Digital Commons Network^™

Providers' Treatment For Overweight Navy Members And The Effect On Motivating Lifestyle Changes, Misty Scheel

Walden Dissertations and Doctoral Studies

In the military, excessive weight could put members at risk for training injuries, loss of potential career opportunities, and possible discharge from military service. This could increase cost to United States' national defense through increased injuries, decreased retention due to early discharge, cost of retraining, and lifelong chronic health conditions. The purpose of the study was to determine if there was a correlation or predictive value between active duty Navy members' perception of care provided for weight management and the active duty Navy member's motivation for weight management interventions. The social capital theory served as the theoretical framework for this …

Emergency Department Use For Nontraumatic Dental Conditions And Adult Oral Health, Cheryl Anne Lassiter-Edwards

Walden Dissertations and Doctoral Studies

Nontraumatic dental-related emergency department visits has resulted in a financial burden to hospitals across the United States. This study investigated whether there is a relationship between adult preventive dental care and emergency department visits for nontraumatic dental conditions by comparing specific states. Guided by Andersen's behavioral model of health services utilization, this retrospective quantitative study also investigated associations between state-specific community water fluoridation and dental-related emergency department visits. The population of interest was adult Medicaid enrollees who visited the emergency department for non-trauma-related dental conditions in the top 5 most populous states as identified in the 2012 NHAMCS survey. These …

Stroke Risk Factor Knowledge, Attitude, Prevention Practices, And Stroke, Adaku Ngozika Madubuko

Walden Dissertations and Doctoral Studies

Regardless of the advances that have been made in stroke research and treatment and the overall decrease in stroke mortality, the stroke mortality rate for African Americans is still high at 45.2/100,000 and is still the leading cause of adult disability. Knowledge of the risk factors of stroke is paramount to reducing the morbidity and mortality of stroke, but knowledge of stroke risk factors has been found to be suboptimal in the African American population. The purpose of this study was to examine if there is a relationship between the knowledge, perception, and sources of stroke information of risk factors …

Health Disparities Among Hispanic Americans With Type 2 Diabetes, Nelson Sitton

Walden Dissertations and Doctoral Studies

The ongoing increase in Type 2 diabetes among Hispanic Americans challenges the American public health system, particularly with health issues arising from not following appropriate health directives for the disease. This quantitative, cross-sectional, correlational study used primary data to assess the relationship between diabetes knowledge (as measured by the Diabetes Knowledge Questionnaire), health literacy level (as measured by the Short Assessment of Health Literacy-Spanish and English), education level, self-efficacy (as measured by the Diabetes Self-efficacy questionnaire), and self-reported diabetes self-care behaviors (as measured by the Summary of Diabetes Self-care Activities) among a sample of Hispanic Americans with Type 2 diabetes. …

Inpatient Rehabilitation, Diabetes, And The Risk Of Clostridium Difficile Infection, Kerry A. Flint

Walden Dissertations and Doctoral Studies

Clostridium difficile is a frequent cause of healthcare-associated infections (HAI) and is associated with increased risk of morbidity and mortality. Studies suggest environmental and host characteristics increase patient's susceptibility to C. difficile infection (CDI). However, few studies have examined the risk of CDI among those with diabetes or patients in the acute rehabilitation (AR) setting. A case-control study, using secondary data (n = 473), evaluated the relationship between CDI and diabetes and identified modifiable environmental exposures. An ecosocial framework was used to examine the relationship between these two complex diseases among hospitalized patients in an AR setting. Results of the …

Delivering Impact For Adolescent Girls: Emerging Findings From Population Council Research, Population Council

Poverty, Gender, and Youth

Despite numerous global commitments to invest in improving the lives of adolescent girls, questions remain as to what package of interventions can deliver the best outcomes. This report synthesizes findings from nine recent Population Council impact evaluations, conducted around the world, which indicate that empowerment and asset-building interventions for adolescent girls can improve education, health, economic, social capital, gender-equitable attitude, and violence outcomes for girls. The report includes implications for programs and investment, and identifies open questions for further research and evaluation.

Health Promotion In Elementary School Students, Madelyn J. Miles

Lewis Honors College Capstone Collection

The following project was created to address the rising epidemic of childhood obesity. Childhood obesity is caused by many factors such as genetics, metabolism, community and neighborhood design, diet, exercise, and short sleep duration (Center for Disease Control: Childhood Obesity Facts). Social determinants of health, systems of oppression, and stigma can all influence the obesity epidemic. These include but are not limited to social status, location, culture, age, sexuality, ethnicity, and race. These identities can influence affordability and access to healthcare and further contribute to the obesity epidemic. It is important to understand these issues as a future provider. A …

Collaboration Across The Curriculum: Urban Planning & Public Health, Lula Geyre

Senior Honors Theses and Projects

The way our communities are designed impacts our health. and there is an increasing need for collaboration between urban planners and public health professionals. Yet, it is not clear to what extent universities are preparing public health and planning students to work together. Our research will shed light on this important topic by evaluating the course requirements for both of these disciplines in accredited institutions and look at how they are addressing interprofessional issues such as land development, transportation policies, air/water quality, and community growth issues. The current study explores the availability of interdisciplinary courses in accredited undergraduate and graduate …

The Effectiveness Of Interventions And Bundles For Central Line-Associated Bloodstream Infections In The Neonatal Intensive Care Unit, Mohamad Alhamwi

Honors Undergraduate Theses

Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing CLABSI in NICUs.

Methods: A systematic literature search was conducted using CINAHL Plus with Text, Cochrane Database of Systematic Reviews and MEDLINE from January 2008 up to 2018. There were multiple …

Marijuana Use Among Pregnant Women In A High-Risk Population, Shanice A. Akoto

Master of Public Health Program Student Publications

Background: Marijuana is the most commonly used illicit substance in pregnancy, often used concurrently with tobacco, increasing the risk for prematurity and low birth weight. Programs such as Healthy Start and CenteringPregnancy® provide resources and prenatal care to women in underserved communities in hopes of improving birth outcomes.

Objective: Evaluate marijuana use in pregnant women living in Montgomery County, Ohio in the highest risk zip codes (45402, 45403, 45405, 45414, 45416, 45417, 45426) and determine if use at delivery is lower in women enrolled in CenteringPregnancy® compared to women who were not. Methods: A secondary analysis of previously collected de-identified …

The Association Of Perfluoroalkyl Substances Exposure And Metabolic Syndrome In U.S. Adults, David B. Leary

Master of Public Health Program Student Publications

Background: Perfluoroalkyl substances (PFASs) are persistent synthetic compounds that have been environmental contaminants since the 1950s. Exposure in the general population can be through food and water ingestion, use of non-stick cookware, and dust from stain-resistant carpet. Studies have suggested PFASs act as endocrine disrupters and to affect liver and immune function, as well as cause increases in serum lipid levels.

Objective: To explore the association between six common detectable PFASs and the metabolic syndrome (MetS) in United States (U.S.) adults. Methods: Data from 739 participants aged 20 years and older from the 2013-2014 National Health and Nutrition Examination Survey …

Food For Thought: Eating Habits Of College Freshmen Examined Through The Socio-Ecological Model, Malia T. Morris Ms.

Undergraduate Theses, Professional Papers, and Capstone Artifacts

The purpose of this project is to assess the dietary habits of college freshmen living in on-campus housing. A review of the literature regarding college student eating behavior is completed and examined through the socio-ecological model in order to identify key determinants affecting students’ meal choices. The second component of this project develops potential intervention plans specifically designed for UM students to improve eating habits campus wide.

Geographic And Multilevel Influences Of School Environments On The Development Of Obesity And Physical Activity Among School Children In A U.S.-Mexico Border Community, Teresa M. Anchondo

Open Access Theses & Dissertations

Childhood obesity, especially in Hispanic populations, is the most serious public health challenge of the 21st century (World Health Organization, 2014). Identifying risk factors at the individual, school and neighborhood level will help prevent the development of poor health outcomes such as diabetes and heart disease. The purpose of this study was to determine the associations between neighborhood deprivation, the retail food environment, obesity and physical fitness in children residing in El Paso, Texas. The study population included children in grades three through eight attending school in the El Paso Independent School District from 2009 to 2013. Approximately 42,000 student …

Essential Components Of Participation For An Exercise Program For Underserved, Older, African-American Females, Marina Meinert

Honors Undergraduate Theses

Physical activity (PA) is beneficial to people of all ages and ethnicities. Regular physical activity can reduce the risk of multiple chronic diseases, improve mood and sleep and allows your body to function better overall (CDC, 2018). However, populations that are more vulnerable to adverse health risks may benefit more than others from regular physical activity. This study was designed to identify the motivating factors for physical activity in a sample of older, African-American women of lower socioeconomic status (SES). This particular subgroup was chosen because of their increased risk of obesity and cardiovascular disease due to unhealthy lifestyle factors, …

Root-Cause Analysis Of Persistently High Maternal Mortality In A Rural District Of Indonesia: Role Of Clinical Care Quality And Health Services Organizational Factors, Mohammad Afzal Mahmood, Ismi Mufidah, Steven Scroggs, Amna Rehana Siddiqui, Hafsa Raheel, Koentijo Wibdarminto, Bernardus Dirgantoro, Jorien Vercruyssen, Hayfaa A. Wahabi

Community Health Sciences

Background: Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants.
Method: Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays.
Findings: The root causes were found in poor quality of care, which caused …

The Role Of Programs And Policies In Shaping The Observed School Nutrition Environment And Rural Childhood Obesity, Shadai Martin

Electronic Theses and Dissertations

Childhood obesity is an ongoing public health concern that impacts many children in the United States. Research has shown that the prevalence of childhood obesity is higher in rural populations compared to non-rural populations. This may be attributable to differences in the school nutrition environment, particularly school meals and school wellness policy implementation. In order to design effective intervention targeted at weight management and obesity reduction, information regarding the school nutrition environment must be known. Therefore, the purpose of this research was to examine the school nutrition environment, particularly school lunch participation and weight outcomes between metro, non-metro and rural …

Weight Management Related Factors And Healthy Behaviors In Adults, Sumadhuri Pamarthi

Electronic Theses and Dissertations

Obesity is an ongoing global pandemic that affects more than one in three adults in the United States. Being overweight or obese also increases the risk of chronic health conditions. Weight management does not only center on immediate weight loss but also on the proper maintenance of an appropriate body weight over the years. Methods of weight management include eating a healthy diet and meeting physical activity guidelines. Such weight management practices are important to ensure that the people suffering from obesity can decrease risks of morbidity or even mortality. Nevertheless, unhealthy weight management strategies might lead to unintended health …

Wic Participation And Breastfeeding After The 2009 Wic Revision: A Propensity Score Approach, Kelin Li, Ming Wen, Megan Reynolds, Qi Zhang

Community & Environmental Health Faculty Publications

In this study, we examined the association between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and breastfeeding outcomes before and after the 2009 revisions. Four-thousand-three-hundred-and-eight WIC-eligible children younger than 60 months were included from the 2005-2014 National Health and Nutrition Examination Survey (NHANES). We compared two birth cohorts with regard to their associations between WIC participation and being ever-breastfed and breastfed at 6 months. We estimated the average effect of the treatment for the treated to assess the causal effect of WIC participation on breastfeeding based on propensity score matching. The results showed that …

A Web-Based Interactive Tool To Reduce Childhood Obesity Risk In Urban Minority Youth: Usability Testing Study, Sandra Verdaguer, Katrina F. Mateo, Katarzyna Wyka, Tracy A. Dennis, May May Leung

Publications and Research

Background: Childhood obesity is a serious public health issue among minority youth in the United States. Technology-enhanced approaches can be effective for promoting healthy behavior change.

Objective: The purpose of this study was to test the usability of prototypes of a Web-based interactive tool promoting healthy dietary behaviors to reduce childhood obesity risk in urban minority youth. The Web-based tool comprised a manga-style comic with interactive features (eg, sound effects, clickable pop-ups), tailored messaging, and goal setting, and was optimized for use on tablet devices.

Methods: Latino and black/African American children ages 9 to 13 years were recruited to participate …

Healthy Heart Project, Emily Hurst

Undergraduate Theses, Professional Papers, and Capstone Artifacts

The Healthy Heart program has been offering fitness testing, cardiovascular and chronic disease testing and education, and clinical experience for students in the course KIN483: Exercise, Disease, and Aging for a number of years. The program offers an important service to the Missoula community by providing each participant with accurate health indicators and results, such as ECG (heart) rhythms, cardiovascular fitness, flexibility and strength measures, body composition, and peripheral artery disease screening. The program gives students experience learning practical skills by performing a 2-hour exercise testing session, communicating with a community member, analyzing testing data, and compiling then discussing results. …

An Exploration Of Care Coordination And Management For The Medicaid Hiv Population Within Upstate New York Health Homes, Esemikelu Oghenejobo

Legacy Theses & Dissertations (2009 - 2024)

Within the U.S. healthcare system, there has been a renewed focus to improve the delivery of care services, to increase the quality of care, and to decrease costs. The Affordable Care Act introduced the health home (HH) model to serve vulnerable, Medicaid populations who are experiencing difficulty managing their care and navigating complex healthcare systems. The HH was a voluntary state option; of which New York State (NYS) chose to participate. Additionally, NYS was granted a Medicaid 1115 waiver to fully implement an ambitious re-design of NYS’s Medicaid program. NYS invested in the HH as a key model to address …

The Independent And Joint Effects Of Prenatal Depression And Mercury Exposure On Infant Birth Size Outcomes : A Preliminary Analysis, Meredith Spivak

Legacy Theses & Dissertations (2009 - 2024)

Prenatal exposure to depression and mercury have been independently linked to adverse infant outcomes. Though results specific to birth size remain inconsistent, they are generally associated with smaller infant anthropometrics. Increasingly, research has shifted towards examining co-occurring, cross-disciplinary exposures, and thus more studies are examining if and how psychosocial and environmental exposures jointly contribute to health. This study examines the independent effects of prenatal depression and mercury exposures on infant birth size, and also whether these exposures jointly contribute to adverse infant birth size outcomes. This study uses data from the Albany Infant and Mother Study (AIMS), an ongoing birth …

Nutrition Transition, Trace Elements In Nails, And Blood Pressure Along The Interoceanic Highway, Madre De Dios, Peru, Stacy M. Pettigrew

Legacy Theses & Dissertations (2009 - 2024)

The paving of the Interoceanic Highway (IOH) brought rapid development to the Madre de Dios (MDD) region in the Peruvian Amazon. Development brings concerns of toxic trace element exposures, and road development has been a major driver of the transition from traditional to calorie-dense processed ‘Western’ diets in lower and middle-income countries. Investigacion de Migracion, Ambiente, y Salud (IMAS) (Investigation of Migration, the Environment, and Health) is the first analysis of health, diet, and integrated toxic trace elements in nails in the region. In 2014 we collected household surveys from 310 households in 46 communities along the IOH and nails …

Exploring Barriers And Opportunities For Pre-Eclampsia And Eclampsia Prevention And Management In Ethiopia, Pooja Sripad, Hussein Ismail, Amy Dempsey, Karen Kirk, Charlotte E. Warren

Reproductive Health

The Ending Eclampsia Project is a five-year cooperative agreement between the United States Agency for International Development (USAID) and the Population Council, in partnership with the Federal Ministry of Health Ethiopia, which seeks to expand access to quality underutilized interventions and commodities for the prevention and treatment of pre-eclampsia/eclampsia (PE/E). This report presents qualitative findings from formative research conducted to: 1) assess the policy and health systems environment related to PE/E prevention and management, 2) identify potential bottlenecks in the supply chain, 3) investigate PE/E knowledge, attitudes, and practices at policy, health system, and community levels, 4) describe the barriers …

Accessibility And Affordability Of Healthy Foods In Food Deserts In Florida: Policy And Practice Implications, Lauri Wright, Palak Gupta, Kumiko Yoshihara

Florida Public Health Review

Food deserts are areas where people experience limited access to healthy and affordable food. People with limited access to affordable food have been shown to have higher rates of obesity and obesity-related, chronic diseases. The purpose of this study was to assess the availability and affordability of healthy foods in retail outlets of food deserts in Florida. Eighteen food deserts in two large metropolitan areas were assessed using the USDA Food Store Survey Instrument. Overall, stores within food deserts were missing 43.16% of food items and convenience stores were missing food items almost seven times more than supermarkets. Food items …

The Relationship Between Physical Dating Violence And Alcohol And Drug Use Among High School Students In An Urban Florida County, Stacey B. Griner, Michele Johnson Moore, Kristina Wilson

Florida Public Health Review

Physical dating violence (PDV) is associated with a number of serious behavioral and psychological consequences for adolescents who have been victimized. However, there are few studies investigating the relationship between PDV and alcohol and drug use specifically among high school students in Florida. This study analyzes data from the 2013 Youth Risk Behavior Survey in an urban school district in Florida. Alcohol use, drug use, and sociodemographic factors were significantly associated with PDV. After controlling for individual factors, odds of experiencing PDV were higher among those who reported current alcohol use (aOR: 2.38, [95% CI 1.53-3.69]) and those who reported …

Hepatitis C Screening Practices In A Local County Health Department: A Gap Analysis, Andrew Blix, Barbara B. Little

Florida Public Health Review

Hepatitis C virus (HCV) infection is a growing problem in the United States and most patients remain undiagnosed. CDC guidelines from 2012 recommend one-time screening of everyone born from 1945-1965. The penetration of this guideline is relatively unknown and the literature reveals that most efforts for improvement are poorly sustained. The purpose of this study was to compare a Florida county health department’s screening practices to national guidelines. In addition, provider-level barriers to screening were assessed in order to develop tailored recommendations for improvement. Using a serial cross-sectional design, data was examined to determine HCV screening prevalence for patients born …

The Challenging Dual Role Of Being A Public Health Professional Degree-Seeking Student And Having A Life Outside Of School – A Commentary, Kristen L. Brewer

Florida Public Health Review

This paper is part of a continuing series of papers describing the experiences of students as they contend with academic studies, marriage and family, job-related responsibilities, and other activities that compete with being a full-time student. In this paper, the author discusses “multi-tasking,” the intellectual challenges of school, the all-consuming nature of advanced education, and the irony of personal, social, and health sacrifices one makes while seeking a public health degree – asking rhetorically, “Is it worth it?”

Community-Based Participatory Research At Jacksonville, Florida Superfund Ash Site: Toxicology Training To Improve The Knowledge Of The Lay Community, Alan Becker, Sandra Suther, Cynthia Harris, Grazyna Pawlowicz, Gale Disney-Tucker, Matthew Dutton, Fran Close, Aaron Hilliard, Richard Gragg

Florida Public Health Review

Until the late 1960’s, Jacksonville, Florida incinerated its solid waste with the resultant ash deposited in landfills or used to fill flood-prone areas. These filled areas were later developed into parks, school sites and residential areas. Lead in soil at these sites was the major toxicant of concern and driver of clean-up actions. During the period of assessment of lead-levels in soil, there were no established lines of communication between the City and residents of affected neighborhoods resulting in mistrust in the community. To address communication issues, a community-based, culturally sensitive Community Environmental Toxicology Curriculum (CETC) and a short video …

Adolescent Girls Empowerment Program (Agep): Endline Results—Executive Summary, Population Council

Poverty, Gender, and Youth

Adolescent girls in Zambia face a range of risks and vulnerabilities that challenge their healthy development from girls into young women, and they often lack the social, health, and economic assets that are necessary to mitigate these risks. The issues that confront vulnerable girls—high rates of gender-based violence, unsafe sex that puts girls at risk for unwanted pregnancies and HIV infections, school dropout, lack of economic resources and income-generating options, and lack of agency and participation—are interdependent and have similar causes. The vulnerabilities confronting Zambian adolescent girls formed the basis for designing the Adolescent Girls Empowerment Program (AGEP), which 1) …