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- All Subjects: public health
- Creators: Jehn, Megan
Description
This study examines associations between clean water, sanitation, mosquito net usage, and immune biomarkers among the Tsimane, a remote subsistence population of forager-horticulturalists with a high pathogen load. Interviews with heads of household (n=710, aged 18-92, median age 40 years) were conducted to ascertain household water sources, ownership and usage of mosquito nets, and latrine use. In this sample, 21% of households used latrines, 20% always boiled their water, and 85% used mosquito nets. Regression models estimate their associations biomarkers of pathogen exposure, including white blood cell count (WBC), hemoglobin (Hb), eosinophils, and sedimentation rate (ESR). Controlling for age, sex, and distance from the closest market town, latrine use (Std. β = -0.11, p= 0.017) and boiling water (Std. β = -0.08, p= 0.059) are associated with lower WBCs. Latrine use is marginally associated with higher hemoglobin (Std. β = 0.09, p= 0.048), but not boiling water (p= 0.447). ESR trends toward lower levels for households that always boil water (Std. β= -0.09, p= 0.131), but is not associated with latrine use (p=0.803). Latrine use was significantly associated with lower eosinophil counts (Std. β= -0.14, p=0.013), but not boiling water (p=0.240). Mosquito nets are not associated with any of these biomarkers. Both boiling water and latrine use are associated with better health outcomes in this sample. These results suggest that scarce public health resources in rural subsistence populations without malarial risk may wish to prioritize boiling water and latrine use to improve health outcomes.
ContributorsDinkel, Katelyn Aubree (Author) / Trumble, Benjamin (Thesis director) / Costa, Megan (Committee member) / Jehn, Megan (Committee member) / School of Mathematical and Statistical Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
Background: This study examines how pro-vaccine flu messages, guided by the Extended Parallel Process Model (EPPM), affect parents’ intentions to vaccinate their children.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
ContributorsHall, Sarah (Author) / Jehn, Megan (Thesis advisor) / Mongeau, Paul (Committee member) / Hruschka, Daniel (Committee member) / Margolis, Eric (Committee member) / Arizona State University (Publisher)
Created2015
Description
Short-term medical missions (STMMs) are groups of volunteer medical providers who travel to provide health care, including basic services and surgeries, to global low-income populations. STMM organizations present their work as contrary to both public and private systems within Guatemala that do not adequately serve the patient population, though they operate within the same framework as other providers and mirror the same neoliberal ideology in their planning, organization and strategy, and execution. STMMs strive to offer free, high-quality access to surgeries and basic health care services via volunteer medical providers willing to dedicate their time and skill to low-income patients. The patient population of STMMs in Guatemala, who are often rural, indigenous, and low-income, already experience diminishing access to health care due to neoliberal health policies and discrimination within the existing health care landscape, going to great lengths to access quality health care services. This research investigates the planning, organization and strategy, and execution of STMMs through the lens of the enduring influence of neoliberal health ideologies on volunteer medical providers and existing health resources in Guatemala. Organizational strategies that prioritize the ease of travel for volunteer medical providers mirror the geographical lack of health care access, neglect of indigenous language services in the health care context, and urban focus already existing in the country’s public health care system. The patient population experiences heightened vulnerability exacerbated by STMMs when seeking care because of their low adherence to Guatemalan law surrounding registration requirements for foreign medical providers and poor institutional accountability, burdening patients, who lack legal literacy and financial resources, with denouncing malpractice or post-operative problems. Finally, STMM providers expect patients to both demonstrate passivity, humility, and material deficiency and show that they can be ‘good’ patients—able to understand and abide by the authority of the medical providers, know what information to provide, and communicate effectively—essentially, to be good health consumers. Ultimately, this research demonstrates how neoliberal health ideologies remain deeply engrained in the psyche of STMM organizations, despite their targeted approach to deliver health care to patients struggling to access services in Guatemala’s chaotic health care landscape.
ContributorsDriese, Mary Catherine (Author) / Maupin, Jonathan N (Thesis advisor) / Hall-Clifford, Rachel (Committee member) / Jehn, Megan (Committee member) / Arizona State University (Publisher)
Created2022
Description
The COVID-19 pandemic has renewed interest in the importance of indoor air quality for health. The spread of respiratory aerosols is the primary mechanism for COVID-19 transmission, making it crucial to understand the role of effective ventilation in managing the risk of disease transmission. The concentration of exhaled carbon dioxide (CO2) in indoor spaces can be used as a proxy measure of ventilation efficiency. Poor indoor air quality has been associated with a range of acute and chronic health problems, including respiratory issues, cardiovascular disease, and cancer. Poor air quality may also impair cognitive performance and productivity. Social and economic inequalities exacerbate the impact of indoor air quality issues, making it crucial to address these problems in an equitable manner. Public libraries have been identified as an effective intermediary for providing education and free air quality monitoring technology to communities, with the ultimate goal of promoting awareness and increasing access to tools to promote accountability for maintaining high indoor air quality standards. The primary objectives of this initiative are to: 1) develop a citizen science toolkit for assessing indoor air quality in public spaces and deploy the toolkit to public libraries in Arizona; and 2) to conduct a program evaluation to determine whether this kit can be effectively deployed through public libraries to promote citizen science efforts and engage community members in promoting healthier indoor air quality, identify areas where improvements can be made, and prepare the program to be scaled to a larger audience.
ContributorsYoung, Parker (Author) / Jehn, Megan (Thesis director) / Cavalier, Darlene (Committee member) / Barrett, The Honors College (Contributor) / School of Molecular Sciences (Contributor) / School of International Letters and Cultures (Contributor)
Created2023-05
Description
Latest estimates show that roughly 188 individuals in the United States die everyday due to an opioid-related overdose. This dissertation explores three avenues for
mitigating opioid use disorder (OUD) and the opioid epidemic in the United States (1.)
How can researchers and public health professionals identify areas most in need of
treatment for OUD in an easy-to-use and publicly accessible interface?; (2.) What do
practitioners see as opportunities for reducing barriers to treatment?; and (3.) Why do
differences in opioid mortality exist between demographic groups? To address question
one, I developed an interactive web-based to assist in identifying those counties with the
greatest unmet need of medically assisted treatment (MAT). To answer question two, I
conducted a study of stakeholders (medical providers, peer support specialists, public
health practitioners, etc.) in four New Mexico counties with high unmet need of MAT. to
identify cultural and structural barriers to MAT provision in underserved areas as well as
opportunities for improving access. To answer the third question. I conducted a
systematic review of peer-reviewed literature and government reports to identify how
previous research accounts for race/ethnic and sex disparities in opioid-related
mortality. While many opioid mortality studies show demographic differences, little is
known about why they exist. According to the findings of this systematic review, research
needs to go beyond identifying demographic differences in opioid-related mortality to
understand the reasons for those differences to reduce these inequities.
ContributorsDrake, Alexandria (Author) / Hruschka, Daniel (Thesis advisor) / Jehn, Megan (Committee member) / Scott, Mary Alice (Committee member) / Arizona State University (Publisher)
Created2023
The Association Between School COVID-19 Mitigation Policies and School-Associated COVID-19 Outbreaks
Description
SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is an enveloped single-stranded positive-sense RNA virus that originated in China and has rapidly spread worldwide. With the Delta variant arriving before many K-12 schools in Arizona resumed in-person learning for the 2021-2022 academic year, a plethora of mitigation measures were utilized by schools. Public schools in both Maricopa and Pima county without mask mandates were found to be 3.5 times more likely to have COVID-19 outbreaks in comparison to those with mask requirements at the start of the school year. In addition, when analyzing the presence of three other mitigation measures (cohorting, random testing, and use of improved air filtration), only 5.42% were found to use all four mitigation measures.
ContributorsGue, Matthew (Author) / Jehn, Megan (Thesis director) / Ross, Heather (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2022-05
Description
Objective: To provide insight into the World Health Organization SAGE Working Group Vaccine Hesitancy Survey by applying the tool to populations across Maricopa County, Arizona. Design: An online survey was conducted using the Qualtrics Survey Software, of individuals residing in Maricopa County, Arizona during the month of October 2019. Results: Of 209 respondents, the followed demonstrated to be the top 3 reasons for either having not received the flu shot yet or having not planned to receive the flu shot: “I’m healthy, I don’t need it”(20.1%); “Worried I might get the flu from it”(17.7%); “I don’t think it works”(17.7%) Statistical analysis demonstrated that vaccine hesitant and non-hesitant respondents are likely to respond differently to topics covering: safety of vaccines; self-perceived health status; importance of the flu shot among one’s peers; flu vaccine related knowledge Conclusions: The WHO VHS applied to the population of Maricopa County, Arizona reported little hesitancy towards the seasonal flu vaccine. Statistical analysis of Vaccine Hesitant respondents vs. Non-Hesitant respondents demonstrates that specified public health education focused on the immunological implications of vaccines may be needed for the hesitant population to gain confidence in vaccine efficacy. A more diverse respondent group that consists of residents beyond the county lines of Maricopa is needed to understand the full scope of vaccine hesitancy that exists in Arizona.
ContributorsMaroofi, Hanna (Co-author, Co-author) / Jehn, Megan (Thesis director) / Muabyi, Anuj (Committee member) / School of International Letters and Cultures (Contributor) / School of Life Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Contact tracing was deployed widely during the COVID-19 pandemic to attempt to stop the spread of SARS Co-V-2. This dissertation investigates the research on contact tracing from a scientometric perspective and looks qualitatively at how case investigators and contact tracers conducted public health practice during the pandemic. Through approaching the public health practice of contact tracing from both a broad, top-down angle, and an on the ground experiential approach, this dissertation provides insight into the issues facing contact tracing as a public health tool.
ContributorsWhite, Alexandra C. (Author) / Jehn, Megan (Thesis advisor) / Hruschka, Daniel (Committee member) / Gaughan, Monica (Committee member) / Arizona State University (Publisher)
Created2022
Description
Background. Street food stands (SFS) are common ways in which people in Mexico access food, having been a part of the environment and culture of Mexican food for generations. However, no studies have used a validated assessment tool to reliably measure food and beverage availability at a variety of SFS. Nor have the availability, density, variety, and distribution of SFS and street foods and beverages been assessed across neighborhood income levels.Objective: This dissertation’s goal was to decrease gaps in knowledge about the role SFS may play in food availability in the Mexican food environment.
Methods: Survey design and ethnographic field methods were used to develop, test, and validate the Street Food Stand Assessment Tool (SFSAT). Geographic information system and ground-truthing methods were used to identify a sample of street segments across 20 neighborhoods representing low-, middle- and high-income neighborhoods in Mexico City on which to assess the availability, density, variety, and distribution of SFS and the foods and beverages sold at these food venues using the SFSAT.
Results: A sample of 391 SFS were assessed across 791 street segments. Results showed that SFS were found in all neighborhoods. Contrary to the initial hypothesis, most SFS were found in middle-income neighborhoods. While the availability of street foods and beverages was higher in middle-income neighborhoods, the variety was less consistent: fruit/vegetable variety was high in high-income neighborhoods whereas processed snack variety was higher in low-income neighborhoods. SFS were most often distributed near homes, transportation centers, and worksites across the three neighborhood income levels.
Conclusion: This study bridged the gap in knowledge about the availability, density, variety, and distribution of SFS and products sold at these sources of food by using an assessment tool that was developed, tested, and validated specifically for SFS. The findings showed that SFS were found across all neighborhoods. Furthermore, results also suggested that SFS can be a source of healthy food items. Additional studies are needed to understand the relationship between SFS availability, food consumption, and health outcomes in the Mexican population.
Methods: Survey design and ethnographic field methods were used to develop, test, and validate the Street Food Stand Assessment Tool (SFSAT). Geographic information system and ground-truthing methods were used to identify a sample of street segments across 20 neighborhoods representing low-, middle- and high-income neighborhoods in Mexico City on which to assess the availability, density, variety, and distribution of SFS and the foods and beverages sold at these food venues using the SFSAT.
Results: A sample of 391 SFS were assessed across 791 street segments. Results showed that SFS were found in all neighborhoods. Contrary to the initial hypothesis, most SFS were found in middle-income neighborhoods. While the availability of street foods and beverages was higher in middle-income neighborhoods, the variety was less consistent: fruit/vegetable variety was high in high-income neighborhoods whereas processed snack variety was higher in low-income neighborhoods. SFS were most often distributed near homes, transportation centers, and worksites across the three neighborhood income levels.
Conclusion: This study bridged the gap in knowledge about the availability, density, variety, and distribution of SFS and products sold at these sources of food by using an assessment tool that was developed, tested, and validated specifically for SFS. The findings showed that SFS were found across all neighborhoods. Furthermore, results also suggested that SFS can be a source of healthy food items. Additional studies are needed to understand the relationship between SFS availability, food consumption, and health outcomes in the Mexican population.
ContributorsRosales Chavez, Jose Benito (Author) / Jehn, Megan (Thesis advisor) / Bruening, Meg (Thesis advisor) / Lee, Rebecca E (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2020