Digital Commons Network^™

Adolescent Girls Empowerment Program (Agep): Nutrition, Paul C. Hewett, Amanda L. Willig, Jean Digitale, Erica Soler-Hampejsek, Natalie Jackson Hachonda, Jere R. Behrman, Karen Austrian

Poverty, Gender, and Youth

Adolescence is a critical period in the lives of young people and potentially a time to reap lasting benefits from interventions that improve general, sexual, nutritional, and maternal and child health. The government of Zambia is committed to improving the nutritional status of adolescents and pregnant women and their children. Nonetheless, adolescent girls in Zambia remain at risk for macro- and micro-nutrient deficiencies that have deleterious effects on growth, development, and maternal and child health. The Adolescent Girls Empowerment Program (AGEP) nutritional curriculum, developed in partnership with PATH, was tailored to provide age-appropriate information and covered six sessions on nutrition. …

Adolescent Girls Empowerment Programme: Endline Technical Report, Karen Austrian, Erica Soler-Hampejsek, Paul C. Hewett, Natalie Jackson Hachonda, Jere R. Behrman

Poverty, Gender, and Youth

The theory of change behind the Adolescent Girls Empowerment Program (AGEP) posited that adolescent girls are empowered by building social, health, and economic assets that they can then draw on to reduce vulnerabilities and expand opportunities. In the long term, they will then increase their likelihood of completing school, delaying sexual debut, and reducing risks of early marriages, unintended pregnancies, acquisition of HIV, and other possibly detrimental outcomes. This endline report indicates that, while there were some changes for the program participants in the medium and long term, they did not translate into longer-term effects on reproductive and demographic outcomes …

Community-Level Assessment Of Droughts In Odisha: Effects, Resilience, And Implications, Sangram Kishor Patel

Poverty, Gender, and Youth

India has been severely affected by drought—one-third of the country is either drought-prone or classified as desert. Odisha’s geographic location makes it vulnerable to various natural disasters and climatic risks so the Population Council conducted a study there to explore the impact of drought on people and their resilience, as well as examine the perceptions of state-level infrastructure and institutional initiatives to strengthen responses to droughts. The study found that farmers, laborers, and the poor are severely affected physically, financially, and psychologically as a result of consecutive droughts that have affected agriculture and livelihoods. The report notes a number of …

Communicating Nutrition Information At The Point Of Purchase: An Eye‐Tracking Study Of Shoppers At Two Grocery Stores In The United States, Mike Bartels, Katherin Tillack, Chung‐Tung Jordan Lin

United States Food and Drug Administration: Publications

Providing nutrition information at the point of purchase is one approach that can be used to help consumers adopt and maintain a healthy diet. Previous research has examined consumer self‐reported notice and use of the information as well as how the design of the information affects its attention and use in a laboratory environ‐ ment using eye‐tracking methodology. This study advances the literature by applying eye‐tracking methodology to explore consumer visual and choice behavior in a real shopping environment, and by recognizing that nutrition information competes with other visual stimuli in the store and consumers are vulnerable to a “limited …

Effect Of Maternal Blood Heavy Metal Level On Brain-Derived Neurotrophic Factor And Pregnancy Outcomes Among Myanmar Migrants In Samut Sakhon Province, Thailand, Ye Htet Zaw

Chulalongkorn University Theses and Dissertations (Chula ETD)

BACKGROUND: Lead, mercury, cadmium, and arsenic are the priority heavy metals of major public health concern in developing countries. Thailand is a newly industrialized country raising high human workloads of migrant workers form neighbored countries, mostly Myanmar. Exposure to these metals can cause cognitive impairment and depressive disorders through an effect on brain-derived neurotrophic factor (BDNF), which is an important biomarker of pregnancy. Pregnancy outcomes including preeclampsia, preterm birth and low birth weight are major burdens for maternal and child health. Although a number of prior studies have examined the effects of heavy metals on pregnancy, there are few studies …

Association Of Objective Measures Of Sleep And Inflammation Markers On Police Officers: A Cross-Sectional Analysis, Megan R. Buss

Theses and Dissertations

Police officers are a unique occupational group due to the fact that they have more health problems than many other occupations. These health problems could be a result of elevated inflammation markers caused by poor sleep. Sleep influences circadian rhythms, which thereby influences the function of the immune system. The immune system is responsible for the body’s inflammatory response using pro-inflammatory cytokines such as IL-6, CRP, Fibrinogen, and TNF-a. These cytokines can become elevated if disruption of the sleep cycle occurs. Elevated levels of inflammatory markers are associated with increased risk of cardiovascular disease. Police officers also work shifts and …

Assessing Condom Use Among Navajo Men In The Southwest, Terra E. Yabeny

Walden Dissertations and Doctoral Studies

The Navajo tribe reports extraordinarily high number of cases of sexually transmitted diseases (STDs), such as gonorrhea, chlamydia, and human immunodeficiency virus (HIV) among men who have sex with men (MSM) and heterosexual populations. The purpose of this qualitative study was to explore the cultural value of adil' idli (self-respect) and how this cultural practice might influence health behaviors in sexual activity, condoms use, and acquiring of STDs among Navajo men. The Health Belief Model (HBM) was the theoretical foundation for providing a deeper understanding of the social, environmental, and cultural factors of condom use among Navajo men. Research questions …

Minimizing Home Health Care-Acquired Pressure Injuries Through Effective Nursing Teamwork, Juliana Baah

Walden Dissertations and Doctoral Studies

Pressure injuries (PIs) affect an estimated 2.5 million people in America and cost the nation approximately $11.6 billion each year. The goal of this DNP project was to minimize the rate of PIs at a home health care agency through effective teamwork. Prevention of PIs is very important because PIs damage patients' skin integrity, cause significant amount of pain, are costly to treat, and cause life-threatening infections. The purpose of this DNP project was to evaluate nursing compliance with PI prevention measures and the level of nursing teamwork at the project agency. The Braden-Bergstrom conceptual framework was used to explain …

Predictors Of Binge Drinking In High School Youths In Montgomery County, Maryland, Lum M. Fube

Walden Dissertations and Doctoral Studies

Underage drinking is a major problem in the United States, leading to increased morbidity and mortality. About 43,000 deaths a year result from binge drinking in youths at a cost of $24 billion in 2010 to the U.S. economy. The purpose of this quantitative dissertation was to examine the predictors of binge drinking in high school youths in a highly racial diverse community of Montgomery County, Maryland. The social ecological model was the theoretical framework used for this study due to the presence of both personal and contextual factors that influence behavior. Using binary logistic regression to analyze data from …

Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth

Walden Dissertations and Doctoral Studies

Adolescent obesity is a growing health concern in the United States due to its increasing prevalence and comorbidities that can reduce longevity and increase morbidity. Advanced practice nurses (APNs) providing care in school-based health centers (SBHC) located in marginalized communities are uniquely positioned to work with adolescent students challenged with obesity. The management of adolescent obesity requires advanced skills and knowledge to promote healthy lifestyles, prevent obesity, and to directly address the many factors that contribute to the condition. The purpose of this project was to develop an education program for APNs to prepare them to work with students in …

Improving Nutrition Among Supplemental Nutrition Assistance Program Recipients Using A Monetary Incentive Model, Jezabel Urbina

Walden Dissertations and Doctoral Studies

The Supplemental Nutrition Assistance Program (SNAP) is the United States' largest government assistance program that aims to alleviate food insecurity. The SNAP program allows low-income individuals and families the ability to purchase nutritious foods through a monthly benefit. However, the current body of literature presents evidence of the program's counterproductive effect. The purpose of this study was to determine whether incentivizing SNAP recipients to purchase additional fruits and vegetables was beneficial in increasing such purchases. Social cognitive theory was used as a theoretical framework to address research questions associated with shopping patterns and attitudes and beliefs. This quantitative study used …

Women's Perceptions Of Malaria In The Western Rural Areas Of Sierra Leone, Marcella Davies

Walden Dissertations and Doctoral Studies

Malaria is one of the leading causes of death for children and women in Sierra Leone. The purpose of this qualitative study was to explore and understand the lived experiences of women from the rural areas of Sierra Leone regarding malaria. A purposive sample of Krio women from the western rural area, aged 21-55 years, spoke English, and had taken care of someone with malaria described their perceptions and lived experiences with the disease in face-to-face interviews. The research questions were based on the health belief model and focused on knowledge, beliefs, and perceptions about malaria prevention and treatment. Interpretative …

Efficacy Of Methods Available To Remove Environmental Tobacco Smoke In Vehicles, Brian Albert Nielson

Walden Dissertations and Doctoral Studies

Environmental tobacco smoke (ETS) is a serious public health threat. Residual ETS in vehicles unknowingly exposes future occupants to environmental tobacco smoke. Reducing or removing exposure to ETS has been proven to reduce long-term health complications. This quasi-experimental study investigated 5 cleaning methods and their effect on air particulate matter2.5 (PM2.5) along with the correlation between air nicotine levels and PM2.5 levels. Study variables included cleaning methods as the independent variable, and changes in air nicotine and PM2.5 levels as the dependent variables. This study is framed within primary prevention and risk reduction based on the harm reduction theory. The …

Predictors Of Nutritional Counseling Among Adolescents By Physicians In California, Jean Kigozi

Walden Dissertations and Doctoral Studies

The prevalence of obesity in the United States was stable at 17% from 2011-2014 among approximately 13 million children and adolescents 12-19 years of age, according to the Centers for Disease Control and Prevention. Nutritional counseling has been recommended, and while most physicians agree that it is necessary, it is not happening consistently. The purpose of this study was to examine the association between dietary intake, physical activity, and body mass index (BMI) characteristics of youth 12-17 years old in California and the receipt of nutritional counseling. Social cognitive theory guided this quantitative cross-sectional analysis of archived data from 814 …

County Health Leadership And Readiness For Noncommunicable Disease Services, Paul Wekesa Agunga

Walden Dissertations and Doctoral Studies

Premature mortality resulting from the growing global burden of noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lower-middle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. The purpose of this study was to investigate whether any relationship exists between leadership practices at the county level and readiness for NCD services in Kenya. Path-goal and adaptive leadership theories were used to guide this quantitative correlational study, using secondary data from a 2013 Service Availability …

Using Social Cognitive Theory To Predict Counseling Behaviors In Registered Dietitians, Marianela Guerrero

Walden Dissertations and Doctoral Studies

Obesity and morbid obesity affect more than 30% of Americans, which emulates the rate of smoking as the leading preventable cause of disease and death in the United States. The prevalence of obesity among adults in the United States increased dramatically between 1980 and 2010 (16% to 36%). The integration of the social cognitive theory (SCT) constructs such as self-efficacy, self-control, environment and expectations in the study instrument allowed identifying the impact of personal, social and economic factors on Registered Dietitians (RDs) counseling behaviors with obese clients. The goal of this quantitative cross sectional study was to investigate the association …

Common Diagnoses Among Refugee Populations: Linked Results With Statewide Hospital Discharge Database, Kerui Xu, Shinobu Watanabe-Galloway, Ming Qu, Brandon Grimm, Jungyoon Kim

Journal Articles: Epidemiology

BACKGROUND: According to the U.S. State Department's Refugee Processing Center and the U.S. Census Bureau, in the fiscal year 2016, among all states in the United States, Nebraska resettled the highest number of refugees per capita.

OBJECTIVES: The objectives of this study were to determine the most common reasons for refugees utilizing hospital services in Nebraska between January 2011 and September 2015, and to examine whether refugee patients had increased risks for adverse health conditions compared to non-refugee patients.

METHODS: Statewide linkage was performed between Nebraska Medicaid Program's immigration data, and 2011-2015 Nebraska hospital discharge data inpatient and outpatient files. …

Implementation Of An Evidenced-Based Opioid Treatment Program To Improve Maternal-Child Outcomes In Eastern Kentucky, Jordan Rice

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

The Kentucky River Area District Health Department proposes implementation of CHARM-Kentucky, a treatment program for pregnant women with opioid use disorder (OUD), in eastern Kentucky. Over 115 Americans die each day from an opioid overdose, resulting in approximately 42,000 deaths in 2016. In addition to an overall increase in opioid use in recent years, the use of opioids in pregnancy has also increased from 1.19 per 1,000 hospital births in 2000 to 5.63 in 2009. Opioid use during pregnancy results in poor neonatal outcomes including: low birth weight, preterm delivery, small head circumference, increased child maltreatment, and risk for long-term …

Wellbeing Begins With Employees: Exploring Associations Of Physical Health In A Head Start Organization, Kristin Snyder, Madelyn Hill

Master of Public Health Program Student Publications

The purpose of this research was to describe self-reported physical health status, behaviors, and wellbeing interests of teachers and other staff within a Head Start agency. Information on overall health, behaviors, demographics, and interests in wellbeing programs was collected through a 58-item questionnaire (N = 312). A majority of participants were white (66.8%), female (93.7%), and half were teachers (49.4%). Bivariate analyses and an ordinal logistic regression were performed to test the association of physical health with independent variables, health behaviors, and demographics. Associations with “very good/excellent” physical health displayed by the regression model include mental health, chronic conditions, vegetable …

Hope Center For Families: Addressing Health Needs Through A Two Generation Model, Brianna Burlock

Master of Public Health Program Student Publications

This project’s objective is to explore how the Two Generation Model of the Hope Center for Families can address the health needs of the zip code 45406 community in order to combat negative health outcomes for impoverished families. The investigator researched studies regarding the Two Generation Model and previous organizational applications of the model. Interviews were held with the partners of Hope Center for Families and with an organization that uses the Two Generation Model. The interviews were analyzed for recurring themes after listening to each of them several times and then transcribed. A logic model for the Hope Center …

Does Self-Efficacy Mediate The Relationship Between Parenting Style And Adolescent Fruit And Vegetable Consumption?, Sumayyah S. Shermadou

Master of Public Health Program Student Publications

Background: Inadequate fruit and vegetable (FV) consumption is a serious public health issue in children and adolescents that is influenced by the type of parenting style and one’s self-efficacy.

Purpose: The purpose of the study was to determine the association between parenting style and adolescent FV consumption and whether adolescent self-efficacy mediates this relationship.

Methods: Data retrieved from the Family, Life, Activity, Sun, Health, and Eating (FLASHE) study were used to perform statistical analyses on 1,382 parent – adolescent dyads. A mediation analysis using the causal steps approach was used to determine whether adolescent self-efficacy mediated the effect of parenting …

Epidemiology Of Young Adult Renal Cell Carcinoma In Kentucky: Incidence, Clinicopathologic Features, And Cancer-Specific Survival, Jason R. Bylund

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

Introduction:

Renal cell carcinoma (RCC) is an important cause of morbidity and mortality in our country. Previously reported data suggest that the overall incidence of RCC continues to rise and may be accelerating even faster among younger adult patients.

Methods:

Data for analysis included the combined NPCR-SEER USCS public use database and the Kentucky Cancer Registry dataset. Incidence rates and trends by age group and location were calculated and tested. Clinicopathologic features of disease among Kentucky cases were analyzed by age group. Cancer-specific survival (CSS) analysis was performed, along with Cox proportional hazards regression to test for association of younger …

An Assessment Of Agreement In Detection Methods For Histophilus Somni In Bovine Lungs, Laura Michelle Arnold

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

Objectives: To examine the inter-laboratory agreement between multiplex realtime quantitative polymerase chain reaction (qPCR) assay results and aerobic culture results on bovine lung samples for detection of Histophilus somni (HS), and to assess associations of laboratory-derived factors on test agreement.

Methods: A survey of records from the University of Kentucky Veterinary Diagnostic Laboratory (UKVDL) was conducted to evaluate test results from grossly pneumonic bovine lung samples submitted during the period April 1, 2015 through August 31, 2018. Cohen’s kappa coefficient with 95% confidence interval (CI) was calculated to describe the extent of agreement. Animal, environmental and laboratory factors were examined …

Understanding Perceptions Of Child Maltreatment Risk: A Qualitative Study Of Early Head Start Home Visitors, Alayna Schreier, Kelsey Mccoy, Mary F. Flood, Brian Wilcox, David J. Hansen

Department of Psychology: Faculty Publications

Infants and toddlers enrolled in Early Head Start are at increased risk for child maltreatment. Within Early Head Start, home visitors are in a unique position to identify the families most likely to experience maltreatment by identifying characteristics and behaviors of children, caregivers, families, and environments that are of concern. However, research has demonstrated that home visitors are often ill-equipped to identify and address risk factors such as parental mental health concerns, substance abuse, and domestic violence. Further, little is known about how home visitors understand and perceive risk for maltreatment and identify vulnerable families. The study sought to identify …

The Good, The Bad, And The Ugly Of Calcium Supplementation: A Review Of Calcium Intake On Human Health., Kelvin Li, Xia-Fang Wang, Ding-You Li, Yuan-Cheng Chen, Lan-Juan Zhao, Xiao-Gang Liu, Yan-Fang Guo, Jie Shen, Xu Lin, Jeffrey Deng, Rou Zhou, Hong-Wen Deng

Manuscripts, Articles, Book Chapters and Other Papers

Calcium is an important integrative component of the human body and critical for human health. It has been well established that calcium intake is helpful in the prevention and treatment of osteoporosis, which has become one of the most serious public health problems across the world. However, community-dwelling adults with and without osteoporosis are rarely concerned or even not aware of the potential side effects of high or inappropriate doses of calcium intake. Some recent studies have revealed that excessive calcium intake might increase the risks of cardiovascular diseases. The purpose of this article was to review the health benefits, …

Serum Tumor Necrosis Factor-Alpha Associates With Myocardial Oxygen Demand And Exercise Tolerance In Postmenopausal Women, Stephen J. Carter, David R. Bryan, William H. Neumeier, Stephen P. Glasser, Gary R. Hunter

Internal Medicine Faculty Publications

The functional implications of serum tumor necrosis factor-alpha (TNF-α), a marker of oxidative stress, on hemodynamic parameters at rest and during physical exertion are unclear. The aims of this investigation were to examine the independent associations of TNF-α on myocardial oxygen demand at rest and during submaximal exercise, while also evaluating the association of TNF-α on exercise tolerance. Forty, postmenopausal women, provided blood samples and completed a modified-Balke protocol to measure maximal oxygen uptake (VO_2max). Large artery compliance was measured by pulse contour analyses while rate-pressure product (RPP), an index of myocardial oxygen demand, was measured at rest …

Experimentally Investigating The Joint Effects Of Physical Activity And Sedentary Behavior On Depression: A Randomized Controlled Trial, Jeremiah Blough

Electronic Theses and Dissertations

Objective: To experimentally examine whether increasing sedentary behavior, among a young adult active population, for one week is still associated with increased depression symptomology even when allowing for a moderate engagement in physical activity (PA). Methods: Participants were confirmed as active via self-report and accelerometry during baseline and randomly assigned to one of three experimental groups. The Sedentary Intervention Group (n=19) reduced steps to less than 5000/day and were not alloto exercise for one-week; the Reduced MVPA (moderate-to-vigorous PA) Group (n=18) reduced steps to less than 5000/day but exercised for 50% of their previously reported vigorous PA for one-week; and …

Evaluation Of Barriers For Small-Scale Fruit And Vegetable Growers In Kentucky, Amanda Schroeder Hege

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

The food system in the United States has witnessed significant challenges resulting in food security and safety concerns, environmental damage, economic distress, and a decline in our population’s health. While the last fifty years showed a drop in land and workforce dedicated to farming, industrialized farms are producing an overabundance of cheap corn that directly supplies inexpensive, unhealthy foods leading to American’s diets falling short of recommendations for good health, thus contributing to the obesity epidemic. This study utilizes an upstream approach to learn from farmers’ ability to grow good food that promotes healthy people, environments, and communities. Specifically, the …

The Relationship Between Access To Healthcare And Heart Disease Mortality In Kentucky, 2012-2014, Nima Farsi

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

Cardiovascular disease is the cause for a large portion of the mortalities in the United States. Furthermore, Kentucky has one of the highest heart disease mortality rates out of all 50 U.S. States. This study hypothesized that heart disease mortality in Kentucky counties has a positive relationship with lack of accessibility to healthcare. Furthermore, this ecological study hypothesized that because there is no available usual source of a healthcare providers and ultimately a lack of accessibility to receive diagnostic/preventative services for this population, the high rate of cardiovascular disease mortality in Kentucky is dependent on access to healthcare services.

This …

Implementing The National Diabetes Prevention Program In Mason County, Kentucky, Cassandra Yelton

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

The National Diabetes Prevention Program (DPP) is sponsored by the Centers for Disease Control and Prevention (CDC). The program’s goal is to reduce the incidence of diabetes through dietary modification and physical activity. On one hand, the DPP is currently offered by various organizations through the country. On the other hand, the DPP is mostly unavailable in rural areas, especially the Diabetes Belt. The Diabetes Belt is in the eastern Appalachian region of the United States. People who live in this area of the country are more likely to develop diabetes than those who do not. Mason County, Kentucky has …