Epidemiology Commons^™

Association Of Social Support And Depressive Symptoms Among African Americans, Jacketta Renee Cobbs

Walden Dissertations and Doctoral Studies

Depression affects over 120 million individuals worldwide; in the United States, depression is a leading cause of disability for individuals’ ages 15-44 years. Social support can affect both physical and depressive symptoms; therefore, most patients with heart failure (HF) need support from family and/or friends to effectively manage their health condition. This indicates family and/or friends are expected to be the core support system for long term care of those with HF. The purpose of this study was to determine whether social support contributes to depressive symptoms among African Americans with HF. The research questions examined the experience of different …

The Association Between Central Line Insertion Practices And Central Line-Associated Bloodstream Infections, Mona Elgowainy

Walden Dissertations and Doctoral Studies

Healthcare-associated infections, specifically central line-associated bloodstream infections (CLABSI), continue to remain a serious public health concern in the United States. Though CLABSI can often be prevented, healthcare professionals struggle to have a positive impact on CLABSI rates. The primary purpose of this study was to determine whether CLIP Bundle adherence has an impact on CLABSI standardized infection ratio (SIR) rates in various patient care areas in California. The research questions were focused on assessing whether there was an association between patient care areas, CLABSI rates, and CLIP Bundle adherence scores. A quantitative, cross-sectional study design utilizing secondary data was used …

Prevention Practices And West Nile Virus Infection Among Ethnic Minorities, Texas, Bayabel Debebe Mengistu

Walden Dissertations and Doctoral Studies

Abstract

West Nile virus (WNV) is a major public health problem and the cause of nearly 25% of the world's economic burden of disease. While the risk factors for developing West Nile fever and West Nile disease from WNV infection have been identified, it is not known how knowledge, attitude, behavior (KAB), access to health care (AHC), and comorbidities are associated with prevention practices of WNV infection among ethnic minorities. The aim of this study was to examine the association between KAB, AHC, comorbidities, and prevention practices of WNV infection among ethnic minorities in Texas. KAB, AHC. Comorbidities were used …

Amyotrophic Lateral Sclerosis Patients' Sociological Resilience, Self-Determination, And Decision-Making For Life-Sustaining Treatments, Jeremy Jon Van Tress

Walden Dissertations and Doctoral Studies

People with amyotrophic lateral sclerosis (ALS) suffer from a rare, progressive, untreatable, and fatal neuromuscular disease. Their decision-making for life-sustaining treatments may not be fully self-deterministic. While researchers have examined resilience and self-determination in people with mental health problems and chronic illness, none have researched these variables in ALS patients from a socioecological framework. The purpose of this study was to explore the relationships between people with ALS socioecological resilience, self-determination, and decision-making for life-sustaining treatments. A cross-sectional concurrent mixed-methods design was used, with online surveys completed by 197 people with ALS who were solicited through the National ALS Registry. …

Area-Level Factors Linked To Obesity In African American And Caucasian Women In Michigan, Marjorie Arrey

Walden Dissertations and Doctoral Studies

Obesity is a major public health crisis, affecting every segment of the U.S. population. African American women have higher prevalence of obesity than all other subpopulations and are disproportionately burdened by the disease and its comorbidities. Despite this disparity, African American women are often underrepresented in obesity research. This research examined obesity-related risk factors specific to African American women compared to those for Caucasian women. The design was based on the socioecological model and social cognitive theory, both emphasizing the impact of social factors on health outcomes. The data set included only adult Michigan women from the NHANES study. Multiple …

Examining The Mortality Risk Of A Population With Mental Illness, Glorimar Ortiz

Walden Dissertations and Doctoral Studies

Individuals with mental illness experience increased mortality and premature death. In a sample composed of 88% decedents with mental illness who were Black, the findings from three research studies provided insight about excess and premature mortality, odds of dying by cause of death, and risk factors associated with premature mortality. The purpose of this quantitative study was to examine the mortality of a population group with mental illness that was served in a public mental health system (PMHS). The ecoepidemiological life course framework for health, disease, and mortality was used to link mechanisms that may influence health and longevity in …

Hiv Prevention: Pre-Exposure Prophylaxis, Sexual Decision Making, Risk Taking, And Condoms, Jonathan D. Spencer

Walden Dissertations and Doctoral Studies

HIV is an infectious disease that continues to have new cases each year within high-risk populations, such as men who have sex with men (MSM). To help in the fight against new HIV infections within the MSM population, new medications such as pre-exposure prophylaxis (PrEP) are being used. The purpose of this cross-sectional online survey study was to address whether PrEP use had any relationship with (a) sexual decision-making, (b) risk-taking, and (c) condom use in the MSM population 18-64 years of age, after controlling for socioeconomic status, race, and age while using the behavioral disinhibition and risk compensation models. …

Health Outcomes Associated With Gulf War Illness, Shannon K. Barth

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background:

Nearlythirty years after the 1990-1991 Persian Gulf War a definitive case definition for Gulf War Illness (GWI) is lacking. The objective is to explore health outcomes associated with GWI using currently accepted classifications in order to better understand GWI by examining pre-war medical conditions as predictors of probable GWI, mortality outcomes of veterans with probable GWI, and female-specific medical conditions among women with probable GWI. Additionally, we utilize an alternative GWI case definition.

Methods:

Data come from theDepartment of Veterans Affairs (VA)1995-1997 National Health Survey of Persian Gulf War Era Veterans, a population-based survey of deployed …

Hepatitis B In At-Risk Groups: Three Studies To Guide Education, Testing, And Vaccination Efforts In West Virginia, Stacy Tressler

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background and Objectives: For over a decade, West Virginia’s (WV) rate of acute hepatitis B has been the highest in the United States (US). In 2017, WV’s rate was 11.7 per 100,000 population, almost 12 times higher than the national rate. The increase in acute hepatitis B cases is largely due to substance misuse, including injection drug use (IDU). Hepatitis B is a vaccine preventable disease yet many at-risk adults remain unvaccinated and susceptible to infection. The objectives of our studies are to 1) describe yearly changes in acute hepatitis B incidence in WV and assess county-level impact of the …

Association Of Common Chronic Pain Conditions To Incident Alzheimer’S Disease And Related Dementias In Two Cohorts Of Older Medicare Beneficiaries, Sumaira Khalid

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objective: The purpose of this research was to study the collective and incremental association of common non-cancer chronic pain conditions (NCPC) to risk for Alzheimer’s disease and related dementias (ADRD); to explore the potential mediating influence of mood and sleep disorders; and to assess the potential synergistic effects of NCPC’s and multimorbidity on ADRD risk. This research also aimed to study the contribution of NCPC to ADRD risk in poor, rural, underserved United States populations who suffer a disproportionate burden of ADRD risk factors. To achieve these goals, this dissertation pursued three specific aims: 1) assess the association of …

Multimorbidity, Immune Checkpoint Inhibitor Use, And Healthcare Expenditures Among Older Patients With Late-Stage Melanoma, Pragya Rai

Graduate Theses, Dissertations, and Problem Reports (ETD)

With decades of unchanged cancer care with no added survival benefit, immune checkpoint inhibitors (ICI) changed the treatment landscape of late-stage melanoma in 2011. A key factor in determining the use of ICIs is the presence of pre-existing chronic conditions, which can influence the outcome. However, the prevalence of multimorbidity (defined as presence of two or more chronic conditions) among older patients with late-stage melanoma remains unknown. It also remains unknown if the presence of multimorbidity factors into the use of ICIs. Hospital-related factors associated with ICI use have been studied. Yet, patient-level factors, such as age, sex, marital status, …

Changing Dynamics Of Opioid Overdoses In West Virginia And Impact Of Medication For Opioid Use Disorder And Recurrence Of Overdose On Reducing Mortality Among West Virginia Medicaid Beneficiaries, Zheng Dai

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background

With increasing number of opioid overdoses in West Virginia (WV) in recent years and limited number of people receiving treatment, the dissertation study aims to better understand fatal overdose problems in WV and the impact of medication for opioid use disorder (MOUD) in preventing overdose deaths.

Method

WV drug-related deaths from 2005 to 2018 was used to describe the involvement of fentanyl and FAs. WV Medicaid claim data was analyzed to describe the recurrent opioid overdose and the changes in receipt of MOUD. Further, a Medicaid opioid overdose cohort was created to evaluate the effect of occurrence of recurrent …

Population Density And Spatial Distribution Of Neglected Tropical Diseases In Sierra Leone, Abou B. Funna

Walden Dissertations and Doctoral Studies

Neglected tropical diseases (NTDs) are the most common health conditions affecting the poorest residents of sub-Saharan Africa (SSA). These infections affect an estimated 2 billion people worldwide, including 500 million people living in SSA. About 85% of NTD infections are a result of helminth infections; hookworm is also a common occurrence among SSA’s poorest people, especially children. Schistosomiasis is the 2nd most prevalent NTD after hookworm. This quantitative correlational study investigated population distribution and the spread of NTDs in Sierra Leone. The focus was on 5 major NTDs: ascariasis, hookworm, schistosomiasis, soil-transmitted helminthiasis, and trichuris. Data were obtained from the …

Leveraging Technology To Blend Large-Scale Epidemiologic Surveillance With Social And Behavioral Science Methods: Successes, Challenges, And Lessons Learned Implementing The Unite Longitudinal Cohort Study Of Hiv Risk Factors Among Sexual Minority Men In The United States, H. Jonathon Rendina, Ali J. Talan, Nicola F. Tavella, Jonathan Lopez Matos, Ruben H. Jimenez, S. Scott Jones, Brian Salfas, Drew Westmoreland

Publications and Research

The use of digital technologies to conduct large-scale research with limited interaction (i.e., no in-person contact) and objective endpoints (i.e., biological testing) has significant potential for the field of epidemiology, but limited research to date has been published on the successes and challenges of such approaches. We analyzed data from a cohort study of sexual minority men across the United States, collected using digital strategies during a 10-month period from 2017 to 2018. Overall, 113,874 individuals were screened, of whom 26,000 were invited to the study, 10,691 joined the study, and 7,957 completed all enrollment steps, including return of a …

Disparities In Health Behavior Risks Among Employed And Disparities In Health Behavior Risks Among Employed And Unemployed Black And White Older Adults, M. Courtney Hughes, Tamara A. Baker, Hansol Kim

Faculty Articles, Papers, and Other Scholarship

Objective: Examine health behavior risk rates and disparities in health behavior risks related to race and employment among older adults.

Methods: A cross-sectional analysis of a representative sample of noninstitutionalized adults aged 65 and older (150,669 in 2015 and 168,011 in 2016) from the Behavioral Risk Factor Surveillance System. Self-reported health behavior risks were measured as well as multiple logistic regression analyses assessing the independent effects of demographic variables on health behavior risks.

Results: Employed older adults have greater health behavior risks than unemployed older adults. Black employed older adults have greater health behavior risks than Black unemployed older adults …

Mothers' Knowledge, Clinic Staff, Community Support, And Breastfeeding Practices, Ubong Usua

Walden Dissertations and Doctoral Studies

Among low-income mothers enrolled in the Women Infant and Child (WIC) program and Medicaid, the rate of initiating breastfeeding immediately after delivery is low (57%) compared to high-income mothers (74%). Among the many factors contributing to this are low-income mothers' poor knowledge of the benefits of breast-feeding and lack of support and encouragement from clinical staff, family, and community. However, few studies have singled out the role of community and family support in improving maternal knowledge and breastfeeding practices. Using the Theory of Planned Behavior framework, this quantitative study used WIC data from the Texas Department of Health and Human …

Health Information Seeking Among General Public In India During Covid 19 Outbreak: Exploring Healthcare Practices, Information Needs, Preferred Information Sources And Problems, Nida Nafees, Daud Khan

Library Philosophy and Practice (e-journal)

Background: As of October 1, 2020, World Health Organization (WHO) reports that COVID-19 has spread in 216 countries or territories or areas which results into throwing billions of lives under lockdown as healthcare services struggle to cope. Therefore, timely access to healthcare information during COVID-19 crisis is mandatory to restrain its spread.

Objectives: To comprehend the information needs and seeking behaviour of general public during COVID-19 outbreak in India.

Methods: A national survey through an online questionnaire was conducted in India and 1310 respondents participated in the study through snowball sampling technique.

Results: The most decisive information needs of majority …

Reducing Morbidity: Establishing A Relationship Between Perioperative Normothermia And Colon Surgical Site Infections, Nychie Dotson

Walden Dissertations and Doctoral Studies

Healthcare-associated infections (HAIs) are an emerging public health threat. Every day in the United States, HAIs impact 1 in 31 hospitalized patients. Surgical site infections (SSIs) account for over 40% of all reported HAIs and have an increased risk for morbidity and mortality. Surgery associated with colon procedures present an increased risk for infection, morbidity, and mortality. There has been vast work to prevent colon SSIs; however, there remain areas for improvement and exploration. The main research question evaluated the relationship between maintaining perioperative normothermia and colon SSIs. Secondary research questions explored additional risk factors to include age, gender, obesity, …

Factors Contributing To Community-Associated Carbapenem Resistant Enterobacteriaceae Infections In The United States, Zabrina Lockett

Walden Dissertations and Doctoral Studies

Carbapenem-resistant Enterobacteriaceae (CRE) health care acquired infections are a serious public health threat due to a high mortality rate, economic burden, and depletion of last resort CRE antimicrobials. CRE infections have emerged as community-associated type infections in the United States. For CRE to now have that type of potential is cause for immediate and extensive action. The prevalence of CRE infection cases that were reported as community-associated CRE and health care acquired CRE by examining specific clinical characteristics between 4 selected states that were reported to respective state health departments and the Centers for Disease Control were explored in this …

Microcystins And Liver Disease Mortality, Insights From An Ecological Study, Rajesh Tirpaul Melaram

Walden Dissertations and Doctoral Studies

Microcystins (MCs) are toxic secondary metabolites produced by freshwater cyanobacteria. Algal bloom subsidence can stimulate MC release, which can impair liver function if orally exposed to in large doses. The purpose of this retrospective, U.S. ecological study was to determine if MC exposure represented an environmental risk factor for liver disease mortality using a socioecological approach. A longitudinal ecological substudy investigated the association between average total MCs in Lake Washington and Lake Manatee and age-adjusted chronic liver disease (CLD)/cirrhosis death rates in Brevard County and Manatee County, Florida (FL). A prediction model of total MCs was deduced by quantifying levels …