Public Health Education and Promotion Commons^™

Building Academic-Community Partnerships To Reduce Rural Health Disparities, Latoya J. O'Neal, Marcia Brown, Biswadeep Dhar, Noemi Reyes, Brittany Blake, John Diaz, Karla Shelnutt

Journal of Extension

Rural health disparities are increasing in the United States. Academic–community partnerships between Extension and faith-based organizations present a unique opportunity to improve health outcomes in rural areas. The main objective of this study was to identify the perceived barriers, needs, and strategies for implementing effective and sustainable health promotion programs through Extension and faith community partnerships. We conducted semi-structured interviews with Extension professionals and faith community leaders (N = 15). Our results suggest that academic–community partnerships could leverage shared needs, resources, and strategies to serve as a model for reducing health disparities among low-income, minoritized adults residing in rural …

Barriers To Asthma Management And Specialty Care Among Low-Income Families In South Jersey, Sally Park, Courtney Ray-Fofana, Christal Onwuegbule

Rowan-Virtua Research Day

Asthma is a chronic respiratory condition that remains a significant public health concern, particularly among low-income and underserved populations. This poster presents a focused review of existing literature and publicly available data to examine barriers to asthma management and access to specialty care in South Jersey, with emphasis on counties such as Camden, Atlantic, and Cumberland.

Data were synthesized from sources including PubMed, the New Jersey Department of Health, and the National Institutes of Health to evaluate asthma prevalence, disease burden, and the impact of social determinants of health. Current estimates suggest that approximately 8.8%–9.0% of adults in New Jersey …

A Planetary Health Approach To Address Food Insecurities In New Mexico, Mariah Kennell

Doctor of Nursing Practice Scholarly Projects

Food insecurity remains a persistent public health concern throughout New Mexico, impacting both rural and urban populations and contributing to significant health disparities. Limited access to affordable, locally sourced fresh foods exacerbates chronic disease burden and undermines community health. The purpose of this Doctor of Nursing Practice project was to conduct a comprehensive policy analysis to identify feasible state-level strategies to improve food access through strengthening local food systems. Using the Centers for Disease Control and Prevention POLARIS policy analysis framework, a structured evaluation of existing and potential state and community-level policies was conducted. The analysis incorporated stakeholder interviews with …

Challenges, Stressors, And Resilience Resources Experienced By Older Black Women In Rural South Carolina Throughout The Covid-19 Pandemic, Arielle N'Diaye, Camryn Garrett, Sarah Wilcox Phd, Bankole Olatosi Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D.

Faculty Publications

Background

Resilience has been established as a protective factor against mental health challenges (e.g., anxiety, depression). From an intersectional perspective, the stressors experienced by Black women living in rural communities are likely to have been exacerbated during the COVID-19 pandemic. This study aims to identify the challenges and stressors experienced and the resilience resources available to and relied upon by rural, Black women, during the pandemic.

Methods

Individual, in-depth, structured interviews (n = 24) were conducted among Black women living in rural South Carolina, recruited by local community health workers, from January to April of 2024. All interviews were recorded, …

A Qualitative Analysis Of Progress, Successes, And Challenges Among Indiana Recipients As Part Of A National Initiative To Reduce Covid-19–Related Health Disparities, Marla Winters, Lily Darbishire

Purdue Journal of Service-Learning and International Engagement

In light of the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) provided funding to states as part of the CDC Disparities Grant initiative. The aim of the funding was to reduce chronic disease and COVID-19–related health disparities among vulnerable communities through four unique strategies. Funding was awarded to the Indiana Department of Health (IDOH) to begin an Indiana chapter of this initiative, called Indiana Healthy Opportunities for People Everywhere (I-HOPE). From 2021 to 2023, the IDOH provided I-HOPE funding to local communities (subgrantees) to support the design and implementation of programs to improve community health. For example, …

Socioeconomic Factors Affecting Pulmonary Functiontest Follow-Up Rates, Celine Agidigbo

Williams Honors College, Honors Research Projects

Background

Chronic obstructive pulmonary disease (COPD) and asthma are associated with significant physical, mental, and social burdens that impact patients’ quality of life (Franssen et al., 2018). Pulmonary function testing (PFT) is an essential diagnostic test for identifying and managing pulmonary conditions. Missed or delayed follow-up after abnormal PFT results may derail disease management and lead to frequent hospital readmissions, thereby disease management and patient outcomes.

According to Braveman et al. (2010), socioeconomic status (SES), defined by factors such as income, education, and employment, has been widely associated with disparities in healthcare access and outcomes. This paper examines the impact …

Social Determinants Of Health Affecting Cardiovascular Health Among South Asian Americans, Ann Mary Thomas

Honors Undergraduate Theses

Background: South Asian Americans experience disproportionately high rates of cardiovascular disease, yet the social determinants contributing to these disparities remain understudied.

Objective: This systematic review examines the role of social determinants of health (SDOH) in shaping cardiovascular outcomes among South Asian Americans.

Methods: A systematic literature search was conducted across PubMed, MEDLINE, and Web of Science using predefined search terms related to South Asian populations, cardiovascular health, and SDOH. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 reporting guidelines, and study screening and management were performed using Covidence. A total …

Examining The Barriers To Healthcare Among Native Hawaiian And Pacific Islander Populations Living In Hawaii, Gracie L. Kaye

Honors Undergraduate Theses

The state of Hawaii was annexed by the United States in 1898, and served as a starting point from which the U.S. influenced Hawaii's socioeconomic conditions and healthcare access. The literature review examines healthcare views and outcomes among Native Hawaiian and Pacific Islander residents, utilizing various tools and resources to investigate how these factors have impacted overall health statistics and the reasons behind these trends. Results found that the western colonization of the island and the disease outbreaks led to an initial mistrust of “western ideas.” Additionally, due to long-standing cultural beliefs, there is a natural preference for traditional cultural …

Geospatial Analysis Of Breast Cancer Incidence, Mortality, And Access To Screening In Rural And Appalachian Virginia, Jennifer Osher, Caleb Brown, Phillip Nichols, Tariq Ayubi, Jeremy Powers

Journal of Appalachian Health

Introduction: Breast cancer is the most common malignancy among women in the United States (U.S.), despite recent survival rates improving nationally. However, rural and Appalachian regions have experienced slower mortality declines. These communities face unique health care-related challenges that may contribute to observed disparities.

Purpose: The purpose of this study is to assess differences in breast cancer incidence, mortality, and mortality-to-incidence ratio (MIR) between Appalachian and non-Appalachian counties, as well as rural and non-rural counties in Virginia (VA). Furthermore, we aim to evaluate whether availability of mammography is associated with these differences.

Methods: County-level breast cancer incidence and mortality data …

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 …

Vitamin D Deficiency And Cardiovascular Health Disparities In High-Melanin Populations: A Scoping Review, Jalen K. Luter, Silver R. Kaylor, Michael S. Boyer

Doctoral Projects

Cardiovascular disease (CVD) remains a leading cause of mortality and disproportionately affect individuals with darker skin tones, partly due to vitamin D deficiency (Sabzmakan et al., 2014). This Doctor of Nursing Practice (DNP) project uses a scoping review methodology to examine the relationship between vitamin D deficiency and cardiovascular outcomes, with an emphasis on high-melanin populations. Guided by the Joanna Briggs Institute Framework, the review synthesizes existing evidence, identifies gaps in representation and biomarker use, and highlights social and biological contributors to disparity. Databases including PubMed, CINAHL, EMBASE, and Scopus were searched, and studies were screened using standardized inclusion criteria: …

Social Determinants Of Self-Reported Health In Vulnerable Populations During A Polycrisis In Lebanon, Rindala Fayyad, Marie Elizabeth Ragi, Hala Ghattas Ph.D., Stephen J. Mccall

Faculty Publications

Importance: In the context of a polycrisis, which is characterized by multiple interconnected and mutually reinforcing crises, humanitarian and health needs increase. It is therefore crucial to identify social determinants impacting health and well-being of vulnerable populations to better inform appropriate interventions.

Objective: To assess the association between social determinants and pain frequency, self-rated health, and depression over time among vulnerable populations during a polycrisis in Lebanon.

Design, Setting, and Participants: In this population-based longitudinal cohort study, data were collected in Sin-El-Fil, a suburb of Beirut, Lebanon, in 4 waves: June 28 to October 26, 2022; September 8 to December …

Geographic Disparities In Birth Outcomes: County-Level Investigation On Pm2.5 And Low Birth Weight In The United States, Eunice Y. Park, Ranju Mainali

Department of Public Health Scholarship and Creative Works

Exposure to air pollution adversely affects health and is highly associated with birth outcomes. This study analyzes the relationship between air pollution and low birth weight (LBW; less than 2,500 g at birth) at the county level in the United States. Using the latest publicly available data from the County Health Rankings and Roadmaps across 3,027 counties and equivalents, simple and quantile regression analyses were conducted to test the association between the average daily density of fine particulate matter (PM2.5) and LBW. The LBW data were from 2016 to 2022 from the National Center for Health Statistics and PM2.5 data …

Understanding Rural Health Through Rae Garringer's Country Queers: A Love Letter, Bradley A. Firchow

Journal of Appalachian Health

Rae Garringer’s Country Queers: A Love Letter examines the experiences of queer individuals in rural America, emphasizing the relationship between place and identity. Through oral histories, the book presents perspectives on community, resilience, and healthcare access. While not centered on medical care, it highlights challenges in obtaining affirming services in rural areas. Garringer’s experience as a standardized patient provides additional context on healthcare gaps. For public health professionals, Country Queers offers insight into the structural and social factors affecting rural LGBTQ2+ populations, contributing to a broader understanding of community health and identity in Appalachia and similar regions.

Models Of Care For Indigenous Children In Rural And Remote Settings: A Global Scoping Review, Joseph Freeman, Thomas Stubbs, Verity Chadwick, Anita Pickard, Tuguy Esgin, Elizabeth J. Elliott, Alexandra Martiniuk

Research outputs 2022 to 2026

Indigenous communities internationally have demonstrated remarkable strength despite significant challenges. Health disparities among Indigenous peoples persist due to historical injustices and ongoing racial discrimination, not inherent vulnerabilities. Disparities are rooted in a legacy of colonisation, systemic exclusion, and socio-economic inequities impacting access to healthcare, education, and employment. Preliminary searches show limited literature on models of care for remote living Indigenous children. This review aimed to identify internationally, effective models of care for Indigenous children in rural and remote areas. A scoping review was conducted, analysing literature on models of care for remote Indigenous children. This study followed the JBI’s Scoping …

2024 Health Equity Impact Report, Children's Health, Stormee Williams

Publications

The Health Equity Impact Report from Children’s Health outlines the organization’s strategy and progress in advancing equitable pediatric care. The report highlights efforts to identify and address social determinants of health—such as food insecurity, housing instability, and access to transportation—through systemwide screening and targeted interventions.

Patient-Clinician Communication In The Appalachian Region: A Scoping Review, Kawther Al Ksir, Hadii M. Mamudu, Chidiebube J. Ugwu, Emily K. Flores, Tracy Fasolino, Holly Wei, Rick L. Wallace, Florence M. Weierbach

Journal of Appalachian Health

Introduction: Effective communication between patients and clinicians is a critical component of quality health care, influencing disease prevention, management, and outcomes. In regions with unique socioeconomic and geographic challenges, communication barriers can further exacerbate health disparities. Understanding the factors that facilitate or hinder patient-clinician communication is essential for developing targeted interventions that improve health care delivery.

Purpose: This review explores the existing literature on patient-clinician communication concerning cardiovascular disease (CVD) in the Appalachian Region with the aim to understand existing gaps and interventions.

Methods: PubMed and Web of Science databases were utilized to conduct a systematic search. The Population, Concept, …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Associations Between County-Level E-Cigarette-Inclusive Tobacco 21 Law Population Coverage And E-Cigarette Use Behaviors Among United States Adolescents In Monitoring The Future, James H. Buszkiewicz, Catherine A. Vander Woude, Yanmei Xie, Steven Cook, Bukola Usidame Peters, Megan E. Patrick, Michael R. Elliott, James F. Thrasher Ph.D., Ma, Ms, Nancy L. Fleischer

Faculty Publications

Background and aims: In the United States (US), Tobacco 21 (T21) laws set the minimum legal sale age for all tobacco products to 21 years. This study aimed to examine whether e-cigarette-inclusive T21 laws were associated with e-cigarette use behaviors and related disparities among US adolescents. Design: We used nationally representative, repeated cross-sectional Monitoring the Future data to compare self-reported current e-cigarette use (2014–2022) and first e-cigarette initiation (2015–2022) among adolescents in counties with 100% ('full') versus < 100% ('partial or no') e-cigarette-inclusive T21 law population coverage using modified Poisson regression, examining differences by sex, race and ethnicity, parental educational attainment and college educational expectations through interactions. Setting: United States. Participants: 8th, 10th and 12th graders. Measurements: County-level e-cigarette-inclusive T21 law population coverage was determined using Tobacco 21 Population Coverage Database and US Census Bureau population data. Current e-cigarette …

Changes In The Perceptions Of The Neighborhood Environment And Physical Activity Patterns Among Mexican Americans On The Texas-Mexico Border, Natalia I Heredia, Soo Kyung Park, Minjae Lee, Lisa Mitchell-Bennett, Paul Yeh, Rose Gowen, Arturo Rodriguez, Miryoung Lee, Belinda M Reininger

Faculty, Staff and Student Publications

INTRODUCTION: Little research on the association of neighborhood environment with physical activity in resource-poor communities has been done. This study assessed changes in perceptions of the neighborhood environment and the association between those perceptions and physical activity in Mexican Americans on the Texas-Mexico border in an area where there would be community efforts to enhance pedestrian and cycling infrastructure and programming.

METHODS: We analyzed data from a population-based cohort of Mexican American individuals on the Texas-Mexico border. From 2008 to 2018, interviewer-administered questionnaires were used to collect perceptions of neighborhood environment and physical activity at baseline, 5- and 10-year follow-ups, …

Unveiling The Impact: Structural Racism And Childhood Lead Exposure's Health Consequences In Philadelphia, Mahhum Naqvi, Mahrukh Naqvi, Justin Stout, Colton Spencer

Rowan-Virtua Research Day

Childhood lead exposure poses a significant risk to health and well-being, adversely affecting brain function, nervous system development, and behavioral patterns. This study examines the health disparities and inequities associated with childhood lead exposure in Philadelphia, focusing on structural racism and residential segregation as crucial lenses for analysis. By delving into the sociocultural context of lead exposure, this study underscores the imperative of collaborative efforts among stakeholders to safeguard Philadelphia's most vulnerable populations. Healthcare professionals and policymakers play pivotal roles in enhancing funding and prevention strategies. Addressing this issue through the prism of structural racism allows for the identification and …

Diabetes Health Education For South Jersey Communities, Heaven Chu, Sarah Tamous, Ashhabal Kavvi, Amin Khan

Rowan-Virtua Research Day

Diabetes is a chronic health condition that hinders the body’s metabolic process using insulin to maintain glycemic homeostasis. It is prevalent worldwide, with about 10% of the global adult population affected. Socio-economic and cultural factors and determinants make diabetes and diabetes management more of a health risk for certain populations rather than others. The prevalence of diabetes in the United States is higher than the global average and the risk factors disproportionately affect disadvantaged communities.

This study was designed to investigate health disparities in diabetes among a diverse population sample. The study included researching the disparities of diabetes patients in …

Barriers In Health Care Leading To High Maternal Mortality Rates In Southern New Jersey, Katarina Rusinak, Muznah Khan, Ava Dinardo, Nayarith Lopez

Rowan-Virtua Research Day

Maternal mortality remains a significant issue in New Jersey, particularly in the Southern counties where rates are alarmingly high. This study investigates barriers faced by mothers in these areas, utilizing data from state health departments, as well as the CDC. Findings reveal clear disparities in healthcare access and resources, exacerbated by high poverty and rural settings. Proposed interventions include educational posters and community workshops to empower expecting mothers and families. However, challenges such as low attendance and limited effectiveness of interventions underscore the need for comprehensive, sustainable solutions to tackle maternal mortality in Southern New Jersey.

Assessing Lung Cancer Screening Protocols And Outcomes: A Comparative Analysis Between Indonesia And The United States, Priscilla Sitorus

Nursing | Student Research Posters

After losing a loved one to lung cancer, it can be difficult to process, especially when the diagnosis could have been made earlier. However, some may struggle to trust a healthcare system when screening protocols and care vary significantly, to the extent that it may seem unclear. Amongst both men and women, lung cancer is the worldwide leading cause of cancer-related mortality (World Health Organization, 2023), thus further creating a considerable amount of challenges that not only takes part in communities, but the overall healthcare system. Despite the increasing rate of lung cancer, Indonesia has limited screening programs available for …

Physical Activity Barriers And Facilitators In African American Women: A Social Ecological Models Perspective, Leah Ann Carter

LSU Doctoral Dissertations

African American (AA) women experience poor health outcomes that can be addressed by increasing PA engagement. Understanding how PA barriers and facilitators occur at multiple levels of influence may help tailor PA interventions for AA women. Although prior work has established barriers to PA that are unique to African American women, few studies identify the sociocultural norms associated with these impediments. Little is known about the cultural implications of barriers such as haircare maintenance, and public policy.

The primary aim of this dissertation was to capture AA women’s voice about PA barriers and facilitators using the social ecological model framework. …

Emergency Total Proctocolectomy In An Uninsured Hispanic Man With Colorectal Adenocarcinoma Secondary To Familial Adenomatous Polyposis, Barbara Malaga-Espinoza, Diana Othon, Yilen K. Ng-Wong, Vamsikalyan Borra, Aramide Tijani, Fatimah Bello

Research Symposium

Background: FAP is a rare genetic disorder classically inherited in an autosomal dominant pattern, which affects about 1 in 8 300 individuals (1). The Hispanic population has limited data regarding the spectrum of FAP mutation and clinical manifestation, although there is significant anecdotal evidence that the prevalence might be higher, with one only known Hispanic familial cancer registry in Puerto Rico (2).

Case Presentation: We are reporting the case of a 25-year-old Hispanic gentleman with a strong family history of Familial Adenomatous Polyposis (FAP) and Colorectal Cancer (CRC) who presented for evaluation of abdominal pain, recurrent bloody stools, and profound …

Assessing Lung Cancer Screening Protocols And Outcomes: A Comparative Analysis Between Indonesia And The United States, Priscilla Sitorus

Nursing | Senior Theses

Background/Significance: Social inequity is a large problem within the healthcare system, especially in third-world countries, like Indonesia. Poor access to healthcare and screening protocols can contribute to delayed diagnoses, poorer outcomes, and increasing mortality rates. Purpose: This study aims to assess the effectiveness of lung cancer screening protocols in Indonesia compared to California and help identify potential barriers and factors in lung cancer screening in both regions. This will later help reform policy interventions and decisions to improve community access. Methods: The study will be divided into two portions using a mixed method approach. The qualitative component will include lung …

Disparities In Mortality Between Appalachian And Non-Appalachian Regions Of Kentucky, Sonali S. Salunkhe, Sahal Alzahrani, Beatrice Ugiliweneza

Journal of Appalachian Health

Introduction: In the opioid epidemic, the U.S. faces a significant public health crisis, with some areas of the country, such as rural and Appalachian regions, suffering more than others. The differential regional impact of the crisis in Kentucky—a state with both non-metropolitan/metropolitan and Appalachian/Non-Appalachian statuses—has not yet been documented despite such knowledge being essential to the success of overdose prevention efforts.

Purpose: This study compares all-cause, drug- and opioid-related mortality between counties in different regions of Kentucky: Appalachian non-metropolitan, Appalachian metropolitan, non-Appalachian non-metropolitan, and non-Appalachian metropolitan.

Methods: Age-adjusted mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online …

Feasibility Of Using Podcasts For Knowledge Dissemination To Reduce Health Disparities For Women Targeting Preventative Initiatives And Lifestyle Medicine Interventions, Kristin Stovern

Doctor of Nursing Practice Scholarly Project

The purpose of this feasibility project was to look at podcasts to shed light on the issues that affect the well-being of women with gender-based disparities in healthcare. Women face persistent obstacles when it comes to the quality of healthcare they receive. One of the barriers that has been ever-present is with failure of the medical system to rigorously study the effects of diseases and drugs on women or to fund studies on women’s health conditions. Implicit biases and lack of access to care inhibit the quality of healthcare. Collectively, these issues result in unnecessary sickness, disability, and decreased quality …

From Awareness To Action: Understanding And Addressing Health Disparities, Aamira Shah

The Cardinal Edge

In the United States, marginalized groups consistently face barriers to healthcare services necessary for maintaining quality of life and achieving positive health outcomes. Health disparities can be defined as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by populations that have been disadvantaged by their social or economic status, geographic location, or environment” (CDC, 2008). With input from insightful interviews, this article seeks to investigate specific challenges faced by marginalized groups in the healthcare setting and provide potential solutions to reduce health disparities.