Digital Commons Network^™

A Method For Identifying Positive Deviant Local Health Departments In Maternal And Child Health, Tamar A. Klaiman, Athena Pantazis, Betty Bekemeier

Frontiers in Public Health Services and Systems Research

Local health departments (LHDs) are under increasing pressure to improve performance with limited resources. While research has found that financial resources may be associated with better health outcomes, there are some LHDs that maintain exceptional performance, even with limited budgets. Our interest was identifying LHDs that positively deviate in MCH outcomes compared to their peers while taking into account local context including geography and finances. We found that our method for identifying positive deviants was effective, and that LHD expenditures may not be linked to MCH outcomes. The next step in our work is to conduct in-depth analysis with positive …

Health Reform Implementation: Update And Implications For Kentucky, Glen P. Mays

Health Management and Policy Presentations

This talk reviews the progress of health reform implementation in Kentucky with a focus on opportunities for aligning systems for medical care, public health, and social support delivery to improve population health.

Unifying Systems For Population Health: Infrastructure, Incentives & Evidence For Collective Action, Glen P. Mays

Health Management and Policy Presentations

This presentation, part of the SBM Presidential Symposium on Aligning Family, Clinical, and Community Systems, reviews the collective action problems that are commonly encountered in implementing multi-sector population health improvement strategies, and examines research on ways of using public health strategies and infrastructure to overcome these problems.

The Baby Friendly Hospital Initiative, Kathryn E. Brackett

Senior Honors Theses

Abstract

The Baby-Friendly Hospital Initiative (BFHI) is a worldwide movement started by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that is aimed at providing hospitals with a certification that guarantees the best possible patient-centered care for mothers and infants. It focuses on breastfeeding as optimal infant nutrition, and implements strategies to encourage and support mothers to breastfeed their infants exclusively for six months after birth. The Ten Steps to Successful Breastfeeding are a set of 10 simple, easy to understand guidelines developed by WHO and UNICEF for implementing this initiative in the hospital setting and …

Adverse Health Effects Of Intestinal Parasitic Infections In Rural Peruvian Clinic Patients, Jonathan M. Stofer

Master of Public Health Program Student Publications

Intestinal Parasitic Infections (IPIs) pose a significant global health concern. IPIs annually contribute to 3.5 billion infections and 450 million illnesses worldwide. In hyperendemic countries, IPIs pose a significant economic and health burden, especially in rural areas. IPIs have many routes of transmission and cause a wide range of symptoms associated largely with poor health, impeded growth, and worsening of secondary infections. Such diseases are widespread in poor communities living in the Peruvian Amazon. This study aims to describe common chief complaints, diagnoses, treatments, as well as behaviors and practices associated with IPIs presenting in clinic patients. As part of …

Childhood Obesity And Familial Hypercholesterolemia: Genetic Diseases That Contribute To Cardiovascular Disease, Alyssa Caudle

Senior Honors Theses

Childhood obesity occurs as the result of an imbalance between caloric intake and energy expenditure. Genetic risk factors for obesity have become an area of research due to its permanency. Mutated genes such as Fat Mass and Obesity Associated (FTO), Leptin (LEP), Leptin Receptor (LEPR), Melanocortin 4 Receptor (MC4R), Adiponectin C1Q and Collagen Domain Containing (ADIPOQ), Proprotein Convertase Subtilisin/Kexin Type 1 (PCSK1), and Peroxisome Proliferator-Activated Receptor Gamma (PPARG) all contribute to the development of childhood obesity. In the presence of high cholesterol caused by obesity, the genetic condition known as familial hypercholesterolemia is exacerbated. Familial hypercholesterolemia is caused by a …

Frailty And Depression: A Latent Trait Analysis, Matthew Lohman

Theses and Dissertations

Background: Frailty, a state indicating vulnerability to poor health outcomes, is a common condition in later life. However, research and intervention progress is hindered by the current lack of a consensus frailty definition and poor understanding of relationships between frailty and depression. Objectives: The goal of this research is to understand the interrelationships between frailty and depression among older adults. Specifically, this project aims 1) to examine the construct overlap between depression and three definitions of frailty (biological syndrome, medical burdens, and functional domains), 2) to determine the degree to which this overlap varies by age, gender, race/ethnicity and other …

Visual Influences On Self-Served Foods, Tami Cirerol

College of Health Sciences Presentations

Objective: With an increasing dinner plate and portion sizes, a better understanding of self-serving food behaviors is needed to help individuals develop and maintain healthy eating habits. The goal of this project is to educate students on the Delboeuf Illusion to increase self-efficacy and minimize over-serving food to oneself.

Method: This project examines four aspects of self-serving behaviors of college students by using pre- and post-test measurements. An understanding of the difference between a serving and a portion, and daily-recommended servings, is evaluated. Knowledge of food serving equivalencies to common, everyday objects is reviewed. The influence of the Delboeuf Illusion …

Health Literacy Of Older Refugees And Its Impact On Health Communication With Health Care Providers, Mohamed Almehawes

College of Health Sciences Presentations

Senior refugees often face great challenges in the process of resettling in the United States. In addition to the struggle to gain Basic English language skills to pass the Citizenship Exam, they are most likely to suffer other health issues related to their age status. The purpose of this qualitative study is to look into barriers to health as they are related to health literacy in older refugee population enrolled in ELC program and its impact on their access to healthcare. Data gathering will be accomplished using three methods including: searching the materials presented in the (ELC)class for health literacy …

Trends In The Use, Sociodemographic Correlates, And Undertreatment Of Prescription Medications For Chronic Obstructive Pulmonary Disease Among Adults With Chronic Obstructive Pulmonary Disease In The United States From 1999 To 2010, Earl S. Ford, David M. Mannino, Anne G. Wheaton, Letitia Presley-Cantrell, Yong Liu, Wayne H. Giles, Janet B. Croft

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: The extent to which patients with COPD are receiving indicated treatment with medications to improve lung function and recent trends in the use of these medications is not well documented in the United States. The objective of this study was to examine trends in prescription medications for COPD among adults in the United States from 1999 to 2010.

METHODS: We performed a trend analysis using data from up to 1426 participants aged ≥20 years with self-reported COPD from six national surveys (National Health and Nutrition Examination Survey 1999-2010).

RESULTS: During 2009-2010, the age-adjusted percentage of participants who used any …

Perinatal Distress In Women In Low- And Middle-Income Countries: Allostatic Load As A Framework To Examine The Effect Of Perinatal Distress On Preterm Birth And Infant Health, Shahirose Sadrudin Premji

School of Nursing & Midwifery

In low- and middle-income countries (LMIC), determinants of women's and children's health are complex and differential vulnerability may exist to risk factors of perinatal distress and preterm birth. We examined the contribution of maternal perinatal distress on preterm birth and infant health in terms of infant survival and mother-infant interaction. A critical narrative and interpretive literature review was conducted. Peer-reviewed electronic databases (MEDLINE, Embase, Global Health, CINHAL), grey literature, and reference lists were searched, followed by a consultation exercise. The literature was predominantly from high-income countries. We identify determinants of perinatal distress and explicate changes in the hypothalamic-pituitary-adrenal axis, sympathetic, …

An Analysis Of The Weight Watchers And Atkins Diets: The Effects Of Calorie Restriction And Nutrition Levels, Heather Brown

Senior Honors Theses

The purpose of this study was to determine the effectiveness of a calorie-restricted diet versus one with restricted food groups. To accomplish this, a survey with 19 participants, age ranging from 25 to 74 years, was taken for people who attempted Weight Watchers, a calorie-restricted diet, and Atkins, a low-carbohydrate diet. The success rates of each of these diets will be compared and analyzed in this study. Participants reported short-term and long-term weight loss results. For the data analysis, descriptive statistics and two independent t-tests were performed. For short-term weight loss on Atkins, M = 20.25, and on Weight …

Blood Pressure Monitoring Of Hypertensive Patients In Primary Care: Barriers And Facilitators To Ambulatory, Office, And Home Blood Pressure Monitoring In The Context Of The Triple Aim, Elizabeth Andrews

Muskie School Capstones and Dissertations

Hypertension represents a population health issue in that many patients are misdiagnosed and over-or-under medicated. Research has indicated that overestimating the true blood pressure by 5 mmHg leads to over 30 million Americans being inappropriately treated with blood pressure medication (Handler, 2009). Blood pressure measurements taken in the office are often inaccurate due to patient behaviors, improper technique, and observer errors, yet providers are still using this method to diagnose hypertension. Therefore, considering other methods of blood pressure for the diagnosis and management of hypertension is important to the healthcare quality for millions of Americans.

The main objective of this …

Defining Obesity: An Argument For The Social Environment Perspective, Meghan Mcinnis

Annual Undergraduate Conference on Health and Society

It is well documented that obesity is a growing problem in the U.S. and worldwide. By 2010, 35.9% of U.S. adults age 20 and older were obese (Overweight and Obesity, CDC). Obesity has been associated with many health problems, including hypertension, type 2 diabetes, osteoarthritis, stroke, and cardiac disease (Lucey, 2008, p.202). What has just been described is the traditional, medicalized narrative of obesity. In this narrative, obesity is viewed as an epidemic that demands an immediate and widespread response (Lucey, 2008, p.202). The blame is placed largely on individuals, while social factors, such as socioeconomic status and neighborhood environment, …

Harnessing Community Engaged Scholarship For Collective Action To Improve Population Health, Glen P. Mays

Health Management and Policy Presentations

The growing body of theoretical and empirical scholarship on collective action problems offers important lessons about strategies for improving health on a population-wide basis.

Methamphetamine: The Effect On The Child From Womb, Birth And Beyond, Chiara L. Keune

Graduate Research - Criminal Justice Sciences

Globally the use of methamphetamine surpasses that of heroin and cocaine combined. As a drug that facilitates weight loss and provides the user with increased energy, it is particularly appealing to women. This raises concerns about its use by pregnant women. This poster highlights what is known about the effects of methamphetamine by pregnant women on the unborn child, and on the long term consequences for the children of these women.

Cardiovascular Disease Risk Among The Mexican American Population In The Texas-Mexico Border Region, By Age And Length Of Residence In United States, Jennifer J. Salinas, Bassent Abdelbary, Anne R. Rentfro, Susan P. Fisher-Hoch, Joseph B. Mccormick

Physician Assistant Studies Faculty Publications

Introduction: Although the relationship between health behaviors and outcomes such as smoking and obesity with longer residence in the United States among Mexican American immigrants is established, the relationship between length of residency in the United States and risk for cardiovascular disease (CVD) is not fully understood. The objective of this study was to determine the relationship between immigrant status, length of residence in the United States, age, and CVD markers in a sample of Mexican American adults living in Brownsville, Texas.

Methods: We categorized participants in the Cameron County Hispanic Cohort study as immigrants in the United States for …

Prepregnancy Low-Carbohydrate Dietary Pattern And Risk Of Gestational Diabetes Mellitus: A Prospective Cohort Study, Wei Bao, Katherine Bowers, Deirdre K. Tobias, Sjurdur F. Olsen, Jorge Chavarro, Allan Vaag, Michele Kiely, Cuilin Zhang

Publications and Research

Background: Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown.

Objective: We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM.

Design: We included 21,411 singleton pregnancies in the Nurses’ Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat; an animal LCD score on the basis of intakes of carbohydrate, animal protein, and animal …

Healthcare Access And Health Outcomes In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

In a publication from the Robert Woods Johnson Foundation, it was recognized that a person’s zip code was a more important predictor of health than their genetic code. Where we live influences not only our access to health care, but other health indicators as well. Clark County has a low primary care physician to population ratio compared to other counties in Nevada and in the US. Clark County also has highest rates of uninsured in the Mountain West and among the highest in the nation.

Southern Nevada fared worse than other Mountain West Metropolitan areas in health indicators and preventative …

Creating Learning Systems: Lessons From Public Health Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Practice-based research networks (PBRNs) provide powerful mechanisms for implementing research studies that evaluate the health and economic effects of delivery system innovations. This presentation reviews strategies, emerging findings, and lessons learned from PBRNs and related studies conducted in U.S. public health settings. We give special focus to studies that examine multi-organizational and cross-sectoral strategies for population health improvement.

Skin Cancer Prevention Coverage In Popular Us Women’S Health And Fitness Magazines: An Analysis Of Advertisements And Articles, Corey Hannah Basch, Danna Ethan, Grace Clarke Hillyer, Alyssa Berdnik

Publications and Research

The desire to be tan is a phenomenon that public health researchers have investigated, as exposure to UV radiation increases the chances of developing skin cancer. Media messages in women’s magazines have been shown to contribute to this problem. Much less is known about the prevalence of skin cancer prevention messages in these magazines. This study's aim was to identify the number and type of articles and advertised products devoted to skin health (sun protection and skin cancer prevention in particular) within five popular U.S. greater than women’s health and fitness magazines. We analyzed articles and advertisements over seven months …

International Epidemics: Interdisciplinary Thinking And Global Citizenship, Rajini Srikanth, Louise Penner

Office of Community Partnerships Posters

The Honors College aims to serve as a crucible for curricular innovation by enriching and deepening classroom study with on-the-ground learning. The symposium is a year-long course, with the winter session field trip giving students a two-week immersion in the details of HIV/AIDS health care delivery in one province of South Africa. Upon return, students volunteer at health centers or nonprofits exploring related topics, while continuing to study the complexity of South Africa’s history and its attitudes and approaches toward HIV/AIDS at the medical, cultural, economic, and social levels.

2009 H1n1 And Seasonal Influenza Immunization Among Pregnant Women: A Comparison Of Different Sources Of Immunization Information, Bonny Specker, Betty Wey, Jill Fuller, Marie-Noel Sandoval, Maureen Durkin, Nancy Dole, Emmanuel B. Walter

Ethel Austin Martin Program Publications

Validity of prenatal immunization data from different sources has not been assessed. We evaluated prenatal 2009 H1N1 and seasonal influenza (FLU) data obtained from state immunization information systems (IIS), medical record abstraction (MRA), and participant recall using medical care logs (NCS-MCL). 2009 H1N1 and FLU data were obtained from IIS and MRA for 325 pregnant women participating in the National Children's Study at three locations (SD/MN, NC, WI). Women recalled immunizations at first pregnancy visit and at 16-17 and 36 weeks' gestation (NCS-MCL). The proportion of women with vaccine information obtainable from each data source was determined, and proportions immunized …

Politics Of Health: The 2013 Integration Policy’S Effect On Immigrant Access To Care, Amy Chang

Independent Study Project (ISP) Collection

In September of 2013, King Mohammed VI announced a regularization campaign, implementing a new policy of integration with respect to undocumented immigrants in the country. Deviating from former official discourse, the new measure allowed in principle for—among provision of residence cards and lifted criminalization of undocumented immigrants—greater immigrant access to healthcare services. The purpose of the following research was to assess whether the effects of this new provision are being positively felt on the ground in ensuring inclusivity of health services.Individual interviews on personal experiences with the Moroccan healthcare system were held with members of various immigrant sub-populations: refugees, asylum …

Cleft Lip And Palate In India: Determining The Socioeconomic Factors That Influence Quality Of Life And Treatment Received, With A Focus In Rural Nainital District, Uttarakhand State, Ellery Ward

Independent Study Project (ISP) Collection

Cleft lip and cleft palate are birth defects that range in severity, and may cause serious physical and social challenges to those who are born with them. This project sought to determine the socioeconomic factors that influence the lives of people with cleft lip and or cleft palate in India, and the treatment, or lack thereof, which they receive. Specific focus was given to the rural and mountainous area of Nainital district in Uttarakhand state. This study was carried out with the assistance of the Aarohi organization located in the Satoli village in Nainital district. Interviews with one plastic surgeon …

Avoiding The Freshman 15, Samuel Earls, Robin Hume

Counseling Concepts and Applications for Student Affairs Professionals (CNS 577)

Students face many challenges as they transition into college. One of the most publicly-known issues is the “Freshman Fifteen,” which refers to the average amount of weight that college freshmen are rumored to gain. Students in college often encounter all-you-can-eat buffets, a culture rife with alcohol consumption, an increased level of stress from classes, and other environmental factors that can lead to an unhealthy lifestyle if not properly addressed. This video pamphlet aims to combat the “Freshman Fifteen,” or in general an unhealthy lifestyle at college, by providing pertinent nutritional information and exercise tips. The accompanying brochure provides additional tips …

Safety Policy And Procedure In Ohio High School Basketball, Issa Walker

Master of Public Health Program Student Publications

There are projected to be seven million high school adolescents from roughly 20,000 high schools who partake in local sports programs annually. Children and adolescents are increasingly participating in sports, and this expanding involvement brings forth issues regarding possible risks of sports-related injury (Vanderlei et al. 2013). Although the involvement in sports is proven to be advantageous for the physical and mental well-being of human beings, injury rates are a public health concern. In the United States, young athletes are responsible for more than two million injuries, 500,000 physician visits, and 30,000 hospitalizations per year (Centers for Disease Control & …

Genetic Risk Of Progression To Type 2 Diabetes And Response To Intensive Lifestyle Or Metformin In Prediabetic Women With And Without A History Of Gestational Diabetes Mellitus., Shannon D Sullivan, Kathleen A. Jablonski, Jose C Florez, Dana Dabelea, Paul W Franks, Sam Dagogo-Jack, Catherine Kim, William C Knowler, Costas A Christophi, Robert Ratner, Diabetes Prevention Program Research Group.

GW Biostatistics Center

OBJECTIVE The Diabetes Prevention Program (DPP) trial investigated rates of progression to diabetes among adults with prediabetes randomized to treatment with placebo, metformin, or intensive lifestyle intervention. Among women in the DPP, diabetes risk reduction with metformin was greater in women with prior gestational diabetes mellitus (GDM) compared with women without GDM but with one or more previous live births.

RESEARCH DESIGN AND METHODS We asked if genetic variability could account for these differences by comparing β-cell function and genetic risk scores (GRS), calculated from 34 diabetes-associated loci, between women with and without histories of GDM.

RESULTS β-Cell function was …

Metabolic Syndrome Components And Their Response To Lifestyle And Metformin Interventions Are Associated With Differences In Diabetes Risk In Persons With Impaired Glucose Tolerance, H. Florez, M. Temprosa, Trevor J. Orchard, Kieren J. Mather, Santica M. Marcovina, Elizabeth Barrett-Connor, Edward Horton, C. D. Saudek, F. X. Pi-Sunyer, R. E. Ratner, R. B. Goldberg

GW Biostatistics Center

Aims

To determine the association of metabolic syndrome (MetS) and its components with diabetes risk in participants with impaired glucose tolerance (IGT), and whether intervention-related changes in MetS lead to differences in diabetes incidence.

Methods

We used the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) revised MetS definition at baseline and intervention-related changes of its components to predict incident diabetes using Cox models in 3234 Diabetes Prevention Program (DPP) participants with IGT over an average follow-up of 3.2 years.

Results

In an intention-to-treat analysis, the demographic-adjusted hazard ratios (95% confidence interval) for diabetes in those with MetS (vs. …

Translational Nutrition: A Review Of The Application Of Nutrition Science, Regulation, And Outreach Case Study: Farm Fresh Rhode Island, Eliza Zalis

Public & Community Service Studies Student Scholarship

This project examines the avenues by which nutrition science impacts individuals in society. It examines the factors that influence consumer behavior and food choice and the importance of health literacy in guiding nutrition and health. It elucidates the role of the Food and Drug Administration (FDA) in regulating food labeling and the implications that such regulation has on consumer perception and possible health outcomes. Further, this project outlines recently proposed changes to the “Nutrition Facts” panel. In investigating nutrition education and outreach programs, this project includes a case study of Farm Fresh Rhode Island and the organization’s nutrition initiatives.