Medicine and Health Commons^™

A Mixed Methods Study Of Cultural Competence Among Nursing Students In Kenya, Sylvia Waweru

Nursing Theses and Dissertations

Significance and Background: Kenya has been experiencing an increase in cultural and ethnic diversity. As a result of cultural differences, health disparities among ethnic groups in Kenya are increasing. A component of patient centered care involves the incorporation of cultural aspects of health and illness in the delivery of nursing care. Understanding cultural competence of nursing students will provide guidance on educational needs related to cultural competence.

Purpose:. The purpose of this study was to assess nursing students’ cultural competence (CC) in the areas of cultural awareness, knowledge, sensitivity, skills, encounters and desire. Nursing students’ views on caring for …

The Effects Of Hormonal Contraceptive Use On Perceptions Of Social Stress In Women, Ashton Jones

Biological Sciences Undergraduate Honors Theses

Hormonal contraceptives are widely used due to their efficiency in preventing pregnancy. Although women are often informed of the physical effects of hormonal contraceptives, there is little emphasis on mental effects, such as increased rates of depression and changes in social perception. The current study examined perceptions of social stress among women before beginning hormonal contraceptives, and two months after using hormonal contraceptives. I hypothesized that women would experience increased social stress after beginning hormonal contraceptives, compared to a control group of women who were also assessed twice. Results did not support this hypothesis; there was no difference in interpersonal …

Perceived Covid-19 Threat Across The Intersections Of Age, Race/Ethnicity, And Gender, Christina Varghese

Sociology and Criminology Undergraduate Honors Theses

Studying how perceived threat of the novel coronavirus 2019 (COVID-19) differs across intersections of age and race/ethnicity as well as age and gender will create a basis for identifying subgroups at greater risk of negative mental health outcomes. I analyzed nationally representative survey data collected in February 2021 from the Pew Research Center’s American Trends Panel (N=9,069). To measure perceived threat, the respondents were asked whether COVID-19 is considered 0) no threat, minor threat, or 1) major threat for personal and population health. Race/ethnicity, gender, and age categories are used as independent variables. Results from logistic regression models indicate that …

Public Health Contagion Of White Supremacy: Examining The Pipeline Of Attitudes About Racism And Racial History Education Among High School Students., Trinidad Jackson

Electronic Theses and Dissertations

We are living in compounded states of upheaval. Violence and exemption from it across socioecological levels have shaped how humans survive, thrive, and die. While different violence typologies exist, the U.S., prioritizes interpersonal violence as its primary target of intervention, often through structural means that foster and reinforce interpersonal violence. The omission of structural and cultural agents and outcomes of violence allows perpetrators to infiltrate and reproduce savage, dehumanizing ideologies in perpetuity. Instead of sustaining societal pillars that oppress and destroy, we must fertilize public health research, practice, and sociopolitical activism with pillars that both inform and activate liberatory consciousness …

When Worlds Collide: Boundary Management Of Adolescent And Young Adult Childhood Cancer Survivors And Caregivers, Elizabeth A. Ankrah, Arpita Bhattacharya, Lissamarie Donjuan, Franceli L. Cibrian, Anamara Ritt-Olson, Joel Milam, Lilibeth Torno, Gillian R. Hayes

Engineering Faculty Articles and Research

Adolescent and young adult childhood cancer survivors experience health complications, late or long-term biomedical complications, as well as economic and psychosocial challenges that can have a lifelong impact on their quality-of-life. As childhood cancer survivors transition into adulthood, they must learn to balance their identity development with demands of everyday life and the near- and long-term consequences of their cancer experience, all of which have implications for the ways they use existing technologies and the design of novel technologies. In this study, we interviewed 24 childhood cancer survivors and six caregivers about their cancer survivorship experiences. The results of our …

Benefits Of, Barriers To, And Needs For An Artificial Intelligence-Powered Medication Information Voice Chatbot For Older Adults: Interview Study With Geriatrics Experts, Meghana Gudala, Mary Ellen Trail Ross, Sunitha Mogalla, Mandi Lyons, Padmavathy Ramaswamy, Kirk Roberts

Faculty, Staff and Student Publications

BACKGROUND: One of the most complicated medical needs of older adults is managing their complex medication regimens. However, the use of technology to aid older adults in this endeavor is impeded by the fact that their technological capabilities are lower than those of much of the rest of the population. What is needed to help manage medications is a technology that seamlessly integrates within their comfort levels, such as artificial intelligence agents.

OBJECTIVE: This study aimed to assess the benefits, barriers, and information needs that can be provided by an artificial intelligence-powered medication information voice chatbot for older adults.

METHODS: …

Emerging Viral Diseases: Generation Z'S Outlook, Ian Mcwhorter

Honors Projects

Generation Z differs notably from previous generations like Baby Boomers or Generation X. In recent years, young adults have been persisting through the COVID-19 pandemic, though not unscathed. This paper seeks to answer the following question: How does Generation Z differ in its outlook on Viral diseases compared to previous generations? Using a series of three surveys conducted on three seperate Viral diseases (HIV, Zika, and COVID 19), it was found that while Generation Z has improved in its ability to combat Viral outbreaks due to factors like high digital literacy, other factors such as poorer mental health show that …

Change Of Air Quality Knowledge, Perceptions, Attitudes, And Practices During And Post-Wildfires In The United States, Alessandro Del Ponte, Lina Ang, Lianjun Li, Noah Lim, Wilson Tam Wai San, Wei Jie Seow

Political Science Faculty Articles and Research

Amid worsening climate change, the recurrent wildfires have substantially worsened air quality in the Western United States (U.S.). Understanding the knowledge, attitudes, perception, and practices (KAPP) over time in response to natural disasters such as wildfires is crucial for public health interventions and disaster preparedness. This is the first study to investigate the change in air quality KAPP over time in response to natural disasters. Previous studies have only assessed KAPP at a fixed time point. Using a two-wave panel survey (during and post-wildfires), we assessed the association between KAPP and respiratory health indicators as well as the changes over …

Citizenship Matters: Non-Citizen Covid-19 Mortality Disparities In New York And Los Angeles, Jason A. Douglas, Georgiana Bostean, Angel Miles Nash, Emmanuel B. John, Lawrence M. Brown, Andrew M. Subica

Health Sciences and Kinesiology Faculty Articles

U.S. non-citizen residents are burdened by inequitable access to socioeconomic resources, potentially placing them at heightened risk of COVID-19-related disparities. However, COVID-19 impacts on non-citizens are not well understood. Accordingly, the current study investigated COVID-19 mortality disparities within New York (NYC) and Los Angeles (LAC) to test our hypothesis that areas with large proportions of non-citizens will have disproportionately high COVID-19 mortality rates. We examined ecological associations between March 2020–January 2021 COVID-19 mortality rates (per 100,000 residents) and percent non-citizens (using ZIP Code Tabulation Areas (ZCTA) for NYC and City/Community units of analysis for LAC) while controlling for sociodemographic factors. …

Making Forests, Making Communities: An Ethnography Of Reforestation In Monteverde, Costa Rica, Megan Brown

Anthropology Theses and Dissertations

Reforestation is not just planting trees in the ground. More than net increase in forest cover, reforestation is a complex political endeavor undertaken by both humans and non-humans and a popular climate change mitigation tactic. However, little research has examined the dynamics between selection of specific reforestation strategies, health, and community resilience, particularly with attention to entanglements between the lives of both human and non-human forest dwellers. This ethnographic work, based on six months of in-person fieldwork and six months of digital ethnography, examines reforestation and forest relations in Costa Rica’s Monte Verde zone, a region which experienced widespread deforestation, …

Interrogating Race And Place-Based Inequities In Hiv And Covid-19, Rohan Khazanchi

EMET Projects

Over the last four years, I have developed a research focus examining the intersections of race, place, and health. My M.D. Honors Thesis reflects a snapshot of these efforts. In this collection of brief research reports, I leverage area-based measures to investigate structural inequities in three contexts: the HIV epidemic in our hyperlocal community, the early stages of the COVID-19 pandemic, and clinical trials for novel COVID-19 therapeutics. I apply novel social epidemiologic tools to measure and explore disparate outcomes. And, in reflecting upon my findings, I discuss concrete implications for clinicians, researchers, and policymakers alike.

Chapter 1: Neighborhood-Level Deprivation …

La Política Cultural Del Aborto: Las Percepciones Y El Manejo Del Aborto En Arica, Chile, Eva Strelitz-Block

Independent Study Project (ISP) Collection

Chile has a long history of restricting access to legal abortion. Until 2017, when the government passed the law N° 21.030 decriminalizing abortion on three grounds, abortion was completely illegal. However, despite this movement towards decriminalization, legal abortion access is still very limited and highly restricted. In this criminalized, highly stigmatized environment, self-managed abortion has emerged as a way to transform the landscape of abortion. This qualitative, exploratory study seeks to explore perceptions of abortion and practices of abortion management both within and outside of the official healthcare system among women and people with the capacity to become pregnant and …

Healing In The Himalayas: Mustangi Medical Practitioners’ Perspectives On Integrative Approaches To Chronic Illness, Lucia Morey

Independent Study Project (ISP) Collection

The purpose of this Independent Study Project is to capture a snapshot of the opinions and experiences of 13 health practitioners from 7 villages and towns in Mustang. Specifically, I asked independent healers (IH), amchis and health post workers about their practices and perspectives on chronic illness, integrative medicine and the intersection of the two. I found that there is a flow of information in one general direction, with practitioners along a continuum of most to least globally recognized. Understandably, the least well known (independent healers) are aware of Traditional Tibetan Medicine (TTM) and conventional Western medicine (CWM). Subcategories of …

The Ethics Of Medical Voluntourism: The Conceptualization And Management Of ‘Doing Harm’ Within The Business, Katelyn Dohler

Independent Study Project (ISP) Collection

Although medical voluntourism programs are rapidly growing in popularity, deep ethical controversies overly the industry. In particular, understanding how the field of medical voluntourism follows a business model sheds insight on the sources of tension and conflicts of interest that can arise within organizations and the sector as a whole. However, understanding the roles of individual motivations and societal pressures in the development of these ethical controversies is relatively unexplored.

Through an inductive thematic analysis of data gathered from literature review and expert interviews, this project investigates these driving factors behind the rapidly growing business, how these driving factors contribute …

The Correlation Between Vaccine Hesitancy And Privilege: Exploring The Degree To Which Education And Income Foster Resistance To Vaccination Efforts, Sophie Goldenberg

Independent Study Project (ISP) Collection

Vaccine hesitancy is a public health issue of growing concern. Extensive pre-existing literature offers several explanations and conflicting viewpoints regarding reluctance toward vaccinations. However, minimal research has been done exploring the upstream social determinants driving vaccine hesitancy. Utilizing academic and gray literature and interviews with experts in the field, this study addresses this gap in knowledge with the research question: To what extent does privilege impact vaccine hesitancy and resistance? Vaccine hesitancy appears globally and is particularly concerning given the re-emergence of vaccine-preventable diseases (VPDs). Additionally, due to inconsistent causes, vaccine hesitancy is difficult to combat. In referencing the history …

Evaluating The Validity Of Restrictions On Blood Donation Eligibility For Men Who Have Sex With Men (Msm) In The United States, France, And Switzerland, Swathi Gorantla

Independent Study Project (ISP) Collection

For the first time in a decade, the number of new human immunodeficiency virus (HIV) diagnoses is higher for heterosexual people compared to gay and bisexual men (Florêncio, 2022). Additionally, in the United States, the American Red Cross has declared a national blood crisis due to the nationwide shortage of donated blood. During this crisis, charged with the new information on HIV diagnosis rates, many advocates for the Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) community question why discriminatory policy surrounding gay and bisexual men donating still exist around the world. These policies are changing worldwide – several European countries have …

Microplastics, The Environment, And Reproductive Health: How Is The Accumulation Of Microplastics In Our Environment And Bodies Impacting Reproductive Health?, Katherine Hayward

Independent Study Project (ISP) Collection

As global trends in both production and consumption of plastics continue to evolve, the bioaccumulation and biomagnification of microplastic particles in our everyday lives follow suit. This increasingly relevant problem has only recently been explored in the context of global health, and more specifically, reproductive health. Along with this steady increase in plastics and our exposure to them, researchers have separately observed adverse patterns in reproductive health. The chemicals involved throughout the microplastic life cycle may be playing a key role in these simultaneous patterns. With the aid of previous studies and publications on microplastics, exposure pathways, endocrine disruptors, and …

Unhealthy Workplace Conditions Contribute To Physician Suicide, Mariah Brennan Nanni, Alexandra Punch

Population Health Research Brief Series

Physicians have the highest suicide rate of all professions. High-stress working environments, long hours, burnout, substance use, and financial stress all contribute to high physician suicide rates. Adding fuel to the fire, COVID-19 has intensified this long-term problem. This issue brief describes the unhealthy workplace conditions that contribute to poor mental health among physicians and calls for policies that encourage physicians to seek help and rest without the fear of punishment.

Endocrine-Disrupting Chemicals And Breast Cancer: Disparities In Exposure And Importance Of Research Inclusivity, Ashlie Santaliz Casiano, Annah Lee, Dede Teteh, Zeynep Madak Erdogan, Lindsey Trevino

Health Sciences and Kinesiology Faculty Articles

Endocrine-disrupting chemicals (EDCs) are known contributors to breast cancer development. EDC exposures commonly occur through food packaging, cookware, fabrics, and personal care products as well as through the environment. Increasing evidence highlights disparities in EDC exposure across racial/ethnic groups, yet breast cancer research continues to lack the inclusion necessary to positively impact treatment response and overall survival in these socially disadvantaged populations. Additionally, the inequity in environmental exposures has yet to be remedied. Exposure to EDCs due to structural racism poses an unequivocal risk to marginalized communities. In this review, we summarize recent epidemiological and molecular studies on two lesser-studied …

Intergenerational Risk And Resilience Pathways From Discrimination And Acculturative Stress To Infant Mental Health, Sabrina R. Liu, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Preconception and prenatal stress impact fetal and infant development, and women of color are disproportionately exposed to sociocultural stressors like discrimination and acculturative stress. However, few studies examine links between mothers’ exposure to these stressors and offspring mental health, or possible mitigating factors. Using linear regression, we tested associations between prenatally assessed maternal acculturative stress and discrimination on infant negative emotionality among 113 Latinx/Hispanic, Asian American, Black, and Multiethnic mothers and their children. Additionally, we tested interactions between stressors and potential pre- and postnatal resilience-promoting factors: community cohesion, social support, communalism, and parenting self-efficacy. Discrimination and acculturative stress were related …

Correlation Between Social Media Use And Eating Disorder Symptoms: A Literature Review, Makenna Rose Burger

Kinesiology and Public Health

Importance: Social media is a pervasive influence in modern society presenting many potential public health implications.

Objective: The purpose of this literature review is to synthesize current research regarding social media and eating disorders.

Methods: Primary research was gathered from Google Scholar and OneSearch database resulting in 7 articles. Articles were examined for common themes.

Results: Common themes found in the resulting research is the prevalence of ‘thinspiration’, gamified content, and overlap of eating disorders with other mental illnesses. Several articles found a significant correlation between social media use and the severity of eating disorder symptoms. …

Adverse Childhood Experiences And Resilience In Medical School Students: A Scope Of Medical Literature, Andrea Soto Abarca, Yvette Cortino, Juan C. Lopez-Alvarenga, Maya Guevara

MEDI 9331 Scholarly Activities Clinical Years

Background: Adverse childhood experiences (ACEs) represent certain types of childhood trauma that are associated with long-term negative effects on health and wellbeing. The elevated number of ACEs can lead to depression, suicidality, alcoholism, and substance use. Factors that can protect a person from increased health risks include resilience, which is broadly defined as the ability to overcome challenges or bounce back from adversity. Few studies have analyzed the exposure of ACEs in medical students, however, there has been extensive literature on how low levels of resilience are linked to higher rates of depression, fatigue, and burnout among medical students. …

Information Trust And Covid-19 Vaccine Hesitancy Amongst Middle-Aged And Older Adults In Singapore: A Latent Class Analysis Approach, Micah Tan, Paulin Tay Straughan, Grace Cheong

Research Collection School of Social Sciences

Rationale: COVID-19 vaccine hesitancy presents significant challenges for public health. Objective: Vaccine hesitancy among middle-aged and older adults has been a significant barrier in Singapore’s battle against COVID-19. We hypothesize that the trust middle-aged and older adults place in various sources of information influences vaccine hesitancy, and that distinct typologies of trust can be identified to better inform targeted health communication efforts. Method: Data from a nationally representative panel survey of Singaporeans aged 56–75 (N = 6094) was utilized. Modules fielded in August and November 2020, and June 2021 were analyzed, assessing social networks, trust in sources of information, and …

Development Of A Men’S Health Course For First-Year Undergraduates Using Culturally Responsive Teaching Strategies, Ania A. Majewska, Johnasha D. Stuart, Kelsey M. Gray, Pearl V. Ryder, Ethell Vereen

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Purpose

A novel first-year experience course was developed using culturally responsive teaching strategies at an undergraduate liberal arts college in the southeastern USA to promote health advocacy and to provide students with an overview of male health. The course focuses on the biological, sociocultural, economic and gender influences that shape men's health beliefs and practices. It also emphasizes health disparities in the USA among Black/African American men compared to other racial groups and intervention strategies to improve health outcomes.

Design/methodology/approach

The lecture and laboratory components of the course were designed as a blended learning environment with a modified flipped class …

Choosing To Thrive: An Autoethnographic Journey Of Cancer, Companionship, And Carrots, Bruce Lilyea

The Qualitative Report

In this autoethnography, I explore the companionship experience of someone supporting a cancer patient who is endeavoring to thrive in the face of this disease. A wide range of studies has been conducted on the emotional and social issues relating to cancer and specifically to breast cancer. Appropriately, most of the research relating to the personal narrative focuses on the stories of the person who has been diagnosed with cancer, and limited research has highlighted the perspective and experiences of their companions. My primary goals for this autoethnographic research are to: (1) Begin to answer the question: What role do …

Four Corners: A Values Clarification Exercise, Montsine Nshom

Open Educational Resources

Four Corners is a values clarification activity that asks participants to stand/show whether they strongly agree to strongly disagree with a specific statement, and reflect on their position during and after the activity. This four corners activity is designed to help students think about and discuss topics that are pertinent to urban community health and public health.

No prior reading or coursework is required; it is a good option for the first day of class to introduce key themes that will be covered during the course as well as practice ground rules and class discussion norms.

Maternal Wellness: Self, Matrescence, Obstetric Violence, And Self-Care, Vanessa V. Vales-Lewis

Dissertations, Theses, and Capstone Projects

In this dissertation, I engage in a self-study through an examination of my experience of matrescence (i.e., the transition to motherhood). I discuss my praxis in the development of a self-study on maternal wellness as it applies to my well-being as both a researcher and the researched. In Chapter 1, I preface this study by highlighting critical scholars and the bricoleurs who have been foundational in my undertaking of this work on a narrative study on maternal wellness. Using bricolage as part of a research methodological framework that involved key scholarly methodologies of authentic inquiry, emergence and contingence, and narratology, …

“We Are Doing The Absolute Most That We Can, And No One Is Listening”: Barriers And Facilitators To Health Literacy Within Transgender And Nonbinary Communities, C. Riley Hostetter, Jarrod Call, Donald R. Gerke, Brendon T. Holloway, N. Eugene Walls, Jennifer C. Greenfield

Graduate School of Social Work: Faculty Scholarship

Transgender and nonbinary (TNB) individuals face disparities in nearly every aspect of health. One factor associated with poor health outcomes in other marginalized populations is health literacy, yet no identified studies examine health literacy in TNB samples. Moreover, most health literacy frameworks focus primarily on the capacities of individual patients to understand and use healthcare information, with little attention given to provider literacy and environmental factors. In partnership with a statewide LGBTQ advocacy organization, we recruited 46 transgender and nonbinary individuals to participate in seven focus groups conducted in urban, suburban, and rural locations throughout Colorado. TNB participants consistently engaged …

Disability And Health In African Americans: Population Research And Implications For Occupational Therapy Community-Based Practice, Emily Schulz, Debarchana Ghosh, Eddie M. Clark, Beverly R. Williams, Randi Williams, Lijing Ma, Crystal L. Park, Cheryl L. Knott

The Open Journal of Occupational Therapy

Background: Population-based research and community-based interventions are integral to occupational therapy’s scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African American population, guided by the Person-Environment-Occupation-Performance Model.

Method: Using data from an observational cross-sectional nationwide telephone survey of African American adults, we examined differences between African Americans who are receiving disability payments (RDP) and those who are employed full time (FTE) on several physical health behaviors and psychosocial health indicators. We further compared the differences between African Americans RDP versus those FTE on those physical health …

Diabetes Mellitus Among Black/African Americans: A Critical Discourse Analysis Of Epigenetic Research, Eliana Jacobs

Honors Undergraduate Theses

During their lifetime, Black/African Americans have a higher likelihood of developing the diabetes mellitus metabolic disorder than other racial and ethnic groups in the United States. While research indicates that socioeconomic status, diet, and obesity factor into race disparities, the epigenetics field additionally identifies historical and contemporary racism as contributors to race disparities. This study is a qualitative analysis that examines a sample of health science research articles that use an epigenetics approach to understand diabetes among Black/African Americans. I analyzed the extent and mechanisms through which articles subtly reproduce dominant stereotypes of Black/African Americans and diabetes through representations of …