Public Health Education and Promotion Commons^™

Diagnosing The Discourse: How The Academy Of Breastfeeding Medicine Constructs And Constrains Treatment Of Tethered Oral Tissues, Mary E. Miller

Antioch University Dissertations & Theses

While breastfeeding is recognized as fundamental to global public health, oral restrictions that can affect infant latch, milk transfer, and feeding efficiency warrant further examination within policy frameworks. This dissertation proposes an expanded conceptualization of tethered oral tissues (TOTs) that encompasses not only anatomical frenal restrictions but also fascial tensions, neuromuscular limitations, and other conditions restricting orofacial function that may be congenital or acquired. The purpose of this study was to critically examine how this clinical guidance document shapes understandings and responses to TOTs. Using Carol Bacchi’s “What’s the Problem Represented to Be?” approach, a critical discourse analysis of the …

Effectiveness Of Occupational Therapy-Inspired Educational Sessions For Mothers Accessing Women, Infants, And Children (Wic) Services, Samantha Annette Merew

Graduate Theses, Dissertations, and Problem Reports (ETD)

This doctoral capstone project examined the effectiveness of occupational therapy (OT)-inspired group and one-on-one educational sessions designed to support the emotional, mental, and social well-being of pregnant and postpartum mothers accessing Women, Infants, and Children (WIC) services in Onslow County, North Carolina. Grounded in the Model of Human Occupation and Cognitive Behavioral Frame of Reference, the program aimed to address gaps in holistic maternal health support, particularly among low-income and at-risk populations. Eight structured group sessions and five one-on-one sessions were developed, implemented, and evaluated, focusing on topics such as stress management, emotional regulation, self-care, role transition, and self-advocacy. A …

The Effect Of The Affordable Care Act Medicaid Expansion On The Risk Of Hospital Closure And Adolescent Hpv Immunization In Rural Counties, Juliette Des Rosiers

Scripps Senior Theses

From 2005 to 2025, over 200 rural hospitals shut their doors, often citing increased operational costs, staffing shortages, low patient volume, regulatory barriers, financial challenges exacerbated by the COVID-19 pandemic, and uncompensated care as common contributors to the closures. Rural patients are often referred by their primary care physician to a hospital for regular immunizations, since smaller clinics have less capacity to provide immunizations due to a shortage of pediatricians and limited vaccine stock. A crucial vaccine that is not required by schools and underutilized in rural areas is that against human papillomavirus (HPV), a virus that infects cutaneous and …

Predictors Of Quality Of Family Planning Counselling In Ethiopia: Multilevel Analysis Of The Spa Survey 2021/22, Kalayu Brhane Mruts, Tesfay Brhane Gebremariam, Amanuel Tesfay Gebremedhin

Research outputs 2022 to 2026

Background: High-quality family planning (FP) counselling is essential for informed contraceptive choice, reducing discontinuation, and improving reproductive health. However, many women in sub-Saharan Africa continue to face barriers. This study examined client-, provider-, and facility-level determinants of FP counselling quality in Ethiopia using nationally representative, multi-source data. Methods: We analysed data from the 2021/22 Ethiopia Service Provision Assessment, including 2,224 women who received or were prescribed injectables, pills, or implants. Counselling quality was assessed using a 15-item checklist derived from direct observations and client exit interviews. Multilevel ordinal logistic regression was applied to identify predictors at the client-, provider-, and …

Scope And Adherence To The Consider Statement In Aboriginal And Torres Strait Islander Injury Prevention Research In Australia, Bep Uink, Michelle Barrett, Courtney Ryder, Aleina Humphreys, Graham Peter Barker

Research outputs 2022 to 2026

Introduction: Effective injury prevention for Aboriginal and Torres Strait Islander people hinges on the availability of culturally safe policies, resources and programmes, alongside best-practice research. Contemporary injury prevention research has increasingly centred Aboriginal and Torres Strait Islander knowledges, yet there is still room for improvement. Identification of relevant resources, policies and programmes, as well as the extent to which injury prevention research meets international criteria for ethical research with Aboriginal and Torres Strait Islander peoples will provide practitioners with critical insights into best-practice injury prevention initiatives. Method: We examined the breadth and scope of Aboriginal and Torres Strait Islander injury-related …

Implementation Strategies For Evidence-Based Healthcare Interventions In Rural And Remote Settings: A Scoping Review, Anna Chapman, Cadeyrn J. Gaskin, Hannah Beks, Charlene Wright, Skye Marshall, Elizabeth A. Johnston, Rebecca J. Bergin, Sharina Riva, Fiona Crawford-Williams, Camille E. Short, Nicole Kiss, Sze Lin Yoong, Nicolas H. Hart, Anna Wong Shee, Helena Rodi, Hannah Jongebloed, Anna Ugalde

Research outputs 2022 to 2026

Globally, people living in rural and remote areas experience poorer healthcare access and outcomes than urban populations. Applying implementation strategies that support the translation of evidence-based healthcare interventions may help reduce these inequities; however, real-world implementation is complex, and it remains unclear how strategies are applied and tailored to rural and remote contexts. This scoping review synthesised evidence on implementation strategies for healthcare interventions in rural and remote settings of high-income countries. Five databases (Ovid MEDLINE, Embase, Cochrane CENTRAL, CINAHL, Web of Science) were searched for peer-reviewed studies published between 1/1/2000 and 25/10/2024. Extracted data were synthesised using a descriptive …

Promoting The Concept Healthy Ageing For Use In Gerontological Health And Social Care Policy And Practice, Claire Donnellan

Research outputs 2022 to 2026

Aims: The concept of healthy or successful ageing dates back to the 1960s, where its goal is more realistic in today's ageing society as a result of effective interventions to control and reduce disability and health risks. The aim of this paper is to outline the importance of defining ageing, the semantics and indicators used, and to identify common challenges for health professionals' understanding and application of a healthy ageing approach in their everyday clinical practice. Design and Methods: This discursive paper demonstrates how realistic ageing indicators are for highlighting the variation and impact of challenges associated with ageing. It …

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 …

Oral Health Access Among Ethnic Minority Older Adults In The United States, Jasleen K. Sodhi

Honors Undergraduate Theses

Oral healthcare is a critical yet often overlooked component of overall health among U.S. adults. Ethnic minorities for older adults face heightened risks of poor oral health and related health conditions, while experiencing disparities in access to care. This study aimed to systematically examine and synthesize existing literature to assess the extent to which oral health disparities exist among ethnic minority older adults in the U.S. and explore the roles of socioeconomic factors on these disparities. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, we conducted a systematic review of peer-reviewed articles published in English …

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 …

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

The Correlation Between 25(Oh)D, Blood Lead Levels, And Delta-Aminolevulinic Acid Dehydratase Activity Among Indonesia Male Workers, Ratih Fadhillah, Muhammad Ilyas, Liem Jen Fuk, Levina Chandra Khoe, Muchtaruddin Mansyur

Occupational and Environmental Medicine Journal of Indonesia

Background Lead exposure disrupts the heme synthesis pathway by modifying the activity of Delta-Aminolevulinic Acid Dehydratase (ALAD), contributing to oxidative stress. Vitamin D has been suggested as an antioxidant to influence oxidative balance, but evidence regarding its association with ALAD activity in lead-exposed populations remains limited. This study aimed to analyze the associations between blood lead levels (BLL), serum 25-hydroxyvitamin D [25(OH)D], ALAD activity, and the 25(OH)D/BLL ratio among Indonesian male workers.

Methods A cross-sectional study was conducted among 90 male workers exposed to lead as part of either their occupation or living environment in Java, Indonesia. Serum 25(OH)D, BLL …

Rare Manifestation Of Scapular Cutaneous Larva Migrans Infection Among Sand Porters In Warm Climate: A Case Report, Prio Hangudi Sampurno, Tri Wisesa Soetisna

Occupational and Environmental Medicine Journal of Indonesia

Background Cutaneous larva migrans is a serpiginous helminthic infection common among certain occupations dealing with contaminated soil especially in warm climate. Most common predilections include the feet, legs, and buttocks with only a fraction of cases found on the trunk and upper extremities.

Case Presentation A rare scapular cutaneous larva migrans manifestation on a thirty-six years old sand porter with high occupational exposure was described. Physical examination revealed progressive pruritic and warm rash in a serpiginous pattern on the left shoulder.

Results Diagnosis was established based on characteristic serpiginous rash physical findings supported by history of contact. This case needed …

Return To Work After Percutaneous Coronary Intervention In Employee With Metabolic Comorbidities: An Evidence-Based Case Report, Bramantyo Eko Wahyudi Mr, Levina Khoe

Occupational and Environmental Medicine Journal of Indonesia

Background This evidence-based case report examines whether metabolic comorbidities independently predict return to work (RTW) after percutaneous coronary intervention (PCI) for myocardial infarction. A 52-year-old male senior manager with type 2 diabetes, hypertension, dyslipidaemia, and central obesity underwent PCI and required structured occupational assessment.

Methods A systematic literature search identified five eligible studies—one national registry cohort, three prospective cohort studies, and one narrative systematic review—critically appraised using Oxford Centre for Evidence-Based Medicine criteria.

Results Metabolic comorbidities showed consistent directional associations with reduced RTW probability in bivariate analyses and independently predicted longterm labour-market exit. However, in multivariate models across three of …

Building Ai Literacy To Redesign Graduate Public Health Courses: A Case Study Of Pubh 520, Darren Liu

2026 Scholarly Teaching Conference: Concurrent Session Papers

As artificial intelligence (AI) becomes increasingly embedded in public health practice, graduate education must move beyond ad hoc responses to AI toward intentional, ethically grounded instructional design. This conference paper presents a case study of the redesign of PUBH 520, a graduate-level public health course, to explicitly integrate AI literacy within course outcomes, assessments, and learning activities. Guided by higher-education AI literacy frameworks, the redesign foregrounded faculty AI literacy as a prerequisite for responsible AI integration, emphasizing ethical reasoning, technical understanding, pedagogical alignment, and reflective assessment practices. Findings suggest that the redesigned course improved coherence among learning outcomes, assessment integrity, …

Alcohol Advertising At The Beach: Insights From Young People In Western Australia, Renee N. Carey, Gemma Crawford, Nicola D'Orazio, Gina S.A. Trapp, Lauren Nimmo, Tina Lam, Jonine Jancey, Justine E. Leavy

Research outputs 2022 to 2026

Background: Advertising and marketing by the alcohol industry serve to normalise alcohol use, with exposure to alcohol advertising linked to earlier and riskier drinking among young people. Advertising that portrays alcohol use in and around waterways is of particular concern, with one in five fatal drownings being associated with alcohol. Objective: This study aimed to explore the types of alcohol advertising that young people were exposed to, and to determine whether exposure to alcohol advertising was related to their alcohol use in aquatic environments. Methods: We surveyed 102 young people aged 18 to 25 years attending a free event at …

Reflecting On Themes From Telehealth Consultations Early In The Pandemic: An Opportunity To Learn From Multiprofessional Colleagues, Maggie Meeks, Laura R. Joyce, John Dean, Lorna Davies, Tika Ormond, Philippa Seaton, Dale Sheehan, Dean Sutherland, Melanie Welfare, Arindam Basu

Research outputs 2022 to 2026

Aims: This study is aimed at documenting the reflections of New Zealand healthcare professionals on the use of synchronous telehealth consultations. Methods: A qualitative narrative inquiry was conducted to explore the practice of telehealth in New Zealand. Purposive sampling was used to identify clinicians from multiple professions who used telehealth during the initial phase of the COVID-19 pandemic. Fifteen semistructured interviews were conducted between October 2020 and May 2021 with clinicians from primary and secondary care, including multiple professional backgrounds. Interview transcripts were analysed thematically. Results: Six themes were identified: (1) equitable access: There were concerns regarding equitable access to …

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 …

Paneugenesis: A Regenerative Systems Hypothesis For Advancing Health Promotion, Craig M. Becker, Leslie Hoglund, Beth Chaney, Joseph G. L. Lee, Michael Stellefson, Alex Davis

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Despite major advances in health promotion science, dominant approaches remain largely prevention-and risk-reduction-oriented. The prevailing orientation creates a substantial opportunity to advance generative, system-design strategies that intentionally produce well-being rather than merely prevent disease. This article proposes paneugenesis as a regenerative systems framework and a testable theoretical model for the intentional creation of net-positive outcomes, thereby extending health promotion beyond its traditional pathogenic emphasis. Paneugenesis integrates systems science, salutogenesis, behavioral science, complexity theory, and quality management principles into a unified four-function process: operationalizing idealized outcomes, identifying key precursors, optimizing processes, and continually plotting progress through feedback mechanisms. The central hypothesis …

Sugar Consumption In Aboriginal Children Explored From A Social Practice Perspective, Amy Budrikis, Angela Durey, Dan Mcaullay, Paul Ward, Hanny Calache, Thierry Ng, Roma Winmar, Linda Slack-Smith

Research outputs 2022 to 2026

Australian Aboriginal children have higher sugar intake and are disproportionately affected by sugar-related diseases such as obesity, diabetes and dental caries than non-Aboriginal children. The intention of this paper was to highlight the need for approaches that can capture the complexity of health practices without reducing them to either individual choice or structural determination. We explore sugar consumption in Aboriginal children from a social practice perspective. Here, the unit of analysis is the practice, not the individual, where the elements of a social practice (competence, materials and meanings) are integrated into its performance. We conducted qualitative research using elements of …

Sexuality Education In An Age Of Resistance: Reflections At The Nexus Of Education, Health And Rights, Sarah Vrankovich, Katrina Marson, Giselle Woodley, Jordina Quain, Hanna Saltis

Research outputs 2022 to 2026

Comprehensive sexuality education (CSE) is internationally recognised as essential to public health and young people’s rights. Yet its implementation in Australia and globally is increasingly undermined by conservative backlash, moral panic and political interference. This paper offers a critical reflection on the current landscape of CSE, drawing on insights from a panel discussion at the 2025 World Association for Sexual Health congress, and collaborative analysis. As early-career researchers, sexologists and practitioners working across education, communications, public health and sexual violence prevention, we utilise our collective experience to examine how various influences shape and constrain the delivery of CSE. We map …

An Evaluation Of Programmatic Assessment Across Health Professions Education Using Contribution Analysis, Janica Jamieson, Claire Palermo, Margaret Hay, Rachel Bacon, Janna Lutze, Simone Gibson

Research outputs 2022 to 2026

Programmatic assessment is gaining traction in health professions education. Despite this popularity, educators continue to grapple with complex contextual factors that impact implementation and outcome attainment. We used contribution analysis, a theory-informed evaluation method, to understand the mechanisms underpinning successful implementation. Applying the six steps of contribution analysis, we developed a postulated theory of change (ToC) and then conducted a qualitative study with programmatic assessment stakeholders (graduates n = 15, supervisors n = 32, faculty n = 19) from four Australian dietetic programs. These data were analysed using the Framework Analysis method and integrated with data derived from a literature …

Rural-Urban Differences In Dental Care Utilization After A Public Health Emergency, Quazi Minhaz Tabassum, Redwan Bin Abdul Baten, Ahmed A. Arif

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Past year dental clinic visits declined among both rural and urban populations after the COVID-19 pandemic. However, rural patients are more likely to report delayed dental service utilization than their urban counterparts.

• Participants residing in Medicaid expansion states or with health insurance coverage were 16% less likely to delay dental visits overall.

• The COVID-19 pandemic further worsened the existing challenges in dental healthcare access for urban and rural communities.

Review Of Current Research Describing The Influence Of Non-Health Care Drivers Of Health In Rural And Urban Populations, Katie Youngen, Julia Cecil, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Social determinants of health (SDOH) (also called social drivers of health) are the conditions of the environment where people live, learn, work, and play that are known to affect health outcomes.¹ The primary objective of this literature review is to summarize the most recent literature related to the Healthy People 2030 domains of a) economic stability, b) education access and quality, c) neighborhood and built environment, and d) social and community context.² Our particular focus is on non-health care drivers of health. The secondary objective is to identify gaps in literature applied to rural populations.

Assessing Sustainable E-Cigarette Prevention Messaging In Public Health Communication, Addo Anim Adinkrah

Graduate Research Theses & Dissertations

This study examines the sustainability of e-cigarette or vaping prevention messaging on X (formerly Twitter) and the message-design strategies used by public health institutions to maintain message visibility over time. Using the McGuire Communication/Persuasion Model and Media Framing theoretical frameworks, the research employs a qualitative thematic analysis based on Braun and Clarke’s six-phase approach to analyze 506 tweets from official accounts affiliated with the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA). The findings reveal that prevention messages are sustained through repeated core warnings and reinforcement of institutional authority rooted in scientific and …

Increasing Hpv Vaccination Among Early Adolescents Using A Game-Based Digital Intervention: A Randomized Controlled Trial, Angela Chia-Chen Chen, Lihong Ou, Elizabeth Reifsnider, Kimberly Arcoleo, Ashish Amresh, Michael Todd

Ellmer School of Nursing Faculty Publications

Background/Objectives: Human papillomavirus (HPV) vaccination coverage among adolescents remains below public health targets despite strong evidence of vaccine effectiveness in preventing HPV-related cancers. Digital interventions (e.g., serious games) may improve HPV vaccine uptake, but evidence for effects on vaccination behavior remains limited. Methods: This secondary analysis of a randomized controlled trial evaluated a co-designed, game-based digital intervention to increase HPV vaccine initiation among unvaccinated youth aged 11-14 years and their parents. The sample included 64 parent-adolescent dyads (33 intervention and 31 usual care dyads). The primary outcome was HPV vaccine initiation at 2-month follow-up. Results: A significantly greater proportion of …

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

Translating Evidence Into Action: Understanding How Community- Based Practitioners Make Intervention Implementation Decisions In Practice, Kristin C. Bennett

Dissertations and Theses (Open Access)

This study examined how community-based practitioners implement public health interventions in practice settings to identify gaps between existing implementation frameworks and real-world practice. Six farmers' markets in Southeast Texas served as cases to understand implementation decision-making by community-based practitioners addressing food access challenges. A qualitative case study approach was employed, using semi-structured interviews with program adopters and key stakeholders to examine how practitioners addressed food access problems, selected interventions, and navigated implementation decisions. This methodology captured the contextual nature of implementation decision-making in community settings. The findings revealed that program adopters recognized health problems through lived experience rather than formal …

Occupational Resilience (Part 2): Toward A Cross-Culturally Relevant Measure Of A Novel Construct, Bernard A. Muriithi, Milan Bimali

Occupational Therapy Faculty Scholarship

Occupational resilience (OR) refers to an individual’s ability to persist in performing an occupation, with the duration and intensity of engagement determining resilience for each occupation. It is a key determinant of both the manner and the extent to which occupations influence health; therefore, it is a promising construct with several potential applications. There are currently no validated OR measures; which problematizes its application. Three considerations were made in designing the Occupational Resilience Measure (ORM 1.0) and evaluating its potential as a cross-culturally relevant measure of OR: 1) the findings of a published study of lived experiences of refugees from …

From Medical Check-Ups To Risk-Based Health Governance: Reframing Fitness-For-Work And Preventive Health In Modern Health Systems, Kasyunnil Kamal, Iqbal Mochtar

Occupational and Environmental Medicine Journal of Indonesia

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