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Human Papillomavirus Vaccination: Barriers, Disparities, And Potential Solutions, Gracie Margaret Chiampas

Chancellor’s Honors Program Projects

No abstract provided.

Physical Activity On Multiuse Trails And In A Novel Bike Park Within An Urban Wilderness, Douglas Gregory

Doctoral Dissertations

Research has shown that the presence of, access to, and use of parks and trails is associated with increased levels of PA. However, little research exists on nature-based, recreational multiuse trails and bike-specific amenities within parks and their impact on PA. Therefore, to explore the effect trails and bike parks have on PA, this dissertation conducted three investigations to: 1) determine the impact of trail/greenway interventions on PA, 2) investigate how seasonality and weather influence nature-based recreational trail use, and 3) develop a demographic and PA profile of bike park users.

Investigation 1 (Chapter 4) systematically reviewed the literature specific …

Spatial Epidemiology Of Prediabetes And Diabetes In Florida, Md Marufuzzaman Khan

Doctoral Dissertations

The burden of diabetes and diabetes-related Emergency Department (ED) visits has increased in Florida. However, Diabetes Self-management Education (DSME) Program participation remained considerably low. Little is known about disparities of DSME participation, diabetes complications, and ED use by diabetes patients in Florida and yet this information is important for guiding health programs aimed at reducing diabetes burden. Therefore, the objectives of this study were to investigate: (a) disparities of diabetes prevalence and DSME participation; (b) disparities of diabetes-related ED visit risks; and (c) prevalence and predictors of stroke among persons with prediabetes and diabetes.

Behavioral Risk Factor Surveillance System and …

Advanced Air Quality Management With Machine Learning, Cheng-Pin Kuo

Doctoral Dissertations

Air pollution has been a significant health risk factor at a regional and global scale. Although the present method can provide assessment indices like exposure risks or air pollutant concentrations for air quality management, the modeling estimations still remain non-negligible bias which could deviate from reality and limit the effectiveness of emission control strategies to reduce air pollution and derive health benefits. The current development in air quality management is still impeded by two major obstacles: (1) biased air quality concentrations from air quality models and (2) inaccurate exposure risk estimations

Inspired by more available and overwhelming data, machine learning …

Leptospira Seroprevalence In Companion Animals In Tennessee, Kellie Anne Mccreight

Masters Theses

Leptospirosis is a re-emerging zoonotic disease in humans and animals. The bacteria Leptospira spp. causing this disease is maintained in the kidneys of animals such as rodents and cattle as well as in the environment. Animals harboring Leptospira spp. in the kidneys frequently shed the bacteria in their urine, contaminating the environment. Contact with contaminated soil and water may result in infection. Animals and humans may develop serious life threatening disease from Leptospira infection. Approximately 1 million new human cases and over 50,000 deaths are reported worldwide. Numerous animal species including rodents, cattle, and dogs may serve as reservoir …

A Machine Learning Approach For Predicting Clinical Trial Patient Enrollment In Drug Development Portfolio Demand Planning, Ahmed Shoieb

Masters Theses

One of the biggest challenges the clinical research industry currently faces is the accurate forecasting of patient enrollment (namely if and when a clinical trial will achieve full enrollment), as the stochastic behavior of enrollment can significantly contribute to delays in the development of new drugs, increases in duration and costs of clinical trials, and the over- or under- estimation of clinical supply. This study proposes a Machine Learning model using a Fully Convolutional Network (FCN) that is trained on a dataset of 100,000 patient enrollment data points including patient age, patient gender, patient disease, investigational product, study phase, blinded …

The Pink Tax: A Comparative Case Study Between Tennessee And Washington State, Megha Chitturi

Baker Scholar Projects

The imposition of an additional luxury tax on menstrual health products, otherwise referred to as the “Pink Tax” or the “Tampon Tax”, is present in some states while absent in others. The decision to repeal such a tax is one that has proven to be critical, as it removes the connotation that such products are of “luxury” and make them more accessible to menstruators throughout the state. As of 2023, twenty-three states have eliminated the tax. The state of Washington falls under that parameter while Tennessee does not. The purpose of this undergraduate honors thesis is to explore the potential …

Healthcare Service Utilization And Life Satisfaction In South Africa, Tamara Chavez-Lindell

Doctoral Dissertations

South Africa has achieved improvements in many health measures over the past 30 years, yet significant disparities in healthcare utilization and health outcomes persist. There is evidence that healthcare utilization has a strong influence on health outcomes and life satisfaction. Unfortunately, rural areas tend to have poorer accessibility and utilization of health services, leading to disparities in health outcomes. In rapidly urbanizing countries such as South Africa, identification of disparities and predictors of public healthcare utilization and life satisfaction may provide information that can be used to guide development of programs aimed at improving population health outcomes, quality-of-life, and overall …

Genealogy Tells: Informing Health And Aging Policies Using East Tennessean Older Women's Family Histories, Perceptions, And Experiences Of Health Inequity, Heather Davis

Doctoral Dissertations

Older women face unique health inequities challenges. This study aims to provide an understanding of older women’s perceptions and situated experiences regarding the gendered health inequities they face and the social determinants (SDH) thereof. It examines how these health inequities are situated in older women’s genealogical (familial) and geographical health and mortality outcomes histories and how their perceptions and experiences of health inequities and their familial mortality outcomes histories are characterized by the geopolitical and social norms in which they live. The purpose of this project is to present policy and decision-makers with insights about and recommendations from older women …

Design And Development Of The Urban Population Health Observatory To Improve Disease Surveillance And Response, Whitney Brakefield

Doctoral Dissertations

Chronic and infectious diseases have a profound impact on the quality and length of life of populations that suffer from these conditions. Scientists, physicians, and health officials are seeking innovative approaches to decrease the morbidity and mortality of deadly diseases. Incorporating artificial intelligence and data science techniques across the health science domain could improve disease surveillance, intervention planning, and policymaking. In this dissertation, we describe the design and development of the Urban Population Health Observatory (UPHO), an explainable knowledge-based multimodal big data analytics platform. A common challenge for conducting multimodal big data analytics is integrating multidimensional heterogeneous data sources, which …

Tennessee’S Covid-19 Response: The Relationship Between Case Numbers And Public Opinion, Chandni Naidoo

Chancellor’s Honors Program Projects

No abstract provided.

Nuclear Security Awareness Survey At A University, Marcia P. Robinson, Naomi German, Destiny B. White, Shraddha V. Rane, Jason Timothy Harris

International Journal of Nuclear Security

The concept of assessing safety culture in an organization emerged with its application at the nuclear power industry and has expanded since then. An assessment of nuclear security, on the contrary, is still under-developed, especially at non-nuclear facilities, such as academic institutions and medical facilities. To identify the level of the awareness and understanding of credible nuclear and radiological threats, response preparedness, security culture, and the integrity of nuclear security systems among non-radioactive material users at a university setting; a campus-wide survey was deployed. A total of 3,336 non-radioactive material users, including students, faculty, and staff participated in the survey. …

An Epidemiologic Study Of Vaccination Exemptions And Pertussis Risk, Corinne B. Tandy

Doctoral Dissertations

The incidence of pertussis, a vaccine-preventable disease that can have severe complications in infants, has been increasing in the United States over the past three decades. Vaccine hesitancy and refusal have also increased and are associated with vaccination exemptions, which in turn are associated with outbreaks of vaccine-preventable diseases, including pertussis. Understanding attitudes towards vaccinations and identifying geographic disparities of vaccination exemptions and pertussis risks is useful for guiding control programs. Therefore, the objectives of this study were to: (i) investigate attitudes towards vaccinations; (ii) identify county-level geographic disparities and sociodemographic predictors of vaccination exemptions in Florida; (iii) investigate county-level …

Rural Hospital Closures And Perceived Access To Care: A Qualitative Descriptive Study In An Appalachian County Of Tennessee, Amanda M. Letheren

Doctoral Dissertations

Background: Tennessee has suffered more hospital closures per capita than anywhere else in the nation. The impact of hospital closures on access to care in rural and economically distressed Appalachian counties of Tennessee is of particular concern because these communities experience great health disparities. Hospital closures may exacerbate these disparities and create additional barriers when accessing care.

Objectives: The aim of this study was to describe community residents’ perceptions of health and access to care following a hospital closure in a rural and economically distressed Appalachian county of Tennessee.

Methods: This study used a qualitative descriptive approach to present community …

Emerging Adults’ Experiences As Receivers Of Sexually Transmitted Infection Disclosures From Sexual Partners: A Three-Part Examination, Kayley D. Mcmahan

Doctoral Dissertations

Each year in the United States, over 20 million cases of sexually transmitted infections (STIs) are diagnosed, mostly among those in the developmental period of emerging adulthood (ages 18-29). Research on STI disclosure to romantic and sexual partners has increased over the last two decades, but this research has (a) generally lacked a developmental and theoretical focus, (b) not examined disclosure recipients, and (c) not been systematically and critically synthesized. To address these limitations, I conducted a three-part examination. First, I systematically reviewed the STI disclosure literature and summarized findings, critical limitations, and future research and intervention directions. Next, I …

A Collective Metamorphosis Of Breastfeeding Mothers: A Phenomenological Exploration Of A Face-To-Face Healthcare Provider Facilitated Peer Support Group, Emily Alexandria Tucker

Doctoral Dissertations

This research study used phenomenology to examine a face-to-face healthcare facilitated breastfeeding support group. Participant observations and phenomenology were used to address the following research questions: 1) what are the lived experiences of the women participating a breastfeeding support group, 2) how does the group influence their lived experiences, and 3) what were the common experiences of these women? The support group participants were observed while the researcher acted as a participant observer over the course of an eleven-month period. There were a total of seven women interviewed about their lived experiences breastfeeding and attending the support group. Data from …

Assessing Basic Needs Insecurity Prevalence And Associated Factors Among College Students Enrolled At A Large, Public University In The Southeastern U.S., Mary Kathleen Robbins

Masters Theses

Abstract

Background: Basic needs insecurity (BNI), defined as having both food and housing insecurity, is an emerging issue on college campuses. Students experiencing basic needs insecurity may be more likely to have poorer academic performance, as well as poorer physical and mental health compared to other students. This research assesses the prevalence of food, housing, and basic needs insecurity among college students enrolled at a large, public university and identifies factors associated with experiencing food, housing, and basic needs insecurity.

Methods: A cross-sectional online survey was conducted at a large, public university in the Southeast U.S. Eligible, enrolled students (n=23,444) …

Relationships Between Postpartum Anxiety, Breastfeeding Self-Efficacy, And Breastfeeding Exclusivity, Rachel Eichholtz

Masters Theses

Background

Though several important barriers to exclusive breastfeeding (EBF) have been identified, the relationship between postpartum anxiety and EBF remains inadequately explored.

Objective

The objective of this study was to determine if there was a significant relationship between postpartum anxiety and EBF and, if so, determine if breastfeeding self-efficacy moderated this relationship.

Methods

This was a cross-sectional, online survey. Eligibility criteria: mothers (at least 18 years of age), with an infant (aged 4-24 weeks), and who had provided breastmilk at least once in the previous two weeks. The survey instrument included demographic questions and three scales: the EPDS (Edinburgh Postpartum …

Human Trafficking Awareness Among Psychiatric Hospital Nursing Staff, Donna J. Czech, Tracy L. Brewer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Human trafficking is a public health crisis on a global, state, and local level. Victims of human trafficking are a vulnerable population who pass-through healthcare systems unrecognized by nurses and other healthcare professionals due to a lack of awareness about identifiable signs, symptoms, and circumstances. Nurses are in a crucial position to assess trafficking victims for a referral. The purpose of this evidence-based practice (EBP) pilot project was to understand nurses’ knowledge and awareness on human trafficking and assess the perceived ability to identify trafficked individuals in a psychiatric care setting for screening and potential referral. Nurses received an online …

Embodying Healing And Joy Through Relationships And Sexual Wellness, Bilqis Amatus-Salaam

Black Issues Conference

With the ways in which Black bodies are policed and carry racial trauma, experiencing joy in a Black body is an act of resistance and liberation. This session will guide attendees in exploring ways to cultivate positive and affirming relationships with oneself and others to experience healing and joy. Foundational information about healthy relationships and healthy sexually will be shared to provide a framework for discussing barriers to experiencing joy and how to navigate these in a way that aligns with an individual’s values. All identities are welcome.

One Spark Can Light A Fire: How To Become A Mental Health Advocate, Marquinta Harvey, Shannon Jackson

Black Issues Conference

One Spark Can Light a Fire: How to Become a Mental Health Advocate

There is increasing awareness surrounding mental health and conversations are beginning to make their way to the forefront of issues that demand significant attention. However, the path from awareness to advocacy remains poorly understood. Mental Illness is an important issue that affects 1 in 4 individuals and unlike most chronic illnesses the onset occurs early in the life spectrum, usually in adolescence and young adulthood.

The issue of mental health is not limited to individual genetic predisposition and/or behaviors but involves many layers related to individual, family-related, …

Prevalence Of Rats And Rodent Borne Pathogens Across Post-Katrina New Orleans, Bruno Marco Ghersi

Doctoral Dissertations

Disasters are happening at an increasingly higher rate and intensity a trend that is expected to continue as more humans migrate to coastal urban areas. Disasters, and as importantly, disaster recovery can affect how native and pest populations will recover. My aim was to improve understanding of disease risk by evaluating the socioecological conditions that have shaped commensal rat recovery and distribution, as well as the pathogens they carry, across New Orleans after Hurricane Katrina. I first estimated relative abundance and distribution of commensal rats from rodent trapping conducted between mid-2014 and early-2017 across 96 sites in 10 areas of …

Adverse Childhood Experiences And Health Related Quality Of Life As Well As Cognitive Decline In Adult Population In Tennessee, Pragya Poudel

Doctoral Dissertations

Adverse childhood experiences (ACEs) have been linked to increased risk of negative health outcomes in later life. At least half of the population in Tennessee experience one ACE. Further, Tennessee ranks amongst the top five states in terms of cognitive decline in adult populations age 45 and above. To our knowledge, there is yet no study that has explored ACEs and adult health outcomes (health-related quality of life (HRQOL) and cognitive decline) in Tennessee.

The goal of this study was to examine the relationship between ACEs [by overall, individual, type/domain, and dose-response effect of ACE] and HRQOL as well as …

Comparing Hpv Vaccination Rates Between Rural And Urban Female Undergraduate Students At The University Of Tennessee, Knoxville, Brynn J. Seaton

Chancellor’s Honors Program Projects

No abstract provided.

Park Usage In Relationship To Available Features And Amenities In A Large Urban Park, Hannah Bradford Clauss

EURēCA: Exhibition of Undergraduate Research and Creative Achievement

Purpose: The purpose of this study was to examine the relationship between park features and park use in a large urban park. At 45.33 acres, West Hills Park has amenities such as athletic courts and fields, picnic areas, and a 1.9-mile paved trail. Methods: Park usage was assessed using the System for Observing Play and Recreation in Communities tool that measures use by gender, age, ethnicity, and moderate to vigorous physical activity (MVPA). Data was collected in 18 zones over four days with three observations per day (morning, midday, and evening). Park features, amenities, and condition, were assessed using the …

A Profile Of Physical Activity In The City Of Knoxville's Lonsdale Park, Carly Scot Eakin

Chancellor’s Honors Program Projects

No abstract provided.

Food Acquisition Strategies Within Theresienstadt Ghetto: An Analysis Of Oral Testimonies, Jaime L. Marquis

Chancellor’s Honors Program Projects

No abstract provided.

A Profile Of Physical Activity In Knoxville Parks, Margaret R. Bailey

Chancellor’s Honors Program Projects

No abstract provided.

Social Determinants Of Child Trafficking Addressed By Government And Non-Government Strategies In South And Southeast Asia: An Integrate Review, Pragya Gautam Poudel, Cristina S. Barroso

Public Health Publications and Other Works

Aims: Child trafficking in South and Southeast Asia is widespread and deeply troubling. While several agencies have initiated anti-child trafficking interventions, it is unknown if they address the 21 social determinants of child trafficking identified by Perry and McEwing (2103). The aim of this integrative review was to explore the anti-child trafficking strategies employed by governments and non-government organizations (NGOs) that target the social determinants of child trafficking in South and Southeast Asia, and identify which levels of the Socio-Ecological Model (SEM) they address.

Methods: The authors performed a literature search for journal articles and reports by researchers, local or …

Understanding The Essentials: A "Serenity House" Health Program, Tory E. Wilder

Chancellor’s Honors Program Projects

No abstract provided.