Digital Commons Network^™

Social Marketing Campaign At Farmers' Markets To Encourage Fruit And Vegetable Purchases In Rural Counties With A High Obesity Prevalence, Emily M. Dewitt

Theses and Dissertations--Nutrition and Food Systems

Farmers’ markets are one food environment venue with the potential to increase fruit and vegetable consumption among rural residents in the United States. This study used the Plate It Up Kentucky Proud social marketing campaign in six rural communities over two years to determine the association between exposure to the campaign and fruit and vegetable purchasing decisions. The availability of recipe cards at the farmers’ market was associated with influencing the purchase of fruits and vegetables (p<0.001); the recipe sample was associated with buying the ingredients for the recipe (p<0.001); taking the PIUKP food sample was associated with a willingness to prepare the food item at home (p<0.001). Utilizing social marketing strategies at farmers’ markets may be an effective way to improve fruit and vegetable intakes in rural communities.

Changes Of Percent Body Fat, Waist Circumference And Fruit And Vegetable Intake Among Division I Collegiate Female Softball Players After Nutrition Curriculum Paired With Technology, Rachel Thomas

Theses and Dissertations--Nutrition and Food Systems

Previous research has found that the quality and intake of collegiate athletes’ diets does not meet the recommended standards. Little research has been completed in regards to the diets of collegiate female softball players. The purpose of this research study was to determine if an 11-week nutrition curriculum paired with a technology could increase fruit and vegetable consumption while decreasing percent body fat and waist circumference. The sample included 14 female softball players. Paired t-test were preformed to compare fruit and vegetable intake, body fat percentage, and waist circumference pre- and post-intervention. Linear regression models were used to determine correlations …

Couples And Weight Loss Surgery: Experiencing Success, Amanda L. Westmoreland

Theses and Dissertations--Family Sciences

Bariatric surgery, also known as weight loss surgery (WLS) is an intervention for individuals who are suffering from obesity and weight-related health complications which often accompany being 100 pounds or more overweight (Smith et al., 2011). Even though bariatric surgery has been shown to be a life-saving and life-enhancing operation, efforts to seek out surgery options, qualify and prepare for the procedure, recover from surgery, and then adapt new routines to support surgery are challenging not only for the patient, but also for the people with whom the patient spends the most time—their romantic partners (Applegate & Friedman, 2008; Bylund, …

Finding The Link Between Social Connectivity And Dietary Intake Among Rural Adolescents In North Carolina And Kentucky, Jordan Elizabeth Mcdonald

Theses and Dissertations--Nutrition and Food Systems

Social networks play a significant role in adolescent decision making, specifically when it comes to dietary outcomes. This study, granted by the United States Department of Agriculture (USDA), assessed the connectivity of these social networks and the impact they have on fruit and vegetable, added sugar and sugar sweetened beverage consumption. Additionally, the relationship between shopping companionship and dietary choices was studied. Positive and negative associations were found among adolescents who shop with parents or friends. It was also found that those adolescents with greater social network cohesion were found to have more negative dietary outcomes. Divulging further into the …

Connecting Self-Efficacy Of Dietary Choices And The Association With Dietary Intake Among Rural Adolescents In North Carolina And Kentucky, Rachel Gillespie

Theses and Dissertations--Nutrition and Food Systems

Determining the level of belief one has in themselves, or their self-efficacy, can be a key factor to improve certain dietary patterns and choices in the rural youth population. Sugar sweetened food and beverage consumption continues to rise and fruit and vegetable intake remains a struggle in rural areas; addressing both the food environment and adolescents’ self-efficacy could have a lasting impact on changing the nature of a generation of rural student’s food and beverage choices. This study measured self-efficacy levels of (n=425) adolescents in rural Kentucky and North Carolina using the Youth Impact Questionnaire and dietary intake using the …

Effectiveness Of A Face-To-Face Weight Loss Intervention Paired With Mobile Technology Among Rural Adults In Kentucky, Thomas Michael Ard

Theses and Dissertations--Nutrition and Food Systems

The obesity epidemic remains a serious issue in the United States leading to significant public health implications and costs. Few weight loss interventions paring mobile technology with face-to-face interventions have been conducted in rural communities. Yet, mobile technology interventions offer good potential for delivery but it is unclear if the combination of these weight loss strategies are beneficial. This study sought to examine how integrating mobile technology with face-to-face weight loss interventions in rural communities affects weight loss. Additionally, to determine if mobile technology paired with face-to-face interventions could increase autonomous and controlled motivation levels among adults in rural Kentucky. …

The Effects Of A 16-Week Introductory Nutrition Course On Dietary Habits And Body Composition Of College Students, Emily Ashton

Theses and Dissertations--Nutrition and Food Systems

As the rates of obesity continue to increase among adolescents and young adults, adopting healthy dietary and lifestyle habits is necessary in order to prevent obesity-related chronic disease later in life. Although several studies have addressed nutrition education and its effect on weight in college students, few studies have assessed percent fat as it relates to a semester-long nutrition course. As such, the effectiveness of a formal introductory nutrition course on lifestyle habits and percent fat of college students was examined. The current study aimed to address the relationship between percent body fat and nutrition education over the course of …

Addressing Barriers To Hepatitis C Treatment Initiation In Kentucky Clinic, Moaz Abdelwadoud

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

Introduction. Hepatitis C virus (HCV) is the most prevalent blood borne infection in the United States and its chronic infection has a high burden on the American healthcare system. Since 2014, the all-oral Directly Acting Antiviral (DAA)-based therapy has been established as the standardized curative treatment for HCV with unprecedented high effectiveness and tolerability. Nevertheless, there is a significant gap between the promise from DAAs benefits and the treatment initiation rates in the United States and Kentucky.

Objectives. The goal of this study is to improve the access to the all-oral DAA-based treatment among HCV patients seeking outpatient …

Living On The Edge: Smallholder Growers’ Responses To A Changing Tobacco Economy In Malawi, Tony S. Milanzi

Theses and Dissertations--Anthropology

This dissertation explores how smallholder tobacco growers in Lilongwe, Malawi, experience and respond to fluctuating and declining incomes, and to a generally unstable market as a result of changes in the global tobacco industry. Policy makers and scholars have for a long-time debated on the question of how smallholder farmers are going to adapt to future institutional and structural changes in global agriculture. Studies on rural livelihood restructuring have revealed that processes of economic globalization have disrupted state marketing institutions, and undermined regulatory frameworks, causing shocks to livelihoods of smallholders across the world. These livelihood shocks affect smallholders’ capacities to …

Urban Garden, Where Art Thou? A Study Of Urban Agriculture In The Dallas Metropolitan Area, Jaronda Williams

MPA/MPP/MPFM Capstone Projects

Food security, the constant access to a variety of food at all times by everyone (USDA), is something not all Americans have the pleasure of experiencing. Beaulac et al. (2007) found evidence of disparities in food access by income and race. A neighborhood lacking access to food is what researchers in Scotland defined as food deserts in the 1990’s (Cummins and McIntyre 2002). Food deserts exist all across America leaving citizens with the hardship of deciding to travel for healthy food options or settle for the poor grocery option in their neighborhood. Millions of Americans are faced with this battle, …

Most Likely To Succeed: The Exploration Of Factors Affecting Successful Completion Of A Practical Nursing Program, Jennifer J. Shoemake

Theses and Dissertations--Educational Leadership Studies

In the realm of higher education, retention is a concept vital to the progression and security of all institutions. This remains true for all nursing programs as well because reports have shown an attrition rate as high as 50% in some nursing programs across the globe. Along with the nursing shortage projected in the next 20 years, retention in nursing programs poses a massive problem for not just higher education but healthcare as well. Therefore, it is important for nursing educators to understand the factors affecting student completion of a nursing program.

This two-phase, mixed-methods study sought to answer the …

Music Therapists’ Self-Compassion, Compassion For Others, And Professional Quality Of Life, Jamie E. Rushing

Theses and Dissertations--Music

As helping professionals, music therapists show compassion to their clients but may lack necessary self-care skills to prevent burnout and promote well-being. Due to a lack of research in this area, this study investigated reported levels of compassion for others, self-compassion, burnout, secondary traumatic stress, and compassion satisfaction among music therapists in relation to age, gender, and years of professional experience. A survey of 575 board certified music therapists in the USA revealed higher levels of compassion for others than self-compassion, low levels of burnout and secondary traumatic stress, and high levels of compassion satisfaction. Burnout strongly negatively correlated with …

Evaluating Nonstructural Carbohydrate Variation Of Cool-Season Grasses Based On Genotype, Management And Environment, Kelly Joan Prince

Theses and Dissertations--Plant and Soil Sciences

Understanding how nonstructural carbohydrates fluctuate in pastures and being able to quantify them is an essential component in successfully managing grazing animals that may require high or low nonstructural carbohydrate diets. The objectives of this study were 1) to evaluate the effects of genotype, management, and environment on water-soluble carbohydrates (WSC) and ethanol-soluble carbohydrates (ESC) in cool-season grass pastures in central Kentucky, and 2) to develop near-infrared reflectance spectroscopy (NIRS) equations to predict WSC and ESC in cool-season grasses. Ten cool-season grass cultivars consisting of Kentucky bluegrass, tall fescue, orchardgrass and perennial ryegrass were sampled in the morning and afternoon …

Utilizing The Social Ecological Model To Address Drinking Behaviors Among College Students Participating In Ncaa Division I Non-Revenue Generating Sports, Andrew M. Smith

Theses and Dissertations--Educational Policy Studies and Evaluation

College students between the ages of 18 and 24 are considered high-risk for alcohol-related negative consequences due to drinking at high-risk levels (Barry, Howell & Salaga, 2015). Within that population, varsity student athletes are considered at even greater risk for those issues (Druckman, 2015; Wechsler, 2002).

With football and men’s basketball being considered the only revenue-generating NCAA Division I sports, non-revenue-generating sports consist of the majority of student athletes (NCAA, 2016). This study is designed to examine high-risk drinking as well as alcohol-related consequences among non-revenue-generating student athletes attending a National Collegiate Athletic Association (NCAA) Division I school.

The sample …

Rooting A Successful Model For Agriculture In A Politics Of Possibility: The Case Of The Land Institute, Alicia Hullinger

Theses and Dissertations--Sociology

This research considers the potential for social movement organizations (SMOs) to bring about a comprehensive transformation to the current system of industrial agriculture by asking, How can a SMO outside a field of power advance an oppositional model while not being coopted by the dominant system? In Part One, I provide the background context for agricultural research systems in the U.S., describing the rise of the current landscape setting the national agenda and its consequences. To explain power dynamics, I apply a synthesis of Pierre Bourdieu’s and Raymond Williams’ relational theory models for considering the trends of dominant, alternative, …

In The Butternut Big Time: Food Hubs, Farmers, And The Development Of Community Agro-Food Economies, Lilian Brislen

Theses and Dissertations--Sociology

Food hubs, a new model of values-based agro-food enterprise, are promoted by their advocates as a means to simultaneously improve the livelihoods of small and mid-sized farmers, increase the social and environmental sustainability of the food system, and supply the ever increasing consumer demand for health, local food. Noting the contradictions embedded in the promise of simultaneously generating both social values and economic value, this study explores how goals of promoting positive social, economic, or environmental change are achieved and/or inhibited when implemented though marketbased activities. Through a series of three in-depth case studies of food hubs in the Southeastern …

Using Exogenous Hormone Application To Suppress Axillary Shoot Development In Tobacco, W. Jesse Carmack

Theses and Dissertations--Plant and Soil Sciences

The variability in the number of basal axillary shoots (ground suckers) among all tobacco (Nicotiana tabacum L.) varieties, has increased since the hydroponic transplant production system became the standard. The larger root ball of hydroponically produced transplants compared to traditionally produced transplants potentially generates a difference in the ratio of auxin (inhibits axillary shoot formation) to cytokinin (promotes lateral branching), that induces basal axillary shoot development. Starting in 2014, studies were conducted to investigate whether the addition of synthetic auxins or cytokinins to hydroponic transplant production could prevent ground sucker formation. Different tobacco cultivars, with high or low ground sucker …

An Evaluation Of An Innovative Weight Management Program In A Primary Care Setting, Susan Peak

DNP Projects

Background- Kentucky ranks third in the nation for childhood overweight and obesity. . Consumption of high dietary fat, excessive use of electronics, low levels of physical activity and consumption of sugar filled drinks are modifiable behaviors believed to be the biggest culprits behind these statistics.

Purpose- The purpose of this evaluation was to assess the implementation of the 5-2-1-0 plan in the management of childhood overweight or obesity within an urban primary care clinic.

Methods- After initiation of the program by the clinic focused interviews with the primary care providers were conducted to evaluate barriers and benefits to …

Evaluation Of A Nurse Navigator Program On The 30-Day Readmission Rate In Heart Failure Patients, Katie A. Winiger

DNP Projects

PURPOSE: The purpose of this study was to evaluate the impact of a registered Nurse Navigator (NN) on hospital 30-day readmissions for patients with heart failure at Norton Healthcare (NHC) in Louisville, Kentucky.

METHODS: This study involved two phases. Phase I was a retrospective descriptive design utilizing a medical record review of 159 patient charts. Group 1, 54 charts, included patients with heart failure who were discharged from NHC for heart failure related illnesses and were seen in a primary care clinic that utilized a NN after discharge from the hospital. Group 2, 105 charts, included patients with heart failure …

Evaluation Of A Primary Care Based Diabetes Education Program, Claire Pfister

DNP Projects

The improved management of diabetes is a critical clinical and economic challenge facing our healthcare system. Educating patients with diabetes to self-manage their disease is a vital component of diabetes care. The purpose of this DNP practice improvement project was to evaluate an innovative health care delivery method of individualized diabetes self-management education (DSME) in primary care. The approach combined individual DSME with a registered dietician and routine diabetes care with the primary care provider into one patient appointment. System data was reviewed to compare referral and attendance patterns of group and individual methods. Changes in clinical indicators of A1C, …

Evaluation Of An Enhanced Recovery After Surgery (Eras) Pathway In Two Hospitals, Jennifer A. Janes

DNP Projects

OBJECTIVE: The purpose of this study is to evaluate the Enhanced Recovery After Surgery (ERAS) pathway utilized at two Norton Healthcare facilities for colorectal and gynecological surgeries. The specific aim is to examine the impact on patient outcomes, clinical effectiveness, and costs.

METHODS: This was a multi-center, pre-post implementation retrospective study of the impact of ERAS pathways on colorectal surgery patients at Norton Audubon Hospital (NAH) and gynecological surgery patients at Norton Women’s and Children's Hospital (NWCH). The sample included 399 patients including patients from both hospitals, pre- and post-ERAS.

RESULTS: The ERAS pathway lead to a significant reduction in …

Evaluation Of Oral Nutritional Supplement Use In Elderly Patients Admitted With Heart Failure, Geri L. Sipe

DNP Projects

PURPOSE: The purpose of this study is to evaluate the effects of enhanced ordering privileges among registered dieticians (RD) on oral nutritional supplement (ONS) ordering frequency and prevalence of oral nutritional supplement use among elderly patients admitted with heart failure (HF).

METHODS: This study was a single facility, retrospective pre-post implementation evaluation of the impact of expanded ONS ordering privileges among elderly patients (age ≥ 65 years old) hospitalized with heart failure at Frankfort Regional Medical Center (FRMC). The sample consisted of 105 patients for the pre-evaluation period and 259 for the post-evaluation period.

RESULTS: There were …

Assessing Provider And Staff Knowledge Of Health Literacy And Satisfaction With A Health Literacy Assessment Tool In A Primary Care Practice, Whitney J. Lynn

DNP Projects

PURPOSE: The purpose of this quality improvement project was to assess provider and staff knowledge about health literacy. Specifically, the knowledge of health literacy and perceived importance, current usage, and benefits of the use of a health literacy assessment tool at a primary care clinic was evaluated pre-intervention. The perceived importance of health literacy as well as satisfaction with, frequency of use, and recommendation of the chosen health literacy assessment tool for future use was evaluated post-intervention.

METHODS: This project used surveys pre- and post-intervention at an urban primary care clinic in the southeastern United States from January to March …

Use Of The Afix Model To Improve Adolescent Hpv Vaccination: A Pilot Research Study, Emily Messerli

DNP Projects

Problem: The CDC estimates one person every 20 minutes every day acquires an HPV-related cancer. Kentucky’s HPV associated cancer burden is among the highest in the nation. Adolescent HPV vaccination rates in Kentucky are far below HealthyPeople 2020 goals. Barriers are multifaceted and include provider, patient and system barriers. The AFIX model is an evidenced based quality improvement program that addresses key provider barriers. The USPSTF findings identify a gap in the literature related to AFIX methods to improve rates of adolescent vaccines.

Objectives: The purpose of this study was to evaluate the effects of an intervention using the AFIX …

Implementing & Evaluating A Nurse-Led Educational Intervention For Bone Marrow Transplant Patients In The Acute Care Setting, Tia T. Wheatley

DNP Projects

Objective: The Bone Marrow Transplant (BMT) Basics Class is a nurse-led educational program dedicated to preparing patients and their caregivers of the treatment outline and self-care behaviors associated with receiving a BMT. The purpose of this project is to evaluate the effectiveness of this intervention in order to support the needs of the BMT patient and promote patient-centered care.

Study Design: Retrospective review to evaluate a quality improvement project.

Participants & Methods: As of July 2016, the BMT Basics Class became a standard of care at an NCI-designated academic cancer center in the southeastern United States. Between July 20, 2016 …

Incidence Rate Of Delirium After Cardiac Surgery And Feasibility Of A Delirium Prediction Rule, Kelly Bohl

DNP Projects

Delirium is an acute, temporary cognitive disorder that is characterized by a change in mental status, altered level of judgement, and changes in perception and behavior. Elderly patients who undergo open cardiac surgery are particularly at risk for developing delirium postoperatively. Although it is a temporary disorder, there are many consequences associated with delirium after cardiac surgery, including a longer length of stay in the hospital, long term functional decline, a greater use of health care resources and an increase in mortality risk. The purpose of this project was to identify the one-year incidence of postoperative delirium after cardiac surgery …

Reducing Preoperative Anxiety In Adolescents Facing Spinal Fusion Surgery, Anna Gayle Parke

DNP Projects

Reducing preoperative anxiety for adolescents facing spinal fusion surgery for the treatment of scoliosis has significant implications for clinical practice and patient outcomes for this specific population. The reality of a pending surgery creates a difficult, uncomfortable, and exhausting state of being that can lead to increased postoperative pain, sleep disturbances, and maladaptive behaviors. This final capstone project inquiry report presents three manuscripts which focus on the reduction of preoperative anxiety in adolescents facing spinal fusion surgery. The first manuscript is a literature review examining current evidence related to preoperative anxiety, adolescents undergoing spinal fusion surgery, and teaching programs aimed …

Increasing Renewable Oil Content And Utility, William Richard Serson

Theses and Dissertations--Plant and Soil Sciences

Since the dawn of agriculture man has been genetically modifying crop plants to increase yield, quality and utility. In addition to selective breeding and hybridization we can utilize mutant populations and biotechnology to have greater control over crop plant modification than ever before. Increasing the production of plant oils such as soybean oil as a renewable resource for food and fuel is valuable. Successful breeding for higher oil levels in soybean, however, usually results in reduced protein, a second valuable seed component. We show that by manipulating a highly active acyl-CoA: diacylglycerol acyltransferase (DGAT) the hydrocarbon flux to oil in …

Genotype × Environment × Management: Implications For Selection To Heat Stress Tolerance And Nitrogen Use Efficiency In Soft Red Winter Wheat, Kathleen Russell

Theses and Dissertations--Plant and Soil Sciences

The complex interaction of genetics, environment and management in determination of crop yields can interfere with selection progress in breeding programs. Specifically, the impact on selection for nitrogen use efficiency (NUE) in wheat (Triticum aestivum L.) under changing climatic conditions can be confounded by these interactions. Temperature increases for the southeastern United States are projected to range from 1-3°C by 2050 with nighttime temperatures increasing more rapidly than day temperatures. High temperatures are known to affect crop development and breeding for tolerance to heat stress is difficult to achieve in field environments. We utilized a multi-environment trial to assess …

Assessment Of Oil Quantification Methods In Soybean And Chia Seeds And Characterization Of Oil And Protein In Mutant Chia (Salvia Hispanica L.) Seeds, Ahmed N. Al-Bakri

Theses and Dissertations--Plant and Soil Sciences

This thesis includes two main parts:

I. Evaluation of techniques for oil (total lipid) quantification of chia and soybean seeds.

This study evaluated ten different methods of seed oil quantification, including some methods that have not been applied to oilseeds before. The main aim of this study was to find one or more techniques that are easy, inexpensive, safe and fast with a small amount of ground seeds. The Soxhlet method was used as a standard to compared between techniques of oil quantification. The oil extraction by the Soxhlet method was evaluated with two solvents petroleum ether and acetone. There …