Public Health Education and Promotion Commons^™

Timing Of Hospital Admission At First Childbirth: A Prospective Cohort Study, Kristen H. Kjerulff, Laura B. Attanasio, Jennifer Vanderlaan, Kristin K. Sznajder

Health Promotion and Policy Faculty Publication Series

Background and aims

It is difficult for women in labor to determine when best to present for hospital admission, particularly at first childbirth. While it is often recommended that women labor at home until their contractions have become regular and ≤ 5-minutes apart, little research has investigated the utility of this recommendation. This study investigated the relationship between timing of hospital admission, in terms of whether women’s labor contractions had become regular and ≤ 5-minutes apart before admission, and labor progress.

Methods

This was a cohort study of 1,656 primiparous women aged 18–35 years with singleton pregnancies who began labor …

Dietary Fat Quality And Serum Androgen Concentrations In Middle-Aged Men, Miika M. Wynne-Ellis, Jaakko J. Mursu, Tomi-Pekka Tuomainen, Elizabeth Bertone-Johnson, Jukka T. Salonen, Jyrki K. Virtanen

Health Promotion and Policy Faculty Publication Series

Average testosterone concentrations in men have declined over the last few decades. The reasons for this are not fully known, but changes in dietary fat quality have been suggested to have a role. This study aimed to investigate the associations of different dietary fatty acids with serum androgen concentrations.

The Massachusetts Public Health Data Warehouse And The Opioid Epidemic: A Qualitative Study Of Perceived Strengths And Limitations For Advancing Research, Elizabeth A. Evans, Elizabeth Delorme, Karl D. Cyr, Kimberly H. Geissler

Health Promotion and Policy Faculty Publication Series

Due to the opioid overdose epidemic, Massachusetts created a Public Health Data Warehouse, encompassing individually-linked administrative data on most of the population as provided by more than 20 systems. As others seek to assemble and mine big data on opioid use, there is a need to consider its research utility. To identify perceived strengths and limitations of administrative big data, we collected qualitative data in 2019 from 39 stakeholders with knowledge of the Massachusetts Public Health Data Warehouse. Perceived strengths included the ability to: (1) detect new and clinically significant relationships; (2) observe treatments and services across institutional boundaries, broadening …

Transitions In Health Insurance During The Perinatal Period Among Patients With Continuous Insurance Coverage, Chanup Jeung, Laura B. Attansio, Kimberly H. Geissler

Health Promotion and Policy Faculty Publication Series

Importance Although health insurance continuity is important during the perinatal period to improve birth outcomes and reduce maternal morbidity and mortality, insurance disruptions are common. However, little is known about insurance transitions among insurance types for individuals who remained insured during the perinatal period.

Objective To examine insurance transitions for birthing individuals with continuous insurance, including those with Medicaid and Medicaid managed care coverage, before, during, and after pregnancy.

Design, Setting, and Participants This cohort study used January 1, 2014 to December 31, 2018 data from the Massachusetts All-Payer Claims Database. The sample included deliveries from January 1, 2015, to …

Dental Fluoride Varnish Application During Medical Visits Among Children Who Are Privately Insured, Kimberley H. Geissler Phd, Andrew W. Dick Phd, Sarah L. Goff Phd, Christopher Whaley Phd, Ashley M. Kranz Phd

Health Promotion and Policy Faculty Publication Series

Fluoride varnish is effective at reducing tooth decay, which affects nearly a quarter of US children ages 2 to 5 years and more than half of children ages 6 to 8 years.^1,2 To increase young children’s receipt of preventive oral health services, the US Preventive Services Task Force recommends medical providers apply fluoride varnish to young children’s teeth during well-child visits through 5 years of age.² Offering fluoride varnish in medical settings may increase young children’s receipt of this service because 89% of children younger than 6 years of age had a preventive medical visit in …

Family Support And Readiness To Consider Smoking Cessation Among Chinese And Vietnamese American Male Smokers, Joan A. Daniel, Jin E. Kim-Mozeleski, Krishna C. Poudel, Angela Sun, Nancy J. Burke, Janice Y. Tsoh

Health Promotion and Policy Faculty Publication Series

Introduction. Smoking prevalence is disproportionately high among Asian American immigrant men with limited English proficiency. Understanding the role of family support may provide insights into culturally acceptable strategies to promote smoking cessation. Aims. This study examined how family support was associated with readiness to consider smoking cessation among Chinese and Vietnamese American male daily smokers. Methods. We analyzed baseline data (N = 340) from a cluster randomized trial of a family-based healthy lifestyle intervention. We assessed the frequency of receiving family support in various forms (encouraging use of cessation resources, praising efforts, checking in, and reminding of familial role). Multiple …

Pubertal Development And Risk Of Premenstrual Disorders In Young Adulthood, Donghao Lu, Jurate Alenaviciute, Ragnar Bjarnason, Unnur A. Valdimarsdóttir, Elizabeth R. Bertone-Johnson

Health Promotion and Policy Faculty Publication Series

STUDY QUESTION

Is pubertal timing associated with risk of premenstrual disorders (PMDs) in young adulthood? SUMMARY ANSWER

Late pubertal development is associated with decreased premenstrual symptom burden and risk of PMDs in young adulthood. WHAT IS KNOWN ALREADY

PMDs, including premenstrual syndrome and premenstrual dysphoric disorder, may begin during the teenage years. Few risk factors in early life have been identified for PMD development. STUDY DESIGN, SIZE, DURATION

A prospective cohort study of 6495 female participants during 1996–2013. PARTICIPANTS/MATERIALS, SETTING, METHODS

We included participants from the Growing Up Today Study (GUTS). Pubertal development was indicated by the timing of menarche, …

Shifting To Virtual Cbpr Protocols In The Time Of Corona Virus/Covid-19, Elizabeth Salerno Valdez, Aline Gubrium

Health Promotion and Policy Faculty Publication Series

COVID-19 has upended community based participatory research (CBPR) projects across the United States and globally. COVID-19 disproportionately impacts historically disenfranchised communities and communities of color, the very communities that CBPR is meant to engage, elevate, and support. In-person activities that help develop rapport and research protocols, build capacity, conduct collaborative data collection and analysis, disseminate findings to the community, and engage in sustainability planning are an impossible practice during the COVID-19 pandemic. The purpose of this article is to describe the challenges and facilitators of shifting to a virtual/online CBPR protocol with a Massachusetts community disproportionately affected by COVID19, as …

School-Based Telemental Health And Family Psychoeducation: A Program Evaluation, Ainat Koren

Doctor of Nursing Practice (DNP) Projects

Background: Telemental Health has been established as an effective model of care in the adult population. There are few studies that addressed the effects of providing child and parent telehealth services in underserved communities where mental health services are sparse. Families who attend face to face mental health support report high levels of satisfaction, show increased knowledge about mental illness/treatment, and youth have a lower risk of relapse.

Purpose: The purpose of this DNP project was to evaluate an innovative Telemental Health model offering timely social/behavioral health support for children/families’ mental health services in rural Massachusetts.

Methods: Process …

Adolescent Mental Health Training For Middle School Educators, Sarah Minton

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Adolescent mental health disorders are an increasing concern in the United States. School systems, specifically educators, are in the unique role to aid in early identification of mental health disorders, as well to intervene in mental health distress. However, mental health training for educators is lacking, leaving educators unprepared to manage mental health concerns within their classroom.

Purpose: The purpose was to utilize an evidence-based training, the “Teacher Knowledge Update Guide” from TeenMentalHealth.org to train middle school educators on the signs and symptoms of mental health conditions in the adolescent population with the intent to increase awareness, knowledge, …

Food Safety And Risk Of Foodborne Illness At A Food Center Extension: Toolkit For Front-Line Volunteers, Sara Anderson

Doctor of Nursing Practice (DNP) Projects

Background: Foodborne illness is a serious public health issue. One in six Americans has an episode of foodborne illness each year and over 50,000 are hospitalized. Food distribution centers are instrumental in decreasing food insecurity, however, some of the food donated is expired or may be damaged leading to increased risk of foodborne illness.

Purpose: The purpose of this project was to educate front-line volunteers at a local food center regarding food safety.

Methods: A toolkit was developed to teach food safety to the front-line volunteers. Seven classes were given to front-line volunteers including a pre and post intervention …

Incidence Of Pediatric Cannabis Exposure Among Children And Teenagers Aged 0 To 19 Years Before And After Medical Marijuana Legalization In Massachusetts, Jennifer M. Whitehill, Calla Harrington, Cheryl J. Lang, Michael Chary, Waqaas A. Bhutta, Michael D. Burns

Health Promotion and Policy Faculty Publication Series

Importance Pediatric health care contacts due to cannabis exposure increased in Colorado and Washington State after cannabis (marijuana) policies became more liberal, but evidence from other US states is limited.

Objective To document the incidence of pediatric cannabis exposure cases reported to the Regional Center for Poison Control and Prevention (RPC) before and after medical marijuana legalization (MML) in Massachusetts.

Design, Setting, and Participants Cross-sectional comparison of pediatric cannabis exposure cases 4 years before and after MML in Massachusetts. The exposure cases included those of 218 children and teenagers aged between 0 and 19 years, as reported to the RPC …

Outreach Strategies To Recruit Low-Income African American Men To Participate In Health Promotion Programs And Research: Lessons From The Men Of Color Health Awareness (Mocha) Project, Louis F. Graham, Lamont Scott, Erus Lopeyok, Henry Douglas, Aline Gubrium, David Buchanan

Health Promotion and Policy Faculty Publication Series

African American men continue to bear a disproportionate share of the burden of disease. Engaging these men in health research and health promotion programs—especially lower-income, African American men who are vulnerable to chronic disease conditions such as obesity and heart disease—has historically proven quite difficult for researchers and public health practitioners. The few effective outreach strategies identified in the literature to date are largely limited to recruiting through hospital clinics, churches, and barbershops. The Men of Color Health Awareness (MOCHA) project is a grassroots, community-driven initiative that has developed a number of innovative outreach strategies. After describing these strategies, we …

Delivering Culturally Competent Care To The Lesbian, Gay, Bisexual, And Transgender (Lgbt) Population, Evan M. Mcewing

Doctor of Nursing Practice (DNP) Projects

Purpose: To this day, the lesbian, gay, bisexual, and transgender (LGBT) communities still experience negative health outcomes due to social stigma and discrimination. Additionally, nursing has lagged behind other health professions in the promotion of culturally competent care to members of this minority group. Several national authorities on LGBT health have proposed guidelines for providing such care to the LGBT population; however, many nursing schools are not integrating these recommendations into their curricula. Methods: Using these national guidelines, an educational program was developed for BSN students at a large south Florida university to improve competency in providing care for LGBT …

Delays In Antiretroviral Therapy Initiation Among Hiv-Positive Individuals: Results Of The Positive Living With Hiv Study, Krishna C. Poudel, David R. Buchanan, Kalpana Poudel-Tandukar

Health Promotion and Policy Faculty Publication Series

Background: Lack of early initiation of antiretroviral therapy (ART) remains a major health concern due to increased risk of premature mortality and further HIV transmission. This study explored CD4+ cell count monitoring in relation to delays in ART initiation among HIV-positive individuals in the Kathmandu Valley, Nepal, where ART coverage was only 23.7% in 2011.

Design: We recruited a total of 87 ART-naïve, HIV-positive individuals aged 18 to 60 years through the networks of five non-government organizations working with HIV-positive individuals. We collected data on the history of ART initiation, CD4+ cell count monitoring, socio-demographic variables, perceived family …

Pneumococcal Pneumonia In The Older Adult: Increasing Patient Education And Vaccination, Jessica E. Valletta

Doctor of Nursing Practice (DNP) Projects

Background:Pneumococcal disease is a transmitted infectious illness that results in serious complications and death every year in the United States. Given their increased susceptibility to the potential complications of this disease, patients aged 65 and older are considered to be high-risk, but vaccination compliance for this population remain well below state and national goals.

Purpose: The purpose of this project was to increase pneumococcal vaccination rates among adults aged 65 and older in a primary care clinic by increasing patient education.

Methods: An educational intervention was implemented within a large primary care practice located in Central Massachusetts. Educational …

Associations Between The Patient-Centered Medical Home And Preventive Care And Healthcare Quality For Non-Elderly Adults With Mental Illness: A Surveillance Study Analysis, Jennifer J. Bowdoin, Rosa Rodriguez-Monguio, Elaine Puleo, David Keller, Joan Roche

Health Promotion and Policy Faculty Publication Series

Background

Patient-centered medical homes (PCMHs) may improve outcomes for non-elderly adults with mental illness, but the extent to which PCMHs are associated with preventive care and healthcare quality for this population is largely unknown. Our study addresses this gap by assessing the associations between receipt of care consistent with the PCMH and preventive care and healthcare quality for non-elderly adults with mental illness.

Methods

This surveillance study used self-reported data for 6,908 non-elderly adults with mental illness participating in the 2007–2012 Medical Expenditure Panel Survey. Preventive care and healthcare quality measures included: participant rating of all healthcare; cervical, breast, and …

Improving Hpv Vaccination Initiation And Completion Rates: A Qi Project, Princy M. Varughese

Doctor of Nursing Practice (DNP) Projects

Human papillomavirus (HPV) is a common sexually transmitted infection in the United States and is the cause of most cervical cancers in women, as well as anogenital cancers, oropharyngeal cancer, and genital warts in both men and women (Centers for Disease Control [CDC], 2014b). The HPV vaccine is recommended for preteen girls and boys to protect against HPV infections (CDC, 2011). In line with the goal of Healthy People 2020, the purpose of this evidence-based quality improvement (QI) project was to implement a text message reminder system, and calculate the completion rate of the 3-dose HPV vaccination series among adolescents …

Copd Dyspnea Palliation Project: Dyspnea Palliation In End-Stage Copd Patients, Kaveri M. Roy

Doctor of Nursing Practice (DNP) Projects

Chronic Pulmonary Obstructive Disease (COPD) is a chronic and incurable disease that affects over 12 million Americans. The number of people with COPD is rising, and it is the third leading cause of death in the United States. Management and palliation of COPD symptoms has become a public health issue. The capstone project, the COPD Palliation Project, was a pilot study that combined nursing case management and patient education to provide optimal patient dyspnea palliation and self-efficacy of dyspnea management to end-stage COPD hospice patients. For the intervention, end-stage COPD patients were taught to use a dyspnea algorithm to palliate …

Food System Planning In Western Massachusetts: A Community Organization Assessment, Arianna R. G. Thompson

Masters Theses 1911 - February 2014

Comprehensive planning for regional food systems is a relatively new focus in the planning field. Heightened national awareness of the economic, environmental and equity implications of our current food system has magnified the importance of planning engagement on food-system issues. While addressing food system concepts is relatively new to planners, community-based organizations have been historic players in the development of food-system programs and critical food-system policy, particularly with regard to food access and local food production. This thesis reviews the status of the regional food system in the Pioneer Valley of Western Massachusetts through an assessment of the efforts of …

Evaluating The Mebactive-Youth As A Measure Of Mental Toughness, Manneh Ghazarians

Masters Theses 1911 - February 2014

The obesity epidemic in youth is increasing, due to the decreasing levels of physical activity within the youth population. One variable that has never been examined as a correlate of physical activity is mental toughness. Mental toughness is a psychological trait characterized by determination, resiliency, and perform optimally regardless of the circumstances. In order to evaluate this trait the MeBActive-Youth was developed. The purpose of this study was to first, evaluate the psychometric properties of the newly developed measure and secondly, to assess the relationship of mental toughness, social support and self-efficacy to physical activity. Participants (N = 106) completed …

Sensory Exploration Of Seasonally And Locally Available Vegetables And Its Effects On Vegetable Consumption Of Western Massachusetts Head Start Children, Shannon Sojkowski

Masters Theses 1911 - February 2014

The current exploratory study, as part of the Massachusetts Farm Fresh (MAFF) research project: 1) examined the effect sensory attributes (i.e. taste profile, color, shape, texture, growth pattern) of the target vegetables have on children’s willingness to explore and consumption and 2) compared these outcomes for: facilitator-guided (FG), vs. children’s self-guided (SG) exploration.

We conducted a 6-week multi-sensory nutrition education intervention with Western Massachusetts Head Start preschoolers (3-5 years of age; n=94 children) using eight vegetable pairs; outcome measures were recorded by observers. Data were analyzed using SPSS version 20.0. Results are reported for 50 children with complete data at …

Heightening Mental Health Awareness On A Diverse, Urban Public University Campus Through A Media Outreach Campaign, Kathleen R. Golden Mcandrew

Doctor of Nursing Practice (DNP) Projects

Abstract

Mental health problems among students on college campuses have increased in severity over the last decade. On-campus health providers have reported seeing students with more complex problems such as depression, bipolar disorder, and mixed diagnoses that require frequent and regular follow-up and treatment. Students who require mental health services assistance from on-campus services need to be informed about what resources and services are available and how to access them. Since most on-campus counseling services are set up as short-term treatment models, providing students with community-based resource options is also important.

The purpose of this capstone project was to examine …

Vitamin D Levels And Risk Of Dyslipidemia Among Us Children With Diabetes And Obesity, Elsina E. Hagan

Masters Theses 1911 - February 2014

Dyslipidemia is increasing among U.S. children, and the prevalence is highest among children with diabetes and obesity. Recently, vitamin D deficiency has been suggested as a possible dietary risk factor for dyslipidemia. Despite the high prevalence of vitamin D deficiency amongst children, virtually no studies have evaluated the association between vitamin D and dyslipidemia among children. We evaluated the vitamin D and dyslipidemia relationship among 240 children and adolescents aged 2 through 21 years who were outpatients of a pediatric endocrinology unit at a large tertiary care facility in Western Massachusetts from April 2008 to April 2010. Eligible children were …

Program Evaluation For Tdap Immunization Standing Orders In A Birthing Hospital, Helen Crean Taugher

Doctor of Nursing Practice (DNP) Projects

Newborn infants are vulnerable to pertussis infections. Although the Advisory Committee on Immunization Practices (ACIP) recommends that babies begin their diphtheria, tetanus and acellular pertussis (DTaP) immunization series at two months of age, the minimum age for administration of the vaccine is six weeks of age (Centers for Disease Control [CDC], 2008). Young infants are at risk for whooping cough infection transmitted from parents, siblings and care-givers during the pre-vaccination period in the first two months of life, particularly pertussis transmitted from their mothers. Since the licensure of adult/adolescent formulations of tetanus, diphtheria and acellular pertussis (Tdap) vaccine in 2005, …