Public Affairs, Public Policy and Public Administration Commons^™

"You Need To Make The Decision You Can Live With": An Observational Study Of Anti-Abortion Centers In Tampa Bay, Anna Broich

USF Tampa Graduate Theses and Dissertations

Anti-Abortion Centers (AACs) pose a grave threat to the reproductive health outcomes of Americans. Disguising themselves as licensed health clinics, AACs target vulnerable communities to prevent or delay abortion care through the spread of medical misinformation, contributing to abortion stigmatization. Situated in a state with a near-total abortion ban, this secret-shopper study aimed to understand the ways in which AACs in Tampa, Florida communicate anti-abortion rhetoric to pregnant people seeking abortions. Under the guise of people who suspect they are pregnant searching for abortion care, the main researcher and her assistants conducted the first phase of the study through 25 …

The Social Standing Versus The Mind Standing Of Older Adults In Egypt: Cross-Sectional Analysis Of The Relationship Between Social Capital And Cognitive Functions, Shaza H. Shinaishen Dr

Theses and Dissertations

Introduction: Egypt's population, much like that of other countries, is expected to age considerably over the course of the coming decades. Although biological and socioeconomic predictors of cognitive function have been studied widely, personal level social capital remains unexplored, especially in LMICs.

Purpose: This study primarily investigates the relationship between individual social capital and cognitive functioning among older adults aged 65 years and older in Egypt using the structural and cognitive components of social capital, including group membership, civic engagements, and caregiving roles.

Methods: A cross-sectional survey on 363 older individuals in different geographical and demographic segments of Egypt using …

Urban-Rural Divide In Inequality’S Impact On Substance Abuse, Jonathan E. Flores

Undergraduate Theses, Capstones, and Recitals

This thesis focuses on investigating the relationship between income inequality, measured through the Gini coefficient, and drug addiction, proxied through substance-related mortality. Specifically, this thesis focuses on how these dynamics vary across rural and urban counties in the United States, using population size as a proxy. County-level data from 2016 to 2020 were collected through both the CDC and the Census Bureau and subsequently analyzed using Stata, with crude death rates from drug and alcohol causes serving as a function of the Gini coefficient, labor force participation, racial composition, and other socioeconomic indicators. Through a quadratic version of the model, …

One Health Integration To Control And Prevent Zoonoses: Application Of Organizational Theory Literature, Lisset M. Dumet Poma, Sherril Gelmon, Julia M. Goodman, Seth E. O’Neal

Hatfield Graduate Journal of Public Affairs

Zoonoses are infectious diseases transmitted between animals and people that disproportionately affect low- and middle-income countries (LMICs). The One Health (OH) approach aims to integrate systems, incentivizing collaboration among animal, human, and environmental systems to address zoonoses and improve health. Innovative solutions for effectively and sustainably achieving systems integration are needed. Organizational theories can facilitate the study of the context of OH implementation, applying comprehensive approaches that recognize the interconnections among organisms, the environment, and social systems, including the diverse entities needing integration (e.g., policy, community, public organizations). This narrative review examines organization and systems literature to provide recommendations for …

Adolescent Preventive Care Outcomes Before And After Covid-19 Onset: What Is The Role Of Telehealth?, Sarah Hayden Knipper

Dissertations and Theses

Adolescents are a developmentally distinctive population with unique primary health care needs; they comprise about 10% of Oregon's population and more than half are covered by the Oregon Health Plan (OHP). This dissertation investigated significant declines in preventive care utilization (well visits and HPV immunizations) among adolescents enrolled in OHP during the COVID-19 pandemic and the relationship between the decline in utilization and the rise in telehealth availability. The study focused specifically on the role of race/ethnicity, geography, and access to health systems in mitigating or exacerbating decreases in preventive care. A mixed methods approach was employed to understand not …

The Effect Of Ex-Ante Government Responsibility For Health On Public Health Financing In Post Pandemic Budgets, Denis Granados, Rylee Roman, Hallie Sidman

Working Papers Series

This paper investigates how pre-pandemic levels of government responsibility for public health financing influenced post-pandemic health spending across selected OECD countries. Using a combination of descriptive analysis and regression modeling, the study examines changes in public health expenditure per capita between 2019 and 2022, focusing on key variables such as the government’s share of health financing, the Total Pandemic Policy Intensity (PPI) index, and GDP per capita. Findings suggest that while all countries increased health spending post-COVID-19, the scale of change varied significantly based on economic capacity, institutional readiness, and political will. Notably, countries with higher pre-pandemic public health investment …

Functional Resilience Of Healthcare In The Critical Juncture Of The Covid-19 Pandemic, Avner Kronisch, Christian Bongiorno, Kerane Smith, John Baker

Working Papers Series

This paper offers a comparative analysis of eight national healthcare systems—spanning democracies, autocracies, and various institutional models—to evaluate resilience during the COVID-19 pandemic. Drawing on Shvetsova et al.’s framework of informational and authority redundancies, and Parker & Klein’s “choke point” theory of healthcare rationing, we examine how institutional structure shaped pandemic response, system adaptability, and continuity of non-COVID services. Using indicators like life expectancy, under-five mortality, hospital capacity, cancer survival, and excess mortality, we explore how systems absorbed shock and maintained essential care. We find that decentralized and polycentric governance structures, when paired with coordination and resource adequacy, enhanced resilience—exemplified …

Covid-19 & Healthcare (Re)Privatization? A Comparative Analysis Of High And Medium Per Capita Gdp Countries, Kristina Donders, Kaitlyn Matthews, Brittany Reyes, Frank. H. Rizzo

Working Papers Series

This paper examines whether the COVID-19 pandemic accelerated healthcare privatization in high- and medium-GDP countries. Drawing on political economy theories of path dependence and privatization, we analyze changes in public and private healthcare expenditures in eight countries: Canada, Chile, Denmark, Georgia, Luxembourg, Norway, the Philippines, and South Korea—comparing data from 2019 and 2022. Using World Bank indicators on healthcare financing, GDP, aging populations, and food insecurity, we find that although healthcare expenditures generally increased during the pandemic, this increase was primarily in public, not private, spending. Case studies of Georgia and South Korea reveal that local economic and demographic pressures, …

How Far-Right Populism Harms Ethnic Minorities’ Health: The Case Of The United States, Dina Rosenberg

Working Papers Series

Public health is a political issue, and the health of ethnic minorities is a key component of it. We argue that far-right populism, whether grassroots or elitist, harms the health of immigrants and minorities. Anti-minority attitudes and policies—such as health chauvinism promoted by far-right populists—along with hate rhetoric and ensuing personal and institutional discrimination create a climate of hostility that negatively affects health outcomes in underprivileged communities. We hypothesize that immigrants and ethnic minorities living in such a climate are more likely to experience health problems and underutilize healthcare. To test this, we leverage the significant variation between U.S. states …

Factors Associated With Caregivers' Concern In Maintaining The Oral Function Of Elderly Living In Long-Term Care Facilities, Susiana Nugraha, Tri Budi Wahyuni Rahardjo, Misako Higashijima, Yuko Hirano

Kesmas

This study investigated the attentiveness of elderly caregivers in long-term care facilities in maintaining oral function. A cross-sectional approach was used to achieve the study's purpose. The sample size formula accounted for 213 caregivers randomly selected from 18 long-term care facilities in 4 provinces. A self-reported questionnaire of sociodemographic characteristics and an adapted Leopold’s oral care checklist was distributed. The average age of study participants was 35.24 (±11.2 SD; aged 18–70 years), dominated by females (62.9%), and only 39% had experienced long-term care training. Multiple linear regression analysis indicated that younger caregivers likely pay more attention in the swallowing periods …

Availability And Distribution Of Stoma Bags For Colorectal Cancer Patients: A Case Study At National Referral And Private Hospitals, Ratna Aryani, Toar Jm Lalisang, Debie Dahlia, Evi Martha, Achir Yani S Hamid, Sukma Wicaturatmashudi, Helen Helen

Kesmas

Stoma bags are essential for colorectal cancer (CRC) patients with stomas. However, access and affordability in Indonesia remain challenging as the National Health Insurance (NHI) does not fully cover these devices. This study aimed to describe the availability and distribution of stoma bags for patients with CRC in national referral and private hospitals, focusing on outpatient access. A qualitative case study was conducted through observations and in-depth interviews with four enterostomal therapy nurses and six patients across three national referral hospitals and one private hospital in the Jakarta Metropolitan Area, Indonesia. Notably, the availability of stoma bags was limited in …

Job Satisfaction Among Health Workers At Primary Health Care In Palembang City, Indonesia, Asmaripa Ainy, Merri Nurmala Sarri, Poppy Fujiyanti, Hartati Inaku, Tannia Tembo

Kesmas

Health workers at primary health care are the frontline providers of community health services. This study aimed to investigate the level of job satisfaction of health workers at primary health care in Palembang City, South Sumatra Province, Indonesia, and its influencing factors. Using a questionnaire developed by the authors' team, the study involved 257 samples. A total of 66.15% of respondents indicated high satisfaction, 21.79% reported moderate satisfaction, and 12.06% expressed dissatisfaction. A statistically significant correlation was found between knowledge, skills, income, promotion opportunities, work supervision, and relationships with colleagues and job satisfaction (p-value <0.001). The correlations were strong, with Spearman's rho of 0.822, 0.869, 0.912, 0.895, and 0.821, respectively. Statistical analysis of the Wilcoxon rank-sum and Kruskal-Wallis tests showed no significant differences in median satisfaction scores between sociodemographic groups (p-value 0.072 to 0.552>0.05). These findings showed that job …

Addressing Socioeconomic Disparities In The Treatment Of Antimicrobial-Resistant Infections: The Role Of Pharmacists In Mitigating Barriers, Arin Wade, Danielle Egbujor, Anna Spalvieri, Owen Fox, Marisa Petrunich, Joshua Honaker, Samantha Mccord, Kasie Landin

Pharmacy and Wellness Review

Antimicrobial resistance is an escalating global threat driven by inappropriate antibiotic use and shaped by socioeconomic disparities. Social determinants of health, including limited healthcare access, poverty, low health literacy, and environmental conditions, contribute to higher rates of resistant infections and poorer treatment outcomes in underserved populations. Barriers such as pharmacy deserts, self-medication, and inadequate stewardship infrastructure amplify these risks. Pharmacists, as accessible and highly trained healthcare professionals, play a critical role in combating antimicrobial resistance by optimizing antibiotic use, delivering culturally competent education, and leading antimicrobial stewardship programs across settings. Community and clinical pharmacists are especially well positioned to bridge …

Shifting To A Culture Of Inclusion By Design: Applying A Mixed-Methods Approach To Advance Accessibility Of Public Health Emergency Information & Communication Technology, Jessica L. Franks, Erin Vinoski Thomas

Developmental Disabilities Network Journal

Adults with intellectual and developmental disabilities (IDD) experience inequities in access to timely, accurate, and understandable information and communication technology (ICT), which increases risk for public health emergency (PHE)-related health disparities and impedes opportunities to achieve optimal health. This study assessed federal COVID-19 webpage accessibility levels and explored existing knowledge of and experience with filing accessibility complaints for federal ICT among adults with IDD. Through a mixed-methods approach, we evaluated compliance with accessibility standards for 18 federal agencies’ COVID-19 webpages (study 1) and interviewed 16 adults with IDD about experiences accessing federal webpages and filing accessibility complaints (study 2). We …

Science Tikkun: A Bioscience Pandemic Framework In A Hebrew Tradition Of Global Repair, Peter Hotez

Center for Medical Ethics and Health Policy Staff Publications

Over the past decade we have seen a steady increase in dangerous pandemic threats. They include two major Ebola epidemics and cholera in Africa; dengue, Zika, yellow fever in the Americas; a COVID-19 pandemic; and H5N1 in Texas. This is happening because of a confluence of modern forces including urbanization, deforestation, and climate change. Yet as pandemics emerge on a crowded and warming planet, anti-science disinformation and antisemitism impede our response. Science tikkun is an overarching framework for repair and redress. It honors the legacy of Maimonides, Teilhard de Chardin, and others who have sought reconciliation between science and religion.

Framing The Future: A Community Health Analysis Of The Pee Dee Region, Stephen Borders, Jean Anton, Rian Fontaine, Donielle Phillips, Treyton Ringer, Jessica Robinson, Caitlin Thompkins

Public Health

This report presents a comprehensive, data-driven analysis of community health across South Carolina’s Pee Dee region, encompassing Florence, Darlington, Chesterfield, Marlboro, Marion, and Dillon Counties. Using tract-level data from CDC PLACES, the U.S. Census, and the National Provider Identifier registry, it assesses chronic health conditions, health behaviors, and social determinants of health. The analysis incorporates the South Carolina Healthy Communities Index (SCHCI) and a Suitability Analysis to identify the region’s most disadvantaged communities. The findings highlight persistent disparities, particularly in rural counties, where high rates of poverty, chronic disease, and unmet basic needs intersect with limited access to care. Despite …

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

How Does Snap Access Prior To Pregnancy Affect Maternal And Infant Health Outcomes?, Sarah Hamersma, Mitch Mcfarlane

Center for Policy Research

Consistent access to healthy food even before pregnancy can play a role in maternal and child health. The Supplemental Nutrition Assistance Program (SNAP) provides food assistance to low-income individuals, including those who do not yet have children (often classified as Able-Bodied Adults Without Dependents, or ABAWDs). Our study uses ABAWD work requirement waivers – which vary within and across counties over a 15-year-period – as a measure of SNAP access for childless women. We use this variation to investigate pre-pregnancy SNAP access and the health of mothers and their infants. Using rich, population-wide Vital Statistics data combined with county-level SNAP …

Long-Term Care Services And Support In The Mountain West, 2023, Taylor Volk, Ivan Sun, Miguel Soriano Ralston, Kristian Thymianos, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data from the American Association of Retired Persons (AARP) report, “Long-Term Services and Supports 2023 State Scorecard Report,” comparing Long-Term Services and Supports (LTSS) systems across multiple dimensions of performance for older adults, people with physical disabilities, and family caregivers for all 50 states. This fact sheet focuses on state-level LTSS system data for the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah.

Costing Care: Unpacking The Drivers Of Medicaid Spending For Nicu Admissions In Nevada, Vidhani Goel, Ana L. Reyes, Bertille Assoumou, Dodds P. Simangan, Farooq Abdulla, Deborah A. Kuhls

Undergraduate Research Symposium Podium Presentations

Overview This study examines how maternal and neonatal factors influence Medicaid spending for NICU admissions in Nevada, with an emphasis on identifying cost-driving health disparities. Approach: A retrospective analysis was conducted using linked data from Nevada’s Birth Registry and Medicaid claims (2015–2021). Infant records were analyzed using univariate and bivariate statistics, and logistic regression models identified associations between maternal/neonatal characteristics and above-median Medicaid spending. Cost trends were assessed using NICU case costs, annual growth rates, and year-to-year fluctuations. Key Objectives: Analyze trends in NICU-related Medicaid spending over a seven-year period. Identify maternal and neonatal characteristics linked to higher NICU costs. …

A Pill Too Expensive: A Comprehensive Review For Exploring Medical Non-Adherence In The Age Of Rising Drug Prices, Vidhani Goel, Roberto Sagaribay

Undergraduate Research Symposium Lightning Talks

Prevalence & Health Disparities:

• Medication non-adherence is a major public health issue.
• High prescription drug costs are a significant barrier.
• Affects chronic conditions like diabetes, hypertension, and mental health disorders.

Potential Solutions:

• Patient assistance programs.
• Use of generic drugs.
• Policy reforms to reduce medication costs.

Future Directions & Solutions:

• Address research gaps in long-term outcomes.
• Explore broader policy interventions.
• Improve accessibility and awareness of assistance programs.

Contributing Factors:

• Leads to worse health outcomes.
• Increases hospitalizations and long-term healthcare costs.
• Affects vulnerable populations (i.e., elderly, uninsured, racial minorities)

Analyzing Healthcare As A Right, Instead Of A Privilege, Saidt Gutierrez

Undergraduate Research Symposium Podium Presentations

Healthcare is a fundamental necessity, yet in many countries including the United States, it remains a privilege rather than a right. This research examines the benefits of universal healthcare by analyzing its impact in countries that have successfully implemented healthcare such as Canada, the United Kingdom, and Germany. This study evaluates the healthcare accessibility, cost efficiency, and health outcomes in these countries against the U.S. This finding will suggest that universal health care leads to lower overall healthcare costs, improve public health, and reduce financial burdens on individuals. By ensuring healthcare as a right, rather than a privilege, the U.S …

Heartache In The Heartland: Unraveling The Social Roots Of Deaths Of Despair In Kentucky, Lyndsey K. Blair, Madeline M. Tomlinson, Michele Abee-Biskis, Jessica Hume, Gabri Warren

Journal of Appalachian Health

Introduction: Deaths of despair (DoD), encompassing suicides, drug overdoses, and alcohol-related liver diseases, have emerged as a critical public health crisis in the United States, with their rise particularly pronounced from 1995 to 2013 and exacerbated by the COVID-19 pandemic. Kentucky, grappling with high rates of substance use disorder, poor mental health, and economic hardship, is at the forefront of this issue, particularly in its rural and Appalachian regions.

Purpose: This study explores the social determinants contributing to DoD in Kentucky, focusing on economic and social factors that influence rising rates of suicide, drug overdose, and alcohol-related liver disease. The …

Surge Scramble: An Evaluation Of Combining The Medical Response And Surge Exercise With The Centers For Disease Control And Prevention’S Pan Flu Scramble, Rebecca L. Thompson

Capstone Experience: Master of Public Health

This report analyzes how Hospital Preparedness Program funding recipients in Nebraska adapted the Center for Disease Control’s Pan Flu Scramble format to meet Medical Response and Surge Exercise (MRSE) requirements in the 2023-2024 fiscal year. By combining the MRSE and Pan Flu Scramble, the recipients created an in-person functional exercise format for the six Nebraska health care coalitions to test their respective chemical plans and the Health Care Crisis Protocol for the State of Nebraska. The report explains the design and conduct of the exercises and provides a comprehensive evaluation of the exercise design and conduct. This report will outline …

State Case Count As An Indicator Of Successful Multistate Outbreak Investigation, Lorisa M. Pennell

Capstone Experience: Master of Public Health

Background/Objectives: Shiga-Toxin producing Escherichia coli (STEC) is a contaminant found in multiple food types and causes multistate outbreaks due to the industrialization of food production. In this report I examine the differences in outbreaks categorized by the regulating agency responsible in outbreak prevention and compare outbreak case counts when organized by positive outbreak investigation and response outcomes.

Methods: STEC Multistate outbreak data was obtained from the Center for Disease Control’s National Outbreak Reporting System (NORS) for outbreaks occurring from 2006-2023. Outbreaks were organized into those regulated by either the US Food and Drug Administration (FDA) or the US Department of …

Enhancing The Eden Alternative Model With Well Standards: A Case Study Analysis, Mariah Stoner

Architecture Masters of Science Program: Theses

This thesis investigates the potential for improving the Eden Alternative Model, a person-centered approach to elder care that emphasizes creating a homelike environment and meaningful relationships, using WELL Standards, a building certification system focused on enhancing human health and well-being through improvements in environmental quality. Through a mixed-methods approach involving quantitative data analysis and qualitative case studies, this research examines how WELL Standards, which cover aspects such as air quality, water quality, lighting, and thermal comfort, can improve environmental quality and resident satisfaction within the Eden Alternative Model. This research introduces a tailored approach to elder care by combining these …

The Burden Of Care: A Phenomenological Inquiry Into The Lived Experiences Of Homeless Shelter Administrators Leading Through The Pandemic And Lasting Implications On Program Operations, Marie Adele Wilson

Doctoral Dissertations and Projects

The theories guiding this study are Maslow's Hierarchy of Needs, conflict theory, and complex systems theory, which explain the relationship between the theory and resource limitations and acquisition, systems, and nature of acquiring human needs. The purpose of this phenomenological study is to describe homeless shelter administrators'/directors' experiences delivering services during the COVID-19 pandemic on the Eastern Coast of the United States and Texas. It further seeks to unravel how the pandemic informed the delivery of services and program administration related to homeless shelters and its impacts. The research questions sought to understand the impact of COVID-19 on delivering services …

The Affordable Care Act: Analyzing Rates Of Healthcare Claim Denial, Lauren Sitter

Political Science Theses and Capstones

The United States healthcare industry is an integral aspect of every American’s life. The Affordable Care Act (ACA) in 2010 reformed the healthcare system by expanding coverage to millions of Americans and eliminating claim denials due to pre-existing conditions. It requires participating states to submit transparency data. Despite these reforms, coverage denials continue and vary by plan category, metal level, and among different states. I analyze data from The Kaiser Family Foundation (2023) and The CommonWealth Fund to test the correlation between claim denial and a variety of variables, including state political culture, plan type, metal level, and out-of-pocket costs. …

Community Voices, Climate Action Choices: Working Towards A Resilient Monterey County, Lesley A. Solano Alonso

Capstone Projects and Master's Theses

Vulnerable communities in Monterey County face disproportionate environmental and health impacts due to climate change, yet many residents remain unaware of the tools and resources available to support local action. This capstone project was implemented in partnership with Ecology Action (EA) and the Resilient Central Coast (RCC) campaign to increase awareness and engagement with the RCC platform. Serving diverse communities across Monterey County, the project included bilingual outreach efforts, community tabling, educational presentations, and a climate action survey. Over 650 residents were engaged directly, resulting in 99 new household sign-ups on the RCC website, a major milestone for the agency. …

Reforming Pensions In Africa: Addressing Coverage, Payout Disparities, And Dementia Outcomes For Sustainable Aging, Cyprian Mostert, Catherine Ajalo, David Andai

Brain and Mind Institute

No abstract provided.