Digital Commons Network^™

Adverse Outcomes Of Co-Occurring Methamphetamine And Opioid Use Among Pregnant And Postpartum Women, Hope Tevis

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background

Overdose mortality rates increased significantly between 2018 and 2021 in the United States (NIH, 2023). Moreover, pregnant and postpartum women (PPW), who were aged 35 to 44 were observed to have the highest overdose mortality rates (NIH, 2023). Although there is existing research that examines the increase of co-occurring opioid and methamphetamine use, it still remains understudied when specifically focusing on PPW. This analysis intends to explore this gap in research by 1) exploring the history of co-occurring methamphetamine and opioid use among PPW who were seeking residential treatment, 2) highlighting the adverse health outcomes that follow co-use among …

Review Of: Coal, Cages, Crisis: The Rise Of The Prison Economy In Central Appalachia, Ted Olson Phd

Journal of Appalachian Health

Ted Olson, PhD, is a professor of both Appalachian Studies and Bluegrass, Old-Time and Roots Music Studies at East Tennessee State University. In this piece, he reviews Professor Judah Schept's Coal, Cages, Crisis: The Rise of the Prison Economy in Central Appalachia and discusses the impacts of incarceration on the health of Appalachia and on its residents more broadly.

Providers’ Stigmas And The Effects On Patients With Opioid Use Disorder: A Scoping Review, Peyton Skaggs, Sarah Beth Bell, F. Douglas Scutchfield Md, Lauren E. Robinson

Journal of Appalachian Health

Introduction: One of the most prevalent, dangerous stigmas in health care is the complex bias toward patients with opioid use disorder (OUD). This stigma damages the vital patient–provider relationship, further perpetuating the opioid epidemic.

Purpose: Unfortunately, research on the relationship between OUD and provider stigma is greatly lacking. To fill this gap, the present in-depth study undertakes a scoping review of research on providers’ stigma toward OUD in order to determine how enacted stigma affects treatment plans.

Methods: Four databases were used to identify articles published from 1999 to 2021. A comprehensive search strategy was developed through a collaborative process …

Gender Differences In Barriers To Entering Substance Use Treatment, Casey A. Baker

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background

Nationally representative data have indicated that less than one in ten individuals with a substance use disorder (SUD) have received recent treatment, suggesting a need for research to examine potential barriers to SUD services. Although research has been conducted to identify some barriers to treatment, there is little research focused on gender differences. To address this gap in research, the present study aimed to examine gender differences in barriers to entering SUD treatment, as well as differences in factors that may impact decisions to enter treatment.

Methods

Participants (N = 62) were recruited from the community as part of …

Effects Of Social Isolation And Adolescent Ethanol Exposure On Adult Drinking And Nicotine Co-Use, Jakob Shaykin

Theses and Dissertations--Psychology

Alcohol use often begins in adolescence and can lead to increased susceptibility to AUD in adulthood. Stress in the form of social isolation during adolescence can also prompt substance use disorders later in adulthood. This thesis determined if exposure to ethanol (EtOH) during adolescence and social isolation alters the trajectory of alcohol and nicotine intake during adulthood. In Experiment 1, adolescent male and female Sprague-Dawley rats were administered intermittent injections of EtOH (2g/kg 20% EtOH, IP) or saline (PND 28-41). EtOH consumption was measured in adulthood (PND 49-55) using a 2-bottle choice procedure where one bottle contained a 0.2% saccharin/15% …

Examining The Perspectives And Experiences Of Nutrition Educators Working With Clients In Substance Use Recovery Settings, Cora Teets, Paula Plonski, Omolola Adedokun, Heather Norman-Burgdolf

Dietetics and Human Nutrition Faculty Publications

Substance use disorder (SUD) is one of the most detrimental health, social, and economic problems in the United States. Limited studies suggest providing tailored nutrition education during SUD treatment correlates with positive recovery outcomes. The University of Kentucky Nutrition Education Program conducted two focus group sessions to explore and determine educators’ instructional and programmatic needs who deliver nutrition education to clients in substance use recovery throughout Kentucky. The study team identified four emerging themes and several subthemes related to Nutrition Education Program educators working with clientele in recovery. The four emerging themes included: (1) current experiences working with the audience, …

An Examination Of Three Transitional Events In The Substance Misuse Trajectories Of Women With Criminal Legal System Involvement, Martha Tillson

Theses and Dissertations--Sociology

Research has consistently demonstrated that criminal legal system (CLS)-involved women are distinct from men in initiation and course of drug use, with important differences on biological, environmental, and sociocultural levels. Thus, the unique pathways and transitions into and out of drug use for women with CLS involvement are critical to consider from a research perspective, but also from a need to develop and support evidence-based, women-centered services in correctional contexts. This dissertation project uses a three-paper format to investigate three aims: (1) to understand CLS-involved women’s initiations to injection drug use and their experiences providing injection initiation assistance (IIA) to …

Opioid Use Disorder Treatment With Buprenorphine: Analysis Of Treatment Utilization And Associated Outcomes In Kentucky, Feitong Lei

Theses and Dissertations--Epidemiology and Biostatistics

Opioid use disorder (OUD) is chronic opioid use that results in clinically significant suffering, impairment, or even death. The opioid epidemic in the United States has become a public health and economic crisis, affecting patients' well-being and the nation's overall health and welfare. Eastern Kentucky was among the first regions affected by the opioid crisis, and Kentucky has historically ranked among the top five states for age-adjusted drug overdose mortality rate.

There are three medications (buprenorphine, methadone, naltrexone) approved by the U.S. Food and Drug Administration to treat OUD. As a partial opioid agonist, buprenorphine is a safe medication for …

The Underlying Issue: Acknowledging The Impact The Race-Based Bias Of Some White Teachers Poses For Black Adolescents, Cerenity Leavell-Barker

DSW Capstone Projects

Current literature fails to assess the race-based bias of some white teachers and its impact on the school-to-prison pipeline. The actions of some white teachers due to unconscious or conscious race-based bias can increase race-based stress experienced by Blacks students and lead to racial trauma. Racial trauma is a traumatic experience that can alter this stage of development and have significant impact on the academic achievement of Black adolescents and influence behaviors perceived as negative. The purpose of this capstone is to enhance awareness and knowledge on the traumatic impact the race-based bias of some white teachers poses for Black …

Screening For Severe Mental Illness In A Correctional Setting Using The Brief Jail Mental Health Screening Tool, Stephanie Kohl

DNP Projects

Abstract

BACKGROUND: Prisoners who are detained in jails and detention centers have higher rates of Severe Mental Illness (SMI) compared to the general population. However, SMI is often unidentified in this population, largely due to lack of assessment using effective SMI screening tools and lack of knowledge among prison staff about the prevalence of SMI and the importance of identification in the correctional setting. Prisoners with SMI often act out violently against others and themselves. Current standard practice for SMI screening varies significantly across jails. Many jails use standard medical questionnaires which help obtain a brief medical history but often …

The Impact On Recovery Capital Following High-Intensity Exercise Adjuvant Therapy In Opioid Addiction Treatment, Aaron M. Macdonald

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

OBJECTIVE: The Counseling Center (TCC), a substance abuse disorder (SUD) recovery facility located in Portsmouth, Ohio, began investigating alternative treatment methods that may improve long-term recovery rates through increased recovery capital (RC). RC takes into account numerous social and physical variables during the recovery phase of SUD and evidence shows a higher RC can lead to better recovery outcomes. TCC partnered with Portsmouth Spartan Kettlebell Club (PSKC), a nearby CrossFit (CF) affiliated gym, and created a partnership that allowed clients at TCC to participate in a guided CF program. The purpose of this study was to examine how this program, …

Understanding Polarizing Community Perspectives On Harm Reduction Strategies: Challenges To Addressing The Opioid Crisis In Appalachian Pennsylvania, Stephanie L. Creasy Mph, Jessica R. Thompson Med, Christina F. Mair Phd, Jessica G. Burke Phd

Journal of Appalachian Health

Introduction: Rural communities face barriers to opioid treatment and overdose prevention including concerns about stigma and lack of harm reduction services.

Purpose: The aim of this study was to explore community perspectives and understanding of harm reduction approaches to opioid use and overdose in a high-risk Northern Appalachian case community in Pennsylvania.

Methods: A small town approximately 10 miles from Pittsburgh was identified as the community with the greatest predicted probabilities of epidemic outbreak using posteriors from spatial models of hospitalizations for opioid use disorders. We interviewed 20 key stakeholders in the case community in using a semi-structured interview guide …

Appalachia: Putting The "Critical" In Race And Crowdsourcing A Pathway Model On Institutional Racism, Lauri Andress, Keri Valentine

Journal of Appalachian Health

As the website Understanding and Dismantling Racism: Crowdsourcing a Pathway Model in Appalachia explains, we are seeking assistance in refining a pathway model that elucidates institutional racism from the unique standpoint of Appalachia. We think that Appalachia has a distinctive cultural toolkit that shapes its orientation on issues. Our goal is to use crowdsourcing to harness this unique Appalachian ethos to refine the Pathway model on Institutional Racism based on comments, edits, questions, and ideas left on the website.

Longitudinal Pre-Exposure Prophylaxis (Prep) Acceptability, Initiation And Adherence Among Criminal Justice-Involved Adults In The Usa: The Southern Prep Cohort Study (Specs) Protocol, Katherine Lemasters, Carrie B. Oser, Mariah Cowell, Katie Mollan, Kathryn Nowotny, Lauren Brinkley-Rubinstein

Sociology Faculty Publications

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population.

METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential …

Age At First Alcohol Use And Weapon Carrying Among Adolescents: Findings From The 2019 Youth Risk Behavior Survey, Philip Baiden, Nusrat Jahan, Henry K. Onyeaka, Shawndaya Thrasher, Savarra Tadeo, Erin Findley

Social Work Graduate Research

Background
Although studies have investigated the association between alcohol use and violent behaviors such as weapon carrying, few studies have examined the association between age at first alcohol use and weapon-carrying among adolescents. The objective of this study was to investigate the association between age at first alcohol use and weapon carrying among adolescents.

Methods
Data for this study came from the 2019 Youth Risk Behavior Survey. An analytic sample of 13,442 adolescents aged 14–18 years old (51% female) was analyzed using binary logistic regression. The outcome variable investigated in this study was weapon carrying during the past 30 days, …

Understanding Declining Rates Of Drug Overdose Mortality In Eastern Kentucky, Walsh Center For Rural Health Analysis, University Of Chicago, Center Of Excellence In Rural Health, University Of Kentucky

Center of Excellence in Rural Health Reports

With funding from the Centers for Disease Control and Prevention (CDC) and the National Association of County and City Health Officials (NACCHO), the NORC Walsh Center for Rural Health Analysis and the University of Kentucky Center of Excellence in Rural Health (UK CERH) conducted this study to understand possible factors associated with declining rates of drug overdose mortality in Eastern Kentucky. Several counties in Eastern Kentucky have seen declines in drug overdose mortality rates over the past decade, even as overdose rates have risen in the state of Kentucky as a whole, as well as in the Appalachian regions of …

Adaptation Of A Standard Extended-Release Naltrexone (Xr-Ntx) Protocol For Rural Re-Entering Offenders With Oud, Michele Staton, Hannah K. Knudsen, Sharon L. Walsh, Carrie B. Oser, Erika Pike, Michelle R. Lofwall

Behavioral Science Faculty Publications

BACKGROUND: Despite a growing body of empirical support for the effectiveness of extended-release naltrexone (XR-NTX) to reduce opioid relapse among people with opioid use disorder (OUD) transitioning from a correctional facility to the community, continuity of care following release remains challenging. This paper describes a research-based adaptation of a state's standard of care XR-NTX protocol using the ADAPT-ITT framework for delivery in a non-traditional, non-treatment, community criminal justice setting (P&P office), as well as the expansion of services by a local Federally Qualified Health Center (FQHC) provider who would, for the first time, be going to the jail and P&P …

Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell

Theses and Dissertations--Family Sciences

The World Health Organization (WHO; 2002) has indicated that sexual violence is a serious public health concern, and both the WHO and the United Nations (UN) have declared that violence against women, in particular, is a profound violation of human rights (UN General Assembly, 1993; WHO, 2017). Although the systemic and negative impact of trauma on family and intimate relationships have been well documented, the empirical literature regarding the effects of adult sexual trauma on relationship satisfaction is less robust. These studies are designed to address this gap and will do so with analyses centered on an understudied population: the …

Mitigating Opioid Related Healthcare Use In Kentucky: An Assessment Of The Impact Of Kentucky Revised Statute (Krs) Changes To Opioid Prescribing On Opioid Related Prescribing And Healthcare Utilization, Drew Speer

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The opioid epidemic has impacted few other places more than the state of Kentucky. In 2018, data from the Centers of Disease Control and Prevention (CDC) and the National Institute on Drug Abuse (NIDA) ranked Kentucky as being in the top ten for rate of drug overdose deaths and opioid-involved overdose deaths per 100,000 persons.^1,2 These rankings exist even though prescription opioid dispensing rates have fallen from 102.6 per 100 persons in 2015 to 72.3 per 100 persons in 2019.³ Aligning with this trend, while research shows this problem began with prescription opioids in the late 1990’s, it …

Social Determinants Of Discrimination And Access To Health Care Among Transgender Women In Oregon, Jonathan Garcia, Richard A. Crosby

Health, Behavior & Society Faculty Publications

Purpose: Transgender women in the United States experience health disparities and limited access to gender-affirming health services. This study describes the social determinants of health that shape access to health services for transgender women in Oregon, a state with a high tally of gender-affirming policies.

Methods: We conducted qualitative interviews with 25 transgender women between 18 and 39 years of age. Interviews explored the social, economic, cultural, and legal factors that shape access to health. A Qualtrics survey captured sociodemographic characteristics. We identified facilitators and barriers to accessing gender-affirming services using thematic analysis of qualitative data.

Results: Our participants perceived …

Rural Community Toolbox To Help Battle Opioid Epidemic, Liz Carey

Journal of Appalachian Health

An online data repository and toolbox created by the Office of National Drug Control Policy is designed to provide communities with knowledge and resources to fight the opioid epidemic according to their unique needs.

Listening To Voices In Appalachia: Gathering Wisdom From The Field About Substance-Abuse Recovery Ecosystems, Bruce Behringer

Journal of Appalachian Health

New qualitative data collected through six regional community-based listening sessions and community meetings are presented that describe elements of the Appalachian Regional Commission’s Recovery Ecosystem Model. These data informed the Model, which was used in formulating the new ARC Recovery-to-Work initiative. Input was intentionally solicited from multiple sectors, including persons recovering from substance abuse disorder, treatment and recovery service providers, workforce development agencies, employers, and community advocacy groups.

Substance Use Prevention Services In Juvenile Justice And Behavioral Health: Results From A National Survey, Rodney Funk, Hannah K. Knudsen, Larkin S. Mcreynolds, John P. Bartkowski, Katherine S. Elkington, Ellen H. Steele, Jessica M. Sales, Christy K. Scott

Behavioral Science Faculty Publications

BACKGROUND: This study examined the national availability of substance use prevention (SUP) within juvenile justice (JJ) and their primary behavioral health (BH) providers, and the relationships between the availability of SUP and agency-level measures of organizational structure, staffing, and youth characteristics. A three-stage national probability sampling process was used to select participants for a national survey that included, among other facets of community supervision (CS) and BH practices, questions on agency characteristics, youth characteristics, whether the agency/provider directly provided SUP services, and whether the agency/provider directly provided substance use and/or mental health treatment. This paper focuses on SUP services along …

Students’ Perceptions Of Justice: Application Of Sanctions, Guilt, And Responsibility In Campus Sexual Assault Cases, Diane R. Follingstad, Caihong R. Li, Jaspreet K. Chahal, Claire M. Renzetti

CRVAW Faculty Journal Articles

Despite growing attention to adjudication of campus sexual assault cases, little is known how students perceive “justice” for such cases. The present study examined whether victim, perpetrator, and assault characteristics influenced students’ perceptions of: whether a sanctionable violation occurred; the type of sanction to be applied; perceived severity of the sanction; proportion of guilt attributable to the victim and perpetrator; and level of responsibility of the victim and perpetrator. Fourteen factors pertaining to potential negative evaluation of rape victims were derived; thus, a non-factorial vignette survey design focusing only on each main effect was employed. 846 college students responded to …

Mentoring Multi-College Bystander Efficacy Evaluation – An Approach To Growing The Next Generation Of Gender-Based Interpersonal Violence Intervention And Prevention (Vip) Researchers, Ann L. Coker, Danielle Davidov, Heather M. Bush, Emily R. Clear

Obstetrics and Gynecology Faculty Publications

The Centers for Disease Control and Prevention provided funding (U01 CE002668) to evaluate bystander program efficacy to reduce gender-based violence on college campuses (Aim 1) and to create a mentoring network (Aim 2) for young campus-based researchers interested in violence intervention or prevention (VIP). While an evaluation of this mentoring program is ongoing, our purpose here was to document the strategies used to create, implement, and begin evaluation of this national multi-college mentoring network. As each public college was recruited into this evaluation named multi-college Bystander Efficacy Evaluation (mcBEE), each college was invited to nominate a researcher interested in receiving …

Ethanol Induced Neurotoxicity Through Dysregulation Of Ampk In A Fetal Alcohol Syndrome Model, Jessica Gebhardt

Theses and Dissertations--Medical Sciences

Ethanol consumption during pregnancy is rising in the U.S., including the rate of binge drinking. It is reported around 1 in 27 women engage in binge drinking activities while pregnant. The third trimester is a sensitive period of neuronal growth in which ethanol induced neurotoxicity can cause many harmful effects including Fetal Alcohol Spectrum Disorders. It has been shown that ethanol decreases the activity of AMPK through increasing lipid peroxidation, both of which are correlated to neurotoxicity. AICAR is a synthetic analog of AMP which significantly increases AMPK activity and may have beneficial effects in an organotypic hippocampal model of …

Application Of High Performance Training Strategies To Enhance Occupational Readiness In Law Enforcement Cadets, Gabriel Jose Martinez

Theses and Dissertations--Kinesiology and Health Promotion

Law enforcement requires cadets to achieve a requisite level of physical fitness to prepare for occupational demands. However, there is limited research on the effectiveness of academy exercise programs to optimize physical fitness and occupational physical ability through high performance training strategies more typically utilized in elite athletic populations. Furthermore, there is a paucity of research identifying physical fitness correlates of occupational performance. Collectively, this information will provide academies and practitioners with critical information to develop evidence-based training programs. Therefore, the purposes of this study were to: Aim 1) Examine the effectiveness of integrating autoregulatory progressive resistance exercise (APRE) and …

Utilizing A Community-Based Doula Care Intervention To Reduce Race-Based Perinatal Health Inequities In Jefferson County, Kentucky, Brendan Mathews

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Target Population and Need

The United States is currently the only industrialized nation in the world experiencing increasing rates of

pregnancy-related mortality.

1,2

Black women die at 3-4 times the rate of their white counterparts.

1-5

This disparity

is likely caused by the experience of systemic racism, which increases allostatic load and produces epigenetic

modifications linked to higher likelihood for poor birth outcomes. Biases perpetuated by health care providers

result in black women being less likely to receive quality healthcare and more likely to experience poor perinatal

1-7 to all pregnant women.

health outcomes.

The provision of doula-based care can …

The Importance Of Shared Language In Rural Behavioral Health Interventions: An Exploratory Linguistic Analysis, Michele Staton, Jennifer Cramer, Robert Walker, Claire Snell-Rood, Athena Kheibari

Behavioral Science Faculty Publications

A focus on the use of shared language to enhance congruence in interventionist-client dialogue is missing from traditional research on evidence-based practices and rural behavioral health. This study incorporates qualitative interactional sociolinguistics, which includes discourse analysis (typically written or audio recordings of face-to-face encounters with 11 clients and a study interventionist), to describe those speech patterns in a broad sense (dialect), as well as more specific use of communicative strategies to increase parity in the interaction between a rural interventionist delivering an evidence-based practice in the context of a research study with rural women opioid users in a non-therapeutic context. …

A Comparison Of Appalachian And Non-Appalachian Kentucky Dui Offenders, Megan F. Dickson, Megan Kissel, J. Matthew Webster

Journal of Appalachian Health

Background: Driving under the influence has been an overlooked consequence of the opioid epidemic. Although recent reports have highlighted the increased prevalence of DUI in rural communities and the extensive mental health problems and criminal and drug use histories among rural Appalachian DUI offenders, it is unclear how Appalachian DUI populations compare to DUI offenders in other regions.

Purpose: To help fill this void in the literature, the current study uses a statewide sample to examine how Appalachian DUI offenders differ from non-Appalachian DUI offenders in a predominantly rural state.

Methods: Assessment records were examined for 11,640 Kentucky DUI offenders …