Medicine and Health Sciences Commons^™

A Pilot Randomized Controlled Trial Of Smoking Cessation Induction Treatment For Rural, Underserved Cancer Survivors Across The Continuum Of Motivation To Quit, William Bowling

Theses and Dissertations--Psychology

The United States’ smoking prevalence has decreased substantially, but this public health improvement is unevenly distributed across the population. A promising individual-level approach to cancer control equity is to develop more acceptable and efficacious interventions that are widely disseminated to rural and other disadvantaged cancer survivors. Smoking cessation induction focuses not on long-term abstinence, but on engaging people in the process of making quit attempts and may be ideal for hard-to-reach populations. The aim of this pilot randomized controlled trial was to evaluate the feasibility and acceptability of a smoking cessation induction intervention designed for rural cancer survivors. The treatment …

Social And Biological Determinants Of Pregnancy-Related Mortality And Morbidity In A Rural, Underserved Population, Anna Hansen

Theses and Dissertations--Sociology

Cases of severe maternal morbidity (SMM) and pregnancy-related mortality (PRM) are increasing in the US. Research concerning SMM and PRM has neglected women in Central Appalachia; a largely rural, health-disparate population. The aims of this study are two-fold: (1) Examine patient-level and place-based predictors of SMM/PRM via hierarchical logistic regression modeling, and (2) Elucidate Appalachian healthcare patients’ and providers’ experiences with SMM/PRM, perceptions of contributing factors, and insights on points of intervention.

This study uses a mixed methods approach guided by the WHO’s conceptual framework for action on social determinants of health to identify determinants of SMM and PRM among …

Increasing Hpv Vaccination In Elliott And Lawrence Counties, Keeghan Francis

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

Appalachian counties within Kentucky have higher rates of HPV-related cancers, including cervical cancer. HPV vaccines are effective at reducing the risk of cervical cancer, but vaccination coverage in Appalachia remains low. The proposed program relies on recommended strategies to improve vaccine uptake by increasing access and demand for HPV vaccines. This will be done through school vaccine clinics and parent education on HPV, cervical cancer, and HPV vaccines.

Disparities In Access To Chemotherapy Among Kentucky Stage Iv Non-Small Cell Lung Cancer Patients, Joshua Brown

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

OBJECTIVE: This population-based retrospective cohort study examines the association of sociodemographic disparities with the receipt of chemotherapy among patients with metastatic non-small cell lung cancer in the Commonwealth of Kentucky in the precision oncology and immunotherapy era.

METHODS: Kentucky Cancer Registry data from 2010 through 2017 was analyzed using univariate, bivariate, unadjusted, and adjusted multivariate regressions to assess disparities in our population (N = 9490).

RESULTS:We found no significant difference in receipt of chemotherapy between sexes (OR 0.99, P=0.90) nor races (OR 1.12, P=0.22). Patients diagnosed in an Appalachia county were significantly less likely to receive chemotherapy (OR 0.71, …

Identifying Factors Associated With Syringe Reuse Among People Who Inject Drugs (Pwid) In Appalachia Kentucky, Grayson Keith Fuller

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

Aim: Syringe reuse contributes to the spread of infectious diseases. The purpose of this study is to identify factors associated with syringe reuse among people who inject drugs (PWID) in Kentucky.

Methods: PWID (n=238) completed interviewer-administered questionnaires to collect data on syringe reuse and demographic, behavioral, and clinical characteristics. Negative log binomial regression was used to model the associations.

Results: On average, people reused each syringe 9.3 times (median: 3; IQR: 2-10, range 1-95). Syringe reuse was higher among men [aOR=1.386; 95% CI: 1.041-1.845] and those who injected methamphetamine [aOR=2.122; 95% CI: 1.445-3.116]. Reuse was also higher among those who …