School of Public Health
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The collections in this community comprise faculty research works, as well as graduate theses and dissertations.
Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.
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Item Hepatitis B vaccinations among Koreans: Results from 2005 Korea National Cancer Screening Survey(Springer Nature, 2009-11-25) Juon, Hee-Soon; Choi, Kui Son; Park, Eun-Cheol; Kwak, Min-Son; Lee, SunminLiver cancer is one of most commonly diagnosed cancers among Koreans. Chronic hepatitis B virus (HBV) infection is a major risk factor for liver cancer. HBV infection can be prevented by effective screening and vaccination programs. The purpose of this study is to examine the status of HBV infection and the predictors associated with HBV vaccination. The study population was derived from the 2005 Korea National Cancer Screening Survey (KNCSS). The KNCSS is an annual cross-sectional survey that uses a nationally-representative random sampling to investigate cancer screening rates. A total of 1,786 Koreans over 40 years of age participated in this study. Of all the participants, 5.9% reported HBV positive (HBsAg+, HBsAb-), 41.8% were HBV negative but protected (HBsAg-, HBsAb+), and 52.3% were unprotected (HBsAg-, HBsAb-). Among unprotected individuals (n = 934), 23.1% reported to have received the vaccination. About half of those who had vaccinations completed the 3-shot vaccine series. In multiple analyses, education, having private cancer insurance, alcohol use, having regular check-up, and doing regular exercise were associated with completed HBV vaccination. This study result suggests that we need a liver cancer education program to increase HBV awareness and to increase the liver cancer prevention message among low educated populations.Item Essays on Health Care Satisfaction, Health Insurance, and Cancer Screening Among Veterans(2021) Frost, Sydney; Chen, Jie; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Objective: to determine differences in satisfaction of health care services among veterans based on insurance type/coverage and the impact of service utilization of cancer screening services among female veterans who have received health care services within past 12 months. Methods: IPUMS National Health Interview Survey (NHIS) for the years 2013-2018 were used and logistic regressions applied. Results: veterans with VA-only coverage are significantly more dissatisfied with the services they receive compared to veterans who have any-private coverage. Conclusion: there are differences between satisfaction of care among veterans based on insurance type, but differences do not impact cancer screening utilization among female veterans who utilized health care services within the past 12 months. Future work: findings could be utilized to determine ways to increase satisfaction of care received among veterans within the VA, or drive policy creation to allow veterans to access health care services at non-VA facilities.Item The relationship between health literacy and indicators of informed decision making for colorectal cancer screening among African Americans(2016) Tagai, Erin Kelly; Holt, Cheryl L; Garza, Mary A; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)African Americans are disproportionately affected by colorectal cancer (CRC) incidence and mortality. CRC early detection leads to better treatment outcomes and, depending on the screening test, can prevent the development of CRC. African Americans, however, are screened less often than Whites. Aspects of decision making (e.g., decisional conflict, decision self-efficacy) can impact decision making outcomes and may be influenced by social determinants of health, including health literacy. However the relationship between social determinants of health and indicators of decision making in this population is not fully understood. Additionally, individuals have a choice between different CRC screening tests and an individual’s desire to use a particular screening test may be associated with social determinants of health such as health literacy. This study aimed to examine the relationship between social determinants of health and indicators of decision making for CRC screening among African Americans. A total of 111 participants completed a baseline and 14-month follow-up survey assessing decisional conflict, decision self-efficacy, decisional preference (shared versus informed decision making), and CRC test preference. Health literacy was negatively associated with decisional conflict and positively associated with decision self-efficacy (ps < .05). Individuals who were unemployed or working part-time had significantly greater decisional conflict than individuals working full-time (ps < .05). Individuals with a first-degree family history of CRC had significantly lower decision self-efficacy than individuals without a family history (p < .05). Women were significantly more likely to prefer making a shared decision rather than an informed decision compared to men (p < .05). Lastly, previous CRC screening behavior was significantly associated with CRC test preference (e.g., individuals previously screened using colonoscopy were significantly more likely to prefer colonoscopy for their next screening test; ps < .05). These findings begin to identify social determinants of health (e.g., health literacy, employment) that are related to indicators of decision making for CRC among African Americans. Furthermore, these findings suggest further research is needed to better understand these relationships to help with the future development and improvement of interventions targeting decision making outcomes for CRC screening in this population.