Medicine and Health Sciences Commons^™

Food Insecurity And Residential Segregation Among Adults In The United States: The National Health And Nutrition Examination Survey 2017- March 2020 Pre-Pandemic Data., Chandre' L. Chaney

Electronic Theses and Dissertations

Food insecurity is when a household has insufficient food supply due to limited economic resources. It is a public health issue that continues to persist. The health, social, and economic impact affects millions of people nationwide. Residential segregation is a primary cause of inequities and health disparities. It shapes the differences in socio-economic conditions between Blacks and Whites living in the U.S. This country is segregated across racial lines in many of our most populated metropolitan cities. Americans worship in different churches, learn in disparate schools, and live in separate neighborhoods. Residential segregation has consequences that impact the economy, professional …

Overview Of Transition Care Clinics And Patient No-Shows, Manul Awasthi

Electronic Theses and Dissertations

Introduction

Transition care clinics (TCCs) have proven to be effective in meeting the time-sensitive needs of patients in the post-discharge period and ensuring smooth transitions of patients from hospital to home. These clinics have led to lower readmissions, lower emergency department visits, cost savings, and lower rates of other adverse events following discharge. However, TCCs, including the East Tennessee State University Family Medicine (ETSU-FM) TCC have been facing high rates of patient no-shows.

Aim

The aim of this dissertation is to identify the different components and outcomes of TCC based on the literature. We further aim to analyze the TCC …

A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

Exploring Opportunities For Prevention Of Child Sexual Abuse In A Diverse American Muslim Community., Rishtya Meena Kakar

Electronic Theses and Dissertations

Recognizing the significant mental, emotional, developmental and health consequences for victims of child sexual abuse (CSA) and sociopolitical consequences for families and communities in every cultural, ethnic, and religious group around the world, this study sought to determine key opportunities for prevention of CSA in a diverse American Muslim community using a public health socioecological lens, rooted in aspects of critical theory. While there is considerable research on situational and individual-level risk factors related to CSA cases, there is less research on the societal and community-level processes related to the primary prevention of CSA, especially among minoritized communities. Responding to …

Association Between Prepregnancy Obesity And Health Behaviors, Adverse Conditions, And Birth Outcomes In South Dakota, Lily Sanderson

Electronic Theses and Dissertations

Introduction: Prepregnancy obesity is associated with an increased risk for various adverse outcomes for mother and fetus. These adverse associations exist within the realms of preconception health, prenatal health, birth outcomes, and postnatal health.
Methods: This retrospective cohort study used data from the South Dakota Pregnancy Risk Assessment Monitoring System (SD PRAMS) survey, which is an ongoing statebased surveillance system of maternal behaviors, attitudes, and experiences before, during, and shortly after pregnancy. The 2017 and 2018 SD PRAMS sampled a total of 3,805 mothers who were randomly selected from birth certificate records to be representative of all South Dakota women …

Perceptions Of Local Board Of Health Effectiveness In Georgia, Amber Erickson

Electronic Theses and Dissertations

Objective: The purpose of this study is to examine the perceptions of the local board of health chairpersons in Georgia on their engagement in six governance functions and examining the challenges faced and facilitators perceived by local boards of health in performing the governance functions properly. Methods: For this descriptive mixed method study design, a survey was administered to all local board of health chairpersons and key informant interviews were conducted with a small selection of board of health chairpersons. Descriptive statistics were produced for recoded survey data variables and themes from qualitative data collected through the surveys and interviews …

Identifying Strategies To Increase The Recruitment And Retention Of Minority Males In The Public Health Workforce: A Two-State Comparative Case Study Approach, Melicent R. Miller

Electronic Theses and Dissertations

Non-White males have higher rates of morbidity and mortality from chronic health conditions as compared to Whites. An essential element for achieving success in eliminating health disparities is to increase the presence of racial/ethnic minorities (i.e., people of color) within public health careers. One of the most important competencies for a public health professional is the ability to work in culturally and racially diverse populations. Yet, individuals are significantly more likely to receive their care and experience greater satisfaction from providers that are of the same racial or ethnic background. The racial/ethnic composition of the health professions workforce continues to …

Assessing Public Health Workforce Informatics Competencies: A Study Of Three Health Departments In Metro Atlanta, Olatanwa Adewale

Electronic Theses and Dissertations

Background: There is a need for the public health workforce to be current and versatile in technology usage. Public health leveraging technology usage in service delivery has the potential to improve efficiency and bring it to the forefront in the provision of healthcare services. The purpose of this study was to assess public health workforce informatics competencies in select Atlanta health districts and determine the correlates of public health informatics proficiency.

Methods: A 10-item instrument adapted from the recommendations of a Working Group document by the Centers for Disease Control and Prevention and the 2015 Informatics Capacity and …

“Pissing In The Wind”: Racially Discriminatory Economic Policies’ Impact On Today’S Banking Status, Use Of Alternative Financial Services And Health Outcomes., Gaberiel Jones Jr

Electronic Theses and Dissertations

Centuries of discriminatory policies and practices in the United States have created racially segregated, resource-poor urban communities. Differential benefits of banking and housing legislation were among the consequences of these policies as they contributed to drastic racial inequities in wealth. Today, racial differences in banking status and financial practices persist. However, a void exists in the literature exploring what alternative financial services (AFS) are used in lieu of banks by Black Americans, why those services are used, the thoughts and beliefs of Black Americans about the use of those services, the impact of bank locations on financial behavior patterns, and …

Polydrug Use Among People Who Use Opioids, National Survey On Drug Use And Health 2002 To 2017., Diana Kuo Stojda

Electronic Theses and Dissertations

Introduction: Mortality due to overdose has been increasing since 2010 in the U.S., with an increase in the reported use of heroin and co-use of heroin and prescription opioids. Trends and correlates of polydrug use need to be analyzed to propose policies to reduce overdose risk. The overall objective of this study is to characterize high-risk polydrug groups among people who use opioids (PWUO) to understand the patterns of co-used substances and overdose risk factors. Methods: Publicly available data from the 2002-2017 National Survey on Drug Use and Health were analyzed to obtain weighted prevalence rates and trends …

E-Cigarettes And Conventional Cigarettes: Perceived Risks And Benefits Among College Students, Evi Addoh

Electronic Theses and Dissertations

ABSTRACT Background: Accompanying the decline in cigarette smoking rates has been a rise in prevalence of electronic cigarette (e-cigarette) use. The ongoing investigations on the health impact of e-cigarettes have been accompanied by mixed messages and a lack of consensus which may lead college students to rely on their own perceptions of risk and benefits in deciding whether to use e-cigarettes. Conclusion: Considering the significant association of perceived risks and benefits with e-cigarette and cigarette use this study yields some findings that show the importance of appropriately addressing perceptions. It is paramount to keep the public updated on pertinent research …

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

Electronic Theses and Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …

Examining The Issue Of Compliance With Personal Protective Equipment Among Wastewater Workers Across The Southeast Region Of The United States, Tamara L. Wright

Electronic Theses and Dissertations

Wastewater workers are exposed to different occupational hazards such as chemicals, gases, viruses, and bacteria. Personal Protective Equipment (PPE) is a significant factor that can reduce or increase the probability of an accident from hazardous exposures to chemicals and microbial contaminants. The purpose of this study was to identify wastewater worker’s beliefs and practices on wearing PPE and protections offered by PPE through the integration of the Health Belief Model (HBM). Participants were workers in the wastewater industry, which included wastewater operators, laboratory analysts, maintenance workers, wastewater collection workers, equipment operators, managers, and supervisors (n=272). The instrument was a self-administered …

Attending To Systemic Racism : Advancing Public Health's Approach To Youth Violence Prevention., Billie Faith Castle

Electronic Theses and Dissertations

This dissertation examines how the field of public health addresses the impact of systemic racism on health and how that informs public health’s approach to youth violence prevention. Beginning with an overview of youth violence, it breaks down the concepts of race and racism and how they are addressed within the science. It also reviews concepts that contribute to risk and protective factors of youth violence. The dissertation is written from a Critical Race Theory approach, argues that the social environment contributes to why youth violence is pervasive in certain neighborhoods, and promotes action from a macro-level approach. Seven chapters …

Colorectal Cancer Fit Screening In The Hope Vi Population Of Jefferson County, Kentucky., Jeffrey D. Stone

Electronic Theses and Dissertations

Using pre-post survey data collected from 209 randomly selected African American people from the population of former residents of Clarksdale and Sheppard Square public housing areas, this study explores the relationship between individual characteristics and colorectal cancer screening behavior, measured by the uptake of the Fecal Immunochemical Test (FIT) and by prior colorectal screening, while controlling for neighborhood factors and geographic proximity to healthcare facilities. This particular public housing population is of interest because of their relocation from the downtown area, where healthcare facilities are within walking distances, to other public housing units either in large apartment complexes or scattered …

Reducing Tobacco-Related Health Disparities : Exploring The Barriers And Facilitators To Smoking Cessation Among Individuals Experiencing Homelessness., Bernadette Guzman Antoon

Electronic Theses and Dissertations

Although the prevalence of smoking has declined in the U.S., vulnerable populations continue to suffer from tobacco-related health disparities. An estimated 68.0-80.0% of homeless adults are current cigarette smokers compared to 15.1% in the general population. The large gap in smoking rates suggests that current tobacco cessation programs designed to reduce smoking have little impact among individuals experiencing homelessness. The purpose of this study was to explore the barriers and facilitators to smoking cessation among the homeless. The second aim of this study was to explore if the barriers and facilitators to tobacco cessation differed among male smokers experiencing homelessness …

Assessment Of The Knowledge And Skills Of School Personnel To Respond To Diabetic Emergencies In Georgia Public Schools, Alesha Wright

Electronic Theses and Dissertations

Diabetes is a common chronic disease that affects children in the United States. As children with diabetes attend school, the ability to appropriately manage their diabetes is essential to preventing life-threatening health complications. The purpose of the study was to assess school personnel’s knowledge of diabetes and perceived self-competence in performing diabetes management skills in response to a diabetic emergency. For the present study, a diabetic emergency was operationalized to include hypoglycemia, hyperglycemia, or diabetic ketoacidosis. A cross-sectional survey design, utilizing a fifty-two item self-administered questionnaire that accentuated the causes and symptoms of diabetes, definition of hypoglycemia and hyperglycemia, and …

Assessing Health Department Readiness For Public Health Accreditation Through Quality Improvement, Christian L. Williams

Electronic Theses and Dissertations

Engaging in quality improvement (QI) activities can help local and state health departments improve current processes, develop more effective new processes, increase leadership capacity, and prepare for public health accreditation. Public health organizations that have implemented QI processes have seen improvements in health outcome indicators, delivery of the 10 essential services, patient satisfaction, and performance management.

Quality improvement is the foundation of the Public Health Accreditation Board‟s (PHAB) program and further pushes health departments, at both the local and state level, to adopt QI activities within their organizations. There are numerous potential benefits associated with accreditation in public health, one …

Preventing Childhood Obesity: A Mixed Methods Study Into The Perceptions Of African Americans In A Rural Community, Dayna S. Alexander

Electronic Theses and Dissertations

Preventing childhood obesity is a global priority due to adverse health risks and financial burdens. With childhood obesity rates stabilizing it is difficult to determine which factors alone (i.e., genetic, environmental, behavioral, or demographic) increase susceptibility to childhood obesity. Parents influence childhood obesity risk factors through their parenting styles and behaviors. Social behavioral theories and public health evidence demonstrate including parents in childhood obesity efforts could assist in reducing childhood obesity rates. The objective of this study was to assess perceptions of childhood obesity among African Americans with children enrolled in a rural elementary school in the Deep South. The …

Identifying The Behavior, Attitudes, And Knowledge Of Tobacco Use Among Students Enrolled In Orientation Courses In Six Community Colleges In The Tennessee Board Of Regents System, G. E. Boone

Electronic Theses and Dissertations

The purpose of this study was to examine the behavior, attitudes, and knowledge regarding tobacco use of students enrolled in orientation courses in Tennessee community colleges. The six community colleges selected for the study were members of the Tennessee Board of Regents system that offered mandatory orientation courses. Data were collected by use of the College Tobacco Behavior, Attitude, and Knowledge Survey . A response rate of (72.5%) from 700 students was analyzed. Three research questions guided the study and 17 null hypotheses were formulated and tested at the.05 alpha level of significance. Data were analyzed by using t -tests, …

The Nature, Scope, And Consequences Of Drug And Alcohol Use Of Students Enrolled At Three Southern Appalachian Community Colleges, Jewel D. Morgan

Electronic Theses and Dissertations

The primary purpose of this study was to determine the nature, scope, and consequences of drug and alcohol use by students enrolled at three southern Appalachian community colleges: Mountain Empire Community College (MECC) in Virginia, Northeast State Technical Community College (NSTCC) in Tennessee, and Southwestern Community College (SCC) in North Carolina. An additional purpose was to use this information to formulate recommendations for new and improved preventive substance-abuse programs. The design for this study was descriptive research. The Core Alcohol and Drug Survey (CORE) was selected as the appropriate instrument for use in this study. The 23-item questionnaire was designed …

Collegiate Activities That Influence Adult Physical Fitness Habits, Linda L. King

Electronic Theses and Dissertations

This descriptive/correlational study analyzed the perception of recent graduates regarding the effectiveness of the college environment at Milligan College in influencing adult fitness habits. Graduates were divided into five activity level groups through a self-report of physical activity. The purposes of the research were to determine if significant differences existed between the dependent variable, activity level, and the independent variables such as: (a) participation in specific college activities, (b) preferences for types of exercise, (c) social influence, (d) influence of a required freshman fitness course, and (e) environmental barriers. A profile of the student most likely to exercise after graduation …

A Case Study Of An Elementary School-Based Health Clinic, Sheila K. Jones

Electronic Theses and Dissertations

The purpose of this study was to perform a qualitative analysis of an elementary school-based health clinic (SBHC). This situational analysis was performed to further understand the impact of accessible primary health care on an elementary school population. Data were collected through 30 participant interviews of parents, educators and medical personnel. Additional data were collected through the clinic files, and a t-test was used to compare the attendance and achievement data of clinic consumers for the clinic year against records from the previous year. The researcher presented information on the steps of SBHC development to include community campaign procedures. The …

Southern Appalachian Settlement Schools As Early Initiators Of Integrated Services, Eloise H. Jurgens

Electronic Theses and Dissertations

This historical-descriptive study examined Southern Appalachian settlement schools as early initiators of integrated health and social services with education from the 1900s through the 1970s. Three schools were studied: Hindman Settlement School (KY), Pine Mountain Settlement School (KY) and Crossnore School, Inc. (NC). The purpose of the study was to determine the type and extent of services provided, the relationship of the settlement schools with their respective county public school system, and the transfer, if any, of integrated services from the settlement schools to public schools as the public schools took over educational responsibilities once offered by the settlement schools. …

Moraxella (Branhamella) Catarrhalis: A Molecular Epidemiology Study, Lyndell R. Gill

Electronic Theses and Dissertations

Moraxella (Branhamella) catarrhalis is the third-most-frequently isolated microorganism associated with acute exacerbations of chronic bronchitis in patients during their stay at the Mountain Home VA Medical Center (MHVAMC). In order to develop a practical, epidemiologically-meaningful typing method for M. (B.) catarrhalis, we tested two methods based on analysis of chromosomal DNA for typeability, reproducibility, and ability to differentiate between unrelated strains (discriminatory power, D). M. (B.) catarrhalis isolants from MHVAMC from 7/1/87-6/30/88 were grown overnight in broth and embedded in agarose. DNA was isolated by standard methods. The DNA was subjected to: (1) restriction endonuclease digestion (with either Bgl II …

Molecular And Cellular Analysis Of Chlamydia Trachomatis: Persistence And Reactivation, Kimberly R. Tau

Electronic Theses and Dissertations

Chlamydia trachomatis (CT) is the most prevalent sexually-transmitted infection in the United States. It has been suggested that CT infections can become latent. This has not been substantiated. CT persistence was examined at the molecular and cellular level in vitro and in vivo. Penicillin treatment of CT in vitro results in abnormal inclusions and reduced recovery of infectious CT. Penicillin did not inhibit initial stages of infection, but did downregulate CT rRNA levels after 25 hours post-inoculation (p.i.). DNA amplification was employed to differentiate between a resolved infection and a persistent one. Utilizing a primer pair that amplified a 144 …