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The Accuracy And Feasibility Of Production Records To Measure Food Selection In School Cafeterias, Erin R. Krafka, Ellen M. Claiborne

Master of Public Health Program Student Publications

Background: New meal pattern requirements have recently been introduced and emphasize the serving of vegetable subgroups. These regulations ensure students are offered certain food items, and the selection and consumption of these items are essential to track their progress and effectiveness. This study investigates whether production records are a feasible tool in tracking selection across time by comparing production records with direct observation of food selection in the lunchroom.

Methods: Food selection was measured through direct observation and production records for two consecutive weeks. The frequencies of daily items served were entered into Excel and each food item was coded …

Relactation In Emergencies, Ashley N. Franz

Master of Public Health Program Student Publications

Disaster situations in the United States are unique entities that require solutions which are well thought out, appropriate for the population and planned well in advance. Infant and young child feeding in emergencies is no exception. While in peacetime infants may be safely nourished with both breastmilk and infant formula, disaster situations often add a level of complexity to feeding with infant formula, including lack of access to potable water and ability to effectively sterilize feeding items. Such complexities, along with the important and undeniable fact that breastmilk is the ideal form of food for all babies (and especially in …

A Pilot Study Of Arsenic In Young Children From Two Rural West Texas Communities: Blood Levels, Household Water Levels, And Behavioral Outcomes, Michelle Del Rio

Open Access Theses & Dissertations

Background & Significance: Heavy metals have been identified as a child health hazard because children are highly vulnerable to the effects of exposure, which can be physical, cognitive, and behavioral. Levels of arsenic (As) greater than the EPA Maximum Contaminant Level (10μg/L) were identified in some household water samples in two rural west Texas communities located within 20 miles of the U.S.-Mexico border by a Health Impact Assessment conducted in 2013 (Hargrove, Juarez-Carillo, & Korc 2015). Whether home water samples predicted child blood As levels needed to be examined. Since lead (Pb) is another common heavy metal contaminant in the …

Development Of A Nutrition Education Tool To Reduce The Risk Of Childhood Obesity In A Northwest Arkansas Hispanic Population, Katherine Ross, Mallori Sando, Cynthia Moore

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

The goal of this qualitative research project is to create a bilingual education tool to equip the participants of the English as a Second Language (EASL) class at the Elmdale Elementary School, in Springdale, Ark., to reduce the risk of childhood obesity in their children. Adults of Hispanic descent are at a high risk for developing obesity and so are their children. Children who are overweight and/or obese have a high risk of developing heart disease, diabetes, high blood pressure, and other health complications. As a side effect of the language barrier some Hispanics experience, it may be difficult for …

The Prevalence Of Adverse Cardiometabolic Responses To Exercise Training With Evidence-Based Practice Is Low, Lance C. Dalleck, Gary Van Guilder, Tara B. Richardson, Chantel A. Vella

Health and Nutritional Sciences Faculty Publications

Background: The purpose of this study was to determine the prevalence of individuals who experienced exercise-induced adverse cardiometabolic response (ACR), following an evidence-based, individualized, community exercise program.
Methods: Prevalence of ACR was retrospectively analyzed in 332 adults (190 women, 142 men) before and after a 14-week supervised community exercise program. ACR included an exercise training-induced increase in systolic blood pressure of $10 mmHg, increase in plasma triglycerides (TG) of .37.0 mg/dL ($0.42 mmol/L), or decrease in high-density lipoprotein cholesterol (HDL-C) of .4.0 mg/dL (0.12 mmol/L). A second category of ACR was also defined – this was ACR that resulted …

Impact Of Kentucky Vaccination Exemption Laws On Pertussis Incidence, Katherine Blain

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

Purpose: According to CDC statistics, prior to pertussis vaccine development in the 1940’s, about 200,000 children contracted pertussis annually. Today, although this number has decreased drastically, pertussis cases began trending upward again in the 1980’s. There are several proposed contributory factors, including vaccination exemption. In Kentucky, there are both medical and religious exemptions to mandatory school vaccines. The purpose of this study was to examine possible correlations between reported school vaccination exemptions and pertussis incidence in Kentucky counties between the years 2004-2012.

Methods: This study retrospectively analyzed data from 120 Kentucky counties between 2004-2012. The Commonwealth of Kentucky School Annual …

The Comorbidity And Temporal Relationship Between Anxiety Disorders, Eating Disorders, And Personality Disorders, Mitchell C. Duross

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

Background - Population-level data on the prevalence of comorbidity between anxiety-, eating-, and personality disorders remain relatively unexplored. Additionally, the potential existence of a temporal relationship among these three classes of mental disorder is also of interest.

Methods - Lifetime prevalence of, and temporal relationships among, anxiety-, eating-, and personality disorders were assessed using Part II WHO Composite International Diagnostic Interview data from the National Comorbidity Survey- Replication, a nationally representative household survey (n=5692).

Results - Lifetime prevalence estimates for any anxiety-, eating-, and personality disorder were 59.8%, 2.8%, and 13.5%, respectively, among those diagnosed with at least one core …

Fatal Injuries Among Young Workers In Kentucky, 2005-2014, Allison Christian

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

Background: Young workers have been more vulnerable to fatal and nonfatal work injuries. To gain a comprehensive understanding of the injuries that led to fatalities in younger workers, the goal of this study was to compare characteristics of young worker fatal injuries in those aged 16-24 to all workers aged 25 and older in Kentucky using a descriptive analysis.

Methods: A retrospective analysis of fatalities among workers under the age of 25 compared to workers aged 25 and older was performed over a ten-year period from 2005-2014 using Kentucky Fatality Assessment and Control Evaluation (FACE) program data.

Results …

Pulmonary Function Among Latino Thoroughbred Workers - A Pilot Study, John C. Flunker

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

Background/Objectives

Evidence suggests working in horse barns is associated with adverse respiratory effects among Latino thoroughbred workers, yet no studies to date have measured pulmonary function. We examined the prevalence of self-reported respiratory symptoms, abnormal pulmonary function, and associated occupational factors among Latino thoroughbred farmworkers.

Methods

Participants were recruited via a community-based, purposive sampling strategy and participated in an interview-administered survey and spirometer test. Surveys and spirometry tests were administered to 80 participants by two trained health promoters (Promotoras) in July-September 2014. Pulmonary function (abnormal/normal) was classified by a pulmonologist. Demographic and occupational factors were assessed for associations with respiratory …

Relationship Of Bmi And Weight Perception To Weight Controlling Behaviors In 9th-12th Graders In The United States, Natalie Jones

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

Research indicates that high school students constitute the largest portion of those participating in unhealthy weight control behaviors. There is, however, little research that indicates what this behavior is influenced from. This study investigated the relationship of Body Mass Index (BMI) and (discordant or concordant) weight perception to weight control behaviors among 9th-12th graders in the United States. Using data from the 2013 Youth Risk Behavior Surveillance System (YRBSS), over 40 states and 13,000 surveys completed. Multiple Chi-square tests were performed, examining the association between BMI and weight perception in relation to weight control behaviors. We then examined whether perception …

Assessment Of Breastfeeding Policies In A Sample Of Inner City Child-Care Centers In North-Central Kentucky, Ana Maria Machado

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

Protection, promotion, and support of breastfeeding (BF) are critical public health needs. Breastfeeding has been proven to provide the healthiest start in life and has been shown to have a myriad of health benefits for infants, mothers and society at large. Exclusive and long term breastfeeding has been found to have protective function against the prevalence of obesity as well as many other adverse health outcomes. Higher levels of breastfeeding support in the child-care setting have been associated with higher likelihood of duration of breastfeeding for mothers and infants. The primary objective of this study was to assess the current …

Correlates Of Depression And Poor Respiratory Health: A Cohort Study In A Rural County, Stephanie Courtney

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

Objective

High rates of depression are widespread globally and are among the leading causes of disability. To better understand the effects of depression on health outcomes, more research is necessary. This study examines the associations between depression and adverse respiratory outcomes among a cohort of Iowa residents living in a rural county. This study also investigates differences in the reporting of chronic and incident respiratory outcomes.

Methods

Data were obtained from the Keokuk County Rural Health Study (1994-2004) for individuals 18 years of age or older (N=1012). The primary outcome, poor respiratory health (PRH), was based on self-reported diagnoses for …

Injury Prevention In An Industrial Environment Via Strategic Job Placement, Michelle Cooper

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

Objectives. This study investigated the effects of an injury prevention program, specific to work related musculoskeletal disorders (WMSDs), which placed employees into jobs based on their physical abilities compared to the physical demands of their prospective jobs.

Methods. Employee injury data (N=3550) from a large auto manufacturer in the U.S. was analyzed to examine changes in injury rates for employees that were hired pre versus post-strategic placement. Bivariate and multivariate analyses were used to determine dependence between placement, injury within 120 days of hire and gender.

Results. Chi-square tests of independence revealed that injury rates and job placement may be …

The Use Of Local Tax Dollars In Kentucky Local Health Departments To Sustain Programs From 2009-2013, Crystal A. Miller

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

This is a descriptive “case” study of public health finance in Kentucky, no data from other states were examined. The data used in this study were provided by the Kentucky Department for Public Health (KDPH). The data used in this study are longitudinal (2009-2013) and the core focus of this study is on: 1) changes in funding from the state to the 57-61 local health departments (single county and multi-county district departments) 2009-13, 2) changes in restricted and un-restricted fund reserves among local health departments, and 3) an examination of the local taxing districts and greater reliance on use of …

Gender-Biased Sex Selection In South Asia: The Situation And Promising Approaches To Restore Balance, Population Council

Poverty, Gender, and Youth

This project summary indicates that sex ratios at birth in South Asia vary considerably. While the sex ratios at birth in Bangladesh and Pakistan have been normal at the country level (103 and 102.5 males per 100 females, respectively), Nepal is showing signs of disturbed sex ratios at birth, with a sex ratio of 106 males per 100 females, and the situation in India is particularly adverse, with a sex ratio at birth of 110 males per 100 females. In all of these countries, preconditions for a deterioration of the sex ratio at birth are evident. Preferences are expressed for …

Farm To School Programs And Children's Dietary Behaviors, Kathleen Evers

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

There is an increasing promotion of the importance of fruit and vegetable consumption through prevention efforts, specifically in school systems, to control and prevent childhood obesity. Farm to School (FTS) programs offer interactive hands on experiences involving fruits and vegetables. This study examines a specific FTS program including a farmer interaction, and a broccoli taste testing experience for kindergarten and fourth grade students in a rural Kentucky county. By using a digital still photography method of plate waste, the decisions of approximately 115 students to take/not take broccoli and percentage of students’ consumption of broccoli was analyzed. Using chi-square and …

Evidence-Based Hospitals, David R. Bardach

Theses and Dissertations--Epidemiology and Biostatistics

In 2011 the University of Kentucky opened the first two inpatient floors of its new hospital. With an estimated cost of over $872 million, the new facility represents a major investment in the future of healthcare in Kentucky. This facility is outfitted with many features that were not present in the old hospital, with the expectation that they would improve the quality and efficiency of patient care. After one year of occupancy, hospital administration questioned the effectiveness of some features. Through focus groups of key stakeholders, surveys of frontline staff, and direct observational data, this dissertation evaluates the effectiveness of …

Developments In Nonparametric Regression Methods With Application To Raman Spectroscopy Analysis, Jing Guo

Theses and Dissertations--Epidemiology and Biostatistics

Raman spectroscopy has been successfully employed in the classification of breast pathologies involving basis spectra for chemical constituents of breast tissue and resulted in high sensitivity (94%) and specificity (96%) (Haka et al, 2005). Motivated by recent developments in nonparametric regression, in this work, we adapt stacking, boosting, and dynamic ensemble learning into a nonparametric regression framework with application to Raman spectroscopy analysis for breast cancer diagnosis. In Chapter 2, we apply compound estimation (Charnigo and Srinivasan, 2011) in Raman spectra analysis to classify normal, benign, and malignant breast tissue. We explore both the spectra profiles and their derivatives to …

The Association Between Dietary Sodium, Salt, And Elevated Blood Pressure Among Hispanic Adults In El Paso, Texas, Cynthia Chacon

Open Access Theses & Dissertations

Introduction: High blood pressure (hypertension) is the leading cause of cardiovascular disease (CVD) which represents a worldwide public health concern, and continues to be the number one cause of death among both men and women affecting 1 out of 3 adults in the United States. Furthermore, there is evidence suggesting that high levels of dietary sodium and salt consumption intake can not only increase an individual's blood pressure level, but also their risk for CVD, heart attack, or stroke. Objective: To conduct a secondary data analysis to assess the association between sodium and salt intake and blood pressure among Hispanic …

Health Literacy Proficiency, Sources Of Health Information, And Perceived Barriers To Health Literacy Among Selected Members Of The Hmong Community In Minnesota, Amanda Vang

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to determine health literacy proficiency, sources of health information, and perceived barriers to health literacy among selected members of the Hmong community in Minnesota. Data for this cross-sectional study were collected using the Short Assessment on Health Literacy-English (SAHL-E) screening tool and a questionnaire. The SAHL-E screening tool and a questionnaire were distributed to 40 Hmong residents in the St. Paul/Minneapolis in Minnesota. When combining the numbers of health literacy scores, a mean of 15.5 was reported. The overall findings of this research assessed that the Hmong community in Minnesota has adequate health literacy …

Assessment Of Vitamin D Levels And Depression Among Adults In The United States, Troy Jean-Luc Owens

Walden Dissertations and Doctoral Studies

Vitamin D is essential to optimizing health; vitamin D deficiency (VDD) can increase risk of hypertension, cardiovascular disease, and insulin resistance. VDD occurs when individuals do not receive sufficient oral intake or obtain adequate sun exposure. Previous researchers indicated there is a relationship between VDD and depression, while others have indicated there is no relationship. The purpose of this study was to examine the relationship between vitamin D levels and depression, and how this relationship might be moderated by an individual's demographic characteristics (gender, age, smoking status, or marital status). This study was a quantitative data analysis of archival data …

The Association Between Exhaled Nitric Oxide In Exhaled Breath Condensate And Chronic Obstructive Pulmonary Disease, Colin Mitchell

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD), a progressive and nonreversible disease, is a leading cause of mortality and morbidity throughout the world. Detecting COPD early in the disease process will help in decreasing later stage COPD severity. Because airway inflammation is a hallmark of COPD, it has been proposed that measuring exhaled nitric oxide, a marker of inflammation, in exhaled breath condensate could prove to be an inexpensive and efficient method to detect COPD in outpatient settings. Using the hypothetico-deductive theory as a guideline, this study used secondary data from the National Health and Nutrition Examination Survey 2007 to 2010 to …

Knowledge Of Diabetes Mellitus And Health-Preventive Behaviors Among African American Adults, Wanka Ndifor

Walden Dissertations and Doctoral Studies

The purpose of this study was to gain insight into the risk within the African American population of developing diabetes, its complications, and the benefits associated with timely management and treatment of diabetes. The study also looked at how such knowledge may be related to preventive health behaviors. The Risk Perception Survey-Developing Diabetes and the Behavioral Risk Factor Surveillance System questionnaires were employed in this study. The theoretical basis of this study was the health belief model. This was a cross sectional, quantitative study with 126 participants. Descriptive analysis was employed to calculate the mean scores and frequencies across each …

Relationships Between The Coordinated School Health Program And Childhood Obesity In Tennessee, Tekeela Shonta Green

Walden Dissertations and Doctoral Studies

Childhood obesity rates have increased nationwide, but rates of childhood obesity are higher in Tennessee (TN). The Coordinated School Health (CSH) Program is a multicomponent approach designed to improve academics and health in children in Tennessee; however, researchers have not evaluated the 8 components of the plan and the impact it has on weight in children. The purpose of the study was to determine if a relationship existed between the Coordinated School Health Program and obesity in children. The conceptual framework for this study was Bandura's social cognitive theory. One hundred forty CSH coordinators in TN were surveyed and the …

Weight Management Of Women Of Childbearing Age, Marcia Hagen

Walden Dissertations and Doctoral Studies

Black River Memorial Hospital identified obesity as a priority health concern in its rural service area; this concern was in line with the county's needs assessment. It was identified that women of childbearing age affect the lifestyle and health choices of their families and that they are at higher risk for the additional health risks associated with obesity affecting pregnancy and birth. Despite the identification of these risk factors, the factors that affect healthy weight management have not been well understood. Using the life course theory, a qualitative inquiry in the form of a structured interview was developed with local …

Patchy Progress On Obesity Prevention: Emerging Exemplars, Entrenched Barriers, And New Thinking, Christina A. Roberto, Boyd Swinburn, Corinna Hawkes, Terry T-K Huang, Sergio Costa, Marice Ashe, Lindsey Zwicker, John H. Cawley, Kelly D. Brownell

Publications and Research

Although there have been positive pockets of change, no country has yet turned around its obesity epidemic. Preventing an increase in obesity prevalence will require urgent actions from government as well as a broader spectrum of stakeholders than previously emphasized. In this paper, we review a number of regulatory and non-regulatory actions taken around the world to address obesity and discuss some of the reasons for the patchy progress. In addition, we preview the papers in this Lancet series, which each identify priority actions on key obesity issues and challenge some of the entrenched dichotomies that present obesity and its …

African American Eighth Grade Students' Attitudes Toward Hiv/Aids In The District Of Columbia, Enock Kolawole Adewuyi

Walden Dissertations and Doctoral Studies

The group most affected by HIV/AIDS, according to the Centers for Disease Control and Prevention (CDC), is African Americans. The purpose of this study was to explore the knowledge of HIV/AIDS held by African American children as a first step towards developing prevention strategies for these youths. In order to bridge the knowledge-behavior gap, this study sought to investigate the attitude towards HIV/AIDS of African American 8th grade students. The study involved secondary data from the 2012 District of Columbia (DC) Middle School Youth Risk Behavior Survey, obtained from the District of Columbia Office of Superintendent of Education (OSSE). Guided …

Peer Support Education For Uncontrolled Hypertension Among African Americans Adults, Melvina Juliana Semper

Walden Dissertations and Doctoral Studies

Hypertension is a major chronic health problem that can lead to heart attack, stroke, and kidney failure. African Americans disproportionately suffer from the morbidity and mortality of hypertension-related illnesses. The purpose of this comparative project was to determine the impact of peer support educational workshops as an avenue for lifestyle modification, using changes in blood pressure (BP) before and after participation. The target population consisted of 64 African Americans with hypertension in Brooklyn NY, aged 20 to 65 years old. BP measurements were taken within 1 month before and after participating in a weekly peer support educational workshop facilitated by …

Preventative Strategies To Improve Birth Outcomes Among African American Women In Rhode Island, Yvonne Michele Heredia

Walden Dissertations and Doctoral Studies

Despite increased access to prenatal care, birth outcomes continue to be a major source of disparity among women in the United States. The focus on lifestyle choices and negative behaviors prior to a pregnancy to reduce adverse birth outcomes has become a well-documented strategy. The purpose of this study was to determine if preparing for a pregnancy in advance improves birth outcomes for African American women of childbearing age between the ages of 12 and 45 years in the State of Rhode Island (RI). The theoretical foundation for this study was based on Prochaska's model of change, which is also …

Are New Sodium Targets In The National School Lunch Program Feasible And Are They Necessary?, Yaneve Shemesh

PCOM Biomedical Studies Student Scholarship

In many societies, high salt intake is a continuing issue in adults, and is of growing concern in children due to the prevalence of processed foods. In response, the USDA has set three targets for sodium in meals offered in the National School Lunch Program (NSLP), and the National School Breakfast Program (NSBP). This 8-year goal is meant to decrease overall sodium levels in both meal programs. However, many associated with school nutrition ask if there is significant evidence to show what effect sodium plays on children’s health, and thus determine if these targets are necessary or achievable. In addressing …