Medicine and Health Sciences Commons^™

Evaluating How Physical Activity Affects The Perception Of Resilience In Box Butte County, Nebraska, Eric Pulver

Capstone Experience

Physical activity is one of the modern hallmarks for good health in individuals and the public, in general. Resiliency is a growing concentration in all levels of disaster preparedness where the focus is on how to deal with the growing number of disasters stemming from global climate change. This research project’s aim is to look at the possible relationships between physical activity and resiliency in a rural Nebraska population. This was done with the use of a cross-sectional study utilizing a fifteen-question survey to gather demographics, assess the amount of physical activity, and then apply a perception of resilience tool …

Examining Mental Health Disparities In A Rural County: A Community Health Needs Assessment Analysis, Dustin M. Schulz

Capstone Experience

Over 20% of adults in the United States experience some form of mental illness each year. Those residing in rural areas can see increased prevalence of mental illness, and typically face disparities in access and availability of services for mental health. The goal of this project was to examine the impact of mental health in Woodford County, Illinois using data collected through the 2022 Community Health Needs Assessment (CHNA) process, with the intent of identifying areas of improvement that could be implemented at the local level. Analysis of the CHNA data was conducted using frequency analysis in SAS 9.4 through …

Management Of Youth Sport-Related Concussion By Urban And Rural Practitioners: A Pilot Study, Brett R. Fox

All NMU Master's Theses

Sport-related concussions (SRC) occur at alarming rates among high school athletes (ages 13-18), which made the Center for Disease Control and Prevention and other agencies classify it as an “epidemic”. If improperly managed, physical, mental, and emotional consequences can occur for SRC patients. Due to these consequences all 50 states in the US have passed legislation requiring medical release from a practitioner before a student-athlete can return to athletics following an SRC, yet there is no universally accepted consensus on how to medically manage this common injury. A 22-item, validated survey was distributed to Michigan practitioners who sign off on …

Implementation And Evaluation Of A Syphilis Screening Tool To Increase Patient Testing For Syphilis Among Adults 18 Years And Older In A Rural Primary Care Clinic, Valeria S. Wiggins

Doctor of Nursing Practice Projects

Background: Sexually transmitted infections (STIs) are an increasing epidemic in the United States (U.S.) that need immediate interventions to reverse the effects of syphilis on the sexual health of adults in rural populations. Many are unaware of the growing rate of syphilis and the overall impact it causes nationally. When syphilis is detected early, it can be easily treated and cured. Rural primary care providers are ideal candidates for implementing education, screening, testing, and treatment.

Purpose: The Doctor of Nursing Practice (DNP) project aims to increase the frequency of screening patients in rural primary care clinics for high-risk sexual behaviors. …

Expand Nemt Across Central And Western Nebraska, Bri Parr

Theses/Capstones/Creative Projects

The average age of adults in the US is increasing, especially in rural areas. Approximately 60 million individuals live in the rural US, including millions of Medicare beneficiaries. Older rural Americans are more likely to be in poverty, unhealthy, and medically underserved. They rely heavily on government health insurance programs, such as Medicare, to provide for their health care needs. Unfortunately, for many older adults living in rural areas, health care is both difficult to access or in some cases completely unavailable. This is due to several factors, including the lack of specialist care in rural areas (mental health specialists, …

Positive And Negative Deviant Counties: Identification Of Factors Associated With Health Outcomes, Olivia Egen

Electronic Theses and Dissertations

Rural counties in the United States vary drastically on metrics related to socioeconomic status and dominant economic industry as well as health behaviors and outcomes. This study sought to understand the underlying structural reasons why some rural counties have better or worse than expected health outcomes using a positive deviance (PD) approach. The study aimed to: 1) create an area deprivation index and divide counties into quartiles using the index; 2) identify positive, negative, and non-deviant counties using health outcome metrics; 3) analyze differences between deviance on a variety of local public health system metrics; and 4) analyze differences between …

Rural And Agricultural Natural Disaster Stress And Recovery Study: Identifying Experiences And Community Preferences, Kristin K. Gaffney

Capstone Experience

Objective: The Rural Natural Disaster Stress and Recovery study surveyed flood and tornado affected residents (N=159 for analysis) in Arkansas and Nebraska, U.S., to address three hypotheses: 1) agricultural producers have different stress and recovery experiences compared to non-agricultural counterparts, 2) rural residents prefer community resources over external resources for disaster stress relief, and 3) communities can provide effective emotional health supports after disaster.

Methods: Demographics, exposure, stress, and recovery measures, and a resource use and effect inventory were analyzed in SAS with Chi-square tests, t-tests, Wilcoxon tests, and multiple linear regression modeling to identify differences between agricultural and non-agricultural …

A Comprehensive Literature Review Of Recruitment And Retention Strategies For Primary Care Providers In Rural Communities, Christian Folken

Capstone Experience

Workforce trends within the United States indicate a growing crisis in the availability and distribution of primary care providers. Rural communities have been disproportionately affected by the lack of primary care providers. The gap in available primary care services in rural areas severely affects the population health outcomes of these communities. There is a critical need for rural healthcare systems to effectively understand and implement recruitment and retention strategies of primary care providers to meet the needs of their patients and community. The goal of this paper is to provide a centralized resource of evidence-based strategies regarding the recruitment and …

Healthcare Safety-Net In The United States: Patient Satisfaction Across Rural And Urban Hospitals, Vivian Ho

Senior Theses

Objective. To examine rurality and other hospital characteristics associated with patient satisfaction across hospitals in the United States.

Data. Nationwide hospital data from the 2019 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and the 2020 Centers for Medicare & Medicaid Services (CMS) Provider of Services (POS) file.

Study Design. Hospital ZIP-codes were categorized into urban, rural micropolitan, or small/isolated rural based on Rural-Urban Commuting Area (RUCA) codes. Patient satisfaction measures from the HCAHPS survey were linked to the CMS POS data for hospital characteristics, yielding 2,357 urban, 749 rural micropolitan, and 1,343 small/isolated rural hospitals. ANOVA and …

Rural Pregnant Women’S Experiences With Substance Use Disorder: A Qualitative Study, Cami Weber

Dissertations

Rural pregnant women with substance use disorder (SUD) are an understudied vulnerable population that often experiences poor pregnancy outcomes (Higgins et al., 2019; Jumah, 2016; Kramlich et al., 2018; Shaw et al., 2015). Despite the high prevalence and high burden associated with SUD, rural women are less likely than non-pregnant women to seek addiction treatment and complete an outpatient treatment program during pregnancy (Shaw et al., 2015). This study aimed to give voice to rural Missouri women with SUD. The research questions explored the life experiences and motivations for seeking treatment using a qualitative, descriptive research design with grounded theory …

Providers’ Perspectives On Barriers Associated With Repeat Teen Pregnancies In Rural Southeastern United States, Vanessa Iheoma Iheanachor

Walden Dissertations and Doctoral Studies

Teen (or adolescent) pregnancy remains a significant public health problem in the United States. Rapid repeat pregnancy, defined as any pregnancy that occurs within 24 months of a previous birth, has been linked to adverse maternal and neonatal outcomes. The purpose of this quantitative, cross-sectional study was to understand the perceptions of health care providers (HCPs) regarding barriers that influence repeat pregnancies among adolescents in rural southeastern United States. The theoretical framework that guided this study was Urie Bronfenbrenner’s social ecological model. A survey instrument was developed and disseminated to HCPs using Qualtrics, an online survey platform. Data (n=32) were …

Factors Associated With Nonmedical Prescription Opioid Use And Prescription Opioid Misuse Among Rural Americans, Brittany Cox

Walden Dissertations and Doctoral Studies

Opioid misuse is a rapidly evolving health epidemic in the United States, leading to opioid use disorders, overdose deaths, and disparities in treatment. The rural population may be more susceptible given socioeconomic status, less educational attainment, and lower income. The impact on specific populations is not well understood. The purpose of this study was to identify the association of nonmedical prescription opioid use (NPOU), prescription opioid misuse (POM), and treatment-seeking with race, age, sex, education, and insurance status among rural Americans. The social-ecological model (SEM) served as the theoretical framework. The SEM described the interplay between individual, relationship, community, and …

Opioid Overdose Deaths In Vermont: Comparing Rates Of Mortality In Urban Versus Rural Settings, Jamie Bernier, Jonna Thomas, Sindhu Donepudi, Sierra Serino, Mia Crisafulli, Joseph Zamboni

Master of Public Health Culminating Projects

Objective: To investigate differences in opioid-related overdose death in Vermont based on urban versus rural setting.

Methods: A retrospective cohort study was conducted using Vermont’s Electronic Death Registration System from 2015-2019. After applying exclusion criteria, 570 subjects were included in bivariate logistic regression analyses.

Results: Individuals who died in urban areas had 45.8% lower odds of death due to opioid use than those in rural areas. For every one-year increase in age, odds of overdose death decreased by 4.6%. For females, odds of death due to opioid use was 19.4% lower than the odds for males.

Conclusions: Vermont residents who …

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 …

Parental Status As A Modifying Factor In Covid-19 Vaccination Status: A Mixed Methods Approach, Mackenzie Carter

All Master's Theses

Introduction: Vaccines are the best protection against COVID-19 and have been proven to be safe and effective. Parental efforts to protect their children by complying with or refusing pediatric vaccinations have previously been studied. However, the author found little research on how parental status affects the vaccination decisions for the parents. Using an explanatory sequential mixed-methods approach and the Health Belief Model, this study examines how parental status influences parental COVID-19 vaccination status. Methods: A local health department conducted a quantitative survey on COVID-19 vaccination attitudes and beliefs from September to October 2021. The COVID-19 vaccination status of parents of …