Medicine and Health Sciences Commons^™

Evaluating The Decision Making Process Of Pediatricians' Recommendations For First Complementary Foods In Infants, Gretchen Schmoyer

Master of Public Health Capstone Presentations

The purpose of this research study was to document the feeding guidelines from medical associations, understand what pediatricians are recommending to new mothers, and to capture the response from mothers regarding their understanding and personal practices in feeding. Previous studies have found that mothers were not following feeding recommendations by the American Academy of Pediatrics (AAP). Furthermore, the role of infant rice cereal as an early first food is currently under debate. Qualitative research was conducted through interviews with five mothers of children under 2 years, five healthcare providers in pediatric settings, and three policy experts. The Theory of Reasoned …

Low-Income African American Women's Perceptions Of Primary Care Physician Weight Loss Counseling: A Positive Deviance Study, Elaine Seaton Banerjee, Md

Master of Public Health Capstone Presentations

The purpose of this study was to qualitatively and quantitatively evaluate the interactions between low-income, African American women who successfully lost weight and the healthcare system. This mixed methods study followed a positive deviance approach, identifying a population at high risk for obesity and then identifying positive deviants within this population. In this case, positive deviants were low-income, African American women who had been obese, and had successfully lost at least 10% of their weight and maintained this loss for at least six months. We collected data from electronic medical records (EMR) and participant surveys of both positive deviant cases, …

Whole Person Orientation In Primary Care: Understanding Priorities And Assessing Performance, Shannon Doyle

Master of Public Health Capstone Presentations

The purpose of this project was to use a participatory research methodology to develop a framework for understanding the concept of whole person orientation in primary care delivery. Whole person orientation is one of the seven Joint Principles of the Patient Centered Medical Home (PCMH) authored by the American Academy of Family Physicians in partnership with several other physician organizations. Although the PCMH model of primary care has been touted as part of the solution to the U.S. healthcare system’s cost and quality issues, there are few tools available to evaluate implementation of the essential components and none at all …

Addressing Hispanic Adolescent Mental Health In The Texas Border Region: A Policy Analysis, Brian Zepka

Master of Public Health Capstone Presentations

Distinguished MPH Capstone Project 2015

The Texas border region experiences adverse cultural, socioeconomic, environmental, and political challenges that influence the mental health status of adolescents living along the border. The purpose of this research was to provide informed advice to relevant policy makers and facilitate decision-making concerning access to culturally competent mental health services for Hispanic adolescents in this region. A systematic literature review was performed to assess the evidence of barriers these adolescents face when accessing mental health services. Interviews with relevant key stakeholders in the region were then conducted to identify their perspectives on barriers to care. The …

The Effect Of The Sphere Standards On The Incidence Of Communicable And Infectious Diseases In A Complex Humanitarian Emergency, Masashi Rotte

Master of Public Health Capstone Presentations

The purpose of this study was to determine what effect achieving the Sphere Standards relating to water and sanitation had on the incidence of communicable diseases in a returnee camp in South Sudan during a complex humanitarian emergency. The water and sanitation infrastructure of the returnee camp was tracked over time until it met the Sphere Standards. The total camp population was also tracked over the same period of time and compared to daily counts of diseases diagnosed in a medical clinic at the camp. A daily incidence of disease was then calculated for each communicable disease that was tracked. …

Knowledge And Attitudes Assessment Of Out-Of-Hospital Emergency Physicians In Yerevan, Armenia, Aline Baghdassarian, Md

Master of Public Health Capstone Presentations

Out-of-hospital emergency care is in an early stage of development in Armenia. While efforts are underway by the Ministry of Health (MOH) and other organizations to reform the emergency medical services (EMS) system, little data exists on the status of pediatric emergency care (PEC). To evaluate the knowledge and attitudes of out-of-hospital emergency physicians (EPs) in pediatric rapid assessment and resuscitation, and to identify areas of improvement to the pediatric EMS system and PEC education in the capital, Yerevan, a cross-sectional, anonymous, self-administered Knowledge and Attitudes survey regarding pediatric rapid assessment and resuscitation was distributed to all out-of-hospital EPs in …

Smoking Mediates The Relationship Between Adverse Childhood Experiences And Chronic Obstructive Pulmonary Disease In The Brfss Data, Andrew Messersmith

Master of Public Health Capstone Presentations

Associations between adverse childhood experiences (ACEs) and adult health outcomes are well grounded in the empirical literature; such studies generally find both direct and indirect effects of ACE on health outcomes such as liver disease, cancer, and heart disease. In this study, the association between ACEs and chronic obstructive pulmonary disease (COPD) was examined, and smoking was assessed as a partial mediator in the ACE-COPD relationship. Data were collected from five states in which an eight category ACE module was included in the 2011 Behavioral Risk Factor Surveillance System (BRFSS). Logistic regression models were developed to test the mediational hypothesis-that …

Emergency Department Utilization: An Analysis Of The Thomas Jefferson Community Benefit Areas In North Philadelphia, Bettina Berman

Master of Public Health Capstone Presentations

The Emergency Department (ED) is a place where disaster preparedness, public health surveillance, and in many cases, ambulatory primary care is provided. The increase in ED visits, combined with expanded services, has led to overcrowding and significant strains on resources. The purpose of this study was to conduct a retrospective data analysis of emergency department utilization in the Thomas Jefferson University Hospital (TJUH) community benefit areas in North Philadelphia and to determine if patients were utilizing the ED for conditions which could have been treated in the outpatient setting. A comprehensive literature review was conducted. The review focused on studies …

Emergency Department Utilization Among South Philadelphia Residents And Frequent Users In The Jefferson Community Benefit Area, Melissa Mccarey

Master of Public Health Capstone Presentations

Over the past decade, the rate of emergency department (ED) visits increased at almost double the rate that would be expected due to normal population growth. The implications of this increase in ED usage include decreased quality of care, overcrowding, increased wait times, and increased healthcare costs. The purpose of this analysis is to examine health issues, concerns, and underling social determinants of frequent ED users and South Philadelphia Residents who use the Thomas Jefferson University or Methodist Hospital emergency departments. This project is a retrospective data analysis using descriptive statistics, measures of central tendency, and cross-tabulation analysis to analyze …

The Effects Of A Standardized Patient Education Program On Self-Management Outcomes In Patients With Hiv, Jason J. Schafer

Master of Public Health Capstone Presentations

The purpose of this pilot study was to determine the potential impact of a standardized HIV education program delivered during a provider visit on patient self-management of HIV as measured by adherence to care. Following a baseline assessment of HIV knowledge and adherence using validated tools, eligible patients were randomized to receive the standard of care normally provided in clinic, or the standard of care and a10-minute scripted educational presentation delivered during the clinic visit. Following the presentation, patients in the intervention group received the same knowledge assessment tool they received at baseline to identify knowledge changes. Patient adherence to …

Type Ii Diabetes And Dietary Preferences In A Rapidly Urbanizing Region Of West Africa, Megan Doherty

Master of Public Health Capstone Presentations

This study aims to identify themes in food preferences, knowledge, attitudes and behaviors (KAB) among a mix of rural and urban Ghanaians in the greater Kumasi region; to inform health interventions targeting better patient management of type II diabetes in a rapidly urbanizing region of Ghana; and to inform social marketing strategies by providing insight into consumption patterns. Urban centers in Sub-Saharan Africa have been especially impacted by the persistence of infectious disease and accompanying rise in non-communicable disease prevalence, including type II diabetes. In fact, type II diabetes recently registered as tenth among top causes of death in Kumasi, …

Got Worms?: Planning And Evaluation Of A Culturally Appropriate Health Education Pilot Program For The Control Of Soil-Transmitted Helminth Infections In Rwandan Village Children, Pier Hart

Master of Public Health Capstone Presentations

Infections with parasitic intestinal worms known as soil-transmitted helminthes (STH) are endemic in most poor countries in Africa, Asia and Latin America. In Rwanda, the prevalence of helminth infections among school-age children was found to be nearly 70%. Chronic STH infections are associated with malnutrition and anemia, which cause physical and cognitive developmental problems. These morbidities negatively affect educational attainment and vocational productivity and thereby perpetuate the cycle of poverty in affected communities. Control of STH requires both regular deworming treatments and changes in health behaviors relevant to transmission, including personal hygiene and sanitation practices. In Rwanda, a nationwide program …

The Need For A Sugar-Sweetened Beverage Tax In Philadelphia – Policy Analysis, J M. O'Dell

Master of Public Health Capstone Presentations

The goal of this study was to analyze sugar-sweetened beverage tax policy as one strategy to fight America’s obesity epidemic. Obesity is an enormous problem that plagues individuals worldwide. The prevalence of obesity is high in this country, exceeding 25% in 33 states. In Pennsylvania in 2009, 27.7% of adults were labeled as obese. Additionally, there are many more Philadelphians who are overweight or obese (900,000) than who are at a healthy weight (600,000). Obesity is extremely complex and has several causes. One cause of obesity and the main concern of this study is the consumption of sugar-sweetened beverages. Sugar-sweetened …

Assessing Nutrition Knowledge, Skill And Attitudes In Adolescent Girls, Tatyana Jean

Master of Public Health Capstone Presentations

There is still much to be understood about the nutrition habits of adolescents who are just beginning to break away from familial habits and developing individual identities. The African American community in particular, is known to experience disproportionate amounts of overweight and obesity resulting in chronic diseases such as diabetes and hypertension. This study used quantitative and qualitative measures to assess the nutrition skills, knowledge, and attitudesof African American girls aged 14-17. After data analysis, it was found that African American adolescent girls had high body image and self esteem but poor nutrition skill and knowledge. Body image and weight …