Other Public Health Commons^™

Costing Of Actions To Safeguard Vulnerable Mexican Households With Young Children From The Consequences Of Covid-19 Social Distancing Measures, Mireya Vilar-Compte, Víctor Pérez, Graciela Teruel, Aranzazu Alonso, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

COVID-19 has imposed unprecedented challenges to society. As the pandemic evolves, the social distancing measures that have been globally enforced, while essential, are having undesirable socioeconomic side effects particularly among vulnerable populations. In Mexico, families who depend upon informal employment face increased threats to their wellbeing, and households who in addition have young children may face long-term consequences. The Mexican government has not yet taken actions, but a coalition of non-governmental organizations is advocating in partnership with academic institutions for social protection actions such as a cash transfer and basic services subsidies for families with young children, subsisting from the …

Baseline Health Assessment Of A Rural Delta Community, Sydney Mitchell

Honors Theses

The Lower Mississippi Delta is characterized by poverty, chronic health issues, health disparities, and food insecurity. The rural Delta communities are primarily African American, experiencing disproportionately higher rates of poverty, job loss, and chronic health problems. Historically, chronic health issues have persisted in these areas over time, including obesity, hypertension, and diabetes, which have only seemed to increase in this region. The food environment in this rural region tends to assist in the creation of the largely obesogenic population which, in turn, contributes to the increased prevalence of diabetes and hypertension and a lower quality of life. Many residents in …

The Impact Of State-Level Laws On Syringe Service Program Access And Risk Environment Of People Who Inject Drugs (Pwid), Samuel Pettyjohn

Electronic Theses and Dissertations

Background: Understanding concentrated areas with high rates of opioid use disorder (OUD) allows for improved placement of Narcan access points through syringe services programs (SSPs). People Who Inject Drugs (PWID) have lower risk of contracting infectious diseases the closer they are to SSPs. Tennessee law prohibits SSPs within 2000ft of a school or park, impacting the placement of SSPs in non-urban areas. Testing factors related to SSP siting placement within a system dynamic model can better determine the relationship between PWID risk environment and SSP access and utility.

Methods: We identified areas of greatest need for harm reduction interventions within …

¡Sí, Yo Puedo Vivir Sano Con Diabetes! A Self-Management Randomized Controlled Pilot Trial For Low-Income Adults With Type 2 Diabetes In Mexico City, Robin Whittemore, Mireya Vilar-Compte, Selene De La Cerda, Roberta Delvy, Sangchoon Jeon, Soraya Burrola-Méndez, Mariana Pardo-Carrillo, Annel Lozano-Marrufo, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: Type 2 diabetes (T2D) is a worldwide epidemic and a leading cause of death in Mexico, with a prevalence of 15.9%, and >70% of diagnosed adults have poor glycemic control [glycated hemoglobin (HbA1c) >7.5%]. We developed a diabetes self-management education program contextualized to the study population, including dietary preferences, health literacy, and health system.

Objectives: We aimed to evaluate the efficacy of a self-management + text message program (¡Sí, Yo Puedo Vivir Sano con Diabetes!) on primary (HbA1c), and secondary behavioral (self-management), clinical, and psychosocial outcomes in adults with T2D in Mexico City.

Methods: Participants were recruited at public …

Is There A Correlation Between The Patient-Doctor Relationship Questionnaire And Other Patient-Reported Experience Measures?, Amanda I. Gonzalez, Joost T.P. Kortlever, Léon Rijk, David Ring, Laura E. Brown, Lee M. Reichel

Patient Experience Journal

Patient reported experience measures (PREMs) can quantify the quality of the patient-clinician relationship, which is associated with adherence and improved health. However, the scales used to assess PREMs have large ceiling effects, which limits our ability to learn and improve. This study assessed the correlation of four PREMs: the patient-doctor relationship questionnaire (PDRQ), a measure of perceived empathy, a measure of satisfaction with the visit, and a measure of communication effectiveness. We also assessed ceiling effects. We prospectively enrolled 103 new and return patients in this cross-sectional study. Patients completed a demographic questionnaire, the PDRQ, Jefferson Scale of Patient Perceptions …

The Weekend Effect Among High Ed Utilizers, Wilson Tan, Adam Block

Annual SHSP Student Research and Scholarship Day

No abstract provided.

Adults With I/Dd And Secondary Gastrointestinal Conditions: An Analysis Of Healthcare Utilization Patterns And Clinical Characteristics, And Implications For Patient-Centered Delivery Innovations, Kerry Watson, Kenneth Knapp, Tricia Patrick

Annual SHSP Student Research and Scholarship Day

The objective of this research was to create healthcare transformation policies for adults with intellectual and developmental disabilities (I/DD) who also present with secondary gastrointestinal (GI) conditions. Key perspectives and analyses used to achieve this research aim were the patient-centered medical home for GI patients (DGBI-PCMH), the biopsychosocial model, and population segmentation.

Liposomal Bupivacaine Results In Cost Savings While Managing Post-Operative Pain In Fragility Intertrochanteric Hip Fractures, Nainisha Chintalapudi, Avinesh Agarwalla Md, Joana Lu Pa, Hrayr G. Basmajian Md, Joseph N. Liu Md, Nirav H. Amin Md

Annual SHSP Student Research and Scholarship Day

No abstract provided.

An Exercise Program To Prevent Frailty In Community-Dwelling Older Adults: A Proposed Pilot Study, Kendra Harrington, Mikhail Beg, Laura Kelly, Jinto Mathew, Neil Ryan

Annual SHSP Student Research and Scholarship Day

No abstract provided.

Development Of A Diabetes Self-Management + Mhealth Program: Tailoring The Intervention For A Pilot Study In A Low-Income Setting In Mexico, Robin Whittemore, Mireya Vilar-Compte, Soraya Burrola-Méndez, Annel Lozano-Marrufo, Roberta Delvy, Mariana Pardo-Carrillo, Selene De La Cerda, Ninfa Pena-Purcell, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: Type 2 diabetes (T2D) is a public health pandemic disproportionately affecting low- and middle-income countries. The purpose of this formative research was to adapt evidence-based diabetes self-management education programs to the context of Seguro Popular clinics in Mexico. A theory-based mHealth (pictorial text messaging) component was developed.

Method: Our formative research and development of the program protocol consisted of six phases: (1) interviews and focus groups with stakeholders on the challenges to T2D management, curriculum content needs, and the use of mHealth as a supplement to a DSME program; (2) review of the theoretical underpinning, curriculum, and interactive strategies …

A 12-Lead Electrocardiogram Database For Arrhythmia Research Covering More Than 10,000 Patients, Jianwei Zhang, Jianming Zhang, Sidy Daniako, Hai Yao, Hangyuan Guo, Cyril Rakovski

Mathematics, Physics, and Computer Science Faculty Articles and Research

This newly inaugurated research database for 12-lead electrocardiogram signals was created under the auspices of Chapman University and Shaoxing People’s Hospital (Shaoxing Hospital Zhejiang University School of Medicine) and aims to enable the scientific community in conducting new studies on arrhythmia and other cardiovascular conditions. Certain types of arrhythmias, such as atrial fibrillation, have a pronounced negative impact on public health, quality of life, and medical expenditures. As a non-invasive test, long term ECG monitoring is a major and vital diagnostic tool for detecting these conditions. This practice, however, generates large amounts of data, the analysis of which requires considerable …

Cancer Health Disparities Among African Americans: A Socioecological Approach, Seth M. Spitzley

The Hilltop Review

Research shows that health outcomes are influenced by race or ethnicity, socioeconomic status, education and literacy levels, and the physical environment (U.S. Department of Health and Human Services, 2014). The health statuses of minority groups, such as African Americans, are adversely impacted by inequality (Randall, 2009). In Kalamazoo, Michigan, the leading cause of death for all residents in Kalamazoo County was cancer, where black individuals have the highest death rate among any other racial or ethnic group. That African Americans comprise less than 11% of the population in Kalamazoo County thus suggests that African Americans are disproportionately impacted by cancer …

Association Between Breastfeeding And Child Stunting In Mexico, Ana Paola Campos, Mireya Vilar-Compte, Summer Sherburne Hawkins

Department of Public Health Scholarship and Creative Works

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. How-ever, in low-and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breast-feeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed-and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breast-feeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

Blueprint For Shared Safety Strategic Plan, Reann Ramos

Capstone Projects and Master's Theses

The Blueprint for Shared Safety strategic plan will be adopted by Santa Cruz County Community Corrections Partnership as a framework of principles and practices that community leaders can use to lead shared safety strategies. By shifting the focus from the traditional criminal justice system to investments that can truly make our communities safer, the Blueprint aims to re-envision public safety together. The Community Corrections Partnership Community Education and Engagement Workgroup (CCP CEEW) has conducted data analysis to identify the key assets and gaps in Santa Cruz County. After identifying the key assets and gaps there were recommendation review sessions that …

Using Community Pharmacy Immunization Screening Forms To Identify Potential Immunization Opportunities, Albert T. Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine needs …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Healthy Older Adults’ Motivation And Knowledge Related To Food And Meals, Kai Victor Hansen

The Qualitative Report

The population over 60 years old is growing rapidly in Norway and in many other countries, and researchers often focus on elderly people and various diseases. This article examines the healthy elderly who are active in their daily lives to understand their motivation and knowledge about food and meals. The method used was CurroCus® group interviews, or fast focus groups. Nine CurroCus® groups were conducted, lasting for 37 to 56 minutes (average = 45 minutes). Altogether, 76 persons participated, ranging in age from 60 to 87 years; participants were predominantly female (>80%). The article discusses two areas: motivation and …

The Upper East Side Vs Central Harlem: What Is Responsible For The Dermatology Disparities That Shaped These Communities?, Zakiya Cush, Jeffrey Weinberg

Annual SHSP Student Research and Scholarship Day

Very few studies have been done to understand why there is a paucity of dermatology practices in the Central Harlem (CH) community in Manhattan. This ecological and exploratory study will identify factors such as, geographical location, race, socioeconomic status, health care and medical education, as reasons why there is a disparity between the dermatology services in the CH community versus the Upper East Side (UES) of Manhattan. Thus, examining the differences in the neighborhoods as a mediator, it is hypothesized there is a need for increased dermatology practices to CH, as not catering to the clinical needs of a community …

Challenges To Diabetes Self-Management For Adults With Type 2 Diabetes In Low-Resource Settings In Mexico City: A Qualitative Descriptive Study, Robin Whittemore, Mireya Vilar-Compte, Selene De La Cerda, Denise Marron, Rosabelle Conover, Roberta Delvy, Annel Lozano-Marrufo, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: The prevalence of type 2 diabetes (T2D) in Mexico is one of the highest in the world, with high morbidity and mortality, and difficulty meeting glycemic targets. The purpose of this study was to identify the challenges for T2D self-management as perceived by both adults with T2D and health care providers in primary health clinics from Seguro Popular in Mexico City.

Methods: This was a qualitative descriptive study conducted in three Seguro Popular primary care clinics in Mexico City using convenience sampling. Semi-structured interviews were conducted with participants and data were analyzed using a content analysis approach.

Results: The …

Wellness For One, Healthy Community For All: Improving A Multidimensional University Wellness Programlth, Shea Gaier

Master's Projects and Capstones

Background: Evidence suggests that college students are often unaware of the seven

dimensions of wellness (Social, emotional, environmental, financial, physical, intellectual, and spiritual). According to interviews, most students think of physical wellness only when it comes to wellness. Besides the dimensions of wellness, students have shown to gain substantial benefits from increasing their knowledge of school resources regarding personal health.

Methods: This was a quality improvement project for the Wellness Matters Program that encompassed a Plan, Do, Study, Act cycle. The goal was to improve the program by adding a comprehensive educational workshop and optimizing the one-on-one sessions. Pilot tests …

Short Relative Leg Length Is Associated With Overweight And Obesity In Mexican Immigrant Women, Mireya Vilar-Compte, James Macinko, Beth C. Weitzman, Carlos M. Avendaño-Villela

Department of Public Health Scholarship and Creative Works

Background: Prior research suggests that undernutrition and enteric infections predispose children to stunted growth. Undernutrition and infections have been associated with limited access to healthy diets, lack of sanitation, and access barriers to healthcare - all associated with human rights. Stunting has also been documented to be a major determinant of subsequent obesity and non-communicable diseases. Short leg length relative to stature during adulthood seems to be a good proxy indicator tracking such barriers, and has been reported to be associated with adverse health effects during adulthood. Our objective was to examine the association between relative leg length (as measured …

God, I Hope This Part Of My Life Is Over: A Focused Ethnography Of A Correctional Youth Facility’S Therapeutic Climate, Eric Meyer

Theses & Dissertations

Although all prisons have the same goal of isolating offenders from society, the precise strategies used vary from one jurisdiction to the next. Some prisons use means of punishment to gain inmate compliance. Other prisons concentrate their limited resources on rehabilitation. Contained within the following pages are details of a focused ethnography that was completed in a state correctional youth facility that housed males between the ages of 15 and 21 years, all of whom were convicted of violent crimes. This study had the objective of exploring the climate of therapy in this correctional youth facility where rehabilitative programs were …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

Differences In Tsimane Children’S Growth Outcomes And Associated Determinants As Estimated By Who Standards Vs. Within-Population References, Melanie Martin, Aaron Blackwell, Hillard Kaplan, Michael Gurven

Economics Faculty Articles and Research

Anthropometric measures are commonly converted to age stratified z-scores to examine variation in growth outcomes in mixed-age and sex samples. For many study populations, z-scores will differ if calculated from World Health Organization (WHO) growth standards or within-population references. The specific growth reference used may influence statistical estimates of growth outcomes and their determinants, with implications for biological inference. We examined factors associated with growth outcomes in a sample of 152 Tsimane children aged 0–36 months. The Tsimane are a subsistence-scale population in the Bolivian Amazon with high rates of infectious disease and growth faltering. To examine the influence of …

Elevating Communities Into Self-Sufficiency Through Federally-Funded Health Partnerships, Nalleli Martinez

Master's Projects and Capstones

Purpose: This qualitative study is to identify programing that encourages increased self-sufficiency in SNAP recipients. The goal was to identify themes related to successful self-sufficiency programming at federally-funded health centers/health programs (HCHPs). The study also investigated the role of social determinants of health in relation to achieving self-sufficiency.

Method: A series of 45-minute to 1-hour-long interviews were conducted to explore the perspectives of seven total staff at seven federally-funded HCHPs across the U.S. western region. Using Nvivo, a qualitative data analysis software, responses were categorized into six themes: patient-centered care, one-stop-shop/integrated care model, community partnerships, organizational and staff support, leadership …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

An Iterative Process For Training Design And Implementation Increased Health Workers' Knowledge For Taking Nutrition Behavior Change To Scale, Wendy Gonzalez, Anabelle Bonvecchio Arenas, Armando García-Guerra, Mireya Vilar-Compte, Alejandría Villa De La Vega, Laura Quezada, Cynthia Rosas, Ana Lilia Lozada-Tequeanes, Amira Hernández

Department of Public Health Scholarship and Creative Works

The shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services. Objective: The objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific objective is to provide a case study and highlight challenges, as well as elements to successfully mitigate these, and discuss potential applications of findings beyond the Mexican context. Methods: The …

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

College of Graduate Studies: Theses & Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …

Public Health Workforce Perceived Impact Of Emerging Issues In Public Health, Kristie C. Waterfield

College of Graduate Studies: Theses & Dissertations

Background: In an era where public health has been viewed as a global, multi-disciplinary field, the public health workforce has remained united to unfailingly holding fast to the mission of protecting, promoting, and improving the health of the public. However, the practice of public health is consistently evolving, and the workforce is continually facing a mirage of challenges. In order to overcome these challenges, practitioners need to be up-to-date on the necessary knowledge and skills to effectively deliver the core public health services.

Purpose: The purpose of this research was to explore the perceived impact of emerging trends in public …

Syndemics Of Severity And Frequency Of Elder Abuse: A Cross-Sectional Study In Mexican Older Females, Mireya Vilar-Compte, Pablo Gaitán-Rossi

Department of Public Health Scholarship and Creative Works

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.

Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.

Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had …