Public Health Commons^™

Examining Young Adult E-Cigarette Users By Device Type: A Latent Class Analysis, Mufazzela Tabassum

Health, Human Performance and Recreation Undergraduate Honors Theses

Examining Young Adult E-Cigarette Users by Device Type: A Latent Class Analysis

Purpose. This study examined which factors influence the type(s) of e-cigarette devices someone uses and if there are heterogeneous groups of young adult e-cigarette users.

Methods. This study first quantitatively explored if there are heterogeneous groups of e-cigarette users by utilizing data from an online cross-sectional survey. E-cigarette users (n = 595) were able to participate in the survey if they were 18-29 years of age, used an e-cigarette for 1-5 days in the past 30 days, own their own e-cigarette, and live in the United States. Participants …

Predictive Power Of Wastewater For Nowcasting Infectious Disease Transmission: A Retrospective Case Study Of Five Sewershed Areas In Louisville, Kentucky, Fayette Klaassen, Rochelle H. Holm, Ted Smith, Ted Cohen, Aruni Bhatnagar, Nicolas A. Menzies

Faculty Scholarship

Background: Epidemiological nowcasting traditionally relies on count surveillance data. The availability and quality of such count data may vary over time, limiting representation of true infections. Wastewater data correlates with traditional surveillance data and may provide additional value for nowcasting disease trends. Methods: We obtained SARS-CoV-2 case, death, wastewater, and serosurvey data for Jefferson County, Kentucky (USA), between August 2020 and March 2021, and parameterized an existing nowcasting model using combinations of these data. We assessed the predictive performance and variability at the sewershed level and compared the effects of adding or replacing wastewater data to case and death reports. …

Data Quality: Integral To Cauti Surveillance And Improvement In Non-Critical Care Units, Mary Grace Daria

Master's Projects and Capstones

Background: Urinary tract infections (UTIs) are the most common type of healthcare-acquired infection (HAI), with 75% approximately associated with urinary catheter use. The key to preventing UTIs is to avoid the use of indwelling urinary catheters (IUCs). This study explores denominator data extract logic modifications to increase IUC data capture and accuracy. It is set in a 249-bed acute care, teaching hospital in the Diablo Service Area in Northern California.

Problem: The electronic system used to extract the CAUTI denominator data is inconsistently capturing the IUC device days from the electronic medical record (EMR). This has regulatory reporting ramifications and …

Toxic Fashion: Evaluation Of Chemicals In Clothing And Recommendations For The Amended Tsca, Gregory Zajac

Master's Projects and Capstones

The fashion industry is one of the largest polluting industries in the world and its rising environmental impact is partly due to the dominance of fast fashion business models. Recently researchers and advocates have found that large amounts of chemicals are used by textile manufacturers to produce clothing, some proven to be toxic in other applications. The risk of exposure to these classes of chemicals is a growing concern. With the risk management model, a qualitative examination was conducted on existing policies in the United States that regulate chemicals used by the industry. Despite some policy changes regarding chemical exposure …

Improving Intimate Partner Violence Screening In A Women’S Health Practice Through Implementation Of An Evidence-Based Screening Tool, Jasmine Weber

Doctor of Nursing Practice Projects: College of Nursing

The purpose of this quality improvement project was to implement intimate partner violence screening in an outpatient women’s health clinic with no prior screening process in place. Current recommendations are to screen all reproductive age women for intimate partner violence 6 . During a three-month period 170 patients out of 260 eligible patients were screened using the HARK screening tool, 7 of those patients screened positive and were offered referrals to social work. While universal IPV screening was not achieved, a screening rate of 64% is a remarkable improvement from an apparent absence of screening prior to project implementation.

Effect Of The Announcement Of Human-To-Human Transmission On Teleconsultation Services In China During Covid-19, Mairehaba Maimaitiming, Jingui Xie, Zhichao Zheng, Yongjian Zhu

Research Collection Lee Kong Chian School Of Business

Objectives: Telemedicine enables patients to communicate with physicians effectively, especially during the coronavirus disease (COVID-19) pandemic. However, few studies have explored the use of online health care platforms for a comprehensive range of specialties during the COVID-19 pandemic. This study aimed to investigate how telemedicine services were affected by the announcement of human-to-human transmission in China. Methods: Telemedicine data from haodf.com in China were collected. A difference-in-differences analysis compared the number of telemedicine use and the number of active online physicians for different specialties in 2020 with the numbers in 2019, before and after the announcement of human-to-human transmission. Results: …

‘It’S Been A Lifelong Thing For Me’: Parents’ Experiences Of Facilitating A Healthy Lifestyle For Their Children With Severe Obesity, Liz A. Saunders, Ben Jackson, Lisa Y. Gibson, Justine Doust, James A. Dimmock, Elizabeth A. Davis, Lyndsey Price, Timothy Budden

Research outputs 2022 to 2026

Objective: For parents and guardians, assisting children/adolescents with severe obesity to lose weight is often a key objective but a complex and difficult challenge. Our aim in this study was to explore parents’ (and guardians’) perspectives on the challenges they have faced in assisting their children/adolescents with severe obesity to lead a healthy lifestyle. Methods: Thirteen parents/guardians were interviewed from a pool of families who had been referred but did not engage between 2016 and 2018 (N = 103), with the Perth Children’s Hospital Healthy Weight Service, a clinical obesity program for children/adolescents (parent age M = 43.2 years, children …

The Psychological Science Accelerator's Covid-19 Rapid-Response Dataset, Erin M. Buchanan, Andree Hartanto

Research Collection School of Social Sciences

In response to the COVID-19 pandemic, the Psychological Science Accelerator coordinated three large-scale psychological studies to examine the effects of loss-gain framing, cognitive reappraisals, and autonomy framing manipulations on behavioral intentions and affective measures. The data collected (April to October 2020) included specific measures for each experimental study, a general questionnaire examining health prevention behaviors and COVID-19 experience, geographical and cultural context characterization, and demographic information for each participant. Each participant started the study with the same general questions and then was randomized to complete either one longer experiment or two shorter experiments. Data were provided by 73,223 participants with …

Greater Traditionalism Predicts Covid-19 Precautionary Behaviors Across 27 Societies, Theodore Samore, D. M. T. Fessler, A. M. Sparks, C. Holbrook, L. Aaroe, Norman P. Li, Kai Lin Lynn Tan, Et Al

Research Collection School of Social Sciences

People vary both in their embrace of their society’s traditions, and in their perception of hazards as salient and necessitating a response. Over evolutionary time, traditions have offered avenues for addressing hazards, plausibly resulting in linkages between orientations toward tradition and orientations toward danger. Emerging research documents connections between traditionalism and threat responsivity, including pathogen-avoidance motivations. Additionally, because hazard-mitigating behaviors can conflict with competing priorities, associations between traditionalism and pathogen avoidance may hinge on contextually contingent tradeoffs. The COVID-19 pandemic provides a real-world test of the posited relationship between traditionalism and hazard avoidance. Across 27 societies (N = 7844), we …

Frailty And Pain In An Acute Private Hospital: An Observational Point Prevalence Study, Rosemary Saunders, Kate Crookes, Karla Seaman, Seng Giap Marcus Ang, Caroline Bulsara, Max K. Bulsara, Beverley Ewens, Olivia Gallagher, Renée Graham, Karen Gullick, Sue Haydon, Jeff Hughes, Kim-Huong Nguyen, Bev O’Connell, Debra Scaini, Christopher Etherton-Beer

Research outputs 2022 to 2026

Frailty and pain in hospitalised patients are associated with adverse clinical outcomes. However, there is limited data on the associations between frailty and pain in this group of patients. Understanding the prevalence, distribution and interaction of frailty and pain in hospitals will help to determine the magnitude of this association and assist health care professionals to target interventions and develop resources to improve patient outcomes. This study reports the point prevalence concurrence of frailty and pain in adult patients in an acute hospital. A point prevalence, observational study of frailty and pain was conducted. All adult inpatients (excluding high dependency …

Life In A Time Of Covid: Retrospective Examination Of The Association Between Physical Activity And Mental Well-Being In Western Australians During And After Lockdown, Ben Piggott, Paola Chivers, Kiira Karoliina Sarasjärvi, Ranila Bhoyroo, Michelle Lambert, Lynne Millar, Caroline Bulsara, Jim Codde

Research outputs 2022 to 2026

Background: The aim of this study was to examine physical activity and sedentary behaviours during Western Australia’s COVID-19 lockdown and their association with mental well-being. Methods: Participants completed activity related questions approximately two months after a three-month lockdown (which formed part of a larger cross-sectional study from August to October 2020) as part of a 25-minute questionnaire adapted from the Western Australia Health and Well-being Surveillance system. Open-ended questions explored key issues relating to physical activity behaviours. Results: During the lockdown period, 463 participants (female, n = 347; 75.3%) reported lower number of active days (W = 4.47 p < .001), higher non-work-related screen hours per week (W = 11.8 p < .001), and higher levels of sitting time (χ2=28.4 p <. 001). Post lockdown body mass index was higher (U = 3.0 p =.003), with obese individuals reporting the highest non-work-related screen hours per week (Wald χ2= 8.9 p =.012). Inverse associations were found for mental well-being where higher lockdown scores of Kessler-10 (p =.011), Dass-21 anxiety (p =.027) and Dass-21 depression (p =.011) were associated with lower physical activity levels. A key qualitative message from participants was wanting to know how to stay healthy during lockdown. Conclusions: Lockdown was associated with lower physical activity, higher non-work-related screen time and more sitting time compared to post lockdown which also reported higher body mass index. Lower levels of mental well-being were associated with lower physical activity levels during lockdown. Given the known positive affect of physical activity on mental well-being and obesity, and the detrimental associations shown in this study, a key public health message should be considered in an attempt to maintain healthy activity behaviours in future lockdowns and similar emergency situations to promote and maintain positive well-being. Furthermore, consideration should be given to the isolation of a community due to infectious disease outbreaks and to recognise the important role physical activity plays in maintaining weight and supporting good mental health.

Perspectives Of Health Service Providers In Delivering Best-Practice Care For Aboriginal Mothers And Their Babies During The Postnatal Period, Jocelyn Jones, Angela Durey, Natalie Strobel, Kimberley Mcauley, Karen Edmond, Juli Coffin, Daniel Mcaullay

Research outputs 2022 to 2026

Background: Evidence suggests that Aboriginal babies in Western Australia are not receiving adequate primary health care in their first 3 months of life, leading to questions about enablers and constraints to delivering such care. This paper presents findings from a qualitative research project investigating health providers’ perceptions and experiences of best and current practice in discharge planning, postnatal care and health education for Aboriginal mothers and their newborn babies. Methods: Constructivist grounded theory guided this research involving 58 semi-structured interviews conducted with health providers who deliver care to Aboriginal mothers and infants. Participants were recruited from hospital-based and primary health …

Exploring The Associations Between Sexism, Physical Behaviors, And Psychosocial Correlates Of Physical Activity In Young Women, Melanna Cox

Doctoral Dissertations

Physical behaviors (PB), defined as physical activity (PA) and sedentary behavior (SB), tend to be less favorable in women than in men. Low self-efficacy (SE) and social support (SS), and gender norms hinder women’s PB. Benevolent sexism, a theory on gender norms, could explain the gender disparity. PURPOSE: To 1) assess the associations among benevolent sexism endorsement (BSEN), experiences with benevolent sexism (EBS), PB, SE, and SS, 2) evaluate if BSEN or SE mediate the relationship between EBS and PB, and 3) develop a questionnaire that measures a woman’s sexist experiences in PA. METHODS: Study 1: Women (N=186) completed a …

Mining High Impact Combinations Of Conditions From The Medical Expenditure Panel Survey, Arjun Mohan

Masters Theses

The condition of multimorbidity — the presence of two or more medical conditions in an individual — is a growing phenomenon worldwide. In the United States, multimorbid patients represent more than a third of the population and the trend is steadily increasing in an already aging population. There is thus a pressing need to understand the patterns in which multimorbidity occurs, and to better understand the nature of the care that is required to be provided to such patients.

In this thesis, we use data from the Medical Expenditure Panel Survey (MEPS) from the years 2011 to 2015 to identify …

Adverse Childhood Experiences And Current Cannabis Use Among U.S. Young Adults, Afolakemi C. Olaniyan, Keith A. King, Laura A. Nabors, Ashley L. Merianos

Health Behavior Research

Cannabis use is a significant public health issue among U.S. young adults. The objective of this study was to assess the associations between adverse childhood experiences (ACEs) and current cannabis use among U.S. young adults. We conducted a secondary analysis of the 2021 Behavioral Risk Factor Surveillance System (BRFSS) data, which involved 498 U.S. young adults 18-24 years old who had data available for analysis on ACEs and current cannabis use. Unadjusted and adjusted logistic regression models were fitted to examine the associations between ACEs and current cannabis use. Adjusted models included participants’ sex, race/ethnicity, education level, and household income …

Psychometric Properties Of The Adolescent And Young Adult Men – Health Indicators Scale (Ayam-His), Michael J. Rovito, Shari Dworkin, Keri Allen, Kathy E. Rovito, Sydney Martinez

Health Behavior Research

The goal of this current study was to evaluate the psychometric properties of the AYAM-HIS among a select sample of AYAMs, a priority population experiencing disparate health outcomes compared to women. These preliminary results indicate that AYAM-HIS yielded reliable and valid data, thus providing a means to measure indicators of health behaviors and possible outcomes within this population. The AYAM-HIS can provide the necessary information to assess current health behaviors so as to provide a foundation from which interventions can be designed. Future research into reducing survey fatigue related to AYAM-HIS and testing with diverse populations are warranted.

Sociodemographic Factors Influencing Pandemic-Era Ehdi Use And Access, Nicole Perez, David Adkins, Marissa Schuh, Jennifer B. Shinn, Lori Travis, Matthew L. Bush

Journal of Early Hearing Detection and Intervention

Objective: The COVID-19 pandemic impact on Early Hearing Detection and Intervention (EHDI) programs is unknown. This research evaluated sociodemographic factors influencing adherence to EDHI diagnostic testing and the incidence of infant hearing loss during the pandemic.

Method: We evaluated EHDI adherence and incidence of hearing loss in Kentucky before and during the COVID-19 pandemic. Using univariate and multivariate analysis, we evaluated the association of these outcomes to sociodemographic variables.

Results: There were 71,206 births and 1,385 referred infant hearing screening tests during the study period. Infants during the pandemic had a 24% lower odds of hearing testing adherence (OR …

Factors Contributing To Late Identification Of Deaf/Hard Of Hearing Children In Louisiana, Danielle D. Mercer, Tri Tran, Dawne Mccabe, Terri Ibieta, Dana Hubbard

Journal of Early Hearing Detection and Intervention

To ensure children who are Deaf/Hard of Hearing (D/HH) receive supports they need to reach their full potential, it is imperative that they be identified as early as possible. Early Hearing Detection and Intervention benchmarks stipulate children who are D/HH be enrolled in early intervention no later than 6 months of age. A major barrier to early enrollment is late identification. We reviewed records of children identified as D/HH in Louisiana after 6 months of age for 2015-2020 birth cohorts to determine factors contributing to the late identification. Cases were examined in-depth after it was determined that a diagnosis was …

Strategy For Expanding Nutrition Professionals’ Competency: A Pilot Case Study In Dissemination And Implementation Science Training, Ayron E. Walker, Elizabeth A. Claydon, Samantha E. Scarneo-Miller, Daniel Totzkay, Melissa D. Olfert

Health Behavior Research

Dissemination and Implementation (D&I) science trainings are essential to build knowledge among a variety of current and future health professionals.

The objective of this study was to pilot-test and assess implementation of a nutrition-specific D&I science training.

Participants (students enrolled in nutrition and public health programs) completed pre/post surveys and exit interviews. Descriptive statistics and a qualitative thematic analysis used deductive coding; in which coding and theme development are directed by existing concepts. Initial coding was completed by one researcher and validated by an additional researcher to describe and provide examples of the categories the Kirkpatrick Model and Implementation Outcomes …

A Primary Qualitative Study Exploring Adult Bame Individuals' Experiences Regarding Physical Activity From The North-East Of England During The Covid-19 Pandemic, Johnson Mbabazi, Fiona Macgregor, Jeff Breckon, Barry Tolchard, Edward Kunonga, Dorothy Irene Nalweyiso, Abiola Fashina, Lawrence Achilles Nnyanzi

International Journal of Physical Activity and Health

Researchers have found that people from BAME communities have worse health outcomes from many health interventions and face health disparities. BAME individuals experience health inequities and lower health intervention results. The experiences of adult Teesside-based BAME individuals' regarding physical activity (PA) during the COVID-19 pandemic were mapped onto the capability, opportunity, and motivation model of behaviour (COM-B). Twelve adult BAME participants were interviewed using semi-structured interviews that lasted 40 to 60 minutes and captured participant perceptions of how their PA and perceptions related to living a healthy PA lifestyle during the pandemic between April and August 2022 via Microsoft Teams. …