Medicine and Health Commons^™

How Has Telehealth Impacted Access To Mental Health Services In The Hispanic Population In Minnesota?, Jesse Ochoa

Theses and Graduate Projects

Background: The Hispanic population in the US continues to grow and mental health services still have barriers lowering access to care.

Purpose: The purpose of this literature review is to look at the stressors and perceptions of mental health in Hispanics and analyze how telehealth has impacted access to care despite the barriers present.

Methods: A comprehensive literature review was conducted using google scholar using the search terms With this search criteria, 600 articles were available. Inclusion criteria were studies that provided a comprehensive view about specific topics like telehealth with the hispanic population, mental health specific to Hispanic needs, …

Maternal Mortality In American Indian And Alaska Native Women: It Is Time To Prevent The Preventable, Brynn Cusack

Theses and Graduate Projects

Background: A concerning disparity exists between maternal mortality rates of American Indian and Alaska Native (AIAN) women and White women. Contributing factors include historical trauma, systemic inequities, inadequate funding, and deprioritization of the health of AIAN people.

Purpose: This literature review aims to address the research question: “Why were American Indian and Alaska Native women two times more likely to die of pregnancy-related causes than White women in the US during the period of 2017 through 2019?” The review explores historical context, current evidence, potential causes and interventions that can address AIAN maternal mortality.

Methods: A comprehensive literature review was …

The Bench To Community Initiative: Community-Based Participatory Research Model For Translating Research Discoveries Into Community Solutions, Jazma L. Tapia, Abigail Lopez, D. Bing Turner, Tonya Fairley, Tiah Tomlin-Harris, Maggie Hawkins, Pastor Rhonda Holbert, Lindsey S. Treviño, Dede K. Teteh-Brooks

Health Sciences and Kinesiology Faculty Articles

Methods: Community-based participatory research (CBPR) is an effective methodology for translating research findings from academia to community interventions. The Bench to Community Initiative (BCI), a CBPR program, builds on prior research to engage stakeholders across multiple disciplines with the goal of disseminating interventions to reduce breast cancer disparities and improve quality of life of Black communities.

The BCI program was established to understand sociocultural determinants of personal care product use, evaluate the biological impact of endocrine disrupting chemicals, and develop community interventions. The three pillars of the program include research, outreach and engagement as well as advocacy activities. The research …

Neighborhood Socioeconomic Context Predicts Pediatric Asthma Exacerbation, Ashley W. Kranjac, Zeev N. Kain, Louis Ehwerhemuepha, Michael Weiss, Brooke N. Jenkins

Sociology Faculty Articles and Research

Causes of asthma exacerbation in children have been studied extensively at the individual level, but contributions of neighborhood-level factors are less explored. We test which distinctive residential characteristics produce variation in uncontrolled asthma among pediatric patients. We extracted electronic medical record data from pediatric patients living in Southern California and used multilevel modeling techniques to isolate which neighborhood characteristics drive inequitable asthma control. Above and beyond the individual-level factors known to predict inadequate disease control, neighborhoods with greater concentration of non-Hispanic black residents (odds ratios [OR] = 1.02; 95% confidence interval [CI]: 0.99-1.03; P < .05), higher proportions of female-headed households (OR = 1.01; 95% CI: 0.99-1.01; P < .05), and higher levels of ambient air pollution (OR = 1.05; 95% CI: 1.01-1.10; P < .001) associate with greater odds of asthma exacerbation. The interplay between community characteristics and asthma management during childhood is complex, and place-based initiatives are needed to narrow the gap in asthma exacerbation.

Evidence-Based Prostate Cancer Screening Interventions For Black Men: A Systematic Review, Abigail Lopez, Jared T. Bailey, Dorothy Galloway, Leanne Woods-Burnham, Susanne B. Montgomery, Rick Kittles, Dede K. Teteh-Brooks

Health Sciences and Kinesiology Faculty Articles

Abstract

Prostate cancer is the second leading cause of death for men in the U.S. and Black men are twice as likely to die from the disease. However, prostate cancer, if diagnosed at an earlier stage, is curable. The purpose of this review is to identify prostate cancer screening clinical trials that evaluate screening decision-making processes of Black men.

Methods

The databases PubMed, Ovid MEDLINE, CINAHL Plus, and PsychInfo were utilized to examine peer-reviewed publications between 2017 and 2023. Data extracted included implementation plans, outcome measures, intervention details, and results of the study. The Critical Appraisal Skills Programme was used …

Achieving Equitable Cardiovascular Care For All: Acc Board Of Trustees Health Equity Task Force Action Plan, Paul L Douglass, Dipti Itchhaporia, Biykem Bozkurt, Robert O Roswell, Akshay Khandelwal, Quinn Capers, Kathryn Berlacher, Modele O Ogunniyi, Alison L Bailey, Phillip D Levy, Aubrey J Grant, Jack Tocco, Angela Natcheva, Akua G Asare, Ami B Bhatt, Jennifer H Mieres, Maghee F Disch, Melvin R Echols

Faculty, Staff and Students Publications

Advancements in cardiovascular (CV) disease management are notable, yet health inequities prevail, associated with increased morbidity and mortality noted among non-Hispanic African Americans in the United States. The 2002 Institute of Medicine Report revealed ongoing racial and ethnic health care disparities, spearheading a deeper understanding of the social determinants of health and systemic racism to develop strategies for CV health equity (HE). This article outlines the strategic HE approach of the American College of Cardiology, comprising 6 strategic equity domains: workforce pathway inclusivity, health care, data, science, and tools; education and training; membership, partnership, and collaboration; advocacy and policy; and …

Pediatric Obesity In The United States: Age–Period–Cohort Analysis, Ashley W. Kranjac, Dinko Kranjac, Roxanne I. Aguilera

Sociology Faculty Articles and Research

The rates of obesity among American children aged 2–5 years has reached a historic high. It is crucial to identify the putative sources of population-level increases in obesity prevalence among preschool-aged children because early childhood is a critical window for obesity prevention and thus reduction of future incidence. We used the National Health and Nutrition Examination Survey data and hierarchical age–period–cohort analysis to examine lifecycle (i.e., age), historical (i.e., period), and generational (i.e., cohort) distribution of age- and sex-specific body mass index z-scores (zBMI) among 2–5-year-olds in the U.S. from 1999 to 2018. Our current findings indicate that period effects, …

A Qualitative Exploration Of Well-Being In Cancer Survivorship: Implications For Counselors, Hallie M. Sylvestro, Lindsey K. Umstead, Heather Delgado, Christopher Lawrence, Keith Mobley, Kelly L. Wester, Andrew Wood

Adultspan Journal

Adult cancer survivors represent an important–and growing–population that could benefit from counseling services. This study employed consensual qualitative research to examine the well-being experiences of eight cancer survivors. Findings suggest a broad range of changes to individual well-being following cancer diagnosis and treatment, and indicate counseling can provide an ideal setting for processing such changes. Recommendations for counseling practice and future research are provided.

Feasibility Of Fit24, A Digital Diabetes Prevention Program For Hispanic Adolescents: Qualitative Evaluation Study, Erica G Soltero, Salma M Musaad, Teresia M O'Connor, Debbe Thompson, Keith Norris, Bettina M Beech

Faculty, Staff and Students Publications

BACKGROUND: Digital health interventions are promising for reaching and engaging high-risk youth in disease prevention opportunities; however, few digital prevention interventions have been developed for Hispanic youth, limiting our knowledge of these strategies among this population.

OBJECTIVE: This study qualitatively assessed the feasibility and acceptability of Fit24, a 12-week goal-setting intervention that uses a Fitbit watch (Fitbit Inc) and theoretically grounded SMS text messages to promote physical activity and sleep among Hispanic adolescents (aged between 14 and 16 years) with obesity.

METHODS: After completing the intervention, a subsample of youth (N=15) participated in an in-depth interview. We categorized the themes …

Health Disparities In Slipped Capital Femoral Epiphysis (Scfe) Presentation, Rithika Ginjupalli, George Thomas, Rohit Siddabattula, Richard M. Schwend, Caleb Grote

Research Days

This study identifies various health disparities in SCFE presentations using neighborhood-level determinants COI and ICE in addition to sociodemographic determinants such as race and gender.

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Mortality In Medicine, Maren Dougherty

Honors Projects

Practitioners in the medical field attend to health issues across one’s lifespan from birth to death and everything in between. A common conflict in today’s practice of medicine is establishing the true function of medicine. The complete reliance on medicine to ward off death proliferates the biomedicalization of natural life processes, like death. Biomedicalization is the process in which medical authority and its accompanying technology begin to control other aspects of daily life. With medicine’s ultimate goal being to cure disease and fight death, it interferes with the inevitability of human mortality. End-of-life treatment can be taken too far without …

Evaluation Of Unexplained Bone Fractures In A 3-Month-Old Infant – A Case Report, Hannah Ngo, Rachel Silliman Cohen

Rowan-Virtua Research Day

Child physical abuse is a significant cause of injury in infants and young children and can present in a variety of ways. Failure to recognize abuse in infants and young children can be life-threatening and is often recurrent until safety interventions occur. Consequently, it is of paramount importance that providers strongly consider child physical abuse on the differential, along with metabolic bone disease and accidental traumatic injury, when evaluating fractures in young children and infants. This case report will focus on the evaluation of a 3-month-old male infant who was admitted to the hospital with irritability and decreased right arm …

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 …

Cost-Effectiveness And Outcomes Of Utilizing Tisagenlecleucel Therapy (Car T-Cell) In Pediatric Acute Lymphoblastic Leukemia In Comparison To Standard Of Care (Soc) Therapies: A Scoping Review, Andrew Atschinow, Evangeline Attota, Warren Chan, Pooja Kasarapu, Priyal Shah, Karina Vizzoni

Rowan-Virtua Research Day

Aims

This review aims to assess the correlations between outcomes and cost of treatment methods for pediatric acute lymphoblastic leukemia patients, specifically comparing CAR T-cell therapy and Standard-of-Care (SoC) therapy. The socioeconomic background of patients will also be taken into consideration to see if there are differences in their outcomes.

Methods

Peer-reviewed publications were collected from PubMed and Web of Science. The keyword strings used were “acute lymphoblastic leukemia,” “pediatric acute lymphoblastic leukemia,” “pediatric,” “CAR T-cell therapy,” and “cost-effectiveness.” 27 citations were obtained. Titles were screened by 6 authors. Articles met the inclusion criteria including potential Quality-Adjusted Life Year (QALY) …

Relationship Between Caregiver Burden And Socioeconomic Status, Nikitha Pappachen, Maithri Goud

Rowan-Virtua Research Day

In this study, caregiver burden measures the psychosocial strain a caregiver experiences as a result of caring for a person with autism. In addition, this study focuses on the effect of socioeconomic status on caregiver burden. A previous study found an association between lower primary caregiver education level and more sleep problems for children with autism³. Thus, the finding focuses on the child with autism as opposed to the caregiver burden. Other studies focus on elements that affect caregiver burden such as sleep quality, mental health, and cultural aspects. If it is known that socioeconomic status significantly affects …

Overcoming Disparities In The Treatment Of Alzheimer’S Disease, Christian Gamboa, Tribhuvan Lanka, Elaine Flowers, Nayarith Lopez

Rowan-Virtua Research Day

Background: Deaths due to Alzheimer’s have been increasing at an exponential rate for the last 24 years, with an astounding 145% increase between the years 2000-2024. Early detection is key to slowing down the rate of decline. Unfortunately, Latino and African American individuals delay seeking care, which predisposes them to worse outcomes. To date, socioeconomic limitations are the main factors leading to delayed care in Latino and African American communities. A service project was developed with the aim of addressing limitations that result in delays to seeking care within Latino and African American communities.

Methods: A systematic review of available …

Association Between Cultural Factors And Postpartum Depression, Usha Modukuru

Rowan-Virtua Research Day

Postpartum depression (PPD) is present in 17.22% of the world population. The negative physical and psychological impacts of PPD impact not only the mother, but also those around her. This raises the importance of identifying factors contributing to its onset. Studies have shown that PPD prevalence rates vary between non-Western and Western regions of the world. Cultural postpartum practices differed significantly region to region. Search terms including postpartum depression and cultures were used to find peer-reviewed articles, primary surveys, and patient interviews between 2013-2023. Qualitative analyses were performed on the results. Ethnokinship cultures, commonly present in non-Western countries, prioritized social …

Is There An Association Between Living In A Rural Area And The Incidence Of Postoperative Complications Or Hospital Readmissions Following Left Ventricular Assist Device (Lvad) Implantation, Compared To Urban Lvad Recipients?, Samrat Gollapudi, Abhiram Gollapudi, Srinidhi Banala, Sheraj Singh, Bhaumik Patel

Rowan-Virtua Research Day

Background: Left ventricular assist devices (LVADs) are utilized as a therapeutic option for patients with end-stage heart failure. While LVAD implantation can significantly improve survival rates and quality of life, the procedure is not without risks, and postoperative complications are common. This review aims to investigate whether there is an association between living in a rural area and the incidence of postoperative complications or hospital readmissions following LVAD implantation, compared to urban LVAD recipients.

Methods: A comprehensive review of the literature was conducted, examining studies that compared postoperative outcomes between rural and urban LVAD recipients. Data were extracted on adverse …

Addressing The Black Maternal Mortality Rate, Kennedy Sanders, Venkateswar Venkataraman, Kate Whelihan

Rowan-Virtua Research Day

Introduction: As of 2021, the Black maternal mortality rate in the United States was 69.9 deaths per 100,000 live births as compared to the national average of 32.9 and the White American average of 26.61. It has been demonstrated that this discrepancy is not fully explained by socioeconomic status. Doulas are professionals who provide support and guidance throughout pregnancy, birth, and early parenthood. Encouraging the use of doulas may be an effective approach to improve the birth experience for Black mothers. Methods: A literature review was performed using PubMed and the following search strings: maternal mortality rate (+race, +race +ethnicity, …

Sunscreen Cost And Its Effect On Skin Cancer In Low-Income Communities: A Systemic Review, John Sauer

Rowan-Virtua Research Day

This research examines the pivotal connection between sunscreen affordability and its impact on skin cancer prevalence, especially in low-income communities. Despite universal dermatological recommendations for daily sunscreen use, stringent criteria contribute to elevated prices, averaging around $10 for a 6 oz unit. This financial strain is compounded for families adhering to recommended application rates, leading to significant economic burdens. Outdoor laborers, less likely to follow guidelines, face heightened risks. Government programs' excluding sunscreen costs further exacerbate challenges for low-income communities, contributing to increased skin cancer incidence. This review aims to establish a correlation between sunscreen cost and skin cancer rates, …

Barriers To Healthcare Access Between English And Spanish Speakers In An Underserved Population, Adeena Javed, Dale Johnson, Gerardo J. Rivera-Colón, Nathaniel J. Byrnes, Kristin Bertsch, Anne C. Jones

Rowan-Virtua Research Day

• According to the NJ State Department of Health, Atlantic County has higher rates of smoking, respiratory disease, hypercholesterolemia, as well as death rates due to coronary heart disease, HIV, and all cancers compared to the NJ state average1,2.

• With over 20% of Atlantic County's population identifying as Hispanic, Spanish speakers encounter greater obstacles compared to their English-speaking counterparts in accessing healthcare services and improving health outcomes1,2 .

• Existing research indicates that various factors, including health insurance coverage, proximity to healthcare facilities, transportation options, health literacy levels, and trust in the medical profession, significantly influence access to healthcare …

Associations Between Stress, Health Behaviors, And Quality Of Life In Young Couples During The Transition To Survivorship: Protocol For A Measurement Burst Study, Dalnim Cho, Michael Roth, Susan K Peterson, Kristofer Jennings, Seokhun Kim, Shiao-Pei Weathers, Sairah Ahmed, J Andrew Livingston, Carlos Barcenas, Y Nancy You, Kathrin Milbury

Faculty, Staff and Student Publications

BACKGROUND: Cancer is a life-threatening, stressful event, particularly for young adults due to delays and disruptions in their developmental transitions. Cancer treatment can also cause adverse long-term effects, chronic conditions, psychological issues, and decreased quality of life (QoL) among young adults. Despite numerous health benefits of health behaviors (eg, physical activity, healthy eating, no smoking, no alcohol use, and quality sleep), young adult cancer survivors report poor health behavior profiles. Determining the associations of stress (either cancer-specific or day-to-day stress), health behaviors, and QoL as young adult survivors transition to survivorship is key to understanding and enhancing these survivors' health. …

Inter-Institutional Analysis Of Skin Of Color Representation In Dermatological Lecture Content At Md And Do Medical Schools, Oluwafunke Oluwatosin Ogunremi, Blake Fredericksen, John Komas, Sana Ismail, Siri Knutsen-Larson Md, Valeriy Kozmenko Md, Afia Albin Do

Aesculapius Journal (Health Sciences & Medicine)

The purpose of this study was to analyze the lecture materials provided in medical schools through a diversity lens. Skin pathologies manifest distinctively on various shades of skin and physicians must be equipped with the proper knowledge to identify and diagnose these conditions accurately and promptly. For most medical students, images in prominent textbooks and lecture slides are their first encounter with disease presentations. Therefore, it is important to analyze the diversity of skin tones in the content that is being delivered. Specifically, the use of images featuring darker skin tones compared to those depicting lighter skin tones. This study …

The Increase Of Allergies In Developed Countries: A Comparison Of The Quality Of Life And Psychosocial Burden Of Individuals With Food Allergies In Switzerland And The United States Of America, Adrienne Ell

Independent Study Project (ISP) Collection

The Hygiene Hypothesis suggests that as societies become increasingly sterile and there is less exposure to microorganisms early in life; consequently, there is an increase in inflammatory autoimmune disorders and allergies due to a maladapted immune system to the new sterile environment. This hypothesis can offer a possible explanation for the observed increase in allergies, specifically food allergies, in developed countries. To explore the psychosocial burden of allergies and evaluate the quality of life this paper will explore the food allergen labeling policies for prepackaged foods, the regulation of allergen information for non-prepackaged foods, and the psychosocial burden food allergies …

The Digital Transition: Are Adults Aged 65 Years Or Older Willing To Complete Online Forms And Questionnaires In Patient Portals?, Nancy P Gordon, Sherry Zhang, Joan C Lo, Christina F Li

Faculty, Staff and Student Publications

INTRODUCTION: Patients are being encouraged to complete forms electronically using patient portals rather than on paper, but willingness of older adults to make this transition is uncertain.

METHODS: The authors analyzed data for 4105 Kaiser Permanente Northern California 2020 Member Health Survey respondents aged 65-85 years who answered a question about willingness to complete online forms and questionnaires using a patient portal. Data weighted to the Kaiser Permanente Northern California membership were used to estimate percentages of older adults willing to complete patient portal forms and questionnaires. Chi-square tests and log-Poisson regression models that included sociodemographic, internet use, and patient …

A Social Media–Delivered Melanoma Prevention Program For Young Women Engaged In Frequent Uv Tanning: Protocol For A Randomized Controlled Trial, Jerod L. Stapleton, Sharon L. Manne, Sherry L. Pagoto, Allison Leip, Kathryn Greene, Joel Hillhouse, Allison S. Merritt, Brent J. Shelton

UK CARES Faculty Publications

Background: Rates of melanoma have increased dramatically in the United States over the past 25 years, and it has become among the most prevalent cancers for young adult women. Intentional skin tanning leads to a pattern of intense and intermittent UV radiation exposure that is associated with increased risk of melanoma. Frequent tanning is most common among young women and is linked to a variety of sociocultural pressures that negatively impact body image and drive appearance control behaviors. Unfortunately, there are no established interventions designed for frequent tanners. This intervention addresses this gap with unique content informed by body image …

Facilitators To Cervical Cancer Screening In A Minority, Urban, Underserved Population, Noel Higgason, Linh Nguyen, Yen-Chi Le, Ogochukwu Juliet Ezeigwe, Tong Han Chung, Natalia Williams, Xochitl K Olguin, Abigail S Zamorano

Faculty, Staff and Student Publications

OBJECTIVES: Cervical cancer has markedly declined due to widespread use of screening, but Hispanic women continue to bear a disproportionate amount of the cervical cancer burden due to under-screening. Previous studies have explored barriers to screening but have failed to identify targetable facilitators in this group. We aimed to assess facilitators to cervical cancer screening among a predominantly urban, Hispanic population who presented to a no-cost, community-based clinic.

METHODS: Patients completed demographic and health information, a validated social determinants of health (SDOH) screen, and a self-reported facilitators survey on factors which enabled them to present to clinic. Descriptive statistics were …

Social Determinants Of Health Framework To Identify And Reduce Barriers To Imaging In Marginalized Communities, Mohab M Elmohr, Zulqarnain Javed, Prachi Dubey, John E Jordan, Lubdha Shah, Khurram Nasir, Eric M Rohren, Christie M Lincoln

Faculty, Staff and Students Publications

Social determinants of health (SDOH) are conditions influencing individuals' health based on their environment of birth, living, working, and aging. Addressing SDOH is crucial for promoting health equity and reducing health outcome disparities. For conditions such as stroke and cancer screening where imaging is central to diagnosis and management, access to high-quality medical imaging is necessary. This article applies a previously described structural framework characterizing the impact of SDOH on patients who require imaging for their clinical indications. SDOH factors can be broadly categorized into five sectors: economic stability, education access and quality, neighborhood and built environment, social and community …

Toward Standardization, Harmonization, And Integration Of Social Determinants Of Health Data: A Texas Clinical And Translational Science Award Institutions Collaboration, Catherine K Craven, Linda Highfield, Mujeeb Basit, Elmer V Bernstam, Byeong Yeob Choi, Robert L Ferrer, Jonathan A Gelfond, Sandi L Pruitt, Vaishnavi Kannan, Paula K Shireman, Heidi Spratt, Kayla J Torres Morales, Chen-Pin Wang, Zhan Wang, Meredith N Zozus, Edward C Sankary, Susanne Schmidt

Faculty, Staff and Student Publications

INTRODUCTION: The focus on social determinants of health (SDOH) and their impact on health outcomes is evident in U.S. federal actions by Centers for Medicare & Medicaid Services and Office of National Coordinator for Health Information Technology. The disproportionate impact of COVID-19 on minorities and communities of color heightened awareness of health inequities and the need for more robust SDOH data collection. Four Clinical and Translational Science Award (CTSA) hubs comprising the Texas Regional CTSA Consortium (TRCC) undertook an inventory to understand what contextual-level SDOH datasets are offered centrally and which individual-level SDOH are collected in structured fields in each …