Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

An Examination Of The Relationship Between Childhood Punishment And Adult Ipv, Anna G. Griffith

Honors College Theses

The goal of this project is to examine the relationship between childhood punishment and experiencing intimate partner violence (IPV) as an adult. Using an anonymous, self-report survey, students from Georgia Southern University were asked about their experiences with IPV, as well as their experiences of childhood punishment administered by both mother and father. The results show that children who receive corporal, verbal, and emotional punishment from their mother are more likely to experience all forms of IPV later in life. When analyzing the same relationships with fathers, corporal punishment is not associated with IPV while verbal and emotional punishment is.

Screen Media Use Among Children And Adolescents – Applications Of Supervised And Unsupervised Machine Learning And Sentiment Analysis, Yifan Zhang

Graduate Theses, Dissertations, and Problem Reports

Screen media has become increasingly pervasive in our everyday lives and has profoundly changed the way people communicate and interact with each other. However, we are still unclear about the long-term influence of screen media use on our physical health, mental health, and social wellbeing. Children and adolescents are in an important stage of brain development and are susceptible to the environmental influence that screen media possess. This dissertation pursued three aims to address research gaps related to screen media use among children and adolescents: 1) identify topics and knowledge gaps in screen media use research among children and adolescents …

Overcoming Obesity: Provider Reminders And Education In Pediatrics, Michelle Warren

Evidence-Based Practice Project Reports

The prevalence of pediatric overweight and obesity is rising globally (Di Cesare et al., 2019) and results in lifelong chronic health problems and an estimated annual healthcare cost of $14.1 billion (Trasande & Chatterjee, 2009). The purpose of this evidence-based practice project was to address overweight and obesity in patients between the ages of five and 12 years through the provision of provider reminders, education, and guidelines. Primary outcomes included frequency of diagnosis, frequency of patient referrals, return to see times, and frequency of patient nutrition and activity education while secondary outcomes included patient weight, body mass index (BMI), and …

Effectiveness Of A Multi-Component Intervention Program For Treating Childhood Obesity, Suzy Free

Evidence-Based Practice Project Reports

Childhood obesity is one of the most chronic childhood illness worldwide (Centers for Disease Control and Prevention [CDC], 2019; World Health Organization [WHO], 2019). The prevalence of childhood obesity has been described as one of the most common chronic childhood conditions (CDC). The purpose of this evidence-based practice (EBP) project was to reduce the BMI scores of obese children using a multi-component intervention program that incorporates healthy eating, physical activity, and family involvement. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model was used to facilitate the implementation of this EBP project. The synthesis of the appraised literature established that utilizing …

Timely Access To Maternal, Neonatal And Child Healthcare For Rural Communities In Rwanda: The Role Of Community Health Workers, Jean Bosco Bigirimana

Electronic Thesis and Dissertation Repository

Abstract

Introduction: In Rwanda, although there has been some progress in health care delivery as expressed in the reduction in maternal and child mortality, rates are still high and geographically variable. Improving equitable access to quality healthcare services for maternal, neonatal and child healthcare (MNCH), community-based maternal, neonatal and child healthcare (CBMNCH) depends upon using “community health workers” (CHWs). Yet CHWs program faces difficulties that upset delivery of the quality of the comprehensive package of services. Unfortunately, little is known about CHWs` performance and job satisfaction in the provision of CBMNCH.

Goal: The study aimed to provide insight into …

Incorporating Oral Health Care In Pediatric Primary Care Practice, Salamatu Yusif

Evidence-Based Practice Project Reports

The most common chronic disease in childhood is dental caries and is more prevalent than asthma and hay fever (HHS, 2000). Data show that in the United States from 2011-2014, 24% of children aged 2-5 years had experienced dental caries in their primary teeth, with 11% having untreated caries (Dye et al., 2017). Primary care clinicians have an important role to play in promoting children’s oral health as much as dentists because they have more contact with children. The purpose of this evidence-based practice project was to integrate an evidence-based oral health program for children in a pediatric primary care …

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

Examining The Effect Of Socioeconomic Factors On Kindergarten Vaccination Rates In Kentucky Counties, Abigail Wiggins

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

The purpose of this project is to examine the relationship between county-level socioeconomic factors and immunization compliance rates among kindergarten age children. All 120 counties in Kentucky were included in this evaluation.

County-level percent of uninsured children, number of children in poverty, children receiving free lunch (percentage), unemployment rate (percentage), and high school graduation rate were assessed. Socioeconomic data for each county were compared to county-level kindergarten vaccination rates. All vaccination data were obtained from the 2015-2016 Kentucky Annual School Immunization Survey Report. All socioeconomic county data were obtained from the 2016 County Health Rankings data, published by the Robert …

The Effects Of Child Restraint System Use And Motor Vehicle Collision Severity On Injury Patterns And Severity In Children 8 Years Old And Younger., Peyton A. Schroeder

Electronic Thesis and Dissertation Repository

Motor vehicle collisions (MVCs) are a leading cause of injury and death for children under the age of 14 years in North America. Children, eight years old or younger, are required to use a child restraint system (CRS) when travelling in a vehicle in Canada. In the present study, the hypothesis that head injury severity of children in this age group, seated in rear rows of vehicles in MVCs, will be influenced by the types of restraint systems used was not supported by the data; however, other secondary aspects of collision data were explored. There were injury patterns that involved …

Rates Of Developmental And Behavioral Screening Of Young Children: Implications For Health Care Policy And Practice, Shirley Berger

Dissertations and Theses

Background: The skills and capacities developed during early childhood are the foundation for a child’s future academic functioning, economic productivity, and lifelong health and mental health. When young children have developmental delays or disabilities, early identification and intervention lead to better outcomes; however, only a minority are identified before school entry. Primary care is an important setting for identification of developmental and behavioral conditions as most young children attend well-child visits regularly and parents expect developmental guidance from pediatricians. Two key pediatric preventive services are recommended: developmental monitoring/surveillance at every well-child visit and developmental screening at 9 months, 18 months, …

Sun Prevention Fun (Spf): A Multicomponent Sun Prevention Program For Children In Kindergarten And First Grade, Sarah Gouker

Evidence-Based Practice Project Reports

Skin cancer is an important topic in the United States due to the recent increase in cost and mortality. The purpose of this evidence-based practice (EBP) project was to determine if the early implementation of a multicomponent sun prevention program positively impacted kindergarten and first grade students’ knowledge and behavioral intentions to practice safe sun techniques after a one week period. Kotter’s Model of Change and the ACE Star model were utilized to guide this EBP project. An exhaustive review of the literature yielded 12 articles which were used to develop best practices for education on sun safety. The quality …

Assessing Asthma-Specific Health-Related Quality Of Life In Children With An Ecological Systems Approach, Jamyia Clark

Walden Dissertations and Doctoral Studies

Despite initiatives and management efforts to minimize exacerbation and adverse outcomes, asthma remains a leading cause of childhood chronic disease in the United States. Environmental, personal, and social factors have been associated with an increase of asthma morbidity. However, little is known about how they cumulatively affect children's quality of life. This study applied a multifactorial conceptual model grounded by the ecological systems theory framework to ascertain which environmental, personal, and social factors were cumulatively associated with adverse health-related quality of life (HRQoL) in children with asthma ages 5-17 years. A national, cross-sectional survey, the Behavioral Risk Factor Surveillance System …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

An Investigation Of The Relationship Between Child, Family, And Community Factors And Early Childhood Oral Health And The Utilization Of Dental Health Services, Nicole Holt

Electronic Theses and Dissertations

Background / Objective: Children under the age of 5 years bear a disproportionate burden of oral disease. The aim of this study is to investigate how child, family, and community determinants impact dental care utilization, and parental report of child’s oral health. Methods: Data for this study came from the 2011/2012 National Survey of Children’s Health for children aged 1 to 5 years old. Dependent variables evaluated were if the child had an oral health problem, been to a dentist in the past year, and parents description of the child’s teeth. Independent variables were selected from child, family, and community …

Childhood Sexual Abuse Screening And Prevention In The Primary Care Setting: A Survey Of Pediatric Healthcare Providers In The State Of Vermont, Kelley Eileen Groll

Graduate College Dissertations and Theses

ABSTRACT

Background. Childhood sexual abuse (CSA) is a silent, but pervasive concern across the United States, the prevalence of which is often vastly underestimated. Some research indicates that as many as one in four girls and one in six boys become victims of CSA. CSA is classified as an adverse childhood experience (ACE), which has been shown to have serious longstanding negative physical, emotional, and mental health impacts. The pediatric primary healthcare provider is well posed to intervene to detect and prevent the occurrence of CSA.

Objective. The overall goal of this study is to gain an understanding of the …

Effects Of Multimodal Fever Education On Parents Of Febrile Children, Teresa S. Parkhouse

Evidence-Based Practice Project Reports

Insufficient knowledge regarding the physiology and appropriate management of fever in children often contributes to an increased parental anxiety, inappropriate antipyretic use, and overutilization of medical resources (Chang, Liu, & Huang, 2013; Crocetti, Moghbeli, & Serwint, 2001; Schmitt, 1980). Parental concerns regarding childhood fever can lead to an overuse of health care resources as febrile illness in children accounts for approximately 20% of emergency department visits, 30% of office visits, and over 50% of after-hour phone calls to private physicians (Zomorrodi & Attia, 2008). Research shows that multidimensional educational interventions are most effective in improving parental management of fever (Young …

Determinants Of Usage Of Age-Appropriate Child Safety Seats In Connecticut, Giuseppina Mendillo Violano

Walden Dissertations and Doctoral Studies

In the United States, motor vehicle crashes are one of the leading causes of unintentional injury death and disability for children ages 1'15 years. Despite local, state, and federal legislative and educational efforts, children continue to be restrained improperly and thus face harm. Identifying behaviors and barriers that place child occupants at risk is crucial for implementing focused, injury-prevention programs and policies. The purpose of this study was to evaluate the effectiveness of Connecticut's child passenger safety law that was strengthened in 2005. This study involved a multifactorial approach to predicting child seat use, guided by Roger's diffusion of innovations …

Assessing The Structural Validity Of The Measure Of Processes Of Care (Mpoc-20) In Children With Epilepsy, Kariym Christopher Joachim

Electronic Thesis and Dissertation Repository

The goal of this thesis was to determine whether the 20-item Measure of Processes of Care (MPOC-20) questionnaire remains structurally/factorially valid among children with epilepsy, and to propose adaptations if it did not. Establishing the MPOC-20’s structural validity in this population makes it possible to draw conclusions on the potential effects of parent-perceived Family-Centred Care (FCC) on health outcomes within this population. Data came from the Health-related Quality of Life for Children with Epilepsy Study (HERQULES). Confirmatory Factor Analysis (CFA) indicated that the original five factor model fit poorly in children with epilepsy. An exploratory analysis within a CFA framework …

The Lunches Study: Elementary School Children's Packed Lunch Contents And Intake In The Traditional Vs. Balanced School Day Schedule, Lisa Neilson

Electronic Thesis and Dissertation Repository

The Balanced School Day (BSD), an alternative to the Traditional Schedule (TS), provides two 20-minute eating periods during the school day, rather than a midday lunch break. Widespread implementation of the BSD schedule has occurred across Ontario with limited systematic evaluation of potential health outcomes. The purpose of this study was to compare the food and nutrient value of grade 3 and 4 students’ packed lunch contents and consumption in the BSD versus TS, by direct observation. When compared to the TS, more BSD students had a sugar-sweetened beverage packed in their lunch. Greater portions of snack items were also …

Primary Health Service Use By Mothers And Children From London-Middlesex, Ontario, Catherine Holtz

Electronic Thesis and Dissertation Repository

Primary health service use (P-HSU) may be influenced by predisposing and enabling factors measured at individual- and contextual-levels but is equitable when driven by need factors. Objectives: 1) Estimate the effect of residential location on maternal and child P-HSU; 2) Assess P-HSU inequity by determining whether the effects of need factors on P-HSU are dependent on predisposing and enabling factors; 3) Describe perceived unmet healthcare needs in the maternal-child population observed to have inequitable P-HSU. Methodology: The sample of 1451 mother-child pairs was from a prenatal cohort recruited from London, Ontario between 2002 and 2004, with follow-up until children were …

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

Effects Of A School-Based Education Intervention On Bmi And Physical Activity, Lauren M. Panner

Evidence-Based Practice Project Reports

In 2011, the CDC reported that there are 12.5 million obese children and adolescents living in the United States (U.S.). The financial burden of childhood obesity in the U.S. is estimated to be 14 billion dollars. The objective of this evidence-based practice (EBP) project was to answer the question: In school-aged children, how does school-based, structured, family-oriented physical activity education affect body mass index (BMI) compared to usual education over an eight week time period? The Stetler Model of EBP and the health belief model were used to guide this project in a rural, Northwest Indiana elementary school. For eight …

Healthy Skin Is In: Effects Of A Multifaceted Sun Safety Program For Adolescents, Lindsay A. Munden

Evidence-Based Practice Project Reports

Skin cancer is a common, potentially life threatening disease notably on the rise among young Americans. A substantial portion of lifetime exposure to ultraviolet (UV) radiation, the greatest modifiable risk factor for skin cancer development, occurs during childhood and adolescence. Schools infrequently integrate sun safety education into the classroom and many lack essential sun safety policies. The purpose of this EBP project was to implement a multifaceted educational intervention providing middle school students with the knowledge behavioral skills needed to minimize the risk of developing skin cancer. The Health Belief Model and ACE Star Model of evidence-based practice guided this …

Childhood Obesity: Prevention & Intervention, Carrie Beth Lossing

Psychology and Child Development

Childhood obesity rates have skyrocketed in the recent years. These trends are alarming since childhood obesity has been linked to numerous health conditions, socioemotional consequences, and academic consequences. This project examines the factors that have been associated with childhood obesity and the consequences of being obese or overweight for children. This project also presents lifestyle changes that parents can make to reduce the likelihood of their children becoming overweight or obese.

Using Iphones To Enhance And Reduce Face-To-Face Home Safety Sessions, Julie Jabaley

Public Health Theses

Innovative handheld technologies are changing the possibilities for delivering public health interventions. The present research describes a preliminary examination of the effects of iPhone™ both as an assessment tool for data collection and as an enhancement to an in-home child safety intervention. Three families with children under age seven were trained to use an iPhone to video targeted rooms in their homes following SafeCare® safety module intervention implementation during which rooms were secured for accessible safety and health hazards. The iPhone was used to communicate feedback, logistical information, and clarification of safety content. The effectiveness of iPhone and iPhone video …