Medicine and Health Sciences Commons^™

Evidence To Inform An Integrated Social And Behavior Change Strategy In The Sahel, Leanne Dougherty, Jessie Pinchoff

Sexual and Reproductive Health, Rights, and Choices

Breakthrough RESEARCH completed this literature review, which summarized the evidence, or lack thereof, in the Sahel, to establish a rationale for the planned RISE II SBC evaluation as described in the study protocol. The literature review provides an overview of the health and development challenges in the region, along with priority health behaviors and their determinants followed by a description of SBC programmatic approaches that have addressed behavioral determinants and health outcomes in the region.

Agricultural And Finance Intervention Increased Dietary Intake And Weight Of Children Living In Hiv-Affected Households In Western Kenya, Lisa M. Butler, Shiva Bhandari, Phelgona Otieno, Sheri D. Weiser, Craig R. Cohen, Edward A. Frongillo Jr.

Faculty Publications

We tested whether a multisectoral household agricultural and finance intervention increased the dietary intake and improved the nutritional status of HIV-affected children. Two hospitals in rural Kenya were randomly assigned to be either the intervention or the control arm. The intervention comprised a human-powered water pump, microfinance loan for farm commodities, and training in sustainable farming practices and financial management. In each arm, 100 children (0-59 mo of age) were enrolled from households with HIV-infected adults 18-49 y old. Children were assessed beginning in April 2012 and every 3 mo for 1 y for dietary intake and anthropometry. Children in …

The Effect Of Care Coordination On Hemoglobin A1c For Type 2 Diabetes Patients, Lee Ann Hinsky

Electronic Theses and Dissertations

The purpose of the study was to test the impact of care coordinator visits by primary care registered nurses on serum hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes. In the study, the researcher compared 2 groups of type 2 diabetes patients—those who had care coordinator visits from registered nurses and those who did not—through retrospective data collection and analysis from the patients’ electronic medical record from July 2018 through December 2018. An independent samples t test was used to compare the means of the intervention and control groups’ change in HbA1c levels. The intervention and control groups …

Psychosocial Mediators Of Perceived Stigma And Suicidal Ideation Among Transgender Women, Krishna Kiran Kota, Laura F. Salazar, Rachel E. Culbreth, Richard A. Crosby, Jamal Jones

Health, Behavior & Society Faculty Publications

BACKGROUND: Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation.

METHODS: Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact …

A Brief Educational Intervention Enhances Basic Cancer Literacy Among Kentucky Middle And High School Students, Lauren Hudson, Kerrigan M. Samons, Haley E. Dicken, Chris Prichard, L. Todd Weiss, Jean Edward, Robin C. Vanderpool, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Kentucky experiences the highest overall cancer incidence and mortality rates in the USA with the greatest burden in the eastern, Appalachian region of the state. Cancer disparities in Kentucky are driven in part by poor health behaviors, poverty, lack of health care access, low education levels, and low health literacy. Individuals with inadequate health literacy are less likely to participate in preventive measures such as obtaining screenings and making healthy lifestyle choices, thus increasing their chances of developing and dying from cancer. By increasing cancer literacy among youth and adults, it may be possible to decrease cancer disparities across Kentucky. …

Enhancing Immunization Rates In Two Urban Academic Primary Care Clinics: A Before And After Assessment, Zeeshan Yacoob, Christopher Cook, Fabiana Kotovicz, Jessica J.F. Kram, Marianne Klumph, Marisa Stanley, Paul Hunter, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Immunization rates in many cities in the United States remain suboptimal compared to Healthy People 2020 Goals and are lower than national averages. This study aimed to determine whether a lecture-based educational intervention targeted at nurses and medical assistants would improve vaccination rates.

Methods: We conducted a quality improvement study in two urban academic family medicine clinics serving a predominantly Medicaid patient population as well as a sizable proportion of refugees. The intervention consisted of 3 lectures that were delivered to clinic nurses and medical assistants. Vaccinations in 1689 patients — 872 in the 3-month preintervention period, 817 in …

Appalachian Environmental Health Literacy: Building Knowledge And Skills To Protect Health, Anna G. Hoover, Annie Koempel, W. Jay Christian, Kimberly I. Tumlin, Kelly G. Pennell, Steven Evans, Malissa Mcalister, Lindell E. Ormsbee, Dawn Brewer

Journal of Appalachian Health

Environmental health literacy (EHL) is an emerging, multidisciplinary field that promotes understanding of how environmental exposures can affect human health. After discussing the regional relevance of environmental health knowledge and skills, this article describes three ongoing Appalachian projects that are focused on measuring and building EHL.

Cancer Health Disparities Among African Americans: A Socioecological Approach, Seth M. Spitzley

The Hilltop Review

Research shows that health outcomes are influenced by race or ethnicity, socioeconomic status, education and literacy levels, and the physical environment (U.S. Department of Health and Human Services, 2014). The health statuses of minority groups, such as African Americans, are adversely impacted by inequality (Randall, 2009). In Kalamazoo, Michigan, the leading cause of death for all residents in Kalamazoo County was cancer, where black individuals have the highest death rate among any other racial or ethnic group. That African Americans comprise less than 11% of the population in Kalamazoo County thus suggests that African Americans are disproportionately impacted by cancer …

Does Age Affect The Association Between Race/Ethnicity And Hpv Screening: A Retrospective Cohort Study Of United States Women, Keila L. Marlin, Mph, Larissa R. Brunner Huber, Ph.D.

Journal of Health Disparities Research and Practice

Many studies have demonstrated disparities in awareness of and knowledge about human papillomavirus (HPV) among young, immigrant, and minority populations. Yet, there is a lack of existing research that has investigated the role of race/ethnicity and HPV screening, and how it varies by age. The purpose of this study was to evaluate this association using 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. This study included 120,646 women who self-reported information on race/ethnicity, HPV screening, and age. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CIs). A stratified analysis was conducted to determine if age …

Context Matters: Construct Framing In Measures Of Physical Activity Engagement Among African American Women, Stephanie M. Mcclure, Travis Loux, Enbal Shacham, Eileen Gillespie, Denise Hooks-Anderson

Journal of Health Disparities Research and Practice

Assessment of psychosocial factors influencing health behavior typically privileges conceptual consistency (framing constructs similarly across contexts) over conceptual specificity (context-specific framing). Modest statistical relationships between these factors and health behaviors, and persistent racial disparities in health outcomes raise questions about whether conceptually consistent framing fully captures relevant predictors. Ethnographic studies suggest not - that perceptions influencing health behaviors are multifaceted and contextual. To test this, we added items querying contextualized predictors of intention to engage in leisure-time physical activity (LTPA) to a Theory of Planned Behavior (TPB)-based survey and examined the psychometrics of the adapted subscales. We measured internal consistency …

Effects Of Quantitative Literacy On Healthcare Decision-Making: An Aural Context, Robert G. Root, Sonia Bhala

Numeracy

We propose a relationship between sensory modality, numerical formatting, and performance on a survey simulating healthcare decision-making. We examine the current literature on aural health literacy, and specifically aural literacy coupled with health numeracy. We then create a survey instrument called the Bhala test for this purpose and demonstrate that it is moderately internally consistent and provides results that correlate with the NUMi assessment, a widely accepted measure of health numeracy. The quantitative information provided in the Bhala test has two treatments, percentage and natural frequency formats, in an effort to determine which format is easier for subjects to use …

Social, Economic, And Political Events Affect Gender Equity In China, Nepal, And Nicaragua: A Matched, Interrupted Time-Series Study, Tuan T. Nguyen, Ashley Darnell, Amy Weissman, Edward A. Frongillo Jr., Roger Mathisen, Karin Lapping, Timothy D. Mastro, Mellissa Withers

Faculty Publications

: Progress in gender equity can improve health at the individual and country levels.: This study's objective was to analyze recent trends in gender equity and identify historical and contextual factors that contributed to changes in gender equity in three countries: China, Nepal, and Nicaragua.: To assess gender equity trends, we used the Gender Gap Index (GGI) from the World Economic Forum's Global Gender Gap Report (2006-2017). The GGI incorporated data on economic participation, educational attainment, health, and political empowerment for almost 150 countries. We selected China, Nepal, and Nicaragua because of their major changes in GGI and diversity in …

Nutrition Intervention Using Behavioral Change Communication Without Additional Material Inputs Increased Expenditures On Key Food Groups In Bangladesh, Andrea M. Warren, Edward A. Frongillo, Phuong H. Nguyen, Purnima Menon

Faculty Publications

Background

Behavioral change communication (BCC) promotes skills and knowledge to improve infant and young child feeding, but without additional material inputs, recipients must develop strategies to translate knowledge into action. Using data from the Alive & Thrive initiative in Bangladesh (2010–2014), we aimed to test whether households receiving the intensive intervention (opposed to the nonintensive intervention) increased expenditures on key foods for mothers and children (e.g., foods that were promoted by the intervention and also changed in maternal and child diets).

Methods

The intensive intervention provided interpersonal counseling, community mobilization, and mass media campaigns to promote breastfeeding and complementary feeding. …

Effects Of The Affordable Care Act On The Receipt Of Colonoscopies Among The Insured Elderly, Minjee Lee, M Mahmud Khan, Heather M. Brandt, Ramzi G. Salloum, Brian Chen

Faculty Publications

BACKGROUND: The Affordable Care Act (ACA) waived deductibles and eliminated coinsurance for colonoscopies for Medicare beneficiaries beginning in January 1, 2011. This study investigated the effect of the ACA's directive to remove the financial barriers on the receipt of colonoscopies among the elderly insured, who are predominantly covered by Medicare. METHODS: Data from the 2008-2016 Behavioral Risk Factor Surveillance System (BRFSS) were used to examine the receipt of colonoscopies in two years prior to the implementation of the ACA (2008 and 2010) and three years after the change (2012, 2014, and 2016). Multivariate logistic regressions were estimated to examine the …

Community Outreach And Education Project: Hepatitis A And B Vaccines In High Risk Populations, Ellen Wright

Master of Science in Nursing Theses and Projects

The Community Outreach and Education Project targets high risk groups within Gaston County to increase education and vaccination against Hepatitis to, in turn, lower countywide Hepatitis rates. Through implementation of the project, Gaston County Department of Health and Human Services-Public Health (GCDHHS-PH) will partner with Community sponsors to gain access to their high-risk clients. Sponsors will be educated on the impact of prompt intervention in slowing the spread of hepatitis throughout high risk groups. Once an agreement is made between GCDHHS-PH and Community sponsors, GCDHHS-PH will present to participating facilities and begin screening, educating, and vaccinating high-risk individuals.

Constituting Safety In Hunter’S Education: An Analysis Of Safety Messages In Texas Hunter’S Training Discourse, R. Tyler Spradley

International Crisis and Risk Communication Conference

Risk communication includes safety messages to reduce the likelihood of hazard and increase the likelihood of reliability. Hunter’s education in the state of Texas uses safety messages to reduce fatal or injurious incidents and to promote a positive image of hunting as a safe, leisure sport. Analysis of Texas’ hunters education training materials and messages related to safety reveals that safety messages construct an image of hunters as practicing safety first, conservationists, ethical, law abiding, and other-oriented. Given Texas safety record, much is to be learned about safety messaging that adopts a positive or ideal image that the trainee identifies.

Strengthening Sideline Decisions About Concussions In Youth Sports (Strides): A Mixed Methods Approach, Ann Guernon

Graduate Research Theses & Dissertations

Background: Sport-related concussion in youth is a serious public health concern, and coaches of youth sports are frequently tasked with the role of primary decision maker about potential concussion during athletic activities.

Objective: To explore factors that influence coach decision-making about concussion in the moments during athletic activity that an injury may occur.

Methods: An exploratory sequential mixed methods study was conducted to identify coach-reported factors that influence decision-making about potential concussion and develop tools to evaluate prevention and management strategies that support coach decision-making during athletic activities. The study involved three phases: (1) semi-structured interviews with 16 coaches of …

Vitamin D Levels In Relation To Low Back Pain During Adolescence, Abdullah Al-Taiar, Abdur Rahman, Lemia Shaban, Anwar H. Albaloul, Sean Banaee, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

This study aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D) level and low back pain (LBP) among adolescents while adjusting for potential confounders pertinent to this age group including the weight of school bags, BMI and physical activity. A cross-sectional study was conducted on 760 randomly selected adolescents in middle schools. Data on LBP and the risk factors for LBP were collected from parents by a self-administered questionnaire and from adolescents by face-to-face interview. Blood samples were tested in an accredited laboratory; and 25(OH)D was measured using liquid chromatography-tandem MS. The lifetime prevalence and the 6-month prevalence of LBP …

2017 Statewide Child Death Report, Nevada Institute For Children's Research And Policy, Dawn L. Davidson, Elizabeth Holka

Nevada Institute for Children's Research and Policy Reports

The purpose of this report is to provide comprehensive information regarding the circumstances by which children die in Nevada in order to prevent future child deaths and improve the health and safety of children in the state.

Ua35/3 Memoranda, Wku Provost

WKU Administration Documents

2020 memoranda issued by the WKU Provost to faculty & staff via email.

• Center for Innovative Teaching & Learning January Workshops
• Fall to Fall Retention of All FFY as of Census by Selected Categories
• Updates fromt the Provost
• COVID-19
• COVID-19 or Coronavirus Update
• COVID-19 Update from the Provost's Office
• Announcing the 2020 College Faculty Award Winners
• WKU Announces New Associate Provost for Research & Graduate Education
• Budget Communication
• Summer School Updates from the Provost
• Amendment to PDF Policy
• FY2020-21 Budget Executive Committee Recommendations
• Provost's Message

Ua12/4 Student Affairs Health Services, Wku Archives

WKU Archives Collection Inventories

Records created by Health Services.

Supports For Migrant Farmworkers: Tensions In (In)Access And (In)Action, Susana Caxaj, Amy Cohen, Sarah Marsden

Health and Rehabilitation Sciences Publications

Purpose: This study examined the role of support actors in promoting or hindering access to migrant agricultural workers' (MAWs) needs, and, to determine the factors that influence adequate support for this population.
Methodology: Employing a Situational Analysis methodology, we carried out focus groups and interviews with 35 support actors complimented by a community scan (n=28) with public-facing support persons and a community consultation with migrant agricultural workers (MAWs).
Findings: Two major themes were revealed: (In)access and (In)action, and; Blurred Lines in Service Provision. The first illustrated how support actors could both reinforce or challenge barriers for this population through tensions …

Addressing Cardiovascular Disease Among Populations Disproportionately Impacted In The United States, Michael Leron Sells

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) causes the most deaths in the United States and is disproportionately impacting certain groups more than others. A gap in the research exists when focusing on national data for those who bear the highest burden of CVD amongst people with hypertension when cardiovascular morbidity and mortality are examined. There is also a need to investigate the relationships between key indicators for CVD health disparities in people with hypertension. The purpose of this quantitative study is to investigate the cumulative effect of key health disparities indicators such as race, age, gender, education, and income using national-level surveillance data …

An Interpretive Qualitative Study Of Idaho Head Start Families Facing Food Insecurity, Sherry Deiter

Walden Dissertations and Doctoral Studies

The purpose of this basic interpretive qualitative study was to examine food insecurity among Idaho Head Start enrolled families, focusing on barriers and deterrents to accessing available nutrition assistance programs. The social-ecological model (SEM) was used as the theoretical foundation for this study. Based on this model, the research questions were designed to explore experiences of participants related to individual, interpersonal, community, organizational, policy, and educational factors that influenced food insecurity. Parents who had children enrolled in Idaho Head Start programs that met purposeful sampling criteria were recruited for the study. A total of 11 parents, all who had experiences …

Evaluating Integrated Treatment On Recidivism For Female Offenders In Criminal Justice System, Oyin T. Popoola

Walden Dissertations and Doctoral Studies

The burden of co-occurring disorders (CODs) among offenders in the criminal justice system (CJS) in the United States, particularly among the female population, is threatening the communities. About 80% of women in the CJS were diagnosed and treated for CODs, and 63% tend to be rearrested. The study examined the possible influence of CODs, integrated treatment of CODs, and gender, on recidivism while controlling for other demographic factors. The study was based on the conceptual framework of integrated dual disorder treatment (IDDT) and feminist criminology theory. Cross-sectional quantitative study design was applied on a secondary dataset from the 2017 Treatment …

Sexual Orientation, Body Mass Index, And Methamphetamine Use Among Chicago Youth, Nileshkumar Panchal

Walden Dissertations and Doctoral Studies

Drug use and obesity are two of the most challenging health-related issues that young people face. Obesity, substance abuse, and drug addiction lead to brain dysfunction, which can decrease the quality of life and academic performance as well as increase the vulnerability of developing chronic diseases. To date, there has been little research to determine whether sexual orientation influences the relationship between body mass index (BMI) and methamphetamine use. Focusing on youth, the relationship between BMI, methamphetamine use, and sexual orientation were examined in this study through secondary data analysis of the Youth Risk Behavioral Surveillance System in Chicago. Guided …

African American Maternal Mortality In The United States: A Quantitative Analysis Of Chronic Disease And Maternal Deaths, Glory Inyang

Walden Dissertations and Doctoral Studies

African American women have higher rates of chronic disease including diabetes and cardiovascular related disease compared to White women and are 3 to 4 times more likely to die during childbirth, more than any other ethnic group in the United States. . When African American women become pregnant these conditions may influence their maternal health outcomes. This study aimed to determine difference in pregnancy related death associated with chronic conditions between African American women and White women. Based on secondary/archival data from the Center for Disease Control and Preventions' 2017 National Center for Health Statistics Mortality Multiple Cause Files a …

Understanding The Attitudes And Perceptions Towards Lung Cancer Screening Amongst United States Veterans: A Qualitative Study, Shannon Nugent, Kristine Pham, Mph, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: Lung cancer is the leading cause of cancer mortality in the United States, with this rate disproportionately affecting the veteran population. Despite USPSTF recommendations, screening rates are low and underutilized. The purpose of this study is to understand veterans’ knowledge, attitudes and beliefs surrounding lung cancer and lung cancer screening to better address barriers to screening.

Methods: Five interviews were conducted with veteran community members, and three were conducted with key informants for a current total of eight interviews. Key informants included Philadelphia community leaders who work with veterans. Interviews explored lung cancer screening knowledge, motivating factors and barriers …

Telehealth Efforts To Reduce Hospital Readmissions Of Congestive Heart Failure Patients, Sirfornia L. Deasfernandes

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a chronic condition that affects millions of individuals in the United States. There is no cure for CHF, but medical interventions can help treat the symptoms and improve health outcomes. The purpose of this quantitative study was to determine if telehealth services help to reduce the readmission status of patients diagnosed with CHF. The theoretical framework used in this study was the individual and family self-management theory to help focus on self-management behaviors that contribute to improving the patients' health outcomes. The research questions were focused on addressing CHF patients receiving telehealth services and whether …

Association Of Social Support And Depressive Symptoms Among African Americans, Jacketta Renee Cobbs

Walden Dissertations and Doctoral Studies

Depression affects over 120 million individuals worldwide; in the United States, depression is a leading cause of disability for individuals’ ages 15-44 years. Social support can affect both physical and depressive symptoms; therefore, most patients with heart failure (HF) need support from family and/or friends to effectively manage their health condition. This indicates family and/or friends are expected to be the core support system for long term care of those with HF. The purpose of this study was to determine whether social support contributes to depressive symptoms among African Americans with HF. The research questions examined the experience of different …