Digital Commons Network^™

Social Disparities In Exposure To Point-Of-Sale Cigarette Marketing, Mohammad Siahpush, Evi A. Farazi, Jungyoon Kim, Tzeyu L. Michaud, Aaron Yoder, Ghada Soliman, Melissa Tibbits, Minh N. Nguyen, Raees A. Shaikh

Journal Articles: Epidemiology

While most ecological studies have shown that higher levels of point-of-sale (POS) cigarette marketing are associated with larger proportions of residents from lower socioeconomic and minority backgrounds in neighborhoods, there are no studies that examine individual-level social disparities in exposure to POS cigarette marketing among smokers in the United States. Our aim was to examine these disparities in a Midwestern metropolitan area in the United States. We conducted a telephone survey to collect data on 999 smokers. Cigarette marketing was measured by asking respondents three questions about noticing advertisements, promotions, and displays of cigarettes within their respective neighborhoods. The questions …

Evaluation Of Guideline-Recommended Combined Antiretroviral Treatment Regimens In Commercially-Insured Patients Living In The United States Between 2007 And 2009, Joye Brigitte Allen

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

Background: Randomized clinical trials of combination antiretroviral therapy (cART) inform the use of specific antiretrovirals (ARV) and their combination for optimizing therapeutic efficacy. It is critical that patients have access to and receive the most appropriate first-line treatment.

Objective: To examine factors that impact receiving initial guideline-recommended cART within a cohort of commercially insured patients in the United States (US)

Research Design: A population based cohort study.

Data Sources: A secondary administrative insurance claims database.

Subjects: Employed, commercially insured individuals with HIV who were continuously eligible for insurance coverage from January 2007 through December 2009 and received a new ARV …

Undiagnosed Pulmonary Obstruction And Restriction And Dust Exposure: Pilot Investigations Examining The Relationship Among Agricultural Workers, Caroline E. Holsinger

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

Chronic obstructive pulmonary disease (COPD) is a progressive disease that is characterized by limited airflow.1 In the United States (U.S.) alone, COPD is the third leading cause of death.2,3 While smoking remains the strongest risk factor for COPD, 20 percent of patients who die from COPD have never smoked.5–7 The American Thoracic 3 Society showed that about 15% of COPD cases might be attributable to workplace exposure.8 Agricultural dust exposure has long been recognized as a cause of decreased respiratory function, and exposures to both forms of dust may exacerbate other important risk factors of COPD and lead to the …

Socioeconomic Status-Related Inequities On Maternal Health Services: Trends, Associations, And Outcomes, Nibretie Gobezie Workneh

Walden Dissertations and Doctoral Studies

Maternal Mortality Rate (MMR) in Ethiopia remains one of the highest in the world due in part to very limited use of maternal health services. However, the underlying factors for limited use of the services and hence the high MMR are not well known. The purpose of this study was to identify factors associated with use of maternal health services and maternal health risks, to analyze inequity patterns between use of maternal health services and maternal health risks, and to measure the magnitude and trends in inequity. Behavioral-cultural and structural theories of health inequalities were used to frame the study. …

Emerging Technologies To Measure Neighborhood Conditions In Public Health: Implications For Interventions And Next Steps, M. Schootman, E. J. Nelson, K. Werner, E. Shacham, M. Elliott, Kendra Ratnapradipa, M. Lian, A. Mcvay

Journal Articles: Epidemiology

Adverse neighborhood conditions play an important role beyond individual characteristics. There is increasing interest in identifying specific characteristics of the social and built environments adversely affecting health outcomes. Most research has assessed aspects of such exposures via self-reported instruments or census data. Potential threats in the local environment may be subject to short-term changes that can only be measured with more nimble technology. The advent of new technologies may offer new opportunities to obtain geospatial data about neighborhoods that may circumvent the limitations of traditional data sources. This overview describes the utility, validity and reliability of selected emerging technologies to …

Enough Smoke: Implementation Of An Evidence-Based Smoking Cessation Program In Owsley County, Kentucky, Meghan Fay Johnson

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

In 1964, the first United States (U.S.) Surgeon General’s Report explicitly stating the dangers of smoking, including an increased risk of lung cancer, was released. Fifty years later, the U.S. continues to carry the significant health and economic burdens for failing to heed this public health warning. Owsley County, Kentucky, located in the heart of the Appalachian is one of the most impoverished and medically underserved counties in the U.S., ranking last in almost every category of overall health outcomes in the state. The county is also entirely rural, with no major cities within an 80-mile radius. In every health …

Abortion, Informed Consent, And Regulatory Spillover, Katherine A. Shaw, Alex Stein

Indiana Law Journal

The constitutional law of abortion stands on the untenable assumption that any state’s abortion regulations impact citizens of that state alone. On this understand-ing, the state’s boundaries demarcate the terrain on which women’s right to abortion clashes with state power to regulate that right.

This Article uncovers a previously unnoticed horizontal dimension of abortion regulation: the medical-malpractice penalties imposed upon doctors for failing to inform patients about abortion risks; the states’ power to define those risks, along with doctors’ informed-consent obligations and penalties; and, critically, the possi-bility that such standards might cross state lines. Planned Parenthood v. Casey and other …

The Double-Edged Sword Of Health Care Integration: Consolidation And Cost Control, Erin C. Fuse Brown, Jaime S. King

Faculty Publications By Year

The average family of four in the United States spends $25,826 per year on health care. American health care costs so much because we both overuse and overpay for health care goods and services. The Affordable Care Act's cost control policies focus on curbing overutilization by encouraging health care providers to integrate to promote efficiency and eliminate waste, but the the cost control policies largely ignore prices. This article examines this overlooked half of health care cost control policy: rising prices and the policy levers held by the states to address them. We challenge the conventional wisdom that reducing overutilization …

Spatial Analysis Of Newborn Hearing Screening In New York State, Nafin Harun

Legacy Theses & Dissertations (2009 - 2024)

Spatial Analysis of Newborn Hearing Screening in New York State

Adolescent Girls Empowerment Programme: Research And Evaluation Mid-Term Technical Report, Karen Austrian, Paul C. Hewett, Erica Soler-Hampejsek, Fiammetta Bozzani, Jere R. Behrman, Jean Digitale

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Programme (AGEP) was a social, health, and economic asset-building program targeting vulnerable adolescent girls aged 10–19. The Population Council, in partnership with the Young Women’s Christian Association of Zambia, successfully implemented the AGEP program from late 2013 to early 2016. The results presented in this midterm report have implications for recommendations on future programming for adolescent girls in Zambia and elsewhere and should be coupled with burgeoning evidence from AGEP and the literature to adapt programming for vulnerable adolescent girls in order to improve impact. While the underlying root causes of girls’ vulnerabilities are interrelated, it …

School-Based Youth Physical Activity Promotion: Thoughts And Beliefs Of Pre-Service Physical Education Teachers, Jerome N. Rachele, Thomas F. Cuddihy, Tracy L. Washington, Steven M. Mcphail

Australian Journal of Teacher Education

Physical education teachers are central to the facilitation of school-based physical activity promotion. However, teachers have self-reported a lack of knowledge, skills, understanding, and competence to successfully implement these strategies. The aim of this investigation was to explore the beliefs and perceptions of pre-service physical education teachers, concerning their potential roles in future school-based programs designed to promote student physical activity. Fifty-seven pre-service physical education teachers (21 males and 36 females) had complete data and were included in the analysis. Participants responded positively, and did not reveal concerns about their capacity to facilitate school-based physical activity promotion during practicum, and …

Social Capital And Social Networks: The Importance Of Social Ties For Health Among Residents Of Disadvantaged Communities, Stephanie Child

Theses and Dissertations

Access to social capital via social networks is important for health and may be linked with chronic disease, including obesity and hypertension. Socioeconomic status (SES) may influence access to social capital and social network characteristics, and may also moderate the relationship between social capital, social networks, and health. Yet few studies have explored relationships between social capital, social networks, and chronic disease among resource poor individuals.

Respondent-driven sampling was employed to recruit participants (n=430) from low-income communities in the US South for a household survey as part of the Greenville Healthy Neighborhoods Project. The survey collected information about participants’ SES …

Sustainable Improvement In Immunization Rates For Seniors: A Local And Community-Wide Effort, Linda C. Lopez

Master of Public Health Program Student Publications

Objective: Overall: To improve influenza and pneumococcal immunization rates in patients age ≥65 years by developing relationships with community organizations that would provide opportunities for community member education about adult vaccines. Pre/post Surveys: To assess potential changes in influenza and pneumococcal immunization knowledge and opinions in community members exposed to an educational presentation.

Methods: Using personal and university resources, contact was made with several organizations serving the senior, underserved population in West Dayton, Ohio. An educational presentation about adult immunizations was developed and used at ten community events. The presentation included oral and written communication, and was based on the …

Hiv Testing Health Care Related Discrimination Among Black And White Men From The 2006-2008 Sexual Acquisition And Transmission Of Hiv Cooperative Agreement Program (Sathcap), Kenisha Cantrell

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

Background: The study investigated whether experiencing difficulty obtaining heath care due to different forms of discrimination impacts Black and White men being tested for HIV. It is important to discover if discrimination as a structural factor inhibits progression through the HIV Care Continuum among Black men. Structural factors may better explain the origin of HIV prevalence disparities and how the social factors affect Black men being tested for HIV.

Methods: Data utilized was collected through the 2006-2008 Sexual Acquisition and Transmission of HIV Cooperative Agreement Program implemented in 6 U.S. cities and one Russian city: Los Angeles, CA; Chicago, IL; …

We Have The Tools To End Hiv: Benefits, Barriers, And Solutions To Expanded Utilization Of Pre-Exposure Prophylaxis (Prep) In The Us Deep South, Jason Ervin, Allison Weller Tikare, Carolyn Mcallaster

Faculty Scholarship

No abstract provided.

Incidence Of Non-Hodgkin's Lymphoma By Residential Proximity To Superfund Sites In Kentucky: A Multivariate Analysis, William Brent Webber

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

Non-Hodgkin’s Lymphoma (NHL) is a category of cancers that arise from the lymphocytes of the immune system. The rates of NHL in the United States and Kentucky began to rise in the mid-20th Century, shortly after the manufacture, use, and disposal of numerous chemical substances began to increase during and after the Second World War. While the etiology of NHL is not fully known, there are several chemical substances for which evidence exists of a possible link between exposures and development of NHL and other cancers. Several of these substances are also present in sites within Kentucky designated by the …

Equine Leptospirosis Seroprevealence In The Central And Bluegrass Regions Of Kentucky From 1993 - 2015, Charlene Siza

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

BACKGROUND

Leptospirosis is a worldwide zoonotic bacterial disease of significant importance for both human and animal health. There are many sources of infection and shedding of the bacteria, including horses. There is a known occupational hazard for leptospirosis, especially in occupations that work directly with animals or animal products. This study examined the prevalence of equine leptospirosis in Kentucky in relation to trends over time and geographical distribution.

METHODS

Data was obtained from the University of Kentucky Veterinary Diagnostic Laboratory(UKVDL) on equine leptospirosis from 1993 through September 2015. Overall seropositive prevalence and prevalence stratified by serovar were calculated. Furthermore, distribution …

An Analysis Of The Role Of Medicaid Expansion On Mobile Mammography Units And Breast Cancer Screening In The Commonwealth Of Kentucky, Joseph Chiweshe

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

Introduction

Breast cancer and adequate screening remains a significant scientific, clinical and societal challenge both in Kentucky and in the U.S. To date, the lack of medical insurance has been implicated as a barrier to the provision of breast cancer screening not only to those within the Commonwealth of Kentucky but amongst the general population of the United States.

Methods

The Kentucky Department of Health provided study data utilized in our analysis. The data requested consisted of Medicaid claims for mammography screens for all counties in the Commonwealth of Kentucky. In addition, data gathering occurred via interviews with four Mobile …

Colorectal Cancer Prevention In The North Slope Borough Of Alaska Utilizing The Flu-Fit Intervention, Jennifer Jenkins

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

The intention of the Flu-FIT intervention is to increase colorectal cancer screening rates by combing two annual activities into one visit that doesn’t necessitate a doctors visit. The original study increased colorectal cancer screening rates by 14 percentage points and this program should be able to show similar results in the North Slope Borough of Alaska. The North Slope Borough has the highest incidence rate of colorectal cancer in the United States, and this proposed intervention could lead to a reduction in that rate by increasing screening and knowledge about colorectal cancer in the community.

Hispanic Agricultural Workers: The Nexus Of Demographics, Employment Characteristics, And Health, Ashley Michelle Bush

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

Agriculture, which is home to elevated occupational injury and illness rates, has a substantial demographic makeup of Hispanic workers. Hispanic farmworkers are at increased risk of poor occupational health outcomes due to the precarious nature of work and other socio-ecological influences. These adverse occupational health outcome counts are inadequate and undercounted, failing to capture the true scope of agricultural work. To gain more knowledge about agriculture, this capstone will focus on the personal and work characteristics of agricultural workers to help further understand disparities within the agricultural sector by: providing a literature review of agricultural worker health; examining missed work …

Circumstances Contributing To Suicides Among Pregnant, Postpartum And Non-Pregnant Women (15 - 54 Years) In Rural And Urban Counties In The U.S., Nvdrs 2003-2012, Akosua Korantema Adu

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

Abstract withheld upon request.

Characterizing Health Risks In Privately-Supplied Drinking Water Due To Agricultural Practices In Rural Western Kentucky, Karen Schroeder Card

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

At least 400,000 people in Kentucky rely on private water wells or springs for drinking water. 551 households that rely on private water wells for drinking water were surveyed in 2009 about adverse health outcomes, including selected cancer incidence, adverse birth outcomes, and yearly incidence of diarrheal illness. Survey recipients were drawn from a population of well owners in the Jackson Purchase Region of Kentucky whose wells were tested for nitrate-nitrogen (NO3-N), triazine pesticides, and E. coli or total coliforms, by Kentucky Geologic Survey within the previous 15 years. 214 questionnaires were returned and matched to water quality data for …

Boîte À Outils: Renforcement Des Compétences, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

Grâce à un processus appelé «conception intentionnelle», les outils d’apprentissage du Population Council aident à centraliser les besoins des filles. Ces outils s'appuient sur des preuves de la nécessité de maintenir les filles en bonne santé, de les intégrer socialement et de les préparer économiquement. La boîte à outils Renforcement des Compétences du Population Council aide les praticiens, les décideurs et les défenseurs à élaborer un contenu adapté, significatif et positif pour aider des sous-populations spécifiques de filles. La boîte à outils guide les praticiens à travers une série d'étapes qui doivent être suivies pour définir des cibles de bon …

Risk Factors Associated With Severe Acute Respiratory Infections Cases, Ryan Gatdula Ortiguerra

Walden Dissertations and Doctoral Studies

The close proximity of the United States to the Mexican border poses a concern for communicable diseases because of the high flow of population movement. The purpose of this retrospective, quantitative study was to identify risks associated with respiratory diseases using an analysis of archived data from the Severe Acute Respiratory Illness (SARI) surveillance program. Based on the epidemiologic triangle theory, demographic and etiologic factors were analyzed to examine any associations with SARI in this population. Between 2010 and 2012, 798 subjects enrolled in this program, with 336 (42.1%) testing positive for respiratory pathogens. Chi square analysis determined that age …

Behaviors Related To Hiv Infections In Rural Versus Urban Regions Of Nigeria, Michael Ifeanyi Okeke

Walden Dissertations and Doctoral Studies

Efforts by the Federal Republic of Nigeria and international nongovernmental agencies to reduce the impact of HIV in Nigeria have not yielded the anticipated results. This study focused on the association between attitude, religious beliefs, knowledge of HIV, sexual risk behavior, and HIV epidemiology in rural and urban Nigeria. This quantitative study used social-cognitive theory and problem theory. The study was based on the Nigerian Demographic and Health Survey (NDHS) 2013 data including a sample of 33,006 participants. Specific covariates including gender, sexual partners over the past years, age at first sexual encounter, socioeconomic status, and literacy level were obtained …

Is There A Trade-Off? Infant Health Outcomes And Managed Care Competition, Shana L. Moore

Theses and Dissertations--Public Policy and Administration

This study offers insights into the impact of competition among Managed Care organizations (MCOs) on infant birthing charges and birth outcomes. Kentucky provides one of the nation’s first case studies to determine successes and failures of Medicaid MCOs, and by doing so, provides a prediction of the impact of Patient Protection Affordable Care Act (PPACA) competition on healthcare costs and birth outcomes. An analysis of a natural policy experiment in the state of Kentucky reveals that infants insured by a Medicaid MCO stay longer in hospitals, are less healthy, and cost more than those insured under Traditional Medicaid prior to …

Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls

Walden Dissertations and Doctoral Studies

Over 17 million food-insecure households are associated with increasing obesity rates across the United States. Although food insecurity and obesity are distinct social concerns, the two are linked and may be influenced by poverty and geographic location. Public health authorities and state leaders responsible for the health and nutrition of rural populations in particular would benefit from this information. The purpose of this quantitative cross-sectional study was to examine whether poverty mediated the relationship between food insecurity and obesity among urban and rural adults. The study was guided by the poverty, food insecurity, and obesity conceptual framework. The study addressed …

Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader

Walden Dissertations and Doctoral Studies

Widespread consumption of canned tuna fish since the 1950s may explain some of the increase in breast cancer prevalence in the United States and Europe. Although canned tuna is the primary source of human exposure to methylmercury, its role as an estrogen activating metalloestrogen has been overlooked in the etiology and incidence of breast cancer. Carcinogenic theory asserts that increased exposure to estrogen elevates the risk of breast cancer. The purpose of this population-based, case control study was to examine the association between canned tuna consumption, total blood mercury, and breast cancer in the NHANES 2003-2006 surveys. A multivariable logistic …

Time To Diagnosis Of Second Primary Cancers Among Patients With Breast Cancer, Edward Okezie Irobi

Walden Dissertations and Doctoral Studies

Many breast cancer diagnoses and second cancers are associated with BRCA gene mutations. Early detection of cancer is necessary to improve health outcomes, particularly with second cancers. Little is known about the influence of risk factors on time to diagnosis of second primary cancers after diagnosis with BRCA-related breast cancer. The purpose of this cohort study was to examine the risk of diagnosis of second primary cancers among women diagnosed with breast cancer after adjusting for BRCA status, age, and ethnicity. The study was guided by the empirical evidence supporting the mechanism of action in the mutation of BRCA leading …

Perceived Barriers To Oral Health Care Access For Massachusetts' Underserved Parents, Doudelyne Cenafils-Brutus

Walden Dissertations and Doctoral Studies

Poor oral care is detrimental to the overall health of the population. In the United States, oral health diseases affect millions of individuals, especially children and adolescents. Guided by the health belief model, the purpose of this study was to identify parents' perceived barriers to oral health care access among their 5- to 10-year-old children. A phenomenological approach was used to gather data and thematically analyze interview data from 20 parents who were recruited from a health center in the northeastern United States. All participants had at least one child between 5-10 years old and all identified as under-served. Data …