Characterizing Region Iv State Health Agency - Central Office's Workforce Needs: Results From The 2021 Public Health Workforce Interest And Needs Survey (Ph Wins), Ashley Carroll

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

The purpose of this project was to examine the Region IV State Health Agency – Central Office workforce in regards to retention and reasons for leaving; workforce satisfaction levels and how that influences retention; and training gaps among non-supervisors. An extensive review of existing literature was completed and showed that since the great recession, there has been a loss of 40,000 positions at state and local governmental health agencies (Castrucci & Lupi, 2020). In addition, from 2008 to 2019, there has been a 16 percent decline in the national public health workforce, and 47 percent of public health workers plan …

The Impact Of Flooding Events In Kentucky Counties On Preventable Asthma Hospitalizations, Mckaylee Copher

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

Objective: Given the frequency and intensity of flooding, along with the disparities in respiratory illnesses in Kentucky, this study aims to determine if there is an association between flooding and asthma is crucial to the health of the state population.

Methods: Preventable asthma hospitalizations in adults aged 18-39 were obtained from the Kentucky Cabinet of Health and Family Services, Health and Facility Services Data and included the count of admissions of an ICD-9 diagnosis of asthma, as determined by hospital discharge data. FEMA disaster declarations were used to identify 69 counties that had floods during the period of 2008-2015. A …

Concussion Perceptions And Reporting Behaviors By Individual And Team Sport Participation Among Female Diii Student-Athletes, Bethany L. Stewart

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

Abstract

Purpose. This study aimed to analyze differences between individual and team sport participation and academic year on perception of concussion and reporting behaviors.

Methods. A cross-sectional study was conducted using original data from the Perceptions and Likeliness to Report Concussions in Collegiate Athletes survey distributed to student-athletes from April 2021 to December 2022. The study population was restricted to current residents of the United States, current enrollment in college or university, female-identifying, and between the ages of 18 and 24, yielding a final population of 135 for analysis. Statistical frequency analyses were obtained, then stratified by team and individual …

Psychosocial Outcomes Post-Concussion Of Female Collegiate Athletes, Victoria Farley

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

Concussions are traumatic brain injuries impacting upwards of 3 million athletes per year. Female collegiate athletes are an essential group of athletes to investigate as they account for 47% of all collegiate athletes and often suffer more severe concussions with worse concussion symptoms than their male counterparts. Many symptoms are associated with concussion such as dizziness nausea, headaches, and instability, however, some injury symptoms extend beyond physical symptoms. The symptoms that extend beyond physical often mimic different psychosocial factors like depression and anxiety. This study investigated the associations of injury, the duration of symptoms, and the psychosocial impacts of injury …

Cardinal's Blues: Implementation Of A School-Based Cognitive Behavioral Therapy Program For Jefferson County Public Schools In Louisville, Kentucky, Loui Chang

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

With the increasing rate of adolescent depression and anxiety1 2, developing mental health interventions is necessary. Many adolescents’ times spent in schools increased compared to 20 years ago5, which makes school-based intervention programs suitable for reaching adolescent population effectively. Though there are numerous treatment providers available in Jefferson County, Kentucky, the school-based prevention programs addressing adolescent’s negative mental health outcomes have never been implemented. The Blueprints for Healthy Youth Development developed a program called the Blues Program24. The Blues Program provides an adapted version of group Cognitive Behavioral Therapy sessions to train and educate adolescents coping skills and cognitive restructuring24. …

Maternal Occupation And Pediatric Brain Cancer In Kentucky, Mary Begley

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

Pediatric brain cancer is a rare and potentially deadly diagnosis that affects children in Kentucky at a higher incidence than those nationally. Limited exposures in children early in life to warrant the development and progression of brain cancer point to the role parental exposures experienced in the period prior to conception and throughout pregnancy may play in its development. Many of these exposures may be experienced through occupation. Data on a subset of pediatric brain cancer cases in Kentucky was compared to all cases diagnosed in the state from 1995 to 2019. Survey data of the study sample was collected …

Impact Of Insurance Payer On Stage At Diagnosis Of Prostate Cancer, Hunter M. Stiff

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

Objectives: Prostate cancer (CaP) is the most common site of cancer in men in the United States and is very treatable when diagnosed in localized and regional stages. While there are widely available forms of screening that can detect CaP in its early stages, factors that can affect healthcare access such as health insurance, race, and Appalachian residency have been linked with differences in rates of distant-stage CaP diagnosis. This study aimed to explore the relationships between health insurance, race, Appalachian residency, and late-stage CaP diagnosis in the state of Kentucky.

Methods: A sample of 26,622 men from the state …

A Case Study In Program Evaluation: Evaluation Of A Hypertension Self Management Program, Bailey N. Schenk

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

The CDC's program evaluation process framework is a six-step approach that guides public health practitioners in the evaluation of public health programs. The framework includes engaging stakeholders, describing the program, focusing the evaluation design, gathering credible evidence, justifying conclusions, and ensuring use and sharing of lessons learned. Each step is important in developing a comprehensive and effective program evaluation. This evaluation discusses the application of the six steps of the CDC's program evaluation process framework and how it was utilized in evaluating a hypertension self-management program at a local health department.

Implementing A Mobile Saliva Rinse Screening For P16 Markers For Hpv (Human Papillomavirus) Positive Head And Neck Cancers In Central Kentucky, Madeline Brown

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

Rates of HPV-related head and neck cancers are increasing across the nation and more specifically, there has been a significant increase in the state of Kentucky. This study focuses on the implementation of a mobile clinic saliva-rinse screening program. This program will be set up at UK Athletics Men's basketball and football games in hopes of recruiting middle aged men ages 45-60, who are the target audience of the study. This is the population with highest prevalence for HPV positive head and neck cancers and also the population least likely to visit their health providers regularly. A quick saliva rinse …

Breastfeeding Promotion In The Workplace, Katie C. Nettesheim

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

Breastfeeding is one of the best things a mother can do for her baby. It has many protective qualities including a reduced risk of sudden infant death syndrome (SIDS), asthma, obesity, type 1 diabetes, respiratory infections, ear infections, and stomach bugs for the baby (CDC, 2022). There are also protective qualities for the mother as well, including a reduced risk of high blood pressure, breast and ovarian cancer, and type II diabetes. Breastfeeding exclusively, the infant only receives breastmilk and no other supplementation for 6 months, which maximizes the many benefits that breastfeeding has.

Rural areas of the United States …

Prevalence Of Multimorbidity In The Atherosclerosis Risk In Communities Study At Baseline, Katie Highfill

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

Aim: The aim of this study is to examine the prevalence of multimorbidity among middle-aged adults in the Atherosclerosis Risk in Communities Study at baseline by examining the demographic and socioeconomic characteristics of the participants.

Methods

I included 15,698 participants from the Atherosclerosis Risk in Communities (ARIC) baseline visit. Participants were randomly selected from 4 different locations in the United States. Multimorbidity was defined as the prevalence of 2 or more chronic conditions in an individual. Three different multimorbidity definitions (MM1, MM2, and MM3) were created with different inclusion criterion. Prevalence of each multimorbidity definition was analyzed among participants using …

Epidemiology Of Sars-Cov-2 Breakthrough Infections In Kentucky March 1st 2021 - December 31st, 2022, Harrison Hynes

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

Objective: Provide epidemiologic overview of SARS-CoV-2 breakthrough infections in Kentucky considering both demographic and geographic variables.

Background: We believe descriptive information of breakthrough cases for a defined population will provide public health practitioners with useful information relating to SARS-CoV-2 infection control and vaccination efforts.

Methods: We obtained SARS-CoV-2 case data from the Kentucky Department for Public Health COVID-19 case repository, which mirrors National Electronic Disease Surveillance System (NEDSS) data. The study sample used for analysis comprised 147,000 individuals who tested positive for SARS-CoV-2 in Kentucky between the dates of March 1^st, 2021 and December 31^st, 2022. …

Real-Time Surveillance Of The Drug Epidemic: An Assessment And Comparative Visualization Of Substance Abuse In The Commonwealth Of Kentucky, Julia Van Hosen

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

The purpose of this study was to implement and examine a new surveillance system for Kentucky State Police’s forensics unit to track trends of illicit drugs and drug trafficking, and to see if the implementation of this new system was associated with a decrease in overall drug counts over a period of five months. An extensive review of the literature showed that the drug epidemic in the United States continues to worsen, with public health and law enforcement institutions leading the fight in attempting to end the epidemic, but little evidence showing these two joining forces to work together.

Results …

Changes In Severity Of Diabetes At Diagnosis Following The Onset Of The Sars-Cov-2 Pandemic, Annelise King

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

During the SARS-CoV-2 pandemic it was seen that diabetes was a risk factor for severe COVID-19. The objective of this study is to assess the severity of diabetes at diagnosis during the COVID-19 pandemic compared to pre-pandemic to see how the pandemic and SARS-CoV-2 infection impacted the severity of diabetes. This study used University of Kentucky electronic health records of 13,794 patients who developed diabetes. The majority of patients were female, white non-Hispanic, 65+, and living in an urban area. There were differences seen between the COVID-19 positive and negative cohorts in the DKA and HbA₁c variables, with …

Saint Louis, Missouri Maternal Mortality Prevention Program: Rose Program, Abbi Peck

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

In the United States, maternal mortality has become a growing public health concern after recent studies revealed significant disparities in maternal health outcomes when compared to other high-income countries (The Commonwealth Fund, 2020). The World Health Organization (WHO) defines maternal mortality as the death of a pregnant woman or the death of a woman within 42 days of delivery, miscarriage, termination, or ectopic pregnancy (Centers for Disease Control and Prevention, 2022a). From 2017-2019, the maternal mortality in Saint Louis, Missouri, the state’s largest and most populated metropolitan area, was determined to be 36.4 maternal deaths per 100,000 live births. This …

Health Management And Policy Capstone: A Case Study In Program Evaluation, Kelsey R. Gatton

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

Program evaluation of a hypothetical comprehensive hypertension self-management program as directed by the CDC Framework for Program Evaluation in Public Health.

The Prepare Mobile Program For Hiv Prevention In Washington D.C., Gabrielle Cochran

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

Incidence rates of HIV have decreased in the United States in the past decade, but the southern United States has higher rates of HIV than other regions, and cities in the south, like Washington D.C., have some of the highest rates of HIV incidence in the nation. Risky sexual behavior, needle sharing, and substance use increase the risk of transmitting or acquiring HIV, and these behaviors are more common among unhoused people (CDC, 2021; CPPH, 2022).

Expansion of community resources in cities with high levels of HIV have allowed for many people at high risk for HIV to comply with …

Rapid Scoping Review Of The Epidemiological Evidence For Mercury Exposure And Prevalence Of Alzheimer’S Disease, Rebecca Mattingly

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

This rapid scoping review examines the current body of epidemiologic research evaluating the potential linkage between environmental exposure to mercury and Alzheimer's disease (AD). Alzheimer’s disease accounts for 60-80% of all neurodegenerative disease in the United States and was the seventh leading cause of death in Kentucky in 2020. The exact etiology of AD needs further investigation; however, environmental factors such as pesticides, arsenic, cadmium, lead, and mercury have been correlated with development of AD lesions, cognitive decline, and AD. Mercury is a toxic metal that can be found in air, water, and soil, both from natural and human-made sources. …

Trends In Respirable Coal Mine Dust Concentration (Mg/M3) Based On Coal Miners’ Occupational Designation: An Analysis Of The Msha Coal Dust Samples Data Set (2000-2022), Aaron Blake Charles

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

Rates of Coal Workers' Pneumoconiosis (CWP) have recently increased in prevalence over the past 20 years. Recent regulation (Phase III) by the Mining Safety and Health Administration to lower the coal dust standard to 1.5 mg/m3 has been mandated to assist in reducing the burden of CWP. Occupations in the coal mining industry have different exposures to coal dust depending on their occupational responsibilities. This study examined the respirable coal dust trends for underground and surface mining occupations from 2000 to 2022. The ultimate goal is to see how respirable coal dust exposures have changed in multiple occupations over this …

Health Management And Policy Capstone: A Case Study In Program Evaluation, Bradford Brewer

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

Hypertension has risen steadily among adults in United States over the past 30 years. This increase has also been marked by a significant increase in reported prevalence rates of cardiovascular diseases. In response, the Centers for Disease Control and Prevention (CDC) funded the Lexington-Fayette County Health Department to deliver a hypertension self-management program for adults aged 35 and older. This manuscript follows the six steps of CDC program evaluation to aid Lexington citizens with uncontrolled high blood pressure (≥140/90 mmHg) in successful hypertension self-management. This evidence-based community intervention helps patients take responsibility for managing their hypertension with assistance from health …

Blue Oval Sk Battery Park Environmental Impact And Community Guide, Warren Rummage

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

This Capstone Project Paper will discuss the potential effects of the BlueOval SK Battery Park being constructed in Glendale, Kentucky based on knowledge attained from open records requests and available publicly online. Based on the process of attaining said information, a Community Guide has been generated and is available to distribute to concerned community members. It is the hope that this work will enable those in Hardin County, and possibly beyond, to ensure their environment and community health are prioritized during the construction phase and eventual operation of the EV-battery manufacturing faciliities on this massive 1,500 acre plot of land.

Fork It, Kylee Pipgrass

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

Obesity prevalence is at an alarmingly high rate within the United States, but especially in rural areas of Kentucky. Obesity can lead to a variety of negative physical health outcomes including heart disease, diabetes, stroke, and some cancers. There are also mental disorders associated with obesity through mechanisms such as weight stigma and self-perception. Similar to obesity rates, prevalence and mortality associated of these health outcomes are also seen at disproportionately higher rates in rural, Appalachian Kentucky. Causes for increased obesity and obesity related consequences include some genetic factors as well as behavioral factors like physical inactivity, poor diet, stress, …

Epidemiology Of Angiosarcomas In Kentucky, 2000-2019, Emma Gough

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

Background/Objective: Angiosarcomas are rare, highly aggressive malignant soft-tissue sarcomas of vascular or lymphatic origin. The purpose of this study is to describe geographical distribution of angiosarcoma in Kentucky and to examine the epidemiology of angiosarcoma in Kentucky from 2000 to 2019, including the most common sites where angiosarcomas occurred and risk factors affecting survival. Methods: A sample of 246 angiosarcoma patients was received from the Kentucky Cancer Registry (KCR). Kaplan-Meier curves were produced to examine overall survival, as well as survival by age, insurance type, tumor size, and SEER site. A Cox proportional hazards regression analysis was conducted to estimate …

Roadway Density And Lung Cancer Histology In Kentucky, Mahala Pettus

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

The purpose of this article was to examine the relationship between a proxy measure of exposure to automotive exhaust – roadway density – and risk for adenocarcinoma lung cancer. Using data from the Kentucky Cancer Registry and the Kentucky Geoportal Data Clearinghouse, we conducted a cross-sectional study of the distribution of adult lung cancer cases by histological type across the state of Kentucky. The north-central region of Kentucky has a higher prevalence of adenocarcinomas and greater roadway density. Among adenocarcinoma cases in Kentucky, there are more non-smokers than other types of tobacco use. As smoking rates decrease in Kentucky, and …

Implementation Of A School-Based Adolescent Pregnancy Prevention Program In Harlan County, Kentucky, Jaycea Frederick

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

Kentucky has the 6^th highest rate of adolescent pregnancy in the United States and Harlan County ranks among the highest rates in the state. Adolescent pregnancy is a public health problem and costs taxpayers in the United States around $9.4 billion each year. Overall, there have been declines in adolescent pregnancy but the national average soars above those in other Western industrialized nations such as the United Kingdom. Implementing a comprehensive sexual health education program in a public school setting is an efficient strategy to reach numerous adolescents and influence sexual health knowledge and help to delay the initiation …

Sociodemographic Factors Related To Late-Stage Lung Cancer Diagnosis In Kentucky, Kaylee Stickler

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

Lung cancer is the leading cause of cancer mortality in the United States, and the state of Kentucky has a significant burden of lung cancer morbidity and mortality. The aim of this study is to examine the sociodemographic factors associated with late-stage lung cancer diagnosis in Kentucky. The present study is a retrospective, population-based cohort study that utilizes data from the Kentucky Cancer Registry to examine the associations between late-stage lung cancer diagnosis and sociodemographic factors. Descriptive, bivariate, and multivariable analyses were conducted to estimate the significance of these associations. Significant relationships between the variables of sex, age, Appalachian status, …

Covid-19 Vaccine Acceptance, Hesitancy, And Refusal Among Educators In Spring Of 2021, Jenifer O'Brien

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

The COVID-19 pandemic provided unprecedented vaccine development and deployment. Educators were among the first non-healthcare occupations to become eligible for the vaccine, and were an early predictor of vaccine hesitancy especially among educated females. By the spring of 2021, 87% of teachers had received at least one dose of the COVID-19 vaccine. Among those who expressed hesitancy, no defining demographic factors were found. Those who expressed hesitancy commonly cited a rushed vaccine development process and fear of long term side effects as reasons against vaccination.

Gender Differences In Barriers To Entering Substance Use Treatment, Casey A. Baker

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

Background

Nationally representative data have indicated that less than one in ten individuals with a substance use disorder (SUD) have received recent treatment, suggesting a need for research to examine potential barriers to SUD services. Although research has been conducted to identify some barriers to treatment, there is little research focused on gender differences. To address this gap in research, the present study aimed to examine gender differences in barriers to entering SUD treatment, as well as differences in factors that may impact decisions to enter treatment.

Methods

Participants (N = 62) were recruited from the community as part of …

The Meals On Wheels-Breathitt: A Health Campaign For Reducing Food Insecurity Among The Older Adults In Breathitt County, Kentucky., Sarah Haroon

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

The population of the United States of America is aging at a faster rate than ever before. More than 1 in 6 Americans are now 65 or older (The Washington Post, 2023). Since 2010, compared to people under 65, there has been close to a two-hundred percent increase in people 65 and above (The Washington Post, 2023). The rise in the aging U.S. population is due to increased life span and people living longer (U.S. Census Bureau, 2020). Furthermore, life expectancy for the total U.S. population is projected to increase by six years, from 79.7 in 2017 to 85.6 by …