Community Health and Preventive Medicine Commons^™

Impact Of A Provider Flagging System On Increasing Ezetimibe Utilization In High-Cardiac Risk Adults, Janessa Creado

Student Scholarly Projects

Practice Problem: Cardiovascular disease continues to be the leading cause of mortality globally. Often, healthcare providers fail to follow evidence-based guidelines in their practice.

PICOT: In high cardiac-risk, adult patients with low-density lipoprotein cholesterol (LDL-C) levels greater than 70 milligram/deciliter (mg/dl) despite being on a maximum tolerated dose of statin (P), what was the effect of a provider flagging system to initiate ezetimibe (I) compared to standard care (C) on increasing the utilization of ezetimibe according to the 2018 American Heart Association (AHA) guidelines (O) within 8 weeks (T)?

Evidence: An extensive evidence literature review …

A Quality Improvement Initiative For Hiv Prevention In Underserved Communities, Meredith E. Clement, Angie D. Settle, Claudia T. Martorell, Jeffrey D. Carter, Melissa Rodriguez, Chelsie Anderson Chadha, Bonnie Douglas, Laura Simone, Leah Molloy

School of Medicine Faculty Publications

Infectious Diseases Week, IDWeek 2023, October 11 - 15, 2023, Boston, MA

Pulmonary Specialist-Supported Health Coaching Delivered By Lay Personnel Improves Receipt Of Quality Care For Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial, Rachel Willard-Grace, Danielle Hessler, Beatrice Huang, Denise Devore, Chris Chirinos, Jessica Wolf, Devon Low, Chris Garvey, Doranne Donesky, Stephanie Tsao, David H. Thom, George Su

Journal of Patient-Centered Research and Reviews

Purpose: Half of people living with chronic obstructive pulmonary disease (COPD) do not receive high-quality, evidenced-based care as described in international guidelines. We conducted secondary data analysis of a previously published study to assess the ability of a model of lay health coaching to improve provision of guideline-based care in a primary care setting.

Methods: As part of a randomized controlled trial, we recruited English- and Spanish-speaking patients with moderate to severe COPD from primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive usual care or 9 months of health coaching from primary care …

Point Of Care Testing: Best Practice Toolkit For Improving Access To Point Of Care Testing In Mobile Medicine, Michaela Gist

Student Scholarly Projects

Practice Problem: Healthcare for persons experiencing homelessness (PEH) is a complex issue. Chronic and communicable diseases are disproportionately represented within this population. Healthcare spending is 2.5 times more costly in comparison to those who have not experienced homelessness. Although mobile health clinics aim to reduce the concerns with access to care, they do not eliminate barriers if the appropriate tests are not immediately available.

PICO: In the homeless population treated in mobile medicine (P), what is the effect of point of care testing (I) on turnaround time (O) compared with outside laboratory testing (C)?

Evidence: Critical analysis of the literature …

Understanding The Mechanisms Of Change In The Supportive And Respectful Maternity Care Intervention In Sindh, Pakistan: Provider Perspectives, Bilal Iqbal Avan, Waqas Hameed, Bushra Khan, Muhammad Asim, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Introduction: We conducted this qualitative investigation to explore the mechanisms of change in providing respectful care resulting from the supportive and respectful maternity care intervention (S-RMC) in Sindh, Pakistan.
Methods: We applied the principles of realist evaluation methodology with a descriptive explanatory research design. We conducted in-depth interviews with 36 maternity care providers at secondary-level public health facilities where S-RMC was implemented for 6 months. The S-RMC broad components included capacity-building of maternity teams and systemic changes for improvements in governance and accountability within public health facilities. Data were analyzed using a deductive content analysis approach.
Results: We identified mechanisms …

Hyperleptinemia Contributes To Antipsychotic Drug-Associated Obesity And Metabolic Disorders, Shangang Zhao, Qian Lin, Wei Xiong, Li Li, Leon Straub, Dinghong Zhang, Rizaldy Zapata, Qingzhang Zhu, Xue-Nan Sun, Zhuzhen Zhang, Jan-Bernd Funcke, Chao Li, Shiuhwei Chen, Yi Zhu, Nisi Jiang, Guannan Li, Ziying Xu, Steven C Wyler, May-Yun Wang, Juli Bai, Xianlin Han, Christine M Kusminski, Ningyan Zhang, Zhiqiang An, Joel K Elmquist, Olivia Osborn, Chen Liu, Philipp E Scherer

Faculty, Staff and Students Publications

Despite their high degree of effectiveness in the management of psychiatric conditions, exposure to antipsychotic drugs, including olanzapine and risperidone, is frequently associated with substantial weight gain and the development of diabetes. Even before weight gain, a rapid rise in circulating leptin concentrations can be observed in most patients taking antipsychotic drugs. To date, the contribution of this hyperleptinemia to weight gain and metabolic deterioration has not been defined. Here, with an established mouse model that recapitulates antipsychotic drug-induced obesity and insulin resistance, we not only confirm that hyperleptinemia occurs before weight gain but also demonstrate that hyperleptinemia contributes directly …

To Screen Or Not To Screen: Prostate Cancer In Liver Transplant Candidates, Patrick Twohig, Jared Schober, Timothy Mccashland, Thoetchai Peeraphatdit

Graduate Medical Education Research Journal

Prostate cancer screening is a controversial topic in the general population and is even more contested among liver transplant candidates. Not only should transplant programs be concerned about the risk of false positive screening results but also the competing risks of death and the diagnostic and therapeutic effects of true prostate cancer, which often does not cause significant morbidity or mortality in organ transplant recipients. Our letter highlights a best-practices approach to prostate cancer screening in transplant candidates using available research and consensus guidelines.

Qa-Snare Syntaxin 18 Mediates Lipid Droplet Fusion With Snap23 And Sec22b, Yuhui Fu, Binbin Ding, Xiaoxia Liu, Shangang Zhao, Fang Chen, Linsen Li, Yi Zhu, Jingxuan Zhao, Zhen Yuan, Yafeng Shen, Chaofeng Yang, Mengle Shao, She Chen, Perry E Bickel, Qing Zhong

Faculty, Staff and Students Publications

Lipid droplets (LDs) are dynamic lipid storage organelles that can sense and respond to changes in systemic energy balance. The size and number of LDs are controlled by complex and delicate mechanisms, among which, whether and which SNARE proteins mediate LD fusion, and the mechanisms governing this process remain poorly understood. Here we identified a SNARE complex, syntaxin 18 (STX18)-SNAP23-SEC22B, that is recruited to LDs to mediate LD fusion. STX18 targets LDs with its transmembrane domain spanning the phospholipid monolayer twice. STX18-SNAP23-SEC22B complex drives LD fusion in adiposome lipid mixing and content mixing in vitro assays. CIDEC/FSP27 directly binds STX18, …

Evaluation Of The Us Covid-19 Scenario Modeling Hub For Informing Pandemic Response Under Uncertainty, Emily Howerton, Lucie Contamin, Luke C Mullany, Michelle Qin, Nicholas G Reich, Samantha Bents, Rebecca K Borchering, Sung-Mok Jung, Sara L Loo, Claire P Smith, John Levander, Jessica Kerr, J Espino, Willem G Van Panhuis, Harry Hochheiser, Marta Galanti, Teresa Yamana, Sen Pei, Jeffrey Shaman, Kaitlin Rainwater-Lovett, Matt Kinsey, Kate Tallaksen, Shelby Wilson, Lauren Shin, Joseph C Lemaitre, Joshua Kaminsky, Juan Dent Hulse, Elizabeth C Lee, Clifton D Mckee, Alison Hill, Dean Karlen, Matteo Chinazzi, Jessica T Davis, Kunpeng Mu, Xinyue Xiong, Ana Pastore Y Piontti, Alessandro Vespignani, Erik T Rosenstrom, Julie S Ivy, Maria E Mayorga, Julie L Swann, Guido España, Sean Cavany, Sean Moore, Alex Perkins, Thomas Hladish, Alexander Pillai, Kok Ben Toh, Ira Longini, Shi Chen, Rajib Paul, Daniel Janies, Jean-Claude Thill, Anass Bouchnita, Kaiming Bi, Michael Lachmann, Spencer J Fox, Lauren Ancel Meyers, Ajitesh Srivastava, Przemyslaw Porebski, Srini Venkatramanan, Aniruddha Adiga, Bryan Lewis, Brian Klahn, Joseph Outten, Benjamin Hurt, Jiangzhuo Chen, Henning Mortveit, Amanda Wilson, Madhav Marathe, Stefan Hoops, Parantapa Bhattacharya, Dustin Machi, Betsy L Cadwell, Jessica M Healy, Rachel B Slayton, Michael A Johansson, Matthew Biggerstaff, Shaun Truelove, Michael C Runge, Katriona Shea, Cécile Viboud, Justin Lessler

Faculty, Staff and Student Publications

Our ability to forecast epidemics far into the future is constrained by the many complexities of disease systems. Realistic longer-term projections may, however, be possible under well-defined scenarios that specify the future state of critical epidemic drivers. Since December 2020, the U.S. COVID-19 Scenario Modeling Hub (SMH) has convened multiple modeling teams to make months ahead projections of SARS-CoV-2 burden, totaling nearly 1.8 million national and state-level projections. Here, we find SMH performance varied widely as a function of both scenario validity and model calibration. We show scenarios remained close to reality for 22 weeks on average before the arrival …

Community Health Workers, Stress Reduction, And Racial Equity In Infant Vitality, Justin Rex

ICS Fellow Lectures

How can communities help mothers reduce stress during pregnancy and provide the social supports that contribute to infant vitality? This talk presented findings from an evaluation of the Northwest Ohio Pathways HUB program, a nationally recognized best practice program model that pairs at-risk mothers with community health workers (CHWs) who connect mothers to services that reduce pregnancy risks. The talk included stories from mothers and CHWs about the challenges and stresses they face as well as data from interviews and surveys that quantify the impact CHWs have for reducing mothers' stress and providing supports that help mothers and their children …

Psychostimulant Misuse Among American Indian, Alaskan Native, Or Native Hawaiian College Students In The U.S. From 2015 To 2019, Fares Qeadan, Sydney Ross, William A. Barbeau, Erin F. Madden, Kamilla L. Venner, Kevin English

Parkinson School of Health Sciences and Public Health

Introduction: This study examines factors associated with psychostimulant misuse, including polysubstance use and social factors, among the understudied American Indian/Alaska Native/Native Hawaiian (AI/AN/NH) college student population.

Methods: Data were from the 2015 to 2019 American College Health Association-National College Health Assessment IIc (ACHA-NCHA IIc) survey. Multivariable logistic regression models and odds ratios were used to estimate associations between psychostimulant misuse and potential risk and protective factors among AI/AN/NH college students, including licit and illicit substance use, social support, relationship factors, exposure to violence or abuse, mental health symptoms, drug and alcohol education, and sample demographics.

Results: Opioid misuse among AI/AN/NH …

Modification, Validation, And Testing Of The Eating And Food Literacy Behaviors Questionnaire With Cooking Enjoyment With Young Adult University Students, Imani J. Carr

LSU Doctoral Dissertations

A modified version of the Eating and Food Literacy Behaviors Questionnaire (EFLBQ) with a new construct called cooking enjoyment was developed and validated. The instrument was titled the Eating and Food Literacy Behavior Questionnaire with Cooking Enjoyment (EFLBQ-C). The EFLBQ-C was developed with data from 18- to 30-year-olds who attended a university in the United States collected by an online survey platform. The 515 students who completed the questionnaire answered using a 4-point Likert scale of Never=1,” “Seldom=2,” “Often=3,” and “Always=4.” The responses were divided into an EFLBQ-C cohort (Group 1: 258 participants) and an EFLBQ cohort (Group 2: 257 …

Garden-Based Nutrition Education For Low Income Hispanic School Children, Larry Bui

Nursing | Student Research Posters

Background: Childhood obesity is a pressing public health concern in the United States, with rates continuing to increase in recent years. This problem disproportionately affects Latino children as well as those from low socioeconomic status. It's well established that nutrition knowledge deficiencies and resulting poor dietary habits are some of the most common contributing factors to childhood obesity. Garden-based nutrition education programs have been introduced as a way to remedy this knowledge deficit, however a gap remains as to whether or not this model can be viable for low-income, culturally diverse populations. Aim: The purpose of this literature review is …

Patient Navigational Tool Increase Resource Use In A Latino Population, Kimberly Burrus

Student Scholarly Projects

Practice Problem: The practice problem is a patient navigation tool in a mobile health clinic for the Latino population to help improve utilization of resources within Daviess County, Indiana, and improve overall health literacy and health of those populations?

PICOT: The PICOT question that guided this project was: In a mobile health clinic serving Latino populations (P), does a navigation tool (I) compared to current practices (C) improve utilization of services (O) within a 12-week timeframe (T)?

Evidence: The evidence that guided this project showed patients with limited English proficiency, immigrant families have a disparity of health literacy, and an …

Review Of The Literature: Analysis Of The Effectiveness Of Mobile Integrated Health - Community Paramedicine Programs In Reducing Pre-Hospital Ems Calls And Transportations, Annika N. Schultz, Justin Gambini

Doctor of Medical Science (DMSc)

Pre-hospital Emergency Medical Service (EMS) systems, including fire departments and ambulance transport services, are increasingly overburdened with high call volumes and unnecessary utilization of services leading to provider burnout, depletion of resources and rising healthcare costs. Many local EMS systems have recognized a need for a more sustainable solution to help reduce the number of unnecessary 9-1-1 calls and transportation to the Emergency Department (ED). Local agencies are beginning to expand the role and scope of practice for paramedics through programs referred to as Mobile Integrated Health – Community Paramedicine (MIH-CP). This new branch of medicine aims to provide patient-centered …

See Me, Hear Me, Know Me: Perspectives On Diet And Physical Activity Influences Among Teens Living In Rural Texas Communities, Debbe Thompson, Julie Miranda, Chishinga Callender, Jayna M Dave, Godlove Appiah, Salma M A Musaad

Faculty, Staff and Students Publications

Teens in rural communities are at greater risk of obesity than teens in urban areas. Diet and physical activity influence obesity risk. Understanding their perspectives is an important step in intervention design. This qualitative investigation explored teen perspectives on how living in a rural community influenced their diet and physical activity choices. Forty parent-teen pairs were recruited. Data collection included surveys and telephone interviews. This paper reports teen perspectives identified in the first interview. Thematic analysis was used to code and analyze the data. Findings revealed that the primary factor driving teens' diet and physical activity behaviors was the teens …

The Relationship Between Cancer Screening Utilization And Racial Discrimination: A Systematic Review, Priya Small, Amanda M. Hinson-Enslin, Timothy Crawford, Joanna Anderson

Journal of Ideology

Objective. To assess literature about cancer screening and cancer screening adherence among people of color and how discrimination impacts cancer screening and cancer screening adherence outcomes among patients of color.

Methods. PRISMA guidelines were used for the systematic review. EBSCO/MEDLINE, Web of Science, and CINAHL were searched and articles were uploaded in to Rayyan Systematic Review software. Three independent reviewers identified additional articles by searching reference lists of relevant articles; they completed the screening process and reviewed the included articles.

Results. Nine eligible studies were included, among which two were qualitative and seven were quantitative. Studies included one cancer screening …

The Use Of Alcohol Impregnated Port Catheters For Decreasing Central Line Infections In Acute Care, Shana M. Coons

Student Scholarly Projects

Practice Problem: Lack of proper sterile protocol for central lines was noted as a problem in the acute care units, causing CLASBI rates to be higher than the national average at the hospital in question.

PICOT: In hospitalized acute care adult patients 18 years of age and older with central lines, how does the use of alcohol impregnated port protectors (AIPPs) compared to current central line sanitation practices affect central-line associated infections (CLASBI) within 10 weeks?

Evidence: The literature evidence suggests that Alcohol Impregnated Port Protectors (AIPPs) decrease CLASBI rates and provide better outcomes for acute care patients with central …

Maternal And Perinatal Outcomes Of Women With Vaginal Birth After Cesarean Section Compared To Repeat Cesarean Birth In Select South Asian And Latin American Settings Of The Global Network For Women's And Children's Health Research, Lester Figueroa, Margo Harrison, Manolo Mazariegos, Shivaprasad Gouda, Avinash Kavi, Richard Derman, Archana Patel, Prabir Das, Sarah Saleem, Farnaz Naqvi

Community Health Sciences

Objective: Our objective was to analyze a prospective population-based registry including five sites in four low- and middle-income countries to observe characteristics associated with vaginal birth after cesarean versus repeat cesarean birth, as well as maternal and newborn outcomes associated with the mode of birth among women with a history of prior cesarean.
Hypothesis: Maternal and perinatal outcomes among vaginal birth after cesarean section will be similar to those among recurrent cesarean birth.
Methods: A prospective population-based study, including home and facility births among women enrolled from 2017 to 2020, was performed in communities in Guatemala, India (Belagavi and Nagpur), …

Strategies For Culturally Safe Research With Native American Communities: An Integrative Review, Teresa Brockie, Kyle X. Hill, Patricia Davidson, Ellie Decker, Lydia Koh Krienke, Katie E. Nelson, Natalie Nicholson, Alicia M. Werk, Deborah Wilson, Deana Around Him

Indigenous Health Faculty Publications

Background: A history of unethical research and deficit-based paradigms have contributed to profound mistrust of research among Native Americans, serving as an important call to action. Lack of cultural safety in research with Native Americans limits integration of cultural and contextual knowledge that is valuable for understanding challenges and making progress toward sustainable change. Aim: To identify strategies for promoting cultural safety, accountability, and sustainability in research with Native American communities. Method: Using an integrative review approach, three distinct processes were carried out: (1) appraisal of peer-reviewed literature (Scopus, PubMed, and ProQuest), (2) review of grey literature (e.g. policy documents …