventia: The Indonesian Journal of Public Health

Hypertension is a public health issue that is unevenly distributed across regions. The high prevalence in West Java (34.4%) with a large population makes the management of hypertension crucial. Differences in economic and environmental conditions are thought to influence the distribution of hypertension, thus requiring spatial analysis. This study used an ecological approach by analyzing data from districts/cities in West Java in 2023. Secondary data were used to measure hypertension prevalence and to assess socioeconomic and environmental factors. The analysis was conducted using univariate Moran's Index, Local Indicators of Spatial Association (LISA), and the Spatial Autoregressive Model (SAR). The prevalence …

Examining The Psychometric Properties Of The Big Three Perfectionism Scale–Short Form (Btps-Sf) Among Malaysian Chinese Students At A Private University, Kam-Fong Lee, Ashraf Sadat Ahadzadeh, Shin Ling Wu

Makara Journal of Health Research

Background: Perfectionism is increasingly prevalent among young adults and is a significant predictor of pathological and behavioral outcomes. Despite its relevance, validated and reliable measures of perfectionism tailored to university students, particularly within the Malaysian cultural and academic context, are lacking. This study addresses this gap by examining the psychometric properties of the BTPS-SF among Chinese students at a private university in Malaysia.

Methods: Data were collected using a cross-sectional design with convenience and snowball sampling from 380 students aged 18–25 years, predominantly from a Chinese student population.

Results: The results of the exploratory factor analysis, conducted …

Questionnaire For Eudaimonic Well-Being: Psychometric Validation Among Malaysian Youth, Mohd Ahsani A. Malek, Nurulwahida Saad, Suzana Mohd. Hoesni, Muhamad Ariff Ibrahim, Nurul Shafira Adi, Mohd Nazir Mohd Nazori

Makara Journal of Health Research

Background: The rising prevalence of mental illness underscores the need to understand how individuals can live and flourish under such conditions. In Malaysia, research has largely emphasized diagnosis and treatment, with limited focus on positive psychology and few validated instruments. This study aimed to translate and validate the questionnaire for eudaimonic well-being (QEWB) among Malaysian youth.

Methods: The QEWB was translated into Malay using back-to-back translation and administered to undergraduates from four public universities through a cross-sectional survey design. Convenience quota sampling was used, resulting in 229 respondents completing the online form to measure sociodemographic characteristics, eudaimonic well-being, …

Rural Community Perspectives On Hurricane Helene In Western North Carolina, Jennifer A. Horney, Lilly Moreau, Search Wnc

Journal of Appalachian Health

Introduction: After making landfall on the Florida Gulf Coast in September 2024, Hurricane Helene impacted Western North Carolina (WNC) with historic flooding, landslides, and hurricane-force winds. More than 100 deaths in the region were attributed to the storm’s direct impacts.

Purpose: The purpose of this study was to assess community perspectives of long-term recovery in Mitchell and Yancey Counties, two rural WNC counties severely impacted by Hurricane Helene.

Methods: A 14-question interview guide was developed based on prior disaster research and the community engagement work of Sustaining Essential and Rural Community Healthcare (SEARCH). Questions covered post-Helene experiences related to access …

Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.

Journal of Appalachian Health

Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …

Health Data And Policy Related To Methamphetamine-Use Suicide In Mississippi, Mary C. Drane

Honors Theses

The purpose of this research is to investigate how methamphetamine use in Mississippi, especially in its rural areas, intersects with public health, policy, and suicide outcomes in the state. Mississippi's methamphetamine crisis has evolved significantly, shifting from locally produced drugs to cartel-supplied crystal methamphetamine, while state and federal policies have struggled to keep pace with the scale and complexity of the problem. Using a convergent parallel mixed-methods design, this research analyzed CDC Wonder multiple causes of death data and SAMHSA Treatment Episode Data Set Admissions (TEDS-A) data from 2018 to 2024 alongside four qualitative key informant interviews with stakeholders across …

Risk Factors Of Leptospirosis Among Agricultural Workers In Southeast Asia: Literature Review, Ronggo Adi Wibowo, Wawa Najwa Nurzakia, Meirany Sasitha Kirana, Yulia Arthemisia Wijaya, Jasmine Ayumaharani Sekaryudha, Dwi Sarwani Sri Rejeki, Rosita Dwi Jayanti

Jurnal Epidemiologi Kesehatan Indonesia

The agricultural sector is the primary source of livelihood for communities in Southeast Asia; however, these activities increase the risk of exposure to zoonotic diseases, particularly leptospirosis. Southeast Asia is one of the regions with the highest incidence of leptospirosis in the world. This literature review aims to identify risk factors for leptospirosis among agricultural workers in Southeast Asia. The search for research articles utilized three databases (Google Scholar, PubMed, and ScienceDirect) using a descriptive approach based on literature review and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 9,800 articles were screened for …

Prephiral Bacterial Infectious Agent Triggers Neuroinflammatory Responses And Neurobehavioral Impairment In Wild-Type Mice, Hadeer Atalah

Theses and Dissertations

Neurodegenerative diseases, including Alzheimer's and Parkinson's, present an increasing global challenge, with chronic neuroinflammation identified as a principal factor alongside genetic, environmental, and infectious influences (Boyd et al., 2022).  Epidemiological data associate bacterial infections with a 40% heightened risk of Parkinson's disease; however, the mechanisms—especially the direct connection between peripheral sepsis and the silent onset of central nervous system pathology absent acute meningitis—are inadequately investigated (Smeyne et al., 2021), particularly concerning common pathogens like Klebsiella pneumoniae in high-burden areas such as Egyptian ICUs, where it constitutes 30% of cases (Alkompoz et al., 2023). This study filled the gap by creating …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

From Vision To Impact: Strategic Planning For The South Health District, Jason D. Butler Jr

College of Graduate Studies: Theses & Dissertations

This study presents a community health assessment and strategic planning process for the South Health District (SHD), a rural, multi-county public health district.  Using a mixed-methods approach, quantitative surveys and qualitative data from County Nurse Managers, County Boards of Health, and internal staff were integrated with secondary sources to identify community health priorities and organizational gaps.  Broad stakeholder engagement through surveys, SWOT workshops, and town-hall meetings ensured credibility and contextual relevance.

Findings revealed challenges in behavioral health, substance abuse, chronic disease, access to preventive services, transportation, workforce capacity, communication, and infrastructure.  Four strategic issues—Communication, Workforce Development and Retention, Purpose-Driven District, …

Public Perception About Covid-19 Vaccine Hesitancy In South Central Nebraska, Rita Nnenne Oparaocha

Biology Theses, Dissertations, and Student Creative Activity

The COVID-19 pandemic created a shift in the trajectory of vaccination hesitancy, altering risk perceptions and vaccination attitudes among individuals in rural communities. The 5C framework highlights confidence, complacency, constraints, calculation, and collective responsibility as influencing factors of vaccine hesitancy. This study assessed the proportion of adults who refused COVID-19 vaccination and identified the individual reasons for hesitancy among those who refused the COVID -19 vaccines in South Central Nebraska. Data was analyzed from a local cross-sectional public health survey administered to 2,034 adult participants over a six-month period (March-August 2024), including 91 respondents who were from outside the seven-county …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

Food, Fitness, And Filipino Culture: Evaluating And Reimagining Chronic Disease Interventions For Filipino Americans Through The Pen-3 Framework, Juliana Mastro

Master's Projects and Capstones

Filipino Americans experience high rates of chronic diseases such as diabetes and hypertension. This paper reviews nutrition and exercise interventions targeting this population through the strengths-based PEN-3 cultural framework, focusing on cultural identity, relationships and expectations, and cultural values. It identifies effective strategies that engage these cultural components, and highlights gaps such as limited research on Filipino-American health outcomes. Recommendations include family-centered approaches, culturally relevant activities like tinikling dance, and community-driven online healthy recipe archives to promote positive health behaviors. These culturally informed strategies aim to improve self-efficacy, support lasting health behavior change and reduce chronic disease prevalence nationwide.

Standardizing The Use Of The Sinc Screening Tool In A Rural Clinic, Madison Foss

DNP Projects

Unmet contraceptive need represents a persistent quality gap in rural primary care, where reproductive health discussions are often inconsistently addressed. A rural primary care clinic in Shelbyville, Tennessee lacked a standardized, evidence-based process for screening women of childbearing age (15–44 years) for contraceptive needs. This quality improvement project evaluated the feasibility and effectiveness of implementing the Self-Identified Need for Contraception (SINC) screening tool to support routine, patient-centered care. The SINC tool consists of a single validated question designed to identify patients who wish to discuss contraception or pregnancy prevention during clinical visits. Plan–Do–Study–Act cycles were used to integrate the tool …

Challenges And Strategies For Hypertension Control In The Young Generation In Indonesia: A Bibliometric Review, Gina Maratus Solihah, Dwi Prijatmoko, Novia Luthviatin

Preventia: The Indonesian Journal of Public Health

Hypertension among young people in Indonesia has become an increasingly alarming public health problem due to lifestyle changes, low awareness, and limited access to preventive health services. This review aims to analyze the challenges and strategies for controlling hypertension in young populations based on national and international literature, supported by bibliometric analysis. Data were obtained from the Web of Science (WOS) database and analyzed using VOSviewer to map research trends, keyword relationships, and collaboration networks related to hypertension in youth. The 2018 Riskesdas data showed that 34.1% of Indonesian adults aged ≥18 years had hypertension, with major risk factors including …

The Influence Of Health Students' Attitudes On Tobacco Control And Tobacco Education On Family Smoking Cessation, Lies Permana, Riza Hayati Ifroh, Annisa Nurrachmawati

Preventia: The Indonesian Journal of Public Health

Health students are aware of how smoking affects people's health. They are typically well-equipped to help smokers quit and play a significant role in tobacco control. The purpose of this study was to determine the role that students have in encouraging their families to quit smoking both before and after studying in health faculty, as well as the impact that health students' attitudes and tobacco control education have on these inquiries. In March and April of 2024, a cross-sectional survey was conducted using the GHPSS questionnaire, with 123 student in Universitas Mulawarman, grade 2nd public health faculty. The findings showed …

Cost-Benefit Analysis Program Percontohan Pengendalian Rabies Berbasis One Health Di Wilayah Sanur, Denpasar Selatan, Marheni Ni Wayan, Sutarsa I Nyoman, Made Subrata

Jurnal Ekonomi Kesehatan Indonesia

Rabies continues to pose a significant public health challenge in Bali Province, Indonesia. The Dharma Program, a rabies control initiative based on the One Health approach, has been implemented in multiple areas of the province. Sustaining and expanding this program requires an economic evaluation that compares the cost burden of rabies under scenarios with and without program implementation. This study was conducted in two pilot villages: Sanur Kaja (SKJ) and Sanur Kauh (SKH). Cost data were obtained from activity reports, published literature, and structured interviews with program managers. Benefit values were estimated using scenario modeling, which included treatment costs, post-exposure …

Evaluating Parent Workshops To Reduce Sexual Health Misinformation, Marshall Farrior

Capstone Projects and Master's Theses

This capstone project addressed the problem of sexual health misinformation among youth in Santa Cruz County, which stems from cultural factors, limited parental communication, and inadequate comprehensive sexual health education. Implemented through the Santa Cruz County Public Health Department’s Teen Health Outreach (THO) program, the project evaluated the effectiveness of parent workshops designed to build the capacity of adults’ knowledge and confidence to discuss sexual and reproductive health topics with youth. Serving primarily Hispanic/Latino communities in Watsonville and Freedom, THO collaborates with local schools and organizations to deliver workshops. The intervention aimed to reduce misinformation by empowering parents as trusted …

Identifying Barriers For Community Pharmacies As Vaccines For Children (Vfc) Providers In Rural Alabama: Opportunities For Solutions, Myra Bajwa

Honors Theses

Significant Human papillomavirus (HPV) vaccination disparities exist between rural and urban areas in the US. A primary contributor is low access to preventive care in rural areas. Among the most promising strategies to overcome this is increasing access through offering HPV vaccination in non-traditional, convenient health settings such as pharmacies. In rural areas, community pharmacies are trusted, convenient pillars of the community. In Alabama, community pharmacies are eligible for enrollment in the Vaccines for Children (VFC) Program, a federally-funded program that provides free vaccines to children and adolescents under 18 years old who are uninsured, underinsured, American Indian, or Alaska …

Understanding The U.S. Maternal Healthcare System At The Intersection Of Asian American Birth Outcomes And The Model Minority Stereotype: A Literature Review, Sophia Hevel

University Honors Theses

This thesis aims to explore the maternal healthcare system in the United States as it pertains to Asian American birthing people, the ways in which their racial, ethnic, and cultural identities are interacted with within the U.S. Healthcare system, and subsequently the detrimental effects of the medical system's devaluation of culturally specific birthing and postpartum practices have on Asian American birthing experiences. This will be accomplished through an exploration of the United States' maternal healthcare system, or rather, its crisis; how Asian Americans navigate a system that has not been structured to support their specific needs; and lastly, a discussion …

Predictors Of Parental Behavior And Child Weight Status, Fidelia Senayah, Heba M. Athar, Allison G. Litton

Journal of Social, Behavioral, and Health Sciences

Childhood obesity is a major health issue globally. The prevalence rate remains high in Ohio, with associated complications among affected children and adolescents. The current study examined the association among obesity risk knowledge, risk perception, feeding behavior, and child weight outcome while controlling for race, gender, income, and education. We collected quantitative data through an online survey of parents in Northwest Ohio (n = 71) using the obesity risk knowledge scale and factors from the Child Feeding Questionnaire. We analyzed data using multiple linear regression. The primary outcome measures were feeding behavior and child weight status. Parental obesity risk …

An Analysis Of The Diagnostic Age Of Skin Carcinomas Across Central Texas, Miguel A. Lopez, Natasha Quailes, Elias Arellano Villanueva, Hamaad Gohar, Maria Villegas

Research Colloquium

Patients seeking healthcare in medically underserved regions often require travel to larger metropolitan hubs across the state of Texas. The Rio Grande Valley (RGV) is home to many such patients who often travel to central Texas for care, which compounds expense and inconvenience. Pockets of central Texas have been reported to have an increased number of dermatologists per 100,000 people. Bexar county ranks among the five most populous counties in the state, with increased access to dermatologic care compared to nearby regions. Using data from the Texas Cancer Registry, this project aims to identify the mean (M) age of diagnosis …

A Study On Nutritional Status Among Regular Gym Goers In And Around Chennai, India, Ettiyappan Thirumurugan, Kalpana Devi Venkatesan, Pavithra Tamilmani, Devika Preetha, Joyce Albert Princy Mariya Selvanathan, Dhanyasree Mohandas, Ameer Basha Sathik, Santhosh Kumar Manjunathan, Ashika Kannadhas Sheeba

Makara Journal of Health Research

Background: The increasing sales of sports supplements indicate a concerning trend, as many gym-goers may misuse these products owing to misinformation and insufficient knowledge, potentially impacting their performance. This issue is further compounded by specific gym trainers who may lack comprehensive information and inadvertently influence their clients' choices. To address this concern, the present study evaluated dietary supplement practices and sports nutrition knowledge among regular gym-goers at fitness centers in Chennai, India.

Methods: A cross-sectional survey was conducted from November 2023 to May 2024 using a validated questionnaire distributed across Chennai, India. A total of 450 participants were …

Improving Hiv Nonoccupational Postexposure Prophylaxis Completion In Survivors Of Sexual Assault, Rebecca Aden

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This project aimed to increase adherence to HIV nonoccupational postexposure prophylaxis (nPEP) among adult survivors of sexual assault using a 24-hour nurse-led callback intervention to reinforce patient education and support treatment completion.

BACKGROUND

This project was implemented within a public healthcare system’s forensic nursing program. Sexual assault survivors face an elevated risk of HIV transmission, yet completion of the 28-day nPEP regimen often remains below 40%. Barriers to completion include limited understanding, gaps in follow-up, as well as psychosocial and socioeconomic challenges.

METHODOLOGY

The FADE QI framework was utilized for this project. The population included adult, non-incarcerated patients who …

Too Sweet To Ignore: How Ssb Intake And Physical Inactivity Affect Bmi In Malang’S Student Population, Indana Tri Rahmawati, Nurnaningsih Herya Ulfah, Anggi Renawati, Yuvica Novita Gunawan

Preventia: The Indonesian Journal of Public Health

The growing incidence of overweight and obesity in young adults has been closely associated with unhealthy lifestyle habits, particularly the high intake of sugar-sweetened beverages (SSBs) and low levels of physical activity. College students are especially at risk due to lifestyle changes that occur during their university experience. This research aims to investigate the SSB consumption patterns, physical activity levels, and their correlation with Body Mass Index (BMI) among university students in Malang City. A descriptive cross-sectional study was carried out with 382 active students chosen through accidental sampling. Data were obtained using an online questionnaire shared through student networks …

Diarrhea Risk Factors Of Toddlers In Jember District, 2022, Annisa Fitrah Aini, Yunus Ariyanto, Adistha Eka Noveyani

Preventia: The Indonesian Journal of Public Health

Diarrhea is a disease characterized by passing feces three or more times a day. The occurrence of diarrhea is also influenced by sociodemographic factors (nutritional status) and environmental factors (access to clean water, access to sanitary latrines, and living in flood-prone areas). The purpose of this research focuses on finding risk factors for diarrhea and mapping the risk factors of diarrhea. This study used an ecological study design, in which the population is all sub-districts in Jember. Secondary data were used in this research. The data were analyzed using statistical correlation analysis using SPSS and mapping using GIS software. The …