Digital Commons Network^™

Reducing Stress Related To Injection Therapy: A Zen Bundle Approach, Valoree Bowen

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Needle fear and stress are common barriers preventing adults from seeking necessary medical treatments, including intramuscular (IM) injection therapy. Research highlights the need for evidence-based interventions to mitigate this fear and improve patient experience.

Objective: This evidence-based pilot project included a Zen Bundle—an intervention incorporating shared decision-making, aromatherapy, and distraction—to evaluate the impact on stress reduction and patient satisfaction in a retail vitamin shop in North Texas.

Methods: The project utilized a pre-and post-intervention design over eight weeks. Participants completed pre-surveys assessing stress levels using a Visual Analog Scale before choosing an intervention (aromatherapy, distraction, or both) during IM …

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …

An Application Of The Transtheoretical Model To Vaping Cessation: Measure Development For The Processes Of Change, Autumn Tamlyn

Open Access Master's Theses

Statement of the Problem: An estimated 18.6% of individuals aged 18-24 and 15.9% of individuals aged 25-29 are vaping, with approximately half of the individuals in each of these groups reporting daily use. With vaping behavior on the rise, the current study aims to provide valuable information to understand patterns of vaping behavior to support intervention development and implementation.

Method: The aim of the current study was to develop a Processes of Change (POC) measure for vaping cessation in a young adult population in the United States. Previous POC measures, extensive qualitative literature review, and review of existing …

Psychological Impacts In Exercise Riders And Professional Jockeys Following Injury, Kelley M. Renner

Theses and Dissertations--Kinesiology and Health Promotion

One of the most well-known equestrian sports, horse racing, is not only a cornerstone of Kentucky’s economy, but also a vital part of its culture, with professional jockeys playing an essential role in the local communities and traditions that define the state. Despite its popularity and financial impact, mental health challenges within the sport have continually been shrouded in silence and ignored in research (Ball et al., 2007). Equally concerning is the high injury prevalence, and psychological impact of these injuries (e.g., psychological distress, depression, anxiety, loss of identity, and self-esteem (King et al., 2022; Losty et al., 2019; McConn-Palfreyman …

Proximity And Density Of Tobacco Retail Locations To Kentucky Schools And The Relationship To Youth Perceptions Of Harm And Susceptibility To E-Cigarette Use, Hannah Cardona

Theses and Dissertations--Kinesiology and Health Promotion

Purpose: To explore the potential relationship between tobacco retailer proximity/density around Kentucky elementary, middle, and high schools, and students’ perceptions, perceived norms, susceptibility to, and use of e-cigarettes. Design: A mixed-methods analysis of youth’s self-reported survey results and geographical data. Setting: 106 Kentucky elementary, middle, and high schools which participated in #iCANendthetrend’s tobacco education program between September 2023 and May 2024. Subjects: Convenience sample of students from Ky schools (N = 7,823) Measures: Items assessing e-cigarette use, susceptibility, perceptions, and perceived norms. Analysis: ANOVA tests used to compare responses of elementary, middle, and high school students. Chi-squared tests were used …

Pathogen Surveillance Of Viruses And Antimicrobial Resistance Through Wastewater Based Epidemiology, William Strike

Theses and Dissertations--Biomedical Engineering

Pandemic surveillance is a cornerstone in public health safety, as it enables identification of pathogens circulating within a community before they become widespread outbreaks. Wastewater based epidemiology has blossomed in recent years due to its success in the SARS-CoV-2 pandemic, but this form of public health surveillance has a global equity problem. A large majority of the wastewater-based surveillance work has been done in large metropolitan cities with access to advanced testing infrastructure, which poses a challenge as we consider where pandemics have historically emerged. Therefore, there is a need to identify, adapt, and develop workflows to meet the needs …

Understanding The Impact Of The Medicaid Expansion On Hospital Length Of Stay And Emergency Department Use In Kentucky, Cameron Bushling

Theses and Dissertations--Epidemiology and Biostatistics

Three related analyses were performed to try to understand the immediate effects of Medicaid expansion on hospital systems in Kentucky. Medicaid expansion led to a large, sudden increase in the number of individuals eligible for various health care needs. This sudden increase in demand for health services lead to initial hypotheses regarding hospitals’ ability to handle this demand. The first analysis examined hospital average length of stay (LOS) using a linear mixed-effects model. Length of stay was modeled longitudinally between 2013 and 2015 to determine if significant changes in the slope of LOS could be detected after expansion (2014). Separate …

Changes In Cancer Diagnosis And Survival In The United States During The Covid-19 Pandemic, Justin T. Burus

Theses and Dissertations--Epidemiology and Biostatistics

The COVID-19 Pandemic led to global societal disruptions as political leaders and public health authorities attempted to control the spread of the newly discovered SARS- CoV-2 virus. While these measures were designed to lessen morbidity and mortality from a novel pathogen, their impact was also felt in many other, often unintended ways. The purpose of this dissertation is to use cancer surveillance research methods to examine the association between COVID-19 Pandemic-related disruptions and changes in the normal diagnosis and care of cancer in the United States.

The first two studies of this dissertation analyzed reductions in cancer diagnoses in the …

Enhancing Public Health Surveillance: Development And Validation Of Machine Learning Models For Suspected Opioid Overdose Detection In Emergency Medical Services Data, Peter J. Rock

Theses and Dissertations--Clinical and Translational Science

The ongoing opioid overdose crisis in the United States requires timely and accurate surveillance systems to inform public health responses. Traditional public health surveillance methods rely on hospital discharge data and death certificates, which suffer from significant reporting delays and miss cases where patients refuse hospital transportation. Emergency Medical Services (EMS) data presents a promising alternative with advantages in timeliness and case ascertainment but lacks validated definitions for suspected opioid overdose (SOO).

This dissertation addresses this critical gap through the development, validation, and fairness assessment of machine learning models with natural language processing (ML-NLP) for identifying SOOs in EMS data. …

Assessing The Effectiveness Of A Modified Cook Together Eat Together Program On Food Resource Management Behaviors In A Rural Setting, Johanna K. Poysti

Theses and Dissertations--Nutrition and Food Systems

This study evaluated the effectiveness of a modified, hybrid Cook Together, Eat Together (CTET) program on food resource management behaviors in a rural setting. A six-week intervention combining virtual and in-person sessions aimed to improve health behaviors, food resource management skills, and self-efficacy. Although most behavioral changes were not statistically significant, participants reported increased confidence in cooking healthy meals on a budget. Positive qualitative feedback from focus group discussions indicated program feasibility and engagement. Strengths and limitations of the study were discussed as well as recommendations for future research were given.

Researching Dementia Indicators Among Rural Populations, Justin S. Yount

Theses and Dissertations--Community & Leadership Development

The study explored potential dementia indicators and risk factors among older adults residing in rural areas who are actively engaged in farming operations. Data was collected in three components a questionnaire, an audiogram test, and a memory impairment screening. 104 people responded to the questionnaire, 133 participants took the audiogram test, and 94 participated in the memory impairment screening. The findings revealed that 80.9% of participants showed no sign of cognitive impairment while 19.1% showed signs of possible impairment. Participants reported moderate levels of physical and social activity, but common risk factors such as elevated BMI, diabetes, hearing loss, and …

Leveling The Playing Field: The Critical Role Of Ada Compliance In Graduate Education, Victoria Davis, Katie M. Mercer, Amber J. Culpepper

Eagles Talking About the Public’s Health

No abstract provided.

Analisis Situasi Masalah Penyakit Infeksi Menular Seksual Di Kota Bogor Tahun 2024, Wardiman Wardiman, Ratna Djuwita, Bai Kusnadi

Jurnal Epidemiologi Kesehatan Indonesia

Abstrak

Infeksi menular seksual (IMS) masih menjadi tantangan kesehatan global, termasuk di Indonesia, terutama pada kelompok usia produktif 15-49 tahun. Di Kota Bogor, angka kasus IMS mengalami peningkatan, namum belum sepenuhnya menggambarkan kondisi yang sebenarnya. Penelitian ini bertujuan untuk menganalisis situasi IMS secara mendalam dan menetapkan prioritas masalah kesehatan menggunakan metode PAHO-adapted Hanlon, yang mengacu pada pembobotan Basic Priority Rating (BPR) berdasarkan lima kriteria utama, yaitu, A=Masalah utama; B=Keseriusan masalah; C=Efektivitas intervensi; E=Ketidakadilan; F=Kapasitas institusi dalam mengatasi masalah. Penelitian ini dilaksanakan di Dinas kesehatan Kota Bogor pada Oktober 2024 hingga Januari 2025, dengan pendekatan kualitatif dan kuantitatif, serta disajikan secara …

Gambaran Putus Obat Berdasarkan Sosial-Demografi Pada Penderita Tuberkulosis Di Indonesia Tahun 2023: Cross-Sectional Study, Anindya Oktaria Yudhanti, Arina Syahida Hurva Radisan Saf, Benita Riska, Enita Fransiska Tamba

Jurnal Epidemiologi Kesehatan Indonesia

Introduction: Tuberculosis is an infectious disease that spreads through the air. Based on data at the international and national levels, there has been an increase. Most pulmonary TB patients are cured with consecutive antibiotic treatment for 6-9 months, but there are still patients who eventually drop out of treatment. This could be a challenge in achieving the international tuberculosis elimination target of 2035 and the national target of 2030. Methods: This study analyzed the socio-demographic distribution and dropout analysis of Tuberculosis patients in Indonesia in 2023 based on SKI data with a cross-sectional study type. Results: The incidence of drug …

Gambaran Kasus Gondongan Pada Sekolah Dasar Negeri 010 Makroman, Samarinda, Dwi Listiani, Ashri Budi Astuti, Jami'an Jami'an, Eko Prasetya Budi, Arif Sumarianto, Irfansyah Baharuddin Pakki

Jurnal Epidemiologi Kesehatan Indonesia

Mumps is an infectious disease caused by a viral infection, often attacking the salivary glands, especially the parotid glands. This disease is self-limiting and common in elementary school children. This study aims to describe the prevalence, symptoms, and impact of mumps in students of SD Negeri 010 Makroman, Samarinda, as well as evaluate risk factors and relevant prevention efforts. With a descriptive research design, data was obtained from a population of 307 students through secondary data from the Makroman Health Center and direct on-site investigations. An attack rate of 3.58% indicates a limited impact on at-risk populations, but it is …

Understanding The Impact Of Language Barriers And Visit Duration On Caregiver Satisfaction In Pediatric Primary Care, Gavin Miller, Liz Vazquez, Joyce Ho, Emma Maynor, Emily L. Allen, Marley F. Fradley, Julian Ruiz, Ana J. Bridges

2025 Honors Symposium

Abstract:

Problem. Children from households that speak languages other than English (LOE) face significant challenges in accessing healthcare, which can lead to poorer health outcomes and inadequate medical care (Flores et al., 2005). Language barriers contribute to these disparities, often resulting in diminished communication between healthcare providers and families (Ramirez et al., 2023). In pediatric primary care, visit duration—defined as the amount of time between when a patient is checked into and out of the clinic—may play a crucial role in facilitating effective communication and improving patient satisfaction (Tsiga et al., 2013). Physicians experience significant time pressure and productivity expectations, …

Comparing Patency Of Pulmonary Stent Implantation And Balloon Angioplasty In Pulmonary Vein Stenosis: A Systematic Review And Meta-Analysis, Izza Batool, Muhammad K. Khan, Muhammad Zohaib, Ibrahim A. Khan, Syed A. A. Bukhari, Shreeja Shah, Khaled Harmouch, Hussam Al Hennawi, Bruce D. Klugherz

Abington Jefferson Health Papers

Pulmonary vein stenosis (PVS) is an insidious diagnosis associated with morbidity and mortality. Pharmacologic therapy may suffice initially, but advanced stages demand mechanical intervention. Pulmonary stent implantation (PSI) and pulmonary balloon angioplasty (PBA) are common strategies, both carrying restenosis risks. This meta‐analysis compares PSI and PBA to determine the superior revascularization strategy. We systematically searched databases until November 2023, identifying 11 studies with 780 patients. Studies, including those involving patients undergoing balloon angioplasty (BA) or stent angioplasty (SA) for PVS, were selected. Case reports, editorials, and cross‐sectional studies were omitted. Primary outcomes included restenosis requiring reintervention, 5‐year freedom from restenosis, …

An Evaluation Of Frank Brown's Free Market, Leigh Ann Mccormick

Theses and Dissertations

Background: This study aimed to conduct an in-depth evaluation of Frank Brown Hall, Free-Market (Food Pantry), within the grant timeframe from January to April 2024. The central objective was to examine the distinct resource demands of students limited to selecting three items each day. By employing careful observation, effective communication, and active listening, we successfully obtained essential student feedback that enhanced our understanding of their needs and preferences, improving the support provided during that semester. Methods: Throughout the grant, data were systematically classified according to the chosen items, the students’ academic majors, and the cumulative number of visits to the …

Addressing Barriers To Preventive Healthcare Access Through Community Outreach In Underserved Populations, Deneisha Sparks

Theses and Dissertations

Access to preventive healthcare is a significant public health challenge, particularly for underserved populations in Muscogee County, Georgia. This project addresses systemic barriers such as transportation, limited health education, and economic constraints, which contribute to health disparities and reliance on emergency room services. Guided by the Social Determinants of Health (SDOH) framework and the Health Belief Model (HBM), the project aims to enhance access to preventive care, improve health literacy and identify barriers to healthcare access.

This program evaluation report examined a community-based initiative that utilized a mobile health unit to improve access to preventive healthcare in underserved areas of …

Flavorful Foes: Assessing Students’ Perceptions Of Processed And Fast Food And Its Health Implications., Soumi Roy Banerjee

Theses and Dissertations

High fast-food consumption is a common public health concern due to its link to a number of non-communicable diseases and mental health, but increased consumption of processed food, rapid urbanization, and changing lifestyles have led to a shift in dietary patterns. People are consuming more foods high in energy fats and free sugars. This mixed methods study was conducted at a college campus in Georgia, to assess knowledge and understanding of the students between the ages of 18 and 22 years about highly processed Fast Food, and its effects on health. Forty student participants were chosen through convenience sampling and …

Why A Healthy Diet Is Important For Women's Health, Halley Doster

Theses and Dissertations

Nutrition plays a critical role in women’s reproductive health, yet many women face barriers to maintaining a balanced diet. This study aimed to examine the relationship between nutritional intake and reproductive health outcomes among women of reproductive age, as well as to assess their knowledge and challenges related to healthy eating. Using a cross-sectional survey design, data were collected from 50 women at a community health center and analyzed using SPSS to generate descriptive statistics and explore patterns through chi-square and regression analyses. Findings revealed that most participants had moderate to low fruit and vegetable intake, and fewer than half …

Attacking Diabetes One Day At A Time, Kyla Duncan

Theses and Dissertations

The "Attacking Diabetes One Day at a Time" initiative targets the growing concern of public health, type 2 diabetes, among under-reserved communities. This comprehensive care program emphasizes the importance of prevention through education, improving lifestyles, and access to care. Based on insights from the Self-Care Management Theory, this initiative seeks to provide individuals with sound, culturally tailored strategies that reduce disease risk and help them manage healthy lifestyles. Major components include educational workshops, and resource navigation. The success of this program, from community engagement through evaluation on a phased implementation plan, is guaranteed. The expected outcomes of this work will …

Prevalence Of Hypertension Among Low-Income Individuals In Muscogee County Columbus, Georgia, Amelia K. Fallah

Theses and Dissertations

This study investigates the prevalence and predictors of elevated blood pressure (BP) among 409 low-income adults in Muscogee County, Columbus, Georgia—a population disproportionately burdened by hypertension. The findings reveal that elevated BP is significantly more prevalent among African Americans (71.4%) compared to non-African Americans (27.1%), highlighting the role of racial disparities influenced by systemic inequities, healthcare access, and chronic stress. Gender differences were modest, with females exhibiting a slightly higher prevalence (77.9%) than males (76.7%), potentially due to age-related hormonal changes post-menopause. Older adults (50+ years) represented most of the sample and showed significantly higher hypertension rates, consistent with established …

Mental Health Trends Among African American High School Students, Alexis Heard

Theses and Dissertations

Adolescent mental health is a major public health issue in the U.S., with African American high school students facing a rapidly worsening crisis. While all youth show increasing rates of depression, anxiety, and suicidality, African American adolescents are at greater risk due to systemic racism, socioeconomic inequality, community violence, and limited access to culturally responsive care. Few national studies have examined mental health trends among this group. This study (1) examines 2011–2021 trends in persistent sadness/hopelessness, suicidal ideation, suicide planning, and suicide attempts among African American high school students; (2) explores gender differences; and (3) compares these patterns to national …

Evaluating A Public Health Program Using The Cdc Framework: A Case Study Approach, Brooke A. Poe

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

In Bourbon County, Kentucky, where rural health challenges and chronic disease burdens persist, a coalition of public health partners set out to improve population-level physical activity through an innovative, community-centered initiative. The Bourbon County Physical Activity Program emerged through collaboration between the Bourbon County Health Department, the University of Kentucky College of Public Health, and UK HealthCare. Together, these partners designed a six-month intervention that combined discounted YMCA memberships, partnerships with employers, a physical activity tracking app with behavioral incentives, and community-wide events to promote accessible and sustained engagement.

Guided by the CDC’s framework for program evaluation in public health, …

Influence Of Perceived Health Provider Communication, Diabetes Duration And Age At Diagnosis With Confidence In Diabetes Self-Care, Courtney L. Ortz, Meredith S. Duncan, Oluwatosin Leshi, William B. Burrows, Brittany L. Smalls

Family and Community Medicine Faculty Publications

Introduction: Several factors influence individuals’ confidence to perform diabetes-related self-care activities, including perceived patient-provider communication, diabetes duration and age at diagnosis. It has been well-documented that patient-provider communication is essential when managing chronic diseases such as diabetes; however, the impact of this communication with diabetes duration and age at diabetes diagnosis on confidence in performing self-care behaviors is obscure.

Research design and methods: We utilized data from the 2021 Household Component of the Medical Expenditure Survey among participants 18 years or older who had completed the Diabetes Care Survey. Ordinal logistic regression models were utilized to assess the association between …

Empowering Reproductive Health & Access To Enhance College Student Well-Being: A Mixed Methods Community Engaged Proposal, Allison Maladore

CGU Theses & Dissertations

This study is a proposal developed in response to the need for the expansion of reproductive health services in institutions of higher education. College-age young adults in the age group of 18 to 24 are particularly vulnerable to unintended pregnancies, sexually transmitted infections, and participate in risky behaviors such as alcohol usage and illicit drug consumption which can increase the likelihood of unsafe sexual behaviors. Reproductive healthcare access is linked to academic success, improved health outcomes, and holistic well-being. The proposal utilizes a community-engaged socioecological approach to create a roadmap and implementation plan to expand reproductive services and access to …

Polymeric Nanocomposites-Based Advanced Coatings For Antimicrobial And Antiviral Applications: A Comprehensive Overview, Rachid Amrhar, Jaspal Singh, Mostafa Eesaee, Pascal Carrière, Alireza Saidi, Phuong Nguyen-Tri

Revues de littérature, synthèses de connaissances

The rise in microbial infections and viral outbreaks has accelerated the development of advanced antibacterial and antiviral coating that effectively minimize infection risks. Amidst rising global health concerns due to infectious diseases, these coatings have emerged as vital solutions for surface protection across various settings. This review focuses on the recent development and in-depth analysis includes synthesis process, inactivation mechanism in photoreactive antimicrobial and antiviral bio-coatings. This review comprehensively explores the development of different nanocomposite materials, including polymers based on metal oxide nanoparticles, metal nanoparticles, graphene-based materials, and organic-inorganic composites. Their practicality and compatibility with diverse surfaces such as ceramics, …

Real-World Clinical And Cost Effectiveness Of Osteoporotic Treatments In Men, Yu Ren

Open Access Dissertations

Osteoporosis is a condition characterized by the loss of bone mass, which increases the risk of fractures. In 2017-2018, the age-adjusted prevalence of osteoporosis among adults aged 50 and over was 12.6%, with 19.6% in women and 4.4% in men. Untreated osteoporosis can lead to a cycle of recurrent fractures that severely impact quality of life and place significant emotional, physical, and financial strain on patients, families, and healthcare resources. Approximately 50% of women and 20% of men will experience at least one fracture in their lifetime. In the United States, an estimated 1.5 million osteoporotic fractures occur each year, …

Evaluating The Early Impact Of Ab 617: Air Pollution, Health Disparities, And Environmental Justice In California, Cherry Cheuk Lam Cheung, Adam Eckerd

School of Public Service Faculty Publications

This study evaluates the initial effectiveness of California’s Assembly Bill 617 (AB 617), enacted to address air pollution impacts in communities designated as environmental justice priorities, a policy approach that has recently been touted as a successful start. These claims of initial success stand in contrast to much of the research on remediation of environmental justice, particularly with respect to air pollution. Despite well-documented disparities in air pollution exposure and its health impacts among racial-ethnic minorities, previous policy efforts to mitigate these effects have had, at best, marginal effects. AB 617 mandates local air districts and the California Air Resources …