Medicine and Health Sciences Commons^™

Traditional And Emerging Modifiable Lifestyle Risk Behaviors For Non-Communicable Diseases In A Sample Of Hispanic/Latino American Adolescents Living In The U.S.-Mexico Border Region, Silvia Salinas Lopez

Open Access Theses & Dissertations

Background: Non-communicable diseases (NCDs) pose a significant global health threat, with modifiable lifestyle risk behaviors (mLRBs) contributing substantially to their onset. This study examined traditional and emerging mLRBs and their distribution on cross-sectional health outcomes among Hispanic/Latino in-school adolescents living on the U.S.-Mexico border. Methods: This secondary data analysis used information from the cross-sectional 2019 El Paso YHBS obtained through online surveys. The secondary data analyzed the prevalence, clustering, and co-occurrence of mLRBs of 539 Hispanic/Latino high school students. Results were compared to mLRBs findings corresponding to Hispanic/Latino adolescents who participated in the national and state 2019 CDC YRBSS. An …

Barriers And Facilitators To Enrollment For Free And Reduced Price Meals In The School Nutrition Program Among Lawrence Public School Families, Emily Brinkman

Capstone Experience: Master of Public Health

Many low-income families are facing nutrition insecurity, meaning they do not have consistent and equitable access to healthy, safe, affordable foods to meet needs for optimal health and well-being. The impact of nutrition insecurity is especially concerning for children as they are more likely to face adverse outcomes that can limit physical, intellectual, and emotional potential across the lifespan. The U.S. Department of Agriculture administers the School Nutrition Programs that can help improve access to nutritious foods. Eligible families can apply for their children to receive free or reduced-price school meals based on income level and household size. However, many …

Spotlight On Mental Health On A Healthcare Campus: An Assessment Of Psychological Trauma Awareness, Training, And Treatment In The University Of Nebraska Medical Center College Of Public Health Community, Jenny E. Mueller

Capstone Experience: Master of Public Health

Background: Psychological trauma has been recognized as a public health concern of epidemic proportions globally. Public health community awareness of and education in trauma is likely to be integral to preparing future public health professionals to work effectively and safely in the field. Currently, the extent of trauma awareness, training, and treatment on the University of Nebraska Medical Center College of Public Health (UNMC COPH) campus is not known.

Aims: The aims of this project are to investigate and assess the level of psychological trauma awareness, training, and treatment on the UNMC COPH campus; and to provide recommendations for actions …

From Vapor To Vice: Unraveling The Links Between Vaping And Traditional Substance Abuse Among Youth, Ayana Powell

Capstone Experience: Master of Public Health

ABSTRACT:

Objective: To evaluate whether vaping or using e-cigarettes is associated with the use of traditional substances, such as cigarettes, alcohol, and marijuana.

Methods: Using data from the Monitoring the Future surveys, a multivariable logistic regression model was performed, and prevalent odds ratio were calculated to evaluate the association between vaping and traditional substances.

Results: Vaping use among U.S. adolescents and teenagers was found to be an associated with use of traditional substances (cigarette use [OR]= 6.36 [CI]= 4.84, 8.38; alcohol use [OR]=5.80 [CI]= 5.28, 6.38; and marijuana use [OR]= 7.77 [CI]= 6.95, 8.70).

Conclusion: This study will assist …

Strategies To Encourage Recall And Prevent Relapse After Full Mouth Rehabilitation Under General Anesthesia In Children, Claire Koukol

Capstone Experience: Master of Public Health

Background: Dental caries are preventable. Dentists utilize many prevention strategies in the office and provide at-home education to families. However, once a child develops Early Childhood Caries (ECC), especially in more severe cases, they may need general anesthesia (GA) to complete treatment. While this is an effective way to achieve full mouth dental rehabilitation (FMDR), this burdens the healthcare systems and families and does not come without risk to the patient. Patients with high caries experience remain at high risk of caries relapse after FMDR under GA, sometimes necessitating additional FMDR under GA. While there has been a significant amount …

The Power Of An Effective Safety Culture, Justin B. Negley

Capstone Experience: Master of Public Health

Workplace injuries and illnesses have continued to decrease significantly through increased regulations, awareness, and technological advances. These enhancements are not enough to continue to drive these rates lower. A robust safety culture within an organization is required to truly affect change that will continue to diminish the occurrence of injuries and illnesses within the workplace. This project seeks to define the key aspects and elements that are fundamental to a culture of safety as a top priority amongst competing demands. The foundations of a robust safety culture were identified through a systematic literature review, a site comparison example of safety …

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience: Master of Public Health

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …

Nutrition Needs Assessment For A Produce Prescription Program In The Pediatric Dental Setting, Zachary Houser

Capstone Experience: Master of Public Health

More than half of young people in the U.S. aged 2-19 have a poor-quality diet, including low fruit and vegetable (FV) intake (Liu et al., 2020). Poor nutrition increases health risks, including chronic diseases such as dental caries and obesity, low-income households experience higher rates of poor nutrition and subsequent health burdens (AAPD, 2022b). Produce prescriptions (PPR) are a type of financial incentive program that can improve FV intake among low-income populations (Ridberg et al., 2019). PPR programs are often conducted in a primary medical setting (Little et al., 2022); however, no literature describes PPR programs conducted in a dental …

Body Mass Index And Acute And Chronic Work-Related Injuries; A Random Sample Analysis Of Occupational Health Clinic Records, Nicole M. Lundy

Capstone Experience: Master of Public Health

Workplace injuries are detrimental because they impact the productivity and wellbeing of workers. The ultimate goal is to minimize job-related injuries due to workplace exposure. This study examines the relationship between body mass index (BMI), age, gender, and injury patterns. Data was collected through a chart review of patients from an occupational medicine health clinic in Grand Rapids, Michigan from January 2022 through December 2022.

This was an exploratory study with no population sample control group. Variables investigated were body mass index, gender, age, and type of injury sustained. The injuries were classified by body part into head, back, lower …

Evaluating The Utility Of Hospital Full-Scale Exercises In Veteran Health Administration's Emergency Departments, Brian Barhorst

Capstone Experience: Master of Public Health

The Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) serves nine million veterans annually. Preparing for and responding to emergencies locally and nationally remains one of its critical missions. While VA policy requires the Homeland Security Exercise and Evaluation Program (HSEEP) methodology to conduct national-level exercises, local medical facility exercises mandated by The Joint Commission do not hold the same requirement. This evaluation assesses the effectiveness of hospital-based exercises within the Veterans Health Administration in preparing VA Emergency Departments (EDs) and Urgent Care Centers (UCCs) for local disasters by querying ED/UCC Medical and Nursing Directors about their experiences with …

Nurse Initiated Standing Orders: A Process Improvement At An Emergency Department In Interior Alaska, Justin D. Melberg

Capstone Experience: Master of Public Health

Emergency Departments (EDs) are a valuable and limited public health resource. In addition to treating acute medical emergencies, EDs bridge the gaps in urgent care and primary care accessibility, operating twenty-four hours a day, seven days a week, providing care regardless of an individual’s ability to pay. EDs across the country operate at or above capacity regularly, and overcrowding is projected to increase due to decreased facilities and available inpatient beds. Innovative measures are necessary to increase patient throughput and decrease length of stay while maintaining quality care. Nurse initiated standing orders, also known as nurse driven protocols, standing orders, …

Geospatial Distribution Of Pharmacist Diabetes Management Within A Patient Centered Medical Home Model In Omaha, Nebraska, Anthony Donovan

Capstone Experience: Master of Public Health

Patients with uncontrolled diabetes, defined as a hemoglobin A1c value greater than 9%, are at an increased risk of diabetes progression. Primary care is often the first point of contact where patients with uncontrolled diabetes are identified and treated. Pharmacists are utilized in diabetes medication management of patients with uncontrolled diabetes as one component of primary care multidisciplinary models of care. This descriptive project describes the geospatial distribution of patients with uncontrolled diabetes from a single institution in the Omaha, Nebraska area who were exposed to pharmacists within a Patient Centered Medical Home (PCMH) model of care compared to those …

Evaluating Lack Of Access To Secondary Prevention-Based Healthcare Services Between Racial/Ethnic Groups In The United States: A Logistic Regression Analysis Using 2022 Brfss Cross-Sectional Data, Samuel Ortiz Severiano

Capstone Experience: Master of Public Health

Objective: To determine whether racial/ethnic minorities have reduced access to preventive healthcare services in the United States, with participation in routine checkups serving as the metric for access. Methods: Performing logistic regression analysis comparing the length of time since the last routine checkup between different racial/ethnic groups in the study population. Those who haven’t had a routine checkup in at least 12 months served as the comparison group. Results: Black populations were 66% less likely to not have access to preventive care compared to White populations, while Asian, American Indian/Alaskan Native, and Native Hawaiian/Pacific Islander populations were 8.5% more likely …

Associations Between Self-Reported Cognitive Decline And Chronic Diseases: A Cross-Sectional Analysis Of Behavioral Risk Factor Surveillance System (Brfss) 2022, Hailey Child

Capstone Experience: Master of Public Health

Objective: This study seeks to capture how self-reports measure cognitive decline. The association between chronic conditions and cognition with age consideration in individuals aged 45 and older is investigated.

Methods: Univariate analysis generates frequencies and weighted percentages of 2022 BRFSS data. Chi-square tests and polytomous regressions generate odds ratios for bivariate analyses. A weighted multiple logistic regression model stratified by age group analyzes self-reported cognitive decline.

Results: Respondents ages 45 to 54 with three or more chronic diseases have the highest odds (OR = 6.81; 95% CI = 4.42, 10.48) of cognitive decline. Respondents 75 and older …

Mental Health Perceptions Among Us Veterans And Non-Veterans: 2022 Behavioral Risk Factor Surveillance System, Nicole Frederickson

Capstone Experience: Master of Public Health

Objective. To determine the association between veteran status and perceived mental health in US adults.

Methods. 2022 Behavioral Risk Factor Surveillance System cross-sectional telephone survey data were used. Analyses were adjusted for confounding sociodemographic and health-related characteristics. Weighted multinomial logistic regression was used to determine the association between veteran status and reporting 0, 1-13, or 14+ poor mental health days.

Results. A total of 430,653 individuals were included in this analysis. Veteran status was associated with decreased odds of reporting 1-13 poor mental health days than nonveterans (OR=0.81; 95% CI 0.77, 0.86) but greater odds of reporting 14+ poor mental …

Adverse Childhood Experiences As Individual Predictors Of Subjective Cognitive Decline: Analyzing The 2022 Behavioral Risk Factor Surveillance System, Ruthie Schmitt

Capstone Experience: Master of Public Health

Objectives. This study explored the association of Adverse Childhood Experiences (ACEs) and Subjective Cognitive Decline (SCD). This study aimed to determine within the United States which ACEs have a stronger association with SCD after 45 years of age by analyzing all 13 ACEs individually with SCD.

Methods. Data were obtained from the 2022 BRFSS. An analytic sample of 42,509 adults over 45 years of age from seven states was analyzed using binary and multivariate logistic regression. The outcome variable investigated in this study was SCD, and the explanatory variables were 13 ACEs.

Results. Of the respondents, 10.4% reported experiencing SCD …

Associations Between Long Covid And Healthcare Access: A Cross-Sectional Analysis Of The Behavioral Risk Factor Surveillance System (Brfss) 2022, Tiffany Elliott

Capstone Experience: Master of Public Health

Objective. To evaluate the association of healthcare access with Long COVID and clinical and sociodemographic factors.

Methods. Data were from the CDC's 2022 Behavioral Risk Factor Surveillance System (BRFSS) surveys regarding four measures of healthcare access and Long COVID. There were 25,549 respondents who reported Long COVID and 95,830 respondents who did not report Long COIVD.

Results. 25,549 (22.0%) of respondents reported Long COVID. Significant associations were found in respondents with public health insurance and delayed medical care due to cost. Those with chronic health conditions were more likely to report Long COVID. Women, certain racial/ethnic groups, …

Association Between Frequent Mental Distress And Insurance Status Using The 2022 Brfss, Christina Clayson

Capstone Experience: Master of Public Health

Objectives

Determine if there is a direct relationship between frequent mental distress and health insurance coverage.

Methods

Data from the 2022 BRFSS was used to calculate adjusted percentages. Crude odds ratios for both mental distress and insurance coverage. Multivariate analysis calculated crude and adjusted odds ratios for frequent mental distress by insurance coverage with income as a covariate.

Results

Individuals reporting frequent mental distress had lower income, less education, and were younger. Individuals without health insurance were more likely to be younger, Hispanic, and not have graduated high school. There was no significant association between frequent mental distress and not …

Assessing How Children Modify The Impact Of Having Health Insurance On Smoking Status Using The 2021 Behavioral Risk Factor Surveillance System Survey, Zak Lippert

Capstone Experience: Master of Public Health

Objective: To understand if children living in the home modify the relationship between health insurance and smoking.

Methods: This analysis used the 2021 Behavioral Risk Factor Surveillance System Survey. The outcome was being a current smoker with health insurance as the exposure. The analysis was stratified by children to determine if children changed how having health insurance impacted smoking. The odds ratios for each stratum were compared to determine if children was a modifying factor.

Results: Children had a modifying effect on health insurance. For someone with children, if they had insurance, their odds of smoking were 0.91 (95% CI: …

Relationship Of Adverse Childhood Experiences And Depression Using The 2022 Behavioral Risk Factor Surveillance System Data In 12 States, Ivy Sovine

Capstone Experience: Master of Public Health

Objective: To determine if reporting adverse childhood experiences (ACE) is linked to depression in adults, taking into consideration the influence of sociodemographic factors.

Methods: A secondary analysis was performed using the cross-sectional 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey data. Twelve states included the optional ACE module, respondents who did not answer the questions about depression, education, or at least one ACE question were excluded from the analysis. The study population included 59,860 respondents. We examined the relationship between depression and ACE by using weighted univariate analysis, bivariate models, and logistic regressions.

Results: Among the respondents, 21% (12,112) reported …

Ordinal Logistic Regression Analysis Of The Frequency Of Marijuana Use Among Adult Informal Caregivers In 20 U.S. States, Behavioral Risk Factor Surveillance System (Brfss) 2021, Athena Plichta

Capstone Experience: Master of Public Health

Objectives. To examine the association between frequency of marijuana use among informal caregivers of persons with dementia (PWD) and other health conditions compared to non-caregivers in 20 U.S. states.

Methods. We used complex survey data from the optional modules Caregiver and Marijuana Use of the 2021 BRFSS survey. Univariate and bivariate analyses were performed to determine the frequency and distribution of sample population characteristics and calculate crude relationships. Ordinal logistic regression modelled the relationship between the three-level outcome and covariates.

Results. Frequency of marijuana use and caregiver status were not associated. There was no difference in increased use among individuals …

Certified Midwives: An Exploration Of Their Impact On Maternal Health Outcomes – A Comprehensive Literature Review, Heather Hollister

Capstone Experience: Master of Public Health

Maternal health outcomes in the United States have been consistently worse than other high-income countries, with a disproportionate impact on women of color. Midwives have long played an important role in maternal health worldwide. The literature review examines the evidence for midwives as key contributors to improving maternal health outcomes. The paper reviews the existing literature on midwifery, including the impact on maternal health, labor and delivery outcomes, and patient satisfaction. Electronic searches were conducted through Cochrane Library, CINAHL, Medline and Embase. Articles were screened according to inclusion and exclusion criteria including that they must be a randomized study; participants …

A Policy Evaluation For California’S Care Act And The Application Of The Social Determinants Of Health, Adelina Mercedes Lang

Capstone Experience: Master of Public Health

In 2022, California passed a legislative bill, SB 1338: the Community Assistance, Recovery, and Empowerment (CARE) Act, which created a new statewide procedure for treating mentally ill homeless adults diagnosed with psychotic disorders through a court-ordered CARE plan. SB 1338 intends to alleviate the mental health and homeless crisis. This capstone project provides an early assessment of SB 1338 using a modified formative policy evaluation methodology, including a scoping literature review and applying a policy assessment using the CDC's Policy Evaluation Framework. A stakeholder survey was also applied to gather stakeholders' perspectives on SB 1338. The literature review supported the …

Cancer Disparities In Southeast Asia: Intersectionality And A Call To Action, Erin Jay G. Feliciano, Frances Dominique V. Ho, Kaisin Yee, Joseph A. Paguio, Michelle Ann B. Eala, Janine Patricia G. Robredo, Kenrick Ng, Jasmine Lim, Khin Thuzar Pyone, Catherine A. Peralta, Jerickson Abbie Flores, J. Seth Yao, Patricia Mae G. Santos, Christian Daniel U. Ang, Gideon Lasco, Jeffrey Shi Kai Chan, Gary Tse, Enrico D. Tangco, T. Peter Kingham, Imjai Chitapanarux, Nirmala Bhoo-Pathy, Gerardo D. Legaspi, Edward Christopher Dee

Ateneo School of Medicine and Public Health Publications

No abstract provided.

Patient Satisfaction With Telemedicine In The Philippines During The Covid-19 Pandemic: A Mixed Methods Study, Alicia Victoria G. Noceda, Lianne Margot M. Acierto, Morvenn Chaimek C. Bertiz, David Emmanuel H. Dionisio, Chelsea Beatrice L. Laurito, Girrard Alphonse T. Sanchez, Arianna Maever Loreche

Ateneo School of Medicine and Public Health Publications

Background: The capacity to deliver essential health services has been negatively impacted by the COVID-19 pandemic, particularly due to lockdown restrictions. Telemedicine provides a safe, efficient, and effective alternative that addresses the needs of patients and the health system. However, there remain implementation challenges and barriers to patient adoption in resource-limited settings as in the Philippines. This mixed methods study aimed to describe patient perspectives and experiences with telemedicine services, and explore the factors that influence telemedicine use and satisfaction. Methods: An online survey consisting of items adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & …

Global Burden Of Cardiovascular Diseases And Risks, 1990-2022, George A. Mensah, Valentin Fuster, Christopher J.L. Murray, Gregory A. Roth, Geminn Louis C. Apostol

Ateneo School of Medicine and Public Health Publications

No abstract provided.

Morphological And Metabolic Criteria Of Covid-19 Vaccine Associated Axillary Nodes On 18-Fluorodeouxyglucose Pet/Ct Imaging In Breast Cancer Patients, Nosheen Fatima, Unaiza Zaman, Areeba Zaman, Sidra Zaman, Rabia Tehseen, Maseeh Uz Zaman

Department of Radiology

Background: In the current era vaccine-associated lymphadenopathy (VAL) is not an uncommon presentation on 18F-FDG PET/CT examinations in patients inoculated with Coronavirus disease 2019 (COVID-19) vaccination. In this study, we are presenting data of VAL on 18F-FDG PET/CT regarding its prevalence, temporal response to vaccination and imaging characteristics of VAL.
Methods: Seventy-eight (78) consecutive vaccinated breast cancer (BC) patients who had 18FDG PET/CT were retrospectively analyzed. All patients had COVID-19 vaccine shots in contralateral arms and none in breast cancer site axilla (BSA). In 35 patients 18FDG avid nodes were found in vaccine site axilla (VSA). In 25 patients 18FDG …

Bridging Gaps: A Qualitative Inquiry On Improving Paediatric Rheumatology Care Among Healthcare Workers In Kenya, Angela Migowa, Sasha Bernatsky, Anthony Ngugi, Helen Foster, Peterrock Muriuki, Roselyter Riang’A, Stanley Luchters

Paediatrics and Child Health, East Africa

Background: Due to the paucity of paediatric rheumatologists in Kenya, it is paramount that we explore strategies to bridge clinical care gaps for paediatric rheumatology patients in order to promote early diagnosis, prompt referral, and optimal management.

Purpose: To identify proposed interventions which can improve the ability of non-specialist healthcare workers to care for paediatric rheumatology patients across Kenya.

Methods: We conducted 12 focus group discussions with clinical officers (community physician assistants), nurses, general practitioners and paediatricians across six regions in Kenya. Interviews were conducted, audio-recorded, transcribed verbatim, and analysed using MAXQDA 2022.2 software.

Results: A total of 68 individuals …

Associations Between Maternal Alcohol Consumption During Pregnancy And Selected Musculoskeletal Birth Defects Among Offspring In The National Birth Defects Prevention Study, Sarah Fisher

Legacy Theses & Dissertations (2009 - 2024)

Maternal alcohol consumption during pregnancy is known to be associated with poor pregnancy outcomes, including fetal alcohol spectrum disorders. However, evidence for associations between alcohol consumption during pregnancy and some major structural birth defects among offspring is conflicting or inconclusive. This dissertation used data from the National Birth Defects Prevention Study (NBDPS), a multi-site, population-based case-control study, to examine associations between maternal alcohol consumption and risk of three major musculoskeletal birth defects: gastroschisis, omphalocele, and craniosynostosis. Our analyses built upon previous analyses of these associations using NBDPS data, including larger sample sizes and more robust analytic methods to explore issues …

Prescription Opioid Misuse Among High School Students In The United States, By Sex And Race/Ethnicity, In 2019 And 2021, Deepika Reddy Kandhi

Legacy Theses & Dissertations (2009 - 2024)

Background: Drug overdose deaths in the U.S. have been increasing and are primarily related to opioid use. In 2019, an estimated 7.2% of US high school students reported misusing prescription opioids in the past 30 days. Prescription opioid misuse in adolescents may lead to development of a substance use disorder, overdose, or other serious harms. Some researchers have observed sex and race differences in prescription opioid use. This study aimed to identify patterns of prescription opioid misuse among adolescent subgroups categorized by both sex and race/ethnicity, to provide insight into intervention development and targeting.Methods: We analyzed data from the Youth …