Digital Commons Network^™

Examining The Association Between Cervical Cancer Screenings, Health Care Access, And Socio-Demographics Among Women Of Urban/Rural Status In Kentucky, Madison Penix

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

Background: This study focuses on cervical cancer screening rates (e.g., Pap testing) among women of urban/rural status in Kentucky. Specifically, this study’s primary objective is to examine the association between cervical cancer screening rates and health care access among the women of interest. Secondarily, this study aims to identify which socio-demographic variables impact cervical cancer screening rates and health care access. The purpose of doing so is to better understand what disparities and barriers might be contributing to the suboptimal screening rates observed throughout Kentucky.

Methods: An empirical analysis utilizing secondary data from the 2020 Behavioral Risk Factor Surveillance Survey …

Implementation Of Farmers Markets In Bell County, Kentucky, Rachael Schmetzer

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

This proposal addresses the link between food insecurity and obesity through the implementation of farmers markets in Bell County, Kentucky as a way to increase access and consumption of fruits and vegetables in this rural, low-income community.

Identifying Factors Associated With Syringe Reuse Among People Who Inject Drugs (Pwid) In Appalachia Kentucky, Grayson Keith Fuller

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

Aim: Syringe reuse contributes to the spread of infectious diseases. The purpose of this study is to identify factors associated with syringe reuse among people who inject drugs (PWID) in Kentucky.

Methods: PWID (n=238) completed interviewer-administered questionnaires to collect data on syringe reuse and demographic, behavioral, and clinical characteristics. Negative log binomial regression was used to model the associations.

Results: On average, people reused each syringe 9.3 times (median: 3; IQR: 2-10, range 1-95). Syringe reuse was higher among men [aOR=1.386; 95% CI: 1.041-1.845] and those who injected methamphetamine [aOR=2.122; 95% CI: 1.445-3.116]. Reuse was also higher among those who …

Effects Of Covid Prevention And Control Policies In Kentucky Schools During The Fall 2020 Semester, Ciaran Allen-Guy

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

Schools are reopening or have already reopened while implementing precautions intended to reduce the transmission of COVID-19. However, evidence on the effects of these strategies or their benefits relative to each other in the school environment is indirect or lacking. This study investigated the effects of some of these strategies as employed by Kentucky schools in the fall 2020 semester using a linear mixed effects regression model using publicly available fall 2020 school incidence data, survey data from school staff, and Kentucky Department of Education data on school faculty and primary enrollment.

Increasing Physical Activity Rates Among High School Girls In Jefferson County, Kentucky, Haley Copeland

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

Obesity rates across the U.S. are increasing, especially among adolescent females. Physical activity rates have been associated with obesity and many related health outcomes. Regular physical activity can help adolescents improve their cardiorespiratory fitness, build strong bones, control their weight, and reduce depression ¹. It can also help reduce the risk of developing health conditions like heart disease, cancer, high blood pressure, osteoporosis, type II diabetes, and obesity ¹. Thus, physical activity among youth provides a risk factor to target, with the intention of eventually decreasing obesity rates.

Recommended physical education class CDC guidelines are not being met …

An Analysis Of The Differences In Health Outcomes And Socioeconomic Factors Between Veteran Smokers And Non-Smokers In Tobacco-Growing States, Jacob Hauser

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

Tobacco usage still remains the single most preventable cause of disease, disability, and death in the United States. Service members and veterans, especially those residing in tobacco-growing states, face higher levels of societal pressure to take up the habit compared to their civilian counterparts. This research investigates why this is the case, the differences in health outcomes, and the differences in socioeconomic factors between the veteran smoking and non-smoking populations before making policy recommendations to policymakers and stakeholders to address this problem.

Covid-19 Mitigation Strategies School Staff In Indiana, Kentucky, And Ohio, Luu Le

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

Abstract

Background: This cross-sectional study aims to identify the difference in COVID-19 mitigation strategies implementation and adherence among elementary, middle, and high schools in Indiana, Ohio, and Kentucky, based on data from the School Staff Health and Wellness Study research at the University of Kentucky in 2020.

Methods: The sample size of the study was 6,794 participants who work at elementary, middle, or high schools in Indiana, Ohio, and Kentucky. Complete case analyses were performed, which included observation with no missingness in variables (N = 5,971). Descriptive statistics were generated, including a table indicating the implementation of COVID-19 mitigation strategies …

Frequency And Type Of Diabetes Screening Tests In A Sample Of Women With Polycystic Ovarian Syndrome: A Descriptive Study, Jacklyn Vollmer

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

Introduction: Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects 6-12% of United States women of reproductive age. Women with PCOS are at an increased risk of developing type 2 diabetes and fall into high-risk groups for screening guidelines put out by the American College of Obstetricians and Gynecologists (ACOG). Guidelines further suggest that an oral glucose tolerance test (OGTT) be used for diabetes screening in women with PCOS as opposed to an A1C or fasting plasma glucose test. The purpose of this study is to examine rates and type of diabetes screening used among a sample of women …

An Analysis Of The Association Between Cognitive Decline And Geographic Residence Among Women Over 65 In The Southeastern United States, Christine Invergo

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

Abstract

Introduction: The United States is an increasingly aging nation, and aging increases the risk of cognitive decline. Information on the relationship between cognitive decline and geographic residence in the U.S. is limited. Available evidence suggests that rural residents tend to suffer persistent disadvantages in cognitive functioning when compared to sociodemographically similar urban peers. This analysis focused on women over 65 years of age living in the southeastern U.S. The primary objective of this analysis was to determine if there was a significant association between geographic residence and cognitive decline. A secondary objective was to explore variables of interest that …

An Analysis Of Rural-Urban Differences In Health Care Access Among Women In The United States, Ellery Denny

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

The purpose of this project was to examine the relationship between women’s health care access and rural and urban America. Extensive review of existing literature was completed and showed that the United States ranked last out of 11 high-income countries in regard to access to care, administrative efficiency, equity, and health care outcomes (Schneider, 2021). Additionally, women in the United States faced heightened financial barriers to health care that men do not, and also faced unique disadvantages that resulted in reduced utilization of care (Cameron, 2010, p. 1649).

Results showed that rural women were significantly more likely to have one …

Comparing Governmental Communication About Covid-19 Layered Protection Strategies In Taiwan, Kenya, And The United States: A Mixed-Method Analysis Of National Health Agency Websites, Cynthia Mofunanya

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

COVID-19 is a novel coronavirus caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It can result in severe respiratory damage. Different countries have recommended different combinations of protections during the COVID-19 pandemic. Various combinations of mitigation strategies or “layered protections” against coronavirus have also been communicated differently across nations. This mixed-methods content analysis seeks to compare COVID-19 mitigation information on three national health agency websites for Taiwan, Kenya, and the United States. Availability and navigability of information was examined for each mitigation strategy. The Web Resource Rating tool was used to assess the quality of the information about …

An Analysis Of The Association Between Cognitive Decline And Geographic Residence Among Women Over 65 In The Southeastern United States, Christine Invergo

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

Abstract

Introduction: The United States is an increasingly aging nation, and aging increases the risk of cognitive decline. Information on the relationship between cognitive decline and geographic residence in the U.S. is limited. Available evidence suggests that rural residents tend to suffer persistent disadvantages in cognitive functioning when compared to sociodemographically similar urban peers. This analysis focused on women over 65 years of age living in the southeastern U.S. The primary objective of this analysis was to determine if there was a significant association between geographic residence and cognitive decline. A secondary objective was to explore variables of interest that …

Youth Who Run Away From Out-Of-Home Care In Wisconsin, 2010-2020, Sydney Shafer

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

A sample of 27,599 youth 5-17 years old who entered the child welfare system in Wisconsin between 2010 and 2020 were analyzed to examine differences in those who run away from out-of-home care and those who do not. Risk factors analyzed included age at entry into the system and measures of sexual abuse, physical abuse, emotional abuse, neglect, witness to family violence, placement restrictiveness, youth home county socioeconomic disadvantage and urbanicity, and distance from placement to home. Analyses were presented in gender- and race- specific strata. In this sample, 2434 (8.8%) ran away from their out-of-home care placement at least …

Disparities In Access To Chemotherapy Among Kentucky Stage Iv Non-Small Cell Lung Cancer Patients, Joshua Brown

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

OBJECTIVE: This population-based retrospective cohort study examines the association of sociodemographic disparities with the receipt of chemotherapy among patients with metastatic non-small cell lung cancer in the Commonwealth of Kentucky in the precision oncology and immunotherapy era.

METHODS: Kentucky Cancer Registry data from 2010 through 2017 was analyzed using univariate, bivariate, unadjusted, and adjusted multivariate regressions to assess disparities in our population (N = 9490).

RESULTS:We found no significant difference in receipt of chemotherapy between sexes (OR 0.99, P=0.90) nor races (OR 1.12, P=0.22). Patients diagnosed in an Appalachia county were significantly less likely to receive chemotherapy (OR 0.71, …

Demographic Characteristics Of Individuals Needing Treatment For Substance Use Disorder, Amber Hill

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

Introduction:

While multiple options are available for the treatment of substance use disorders (SUD), 9% of individuals reported needing treatment within the last year for illicit drug or alcohol use, according to the 2020 National Survey for Drug Use and Health (NSDUH). Despite concerns about widespread disparities in healthcare access and outcomes, there are limited current data regarding demographic characteristics of individuals that need treatment. It is crucial to identify these characteristics from population-based data in order to develop and implement targeted public health interventions.

Methods:

The NSDUH is an annual, nationwide survey that collects data about substance use and …

Recharge Moments, Scott Keel

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

Abstract Title: Recharge Moments

Background: Recent articles from the CDC and other healthcare agencies have demonstrated the detrimental effects that the COVID-19 pandemic is having on the physical and mental health of the healthcare workforce. Unfortunately, they were less informative in regard to those working for local public health departments. Pre-pandemic and concurrent publications on mindfulness-based interventions have demonstrated the positive and protective effects mindfulness-based interventions can have on burnout prevention and resilience promotion. To gain a better understanding of how the current pandemic might be affecting the public health workforce and to assess whether mindfulness-based interventions would be helpful …

The Impact On Recovery Capital Following High-Intensity Exercise Adjuvant Therapy In Opioid Addiction Treatment, Aaron M. Macdonald

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

OBJECTIVE: The Counseling Center (TCC), a substance abuse disorder (SUD) recovery facility located in Portsmouth, Ohio, began investigating alternative treatment methods that may improve long-term recovery rates through increased recovery capital (RC). RC takes into account numerous social and physical variables during the recovery phase of SUD and evidence shows a higher RC can lead to better recovery outcomes. TCC partnered with Portsmouth Spartan Kettlebell Club (PSKC), a nearby CrossFit (CF) affiliated gym, and created a partnership that allowed clients at TCC to participate in a guided CF program. The purpose of this study was to examine how this program, …

Policy Approaches To Address Childhood Obesity, Omoadoni Roseline Obielodan

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

Background: Childhood obesity continues to be a serious international public health concern. Unfortunately, there are limited treatment options for obesity. One notable intervention option is the University of Kentucky (UK) Pediatric high BMI clinic intervention for childhood obesity. The Clinic provides intervention for childhood obesity through healthy lifestyle habits. This intervention has been reported to be effective.

Even though there is evidence that public health policies that promote healthy behaviors would substantially reduce and prevent the alarming prevalence of childhood obesity, the state of Kentucky does not have well-established practical policies that promote healthy behaviors in children. Studies have shown …

Increasing Initiations Of Communication For Students With Moderate And Severe Disabilities Using A Prompt Hierarchy, Ryan Elizabeth Queenan

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

The purpose of this study was to increase initiations of communication for high school students with moderate and severe disabilities using a prompt hierarchy in the context of environmental arrangements. A multiple probe across participants design was used to evaluate the effectiveness of implementing a prompt hierarchy with an environmental arrangement. The results showed that when using a prompt hierarchy in the context of an environmental arrangement were effective in increasing initiations of communication for high school students with moderate and severe disabilities.

Using Concurrent Operant Analyses To Predict Reinforcers To Increase Work Completion In Schools, Amanda Jo Schaefer

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

In this study, a concurrent operant analysis (COA) was conducted for two elementary aged students in a public school to determine if the results yielded a possible reinforcer for work completion. A simultaneous treatments design was used during the COA to evaluate choice making behavior. The results of the COA indicated the student’s choice making behavior was maintained by access to tangibles, access to attention, or escape. The results were then used to create a token economy in which the student could earn their preferred reinforcer for work completion. An alternating treatments design was used to compare work completion during …

Peer Supports Across Inclusive Environments, Lyndsay Mccullers

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Peer-mediated interventions provide opportunities for students with disabilities to learn a variety of different skills and meet individualized goals. Peers can provide targeted social, behavioral, and academic supports to students with moderate and severe disabilities. One specific peer-mediated intervention is peer support arrangements. These interventions involve providing supports to students with disabilities in inclusive classrooms or other instructional contexts. These supports contain four key components: selection of students, training of peers, peer delivery of supports, and adult monitoring. When implemented with fidelity, peer support arrangements provide numerous benefits to both students with and without disabilities.

The Effectiveness Of Peer Training To Increase Communicative Responses By Peers With Disabilities, Amanda Landherr Taylor

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Individuals with disabilities often have social and communication deficits which impact their development of social relationships. Therefore, individuals with disabilities need additional supports and interventions to gain appropriate social and communication skills. Research demonstrates that peer-mediated interventions are an effective way to help increase social interactions between students with disabilities and students without disabilities. There has been research to support that peers can successfully be taught how to use AAC devices and how to initiate and respond to peers with disabilities. Some of the positive effects of peer-mediated intervention include an increase in social communication skills, inclusion, and increased use …

Interdisciplinary Collaboration: Using A Rapid Coaching Intervention To Teach Parents Naturalistic Strategies To Teach Communication, Rose Campbell

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

In this study, a multi-component, rapid coaching intervention that included providing rationales, modeling, coaching during brief practice sessions, and performance-based feedback to train parents of children with communication delays to use naturalistic strategies during play. In addition, this study modeled successful interdisciplinary collaboration. A multiple baseline design across behaviors was used to evaluate the intervention and subsequent changes in the parent’s behavior. Results indicated that hat the rapid coaching model can be effective when it came to teaching parents how to implement naturalistic strategies. Additional data are needed before a definitive decision can be made regarding the effectiveness of the …

Comparison Of In-Person And Virtual Coaching Of Preservice Special Education Teachers, Sydney Green

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Traditionally, university supervisors have provided coaching to special education preservice teachers after direct observations of sessions within the classroom. As a result of the COVID-19 pandemic, many public school districts in the United States enforced visitor restriction policies that made face-to-face observations difficult or impossible. When faced with this challenge, university supervisors were forced to consider alternative ways to provide feedback. Many questioned whether virtual coaching was as effective as in-person coaching in increasing teacher behaviors. Presently, there are limited studies that suggest one delivery method is more effective or efficient than the other. This study used a Repeated Acquisition …

A Retrospective Within-Session Analysis Of Interview Informed Synthesized Contingency Analyses For The Purposes Of Quality Improvement Within A University-Based Clinic, Amy Wolfe

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Functional analysis (FA) is a tool practitioners can utilize to identify the function of challenging behavior. An interview informed contingency analysis (IISCA) is a variation of a FA. In an effort to improve patient care within a university-based clinic, a within-session analysis of the first test condition of an IISCA was conducted to determine if a shorter assessment yield results similar to the full IISCA. An alternating treatments design was used to evaluate differentiated rates of challenging behavior across conditions for eleven client cases at the university-based clinic. A single test session was enough to determine the function of challenging …

The Effects Of Mand-Model Within Shared Reading Activity On Naming Emotions, Paige Nicole Owens

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

There is a need for social communication skills to be explicitly taught to people with intellectual disabilities and complex communication needs. The use of naturalistic language interventions is an evidenced based practice shown to increase social communication skills in learners with disabilities. In addition, these interventions have proven successful when embedded into a storybook reading format. There is limited evidence when using both strategies to teach the skill of naming emotions. The purpose of this study was to determine the effectiveness of a mand-modeling procedure, during storybook reading, to teach middle schoolers with moderate and severe disabilities to name emotions …

An Overview Of Functional Communication Training For Registered Behavior Technicians, Christopher Dollinger

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Functional Communication Training (FCT) is an intervention involving the differential reinforcement of an alternative response (DRA), in which an appropriate communicative response (e.g., asking for a break) is reinforced while the behavior targeted for decrease (e.g., hitting to get out of work) has reinforcement withheld in its presence. Individuals who work as registered behavior technicians (RBT), under the supervision of a board-certified behavior analyst (BCBA), may implement FCT daily. With that being said, many individuals who choose to work as an RBT may not have as deep of an understanding of the concepts and principles of applied behavior analysis (ABA) …

Increasing Accuracy In Police Report Writing, Zachary Greene

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

The current alternative thesis project consisted of creating an online learning course intended to increase the accuracy with which preservice and in-service police officers write police incident reports. The online course consists of 6 separate modules and utilizes principles of applied behavior analysis (ABA) to assist the learner in understanding and applying the content of the modules. Specifically, components of interactive computer training (ICT), consisting of video modeling, voice over narration, interactive activities, and self-pace module design were implemented in the design of the learning course. Opportunities throughout the course allow the learner to self-reflect, self-assess, and receive feedback.

Comparing Self-Delivered To Instructor-Delivered Reinforcement During Vocational Instruction For Students With Intellectual Disability Using Video Activity Schedules, Katherine Elise White

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

In this study, an adapted alternating treatments design was used to compare the effectiveness of teaching vocational task when using self-delivered reinforcement versus instructor-delivered reinforcement while using video prompting. Participants consisted of four high school students who had been diagnosed with intellectual disabilities. Results indicated that instructor delivered reinforcement was slightly more effective at teaching a vocational task for 2 of the 4 participants. The results of the other 2 participants indicated that both forms of reinforcement delivery were similarly effective.

Teaching Children To Use Interaction Strategies With Their Younger Siblings That Are Minimally Verbal, Abby Rucker

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Children that are minimally verbal often lack same- or near-age peer interaction outside of the home environment. This study attempted to bridge that gap by training older siblings of minimally verbal children to use interaction strategies during play sessions. Through this, researchers were able to examine both the fidelity of use of the trained interaction strategies as well as their effect of the younger siblings’ communication skills.