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Enhancing Parent-Child Communication And Promoting Physical Activity And Healthy Eating Through Mobile Technology: A Randomized Trial, Danielle E. Schoffman

Theses and Dissertations

Background

Although rates of pediatric and adult obesity remain high in the U.S., finding scalable and engaging ways to disseminate obesity prevention and treatment for families has been challenging. The purpose of the Motivating Families with Interactive Technology (mFIT) study was to test the feasibility, acceptability, and effectiveness of two remotely-delivered family-based health promotion programs for improvements physical activity (PA), healthy eating, and parent-child communication and relationship quality.

Methods

Parent-child (child age 9-12 years) dyads enrolled in a 12-week mobile intervention to increase physical activity and healthy eating, which included weekly email newsletters and the use of pedometers. Dyads were …

Depression Among Pregnant Latinas In South Carolina, Andrew Fogner

Theses and Dissertations

The aim of the study was to determine the prevalence of depression among pregnant Latinas. To bring to light the importance of prenatal depression prevention, we assessed the effect of the quality of healthcare providers among South Carolina Latinas (n=171). Women answered a validated CES-D and were categorized as depressed (score >16). In multivariate analyses, good perception of quality of healthcare was more likely among women who were not depressed; adjusted odds ratio of 0.75, 95% confidence interval 0.37 – 1.55. The findings show the need for tailoring healthcare to Latinas with prenatal depression prevention. It is imperative to understand …

Quality Over Quantity: Positive Interactions During Family Meals In Food-Insecure Households Compensate For The Negative Impacts Of Household Chaos On Child Emotional Well-Being, But Not Diet Quality, Tiara Nicόl Rosemond

Theses and Dissertations

Family meals are important family activities that have many positive nutritional and emotional benefits for children. Positive family meal experiences may provide opportunities for children to strengthen emotional bonds, leading to a sense of security and, fostering improved children’s self-regulation of healthier food intake and emotional well-being. Unfortunately, children in food insecure households experience higher amounts of chaos, lower diet quality, and worry about having enough to eat compared to children in food-secure households, all of which may affect both family meal frequency and interpersonal quality. Yet, the relationships between food insecurity, household chaos, and family meal frequency and interpersonal …

The Influence Of Prenatal And Early Life Factors On Bmi Z Scores And The Risk Of Being Obese In Early Childhood, Junxiu Liu

Theses and Dissertations

Childhood obesity is a serious public health challenge. The underlying causes behind the rising levels of childhood obesity might be driven by prenatal and early life factors. Recently, several studies have examined the association between gestational weight gain (GWG) and the risk of obesity in the pediatric population. Findings on the association of both inadequate and excessive GWG with offspring obesity are inconsistent and vary by maternal prepregnancy body mass index (BMI) status. Inconsistent findings also exist for the association of GWG and BMIZ as a continuous outcome. Nevertheless, existing studies mainly focus on the BMIZ upper centiles using logistic …

Effect Of Anthelminthic Treatment On Helminth Infection And Related Anaemia Among School-Age Children In Northwestern Ethiopia, Yonas Yimam, Abraham Degarege, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Information about improvements in the health status of population at-risk of helminth infection after anthelminthic treatment helps to evaluate the effectiveness of the large scale deworming program. The objectives of this study were to assess the impact of anthelminthic treatment on the prevalence and intensity of intestinal helminth infection, haemoglobin level and prevalence of anaemia among school-age children.

METHODS: A total of 403 children attending Tikur Wuha Elementary School in Jiga, northwestern Ethiopia were enrolled in this study between February and March 2011. Formol-ether concentration and Kato-Katz methods were used to examine stool for intestinal helminth infections at baseline …

Epidemiology Of Plasmodium And Helminth Coinfection And Possible Reasons For Heterogeneity, Abraham Degarege, Berhanu Erko

Journal Articles: Epidemiology

Understanding the impact of helminth infections on clinical malaria is useful for designing effective malaria control strategies. Plenty of epidemiological studies have been conducted to unravel the nature of interactions between Plasmodium and helminth infection. Careful broad summarization of the existing literature suggests that Schistosoma mansoni and hookworm infections may increase the risk of clinical malaria and associated morbidities, but Trichuris trichiura infection is not associated with the occurrence of clinical malaria and related outcomes. However, findings about effect of Ascaris lumbricoides and Schistosoma haematobium infection on clinical malaria are contradictory. Furthermore, the nature of relationship of helminth infection with …

Breastfeeding Practices Among Native Hawaiians And Pacific Islanders, Ingrid K. Adams, Chizimuzo T.C. Okoli, Akilah Dulin Keita, Ana Maria Linares, Keiko Tanaka, Joshua R. Polanin, Annie Koempel

Dietetics and Human Nutrition Faculty Publications

Background. Breastfeeding is associated with a decreased risk of obesity in the early and adult years. Native Hawaiians and Pacific Islanders (NHPI) experience high rates of obesity which is often obfuscated with aggregated data. Using disaggregated data, we examined breastfeeding practices among NHPI. Methods. Seven databases and reference lists were searched. Two independent researchers extracted relevant studies based on predetermined criteria. Nine studies met our inclusion criteria and a meta-analysis was conducted using random-effects, inverse-various weighted models. Results. Few studies disaggregated NHPI populations when examining breastfeeding practices. Most studies were cross-sectional and our search yielded no randomized or quasirandomized control …

The Disease Burden And The Extent Of Drug Therapy Problems In An Underserved Minority Population Receiving Medication Therapy Management At An Ambulatory Care Free Clinic, D. N. Ombengi, F. A. Ndemo, Ayman M. Noreddin, W. T. Harris

Pharmacy Faculty Articles and Research

Objective: To determine the common medical conditions, medications, and associated drug therapy problems in an underserved minority population receiving medication therapy management services at a large Community Free Clinic compared to the findings of the Minnesota Pharmaceutical Care Project.

Methods: Retrospective cohort study of a random sample of 60 minority patients referred for medication therapy management service at a Community Free Clinic from January 2012 to January 2014. Patient data including demographics, medication experience, past medical and medication history, medical conditions, active medications, allergies, immunization history and drug therapy was systematically evaluated to determine the most common conditions, …

The Evolution Of The Intersection Of Hiv And Breastfeeding In Global Policy, Kristin M. Sinning

Master of Public Health Program Student Publications

Increasing breastfeeding rates and reducing HIV/AIDS are two important global health priorities, and their intersection has led to policies that meet mutual goals of supporting, protecting and promoting breastfeeding and reducing the risk of HIV/AIDS. The World Health Organization has developed and released recommendations, policies, and guidance on infant feeding and the risk of transmission through breastfeeding. This analysis provides a historical, chronological perspective on the global policies for infant feeding in the case of an HIV-positive mother, an analysis of changes, and recommendations for the future. The policies evaluated demonstrate the evolution in knowledge and recommendations for infant feeding …

Strengths And Challenges Of A Rural Ohio Public Health Department: Considerations For Effective Service Delivery And Emergency Preparedness, Cindy L. Harris Graessle

Master of Public Health Program Student Publications

The local public health department is the main entity in cities and counties established to ensure the safety, health, and well-being of its community members. In many cases, particularly in rural areas, the health department may be the community’s closest access to health care, providing not only clinical care, but preventive services as well. These rural health departments have additional challenges that may not be experienced in the larger, more populated metropolitan areas. These challenges include lack of resources and funding that impact daily operations, expanded registered sanitarian responsibilities, and emergency preparedness difficulties with resource allocation and communication. Despite these …

Association Of Secondhand Tobacco Smoke And Abdominal Adiposity In The United States Population, Omar T. Tahtamooni

Master of Public Health Program Student Publications

Background: Secondhand smoke (SHS) exposure occurs when people inhale smoke from tobacco products or inhale smoke that has been expelled by other smokers. Exposure to SHS increases the risk of many metabolic and chronic diseases, such as cardiovascular disease.

Purpose: To evaluate the association between SHS and abdominal adiposity in US adults. Methods: Data from 2011-2012 National Health and Nutrition Examination Survey (NHANES) was used to examine the relationship between SHS exposure and abdominal adiposity, Sagittal Abdominal Diameter [SAD]), after adjusting for covariates (age, gender, ethnicity, and income) (n=4,012). Univariate linear regression analyses were used to predict association of smoking …

Injuries Among Security And Law Enforcement Personnel In The Private Versus Public Sectors, William S. Witt

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

Background and Objectives: Data collected through workers’ compensation may be useful for occupational injury surveillance. This study examined whether differences existed between the public and private sectors of the security and law enforcement industry in Kentucky.

Methods: Using a cross-­‐sectional design, workers’ compensation data from the Kentucky Department of Workers’ Claims was analyzed to evaluate differences in demographic and injury characteristics, as well as award outcomes, stratified by industry sector. The dataset included all workers’ compensation first reports of injury and claims filed by security and law enforcement personnel in Kentucky from 2005 to 2015. Statistical analyzes included chi-­‐square and …

Eat Well, Keep Moving: Decreasing Childhood Obesity In Fulton County, Kentucky, Sandra Onekhena

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

With the high rates of childhood obesity in Fulton County, the Purchase District Health Department proposes the implementation of the Eat Well and Keep Moving Program in all the county’s elementary schools among fourth and fifth graders. It is an interdisciplinary, evidence-based program that will be aimed at our short-term goal of increasing knowledge about nutrition and physical activity and inspiring positive behavioral change. It works by integrating lessons and activities about proper nutrition and activity into various aspects of the children’s lives — in the classroom, cafeteria, at home and in the community. We hope to see children move …

Effect Of Metformin On Body Mass Index In Adolescent Females With Polycystic Ovary Syndrome, Alissa Briggs, Mandakini Sadhir, Maya Todd, Hatim A. Omar

Pediatrics Faculty Publications

Polycystic ovary syndrome (PCOS) is often associated with obesity, insulin resistance, irregular menstrual periods and pelvic pain. Treatment involves hormonal methods for regulation of menstrual cycle, lifestyle changes and metformin for improving insulin resistance and weight. The aim of our study was to compare changes in body mass index (BMI) of adolescent female with PCOS treated with metformin as compared to lifestyle modification only. Participants: Adolescent and young adult females aged I0-25 years diagnosed with PCOS seen for at least two visits for at least one year on the same treatment. Based on treatment plan, participants were categorized as metformin …

Bone Mineral Density, Preventative Behaviors And Risk Factors In African American And Caucasian Mother-Daughter Pairs, Mary Haskins Haskins

Electronic Theses and Dissertations

It is expected that by 2030, elderly minorities will comprise 20.2 million of the total 72.8 million population of Americans over 65 years (pollard, 2013). For African American women over the age of 50, 5% have osteoporosis and an estimated 35% have low bone mass (nof, n.d.). It is estimated that while over 40% of African American women over 80 years meet criteria for treatment, yet less than 12% are actually treated (Cauley, 2011). Striking disparities exist between African American and Caucasian women's likelihood for dual-energy x-ray absorptiometry (dxa) referral, the measurement tool that is used to diagnosis osteoporosis. (Hamrick, …

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

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

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

Birth Cohort Effects In Risk Factors For Alzheimer’S Disease, Kingsley Uzodinma

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

Background and Objectives: The purpose of this study was to assess the presence of birth cohort effects by exploring differences in established risk factors of Alzheimer’s disease (AD) and dementia using case-control designs and also estimate the AD risk among women with respect to their number of biological children.

Methods: This is a case control study design of participants born in 1896 – 1955 and were enrolled in one of the designated Alzheimer’s disease centers (ADCs). The uniform Data Set of the National Alzheimer’s Coordinating center (NACC) include those who had Alzheimer’s disease or mild cognitive impairment (cases) and were …

The Utilization Of Models Of Care Transition To Reduce Medicare Beneficiaries’ Hospital Readmission Rates In Kentucky: A Case Study, Audra Putt

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

Problem: Unsuccessful care transitions for Medicare beneficiaries have resulted in high health expenditures and a diminished quality of care as the 30-day hospital readmission rate has increased. This has prompted the Centers for Medicare and Medicaid Services to require hospitals with high readmission rates to pay penalties. As a result, the Community-based Care Transitions Program was established under Section 3026 of the Affordable Care Act to provide health organizations funding to utilize models of care transition to improve the care transition process. The purpose of this capstone project was to identify whether two community-based organization programs, the Kentucky Appalachian Transition …

Drink Switch Program In South La Schools, Lauren Barker

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

Sugary drinks, including sports and energy drinks, are the number one source of added sugar in the American diet.1 Excess sugar consumption can lead to health complications such as overweight and obesity, and obesity-related chronic diseases such as diabetes, high blood pressure, and cardiovascular disease.2 Sugary drink consumption among youth in Los Angeles is particularly high, and teenagers in Service Planning Area (SPA) 6 of Los Angeles have some of the highest consumption rates in the county, with one out of two reporting consuming at least one sugary drink per day.3 Based on the correlation between sugar consumption and health, …

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

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

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

Identifying Predictors Of Functional Limitations Associated With Depression, Anxiety, And Emotional Problems In Us Adults, Jillian Richardson

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

Depressive disorders are characterized as sharing affected mood, and somatic (e.g. sleep pattern, appetite, and unintentional changes in weight) and cognitive alterations from previous normal daily functioning that are clinically significant. Anxiety disorders are characterized by excessive fear, general or specific anxiety, and related behavioral disturbances that are also clinically significant. This project attempts to identify risk factors that may predict what groups are most likely to be affected by depression and/or anxiety.

Sponsored by the CDC, the National Health Interview Survey collects general health information for non-institutionalized individuals living in the US. Variables for use in logistic regression model …

"Life Skills Training" Prescription Drug Abuse Prevention Among Youth In Bell County, Kentucky, Arveen Kaur

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

Prescription Drug Abuse (PDA) has become a serious public health concern and a major epidemic in the United States (U.S.). According to the 2014 National Survey on Drug Use and Health (NSUDH), approximately 15 million people (aged 12 or older) used prescription drugs in the past year and 6.5 million in past month. Out of these, 2 million Americans (aged 12 or older) either abused prescription drugs or were dependant on them. Almost 5% of adolescents (1.1 million) between the age group 12-17 abused prescription painkillers in 2014. Nationally, Kentucky is among the top five states with highest age-adjusted overdose …

Are There Rural-Urban Differences In Dentist Supply?, Mutlaq Alotaibi

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

The purpose of this project was to examine the supply of dentists in the Commonwealth of Kentucky at the county level. Counties with shortages in dentist supply were determined and associated factors were examined.

Several county-level variables were analyzed. These included total number of dentists, total county population, dentist to population ratio, dentist supply shortage, median household income, median age, percent of Medicaid enrollees, rurality, oral cancer crude incidence and mortality rates per 100,000 and percent of adults missing six or more teeth.

This project showed that 42 of the 120 counties in Kentucky had shortages in dentist supply. Also, …

Undiagnosed Hepatitis C Infection In An Urban Emergency Department, Naseem Ansari

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

Aim: To evaluate the prevalence of previously undiagnosed hepatitis C virus and associated patient risk factors in an urban ED through a universal, integrated screening program, to contextualize results found in terms of gaps in existing HCV screening models and to inform future sustainable and effective screening models.

Methods: ED patients, ages 18-71, that were medically stable, hadn’t had a prior HCV test, and were having blood drawn as part of routine clinical care, were offered (n=2,726) an anti-HCV test, of whom 1,945 accepted. An assessment of correlates to anti-HCV positivity was completed using a binomial logistic regression …

Competitive Food Policy Implementation In Kentucky Schools, Paula Gisler

Theses and Dissertations--Nursing

This study was designed to explore the literature on competitive food policy implementation (CFPI); examines demographic and school factors associated with CFPI; and explores the experiences of school leaders and staff in CFPI using a proposed theoretical framework to guide the research. Competitive foods are those sold in vending machines, a la carte settings, fundraisers, class parties and other venues which compete with foods offered through the national school lunch and breakfast programs. Competitive foods have traditionally been of low nutritional value and high energy density. CFPI may be effective in reducing student calorie intake and BMI. However, evaluation of …

Promoting Healthy Home-Cooked Family Meals: Evaluation Of A Social Marketing Program Targeting Low-Income Mothers, Mollie Y. Dawahare

Theses and Dissertations--Nutrition and Food Systems

Objective: Evaluate how a social marketing approach compares to traditional nutrition education curriculum for promoting behavioral changes related to eating and food.

Design: Nonequivalent comparison group, entry-exit design. Participants from 12 Kentucky counties assigned either comparison or pilot group. Comparison group received traditional nutrition education curriculum and pilot group received the social marketing program, Cook Together, Eat Together (CTET) curriculum. EFNEP’s Behavior Checklist and 24-Hour Dietary Recall were administered at entry and exit of the 8-week programs.

Participants: Females (18-72 years of age) from families eligible to receive SNAP benefits (n=64 comparison group participants, n=60 pilot group participants).

Intervention: …

Evaluation Of A Diabetes Self-Management Program For Hispanics In Lexington Kentucky: A Pilot Study, Miguel A. Gamboa Oropeza

Theses and Dissertations--Nutrition and Food Systems

Hispanics are more affected by diabetes than non-Hispanic whites and they tend to experience more severe complications. Research shows that although self-management is poor among ethnic minorities, it is even more so among Hispanics. The “Taking Ownership of Your Diabetes” (TOYD) program has been shown to be successful in helping individuals manage their diabetes. However, no work has been conducted with Hispanic audiences in Kentucky. TOYD program allows individuals to modify lifestyle risks and solve problems related to diabetes management. The program was translated from English to Spanish. Hispanics males and females between ages 19 to 75 years …

Fruit And Vegetable Availability, Nutrition Education And Access Amongst Food Pantries In California, Maine, Mississippi And South Dakota, Sarah L. Fowler

All Graduate Theses, Dissertations, and Other Capstone Projects

This descriptive study explored the views of food pantry directors in four states regarding pantry fruit and vegetable stock and supply, nutrition education offered, and current practices and perceived barriers to providing access to food pantries to low-income individuals and families in need. This study examined these variables by surveying staff at the food pantries who have direct contact with the individuals and families who utilize the pantries. All survey responses were collected utilizing Qualtrics software and then analyzed in SPSS. There were 87 respondents from four different states, California, Maine, Mississippi, and South Dakota.

The reporting for both fresh …

“Exchange Northern Ky”: An Evidence-Based Needle & Syringe Exchange Program Serving The Northern Kentucky Area Development District, Amanda Hunter

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

Intravenous drug users (IDUs) account for nearly 16% of new HIV infections in the United States and almost one half (48%) of newly reported acute hepatitis C virus (HCV) infections have been found to be IDU related.1 Within the Northern Kentucky Area Development District, hepatitis C infections have soared with an incidence of more than 1,000 newly reported cases during 2015 alone.⁴ Rigorous scientific evidence complied by the U.S. Department of Health & Human Services has indicated that one of the most unique and effective strategies for the curtailing HIV incidence among IDUs is by ensuring users’ access to …

The Physical Activity And Redesigned Community Spaces (Parcs) Study: Protocol Of A Natural Experiment To Investigate The Impact Of Citywide Park Redesign And Renovation, Terry T. K. Huang, Katarzyna E. Wyka, Emily Ferris, Jennifer Gardner, Kelly R. Evenson, Devanshi Tripathi, Gabriel Martinez Soto, Matthew S. Cato, Jon Moon, Julia Wagner, Joan M. Dorn, Diane J. Catellier, Lorna E. Thorpe

Publications and Research

Background: The built environment plays a critical role in promoting physical activity and health. The association between parks, as a key attribute of the built environment, and physical activity, however, remains inconclusive. This project leverages a natural experiment opportunity to assess the impact of the Community Parks Initiative (CPI), a citywide park redesign and renovation effort in New York City, on physical activity, park usage, psychosocial and mental health, and community wellbeing.

Methods: The project will use a longitudinal design with matched controls. Thirty intervention park neighborhoods are socio-demographically matched to 20 control park neighborhoods. The study will investigate whether …