Browsing by Author "Zhang, Mengxi"

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    Implications for spatial non-stationarity and the neighborhood effect averaging problem (NEAP) in green inequality research: evidence from three states in the USA
    Gyanwali, Sophiya; Karki, Shashank; Jang, Kee Moon; Crawford, Thomas W.; Zhang, Mengxi; Kim, Junghwan (Springer, 2024-09-04)
    Recent studies on green space exposure have argued that overlooking human mobility could lead to erroneous exposure estimates and their associated inequality. However, these studies are limited as they focused on single cities and did not investigate multiple cities, which could exhibit variations in people’s mobility patterns and the spatial distribution of green spaces. Moreover, previous studies focused mainly on large-sized cities while overlooking other areas, such as small-sized cities and rural neighborhoods. In other words, it remains unclear the potential spatial non-stationarity issues in estimating green space exposure inequality. To fill these significant research gaps, we utilized commute data of 31,862 people from Virginia, West Virginia, and Kentucky. The deep learning technique was used to extract green spaces from street-view images to estimate people’s home-based and mobility-based green exposure levels. The results showed that the overall inequality in exposure levels reduced when people’s mobility was considered compared to the inequality based on home-based exposure levels, implying the neighborhood effect averaging problem (NEAP). Correlation coefficients between individual exposure levels and their social vulnerability indices demonstrated mixed and complex patterns regarding neighborhood type and size, demonstrating the presence of spatial non-stationarity. Our results underscore the crucial role of mobility in exposure assessments and the spatial non-stationarity issue when evaluating exposure inequalities. The results imply that local-specific studies are urgently needed to develop local policies to alleviate inequality in exposure precisely.
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    National assessment of obstetrics and gynecology and family medicine residents' experiences with CenteringPregnancy group prenatal care
    Place, Jean Marie; Van De Griend, Kristin; Zhang, Mengxi; Schreiner, Melanie; Munroe, Tanya; Crockett, Amy; Ji, Wenyan; Hanlon, Alexandra L. (2023-11-21)
    Objective To examine family medicine (FM) and obstetrician-gynecologist (OB/GYN) residents’ experiences with CenteringPregnancy (CP) group prenatal care (GPNC) as a correlate to perceived likelihood of implementing CP in future practice, as well as knowledge, level of support, and perceived barriers to implementation. Methods We conducted a repeated cross-sectional study annually from 2017 to 2019 with FM and OB/GYN residents from residency programs in the United States licensed to operate CP. We applied adjusted logistic regression models to identify predictors of intentions to engage with CP in future practice. Results Of 212 FM and 176 OB/GYN residents included in analysis, 67.01% of respondents intended to participate as a facilitator in CP in future practice and 51.80% of respondents were willing to talk to decision makers about establishing CP. Both FM and OB/GYN residents who spent more than 15 h engaged with CP and who expressed support towards CP were more likely to participate as a facilitator. FM residents who received residency-based training on CP and who were more familiar with CP reported higher intention to participate as a facilitator, while OB/GYN residents who had higher levels of engagement with CP were more likely to report an intention to participate as a facilitator. Conclusion Engagement with and support towards CP during residency are key factors in residents’ intention to practice CP in the future. To encourage future adoption of CP among residents, consider maximizing resident engagement with the model in hours of exposure and level of engagement, including hosting residency-based trainings on CP for FM residents.
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    Navigating Disparities in Dental Health—A Transit-Based Investigation of Access to Dental Care in Virginia
    Kim, Junghwan; Karki, Shashank; Brickhouse, Tegwyn; Vujicic, Marko; Nasseh, Kamyar; Wang, Changzhen; Zhang, Mengxi (2024-10-30)
    Objective: To identify vulnerable areas and populations with limited access to dental care in Virginia, the study aimed (1) to calculate travel time and accessibility scores to dental care in Virginia using a transit-based accessibility model for all dental clinics and dental clinics participating in the Medicaid dental program and (2) to estimate factors associated with accessibility to dental clinics participating in the Medicaid dental program in Virginia. Methods: The study used building footprints as origins of transit trips to dental care services (or destinations). The study then computed transit-based origin–destination travel time matrices based on the detailed trip information, including in-vehicle and out-of- vehicle travel time. Accessibility scores were calculated by counting the number of dental clinics that can be reached within 60 min. Regression analysis was used to measure factors associated with accessibility scores to dental clinics participating in Medicaid. Results: Residents in smaller regions spent longer travel time to dental clinics by public transit compared with those who resided in larger regions. Medicaid participants also faced longer travel time compared with the general population. Residents spent more than three-fourths of the time waiting for public transit and walking to clinics regardless of where they live and what type of insurance they have. Associations between sociodemographic factors and accessibility scores to dental clinics participating in the Medicaid dental program varied across regions. Conclusions: Disparities in dental care accessibility exist depending on the size of regions and Medicaid participation in Virginia. The disparities in transit-based access to dental clinics and a disproportionate amount of time spent waiting for public transit and walking to dental clinics could be improved through tailored interventions taking into account the sociodemographic and geographic characteristics of each region.