Medicine and Health Commons^™

Which Patient Experiences Are You Capturing? Investigating Differences In Patient Experience Drivers By Race/Ethnicity And Survey Mode, Meike Eilert, Toni Land, Jonathan Shafer

Patient Experience Journal

To address existing disparities in healthcare for underserved populations, healthcare providers and policymakers need to understand how the experiences of these patients differ to take meaningful action. In this study, we examine whether drivers of patient experiences (PX) for underserved populations vary. Using data from the 2018 and 2019 CAHPS Adult PCMH/Adult Primary Care 6 Month (n = 166,349), we examine differences in the importance of PX drivers - effective communication, helpful and courteous staff, timely appointments, and providers’ use of information - across underserved patients. We further examine whether different survey modes compound the observed differences. The findings show …

From 'Pandemic' To 'Endemic' And Beyond: Key Aspects Of Research On Older Singaporeans In A Year Of Transition, Nadya Haifan, Jane Tan, Rachel Wen Yi Ngu, Mindy Eiko Tadai, Yan Er Tan, Grace Cheong, Micah Tan, Wensi Lim

ROSA Research Briefs

The past year has been one marked by transition – as a country we have moved from treating COVID-19 as a pandemic to living with it as an endemic disease. Research conducted by the Centre for Research on Successful Ageing (ROSA) has taken a similar trajectory, expanding the scope of investigations from COVID-19 topics to other areas that are important for the general well-being of older adults in Singapore. This report showcases ROSA’s research involving older Singaporeans and the partnerships that have been forged in the past year. These developments will be presented in two sections. The first outlines the …

Covid-19, Nutrition, And Gender: An Evidence-Informed Approach To Gender-Responsive Policies And Programs, Anna Kalbarczyk, Noora-Lisa Aberman, Bregje S M Van Asperen, Rosemary Morgan, Zulfiqar Ahmed Bhutta, Bianca Carducci, Rebecca Heidkamp, Saskia Osendarp, Neha Kumar, Anna Lartey

Department of Paediatrics and Child Health

In addition to the direct health impacts of COVID-19, government and household mitigation measures have triggered negative indirect economic, educational, and food and health system impacts, hitting low-and middle-income countries the hardest and disproportionately affecting women and girls. We conducted a gender focused analysis on five critical and interwoven crises that have emerged because of the COVID-19 crisis and exacerbated malnutrition and food insecurity. These include restricted mobility and isolation; reduced income; food insecurity; reduced access to essential health and nutrition services; and school closures. Our approach included a theoretical gender analysis, targeted review of the literature, and a visual …

Nurturing Children’S Development Through Healthy Eating And Active Living: Time For Policies To Support Effective Interventions In The Context Of Responsive Emotional Support And Early Learning, Helen Skouteris, Rachael Green, Alexandra Chung, Heidi Bergmeier, Lisa H Amir, Sukhpreet Kaur Baidwan, Angel Marie Chater, Catherine Chamberlain, Ruth Emond, Kay Gibbons, Michelle Gooey, Kostas Hatzikiriakidis, Emma Haycraft, Andrew P Hills, Daryl J Higgins, Oliver Hooper, Sue-Anne Hunter, Pam Kappelides, Sue Kleve, Jacynta Krakouer, Julie C Lumeng, Yannis Manios, Athar Mansoor, Michael Marmot, Louise C Mâsse, Karen Matvienko-Sikar, Zandile June-Rose Mchiza, Caroline Meyer, George Moschonis, Emily R Munro, Teresia Margareta O'Connor, Adrienne O'Neil, Thomas Quarmby, Rachel Sandford, Janet U Schneiderman, Simone Sherriff, Doug Simkiss, Alison Spence, Elizabeth Sturgiss, Dave Vicary, Rebecca Wickes, Luke Wolfenden, Mary Story, Maureen M Black

Faculty, Staff and Students Publications

Fostering the growth, development, health, and wellbeing of children is a global priority. The early childhood period presents a critical window to influence lifelong trajectories, however urgent multisectoral action is needed to ensure that families are adequately supported to nurture their children's growth and development. With a shared vision to give every child the best start in life, thus helping them reach their full developmental potential, we have formed the International Healthy Eating Active Living Matters (HEALing Matters) Alliance. Together, we form a global network of academics and practitioners working across child health and development, and who are dedicated to …

Gender Studies Fall Colloquium, 2022 - “What Is Next For Reproductive Rights And Reproductive Justice?", Ederlina Co

Gender Studies Colloquium

No abstract provided.

Chemical Relaxers And Hair-Straightening Products: Potential Targets For Hormone-Related Cancer Prevention And Control, Adana A. M. Llanos, Jasmine A. Mcdonald, Dede K. Teteh, Traci N. Bethea

Health Sciences and Kinesiology Faculty Articles

"Emerging data show that use of permanent hair dyes, chemical relaxers, and straightening products might contribute to increased risk of hormone-related cancers (1-5) and potentially breast tumors with features indicative of more aggressive phenotypes (6). Given the wide use of these products globally, they are an important source of exposure to potentially harmful chemicals, including endocrine-disrupting chemicals—to which we are ubiquitously exposed (7)—and mutagenic and/or genotoxic compounds. The unequal burden of exposure across populations plausibly contributes to cancer inequities as the groups with the greatest exposure also experience poorer cancer outcomes (8). …

Artificial Intelligence And The Situational Rationality Of Diagnosis: Human Problem-Solving And The Artifacts Of Health And Medicine, Michael W. Raphael

Publications and Research

What is the problem-solving capacity of artificial intelligence (AI) for health and medicine? This paper draws out the cognitive sociological context of diagnostic problem-solving for medical sociology regarding the limits of automation for decision-based medical tasks. Specifically, it presents a practical way of evaluating the artificiality of symptoms and signs in medical encounters, with an emphasis on the visualization of the problem-solving process in doctor-patient relationships. In doing so, the paper details the logical differences underlying diagnostic task performance between man and machine problem-solving: its principle of rationality, the priorities of its means of adaptation to abstraction, and the effects …

Medical Ethics: How Resource Distribution Affects The Decision Making Of Doctors In Rural India: An Explorative And Comparative Study In Jamkhed, Maharashtra, Jared Yee

Independent Study Project (ISP) Collection

Using rural Mahrasthra as a case study, I was able to explore the medical ethics and common dilemmas that occur in Rural India. Through a collection of interviews and articles, I was able to piece together my understanding of some common ethical challenges that India faces, emphasizing ones that were unique to the location and circumstance. Using observations I made through my work in the hospital, I learned that limited resources effects all sides of ethics in the medical field, with a significant effect on economics, hospital structure, and clinical protocol. In an attempt to source the aspects of Indian …

Fighting Heroin Abuse With Heroin: How Legalizing Prescription Heroin Has Changed The Way New Generations Use Drugs, Claire Ridley

Independent Study Project (ISP) Collection

In the 1980s, Switzerland was embroiled in two simultaneous crises: widespread heroin use and spreading HIV/AIDS. Zurich became the capital of heroin consumption, with groups gathering in public parks and sharing needles to inject heroin. In response to these crises, several Swiss cities started conducting randomized control trials where they offered prescription heroin to help people addicted to heroin consume the drug safely and eventually recover from their addiction. As these trials reported positive results of maintaining better health outcomes for those undergoing treatment, the Swiss people supported federally legalizing heroin-assisted treatment and expanding access to harm reduction services in …

Rumination As A Mediator Of The Association Between Racial Discrimination And Depression Among Black Youth, Donte L Bernard, Colleen A Halliday, Funlola Are, Devin E Banks, Carla Kmett Danielson

Faculty, Staff and Student Publications

BACKGROUND: Racial discrimination constitutes a significant risk factor for depressive symptoms among Black youth. Rumination, a maladaptive self-regulatory stress response, is a notable pathway by which racial discrimination contributes to depressive symptoms among racial/ethnic minority adults. Yet, examinations of the mechanistic nature of rumination in the context of racial discrimination among racial/ethnic minority youth remain limited. The present study investigated rumination as a mediator of the association between racial discrimination and depressive symptoms among Black youth.

METHODS: Data for the current study were drawn from baseline questionnaire responses of community recruited Black pre-and-early adolescents (N = 158, 53% female, M …

Examining The Power Dynamics In The Patient-Doctor Relationship In Bio-Medicalized Countries: A Historical And Sociocultural Framework, Molly Dickerson

Independent Study Project (ISP) Collection

Medical humanities research is an increasingly important field of study for medical care. Power dynamics that exist between doctor and patient during the clinical encounter are an integral factor for improving health outcomes and patient satisfaction with their clinician. This research study sought to determine the power dynamics that exist within the patient-doctor relationship in Switzerland and other bio-medicalized countries with similar patient-provider experiences through a historical and sociocultural lens. Four interviews were conducted alongside preliminary research, and the power dynamics identified through this study were social, economic, knowledge-based, and communication. Historical human philosophies about the universe, the role of …

Surveying The Stigma: How The Plhiv Stigma Index Acts As A Validated Framework To Measure Healthcare Discrimination And How It Can Be Adapted To Quantify Mental Health Stigma, Keeley Lariviere

Independent Study Project (ISP) Collection

The PLHIV Stigma Index is an ongoing, international study conducted by and for people living with HIV to measure the stigmatization that people living with HIV experience. As a model that has been proven successful in translating to targeted advocacy campaigns, this paper theorizes on how this Stigma Index could be broadened to capture other aspects of healthcare discrimination. With a growing demand for mental health support and a critically underdeveloped mental healthcare framework, understanding the stigma and discrimination that exist for people living with depression is a good place to start. Using mixed methods analysis from existing literature and …

Declining Career Interest In Primary Care In Switzerland And The United States, William Zhang

Independent Study Project (ISP) Collection

Primary care (PC) lies at the center of modern healthcare systems as the primary point of contact between the general public and quality health care. Primary care physicians (PCPs) are known to provide high quality basic care to members of their surrounding community without consuming a large budget, and thus should be a priority for health sector investments. However, the proportion of medical students becoming PCPs is declining across the world, thus putting affordable global health at risk. The U.S. and Switzerland, even with their high health expenditures and advanced healthcare technologies, are no exception to this trend. Analysis of …

A Case Study Investigating Perceptions Of The Covid-19 Vaccine In Cato Manor And Chesterville, Caitlin Chan

Independent Study Project (ISP) Collection

Despite countries all over the world transitioning to life post COVID-19, there are still many aspects of the pandemic that remain controversial and hot topics of debate. Perhaps among one of the most debated subjects is the question of whether vaccinations are necessary and if they truly had an impact on eliminating the virus. The concept of vaccine hesitancy has become a growing concern and threatens the health of communities around the world.

This project employed a mixed-methodology research design to investigate attitudes towards the COVID-19 vaccine constructed by community members living in the townships of Cato Manor and Chesterville. …

Medical Ethics: How Resource Distribution Affects The Decision Making Of Doctors In Rural India: An Explorative And Comparative Study In Jamkhed, Maharashtra, Jared Yee

Independent Study Project (ISP) Collection

Using rural Mahrasthra as a case study, I was able to explore the medical ethics and common dilemmas that occur in Rural India. Through a collection of interviews and articles, I was able to piece together my understanding of some common ethical challenges that India faces, emphasizing ones that were unique to the location and circumstance. Using observations I made through my work in the hospital, I learned that limited resources effects all sides of ethics in the medical field, with a signficinant effect on economics, hospital structure, and clinical protocol. In an attempt to source the aspects of Indian …

The Social Determinants Of Ideal Cardiovascular Health: A Global Systematic Review, Farah Qureshi, Kelb Bousquet-Santos, Sakurako S. Okuzono, Elaine Tsao, Scott Delaney, Anne-Josie Guimond, Julia K. Boehm, Laura D. Kubzansky

Psychology Faculty Articles and Research

This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = …

Socioeconomic And Comorbid Factors Affecting Mortality And Length Of Stay In Covid-19 Patients, Adam Delora, Ashlynn Mills, David Jacobson, Brendon Cornett, William F Peacock, Anita Datta, Shane P Jenks

Faculty, Staff and Students Publications

Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic exposed and exacerbated health disparities between socioeconomic groups. Our purpose was to determine if age, sex, race, insurance, and comorbidities predicted patients' length of stay (LOS) in the hospital and in-hospital mortality in patients diagnosed with coronavirus disease 2019 (COVID-19) during the early pandemic. Methods Utilizing retrospective, secondarily sourced electronic health record (EHR) data for patients who tested positive for COVID-19 from HCA Healthcare facilities, predictors of LOS and in-hospital mortality were assessed using regression. LOS and in-hospital mortality were assessed using logistic regression and negative binomial regression, respectively. All …

Orange County, Fl Substance Use Disorder Treatment Gap Analysis, Amy Donley Phd, Caroline Austin, Jacquelyn Reiss

Institute for Social and Behavioral Science (ISBS)

The University of Central Florida's Institute for Social and Behavioral Science (ISBS) partnered with the Orange County Drug-Free Office to undertake a gap analysis focused on substance use disorder treatment. Specifically, we designed a study to determine the capacity of treatment options, identify barriers to seeking treatment, and illuminate what works particularly well. The gap analysis results can guide future decisions on allocating resources best to ensure that treatment is accessible to all in need.

A Qualitative Exploration Of Social Support In Males And Females Experiencing Issues With Infertility., Maya Pinzon, Shawna Rotoli

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: The purpose of this study was to qualitatively investigate and compare male and female experiences of infertility in the context of social support.

METHODS: A Qualtrics survey (Qualtrics, Provo, Utah, United States) was posted to online fertility support groups and the responses were thematically analyzed. Only participants that completed the qualitative component of the survey were included in the study. Responses were subsequently thematically analyzed.

RESULTS: A sample of 110 participants (13 males and 97 females) were included in the present study. Thematic analyses revealed that isolation and loneliness, stigma, sentiments of misunderstanding, insensitive reactions, and others' unhelpful attempts …

The Lived Social Experience Of Covid-19 Survivors In Southwestern Nigeria, Endurance Uzobo, Ijeoma Nwanwene, Tolulope Funmilola Ojo

Journal of Social, Behavioral, and Health Sciences

The traditional perceptions of disease causation often reinforce the feelings of stigmatization and discrimination towards individuals who have recovered from an illness. This study investigated the existing social practices with regard to stigmatization and discrimination against COVID-19 survivors in Southwest Nigeria. Using the Psychoanalytic Theory, this phenomenological qualitative study utilized the snowball sampling method and an in-depth interview to sample 25 COVID-19 survivors in Southwest Nigeria. Collected data for this study were analyzed thematically, using content analysis with the aid of the ATLAS.ti software. Findings from the study indicated that COVID-19 survivors generally experience sympathy, hostility, mockery, and social exclusion. …

Does Crime Trigger Genetic Risk For Type 2 Diabetes In Young Adults? A G X E Interaction Study Using National Data, Fangqi Guo, Kathleen Mullan Harris, Jason D. Boardman, Jennifer W. Robinette

Psychology Faculty Articles and Research

Background

Living in neighborhoods perceived as disordered exacerbates genetic risk for type 2 diabetes (T2D) among older adults. It is unknown whether this gene-neighborhood interaction extends to younger adults. The present study aims to investigate whether crime, an objectively measured indicator of neighborhood disorder, triggers genetic risk for T2D among younger adults, and whether this hypothesized triggering occurs through exposure to obesity.

Methods

Data were from the Wave I (2008) National Longitudinal Study of Adolescent to Adult Health. A standardized T2D polygenic score was created using 2014 GWAS meta-analysis results. Weighted mediation analyses using generalized structural equation models were conducted …

A Novel Approach To Assessment Of Us Pediatric Trauma System Development., Mary E. Fallat, Colin Traeger, Sophie Humphrey, Lindsey Gumer, Kahir Jawad, Elissa Butler, Frederick B. Rogers, Frederick P. Rivara, Amelia T. Collings

Faculty and Staff Scholarship

Importance Mature trauma systems are critical in building and maintaining national, state, and local resilience against all-hazard disasters. Currently, pediatric state trauma system plans are not standardized and thus are without concrete measures of potential effectiveness.

Objective To develop objective measures of pediatric trauma system capability at the state level, hypothesizing significant variation in capabilities between states, and to provide a contemporary report on the status of national pediatric trauma system planning and development.

Design, Setting, and Participants A national survey was deployed in 2018 to perform a gap analysis of state pediatric trauma system capabilities. Four officials from each …

Development And Pretesting Of Prescription Opioid Misuse Prevention Messages: Results And Implications For Practice, Holli H. Seitz, Mary Nelson Robertson, Je'kylynn Steen, Sarah G. Dulaney, David R. Buys

Publications

Well-designed health communication campaigns can contribute to the uptake of preventive behaviors, but there has been a lack of attention on using communication research to develop opioid misuse prevention messages. We report the results of two studies designed to inform the development of prescription opioid misuse prevention messages for adults ages 30–59. In Study 1, 16 adults across 4 counties participated in semi-structured interviews to provide input on message concepts addressing six key prescription opioid misuse prevention behaviors. In Study 2, 1,335 adults completed an online, survey-based between-subjects experiment in which participants were randomized to a no message control condition …

Hiv And Housing Insecurity In Louisiana, Hui-Peng Liew, Leslie E. Green

Journal of Rural Social Sciences

This study sought to assign the parishes in Louisiana into distinctive spatial-temporal clusters based on their trends in HIV prevalence and percentages of households with severe housing problems and to assess the parish’s resilience and susceptibility to HIV infection given its pre- existing sociodemographic conditions. Results revealed that trends in the HIV prevalence rates and percentages of households with severe housing problems differed across the five distinct spatial-temporal clusters. The percentage of households with severe housing problems and the percentage of non-Hispanic Black population were positively associated with the HIV prevalence rate while the reverse was true for the percentage …

In The Eyes Of The Beholder: Race, Place And Health, Alfredo J. Velasquez, Jason A. Douglas, Fangqi Guo, Jennifer W. Robinette

Psychology Faculty Articles and Research

Racial and ethnic health disparities are fundamentally connected to neighborhood quality. For example, as a result of historical systemic inequities, racial and ethnic minorities are more likely to live in neighborhoods with signs of physical disorder (e.g., graffiti, vandalism), and physically disordered environments have been noted to associate with increased risk for chronic illness. Degree of exposure to neighborhood disorder may alter peoples' perception of their neighborhoods, however, with those most exposed (e.g., historically marginalized racial/ethnic groups) perhaps perceiving less threat from signs of neighborhood disorder. The purpose of the present study was to examine the complex interrelationships between people …

Active Consideration Of Health And Nutritional Quality Of Food Choices, Christopher R. Gustafson

Cornhusker Economics

Everyone can be positively influenced by effective interventions promoting healthier food choices. A handful of recent papers have documented positive impacts on dietary quality resulting from interventions that remind people to consider health through prompt messages or subtle priming in supermarkets and in controlled, online experiments. These studies have focused on the impact of reminders on nutritional quality rather than explaining how reminders work. An exception, Arslain, Gustafson, and Rose (2021), collected data on multiple elements of individuals' choice processes to trace the impact of reminders on decisions, showing that reminder messages led people to consider a healthier set of …

Life In An Endemic Covid-19: Older Adults' Well-Being, Activity, And Perceptions, Rachel Ngu, Micah Tan, Jia Ying Low

ROSA Research Briefs

The current research brief provides a preliminary examination of whether older adults have been able to ‘return’ to the pre-pandemic way of life in an endemic COVID-19. To do this, we look at several key indicators, including (1) tracking older adults’ overall life satisfaction, activity levels, and trust in government over the past 3 years, (2) older adults’ confidence to resume activities, as well as subjective perceptions about their safety when leaving the home in an endemic COVID-19, and (3) older adults’ ability to adhere to the Home Recovery Program (HRP), where individuals with COVID-19 are able to recover from …

Weight Perceptions And Health Education On Obesity Among Older Adults, Seonghoon Kim, Vicky Mengqi Qin, Xuan Zhang, Kanghyock Koh, Mindy Eiko Tadai, Micah Tan

ROSA Research Briefs

The current brief presents preliminary findings from a special module that measures perceptions of weight and receptivity to health education among older adults. Singapore Life Panel® (SLP) data collected in January 2022 (n=2814) were utilized. Two policy recommendations were made: The main findings highlight that weight misperception is prevalent among older adults. More than a third of respondents (39%) incorrectly perceive their weight status, particularly among overweight and obese older adults, as well as Malay and lower educated respondents. This suggests the importance of public health education for older adults to reduce misperceptions about their own over- and under-weight status, …

Our Bodies, Our Stories: Mental And Physical Self Connection As A Protective Factor In Sexual And Gender Minorities, Emerson A. Todd

Electronic Theses and Dissertations

The mind and body connection has been actively examined in neuroscience and developmental psychology backgrounds. Sociological theorists posit ways that individuals develop a sense of self through mind, body, and the social world. While research on the connection between the mind and body in disabled and aging populations is common, less is known of the everyday impact of these connections for other minority populations. The present study uses mixed-methods research to explore the relationship between mind and body and the impacts on internal and social life. The quantitative aspect of the study found significant relationships between physical and mental health …

A Systematic Review Up To 2018 Of Hiv And Associated Factors Among Criminal Justice-Involved (Cji) Black Sexual And Gender Minority Populations In The United States (Us), Russell Brewer, Santhoshini L Ramani, Aditya Khanna, Kayo Fujimoto, John A Schneider, Anna Hotton, Leo Wilton, Tania Escobedo, Nina T Harawa

Faculty, Staff and Student Publications

Black men who have sex with men (BMSM) and Black transgender women (BTW) are impacted by dual epidemics of HIV and incarceration. We advanced understanding of the relationship between criminal justice involvement, HIV, and other key HIV-related characteristics among these key populations in the US. We conducted a systematic review up to 2018 and 47 articles met the inclusion criteria of scientific publications involving quantitative findings of US-based HIV-related studies focused on criminal justice-involved (CJI) BMSM and BTW. Overall, there was a dearth of studies focused specifically on BTW. Criminal justice involvement was relatively high among BMSM and BTW and …