Medicine and Health Commons^™

Decomposing Trends In Child Obesity, Ashley Wendell Kranjac, Robert L. Wagmiller

Sociology Faculty Articles and Research

We unravel the absolute level and relative prominence of two demographic processes that are relevant for childhood obesity, and that will ultimately determine the long-term course and pace of change in child obesity rates. We leverage data from the National Health and Nutrition Examination Survey to decompose change in child obesity from 1971 to 2012. We partition change into that attributable to (1) healthier, more nutritionally and economically advantaged cohorts in the population being replaced by cohorts of children who are less advantaged (between-cohort change), and (2) the health habits, nutrition, and social and economic circumstances of all cohorts of …

Neverland: A Critical Autoethnography Of Aging With Cystic Fibrosis, Alexandra Ch Nowakowski

The Qualitative Report

In this autoethnography, I analyze stereotypes and misconceptions about people with cystic fibrosis (CF). I examine these illness representations and their social underpinnings through critical analysis of my journey to conclusive diagnosis with CF after first being tested for the disease in early life, and the events that have followed from that turning point. Using experiential data and prior research, I explore and refute harmful misconceptions about life with CF. I challenge the notion that people with CF never grow old. I also contest the idea that people who receive conclusive diagnoses during adulthood only then transition into patient identities. …

Healthcare Access And Poverty Among Central Appalachian Residents, Kacey M. Lefevers

Kentucky Journal of Undergraduate Scholarship

Healthcare access is an important shaping force in the lives of Appalachian people. Appalachians often face both inadequate availability of medical facilities and poverty, which limits access to health insurance and therefore healthcare. This results in reduced life expectancy and health disparity. In this study, the author examines relationships between adequate healthcare and access to healthcare among Appalachian residents. Using a convenience sample of Appalachian residents, the author finds that income, education, and being an Appalachian resident have unique impacts on healthcare access or perceptions of healthcare in general.

Youth-Sized Lab Coats: When Children Become Doctors Through Adolescent Healthcare Brokering, Lindsey Russell

Social Sciences

Child language brokering refers to the practice of children acting as linguistic and cultural mediators in general settings like school, stores, banks and other personal uses. The primary focus of this paper is “adolescent healthcare brokering,” a term coined in 2016 by researchers Jennifer R. Banas, James W. Ball, Lisa C. Wallis and Sarah Gershon, to refer to the use of children as interpreters for family and community members, specifically in the healthcare setting; these cross-lingual communications may occur during regular physician appointments, trips to the emergency department or at specialized visits in fields such as obstetrics or oncology.

This …

Food Insecurity Among South Asian Immigrant Communities In The Inland Empire Of Southern California, Farhan Danish

Electronic Theses, Projects, and Dissertations

Background: Food insecurity amongst South Asian Americans is a major public health issue. The South Asian American (SAA) community is the third largest Asian community in the United States. Despite this fact, very few specific studies have been conducted to investigate the food needs and barriers that exist within the SAA community so as to successfully help them improve dietary habits.

Methods: This study utilized a mixed methods convergent parallel design, where both qualitative and quantitative methods were conducted and analyzed separately and compared and contrasted at the end.

Results: The results of this study demonstrate that ethnic grocery stores …

Racial/Ethnic Differences In Multimorbidity Development And Chronic Disease Accumulation For Middle-Aged Adults, Ana R. Quiñones, Anda Botoseneanu, Sheila Markwardt, Corey L. Nagel, Jason T. Newsom, David A. Dorr, Heather G. Allore

Psychology Faculty Publications and Presentations

Multimorbidity–having two or more coexisting chronic conditions–is highly prevalent, costly, and disabling to older adults. Questions remain regarding chronic diseases accumulation over time and whether this differs by racial and ethnic background. Answering this knowledge gap, this study identifies differences in rates of chronic disease accumulation and multimorbidity development among non-Hispanic white, non-Hispanic black, and Hispanic study participants starting in middle-age and followed up to 16 years.

We analyzed data from the Health and Retirement Study (HRS), a biennial, ongoing, publicly- available, longitudinal nationally-representative study of middle-aged and older adults in the United States. We assessed the change in chronic …

Illness And The American Workplace: Issues And Implications For Employers And Employees, Victoria R. Dolan

Student Theses and Dissertations

This project aims to identify American employee experiences and existing workplace policies and cultures surrounding illness, disability, and sick leave. This approach was taken in order to closely examine what looks to be working well for companies and workers, and what could benefit from a more human centric approach in regards to workplace policy and employee support programs. The study of employee experiences in particular represents a gap in the current scholarly literature regarding illness and illness policy in the American workplace, and more accurately represents the experiences for both employees and employers. Furthermore, it assists with distinguishing the types …

Health Literacy Challenges And Opportunities: Bringing Children’S Mercy And Kansas City Together, Jennifer A. Lyon, Angie Knackstedt, Barbra Rudder, Mamta Reddy Md, Courtney R. Butler

Posters

BACKGROUND: A multidisciplinary group at Children's Mercy Kansas City applied for and received the NNLM MCR's Immersive Workshop Grant in December, 2017, and used the funding to organize and host a two-day immersive, interprofessional workshop in April, 2018, that 1) brought together health literacy-invested groups and individuals within the Kansas City community to learn about health literacy including cultural, language, numeracy and digital inclusion factors; and 2) provided specialized training to targeted CM participants to improve the provision of bedside health information to patients and caregivers. Objectives included: increasing community-wide collaboration, sharing resources, encouraging participants to become change agents, and …

Rationale, Design, And Baseline Characteristics Of Walkit Arizona: A Factorial Randomized Trial Testing Adaptive Goals And Financial Reinforcement To Increase Walking Across Higher And Lower Walkable Neighborhoods, Marc A. Adams, Jane Hurley, Christine Phillips, Michael Todd, Siddhartha Angadi, Vincent Berardi, Melbourne F. Hovell, Steven Hooker

Psychology Faculty Articles and Research

Little change over the decades has been seen in adults meeting moderate-to-vigorous physical activity (MVPA) guidelines. Numerous individual-level interventions to increase MVPA have been designed, mostly static interventions without consideration for neighborhood context. Recent technologies make adaptive interventions for MVPA feasible. Unlike static interventions, adaptive intervention components (e.g., goal setting) adjust frequently to an individual's performance. Such technologies also allow for more precise delivery of “smaller, sooner incentives” that may result in greater MVPA than “larger, later incentives”. Combined, these factors could enhance MVPA adoption. Additionally, a central tenet of ecological models is that MVPA is sensitive to neighborhood environment …

Addressing Barriers To Preventative Health Care For Transgender Populations: A Systems Approach To Improving Access To Gynecological Care, Meghan N. Flynn

Master's Theses

The current study addresses the lack of research exploring the individual and systemic barriers to accessing gynecological care for transgender populations. An integrated mixed-methods needs assessment was designed to explore the individual and systemic barriers to gynecological health care for transgender and gender diverse populations. Participants of the study included established community providers known to serve the transgender community through advocacy or research efforts, as well as clinical psychologists and medical professionals working in gynecological settings. The study includes a brief quantitative survey, which measured “Perceptions of Inclusivity Importance” among key stakeholders. Following the survey, participants were invited to engage …

Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice Woods

Dissertations

Objective:The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method:A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician’s orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …

The Influence Of Interpersonal Dyadic Differences On Condom Use Among Men Who Have Sex With Men, Andrew M. O'Neil

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Men who have sex with men (MSM) continue to be disproportionately affected by HIV/AIDS and other STIs. Condom use is one of the most effective methods of prevention, but rates of condom use have been steadily declining among MSM. Therefore, determining what factors influence condom use decision-making among MSM is important. Interpersonal factors such as physical attractiveness, race, and age have been explored in relation to condom use. However, there is a dearth of research exploring the influence of discrepancies between casual partners in these social categories and its influence on condom use directly.

Purpose: The purpose of this …

Female Genital Mutilation In The United States: Estimating The Number Of Girls At Risk, Phyllis Chesler

Dignity: A Journal of Analysis of Exploitation and Violence

Female genital mutilation (FGM) destroys the capacity of women to experience sexual pleasure. It causes serious medical complications such as bleeding, painful urination, cysts, dangerous and recurrent bladder and urinary tract infections, the growth of scar tissue that make marital intercourse a nightmare and that turns childbirth into an experience of danger and torture. Due to immigration, FGM now poses a potential health crisis in the West, both in Europe and in the United States. To estimate how many girls who live in the West are at risk, one can measure the prevalence of FGM in the non-Western countries where …

How Professional Physical Therapist Education Programs Develop Cultural Competence Within Their Students: An Exploratory Concurrent Mixed Methods Study, Dustin E. Domingo

Dissertations

Purpose: The purpose of this exploratory concurrent mixed methods study was to describe experiences that shape the factors of cultural intelligence (CQ) as perceived by students of professional physical therapist education programs. In addition, it was the purpose of this study to determine whether any particular factor of cultural intelligence influenced one’s overall cultural competence according to the cultural competence continuum by Cross et al. (1989).

Methodology: Students in a professional physical therapist education program completed a questionnaire, which included Likert scale questions, open ended questions, and a 37-item self-assessment based on the expanded cultural intelligence scale by Van Dyne …

A Study Of Music: Music Psychology, Music Therapy, And Worship Music, Jessica Whittemore

Senior Honors Theses

There are three specific fields related to music: the psychology of Music and how it affects human brain and functions, the methodology of Music Therapy and how it affects individuals undergoing treatment, and the psychological effects of Worship Music and how it can be used in music therapy. Music therapy is a growing field in which the therapeutic outcomes greatly benefit the patients. The overall purpose is to create a greater understanding of music and music therapy in order to a provide a system for introducing group worship services into music therapy to ultimately bring spiritual healing to individuals.

Perceptions Of Mental Health: Eight Conversations With Mainers From Africa, Teresa Sosa, Emelda Ogweta

Thinking Matters Symposium Archive

As of 2016, 42 million refugees from around the world had been forced to flee their homes due to war, persecution, or natural disaster (George & Jettner, 2016). Due to these factors, as well as relocation and resettlement, refugees are at a significant risk for trauma and other mental health issues (George & Jettner, 2016). While the literature consistently validates this heightened risk for mental illness in refugees, more research is needed into refugee's perspectives on mental health. Through analysis of semi-structured interviews with eight refugees from Africa, this phenomenological study investigated refugee's perceptions of mental health and mental illness. …

Z4, A Slow Puncture: An Autoethnographic Exploration Of Language, Embodiment, And Meaning-Making, Charlotte Rose Samuels

Independent Study Project (ISP) Collection

In my ISP, I explored language as it relates to the ways in which people living in Cato Manor make sense of HIV/AIDS in their community. With 7.1-7.2 million people living with HIV (PLWHIV) in South Africa, individuals across the country are either infected or affected by illness. KwaZulu-Natal (KZN), the province with the highest rate of HIV, is also the province that was surveyed with the disproportionately highest internal stigma rates for PLWHIV. High prevalence of HIV, particularly in KZN, calls for a constant contextualization of life in the presence of illness.

Throughout the world, metaphor and symbolism is …

From The American People: An Autoethnographic Exploration Of South African Ngos' Perceptions Of Pepfar, Antonia Asher

Independent Study Project (ISP) Collection

The aim of this research was to understand what the ideal partnership would be between United States (US) governmental aid agencies and South African non-governmental organizations (NGOs), specifically concerning HIV/AIDS programs funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR), from the perspective of NGOs. PEPFAR is the largest relief fund for a single disease; thus, I additionally sought to deeply reflect upon myself as a US citizen in South Africa, a country that has received trillions of dollars from taxpayers such as myself.

To accomplish this, I interviewed NGO staff about the nature of current partnerships, outcomes …

Vaccine Hesitancy In The United States And Switzerland, Anna E. Lunderberg

Independent Study Project (ISP) Collection

Vaccine hesitancy (VH), or the reluctance or refusal to participate in vaccination programs, is a complex phenomenon with far-reaching impacts on society. VH can impact vaccine uptake and facilitate subsequent outbreaks, as seen with the case of measles. Perceptions of vaccination are similar in the United States and Switzerland, and misinformation in each country contributed to VH through impaired parental risk-benefit analysis; parental analysis and subsequent VH is associated with both anti-vaccination messages gaining prominence and a decrease in the public perception of the health risk from vaccine-preventable diseases (VPDs). There are many proposed strategies for addressing VH on both …

Quality Over Quantity: A Comparative Analysis Of The Quality Measures And Performance Between Switzerland And The United States, Lexi Farina

Independent Study Project (ISP) Collection

Even in the best health systems, poor quality of care continues to cause harm to patients and prevent them from receiving the best treatment possible. Thus, it is important to record and report quality of care measures because they can help inform policy changes and improve performance. In this paper, a comparative analysis between the United States and Switzerland is conducted to understand the process for defining and assessing quality indicators in each country as well as compare their quality of care performance results. The methods for this study include a literature review of relevant background information relating to quality …

Cancer Management In Kenya - Awareness And The Struggles Patients Face To Access Treatment, Care & Support, Ashley Nmoh

Independent Study Project (ISP) Collection

The amount of cancer cases in Africa, and Kenya specifically, are rising at an alarming rate. This study was conducted to determine the challenges that patients with cancer in Kenya face to access treatment, care and support. Thirty-nine cancer patients were interviewed and thirty cancer patients filled out a questionnaire about their experiences of having cancer in Kenya. In addition, twenty key informants were interviewed including doctors, caregivers, cancer NGO executives, a researcher, a psychologist, a National Health Insurance Fund official and a director from the Ministry of Health. A breast cancer awareness survey was also administered to fifty-nine women …

My Body, Their Choice: Childbearing Attitudes And Practices In Jamkhed, Maharashtra, Sienna Sewell

Independent Study Project (ISP) Collection

Understanding the beliefs and practices of women and their families during pregnancy and childbirth is fundamental to the creation of successful public health interventions that target maternal and infant mortality. This study explores the childbearing practices of women in rural Jamkhed, as well as the social and economic factors that influence family planning, reproductive health-seeking, and delivery. Interviews and quantitative surveys were conducted with women in villages that have partnered with the Comprehensive Rural Health Project (CRHP) to examine how and why women access prenatal care during pregnancy. The influence of CRHP’s “Jamkhed Model” on healthcare access is considered in …

Exploring Mobility Help-Seeking Behavior Among People With Physical Disabilities: A Case Study Of Jaipur Foot, Alex Podell

Independent Study Project (ISP) Collection

It is estimated that as many as 90 million people living in India experience some sort of disability (The World Bank, 2007). As India’s population keeps growing and aging, not only will the medical aspects, but also the societal impacts of disability need to be brought to the forefront of discussion, developmental strategy, and policy implementation. This study sought to analyze factors influencing the process of seeking help from formal and informal sources for people with physical disabilities. Data was collected from 10 people with physical disabilities receiving a variety of mobility aids from the NGO, Bhagwan Mahaveer Viklang Sahayata …

Sirva Todos Como Un Hermano: Las Filosofías De Los Médicos Tradicionales Mapuches Hacia Los Pacientes Winka, Andrew Turner

Independent Study Project (ISP) Collection

In recent years, the popularity of traditional Mapuche medicine has increased drastically among non-Mapuche, Winka, Chileans. This increase in the soliciting of services as well as an expansion of intercultural health programming exists within the context of the ongoing Mapuche conflict in which Mapuche activists in the Araucunía region are fighting for the territorial and societal rights of their indigenous communities. To ascertain the effects of Winka medical solicitation on Mapuche medical practioners, semi-structured interviews were utilized. 8 Mapuche medical practioners and associated community members such as intercultural hospital directors and Lonkos were interviewed. Participants were questioned about the personal …

Los Microcosmos De La Interculturalidad? Una Mirada Al Cómo Los Trabajadores De La Salud Biomédica De Orígen Indígena Relacionan Con Los Modelos De Salud Tradicional Y Occidental, Taylor Lord

Independent Study Project (ISP) Collection

Research Question: How does a biomedical health professional with indigenous roots in Chile relate the biomedical model of healthcare with the alternative indigenous model in their practice?

Objectives: The primary objective of this study was to understand how and if a biomedical health professional with indigenous roots relates and integrates two models of healthcare in their daily practice. A Secondary objective was analyzing if integration affects philosophy of care in relation to patients in critical conditions. In sum, it looked to study biomedical health professionals with indigenous roots as potential microcosms of interculturality that can demonstrate the benefits of a …

Pasantía En Red Oss: Más Que Una Clínica, Saad Ehsan

Independent Study Project (ISP) Collection

RED OSS es una organización en Conchalí, Santiago que provee pruebas rápidas de VIH y actualiza otras pruebas para ETS en una manera gratuita desde 1991. Durante mi pasantía, investigué como una organización disminuye las desigualdades de salud. También aprendí sobre el financiamiento de RED OSS, las pruebas rápidas y el nicho de RED OSS en un país con un sistema pública. Utilicé observaciones y entrevistas para estudiar la clínica. Tuve oportunidades para asistir los talleres para prevenir homofobia y ver las consejerías con un voluntario. También actualicé el sitio web para reflejar los servicios que RED OSS ofrece. En …

Social Support And Discrimination: The Experiences Of Recovering Heroin Addicts In Kunming, China, Phoebe Li

Independent Study Project (ISP) Collection

Opioids have had a long, complex position in Chinese society, dating all the way back to the Ming dynasty. In 1949, 5% of the overall Chinese population and 25% of the population in Yunnan smoked opium regularly, which led to societal collapse and economic downturn. Since then, the Chinese government has used many different methods to attempt to control drug use and trafficking, including registering all users, executing traffickers, and using Compulsory Rehabilitation Centers. Starting in 2008, the government switched to a harm reduction approach and began to invest in methadone clinics, community support groups, and needle exchange programs. Because …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …

Escaping Death: Naloxone's Chemical Nature And Potential To Combat The Opioid Epidemic, Abigale Miller

Honors Program: Senior Projects (Public)

Naloxone is a life-saving drug with the ability to reverse an opioid overdose. As the opioid epidemic’s death toll rises, we can turn to Naloxone as a tool to combat the crisis. The epidemic, born of corruption, has a wide reach among the people of the United States, with especially firm grasps on middle-aged people, sufferers of chronic pain, white Americans and those living in the eastern portion of the country. Naloxone’s elegant design saves lives by effectively competing for a position on an opioid biding receptor in the brain to almost instantly end an overdose and restore normal breathing. …