Medicine and Health Commons^™

The Texas Electorate's Views Of Health Care As A Human Right, Community Health Centers, And Certain Matters Of The Health Care Safety Net, Scott Elphingstone

Graduate Liberal Studies Theses and Dissertations

In a country in which the government does not recognize a right to health care,social safety nets are the last hope for persons without insurance or other means to pay for needed care. In United States, community health centers, hospital emergency rooms, and private charities comprise that safety net. Community health centers offer a practicable alternative for politicians and citizens who want to help improve the lives of persons who struggle to access health care. This dissertation reviews the political history of community health centers from their founding as part of the War on Poverty in the 1960s through Democratic …

Learning To Be An Autistic Therapist: Personal Steps Towards An Autism-Affirming Psychotherapy, Sasha D. Strong

Ought: The Journal of Autistic Culture

How can Autistic therapists understand and support themselves, and how can this help them support their clients? In this paper, I recount my personal journey of healing and growth as an Autistic psychotherapist, 16 months after self-identification. Here is an overview of conceptual frameworks from #actuallyautistic authors, critical theory, queer theory, and social justice that I have found helpful. I also share some of the therapeutic and wellness approaches that have been important to me, including mindfulness and bodyfulness. Organic knowing has been pivotal for me in discerning between masking and aliveness, and regaining a choice around masking behaviors. This …

The Camden Study - A Pregnancy Cohort Study Of Pregnancy Complications And Birth Outcomes In Camden, New Jersey, Usa., Stephanie Shiau, Xinhua Chen, Ayana April-Sanders, Ellen C Francis, Shristi Rawal, Megan Hansel, Kehinde Adeyemi, Zorimar Rivera-Núñez, Emily S Barrett

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women.

METHODS: From 1985-2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White …

Reduction Of Seclusion And Restraint Among Children And Adolescents In An Inpatient Psychiatric Hospital: A Health Policy Analysis, Huma Moez

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Seclusion and restraint (SR) or restrictive intervention in inpatient/ acute psychiatric hospitals, emergency departments, crisis stabilization units, residentials, or group homes is a pressing and an immediate concern in mental health settings, particularly for children and adolescents, for whom SR rates are higher. The Joint Commission and other national organizations have made significant strides in prioritizing the reduction and elimination of SR among children and adolescents due to its negative physical and psychological consequences.

Objective: This DNP project will aim to provide the results of a policy analysis to present evidence-based techniques and a resulting re-envisioned policy recommendation to …

What Factors Contribute To Racial Disparities In Asthma Prevalence In The United States?, Ali Jones, Marc A. Garcia

Population Health Research Brief Series

Asthma is strongly associated with the environmental factors in which one lives. Poor environmental factors, such as motor vehicle pollution and lack of emergency room access, lead to a higher prevalence of asthma among Black individuals than White individuals. This brief uses data from the U.S. Centers for Disease Control and Prevention to highlight Black-White disparities in asthma from 2019-2021 and demonstrates how living in unhealthy conditions results in a higher burden of asthma in Black communities.

Foster Care, Substance Use, And Social Determinants Of Health In South Carolina: A Geographic Approach, Patricia Carbajales-Dale

All Dissertations

Foster care is a critical intervention for vulnerable children, with approximately 400,000 children entering the system annually in the United States. Parental substance use, second only to neglect, is now a leading cause of foster care entry. While previous research has explored the relationship between socioeconomic factors and foster care, few studies have incorporated spatial approaches at the neighborhood level to understand how factors such as economic inequality, healthcare disparities, and substance use influence foster care entries. This study addresses that gap by integrating spatial analysis and machine learning techniques to examine the geographic and social dynamics underlying foster care …

Mortalidad Por Cirrosis En Guatemala 2018: Patrones E Inequidades, Cristian Ramírez, Luis Pablo Méndez-Alburez, María Fernanda Piedrasanta, Alejandro Cerón

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por cirrosis en Guatemala. El propósito es identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir por cirrosis en Guatemala muestra marcadas desigualdades por departamento, las cuales son mayores al comparar por municipio. El riesgo de morir es también más alto en hombres, en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Las medidas de salud pública orientadas a los municipios y grupos en mayor riesgo son de suma importancia para la prevención de muerte por …

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.

State Capacity And Covid-19 Responses: Comparing The Us States, Kiran Auerbach, Joshua Y. Lerner, Hannah M. Ridge

Political Science Faculty Articles and Research

This article addresses the interstate differences in outcomes from the coronavirus disease COVID-19 pandemic by focusing on state capacity. State capacity refers to states’ ability to create and implement policy. We posit that states want to limit death and destruction within their borders. COVID-19 created an instance in which states had a shared, preferred outcome but had very different levels of success. Using a novel measure of state capacity that allows for subnational comparisons – and is independent of ideological political will – we show that states with greater capacity experienced fewer excess deaths during 2020 and more successfully distributed …

Partnering With Communities To Understand Social Determinants Of Health (Sdoh) Impacts On Access To Shared Micromobility, Elizabeth K. Mcclain, Kaitlynn Walker, Ganesh Kumar, Ashley Bright, Clare Aziz, Ann W. Banchoff, Zacharia N. Doueiri, Abby C. King, Suman Mitra

Civil Engineering Faculty Publications and Presentations

This study explored the facilitators and barriers of community bike share use in a mid-sized city with high incidence of poverty and racial diversity using a community-based participatory action research (CBPAR) photovoice framework with the Stanford Our Voice (OV) Discovery Tool digital application. Community members participated in one of three community citizen science walks with follow up focus groups facilitated by osteopathic medical student researcher to address “What makes it easy or hard to ride a bike using the bike share?” Twenty-seven diverse community members partnered with four osteopathic medical students exploring vulnerable individuals’ lived experiences, beliefs/understanding of the Social …

Understanding The Impact Of Covid-19 On Yoga Instruction: Examining Teaching Methodology, Class Components, And Injury Patterns In The Northeastern Us, Sojung Kim, June Solow, Donald H Lein, Harshvardhan Singh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVES: This study aimed to examine the impact of COVID-19 on the perspectives of yoga instructors (YIs) regarding teaching methodology, class components, and yoga-related injuries among their clients DESIGN: A cross-sectional design in this study.

SETTING: A total of 407 YIs from Northeastern United States completed a customized, web-based survey.

MAIN OUTCOME MEASURES: Chi-square tests were carried out to determine changes in yoga teaching format before and during the pandemic, as well as the counts of yoga related injuries between face-to-face (FtoF) and online teaching format. Independent t tests were used to compare the characteristics of yoga teaching elements.

RESULTS: …

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' …

Protein Consumption And Risk Of Cvd Among Us Adults: The Multi-Ethnic Study Of Atherosclerosis (Mesa), Ji Yun Tark, Ruosha Li, Bing Yu, Alexis C Wood, Nikhil S Padhye, Marcia C De Oliveira Otto

Faculty, Staff and Students Publications

BACKGROUND: Although some randomized trials have reported beneficial effects of protein intake on cardiometabolic risk factors, evidence from prospective studies have not supported a strong link between protein intake and cardiovascular disease (CVD) risk. It is also unclear whether diversity in protein intake plays a role in CVD risk.

OBJECTIVE: We investigated prospective associations of (1) protein intake, overall and by food source and (2) diversity of protein sources with risk of CVD, coronary heart disease (CHD), and stroke.

METHODS: In a multi-ethnic cohort of 5879 U.S. adults (45-84 years), who were free of CVD at baseline, protein intake was …

Ancds Diversity Writing Group Discussion: The Evidence Base For Neuro-Rehabilitation Of Acquired And Degenerative Communication Disorders In Diverse Populations: What Is Available, What Is Needed, And Reasons Why, Gloriajean Wallace, Ivan Portillo, Latoya Roberts, Whitney Postman, Gerald Imaezue, Anthony Pak-Hin Kong, Taryn Malcolm

Library Presentations, Posters, and Audiovisual Materials

This presentation will discuss evidence-based practice (EBP), with a focus on available research that supports the neurorehabilitation care of people with neurogenic disorders, including the increasingly large number of people from culturally and linguistically diverse communities.  Presenters will provide the audience with preliminary findings of the ANCDS Diversity Writing group.  Presenters will then provide the audience with thoughts about topics related to neurorehabilitation care of people from diverse communities, including topics relating to academic and clinical training, professional training, current practices, and conversation focused on cultural and linguistic considerations including the use of interpreters and translators.  The presentation will pinnacle …

Exploring Body Composition And Sexual Behavior In South Texas College Students, Soyoung Kwon, Shannon Shen

Journal of Social, Behavioral, and Health Sciences

In this exploratory study, we examined the understudied relationship between body composition and sexual behavior among freshmen college students, addressing a gap in empirical research. Our sample consisted of 217 nonclinical college students recruited from a university in the southwestern United States; a majority of the students were Hispanic (70%) and freshmen (95%). Using multivariate logistic regression, we explored associations of body mass index, body fat percentage, and fat mass index with sexual behaviors. More than half of the participants were either overweight (22.5%) or obese (30.4%), and nearly 70% fell outside the healthy range of body fat. Results showed …

Demographic Characteristics, Perinatal Smoking Patterns, And Risk For Neonatal Health Complications Among Pregnant Smokers In The United States Who Begin Using Electronic Cigarettes During Pregnancy: A Descriptive Study Using Population-Based Surveillance Data., Hui Nian, Rachel Odland, Samantha Mindlin, Lin Ammar, Hilary Tindle, Angela M Miller, Kelli K Ryckman, Ethan Xie, Tina V Hartert, Brittney M Snyder, Steven M Brunwasser, Pingsheng Wu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Health agencies have called for research evaluating e-cigarette (EC) use in supporting prenatal smoking cessation. This study aimed to describe (1) the characteristics of smokers who begin using electronic cigarettes (ECs) during pregnancy, (2) how frequently smokers reduce or eliminate pre- and post-natal combustible cigarette (CC) use, and (3) the risk for neonatal health complications among smokers who initiate ECs during pregnancy.

AIMS AND METHODS: Pregnant women using CCs exclusively during prepregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified …

Credentialing Care: Covid-19 And The Bureaucratization Of Doulas, Ellen Block, Julie Johnson Searcy, Angela N. Castañeda

Sociology Faculty Publications

Doulas in the United States offer embodied, informational, and continuous one-on-one care to birthing people. Doulas have historically sought certification to gain knowledge through training and to gain legitimacy for healthcare providers and clients. During the COVID-19 pandemic, hospitals required doulas to provide proof of certification. The COVID-19 pandemic, and the proliferation of state-sponsored doula programs, has sparked a shift in how doulas are viewed and regulated, enabling new forms of bureaucratic oversight and control. Based on participant observation, surveys, and semi-structured interviews, we examine the connection between certification and care including motivations doulas have for certification, the perceived value …

Young Children’S Mental Well-Being In Low-Income South African Settings: A Qualitative Study, Catherine E. Draper, Caylee J. Cook, Elizabeth A. Ankrah, Jesus A. Beltran, Franceli L. Cibrian, Jazette Johnson, Kimberley D. Lakes, Hanna Mofid, Lucretia Williams, Gillian R. Hayes

Engineering Faculty Articles and Research

This qualitative study aimed to capture community perspectives of the risks and protective factors for social emotional development and mental health of young children in low-income South Africa settings, and was conducted as one component of a larger study with the ultimate aim of co-designing the Mazi Umntanakho (‘know your child’) digital tool. Twenty focus group discussions (n = 154, 97% female) were held with staff of community-based organisations (CBOs) and community health worker (CHW) programmes in urban and rural sites from four geographical regions. Data were analysed thematically, and grouped according to components of nurturing care (responsive caregiving, safety …

Gender And Sexuality Awareness In Medical Education And Practice: Mixed Methods Study, Rola Khamisy-Farah, Eden Biras, Rabie Shehadeh, Ruba Tuma, Hisham Atwan, Anna Siri, Manlio Converti, Francesco Chirico, Łukasz Szarpak, Carlo Biz, Raymond Farah, Nicola Bragazzi

Faculty, Staff and Students Publications

BACKGROUND: The integration of gender and sexuality awareness in health care is increasingly recognized as vital for patient outcomes. Despite this, there is a notable lack of comprehensive data on the current state of physicians' training and perceptions in these areas, leading to a gap in targeted educational interventions and optimal health care delivery.

OBJECTIVE: The study's aim was to explore the experiences and perceptions of attending and resident physicians regarding the inclusion of gender and sexuality content in medical school curricula and professional practice in Israel.

METHODS: This cross-sectional survey targeted a diverse group of physicians across various specializations …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …