Digital Commons Network^™

Farm Work Injuries Among A Cohort Of Children In Kentucky, Usa, Steven R. Browning, Susan C. Westneat, Deborah B. Reed

Epidemiology and Environmental Health Faculty Publications

Children residing on farms with livestock may be at an increased risk for work-related injuries, compared to children who work on other commodity farms. This study characterizes children's work tasks on Kentucky farms and assesses whether children who work on beef cattle farms are at an increased risk for farm work injuries. The results of a cohort study of children aged 5-18 years (N=999 at baseline) working on family farms in Kentucky, followed for two consecutive years after an initial enumeration five years previously, found that 70% of the children were involved in animal-related chores. Across all age groups, children …

Availability Of Buprenorphine Treatment In Kentucky, Elijah T. Myers, Tyrone F. Borders

Institute for Rural Health Policy Reports

Drug overdose and substance use treatment admissions data indicate that opioid use is problematic in Kentucky, but little information exists about the geographic availability of buprenorphine treatment across the state. Furthermore, there is even less information about the characteristics of the physicians prescribing buprenorphine. This report describes the availability of buprenorphine treatment in Kentucky.

Health And Health Care In Kentucky: Variations By Region And Metro/Micro/Rural Status, Tyrone F. Borders, Keith Branham

Institute for Rural Health Policy Reports

Health policy makers and health system managers frequently make decisions to allocate and organize resources according to differences in unmet needs across geographic areas. This report describes, compares, and contrasts key health, health behavior, and health care access indicators by region and metropolitan status in Kentucky.

Living With Traumatic Brain Injury In A Rural Setting: Supports And Barriers Across The Continuum Of Care, Anne L. Harrison, Elizabeth G. Hunter, Heather Thomas, Paige Bordy, Erin Stokes, Patrick H. Kitzman

Physical Therapy Faculty Publications

Purpose: Traumatic brain injury (TBI) is prevalent in Kentucky and comes with a high cost in care and quality of life for individuals and caregivers affected. Many people living with the condition of TBI have unmet needs. Research among people living with TBI in rural areas is limited. The purposes of this study were to (1) increase understanding of the lived experience of people with TBI and caregivers in rural regions of Kentucky across the continuum of their care and (2) provide their perspectives on barriers and facilitators of optimal function and well-being.

Methods: A qualitative descriptive interview study was …

Kentucky Special Report: State-Level Field Network Study Of The Implementation Of The Affordable Care Act, Julia Costich, Glen P. Mays

Health Management and Policy Reports

No abstract provided.

Colorectal Cancer Prevention: Perspectives Of Key Players From Social Networks In A Low-Income Rural Us Region, Nancy E. Schoenberg, Kathryn Eddens, Adam Jonas, Claire Snell-Rood, Christina R. Studts, Benjamin Broder-Oldach, Mira L. Katz

Behavioral Science Faculty Publications

Social networks influence health behavior and health status. Within social networks, “key players” often influence those around them, particularly in traditionally underserved areas like the Appalachian region in the USA. From a total sample of 787 Appalachian residents, we identified and interviewed 10 key players in complex networks, asking them what comprises a key player, their role in their network and community, and ideas to overcome and increase colorectal cancer (CRC) screening. Key players emphasized their communication skills, resourcefulness, and special occupational and educational status in the community. Barriers to CRC screening included negative perceptions of the colonoscopy screening procedure, …

The Utilization Of Models Of Care Transition To Reduce Medicare Beneficiaries’ Hospital Readmission Rates In Kentucky: A Case Study, Audra Putt

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

Problem: Unsuccessful care transitions for Medicare beneficiaries have resulted in high health expenditures and a diminished quality of care as the 30-day hospital readmission rate has increased. This has prompted the Centers for Medicare and Medicaid Services to require hospitals with high readmission rates to pay penalties. As a result, the Community-based Care Transitions Program was established under Section 3026 of the Affordable Care Act to provide health organizations funding to utilize models of care transition to improve the care transition process. The purpose of this capstone project was to identify whether two community-based organization programs, the Kentucky Appalachian Transition …

Focas Appalachia: A Cervical Cancer Prevention Program For The Women Of The Kentucky River Area Development District, Chrisanthi M. Masero

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

In response to the National Institute of Health’s (NIH) funding announcement, the Kentucky River District Health Department (KRDHD) proposes to implement an evidence-based cervical cancer prevention program in the Kentucky River Area Development District (KRADD) in southeastern Appalachian Kentucky. The proposed evidence-based program was part of the National Cancer Institute’s (NCI) “Public Health Approaches to Breast and Cervical Cancer” research initiative and is one of nine cervical cancer Research Tested Intervention Programs (RTIPs) on the NCI’s RTIP database. The Forsyth County Cancer Screening Project (FoCaS) was designed to improve the beliefs, attitudes, and behaviors regarding breast and cervical cancer screening …

The Link Between Smoking, Lung Cancer And Socioeconomic Factors In Kentucky, Shreya Berlia

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

Background and Purpose

Lung cancer is the leading cause of cancer death and the second most diagnosed cancer in both men and women in the United States. An estimated 158,080 deaths from lung cancer are expected to occur in 2016, which will account for approximately 1 in 4 of all cancer deaths. The 1- and 5-year relative survival rates for lung cancer are 44% and 17%, respectively. The incidence rate for lung cancer has been declining since the mid-1980s in men, but only since the mid-2000s in women. Tobacco smoke is the leading cause of preventable disease and death in …

Are There Rural-Urban Differences In Dentist Supply?, Mutlaq Alotaibi

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

The purpose of this project was to examine the supply of dentists in the Commonwealth of Kentucky at the county level. Counties with shortages in dentist supply were determined and associated factors were examined.

Several county-level variables were analyzed. These included total number of dentists, total county population, dentist to population ratio, dentist supply shortage, median household income, median age, percent of Medicaid enrollees, rurality, oral cancer crude incidence and mortality rates per 100,000 and percent of adults missing six or more teeth.

This project showed that 42 of the 120 counties in Kentucky had shortages in dentist supply. Also, …

"Life Skills Training" Prescription Drug Abuse Prevention Among Youth In Bell County, Kentucky, Arveen Kaur

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

Prescription Drug Abuse (PDA) has become a serious public health concern and a major epidemic in the United States (U.S.). According to the 2014 National Survey on Drug Use and Health (NSUDH), approximately 15 million people (aged 12 or older) used prescription drugs in the past year and 6.5 million in past month. Out of these, 2 million Americans (aged 12 or older) either abused prescription drugs or were dependant on them. Almost 5% of adolescents (1.1 million) between the age group 12-17 abused prescription painkillers in 2014. Nationally, Kentucky is among the top five states with highest age-adjusted overdose …

Enough Smoke: Implementation Of An Evidence-Based Smoking Cessation Program In Owsley County, Kentucky, Meghan Fay Johnson

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

In 1964, the first United States (U.S.) Surgeon General’s Report explicitly stating the dangers of smoking, including an increased risk of lung cancer, was released. Fifty years later, the U.S. continues to carry the significant health and economic burdens for failing to heed this public health warning. Owsley County, Kentucky, located in the heart of the Appalachian is one of the most impoverished and medically underserved counties in the U.S., ranking last in almost every category of overall health outcomes in the state. The county is also entirely rural, with no major cities within an 80-mile radius. In every health …

Examining Associations Between Prevalence Of Chronic Obstructive Pulmonary Disease And Self-Perceived Health-Related Quality Of Life Among Adults In Kentucky, Seth Siameh

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

Introduction

The objective of this study is to examine associations between Chronic Obstructive Pulmonary Disease (COPD) prevalence in Kentucky and measures of health-related quality of life (HRQOL) using a large population-based sample.

Methods

Data from the 2013 Kentucky Behavioral Risk Factor Surveillance System (BRFSS) was used to calculate age-adjusted prevalence of COPD among various population subgroups (N=10,958). Multivariable logistic regression models were used to estimate adjusted odds ratios for COPD and HRQOL measures.

Results

In 2013, the age-adjusted prevalence of self-reported COPD among Kentucky adults aged ≥18 years was 10.3% (standard error [SE], ±0.4; 95% CI, 9.5 – 11.2). Kentucky …

Self Center: Addressing Teen Pregnancy In Wolfe County, Ky, Lindsey Smith

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

Teen pregnancies and births are at an all-time low across the United States. Despite this decline in rates within the last decade, the teen pregnancy rate in Kentucky remains significantly higher than that of the overall United States. Additionally, teen pregnancy still has significant economic and health impacts on both teen parents and their children. In rural communities, such as Wolfe County, KY, teen birth rates are approximately one-third higher than the rest of the country. Self Center is an evidence-based teen pregnancy prevention program that involves school-linked reproductive health services and provides participants with education, counseling, and healthcare services. …

Eat Well, Keep Moving: Decreasing Childhood Obesity In Fulton County, Kentucky, Sandra Onekhena

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

With the high rates of childhood obesity in Fulton County, the Purchase District Health Department proposes the implementation of the Eat Well and Keep Moving Program in all the county’s elementary schools among fourth and fifth graders. It is an interdisciplinary, evidence-based program that will be aimed at our short-term goal of increasing knowledge about nutrition and physical activity and inspiring positive behavioral change. It works by integrating lessons and activities about proper nutrition and activity into various aspects of the children’s lives — in the classroom, cafeteria, at home and in the community. We hope to see children move …

An Assessment Of Workplace Injury In Kentucky’S Commercial Logging Industry, Logan Ray

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

Objective: To identify demographic, operational, and task-related characteristics associated with increased frequency and severity of injury in Kentucky’s commercial loggers.

Methods: Kentucky Master Loggers attending mandatory continued education courses completed a survey tool eliciting demographic and operational characteristics of their companies, and details of any on-site injury in the years 2012 through 2015 that led to medical costs, lost days or time, and/or decreased production. Associations to injury frequency and injury severity were assessed using logistic regression analysis.

Results: 86 Kentucky Master Loggers representing 66 of Kentucky’s 120 counties reported 33 accounts of non-fatal logging injury. Master Loggers were full-time …

Development Of Multiple Primary Cancers In Lung Cancer Patients: Appalachian Vs. Non-Appalachian Populations Of Kentucky, Vira Pravosud

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

OBJECTIVE: This study examined whether there were differences in the development of multiple primary cancers in lung cancer patients residing in the Appalachian versus Non-Appalachian regions of Kentucky. The study also identified other factors associated with the development of another primary cancer in lung cancer patients.

HYPOTHESIS: Lung cancer patients residing in Appalachian Kentucky are more likely to develop multiple primary cancers compared to patients residing in Non-Appalachian Kentucky.

METHODS: This was a retrospective, population-based cohort study of Kentucky patients (N=26456) aged 20 years and older, diagnosed with primary lung cancer between January 1, 2000 and December 31, 2013. The …

Behavioral Modification Program To Control Obesity Among School Children In Knott County, Kentucky, Samjhana Shakya

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

Childhood obesity is one of the major public health concerns in the United States (US). Obese children have a greater likelihood of developing cardiovascular disease risk factors such as high blood pressure and cholesterol, and impaired blood glucose[7].The prevalence of obesity among children 2 to 5 years of age in Kentucky was 15.7% (US average 8.4%) and 17.6% (US average 17%) among adolescents in Kentucky being higher than the national averages [8,3].

A major goal of the Behavioral Modification Program is to promote healthy behaviors among elementary school children to control obesity by modifying eating, physical activity and screen time …