Digital Commons Network^™

Commercial Tobacco Retail Marketing In Rural Communities In Appalachian Kentucky, 2024, Saber Feizy, Judy Van De Venne, Melissa Abadi, W. Jay Christian, Jayani Jayawardhana, Bethany Shorey Fennell, Delvon T. Mattingly, Shyanika W. Rose

Behavioral Science Faculty Publications

Objective: To investigate heterogeneous commercial tobacco marketing patterns across rurality gradient.

Methods: We conducted audits in all retail stores (n = 279) selling at least one commercial tobacco/nicotine product in eight U.S. Appalachian Kentucky counties in 2024, comprising rural and peri-urban catchments. Trained auditors assessed product availability, discounts, and advertising. Stores were linked to census tract demographics and Index of Relative Rurality (IRR) quartiles. Poisson models assessed prevalence rates of exterior and interior ads and discounts for cigarettes, nicotine vapes, and nicotine pouches (ONP) by IRR quartiles.

Results: Most stores carried cigarettes, cigarillos, and smokeless products, and over 50 % …

Differential Speed And Accuracy Trade-Off In Working Memory Retrieval And Bilateral Precuneus Between Older Men And Women, Darlingtina K. Esiaka, Stephanie Strothkamp, Aghayeeabianeh Banafsheh, Lucas S. Broster, David K. Powell, Gregory Jicha, Yang Jiang

Behavioral Science Faculty Publications

Background

Despite various hypotheses, including differences in longevity, hormones, genetics, and neuroanatomy, the reasons for the higher prevalence of Alzheimer's disease in older women compared to men remain unclear. Emerging evidence suggests that the precuneus, a key region of the default mode network, is linked to internally focused processes like memory retrieval. We examined the relationship between precuneus volumes and task performance (accuracy and reaction time) during working memory retrievals in cognitively normal older adults.

Method

A cohort of older participants (N = 45; 25 women; M_age = 77) from the University of Kentucky Alzheimer's Disease Research Center …

Disparities In Discrimination Distress Among U.S. Youth, Delvon T. Mattingly, Meman Diaby, Osayande Agbonlahor, Shyanika W. Rose, Carrie B. Oser, Nancy L. Fleischer, Adam M. Leventhal, Joy L. Hart

Behavioral Science Faculty Publications

Introduction

Racial and ethnic discrimination differentially affects youth in the U.S. However, evidence of U.S. youth discriminatory experiences at the national level is scant.

Methods

Using data from the 2023 National Youth Tobacco Survey on youth aged ≥9 years (N=22,069), the authors used the 15-item Adolescent Discrimination Distress Index to create a binary indicator of any discrimination and mean summary scale (i.e., overall) and subscales (i.e., educational, institutional, and peer) representing frequencies of distress. The authors estimated the distribution of each discrimination measure overall and examined differences by the intersection of gender, race, and ethnicity.

Results

More than half the …

Disparities In Use Modalities Among Adults Who Currently Use Cannabis, 2022–2023, Meman Diaby, Osayande Agbonlahor, Bethany Shorey Fennell, Joy L. Hart, Delvon T. Mattingly

Behavioral Science Faculty Publications

Purpose

Following the legalization of cannabis in several U.S. states, the cannabis market has expanded, leading to a wider range of products including smoked, edible, and vape products which have variable health effects. This proliferation highlights the need for more research on patterns of current cannabis use among U.S. adults.

Methods

We used combined data on adults who currently use (i.e., past 30-day use) cannabis (n = 16,999) from the 2022 and 2023 National Survey on Drug Use and Health. We analyzed whether seven cannabis use modalities including smoking, vaping, dabbing, consuming edibles, taking pills, applying topicals, and absorbing …

Examining The Relationship Between Racial, Ethnic, And Economic Residential Segregation And Cigarette Smoking Among A Nationally Representative Sample Of Young Adults, Shyanika W. Rose, Mary Kay Rayens, Mona Azadi, Elexis C. Kierstead, Amanda Y. Kong, Kimberly Horn

Behavioral Science Faculty Publications

Introduction

Predominantly Black, Hispanic or Latino, and lower-income communities are overexposed to tobacco. This study investigated the relationship between cigarette smoking and racial/ethnic and economic segregation using the Index of Concentration at the Extremes (ICE). Aims and Methods

A nationally representative sample of 4091 (aged 18–34 years) was surveyed between September and October 2016. We calculated census-tract population estimates to form ICE measures for ethnicity, race, income, ethnicity and income, and race and income. Quintiles were determined, with Quintile 1 (Q1) representing the most Hispanic/Latino, Black, and lowest-income neighborhoods and Q5 representing the most non-Hispanic/Latino, White, and highest-income neighborhoods. State …

Psychometric Properties Of The Gad-7 Among College Students: Reliability, Validity, Factor Structure, And Measurement Invariance, Agnes E. White, Justin E. Karr

Psychology Faculty Publications

The GAD-7 (seven-item Generalized Anxiety Disorder Scale) is a brief, freely available questionnaire measuring anxiety, which is a common mental health problem among college students. The current study examined the psychometric properties of the GAD-7 among undergraduate students from a public midwestern university (n = 582; M = 19.0 +/- 1.0 years old; 79.4% women; 81.6% White) who completed the GAD-7, State-Trait Anxiety Inventory-Trait subscale (STAI-T), and Behavioral Inhibition and Activation Scale-Reward subscale (BIAS-R). The psychometric properties of two GAD-7 models were examined: a one-factor model, equivalent to a single total score, and a two-factor model, including cognitive-emotional and somatic …

Appalachian Primary Care Patients’ Quit Readiness And Tobacco Treatment Receipt, Jessica L. Burris, Abigayle R. Feather, Asal Pilehvari, Sarah Cooper, Amie M. Ashcraft, Roger Anderson, Amy K. Ferketich

Psychology Faculty Publications

Introduction: Healthcare providers should facilitate smoking cessation, and primary care is an ideal setting for delivering this evidence-based care. This study’s objective was to describe readiness to quit smoking combustible cigarettes among adult Appalachian primary care patients and determine their providers’ implementation of an established tobacco treatment model.

Methods: As part of a randomized clinical trial, 298 providers in 10 health systems across 4 states received tobacco treatment training. Periodically between January 2022 and June 2023, anonymous surveys were distributed to patients after primary care visits. The survey included questions about demographics, visit type, smoking status, readiness to quit, and …

Examining The Communication Work Of Women Who Have Tested Brca-Positive: “I Feel This Responsibility To Let People Know”, Summer C. Martin, Allison M. Scott, Anne M. Stone

Communication Faculty Publications

Inheriting a pathogenic variant in the BRCA1 or BRCA2 gene considerably increases a woman's risk levels for developing breast and ovarian cancer. In addition to serious physical health implications, women with a BRCA pathogenic variant may face psychosocial challenges, including those related to navigating the often demanding process of communicating about topics regarding BRCA with family and other social network members. Based on in-depth interviews with 24 women who tested BRCA-positive, we found that—consistent with the conceptualization of communication work articulated by Donovan-Kicken et al. (2012) as an extension of the theory of illness trajectories (Corbin & Strauss, 1988)—the labor …

A Unique Inflammaging Profile Generated By T Cells From People With Obesity Is Metformin Resistant, S. Santacruz‑Calvo, S. Saraswat, Gabriella Kalantar, E. Zukowski, H. Marszalkowski, Aida Javidan, F. Gholamrezaeinejad, L. P. Bharath, P. A. Kern, X. D. Zhang, Barbara S. Nikolajczyk

Pharmacology and Nutritional Sciences Faculty Publications

The alarmingly high prevalence of obesity in older adults coupled with the negative health effects of chronic inflammation in both obesity and aging highlight the importance of studies investigating the impacts of obesity on age-related inflammation. Since shifts in peripheral T-cell metabolism and function drive systemic inflammation in both obesity and aging, we hypothesize that obesity impacts the Th17-dominated inflammaging profile we identified in lean subjects and thus modifies the anti-inflammatory effects of geroprotective drugs like metformin. New cytokine profiling data showed that CD4+ T cells from older people with obesity generate a profile that specifically excludes Th17 cytokines. Metformin …

Bilirubin Hepatic And Intestinal Transport And Catabolism: Physiology, Pathophysiology, And Benefits, Zachary A. Kipp, Sally N. Pauss, Genesee J. Martinez, Terry D. Hinds, Jr., Wang-Hsin Lee

Pharmacology and Nutritional Sciences Faculty Publications

Bilirubin, a metabolite derived from heme degradation, has traditionally been regarded as a waste product and a marker of liver injury. However, increasing evidence suggests that bilirubin also functions as a hormone, and reduced levels are associated with metabolic dysfunction. Studies have shown a strong association between low circulating bilirubin levels and an increased risk of metabolic disorders and cardiovascular disease. To advance bilirubin-based treatment strategies, it is essential to elucidate the mechanisms underlying bilirubin transport and metabolism. Therefore, we provide an in-depth discussion of bilirubin production and its subsequent fates, with a particular focus on the transport between the …

Cd47: An Immunoregulatory Nexus In Liver And Gastrointestinal Disorders, Josephine Otuagomah, Alana Newcomb, Taesik Gwag, Shuxia Wang

Pharmacology and Nutritional Sciences Faculty Publications

Cluster of differentiation 47 (CD47) is a widely expressed transmembrane protein that serves as a critical immunoregulatory checkpoint in both homeostatic and pathological conditions of the digestive system. It interacts with signal regulatory protein alpha to send a ‘do not eat me’ signal, thereby preventing phagocytosis and shaping immune responses. Beyond immunity, CD47 also influences cell death, growth and metabolism through interactions with integrins and thrombospondin-1. Recent studies implicate CD47 as a central nexus in the pathogenesis of diverse liver and gastrointestinal disorders, including metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction-associated steatohepatitis, inflammatory bowel disease, liver ischaemia-reperfusion injury, drug-induced liver …

Gut Microbiome, Neuroinflammation, And Fetal Alcohol Spectrum Disorders: Insights From Rodent Models, Abdulrahman M. Busayli, Wenhua Xu, Ghaidaa A. Raffah, Gang Chen

Pharmacology and Nutritional Sciences Faculty Publications

Fetal alcohol spectrum disorder (FASD) is a significant public health issue that affects children. It results from ethanol exposure during pregnancy, leading to considerable physical, neurodevelopmental, behavioral, and cognitive deficits. The exact mechanism is not well understood. Recently, considerable attention has been focused on the influence of gut microbiome on brain development through the gut–brain axis. Changes in the gut microbiome resulting from ethanol exposure may contribute to the pathology of FASD, potentially involving neuroinflammation. This literature review summarizes the existing research and primary animal studies on the impact of early ethanol exposure on the gut microbiome, neuroinflammation, brain development, …

Calcineurin/Nfat Inhibitors Maintain Cognition In A Preclinical Prevention Study In An Aging Canine Model Of Alzheimer Disease, Lorena Sordo, Margo F. Ubele, Kathy Boaz, Jennifer L. Mefford, Erin Dehnart Jones, Katie L. Mccarty, Hollie Y. Van Rooyen, Jeffrey R. Smiley, Stasia A. Bembenek Bailey, Jessica A. Perpich, Beverly Meacham, David K. Powell, Frederick Bresch, Jacob W. Crump, Michael J. Phelan, Jessica A. Noche, Craig E. Stark, László G. Puskás, Christopher M. Norris, Elizabeth Head

Pharmacology and Nutritional Sciences Faculty Publications

Brain signaling of calcineurin (CN) and nuclear factor of activated T-cells (NFAT) transcription factor increases in Alzheimer disease (AD) and is associated with synaptic loss, neurodegeneration, neuroinflammation, amyloid-β (Aβ) production, and cognitive decline. CN/NFAT inhibitors ameliorate these neuropathologies in mouse models of AD. Further, chronic use of tacrolimus in transplant patients reduces risk of AD. Beagles naturally develop Aβ plaques and cognitive dysfunction. We evaluated the impact of FDA-approved CN inhibitor, tacrolimus, and experimental NFAT inhibitor, Q134R, on cognitive outcomes during a three-year prevention study in 37 middle-aged beagles. While beagles treated with CN/NFAT inhibitors showed differences in the pattern …

Adolescents’ And Parents’ Perspectives On Using The Medsmarxt Families Intervention In Emergency Departments For Opioid Medication Safety Education: Mixed Methods Study, Olufunmilola Abraham, Sara Nadi, Irene Hurst

Pharmacy Practice and Science Faculty Publications

Background: The opioid crisis has significantly impacted adolescents and their families. This is attributed in part to increased opioid prescriptions in pediatric emergency departments (EDs) due to acute pain conditions and injuries. Although EDs frequently prescribe opioids, no effective preventative interventions have been implemented to educate adolescents and their families on safe opioid use. This study evaluates the MedSMA℞T Families intervention, which consists of an engaging serious game, Adventures in PharmaCity, and a personalized Family Medication Safety Plan (FMSP) with the aim of reducing opioid misuse and promoting opioid medication safety. The MedSMA℞T Families intervention was developed to educate adolescents …

Barriers To And Facilitators Of Buprenorphine Dispensing For Opioid Use Disorder: Evidence From Focus Groups In Appalachian Kentucky, Douglas R. Oyler, Dustin K. Miracle, Hannah Hesener, Laura Stinson, Monica Roberts, Adrienne Matson, Patricia R. Freeman

Pharmacy Practice and Science Faculty Publications

Background: As efforts to increase buprenorphine prescribing continue to intensify, pharmacy dispensing plays an important role in access to essential medications for opioid use disorder. Existing survey research suggests stigma and regulatory concerns are barriers to pharmacists dispensing buprenorphine, but facilitators are less clear, as are in-depth perceptions of pharmacists regarding buprenorphine.

Objective: To assess barriers and facilitators to buprenorphine dispensing in Appalachian Kentucky using a series of focus groups with pharmacy employees.

Methods: Between September and October 2023, 5 structured focus groups were conducted with a total of 19 pharmacists and pharmacy technicians across a mixture of high- and …

Ceramide Homeostasis In Hepatic Lipid Droplets, Leobarda Robles-Martinez, Kylie H. Morin, Mariana Nikolova‑Karakashian

Physiology Faculty Publications

Almost all eukaryotic cells have the capacity to form lipid droplets (LDs) in conditions of excess energy. Traditionally thought to be just inert fat reservoirs, LDs have recently emerged as important metabolic regulators of cellular stress response that buffer excess free fats and protect cells from lipotoxicity. Ceramide is a bioactive lipid that accumulates in metabolic tissues during fat oversupply. Emerging evidence suggests that sphingolipids and sphingolipid-metabolizing enzymes are found in the LDs and affect LD biogenesis and functions. This article aims to summarize the evidence, delineate some plausible functions of ceramide in hepatic LD biogenesis, and illustrate some of …

Impact Of Fast Advancement And Early Fortification Of Enteral Feedings In Preterm Infants, A Retrospective, Observational Study., Enrique Gomez-Pomar, Holly Clarke, Jamie Adams

Pediatrics Faculty Publications

UNLABELLED: We aimed to evaluate the outcomes and growth of preterm infants at a Neonatal Intensive Care Unit that focuses on early initiation, fast advancement, and early fortification of enteral feeds.

METHODS: Retrospective study conducted at a community hospital level III NICU. Extensive feeding data and outcomes were collected by utilizing a NutritionIQ software application, NICUtrition®. Infants born between 26- and 34-weeks gestational age were included, whereas infants with congenital defects, deceased or with incomplete data were excluded. Frequency and descriptive statistical analysis were conducted using chi-square and Fisher's exact test. Unadjusted odds ratios were computed for categorical variables and …

Rcpneoperu Trial: A Cluster Randomized Pilot Trial To Assess Traditional Neonatal Resuscitation Compared To Partially Virtual Training In Remote Areas., Carlos A Delgado, Enrique Gómez Pomar, Pablo Velásquez, Víctor Sánchez, Roberto Shimabuku, Luis Huicho

Pediatrics Faculty Publications

OBJECTIVE: To assess the effects of a neonatal resuscitation training program using traditional training and partial distance learning.

METHOD: Through an open cluster-randomized trial, the authors compared a traditional approach involving face-to-face theory and practice sessions using information and communication technology to offer theory and distance examination, followed by face-to-face practice. Twelve health facilities were allocated by blocked randomization. Comparisons were made adjusting for clustering in qualitative and quantitative data. The primary outcome was the percentage of infants with heart rates ≥100 per minute at the second minute after birth. The authors performed a cluster-level analysis for cluster randomized trials, …

Congenital Malignant Ectomesenchymoma Presenting As A Neck Mass In A Newborn, Ianna S. C. Blanchard, Ravi C. Bhavsar, Ashley M. Olszewski, Nathan R. Shelman, John A. D'Orazio, Prasad Bhandary, Thitinart Sithisarn

Pediatrics Faculty Publications

Background: Malignant Ectomesenchymoma (MEM) is a rare, aggressive soft tissue neoplasm with both neuroectodermal and mesenchymal differentiation. Congenital cases are extremely uncommon, posing significant diagnostic and therapeutic challenges.

Case Presentation: We report a case of a full-term male neonate presenting with a large congenital neck mass and respiratory distress at birth. Imaging revealed a lobulated, heterogeneously enhancing mass in the left submandibular region with a mass effect on the airway. Open biopsy and gross resection on day six of life confirmed MEM with rhabdomyoblastic and neuroectodermal differentiation. Post-surgical staging classified the tumor as Stage I, Clinical Group II. Despite initial …

Clinical Correlation Of Sars-Cov-2 Wastewater Passive Sampling In Long-Term Care Facilities And Wastewater Treatment Plants, William Strike, Alexus Lori Rockward, Blazan Mijatovic, Ann Noble, Cullen Olsson, Soroosh Torabi, Mohammad Dehghan Banadaki, Reuben Adatorwovor, James W. Keck, Scott M. Berry

Biomedical Engineering Faculty Publications

Wastewater-based epidemiology (WBE) is a promising tool for improving health outcomes through early detection and cost-effective pathogen surveillance. Long-term care facilities (LTCFs) serve and employ vulnerable populations that may particularly benefit from the use of WBE, but financial and technical costs associated with standard sampling methods limit the feasibility of WBE in the LTCF setting. In this work, we used passive sampling to simplify the wastewater analysis process and compared its performance to the standard composite sampling method. Moore swabs and automatic composite samplers were used concurrently to sample wastewater from two LTCFs, and samples were analyzed for SARS-CoV-2 concentration. …

Affordable Miniaturized Speckle Contrast Diffuse Correlation Tomography Device For Depth-Sensitive Mapping Of Cerebral Blood Flow In Rodents, Fatemeh Hamedi, Faezeh Akbari, Mehrana Mohtasebi, Chong Huang, Li Chen, Lei Chen, Guoqiang Yu

Biomedical Engineering Faculty Publications

Significance: Continuous and longitudinal monitoring of cerebral blood flow (CBF) is critical for understanding brain pathophysiology and guiding interventions. Although rodents are the primary models in neuroscience, existing imaging modalities often fail to provide the optimal combination of low cost, high spatiotemporal resolution, wide head coverage, and sufficient penetration depth for small-animal brain imaging.

Aim: Leveraging a clinical speckle contrast diffuse correlation tomography (scDCT) system, we aimed to develop an affordable, user-friendly, fast, and miniaturized scDCT (mini-scDCT) device tailored for depth-sensitive CBF imaging in small rodents.

Approach: The mini-scDCT replaces bulky and costly optoelectronic components with compact, low-cost alternatives while …

Implementing Wastewater-Based Epidemiology For Long-Read Metagenomic Sequencing Of Antimicrobial Resistance In Kampala, Uganda, William Strike, Temitope O. C. Faleye, Brian Lubega, Alexus Lori Rockward, Soroosh Torabi

Biomedical Engineering Faculty Publications

Antimicrobial resistance (AMR) is an emerging global threat that is expanding in many areas of the world. Wastewater-based epidemiology (WBE) is uniquely suited for use in areas of the world where clinical surveillance is limited or logistically slow to identify emerging threats, such as in Sub-Saharan Africa (SSA). Wastewater was analyzed from three urban areas of Kampala, including a local HIV research clinic and two informal settlements. Wastewater extraction was performed using a low-cost, magnetic bead-based protocol that minimizes consumable plastic consumption followed by sequencing on the Oxford Nanopore Technology MinION platform. The majority of the analysis was performed using …

A 40-Week Phase 2b Randomized, Multicenter, Double-Blind, Placebo-Controlled Study Evaluating The Safety And Efficacy Of Memantine In Amyotrophic Lateral Sclerosis, Salman Bhai, Todd Levine, Dan Moore, Robert Bowser, Andrew J. Heim, Maureen Walsh, Aziz Shibani, Zachary Simmons, James Grogan, Namita A. Goyal, Raghav Govindarajan, Yessar Hussain, Tania Papsdorf, Tiffany Schwasinger-Schmidt, Nick Olney, Kim Goslin, Michael Pulley, Edward J. Kasarskis, Michael Weiss, Susan W. Katz, Suzan Moser, Duaa Jabari, Omar Jawdat, Jeffrey Statland, Mazen M. Dimachkie, Richard Barohn, Neuromuscular Study Group And Western Als Consortium Memantine Als Study Group

Neurology Faculty Publications

Introduction: Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease with no known cure, limited treatment options with minimal benefits, and significant unmet need for disease modifying therapies.

Aims: This study investigated memantine's impact on ALS progression, with an additional focus on the effects of memantine on cognitive and behavioral changes associated with the disease.

Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted from December 2018 to September 2020. ALS patients were enrolled in-person and remotely across 13 sites in the United States. Participants were randomized to memantine (20 mg twice daily) or placebo in a 2:1 ratio …

Interaction Between Riluzole Treatment And Dietary Glycemic Index In The Disease Progression Of Amyotrophic Lateral Sclerosis, Ikjae Lee, Hiroshi Mitsumoto, Seonjoo Lee, Edward J. Kasarskis, Michael Rosenbaum, Pam Factor-Litvak, Jeri W. Nieves

Neurology Faculty Publications

Objective: We examined whether riluzole treatment modifies the associations between the dietary glycemic index (GI) and load (GL) and disease progression in amyotrophic lateral sclerosis (ALS).

Methods: Sporadic ALS patients in the Multicenter Cohort Study of Oxidative Stress who completed a baseline food frequency questionnaire were included (n = 304). Interactions between baseline riluzole treatment and GI/GL on functional decline and tracheostomy-free survival were examined using linear regression and Cox proportional hazard models adjusted for covariates. Age, sex, disease duration, diagnostic certainty, body mass index, bulbar onset, revised ALS functional rating scale (ALSFRS-r) total score, and forced vital capacity, from …

Blood Biomarkers In Down Syndrome: Facilitating Alzheimer’S Disease Detection And Monitoring, Melissa E. Petersen, Lisi Flores-Aguilar, Elizabeth Head, Laia Montoliu-Gaya, Andre Strydom, Sarah E. Pape, Juan Fortea, Nicholas J. Ashton, Chinedu Udeh-Momoh, Sid E. O’Bryant, Dwight German, Florin Despa, Mark Mapstone, Henrik Zetterberg

Neurology Faculty Publications

Blood-based biomarkers continue to be explored for disease detection, monitoring of progression, and therapeutic outcomes as the diagnostic determination of Alzheimer’s Disease in Down Syndrome (DS-AD) remains challenging in clinical settings. This perspective highlights the current status of this effort. Overall, amyloid (A), tau (T), and neurodegeneration (AT[N]) blood-based biomarkers have been shown to increase with disease pathology for individuals with DS. Phosphorylated tau biomarkers (p-tau217, p-tau181) have been consistently shown to track disease progression for DS-AD and are likely good candidates for use in clinical settings. Biomarkers of inflammation (glial fibrillary acidic protein) also show promise; however, additional work …

Lgbt People's Sense Of Linked Fate: Belonging And Utility, Kay Hales

Theses and Dissertations--Political Science

This is a three study dissertation. While the LGBT community is often referred to as a monolith, research suggests that it may be separate subgroups under one umbrella. Linked fate is the sense that what happens to one member of a group will affect all other group members with consequences for political behavior. While research on racial identity groups suggests that members often feel a sense of linked fate with other group members, this research has not been generalized or explored in the LGBT community. This study empirically explores whether there is a sense of linked fate in the LGBT …

A Case Study In Program Evaluation, Soma Dutta

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

Program evaluation is a systematic process of assessing a program’s design, implementation, and outcomes to determine its effectiveness, efficiency, and impact, guiding data-driven improvements and decision-making. The Centers for Disease Control and Prevention (CDC) Evaluation Framework provides a structured approach to assessing public health programs, ensuring they are effective, accountable, and continuously improving. By systematically applying this framework, evaluations can provide actionable insights that inform program improvements, guide resource allocation, and ensure that evaluations are practical and meaningful to all stakeholders involved (Centers for Disease Control and Prevention, 2024).

The Bourbon County Health Department (BCHD) has implemented a Physical Activity …

A Case Study In Program Evaluation: Evaluation Of The Bourbon County Physical Activity Initiative, Michaela D. Amburgey

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

This evaluation examines the Bourbon County Physical Activity Initiative, which aims to increase physical activity levels in Bourbon County, Kentucky. The initiative includes increased access to exercise opportunities, community events, and an incentive-based activity tracking system. This evaluation assesses the program’s implementation, effectiveness, and provides recommendations for improvement. By utilizing evaluation findings, public health practitioners can enhance decision-making, optimize resource allocation, and improve population health outcomes.

Bones And Brains: The Association Between Osteoporosis And Depression, Mason Taylor

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

Introduction: Osteoporosis and depression are two public health problems that are increasing in prevalence. Previous studies have found a positive association between the two variables in women and men and women together, but there is a gap when looking at men. Therefore, it was important to investigate the odds of depression in men, women, and men and women together to make comparisons by sex.

Methods: 1,602 participants aged 65 and older were included in the study from the National Health and Nutrition Examination Survey (NHANES) 2017 – March 2020 Pre-Pandemic dataset. One unadjusted and seven adjusted models were created for …

Evaluation Of The Bourbon County Health Department Physical Activity Program, Walker S. Hancock

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

Bourbon County has a low physical activity rate. A program has been implemented to increase rates of physical activity. An evaluation has been performed using the CDC’s 6-step program evaluation process framework.

According the the framework, two recommendations were made. The first one is to increase access to parks or exercise facilities for those outside of Paris city limits. The second one is to increase the number of indoor facilities for people to use during the cold, winter months.