Medicine and Health Sciences Commons^™

Relationships Between Complex Pediatric Health Conditions And The Built, Physical And Social Environments, Brittany Corley

Theses & Dissertations

The relationship between human health and the environment is complex and overall poorly understood. The environment has a lasting impact on health, and the processes appear to start at conception. Thus, this dissertation examines the potential relationship between pediatric health and the environment.

The first relationship examined was between the built environment and comorbid Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder. Many publications have reported the relationship between socioeconomic disadvantage, Attention Deficient Hyperactivity Disorder, and Autism Spectrum Disorder. However, the link between the built environment and Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder symptom severity is poorly understood. …

Public Health Perspectives On Sexual Health And Family Planning, Molly Mccarthy

Theses & Dissertations

Large bodies of evidence document the importance of sexual and reproductive health (SRH) in the lives of individuals and among populations. Of particular interest are sexually transmitted diseases (STDs), due to their potential for long-term health consequences, and unintended pregnancy because of its association with social and economic outcomes for women and families.

This dissertation addressed three distinct but related areas of reproductive health and family planning: counseling for condom use following an STD test, counseling for contraception following a pregnancy test in a clinical setting, and the effect of abortion on having and achieving long-term plans. These topics are …

Predictors Of Compliance And Predictive Values Of The Breast Cancer Screening Program Of The Oman Cancer Association (2009-2016), Sultan Al Balushi

Capstone Experience

Background: Most breast cancers in Oman are diagnosed at advanced stages and therefore early detection is important. The Oman Cancer Association (OCA) initiated a mobile mammography program in 2009 but no studies have evaluated the impact of the program. This study aimed to estimate the proportion of OCA-screened women who had repeated mammography (compliance) and the associated predictors. The sensitivity and specificity of the program were also evaluated.

Methods: Data for 13,079 women screened in the mammography clinic of OCA from 2009-2016 and medical records of all breast cancer patients seen at Royal and Sultan Qaboos University hospitals during the …

Analysis Of Food Security, Snap Benefit Duration, Income Level And The Relationship With Depression In Households With Children In Omaha., Tatiana Tchouankam

Capstone Experience

Food insecurity is defined as a lack of access to “sufficient, safe, and nutritious food that meets individuals’ dietary needs and preferences for an active and healthy life.” From 2015 to 2016, the number of people undernourished increased from 777 million to 815 million worldwide. Food insecurity affected 12.3 % of Nebraskans and 13.8% of the residents in Douglas County during the same year. There is evidence of associations between food insecurity, income level, and several adverse health outcomes, specifically with regards to mental health. The objective of this study was to examine food security, SNAP benefit duration (i.e., how …

Establishing An Active Reproductive Health Center And A Sliding Fee Scale At Bellevue Health Clinic, Gbadero Yerokun

Capstone Experience

Abstract

Goal

To collect preliminary data that will be used by Bellevue Health Clinic leadership to make decisions about expanding upon reproductive health services, and creating a sliding fee scale for services provided.

Objectives

To describe aspects of the scope of reproductive health care services provided by Title X-funded clinics in Lincoln, Omaha, Fremont, Grand Island, Tecumseh, Hastings, Gering, Norfolk and North Platte (14 total). The project will also compare and contrast existing sliding scale fees provided at these sites and provide subjective answers from key informants of how Title X funding and a sliding fee scale impact the population. …

Examination Of Collaborative Efforts Of Central District To Achieve Success Of The Community Health Improvement Plan, Liene Topko

Capstone Experience

This was a quality improvement project that helped Central District Health Department (CDHD) work more closely with their community partners to identify the activities and programs that are currently in place to address priority health needs that were included in the 2016 Comprehensive Community Health Needs Assessment (CHNA). The purpose of this project is to identify the specific activities and programs that are being implemented by the health department and community partners in relation to the priority needs. These activities and programs were identified by conducting a survey of the major community partners. The findings from the survey helped to …

Employee Wellness At Private Clinic In Omaha, Ne: Social Marketing And Health Communications Perspective, Olivia Chambers

Capstone Experience

Midwest Gastrointestinal Associates (MGI) is a private clinic in Omaha, Nebraska that reached out to the College of Public Health for assistance in the clinic’s employee wellness program. An MPH student with a background in health and wellness provided MGI with a health promotion intervention to increase employee participation rates. A change was made to the wellness program in 2017 away from monthly health challenges and points—to small gifts distributed to all employees to increase engagement and morale. An initial program evaluation was performed to understand employee understanding and needs. Discovered was the need for an outlet employees could turn …

Evaluation Of Adult Mental Health First Aid: Findings From 2015-2017 Post-Course Surveys, Gina Schwieger

Capstone Experience

Abstract

Introduction: Lack of knowledge about mental health, lack of access to mental health care, and stigma create substantial barriers to the overall United States adult population from seeking or helping individuals with behavioral health issues. This study evaluated Adult Mental Health First Aid (MHFA) courses, an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing the community’s confidence in helping and frequency of referring people in need.

Methods: This retrospective evaluation of 2015-2017 Adult MHFA courses, utilizes qualitative and quantitative data from post-course surveys completed by course participants. Quantitative data was measured using a five-point Likert Scale. …

The Current Burden Of Chlamydia And Gonorrhea Infections In The Three Rivers Health District, Donna Jordan

Capstone Experience

Background: The proportion of Chlamydia and Gonorrhea in Douglas County, Nebraska is significantly higher than Nebraska and the U.S. Consequently, the Douglas County Health Department has initiated numerous programs to combat STIs. However, the prevalence of Chlamydia and Gonorrhea has sharply increased in recent years. Adjacent to Douglas County is the Three Rivers Health District, including Dodge, Saunders, and Washington Counties. Few studies have assessed the burden of Chlamydia and Gonorrhea in the Three Rivers Health District.

Objectives: The objectives of the study were to 1) Compare Chlamydia and Gonorrhea by age, gender, and ethnicity for Dodge, Saunders, and Washington …

Hpv Vaccination Of Children Among Motherse Of Mexican Origin, Bibiana M. Carvajal-Suarez

Capstone Experience

Background. The Human Papillomavirus (HPV) is a causative agent for the development of cancer which is a public health concern worldwide. In the United States (US), the highest incidence of cervical cancer is among Hispanics/Latinos. Although Hispanics/Latinos show the highest utilization rate of HPV vaccine, in general, the vaccination rates are still behind the Healthy People 2020 goal of 80%. The knowledge about this virus has been found low or nonexistent among most populations in the US, especially among minorities and populations with lower education and socioeconomic status. The knowledge and beliefs of Hispanic/Latin mothers about HPV and HPV …

The Exploration Of Historical, Cultural, And Healthcare Utilization Factors When Clinically Treating Refugee Patients: Healthcare Providers’ View, Kandy Do

Capstone Experience

The objective of this project is to explore historical, cultural, and healthcare utilization factors that are significant to healthcare providers in their practice to clinically treat refugee patients holistically and equitably. Semi-structured interviews supported by a pre-interview questionnaire were conducted with 14 healthcare providers, who have experience in working with refugee patients. Purposive and snowball sampling method was used to recruit 14 healthcare providers. Thematic analysis was used to analyze qualitative data. Descriptive analysis was performed on the pre-interview questionnaire results. To our knowledge, there is limited research exploring historical, cultural, and healthcare utilization factors that are relevant for providing …

Survey Of Indoor Air Quality In Residences Of Wic Participants In Lincoln, Nebraska, Eun Hee Kwon

Capstone Experience

Since 1992, Women, Infants, and Children at the Lincoln Lancaster County Health Department has provided supplemental food benefits, nutrition information, breastfeeding support, immunization referrals, and dental services to support low-income families and their children. However, statewide, the retention rate has been dropping since 2009, and if this continues, it can result in adverse health outcomes. As part of the Service Learning activities, this study aims to evaluate current services on clients’ experiences and improve their satisfaction by conducting the WIC participant-centered services survey. This cost-effective intervention program has been working successfully, however it does not provide the information of environmental …

Epidemiologic And Spatial Differences In Colorectal, Lung, Breast, And Prostate Cancer Mortality-To-Incidence Ratios Between Blacks And Whites In Louisiana, Anas Almatrafi

Capstone Experience

Mortality and Incidence rates are widely used as indicators of health disparities among different racial groups. The current study used the mortality-to-incidence ratio (MIR) to provide a better population-based indicator of survival that can be used as an alternative and more accurate measure of the fatality based on incidence. This study intended to calculate and map MIRs for colorectal, lung and bronchus, breast and prostate cancers in Louisiana by race (Blacks vs Whites), sex, age groups, and geography. Age-adjusted mortality and incidence rates were calculated using the latest data release of the Surveillance, Epidemiology, and End Results (SEER) Program (1973-2014). …

Youth Focus Groups: Design And Analysis Plan For The Bears Project, M. Renee Beacom Claborn

Capstone Experience

This capstone project produced a qualitative research design and analysis plan for youth focus groups as part of a Quality Improvement project at OneWorld Community Health Center (OWCHC) School-Based Health Center (SBHC) located at Bryan High School (BHS) in a program called BEARS. The intended use of this project is to serve as a reference guide for BEARS program planners to utilize as part of the data collection and analysis processes. The purpose for collecting qualitative data for this project is three-fold. 1. To explore adolescents’ perspectives of risk behaviors and associated health determinants common to their age group 2. …

Multilevel Worksite Wellness Intervention To Improve Individual Behaviors And The Worksite Environment, Mariah Morgan

Capstone Experience

Due to increasing obesity rates, public health approaches must focus on improving healthy behaviors and reducing the risk of obesity-related health problems (“Nebraska State Nutrition Profile,” 2012; “State of Obesity,” 2016). Worksites offer opportunities to stimulate behavior change through environmental supports and provide natural structures for social support; therefore, worksites are ideal locations for teaching and implementing health promotion programs (Beresford et al., 2001; Salinardi et al., 2013; Sorensen et al., 1996; Touger-Decker et al., 2008). The Social Ecological Model (SEM), which illustrates that various factors are intertwined at multiple levels to influence behaviors, has been shown to produce significant …

Assessment Of Ems Workforce In Nebraska With Future Strategies, Matt Holt

Capstone Experience

Well-trained and fully staffed Emergency Medical Services (EMS) play a key role in improving the health of the surrounding community through rapid response, on scene care, and transportation to an appropriate facility. EMS is an integral part of the community, vital to limiting the severity of injuries, preventing morbidity, and improving the health of their populations. In order to ensure Emergency Medical Services in Nebraska are able to meet the needs of their populations and continue providing high-level care, an assessment of the State’s EMS workforce was conducted. By completing a workforce assessment, we gained a better understanding of the …

The Use Of Electronic Health Records Data For Public Health: A Snapshot Of Current Practices In Nebraska’S Local Health Departments, Kushal Karan

Capstone Experience

Background: Public health issues are constantly changing and require local health departments (LHDs) to continually evolve in their approaches to address these issues. Advancements in health information technology (HIT), such as electronic health records (EHRs), play an important role in the collection of data that can be used to improve population health.

Objective: The purpose of this project was to assess the current use of electronic health records data by Nebraska’s local health departments and identify the data or tools they are using to address the health needs of the populations they serve.

Methods: In this study, a Mixed-Methods approach …

Awareness And Attitudes Of The Latino Community In Omaha On Colorectal Cancer And Screening, Roger Gonzales

Capstone Experience

No abstract

Primary Care Provider’S Perspectives Of Integrating Public Health Into The Prevention And Management Of Type Ii Diabetes Mellitus In Rural Nebraska, Emma Frost-Briley

Capstone Experience

Through the 2011 Community Health Needs Assessment, the Four Corners Health Department has identified type II diabetes mellitus as one of the communities top concerns within their communities. The goals of this project were: to develop a survey to assess the state of current practices of primary care providers on type II diabetes mellitus in the health department district, to identify primary care providers views on prevention, treatment, and management of type II diabetes mellitus in the health department district, and to examine primary care providers and local health department’s views on how primary care and public health can be …

The Development Of A School Lunch Observation Measure To Assess School District Lunch Menu Implementation, Mariam Taiwo

Capstone Experience

Background: The most recent estimate of the prevalence of child and adolescent obesity in the United States is 17% (Ogden, Carroll, Lawman, & et, 2016). Based on evidence that the availability of healthy food at schools can significantly impact the nutrition behaviors of children, the Healthy and Hunger Free-Kids Act sets policy for the United States Department of Agriculture (USDA), which includes the National School Lunch Program (NSLP) and the School Breakfast Program (SBP) (USDA, 2017a). School food authorities (SFAs) are responsible for administering school feeding programs (Byker, Pinard, Yaroch, & Serrano, 2013). In other words, local school authorities (school …

Factors Associated With Fatalities In Production Agriculture, Moses New-Aaron, Jessica Semin, Risto Rautiainen, Murray Madsen

Posters and Presentations: College of Public Health

Background: Studying the work environment and demographics of agricultural workers involved in fatal incidents can provide valuable information on the cause of fatalities and lead to better prevention measures.

Objectives: To determine populations at risk of fatalities and the determinants of fatalities in production agriculture.

Method: Agricultural injury and fatality data were obtained from Press clippings and Google alerts covering seven Midwest States (SD, ND, MN, IA, NE, KS and MO). Google Alerts were collected based on key words including: “farm accident”, “farm incident”, “farm death”, “ranch accident”, ”ranch incident”, “ranch death”, “ATV farm death”, “ATV ranch death”, “livestock death”, …

Frequently Identified Gaps In Antibiotic Stewardship Programs In Critical Access Hospitals, Philip Chung, Regina Nailon, Kate Tyner, Sue Beach, Scott Bergman, Margaret Drake, Teresa Fitzgerald, Elizabeth Lyden, Mark Rupp, Michelle Schwedhelm, Maureen Tierney-Brenran, Trevor Van Schooneveld, Muhammad Salman Ashraf

Posters and Presentations: Nebraska ASAP

Background: Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) is a CDC funded project. ICAP team works in collaboration with NE Department of Health and Human Services (NEDHHS) to assess and improve infection prevention and control programs (IPCP) in various health care settings including resource limited settings like critical access hospitals (CAH). Little is known about the existing gaps in antimicrobial stewardship programs (ASP) of CAH. Hence, we decided to study the current level of ASP activities and factors associated with these activities in CAH.

Methods: NE ICAP conducted on-site surveys in 36 CAH from October 2015 to February …

Comparison Of Agricultural Injury And Fatality Characteristics Obtained From Media Monitoring Versus Official Statistics, Moses New-Aaron, Jessica Semin, Risto Rautiainen, Murray Madsen

Posters and Presentations: College of Public Health

Objective of project:

1. Compare the characteristics of fatal injuries reported by CFOI and CS-CASH media monitoring

2. Analyze the agreement between CFOI reported injuries and CS-CASH media monitoring fatal injuries

Planning/Research Method:

Background:

The Bureau of Labor Statistics, Census of Fatal Occupational Injuries (CFOI) provides statistics on occupational fatalities, but information on individual cases is not reported. The Central States Center for Agricultural Safety and Health (CS-CASH) tracks media reports of agricultural injury and fatality cases to augment CFOI data.

Methods:

Data was obtained from variety of sources. The primary data source was "Google Alerts" and other sources includes …

Patient-Centered Medical Home Adoption In School-Based Health Centers, Abbey Gregg

Theses & Dissertations

The patient-centered medical home (PCMH) is promoted as a primary care delivery design that can improve health care quality and patient outcomes while controlling health care costs. To achieve PCMH recognition, primary care providers must implement practice-level changes in order to deliver care that is comprehensive, coordinated, accessible, high quality, and whole-person oriented. This practice transformation requires advanced use of health information technology, staff investment in quality improvement and care coordination, and significant investments of both financial and human resources to support these activities. As a safety-net provider, school-based health centers (SBHCs) serve vulnerable children that typically experience barriers to …

Structural Violence And Gender-Based Violence In The United States, Sarbinaz Z. Bekmuratova

Theses & Dissertations

Three components of the dissertation project examined the relationship between three different constructs of structural violence and women’s experience of different violence types in their lifetime in the United States. The violence types examined in the study included psychological aggression, coercive control and entrapment, physical violence, stalking, sexual violence, and rape. 2010 National Intimate Partner Violence and Sexual Violence Survey with the final sample size of 9,827 was used for all three portions of the study to analyze the association of structural violence with six types of violence. Additional datasets used were Institute for Women’s Policy Research’s Status of Women …

Hospital Based Emergency Department Visits With Dental Conditions: Outcomes And Policy Implications In The States Of California, Nebraska And New York, Sankeerth Rampa

Theses & Dissertations

The purpose of this dissertation was to present state-level estimates of hospital-based emergency department (ED) visits with dental conditions across all ages in the states of California, Nebraska, and New York. Also, this dissertation examined the outcomes and impact of changes in Medicaid policies on the utilization of ED with dental problems. State Emergency Department Databases (California, Nebraska, and New York), a component of the Healthcare Cost and Utilization Project (HCUP) was used for this dissertation. Dental conditions were identified by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. High-risk groups visiting EDs with dental conditions were …

Refugee Health Needs Assessment In Omaha, Nebraska, Dejun Su, Drissa Toure, Kandy Do, Naw Latt Nlam, Jessica Ern

Reports: Center for Reducing Health Disparities

No abstract provided.

Epidemiologic And Clinical Profiles Of Uterine Cancer In The Gharbiah Province Of Egypt, Saad Alshahrani

Theses & Dissertations

Background: Uterine cancer is one of the top-ranking cancers of women with wide international variations in incidence rates. Egypt has a lower incidence of uterine cancer than other countries in the Middle East. In addition to the international incidence variation, there are also wide variations in incidence by rural and urban areas within countries. Therefore, this research project focused on the Gharbiah province, north of Cairo in the Nile Delta, with the aims of investigating demographic and clinical characteristics of uterine cancer, assessing rural/urban variation in incidence rates, and evaluating the possible role of hysterectomy in under-estimating the disease incidence …

Sex And Sexuality Of Breast Cancer Survivors, Aja D. Kneip Pelster

Theses & Dissertations

With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the United States. A large group of this population consists of breast cancer survivors. The purpose of this research was to explore the intersection of breast cancer survivorship, at points beyond the termination of treatment, and sexuality, including expressions and performance of gender, relationships, and sexual behavior. The current study used semi-structured interviews, conducted with 21 Midwestern women at least 6-months post-treatment, to better understand the intersection of these two concepts. Following traditions of narrative and phenomenological qualitative research, the women’s own …

Epigenetic Modifications Of Human Placenta Associated With Preterm Birth, Drissa Toure

Theses & Dissertations

Preterm birth is a complex multifactorial process. Despite the well-known role of the placenta in supporting the fetal development and maternal-fetal tolerance, the placental epigenetic modifications and preterm birth (PTB) remains poorly understood and under investigated. Various maternal and environment factors can influence epigenetic programming during fetal development to affect the functioning and structures of organs, including the placenta, which can lead to adverse pregnancy outcomes, including PTB. The understanding of the placental epigenetic alterations and maternal determinants associated with PTB are apparently indispensable for the development of actual diagnosis and methods of prevention and treatment of premature labor. The …