Understanding Access to Health Information: The Role and Measurement of Social Location

The purpose of this research is to explore how application of social location theory may improve data collection on health information access in order to better inform and improve the effectiveness of health communication and messaging. This dissertation proposes a framework to understand how people obtain health information based on the idea of social location, Ritzer and Bell’s (1981) levels of social reality, and Dahlberg & Krug’s (2002) social ecological model. This research addressed the extent to which three studies of health information access support the use of such a framework, and if so, how its application could improve our understanding of access to health information, and correspondingly, our methods of health communication. The first study examined the Douglas County Community Health Survey, a population-based telephone survey of 1,503 respondents ages 18 and older living in Douglas County, Nebraska in 2013. This study assessed how elements of social location influence respondents’ primary health information source and the number of health information sources used. The second study drew on the 2011-2013 National Survey of Family Growth to examine sources of sex education (formal, parents, and doctor) and topics covered with each source (abstinence, STDs, and contraception) among a nationally-representative sample of 15-24 year-old male and female respondents. The third study looked at data from an online survey of 757 LGBTQ adults in the state of Nebraska. Demographic characteristics, health care access, minority status, outness to health care provider, personal autonomy, and discrimination experience were compared among participants who did or did not report seeking health information online. Finally, the results of the three studies were synthesized into a Social Location Framework. This framework provides a visual representation of how elements of social location relate to each other and collectively contribute to health information access, and provides for identification of potential gaps in the measurement of access to health information

Barriers to Summer Food Service Program (SFSP) Implementation Before and After COVID-19: A Qualitative, Collective Case Study

Objectives: SFSP, as a federal food assistance program, could ensure that children have sufficient nutritious food during summer. According to a 2016 USDA report, only 0.4–0.6% of eligible children participated in this program in Nebraska, which makes for one of the lowest SFSP participation rates in the U.S. This study aims to better understand how the COVID-19 pandemic has impacted SFSP implementation in urban and rural settings across the state. Conclusions: Insights from this study may inform the development of policies that expand food access to vulnerable families. On the organizational level, this includes providing participating kids and their parents with both meal distribution options - meal sites and delivery options - during summer. On the policy level, this calls for revising the eligibility of SFSP by decreasing the threshold level from 50% to 30% to allow more schools in low-income neighborhoods to participate

Serving Refugees in a Pandemic: Insights from Yazidis in the Midwest

There is a critical need for research to examine factors that hinder or facilitate access to healthcare in the context of COVID-19. The coronavirus pandemic has exacerbated barriers to healthcare for marginalized communities globally, leaving many without access to needed health services. Resettled refugees, in particular, must grapple with added challenges to locating and obtaining culturally appropriate healthcare services. Recent focus groups shed light on the experiences of Yazidi refugees in the U.S. Midwest during COVID-19. Yazidis are a historically persecuted religious and ethnic minority group from northern Iraq (Kizilhan, 2017). Many Yazidis migrated to the U.S. on Special Immigrant Visas after providing interpretation services for the U.S. Army. Focus groups reflected diverse perspectives from health care providers, social workers, Yazidi community members, and cultural centers. Findings reveal four critical areas that limit access to healthcare: (1) language barriers; (2) economic barriers; (3) social barriers; and (4) cultural stigma. In this commentary, we explore how these barriers contribute to adverse health experiences and outcomes during the COVID-19 pandemic, and offer insights relevant to public health practice with marginalized communities

Dust in Comet C/2007 N3 (Lulin)

We report optical imaging, optical and near-infrared polarimetry, and Spitzer mid-infrared spectroscopy of comet C/2007 N3 (Lulin). Polarimetric observations were obtained in R (0.676 micron) at phase angles from 0.44 degrees to 21 degrees with simultaneous observations in H (1.65 micron) at 4.0 degrees, exploring the negative branch in polarization. Comet C/2007 N3 (Lulin) shows typical negative polarization in the optical as well as a similar negative branch near-infrared wavelengths. The 10 micron silicate feature is only weakly in emission and according to our thermal models, is consistent with emission from a mixture of silicate and carbon material. We argue that large, low-porosity (akin to Ballistic Particle Cluster Aggregates) rather absorbing aggregate dust particles best explain both the polarimetric and the mid-infrared spectral energy distribution.Comment: 18 pages, 9 figures, 3 table

“Many people have no idea”: a qualitative analysis of healthcare barriers among Yazidi refugees in the Midwestern United States

Background: The COVID-19 pandemic has shed new light on inequities in healthcare access faced by immigrant and refugee communities. To address ongoing disparities, there is an urgent need for ecological approaches to better understand the barriers that hinder and resources that facilitate access to healthcare. This study investigates barriers to healthcare system access faced by Yazidi refugees in the Midwestern United States. Methods: Informed by the Interpretative Phenomenological Approach, three focus group meetings with a community advisory board were conducted between September 2019 and January 2020. The nine-member focus group included social workers, healthcare providers, and members of the Yazidi community. Meeting recordings were transcribed into English, coded for themes, and validated. Results: We describe themes related to specific barriers to healthcare access; analyze the influence of relational dynamics in the focus group; explore experiential themes related to healthcare access in the Yazidi community, and finally interpret our findings through a social-ecological lens. Conclusion: Community agencies, healthcare organizations, policymakers, and other stakeholders must work together to develop strategies to reduce systemic barriers to equitable care. Community representation in prioritysetting and decision-making is essential to ensure relevance, acceptability, and utilization of developed strategies

“Many people have no idea”: a qualitative analysis of healthcare barriers among Yazidi refugees in the Midwestern United States

Background: The COVID-19 pandemic has shed new light on inequities in healthcare access faced by immigrant and refugee communities. To address ongoing disparities, there is an urgent need for ecological approaches to better understand the barriers that hinder and resources that facilitate access to healthcare. This study investigates barriers to healthcare system access faced by Yazidi refugees in the Midwestern United States. Methods: Informed by the Interpretative Phenomenological Approach, three focus group meetings with a community advisory board were conducted between September 2019 and January 2020. The nine-member focus group included social workers, healthcare providers, and members of the Yazidi community. Meeting recordings were transcribed into English, coded for themes, and validated. Results: We describe themes related to specific barriers to healthcare access; analyze the influence of relational dynamics in the focus group; explore experiential themes related to healthcare access in the Yazidi community, and finally interpret our findings through a social-ecological lens. Conclusion: Community agencies, healthcare organizations, policymakers, and other stakeholders must work together to develop strategies to reduce systemic barriers to equitable care. Community representation in prioritysetting and decision-making is essential to ensure relevance, acceptability, and utilization of developed strategies

The Nature of the Long-Lived Excited State in a Ni^(II) Phthalocyanine Complex Investigated by X-Ray Transient Absorption Spectroscopy

The nature of the photoexcited state of octabutoxy nickel(II) phthalocyanine (NiPcOBu₈) with a 500 ps lifetime was investigated by X‐ray transient absorption (XTA) spectroscopy. Previous optical, vibrational, and computational studies have suggested that this photoexcited state has a ligand‐to‐metal charge transfer (LMCT) nature. By using XTA, which provides unambiguous information on the local electronic and nuclear configuration around the Ni center, the nature of the excited state of NiPcOBu₈ was reassessed. Using X‐ray probe pulses from a synchrotron source, the ground‐ and excited‐state X‐ray absorption spectra of NiPcOBu8 were measured. Based on the results, we identified that the excited state exhibits spectral features that are characteristic of a Ni^(1, 3)(3d_(z²), 3d_(x²-y²)) state rather than a LMCT state with a transiently reduced Ni center. This state resembles the (d,d) state of nickel(II) tetramesitylphorphyrin. The XTA features are rationalized based on the inherent cavity sizes of the macrocycles. These results may provide useful guidance for the design of photocatalysts in the future

Multiabsorber Transition-Edge Sensors for X-Ray Astronomy

We are developing arrays of position-sensitive microcalorimeters for future x-ray astronomy applications. These position-sensitive devices commonly referred to as hydras consist of multiple x-ray absorbers, each with a different thermal coupling to a single-transition-edge sensor microcalorimeter. Their development is motivated by a desire to achieve very large pixel arrays with some modest compromise in performance. We report on the design, optimization, and first results from devices with small pitch pixels (<75 m) being developed for a high-angular and energy resolution imaging spectrometer for Lynx. The Lynx x-ray space telescope is a flagship mission concept under study for the National Academy of Science 2020 decadal survey. Broadband full-width-half-maximum (FWHM) resolution measurements on a 9-pixel hydra have demonstrated E(FWHM) = 2.23 0.14 eV at Al-K, E(FWHM) = 2.44 0.29 eV at Mn-K, and E(FWHM) = 3.39 0.23 eV at Cu-K. Position discrimination is demonstrated to energies below <1 keV and the device performance is well-described by a finite-element model. Results from a prototype 20-pixel hydra with absorbers on a 50-m pitch have shown E(FWHM) = 3.38 0.20 eV at Cr-K1. We are now optimizing designs specifically for Lynx and extending the number of absorbers up to 25/hydra. Numerical simulation suggests optimized designs could achieve 3 eV while being compatible with the bandwidth requirements of the state-of-the art multiplexed readout schemes, thus making a 100,000 pixel microcalorimeter instrument a realistic goal