Community Psychology Commons^™

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 …

Dissecting The Heterogeneous Effects Of Opioid Prescribing Limit Laws On Pediatric Mortality: A Multidimensional And Negative Binomial Modeling Approach, Francine R. Vega

Dissertations and Theses (Open Access)

Opioid prescribing for children and adolescents continues to be a significant health crisis in the United States. Early naïve exposure to opioid prescriptions has been linked to later misuse, opioid use disorder, and death. In response to the crisis, many states have implemented opioid prescribing limit laws (OPLLs) aimed at reducing exposure to opioids. These laws vary widely in their approach, including differences in dosage restrictions, prescription duration limits, informed consent requirements, educational provisions, and whether they offer explicit protections specifically for minors. Despite their widespread adoption, there is limited understanding of how heterogeneity in legal regulations affects outcomes for …

Rethinking Health Systems Responsiveness In Low–And Middle-Income Countries, Meesha Iqbal

Dissertations and Theses (Open Access)

Health systems responsiveness (HSR) refers to a health system’s ability to meet legitimate non-health expectations of the population. Traditionally, HSR has been conceptualized across eight domains: respect for dignity, autonomy, confidentiality, prompt attention to health needs, availability of basic amenities, choice of provider, access to social support networks, and clarity of communication. However, as the expectations of populations in high-income countries (HICs) and low- and middle-income countries (L&MICs) differ significantly due to diverse social and cultural contexts, the conceptualization of HSR also varies. We conducted a systematic review of literature to adapt and contextualize the HSR framework for L&MICs based …

Modeling Buprenorphine Treatment Discontinuation In Opioid Use Disorder – Predictors And Disparities Using Statistical And Machine Learning Approaches, Wanru Guo

Dissertations and Theses (Open Access)

Background: Opioid Use Disorder (OUD) remains a major public health crisis in the U.S., and while buprenorphine is an effective treatment, early discontinuation undermines its impact. Existing statistical and machine learning (ML) models often overlook key social and healthcare-related predictors and fail to capture subgroup disparities, limiting their utility for equitable intervention design. This study addresses these gaps using a nationwide, longitudinal dataset and a two-stage modeling approach focused on disparity identification. Methods: We analyzed buprenorphine treatment episodes for OUD from the IQVIA Pharmetrics Plus database (2006–2023), defining discontinuation as episodes lasting under 180 days. A Cox proportional hazards model …

Addressing The Public Health Concern Of Maternal Mortality In Houston, Texas, Lucy Couture

Dissertations and Theses (Open Access)

Maternal mortality remains a pressing public health concern in the United States, with disproportionate consequences for marginalized communities. Despite being a developed nation, the U.S. reports one of the highest maternal mortality rates among its peers, with approximately 80% of maternal deaths deemed preventable. Texas reflects this national crisis, particularly affecting Black women, whose maternal mortality rate is significantly higher than that of other racial and ethnic groups. This thesis explores maternal mortality trends in Houston, Texas, analyzing the roles of systemic inequities, social determinants of health, and disparities in access to quality care. Drawing on data from the Texas …

A Quantitative Examination Of Tobacco And Marijuana Use On Oral Health Outcomes Among Young Adults In Texas, Meenakshi Dasagi

Dissertations and Theses (Open Access)

This dissertation aimed to quantify the relationship between methods of tobacco and marijuana use and their impact on oral health. Tobacco use was defined as smoking combustible tobacco (cigarettes, cigars, and hookah) or electronic aerosolized vaping nicotine with an e-cigarette.5,9 Similarly, marijuana use was defined as smoking combustible marijuana (joints, blunts, and spliffs) or vaping marijuana with an e-cigarette.8 Despite the prevalence of nicotine vaping and marijuana use among young adults1,3-4,7,14-15, there is limited evidence of their association with oral health in Texas. To address this issue, this dissertation comprising three studies analyzed longitudinal data from the Texas Adolescent Tobacco …

Building Futures: How The Built Environment, Out-Of-School Time Programs, And Community Service Participation Relate To Social-Emotional Development Of U.S. Youth, Bailey A. Perez

Dissertations and Theses (Open Access)

Background: This dissertation aimed to explore the relationship between built environment features, participation in out-of-school time (OST) programs, participation in community service activities, and the social-emotional development of youth aged 6 to 17 years residing within the United States (US). Previous research indicates that built environment features, as well as participation in OST programs and community service activities, could impact youth’s social-emotional development. However, few studies have explored these effects on individual social-emotional development measures in this specific age group. In addition, little is known regarding whether built environment features and youth’s sex moderates the relationship between youth participation in …

Latent Classification Of Multi-Model Non-Homogeneous Continuous-Time Markov Chains, Joonha Chang

Dissertations and Theses (Open Access)

The continuous-time Markov chain (CTMC) model and latent clustering models are commonly used to study longitudinal measures of categorical outcomes. Because of its simple but powerful Markovian property, CTMC models have been widely used in medical and public health researches. Due to limitations in the standard CTMC model, there have been some studies on non-homogeneous continuous-time Markov chain (NH-CTMC) that utilized time-dependent rates, but the progresses have been limited. NH-CTMC can be more powerful than CTMC by its default nature of time-dependent rate that can be fitted to a wider range of applications in medical studies. In this study, we …

Prevalence Of Adverse Childhood Experiences And Its Dose-Response Association With Anxiety-Related Stress Symptoms In Young Adults Ages 18 To 44 Years Old In The United States, Kenechukwu O. Nwosu

Dissertations and Theses (Open Access)

Introduction: Adverse childhood experiences are common in the United States with about 64% of the population affected. Adverse childhood experiences are predictors of many chronic diseases including mental illnesses like anxiety. Though non-Hispanic whites are mostly afflicted by anxiety compared to their racial counterparts, minority races like non- Hispanic Black/African Americans disproportionately suffer more dire consequences due to the chronicity of untreated conditions which often result from lack of access to care among other barriers. Methods: This is a retrospective cross-sectional study. BRFSS 2022 data set was used to identify 56,598 respondents, ages 18 to 44 years old for analysis. …

Tavr In Older Adults, Abdulla A Damluji, Gwen Bernacki, Jonathan Afilalo, Radmila Lyubarova, Ariela R Orkaby, Min Ji Kwak, Scott Hummel, James N Kirkpatrick, Mathew S Maurer, Nanette Wenger, Michael W Rich, Dae Hyun Kim, Roberta Y Wang, Daniel E Forman, Ashok Krishnaswami

Faculty, Staff and Student Publications

Calcific aortic stenosis can be considered a model for geriatric cardiovascular conditions due to a confluence of factors. The remarkable technological development of transcatheter aortic valve replacement was studied initially on older adult populations with prohibitive or high-risk for surgical valve replacement. Through these trials, the cardiovascular community has recognized that stratification of these chronologically older adults can be improved incrementally by invoking the concept of frailty and other geriatric risks. Given the complexity of the aging process, stratification by chronological age should only be the initial step but is no longer sufficient to optimally quantify cardiovascular and noncardiovascular risk. …

Assessing Effective Communication Styles And Preferences Between Health Researchers And State Policymakers, Shelby Flores-Thorpe

Dissertations and Theses (Open Access)

This dissertation examined how health researchers and state policymakers can effectively communicate with each other to support the use of evidence-based public health information in the policymaking process. To achieve this, a systematic review, analysis of TX RPC Project data, and semi-structured interviews were conducted among health researchers and policymakers. The systematic review found that email, in-person meetings, and phone calls were the best way to reach policymaking offices at the federal and state levels. When providing policymaking offices with data, health researchers should provide briefs, summaries, fact sheets, or one-pagers to support legislative offices’ need for information. Shorter reports …

Effect Of Body Mass Index Percentile On Complicated Appendicitis, Postoperative Complications And Health Service Utilization Among Pediatric Patients In The United States, Nutan Hebballi

Dissertations and Theses (Open Access)

While overweight and obesity have been extensively studied for complicated appendicitis, postoperative complications, and health service utilization, the effects of being underweight are unknown. This dissertation assesses the associations between the body mass index (BMI) spectrum with complicated appendicitis, postoperative complications, and healthcare service utilization in pediatric patients.  A retrospective review of pediatric patients who underwent appendectomy surgery (01/01/2016-12/31/2020) was conducted using the National Surgical Quality Improvement Program database. Computed age and gender-specific BMI percentiles were categorized into underweight, normal weight, overweight and obese. The 30-day postoperative complications were grouped into minor, major, and any. Healthcare service utilizations were compared …

Diet By Genomic Interactions In Determining Metabolic Traits And Profiles On Glucose Metabolism Among Mexican Americans In Starr County, Texas, Shinhye Chung

Dissertations and Theses (Open Access)

Worsening glycemia, prediabetes and diabetes, is one of the essential diseases in public health, considering their high prevalence, the enormous impact on multiple organs, and the economic burden on the community. Various factors can affect the pathogenesis of worsening glycemia, and this study focused on macronutrient intake, genes, and their interactions with metabolome data. 616 self-reported Mexican American participants in Starr County were recruited with informed consent. 308 identified and 2,471 unidentified metabolites were used for the analysis, and all the metabolites were inverse normalized with less than half of the missing rate. Each of the five glycemic and lipid …

Economic And Policy Determinants Of National Abortion Rates: A Cross-National Study, Olufunke Akiyode

Dissertations and Theses (Open Access)

Abortion is as old as humanity and exists in all cultures. The number and rate of abortions differ among countries and regions of the world. Some determinants of abortion may include economic indicators and policy restrictiveness. This study analyzes the economic and policy determinants of abortion by evaluating the association of income and policy on abortion rates. It uses a panel data regression to examine the association between income, Gini Coefficient and abortion rates. Gini Coefficient measures income inequality, and GNI represents a country’s income. Publicly available longitudinal data obtained from the World Bank, United Nations, United Nations Population Development …

Difference In Smoking Patterns And Quitting Status Between Premium And Non-Premium Cigar Users After Two Years Of Follow Up In Us Adults: Findings From The Population Assessment Of Tobacco And Health (Path) Study, 2016-2019, Sarah Valencia

Dissertations and Theses (Open Access)

Previous studies have described the demographics, purchasing behaviors, trends in frequencies of cigar use, and quitting status among cigar poly users, however, there has not been a study that evaluates differences in demographic characteristics and quitting status for premium and non-premium U.S. adult cigar users. This study used secondary data analyses of the Population Assessment of Tobacco and Health (PATH) Study public-use files dataset for adult traditional cigar users in wave 4 (2016-2018) and wave 5 (2018-2019). Traditional cigars were classified as premium or non-premium at wave 4 (2016-2018) using the brand and price per stick of cigar that was …

Viral Particle Detection In Wastewater, Katelyn Clark

Dissertations and Theses (Open Access)

Wastewater is an underutilized resource for recognizing the epidemiology of pathogen transmission and infections within a community that has the potential to mitigate disease outbreaks. Pathogens of public health concern, such as adenovirus, norovirus, and SARS-CoV-2, occur in wastewater from excretion of infected individuals. Despite the potential for wastewater pathogen data to predict future outbreaks, the relationship between viral shedding patterns in wastewater and case counts of infectious disease remains unclear. An evaluation of the peer-reviewed literature was conducted to compile characteristics of adenovirus, norovirus, and SARS-CoV-2 in the wastewater environment. These characteristics were considered in prioritizing the key pathogens …

A Systematic Review And Meta-Analysis Of Long Term Physical And Mental Sequelae Of Covid-19 Pandemic: Call For Research Priority And Action, Na Zeng, Yi-Miao Zhao, Wei Yan, Chao Li, Qing-Dong Lu, Lin Liu, Shu-Yu Ni, Huan Mei, Kai Yuan, Le Shi, Peng Li, Teng-Teng Fan, Jun-Liang Yuan, Michael V Vitiello, Thomas Kosten, Alexandra L Kondratiuk, Hong-Qiang Sun, Xiang-Dong Tang, Mei-Yan Liu, Ajit Lalvani, Jie Shi, Yan-Ping Bao, Lin Lu

Faculty, Staff and Students Publications

The long-term physical and mental sequelae of COVID-19 are a growing public health concern, yet there is considerable uncertainty about their prevalence, persistence and predictors. We conducted a comprehensive, up-to-date meta-analysis of survivors' health consequences and sequelae for COVID-19. PubMed, Embase and the Cochrane Library were searched through Sep 30th, 2021. Observational studies that reported the prevalence of sequelae of COVID-19 were included. Two reviewers independently undertook the data extraction and quality assessment. Of the 36,625 records identified, a total of 151 studies were included involving 1,285,407 participants from thirty-two countries. At least one sequelae symptom occurred in 50.1% (95% …

Good Faith: Surveillance And Evaluation Of 911 Good Samaritan Laws In The United States, Shane W. Reader

Dissertations and Theses (Open Access)

To fight soaring overdose mortality rates in the United States, lawmakers adopted a variety of harm reduction tools. Among these, 911 Good Samaritan Laws (GSLs) derive their name from the biblical parable of the Good Samaritan, a bystander who broke cultural convention to come to the aid of a man beset by thieves. These laws provide limited criminal immunity for bystanders in possession of controlled substances to encourage them to report drug overdoses. While previous studies associate GSLs with a modest reduction in opioid mortality, analyses often model them as equivocal or divide them coarsely across individual provisions. Evaluating these …

Investigating Fruit And Vegetable Variety In A National Food Co-Op: A Brighter Bites Evaluation, Katherine G. Hearne

Dissertations and Theses (Open Access)

American children eat fewer fruits and vegetables (F&V) and less variety of F&V than recommended for health. Food cooperatives and other programs have become a popular way to increase F&V intake, but little is known about the variety of F&V distributed by these programs or its relationship with program attendance or child F&V intake. Brighter Bites is a national, school-based food co-op distributing rescued, donated, fresh F&V to families in low-income schools. We evaluated, for the first time, the variety of F&V Brighter Bites distributed to families in the 2018-2019 school year and the relationships between that variety and both …

Understanding Young Adult Tobacco And Marijuana Use, Shazia Rangwala

Dissertations and Theses (Open Access)

In 2015, young adults in the United States (U.S.) reported co-use of tobacco and marijuana at a much higher rate than exclusive use of marijuana. While there is some qualitative research specific to using tobacco and marijuana separately, there is a lack of qualitative research studying poly/dual or co-use of these products and to understand the complex interactions between the varied modes of delivery for tobacco and marijuana. Qualitative research in this area is important especially due to the major developmental shifts that occur as youth transition into young adulthood. The proposed study is a descriptive analysis of qualitative data …

Dataset: Knowledge And Attitude Retention Following An Implicit Bias Classroom Workshop, Yuanyuan Zhou, Joel Purkiss, Malvika Juneja, Jocelyn Greely, Anitra Beasley, Anne Gill

Faculty, Staff and Students Publications

Background: Baylor College of Medicine provides a classroom-based implicit bias workshop to all third-year medical students to increase students’ awareness of their unconscious bias and develop strategies for reducing health care disparities. The workshop meets our immediate goals and objectives. However, we are unsure if the benefit would be long-term or diminish over time.

Methods: To examine the concept retention from the implicit bias classroom workshop, we administered a self-developed seven-item seven-point Likert-scale survey to our medical students at pre-, post-, and one-year post-workshop attendance.

Results: The data set was comprised of survey results from two cohorts of our third …

Survival Analysis Of Colorectal Cancer Patients With Liver Metastasis, Brandon O’Grady

Dissertations and Theses (Open Access)

Background- Colorectal cancer is the third most common cancer in the world. I investigated the survival rates among colorectal cancer patients diagnosed with hepatic metastasis to see if any variables are associated colorectal risk and survival. Methods- Patients were diagnosed from 2000-2019 and collected through MD Anderson’s database. A descriptive analysis, univariate analysis, Kaplan-Meier with Mantel log-rank test, Cox proportion hazard regression and a Stratified Cox Model was performed to investigate death. A competing risk regression was implemented to investigate liver recurrence. Results- There was a clear difference in the survival outcome between liver surgery patients and non-liver surgery patients …

Applications Of Statistical Methods Studying The Impact Of Mobilization Regimes On The Total Collection Yield Of Hematologic Stem Cell, Mengchen Ding

Dissertations and Theses (Open Access)

Hematologic malignancies are cancers that develop in the blood, bone marrow, and lymph nodes. Hematopoietic stem cell transplantation (HSCT) is a critical therapeutic approach that contributes to offer a potential cure for hematologic cancers and other hematologic disorders by replacing abnormal bone marrow with healthy bone marrow components to help bone marrow function recovery. Peripheral blood is the primary resource for collecting hematopoietic stem cells (HSCs). The collection yield of HSCs is critical for successful transplantation. Few articles have discussed this topic that the collection of stem cells not only from healthy donors but also from donors with a hematologic …

The Comparative Effect Of Automated Reminders/Recalls Interventions On The Appointments Rate Of Adolescent Wellness Care Visit, Biai Dominique Elmir Digbeu

Dissertations and Theses (Open Access)

An Adolescent Wellness Care (AWC) visit is an annual preventive doctor visit predestined to assess the overall health of adolescents aged between 12 and 21 years old. Compared to their younger counterparts, adolescents who are using public insurance are at risk of not completing AWC visits due to several factors related to age or providers disparities in their living environment. This research was a quasiexperimental study aiming to compare two methods of automated Reminders/Recalls (RR) interventions, ‘phone-only’ versus ‘phone-and-text’, in order to evaluate which method is more effective in helping parents/guardians or young adults to schedule an AWC visit. A …

Characterization Of Age-Associated Copd Progression In The Copd Gene Cohort, Lauryn A. Winter

Dissertations and Theses (Open Access)

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating lung disease affecting primarily older adults. Incidence, morbidity and mortality from COPD are increasing worldwide. The purpose of this study was to determine the associations between age at baseline and markers of disease progression in COPD patients using data generated by the Genetic Epidemiology of COPD (COPD Gene) study. Participants with COPD were stratified by age (younger: age <65 years, elderly: age ≥ 65 years) and disease characteristics (lung function, exercise tolerance, exacerbation history, and comorbidity burden) at baseline and five-year follow up were compared between groups. Associations between age group and changes in these measures were also assessed. Disease characteristics differed significantly between elderly and younger COPD patients at both study visits. Elderly COPD patients had worse lung function and more comorbidities than younger COPD patients, while younger COPD patients reported more dyspnea and more frequent and severe exacerbations than elderly COPD patients. Following covariate adjustment, elderly participants were less likely than younger participants to develop new frequent exacerbations over the study period (relative risk ratio (95% confidence interval): 0.42 (0.20, 0.87)). There were no other significant associations between age group and markers of disease progression. These results suggest that although elderly COPD patients exhibit evidence of more severe lung function impairment than younger COPD patients, the rate of disease progression is similar between elderly and younger patients. However, further exploration is needed to understand the possible contribution of survivorship bias to this finding. Nevertheless, this study supports the importance of early detection and early intervention to slow disease progression and maximize both life expectancy and quality of life for COPD patients.

Asthma-Copd Overlap Syndrome And Disease Progression In The Copdgene Cohort Study, Caitlyn Winter

Dissertations and Theses (Open Access)

Chronic Obstructive Pulmonary Disease (COPD) is a debilitating and degenerative lung disease characterized by progressive airway obstruction and alveolar destruction. When asthma and COPD co-occur and interact, with asthma having been diagnosed first, the resulting respiratory disease is called Asthma-COPD Overlap Syndrome (ACOS). Current research suggests that persons with ACOS may have more severe respiratory disease and lifestyle limitations than those with either disease alone. The purpose of the current study was to determine if and how disease progression differs in patients with ACOS versus COPD only, using data collected during the COPDGene cohort study. Demographic characteristics and disease outcome …

Breastfeeding Duration And Reasons Given For Early Cessation Of Breastfeeding Among Wic Mothers, Amy Willa

Dissertations and Theses (Open Access)

The Breastfeeding Duration and Reasons for Early Cessation of Breastfeeding Among WIC Mothers study was conducted to describe the duration of and factors associated with early breastfeeding cessation among the Women, Infants, and Children (WIC) population. We collected data from a random sample of WIC medical records, sampling medical records belonging to mothers who initiated breastfeeding an infant but did not breastfeed to 52 weeks. Data were analyzed to answer the questions: How long do WIC mothers breastfeed? What reasons are given during counseling sessions at WIC for early cessation of breastfeeding? Do socio-economic, demographic, or medical factors influence the …

The Direct Primary Care Model: Practice Characteristics And Patient Experience, James David Miller

Dissertations and Theses (Open Access)

The Direct Primary Care practice model has been growing in both number of practices and public awareness. However, there has been little academic research about this emerging practice model. This research is aimed to describe the current state of the DPC practice model by examining the services provided, geographic distribution of practices, statistical distribution of membership fees, demographic characteristics of physicians using the model and to determine whether regional pricing variation existed. In addition, differences were analyzed between the patient satisfaction levels in DPC and fee-for-service practices. A dataset was created by visiting the website of all known, non-corporate, DPC …

Cross-Sectional Analysis Of The Relationship Between Violent Crime And Mental Health Disorders In A Sample Of Homeless Adults Recently Released From Jail, Addison Ransom

Dissertations and Theses (Open Access)

Adverse mental health conditions among incarcerated populations are high, and treatment for these conditions is particularly low. Additionally, there is a culture of stigma in the United States towards those with mental health conditions and violent criminal history, contributing to mass incarceration. The present cross-sectional study sought to assess the association between violent criminal history and mental health symptoms among recently incarcerated homeless adults in Dallas, Texas. This study included 230 participants, taking place at The Bridge Homeless Recovery Center, evaluating non-violent versus violent criminal history. Outcome measures of positive screens for post-traumatic stress disorder, generalized anxiety disorder, and depression …

Atitiudes Tow Ards Computer Games For Learning And Pl.A Yer Archetypes: An Exploration Of Measures On Preintervention Player Characteristics For Serious Game-Based Interventions, Benjamin Lee

Dissertations and Theses (Open Access)

Serious game-based interventions offer promising health outcome results with the aid of pre-intervention player tailoring and the development of measurements that evaluate pre-intervention player characteristics and subgroups. Video gaming measures can potentially provide helpful tailoring information that discerns individual video gaming preferences which could influence their overall user experience. It is critical that measures that target adolescent video gaming be psychometrically validated. There is a gap in the literature with psychometrically validated measures evaluating adolescent attitudes towards computer games for learning and gaming archetypes. Therefore the aims of this dissertation were to 1) evaluate the psychometric properties (i.e., reliability and …