APHA 2021 - Virtual and In-Person

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Student Presentation Schedule

Presentation Schedule

Student Presentation Abstracts

Listed in order of student last name. Bolded names denote first author.

Social determinants of permanent tooth loss among older U.S. adults: Findings from the 2017-2018 national health and nutrition examination survey

Jennifer Archuleta, PhD Student

Permanent tooth loss is a significant public health issue among adults aged 65 and older in the U.S. It is an irreversible condition that impairs oral function and negatively impacts quality of life. Social determinants of health such as poverty can lead to disproportionate outcomes for this health issue.
Objective. To assess the relationship between poverty and permanent tooth loss among participants ages 65 and older from the 2017-2018 National Health and Nutrition Examination Survey (NHANES).
Methods. Data are from 2017-2018 NHANES, a surveillance study administered by the National Center of Health Statistics. NHANES collects demographic, health, and nutritional information from a representative sample of 5,000 people in the U.S. every two years. Analyses will be restricted to respondents aged 65 and over at the time of data collection with non-missing responses (n=1,392). Independent variables included poverty, race/ethnicity, sex, age, education, marital status, health insurance, time since last preventive dental visit, unmet dental care need, consumption of sugary beverages, alcohol consumption, and smoking. Negative binomial analyses will be performed.
Results. Results will indicate whether poverty is a determinant of permanent tooth loss among participants. Other significant mediators will be analyzed.
Conclusions. This study highlights how social determinants of health are linked to increased risk of permanent tooth loss in older adults. This information can inform and improve current health policy. Public safety nets such as Medicare do not even offer basic oral health services. Oral health prevention among low-income older adults must be addressed, especially with an aging U.S. population.

“missing” context, “missing” data: An ecosocial assessment of the disproportionate COVID-19 burden among filipina/x/os

Adrian Bacong, PhD Student

Significance: Asian Americans are recognized as having similar burdens as Whites in evaluations of COVID-19 disparities, de-emphasizing their need for research and action. This narrative is shaped by the racialization of Asians as “model minorities,” backed by data collection and reporting that aggregate those who identify as Asians, obscuring impacts on individual Asian subgroups, including Filipina/x/os. While some work has examined COVID-19’s impact on the broader Filipina/x/o population, much has centered on Filipina/x/os in healthcare.
Objective: To provide an overarching assessment of the ways in which the impacts of COVID-19 on the Filipina/x/o Americans is made invisible.
Methods: We draw from Ecosocial Theory and the National Institutes of Minority Health and Health Disparities research framework to provide an assessment of COVID-19’s impact on Filipina/x/o Americans.
Results: We present this framework to understand the COVID-19 pandemic in the Filipina/x/o community by highlighting the history of colonialism between the U.S. and the Philippines, the overrepresentation of Filipina/x/os in healthcare and the significant proportion of Filipina/x/os living in multigenerational households. the impact of COVID-19 on mental health, and how non-governmental organizations, researchers, and community organizers have stepped in to fill key gaps in data collection.
Discussion: Interventions based on the factors outlined are needed, including data disaggregation and recognizing knowledge generated by the community as foundational insights. These issues may be relevant for other marginalized communities, who may also be “erased” by current practices.

Addressing the needs of the most socially vulnerable: Telehealth medication abortion services in three states during COVID-19

Anna Fiastro, PhD Student

Objective: To examine provision of medication abortion during COVID-19 by family medicine providers partnering with online telemedicine service Aid Access.
Study Design: We assessed the characteristics of patients residing in New Jersey, New York, and Washington who received medication abortion through the Aid Access platform between April and November 2020. We examined geographic location and social vulnerability of those who received online abortion care. Social vulnerability was determined by the CDC Social Vulnerability Index (SVI), where higher scores indicate greater levels of disadvantage.
Results: Over 7 months, three family medicine providers using the Aid Access platform provided medication abortion care to 534 residents of NJ, NY, and WA. Patients resided in 20 of 21 counties in NJ, 51 of 62 counties in NY, and 27 of 39 counties in WA, and the majority (70.6%) lived in urban areas. Among those who received services, almost one-quarter (24.0%) lived in high SVI counties, with roughly one-third living in medium-high SVI counties (32.6%), followed by a quarter (25.5%) living in medium-low SVI counties. More than 60% of NJ and NY patients lived in counties with high or medium-high SVI. In WA, patients mostly lived in counties with medium-low (60%) or low SVI (18%).
Conclusions: Family medicine providers are successfully providing abortion services with asynchronous online consultations and medications mailed directly to patients. By providing care online, a single provider can serve people residing across a state and meet the needs of patients in socially vulnerable communities.

Social media for public health: Lessons learned from a student and faculty led COVID-19 campaign

Jane Lee and Tram Nguyen, MPH Students

The COVID-19 outbreak prompted urgency for health communication to the public. However, translated information for non-English speaking communities is often limited and inaccurate. In Los Angeles County (LAC), a third of residents have limited English proficiency. Social media and community outreach can reach this audience with timely and reliable multilingual information.
The project aims to provide prompt, easy, and accurate COVID-19 information and resources in Spanish, Chinese, Korean, Vietnamese, and Tagalog for linguistically isolated groups in LAC to slow transmission. A team of public health students and faculty developed and disseminated COVID-19 information on Facebook, Instagram, Twitter, TikTok, KakaoTalk, and Mailchimp. The team created and translated infographics and videos, consulted marketing professionals, ran marketing campaigns, and made a social media toolkit. A comparative effectiveness research approach demonstrated the need for traditional community outreach to reach vulnerable groups. Presentations, emails, and print material were sent to community-based organizations.
Across platforms from June 1st, 2020 - March 12th, 2021, the campaign delivered 1,663 followers and developed 28 videos, 200 infographics, 150 print materials, and 7 English and Spanish newsletters. Topics included the intersection of COVID-19 and chronic health, domestic violence, and vaccinations. Instagram gamification and Facebook advertising engaged and shared information with targeted audiences, reaching 41,000 people total. These methods can powerfully communicate health-related information to multilingual, multigenerational community members. The combined strategies provide a foundation for how future groups may collaborate with CBOs and governmental agencies and utilize social media to communicate critical health-related messages in a disaster.

Psychiatric-related emergency medical service calls among older adults in California during the COVID-19 pandemic

Esmeralda Melgoza, PhD Student

As of March 24, 2021, adults ages 50 and older constitute 34.1% of California's population, but 93.3% of COVID-19-related deaths. Efforts to protect the public’s health, including safer at home orders and social distancing measures, have focused on preserving and maintaining physical health. Ironically, however, these efforts have reduced protective factors known to buffer the negative consequences of psychological stress, including social interactions with family and friends, and social support. The physical threat of COVID-19 combined with the loss of socio-emotional resources increase the risk of psychiatric episodes, especially among older adults. This study examines psychiatric-related EMS calls among adults ages 50 and older in California during the COVID-19 pandemic. A two-year comparative retrospective cohort analysis from January 2019 to December 2020 examines trends in psychiatric-related EMS calls among older adults using data from the California Emergency Medical Services Information System (CEMSIS). This study suggests an increase in psychiatric-related EMS calls among older adults in California during the COVID-19 pandemic compared to the previous year. Psychiatric-related EMS calls are also highest among older adults who are female and members of ethno-racial groups, including Latinos and African Americans, a finding likely influenced by the disproportionately high impact of COVID-19 on these populations.

Person-centered integration of support persons into maternity care (PC-ISP) in Kenya: Examining the context of access to support during childbirth

Michelle Nakphong, PhD Student

Poor quality of care has been identified in 90% of maternal deaths in Kenya, underlying insufficient progress towards UN Sustainable Development Goals for reducing maternal mortality. While access to preferred social support is one essential component of quality care and is posited to improve clinical quality and person-centered outcomes, failure to integrate support persons into maternity care remains a major barrier. Measurably understanding the context of support during childbirth and its relationship to the quality of care represents a notable gap in literature. This study introduces a novel concept, the Person-centered integration of support persons into maternity care (PC-ISP), including communicating information to family members, facilitating decision-making support, making them feel welcome, and engaging with their questions and concerns. We used data from the Strengthening Person-Centered, Accessibility, Respectful Care, and Quality (SPARQ) study in Kenya, which surveyed 1,197 women following delivery and 606 of their support persons from 6 facilities. We used multiple regression analyses with cluster robust standard errors to examine factors associated with women’s met preferences for PC-ISP. Most women desired integrating support persons (73.6-92.8% for various types), however, only 49.7-76.5% of women reported having preferences met in care. Met PC-ISP preferences varied by women’s social position (e.g., employment), relationships to support persons (e.g., relational connectedness, involvement), and facility type (e.g. government health centre vs. government hospital). Findings highlight social disparities in access to support during childbirth and suggest that women’s choice for support person and institutional context are important factors for respectful and person-centered maternity care.