Digital Commons Network^™

Improving Black Maternal Outcomes In Christian County, Ky: A Social Marketing Approach To Perinatal Provider Change, Ariel A. Arthur

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

Compared to other states in the country, Kentucky has historically poor population health outcomes. While the statewide maternal mortality rate is 16.1 per 100,000 live births, this statistic belies the stark racial disparities that exist. In 2018, the pregnancy-related death rate for Black women was 40.2 per 100,000 live births compared to 13.1 for White women. This pattern is persistent even after controlling for socioeconomic status, prenatal care, and other protective factors. Research shows that institutional and interpersonal racism when receiving obstetric care contributes to poor childbirth and postpartum outcomes for Black women. Additionally, geography and rural status may compound …

Implementation Of A Postpartum Depression Program In A Rural Kentucky County, Abby Cecil

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

This paper aims to describe the process of implementing a Postpartum Depression (PPD) prevention program in low-income women residing in rural communities. The paper describes the process of recruiting women in this population, where and how the program will be integrated into an existing clinic, and how the program will be sustained. PPD is a significant global public health problem that can be prevented and treated. The ROSE program (Reach Out, Stay Strong, Essentials for new mothers) is a series of classes that provide informational and social support to prevent PPD. This evidence-based program has been previously successful in reducing …

Patient Access To Glp-1 Ra’S: A Medicare Part D Policy Analysis, Celine Hummer

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

This policy analysis examines the evolving landscape of GLP-1 receptor agonists (GLP-1 RAs) and their implications for Medicare Part D coverage. Initially developed for managing type 2 diabetes, GLP-1 RAs have rapidly gained popularity due to their efficacy in treating obesity and reducing cardiovascular events, leading to broader therapeutic applications. However, access to these medications under Medicare Part D is limited by high costs and coverage restrictions, particularly when used for obesity without diabetes. This analysis evaluates current Medicare Part D policies, including specialty drug tier placement, formulary restrictions, and the potential impact of recent legislative initiatives such as the …

Breastfeeding Perceptions And Decisions Among Hispanic Participants In The Special Supplemental Nutrition Program For Women, Infants, And Children: A Qualitative Study, Emily Fisher, Priyanka Patel, Kathryn G. Wouk, Bidusha Neupane, Futun Alkhalifah, Marilyn M. Bartholmae, Chuanyi Tang, Qi Zhang

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the U.S. WIC served 2.5 million eligible Hispanic women, infants, and children under the age of five in 2021, which is WIC's largest racial/ethnic group. However, limited research has been conducted to understand Hispanic WIC participants' perceptions of WIC breastfeeding recommendations and their breastfeeding decisions. For this qualitative study, we interviewed 18 of these pregnant and postpartum WIC participants on their experiences and decision-making processes related to breastfeeding. Hispanic cultures and home country norms were identified as prominent influences on breastfeeding decisions, along …

The Association Of Skin Cancer Prevention Knowledge, Sun-Protective Attitudes, And Sun-Protective Behaviors In A Navy Population, Rachel Newnam, Uyen Le-Jenkins, Carolyn Rutledge, Craig Cunningham

Ellmer School of Nursing Faculty Publications

Introduction: U.S. Navy service members are primarily between the ages of 18 and 30 years and often required to be outside for extended periods of time in geographical locations with increased and often unfamiliar ultraviolet indexes that collectively increase their risk for skin cancer. Skin cancer is the country's most common form of cancer, yet there is a paucity of skin cancer prevention literature, especially within the U.S. Navy. The purpose of this study was to describe skin cancer risk and skin cancer prevention "cues-to-action" and to determine if skin cancer prevention knowledge was associated with sun-protective attitudes (e.g., prevention …

Association Of Immune Checkpoint Inhibitor Approval On Suicide Rates Among Patients With Cancer: A Pre-Post Analysis With Seer, Rachel Wang

Public Health Theses

Objective: Patients with cancer are at elevated suicide risks compared to the general population, and patients diagnosed with advanced cancers have higher suicide risks compared to those diagnosed with early-staged cancers. Immune Checkpoint Inhibitors (ICIs) were initially approved to treat metastatic melanoma, non-small cell lung cancer (NSCLC), and renal cell carcinoma (RCC), and an unpublished study observed a decreased suicide risk in patients with these cancers at all stages. This study evaluates suicide risks in patients with breast, colorectal, liver, pancreatic, and prostate cancer, of which ICIs have limited effects on, to assess if the lower suicide rates observed previously …

Program Evaluation Case Study: Infectious Disease Reporting Training Program Evaluation, Emily Sekkath Veedu

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

The Lexington-Fayette County Health Department (LFCHD) has developed an educational program aimed at Fayette County Public Schools (FCPS) health and athletics staff members to ensure timely reporting and action in the event of an infectious disease outbreak (4). The program was implemented after a methicillin-resistant staphylococcus aureus (MRSA) outbreak occurred in a Kentucky community, with a high school football team presenting several of the cases (4). It was noted by a school nurse that many people attending an informational session lacked knowledge regarding infection control, suggesting a need for intervention in this community. I have evaluated this program in the …

Recent Trends In Stimulant Prescribing In Kentucky, 2021-2023, Jordan Shannon

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

Abstract

Introduction

Prescription stimulants have a long history of clinical use dating as far back as the 1930s. In the United States stimulant prescribing rates have steadily climbed over the last 3 decades. The primary objective is to describe recent (2021-2023) prescribing trends of stimulant medications in the Commonwealth of Kentucky

Methods

Prescription data collected from Kentucky’s prescription drug monitoring (PDMP) database known as the Kentucky All Schedule Prescription Electronic Reporting System (KASPER). Annual and quarterly trends in stimulant prescribing between 2021-2023 were calculated, examined by age, sex, and geographic location.

Results

Stimulant prescribing increased by ~15% where the majority …

Examining The Feasibility Of Implementing Farm To School Programs In Rural Kentucky Schools: Barriers And Successes Of Initiating Programming As Identified Through Teacher’S Observations, Christina Wilson

Theses and Dissertations--Nutrition and Food Systems

Farm to School (FTS) programs provide experiential learning opportunities to children that have the potential to shape eating patterns and, in turn, improve health and learning outcomes. Participation in FTS programs in Kentucky is growing. However, programming varies widely across schools, and few have an edible school garden. This study examined the feasibility of establishing an edible school garden while incorporating FTS programming by evaluating teachers' observations and experiences. Six rural Kentucky schools were selected to receive a $5,000 grant to initiate an edible school garden and incorporate FTS programming. A Qualtrics survey measured six categories regarding implementation. The results …

Routines And Attitudes Of Smartphone And Tablet Use For Social Connection Among Rural Older Adults, Amanda U. Davis, Chelsea Conrad, Maya Dupree, Deja Myers, Monica Le

Translational Science in Occupation

Background: Loneliness is associated with negative health outcomes for older adults. Social connection may occur using information and communication technologies (ICTs), such as smartphones and tablets and interventions to increase ICT use have shown positive results. Purpose: This study aims to investigate the routines and attitudes of smartphone and tablet use for social connection and secondarily, determine if there is an association between the routines and attitudes and connection. Methods: Participants completed a survey with questions that included demographics, 3-item UCLA Loneliness Scale, Brief Sense of Community Scale, and open-ended questions. Results: Participants (N=21, median age of 76-80) report …

The Role Of An Occupational Therapy Practitioner In Professional Advocacy: A Scoping Review, Sarah Mckinnon, Natalie Petrone, Amanda Tarbet

Translational Science in Occupation

Background: Participation in professional advocacy amongst occupational therapy practitioners (OTPs) is necessary for strengthening the profession. Although advocacy remains essential for practice, specific activities of OTPs in professional advocacy remain inconsistent and unclear.

Purpose: To examine the activities occupational therapy practitioners are engaging in related to professional advocacy. To identify key strategies and future opportunities to strengthen OT practitioner participation in professional advocacy.

Methods: We systematically searched 4 databases and 1 search engine for relevant articles- MEDLINE via PubMed, The Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete via Ebscohost, ERIC via Ebscohost, APA PsycInfo …

Pharmaceutical Messianism And The Politics Of Covid-19 In The United States, Gideon Lasco, Vincen Gregory Yu, Nishtha Bharti

Development Studies Faculty Publications

Throughout the COVID-19 pandemic, public officials in the United States–from the President to governors, mayors, lawmakers, and even school district commissioners–touted unproven treatments for COVID-19 alongside, and sometimes as opposed to, mask and vaccine mandates. Utilising the framework of ‘pharmaceutical messianism’, our article focuses on three such cures–hydroxychloroquine, ivermectin, and monoclonal antibodies–to explore how pharmaceuticals were mobilised within politicised pandemic discourses. Using the states of Utah, Texas, and Florida as illustrative examples, we make the case for paying attention to pharmaceutical messianism at the subnational and local levels, which can very well determine pandemic responses and outcomes in contexts such …

The Effects Of Stigma Within The Prep Care Cascade Among People Who Inject Drugs In Rural Kentucky, Abby Burton

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

Background: Injection drug use has increased HIV burden in low-prevalence communities, specifically within rural Kentucky. Pre-exposure prophylaxis (PrEP) has been successful in terms of HIV prevention, yet uptake remains low among people who inject drugs (PWID). PWID living in rural areas face unique challenges to receiving PrEP care, including significant barriers of substance use- and HIV-related stigma. Recent studies have only started to explore the overlapping effects of these two stigmas. Considering the barriers each stigma independently poses to PrEP care, it is important to investigate their role in tandem for any compounding effects. This paper is a secondary analysis …

A Case Study In Program Evaluation, Lydia Williams

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

The three core functions of public health are assessment, policy development, and assurance, and program evaluation falls under the latter category. A program is incomplete without an in-depth understanding of how well it works and what steps can be taken to make sure there is continuous progress and improvement.

In this case study, I developed an evaluation plan for the Lexington-Fayette County Health Department’s (LFCHD) infectious disease outbreak education program. The need for such a program was realized after a MRSA outbreak among a Kentucky high school football team. This case study employed the Center for Disease Control and Prevention …

Introducing Comprehensive Sexuality Education And Hiv Prevention And Treatment Methods Through Pop-Up Clinics To Secondary School Girls In Kwazulu-Natal, South Africa, Eliza I. Tobin, Joaquin Carlos Pinga, Caitlyn Stanya

Capstone Showcase

Human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system leading to people living with HIV (PLHIV) immunodeficient and more susceptible to other infections or diseases (UNAIDS, 2023b). This can lead to acquired immunodeficiency syndrome (AIDS) within 8-10 years of infection (UNAIDS, 2023b). HIV does not always present symptoms, making it hard for people to identify their HIV status without proper screening. The lack of awareness around a person’s status has led HIV to spread worldwide. In addition to the worldwide spread of HIV, there is no cure for the disease, however, antiretroviral therapy (ART) is mainly used …

Reducing The Prevalence Of Overweight And Obesity In Children Ages 10-13 In Charleston, West Virginia Through A School-Based Nutrition Education And Physical Activity Program, Isabella Tullio, Emma Heffley, Natalie Scardino

Capstone Showcase

Childhood overweight and obesity, the excessive or abnormal accumulation of fat causing a health risk, is primarily caused by lifestyle issues including inadequate physical activity and too many calories from food and drinks (WHO, 2020; Mayo Clinic, n,d). Key determinants of health for childhood obesity include physical environment, socioeconomic status or occupation, education level, and school environments. Children with parents who have low socioeconomic status, live in a food desert, (a neighborhood with limited access to fresh fruits, vegetables, and whole grains), or a food swamp, (a neighborhood with a saturation of fast-food outlets, convenience stores, and corner stores), or …

New York City’S Health Governance And Activism From The 1950s To The 1970s, Andres Valcarcel

Theses and Dissertations

New York City's expansive network of hospitals and preventative health services has an intense history outside of the popular narratives of biomedical and technological advancement. This thesis will discuss the period between the 1950s and 1970s and the various movements and parties that shaped the city's health and hospital system. During this period, New York City's healthcare delivery system became increasingly privatized and commercialized; processes that improved the quality of healthcare yet simultaneously barred the poorest from accessing it. Communities, healthcare workers, and civil rights organizations worked to address perceived faults and extend their agency in health and hospital policy; …

Addressing Healthcare Disparities Faced By Aging Down Syndrome Populations, Rhea Mistry

Pitzer Senior Theses

Down syndrome (DS) is a chromosomal genetic condition that impacts the development of the body and brain. The life expectancy of individuals with DS has drastically improved over the decades, increasing from 9 years in 1929 to 25 years in 1983 and further reaching 60 years by 2002. Individuals with DS face a variety of prominent co-occurring health conditions that are subject to change over time, including cognitive, visual, and hearing impairments, sleep apnea, cardiovascular defects, Down syndrome regression disorder, and dementia. Despite this increase in life span, DS is still most familiar to pediatric care providers, resulting in healthcare …

Racial And Ethnic Disparities In Hospital Practices That Support Breastfeeding In The United States, Jane Lazar Tucker

Open Access Dissertations

Breastfeeding is the optimal form of infant nutrition and has many health benefits for mothers as well as infants (CDC, 2022a; Victora et al., 2016). Though rates of breastfeeding have improved in recent years, disparities in breastfeeding persist among Black and Hispanic women compared to White women (Beauregard et al., 2019; Chiang et al., 2021), despite similar intentions to breastfeed across all racial/ethnic groups (Hamner et al., 2021). Hospital practices that support breastfeeding, such as the baby being placed skin-to-skin immediately after delivery or staying in the room with the mother throughout the hospital stay, are known to predict breastfeeding …

How Individuals’ Opinions Influence Society’S Resistance To Epidemics: An Agent-Based Model Approach, Geonsik Yu, Michael J. Garee, Mario Ventresca, Yuehwern Yih

Faculty Publications

Background: Protecting public health from infectious diseases often relies on the cooperation of citizens, especially when self-care interventions are the only viable tools for disease mitigation. Accordingly, social aspects related to public opinion have been studied in the context of the recent COVID-19 pandemic. However, a comprehensive understanding of the effects of opinion-related factors on disease spread still requires further exploration. Methods: We propose an agent-based simulation framework incorporating opinion dynamics within an epidemic model based on the assumption that mass media channels play a leading role in opinion dynamics. The model simulates how opinions about preventive interventions change over …

Dental Students’ Psychological Stress: A Comprehensive Investigation Of Stress Inducing Factors At Mohammed Vi University Of Sciences And Health, Latifa El Mouden, Elmehdi Fettach

Health Sciences

Dental students are significantly confronted with mental health problems. We conducted a prospective recruitment of students at the Faculty of Dentistry of the Mohammed VI University of Sciences and Health to investigate the determinants of stress specific to this population in order to find solutions to improve their quality of life. In our study, 410 students responded to the survey, the average age of the students was 21.51 ± 2.102 years, 70% were female, 30% were in their 6th year, and 60% of the students were from Casablanca. The average MSP-25B score was 101.94 ± 33.035. In our study, there …

Knowledge Translation Through A Camera Lens, Nancy E. Krusen

Translational Science in Occupation

The journal Translational Science in Occupation (TSO) embraces art and science through the inclusion of a humanities section within the journal. Health humanities gives insight into the human condition (Health Humanities Consortium, 2021). Health humanities enables us to explore daily life occupation, reveal our similarities and differences, and to translate human experience through a variety of media. The following photographs represent concepts of knowledge translation through my camera lens.

Mapping Occupational Therapy Interventions In Adult Patients With Post-Covid Diagnosis: A Scoping Review, Jennifer Ng, Hannah Franks, Marissa Halvorson, Sarah Malone, Claudia L. Hilton Phd, Karthik Mani

Translational Science in Occupation

Importance: Post-COVID patients experience difficulties in their everyday lives due to the persistent nature of their symptoms. This scoping review explores the role of occupational therapists in treating post-COVID patients and examines occupational therapy intervention options for this population.

Objective: This scoping review seeks to answer the following questions: What does the literature say about the role of occupational therapy with post-COVID patients? Which rehabilitation interventions are currently being utilized for treatment? How often are occupational therapists involved in the treatment of and research of post-COVID patient care?

Data Sources: Articles were obtained through an exhaustive search in the following …

Examining Adolescent Sexual Patterns In Creek Town, Nigeria: Insights From A Cross-Sectional Survey And Implications For Tailored Interventions, Rowland Edet, Kabiru K. Salami

Department of Sociology: Faculty Publications

In the dynamic landscape of global health, the sexual behaviors of adolescents are of particular significance due to their profound implications for individual well-being and public health. This article focuses on Creek Town, a vibrant community in Nigeria, and aims to provide a nuanced exploration of the sexual behaviors of adolescents within the context of local culture and socioeconomic factors. A cross-sectional survey design was employed, involving a multi-stage sampling approach with 422 participants. A comprehensive 112-item questionnaire captured various aspects of adolescent sexual behaviors. Additionally, four focus group discussions, including both in-school and out-of-school adolescents, provided qualitative insights. The …

Effects Of Ultrasonic Use On Hearing Loss In Dental Hygienists: A Matched Pairs Design Study, Jessica Suedbeck, Emily A. Ludwig, James Blando, Nathan Michalak

Dental Hygiene Faculty Publications

Purpose: Dental professionals are exposed to hazardous noise levels on a daily basis in clinical practice. The purpose of this study was to compare the hearing status of dental hygienists who utilize ultrasonic scalers in the workplace compared to age-matched control participants (non-dental hygienists) who were not exposed to ultrasonic noise.

Methods: A convenience sample of nineteen dental hygienists (experimental) and nineteen non-dental hygienists (control) was recruited for this study. A matched pairs design was utilized; participants in each group were matched based on age and gender to eliminate confounding variables. The testing procedure consisted of an audiologist performing a …

Correlates Of Transactional Sex Among Black Men And Women Who Misuse Opioids, Shemeka Thorpe, Paige Orphé, Gabriella Pitcher, Kendall Mccleod, Natalie Malone, Danelle Stevens-Watkins

Kinesiology and Health Promotion Faculty Publications

The rise in opioid misuse coincides with increased sexually transmitted infection (STI) and HIV incidence. Transactional sex is an under-researched phenomenon among Black Americans who misuse opioids, and may increase their risk of STI or HIV transmission. Given the disproportionate impact of the opioid epidemic on Black Americans and the risks associated with opioid misuse, the current study aims to investigate sociostructural factors, history of violence, and sexual risk factors associated with transactional sex among Black men and women. A sample of n = 375 Black adult Kentuckians reporting opioid misuse completed a survey including transactional sex, sociostructural, violence history, …

Perception, Awareness, And Practices Toward The Pm2.5 During The Air Pollution Episode Among Chinese Students In Bangkok And Vicinity, Thailand: A Cross-Sectional Study, Jiali Chen

Chulalongkorn University Theses and Dissertations (Chula ETD)

Air pollution poses a significant public health threat to urban populations worldwide. Mobile groups such as international students face unique vulnerabilities, but their risk adaptation capacity remains understudied. This study assessed awareness, perception, and protective measures of PM2.5 among Chinese international students in Bangkok and its vicinity. This study used a validated scale to conduct a cross-sectional survey of 393 participants. The results revealed that while students exhibited a high level of risk perception regarding air pollution (mean score: 48.0 ± 7.6), their awareness was relatively low (mean score: 6.3 ± 2.9), with only 3.8% of respondents demonstrating "high awareness". …

Differences In Health-Related Quality Of Life Among Breast Cancer Survivors By Hispanic Origin In A Cross-Sectional Study, Meera Lakshmanan

Honors Undergraduate Theses

Breast cancer is the second leading cause of cancer-related death among American women. Research has examined the health-related quality of life (HRQOL) among breast cancer survivors of various races/ethnicities, reporting that Hispanic women have lower levels of HRQOL compared to non-Hispanic whites. Hispanics are not a homogenous population, and subpopulations may have different lifestyles, socioeconomic status, and cultural/personal/social ideals that could affect their HRQOL after treatment of breast cancer. The objective of this study was to examine the differences in HRQOL by Hispanic origin among breast cancer survivors in Central Florida.

Patient data was obtained from the Florida Cancer Data …

Student Attitudes Towards Their Program Area Of Study In A College Of Health And Human Services, Melanie Regan

Graduate Research Theses & Dissertations

Poor retention rates can be an indicator of systematic problems within a university’s culture of academic affairs and administration. Improving student retention rates requires an understanding of why students are not returning to campus. This research aimed to develop and implement a survey analyzing students' sensory comfort, relevance, reaction to their area of study, sense of belonging, and self-efficacy within a College of Health and Human Sciences. A descriptive research design was utilized for this study to obtain information on the study population to survey participants' overall attitudes towards their experience in a program of study in a college of …

Healthcare Disparities Among Hypermobile Spectrum Disorder And Hypermobile Ehlers-Danlos Syndrome Patients, Brooke A. Martinez

Honors Undergraduate Theses

Hypermobile Ehlers-Danlos Syndrome (hEDS) is the most common subtype of rare connective tissue disorder called Ehlers-Danlos Syndrome (EDS). Hypermobile Spectrum Disorder (HSD) is a connective tissue disorder that presents itself similarly to hEDS. Both disorders primarily affect individuals assigned to females at birth (AFAB), and symptoms range from joint instability, musculoskeletal pain, dizziness, fatigue, depression, and anxiety. Due to many factors like lack of education or attitudes among medical professionals (MPs), receiving a diagnosis of either of these conditions can be a challenging and grueling journey for patients. An online survey was conducted and distributed over social media platforms to …