Medicine and Health Sciences Commons^™

Improving Healthcare Provider Knowledge And Confidence With Treating The Lgbtq Population Through A Web-Based Education Module, Logan Price

DNP Projects

Background: There is a need for improved healthcare staff and provider knowledge and confidence when treating the LGBTQ population, as many healthcare providers are insufficiently prepared to treat LGBTQ patients (Rowe et al., 2017). This population is at greater risk for mental illness, substance use, and physical illness than the general population due to societal factors such as minority stress and stigma (Cochran et al., 2004; Cochran & Mays 2007; Cochran et al., 2003; Meyer, 2003). Purpose: The purpose of this project is to educate healthcare staff and providers about the LGBTQ population to improve their knowledge and confidence when …

High-Risk Individuals And Naloxone Use: Implications For Thn Programs In Rural Appalachian Communities, Victor Garcia, Lisa Mccann, Erick Lauber, Christian Vaccaro, Melissa Swauger, Alex Daniel Heckert

Journal of Appalachian Health

Introduction: Take-home naloxone (THN) is being made available across rural Appalachia to curb opioid overdose fatalities. Despite this initiative, some opioid users do not possess naloxone, and if they do, do not administer it to others.

Purpose: Research findings on risk factors that contribute to opioid overdose are presented. These factors, identified in a sample of 16 overdose cases, are (1) early onset age of opioid use; (2) progressive opioid use; (3) a transition from pain medication to heroin and fentanyl; (4) fears of being arrested at a naloxone intervention if first responders are contacted, and (5) limited knowledge of …

Online Pilot Grocery Intervention Among Rural And Urban Residents Aimed To Improve Purchasing Habits, Alison A. Gustafson, Rachel Gillespie, Emily M. Dewitt, Brittany Cox, Brynnan Dunaway, Lindsey Haynes-Maslow, Elizabeth Anderson Steeves, Angela C. B. Trude

Dietetics and Human Nutrition Faculty Publications

Online grocery shopping has the potential to improve access to food, particularly among low-income households located in urban food deserts and rural communities. The primary aim of this pilot intervention was to test whether a three-armed online grocery trial improved fruit and vegetable (F&V) purchases. Rural and urban adults across seven counties in Kentucky, Maryland, and North Carolina were recruited to participate in an 8-week intervention in fall 2021. A total of 184 adults were enrolled into the following groups: (1) brick-and-mortar “BM” (control participants only received reminders to submit weekly grocery shopping receipts); (2) online-only with no support “O” …

Effectiveness Of Substance Use Disorder Education On Knowledge And Attitudes Among Entry-Level Obstetric Nurses, Kathryn Hughes

DNP Projects

Background: Substance use disorder (SUD) among pregnant women is a significant public health concern in the United States, particularly in Kentucky. Nursing curriculum has not kept pace with the escalating public health crisis regarding SUD. Graduating nurses joining the obstetric field are often not prepared to meet the unique care needs of this vulnerable population.

Purpose: The purpose of this DNP project was to pilot an educational intervention embedded with content regarding SUD with entry-level obstetric nurses that were enrolled in the nurse residency program at UK HealthCare.

Methods: This project used a quasi-experimental pretest – posttest design. Participants completed …

Evaluation Of A Beverage Educational Intervention For Latino Parents Of Infants And Children Ages Nine Months To Five Years, Natalie Chelf

DNP Projects

Background: The Latino population has the highest rate of childhood obesity in the United States. Sugar-sweetened beverage (SSB) consumption has a positive correlation with increased rates of childhood obesity. Current research shows a deficit in culturally sensitive methods to reduce SSB consumption in the pediatric Latino population.

Purpose: The purpose of this project is to empower parents of Latino infants and young children with the knowledge to reduce or eliminate the consumption of SSBs in their child’s diet.

Methods: The project was a one group pre-test post-test quasi-experimental study design occurring in one pediatric outpatient clinic. The Information-Motivation-Behavioral Skills (IMB) …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

Overcoming The Covid-19 Pandemic For Dementia Research: Engaging Rural, Older, Racially And Ethnically Diverse Church Attendees In Remote Recruitment, Intervention And Assessment, Lisa Kirk Wiese, Ishan C. Williams, Nancy E. Schoenberg, James E. Galvin, Jennifer Lingler

Behavioral Science Faculty Publications

Background: Access to cognitive screening in rural underserved communities is limited and was further diminished during the COVID-19 pandemic. We examined whether a telephone-based cognitive screening intervention would be effective in increasing ADRD knowledge, detecting the need for further cognitive evaluation, and making and tracking the results of referrals.

Method: Using a dependent t-test design, older, largely African American and Afro-Caribbean participants completed a brief educational intervention, pre/post AD knowledge measure, and cognitive screening.

Results: Sixty of 85 eligible individuals consented. Seventy-percent of the sample self-reported as African American, Haitian Creole, or Hispanic, and 75% were female, with an average …

Healthy, Fit, & Strong: A Parent-Child Physical Activity Program For Families With Obese And Overweight Adolescents, Patrick Maloney

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

Over 20% of Kentucky children between the ages of 10-17 are obese, the third highest prevalence in the nation. The Healthy, Fit, & Strong Program works with children with a BMI above the 85th percentile and their parents to improve behaviors related to physical activity (PA) and nutrition. The intervention is a 12-week program which features tri-weekly physical activity sessions and nutrition classes. Both children and parents participate in activities in order to build knowledge and confidence related to healthy behaviors. The goal of this intervention is to improve upon baseline physical activity levels and diet as well as to …

A Mechanistic Model And Therapeutic Interventions For Covid-19 Involving A Ras-Mediated Bradykinin Storm, Michael R. Garvin, Christiane Alvarez, J. Izaak Miller, Erica T. Prates, Angelica M. Walker, B. Kirtley Amos, Alan E. Mast, Amy Justice, Bruce Aronow, Daniel Jacobson

Horticulture Graduate Research

Neither the disease mechanism nor treatments for COVID-19 are currently known. Here, we present a novel molecular mechanism for COVID-19 that provides therapeutic intervention points that can be addressed with existing FDA-approved pharmaceuticals. The entry point for the virus is ACE2, which is a component of the counteracting hypotensive axis of RAS. Bradykinin is a potent part of the vasopressor system that induces hypotension and vasodilation and is degraded by ACE and enhanced by the angiotensin1-9 produced by ACE2. Here, we perform a new analysis on gene expression data from cells in bronchoalveolar lavage fluid (BALF) from COVID-19 patients that …

The Need For Evidence-Based Interventions To Reduce Food Insecurity Among College Students, Sarah Brothers, Stephanie Jilcott-Pitts Phd

Journal of Appalachian Health

Food insecurity is defined as insufficient resources to meet food needs. This is a global problem but is not confined to those countries identified as poor. One group of Americans who are particularly affected, and for whom the effects are particularly severe, is college students.

Mentoring Multi-College Bystander Efficacy Evaluation – An Approach To Growing The Next Generation Of Gender-Based Interpersonal Violence Intervention And Prevention (Vip) Researchers, Ann L. Coker, Danielle Davidov, Heather M. Bush, Emily R. Clear

Obstetrics and Gynecology Faculty Publications

The Centers for Disease Control and Prevention provided funding (U01 CE002668) to evaluate bystander program efficacy to reduce gender-based violence on college campuses (Aim 1) and to create a mentoring network (Aim 2) for young campus-based researchers interested in violence intervention or prevention (VIP). While an evaluation of this mentoring program is ongoing, our purpose here was to document the strategies used to create, implement, and begin evaluation of this national multi-college mentoring network. As each public college was recruited into this evaluation named multi-college Bystander Efficacy Evaluation (mcBEE), each college was invited to nominate a researcher interested in receiving …

The Importance Of Shared Language In Rural Behavioral Health Interventions: An Exploratory Linguistic Analysis, Michele Staton, Jennifer Cramer, Robert Walker, Claire Snell-Rood, Athena Kheibari

Behavioral Science Faculty Publications

A focus on the use of shared language to enhance congruence in interventionist-client dialogue is missing from traditional research on evidence-based practices and rural behavioral health. This study incorporates qualitative interactional sociolinguistics, which includes discourse analysis (typically written or audio recordings of face-to-face encounters with 11 clients and a study interventionist), to describe those speech patterns in a broad sense (dialect), as well as more specific use of communicative strategies to increase parity in the interaction between a rural interventionist delivering an evidence-based practice in the context of a research study with rural women opioid users in a non-therapeutic context. …

A Mentor-Led Text-Messaging Intervention Increases Intake Of Fruits And Vegetables And Goal Setting For Healthier Dietary Consumption Among Rural Adolescents In Kentucky And North Carolina, 2017, Alison A. Gustafson, Stephanie B. Jilcott Pitts, Kristen Mcquerry, Oyinlola Babtunde, Janet Mullins

Dietetics and Human Nutrition Faculty Publications

Introduction—Text-messaging interventions hold promise for successful weight loss interventions. However, there is limited research on text-messaging interventions to improve dietary intake among rural adolescents, who are at greater risk for obesity and related risk factors. The goal of this study was to test an eight-week, mentor-led text-messaging intervention among 14–16-year-old rural adolescents: the “Go Big and Bring It Home” Project to improve fruit and vegetable and healthy beverage intake. Methods and Materials—Eight rural high schools in eastern Kentucky and eastern North Carolina participated (n = 4 were randomized as intervention schools and n = 4 were randomized as control …

Results Of A Feasibility Randomized Controlled Trial (Rct) Of The Toolkit For Optimal Recovery (Tor): A Live Video Program To Prevent Chronic Pain In At-Risk Adults With Orthopedic Injuries, Ana-Maria Vranceanu, Cale A. Jacobs, Ann Lin, Jonathan Greenberg, Christopher J. Funes, Mitchel B. Harris, Marilyn M. Heng, Eric A. Macklin, David Ring

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Orthopedic injuries are the leading cause of hospital admissions in the USA, and many of these patients transition into chronic pain. Currently, there are no evidence-based interventions targeting prevention of chronic pain in patients with orthopedic injuries. We iteratively developed a four-session intervention “The Toolkit for Optimal Recovery” (TOR) which we plan to subsequently test for efficacy in a phase III hybrid efficacy-effectiveness multi-site clinical trial. In order to prevent methodological weaknesses in the subsequent trial, we conducted a feasibility pilot to evaluate the TOR delivered via secure live video versus usual care (UC) in patients with orthopedic injuries …

The Effect Of A School Nurse Intervention Program On Student Absenteeism In Jefferson County Public Schools: A Pilot Study, Eva Stone

DNP Projects

Background: School attendance has a significant impact on student achievement. In early grades, students who miss 10% or more of school are considered chronically absent and at risk to be behind in reading. High school students with similar attendance patterns are less likely to enroll and stay in college after graduation. Evidence shows that the presence of school nurses can result in improved school attendance.
Purpose: The purpose of this pilot project was to implement a targeted school nurse intervention at an elementary, middle and high school in Jefferson County. The intervention included assessment by a registered nurse for children …

Brief Intervention And Buprenorphine Initiation For Opioid Use Disorder In Northern Kentucky Emergency Departments, Cady Cornell

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

The opioid epidemic has had sweeping, devastating effects on the United States. Kentucky has the fifth highest overdose mortality rate in the nation and the Northern Kentucky counties, specifically Kenton and Campbell, have been especially affected. Their opioid overdose mortality rates are the third and fourth highest in the state, respectively. In order to contribute to ongoing Northern Kentucky community efforts to combat the opioid epidemic, St. Elizabeth Healthcare is proposing to implement The Brief Negotiation Interview (BNI) in our emergency departments in order to provide more comprehensive care. The BNI is a motivational interviewing strategy that has been combined …

The Use Of A Video-Based Intervention To Motivate Gay And Bisexual Men On Prep To Use Condoms, Ethan Cardwell

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

Based on need and available resources, gay and bisexual men who have sex with men (GBMSM) in the Castro neighborhood of San Francisco, California represent the target population for this intervention. Through funding by the Center for Disease Control the Strut Clinic in collaboration with the University of California Berkley is proposing a video-based intervention with the following SMART objectives.

Objective 1: Efficiently develop and integrate a video-based intervention in the Strut Clinic within the first six months of the funding cycle.

Objective 2: Sustain an increase of consistent condom use to 30% of participants and up to a 10% …

Implementing Counseling African Americans To Control Hypertension Intervention In Louisville Metro, Raven Robbins

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

Hypertension disproportionately affects Africans Americans more than their White counterparts. Counseling African Americans to Control Hypertension (CAATCH) is an intervention program that is targeted at African American adults to decrease uncontrolled hypertension. The CAATCH intervention has three components, which includes 1) computerized hypertension education, 2) at home blood pressure monitoring, and 3) behavioral counseling. The CAATCH intervention will be implemented in three sites in the northwest portion of Jefferson County in Louisville, KY. The overall goals of the CAATCH intervention are to decrease the number of participants who suffer from uncontrolled hypertension, increase knowledge of hypertension among participants, increase the …

Microclinic International Social Network Behavioral Health Intervention In Mongolia, Kalli A. Beasley

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

Diabetes is a chronic communicable disease that is projected by 2030 to be the seventh leading cause of death worldwide. In Mongolia diabetes and cardiovascular disease are the number one reason for disability-adjusted life years and trends of diabetes is starting to be observed in the poorer populations. Diabetes in countries like Mongolia are extremely costly to treat using insulin, costing $200 USD per month while the average annual income sits only at $1,466.85 USD. Mongolia has a total population of 2,959,000 and half of its population resides in the capital city of Ulaanbaatar. 60% of residents in capital live …

The Financial Impact Of A Healthy Eating Intervention In A Government Worksite Cafeteria, Andrew M. Wheeler

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

Unhealthy eating habits are associated with a greater risk of obesity and many chronic diseases. Historically, public health nutrition interventions have focused on education of the individual to induce dietary behavior change. However, given that many factors influence food choices, more comprehensive interventions that address these multiple factors are needed. Worksite cafeterias provide a unique opportunity to intervene at multiple levels of influence on employees eating habits. In this paper we used cafeteria sales data to evaluate the changes in purchases and the financial impact of implementing a healthy eating intervention using an environmental change and various promotional efforts to …

Community Of Hope: A Comprehensive Suicide Prevention Intervention At Mit, Kyra Patel

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

Suicide is the second leading cause of death for most age groups in the United States. The current rate of suicide among college students is 7.5 per 100,000 with the rate remaining fairly steady over the past 30 years. While the rate is lower on college campuses, compared to the general population ages 18-24, the issue is still much larger on a college campus due to suicide bereavement or the number of people affected and to what degree they were impacted. As of 2015, MIT (Massachusetts Institute of Technology) had the highest suicide of all reporting colleges. The primary objective …

Promoting Teen Contraceptive Use By Intervention With Their Mothers, Richard A. Crosby, Tom Collins, Lindsay R. Stradtman

Health, Behavior & Society Faculty Publications

Introduction: The purpose of this pilot study was to test a community outreach model designed to help mothers in a rural, medically underserved area navigate their teen daughters to health department services for long-acting reversible contraception (LARC) or alternative contraception.

Methods: The pilot study used a single-group, post-test only design. Mothers of teen daughters (N=142) received a 1-hour, one-to-one intervention session (in outreach settings) from Community Liaisons. Mothers received training on how to communicate with their daughters about LARC and other contraceptive methods. Data were collected from June through October 2014, and analyzed in September 2015.

Results: The authors re-contacted …

A Process Improvement Project To Increase Diabetic Retinopathy Screening Rates As Evidenced By Formal Documentation, Michelle Renae Campbell

DNP Projects

Purpose: To evaluate the effects of a referral process on diabetic retinopathy screening rates among patients with Type 2 diabetes and formal documentation completion rates of these screenings within a primary care setting.

Methods: A referral process for patient referral to an ophthalmologist for annual diabetic retinopathy screening was instituted for a 4-week period within a Norton Community Medical Associates (NCMA) primary care location for Type 2 diabetes patients. Charts of 30 patients pre-intervention were compared with the charts of 30 patients seen during the intervention phase of the study to evaluate the effects of the referral intervention. Demographic data, …

Color Your Plate: A Pilot Nutrition Education Intervention To Increase Fruit And Vegetable Intake Among Older Adults Participating In The Congregate Meal Site Program In Kentucky Senior Centers, Emily Dickens

Theses and Dissertations--Nutrition and Food Systems

The purpose of this study was to determine if the amount and variety of fruit and vegetable intake increased among community-dwelling older adults participating in Kentucky’s congregate meal site program following a series of educational nutrition lessons. A convenience sample (n=35) of community-dwelling older adults at two intervention (n=19) and two control (n=16) senior centers in central Kentucky participated in this quasi-experimental pre-post pilot study. Following the intervention there was a trend towards increased self-reported intake in the variety of fruit and vegetables among the intervention group (range:0.03±3.31 to 1.32±2.75 servings per week); a significant increase in the number of …

Evaluation Of Educational Intervention And Management Of Patients With Type Ii Diabetes Mellitus, Elissa Johnson

DNP Projects

Background: Diabetes is a costly disease with devastating consequences. Patients with poor glucose control whether due to inadequate medical care or limited self-care are most at risk for complications. Evidence supports the efficacy of multifaceted interventions in the treatment of type II diabetes mellitus (T2DM). Patient education, assessing behavioral and psychosocial elements, and focusing on lifestyle change (e.g. diet and exercise) are interventions shown to enhance self-efficacy and promote patient empowerment (Knight, Dornan, & Bundy, 2005).

Study Design: A retrospective chart review of 104 patients with established T2DM was conducted along with a qualitative interview with providers focused on management …

Global School-Based Childhood Obesity Interventions: A Review, Melinda J. Ickes, Jennifer Mcmullen, Taj Haider, Manoj Sharma

Kinesiology and Health Promotion Faculty Publications

Background: The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies.

Methods: A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and …

Effects Of Response Elaboration Training On Sentence Production Of Persons With Chronic Agrammatic Aphasia, Ryan S. Husak

Theses and Dissertations--Rehabilitation Sciences

Purpose: Response Elaboration Training (RET) is a treatment program for increasing the amount of information contained in the speech of individuals with aphasia. This study employed a sentence production task (SPT) to examine whether RET will (1) generalize to a task not worked on in treatment and (2) affect syntactic performance.

Methods and Procedures: Three adults with chronic non-fluent Broca’s aphasia received RET in this prospective, repeated case study. The dependent variable was a SPT requiring the participant to put a verb in a sentence. Changes in the syntactic performance of the participant’s sentence productions were classified across …

Everyday Speech Production Assessment Measure (E-Spam): Reliability And Validity, Tracy N. Watts

University of Kentucky Master's Theses

Purpose: The Everyday Speech Production Assessment Measure (E-SPAM) is a novel test for assessing changes in clients‟ speech production skills after intervention. This study provides information on reliability and validity for the test and overviews its clinical application.

Method & Procedures: E-SPAM, oral reading, and sequential motion rate tasks were administered to 15 participants with motor speech disorders (MSDs). E-SPAM responses were scored using a 5-point system by four graduate students to assess inter-scorer and temporal reliability and to determine validity for E-SPAM.

Results: Findings of this study indicate that the E-SPAM can be scored with sufficient …