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Community Health and Preventive Medicine

Theses/Dissertations

2022

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Full-Text Articles in Medicine and Health Sciences

Parental Status As A Modifying Factor In Covid-19 Vaccination Status: A Mixed Methods Approach, Mackenzie Carter Jan 2022

Parental Status As A Modifying Factor In Covid-19 Vaccination Status: A Mixed Methods Approach, Mackenzie Carter

All Master's Theses

Introduction: Vaccines are the best protection against COVID-19 and have been proven to be safe and effective. Parental efforts to protect their children by complying with or refusing pediatric vaccinations have previously been studied. However, the author found little research on how parental status affects the vaccination decisions for the parents. Using an explanatory sequential mixed-methods approach and the Health Belief Model, this study examines how parental status influences parental COVID-19 vaccination status. Methods: A local health department conducted a quantitative survey on COVID-19 vaccination attitudes and beliefs from September to October 2021. The COVID-19 vaccination status of parents of …


Queer Survival Amidst Hiv/Aids, Covid-19 And Homelessness, Julia Young Jan 2022

Queer Survival Amidst Hiv/Aids, Covid-19 And Homelessness, Julia Young

Pitzer Senior Theses

The treatment and survival of a society's marginalized peoples reveal the true impacts of a pandemic. An analysis of homeless queer youth during the HIV/AIDS and SARS-CoV-2 crises lays bare the systemic failure of the United States government to provide equitable healthcare.

I compare the HIV/AIDS and COVID-19 pandemics in queer homeless youth to demonstrate the dangers of disease moralization via a sociocultural analyses of disease stigma and responsibility politics. Utilizing syndemic theory I draw on the synergistic relationship between disease and illness to describe the unique challenges queer homeless youth face. A syndemic framework is applied to address common …


Mathematical Models Of Infection Prevention Programs In Hospital Settings, Kelly A. Reagan Jan 2022

Mathematical Models Of Infection Prevention Programs In Hospital Settings, Kelly A. Reagan

Theses and Dissertations

Hospitals play a vital role in providing for the healthcare needs of a community. Patients can develop hospital-acquired infections (HAIs) during their hospitalization due to exposure to foreign bacteria, viruses, and fungi. Infection prevention programs target and reduce HAIs, but implementing the infection prevention programs often comes with a cost. The goal of my research is to use mathematical models to quantify the impact of infection prevention programs on cases of HAIs and total healthcare costs. First, I use a Markov chain model to quantify how one infection prevention program reduces general HAIs in the hospital. Then, I calculate the …


Three Waves: The United States Opioid Crisis, Ryan B. Santoro Jan 2022

Three Waves: The United States Opioid Crisis, Ryan B. Santoro

Senior Scholars Papers in Science, Technology, and Society

The past two and a half decades have witnessed widespread suffering, addiction, and death at the hands of the opioid crisis. This paper analyzes the crisis through a series of time periods, broken down into “waves.” Drawing upon primary material in relation to OxyContin advertisements in the 1990’s, this research takes aim at the origin of widespread opioid abuse disorder. By building upon analysis done on the Sackler Family, Purdue Pharma, heroin abuse, fentanyl overdoses, the COVID-19 pandemic and opioids and addiction in modern pop culture, this thesis shows how despite constant change in public policy, the opioid crisis continues …


Bridging The Gaps: Exploring Factors Associated With Goal Achievement Within An Accountable Care Organization Care Coordination Program, Jessica L. Polk Jan 2022

Bridging The Gaps: Exploring Factors Associated With Goal Achievement Within An Accountable Care Organization Care Coordination Program, Jessica L. Polk

Electronic Theses and Dissertations

Background: Healthcare cost in the U.S. has been increasing at an unsustainable rate due to the growing population diagnosed with multiple chronic conditions and a fragmented healthcare system. The high-risk patient population includes persons who over utilize the healthcare system with frequent avoidable hospitalizations, emergency room visits, and exacerbations of their chronic conditions. This high-risk population makes up five percent of the U.S. but accounts for over fifty percent of all healthcare spending. Care coordination models have emerged to focus proactive health interventions for the highest-risk patient populations to reduce overutilization and empower patients to improve long-term health. Evidence has …


Identifying Factors Associated With Syringe Reuse Among People Who Inject Drugs (Pwid) In Appalachia Kentucky, Grayson Keith Fuller Jan 2022

Identifying Factors Associated With Syringe Reuse Among People Who Inject Drugs (Pwid) In Appalachia Kentucky, Grayson Keith Fuller

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

Aim: Syringe reuse contributes to the spread of infectious diseases. The purpose of this study is to identify factors associated with syringe reuse among people who inject drugs (PWID) in Kentucky.

Methods: PWID (n=238) completed interviewer-administered questionnaires to collect data on syringe reuse and demographic, behavioral, and clinical characteristics. Negative log binomial regression was used to model the associations.

Results: On average, people reused each syringe 9.3 times (median: 3; IQR: 2-10, range 1-95). Syringe reuse was higher among men [aOR=1.386; 95% CI: 1.041-1.845] and those who injected methamphetamine [aOR=2.122; 95% CI: 1.445-3.116]. Reuse was also higher among those who …


Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz Jan 2022

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …


Addressing Barriers To Colorectal Cancer Screening In A Federally Qualified Health Center: A Quality Improvement Project, Tania Centra Jan 2022

Addressing Barriers To Colorectal Cancer Screening In A Federally Qualified Health Center: A Quality Improvement Project, Tania Centra

DNP Scholarly Projects

Abstract

Background: Colorectal cancer (CRC) is a leading cause of death from cancer in the United States, despite the availability of several high-quality screening options. Multiple barriers to CRC screening have been identified, including cost (non-insured), younger age, racial or ethnic minority, recent immigration to the U.S. (non-English speaking), fear or distrust of the healthcare system and rural residence. Addressing health equity within underserved populations requires improved access to CRC screenings per evidence-based guidelines.

Local Problem: The mean CRC screening rate for the designated Federally Qualified Health Center (FQHC) was 33.7% for the 5 months preceding this quality improvement (QI) …


Implementation Of Physical Activity In Kentucky Public Schools: From Theory To Policy, Nancy Kearns Jan 2022

Implementation Of Physical Activity In Kentucky Public Schools: From Theory To Policy, Nancy Kearns

Theses and Dissertations--Rehabilitation Sciences

Physical activity in schools improves academic performance and fitness measures in children. However, state policy supporting implementation of physical activity remains poor. Identifying specific barriers to implementing physical activity minutes in Kentucky public schools is pivotal in preserving the cognitive and physical health of our children. This is of particular interest as physical activity minutes remain low despite the positive effects of exercise on cognition. The purpose of this dissertation is to provide policymakers and school administrators a method of identifying current policies, attitudes and infrastructure that inhibit the implementation of physical activity minutes in public schools. Thus, the findings, …


Education And Awareness Of Workplace Hazards: An Educational Intervention For First Responder Trainees, Emily Portune Jan 2022

Education And Awareness Of Workplace Hazards: An Educational Intervention For First Responder Trainees, Emily Portune

All Master's Theses

First responder paramedics, emergency medical technicians (EMTs), and firefighters provide emergency services to communities everywhere, often in life-threatening circumstances. At the same time, these first responders face high-stress life and death situations and may also endure unique workplace hazards like racism, sexual harassment and discrimination, verbal and physical patient assault, and extreme sleep deprivation. These hazards make prehospital providers vulnerable to mental illness, a fact proven by preexisting research that found more than 85% of first responders reported negative mental health symptoms and outcomes directly related to their career. Not only are prehospital providers at high risk of mental illness; …


Who's Included? A Systematic Review Of Socio-Demographics And Participant Recruitment Within The Investigation Of Periodontal Disease And Its Treatment Effect On Hemoglobin A1c, Jaclyn L. Johnson Jan 2022

Who's Included? A Systematic Review Of Socio-Demographics And Participant Recruitment Within The Investigation Of Periodontal Disease And Its Treatment Effect On Hemoglobin A1c, Jaclyn L. Johnson

All Master's Theses

Diabetes mellitus and periodontal disease are major global public health concerns. Within the United States (U.S.) over 34 million adults have diagnosed diabetes (Centers for Disease Control and Prevention [CDC], 2020a), and 64 million U.S. adults have periodontitis (American Academy of Periodontology [AAP], 2021a). Research has shown that persons with diabetes have a coinfection with periodontal disease at a rate between 2.6 and 2.9 times higher than persons without diabetes (Wang et al., 2014). Diabetes and periodontal disease collectively and disproportionately affect persons of low socioeconomic status (SES), age, and particular racial/ethnic identities (AAP, n.d.b; CDC, 2021; Connolly et al., …


A Novel Approach To Reducing Adiposity Among Young Men, Jean M. Reading Jan 2022

A Novel Approach To Reducing Adiposity Among Young Men, Jean M. Reading

Theses and Dissertations

Background

Lifestyle intervention is the first line treatment for obesity. Yet, young men are underrepresented in lifestyle interventions, which is posited to be the result of unmet needs and overall low concern for weight management. The aims of this dissertation are to:

Papers 1 and 2: Test the preliminary efficacy, feasibility, and acceptability of a self-guided lifestyle intervention for young men.

Paper 3: Explore the behavioral and physiological factors associated with changes in adiposity among young men and women enrolled in a more intensive lifestyle intervention.

Results

Papers 1 and 2: The self-guided intervention produced modest weight …


Pharmacists' Role In Opioid Use Disorder And Overdose Prevention And Treatment And Their Attitudes And Perceptions Towards Distributing Naloxone Under A Standing Order, Stephen C. Ijioma Jan 2022

Pharmacists' Role In Opioid Use Disorder And Overdose Prevention And Treatment And Their Attitudes And Perceptions Towards Distributing Naloxone Under A Standing Order, Stephen C. Ijioma

Theses and Dissertations

Background: Opioids are a class of drugs that bind to opioid receptors (mu, delta, and kappa), located in the central and peripheral nervous systems, to exert responses such as analgesia, respiratory depression, euphoria, and miosis. The opioid epidemic is characterized in large part by an increase in opioid overdose deaths. Community pharmacists are one of the most accessible healthcare professionals who frequently interact with patients and can implement OUD and opioid overdose prevention strategies. Treatment for opioid overdose and OUD include naloxone for overdose deaths as well as medication-assisted treatment for OUD.

Objective: The specific aims of this thesis include …


The Assessment Of Emergency Preparedness Among University Students, Arliah Cox Jan 2022

The Assessment Of Emergency Preparedness Among University Students, Arliah Cox

All Graduate Theses, Dissertations, and Other Capstone Projects

University students have been an understudied population when it comes to the topic of emergency/ disaster preparedness. While there have been a few studies carried out to examine students’ perceptions of preparedness, the level of preparedness must be determined to be able to close the gap when it comes to barriers preventing them from being prepared. One hundred and eighty-seven undergraduate participants at a Midwestern university completed both online and in-person surveys in March 2022. The survey included questions regarding emergency/ disaster preparedness, perception of being prepared, and barriers which can prevent preparedness. Results showed that a lack of time …


Stress Coping Responses Of Undergraduate University Students Prior To & Since The Onset Of The Covid-19 Pandemic, Kaylee Diefenderfer Jan 2022

Stress Coping Responses Of Undergraduate University Students Prior To & Since The Onset Of The Covid-19 Pandemic, Kaylee Diefenderfer

All Graduate Theses, Dissertations, and Other Capstone Projects

The stress coping mechanisms used by undergraduate university students affects their psychological well-being, stress level, and mental health outcomes. Increasing students’ use of positive coping mechanisms may increase academic outcomes, and overall health and well-being. This study evaluated the stress coping mechanisms used by undergraduate university students prior to and since the COVID-19 pandemic began. The Brief COPE inventory was used to measure stress coping responses. The results of this research indicated a significant change in 9 out of the 14 main coping mechanisms used by undergraduate university students prior to since the pandemic began. The top two stress coping …