Community Health Commons^™

Association Of Unmet Social Needs With Disease-Related Outcomes In Pediatric Patients With Sickle Cell Disease, Molly Sonenklar, Sarah Marks, Cerelia Donald, Cecelia Valrie, Wally Smith, India Sisler

School of Medicine Faculty Publications

Background: Social determinants of health (SDoH) are socioeconomic factors that influence health and well-being, though when unmet can greatly contribute to health disparities. Individuals with sickle cell disease (SCD) are at increased risk of mortality, disability, and healthcare utilization. However, there are limited data linking specific social needs with disease outcomes in this population. Therefore, we sought to identify the unmet needs in one institution and their association with healthcare utilization. Methods: Children with SCD and their guardians answered demographic and SDoH questionnaires during routine Sickle Cell Clinic appointments. We defined an unmet social need as any positive answer to …

Understanding Provider Competency In Gender Affirming Care, Vanessa Castle, Lindsay Gietzen

Pacific Journal of Health

Lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual plus (LGBTQ+) individuals, especially transgender patients, face many healthcare disparities. It is extremely important for them to have access to high-quality healthcare, particularly Gender Affirming Care (GAC), to support their well-being and mental health. However, many healthcare providers, including clinical social workers, NPs, PAs, and MDs lack proper training to offer GAC. The current training opportunities available are often basic and lack comprehensive, detailed information. To reduce healthcare barriers for the transgender and gender-diverse community, we must have comprehensive training on GAC available for providers so they can treat their patients with …

Occupation-Based Programming For An Addiction Recovery Program, Mckenna Howard, Susan Macdermott Otd, Otr/L

Fall 2024 OTD Capstone Symposium

Addiction can impact engagement in many different occupations and occupational therapists can assist in returning to engagement in meaningful occupations. This capstone project focused on creating occupation-based programming for an addiction recovery program. This program aims to enhance engagement, skills, and confidence in daily occupations to promote overall well-being during recovery.

Understanding And Intervening In Children's Tick Risk Perceptions And Protective Behaviors: A Grounded Theory, Ariel Dawdy

Department of Entomology: Dissertations, Theses, and Student Research

Children, ages 8 years and younger, are at a particularly high risk of contracting a tick-borne disease. This is partially due to the misconceptions spread about tick protective behavior and a poor understanding of how antibiotic treatment can help. Because most communities and families believe that tick control is the individual’s responsibility, looking at the interaction between ticks and human children is essential to understanding the individual’s motivations to protect themselves. To help alleviate the number of individuals contracting tick-borne diseases, misconceptions must be addressed, intervention programs implemented, and a behavioral change must occur. This study used a qualitative research …

Addressing The Public Health Concern Of Maternal Mortality In Houston, Texas, Lucy Couture

Dissertations and Theses (Open Access)

Maternal mortality remains a pressing public health concern in the United States, with disproportionate consequences for marginalized communities. Despite being a developed nation, the U.S. reports one of the highest maternal mortality rates among its peers, with approximately 80% of maternal deaths deemed preventable. Texas reflects this national crisis, particularly affecting Black women, whose maternal mortality rate is significantly higher than that of other racial and ethnic groups. This thesis explores maternal mortality trends in Houston, Texas, analyzing the roles of systemic inequities, social determinants of health, and disparities in access to quality care. Drawing on data from the Texas …

Obesity: Influencing Behavioral Consumption Through Meal Kit Distribution, Alejandro Hernandez

Capstone Projects and Master's Theses

Founded in 2002, Everyone’s Harvest is a grassroots nonprofit dedicated to providing access to healthy, affordable fruits and vegetables through certified farmers markets and community food programs. Its key initiatives—Fresh Rx, Market Match, Edible Education and Farms Together —focus on alleviating nutrition insecurity and combating diet-related health conditions by providing vulnerable populations the resources to purchase, or receive, fresh produce and gain nutritional knowledge. This study explores a new intervention: the distribution of farmers' market meal kits as a complementary strategy to the current Edible Education program. These meal kits, which feature seasonally available produce and pre-measured ingredients, aim to …

Volunteering For Medically Underserved Children: Clinic With A Heart–Back-To-School Clinics, Isabella Marie Kerby Kessinger

Honors Program: Senior Projects (Public)

Medically underserved children, often from low-income families or areas with limited healthcare resources, face significant barriers in accessing essential medical services and represent a fundamental challenge to equity and social justice. School physicals and back-to-school clinics play a crucial role in addressing these healthcare needs, serving as a gateway to educational and extracurricular opportunities.

Clinic With a Heart (CWH), a non-profit medical and dental clinic in Lincoln, Nebraska, serves as a model for addressing healthcare disparities. In 2023, CWH provided 3,109 visits to 1,846 unique patients, with 83% lacking health insurance and 63% having household incomes below $16,000 annually. The …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Bridging The Gap: Fostering Open Dialogue On Resource Access And Service Needs, Cameron Castillo

Capstone Projects and Master's Theses

This project investigates whether there are additional resources desired by clients or are needed to better support said clients in their recovery at the Interim, Inc. organization. This agency is a nonprofit organization whose sole purpose is to build community connections through providing services to individuals facing mental health and substance use challenges. While there is a wide range of programs available, there may still be clients with unmet needs. The purpose of this project was to identify any service gaps by conducting separate surveys of clients and staff members. Through the use of open-ended questions, the expectation of receiving …

Interprofessional Approach To Anxiety And Depression, John M. Sedrak, Benjamin Jones, Dominique Denbow, Ezra Aistrop-Gormley

CAIEP Fall Showcase 2024

A multidisciplinary approach for treating a patient from El Paso, Texas, with complex social and psychiatric challenges, including comorbid depression and anxiety. She faces limited access to resources, a sparse support system, and escalating social barriers. Environmental stressors, such as traffic pollution that exacerbates her asthma, and minimal community engagement further impact her mental health. An interprofessional care plan included mental health counseling, community outreach to enhance social support, and medical management to comprehensively address her interconnected health needs.

Who Cares For The Caregiver? Exploring Extension’S Role In Informal Caregiving Support, Mckenzie R. Tuttle, Erin L. Martinez, Aimee Fox

Journal of Extension

Family caregivers provide invaluable service by taking on the responsibility of caring for older adults in the United States. With a growing aging population, the need for family caregivers and demands on their time and resources will continue to increase. Although a variety of caregiving resources and support services exist, family caregivers often lack the awareness, time, transportation, or financial resources to connect to services. There is a critical need to address the barriers that prevent caregivers from accessing services. In this commentary, we highlight barriers and make recommendations for improving conversations, research, and practice to meet this growing problem.

Impacting Community Well-Being Through Effective Engagement Using The Seed Method, Carlin Rafie, Emily B. Zimmerman, Angelina Hargrove, Theodora Biney Amissah, Samantha Lee

Journal of Extension

Cooperative Extension can make a significant impact on health in the United States through effective community engagement that focuses on the complex socio-ecological factors that impact health. The Stakeholder Engagement in Question Development Method (SEED Method) employs community based participatory research principles to engage communities in research, problem-solving, and action planning. Projects employing the SEED Method engage community members from diverse backgrounds, create community capacity, result in tangible outcomes, and foment inter-organizational trust and networking. A SEED Toolkit is available on the Extension Foundation Campus site and provides implementation instructions, tools and timelines, and potential applications within Extension.

Post-Pandemic Needs Of Unpaid Family And Friend Caregivers To Effectively Continue Caregiving Duties In One Northern Ontario Health Authority, Jodi Webber, Erin Mulroney, Mark Tatasciore, Brianna Smith, Patti-Jo Duggan, Louis Ferron, Hannah Albani, Bianca Feitelberg, Laura Tenhagen, Sophia Myles

Patient Experience Journal

The Covid-19 pandemic had a significant impact on the support networks for older adults and caregivers as health and social care systems were forced to dramatically change the ways patients and clients interacted with providers, services, and programs. In Northern Ontario, caregivers are older, caring in more intense situations, more likely to be caring for multiple care recipients simultaneously and less likely to be in contact with health professionals. This research sought to explore the post-pandemic needs of caregivers in a Northern Ontario health catchment to better understand the needed supports. Using a collaborative and co-design approach with caregiver advisors …

Preferences For Starting Daily, On-Demand, And Long-Acting Injectable Hiv Preexposure Prophylaxis Among Men Who Have Sex With Men In The United States (2021-2022): Nationwide Online Cross-Sectional Study, Duygu Islek, Travis Sanchez, Jennifer L. Glick, Jeb Jones, Keith Rawlings, Supriya Sarkar, Patrick S. Sullivan, Vani Vannappagari

School of Public Health Faculty Publications

BACKGROUND: Long-acting (LA) injectable preexposure prophylaxis (PrEP) and on-demand PrEP may improve overall PrEP uptake among men who have sex with men (MSM), but little is understood about the PrEP option preferences of MSM in practical scenarios where they may choose between various PrEP options. OBJECTIVE: This study aims to examine the preferences for starting various PrEP options among a US nationwide online convenience sample of MSM from September 2021 to February 2022. METHODS: Participants reporting no prior HIV diagnosis were provided brief descriptions of each PrEP option and were asked, "If [PrEP option] were available from your local doctor …

Examining Ptsd Prevalence Among Underserved Populations In The Integrated Community Mental Health Setting 2019 To 2022, Siran Koroukian, Stephen Zyzanski, Kurt C. Stange

Faculty Scholarship

Background: The prevalence of Post Traumatic Stress Disorder (PTSD) has been rising since the start of the COVID-19 pandemic, and affects females, sexual and gender minorities, and individuals with social risks at higher rates. Objective: This study examines if the prevalence of PTSD increased from 2019 to 2022 among patients who received care in a national network of safety-net, community-based health centers with integrated behavioral health programs that serve patients at high risk for PTSD. Methods: We analyzed electronic health record data from patients with 1 or more behavioral health visits during 2019 to 2022 using repeated cross-sectional data to …

A Pilot Randomized Clinical Trial Of A Smartphone-Based Application To Support At-Home Psa Screening And Culturally Tailored Prostate Cancer Education For African American Men: A Study Protocol, Jordan Neil, Bingjing Mao, Ruosi Shao, E. Ogunsanya Motolani, Summer Frank-Pearce, Michael Businelle, Michael Cookson, Kelly Stratton, Mark Doescher, Stephanie Pharr, Valerie Moise, Brianna Fleshman, Jack Fronheiser, Kimberly Estrada, Iván Flores, David Bradley, Ashley Kendrick, Adam C. Alexander

School of Public Health Faculty Publications

Background: Prostate cancer is the most diagnosed cancer in Black/African American men (AA) and the second‑leading cause of cancer-related deaths. A prostate-specific antigen (PSA) blood test is an early detection screening tool for prostate cancer, but uptake of PSA screening remains low among AA men. Greater PSA screening rates among AA men, coupled with earlier treatment, may reduce disparities in prostate cancer outcomes, including mortality. The current pilot study will test the first-of-its-kind mobile health (mHealth) app to improve prostate cancer knowledge and increase PSA screening uptake among AA men using home-based screening methods. Methods: AA men aged 55 to …

Health Outcomes Reported By Healthcare Providers And Clients Of A Community-Based Medically Tailored Meal Program, Jessica M Sautter, Jule Anne Henstenburg, Adrian Glass Crafford, Ian Rowe-Nicholls, Victor S Diaz, Kaitlyn Ann Bartholomew, Julia S Evans, Maria R Johnson, Jeffrey Zhou, Deeksha Ajeya

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Medically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA).

METHODS: Clients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients' …

Successful Application Of Craniosacral Therapy In A Case Of Colic In An 8-Week-Old Baby, Caro O’Neill, Angie Butterfield

Journal of Transformative Touch

This case study reports on the effectiveness of CranioSacral Therapy (CST) for an eight-week-old baby boy experiencing colic. A CST pediatric protocol was utilized during two sessions, a week apart, in May 2023. An improvement in symptoms was recorded after the first treatment. After the second treatment the baby was no longer presenting with symptoms related to infant colic. This case suggests that CST can be an effective support for babies experiencing infant colic.

Word count: 75

Summary Of: Reaching Structurally Vulnerable Populations Using Low-Barrier Covid-19 Testing Clinics Co-Created With Community Based Organizations, David Ngandu, Gloria Sclar, Ambia Ahmed, Sumayo A Awale, Caroline Fernandes, Joshua Goldstein, Hina Hashmi, Shruti Joshi, Et Al.

Northern New England Clinical & Translational Research

The COVID-19 pandemic disproportionately affected people from structurally vulnerable communities. There was a need to improve COVID-19 testing in these communities to reduce viral spread and connect to treatment.

Study @ "Reaching Structurally Vulnerable Populations Using Low-Barrier COVID-1" by David Ngandu, Gloria D Sclar et al.

Socio-Economic Disparities In Prenatal Prognosis And Intervention Accessibility, Simona Raluca Iacoban, Madalina Piron Dumitrascu, Camil Laurentiu Bohiltea, Ioan Dumitru Suciu, Silviu Cristian Voinea, Nicolae Suciu

Journal of Mind and Medical Sciences

Objectives. This study aimed to assess the impact of socio-economic factors on prenatal care accessibility and outcomes and to evaluate the effectiveness of specialized integrative prenatal care in mitigating these disparities. Materials and Methods. A prospective cohort study was conducted between 2020 and 2023 in Bucharest, Romania, involving 100 pregnant women. Participants were equally divided into two groups that received standard and specialized prenatal care. Data were collected through structured interviews, medical record reviews, and standardized questionnaires at multiple time points during pregnancy and postpartum. Results. Women receiving integrative care had longer gestation periods (37.8 vs. 37.6 weeks), higher average …