Medicine and Health Sciences Commons^™

Evaluation Of A Childhood Community-Based Comprehensive Asthma Management Program, Stephanie E. Welsh

Master of Public Health Program Student Publications

Background: The Dayton Children’s Hospital Comprehensive Asthma Management Program incorporates Community Health Worker (CHW) interventions to improve child asthma control and reduce urgent health resource utilization.

Methods: Children in grades two to five with parent- or physician-identified asthma received one of three levels of intervention, based on self-selection by caregivers: (1) child asthma education; (2) child and caregiver asthma education; (3) child and caregiver asthma education, plus home assessments. Child Asthma Risk Assessment Tool (CARAT) scores were collected before intervention to assess risk. Childhood Asthma Control Test (C-ACT) scores and urgent health visit numbers were collected before and after intervention. …

The Association Between Secondhand Smoke Exposure And Metabolic Syndrome In Children With Elevated Bmi, Alexandra Lawson

Master of Public Health Program Student Publications

Background & Purpose: The childhood obesity epidemic is associated with increased metabolic syndrome (MetS) and cardiovascular morbidity. The purpose of this study was to determine whether secondhand tobacco smoke exposure (SHSe) is associated with MetS in children with elevated body mass index (BMI).

Method: A retrospective chart review was conducted on children aged six to 11 years with elevated BMI seen in a pediatric lipid clinic from 2008-2014. Data included age, sex, race, BMI, and five MetS criteria. MetS was defined as BMI ≥85th percentile and ≥two of the following: systolic or diastolic blood pressure ≥90th percentile, HDL/dL, triglycerides >150 …

Are Maternal Child Health Outcomes Affected By Adequacy Of Prenatal Care In Montgomery County, Oh?, Amy Rouse

Master of Public Health Program Student Publications

Background: Prenatal Care has been recommended by the World Health Organization for all pregnant women in order to improve health outcomes of the mother and the child. However, recommendations for the number of visits required to provide adequate health care and improve outcomes continue to be debated. Understanding if adequate prenatal care is improving maternal child outcomes is essential before making these recommendations. This research aims to determine if in Montgomery County, OH the adequacy of prenatal care influenced gestational age at birth, birth weight, breastfeeding rate, rate of cesarean sections, and smoking cessation rates.

Methods: De-indentified birth data was …

Rights Of Ohio Mothers: Best Practices For The Pediatric Patient With A Life-Threatening Illness, Kelly Peekstok

Master of Public Health Program Student Publications

The purpose of this paper is to evaluate and review current best practices with regards to a minor’s refusal of life-sustaining medical treatment. The policies of other developed countries and states within the United States serve as a guide for developing evidence-based guidelines for Ohio healthcare professionals. Four specific cases were identified and then analyzed. The results showed that in three of the four cases, the wishes of the minor were followed. While each case contains its own set of complexities, creating a developmental guideline for healthcare organizations will ensure protection of the minor’s capacity to make autonomous decisions.

Correlation Of Discharge Diagnostic Codes With Laboratory-Confirmed Methicillin-Resistant Staphylococcus Aureus Bloodstream Infections At A Large Pediatric Hospital, Andrew J. Kreppel

Master of Public Health Program Student Publications

Background: Methicillin-resistant Staphylococcus aureus (MRSA)-specific hospital discharge codes were introduced in October 2008. The purpose of this project is to study the correlation of these codes with laboratory-proven pediatric MRSA bloodstream infections.

Methods: Laboratory and discharge databases were used to identify patientsChildren’s Hospital Medical Center from October 2008 through December 2010 with MRSA bloodstream infections. The laboratory database identified patients with a positive blood culture for MRSA, and the discharge database identified patients with an MRSA bloodstream discharge code (038.12 for MRSA sepsis or 041.12 for MRSA infection with either 790.7 for bacteremia or 771.81 for newborn sepsis or 771.83 …

Trends In Maternal And Infant Health: An Analysis Of Births In Montgomery County, Ohio, 2000-2010, Abby Burns

Master of Public Health Program Student Publications

The demographic characteristics of women who give birth are continually changing. Age, education, use of assisted reproductive technology, BMI before pregnancy, and weight gain during pregnancy are maternal factors that play a role in maternal and fetal health. Other factors including induction, route of delivery, calculated gestational age, and birthweight help determine and identify complications of pregnancy. The purpose of this study is to analyze trends of maternal demographics, risk factors, and birth outcomes associated with poor health outcomes. This research is a secondary analysis of Ohio Natality Statistical Files collected by the Ohio Department of Health, Center for Vital …

Pertussis In Ohio: A Descriptive Analysis Of The 2010 Columbus Outbreak And Patterns Of A Reemerging Childhood Disease, Christopher Rohde

Master of Public Health Program Student Publications

Objective: In 2010, Columbus, Ohio experienced the largest outbreak of pertussis that it has had in the past 25 years. Similar outbreaks are occurring across the nation on an increasing basis. This descriptive study examines the 2010 outbreak and describes the demographics of the affected population. Comparison is made to previous and current pertussis incidence in Ohio and outbreaks elsewhere in the United States. Contributing factors to the increasing occurrence of pertussis outbreaks are discussed.

Methods: Raw data was obtained from the Columbus Public Health epidemiology department and is gathered through the Ohio Disease Reporting System (ODRS). Pertussis cases are …

The Influence Of School Eating Environment On Children's Eating Behaviors: An Examination Of The Snda-Iii, Sabrina M. Neeley

Master of Public Health Program Student Publications

The prevalence of childhood overweight and obesity in the United States has prompted researchers to examine the factors that contribute to children’s food choices and consumption. Schools provide ample opportunities to teach children healthy eating habits, as well as create eating environments that are conducive to healthy eating behaviors. The National School Lunch Program (NSLP) provides federally assisted meals to millions of children every day and the assessment of the NSLP provides an opportunity to examine the school-eating environment. Hierarchical and logistic modeling of the SNDA-III, the USDA assessment of the NSLP, was conducted to determine relationships between environmental factors …

Gaps And Strengths In Us Policies On Infant And Young Child Feeding: An Analysis Based On The Global Strategy On Infant And Young Child Feeding, Linda J. Smith

Master of Public Health Program Student Publications

This research project reviews the evidence on the significance of infant and young child feeding to public health goals, analyzes US policy documents in relationship to the Global Strategy using the World Breastfeeding Trends Initiative (WBTi) to quantify the findings into a national score, and then summarizes the gaps and strengths in US policies and makes recommendations. Using the WBTi scoring system, strengths for the US exist in national policy, Baby-Friendly Hospital Initiative, monitoring and evaluation, and complementary feeding. Mother support and community outreach, information and support were moderate. Gaps exist in policies on infant feeding in emergencies and for …

Prevalence Of Metabolic Abnormalities In Children With Varying Degrees Of Obesity, Leah Sabato

Master of Public Health Program Student Publications

As the prevalence of obesity among children has risen, metabolic syndrome, a cluster of abnormalities which includes obesity, altered glucose metabolism, hypertension, and dyslipidemia, has increasingly become recognized in the pediatric population. Metabolic syndrome has been studied extensively in adults, and there is increasing interest to understand the condition in adolescents; however, studies of metabolic syndrome in younger children are limited. The purpose of this study is to examine the prevalence of metabolic syndrome and its individual components among children aged 6-10 years. Demographic, anthropometric, and biochemical data were gathered retrospectively from the medical records of 222 obese children aged …

Prevalence Of Obesity Among Head Start Preschoolers In Western Ohio, Angela Sims

Master of Public Health Program Student Publications

Objective: The intent of this study was to examine low income Head Start overweight and obese preschoolers, ages 3-5, in 8 western Ohio counties. Variables of interest included: obesity status, rural versus metropolitan location, home versus center-based Head Start, and access to physicians.

Methods: Data was collected retrospectively from the host Head Start site located in Piqua, Ohio. All Head Start enrolled preschoolers (N=1,181) ages 3 to 5 within the 8 western Ohio counties and 43 programs were studied. All children were considered of low income based on their acceptance into the Head Start program.

The data was retrieved from …

The Effect Of Prenatal Care And Other Factors On Preterm Births In Montgomery County 2007-2009, Leslie A. Schmieder

Master of Public Health Program Student Publications

Introduction Preterm birth is defined as a baby who is born before 37 weeks of pregnancy. Problems with preterm birth include an increased risk for health complications throughout life as well as having significantly more medical expenses compared to a full term infant. Prenatal care has shown to decrease the risk for preterm birth nationally. The objective of this project was to analyze prenatal care and other risk and demographic factors to determine their association with preterm birth in Montgomery County.

Method Data used included the 2007-2009 Montgomery County Birth Certificate Data for mothers who had singleton births. The Kessner …

Diabetes Obesity-Wellness Opportunity Program (Dowop) Evaluation, Francis Banahene

Master of Public Health Program Student Publications

The aim of the study was to evaluate Diabetes Obesity - Wellness Opportunities Program (DOWOP) for overweight and obese adolescents aged eight to 14 years.

The study was conducted over 14 weeks at Victor J. Cassano, Sr. Health Center in Dayton, Ohio. Thirteen weekly nutrition, exercise and cognitive presentations were held. Cooking class was held on week thirteen. Participants completed food and activity diaries. The program sessions focused on healthy eating, increasing physical activity, decreasing sedentary behavior and supporting participants maintain healthy lifestyle.

Nurses recorded BMI and waist circumference at baseline, week 7 and week 14. Program administrators were interviewed …

Maternal Characteristics And Infant Birth Weight In Dayton, Ohio, Matthew Pellerite

Master of Public Health Program Student Publications

Objective: To better understand and identify modifiable maternal risk factors that are driving the increased incidence of low birth weight (LBW) in Montgomery County.

Background Information: LBW has lifelong effects on growth and development. These medical and social implications are coupled with an enormous economic burden. In the US, over 5.8 billion dollars are spent annually to care for LBW babies. Despite the recognition of these medical and economic challenges and the implementation of public campaigns to decrease rates, LBW trends have continued to increase. Between 1995 and 2005 the LBW rates in the US incrementally increased from 7.3% to …

Gender Differences In Risk Behaviors Of Adolescents Enrolled In An Inner City Charter High School, Kimbra Dent

Master of Public Health Program Student Publications

Adolescents engage in health risk behaviors (Grunbaum, 2001). Persons engaging in high‐risk behaviors during adolescence have disproportionally poor health as adults (Grunbaum et al., 2003; Resnick et al., 1997). Adolescents comprise a target group for health promotion and education programs to establish healthy lifestyle choices that transcend into adulthood. The purpose of this descriptive research study was to identify, analyze, and compare the health interests and health risk behaviors between male and female inner city, adolescent, charter high school students. The study served as a needs assessment before a health promotion and education program was implemented into the high school. …

The Relationship Of Maternal Age, Trimester Of Entry Into Prenatal Care, Maternal Postpartum Depression, And Race With Birth Weight Of Infants Born In Cincinnati, Ohio, Kelli Kohake

Master of Public Health Program Student Publications

Healthcare, resources, and technology in the United States (U.S.) has improved, yet the U.S. ranks 29th in the world for the highest infant mortality rates – behind other less developed countries. Within the U.S., Ohio (and Hamilton County in particular) has high rates of infant mortality. Low birth weight and preterm births are a major cause of infant mortality. Data analysis was done consisting of descriptive statistics and Analysis of Variance of the prenatal patients served at the Cincinnati Health Department health centers who delivered in 2009, with dependent variables of birth weight and postpartum depression. Independent variables included maternal …

Environmental Influences On Pediatric Obesity: An Examination Of The 2007 National Survey Of Children's Health (Nsch), Donny Dunfee

Master of Public Health Program Student Publications

Obese children are more likely to become obese as adults; hence, they are at increased risk for a number of adult diseases. As with adult obesity, several variables contribute to the increasing prevalence of childhood obesity. The intent of this report is to illustrate the connection between childhood obesity and the social environmental interactions of populations. With the increasing prevalence of obesity in adults and children, healthcare and public health professionals view childhood overweight and obesity as one of the most serious public health concerns of our time. This research conducts a secondary analysis of the National Survey of Children’s …

Assessment Of Support Service Needs Of Primary Caregivers Of Hiv And Aids Infected Children: A Review Of Literature And Suggestions For Practice, Barry Eneh

Master of Public Health Program Student Publications

Summary: With the advent of highly active antiretroviral treatment, routine screening and treatment options for pregnant women for perinatally acquired HIV and AIDS, infection is on dramatic decline in the U.S. In spite of the declines and the medical advances, primary and informal caregivers of infected children continue to face innumerable challenges with regard to the availability, access and utilization of non-medical supportive service care needs. HIV/AIDS continues to create unique challenges for infected children and the non-infected family caregivers at multiple levels; impacting their relationships, resources and resilience.

Objective: This literature review identifies and assesses the unique and critical …

Preterm Birth Rates In Pregnant Women With Sexually Transmitted Infections: Cincinnati Public Health Centers 2005 And 2006 Deliveries, Elizabeth Singhoffer

Master of Public Health Program Student Publications

Objective: To evaluate the differences in prenatal maternal infections in women served by the City of Cincinnati health centers that have or have not had a preterm birth.

Methods: A retrospective and observational study of medical records of 738 patients seen at the City of Cincinnati health centers, who delivered in the years of 2005 and 2006. The usable data resulted in 668 total subjects. Data collected included types of health care visits prior to index pregnancy, if preconception/ reproductive health care was discussed, demographics, gestational age at first prenatal visit and at delivery, insurance at first prenatal visit and …

Retrospective Comparative Analysis Of The Socio-Demographic Characteristics Of Pregnant Abortion-Minded Clients Versus Pregnant Non-Abortion-Minded Clients In A Crisis Pregnancy Center In Montgomery County, Ohio, Betsy Liliana Cote

Master of Public Health Program Student Publications

Purpose: The purpose of this study is to compare socio-demographic characteristics of pregnant abortion-minded women versus pregnant non-abortion minded women who had consulted a crisis pregnancy center in Montgomery County, Ohio. The findings will be used to help develop public health prevention programs for unintended pregnancies.

Methods: A database sample of 581 records collected by a crisis pregnancy center in t Montgomery County was used for this study. Criteria for inclusion were women obtaining a positive pregnancy test, whose pregnancy intentions were assessed as being either abortion-minded or non-abortion-minded. Socio-demographic characteristics such as age, marital status, household income, education, religious …

How Should Health Departments Manage Prenatal Care?, Julianne Nesbit

Master of Public Health Program Student Publications

Objective: To compare how health departments in the southwest district of Ohio manage prenatal care, defined as preventative care provided immediately preceding, during, and following pregnancy, to determine if there is a better management technique based on cost and/or characteristics of jurisdictions.

Design: Qualitative descriptive analysis of prenatal services at local health departments in the southwest district of Ohio for 2004.

Setting and Participants: Health Departments in the southwest district of Ohio.

Main Outcome Measures: Comparison of the types of services currently being used to provide prenatal care services (i.e., direct, contracted, combination, or no service) including budgeting and cost …