Community Health and Preventive Medicine Commons^™

A Multi-Modal Intervention To Decrease Hpv Vaccine Hesitancy And Increase Uptake In Young Adult Women, Rylee Cartales

Evidence-Based Practice Project Reports

Human Papillomavirus (HPV) is the leading cause of cervical cancer worldwide and the most common sexually transmitted disease, yet hesitancy towards the HPV vaccine remains high and uptake of the HPV vaccine remains remarkably low (CDC, 2021b). The purpose of this evidence-based practice (EBP) project was to determine if the implementation of a multimodal intervention including a motivational interview, strong provider recommendation, and educational materials will decrease HPV vaccine hesitancy and consequentially increase uptake of the vaccine. Eleven young adult women ages 18-26 from a rural outpatient Obstetrics and Gynecology (OBGYN) clinic in Indiana participated in this project. After agreeing …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

The Relationship Between Parental Trauma History And Perceptions Regarding Their Child’S Healthcare And Utilization Of Healthcare Services, Krishna Patel

Theses and Dissertations

Abstract

TITLE: The Relationship Between Parental Trauma History and Perceptions Regarding Their Child’s Healthcare and Utilization of Healthcare Services

Adverse child events (ACEs) have been associated with a number of physical and mental health problems and have also been linked to increased health care utilization. While parents who have an ACE history may tend to seek healthcare services for themselves, limited studies have examined the impact of their trauma history on seeking healthcare services for their child. Healthcare utilization may also depend on the parents’ level of health anxiety, as well as their anxiety about their child’s health status. This …

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

Electronic Thesis and Dissertation Repository

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …

Incidence And Determinants Of Hypertensive Disorders Of Pregnancy In The Us: Hospitalization Discharge Rate For Preeclampsia, Eclampsia, And Gestational Hypertensions, 2016-2018., Kahir S. Jawad

Electronic Theses and Dissertations

Background: Hypertension remains one of the most prevalent medical issues in pregnancy. It contributes considerably to maternal and fetal morbidity and mortality, making it one of the most significant public health problems. Although various epidemiological studies have been conducted over the past decades to assess the disease incidence and key risk factors associated with hypertensive disorders of pregnancy, current incidence rates and trends are lacking. This is a novel and significant study because there are no current population-based incidence estimates of hypertensive disorders of pregnancy and their subtypes and very few studies with the power to explore a wide range …

Epidemiology Of Island And Mainland Populations: How Does Culture Influence Health Risk Factors Of Non-Communicable, Chronic, And Metabolic Diseases?, Jake Thomas D. Palisoc

Honors Projects

Non-communicable diseases (NCDs), including chronic and metabolic diseases, are responsible for 74% of global mortality and are strongly influenced by health risk factors. Geographical differences in NCDs have been identified in several countries but have not been completely explained through cultural factors, specifically island and mainland cultures. This study aimed to develop an epidemiological framework for determining diseases with the highest mortality for further investigation regarding different health risk factors rooted in a specific population’s cultural foundations. Preliminary findings indicated diabetes type II (D2) and CKD caused by hypertension and D2 to have the highest risk factor and mortality percentage …

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse

Graduate Theses, Dissertations, and Capstones

Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of …

Relationships Among Pregnancy, Substance Use, Social Determinants Of Health And Assessment, Referral, And Utilization Of Treatment: A Secondary Analysis Of Nsduh Data, Heather Lynn Coddington

Graduate Theses, Dissertations, and Problem Reports

ABSTRACT

Relationships Among Pregnancy, Substance Use, Social Determinants of Health and Assessment, Referral, and Utilization of Treatment: A Secondary Analysis of NSDUH Data

Heather Coddington

Background: Assessment and referral for substance use disorder during pregnancy is crucial to improving outcomes for mothers and newborns during the antepartum and postpartum period. Healthcare professionals are essential during the entirety of the pregnancy during each trimester to provide effective communication when assessing for substance use early and throughout each trimester of pregnancy. The purpose of this study was to determine if there was a relationship between assessment, referral, and utilization of treatment …

The Effect Of An Educational Handout On Knowledge, Awareness And Attitudes Of Pre-Exposure Prophylaxis (Prep) Among Participants At A Needle And Syringe Exchange Site, Mckenzie Buckel

DNP Projects

Background: In 2018, the total number of HIV cases in the United States was 1.2 million. Almost 186,500 of these cases were attributed to intravenous drug use. With the adherence to pre-exposure prophylaxis (PrEP) there is approximately a 49% decrease in the rates of HIV among people who inject drugs and the most significant barrier to PrEP among this population is a lack of awareness and knowledge.

Objective: The purpose of this study was to determine participants’ of a needle and syringe exchange site knowledge, awareness and attitudes of PrEP after reviewing an educational handout about PrEP.

Methods: A quasi …

Development Of A Community-Based Plan For An Effective Behavioral Intervention To Reduce Childhood Obesity In A Rural Appalachian Community, Jennifer Stacy Wells

Theses and Dissertations--Nutrition and Food Systems

Rural children experience increased rates of obesity and reduced access to specialized weight management facilities, which makes receiving the recommended frequency of care difficult. Clinical-community partnerships, recommended by the American Academy of Pediatrics (AAP) to expand access, have been shown to be a feasible strategy of care delivery. Examination of literature and stakeholder interviews were used to inform the development of a collaborative pediatric weight management program in a rural, Appalachian community. Screening articles as well as intervention articles were reviewed. Outcomes of screening articles reviewed included BMI measures (3), screening practices (7), and referral practices (4). Common outcomes of …

Rising Costs Of Insulin And Effects Of Self-Management In Type 1 Diabetes, Justine Yadao

Nursing | Senior Theses

Background

Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes is a chronic condition where the pancreas may not be able to produce little to no insulin. This type of diabetes can be attributed to some factors such as age, family history, environmental factors or types of viruses. It is seen more often in children or adolescence but can develop in adults, averaging approximately 5-10% of the population.

Insulin is a type of hormone produced in the pancreas naturally or can be manufactured in the laboratory. People with Type 1 Diabetes need insulin from an exogenous source to …

Increasing The Prescribing Of Pre-Exposure Prophylaxis (Prep) With A Pre-Exposure Prophylaxis Screening Tool, Cassey Hall

Student Scholarly Projects

Practice Problem: Human Immunodeficiency Virus (HIV) is one of the leading pandemics in the world. In 2019, 38 million people were living with HIV around the world. Of those, roughly 87% were aware of their HIV status.

PICOT: In patients with high risk for HIV, how does implementing a pre-exposure (PrEP) screening tool compared to randomly screening for pre-exposure prophylaxis (PrEP) affect the prescribing of pre-exposure prophylaxis (PrEP) within eight weeks?

Evidence: In 2015, the World Health Organization (WHO) recommended PrEP for the prevention of HIV in high-risk individuals. The patients include men who have sex with …

Identifying Critical Aging Care Challenges And Opportunities In High-Income Countries: A Cross-Country Comparison Of Denmark, Germany, And The United States, Cassandra Martin

Capstone Collection

Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Quality Improvement: Piloting A Pediatric Obesity Prevention Screening Tool And Intervention In A Family Practice Setting., Erin Shaye Semeyn

Doctor of Nursing Practice Papers

Background: In the United States today, nearly one third of children fall into the category of overweight or obese. Because it is extremely difficult to treat childhood obesity once it occurs, prevention is the optimal approach to childhood overweight and obesity (Brown & Perrin, 2018; Cooper & Mandel, 2020). An ideal time to address obesity prevention health behaviors is during pediatric primary care visits. Since the COVID-19 pandemic began in the United States in 2019, visits to primary care offices, including visits to an urban university-based family practice clinic in Kentucky, dropped as some pediatric patients and their caregivers worried …

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

How Environmental Change Will Impact Mosquito-Borne Diseases, Arsal Khan

Master's Projects and Capstones

Mosquitos, the most lethal species throughout human history, are the most prevalent source of vector-borne diseases and therefore a major global health burden. Mosquito-borne disease incidence is expected to shift with environmental change. These changes can be predicted using species distribution models. With the wide variety of methods used for models, consensus for improving accuracy and comparability is needed. A comparative analysis of three recent modeling approaches revealed that integrating modeling techniques compensates for trade-offs associated with a singular approach. An area that represents a critical gap in our ability to predict mosquito behavior in response to changing climate factors, …

Evaluation Of Awareness, Knowledge, And Preventive Intervention Of Nonalcoholic Fatty Liver Disease Among Chinese Young Adults, Yi Du

Theses & Dissertations

The prevalence of nonalcoholic fatty liver disease (NAFLD) among Chinese young adults (CYA) aged 18-25 years ranges from 4.7% to 15.1% and has kept increasing in recent years. Previous studies reported limited awareness and knowledge of NALFD among middle-aged and older Chinese populations, however, they have not investigated awareness in CYA, for which there is no well-validated questionnaire. There is currently no efficacious educational intervention on NAFLD for CYA.

The objectives were 1) to develop and validate a questionnaire which can be used to assess the awareness and knowledge of NAFLD among CYA; 2) to assess the awareness and knowledge …

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

Covid-19 Vaccine Uptake Among College Students, Erin Hoening, Elizabeth Morse, David Phillippi, Krystal Huesmann

DNP Scholarly Projects

Background: Public health strategies to improve COVID-19 vaccine uptake among college students living in residential communities varied, some universities opted to mandate COVID-19 vaccines while other universities opted to promote and influence the choice for vaccination.

Purpose: This descriptive, cross-sectional study examined the voluntary uptake of COVID-19 vaccines among residential students on a college campus in the southeastern U.S. that elected an evidence-driven health promotion strategy that included strong health promotion messaging coupled with coordinated efforts to make the vaccine accessible and appealing to students on campus.

Methods: Analysis of vaccine uptake was derived from campus electronic health records during …

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 …

Physical Activity As A Predictor Of Obesity In Autistic Children, Cody A. Mullins

MSU Graduate Theses

Research has found autistic children to be 40% more likely to be obese compared to their non-autistic peers. Reduced physical activity (PA) is thought to be a contributing factor to the increased prevalence of obesity in autistic children. This was one of the first studies to investigate the PA behaviors of autistic children during an adapted physical education (APE) class using accelerometry. The purpose of this study was to examine the PA of autistic children and determine the relationship between PA and obesity. Participants were recruited from a school for students with disabilities who participate in a once-weekly APE class …

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; …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Relation Of Breastfeeding Duration With Blood Pressure And Arterial Stiffness, Lohita Kollipara, Abbi Lane-Cordova, Xuewen Wang

Senior Theses

Background: The purpose of this analysis was to investigate the effects of differing breastfeeding duration on vascular function.

Methods: A study was designed to explore the breastfeeding patterns of 79 participants who delivered a singleton fetus 6 months-3 years ago and were aged 18-45 years old. Participant breastfeeding and dietary habits were self-reported using surveys. Breastfeeding groups were established by following the American Association of Pediatric guidelines on breastfeeding duration: Women who did versus did not breastfeeding for 6 months continuously. Blood pressure was measured using a standard oscillometric cuff, while SphygmoCor® technology was used to measure pulse wave velocity. …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …