Medicine and Health Commons^™

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

College of Graduate Studies: Theses & Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Deadly Divisions: Class And Stigma As Fundamental Social Causes Of Spatial Health Inequalities, Misty Lee Harris

Graduate Theses, Dissertations, and Problem Reports (ETD)

The objective of this dissertation is to investigate how class and stigma influence spatial inequalities in health across the US, from the structural to the individual level. Class, stigma, and subsequent access to capital resources are not equally distributed across the US. Women, poor, and minority populations continue to have unequal access to capital resources across the country, though this is spatially determined. Similarly, while there are health inequalities along the same social cleavages at the national level, they differ significantly across localities. Research has not paid enough attention to the fundamental social causes of inequities, resulting in the inability …

Revisiting The Rainbow: Culturally Responsive Updates To A Standard Clinical Resource, Angela M. Dietsch, Richard Mocarski, Debra A. Hope, Nathan Woodruff, Miechelle Mckelvey

Department of Special Education and Communication Disorders: Faculty Publications

Purpose

Cultural responsivity is essential for efficacious and affirming clinical relationships. This may be especially important with historically marginalized clients, such as transgender and gender-diverse (TGD) people seeking behaviorally based affirming communication services. We recommend modifications to standard tools for diagnostics and training that otherwise might undermine our efforts to create an inclusive and affirming environment.

Method

Modifications to the Rainbow Passage, a standardized paragraph utilized for eliciting speech samples in clinical settings, focused on nongendered terminology and the elimination of content with religious connotations.

Results

The recommended edits to the Rainbow Passage maintain similar length, cadence, and phonetic balance …

Living Alone During Old Age And The Risk Of Dementia: Assessing The Cumulative Risk Of Living Alone, Benjamin A. Shaw, Tse-Chuan Yang, Seulki Kim

Department of Sociology: Faculty Publications

Objectives: This study examines the association between living alone during old age and dementia. Whereas most previous studies on this topic utilize measures of living alone status that were obtained at a single point in time, we compare this typical approach to one that measures long-term exposure to living alone among older adults and assesses whether dementia is more likely to occur within individuals with more accumulated time living alone. Methods: Data come from the Health and Retirement Study, with a follow-up period of 2000–2018. A total of 18,171 older adults were followed during this period, resulting in 78,490 person-waves …

Development Of Competency-Based Online Genomic Medicine Training (Cogent), Susanne B Haga, Wendy K Chung, Luis A Cubano, Timothy B Curry, Philip E Empey, Geoffrey S Ginsburg, Kara Mangold, Christina Y Miyake, Siddharth K Prakash, Laura B Ramsey, Robb Rowley, Carolyn R Rohrer Vitek, Todd C Skaar, Julia Wynn, Teri A Manolio

Faculty, Staff and Student Publications

The fields of genetics and genomics have greatly expanded across medicine through the development of new technologies that have revealed genetic contributions to a wide array of traits and diseases. Thus, the development of widely available educational resources for all healthcare providers is essential to ensure the timely and appropriate utilization of genetics and genomics patient care. In 2020, the National Human Genome Research Institute released a call for new proposals to develop accessible, sustainable online education for health providers. This paper describes the efforts of the six teams awarded to reach the goal of providing genetic and genomic training …

Integrating Feminist Approaches In Counseling Work With Adult Women, Kristen M. Toole

Adultspan Journal

The scope of ‘women’s issues’ in counseling is an ever-evolving landscape. Recent events such as the reversal of Roe v. Wade and the disproportionate impact of COVID-19 on women serve as powerful reminders of the necessity of this focus while underscoring a deep-rooted history of oppressive patriarchal structures. Therefore, counselors must remain informed of the unique considerations surrounding adult women in counseling and acquire proficiency in versatile techniques to meet this population’s nuanced needs. This article examines the complexity of contemporary womanhood and explores the fundamentals of Feminist Counseling Theory (FCT), a holistic, multiculturally conscious, social justice theory in counseling. …

The Maternal And Infant Environmental Health Riskscape Study Of Perinatal Disparities In Greater Houston: Rationale, Study Design And Participant Profiles, R Jeanne Ruiz, Kristyn Grimes, Elizabeth Spurlock, Angela Stotts, Thomas F Northrup, Yolanda Villarreal, Robert Suchting, Melissa Cernuch, Liza Rivera, Raymond P Stowe, Rita H Pickler

Faculty, Staff and Student Publications

BACKGROUND: Pregnant Mexican Americans (hereafter called Latinas) and Black/African American women are at increased risk for psychological distress, contributing to preterm birth and low birthweight; acculturative stress combined with perceived stress elevates depressive symptoms in Latinas. Based on our prior research using a psychoneuroimmunology framework, we identified psychological and neuroendocrine risk factors as predictors of preterm birth in Latina women that are also identified as risk factors for Black/African American women.

METHODS/DESIGN: In this prospective, randomized controlled trial with parallel group design we will explore psychosocial, neuroendocrine, and birth outcome effects of the Mastery Lifestyle Intervention (MLI). The MLI is …

Exome Array Analysis Of 9721 Ischemic Stroke Cases From The Sign Consortium, Huichun Xu, Kevin Nguyen, Brady J Gaynor, Hua Ling, Wei Zhao, Patrick F Mcardle, Timothy D O'Connor, O Colin Stine, Kathleen A Ryan, Megan Lynch, Jennifer A Smith, Jessica D Faul, Yao Hu, Jeffrey W Haessler, Myriam Fornage, Charles Kooperberg, On Behalf Of The Trans-Omics For Precision Medicine Topmed Stroke Working Group, James A Perry, Charles C Hong, John W Cole, Elizabeth Pugh, Kimberly Doheny, Sharon L R Kardia, David R Weir, Steven J Kittner, Braxton D Mitchell, Sign Consortium

Faculty, Staff and Student Publications

Recent genome wide association studies have identified 89 common genetic variants robustly associated with ischemic stroke and primarily located in non-coding regions. To evaluate the contribution of coding variants, which are mostly rare, we performed an exome array analysis on 106,101 SNPs for 9721 ischemic stroke cases from the SiGN Consortium, and 12,345 subjects with no history of stroke from the Health Retirement Study and SiGN consortium. We identified 15 coding variants significantly associated with all ischemic stroke at array-wide threshold (i.e., p < 4.7 × 10-7), including two common SNPs in ABO that have previously been associated with stroke. Twelve of the remaining 13 variants were extremely rare …

Racial Disparities In Physician And Non-Physician Health Professionals: Investigating Barriers For Pre-Professional Students, Emily Remer

Honors Projects

“Diversity” is a buzzword across today’s educational, professional, and office settings. With so many looking to “diversify” their fields, it is important to note the endless ways in which people are diverse. From culture to religion to age to gender to race, and the intersectionality of them all, there has been a push to increase diversity as a means to better serve individuals in minority groups. While all forms of diversity are important, as is their intersectionality, the purpose of this project is to focus on racial disparities. There is no question that racial disparities exist across many roles we …

Examining Effective And Realized Healthcare Access In The West South Central Division., Katherine Cameron

Electronic Theses and Dissertations

This study explores realized and effective access domains outlined by Andersen’s Behavioral Model of Health Services Use. Exploring other domains of access is critical to understanding how the healthcare system functions (Kirby & Yabroff, 2020). This study evaluates rural-urban and racial/ethnic differences in access to care using two underresearched domains of healthcare access. It also allows for exploring access disparities within rural communities amongst minority populations. This dissertation is divided into five chapters. Chapter One provides an overview of health disparities and inequities and a brief overview of the study. Chapter Two details a high-level history of racism and its …

Assessing Treatment Access, Medication Use, Caregiver Strain And Emergency Service Use In Families Of Youth With Autism, Emmaline Thorpe

Psychological Science Undergraduate Honors Theses

Background: Families with autistic youth utilize emergency services (e.g., police, emergency department) at greater rates than neurotypical peers. While research has recently explored this phenomenon, unknowns remain in how pharmaceutical, therapeutic, family (e.g., caregiver strain), and child factors (concurrent challenging behaviors) may influence the likelihood of this population resorting to emergency care. Method: The current study recruited caregivers (N = 55) of youth with autism and co-occurring challenging behaviors (ages 2 – 22) to complete an online survey regarding their use of emergency services, child medication and therapy, and caregiver strain. Caregivers were compensated for their time. Results: Outcomes revealed …

The Impact Of Having Foreign Domestic Workers On Informal Caregivers Of Persons With Dementia: Findings From A Multi-Method Research In Singapore, Qi Yuan, Yunjue Zhang, Ellaisha Samari, Anitha Jeyagurunathan, Tee Hng Tan, Fiona Devi, Peizhi Wang, Harish Magadi, Richard Goveas, Li Ling Ng, Mythily Subramaniam

Research Collection School of Social Sciences

Background: Informal caregivers of persons with dementia (PWDs) sometimes engage foreign domestic workers (FDWs) to support their caregiving journey. However, there has not been much research to establish if this is really beneficial. The current study aims to investigate whether engaging FDWs specifically for caregiving of PWDs truly moderates caregiver stress and to explore caregivers’ experiences of engaging FDWs. Methods: A multi-method study design with a quantitative and qualitative sub-study was adopted. For the quantitative sub-study, 282 informal caregivers of PWDs were recruited. Propensity score matching analysis was used. For the qualitative sub-study, 15 informal caregivers with FDWs were interviewed. …

Parents’ Knowledge, Attitudes, And Practices Of Childhood Obesity In Singapore, Paulin Tay Straughan, Chengwei Xu

Research Collection School of Social Sciences

The obesity pandemic is increasingly threatening Asian populations. This is especially so for children from higher-income countries, such as Singapore. Among the various driving factors of obesity, parents’ health knowledge, attitudes, and practices are underexplored. The present study uses a nationally representative sample of 1,491 responses from Singapore to investigate parental knowledge, attitudes, and practices (KAP) about childhood obesity. Latent class analysis (LCA) on parents’ responses to the KAP survey reveals four unique parenting patterns: the limited knowledge group, the group with negative attitudes, the best practice group, and the limited practice group. Children of families in the best practice …

Acid Attacks: An Overview Of Legal Measures And Motivation Trends In India, Pakistan, Bangladesh, Colombia, And Cambodia, Gaia Calcini

Dignity: A Journal of Analysis of Exploitation and Violence

Vitriolage is a form of widespread violence around the world. This research analyzed legislative measures against the practice adopted by India, Bangladesh, Pakistan, Colombia, and Cambodia. The strengths and weaknesses of the different legal systems were examined. Motivational trends on why the violence was committed were reviewed in the literature in these countries. It was found that acid attacks are a form of gender-based violence. Countries where the measures were adopted to prevent attacks but failed to achieve the goal did not consider the attacks as a part of a broader problem. The only country that seems to have achieved …

A Cross-National Comparison Of The Linkages Between Family Structure Histories And Early Adolescent Substance Use, Haley Stritzel, Michael Green, Robert Crosnoe

Faculty, Staff and Student Publications

Family structure can influence adolescent health with cascading implications into adulthood. Life course theory emphasizes how this phenomenon is dynamic across time, contextualized in policy systems, and grounded in processes of selection and socialization. This study used data from the U.S. (National Longitudinal Survey of Youth 1979 Child and Young Adults, n = 6,236) and U.K. (Millennium Cohort Study, n = 11,095) to examine associations between a single mother family structure between ages 0-14 and early adolescent substance use at age 14 across time and place, using inverse probability of treatment weighting to explore how results varied by selection into …

Urban Health: A Practical Application For Clinical Based Learning, Cynthera Mcneill, Umeika Stephens, Tara Walker

Open Textbooks

Urban Health: A Practical Application for Clinical Based Learning is an openly licensed, peer-reviewed textbook for clinical-based nursing educators covering barriers in urban health and their impact on patient health outcomes. The authors explore perspectives of urban communities, urban patients, and urban healthcare providers to offer insight into how healthcare providers can address disparities in urban healthcare, provide meaningful care with the lived experiences of urban patients in mind, and improve patient-provider communication by moving towards a more solution-driven, team-based care approach. Features include learning activities, exemplars, and case studies.

Effect Of Covid-19 Pandemic On Volunteerism And Fundraising Management Strategies In Nonprofits And Rebuilding Tactics Of Ronald Mcdonald House Charities Of Chicagoland And Northwest Indiana (Rmhc-Cni), Humza Wolf

Nonprofit and NGO Studies Student Projects

The financial sustainability of nonprofits depends highly on volunteerism and funding strategies which got impacted during Coronavirus 2019 (COVID-19) Pandemic. This capstone study explores to what extent nonprofits got affected and evaluates the efforts of Ronald McDonald House Charities of Chicagoland & Northwest Indiana (RMHC-CNI) to improve the provision of support for underprivileged families of critically ill children. The continual efforts to overcome financial hurdles escalated in pandemic. Mixed method research design was used to collect, analyze, and triangulate both quantitative and qualitative research methods in this single study to understand the research problem. Interpretive approach encompassed the complexities of …

Exploring The Relationship Between Medical Research Literacy And Respondents’ Expressed Likelihood To Participate In A Clinical Trial, Jennifer Dykema, Cameron Jones, Dana Garbarski, Mia Farias, Dorothy Farrar Edwards

Sociology: Faculty Publications and Other Works

Medical research literacy (MRL) is a facet of health literacy that measures a person’s understanding of informed consent and other aspects of participation in medical research. While existing research on MRL is limited, there are reasons to believe MRL may be associated with a willingness to participate in medical research. We use data from a racially balanced sample of survey respondents (n = 410): (1) to analyze how MRL scores vary by respondents’ socio-demographic characteristics; (2) to examine how MRL relates to respondents’ expressed likelihood to participate in a clinical trial; and (3) to provide considerations on the measurement of …

Which Patient Experiences Are You Capturing? Investigating Differences In Patient Experience Drivers By Race/Ethnicity And Survey Mode, Meike Eilert, Toni Land, Jonathan Shafer

Patient Experience Journal

To address existing disparities in healthcare for underserved populations, healthcare providers and policymakers need to understand how the experiences of these patients differ to take meaningful action. In this study, we examine whether drivers of patient experiences (PX) for underserved populations vary. Using data from the 2018 and 2019 CAHPS Adult PCMH/Adult Primary Care 6 Month (n = 166,349), we examine differences in the importance of PX drivers - effective communication, helpful and courteous staff, timely appointments, and providers’ use of information - across underserved patients. We further examine whether different survey modes compound the observed differences. The findings show …

From 'Pandemic' To 'Endemic' And Beyond: Key Aspects Of Research On Older Singaporeans In A Year Of Transition, Nadya Haifan, Jane Tan, Rachel Wen Yi Ngu, Mindy Eiko Tadai, Yan Er Tan, Grace Cheong, Micah Tan, Wensi Lim

ROSA Research Briefs

The past year has been one marked by transition – as a country we have moved from treating COVID-19 as a pandemic to living with it as an endemic disease. Research conducted by the Centre for Research on Successful Ageing (ROSA) has taken a similar trajectory, expanding the scope of investigations from COVID-19 topics to other areas that are important for the general well-being of older adults in Singapore. This report showcases ROSA’s research involving older Singaporeans and the partnerships that have been forged in the past year. These developments will be presented in two sections. The first outlines the …