Digital Commons Network^™

Five Rivers Family Health Center Community Health Needs Assessment, Kara Yutzy

Master of Public Health Program Student Publications

Objectives: To conduct a community health needs assessment (CHNA) on the three zip codes around Five Rivers Family Health Center (FRFHC) in order to guide healthcare professionals in creating goals and priorities for needed health services in their health center’s targeted community.

Methods: The investigator gathered zip code specific data from the American Community Survey, Public Health - Dayton & Montgomery County, the Dayton Police Department, and other online sources for the FRFHC CHNA zip codes. Data on the targeted zip codes was compared to data from Montgomery County, Ohio, and the United States.

Results: The greatest disparities between the …

Strengthening Community-Based Services For Children And Families Affected By Hiv: An Evaluation Of The Zambia Family Program, Project Soar

HIV and AIDS

As the US President’s Emergency Plan for AIDS Relief (PEPFAR) pivots its focus to care and treatment, there is strong interest in learning to what extent community-based programs contribute to achieving the public health goals of getting people—including children and adolescents—tested, enrolled in care if infected, and adherent to treatment. This brief describes Project SOAR’s evaluation of the Zambia Family (ZAMFAM) program, which will generate critical evidence to help fill knowledge gaps. The evidence will also guide country and global decisionmakers in strengthening community-based services to better meet the care, support, and treatment needs of vulnerable children and their families.

The Association Between Secondhand Smoke Exposure And Metabolic Syndrome In Children With Elevated Bmi, Alexandra Lawson

Master of Public Health Program Student Publications

Background & Purpose: The childhood obesity epidemic is associated with increased metabolic syndrome (MetS) and cardiovascular morbidity. The purpose of this study was to determine whether secondhand tobacco smoke exposure (SHSe) is associated with MetS in children with elevated body mass index (BMI).

Method: A retrospective chart review was conducted on children aged six to 11 years with elevated BMI seen in a pediatric lipid clinic from 2008-2014. Data included age, sex, race, BMI, and five MetS criteria. MetS was defined as BMI ≥85th percentile and ≥two of the following: systolic or diastolic blood pressure ≥90th percentile, HDL/dL, triglycerides >150 …

Attitudes And Factors Affecting Acceptability Of Self-Administered Cervicovaginal Sampling For Human Papillomavirus (Hpv) Genotyping As An Alternative To Pap Testing Among Multiethnic Malaysian Women., Mahirah Ma'som, Nirmala Bhoo-Pathy, Nazrila Hairizan Nasir, Jerome Bellinson, Shridevi Subramaniam, Yuntong Ma, Siew-Hwei Yap, Pik-Pin Goh, Patti Gravitt, Yin Ling Woo

Global Health Faculty Publications

OBJECTIVE: The objective of this study was to determine the attitudes and acceptability of self-administered cervicovaginal sampling compared with conventional physician-acquired Papanicolaou (Pap) smear among multiethnic Malaysian women.

METHOD: A cross-sectional study was carried out via interviewer-administered surveys from August 2013 through August 2015 at five government-run, urban health clinics in the state of Selangor. Subjects were participants from an ongoing community-based human papillomavirus (HPV) prevalence study who answered a standard questionnaire before and after self-sampling. The cervicovaginal self-sampling for HPV genotyping was performed using a simple brush ('Just for Me'; Preventive Oncology International, Hong Kong). Detailed data on sociodemographics, …

Assessment Of Effectiveness And Scalability Of Unicef-Sponsored Projects To Prevent Violence Against Children And Women In Papua, South Sulawesi, And Central Java., Marc C. Edberg, Hina Shaikh, Leah Keller

Center for Social Well-Being and Development

No abstract provided.

Promoting Healthy Eating And Physical Activity: A Qualitative Examination Of Community-Based Obesity Interventions In Rural Kentucky, Brooke F. Butterworth

Theses and Dissertations--Nutrition and Food Systems

Rural Americans are medically underserved groups and are at greater risk of becoming obese than urban Americans. The purpose of this qualitative study was to determine the perceived causes of obesity in six counties of rural Kentucky and to determine how to customize strategies to reduce obesity in these areas. University of Kentucky Cooperative Extension Service Agents formed coalitions in each of the six counties to assess their communities’ needs and assets to inform plans for implementing evidence-based obesity interventions. Between February and August of 2015, the coalitions were convened for a total of 11 meetings. Each of the coalition …

Youth-Led School Health Initiatives: Perceptions And Processes, Lila Murphy Gutuskey

Wayne State University Dissertations

Disparities in obesity prevalence, based on a child’s race and income, establish that health interventions should prioritize these target populations. Additionally, children who are from low-income families in urban neighborhoods and of ethnic minorities have unequal access to environmental determinants of healthy eating (HE) and physical activity (PA). Schools might be the best setting for health interventions, given the understanding that a school’s mission should be to educate the whole child and the substantial amount of time that a child spends in school. The purpose of this study was to examine student-led, school-health interventions in four elementary schools. The Fuel …

The State Of Children's Health: 2016 Community Health Needs Assessment For The Kansas City Region, Margo Quiriconi

Community Benefits

The State of Children’s Health: 2016 Community Health Needs Assessment for the Kansas City Region (2016 CHNA) is the second assessment since the Patient Protection and Affordable Care Act of 2010 (ACA) required hospitals to conduct a triennial community health needs assessments. In addition to fulfilling the ACA requirements and subsequent IRS Section H/Form 990 mandate, the 2016 CHNA process is undertaken:
• to examine the current health status of children and identify unmet health needs in the Children’s Mercy leading service area
• to identify the current health priorities—as well as new and emerging health concerns—among children and families …

Immigrants And Refugees As Vulnerable Populations: Considerations For School Based Health Centers, Gaïa D. C. Oliver

Master of Public Health Program Student Publications

School based health centers (SBHC) have been shown to benefit domestic populations both in terms of bettering health and bettering academics while being effective over the long term. There is, however, lacking evidence on how they impact immigrant and refugee communities, which are some of the most vulnerable United States communities in terms of health risks. Through discussion of literature, this paper defines and reviews the criteria for vulnerable populations and explains how this term applies to immigrant and refugee populations. School based health centers and their documented health and academic benefits for domestic high risk populations are discussed and …

From Their Home To Ours: Establishing Environmental And Health Literacy Via Urban Gardening For At-Risk Youth, Tiffany B. Hunter

Master of Public Health Program Student Publications

The Global Health concentration of the Master of Public Health highly encourages its students to participate in efforts which promote health and prevent disease either for a cultural group abroad or with a local disparate group (e.g. first-generation immigrants, established minority groups). The current research aimed to develop a similar model of community engagement and health promotion within an urban setting as witnessed in a developing country.

During an internship with Israel’s Ministry of Health, I witnessed a successful community garden and environmental education program designed for children whom reside in an Arab village. Much like the Israeli Arab community …

Significance Of Epicardial And Intrathoracic Adipose Tissue Volume Among Type 1 Diabetes Patients In The Dcct/Edic: A Pilot Study., Sirous Darabian, Jye-Yu C Backlund, Patricia A Cleary, Nasim Sheidaee, Ionut Bebu, John M. Lachin, Matthew J Budoff, Dcct/Edic Research Group

GW Biostatistics Center

Introduction

Type 1 diabetes (T1DM) patients are at increased risk of coronary artery disease (CAD). This pilot study sought to evaluate the relationship between epicardial adipose tissue (EAT) and intra-thoracic adipose tissue (IAT) volumes and cardio-metabolic risk factors in T1DM.

Method

EAT/IAT volumes in 100 patients, underwent non-contrast cardiac computed tomography in the Diabetes Control and Complications Trial /Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study were measured by a certified reader. Fat was defined as pixels’ density of -30 to -190 Hounsfield Unit. The associations were assessed using–Pearson partial correlation and linear regression models adjusted for gender and age …

Lymphoblastoid Cell Lines As A Tool To Study Inter-Individual Differences In The Response To Glucose., Michael A Grassi, Vidhya R Rao, Siquan Chen, Dingcai Cao, Xiaoyu Gao, Patricia A. Cleary, R Stephanie Huang, Andrew D Paterson, Rama Natarajan, Jalees Rehman, Timothy S Kern

GW Biostatistics Center

BACKGROUND: White blood cells have been shown in animal studies to play a central role in the pathogenesis of diabetic retinopathy. Lymphoblastoid cells are immortalized EBV-transformed primary B-cell leukocytes that have been extensively used as a model for conditions in which white blood cells play a primary role. The purpose of this study was to investigate whether lymphoblastoid cell lines, by retaining many of the key features of primary leukocytes, can be induced with glucose to demonstrate relevant biological responses to those found in diabetic retinopathy.

METHODS: Lymphoblastoid cell lines were obtained from twenty-three human subjects. Differences between high and …

An Analysis Of Water Collection Labor Among Women And Children In 24 Sub-Saharan African Countries., Jay Graham, Mitsuaki Hirai, Seung-Sup Kim

Environmental and Occupational Health Faculty Publications

BACKGROUND: It is estimated that more than two-thirds of the population in sub-Saharan Africa (SSA) must leave their home to collect water, putting them at risk for a variety of negative health outcomes. There is little research, however, quantifying who is most affected by long water collection times.

OBJECTIVES: This study aims to a) describe gender differences in water collection labor among both adults and children (< 15 years of age) in the households (HHs) that report spending more than 30 minutes collecting water, disaggregated by urban and rural residence; and b) estimate the absolute number of adults and children affected by water collection times greater than 30 minutes in 24 SSA countries.

METHODS: We analyzed data from the Demographic Health Survey (DHS) and the Multiple Indicator Cluster Survey (MICS) (2005-2012) to describe water collection labor in 24 SSA countries.

RESULTS: Among households spending more than …

Redrawing The Us Obesity Landscape: Bias-Corrected Estimates Of State-Specific Adult Obesity Prevalence., Zachary J Ward, Michael W. Long, Stephen C Resch, Steven L Gortmaker, Angie L Cradock, Catherine Giles, Amber Hsiao, Y Claire Wang

Prevention and Community Health Faculty Publications

BACKGROUND: State-level estimates from the Centers for Disease Control and Prevention (CDC) underestimate the obesity epidemic because they use self-reported height and weight. We describe a novel bias-correction method and produce corrected state-level estimates of obesity and severe obesity.

METHODS: Using non-parametric statistical matching, we adjusted self-reported data from the Behavioral Risk Factor Surveillance System (BRFSS) 2013 (n = 386,795) using measured data from the National Health and Nutrition Examination Survey (NHANES) (n = 16,924). We validated our national estimates against NHANES and estimated bias-corrected state-specific prevalence of obesity (BMI≥30) and severe obesity (BMI≥35). We compared these results with previous …

A New Look At Care In Pregnancy: Simple, Effective Interventions For Neglected Populations, Stephen Hodgins, James M. Tielsch, Kristen Rankin, Amber Robinson, Annie Kearns, Jacquelyn Caglia

Global Health Faculty Publications

Background

Although this is beginning to change, the content of antenatal care has been relatively neglected in safe-motherhood program efforts. This appears in part to be due to an unwarranted belief that interventions over this period have far less impact than those provided around the time of birth. In this par, we review available evidence for 21 interventions potentially deliverable during pregnancy at high coverage to neglected populations in low income countries, with regard to effectiveness in reducing risk of: maternal mortality, newborn mortality, stillbirth, prematurity and intrauterine growth restriction. Selection was restricted to interventions that can be provided by …

Knowledge, Confidence, Intention, And Motivation: Hegemonic Masculinity's Influence Upon Nutritional Habits Of Males, Sara Chizmar

Honors Undergraduate Theses

With the increasing incidence of chronic diseases such as Type 2 Diabetes Mellitus and cardiovascular disease and the growing obesity epidemic, the need to increase nutritional literacy amongst the general public is paramount. Men tend to lack a strong base of nutritional knowledge. Masculinity is one of the factors preventing many men from making good nutritional choices.

The aim of this study was to investigate hegemonic masculinity in relation to current level of nutritional knowledge as well as perceptions and attitudes regarding dietary behaviors and intention to eat a healthy diet among a sample of males. A convenience sample of …

The Association Between Latent Tuberculosis Infection And Diabetes Mellitus Control In The United States, Whitney L. Remy

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

Rationale: Diabetes mellitus (DM) is recognized as a common comorbid condition for tuberculosis (TB). Those with comorbid conditions are more likely to develop active TB, to have trouble with treatment, and to have more severe symptoms.

Objective: To measure the prevalence and distribution of latent tuberculosis infection (LTBI) and DM control in the United State and test their association when measured by tuberculin skin test (TST) or QuantiFERON®-TB Gold In-Tube blood test (QFT-GIT) and by HbA1c, respectively. Literature Review: One-third of the world population is infected with TB. Ten percent of TB cases worldwide are linked to diabetes mellitus. Studies …

An Analysis Of Western Medicine Mistrust Among Selected African Immigrant Women In Minnesota, Wanjiru Julie Gicheru

All Graduate Theses, Dissertations, and Other Capstone Projects

Mistrust in Western medicine contributes to many individuals noncompliance, avoidance of treatment, or seeking other outlets or alternative treatments. As a result, health outcomes are poorer for those individuals who proactively avoid treatment from health care professionals. Factors that contribute to racial and ethnic health disparities have been accounted for in research and literature; however, immigrant health disparities have not been well studied. The primary purpose of this study was to analyze factors that contributed to Western medicine mistrust among selected African immigrant women in Minnesota. Participants were recruited from community centers, churches, and by snowball sampling within the Minneapolis-Saint …

Container Culture: An Educational Program To Reduce The Overuse, Ashleigh R. Toy

Occupational Therapy Doctorate Capstone Projects

The increased pace of society, improved safety, mobility and the need for parent efficiency have created a vast market of infant products to meet these demands: car seats that clip in and out of everything from the car to the grocery cart, jumpers, walkers, exersaucers, swings, bouncers and bumbos. These infant equipment products are helpful and can be beneficial if used effectively, however, the problem synthesized from the literature and clinical observation is that these containers designed to support safety and mobility are being overused causing a decrease in tummy time and human interaction which is leading to delays in …

Risk Factors For Tuberculosis And Multidrug-Resistant Tuberculosis Complications Among Foreign-Born Persons In Houston, Texas, James N. Isaboke

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a leading public health problem across the world. For various reasons, TB and multidrug-resistant tuberculosis (MDR-TB) have increased. Clarification on TB/HIV co-infection and homelessness as risk factors for TB and MDR-TB is required to inform policy interventions to reduce TB-related morbidity, mortality, and healthcare costs. In this quantitative study, data from the Houston Health Department (N = 341) were analyzed to explore the relationship between TB and MDR-TB outcomes and TB/HIV co-infection and type of housing/homelessness. Foreign-born persons are disproportionately affected in the United States. The socio-ecological model provided a theoretical framework for the investigation. Multiple and …

Perceptions Of Cameroonian Women Regarding Cervical Cancer Prevention, Anna Nkapsah Nji

Walden Dissertations and Doctoral Studies

Women in Cameroon as well as those residing in the Maryland-Washington Metropolitan area and the Diasporas suffer a disproportionate rate of cervical cancer morbidity and mortality due to the vast disproportion in the distribution of healthcare services. The widespread human papillomavirus (HPV) vaccination holds promise for helping to attenuate the disproportion in cervical cancer screening and prevention services. Literature from other countries including Cameroon suggests that barriers to the uptake of cervical cancer screening include: culture, religion, the psychological impact of embarrassment, the influence of husbands, cost, discomfort, and vulnerability. The purpose of this study was to gain an understanding …

Hiv Risk Perceptions Of Hiv-Infected Adults Ages 30 To 49 Years In Atlanta, Georgia, Esther Nduta Mune-Ashford

Walden Dissertations and Doctoral Studies

More than 49,081 people were diagnosed with HIV in the United States in 2011. Of those 49,081 HIV-infected persons, 1 in 6 was not aware of being HIV positive. In 2011, Georgia had the 5th highest number of HIV diagnoses among the 50 U.S. states. This phenomenological study aimed to understand the lived experiences of HIV-infected adults, ages 30 to 49 years in Atlanta, Georgia, by understanding their perceptions of risk prior to contracting HIV. The health belief model was used to guide this study because it explains and predicts health-related behaviors and it has been used in previous studies …

Public Health Leaders' Perceptions Of And Attitudes Concerning Eating Disorders, Karin L. Lightfoot

Walden Dissertations and Doctoral Studies

Eating disorders are associated with high mortality rates. Most eating disorder prevention research is conducted within the fields of psychology and psychiatry, not in public health. This gap in public health research can lead to insufficient attention to the root causes of eating disorders and minimal upstream prevention efforts. The purpose of this phenomenological study was to identify public health leaders' perceptions of and attitudes concerning eating disorders as a public health issue. Objectification theory was used to describe how societal expectations have created an environment in which people's self-worth is based on their outward physical appearance. Ecological theory was …

Relationship Between Family Income And Obesity Among African American Adults, Charles Dadzie Boison

Walden Dissertations and Doctoral Studies

Obesity is a chronic disease that is caused by a number of factors such as diet, genetics, physical inactivity, and poor dietary habits. This research focused on how income affects obesity among a target population in the African American community in Durham, North Carolina (NC). It has been noted that chronic diseases that are diet-related, for example, obesity, diabetes, hypertension, and high cholesterol, affect African Americans disproportionately, especially those who earn low income. Some studies have also reported that those who make higher income have higher rates of obesity. This inconsistency and gap in the literature prompted research on this …

Comparison Of Thyroid Disease Mortality Between Urban And Rural Populations In Southwest Georgia, Donyale Bouie Childs

Walden Dissertations and Doctoral Studies

Twenty million people in the United States have some form of thyroid disease. In 2014, there were 62,980 new cases of thyroid cancer and 1,890 deaths. Water source is a known risk factor for thyroid disease. Pollutants that are known to alter thyroid function can find their way into water sources. The effect of various water sources on thyroid- related mortality has not been determined in the state of Georgia. The purpose of this correlational study was to investigate whether invasive thyroid disease mortality differs between urban participants who drank municipal water and rural participants who drank untreated water in …

Influence Of Patient Engagement Protocol On Health Outcomes And Medication Adherence Of Patients With Metabolic Syndrome, Angela H. Mcconnell

Walden Dissertations and Doctoral Studies

August 2016

Management of metabolic syndrome (MetS) may be enhanced by promoting patient engagement. Training health care providers in the conceptual and practical application of integrative patient centered care tools may promote patient lifestyle behaviors for better management of MetS. The purpose of this quantitative quasi-experimental study was to assess the impact of training providers in integrative patient centered care for patients with MetS. The biopsychosocial construct provided the conceptual framework for the study. Two groups of physicians were included; one received training in an integrative model (IM) while the second received no training and provided usual care (UC). Following …

The Effect Of Dietary Fruits & Vegetable Consumption And Physical Activity On Obesity In African American Adolescent Females., Tanisha Brooks

Walden Dissertations and Doctoral Studies

Obesity is epidemic among Black adolescent females, and adolescent obesity often leads to adult obesity. Previous research suggests that there may be an interaction between physical activity and dietary fruit and vegetable intake on body mass index (BMI) in obese adolescent females in general, but it was unclear whether the same pattern is evident in Black adolescent females, who, on average, tend to have low levels of physical activity and fruit and vegetable intake. Bandura's social learning theory implies the possibility that adolescent females might model their behaviors on the behavior of others in their high school years, including physical …

Type 2 Diabetes In Offspring Of Diabetic African American Women, Toby Valentino Yak

Walden Dissertations and Doctoral Studies

The prevalence of Type 2 diabetes is greater among African American women and their offspring than it is among Caucasian women and their offspring. In Iowa, there has been a gap in public health knowledge regarding risk factors associated with Type 2 diabetes in African American women and their offspring. The behavioral change wheel model was used to guide this study. This research study was a quantitative, retrospective cohort using primary data to investigate the association between a sample of diabetic African American and the occurrence of diabetes in their offspring. The sample included 105 diabetic African American women between …

Food Labeling And Consumer Associations With Health, Safety, And Environment, Joanna K. Sax, Neal Doran

Faculty Scholarship

The food supply is complicated and consumers are increasingly calling for labeling on food to be more informative. In particular, consumers are asking for the labeling of genetically modified organisms (GMO) food based on health, safety and environmental concerns. At issue is whether the labels that are sought would accurately provide the information desired. The present study examined consumer (n = 181) perceptions of health, safety and the environment for foods labeled organic, natural, fat free or low fat, GMO, or non-GMO. Findings indicated that respondents consistently believed that foods labeled GMO are less healthy, safe and environmentally-friendly compared to …

Strengthening Factory Health Systems Under Levi Strauss & Co.'S Worker Well-Being Initiative In Egypt, Population Council, The Evidence Project

Reproductive Health

The pilot intervention described in this brief took place at an apparel manufacturing company, Lotus, located in Port Said, Egypt as part of the Worker Well-being Initiative. Worker Well-being is an initiative of Levi Strauss & Co. and the Levi Strauss Foundation that seeks to move beyond a “do no harm” compliance model of labor rights in its global supply chain. The interventions in Egypt have contributed to the overall development of a health system–strengthening approach to private workplaces, which is a new concept for management. The work in Egypt contributed to a collaboration between the Evidence Project/RAISE Health and …