Digital Commons Network^™

Improving Diabetes Self-Management Through A Partnership Between Clinical Providers And Community Educators In Appalachian Communities, Soghra Jarvandi, Lydia Hoskins, Karen Carver, Andrew May

Journal of Appalachian Health

Introduction: The burden of diabetes is an increasing public health challenge, especially in the Appalachian Region.

Purpose: This study assessed the impact of a community-based diabetes education program on glycemic control.

Methods: Health Extension for Diabetes (HED) is a 4-month diabetes education program offered by Extension educators in collaboration with clinical providers. Participants’ data were collected via phone interviews at baseline and after completing the program. Assessments included self-reported HbA1c, socio-demographics, diabetes knowledge, self-efficacy, and self-management behaviors. Data were analyzed by SAS software using paired analyses.

Results: Of the 105 participants in the program, 87 (83%) completed the post-assessment. Among …

Leadership And Creative Placemaking In Central Appalachia: Morehead, Kentucky, Toni C. Hobbs

Theses and Dissertations--Arts Administration

In rural Appalachia, longstanding patterns of extractive economic development, coupled with limited public investment and uneven institutional support, have contributed to persistent economic stagnation and a diminished sense of pride among residents. These conditions reflect deeper structural challenges, including economies shaped by resource extraction and external control. Addressing these conditions is critical to fostering economic growth, promoting cultural heritage, and enhancing overall well-being in the region. By cultivating resilient communities, leaders can create environments in which both the economy and local pride can thrive, contributing to a more prosperous and unified Appalachian region.

This study investigates the organizational and leadership …

Stronger Starts: Advancing Maternal And Infant Health In Breathitt County, Kentucky, Madisyn Smith

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

Maternal and infant health outcomes remain significantly poorer in rural Appalachian communities, where structural and socioeconomic barriers limit access to timely and comprehensive care. Kentucky reports elevated rates of preterm birth and infant mortality, with counties such as Breathitt County facing challenges including limited obstetric services, transportation barriers, and high poverty rates. These factors contribute to delayed prenatal care, fragmented services, and increased risk of adverse outcomes.

The Stronger Starts Initiative is an evidence-informed public health program designed to improve maternal and infant health outcomes through a coordinated, multi-level approach. The program integrates nurse-led home visiting, telehealth obstetric consultations, community-based …

Promoting Maternal And Infant Health In Franklin County, Ky: A Community-Based Physical Activity And Education Intervention, Subin Kim

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

Maternal and infant health outcomes are key indicators of population health, yet persistent disparities exist in rural communities across the United States. In Kentucky, Franklin County reflects this pattern, with concerning maternal and infant health indicators despite relatively favorable socioeconomic conditions. Identified challenges include elevated rates of poor physical and mental health days, high drug overdose mortality, provider shortages, and ongoing reproductive health concerns such as tobacco use during pregnancy and increased infant mortality associated with elevated maternal body mass index.

To address these gaps, a three-pronged, community-based prenatal and postpartum physical activity and education program is proposed. The program …

Burnout And Mindful Self-Care Practices Among Bipoc Women Music Therapists: A Cross-Sectional Survey, Melissa V. Peters

Theses and Dissertations--Music

Music therapy as a profession has long acknowledged burnout as a significant occupational concern, yet the experiences of marginalized therapists remain understudied. In particular, little research has explored how burnout and self-care manifest for those who identify as Black, Indigenous, or People of Color (BIPOC) women in a field historically dominated by white women. Most of the existing literature on this topic is focused on the majority identity of music therapists, white women. The purpose of this thesis was to examine the reported levels of burnout among BIPOC women music therapists as well as their reported frequency of engagement in …

Where Does The Money Go? Three Essays On Intergovernmental Transfers, Spending, And Poverty In Indonesia, Jacobus Cd Rijoly

Theses and Dissertations--Public Policy and Administration

Indonesia allocates substantial intergovernmental transfers to local governments; nonetheless, the decrease in poverty remains limited. This dissertation posits that the binding constraint is institutional, specifically the regulations and incentives that dictate the extent to which funds are allocated from the government to designated programs. Institutional pass-through refers to the fraction of a transfer that is allocated to a program expenditure. The three essays integrate estimation, budget composition evidence, and a formal model to explain both modest average effects and heterogeneity across regions and programs.

The first essay evaluates the impact of transfers on provincial poverty from 2001 to 2022 by …

A Scoring Approach For Evaluating And Ranking Complete Streets Projects, Eirini Stavropoulou

Theses and Dissertations--Civil Engineering

Complete Streets is a vital strategy for developing an equitable transportation network that provides access to all users and transportation options to communities. A growing interest in this concept has been noted in the United States, with over 1,700 Complete Streets-related policies implemented nationwide. The Kentucky Transportation Cabinet (KYTC) has developed the “Complete Streets, Roads, and Highways Manual” and the “Complete Streets Policy” aiming to promote a safer and more inclusive transportation system statewide through Complete Streets implementation. A recent KYTC initiative was the development of a scorecard to systematically evaluate Complete Streets projects competing for funding. The scorecard is …

Comparative Analysis Of Community Solar Energy Programs For Developing Sustainable Solar Initiatives In Lexington-Fayette County, Kentucky, Benjamin Kokkonen, Nelson Stone, Widodo Tri Saputro

MPA/MPP/MPFM Capstone Projects

The transition to renewable energy is a critical policy priority for Lexington-Fayette County, Kentucky, as the city aims to achieve net-zero greenhouse gas emissions by 2050. However, expanding solar energy presents a complex challenge: increasing renewable energy capacity while preserving the county’s prime agricultural land. This capstone examines how community solar programs in Virginia, Maryland, and New Jersey can inform the development of a sustainable and equitable solar initiative in Lexington.

Using a comparative program analysis of three state-level community solar models, the research evaluates policies on site selection, financial incentives, equity measures, regulatory enforcement, and program implementation. Findings indicate …

Championing Reproductive And Perinatal Health With The Recovery Community: Improving Access To Healthcare And Health Promotion Resources To Support Recovery, Hartley C. Feld, Alex Elswick, Jeremy Byard, Whitney Beckett, Amanda Fallin-Bennett

Nursing Faculty Publications

Peer recovery support services are instrumental in the promotion of long-term recovery primarily by focusing on building the recovery capital of people with substance use disorders. Women may have specific health-related needs that are not generally part of recovery support staff training. Our team co-created a model by training people with lived experience as coaches to promote the health of women with SUD during the critical period of their reproductive years when mortality from overdose risk is high and can be compounded by issues surrounding pregnancy. We explored the outcomes of a small pilot test of this model to promote …

Addressing Multimodal Transportation Needs Through Complete Streets Implementation, Eirini Stavropoulou, Nikiforos Stamatiadis, William Staats, Teng Wang, Reginald Souleyrette

Kentucky Transportation Center Research Report

Since the early 2000s, over 1,600 transportation agencies in the United States have adopted Complete Streets policies. Recently, the Kentucky Transportation Cabinet (KYTC) published its Complete Streets, Roads, and Highways Manual, which aims to implement a safe and equitable transportation system throughout the state, as well as a Complete Streets policy. The manual and policy offer guidance on integrating Complete Streets principles into road design, however, KYTC currently lacks tools or methods to evaluate how well specific projects address Complete Streets goals. This is problematic because systematic assessments are needed to effectively prioritize projects and allocate scarce funding. Based …

Estimation Of Benefits From Pedestrian And Bicycle Improvements, Dionysios Tzamakos, Nikiforos Stamatiadis, William Staats, Teng Wang, Reginald Souleyrette

Kentucky Transportation Center Research Report

Delivering safe mobility for all users of the transportation system is a key priority of the Kentucky Transportation Cabinet (KYTC). Because many system users rely on pedestrian and bicycle facilities, it is critical for KYTC to balance pedestrian and bicycle facility accommodations with those for motorized users. Currently, the Strategic Highway Investment Formula for Tomorrow (SHIFT) — the Cabinet’s systematic approach to scoring and prioritizing proposed roadway projects — awards up to five points (out of a possible total of 100) for pedestrian and bicycle projects. But the agency lacks a robust method for estimating the benefits of pedestrian and …

Building Sustainable Community-Academic Partnerships While Implementing A Nutrition-Based Blackberry Garden Program At A Senior Center, Dawn Brewer, Annie Koempel, Abbey L. Moellering, Tammy Stephenson, Amy Kostelic, Julie Plasencia, Alexis Sheffield, Ben Guerrant, Alethia Price

UK CARES Faculty Publications

Due to limited access to and low consumption of fruits and vege- tables, older adults are at increased risk of worsening or developing chronic diseases. This paper describes a community-academic partnership that provides a sustainable source of blackberries to attendees of a rural senior center. Qualitative research evaluated the partnership following implementation of a blackberry program. Focus groups and interviews included partners from a senior cen- ter, Cooperative Extension Service, and a detention center. Main themes: group power dynamics influenced communication between research and community leadership teams; unexpected project barriers emerged; and community leadership team sug- gested strategies to promote …

A Case Study In Program Evaluation: A Prospective Program Evaluation Of Timely Reporting And Action Of An Infectious Disease Outbreak, Destiny Cozart

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

Methicillin-resistant Staphylococcus aureus also known as MRSA is an infection of a staph bacteria. High school athletes are at risk of contracting MRSA through skin to skin contact and/or MRSA contaminated equipment. This case study uses the CDC's six-step framework for program evaluation to measure the effectiveness of the online training modules designed to increase the knowledge of staff and stakeholders about MRSA and infectious disease outbreaks. The findings from this evaluation will advise the potential change(s) implemented in training modules, ultimately to enhance competency for decision makers and prevent MRSA and infectious disease outbreak amongst high school athletic programs.

Fodder Shrubs For Improving Incomes Of Dairy Farmers In The East African Highlands, Steven Franzel, C. Wambugu, J. Stewart, J. Cordero, B. D. Sande

IGC Proceedings (1977-2023)

Smallholder dairying is an important enterprise in the highlands of E Africa. Farm sizes average 1-2ha and zero-grazing, cut-and-carry systems predominate. Inadequate protein reduces milk production and forces many farmers to spend scarce cash on commercial dairy meal supplements. In 1991, on-farm trials on fodder shrubs were started in Embu District as a collaborative venture of the Kenya Agricultural Research Institute, the Kenya Forestry Research Institute, and the World Agroforestry Centre. Calliandra calothyrsus was released to farmers in 1995 and was followed by Leucaena trichandra, mulberry (Morus alba), and Sesbania sesban. Farmers produce seedlings of calliandra …

Adoption Of Tropical Legume Technology Around The World: Analysis Of Success, H. M. Shelton, Steven Franzel, M. Peters

IGC Proceedings (1977-2023)

1. Examples of successful adoption of forage legumes are reported from all continents, where they delivered profitability and often provided multipurpose benefits to farmers.
2. Factors vital to successful adoption were: meeting the needs of farmers; building relevant partnerships; understanding the socio-economic context and skills of farmers; participatory involvement with rural communities; and long-term involvement of champions.
3. Organisation of seed supply, achieving scale-up and forming partnerships to implement adoption are key features.
4. Legumes remain an important but under-exploited resource for tropical farming systems. The alternative to legumes will be greater and more costly use of N-fertilisers and purchased protein concentrates.
5. The R&D …

Development And Validity Inquiry Of A Rubric For Interdisciplinary Competencies In Occupational Safety And Health In Capstone Projects Of Carerc Program Graduates, Olumuyiwa Moses Desmennu

Theses and Dissertations--Education Sciences

Emerging demands in the field of interdisciplinary studies reveal a need for competent professionals who can apply their skills and experience to solving complex tasks of the workplace. This has placed inevitable demands on training institutions to adequately equip graduates to deliver on their mandate. Competency appraisal is an effective way to ensure proficiency in graduates. Meanwhile, transparent and valid rubrics provide opportunities for both students and trainers to continuously assess and evaluate the transfer of necessary skills.

This study focused on evaluating interdisciplinary competencies in Occupational Safety and Health (OSH) in the capstone projects of the CARERC program, a …

An Exploration Of Service Needs And Preferences Of Dementia Caregivers In Kentucky, Heehyul Moon, Sunshine Rote, Allison Kacmar, Amy Kostelic, Bari Lewis

Family Sciences Faculty Publications

As Americans live longer, the prevalence of Alzheimer’s disease and related dementias will increase. Caregivers are critical to the care and life quality of people with dementia. Yet, dementia caregivers are at increased risk for health issues, social isolation, and financial challenges. To help educators with the University of Kentucky Cooperative Extension Service work with their local Alzheimer’s Association and the University of Louisville to better support dementia families, we explored caregiver needs and service utilization using an online survey. Our findings highlighted the need for counseling/support, care management skills, resource education, self-care strategies, and legal services. Extension Service Educators …

Exploring Extension Agent Capacity And Readiness To Adopt Policy, Systems And Environmental Change Approaches, Lisa T. Washburn, Heather Norman-Burgdolf, Natalie Jones, Lauren E. Kennedy, Soghra Jarvandi

Dietetics and Human Nutrition Faculty Publications

Introduction: Enhanced Extension outreach strategies combine traditional direct education programs with public health approaches like policy, systems, and environmental (PSE) change. However, the Cooperative Extension system and county-based Family and Consumer Sciences (FCS) Extension agents have historically prioritized direct education programming and diffusion of enhanced outreach strategies has varied. Extension personnel may lack capacity and readiness for successful PSE change implementation. This study explored perceived acceptability, capacity, and readiness for PSE change work among FCS Extension agents in two states.

Method: A survey was developed framed by selected domains from the Consolidated Framework for Implementation Research: Intervention Characteristics, Inner Setting, …

Adoption Of Tropical Legume Technology Around The World: Analysis Of Success, H. M. Shelton, S. Franzel, M. Peters

IGC Proceedings (1977-2023)

Key points

1. Examples of successful adoption of forage legumes are reported from all continents, where they delivered profitability and often provided multipurpose benefits to farmers.

2. Factors vital to successful adoption were: meeting the needs of farmers; building relevant partnerships; understanding the socio-economic context and skills of farmers; participatory involvement with rural communities; and long-term involvement of champions.

3. Organisation of seed supply, achieving scale-up and forming partnerships to implement adoption are key features.

4. Legumes remain an important but under-exploited resource for tropical farming systems. The alternative to legumes will be greater and more costly use of N-fertilisers …

Net Effects Of Wild And Managed Birds In Agroecosystems, Karina Garcia

Theses and Dissertations--Entomology

Agricultural intensification and expansion have reduced biodiversity in agroecosystems, jeopardizing the ecosystem services that nature provides to humans in these landscapes including wildlife-mediated pest control. Among these purveyors of ecosystem services are birds, who can provide services to agroecosystems by consuming arthropod pests. Yet some bird species also act as pests by consuming crops. Herein, I use molecular diet analysis through high-throughput sequencing on DNA extracted from bird fecal samples to examine birds’ diet and classify bird species as consumers of major strawberry pests (Lygus spp.). Additionally, I use targeted PCR approaches to determine which bird species consumed strawberries. …

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

UK CARES Faculty Publications

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

Interventions For Mitigating Drought-Related Livestock Mortality In Africa’S Pastoral Areas: A Review Of Their Relevance And Effectiveness With Special Reference To Kenya, Hallo Dabasso Bulle

IGC Proceedings (1977-2023)

One of the key challenges facing pastoral livestock production in Africa’s drylands is the recurring drought which triggers shortage of grazing resources and massive losses of livestock. Though the pastoralists have traditional drought coping mechanisms, the changing land use, insecure land-tenure arrangements, and the declining natural resource base, have undermined the effectiveness of the mechanisms and worsen the drought impacts. Several interventions have hence been implemented over the years to mitigate the increasing drought impacts and to create more resilient pastoralist societies. Focusing on Kenyan pastoral areas, this study reviewed the relevance and effectiveness of various interventions in reducing the …

The Creeks And Communities Strategy: Accelerating Cooperative Riparian Restoration, Sandra Wyman, Sherman Swanson, Laura Van Riper

IGC Proceedings (1977-2023)

No abstract provided.

Townsville Tropical Savannas — An Innovative Approach To Urban‐Rural Education And Ecotourism, Greg A. Bruce

IGC Proceedings (1977-2023)

No abstract provided.

Farmers Field School Technology Extension Approach Increases Grassland Productivity And Improves Spiritual And Socio‐Economic Welfare Of Communities In Kenya, Apollo B. Orodho, Arwyn Bailey

IGC Proceedings (1977-2023)

No abstract provided.

Participatory Identification Of Factors Inhibiting Integrated Management Of Livestock And Wildlife Production On Kenyan Rangelands, E. N. Muthiani, S. K. Karimi

IGC Proceedings (1977-2023)

No abstract provided.

Multiple‐Use Grasslands: Integrating Forage, Biofuel, And Carbon/Phosphorus Sinks, James P. Muir, B. Lambert, G. W. Evers, T. J. Butler, K. F. Bronson, L. Stanley‐Stevens, R. D. Wittie

IGC Proceedings (1977-2023)

No abstract provided.

Should Environmental Justice Be A National Concern? A Review And Analysis Of Environmental Justice Theories And Remedies, Matthew B. Leveridge

Journal of Natural Resources & Environmental Law

No abstract provided.

How The Legal System Has Failed The Environmental Justice Movement, Karen Smith

Journal of Natural Resources & Environmental Law

No abstract provided.

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

Health, Behavior & Society Faculty Publications

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