Medicine and Health Commons^™

Experiences Of Family Communication And Cascade Genetic Testing For Hereditary Cancer In Medically Underserved Populations-A Qualitative Study, Erica M Bednar, J Alejandro Rauh-Hain, Jose J Garcia, Norma De Aguinaga, Mary Anne Powell, Sylvia L Peral, Roni Nitecki, Kirsten Jorgensen, Natasha L Rudy, Karen H Lu, Charles A Leath, Isabel C Scarinci

Faculty, Staff and Student Publications

UNLABELLED: We sought to explore the intrafamilial communication and cascade genetic testing (CGT) experiences of patients with hereditary cancer from diverse, medically underserved populations and their relatives. Participants included patients receiving oncology care at an urban, safety net hospital in Texas or comprehensive cancer center in Alabama and their first-degree relatives. In-depth semi-structured qualitative interviews were completed wherein patients shared their experiences with genetic counseling (GC), genetic testing (GT), and communicating their results to relatives. Relatives shared their experiences receiving information from the patient and considering CGT. Interviews were transcribed, coded, and themes were identified. Of 25 participating patients, most …

Building Sustainable Community-Academic Partnerships While Implementing A Nutrition-Based Blackberry Garden Program At A Senior Center, Dawn Brewer, Annie Koempel, Abbey L. Moellering, Tammy Stephenson, Amy Kostelic, Julie Plasencia, Alexis Sheffield, Ben Guerrant, Alethia Price

UK CARES Faculty Publications

Due to limited access to and low consumption of fruits and vege- tables, older adults are at increased risk of worsening or developing chronic diseases. This paper describes a community-academic partnership that provides a sustainable source of blackberries to attendees of a rural senior center. Qualitative research evaluated the partnership following implementation of a blackberry program. Focus groups and interviews included partners from a senior cen- ter, Cooperative Extension Service, and a detention center. Main themes: group power dynamics influenced communication between research and community leadership teams; unexpected project barriers emerged; and community leadership team sug- gested strategies to promote …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Differentially Unwell: On Mimi Khúc's "Dear Elia", Seo-Young J. Chu

Publications and Research

[...] Inviting readers to reclaim the stigma of unwellness and collectively to "tend to our unwellness, together," Khúc approaches unwellness as a crucial resource for subverting the "wellness and unwellness" dichotomy entirely. After all, the opposite of "wellness" is not "unwellness"; the opposite of "wellness" does not exist. The opposition itself is an artificial framework, one that reductively harms more than it dialogically helps. We need to move away from these simplistic dualisms, Khúc suggests, and towards more generous, trauma-informed epistemologies. [...]

Implementing Social Determinants Of Health Data Collection In A Large Urban Pediatric Hospital Setting, Stormee Williams, Kristina Hill, Barry Owen, Forest Melton

Research

No abstract provided.

The Impact Of Waiting Times On Patient Satisfaction And Patient Care At A Tertiary Health Care Institution In Kenya: A Cross-Sectional Study, Soud Seif Soud

Master of Internal Medicine

Introduction: Patients spend significant time waiting for care. This often influences patient satisfaction, perceived quality and access to care, and utilisation of various healthcare services. Waiting time and resulting implications remain understudied in low- and middleincome countries like Kenya. This study aimed to describe the impacts of waiting times on patient satisfaction and care at a tertiary healthcare institution in Kenya.

Method: We conducted a prospective cross-sectional study between March 2023 and July 2023 at the Emergency Room (ER) at Aga Khan University Hospital, Nairobi. Data was collected through a structured questionnaire, looking at demographics and patient wait …

Identifying Youth Appeals In Alcohol Alternative Social Media Content Through Framing, Melina Oneal

West Chester University Master’s Theses

Proposed regulations for alcohol advertising prevent beverage companies from targeting people under the legal drinking age. However, similar regulations for alcohol alternative beverages are less explored, which could allow alcohol alternative products to create awareness for alcoholic beverages among youth. Alcohol alternatives beverages, including no-alcohol and low-alcohol products, are increasing in popularity and can function as compliments to alcoholic products to decrease the total alcohol volume consumed or as substitutes for alcoholic products. Framing theory can be operationalized through the Content Appealing to Youth Index, an index of content elements found in research literature to be appealing to youth, to …

Autopathography Across Media: Trauma And Fluid Embodied Subjectivity, He (Kristen) Shen

Honors Theses

Illness memoirs with first-person point of view have gained more attention in recent years among medical sociologists and anthropologists. Different from traditional “case histories”written by doctors that are in danger of ignoring patients’ voices, autopathograhical works delineate narrators’ transformative experiences of persons to patients, emphasizing the importance of gaining social understanding of illness. Focusing on three works within the category of autopathography across genres and media forms in the late 1950s and contemporary periods, The Cancer Journals (1980) written by Audre Lorde, The Collected Schizophrenias (2019) written by Esmé Weijun Wang, and The Diving Bell and the Butterfly (2007) directed …

Health Consequences Of Racial Disparity In Access To Abortion: A Systematic Review, Lacy M. Frye, Calvin Odhiambo

University of South Carolina Upstate Student Research Journal

Prior to the 2022 Dobbs decision, Black women already experienced negative maternal health outcomes at an alarmingly disparate rate in comparison to White women. Given that the Dobbs decision emboldens state power to enforce abortion restrictions or protections, there has been significant strides made in both directions. Nonetheless, within states where reproductive rights have been significantly eroded, the heightened abortion restrictions may compound the limited access that Black women previously had before Dobbs. This, in turn will exacerbate the already disparate negative maternal outcomes that Black women experience. However, research on the relationship between the lack of access to abortion …

Community Scientist Program Provides Bi-Directional Communication And Co-Learning Between Researchers And Community Members, Jessica Alvarado, Larkin L Strong, Birnur Buzcu-Guven, Leonetta B Thompson, Erica Cantu, Chelsea C Carrier, Chiamaka D Chukwu, Cassandra L Harris, Luz K Melendez, Crystal L Roberson, Angela M Ross, Sophia C Russell, Pablo Sanchez, Amirali Tahanan, Blair C Zdenek, Belinda M Reininger, Lorna H Mcneill

Faculty, Staff and Student Publications

Community involvement in research is key to translating science into practice, and new approaches to engaging community members in research design and implementation are needed. The Community Scientist Program, established at the MD Anderson Cancer Center in Houston in 2018 and expanded to two other Texas institutions in 2021, provides researchers with rapid feedback from community members on study feasibility and design, cultural appropriateness, participant recruitment, and research implementation. This paper aims to describe the Community Scientist Program and assess Community Scientists' and researchers' satisfaction with the program. We present the analysis of the data collected from 116 Community Scientists …

Salvation And Sweet Rolls: An Examination Of Mormon Diet Books, Rachel Noorda

English Faculty Publications and Presentations

Religious diet books highlight the overlap between religious and diet cultures. This article examines the intersection of Mormonism, diet culture, and fatphobia through an analysis of Mormon diet books published between 1990 and 2015. The study explores how Mormon diet books leverage the Word of Wisdom (the LDS health code) to promote weight loss and reinforce religious obedience. By framing dietary compliance as a spiritual mandate, these texts link physical health and body size to moral and spiritual worthiness. This conflation of body and spirit, rooted in Mormon theology, amplifies fatphobia by promoting thinness as a sign of obedience and …

Humor Matters: An Adapted Multiple Case Study Exploring Music Therapists’ Perspectives Of Humor With Older Adults, Caleb M. Posey

Theses and Dissertations--Music

Humor is a ubiquitous human experience and a skill retained in older adulthood. It is also an integral but elusive therapeutic tool with numerous benefits and risks to well-being. Therapeutic humor – the application of humor to client well-being – is an emerging area of study. However, scant music therapy literature on humor is available. The purpose of this qualitative thesis was to explore the use and function of humor in music therapy with older adults from the perspectives of experienced music therapists. There were three research questions: (1) how do music therapists describe their use of humor with older …

Social Determinants Of Health: Evaluation Using Rates Of Vision Screening And Follow-Up Examinations, Madeline Dyer

Williams Honors College, Honors Research Projects

Vision care is essential to the quality of life of young children, impacting them over the course of their lives. Social Determinants of Health (SDOH) affect the likelihood of a child having access to appropriate care specified by the Bright Futures. The aim of this study was to assess the impact of SDOH on the completion of vision screening and the rate of follow-up with an eye care provider when applicable. In addition, rates of instrument-based vision screening and recommended ophthalmology follow-up were compared with COI, a metric assessing the quality of resources available and the conditions that matter for …

Self-Perception Of Mental Health, Covid-19 And Associated Sociodemographic-Contextual Factors In Latin America, Pablo Roa, Guillermo Rosas, Gloria Isabel Niño-Cruz, Sergio Mauricio Moreno-López, Juliana Mejía-Grueso, Haney Aguirre-Loaiza, Javiera Alarcón-Aguilar, Rodrigo Reis, Adriano Akira Ferreira Hino, Fernando López, Deborah Salvo, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

This study aimed to estimate the prevalence of alterations in self-perceived mental health during the COVID-19 pandemic and their associated factors in four Latin American countries. This is a cross-sectional study based on data collected from adults in 2021 through the Collaborative Response COVID-19 Survey by the MacDonnell Academy at Washington University in St. Louis (United States). The sample was composed of 8,125 individuals from Brazil, Colombia, Mexico, and Chile. A generalized linear model for a binary outcome variable with a logistic link and fixed country effects was used. There were 2,336 (28.75%) individuals who considered having suffered alterations in …

Colonial Drivers And Cultural Protectors Of Brain Health Among Indigenous Peoples Internationally, Rita Henderson, Joyla A Furlano, Shayla Scott Claringbold, Ashley Cornect-Benoit, Anh Ly, Jennifer Walker, Lisa Zaretsky, Pamela Roach

Faculty, Staff and Student Publications

Despite relatively higher rates of dementia among Indigenous populations internationally, research into drivers of disparities in brain health and cognitive function has tended to focus on modifiable risk factors over cultural understandings and contextual determinants. By seeking to characterize social and cultural factors that shape brain health and cognition in Indigenous populations, this mini scoping review expands prevailing schools of thought to include Indigenous knowledge systems. This reveals important gaps in culturally aligned care. It also reclaims horizons for research important to Indigenous Peoples that have garnered diminished attention in biomedical approaches. Twenty-three sources were included for data extraction. This …

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

Perspectives From Cystinosis: Access To Healthcare May Be A Confounding Factor For Variant Classification, Chen-Han Wilfred Wu, Alicja Tomaszewski, Louisa Stark, Fernando Scaglia, Ewa Elenberg, Fredrick R Schumaker

Faculty, Staff and Students Publications

Genetic variability persists across diverse populations, and it may impact the characterization of heritable diseases in different ancestral groups. Cystinosis is a metabolic disease caused by pathogenic variants in the CTNS gene causing the cellular accumulation of cystine. We attempted to assess the currently poorly characterized prevalence of cystinosis by employing a population genetics methodology. However, we encountered a significant challenge due to genetic variations across different populations, and the consideration of potential disparities in access to healthcare made our results inconclusive. Pathogenic CTNS variants were identified in a representative global population cohort using The Human Gene Mutation Database (HGMD) …

Moral Injury, Identity Dissonance, And Reintegration: A Compendium Of Reintegration And Survey Of United States Military Veterans, Thomas Hodges

Doctor of International Conflict Management Dissertations

How do military moral injuries affect reintegration? All service members leave the military eventually, but reintegration can be challenging, bringing changes in career, family life, and friendships, potentially prompting a loss of purpose, drive, and connection. Service members may also struggle with a crisis of identity upon separating from the military, feeling their military identity is incompatible with civilian life. While these difficulties are common for service members in reintegration, they may be worsened by moral injury, the adverse biological, social, psychological, and spiritual effects of experiencing an event that deeply offends a person’s sense of right and wrong. People …

The Public Performativity Of Trust, Lynette Hammond Gerido

Faculty Scholarship

Building trust between academic medical centers and certain communities they depend on in the research process is hard, particularly when those communities consist of minoritized or historically marginalized populations. Some believe that engagement activities like the creation of advisory boards, town halls, or a research workforce that looks more like community members will establish or reestablish trust between academic medical centers and racialized communities. However, without systematic approaches to dismantle racism, those well-intended actions become public performativity, and trust building will fail. In this essay, we draw upon foundational ethical principles of trust, distrust, and trust building; apply the concept …

Insights From Obstetric Providers And Emergency Medical Technicians On Determinants Of Maternal Morbidity And Mortality Among Underserved, Rural Patients In The United States, Anna Hansen, Nancy Schoenberg, Carrie B. Oser

UK CARES Faculty Publications

Over the past two decades, individuals in the United States (US) have faced a steadily increasing risk of experiencing severe morbidities attributable to pregnancy and dying from pregnancy-related causes. The prevalence of severe maternal morbidity (SMM), defined as the occurrence of end-organ damage in the mother encompassing unexpected outcomes of labor and delivery, has nearly tripled since the turn of the 21st century (Creanga et al., 2014; Neggers, 2016). The prevalence of pregnancy related mortality (PRM), defined as the death of a woman during or within one year of pregnancy due to pregnancy-related complications or aggravated preexisting conditions, has nearly …

From Vapor To Vice: Unraveling The Links Between Vaping And Traditional Substance Abuse Among Youth, Ayana Powell

Capstone Experience: Master of Public Health

ABSTRACT:

Objective: To evaluate whether vaping or using e-cigarettes is associated with the use of traditional substances, such as cigarettes, alcohol, and marijuana.

Methods: Using data from the Monitoring the Future surveys, a multivariable logistic regression model was performed, and prevalent odds ratio were calculated to evaluate the association between vaping and traditional substances.

Results: Vaping use among U.S. adolescents and teenagers was found to be an associated with use of traditional substances (cigarette use [OR]= 6.36 [CI]= 4.84, 8.38; alcohol use [OR]=5.80 [CI]= 5.28, 6.38; and marijuana use [OR]= 7.77 [CI]= 6.95, 8.70).

Conclusion: This study will assist …

The Impact Of The Covid-19 Pandemic On The Well-Being Of People Incarcerated In United States Prisons, Kimberly Rivera

Department of Sociology: Dissertations, Theses, and Student Research

The COVID-19 pandemic has negatively impacted the population as a whole. However, the incarcerated population (which also experiences a variety of health disparities) has been disproportionately affected by the pandemic. Due to overcrowding, poor ventilation, and lack of resources, the incarcerated population already is at a heightened risk for negative health outcomes, made worse by the recent pandemic. To adapt to the rapidly changing conditions during the pandemic in 2020 and into 2022, new safety measures were implemented, but the unintended consequences associated with the implementation of these procedures have yet to be examined empirically. I conducted a qualitative content …

High School Flash Sexual Health Education Curriculum: Lgbtq Inclusivity Strategies Reduce Homophobia And Transphobia, Kari Kesler, Andrea Gerber, B A Laris, Pamela Anderson, Elizabeth Baumler, Karin Coyle

Faculty, Staff and Student Publications

Homophobic and transphobic beliefs that lead to bias-based harassment remain a critical concern for young people in the USA. The aim of the present study was to examine the impact of an inclusive comprehensive sex education program (High School FLASH) on homophobic and transphobic beliefs. Data from this study come from a randomized controlled trial that evaluated the impact of High School FLASH on students' sexual behaviors and related outcomes with 20 schools in two U.S. regions (Midwest and South). Following the baseline survey, the 20 schools were randomly assigned to receive FLASH or a comparison curriculum. Ninth and 10th …

The Associations Of Parental Smoking, Quitting And Habitus With Teenager E-Cigarette, Smoking, Alcohol And Other Drug Use In Gui Cohort ’98, Salome Sunday, Luke Clancy, Joan Hanafin

Articles

We analyse parental smoking and cessation (quitting) associations with teenager e-cigarette, alcohol, tobacco smoking and other drug use, and explore parental smoking as a mechanism for social reproduction. We use data from Waves 1–3 of Growing Up in Ireland (Cohort ’98). Our analytic sample consisted of n = 6,039 participants reporting in all 3 Waves. Data were collected in Waves 1 and 2 when the children were 9 and 13 years old and in Wave 3 at age 17/18 years. Generalized Estimating Equations (GEE) models were used to analyse teenage substance use at Wave 3. Parental smoking was associated with …

Social Determinants Of Health And Lung Cancer Surgery: A Qualitative Study, Dede K. Teteh, Betty Ferrell, Oluwatimilehin Okunowo, Aidea Downie, Loretta Erhunmwunsee, Susanne B. Montgomery, Dan J. Raz, Rick Kittles, Jae Y. Kim, Virginia Sun

Health Sciences and Kinesiology Faculty Articles

Introduction: Social determinants of health (SDOH) are non-clinical factors that may affect the outcomes of cancer patients. The purpose of this study was to describe the influence of SDOH factors on quality of life (QOL)-related outcomes for lung cancer surgery patients.

Methods: Thirteen patients enrolled in a randomized trial of a dyadic self-management intervention were invited and agreed to participate in semi-structured key informant interviews at study completion (3 months post-discharge). A conventional content analysis approach was used to identify codes and themes that were derived from the interviews. Independent investigators coded the qualitative data, which were subsequently …

Association Of Social Vulnerability And Covid-19 Mortality Rates In Texas Between 15 March 2020, And 21 July 2022: An Ecological Analysis, Dennis Ogeto Nyachoti, Nalini Ranjit, Ryan Ramphul, Leah D Whigham, Andrew E Springer

Faculty, Staff and Student Publications

BACKGROUND: Despite the key role of social vulnerability such as economic disadvantage in health outcomes, research is limited on the impact of social vulnerabilities on COVID-19-related deaths, especially at the state and county level in the USA.

METHODS: We conducted a cross-sectional ecologic analysis of COVID-19 mortality by the county-level Minority Health Social Vulnerability Index (MH SVI) and each of its components in Texas. Negative binomial regression (NBR) analyses were used to estimate the association between the composite MH SVI (and its components) and COVID-19 mortality.

RESULTS: A 0.1-unit increase in the overall MH SVI (IRR, 1.27; 95% CI, 1.04-1.55; …

Mothers Get Really Exhausted!” The Lived Experience Of Pregnancy In Extreme Heat: Qualitative Findings From Kilifi, Kenya, Fiona Scorgie, Adelaide Lusambili, S. Luchters, Peter. Khaemba, Veronique Filippi, B. Nakstad, Jeremy Hess, Cathryn Birch, S. Kovats, M.F. Chersich

Institute for Human Development, East Africa

Background: Palliative care (PC) can reduce symptom distress and improve quality of life for patients and their families experiencing life-threatening illness. While the need for PC in Kenya is high, PC service delivery and research is limited. Qualitative research is needed to explore potential areas for PC research and support needed to enable that research. This insight is critical for informing a national PC research agenda and mobilizing limited resources for conducting rigorous PC research in Kenya.

Objectives: To explore perceptions of priority areas for PC research and support needed to facilitate rigorous research from the perspective of Kenyan PC …

Analyzing African American College Student Willingness To Participate In Clinical Trials, Caitlin B. Ulmer

Senior Theses

Previous studies regarding African American participation in clinical trials have found that African Americans participate at a significantly lower rate than other ethnic/racial groups. Scholars argue that this lack of participation in clinical trials is a direct result of historical trauma linked to unethical experiments and African American distrust in the healthcare system. However, there is a gap in the literature because these studies focus on African American individuals above the age of 30. This study aimed to fill the gap by examining clinical trial participation among African American college students within the ages 18 to 23. This study also …

Universal Health Coverage: A Basis For Pandemic Preparedness?, Merline Feero

Independent Study Project (ISP) Collection

Amid extensive research and reporting on the effects of COVID-19 on Universal Health Coverage (UHC) progress, this study explores an often neglected topic: the potential of UHC to contribute to the foundations of pandemic preparedness. Herein, quantitative analysis reveals that countries with higher UHC coverage tend to exhibit greater pandemic preparedness (as determined by the UHC Service Coverage Index and the Global Health Security Index). Complementary qualitative analysis is used to further illustrate and explain the correlation between UHC and pandemic preparedness using four case study countries, integrating literature reviews and relevant expert interviews. Through these methods, a clear tie …

Hidden Hurdles: Evaluating Informal Barriers To Primary Healthcare Access Among Undocumented Migrants In Switzerland, Arantxa Bonifaz Rosas

Independent Study Project (ISP) Collection

Undocumented migrants face heightened difficulties in accessing healthcare due to a combination of legal, financial, and social challenges. Informal barriers to accessing healthcare further exacerbate poor health outcomes among undocumented migrants. In Switzerland, where undocumented migrants have the right to health insurance, barriers to receiving healthcare continue to restrict their access to essential services, such as primary healthcare (PHC). Employing a meta-analysis approach, this qualitative study aimed to broaden existing research on informal barriers hindering access to PHC for undocumented migrants, with a particular focus on the Swiss context. The identified informal barriers centered around health insurance, fear of deportation, …