Medicine and Health Sciences Commons^™

Smoking Cessation In Pregnancy And Gestational Weight Gain In South Carolinian Mothers, 2009-2011, Laquenta Latreese Weldon

Theses and Dissertations

Purpose: To determine if smoking cessation during pregnancy is associated with excessive gestational weight gain (GWG).

Methods: Data came from the 2009-2011 Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing population-based survey of live births in South Carolina (n=2,603). Participant smoking status was classified as nonsmoker (did not smoke before or during pregnancy), persistent smoker (smoked before and throughout pregnancy), or quitter (smoked before but quit during pregnancy). Multinomial logistic regression model was estimated to examine the association between smoking status and meeting the 2009 Institute of Medicine guidelines, while linear regression model was used for the continuous outcomes such …

Longitudinal Study Of The Effectiveness Of The South Carolina Medicaid Policy For The Application Of Fluoride Varnish For Children Age Three And Under, Christine N. Veschusio

Theses and Dissertations

In South Carolina, the burden of dental decay disproportionately affects disadvantaged children enrolled in Medicaid (Dye et al., 2012; Martin et al., 2012; Ayers et al., 2013). To address this oral health disparity, South Carolina’s Medicaid Program initiated payment to physicians for the delivery of fluoride varnish (FV), an evidence-based preventive dental service at the well-child visit, to children up to thirty-six months of age. Fluoride varnish has been found to reduce dental decay by thirty-seven percent when applied two to four times a year (Weyant et al., 2013; Marinho et al., 2013).

Two retrospective cohort studies were undertaken to …

Association Between Electronic Prescribing Among Ambulatory Care Providers And Adverse Drug Event Hospitalizations In Older Adults, Grishma Patel Bhavsar

Theses and Dissertations

Purpose.

This dissertation research sought to determine whether the proportion of physicians using electronic prescribing (e-prescribing) was associated with the hospitalization rate for adverse drug events (ADEs) among patients aged 65 and older in 2011. Additionally, we sought to determine whether increases in the proportion of e-prescribing physicians in a county were associated with decreases in the hospitalization rate for ADE among older adults.

Methods.

Two study designs were used, a cross-sectional study using 2011 data and a pre-post- study using 2008 and 2011 data. Data from the 2008 and 2011 State Inpatient Databases, the Office of the National …

Ecpat: Development And Testing Of Mobile Technology To Engage Youth In Active Living Policy, Systems, And Environmental Health Promotion Efforts, Gina M. Besenyi

Theses and Dissertations

Modifying the built environment is a promising way to promote youth physical activity and reduce obesity. Parks, in particular, are key intervention venues given their low cost and legislated ubiquity. Creating healthy communities, including better parks, will require the interest and participation of multiple constituencies, including youth. Creation of mobile technology environmental audit tools can provide a more interactive way for youth to engage with communities and facilitate participation in participatory action research (PAR) and health promotion efforts.

The purpose of the first study was to describe the development and validity and reliability testing of an electronic version of the …

By Word Of Mouth: A Qualitative Approach To Understanding The Integration Of Preventive Dental Health In Primary Care Settings, Joni D. Nelson

Theses and Dissertations

Childhood and adolescence are sensitive periods in the lifespan when oral and craniofacial appearances can help determine social interactions and lifetime outcomes. In this respect, oral health can be viewed as more than just brushing or flossing for healthy teeth; children’s oral health can influence their social development and behaviors, impact their academic growth, affect their guardian’s responsibility for healthcare cost and create a potential pathway for negative impacts on quality of life. Access to quality oral healthcare is vital for the prevention of unwanted diseases and to avoid the burden of oral health complications. Oral health disparities may not …

Spatial Analysis And Correlates Of Waterpipe Tobacco Smoking Among College Students In The United States, Frederick Richard Kates

Theses and Dissertations

Introduction: In the United States, young adults have the highest prevalence of waterpipe tobacco smoking (WTS) according to National Adult Tobacco Surveys (NATS) published by the Center for Disease Control (CDC). Experimentation of different tobacco products is highest among 18-24 year olds. Most recently, WTS has surged in popularity among this demographic group. The rapid diffusion of WTS among this population has been accelerated by marketing efforts on the Internet. There are misperceptions that WTS is less harmful than smoking cigarettes and there is a proliferation of WTS establishments due to tobacco retail exemptions. Presently, WTS establishments are almost completely …

Public Health Implications Associated With The Practice Of Utilizing Tires To Singe Meat In Three Major Cities Of Ghana: A Concurrent Mixed Methods Study, Tempest D. Hill

Electronic Theses and Dissertations

Utilization of automobile tires to singe meat (e.g., cows) intended for human consumption presents public health risks due to hazardous chemicals released into the environment and meat. This has become a common practice in some African countries such as Ghana. The objective of this study was to investigate the awareness and perception of the residents in three major cities of Ghana (Cape Coast, Kumasi and Accra) using the Health Belief Model and Social Ecological Model. Survey participants (n=196) and focus group discussion members (n=37) completed the study. Data collected from study participants included meat consumption, awareness of the use of …

Complementary Alternative Medicine: Awareness And Perceptions Of Health Care Providers Who Provide Systemic Lupus Care, Carmen Ionie Bartley

Walden Dissertations and Doctoral Studies

The purpose of this study was to explore healthcare providers' awareness and perceptions of complementary and alternative medicine (CAM) use in providing systemic lupus erythematosus (SLE) care. This phenomenolgical study was built upon existing research indicating SLE patients' need to foster better communication about CAM use. Participants were recruited from the Long Island Rheumalogical Clinic in the State of New York. Individual in-depth semistructered interviews were conducted to explore the awareness and perceptions of a purposive sample of 10 healthcare providers who care for patients with SLE. Transcripts were analyzed, and categorical themes were developed. Guided by the use of …

Salmonellosis In Kentucky Cattle - 2003-2014, Azia Elizabeth Ramirez

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

The group of bacteria known collectively as Salmonella has historically been a major cause of both health and economic hardships. In particular, Salmonella in bovine has been estimated to cause the economy to lose billions of dollars annually, both due to the increased morbidity and mortality rates of the cattle themselves and the indirect loss of potential profits, and also results in the spread of the bacteria to humans to ill effect. Salmonella thus can be quite taxing to agricultural communities, the animals upon which they rely, and the consumers that buy said communities’ commodities. Thus, the importance of an …

Breast Cancer Screening For African American Women, Jennifer Ross

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

INTRO Breast cancer is the most common type of malignancy among women in the United States (U.S.) and the second leading killer. Despite the availability of effective breast screening tools, a disparity has formed. Specifically, white women over the age of 40 experienced a higher incidence rate of breast cancer, while African American women experience higher related mortality rate. The purpose of this study was to examine SES and ethnicity/race factors that may influence breast cancer screening rates, and specifically explore how those factors may differ between African American and white women.

METHODS Women between the ages of 50-74 who …

Factors Predicting Beta-Blocker Treatment After Myocardial Infarction In Patients With Type 2 Diabetes, Ryan P. Hickson

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

OBJECTIVE – Beta-blockers remain important for secondary prevention after myocardial infarction (MI). Despite clinical guideline recommendations, the potential for poor glycemic control and masking warning signs of hypoglycemia limit their utilization in type 2 diabetes. This study evaluated factors predicting post-MI beta-blocker initiation among type 2 diabetic patients.

RESEARCH DESIGN AND METHODS – A retrospective cohort of employed, commercially insured individuals was developed using de-identified enrollment files, medical claims, and pharmacy claims from 2007-2009 in the U.S. Inclusion criteria: (1) type 2 diabetes, (2) ≥18 years old, (3) continuous eligibility, (4) MI. Exclusion criteria: (1) females prescribed metformin exclusively without …

Trends In Drug Use During Suicide, 2005-2012, Kentucky, Jacqueline Seals

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

Objective

With high rates of suicides worldwide more research on suicide is necessary for improved prevention strategies. This study examines the trends of positive drug tests at the time of suicide in Kentucky with respect to region, time, and intrapersonal violence.

Methods

Data from the Kentucky Violent Death Reporting System was used to look at all suicides in Kentucky from 2005 to 2012 amongst individuals 10 or older (n= 4691). Trends of opiates, amphetamines, cocaine, marijuana, benzodiazepine, and barbiturates were examined. The relationship of a positive drug test and time and intrapersonal violence were evaluated with an ANOVA test and …

Injury Prevention In An Industrial Environment Via Strategic Job Placement, Michelle Cooper

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

Objectives. This study investigated the effects of an injury prevention program, specific to work related musculoskeletal disorders (WMSDs), which placed employees into jobs based on their physical abilities compared to the physical demands of their prospective jobs.

Methods. Employee injury data (N=3550) from a large auto manufacturer in the U.S. was analyzed to examine changes in injury rates for employees that were hired pre versus post-strategic placement. Bivariate and multivariate analyses were used to determine dependence between placement, injury within 120 days of hire and gender.

Results. Chi-square tests of independence revealed that injury rates and job placement may be …

Pulmonary Function Among Latino Thoroughbred Workers - A Pilot Study, John C. Flunker

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

Background/Objectives

Evidence suggests working in horse barns is associated with adverse respiratory effects among Latino thoroughbred workers, yet no studies to date have measured pulmonary function. We examined the prevalence of self-reported respiratory symptoms, abnormal pulmonary function, and associated occupational factors among Latino thoroughbred farmworkers.

Methods

Participants were recruited via a community-based, purposive sampling strategy and participated in an interview-administered survey and spirometer test. Surveys and spirometry tests were administered to 80 participants by two trained health promoters (Promotoras) in July-September 2014. Pulmonary function (abnormal/normal) was classified by a pulmonologist. Demographic and occupational factors were assessed for associations with respiratory …

The Comorbidity And Temporal Relationship Between Anxiety Disorders, Eating Disorders, And Personality Disorders, Mitchell C. Duross

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

Background - Population-level data on the prevalence of comorbidity between anxiety-, eating-, and personality disorders remain relatively unexplored. Additionally, the potential existence of a temporal relationship among these three classes of mental disorder is also of interest.

Methods - Lifetime prevalence of, and temporal relationships among, anxiety-, eating-, and personality disorders were assessed using Part II WHO Composite International Diagnostic Interview data from the National Comorbidity Survey- Replication, a nationally representative household survey (n=5692).

Results - Lifetime prevalence estimates for any anxiety-, eating-, and personality disorder were 59.8%, 2.8%, and 13.5%, respectively, among those diagnosed with at least one core …

The Impact Of Physical And Psychosocial Factors On Workplace Injuries In Nursing Assistants, Colleen Roberts

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

Objective: The objectives of this study were to 1) Describe the nature and prevalence of workplace injuries in nursing assistants (NAs) and 2) Assess the impact of physical and psychosocial works factors on the occurrence of back injuries and muscle strains in these nursing assistants.

Methods: Data for this study are from the 2004 National Nursing Assistant Survey (NNAS), which was conducted as a supplement to the National Nursing Home Survey (NNHS). The original dataset contained 3,017 records. The data were analyzed as a case-control for this study’s purpose. Cases were defined as participants who had experienced a …

Alcohol Sale Status And Violent Deaths In Kentucky, Usa: 2005-2012, Hanan Abdulghafoor Khaleel

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

Alcohol is one of the major public health problems worldwide because of its association with many health and psychological problems. This study adds to the extant literature by examining the association between being a resident in a wet county and having an alcohol related violent death, an alcohol related suicide, or an alcohol related homicide victimization.

The first aim of this study is to determine whether residents of wet counties have a higher odds of alcohol related violent deaths than residents of dry/moist counties after adjusting for other confounding factors. The second aim is to determine whether residents of wet …

Demographic Disparities In Children With Behavioral Or Conduct Disorders, Caitlin Dunworth

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

This study examines the demographic disparities in children with externalizing behavior disorders, such as oppositional defiant disorder and conduct disorder, utilizing secondary data from the 2011/2012 National Survey of Children’s Health (NSCH). Current literature suggests that children with externalizing behavior disorders are more likely to be male, live in a low-­‐income family, receive lower grades in school, and to develop later conditions such as depression. Chi square tests and logistic regression were used to examine the associations of presence of a current behavioral or conduct problems with age group, race/ethnicity, sex, household income level, and insurance type. Additionally, associations were …

Association Between Stressful Life Events And Change Of Maternal Smoking During Pregnancy Using Prams 2011-2012, Shidie Tang

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

Objective: To examine the association between stressful life events during pregnancy and change of maternal smoking behaviors.

Methods: We used data from the CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS) to conduct the research. Our data included 24 states from 2011-2012. We considered 13 stressful life events and grouped them into four categories: emotional, partner-related, financial and traumatic stressors. Change of Maternal Smoking during pregnancy was defined by smoking at the last trimester of pregnancy versus smoking at 3 months prior to smoking. Confounders included maternal age, race/ethnicity, education, marital status, Medicaid coverage upon delivery and income prior …

The Relationship Of Hispanic Ethnicity, Drug Use, And Bullying With Suicidal Ideation Among Adolescent Females In The 2013 Youth Risk Behavior Surveillance Survey, Erin Camp

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

BACKGROUND: There is little research on the relationship of Hispanic ethnicity, drug use, and bully victimization with suicidal ideation among adolescent females. This study investigates all components and their association with suicidal ideation using the 2013 Youth Risk Behavior Surveillance Survey (YRBSS).

METHODS: Participants were 6,621 adolescent females who completed a self-administered questionnaire (YRBSS). Students answered a series of questions regarding unintentional injuries and violence and alcohol and other drug use.

RESULTS: Results indicated that there was an association between drug use, bully victimization, and suicidal ideation. Bivariate analyses using chi-square tests showed the relationships between these risk factors and …

Correlates Of Depression And Poor Respiratory Health: A Cohort Study In A Rural County, Stephanie Courtney

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

Objective

High rates of depression are widespread globally and are among the leading causes of disability. To better understand the effects of depression on health outcomes, more research is necessary. This study examines the associations between depression and adverse respiratory outcomes among a cohort of Iowa residents living in a rural county. This study also investigates differences in the reporting of chronic and incident respiratory outcomes.

Methods

Data were obtained from the Keokuk County Rural Health Study (1994-2004) for individuals 18 years of age or older (N=1012). The primary outcome, poor respiratory health (PRH), was based on self-reported diagnoses for …

Healthcare Industry Injuries By Patient Contact Status In Kentucky, 2012-2014, Kristen Ranzenberger

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

Objectives

The healthcare industry continues to have a high number of reported injuries. The purpose of this study was to 1) characterize healthcare industry injuries by patient contact status; 2) identify the occupations associated with healthcare injuries by patient contact status; and 3) determine healthcare injury rates by occupation, to gain a better understanding of healthcare industry compensated injuries , and better target healthcare industry safety practices and programs.

Methods

Workers’ Compensation first reports of injuries (FROI) from the healthcare industry in Kentucky were categorized into injuries involving in direct patient contact vs. injuries without direct patient contact using narrative …

The Role Predictors Of Socioeconomic Status Play In Receipt Of The Shingles Vaccination In Adults Aged 50 Years Of Age And Above In The United States, Lesley Williams

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

Introduction: Vaccinations help to prevent deleterious diseases or lessen their side effects, saving millions in healthcare expenditures. While we associate most vaccinations with children, there are specific vaccinations that are indicated in the elderly. The shingles, or herpes zoster, vaccination is indicated in all adults over the age of 50 years of age to prevent the development of or lessen the severity of shingles – the re­‐emergence of chickenpox in the form of painful blisters on the body, however, statistics indicate that only around 20% of the indicated population has ever received that vaccination. Why have so few been …

Concealed Weapon Proliferation And The Impact On Firearm-Related Fatalities And Injuries Due To Assault In Kentucky, 2005-2013, Travis Young

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

Objectives: The objective of our research was to look broadly at firearms and health in the state of Kentucky, where annual gun purchases are rising and laws eliminating restrictions on concealed carry have empowered more than 300,000 citizens to carry firearms in virtually any public setting. As guns become more prevalent, and more readily accessible, will violent crime decrease as some have predicted, or will the potential for conflict escalation cause the opposite effect?

Methods: Utilizing death records for firearm-related homicides and hospitalization and emergency department visit data for injuries occurring due to firearm-related assault, we correlated the rate of …

Impact Of Kentucky Vaccination Exemption Laws On Pertussis Incidence, Katherine Blain

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

Purpose: According to CDC statistics, prior to pertussis vaccine development in the 1940’s, about 200,000 children contracted pertussis annually. Today, although this number has decreased drastically, pertussis cases began trending upward again in the 1980’s. There are several proposed contributory factors, including vaccination exemption. In Kentucky, there are both medical and religious exemptions to mandatory school vaccines. The purpose of this study was to examine possible correlations between reported school vaccination exemptions and pertussis incidence in Kentucky counties between the years 2004-2012.

Methods: This study retrospectively analyzed data from 120 Kentucky counties between 2004-2012. The Commonwealth of Kentucky School Annual …

Proton Pump Inhibitors And Atrial Fibrillation, Dustin Hughes

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

Background

Proton pump inhibitors (PPIs) are widely used drugs in the United States. Atrial fibrillation (AF) affects 2.7 million people in this country and often leads to other serious medical conditions. There is a growing body of evidence suggesting that PPIs may be proarrhythmic. This study seeks to better appreciate the relationship between these popular drugs and the most common arrhythmia.

Methods

This is a nested case-control study using a large, nationally representative insurance database. Members with an incident AF diagnosis between 2007 and 2009 were identified. Each case was matched with one control member, using incidence density sampling, and …

Adolescent Oral Health In Kentucky, 2007 National Survey Of Childhood Health Analysis, Kory Brinker

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

Research indicates that children raised by their grandparents can have poorer health outcomes than their peers living in mother or father based households. There is, however, little research that indicates how childhood oral health is affected by grandparents raising grandchildren. This study investigated grandparent based family structures, and how this family structure affects oral health of Kentucky children. Using data from the 2007 National Survey of Children’s Health, 113 Kentucky children were identified as living with a grandparent as a primary caregiver. Chi-Square analyses were utilized to assess the oral health status of these children, as well as what role …

Farm To School Programs And Children's Dietary Behaviors, Kathleen Evers

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

There is an increasing promotion of the importance of fruit and vegetable consumption through prevention efforts, specifically in school systems, to control and prevent childhood obesity. Farm to School (FTS) programs offer interactive hands on experiences involving fruits and vegetables. This study examines a specific FTS program including a farmer interaction, and a broccoli taste testing experience for kindergarten and fourth grade students in a rural Kentucky county. By using a digital still photography method of plate waste, the decisions of approximately 115 students to take/not take broccoli and percentage of students’ consumption of broccoli was analyzed. Using chi-square and …

Fatal Injuries Among Young Workers In Kentucky, 2005-2014, Allison Christian

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

Background: Young workers have been more vulnerable to fatal and nonfatal work injuries. To gain a comprehensive understanding of the injuries that led to fatalities in younger workers, the goal of this study was to compare characteristics of young worker fatal injuries in those aged 16-24 to all workers aged 25 and older in Kentucky using a descriptive analysis.

Methods: A retrospective analysis of fatalities among workers under the age of 25 compared to workers aged 25 and older was performed over a ten-year period from 2005-2014 using Kentucky Fatality Assessment and Control Evaluation (FACE) program data.

Results …

Relationship Of Bmi And Weight Perception To Weight Controlling Behaviors In 9th-12th Graders In The United States, Natalie Jones

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

Research indicates that high school students constitute the largest portion of those participating in unhealthy weight control behaviors. There is, however, little research that indicates what this behavior is influenced from. This study investigated the relationship of Body Mass Index (BMI) and (discordant or concordant) weight perception to weight control behaviors among 9th-12th graders in the United States. Using data from the 2013 Youth Risk Behavior Surveillance System (YRBSS), over 40 states and 13,000 surveys completed. Multiple Chi-square tests were performed, examining the association between BMI and weight perception in relation to weight control behaviors. We then examined whether perception …