Master of Public Health
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Item Moomoomomma: Creation of a Breastfeeding Community Webpage(2017-08) Harford, Sydni YvonneBackground: More women today breastfeed for shorter periods of time or not at all. Lack of education and promotion has lead society to shame breastfeeding mothers. The drop in breastfeeding rates up to the age of one warrants further research on how to better educate the public on its importance. Purpose: The purpose is to develop a webpage that will help promote and educate individuals about breastfeeding, its benefits, and a breastfeeding mother’s rights. Informal needs assessments suggest that support and education may help to promote further duration of breastfeeding. Secondary data also suggests that further education and support may help to improve a mother’s desire to breastfeed. Creation of a webpage that will promote breastfeeding and education may address these needs. Implementation: Using an informal needs assessment and secondary data, a webpage focusing on breastfeeding education and support was created. Topics to be covered include: breastfeeding and its benefits, a breastfeeding mother’s rights, and exclusively pumping. The site has been promoted on support groups through social media. Conclusion: Further breastfeeding education and promotion is needed. Those who visit the page will become more aware of breastfeeding, its benefits, and a breastfeeding mother’s rights. This page is expected to promote a better understanding and acceptance of breastfeeding within public areas and encourage mothers to breastfeed up to at least the first year of life.Item To Run or Not to Run: Understanding Motives and Barriers Among Female Runners(2018-08) Franco, Alice ElenaThis study examines females’ various motives and barriers for running. Female event participation has grown exponentially over the past two decades. However, current research does not explore levels of runners to include the evolving running culture, nor does it explore stages experienced throughout motherhood in connection to running. Using an online questionnaire, a total of 150 female runners were grouped into different runner levels (e.g. serious, enthusiastic, and incidental) as well as different stages of motherhood (e.g. mothers with young children, mothers with school aged children, mothers with older children, and females with no children). Participants completed the Motivations of Marathoners Scales (MOMS) to measure running motives and a modified version of the Exercise Benefits/Barriers Scale (EBBS) to measure running barriers. Multiple multivariate analysis of variance (MANOVA) analyses were used to test the hypothesized differences. As a group, serious runners endorsed goal achievement, competition, life meaning, psychological coping, and affiliation as reasons for running. Enthusiastic runners were more likely to endorse personal goal achievement than incidental runners. Additionally, mothers with young children were more likely to cite family barriers as barriers to running than mothers with older children or females with no children. The findings’ potential applications to research, programs, policy, and training are discussed.Item Examining the Relationship Between Mental Health Status and Alcohol Consumption Among College Aged Adults(2018-08) Kozam, Narjs OmarMental health disorders and alcohol use have been identified as public health issues. Research indicates that young adults have relatively high rates of mental health disorders and alcohol use. The main purpose of this study is to examine the relationship between mental health status and alcohol consumption among college-aged adults living in California, using the 2016 Behavioral Risk Factor Surveillance System (BRFSS). It was also examined whether race/ethnicity, gender, and income variables affect the relationship. A random sample of 1,087 male and female college-aged adults living in California was used. Using a cross-sectional design, participants completed a phone survey containing demographics and health questions. The dependent variable was alcohol consumption, and the independent variables were race/ethnicity, gender, income, and mental health. A Chi-Square test of independence and a binary logistic regression model were used to answer the research questions. The result of the study indicated that there is no significant relationship between mental health status and alcohol consumption among college-aged adults. Also, race/ethnicity, gender, and income did not predict or modify the relationship between alcohol consumption and mental health.Item The Relationship between Physical Limitations and Depressive Disorders in Adults(2018-08) Taylor, FlorabethDepression has a potential impact on adults with physical limitations. The purpose of the study is to determine if adults with physical limitations have a higher chance of being diagnosed with a depressive disorder than persons who are not physically limited. A cross-sectional design was used to determine the relationship between physical limitation and depressive disorders in adults of the state of California. The study also looked to determine if having a physical limitation influences alcohol use in California adults. Survey responses from 21,034 California adults were used in the study, and a 10% random sample was run three times; the 10% random sample used in the analysis for this study includes 2,029 respondents. Self-reported data from the 2015 California Health Interview Survey (CHIS) was used to determine the relationship between having a physical limitation and depressive disorders, as well as the relationship between physical limitation and alcohol use. A significant relationship was found between physical limitation and depressive disorders. There is also a significant relationship between physical limitation and alcohol use. The result of this study suggests further studies to investigate other factors that may co-exist with physical limitation and the effects on an individual’s risk of having a depressive disorder or use of alcohol.Item Measuring the Impact of a Mental Health Intervention on Perception of Stigma and Help-Seeking Behaviors(2018-08) Berrios, Eileen JMental illness is a condition that alters an individual’s thoughts, feelings, and behaviors. Within the United States, the stigma associated with mental illness is highest among the African American community. African Americans are less likely than other groups to acknowledge the seriousness of a mental illness. The aim of this study was to determine the relationship between perceived mental health stigma and help-seeking behaviors before and after the implementation of a faith-based mental health intervention among African American females. Additionally, income was explored as a possible influence on the relationship between the perception of stigma and help-seeking behaviors. Program participants completed paper-based pre-and post-tests administered by program evaluators during Week 1 and Week 8 of the program. The survey instrument used to collect the pre- and post-test data consisted of a combination of questions mandated by the California Department of Public Health Office of Health Equity and questions developed by the program evaluators. A paired-samples t-test was used to answer the first research question, while a multiple linear regression was used to answer the second question. The findings of the study indicated that participant scores remained closer to “Probably Willing” to socialize, make friends, work, and live with someone who has a mental illness. In addition, neither perceived stigma nor income was found to be a significant predictor of help-seeking behaviors.Item Exploring the Difference Between the Perception of the Effectiveness of Provider Communication Across Ethnicity Categories and Education Level(2018-12) Muñoz, Javier FranciscoPatient experience has the ability to alter an individual’s perception on the effectiveness of provider communication. Patient experience measures the quality of patient-centered care rather than the general satisfaction of a patient’s doctor visit. The aim of this study was to explore the differences between patient experience and the perception of the effectiveness of provider communication for individuals who are of Hispanic or Latino ethnicity compared to non-Hispanic or Latino Medicaid enrollees. In addition, the study explored the differences between patient experience and the perception of the effectiveness of provider communication for individuals at different levels of educational attainment. The Consumer Assessments of Healthcare Providers and Systems (CAHPS) Adult Medicaid survey data was used to determine if there are differences. The CAHPS is a national standard for collecting and reporting information about patient care experience. A Mann-Whitney U test was used to answer the first research question. A Kruskal-Wallis test was used to answer the second research question. The findings of this study determined a difference between Hispanic and Latinos and non-Hispanic and non-Latinos patient experience and perception of the effectiveness of provider communication. In addition, no difference of patient experience and effectiveness of provider communication was found across different levels of educational attainment.Item An Analysis of the Relationship Between Income, Gender, and Perception of Gun Violence in One’s Local Community(2019-04) Hinrichs, Courtney AlexandraGun violence has significant impacts on an individual’s health and well-being. In 2017, Pew Research Center conducted a national probability-based online survey titled the American Trends Panel (ATP) Wave 25. The survey targeted adults living in households in the United States (Pew Research Center, 2017). This cross-sectional research study utilized the Pew Research Center’s American Trends Panel to examine differences in local communities’ perceived problem of gun violence between genders and income levels. In this study, a Pearson Chi-Square was calculated analyzing gender and income level as variables predicting an individual’s perception on the degree of the problem of gun violence in one’s local community. It was found that perception of local community gun violence did not differ between genders. However, perception of local gun violence did significantly differ among income levels.Item An Evaluation of the Relationship between Self-Reported Delays in Seeking Medical Care and Gender(2019-04) Gomez, Sandra VeronicaDelay in seeking medical care has been a growing problem across the nation. People delay medical services that are required for their health every day. Delay in care is attributed to diagnosis of chronic conditions that cost millions of dollars to treat each year in the United States. The purpose of this study was to determine a relationship between delay in seeking medical care, gender, health care cost, and health insurance status. The study was conducted using the 2016 California Health Interview Survey (CHIS), which is a cross-sectional study that interviews California residents and evaluates a variety of heath topics. Subjects were drawn using a random sample of all adults ages 18-80 years of age who were non-institutionalized. The 2,072 participants in the study, males (n= 915) and females (n=1,157) all came from different ethnic backgrounds. A Chi-Square Test of Independence was conducted to analyze the relationship between delay in seeking care, gender, health care cost, and health insurance status. The results indicated no significant relationship between gender and delay in seeking care with only a 3% difference between males and females; 10% of males compared to 13% females reported delays in care in the last 12 months (P > 0.05). A Chi-Square Test of Independence was also conducted to test the relationship between delay in seeking care and health care cost and health insurance status. A smaller sample (n = 224) participants was drawn to only include the subset of the sample eligible: individuals who answered yes or no to delaying care in seeking care. Results indicated no significant relationship between gender and healthcare costs and health insurance status; 39.3% of males stated there was a delay in care due to health care costs, compared to 38.3% females (P > 0.05). Gender, health care cost, and health insurance status were not identified as factors that cause people to delay care. Future studies should evaluate other socioeconomic or social determinant factors.Item Health Insurance and the Impact of Citizenship Status, Employment Status, and Poverty Status(2019-05) Pryde, Sandra MichelleThe Patient Protection and Affordable Care Act’s expanded access to health insurance in 2014 did not guarantee access to health insurance for low-income and undocumented immigrants living in the U.S. While employment status and poverty status are estimated to play a major role in the prediction of health insurance status, this study hypothesized that citizenship status predicts health insurance status the most. Using secondary data from the 2017 California Health Interview Survey (CHIS), this study examined a random 10% sample of the adult respondents. Dichotomous variables were created from the HMO Status, Citizenship Status Employment status, and Poverty level status variables of the CHIS. A chi-square test of independence was performed to determine the relationship between health insurance and citizenship, employment, poverty. A Binary logistic regression was performed to identify the strongest predictor of health insurance status among citizenship, employment, poverty. A significant association between citizenship status and health insurance status was found, (X2 (1) = 40.37, p < .001). The odds of being insured were 4.3 times higher among citizens, compared to non-citizens. Citizenship status had the greatest significant influence on health insurance status (p = .001). Those who are non-citizens are 71% less likely to have health insurance compared to citizens. The findings of this study suggest that policy interventions should include further expansion of health insurance eligibility for immigrants. A wider net of eligibility would improve the uptake in health insurance, leading to better health outcomes with the improved access to healthcare. In order to minimize the barriers to accessible healthcare and for improved health outcomes of our nation as a whole, policymakers must understand the current relationship and impact of citizenship status on health insurance status. This study contributes to that understanding.Item Polycystic Ovarian Syndrome (PCOS), Type 2 Diabetes Risk Factors and Environmental Influences on PCOS(2019-05) Frost, Rebecca GaylePolycystic Ovarian Syndrome (PCOS) is an endocrine condition that affects nearly 4-21% percent of women of reproductive age (Azziz, Carmina, Dewailly, Diamanti-Kandarakis, Escobar-Morreale, Futterweit, Jannsen, Legro, Norman, Taylor, & Witchel, 2006). Symptoms of the syndrome include insulin resistance (IR), infertility, hirsutism, and obesity (Sivanandy, Zuuren, & Aird, 2018). The etiology and cause of the condition remain largely unknown (Roe & Dokras, 2011). The purpose of this study is to examine possible connections between PCOS and Type 2 Diabetes (T2D) by investigating behavioral, obesogenic, and other risk factors associated with T2D. This study also investigates environmental and behavioral exposures experienced by individuals in their daily lives, as well as if these environmental factors correlated with adverse effects on the PCOS condition. Little is known about the environment and its affect, if any, on women diagnosed with PCOS. Two research questions were posed for this study: first, if there is a relationship between PCOS and T2D and second, if there are environmental factors that have any adverse effects on the PCOS condition. The study design was cross-sectional and observational in nature, using a survey administered via social media. Risk factors for T2D include obesity and a higher body mass index (BMI). The results of this study found a statistical association between some areas related to T2D risk factors and an increased likelihood for a selfreported diagnosis of PCOS. On the other hand, this study found no statistical association between environmental factors and adverse effects on the PCOS condition. The public health and future implications of the study are vast. Future analysis could include clinical studies on A1C levels of women with PCOS. This could further define the association between IR and PCOS.Item An Evaluation of the Differences in Self-Reported Serious Psychological Distress, Race, Income, and Insurance Status(2019-08) Holguin, Michelle JosephineMental health is an on-going public health concern that has become a more prominent issue over the last several years. While suicide rates continue to rise, many individuals still do not receive mental health treatment. Further, a large population of adults with mental health disorders do not receive treatment for their condition despite overall increases in treatment rates in the past 20 years (Walker, Cummings, Hockenberry, & Druss, 2015). The purpose of this study was to evaluate the occurrence of serious psychological distress across race categories and income levels as well as the rate of insurance coverage for mental health needs across race categories for those who have reported mental health problems within the last year. Research has shown that individuals from different ethnicities may have different barriers in accessing health services. This study employed a cross-sectional design utilizing data from the 2017 California Health Interview Survey (CHIS). One-way ANOVA tests were used to evaluate separately differences in serious psychological distress across race categories and income levels. A Kruskal Wallis H test was used to evaluate differences in mental health insurance coverage across ethnicity categories. The findings of this study determined a significant difference in serious psychological distress across ethnicity categories (p < .01). A significant difference was also found in serious psychological distress across income levels (p < .01). However, no difference in insurance coverage was found across ethnicity categories.Item Exploration of Factors that Influence Workforce Development Needs for a Local Public Health Department(2019-08) Cheema, KirndeepHealth disparities cause a significantly impact public health employees. Some public health employees have a better understanding of why health disparities exist and are interested in reducing them. It is important that public health staff work together in order to understand why disparities occur. The Improved Health for All discussion series helped determine if public health employees had an interest in addressing health disparities. The discussion series took place at a local public health training session during the sixth and final module. The IHA intervention was designed to educate the staff on the relationship between inequities and health disparities Participants were asked to participate by taking a survey, which measured their behavioral intentions on health disparities and length of employment and the completion of formal public health training. The study used a retrospective pretest design to collect pretest and posttest data from staff at a local health department. In this study, a partial correlation was calculated to determine if length of employment influenced public health employees’ behavioral intentions. This was conducted after controlling for pretest responses, which showed that there was no significant relationship between length of employment and behavioral intention. An Independent Samples t-test was conducted to determine if there was an association between employee age and completion of formal public health training. The results showed that there was a statistically significant difference in age and formal public health training.Item Determinants of Depressive Symptomology among College Students(2019-08) Navarro, Olivia JamileRates of depression among college students is on the rise across the United States, and the consequences are dire. This study aimed to determine if various lifestyle choices protected or put college students at-risk for developing depressive symptomology. This study examined the effect of four potential determinants and depressive symptomology: spirituality, social media use, residential status (on- or off-campus), and employment status among undergraduate college students. This study was conducted at a private Christian university and included 220 participants who completed a paper-based survey. A cross-sectional design from a convenience sample was used. Results of this study found a statistically significant association between fewer depressive symptomologies and “feeling deep inner peace or harmony.” There was also an association found between depressive symptomology and social media use. There were no significant findings for depression and residential status or employment status.Item Exploring the Relationship between Firearm Suicides, Gender, and Occupation in Riverside County, California(2019-08) Hunt, ShaniceSuicide is a leading cause of death in the United States, affecting nearly 47,173 individuals in 2017. Research has shown gender has influenced the method of suicide used by decedents. The purpose of this study is to identify if gender, income, or occupation are predictors of suicide. Additionally, this research will explore the potential influence of occupational firearm access in firearm-related suicide mortality and access to lethal means. Research on firearm and suicide mortality will allow for a better understanding of the epidemiological profile of firearm-related deaths and injury. Such research can inform discussions regarding the potential occupational exposure risks as well as identify policy implications.Item Exploring the Rates and Determinants of Prenatal Care Among Non-Hispanic Black Women(2019-08) Reid, Bianca L'erinThe rates in mortality among non-Hispanic black women have been on the rise across the United States. Overall, black women are up to four times more likely to succumb to a pregnancy-related death than non-Hispanic white women. The participants in this study were taken from the Pregnancy Risk Assessment Monitoring System (PRAMS) survey. This thesis sought to find the association of adequate prenatal care (nine or more prenatal care visits during pregnancy) among non-Hispanic black women by using an observational, cross-sectional study design. There were over 38,500 women within the PRAMS data, which is a representative sample of the make-up of the nation. Most non-Hispanic black women reported that they did not obtain adequate prenatal care, and it was found that there was a significant association of health determinants (education attainment, age range, income levels, and planned or not planned pregnancy) among this group which may have impacted their maternal health experiences. As research continues to unfold the layers of black women’s maternal health, policies must be implemented and enforced to attain significant change that will enhance the lives of black women and future generations.Item An Evaluation of the Relationship Between the use of Methamphetamine and Suicide Ideation(2019-08) Abdellatif, FatimaMethamphetamine (MA) use is a worldwide problem, with more users than cocaine and opiates combined (LaGasse et al., 2012). According to the World Health Organization (WHO) (2019), over 35 million individuals regularly use/abuse one of the types of amphetamine/methamphetamine. Abusing methamphetamine can cause mental health issues and a lot of emergency room visits that cost 23.4 billion in 2005 (Nicosia, 2005). The purpose of this study was to evaluate the relationships between methamphetamine use and suicidal ideation as well as methamphetamine use and depression. The study was conducted using the 2017 National Survey on Drug Use and Health data (NSDUH), which is a cross-sectional study that interviews United States residents and evaluates their drug use and health. Subjects were drawn using a random sample of all adults’ ages 18 years of age and above. The 2,814 participants in the study consisted of 1,407 methamphetamine users and 1,407 non methamphetamine users; however not all participants sampled answered all questions and therefore each analysis features a smaller different sample size all above the minimum sample size required. A Chi-Square Test of Independence was conducted to analyze the relationship between the use of methamphetamine, suicidal ideation, depression and gender. The results indicated a significant relationship between methamphetamine and suicidal ideation (P > 0.043). A smaller sample (n = 597) of participants were eligible to complete the suicidal ideation question and therefore included in the analysis for the research question comparing suicidal ideation in methamphetamine users and those who have never used methamphetamines. Results indicated a significant relationship between methamphetamine use and self-reporting depression (P < .001). An analysis of the 414 individuals in the sample who both used methamphetamines and who responded to the suicidal ideation question indicated no significant relationship between gender and suicidal ideation amongst those who have used methamphetamines at some point; 42.6% of males, compared to 54.4% females (P > 0.503). This study illustrated an association between Methamphetamine use and factor that caused depression and suicidal ideation. Future studies should evaluate other socioeconomic or social determinant factors.Item Exploring the Association between Marijuana Use, Depression, and Suicidal Ideation(2019-08) Mardini, NajwaThe normalization of marijuana and the national increase of its use have been identified as public health issues (Lau et al., 2015; Tilburg, Hodge, & Gourdet, 2019). In addition, depression and mental health in the United States have become an increasingly important issue to address. Current research has indicated a need for further exploration regarding the use of marijuana and the potential mental health issues that could arise from it (Stoner, 2017). The purpose of this study was to explore the association between marijuana use and a major depressive episode (MDE). Additionally, this study explored the potential link between marijuana use and suicidal ideation. Data for this study was obtained from the 2017 National Survey on Drug Use and Health (NSDUH), and participants were U.S. adults ages 18 and older. A cross-sectional study design was used, and a random sample of 108 participants was selected. The results of this study indicated that there was no significant association between marijuana use and experiencing an MDE (X2 (1) = .037, p = .847), and no association between marijuana use and suicidal ideation (X2 (1) = 5.15, p = .174). Additionally, alcohol use, cocaine use, ethnicity, gender, heroin use, methamphetamine use, and school attendance had no effect and did not modify the relationship between marijuana use and experiencing an MDE (X2 (13) =12.386, p = .496).Item Exploring the Relationship Between Depression and Marijuana Abuse Among Pregnant Women in California(2019-08) Gonzales, NancyMarijuana abuse and depression during pregnancy has been a major public health concern across the United States. Marijuana abuse leads to many negative effects for both the mother and the fetus. Negative effects include behavioral issues, low birth weight, and neurodevelopment problems. Depression is also a concern because of the consequences that it may have for the mother and baby especially during their bonding time. The purpose of the current study was to understand how pregnancy impacts depression and marijuana use. Understanding the impact of pregnancy between these two factors can lead to increased health education, resources, treatment and policies for women, researchers, and health professionals. This was a cross-sectional study that used the 2017 California Healthy Interview Survey. The survey interviews California residents from various age groups. Demographic and outcome data were analyzed using a Chi-Square Test of Independence. There was a total of 2,048 respondents included in the study, in which 74 reported a pregnancy. The results indicated that 12.2% (n = 9) of those who reported being pregnant also reported being depressed compared to 26.7% (n = 800) of the sample who reported not being pregnant but experiencing depression. Results indicated a significant relationship between depression and pregnancy (X2(1) = 7.907, p < .05). Those who reported a pregnancy were 62% (OR = .379) less likely to report being depressed compared to those who did not report a pregnancy. A Chi-Square Test of Independence was also conducted to analyze the relationship between marijuana abuse and pregnancy. The results indicated that there was no significant relationship between marijuana use and pregnancy (X2(1) = 3.022, p > .05). Marijuana abuse and depression are important areas that need to be addressed in order to further improve maternal health and birth outcomes across the nation.Item The Relationship between the Acculturation of Older Foreign-Born African Immigrant Parents in the United States and Their Attitude towards the Utilization of Mental Health Services for Children(2019-08) Obideyi, Mary IkeolaRates of mental health disorders are high among U.S. minority adolescents, especially in California where African American adolescents have the highest mental health disorders among any other race/ethnicity (California Health Care Foundation, 2018). Furthermore, African American adolescents utilize mental health services at much lower rates compared to their White counterparts (Division of Diversity and Health Equity, 2017). African American adolescents not utilizing mental health services may be influenced by their parents’ unwillingness to seek mental health services for them (Polaha, Williams, Heflinger, & Studts, 2015; Mukolo, Heflinger, & Wallston, 2010). The purpose of the study was to assess the relationship between the acculturation of older, foreign-born African immigrant parents in the United States and their attitude towards the utilization of mental health services for children. A convenience sample of 104 older foreign-born African immigrant parents were recruited from predominantly African churches and community centers in Southern California. A self-administered, four-page survey questionnaire based on the Suinn-Lew Self-Identity Acculturation Scale and the Parental Attitudes Toward Psychological Services Inventory (PATPSI) were used to measure older foreign-born African immigrant parents’ level of acculturation into the United States and their attitudes towards using mental health services for children. Measures also examined participants’ levels of education, gender, and length of stay in the U.S. Results showed that there was a statistical significance between the relationship of the length of stay in the U.S. and parents’ attitudes toward using mental health services for children (r(90) = .22, p < .05). Future public health directions are discussed at the end of this paper.Item Public Health Workforce Training Gaps(2019-08) Brown, Nicole CorrinneIn 2010, the public health workforce was identified as one of the six public health areas that urgently need quality improvement by the Department of Health and Human Services Office of the Assistant Secretary of Health. In 2014, the Public Health Workforce Interests and Needs Survey (PH WINS) surveyed over 10,000 public health workers on perceived confidence in performing 18 skills based on the core competencies of public health professionals. The purpose of this study was to identify perceived skill gaps between those with a public health degree and non-public health degree and years in the workforce based on a sampling of responses from the PH WINS. Of all participants (n = 1,374), very few (n = 155) had either a Master of Public Health (MPH) or Doctorate of Public Health (DrPH). The majority of the sample were females (72.5%) between the ages of 41 and 60 (60%) and non-Hispanic White (70.2%). Of the 18 public health skills listed in the questionnaire, those with a public health degree were significantly more confident in performing 17 of the skills than those with a non-public health degree. This study helps to identify areas in need of strengthening in the workforce. A competent workforce is important to ensuring success in public health initiatives and programming.