Digital Commons Network^™

Facilitators To Becoming And Remaining Open Defecation Free In Uganda: Implications For Community-Led Total Sanitation Programming, Danette Lee Cagnet

Electronic Theses and Dissertations

Poor sanitation behaviors, including open defecation, present risks for diarrhea, which is credited with 600,000 deaths a year in children under age five. Although CLTS is a solution to ending open defecation, more than half of the investment in producing open defecation free (ODF) communities is lost during the maintenance phase. The purpose of this qualitative, case study was to understand stakeholder perceptions of the facilitators and hindrances to becoming ODF certified and maintaining ODF status and sanitary behaviors in a small village community located in Uganda, East Africa. The researcher held individual interviews and in-person focus group discussions to …

“If I Were To Suffer A Stroke Right Now, The First Place That I Should Be Taken To Is The Traditional Healer”: Community Beliefs And Health-Seeking Practices For Noncommunicable Diseases In Rural Kwazulu-Natal, South Africa, Herbert Chikafu, Innocent Tinashe Mutero Dr., Moses John Chimbari Prof.

The Qualitative Report

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The burden of chronic noncommunicable diseases in rural South Africa is exacerbated by delayed health-seeking. This study explored awareness, beliefs and health-seeking behaviour relating to diabetes, hypertension and cardiovascular diseases in Ingwavuma, a poor rural community in the uMkhanyakude district of KwaZulu-Natal, South Africa. Eight gender and age-stratified Focus Group Discussions (FGD) were conducted in isiZulu using a pre-tested FGD guide with seventy-six participants. Thematic analysis was done to discern views on access to care for noncommunicable diseases. Findings revealed limited awareness of hypertension, diabetes, and cardiovascular-related disease burden. The community practices medical plurality, and consultation with traditional healers …

The Healthy Native Youth Implementation Toolbox: Using Implementation Mapping To Adapt An Online Decision Support System To Promote Culturally-Relevant Sexual Health Education For American Indian And Alaska Native Youth, Christine M Markham, Stephanie Craig Rushing, Jane Manthei, Michelle Singer, Cornelia Jessen, Gwenda Gorman, Melissa F Peskin, Belinda F Hernandez, Lea Sacca, Gabrielle S Evans, Claudia Luna-Meza, Zoe Merritt, Ross Shegog

Faculty, Staff and Student Publications

BACKGROUND: American Indian and Alaska Native (AI/AN) youth experience serious disparities in sexual and reproductive health, including the highest teen birth rate among racial/ethnic groups, and disproportionate rates of sexually transmitted infections (STI), including HIV. A growing number of evidence-based programs (EBPs) that integrate the strengths and cultural teachings of Native communities exist. Yet, multiple factors, including lack of trained personnel, limited resources, and geographic isolation, may hinder their adoption and implementation. Innovative implementation strategies that facilitate the adoption and implementation of sexual health EBPs in Native communities may help reduce these disparities.

METHODS: We applied Implementation Mapping, a systematic …

Examining Food Security, Choices And Barriers Among Community Supported Agriculture Participants During Covid- 19 In Kentucky, Martha J. Biddle, Junghee Kang, Julie Derringer, Anna Rose, Dawn Brewer, Misook L. Chung, Terry A. Lennie, Gia Mudd-Martin, Timothy A. Woods

UK CARES Faculty Publications

The coronavirus disease (COVID-19) pandemic is challenging food security. Our study’s purpose was to examine relationships among food security status, eating patterns and perceived barriers to food choices among shareholders (N = 209) in a Community Supported Agriculture (CSA) program during stay- at-home restrictions due to the pandemic. The food insecure group (n = 33) reported lower consumption of fruits/vegetables, whole grains and greater consumption of fast foods and more barriers to food choices compared to the food secure group (p < .05). A low food insecure proportion (16%) among the CSA participants suggests a potential role of a CSA program to prevent food insecurity.

4-H Student Nutrition Advisory Councils Support Positive Youth Development And Health Outcomes Among Underserved Populations, Shannon Klisch, Katherine E. Soule

Journal of Extension

4-H SNAC Clubs engage youth in low-income schools with majority Latinx enrollment in leadership activities to increase schoolwide health and wellness. 4-H SNAC Clubs aim to develop youth health leaders, establish youth-adult partnerships, and increase access to 4-H in Latinx communities. Outcomes related to healthful living and positive youth development were assessed using the Teen Teacher Retrospective Survey (n=59) across five 4-H SNAC Clubs. Results show positive outcomes related to self-reported health behaviors for students and their families and leadership development. 4-H SNAC Clubs can increase access to 4-H among Latinx youth and support healthier communities through the Supplemental Nutrition …

Disease, Development, And Disorder: Examining The Effect Of Health On Subnational Development And Conflict In Sub-Saharan Africa, Dlorah C. Jenkins

Doctor of International Conflict Management Dissertations

Progress towards achieving the Sustainable Development Goals (SDGs) has been uneven across and within countries - particularly in Africa, least developed countries, and low-income countries. The COVID-19 pandemic has threatened to reverse much of the progress made towards achieving the SDGs, especially SDG 3, which aims to “ensure healthy lives and promote well-being for all at all ages”.

The tendency for disease, underdevelopment, and conflict to occur concomitantly suggests potential causal mechanisms linking them. This study attempts to address two pieces of the puzzle: the causal effect of disease on underdevelopment and the impact of development on conflict risk. Focusing …

The Community Health Worker (Chw) Common Indicators Project: Engaging Chws In Measurement To Sustain The Profession, Keara Rodela, Noelle Wiggins, Kenneth Maes, Teresa Campos-Dominguez, Victoria Adewumi, Pennie Jewell, Susan Mayfield-Johnson

Faculty Publications

Despite progress in documenting the outcomes of Community Health Worker interventions, the lack of standardized measures to assess CHW practice has made it difficult for programs to conduct reliable evaluations, and impossible to aggregate data across programs and regions, impeding commitment to sustainable, long-term financing of CHW programs. In addition, while CHWs have sometimes been involved as data collectors, they have seldom been engaged as full partners in all stages of evaluation and research. This manuscript details the current work being done by the CI Project, demonstrating how CHWs are able to contribute to the integrity, sustainability, and viability of …

Implementation Of Childhood Obesity Prevention And Control Policies In The United States And Latin America: Lessons For Cross-Border Research And Practice, Rafael Perez-Escamilla, Mireya Vilar-Compte, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Progress has been made in the development and widespread implementation of effective interventions to address childhood obesity, yet important challenges remain. To understand how the United States and Latin American countries achieved success in implementing obesity policies and programs (PAPs) and identify improvement opportunities using implementation science principles. We identified three comparative case studies: (1) front-of-food package labeling (Mexico and Chile); (2) Open Streets/play streets (Colombia and the United States); and (3) the Baby-Friendly Hospital Initiative (Brazil and the United States). Information from multiple sources (e.g., scientific and gray literature and key informant interviews) was synthesized to describe barriers, facilitators, …

Building Back Healthier: The Role Of Public Health In State Disaster Recovery Law, Claire Pendergrast, Nicole Errett

Population Health Research Brief Series

When communities are impacted by disasters, state officials must implement efficient and competent recovery strategies with the health and wellbeing of residents in mind. This research brief summarizes findings from a peer-reviewed study showing that few U.S. states explicitly integrate public health into their disaster recovery laws, and the types of public health requirements and authorizations vary substantially across states.

Examining The Benefits Of A Sustained Balance And Fall Prevention Programming For Independent Older Adults Living In A Community Setting, Noah Davis

Legacy Theses & Dissertations (2009 - 2024)

Falls have been an identified public health and social problem since the 1980’s and now recognized as a global health problem in many of the developed nations. The National Council on Aging and the Centers for Disease Control and Prevention acknowledge many evidence-based fall prevention programs. However, there are identified concerns to the programs; for example, a lack of sustained programming for older adults in the community setting. The literature review on fall prevention interventions identifies that few programs are sustained after two years, primarily due to a lack of funding and a lack of interest by older adults. However, …

Evaluating Urban Parks Accessibility And Equity: A Case Study Of Hartford, Ct And New Haven, Ct, Natalie Roach, Mara Tu

Honors Scholar Theses

Public parks provide cities with environmental benefits, positive health effects, recreational opportunities, community building, educational spaces, and public amenities. However, certain populations have been systematically denied their fair share of these benefits because of unjust practices in the creation and maintenance of urban parks. With a lens of environmental justice, the goal of this research was to assess park quality and accessibility of two Connecticut cities, Hartford and New Haven, by gathering publicly available information as well as using GIS tools.

The Trust for Public Land (TPL) has an existing ParkScore rating system that evaluates the quality of a city’s …

Pulling The Food System Up By The Roots: How Do We Build An Equitable Food System In The Twin Cities?, Aubrey A. Hagen

Geography Honors Projects

Prior to 2020, food insecurity was already a pervasive problem in the United States, with limited access to adequate, nutritious foods being linked to numerous poor physical and psychological outcomes. With the onset of the Covid-19 pandemic and civil uprisings in response to police brutality and state-sanctioned violence, the Twin Cities communities are facing overlapping crises that threaten individual and community wellbeing and food security. How do we build a just, equitable, and “crisis-proof” food system? Drawing from theoretical frameworks in social epidemiology and radical food geography, this paper assesses how the local food system and community food insecurity in …

Authentic Youth Engagement In Environmental Health Research And Advocacy, Kathryn M. Cardarelli, Melinda J. Ickes, Luz Huntington-Moskos, Craig Wilmhoff, Angela Larck, Susan M. Pinney, Ellen J. Hahn

Health, Behavior & Society Faculty Publications

Training in environmental health (EH) engages and inspires youth to tackle health promotion and policy change. Yet, there is little guidance on how to successfully nurture and sustain youth engagement. This paper compares four case studies of youth engagement to promote EH in rural and urban communities using the Youth Empowerment Solutions (YES!) framework. Of the case studies in rural (Central Appalachia) and urban (Cincinnati, Ohio) communities, two employ citizen science approaches using PhotoVoice and environmental sampling; one engages youth in a science communication camp; and one focuses on policy advocacy. We compare and contrast these case studies using the …

Vaccine Hesitancy In The Era Of Covid, Nicole Parkerson, Md, Faap, Amy Leader, Drph, Mph

Population Health Leadership Series: PopTalk Webinars

In 2019, the World Health Organization named vaccine hesitancy a top 10 threat to global public health. Vaccine hesitancy threatens to reverse progress made in tackling vaccine-preventable diseases and could compromise our ability to curb a raging global pandemic. Learn about the underlying causes of vaccine hesitancy, what health care professionals can do to lessen vaccine hesitancy among patients, and how research is uncovering the most effective ways to message vaccines to the public.

Smoking Cessation Interventions In South Asian Countries: Protocol For Scoping Review, Sajid Iqbal, Rubina Barolia, Laila Ladak, Pammla Petrucka

School of Nursing & Midwifery

Introduction: Unfortunately, like many other health risks, smoking rate has been on the rise in developing countries. Half of current smokers in the world reside in only three countries of Asia that include India. Many smoking cessation interventions that were developed and successfully implemented in the context of developed countries have not been equally successful in South Asia. Hence, there is a dire need of culturally relevant smoking cessation interventions. We propose a scoping review with objectives to explore the extent and nature of interventions for smoking cessation and its associated factors in South Asian Region by systematically reviewing the …

Facilitators And Barriers To Patient-Centered Outcomes Research Partnership Sustainability In The United States, Tristen L. Hall, Charlene Barrientos-Ortiz, Griselda Peña-Jackson, Courtney Fultineer, Kevin Werner, Justine Sunshine

Journal of Patient-Centered Research and Reviews

Purpose: Engaging patients in research can enhance relevance and accelerate implementation of findings. Despite investment in patient-centered outcomes research (PCOR), short-term funding cannot maintain such efforts beyond the program timeframe. Sustained interaction between researchers, practitioners, patients, and other stakeholders is needed to sustain use of evidence-based practices and achieve maximum benefit. While previous literature describes components of public health program sustainability, such factors do not necessarily apply to the partnerships that implement those programs, and facilitators are likely to differ across disciplines. We sought to determine facilitators and barriers to PCOR partnership sustainability from participant experiences with sustainable and unsustainable …

The Impact Of Socioeconomic Status And Ethnicity On Chronic Obstructive Pulmonary Disease Patients, Donald Garret Abshier

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant medial and financial burdens. For many patients with COPD, multiple socioeconomic factors contribute to health disparities, including income, education, employment status, and race/ethnicity. The purpose of this study was to examine the impact of SES and race/ethnicity on COPD patients. For this cross-sectional study, using secondary data analysis, the Social-Ecological Model (SEM), which discusses five levels of influence, was utilized. Data from over 3,222 participants aged 18 and over, living in Nevada were obtained from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) study. …

Educational Intervention To Change Knowledge And Attitudes Regarding Sexual Behaviors To Reduce Rates Of Sexually Transmitted Infections Among University Of Kentucky’S Sorority Life Students., Julianna Maita

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

Sexually transmitted infections disproportionally affect young adults. Within this age group, women are at an increased risk for contracting and STI and face more severe long-term adverse consequences than men. College aged individuals are at an increased risk for contracting an STI due to risky sexual behaviors such as unprotected sex with multiple partners. College students involved in Greek Life have been found to engage in risker sexual behaviors than non-Greek life students. These individuals perceive themselves to be at a higher risk for contracting an STI and have an increased number of unprotected sexual encounters under the influence of …

Medication Beliefs And Behaviors Of Hypertensive Caribbean Immigrants Living In New York City, Nadia Williams

Walden Dissertations and Doctoral Studies

Hypertension remains a worldwide health phenomenon with serious health consequences including heart attack, stroke, aneurysm, and heart failure. Beliefs about medicines have been shown to influence hypertension outcomes. Medication adherence has emerged as a vital component of hypertension control and management. However, there has been limited research which addresses beliefs about medicines and medication adherence in Blacks of Caribbean origin. The purpose of this quantitative cross-sectional study was to identify the beliefs about medications held among hypertensive Caribbean immigrants living in New York City using the Beliefs about Medicines Questionnaire to identify what factors/barriers were related to these specific medication …

A Study Of Public Awareness About The Threat Of Earthquakes, Mike Allen

Walden Dissertations and Doctoral Studies

Noticeably absent from the existing literature was a correlation study which would have gauged individual awareness for earthquakes. The literature search provided one quantifiable narrative that correlated college education with awareness about earthquakes; the study found that college graduates scored higher points on the awareness test for earthquakes than their counterparts who had no college education. The research question for this study examined the possible correlations between personal characteristics and awareness about earthquakes. A survey was developed and used to find hypothesized correlations between public awareness and a number of variables such as age, gender, education, income, and professional leadership. …

Healthcare Leadership In The Context Of Cognitive Diseases Of Aging: A Community-Based Participatory Research Model, Dean Sherzai

Dissertations

The Problem

The world is facing a tsunami of chronic diseases of the brain such as dementia, Parkinson's, and stroke. But all populations are not affected equally. Though we are all at greater risk of developing these diseases, minority communities such as the Black and Hispanic populations are at much greater risk of succumbing to these conditions. To date we have spent billions of dollars on research and public health measures that have repeatedly failed, but over the last decade it has become evident that much of these diseases can simply be averted through effective public health and community-based measures …

When Duty Calls. A Faith & Health Collaborative Response To Covid 19 And Social Justice: A Commentary, Joe Bohn, Karen Liller

Florida Public Health Review

We provide information pertaining to an interdisciplinary collaboration in West Central Florida that launched a faith & wellness teleconference intervention in March 2020 in response to the COVID-19 crisis. The collaborative partners engaged from across the 4-county region upon community lockdowns in response to the COVID-19 crisis and later addressing calls for social justice due to the deaths of George Floyd and other African Americans. For 17-weeks Christian and Muslim faith leaders provided live messages of hope along with community partners providing wellness (mental health and wellbeing) focused strategies for coping with the crisis. Thematic analysis of anecdoctal comments revealed …

Prevention Of Pediatric Mortality Associated With Malaria: An Exhaustive Literature Review, Taylor Mosley

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Malaria, a disease that is preventable yet frequently fatal, disproportionately affects pediatric African populations at a rate that results in a child under the age of 5 dying every two minutes. Since 1955, the World Health Organization has contributed to a significant reduction in the morbidity and mortality of malaria; however, progress has stalled in recent years. In some countries, particularly those in sub-Saharan Africa, cases have increased since 2015. This literature review seeks to identify factors associated with this incline, as well as what interventions can have the greatest impact to prevent pediatric mortality in areas with the largest …

Generational Impacts Of 1930s Housing Discrimination And The Imperative Need For The Healthy Start Initiative To Address Structural Racism, Brittney Butler, Michael Outrich, Jessica Roach, Arthur James

Journal of Health Disparities Research and Practice

For nearly three decades, Healthy Start Initiative(HSI) has served communities with high rates of adverse pregnancy outcomes--with the goal to lower them by 50%. Despite a large focus on social determinants of health, HSI has narrowly addressed racism. The effects of legal housing discrimination continue to be felt and have profound implications for pregnancy. To understand the historical context of racism in these communities, we geospatially evaluated the relationship between HSI service areas and Home-Owners Loan Corporation(HOLC) graded maps. Using data from John Snow Inc, National Healthy Start Association, and Mapping Inequality we found that 73 of 100 communities served …

Management Of Frequent Ed Users By Community Paramedics Improves Patient Experiences And Reduces Ems Utilization, Oluwakemi Aiyedun Adio, Laura Ikuma, Sonja Wiley

Patient Experience Journal

This study examined a suburban emergency medical system (EMS)-led community paramedicine (CP) program in terms of adherence to protocol, patient-paramedic interactions, patient experience, and cost. Participants (n=57) are frequent emergency department (ED) users (≥ 4 ED visits/year), with a mean age of 59.8±17.6 years and have multiple chronic conditions. Of these, 36 completed a modified Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey at 3- and 6-months following program enrollment. The main outcome measures were adherence to intake goals; types, modes, and frequencies of CP interventions; CG-CAHPS patient experience scores; and cost savings. Cost savings compared …

Evaluating Research Centers In Minority Institutions: Framework, Metrics, Best Practices, And Challenges, Angela Sy, Traci Hayes, Kelly Laurila, Carlamarie Noboa, Robbert J. Langwerden, Michelle M. Hospital, Doris A. Andújar-Pérez, Lakesha Stevenson, Suzanne M.Randolph Cunningham, Latrice Rollins, Hala Madanat, Tanya Penn, Shiva Mehravaran

Faculty Publications

The NIH-funded Research Centers in Minority Institutions (RCMI) program is currently funding 18 academic institutions to strengthen the research environment and contribution to health disparities research. The purpose of this multiphase mixed-methods study was to establish a uniform evaluation framework for demonstrating the collective success of this research consortium. Methods included discussions of aims and logic models at the RCMI Evaluators’ Workshop, a literature review to inform an evaluation conceptual framework, and a case study survey to obtain evaluation-related information and metrics. Ten RCMIs participated in the workshop and 14 submitted responses to the survey. The resultant RCMI Evaluation Conceptual …

Frontline Health: Harmonizing Metrics, Advancing Evidence, Accelerating Policy—Project Overview Brief, Frontline Health Project

Reproductive Health

Despite decades of technological and medical progress globally, half the world’s population still lacks access to essential health care due to insufficient numbers and types of health workers, especially in remote settings. There is growing recognition that well-supported community health workers (CHWs) are essential for effective delivery of primary health care (PHC). Despite broad consensus on the importance of CHWs, few countries have successfully integrated them as part of PHC at scale, and many lack official statistics on the performance of CHW programs. USAID, UNICEF, and the Bill & Melinda Gates Foundation developed a Memorandum of Understanding to collaborate on …

Framework For A Community Health Observing System For The Gulf Of Mexico Region: Preparing For Future Disasters, Paul Sandifer, Landon Knapp, Maureen Lichtveld, Ruth Manley, David Abramson, Rex Caffey, David Cochran, Tracy Collier, Kristie Ebi, Lawrence Engel, John Farrington, Melissa Finucane, Christine Hale, David Halpern, Emily Harville, Leslie Hart, Yulin Hswen, Barbara Kirkpatrick, Bruce Mcewen, Glenn Morris, Raymond Orbach, Lawrence Palinkas, Melissa Partyka, Dwayne Porter, Aric A. Prather, Teresa Rowles, Geoffrey Scott, Teresa Seeman, Helena Solo-Gabriele, Erik Svendsen, Terry Tincher, Juli Trtanj, Ann Hayward Walker

Faculty Publications

© Copyright © 2020 Sandifer, Knapp, Lichtveld, Manley, Abramson, Caffey, Cochran, Collier, Ebi, Engel, Farrington, Finucane, Hale, Halpern, Harville, Hart, Hswen, Kirkpatrick, McEwen, Morris, Orbach, Palinkas, Partyka, Porter, Prather, Rowles, Scott, Seeman, Solo-Gabriele, Svendsen, Tincher, Trtanj, Walker, Yehuda, Yip, Yoskowitz and Singer. The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human …

Assessing Community Capacity Strengthening To Sustain Integrated Social Behavior Change Programming In Northwestern Nigeria, Breakthrough Research

Reproductive Health

Qualitative research by Breakthrough RESEARCH is evaluating efforts to prepare communities, through a community capacity strengthening approach, to sustain community social and behavior change programming to promote healthy family behaviors in northwestern Nigeria. This community capacity strengthening approach, implemented by Breakthrough ACTION Nigeria, engages local leaders and community organizations—specifically Ward Development Committees (WDCs)—to increase community capacities to coordinate local health systems to strengthen services and promote positive social norms and individual behaviors for improved health outcomes.

High Impact Practices—Encouraging Empowerment And Self-Care Through Participatory Women’S Groups And Group Antenatal Care: Supporting Women To Be At The Center Of Their Own Care As Active Participants, Tracy Mcclair

Reproductive Health

The Population Council developed High Impact Practice (HIP) briefs for three strategies that show promise for improving prevention, detection, and management of Hypertensive Disorders in Pregnancy (HDPs). This brief focuses on one of those strategies: encouraging empowerment and self-care through participatory women’s groups and group antenatal care. Key points presented are: highly participatory, group-based interventions—such as community-based women’s groups and group antenatal and postnatal care (ANC/PNC)—provide opportunities for women to share their experiences and knowledge with others, discuss the local context for challenges and how to address them, and promote empowerment and agency; participation in these groups is associated with …