General Public Health
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/29929
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Item A Review of Resources and Accessibility for Alcohol Addiction in Tarrant County(2020) Ajaykumar, Sharanya; Bourgin, Sarah; Mahajan, Anisha; Sahu, Shweta; Hussain, SumeraPurpose: Alcoholism is a disorder that affects 14.4 million adults, ages 18 and older. Therefore, an understanding of alcoholism, its impact on the population, and resources available is crucial to help those suffering from this disease. This study serves as a systematic review of resources available to those suffering from alcoholism at a national, state, and local level with an emphasis on resources within Tarrant County, Texas. Methods: Online scientific archives were used to collect statistics on rates of alcoholism, associated behaviors, and options for treatment for those afflicted. Preliminary research for publicly available resources was done through Google. We chose to conduct our research in this manner to parallel the search behavior of those seeking treatment for alcoholism. We searched colloquial phrases such as "resources for alcohol addiction, Tarrant County" and "alcoholics anonymous Tarrant County" to compile our resources. Results: A plethora of resources are available to those seeking help to combat alcoholism or in need of withdrawal assistance at Tarrant County and beyond. Some of these resources include the National Association of Alcoholism and Drug Abuse Counselors, Alcoholics Anonymous, the Recovery Resource Council, MHMR Tarrant County, Mesa Springs, and Community Addiction Treatment Services. Conclusions: A number of resources are available to those suffering from alcoholism. These resources span a variety of services tailored across age, socioeconomic status, and insurance providers. However, as alcoholism becomes increasingly prevalent within society, the most significant barrier to receiving treatment is a lack of resources due to overcrowding.Item An assessment and literature review of the pedestrian safety within the built environment(2020) Griner, Stacey; Spears, Erica; Young, HaleyPurpose: According to the National Highway Traffic Safety Administration (NHTSA), there were 6,283 pedestrians killed in 2018 due to being struck by an automobile. NHTSA defines a pedestrian as a person who is walking, running, hiking, sitting, or laying down in the built environment. To address this problem, researchers have investigated and designed interventions that create a safe built environment and educate pedestrians. Although research has been conducted to determine the effectiveness of these interventions, auto pedestrian fatalities have risen for the past ten years. To further understand this problem, a literature review was conducted to explore how the built environment and education promotes pedestrian safety. Methods: Health databases were used to assess literature published between 2004 and 2019. Search criteria was specific to the United States and included the following key words: pedestrian safety, built environment, and education curriculum. Studies were reviewed for their relevance, interventions, and program effectiveness. Results: The literature review revealed many engineering strategies to reduce pedestrian contact with an automobile; however, these interventions must coincide with law enforcement monitoring. We found a lack of effective pedestrian education programs addressing unsafe walking habits. Conversely, education programs designed for older adults and children increased their chances of being in an auto-pedestrian accident. Conclusion: This study highlights the need to adopt best practices when addressing auto-pedestrian fatalities in the context of the built environment. It also reveals the complex nature of educational programs and the need to consider the multi-level factors influencing pedestrian behavior.Item An Assessment of Texas Human Papillomavirus Vaccination Rates(2020) Thompson, Erika; Hoff, BrandonPurpose: Previous studies have demonstrated significant differences in Human papillomavirus (HPV) vaccine rates between different regions of the US. However, an analysis of geographic variation of HPV vaccine uptake among different areas of Texas has not been investigated yet. This study examines the geographical variation in HPV vaccine rates within Texas. Methods: This cross-sectional study was conducted using data from the National Immunization Survey and Teen, 2017 (N=20,949). Logistic regression was used to model provider-verified HPV vaccination up-to-date status predicted by area of residence within Texas, while adjusting for the effects of sex, race/ethnicity, maternal education level, household income, and type of health insurance. Results: Approximately 42% of adolescents in Texas were up-to-date on the HPV vaccine, compared to 52% of adolescents in the US as a whole. Adolescents who lived in El Paso County [OR = 2.79, (95% CI: 1.86, 4.18)] or the City of Houston [OR = 2.04 (95% CI: 1.30, 3.21)] were more likely to be up-to-date on the HPV vaccine than adolescents who lived in other areas of Texas. Conclusion: The results of this study indicate a difference in HPV vaccine rates across different areas of Texas. Most previous research on regional differences among US adolescents attributed much of the variation to state-level policies. The results of this study suggest that there may be other factors contributing to HPV vaccine disparity within Texas and further research should be conducted to elucidate these factors.Item Analyzing Sound Levels Produced by a Choral Ensemble During a Choral Concert Event(2020) Taylor, MeghanPurpose: Efforts to quantify the sound levels produced by instrumental ensemble-based instructional activities and understand the role of the conductor in these activities has a robust history. However, these factors have not been widely studied in choral ensemble-based instructional activities. Additionally, the World Health Organization's current estimation that 1.1 billion young people are at risk for noise-induced hearing loss, there is a need for investigating sound levels produced by choral ensembles. The purpose of this study was to quantify and compare the sound characteristics associated with a choral concert event. Methods: This study examined the UNT A Cappella Choir's spring concert event in the Winspear Performance Hall. Sound measurements were taken using two noise dosimeter microphones; one microphone was positioned downstage and another in the choir loft. An aggregate view database and a time series database were created to analyze the data collected during each aspect of the choral event. Results: Obtaining temporal sound measurements during this type of activity is possible regardless of microphone placement. Variability in the sound measurements revealed that the ensemble was able to sing more musically while reducing their overall risk. Conclusion: This research presents a novel understanding of the conductor's role in a choral ensemble-based instructional activity for reducing the risks associated with NIHL. Additionally, this research determined that temporal views of sound can be obtained from multiple vantage points in the room, making it easier for researchers to unobtrusively obtain this data during these events.Item Assessing Accessibility to Domestic Violence Resources within Tarrant County: A Community-Based Study of Prevalence, Barriers, and Proposed Solutions(2020) Das, Siddharth; Bhachawat, Neal; Siddiqui, Umar; Nguyen, Jacqueline; Katamaneni, VarunPurpose: Intimate partner violence is a common issue affecting 1 in 4 women and 1 in 10 men in the U.S. Tarrant county has a higher incidence rate of 1 in 3 women. It is important to understand the impact of abuse on individuals and evaluate the accessibility of resources available. In this study, we aim to perform a systematic review of the resources available to people at a national, state, and local level. Methods: Our study determined which resources at the national, state, and local levels were most likely sought out by domestic violence victims from Tarrant county. From database searches, we selected and inquired various resources about those who sought their services and the barriers that victims typically face. Results: Locally, victims are able to access the following: National Domestic Violence Hotline, National Resource Center on Domestic Violence, Texas Family Violence Program, Texas Council on Family Violence, Freedom House, and SafeHaven. The interplay of national, state, and local programs depends on local entities providing a strong structure for support and referral. For example, SafeHaven is often overwhelmed by those seeking temporary housing, who are then discouraged to seek out further programs or services. Conclusion: Despite the various resources offered to victims, there are many barriers such as distance, finances, social, and cultural factors that can hinder a victim's accessibility to these resources. The significance of these barriers is ultimately the social and health ramifications on victims: increased possibility of emotional distress and disease.Item Childhood Autism Resources in Tarrant County(2020) Nguyen, Alexandra; Stedke, Alexandra; Fernandez, Jazmin; Mayerhofer, Jordyn; Yen, KylePurpose: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication, social interaction, and restricted patterns of behavior, interests, and activities. In 2014, the prevalence of ASD in the United States was about 1 in 59 children and was found across all racial and socioeconomic groups. Although the genetic causes of ASD remain unknown, risk factors include being male, exposure to specific drugs in utero, having other autistic family members, and being born prematurely. Our purpose was to discover available resources for those with ASD in Tarrant County. Methods: A literature search and review was conducted to determine the resources available specifically in Tarrant County to address the different needs of people with autism. Results: A variety of resources exists in Tarrant County for those diagnosed with ASD. These resources continue to grow in their importance and utilization especially as the rate of ASD continues to rise. The Autism Treatment Center (ATC), Hope Center for Autism, MHMR Tarrant County, and Easterseals are just a few organizations available to children with ASD and their families. The services offered include education, therapy, childcare, behavioral support, and outpatient rehabilitation. Certain eligibility requirements and barriers must also be overcome in order to benefit from these services, including age restrictions, transportation, and health insurance. Conclusion: As the rates of autism continue to rise, new resources are becoming increasingly important to this patient population. Tarrant County has several resources in place, however, there are still significant unmet needs.Item Comparative study on the accessibility of opioid dependence treatment in Dallas and Tarrant counties and emergency department encounters linked to an opioid overdose(2020) Fleming, Marc; Roberts-Lagrone, Tyrane; Njoku, CollinsPurpose: Opioid dependency is an emerging health crisis nationwide that affects the Dallas/Fort Worth (DFW) community. There is limited research on the availability of opioid use dependency (OUD) treatment. Our study's objective was to examine the success rate of reaching a licensed OUD provider. Methods: Through the Substance Abuse and Mental Health Services Administration (SAMHSA) website, Texas-waivered providers who were listed to offer medication-assisted opioid dependence treatment were contacted to confirm availability. Providers were contacted during regular business hours between October and December 2019 using a standardized script simulating a patient seeking treatment. The data collected from 235 providers contacted in Dallas and Tarrant counties were compared to opioid-related emergency department (ED) visits found on the Texas Department of State Health Services website in 2014 and 2017. Results: In 2014 there were 308 (11.4%) opioid-related ED visits in Dallas and 228 (8.4%) in Tarrant out of the 2700 ED visits in Texas reported. In 2017 there were 962 (10.5%) in Dallas and 833 (9.1%) in Tarrant out of 9121 visits. Of the 137 providers in Dallas, and the 98 in Tarrant listed on the SAMHSA website who responded, 76 (55.4%) in Dallas and 53 (54.1%) in Tarrant offered OUD treatment. Conclusion: More licensed OUD providers are necessary due to increasing rates of opioid overdoses. These numbers suggest that despite an increase in opioid-related ED visits there is a lack of providers who are truly available to treat people who are dependent on opioids in DFW.Item Comparison of renal function estimation in transgender adults(2020) Howard, Meredith; Yuet, Cheng; Jann, Michael; Gaviola, Marian; SoRelle, Jeffrey; Tran, NicholasPurpose: Renal function assessment typically relies on equations such as Cockcroft-Gault (CG) or Modification of Diet in Renal Disease (MDRD) which consider age, weight, sex, and serum creatinine (SCr). In transgender patients, sex assigned at birth and hormone therapy (HT) may influence renal function estimation. The purpose of this study is to compare renal function estimation among transgender patients with or without HT to identify the most accurate equation. Methods: In this retrospective, matched, case-control study, patients >18 years from a transgender clinic with at least one SCr measurement were included as cases. Cases were matched to a sex assigned at birth and a transition gender control based on age and weight. Comparisons of SCr and CrCl as calculated using CG and MDRD between cases and controls, sex, and HT were completed. Results: 248 matches were included in the initial analysis. Of transgender cases, 148 (60%) were transgender women. Between matched pairs, there was no significant difference in SCr or CrCl estimation using CG or MDRD, regardless of sex assigned at birth. Transgender women taking HT significantly affected SCr (p< .01) and CrCl estimation using MDRD (p< .01), but not CG (p=.21). Transgender men taking HT had significant differences in SCr and CrCl estimation based on CG and MDRD calculations (p< .01). Conclusion: Among transgender patients receiving HT, discrepancies in renal function estimates may occur based on equation type and HT use. Clinicians should exercise prudence utilizing renal function estimates to adjust renally-excreted medications in this population.Item Correlates of Cervical Cancer Screening Among U.S. Women: Findings from the National Health Interview Survey(2020) Thompson, Erika; Galvin, Annalyn; Garg, AshvitaPurpose: While cervical cancer rates have declined dramatically, the Healthy People 2020 goal for cervical cancer screening has not been reached. This study examined factors associated with up-to-date cervical cancer screening among women in the US. Methods: This study utilized data from the 2018 National Health Interview Survey (N=10,714 women, aged 21-70), with the main outcome as cervical cancer screening in the last 5 years (yes/no). Weighted logistic regression modeling estimated the association between cervical cancer screening and predictor variables. Results: Prevalence of up-to-date cervical cancer screening was 78.4%. Compared to White women, women from other races were less likely to receive a screening (aOR=0.71; 95%CI: 0.57, 0.88), and Black women were more likely (aOR=1.49; 95%CI: 1.19, 1.88). Hispanic women had higher odds of cervical cancer screening compared to non-Hispanics (aOR=1.58; 95% CI: 1.26, 1.99). Women between the ages of 20-29, who are divorced/widowed/separated or are not married, who have not talked to their healthcare providers recently, or who have not received HPV vaccination had lower odds of cervical cancer screening. Additionally, women who did not use the internet to search for health information (aOR=0.55; 95%CI: 0.48, 0.63) had lower odds of cervical cancer screening. Conclusion: Findings can inform targeted interventions to improve cervical cancer screening uptake and reduce cervical cancer mortality. Further studies should explore the barriers to cervical cancer screening among women who did not receive cervical cancer screening.Item Detecting Alcohol Consumption Among Homeless Individuals Using Ecological Momentary Assessment, Transdermal Sensors, And Timeline Follow Back Methods(2020) Li, Xiaoyin; Mun, Eun-Young; Businelle, Michael; Lineberry, Shelby; Tan, Zhengqi; Walters,ScottPurpose: The present study examined the extent to which self-reported measures of alcohol use from ecological momentary assessment (EMA) among homeless drinkers corresponded with estimates from a transdermal alcohol sensor (SCRAM) and self-reported timeline follow-back (TLFB) recall measures. Methods: Participants were 63 homeless adults who were receiving services at a homeless shelter in Dallas, TX. Participants' alcohol consumption data were collected via EMA, SCRAM sensor, and a TLFB recall measure at the 4-week follow-up. For each assessment approach, we created two daily alcohol use variables: any use (1= alcohol use positive or 0 = alcohol use negative) and alcohol use quantity. We analyzed data using multilevel models, calculated intraclass correlation coefficients for inter-rater agreement, and estimated pairwise correlations and means across all three assessment methods. Results: Across the three assessment methods, the intraclass correlation coefficient for inter-rater agreement was 0.81 for any alcohol use and 0.76 for alcohol use quantity, indicating excellent agreement. Furthermore, the EMA assessed the quantity of alcohol used was highly correlated with SCRAM peak transdermal alcohol concentration estimate, whereas TLFB had low to modest correlations with EMA and SCRAM measures of alcohol use quantity. Conclusions: Compared with a transdermal alcohol measure, EMA is a valid measure of alcohol use among homeless drinkers. Given the substantial day-to-day variation in alcohol consumption and the ease of EMA compared to biological measures, EMA-based measures of alcohol consumption may be an important tool for clinical research, especially among underserved populations.Item Do Brief Motivational Interventions Reduce Drinking and Driving among College Students? A Meta-analysis of Individual Participant Data(2020) Mun, Eun-Young; Zhou, Zhengyang; Walters, Scott; Li, Xiaoyin; Tan, Zhengqi; Lineberry, ShelbyPurpose, Alcohol-impaired driving (AID) is a serious public health concern in the United States. Although often targeted in brief motivational interventions (BMIs), AID has rarely been examined as a primary outcome in trials. This study examined the effectiveness of BMIs on AID for college students using a two-step meta-analysis of individual participant data. Methods, The data came from Project INTEGRATE, a large-scale synthesis study of individual participant data from BMIs and other individual-focused interventions designed to reduce heavy drinking and related problems among college students. A total of 15 trials assessed AID at baseline and the most immediate follow-up within 12 months post intervention (N=9,992; 58.3% female; 71.8% White; 54.6% 1st-year). Two outcomes were driving shortly after consuming 2+ drinks (25 comparisons), and consuming 4+ drinks (21 comparisons), which were coded to 1 (yes) or 0 (no). We separately analyzed these outcomes in random-effects meta-analysis models using "metafor" for R. Results, Overall, there were no statistically significant intervention effects on AID. The pooled log odds ratios of the combined trials were -0.03 (95% CI: -0.15, 0.09) for driving shortly after consuming 2+ drinks, and -0.10 (95% CI: -0.26, 0.07) for driving shortly after consuming 4+ drinks. Conclusions, Although BMIs are efficacious for reducing drinking and alcohol-related negative consequences, the findings from this meta-analysis indicate that they have little to no effects on AID among college students. Given the public health implications of AID, more focused intervention efforts are needed.Item Does alcohol and tobacco use differ by blood pressure status in middle-aged males and females?(2020) Saavedra, Olivia; Li, Rebecca; Magallanes-Coronado, ErickPurpose: Although various studies relate substance use to development of high blood pressure, no known studies address whether those with high blood pressure have reduced substance use compared to those without. The purpose of this study was to determine whether alcohol and tobacco use differ by blood pressure status in middle-aged men and women. Methods: This cross-sectional analysis used data from the 2017 BRFSS for middle-aged males and females from Indiana, Missouri, North Dakota, Ohio, and South Carolina. Ordered logistic regression analysis by state and gender was used to assess alcohol and tobacco use differed by blood pressure status while controlling for health related, socioeconomic, and demographic factors. Results: Slightly more than half of middle-aged males reported alcohol use and one-fourth current tobacco use; approximately half of middle-aged females reported alcohol use and less than one-fourth current tobacco use. Approximately half of middle-aged males reported ever being diagnosed with high blood pressure while middle-aged females reported varied responses. Adjusted results indicated that alcohol nor tobacco use differed by blood pressure status by gender. Conclusion: Alcohol and tobacco use did not differ by hypertension status in general samples of males and females ages 45-64. For middle-aged adults in both genders, it is recommended that clinicians in a primary care setting continue to screen for hypertension, alcohol use and tobacco use in middle-aged adults. All should be educated on negative effects of substance use especially those with high blood pressure.Item Does Flu Shot Use Differ by Gender in Young Adult Parents with Children?(2020) Zetterberg, Sydney; Katz, Brent; Buehler, Emily; Bowen, MeghanPurpose: With mixed findings for flu shot use by gender and none for parents, the purpose of our study was to assess whether flu shot use differs by gender among young adult parents ages 18 to 44 with children. Methods: This cross-sectional analysis used BRFSS 2017 data for parents ages 18 to 44 from Colorado (N=1367), Maryland (N=1402), Nebraska (N=2550), New York (N=1639), and Utah (N=2620). Multiple logistic regression analysis by state was used to assess the relationship between flu shot use and gender, controlling for health-related, demographic, and socioeconomic status factors. Results: Across states, around one-third of participants reported receiving seasonal flu shots in the past 12 months (34-42%), and approximately half were male (40-46%). Overall, flu shot use did not significantly differ by gender. However, flu shot use was significantly related to health conditions and routine checkup. Conclusions: Overall, flu shot use did not differ by gender among young adult parents ages 18 to 44 with children and only 1 out of 3 in this target population received flu shots. Across states, flu shot use was significantly related to number of health conditions and routine checkups. Based on these results, health care providers should screen for flu shot use among male and female young adult parents and their families. Moreover, with a concerningly low proportion of parents receiving the flu shot, it is imperative that providers educate on its importance for all family members, especially as related to annual checkups and health conditions.Item Does mental and physical health status differ by physical activity in Hispanic females ages 25-44?(2020) Washburn, Laura; Clifton, Caroline; Story, Jaimie; Garza-Castillo, Julie; Hartos, Jessica; Sanders, AnnaIntroduction: Previous studies have shown a relationship between mental and physical health with physical activity; however, these studies did not focus on Hispanic women. Therefore, the purpose of this study is to determine whether mental and physical health differ by physical activity level in Hispanic women ages 25 to 44. Methods: This cross-sectional analysis used 2017 BRFSS data for Hispanic women ages 25 to 44 from California (N=531), Colorado (N=222), Florida (N=495), New York (N=282), and Texas (N=498). Multiple logistic regression analysis for combined state data was used to assess the relationship separately for mental health and physical health with physical activity level while controlling for health behaviors, health status, demographic factors, and socioeconomic status. Results: The majority of participants reported good mental health (61-67%) and good physical health (54-71%), and about one-third reported being physically inactive (24-41%). The results of adjusted analysis indicated that physical activity and physical health were moderately related (OR = 1.49, 95% CI = 1.05, 2.10). However, there was no significant relationship between physical activity and mental health. Conclusion: Overall, physical activity was moderately related to physical health, but not to mental health. These results may generalize to Hispanic females ages 25 to 44 in primary care settings. Providers should always screen for issues with physical health, mental health, and physical inactivity, but only treat physical health and physical inactivity issues concurrently.Item Does mental health status differ by alcohol use for married versus unmarried young adult females?(2020) Madison,; Walters, Tess; Norman, John; Womack, Veda; Hartos, Jessica; Branham, TylerPurpose: Mental health issues are one of the leading causes of disability and excessive drinking can lead to many health risks. The purpose of this study is to assess whether mental health status differs by alcohol use in married versus unmarried young adult females. Methods: This cross-sectional analysis used 2017 data from BRFSS for young adult females ages 18-44 in California(N=1793), Colorado(N=1321), Kansas(N=2932), Texas(N=1755), and Utah(N=2110). Adjusted logistic regression analysis by state was used to determine the relationship between mental health and alcohol use by marital status while controlling for health-related, demographic, and socioeconomic factors. Results: About half of the participants reported 30 days of good mental health in the past 30 days (45-52%) and over half reported alcohol use (53-67%) with the exception of Utah where about one-fourth of participants reported alcohol use (28%). Adjusted statistics results indicated mental health status was inversely related to alcohol use for married young adult females; and was inversely related to tobacco use and positively related to physical health status for both groups. Conclusion: Overall, mental health status was related to alcohol use in married but not related in unmarried young adult females. Primary care providers should take special note of married young adult females when screening mental health and alcohol use. Education is recommended on the importance of mental health and the negative effects of excessive alcohol use. In addition, mental health was related to smoking and physical health in married and unmarried young adult females.Item Does Mental Health Status Differ by Number of Health Conditions in Middle-Aged Females?(2020) Macke, Laura; Chen, YunAn; Hartos, Jessica; Mccloskey, Sydney; Samuels, Kenya; Rostami, ShireenPurpose: The purpose of this study was to determine whether mental health status differs by number of health conditions in middle-aged females. Methods: This cross-sectional analysis used 2017 data for middle-aged females, ages 45-54, from Maine (N=2112), Massachusetts, (N=1285) Minnesota (N=3131), Mississippi (N=1036), and New Hampshire (N=1262). Ordered logistic regression analyses were conducted by state to analyze the relationship between mental health status (low, moderate, high) and number of health conditions while controlling for health-related, socioeconomic, and demographic factors. Results: Across states, over half of participants reported having high mental health status (58-66%) and about three-fourths reported having 1 or more health conditions (64-91%). After controlling for health-related, demographic, and socioeconomic factors, results of adjusted analysis indicated that mental health status was inversely related to 1 or more health conditions (large effect sizes) in the majority of states. Conclusion: Across states, mental health status was found to be highly and inversely related to number of health conditions in middle-aged females and moderately related to smoking. Because this was a population-based study, results may be generalizable to middle-aged females ages 45 to 54 in a primary care setting. Since mental health status and having multiple health conditions in women ages 45 to 54, are moderately prevalent and highly related, practitioners should automatically screen for both. Providers should assess treatment options and refer to a specialist for the patient's mental health and health conditions as needed.Item Does Mental Health Status Differ by Physical Activity in Young Adult Male Veterans and Non-Veterans?(2020) Mott, Jeffrey; Hartos, Jessica; Leveling, Kelsey; Luckemeyer, Teegan; Moore, Meagan; Garrett, MadiPurpose: Studies have shown mental health is related to physical activity, but none focus on the relationship among veterans or in young-adult males. Therefore, the purpose of this study was to assess relations between mental health and physical activity in young-adult male veterans and non-veterans. Methods: This cross-sectional analysis used data from the 2017 BRFSS for male veterans and non-veterans ages 18-44 Alaska (n=404), Hawaii (n=1086), Montana (n=723), Virginia (n=1091), and Wyoming (n=538). Ordered logistic regression analyses were conducted by veteran status to assess the relationship between mental health status and physical activity after controlling for health-related, demographic, and socioeconomic factors. Results: Across states, most participants were non-veterans (82-87%), two-thirds reported a high number of good mental-health days in the past 30 days (62-66%), and half reported being active or highly active (53-56%). After controlling for all other model variables, mental health status was not related to physical activity, but was related to tobacco use in veterans, alcohol use and general health status in non-veterans, and activity limitations and health conditions in both. Conclusion: Overall, about one-third of young-adult males may self-report low or moderate mental health and about one-half will be physically inactive or insufficiently active, and because they may be related to substance use and health-related factors, providers should assess and address these issues concurrently in both young-adult male veterans and non-veterans.Item Does the preference of information source for Self-sampling methods for Sexually Transmitted Infection screening differ by race and ethnicity among young college women?(2020) Griner, Stacey; Maskey, SmritiPurpose: Chlamydia and gonorrhea are the most common bacterial sexually transmitted infections (STIs) with a higher incidence among sexually active young women. Since in-clinic STI screening services are underutilized, self-sampling methods (collecting a vaginal swab at home) could be a potential screening approach to increase STI screening rates. However, there is limited research to understand the best means to inform this population about these methods. This study aims to identify the preferred sources of information for self-sampling methods of STI screening among college women by race/ethnicity. Methods: A quantitative survey was administered among sexually active college women ages 18-24 years old (n=92) ranking their preferred information sources about self-sampling methods for STI screening (healthcare provider, friends, family, partners, internet, college resource, class, other) from most to least preferred. We conducted Kruskal-Wallis tests to compare the ranking of sources by demographic factors (race/ethnicity). Results: Healthcare providers, internet, and college resources were the most preferred sources of information among young college women. While there were no significant differences found in the preference of information source based on ethnicity, women who were biracial, multiracial or from other races preferred partners as an information source as compared to women who were White/Black (p=0.012). Conclusion: Findings suggest that it would be useful to develop future interventions by including healthcare providers, internet, and college resources as primary information sources to improve STI screening rates in this population. Targeted educational interventions for racial subgroups shoulItem Does Weight Status Differ by Smoking Status in Young Adult Males(2020) Hall, Joanna; Payne, James; Coffman, Kaylee; Kerlick, CarolineBecause of the prevalence of both smoking and elevated weight status in the general population and because of the high rate of smoking onset in young adult males, the purpose of this study was to examine the relationship between weight status and smoking status in young adult males. This cross-sectional analysis used 2017 BRFSS data for males ages 18-44 from Colorado (N=1,344), Kentucky (N=1,131), Michigan (N=1,364), and South Carolina (N=986). Ordered logistic regression was performed separately by state to assess relations between weight status and smoking status. Across states, about the same proportion of participants reported obese (18-34%), overweight (34-41%) and normal (31-41%) weight status. Less than half of participants were either current (18-26%) or former (18-22%) smokers. The results of adjusted statistics showed that weight status was significantly related to smoking status in 3 out of 4 states. Participants who were current smokers were about half as likely to report each successive level of weight status compared to those who reported never smoking. Weight status was related to number of health conditions, general health status, and age. The results generalize to young adult males in a primary care practice. The results of analysis indicated that smoking status was moderately and inversely related to weight status in young adult males. Providers should screen for unhealthy weight status and smoking status in young adult males, and should educate patients about the importance of maintaining a healthy weight and on the risks of smoking.Item Emergency Relief Efforts in North Texas(2020) Tierney, Emma; Ahmed, Ibrahim; Calcagno, Alexa; Vachon, Brad; Bibb, Patrick; Powell, JakePurpose: The aim of this study was to provide a comprehensive literature review of modern disasters, the challenges they pose to healthcare, and the architecture of the modern response to them. The study also used available resources to analyze the current state of preparedness for the Dallas-Fort Worth (DFW) area. Methods: A literature review was conducted using PubMed, MEDLINE, Scopus, and Excerpta Medical Database (EMBASE). Because there is no current literature directly comparing DFW to the national and international levels, we used local government websites to compile a list of resources. Results: Healthcare safety nets (HSN) for emergency situations are set in place at local, state, and national levels to provide immediate aid and to prevent future disasters. Examples for North Texas include: The North Central Texas Council of Governments, The Texas Department of Public Safety, and The Federal Emergency Management Agency. Benefits from HSNs during disasters include increased hygiene, decreased hospital congestion, and improved psychosocial care for community members. However, HSNs face barriers to reach patients without adequate access to information and addressing patient needs efficiently during disaster situations. To address these barriers, HSNs perform tabletop exercises to gather key personnel, review emergency protocols, and discuss roles and responsibilities during mass emergencies. Conclusion: Such preparations improve the efficiency of communication channels between first responders, local hospitals, and regional/state emergency programs and facilitate improved care for disaster scenarios.