Community Health and Preventive Medicine Commons^™

Investigating Black Emerging Adult Health And Model Of Care Choices, Alexandra Wynn

Theses and Dissertations

This mixed methods study aimed to analyze the health profiles of Black emerging adults (who do not seek medical care for chronic condition management) college students to identify factors influencing their use of preventive services and their choices in healthcare plans. The study revealed distinct profiles of Black emerging adults based on patterns of factors related to their engagement with healthcare, such as barriers to care, insurance access, usual source of care, self-rated health, intention to seek care, discrimination, trust in physician, medical mistrust, and sex-assigned at birth. Interviews were conducted to investigate the similarities and differences among all participants …

Acceptability Of Anal Human Papillomavirus Home Self-Sampling And Clinician Sampling Among Sexual And Gender Minority Individuals In Milwaukee, Wisconsin: The Prevent Anal Cancer Self-Swab Study, Jenna Nitkowski, Anna R Giuliano, Tim Ridolfi, Elizabeth Chiao, Maria E Fernandez, Vanessa Schick, Michael D Swartz, Jennifer S Smith, Alan G Nyitray

Faculty, Staff and Student Publications

Purpose: Anal cancer has disproportionately high incidence among sexual minority men. We compared acceptability of home versus clinic human papillomavirus (HPV) anal swabbing.

Methods: The Prevent Anal Cancer Self-Swab Study recruited sexual and gender minority individuals in Milwaukee, Wisconsin. Eligible participants were randomized to a home or clinic arm. Home participants received a mailed anal HPV self-sampling kit. Clinic participants attended a clinic appointment where a clinician collected an anal HPV swab. We examined acceptability (overall thoughts, comfort with method, pain, and future willingness to swab) of home versus clinic swabbing using postswab survey responses.

Results: A total of 191 …

Hpv Vaccination In Africa In The Covid-19 Era: A Cross-Sectional Survey Of Healthcare Providers' Knowledge, Training, And Recommendation Practices, Joel Fokom Domgue, Issimouha Dille, Sharon Kapambwe, Robert Yu, Freddy Gnangnon, Lameck Chinula, Gad Murenzi, Nomonde Mbatani, Mala Pande, Fatoumata Sidibe, Joseph Kamgno, Bangaly Traore, Hicham El Fazazi, Mamadou Diop, Pierre-Marie Tebeu, Mohenou Isidore Diomande, Fabrice Lecuru, Isaac Adewole, Marie Plante, Partha Basu, Jean-Marie Dangou, Sanjay Shete

Faculty, Staff and Student Publications

INTRODUCTION: Although the burden of cervical cancer in Africa is highest, HPV vaccination coverage remains alarmingly low in this region. Providers' knowledge and recommendation are key drivers of HPV vaccination uptake. Yet, evidence about providers' knowledge and recommendation practices about the HPV vaccine against a backdrop of emerging vaccine hesitancy fueled by the COVID-19 pandemic is lacking in Africa.

METHODS: A cross-sectional study was conducted in 2021-2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior training, the availability of the HPV vaccine in their practice, whether they recommended the HPV vaccine, …

Association Of Risk Factors And Comorbidities With Chronic Pain In The Elderly Population, Neil Mookerjee, Nicole Schmalbach, Gianna Antinori, Subhadra Thampi, Dylan Windle-Puente, Amy Gilligan, Ha Huy, Megha Andrews, Angela Sun, Roshni Gandhi, William Benedict, Austin Chang, Ben Sanders, Justin Nguyen, Maanika Reddy Keesara, Janet Aliev, Aneri Patel, Isaiah Hughes, Ian Millstein, Krystal Hunter, Satyajeet Roy

Faculty, Staff and Student Publications

INTRODUCTION/OBJECTIVE: Chronic pain disorders affect about 20% of adults in the United States, and it disproportionately affects individuals living in the neighborhoods of extreme socioeconomic disadvantage. In many instances, chronic pain has been noted to arise from an aggregation of multiple risk factors and events. Therefore, it is of importance to recognize the modifiable risk factors. The aim of this study was to investigate the comorbid medical conditions and risk factors associated with chronic pain disorders in patients aged 65 years and older.

METHODS: Our team retrospectively reviewed medical records of elderly patients (65 years and older) who were evaluated …

Beyond Borders: Exploring The Lived Experiences Of International Migrant Women In Nigeria, A Deep Dive Into Healthcare Realities And Utilization, Juliet Nwafor, Rowland Edet, Ezebunwa Nwokoch

Department of Sociology: Faculty Publications

This study explored access to and utilization of healthcare facilities among migrant women in an urban slum community in Nigeria, focusing on factors influencing healthcare-seeking behaviors and the implications for public health interventions. A qualitative case study-oriented research design was employed, involving in-depth interviews with 21 migrant women of reproductive age and 4 key informant interviews with healthcare workers in the Ayobo community of Lagos State, Nigeria. Data collection occurred from June to September 2018, and thematic analysis was used to interpret the findings. Three main themes emerged: living conditions, pattern of healthcare utilization, and factors influencing accessibility and utilization …

Optimizing The Community Health Worker (Chw) Program In Belize And Understanding Its Unique Intermediary Position Within The Health System: Perspective From The World Health Organization (Who) Health Systems Approach, Andrei R. Chell

Electronic Theses & Dissertations (2024 - present)

Human resources for health (HRH) are the backbone of a well-functioning and resilient health system. Issues related to HRH recruitment, retention, planning, leadership and governance have been amplified by the coronavirus disease 2019 (COVID-19) pandemic and have posed additional and unprecedented challenges in many countries. Community health workers (CHWs) in particular, are uniquely positioned to be frontline health care workers (HCWs) that are considered a vital link between communities and the formal health system. Globally, the benefits of CHW programs have been well documented, and there is substantial evidence of the efficacy and effectiveness of these programs. However, countries are …

Post-Covid-19 Cognitive Symptoms In Patients Assisted By A Teleassistance Service: A Retrospective Cohort Study, Lívia Paula Freire Bonfim, Thais Rotsen Correa, Bruno Cabaleiro Cortizo Freire, Thais Marques Pedroso, Daniella Nunes Pereira, Thalita Baptisteli Fernandes, Luciane Kopittke, Clara Rodrigues Alves De Oliveira, Antonio Lucio Teixeira, Milena Soriano Marcolino

Faculty, Staff and Student Publications

INTRODUCTION: Four years after the onset of the COVID-19 pandemic, the frequency of long-term post-COVID-19 cognitive symptoms is a matter of concern given the impact it may have on the work and quality of life of affected people.

OBJECTIVE: To evaluate the incidence of post-acute COVID-19 cognitive symptoms, as well as the associated risk factors.

METHODS: Retrospective cohort, including outpatients with laboratory-confirmed COVID-19 and who were assisted by a public telehealth service provided by the Telehealth Network of Minas Gerais (TNMG), during the acute phase of the disease, between December/2020 and March/2022. Data were collected through a structured questionnaire, applied …

Factors Associated With Hepatitis C-Related Hospitalizations And Inpatient Mortality In The United States, Pre- And Post-Onset Of The Covid-19 Pandemic, Christina R. Samuel

College of Graduate Studies: Theses & Dissertations

Background: Hepatitis C is a significant public health problem in the United States and imposes a substantial burden on the healthcare system. Previous research shows that the COVID-19 pandemic response efforts have overshadowed hepatitis C testing and treatment measures in health care settings across the country. The purpose of this study was to describe and examine the factors associated with hepatitis C-related hospitalizations and inpatient mortality in the United States, pre- and post-onset of the COVID-19 pandemic. Methods: Data were obtained from the 2019-2020 National Inpatient Sample database. The study population included persons aged ≥18 years with hepatitis C-related inpatient …

Can We Talk About Sex? Exploring Teacher Preparedness Of Comprehensive Sex Education Delivery In Southeast Georgia, Tanya Jules

College of Graduate Studies: Theses & Dissertations

In 2022, the CDC estimated that youth and adolescents between the ages of 15 through 24 accounted for almost half of the 2.5 million cases of sexually transmitted infections in the United States. Teachers who deliver accurate sexual health information increase the accessibility of pertinent details to adolescents during crucial years of cognitive development, which could decrease adverse sexual health outcomes among youth. The utilization of a Comprehensive Sex Education (CSE) curriculum addresses all parts of sexual health by covering topics ranging from physical, biological, emotional, and social aspects of sexuality. However, educators who provide sexual health education must follow …

Going Beyond The Exam Room: Increasing Social Determinants Of Health Screenings And Community Referrals In A Community Health Center, Catherine Lightfoot

Doctor of Nursing Practice Projects

Social Determinants of Health (SDH) are factors that affect a patient’s health outcomes but are not medical measurements, prescriptions, or therapies. Instead, they are external forces or social risks a person faces based upon where they live, work, and play. Screening for these risks allows a medical team more information about a patient and their situation and can contribute to personalized care. Screening patients for these determinants in a community health primary care setting is important and is increasingly being aligned with regulations and reimbursements. The purpose of this Doctor of Nursing Practice quality improvement project was to implement change …

Understanding Intention And Behavior Of Practicing Yoga Through The Lens Of Theory Of Planned Behavior Specifically In Rural Communities; A Qualitative Study, Shelley Meyer

Theses and Dissertations--Kinesiology and Health Promotion

While there are known health benefits for participating in yoga, little has been studied on the intention and behavior for why individuals practice yoga especially through a theoretical lens and intense qualitative thematic analysis. Targeting the rural community considers other extenuating circumstances experienced by rural residents that can impact yoga participation in rural areas. Interviews were used to gain insight into a holistic viewpoint with the rich data bringing clarity to an individual’s thought process (of intention) to incorporate yoga (behavior) in their daily life. Utilizing the Theory of Planned Behavior as the theoretical framework for developing interview questions allowed …

An Endemic Issue: Malawi's Struggle To Prevent Childhood Malaria, Hailey A. Smalley

Graduate Student Theses, Dissertations, & Professional Papers

Malaria is one of the most prolific diseases in the world, generating hundreds of millions of cases and hundreds of thousands of deaths a year. In 2021, the World Health Organization initiated preliminary trials for the first malaria vaccine in three countries, including Malawi. This project explores the impact of the malaria vaccine on community perspectives and health outcomes related to malaria , describes ongoing challenges that health workers face when disseminating the vaccine, and explains how Malawi’s experience implementing the malaria vaccine reflects larger trends in international aid.

Health Equity Policy In Colombia: Improving Equal Access To Health Care Services For Individuals With Low-Income, Marian Marin

Honors Undergraduate Theses

In 1993, the last health reform “Law 100” was introduced in Colombia. It has been over 30 years since its implementation, and there have been many changes to the healthcare system in Colombia ever since. The policy increased health insurance coverage to almost 95% of the population, providing better and more affordable patient care. However, increasing the availability of resources does not necessarily make them accessible to all of Colombia’s residents. This study aims to analyze the outcomes of “Law 100” to the system and studies critical obstacles that halt healthcare equity in Colombia, particularly for those in rural and …

Breakfast Skipping In College Students And Its Association With Eating Behaviors, Rebekah E. May

Honors Undergraduate Theses

Background: Breakfast is important in maintaining optimal diet quality and decreasing preventable diet-related disease later in life. Breakfast skipping is highly prevalent in the college population, potentially decreasing self-regulation and diet quality and increasing habits of overeating. However, specific eating styles and diet quality have yet to be studied in breakfast skippers.

Objective: To explore and compare the characteristics of eating style, self-regulation, and diet quality among college students between a day when breakfast is skipped and a day when breakfast is consumed.

Methodology: Undergraduate students (n=103) participating in this observational crossover study completed demographics, the Self-regulation of Eating Behavior …

How Individuals’ Opinions Influence Society’S Resistance To Epidemics: An Agent-Based Model Approach, Geonsik Yu, Michael J. Garee, Mario Ventresca, Yuehwern Yih

Faculty Publications

Background: Protecting public health from infectious diseases often relies on the cooperation of citizens, especially when self-care interventions are the only viable tools for disease mitigation. Accordingly, social aspects related to public opinion have been studied in the context of the recent COVID-19 pandemic. However, a comprehensive understanding of the effects of opinion-related factors on disease spread still requires further exploration. Methods: We propose an agent-based simulation framework incorporating opinion dynamics within an epidemic model based on the assumption that mass media channels play a leading role in opinion dynamics. The model simulates how opinions about preventive interventions change over …

The Impact Of Telehealth-Based Behavioral Lifestyle Program On Hypertension Control In African American Participants: Results From The Heals Med-Tech Randomized Controlled Trial, Sunita Dodani Dodani, Amanda Clarke, Ismail El Moudden, Tharidu Gunawardena, Navdhit Bedi

Department of Medicine Faculty Publications

Introduction: The HEALS Med-Tech program offers a unique blend of lifestyle changes and technology to improve hypertension (HTN) management in African Americans (AAs), a group disproportionately affected by cardiovascular disease (CVD).

Methods: A randomized controlled trial compared HEALS Med-Tech against usual care for uncontrolled hypertension in AAs, focusing on diet, medication adherence, and telehealth.

Results: In a study of 61 participants, HEALS Med-Tech significantly reduced systolic blood pressure by 12.95 mm Hg (p = 0.008) and 9.19 mm Hg (p = 0.013) at 3 and 12 months, respectively, demonstrating improved hypertension control.

Conclusions: HEALS Med-Tech demonstrates potential in HTN management …

Workplace Stress Of Special School Teachers At Three Schools In Bali Province, Made Adhyatma Prawira Natha Kusuma, Agnes Ayu Biomi, Luh Putu Wulandari Artha

Preventia: The Indonesian Journal of Public Health

Workplace stress is often seen as a threat or a problem that comes from the work environment. Stress is a feeling resulting from the interaction between the individual and the work environment. Work stress can happen to anyone at any time, including special school teachers. This research aims to describe the workplace stress of special school teachers at three schools in the Bali Province. This research was conducted in October-December 2022. Researcher used quantitative research method with cross-sectional design and descriptive approach. Data collection is carried out using the Copenhagen Psychosocial Questionnaire-III and the Occupational Diagnosis Survey from the Ministry …

Spatial Analysis Of The Distribution Of Covid-19 Vulnerable Groups To Covid-19 Cases In Brebes Regency, Fatimatuzzahro Fatimatuzzahro, Rara Warih Gayatri

Preventia: The Indonesian Journal of Public Health

The number of COVID-19 cases in Brebes Regency within a year is still quite high. The elderly, Hypertension and Diabetes Mellitus are the most important COVID-19 vulnerable groups and have the highest risk of death. The purpose of this study is to determine the distribution of COVID-19 vulnerable groups and their spatial relationship to COVID-19 cases in Brebes Regency. This study used a correlation or ecology study design. The data used is secondary data obtained from the Brebes Regency Health Office, namely the number of COVID-19 cases, the number of elderly, people with hypertension and diabetes mellitus in 2021. The …

Bivariate Spatial Pattern Based On The Characteristics Of Women Smokers In Indonesia, Diana Rohmandani Putri, Rudi Safarudin, Ammad Khokar, Konain Tayab, Muhammad Taaha Kashif, Erni Astutik

Preventia: The Indonesian Journal of Public Health

The increasing prevalence of smoking among women globally has become a critical public health issue. World Health Organization (WHO) data shows 20 percent of women use tobacco. Women smokers face an increased risk of various diseases. Spatial studies need to be conducted as a basis for planning and providing targeted interventions to reduce the spread of diseases caused by smoking. The study aimed to determine the spatial description of smoking among women in Indonesia. This study analyzed the 2017 IDHS data and used an ecological study design with a descriptive approach and a spatial analysis model. The results are Papua …

Systematic Review Of The Relationship Between Hygiene Practice And The Incidence Of Ascaris Lumbricoides Infection In Southeast Asian Children, Anastasia Rouli Alodia, Ririn Arminsih Wulandari

Preventia: The Indonesian Journal of Public Health

Soil-Transmitted Helminth (STH) infection is one of the Neglected Tropical Diseases (NTDs) that affects around 1.5 billion people worldwide, including regions like Southeast Asia. The most common species infecting humans is Ascaris lumbricoides. Preschool-age and school-age children are particularly vulnerable to STH infection due to their living environments in areas where STH is prevalent. Infection of STH, especially Ascaris lumbricoides, can hinder physical and cognitive development and, in severe cases, cause obstruction of the small intestine. Various factors, such as hygiene practices, can influence the transmission of Ascaris lumbricoides infection in children. This study aims to explore the association between …