Digital Commons Network^™

Evaluating The Caring Cards Program And Its Effect On Mental Health Indicators Among A Self-Defined Agricultural Group In Rural Kentucky, Katrina Clontz

Theses and Dissertations--Community & Leadership Development

Suicide is currently the 11^th leading cause of death in the Unites States (American Foundation for Suicide Prevention, 2024), and is especially high among the farming and agricultural population (Kennedy et al., 2021; Klingelschmidt et al., 2022; Monteith et al., 2020). Additionally, mental health access and outcomes are worse among this population, partially due to the inaccessibility of care in rural areas (Taylor, 2019). Communication among caring individuals is thought to be an effective suicide prevention strategy (Long, 2023; Ross & Bassilos, 2019). The Caring Cards program was developed as a way to facilitate mental health communications among a …

Autism In Agricultural Education: A Case Study Of An Adolescent With Autism Spectrum Disorder And Their Parent On Career And Technical Education, Grace Miller

Theses and Dissertations--Community & Leadership Development

Autism spectrum disorder (ASD) is a unique and often misunderstood diagnosis. Little is known about the experiences of adolescents with ASD. As students with ASD graduate high school, many are under- and unemployed. Career and technical education (CTE) in U.S. schools is intended to prepare all students for careers post-secondary. Agricultural education is one of the predominate career clusters within CTE. This qualitative single case study sought to create a platform for both a student and their parent to share their experiences in agricultural education and CTE. Participants were an adolescent with ASD who had taken at least one year …

Exploring The Impact Of An Appalachian Higher Education Institution Had On Fostering Solidarity, Capacity, And Agency Of Female Appalachian Students Seeking To Positively Influence The Quality Of Life For Themselves And Appalachian Communities, Analiese Mitchell

Theses and Dissertations--Community & Leadership Development

Appalachian women navigating higher education encounter multifaceted challenges, often confronting marginalization and a lack of representation within academic spaces. This study investigates the experiences of female Appalachian students at Mountain University in Kentucky, aiming to shed light on their journey and the university's impact on their lives and communities. Drawing on qualitative data from interviews, the research explores themes of solidarity, capacity, agency, and Quality of Life. Findings reveal a robust sense of solidarity among Appalachian peers and faculty, fostering a supportive environment conducive to personal and academic growth. Participants express opportunities to engage with their communities positively, contributing to …

Implications Of Nanopesticides On Downstream Wetland Ecosystems, Kiley Power

Theses and Dissertations--Biosystems and Agricultural Engineering

Nanopesticides are thought to be a promising course of action for reducing agricultural impacts on the environment, however, little is known regarding the fate and transport of nanopesticides, specifically their influence on downstream wetland ecosystems. The objective of this study was to assess the implications of a nano-Cu fungicide (Kocide 3000) and a neonicotinoid insecticide (imidacloprid) on downstream wetland habitats, particularly their effects on wetland nutrient cycling, using fifteen mesocosm wetlands. The complex interactions between nitrogen, Kocide 3000, and imidacloprid were found to increase nitrate removal rates, decrease phosphate removal rates, and inhibit nitrogen uptake in below-ground biomass. Each treatment, …

The Characterization, Assessment, And Shear Strength Of Turfgrass Soil In North American Thoroughbred Racing, Peter Schmitt

Theses and Dissertations--Biosystems and Agricultural Engineering

Minimizing catastrophic injuries to racehorses, which also protects the riders, is critical for the future of the Thoroughbred racing industry. While the causes of catastrophic injuries are multifactorial, the condition of the racing surface is one of only a few factors that affects all horses in competition. Horse racing surfaces must retain enough shear strength to support the hoof of a Thoroughbred at a gallop. Turfgrass racing surfaces also require healthy turf to reinforce the footing while also achieving a high infiltration rate to allow races to run on the turf soon after or even during rain. This research is …

Utilizing Isotope Tracing To Assess Land Use Implications To Tap And Stream Water Chemistry, Katrina Alexis Mcfadden

Theses and Dissertations--Biosystems and Agricultural Engineering

Water quality is an issue that continues to be worsened by extreme flooding, specifically in Eastern Kentucky. The most recent 2022 flooding event in Eastern Kentucky resulted in loss of human life, over $23.3 billion in damaged infrastructure, and impaired human health. Infrastructure failures, such as leaky pipes, are a growing challenge in these regions as rebuilding has occurred. Therefore, the goal of this project was to evaluate water quality in two of the counties most impacted by the 2022 flood in Kentucky, Breathitt and Perry Counties, using sulfur isotopes as a novel tracer to identify potentially failures in distribution …

The Efficacy Of Wetland Treatment Systems Used To Treat Runoff Mixtures From Different Landscapes Across Kentucky, Emily Nottingham

Theses and Dissertations--Biosystems and Agricultural Engineering

The overarching goal was to improve our understanding of the cumulative effect of increased use and occurrence of commonly detected contaminants of potential concern (CPCs) on nitrogen (N) transformation processes in wetlands. The central hypothesis was that those various mixtures of nutrients and CPCs entering treatment wetlands impact N removal pathways. The first study assessed the current state of the literature on the implications to N removal in wetlands in the presence of pesticides and antibiotics. 181 primary studies were identified. Removal efficiencies for nitrate varied widely across the studies, with CPCs impacting microbial communities. A knowledge gap remains in …

Improving Healthcare Provider Knowledge And Confidence With Treating The Lgbtq Population Through A Web-Based Education Module, Logan Price

DNP Projects

Background: There is a need for improved healthcare staff and provider knowledge and confidence when treating the LGBTQ population, as many healthcare providers are insufficiently prepared to treat LGBTQ patients (Rowe et al., 2017). This population is at greater risk for mental illness, substance use, and physical illness than the general population due to societal factors such as minority stress and stigma (Cochran et al., 2004; Cochran & Mays 2007; Cochran et al., 2003; Meyer, 2003). Purpose: The purpose of this project is to educate healthcare staff and providers about the LGBTQ population to improve their knowledge and confidence when …

Investigating The Correlation Between Social Determinants Of Health And Drug Selling Among People Who Use Drugs In Rural Appalachia, Kentucky, Grace A. Debo

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

Abstract

Aims: To identify demographic, socioeconomic, health and access to resources, and drug use correlates associated with drug selling among adult, people who use drugs (PWUD) in rural Appalachia.

Methods: This cross-sectional study analyzed survey data from the ongoing KyOSK and SNAP projects. The surveys included information on participant characteristics (demographic, socioeconomic), and health and drug use behaviors. Our analysis was restricted to only those who answered the question regarding drug selling (n=738). Both univariate and multivariate logistic regression models were employed to identify correlates of drug selling.

Results: Among 738 participants, 20.6% reported selling or attempting to sell drugs …

Pharmacy Involvement In Increased Access To Opioid Treatment Programs, Catherine O'Rourke

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

The opioid epidemic still affects many Americans today. Despite approved medication treatments for opioid use disorder (OUD), a majority of the population with OUD have not received treatment. Since pharmacists are the most accessible health care professional and had an important role providing care during the COVID-19 pandemic, there has been a push to expand pharmacists’ scope of practice. The primary purpose of this investigation was to identify the benefits and barriers to community pharmacist-led treatment of OUD. The secondary purpose was to determine whether pharmacist participation in opioid treatment programs (OTPs) or office based opioid treatment (OBOT) would be …

The Effects Of Stigma Within The Prep Care Cascade Among People Who Inject Drugs In Rural Kentucky, Abby Burton

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

Background: Injection drug use has increased HIV burden in low-prevalence communities, specifically within rural Kentucky. Pre-exposure prophylaxis (PrEP) has been successful in terms of HIV prevention, yet uptake remains low among people who inject drugs (PWID). PWID living in rural areas face unique challenges to receiving PrEP care, including significant barriers of substance use- and HIV-related stigma. Recent studies have only started to explore the overlapping effects of these two stigmas. Considering the barriers each stigma independently poses to PrEP care, it is important to investigate their role in tandem for any compounding effects. This paper is a secondary analysis …

A Case Study In Program Evaluation, Lydia Williams

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

The three core functions of public health are assessment, policy development, and assurance, and program evaluation falls under the latter category. A program is incomplete without an in-depth understanding of how well it works and what steps can be taken to make sure there is continuous progress and improvement.

In this case study, I developed an evaluation plan for the Lexington-Fayette County Health Department’s (LFCHD) infectious disease outbreak education program. The need for such a program was realized after a MRSA outbreak among a Kentucky high school football team. This case study employed the Center for Disease Control and Prevention …

Trust In Local Health Departments: A Cross-Sector Analysis Of Urban And Rural Communities, Kelsie Kwok

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

Cross-sector collaboration is being looked to as best-practice for addressing complex issues. Given that trust is an important aspect of a well-functioning network, partners may have varying perceptions of trust regarding their counterparts. The primary objective is to examine partnerships and trust scores among six Kentucky communities (three urban, three rural) and their efforts to address unmet social needs. The secondary objective is to discuss differences among urban and rural communities regarding local health departments and the role of trust. A social network analysis (SNA) was conducted using the Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) …

Patterns Into Pathways For Improving Safety Culture: Refined Latent Class Analysis Informs Tailored Decision Support For South Carolina Dss Safety Culture Improvements, Michaela Voit

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

The rising prevalence of exposures to adverse childhood experiences (ACEs) demands a coordinated public health response, as a significant body of research details the cumulative impact of ACEs on chronic morbidities contributing to reduced life expectancy. Child welfare workers (CWW) are embedded in this public health effort, tasked with preventing and mitigating the impacts of ACEs through family and prevention services. The National Partnership for Child Safety (NPCS) may improve the wellbeing of CWWs and the effectiveness of Child Welfare (CW) services by improving the quality of safety culture within CW organizations. To inform NPCS quality improvement efforts, our project …

Association Of Race, Ethnicity, And Gender To Disparities In Functional Recovery And Social Health After Major Lower Limb Amputation: A Cross-Sectional Pilot Study, Sheila M. Clemens, Kiarri N. Kershaw, Zoran Bursac, Szu Ping Lee

Physical Therapy Faculty Publications

Objective: To assess if evidence of disparities exists in functional recovery and social health post-lower limb amputation.

Design: Race-ethnicity, gender, and income-based group comparisons of functioning and social health in a convenience sample of lower limb prosthetic users.

Setting: Prosthetic clinics in 4 states.

Participants: A geographically diverse cohort of 56 English and Spanish speaking community-dwelling individuals with dysvascular lower limb amputation, between 18-80 years old.

Interventions: None.

Main Outcomes Measures: Primary outcomes included 2 physical performance measures, the Timed Up and Go test and 2-minute walk test, and thirdly, the Prosthetic Limb Users Survey of Mobility. The PROMIS Ability …

Combined Motivational Interviewing And Ecological Momentary Intervention To Reduce Hazardous Alcohol Use Among Sexual Minority Cisgender Men And Transgender Individuals, Carolyn Lauckner, Bryce Puesta Takenaka, Fidelis Sesenu, Jaime S. Brown, Sally J. Kirklewski, Erin Nicholson, Kimberly Haney, Reuben Adatorwovor, Donte T. Boyd, Keisa Fallin-Bennett, Arjee Javellana Restar, Trace Kershaw

Biostatistics Faculty Publications

Background: Sexual minority cisgender men and transgender (SMMT) individuals, particularly emerging adults (aged 18-34 years), often report hazardous drinking. Given that alcohol use increases the likelihood of HIV risk behaviors, and HIV disproportionately affects SMMT individuals, there is a need to test interventions that reduce hazardous alcohol use and subsequent HIV risk behaviors among this population. Ecological momentary interventions (EMIs), which use mobile phones to deliver risk reduction messages based on current location and behaviors, can help to address triggers that lead to drinking in real time. Objective: This study will test an EMI that uses motivational interviewing (MI), smartphone …

Using Randomization Tests To Address Disruptions In Clinical Trials, Diane Uschner, Oleksandr Sverdlov, Kerstine Carter, Jonathan Chipman, Olga Kuznetsova, Jone Renteria, Adam Lane, Chris Barker, Nancy Geller, Michael Proschan, Martin Posch, Sergey Tarima, Frank Bretz, William F. Rosenberger

Biostatistics Faculty Publications

Recent examples for unplanned external events are the global COVID-19 pandemic, the war in Ukraine, or most recently Hurricane Ian in Puerto Rico. Disruptions due to unplanned external events can lead to violation of assumptions in clinical trials. In certain situations, randomization tests can provide nonparametric inference that is robust to violation of the assumptions usually made in clinical trials. The ICH E9 (R1) Addendum on estimands and sensitivity analyses provides a guideline for aligning the trial objectives with strategies to address disruptions in clinical trials. In this article, we embed randomization tests within the estimand framework to allow for …

Respiranalyzer, Teng Zhang, Xinzheng Dong, Dandan Wang, Chen Huang, Xiaohua Douglas Zhang

Biostatistics Faculty Publications

Motivation: The analysis of data obtained from continuous monitoring of respiratory signals (CMRS) holds significant importance in improving patient care, optimizing sports performance, and advancing scientific understanding in the field of respiratory health. Results: The R package RespirAnalyzer provides an analytic tool specifically for feature extraction, fractal and complexity analysis for CMRS data. The package covers a wide and comprehensive range of data analysis methods including obtaining inter-breath intervals (IBI) series, plotting time series, obtaining summary statistics of IBI series, conducting power spectral density, multifractal detrended fluctuation analysis (MFDFA) and multiscale sample entropy analysis, fitting the MFDFA results with the …

Individual-Network Based Predictions Of Microbial Interaction Signatures For Response To Biological Therapies In Ibd Patients, Federico Melograna, Padhmanand Sudhakar, Behnam Yousefi, Clara Caenepeel, Gwen Falony, Sara Vieira-Silva, Sreenikhitha Krishnamoorthy, David Fardo, Bram Verstockt, Jeroen Raes, Severine Vermeire, Kristel Van Steen

Biostatistics Faculty Publications

Inflammatory Bowel Disease (IBD), which includes Ulcerative Colitis (UC) and Crohn’s Disease (CD), is marked by dysbiosis of the gut microbiome. Despite therapeutic interventions with biological agents like Vedolizumab, Ustekinumab, and anti-TNF agents, the variability in clinical, histological, and molecular responses remains significant due to inter-individual and inter-population differences. This study introduces a novel approach using Individual Specific Networks (ISNs) derived from faecal microbial measurements of IBD patients across multiple cohorts. These ISNs, constructed from baseline and follow-up data post-treatment, successfully predict therapeutic outcomes based on endoscopic remission criteria. Our analysis revealed that ISNs characterised by core gut microbial families, …

Stigma And Efficacy Beliefs Regarding Opioid Use Disorder Treatment And Naloxone In Communities Participating In The Healing Communities Study Intervention, Nicky Lewis, Barry Eggleston, Redonna K. Chandler, Dawn Goddard-Eckrich, Jamie E. Luster, Dacia Beard, Emma Rodgers, Rouba A. Chahine, Philip M. Westgate, Shoshana N. Benjamin, Janae Holloway, Thomas Clarke, R. Craig Lefebvre, Michael D. Stein, Donald W. Helme, Jennifer Reynolds, Sharon L. Walsh, Darcy Freedman, Nabila El-Bassel, Kara Stephens, Anita Silwal, Michelle R. Lofwall, Janet E. Childerhose, Hilary L. Surratt, Brooke N. Crockett, Amy L. Farmer, James L. David, Laura Fanucchi, Judy Harness, Ben Wilburn, Kelli Bursey, Kristin Mattson, Sarah Mann, Rebecca D. Jackson, Aimee Shadwick, Katherine Calver, Deborah Chassler, Jennifer Kimball, Nancy Regan, Jeffrey H. Samet, Rachel Sword-Cruz, Michael D. Slater

Biostatistics Faculty Publications

Background The HEALing Communities Study (HCS) included health campaigns as part of a community-engaged intervention to reduce opioid-related overdose deaths in 67 highly impacted communities across Kentucky, Massachusetts, New York, and Ohio. Five campaigns were developed with community input to provide information on opioid use disorder (OUD) and overdose prevention, reduce stigma, and build demand for evidence-based practices (EBPs). An evaluation examined the recognition of campaign messages about naloxone and whether stigma and efficacy beliefs regarding OUD treatment and naloxone changed in HCS intervention communities.

Methods Data were collected through surveys offered on Facebook/Instagram to members of communities participating in …

Developing Best Practices For Successful University Fundraising Events, Ravyn Ladenburger

MPA/MPP/MPFM Capstone Projects

This research study addresses the crucial role of fundraising in sustaining universities in the United States, particularly public institutions facing funding challenges. For this paper, fundraising refers to the seeking of financial support from individuals to support initiatives at a nonprofit entity, such as a public university. It identifies a gap in research and professionalization within higher education philanthropy, emphasizing the need for standardized training and empirical research. The focus is on studying the effectiveness of fundraising events, especially in public universities like the University of Kentucky, amidst declining government support and rising operational costs. The research problem to be …

How Do Hospital Characteristics Affect Veteran Patients’ Satisfaction In South Korea?, Miran Jo

MPA/MPP/MPFM Capstone Projects

This study examined the impact of the characteristics of commissioned hospitals on the satisfaction of veterans by using the satisfaction survey data of Korean veterans. As a result of a regression analysis using departments, beds, and specialists as independent variables and satisfaction scores as dependent variables, it was found that there was a positive correlation between the number of specialists and satisfaction in general hospitals. However, in clinics and tertiary hospitals, the number of beds was found to have a negative effect on satisfaction. Additionally, the presence or absence of a Veterans Affairs hospital did not have a significant effect …

Financial Monitoring And Oversight Of Public Higher Education Institutions By States A Descriptive Case Study Analysis, Ryan Kaffenberger

MPA/MPP/MPFM Capstone Projects

Higher education in America is at an inflection point with numerous challenges threatening the traditional business model relied on by institutions across the country. These forces include, but are not limited to: 1) A decrease in the number of high school graduates due to historical declines in birth rates (Grawe, 2018; Western Interstate Commission for Higher Education, 2020) 2) Sustained disinvestment by many states in their higher education institutions which has effectively shifted the cost of education to students and families (Kunkle & Laderman, 2023) 3) Increasing skepticism among Americans of the value of higher education, particularly given its rising …

Defining And Evaluating Quality In Early Childhood Education, Abigail Jacob, Anna Nayyir, Vaughn Nebbitt, Nate Terrell

MPA/MPP/MPFM Capstone Projects

Quality early childhood education is essential to ensure that children grow into well-adjusted, healthy, and happy adults. Early childhood is considered a child’s first five years before kindergarten, and nearly 90% of brain development occurs in these five short years (Brain Development, n.d.). According to the Kentucky Governor’s Office of Early Childhood, preschool attendance decreases the likelihood that the child will drop out of high school, be held back a grade, or be placed in special education (Importance of Early, n.d.). Not only does early childhood education benefit the child, but it can also positively influence society. Early childhood education …

Lfcug's Utilization Of 2022 Opioid Settlement Funds For Recovery Housing, Emily Wiley, Ken Britton Jr, Madelaine Coy

MPA/MPP/MPFM Capstone Projects

Following national settlements to combat the opioid epidemic, Kentucky and its local governments received a collective $842 million to invest in prevention and treatment. To employ these dollars most effectively, Lexington-Fayette Urban County Government (LFUCG) aims to become “recovery ready” as a part of Kentucky’s Recovery Ready Communities (RRC) certification program. This mixed methods comparative case study determined the following high-priority variables that align with RRC certification requirements: recovery housing infrastructure, certification disclosure, and medications for opioid use disorder (MOUD) services. To provide additional insight into Fayette County’s recovery housing landscape, we analyzed the following supplemental variables: vulnerable populations served, …

A Review Of The Individuals With Disabilities Education Act In Kentucky Schools System, Spencer Collins

MPA/MPP/MPFM Capstone Projects

The federal government's role in education has been center stage for the past decade. Policy actors on the right call for a complete deconstruction of the federal Department of Education (ED). In today's partisan fighting over government funding, the topic of education services is critical. With further investigations into education services provided by federal funding, one vulnerable population that needs to be safeguarded is those students with disabilities. Protecting those students with disabilities and ensuring equal access to education and resources provided for non-disabled students should be one of the highest priorities of policy actors within the education sphere today. …

Analysis Of Implementation Of Student Homeless Programs Per County School District In The State Of Georgia, Hannah Watson

MPA/MPP/MPFM Capstone Projects

This report investigates the implementation of federal and state policies concerning homeless students within school districts across Georgia. This analysis focuses on understanding how these policies are translated into practical strategies to meet the unique needs of homeless students, encompassing identification, enrollment, and provision of essential support services that result in proof of academic success. Through a combination of policy assessment techniques of current county school district procedures and services offered to students experiencing homelessness and a descriptive assessment of the contents of the current policies through the lens of public administration theories; we will develop a series of key …

Relationship Between Weir Openings And Green Tide Variation In Korean Rivers, Uisuk Jung

MPA/MPP/MPFM Capstone Projects

On the four major rivers in South Korea (Han River, Nakdong River, Geum River, and Yeongsan River), 16 weirs were installed in 2011 to secure water resources. However, there is controversy that the weirs allow the summer Green Tide (hereafter referred to as GT) to thrive, so the South Korean government has been opening them since 2017 to evaluate their effectiveness. The opening of the weirs was mainly done at three weirs on the Geum River, where there are few constraints, and some on the Yeongsan and Nakdong rivers, depending on the degree of constraints, while the Han River was …

Sports Betting In Kentucky: An Analysis Of Kentucky’S Sports Wagering Legislation Through Local And Regional State Budgetary Revenue Trends, Brett Gillispie

MPA/MPP/MPFM Capstone Projects

Kentucky’s legislation legalizing sports wagering in the Commonwealth and delineating its taxation, HB551 of the 2023 Regular Session of the General Assembly, has been implemented and posted numbers in its early months that suggested it will exceed revenue projections for the Commonwealth. Researchers have raised concerns, particularly in studying West Virginia, which implemented similar legislation in 2019, that sports betting may be cannibalizing existing gambling revenue for states that implement it. However, this was not conclusive. While evidence from West Virginia suggests that sports betting may be cannibalizing existing revenue, evidence from Kentucky and the individual and broader regional trends …

The Impact Of Actuarial Valuation Reporting On State Pension Funds, Samantha Montgomery

MPA/MPP/MPFM Capstone Projects

The U.S. is currently experiencing a public pension funding crisis that has become the topic of news outlets around the country and political talking points for legislators. It is estimated at the end of fiscal year 2023 that the average funded ratio for a public pension program is 78.1%, which equates to total unfunded pension liabilities for state retirement systems being approximately $1.4 trillion (Pension Plan Funded Ratio Rankings 2023, 2024). Pension systems across the U.S. are managed by boards and pension agencies that are charged with fiduciary responsibility to manage the pension funds in a manner that focuses on …