Medicine and Health Sciences Commons^™

Buprenorphine For Medication-Assisted Treatment Of Opioid Use Disorder In Pregnancy: Relationship To Neonatal Opioid Withdrawal Syndrome, Niraj R. Chavan, Kristin Ashford, Amanda T. Wiggins, Michelle R. Lofwall, Agatha S. Critchfield

Obstetrics and Gynecology Faculty Publications

Objective To examine the relationship between antepartum buprenorphine dose for medication-assisted treatment (MAT) of opioid use disorder (OUD) and incident neonatal opioid withdrawal syndrome (NOWS).

Study Design We performed a prospective cohort study of pregnant women with a singleton gestation diagnosed with OUD and receiving buprenorphine for MAT at a tertiary care academic institution from July 2015 to January 2017. We divided the study cohort into two groups—pregnancies with versus without NOWS. Substance abuse patterns in pregnancy, maternal, and neonatal clinical outcomes were compared.

Results The incidence of NOWS was 31.11% (n = 28/90) in our study cohort. Pregnancies …

Protocol For Project Impact (Improving Millions Hearts For Provider And Community Transformation): A Quasi-Experimental Evaluation Of An Integrated Electronic Health Record And Community Health Worker Intervention Study To Improve Hypertension Management Among South Asian Patients, Priscilla M. Lopez, Jennifer Zanowiak, Keith Godfeld, Katarzyna Wyka, Ahmad Masoud, Susan Beane, Rashi Kumar, Phoebe Laughlin, Chau Trinh-Shevrin, Lorna Thorpe, Nadia Islam

Publications and Research

Background: The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative. Building …

Usf Capstone Paper: Master Of Public Health, Rachel Alvarez

Rachel Alvarez

Journal Conversations: Building The Research Self-Efficacy Of An Aboriginal Early Career Academic, Michelle L. Dickson

The Qualitative Report

This paper shows how I used my research journal mainly as a reflective tool throughout the process of applying for and completing a PhD. Embarking on a PhD can be daunting for anyone and I was challenged by my lack of academic self-efficacy. In the absence of a formal academic mentor my research journal became my confidante, a tool that helped me make progress at times when barriers to research seemed insurmountable. It helped me decrease the cognitive dissonance I was experiencing about issues of subjectivity/objectivity and the positioning of my self in the research. This paper shares research journal …

Doula Services Within A Healthy Start Program: Increasing Access For An Underserved Population, Mary-Powel Thomas, Gabriela Ammann, Ellen Brazier, Philip Noyes, Aletha Maybank

Publications and Research

Purpose: Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support.

Description: To address this issue, the New York City Department of Health and Mental Hygiene’s Healthy Start Brooklyn introduced the By My Side Birth Support Program in 2010. The goal was to complement other maternal home-visiting programs by providing doula support during labor and birth, along …

Understanding Public Health Professional Socialization And Professional Identity Formation Experiences, Jennifer M. Freiheit

Theses and Dissertations

Public health is in unstable times with funding decreasing, an exodus of retirees, and a paradigm shift with emergency preparedness and response critically changing the identity of the profession. Public health is at a grave trigger point where if something is not done, the entire field may be in jeopardy of caving in to consolidations, poor succession planning, and a field that cannot work toward the health of the public if they themselves are not operating well. It is commonly accepted that orientation practices exist in public health agencies, but the orientations that currently exist lack transfer to full socialization …

Negative Outcomes Of Teen Sexual Activity: Is There A Regional Effect?, Hannah Latta, Said Shahtahmasebi, Hatim A. Omar

Pediatrics Faculty Publications

A recent victory with respect to teen sexual behavior is the reduction of the national teen birth rate. In 1991, there were 61.8 births per 1000 females aged 15-19. By 2014, this rate plummeted to 24.2 births per 1000 adolescent females. Averages, however, do not reflect state-level variation. For example, in 2014, Kentucky reported 35.3 births per 1000 adolescent females, while New York reported a teen birth rates of 16.1 births per 1000 adolescent females. This report asks: are these discrepancies due to regional factors, and are these differences statistically significant? To examine rural and urban differences in outcomes of …

Increasing The Adherence To Updated Clinical Practice Guidelines For Tb Screening Among Hiv Patients Entering A Congregate Setting Utilizing A Clinical Reminder, Domingo Lopez

Doctor of Nursing Practice

Purpose: The purpose of this Doctor of Nursing Practice project was to update an existing tuberculosis policy for screening HIV-positive individuals entering a south Texas jail to meet current evidence-based guidelines and increase the adherence of jail staff to the updated screening process.

Background and Significance: In 2015, over 700,000 people were jailed in the United States with over 20,000 being HIV-positive. Tuberculosis is highly contagious and spreads through the air. HIV is a virus that targets the immune system. HIV-positive people are 17-22 times more likely to contract tuberculosis. The current screening process at the jail showed a low …

Canines For Disabled Kids, Erin Jerrett, Margarita Mnatsakanyan, Colleen Reynolds, Yin Wang

School of Professional Studies

Canines for Disabled Kids have been working on behalf of children and their families to educate communities and promote service dog partnerships for almost twenty years. Their advocacy with local legislatures, business owners, and community leaders highlighted the difficulties encountered when differentiating service dogs from emotional support/comfort dogs. Service dogs are entitled to access by the Americans with Disabilities Act (ADA), while emotional support/comfort dogs are not protected under the federal statute or to the same rights. Canines for Disabled Kids proposed a study to obtain a current count of licensed service dogs in the Commonwealth and investigate the feasibility …

Association Of Childhood Blood Lead Levels With Firearm Violence Perpetration And Victimization, Lindsay Rae Emer

Theses and Dissertations

Over 10,000 Americans are killed in firearm homicides each year, and an additional 40,000 are injured in nonfatal shootings. There is a significant public health need to identify risk factors that can be modified to prevent firearm violence. Environmental lead exposure is a demonstrated neurotoxicant which causes behavior changes that are known to be criminogenic. More recent research has demonstrated that homicides and nonfatal shootings differ by the circumstances that lead to the shootings (i.e. gang, domestic violence, arguments) and aggregating them could lead to biased results. Although studies have found a relationship between childhood lead exposure and criminal behaviors, …

Social Engagement And Health: A Structural Equation Modelling Analysis Of Downstream Links To Health Outcomes Among White-Collar Professionals, Ahmad Iqmer Nashriq Bin Mohd Nazan

Theses and Dissertations

ABSTRACT

SOCIAL ENGAGEMENT AND HEALTH: A STRUCTURAL EQUATION MODELLING ANALYSIS OF DOWNSTREAM LINKS TO HEALTH OUTCOMES AMONG WHITE-COLLAR PROFESSIONALS

by

Ahmad Iqmer Nashriq bin Mohd Nazan

The University of Wisconsin – Milwaukee, 2017

Under the Supervision of Associate Professor Amy E. Harley

High level of social engagement has been associated with improved health outcomes. Its capacity to influence one’s health has led to the conception of Berkman’s social relationship model which hypothesizes that health is impacted by social relationship through a series of causal processes that begin at the macro-social level (upstream factors) to micro-psychobiological processes (downstream factors). Social engagement …

Hockey Fans In Training: A Pilot Pragmatic 1 Randomized Controlled Trial, Robert Petrella, Dawn P. Gill, Guangyong Zou, Ashleigh De Cruz, Brendan Riggin, Cassandra Bartol, Karen Danylchuk, Kate Hunt, Sally Wyke, Cindy M. Gray, Christopher Bunn, Merrick Zwarenstein

Lifestyle Research Team

Introduction Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months.

Methods Male fans of two ice hockey teams (35–65 yr; body mass index ≥28 kg·m−2) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of …

Fall Protection Training: A Case Study Using Cbt For Latino Construction Workers, David P. Gilkey, Carla Lopez Del Puerto, Megan R. Miller, Carlos Evia, Carla Lopez Del Puertoisnow

Safety Health & Industrial Hygiene

Latino construction workers are at an increased risk of worksite injuries and fatalities due to language, cultural barriers, and ineffective training. This case-study investigated computer-based video training (CBT) for scaffold safety. The CBT training was developed using a participatory approach involving direct input from Latino roofers and framers. This paper focuses on evaluation-improvement of training that combined workers’ ideas of a safe work environment with OSHA standards. Researchers investigated the appropriateness and effectiveness of a brief CBT presentation addressing fall protection and scaffold use among Latino roofers. The results indicated that Latino construction workers at a roofing company in Colorado …

Examination Of Collaborative Efforts Of Central District To Achieve Success Of The Community Health Improvement Plan, Liene Topko

Capstone Experience

This was a quality improvement project that helped Central District Health Department (CDHD) work more closely with their community partners to identify the activities and programs that are currently in place to address priority health needs that were included in the 2016 Comprehensive Community Health Needs Assessment (CHNA). The purpose of this project is to identify the specific activities and programs that are being implemented by the health department and community partners in relation to the priority needs. These activities and programs were identified by conducting a survey of the major community partners. The findings from the survey helped to …

Surgical Plume And Its Implications: A Review Of The Risk And Barriers To A Safe Work Place, Eunice Tan, Kylie P. Russell

Journal of Perioperative Nursing

Every year thousands of health care professionals worldwide are exposed to surgical smoke. There is evidence that this smoke consists of toxic gases, pathogens and particulate matter that is a hazard for patients and the perioperative team. Past research indicates that perioperative staff inconsistently comply with smoke evacuation recommendations. The aim of this study was to identify, review and discuss the issues related to surgical plume and its implications for patients and perioperative staff. The findings of this review relate to: surgical smoke content, its risks to the health of the perioperative staff, preventative measures, infection control measures, compliance with …

A Review Of Suspected Intraoperative Antiseptic Burns: A Quality Improvement Review, Monica Stankiewicz, Michele Wyland

Journal of Perioperative Nursing

No abstract provided.

Global Kidney Exchange: Analysis And Background Papers From The Perspective Of Medical Anthropology, Alejandro Cerón, Kylie Dillinger, Madison Eitniear, Sophia Ernstrom, Walid Hedidar, Christiana Hellinga, Travis Himebaugh, Aaron J. Landau, Julian Nilsson, Lindsey Penn, Madison Redman, Cimmaron Retzik-Stahr, Laurel Schwartz, Isabelle Seeto, Madeline Sweet, Angelina M. R. Thomson, Margaret Wolf, Natalie Wuertz

Anthropology: Undergraduate Student Scholarship

Global Kidney Exchange (GKE) is a program aimed at facilitating trans-national kidney donation. Although its proponents aim at reducing the unmet demand of kidneys in the United States through the trans-nationalization of kidney exchange programs, the World Health Organization (WHO) and The Transplantation Society (TTS) have expressed concerns about its potential effect on black markets of organs and transnational organ trafficking, as well as on low- or middle-income countries health systems. For GKE to be implemented, it would need to be permitted to operate in at least some low- or middle-income countries. Should a low- or middle-income country allow GKE’s …

Unveiling Recovery: A Discourse Analysis Of Mental Illness Recovery Narratives, Elizabeth Albert

Theses and Dissertations

The discussion of mental illness recovery, both academically and socially, has been framed mainly as a morally necessary medical pursuit and has left shadowed the deeper social and cultural implications of recovery ideologies and practices. Previous research has embraced the growing demand for recovery-based practices in mental health organizations, especially those led by persons labeled mentally ill (or “peers”); however, they have yet to more deeply uncover and understand the subjective meanings of recovery. More specifically, how cultural and social interactions of daily life, while both experiencing and being labeled mentally ill, direct the course and meaning of an individual’s …

Prescription Drug Abuse And Provider-Patient Communication: A Qualitative Analysis Of The Perspectives Of Prescribers And Patients, Stephanie M. Mathis

Electronic Theses and Dissertations

Prescription drug abuse is a public health problem of epidemic proportions in the United States. Provider-patient communication underpins many initiatives aimed at preventing and reducing the public health burden of prescription drug abuse. The characteristics of and factors contributing to this interpersonal process, however, have not been fully explored.

The purpose of this research was to examine: 1) the overall problem of prescription drug abuse and provider-patient communication about prescription drug abuse from the patient perspective; and 2) provider-patient communication about prescription drug abuse from the prescriber perspective. In 2014-2015, semi-structured interviews were conducted with 20 patients from primary care …

Access To Healthy Foods: A Descriptive Analysis Of Farmers’ Markets, Food Deserts & Usda Food Assistance Programs In Tennessee Census Tracts, Twanda D. Wadlington

Electronic Theses and Dissertations

Food deserts are a growing problem in the United States, and occur in areas of low-income where people have limited access to healthy foods. In response, the presence of farmers’ markets has grown exponentially, and improved healthy food access. Additionally, the USDA has strived to connect families to healthy foods through food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Senior Farmers’ Market Nutrition Program (SFMNP). This study investigated the relationship between farmers’ markets, their acceptance of food assistance benefits, and their locations within Tennessee …

The Effects Of A Supermarket Tour On Improvement Of Nutrition Knowledge And Eating Behavior, Elizabeth Hall

Electronic Theses and Dissertations

The purpose of this study was to determine if participation in a supermarket tour improves nutrition knowledge and eating behavior in adult participants. Participants were recruited in communities surrounding Food City stores, a local supermarket. Prior to completing a standardized tour, participants completed a survey to assess nutrition knowledge and eating behavior. This survey was given to participants again three months later. A program evaluation was given one time at the end of the tour. Data analysis revealed no significant findings, other than the behavior-based question: “How many meals or snacks on most days included vegetables”. Vegetable consumption appeared to …

Primary Care Provider’S Perspectives Of Integrating Public Health Into The Prevention And Management Of Type Ii Diabetes Mellitus In Rural Nebraska, Emma Frost-Briley

Capstone Experience

Through the 2011 Community Health Needs Assessment, the Four Corners Health Department has identified type II diabetes mellitus as one of the communities top concerns within their communities. The goals of this project were: to develop a survey to assess the state of current practices of primary care providers on type II diabetes mellitus in the health department district, to identify primary care providers views on prevention, treatment, and management of type II diabetes mellitus in the health department district, and to examine primary care providers and local health department’s views on how primary care and public health can be …

The Use Of Electronic Health Records Data For Public Health: A Snapshot Of Current Practices In Nebraska’S Local Health Departments, Kushal Karan

Capstone Experience

Background: Public health issues are constantly changing and require local health departments (LHDs) to continually evolve in their approaches to address these issues. Advancements in health information technology (HIT), such as electronic health records (EHRs), play an important role in the collection of data that can be used to improve population health.

Objective: The purpose of this project was to assess the current use of electronic health records data by Nebraska’s local health departments and identify the data or tools they are using to address the health needs of the populations they serve.

Methods: In this study, a Mixed-Methods approach …

The Exploration Of Historical, Cultural, And Healthcare Utilization Factors When Clinically Treating Refugee Patients: Healthcare Providers’ View, Kandy Do

Capstone Experience

The objective of this project is to explore historical, cultural, and healthcare utilization factors that are significant to healthcare providers in their practice to clinically treat refugee patients holistically and equitably. Semi-structured interviews supported by a pre-interview questionnaire were conducted with 14 healthcare providers, who have experience in working with refugee patients. Purposive and snowball sampling method was used to recruit 14 healthcare providers. Thematic analysis was used to analyze qualitative data. Descriptive analysis was performed on the pre-interview questionnaire results. To our knowledge, there is limited research exploring historical, cultural, and healthcare utilization factors that are relevant for providing …

Evaluation Of Adult Mental Health First Aid: Findings From 2015-2017 Post-Course Surveys, Gina Schwieger

Capstone Experience

Abstract

Introduction: Lack of knowledge about mental health, lack of access to mental health care, and stigma create substantial barriers to the overall United States adult population from seeking or helping individuals with behavioral health issues. This study evaluated Adult Mental Health First Aid (MHFA) courses, an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing the community’s confidence in helping and frequency of referring people in need.

Methods: This retrospective evaluation of 2015-2017 Adult MHFA courses, utilizes qualitative and quantitative data from post-course surveys completed by course participants. Quantitative data was measured using a five-point Likert Scale. …

Youth Focus Groups: Design And Analysis Plan For The Bears Project, M. Renee Beacom Claborn

Capstone Experience

This capstone project produced a qualitative research design and analysis plan for youth focus groups as part of a Quality Improvement project at OneWorld Community Health Center (OWCHC) School-Based Health Center (SBHC) located at Bryan High School (BHS) in a program called BEARS. The intended use of this project is to serve as a reference guide for BEARS program planners to utilize as part of the data collection and analysis processes. The purpose for collecting qualitative data for this project is three-fold. 1. To explore adolescents’ perspectives of risk behaviors and associated health determinants common to their age group 2. …

Analysis Of Food Security, Snap Benefit Duration, Income Level And The Relationship With Depression In Households With Children In Omaha., Tatiana Tchouankam

Capstone Experience

Food insecurity is defined as a lack of access to “sufficient, safe, and nutritious food that meets individuals’ dietary needs and preferences for an active and healthy life.” From 2015 to 2016, the number of people undernourished increased from 777 million to 815 million worldwide. Food insecurity affected 12.3 % of Nebraskans and 13.8% of the residents in Douglas County during the same year. There is evidence of associations between food insecurity, income level, and several adverse health outcomes, specifically with regards to mental health. The objective of this study was to examine food security, SNAP benefit duration (i.e., how …

Multilevel Worksite Wellness Intervention To Improve Individual Behaviors And The Worksite Environment, Mariah Morgan

Capstone Experience

Due to increasing obesity rates, public health approaches must focus on improving healthy behaviors and reducing the risk of obesity-related health problems (“Nebraska State Nutrition Profile,” 2012; “State of Obesity,” 2016). Worksites offer opportunities to stimulate behavior change through environmental supports and provide natural structures for social support; therefore, worksites are ideal locations for teaching and implementing health promotion programs (Beresford et al., 2001; Salinardi et al., 2013; Sorensen et al., 1996; Touger-Decker et al., 2008). The Social Ecological Model (SEM), which illustrates that various factors are intertwined at multiple levels to influence behaviors, has been shown to produce significant …

Employee Wellness At Private Clinic In Omaha, Ne: Social Marketing And Health Communications Perspective, Olivia Chambers

Capstone Experience

Midwest Gastrointestinal Associates (MGI) is a private clinic in Omaha, Nebraska that reached out to the College of Public Health for assistance in the clinic’s employee wellness program. An MPH student with a background in health and wellness provided MGI with a health promotion intervention to increase employee participation rates. A change was made to the wellness program in 2017 away from monthly health challenges and points—to small gifts distributed to all employees to increase engagement and morale. An initial program evaluation was performed to understand employee understanding and needs. Discovered was the need for an outlet employees could turn …

Awareness And Attitudes Of The Latino Community In Omaha On Colorectal Cancer And Screening, Roger Gonzales

Capstone Experience

No abstract