Public Health Commons^™

Acculturation And Causes Of Death Among Filipinos In The Us: Focus On Cancer, Abegail Terso Reyes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Filipinos in the US are 3.4 million, yet the main causes of death among this primarily immigrant population have not been well characterized nor compared with the mortality experience of their counterparts in the Philippines. Age-adjusted mortality rates were computed for the main causes of death for three populations: Filipinos living in the Philippines (FPHs), Filipinos living in California (FCAs), and non-Hispanic whites in California (WCAs). Regression-derived mortality rate ratios stratified by sex were used to compare the populations, using WCA as the referent population. Included causes of death were ischemic heart disease, stroke, cancer and chronic lower respiratory disease, …

Socio-Economic And Cultural Determinants Of Health Care Services Utilization In Ghana, Vickita Akosua Antwiwaa Harvey

UNLV Theses, Dissertations, Professional Papers, and Capstones

The study examines the relationship between socio-economic and cultural determinants of health care service utilization in Ghana using Ghana Demographic and Health Survey (GDHS) 2008 data collected by Ghana Statistical Service (GSS) in which a two-stage sample design was used. The first stage involved a systematic sampling, with probability proportional to size, of 412 clusters using the 2000 Ghana Population and Housing Census as the sampling frame. At the second stage, systematic samples of 30 households from each cluster were selected, making a total of 12,360 sampled households. According to the GSS, data were not collected in some of the …

Application Of The Transtheoretical Model: Assessing Exercise Behavior In African Americans In A Church-Based Setting, Robin Marie White

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sedentary behavior rates are higher among African-American men and women than in other American races and ethnicities, placing them at greater risk for chronic illness. Routine physical activity reduces the risk of chronic health problems such as: (a) overweight and obesity, (b) type 2 diabetes, (c) hypertension, (d) coronary artery disease, (e) stroke, (f) congestive heart failure, and (g) cancers. Assessment of African-Americans' exercise attitudes in a church-based setting may provide information with which to develop effective interventions to improve physical activity. This descriptive, cross-sectional study used components of the Transtheoretical Model (TTM) to assess whether any associations exist between …

Factors Which Predict The Use Of Active Transportation To School Among Children In Clark County, Nv, Sheila G. J. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Active transportation to school (ATS) shows promise for increasing activity levels in children, but prevalence and correlates vary widely in cities and regions with different barriers and supports for active travel. Classification of ATS users is a current issue in the field. The purpose of this study was to determine the prevalence of ATS use and develop a predictive model of ATS for the novel population of children enrolled in grades K-8 in Clark County School District, a large metropolitan school district in Southern Nevada. Methods: This study used a secondary data from the National Center for Safe Routes …

The Reduction Of Central Line-Associated Bloodstream Infections In Intensive Care Units Through The Implementation Of The Comprehensive Unit-Based Safety Program, Michael Andrew Basinger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSIs) are one of the most significant healthcare-associated infections (HAIs) in the Intensive Care Unit (ICU) setting resulting in increased lengths of stay, increased healthcare costs, and higher mortality rates (Institute of Healthcare Improvement [IHI], 2012). Evidence that CLABSIs are largely preventable has created opportunities for healthcare organizations to implement evidence-based bloodstream infection prevention practices to reduce or eliminate these infections (Lissauer, Leekisa, Prease, Thom, & Johnson, 2012). Other efforts to reduce CLABSIs include implementation of safety programs to improve the safety culture in ICUs (Lissauer et al., 2012). One program, the comprehensive unit-based safety program …

Factors Associated With Parental Decision Making And Childhood Vaccination, Zuwen Qiu-Shultz

UNLV Theses, Dissertations, Professional Papers, and Capstones

In order to better understand factors affecting immunization status, logistic regression was used to assess the association of various socio-demographic factors and whether parents would have their child immunized if not a state mandate. Factors included in the study were race, household income, number of children in the household, number of adults in the household, if the child had a primary provider, if the child had a health check-up in the last twelve months, and medical insurance status of the child. The combined Nevada Kindergarten Health Survey Result of 2009-2010 (Year Two) and 2010-2011 (Year Three) conducted by the Nevada …

"Choices" Florida's Version Of Obamacare, Jason Lamarr Wasden

UNLV Theses, Dissertations, Professional Papers, and Capstones

"CHOICES" Florida's version of ObamaCare was a unique case voted in by the public in Alachua County Florida. A mixed methods research design was utilized and provided context in which policy entrepreneurs operated, as well as an explanatory model of internal determinants. Social, economic and political factors were examined to determine the predictor variable in the adoption of the "CHOICES" health services program. The results revealed that voters 51 years of age and older had a greater probability of voting for the Alachua Referendum. "CHOICES" legality has not been under contention but its effectiveness has. This study found that "CHOICES" …

The Effectiveness Of Health Education Materials In Influencing Hiv Testing Behavior: The Unlv-Siphi Study, Rebecca Tsegay

UNLV Theses, Dissertations, Professional Papers, and Capstones

The UNLV-SIPHI (Sexual Health Internet-Based Public Health Intervention) Study focused on HIV prevention by improving HIV testing behavior through the development and dissemination of health education materials. The goal of the UNLV-SIPHI Study was to develop effective, custom-made HIV health education materials that promote the knowledge, intention and practice of HIV testing among UNLV students. The UNLV-SIPHI Study was conducted during Spring 2012 semester in selected UNLV undergraduate classes. An online quasi-randomized-control trial (RCT) was used to measure the difference in HIV testing behavior contributing factors among students exposed to the health education materials. Several nonparametric tests were used to …

Identifying And Correcting Health Hazards In The Home: A Pilot Test Among Homes In Clark County, Nevada, Sabrina La Monica

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Nevada Healthy Homes Partnership (NVHHP) is collaboration between University of Nevada - Las Vegas (UNLV), the Southern Nevada Health District (SNHD), and other public and private housing authorities and health agencies throughout Clark County, Nevada. The primary mission of the NVHHP is to improve the health of Nevada residents, particularly those in disadvantaged communities, by identifying and addressing conditions in the home environment. For this study, a program created by the NVHHP, entitled "Nevada Healthy Homes" (hereafter, Healthy Homes) was piloted. Home health and risk assessments were conducted in 52 homes, with one or more interventions being provided to …

Utilization Of A Metabolic Syndrome Index In Evaluating The Life In Balance Lifestyle Intervention For Prevention Of Type 2 Diabetes Among Urban American Indians And Alaska Natives, Hongbin Jin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: A myriad of diabetes prevention programs modeled on the Diabetes Prevention Program (DPP) are carried out worldwide to fight against the current diabetes pandemic. The percentage of weight reduction is a widely used indicator to evaluate diabetes prevention programs. However, weight change alone may not fully reflect the efficacy of lifestyle intervention. A metabolic syndrome index is a promising novel scale for evaluation of diabetes prevention programs because it is a systematic, comprehensive, and stable indicator that reflects the metabolic risk reduction for diabetes and its complications at multiple levels and dimensions.

Methods: A total of 22 overweight and …

Retrospective Evaluation Of Oral Health Services For Underserved Children In Clark County, Nevada, Earl Taylor Spader

UNLV Theses, Dissertations, Professional Papers, and Capstones

Disparities in utilization of oral health services have been shown to exist through epidemiological investigations and data analysis. Specifically, disparities exist for utilization of preventative dental care (PDC) and unmet dental need (UDN). The disparities in utilization of PDC and UDN are associated with demographic and insurance variables.

To address the oral health disparities, the University of Nevada, Las Vegas-School of Dental Medicine (UNLV-SDM) was created to improve the health of the citizens of Nevada through innovative programs of oral healthcare services to the community. More recently, UNLV-SDM opened a pediatric dental residency training program to provide care directly to …

Elementary School Based Health Centers As Providers Of School Entry Health Exams: Do They Meet The Standards?, Roberta Bavin

UNLV Theses, Dissertations, Professional Papers, and Capstones

The health of today's children is crucial for the future of our society. There are many children without access to healthcare in these turbulent economic times; times that are increasingly uncertain as society maneuvers its way through the maze of healthcare reform. School based health centers (SBHCs) provide a safety net for children needing basic healthcare who are otherwise underserved. School entry health examinations (SEHE) are legal requirements in many states, and are a proven method for identifying health conditions early enough in a child's life that they can be corrected. Treating identified health conditions facilitates academic success for children, …

Association Between Childhood Demographics And Blood Lead Screening---Nevada Kindergarten Health Survey 2010, Lina Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lead, as a toxic substance, invades the human body, and gradually damages the organs. Oftentimes, elevated blood lead levels are not recognized until serious health issues are found. In the United States, approximately 250,000 children aged 1-5 years have elevated blood lead levels greater than 10 micrograms of lead per deciliter of blood (Centers for Disease Control and Prevention, 2004).

However, there is no effective treatment for lead poisoning. Chelation can merely decrease the blood lead levels but cannot reverse the existing damage. To prevent and control childhood lead poisoning, many studies have been conducted to investigate the sources of …

Exploring Geographic Proximity To Fast-Food Restaurants And Convenience Stores With Dental Caries In Patients At The University Of Nevada Las Vegas School Of Dental Medicine, Charles K. Hill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dental caries is present worldwide and has afflicted over 90% of all adults in the United States. Biological determinants of the disease are well understood but social determinants and how they interact with biological factors are not. Programs designed to reduce incidence and prevalence of caries often target certain individuals and involve behavioral change. Some programs are more successful when environmental and societal issues are also addressed (Watt, 2002). Biological and behavioral processes leading to caries should include the modification of social factors to enhance results of prevention programs designed to reduce caries in populations. Preventing disease comes not only …

High-Risk Human Papillomavirus (Hpv): An Emerging Health Issue For Women And Minorities, Dierdre O. Turner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The human papillomavirus (HPV) is the cause of nearly all cases of cervical cancers worldwide. HPV viral DNA is found in more than 99% of cervical cancers. In addition to cervical cancer, HPV is also associated with some breast and oral cancers. White women have been showing a decline in breast cancer rates while black women are continuously showing higher rates of mortality from both breast and cervical cancer. Minority women are also more likely to receive a late diagnosis and are showing increased incidence of oral cancer, which makes study of HPV in women and minorities significant.

To date, …

The Effect Of Low-Cost Incentives On Active Transportation To School Rates Among Elementary School Students, Sheila G.J. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study assessed the effectiveness of a school-based active transportation to school (ATS) encouragement program for elementary school students. ATS shows promise for increasing physical activity and preventing excessive weight gain in children. ATS rates were assessed through frequency counts at the control school (N=697) and intervention school (N=693). The intervention encouraged ATS through the distribution of low-cost incentives on one weekday each week. It also required helmet use for participation and included a Walking School Bus component. Findings from this study suggest that the intervention effectively increased ATS on both intervention and non-intervention days.

Lead Concentrations In Extracted Primary Teeth Among Clark County Pediatric Patients, Jennifer A. Berger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Childhood lead poisoning is a completely preventable condition, yet only a small portion of children in Nevada are screened for elevated blood lead levels. In 2009 only 6.11 percent of children in Nevada were screened for lead indicating that Nevada would benefit from an alternative method of screening for childhood lead exposure. Deciduous teeth are not currently recognized by the Centers for Disease Control and Prevention as diagnostic samples for the measurement for lead exposure. However, this unique and innovative detection method utilizes opportunistic samples that will contribute to the childhood lead poisoning prevention efforts in Nevada.

The objectives of …

Oral Cancer In Nevada: A Public Health Perspective, Karl Kingsley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer is the second leading cause of death in the United States, and oral cancer remains the eighth leading cause of cancer death among US males. Although previous epidemiologic studies have found that overall rates of cancer, including oral cancer, have declined in the US in recent decades – these declines are neither uniform nor consistent within this population. Anecdotal evidence has suggested that rates of oral cancer in Nevada are relatively high, although no evidence was available to support these assertions.

Oral Cancer Epidemiology: Based upon this information, a detailed and thorough epidemiologic examination of oral cancer rates in …

Implementation Of The Wiegand Sun Safety Program Into Physicians’ Offices In Southern Nevada, Breanne Eddington

UNLV Theses, Dissertations, Professional Papers, and Capstones

In this study Nevada Cancer Institute’s Wiegand Sun Safety Program was implemented in 14 clinics in Southern Nevada as a pilot run to increase awareness in children and their guardians through educational materials in pediatricians’ and family physicians’ offices. It was hypothesized that the increased display of information regarding sun safety and skin cancer in physicians’ offices would increase patient and guardian awareness of the subject and increase the likelihood of patients and/or guardians asking their physician questions about skin cancer and sun safety, resulting in an increase in preventive actions by guardians to protect their children from damaging rays …

Nevada "Nurselessness": An Acute Or Chronic Condition? An Examination Of The Etiology And Possible Treatment Alternatives, Jeanine Warren-Newmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Data released by the Department of Health and Human Services in February, 2001, revealed that Nevada has the lowest number of registered nurses per 100,000 population in the nation. The state’s population is growing faster than the nursing programs are currently able to produce new graduates. Current predictions are that the existing nursing shortage will become more severe and have a longer duration than has ever before been experienced. While there may not be one single identifiable causative factor, the aging nursing workforce, low unemployment, and the universal nature of the shortage magnify the problem. This paper focuses on the …