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 …

A Case Study In Program Evaluation, Alyssa Osborne

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

As a result of a Methicillin-Resistant Staphylococcus Aureus (MRSA) outbreak at a local high school, the Lexington Fayette County Health Department (LFCHD) has been tasked with developing a program to ensure timely reporting of actions taken in the event of a MRSA outbreak or disease outbreak of similar nature (1). This program evaluation is guided by the CDC’s 6-step program evaluation framework (2), which was used to inform this assessment.

Evaluating A High School Mrsa Prevention Program: A Case Study, Jamie Henning

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

MRSA poses a significant health risk to athletes nationwide. This case study examines the application of an online training module to address knowledge gaps regarding Methicillin-resistant Staphylococcus aureus (MRSA) among key decision-makers for high school athletes. It reviews the development and initial evaluation of a web-based training program designed to empower decision-makers with the knowledge to prevent MRSA infection and respond to suspected cases. Program evaluation recommended expanding the training module to wrestling staff with improved evaluation methods while continuing implementation and effectiveness assessment for the football staff. Despite initial data quality limitations, the online training module evaluation offered valuable …

Program Evaluation Case Study: Infectious Disease Reporting Training Program Evaluation, Emily Sekkath Veedu

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

The Lexington-Fayette County Health Department (LFCHD) has developed an educational program aimed at Fayette County Public Schools (FCPS) health and athletics staff members to ensure timely reporting and action in the event of an infectious disease outbreak (4). The program was implemented after a methicillin-resistant staphylococcus aureus (MRSA) outbreak occurred in a Kentucky community, with a high school football team presenting several of the cases (4). It was noted by a school nurse that many people attending an informational session lacked knowledge regarding infection control, suggesting a need for intervention in this community. I have evaluated this program in the …

A Case Study In Program Evaluation, Sierra L. Williams

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

The Lexington-Fayette County Health Department (LFCHD) developed an education program targeted toward infectious disease outbreaks. The program ensures timely reporting and action during an infectious disease outbreak within the Fayette County Public Schools (FCPS) system. I have been tasked with evaluating the program and its implementation of training modules through pre and post-surveys to determine if the program is significantly increasing the overall knowledge of program participants and make recommendations for how program aspects can be improved.

Empirical Insights Into Survivorship Care: A Cross-Sectional Study Of Coc Accredited Hospitals In Kentucky, Amanda M. Beckett

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

ABSTRACT

Background:

Cancer survivorship care programs play a vital role in supporting cancer survivors and improving their quality of life. Understanding the landscape of survivorship and the potential barriers is key to optimizing care delivery.

Methods:

The primary purpose of this cross-sectional study was to explore existing cancer survivorship care programs offered by Commission on Cancer (CoC) accredited hospitals in Kentucky. Data from the Markey Cancer Affiliate Network (MCCAN) from 2022 through 2023 was analyzed. Variables included hospital characteristics such as rural code, types of survivorship services offered, and reported barriers to these services.

Results:

Analysis of n=19 CoC facilities …

Evaluation Of Public Radon Messaging In Kentucky As Compared To Three Other States, Abigail Knapp

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

Radon poses a large health risk to those exposed to it, as it is an invisible, odorless, carcinogenic gas. Kentucky has high ambient levels of radon, but public awareness remains low as tobacco has been publicized as the main cause of lung cancer. As Kentucky has the highest incidence of lung and bronchial cancers in the United States, we aimed to examine the state’s health department radon page to see if it has sufficient information to warn residents about radon and provide resources. We reviewed the current Kentucky public messaging, radon rates, testing rates, and legislation compared to Ohio, Washington, …

A Case Study In Program Evaluation, Lydia Williams

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

The three core functions of public health are assessment, policy development, and assurance, and program evaluation falls under the latter category. A program is incomplete without an in-depth understanding of how well it works and what steps can be taken to make sure there is continuous progress and improvement.

In this case study, I developed an evaluation plan for the Lexington-Fayette County Health Department’s (LFCHD) infectious disease outbreak education program. The need for such a program was realized after a MRSA outbreak among a Kentucky high school football team. This case study employed the Center for Disease Control and Prevention …

The Distribution Of Cp-Cre Cases From 2013-2020 In The Commonwealth Of Kentucky, Hannah Hiscox

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

Multidrug-resistant organisms (MDROs), particularly Carbapenem-Resistant Enterobacterales (CRE), pose a significant threat to public health due to their resistance to multiple antibiotics, including carbapenems. CRE infections, especially those producing carbapenemases (CP-CRE), are associated with high morbidity and mortality rates, making them a growing concern in healthcare settings. Despite the prevalence of CRE infections in the United States, limited data exist on the incidence and distribution of CP-CRE infections in specific regions, such as the Appalachian counties of Kentucky.

This study aimed to investigate the cumulative incidence and distribution of CP-CRE cases in Appalachian and non-Appalachian counties of Kentucky, as well as …

Environmental Justice In West Louisville, Ky, Ashley Wright

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

It is evident that West Louisville and Rubbertown are experiencing environmental exposures and related health impacts. It is important for environmental justice (EJ) areas like West Louisville and Rubbertown to gain increased awareness, due to EJ areas commonly being overlooked and forgotten about because of unjust treatment and lack of involvement. Furthermore, all of the data used for this project was publicly accessible. Community residents and the general public can access these data sources to identify which facilities are emitting toxins, as well as specific hazardous substances that are being released, the location of hazardous sites, cleanup status, and more. …

Mccovid Campaign – A Social Media Implementation To Decrease Vaccine Hesitancy In Rural Counties, Harper Ford

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

This capstone will explore the challenges of vaccine hesitancy, a continuously rising problem in the public health field. The focus is primarily on rural millennials in McCracken County, Kentucky. The study identifies key factors contributing to vaccine hesitancy including misinformation, trust issues, and the rapid development of the covid-19 vaccine. To address the above concerns the study proposes a targeted social media campaign using the health belief model to increase COVID-19 vaccine uptake through Facebook ads targeting millennials. The campaigns utilize the leverage of local insights and real-time data to enhance engagement and reduce hesitancy, focusing on adapting strategies based …

A Case Study In Program Evaluation: Evaluation Of A Mrsa Education Program, Kangai Miriti

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

Program evaluations provide a deeper understanding of program components to promote effective program implementation. This evaluation follows the CDC’s 6-step Framework for Program Evaluation in Public Health to evaluate a MRSA education program. This evaluation has been prepared to be presented to the Lexington- Fayette County Health Department.

A Case Study In Evaluation, Laura Nagle

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

The Lexington – Fayette County Health Department is proposing a comprehensive evaluation of programming focused on preventing MRSA infections among high school athletes within Fayette County Public Schools. This document describes the recommended evaluation process.

A Case Study In Program Evaluation, Kayla Shepherd

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

A program evaluation of a case study presented by the College of Public Health. This case study included a fictitious MRSA outbreak at a Kentucky high school football camp and the response of the Fayette County Public School System (FCPS) and the Lexington-Fayette County Health Department (LFCHD). Using the Centers for Disease Control and Prevention's Framework for Program Evaluation, I evaluated the Educational Infectious Disease Program designed by the FCPS and LFCHD. I provided recommendations to help improve the success of the program.

Team Up Against Overdose Deaths, Mary Elizabeth Pendergrass

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

This grant proposal describes a community collaboration strategy for reducing overdose deaths. Utilizing a Community Advisory Board, the goal of the project is to increase awareness, knowledge, and usage of the Good Samaritan Law to obtain emergency medical care.

A Case Study In Program Evaluation, Sydney Wilcoxson

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

Evaluation is a critical component of a successful evidence-based health promotion program or intervention. In public health, evaluations ensure that interventions are achieving their intended objectives, provide feedback on program strengths and weaknesses, and serve as a mechanism of accountability and transparency to stakeholders so that they know their invested resources are being utilized in the most efficient manner. Without evaluation, it would be much more difficult to understand how well the intervention is working, and communication between stakeholders would be significantly affected.

A recently confirmed Methicillin-resistant staphylococcus aureus (MRSA) outbreak on a Fayette County Public Schools (FCPS) high school …

Program Evaluation Case Study, Grace Mullikin

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

Program evaluation case study utilizing Center for Disease Control and Prevention's Case Evaluation Framework.

The Relationship Between Self-Reported Depressive Symptoms At 3 Timepoints And Infant Sleep Practices At 6-Month Follow-Up In A Population Of Mothers In Santo Domingo, Ecuador, Kassidy Lane

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

Abstract

Background

Previous studies have linked maternal depression with poor infant sleep (e.g., waking up at night and infants having trouble settling to sleep). This study examined the relationship between maternal depressive symptoms at three time points and safe infant sleep at 6-month follow-up.

Methods

Data was collected from a randomized clinical trial including 100 women recruited from a health center in Santo Domingo, Ecuador during their third trimester of pregnancy. Log-binomial regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of safe infant sleeping at 6 months among mothers who reported depressive symptoms at 3 …

A Case Study In Prospective Program Evaluation, Sarai Rosemary Combs

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

Evaluation is a helpful tool in public health to provide transparency about community interventions and programs. The following is a prospective evaluation of a case study, looking at a recently designed program by the Lexington-Fayette County Health Department, as a capstone project for the Health Management and Policy concentration of the Masters in Public Health program of the College of Public Health. The health department developed a series of online training modules to increase knowledge of Methicillin-resistant staphylococcus aureus (MRSA) and other similar organism outbreaks and how to respond to these outbreaks. The program targets were Fayette County Public School …

Changes In Primary Care Availability In Appalachia, Whitney Beckett

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

The Affordable Care Act (ACA) was a groundbreaking moment in the United States healthcare system. It affected many different aspects of the system, including access to primary care professionals. Primary care professionals provide a key role in American’s health, especially when it comes to preventative care. With one-third of Americans experiencing barriers to such access, a solution is desperately needed to increase said access. These barriers are especially profound in low-income, underserved areas such as the Appalachian regions of Georgia, Kentucky, Tennessee, and West Virginia. The ACA attempted to increase access via Medicaid expansion; however, not all States expanded their …

A Case Study In Program Evaluation: A Prospective Program Evaluation Of Timely Reporting And Action Of An Infectious Disease Outbreak, Destiny Cozart

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

Methicillin-resistant Staphylococcus aureus also known as MRSA is an infection of a staph bacteria. High school athletes are at risk of contracting MRSA through skin to skin contact and/or MRSA contaminated equipment. This case study uses the CDC's six-step framework for program evaluation to measure the effectiveness of the online training modules designed to increase the knowledge of staff and stakeholders about MRSA and infectious disease outbreaks. The findings from this evaluation will advise the potential change(s) implemented in training modules, ultimately to enhance competency for decision makers and prevent MRSA and infectious disease outbreak amongst high school athletic programs.

Adolescent Vaccination Rates And Pharmacists' Ability To Prescribe And Administer, Paul Jake Faulkner

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

Vaccines are arguably the most significant advancement in healthcare in the prevention of diseases. The CDC has created a series of recommendations to help guide providers and patients toward a healthier future with vaccines. These recommendations were adopted by the Health People Goals 2020 and 2030 to increase each state's rates of completing specific vaccination series by defined age thresholds. This capstone aims to assess if there is a correlation between vaccination rates and pharmacists; specifically to see if states that give less restrictions about vaccinating would have higher rates. It is also important to see if states with more …

Dental Outreach In Academic Dental Settings, Tisha Clayborn

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

Creating an effective outreach program in a dental academic setting involves a strategic approach combining educational objectives and community service. This Dental Outreach Program Guide aligns with organizational objectives, contributes to community well-being, and serves as a model for future outreach initiatives in academic dental settings. This program utilizes the PRECEDE-PROCEED planning model to design and evaluate an oral health strategy. This program aims to outline a strategic plan incorporating evidence-based decision-making, data-driven metrics, and a comprehensive roadmap for successful implementation.

Improving Black Maternal Outcomes In Christian County, Ky: A Social Marketing Approach To Perinatal Provider Change, Ariel A. Arthur

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

Compared to other states in the country, Kentucky has historically poor population health outcomes. While the statewide maternal mortality rate is 16.1 per 100,000 live births, this statistic belies the stark racial disparities that exist. In 2018, the pregnancy-related death rate for Black women was 40.2 per 100,000 live births compared to 13.1 for White women. This pattern is persistent even after controlling for socioeconomic status, prenatal care, and other protective factors. Research shows that institutional and interpersonal racism when receiving obstetric care contributes to poor childbirth and postpartum outcomes for Black women. Additionally, geography and rural status may compound …

Implementation Of A Postpartum Depression Program In A Rural Kentucky County, Abby Cecil

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

This paper aims to describe the process of implementing a Postpartum Depression (PPD) prevention program in low-income women residing in rural communities. The paper describes the process of recruiting women in this population, where and how the program will be integrated into an existing clinic, and how the program will be sustained. PPD is a significant global public health problem that can be prevented and treated. The ROSE program (Reach Out, Stay Strong, Essentials for new mothers) is a series of classes that provide informational and social support to prevent PPD. This evidence-based program has been previously successful in reducing …

Impact Of Insurance Payer On Stage At Diagnosis Of Prostate Cancer, Hunter M. Stiff

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

Objectives: Prostate cancer (CaP) is the most common site of cancer in men in the United States and is very treatable when diagnosed in localized and regional stages. While there are widely available forms of screening that can detect CaP in its early stages, factors that can affect healthcare access such as health insurance, race, and Appalachian residency have been linked with differences in rates of distant-stage CaP diagnosis. This study aimed to explore the relationships between health insurance, race, Appalachian residency, and late-stage CaP diagnosis in the state of Kentucky.

Methods: A sample of 26,622 men from the state …

Breastfeeding Promotion In The Workplace, Katie C. Nettesheim

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

Breastfeeding is one of the best things a mother can do for her baby. It has many protective qualities including a reduced risk of sudden infant death syndrome (SIDS), asthma, obesity, type 1 diabetes, respiratory infections, ear infections, and stomach bugs for the baby (CDC, 2022). There are also protective qualities for the mother as well, including a reduced risk of high blood pressure, breast and ovarian cancer, and type II diabetes. Breastfeeding exclusively, the infant only receives breastmilk and no other supplementation for 6 months, which maximizes the many benefits that breastfeeding has.

Rural areas of the United States …

Prevalence Of Multimorbidity In The Atherosclerosis Risk In Communities Study At Baseline, Katie Highfill

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

Aim: The aim of this study is to examine the prevalence of multimorbidity among middle-aged adults in the Atherosclerosis Risk in Communities Study at baseline by examining the demographic and socioeconomic characteristics of the participants.

Methods

I included 15,698 participants from the Atherosclerosis Risk in Communities (ARIC) baseline visit. Participants were randomly selected from 4 different locations in the United States. Multimorbidity was defined as the prevalence of 2 or more chronic conditions in an individual. Three different multimorbidity definitions (MM1, MM2, and MM3) were created with different inclusion criterion. Prevalence of each multimorbidity definition was analyzed among participants using …

Real-Time Surveillance Of The Drug Epidemic: An Assessment And Comparative Visualization Of Substance Abuse In The Commonwealth Of Kentucky, Julia Van Hosen

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

The purpose of this study was to implement and examine a new surveillance system for Kentucky State Police’s forensics unit to track trends of illicit drugs and drug trafficking, and to see if the implementation of this new system was associated with a decrease in overall drug counts over a period of five months. An extensive review of the literature showed that the drug epidemic in the United States continues to worsen, with public health and law enforcement institutions leading the fight in attempting to end the epidemic, but little evidence showing these two joining forces to work together.

Results …

Changes In Severity Of Diabetes At Diagnosis Following The Onset Of The Sars-Cov-2 Pandemic, Annelise King

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

During the SARS-CoV-2 pandemic it was seen that diabetes was a risk factor for severe COVID-19. The objective of this study is to assess the severity of diabetes at diagnosis during the COVID-19 pandemic compared to pre-pandemic to see how the pandemic and SARS-CoV-2 infection impacted the severity of diabetes. This study used University of Kentucky electronic health records of 13,794 patients who developed diabetes. The majority of patients were female, white non-Hispanic, 65+, and living in an urban area. There were differences seen between the COVID-19 positive and negative cohorts in the DKA and HbA₁c variables, with …