Medicine and Health Sciences Commons^™

The Face Of Cancer In Montgomery County Ohio: A Look At The Population At Risk, Chika E. Okere

Master of Public Health Program Student Publications

The purpose of this study was to identify the population in Montgomery County Ohio who are at the greatest risk for cancer based on age, sex, and race/ethnicity, family history and demographics. The research will also look at modifiable behaviors such as use of tobacco products, physical inactivity, obesity, poor nutrition and heavy drinking of alcohol that increase the risk and identify areas of improvement in data collection for reporting purposes. During 1996-2006, cancer was the second-leading cause of death for residents of Montgomery County.

Methods: Age, sex, race/ethnicity of people in Montgomery County with cancer were examined and using …

Role And Effectiveness Of Community Health Workers Among Underserved Us Populations, Hibo H. Noor

Master of Public Health Program Student Publications

The role of the Community Health Workers (CHWs) in the health care system has great value both domestically and internationally. CHWs have training in healthcare; they are members of the community in which they serve. They have in depth understanding of the barriers to health care the community faces; they can speak the same language, and can promote and improve health status, quality of care and assist managing chronic disease. This paper focuses on the role and documented effectiveness of CHWs in terms of quality, health care services, cost health services, as well as health behaviors and knowledge about the …

The Role Of Misoprostol In The Reduction Of Maternal Deaths In Low Resource Settings: A Systematic Review With Recommendations For Action, Melissa Anne Mcmillian

Master of Public Health Program Student Publications

Objective: The purpose of this systematic review is to determine the role misoprostol currently plays in the reduction of maternal deaths and implications for the future reduction of maternal deaths in low resource settings.

Methods: A comprehensive review of the literature was performed using the following databases: The Cochrane Database, Ebsco, MEDLINE, PubMed, and Electronic Journal Center (EJC). Articles were excluded based upon date published, overt data changes since publication, and setting of misoprostol interventions in tertiary or referral centers that have access to oxytocin. A total of 61 articles were included from 2002-2012 and demonstrated several methodologies and study …

The Dental Safety Net In Montgomery County: A Status Report, Sequoia Y. Butcher

Master of Public Health Program Student Publications

Background: Adult oral health has been identified as a major public health problem by the United States Surgeon General. A substantial number of adults between the ages of 20 and 64 have untreated tooth decay. There are limited treatment options for adults without dental insurance. Low-income adults must turn to free/low cost clinics, or private dentists that accept Medicaid to receive dental care. However, these resources are often limited. When the resources are not available these adults are left to deal with untreated tooth decay which can lead to worsening conditions and other health issues.

Methods: Eleven key-informant interviews were …

Situation Analysis Of Somalia’S 2011 Famine, Ahmed Mohamed Askar

Master of Public Health Program Student Publications

This CE examined the contributing factors of famine in Somalia and developed a situation analysis of Somalia’s 2011 famine. The situational analysis was developed using health and famine indicators. Data from geographic information system (GIS) was also used to supplement analysis to look for trends and patterns of the famine. I predicted that conflict was the leading factor in Somalia’s 2011 famine. I concluded that conflict exacerbated the famine situation in the south of Somalia but in the north (Somaliland) famine was due to climate and lack of permanent rivers and water sources.

Primary Care Survival Skills In An Age Of Reform, Therese M. Zink, Peter Harper, Nancy Arnston, Jean Jansen

Family Medicine Faculty Publications

The Triple Aim - improved outcomes/quality of care, improved patient experience, and reduced cost - is driving health care reform in Minnesota and nationally. Minnesota is among those states moving quickly to new payment models that reward practices for meeting these three goals and is gradually reducing payments based only on increased volume of services. Primary care is growing into a new leadership role to meet these new demands while managing the reality that full funding for population based care is developing more slowly than the rhetoric. There are many encouraging signs, including an expanding interest in primary care medical …

A Descriptive Study Of Childhood Cancer Statistics: Montgomery County, Jamie L. Hartig

Master of Public Health Program Student Publications

Objective: This research describes childhood cancer and identifies variances in childhood cancer statistics in the United States, Ohio, and Montgomery County.

Methods: This is a descriptive analysis of childhood cancer statistics using the Ohio Cancer Incidence Surveillance System (OCISS) (Ohio Department of Health, 2010) and CDC Wonder database (United States Department of Health and Human Services [USDHHS], Centers for Disease Control and Prevention [CDC], & National Cancer Institute [NCI], 2008 & 2011.) Cancer incidences between white children and black children were compared for the years 1999-2009. The OCISS database was also used to compare vital status by race, cancer stage …

Epidemiology Of Tuberculosis In Ohio, Usha Bala Vayuvegula

Master of Public Health Program Student Publications

Background: Tuberculosis (TB) is a global infectious disease often associated with HIV. Study of the distribution and epidemiologic trends may help target prevention and control measures towards high risk areas and groups.

Objective: To determine TB trends in four counties in Ohio, i.e. Franklin, Cuyahoga, Hamilton and Montgomery counties, and to explore differences in distribution of cases across gender, age groups and races.

Methods: TB surveillance data was collected from the Ohio Department of Health website for 12 years (1999-2011). Mean TB rates across gender were compared using the two sample t-test. One way ANOVA was used to compare means …

Are Maternal Child Health Outcomes Affected By Adequacy Of Prenatal Care In Montgomery County, Oh?, Amy Rouse

Master of Public Health Program Student Publications

Background: Prenatal Care has been recommended by the World Health Organization for all pregnant women in order to improve health outcomes of the mother and the child. However, recommendations for the number of visits required to provide adequate health care and improve outcomes continue to be debated. Understanding if adequate prenatal care is improving maternal child outcomes is essential before making these recommendations. This research aims to determine if in Montgomery County, OH the adequacy of prenatal care influenced gestational age at birth, birth weight, breastfeeding rate, rate of cesarean sections, and smoking cessation rates.

Methods: De-indentified birth data was …

Food Deserts And Their Association With Obesity And Diabetes In Ohio, Alexis Holmes, Detra Thompson

Master of Public Health Program Student Publications

Objective- The purpose of this study was to explore the association of food access, and availability, on prevalence of diabetes and obesity in Ohio census tracts designated as food deserts.

Methods- County and census tract-level data were combined from the USDA Food Environment Atlas and USDA Food Desert Locator respectively. Statistical analysis was conducted using IBM Statistical Package for Social Sciences (SPSS). Non-normally distributed variables were assessed using the Mann-Whitney nonparametric U-test and Spearman’s correlation coefficient. Significance was considered at the p

Results- The mean rate of obesity and diabetes in Ohio in food deserts are 29.5% and 10.7%, when …

Foodborne Illness Outbreak Response: A Snapshot Of Ohio, Calen Wherry

Master of Public Health Program Student Publications

Biosurveillance is one of the primary roles of local Public health offices. As the all-hazards (biological, chemical, and radiation emergencies) approach adds to the responsibilities already performed in foodborne illness outbreak response, it is crucial to assess the capabilities and robustness of the local public health Foodborne Illness (FBI) response. By surveying the most populated counties in Ohio with a checklist based on the 2009 Council for Improvement of Foodborne Outbreak Response (CIFOR) guidelines, it was possible to obtain a snapshot of the current outbreak response capabilities. Though only one county reported 100% compliance with the checklist, the overall average …

Exploring The Barriers And Opportunities For Building Social Support Among Burundians And Americans: Dayton, Oh, Colleen Quinlan Saxen

Master of Public Health Program Student Publications

No abstract provided.

Fostering Aging In Place: "Healthy Naturally Occurring Retirement Community" (H-Norc) Qualities In A Southwest Ohio Suburb, Laura A. Previll

Master of Public Health Program Student Publications

This community assessment uses the concept of “H-NORCs” or Healthy Naturally Occurring Retirement Communities as a framework to analyze supports for aging (Masotti, Johnson-Masotti, Fick, & MacLeod, 2006) in Kettering, Ohio -- a first tier suburb of Dayton where the proportion of people over the age of 60 was 23.8% in 2010. In this study, I used focus groups and interviews to collect qualitative data on five H-NORC attributes: (1) economic policies that benefit seniors; (2) types of transportation support for seniors; (3) neighborhood design for physical activity; (4) opportunities for social integration and sense of belonging; and (5) health …

Differences In Immunity Offered By The Influenza Vaccination Among Active Duty Us Air Force Personnel From 2007-2011, Billy D. Pruett

Master of Public Health Program Student Publications

OBJECTIVE: To investigate the potential difference in vaccine effectiveness among Active Duty Air Force (ADAF) personnel vaccinated against influenza from 2007-2011. Particularly, to determine if any difference in the protection offered is based on sex, vaccine type, or both.

METHODS: The proposed study incorporated a cross-sectional design using the Department of Defense’s (DoD) comprehensive databases. Laboratory-confirmed influenza and other Influenza-Like Illness (ILI) cases were identified for each of the four influenza seasons of interest, vaccination status and history was then verified, and 2x2 tables were constructed in order to calculate odds ratios.

RESULTS: No consistent difference in vaccine effectiveness in …

Rights Of Ohio Mothers: Best Practices For The Pediatric Patient With A Life-Threatening Illness, Kelly Peekstok

Master of Public Health Program Student Publications

The purpose of this paper is to evaluate and review current best practices with regards to a minor’s refusal of life-sustaining medical treatment. The policies of other developed countries and states within the United States serve as a guide for developing evidence-based guidelines for Ohio healthcare professionals. Four specific cases were identified and then analyzed. The results showed that in three of the four cases, the wishes of the minor were followed. While each case contains its own set of complexities, creating a developmental guideline for healthcare organizations will ensure protection of the minor’s capacity to make autonomous decisions.

Evidence-Based Hazmat Medical Surveillance, Michael D. Jacobson

Master of Public Health Program Student Publications

Background: Hazardous materials (HAZMAT) teams are tasked with neutralizing substances that pose a dire threat to human health. As a result, communities invest substantially in medical surveillance to protect first responders. Yet, little is known as to the actual exposures, consequent injuries, and cost-effectiveness of medical surveillance.

Objective: The purposes of this study were: 1) Determine actual HAZMAT threats. 2) In light of these threats, evaluate current regulatory requirements, recommendations and practices for their basis in evidence.

Methods: National HAZMAT data was analyzed for trends and compared with local response records from 2008 through 2011. Regulations applicable to medical surveillance …

A Descriptive Analysis Of Lung Cancer In Montgomery County, Ohio, Catherine Klose

Master of Public Health Program Student Publications

Background: Lung cancer statistics are alarming, especially when it is considered by many to largely be a preventable disease. Lung cancers are the leading cause of all cancer deaths, more than breast cancer, prostate cancer, and colon cancer combined. Cancers of the bronchus and lung make up the greatest percentage of the newly diagnosed cancers reported to the Ohio Cancer Incidence Surveillance System (OCISS). The stage of diagnosis of lung and bronchus cancers is an important determinant of survival. Smoking is the primary cause of lung cancer. Race and gender disparities also exist with lung cancer, and socioeconomic factors have …

Analyzing Healthy Lifestyle Initiatives For Seniors: A Descriptive Study Of Senior Centers In Montgomery County, Ohio, Abhinav Rajpal

Master of Public Health Program Student Publications

The population of the elderly is expected to rise due to an increase in life expectancy and the aging baby boomer population. This increase in the elderly population will likely cause a burden on the health care system. This burden can be mitigated by promoting healthy lifestyles such as increased physical activity, healthy eating, and tobacco cessation in the elderly. Additionally, by participating in healthy behaviors, seniors can significantly improve their quality of life. Senior centers are at the forefront of promoting healthy lifestyles for the elderly. By promoting physical, social, and mental well-being, senior centers act as a focal …

Analysis Of An Improved Cook Stove Intervention In Rural Guatemala, Chad Graven

Master of Public Health Program Student Publications

An estimated three billion people cook and heat their homes using open fires and nearly two million people die prematurely from illness attributable to indoor air pollution from solid fuel use. According to the World Health Organization, “every year, indoor air pollution is responsible for the death of 1.6 million people...one death every twenty seconds.” Various international groups, government initiatives, and communities have attempted to improve this indoor air pollution problem around the world by implementing various improved cook stove models. In July, 2011, Partners In Health (PIH) and Equipo Técnico de Educación en Salud Comunitaria (ETESC) co-directed the delivery …

Chronic Disease Prevalence Of A Refugee Population In Dayton, Oh, Sandeep Palakodeti

Master of Public Health Program Student Publications

Introduction: This study aimed to understand the chronic disease burden of anemia, cancer, diabetes mellitus, hypertension, overweight/obesity, stroke, and tobacco use in the domestic as well as a refugee population. It also aimed to examine the current literature on appropriate screening for those conditions.

Methods: 348 refugee screening intake exams from Public Health - Dayton & Montgomery County were analyzed for presence of the conditions stated. Screening intake recommendations from the CDC, the Minnesota Public Health Department, the Canadian Collaboration for Immigrant and Refugee Health, and the Ohio Department of Job and Family Services were examined and compared in order …

Health Enhancing Policies And Environments In Select Montgomery County Senior Centers, Stacey L. Gardner

Master of Public Health Program Student Publications

As the baby boomer generation reaches elderly status, healthcare expenditures in the United States continue to rise. Contributing to healthcare costs is the high prevalence of chronic diseases caused by unhealthy habits of Americans such as tobacco use, lack of physical activity, and consumption of a poor diet. Many chronic diseases can be prevented by engaging in healthier behaviors. Communities and organizations can shift social norms and affect behaviors through policy intervention and environmental strategies. The purpose of this study was to describe policies and environments that foster healthy lifestyles in select senior centers in Montgomery County, Ohio. Specifically, this …

Factors That Influence Food Access In The United States: A Snapshot Of Food Access In Ohio And Kentucky, Maimouna Falls

Master of Public Health Program Student Publications

Background: The United States is one the richest countries in the world with a Gross Domestic Product (GDP) per capita of $48,442, yet many communities lack access to affordable nutritious food. Access to food impacts health outcomes such as obesity and diabetes. The purpose of this study was to determine the association between food access and rates of obesity and diabetes in the states of Ohio and Kentucky.

Methods: County level food access data from 120 counties in Kentucky and 88 counties in Ohio were obtained from the USDA website. The dataset included demographic variables and poverty rates. Food access …

Tetanus Toxoid, Reduced Diphtheria Toxoid And Acellular Pertussis Vaccination And Influenza Vaccination Of Pregnant And Postpartum Women, Colleen M. Mccormick

Master of Public Health Program Student Publications

Introduction: Infants ≤2 months are at greatest risk for morbidity/mortality from pertussis. Tdap vaccines given in late pregnancy or postpartum can protect infants from pertussis. Pregnancy increases risks for maternal and perinatal complications. Influenza vaccine (FLUV) given in pregnancy can protect women and newborns.

Objectives: To determine Tdap and FLUV rates in pregnant and postpartum patients and identify factors associated with vaccination.

Methods: Miami Valley Hospital delivery records from 01/2009-12/2011 were retrospectively reviewed. Data reviewed included age, insurance, race/ethnicity, and county of residence. Descriptive statistics analyzed prevalence of immunization, timing, and demographics. Chi-square and odds ratios detected differences between characteristics. …

Review Of Civil-Military Coordination In Local Disaster Response, Wilfredo J. Nieves

Master of Public Health Program Student Publications

Background: Globally, disasters affect over 200 million people annually. Governments at all levels attempt to mitigate the effects of disasters by providing training and resources to responders in the event of a disaster. When the disaster is of sufficient magnitude, those that respond will require additional resources to adequately attend to disaster victims. County emergency managers assist in making needed additional resources available. Department of Defense (DoD) installations are sources where emergency management agency (EMA) directors may request assistance. The purpose of this research is to understand the resources legal authority available to civilian emergency managers of Ohio Counties in …

Montgomery County Prostate Cancer Study: A Descriptive Study Of Prostate Cancer Incidence & Mortality In Montgomery County, Ohio, 2000-2009, Anthony F. Greaves

Master of Public Health Program Student Publications

Background: Prostate cancer is the most common cancer diagnosed among adult males in the United States. The prognosis of prostate cancer is related to the stage, with a five year relative survival rate of 100% among men diagnosed with early stage prostate cancer. Modifiable risk factors associated with the disease include lifestyle, marital status, tobacco and alcohol history, physical activity, weight, diet, and geographic location. Non-modifiable risk factors include family history and genetic factors, race/ethnicity and nationality, age, and hormonal factors.

Methods: A descriptive study of prostate cancer primary prevention and early detection factors was conducted on men living in …

Improving Childhood Nutrition In Rural Dominican Republic, Christine L. North

Master of Public Health Program Student Publications

This nutrition education intervention seeks to decrease malnutrition and increase overall health status of rural Dominican Republic children in the village of El Cercado, Dominican Republic. Working with the Child Nutrition Program run by Solid Rock International, this educational intervention will target caregivers of children enrolled in the nutrition program. Using a multi-level strategy, this intervention focuses on hygiene practices and safe food preparation, formalized nutrition education, food access and introduction of new foods. Caregivers will take part in five interactive lesson sessions where they will engage in hands-on learning and skill development associated with the target areas. Additionally, clinic …

Walkability At Wright State University, Lan H. Nguyen

Master of Public Health Program Student Publications

The purpose of this study was to examine walkability at Wright State University (WSU), Dayton Ohio using the Postsecondary Education Campus Walkability/Bikeability Semantic-Differential Assessment Instrument. Safety, path quality, and path temperature comfort were the categories of criteria assessed. A total of 66 path segments were assessed on main campus, 50 were assessed during the day and 16 were assessed during the night. The average walkability score was 84.9% for day assessed segments and 82.1% for night assessed segments. Path segments received an overall average grade of B. The findings in this study suggest that the WSU campus is a walkable …

Best Practice For Casualty Simulation - Role-Playing Actor, High Fidelity Mannequin Simulation, Or Virtual Reality?, Robert Sarlay

Master of Public Health Program Student Publications

Objective: The purpose of this systemic review of the literature is to determine the best practice with regards to simulating casualties during a disaster response exercise.

Methods: MEDLINE was searched from 1950 till present for the key terms of disaster, simulation, and emergency preparedness. Articles were included which met the following criteria: English language, human subjects, original research using any research design (with or without intervention), and primary focus of disaster preparedness using simulation, virtual reality, or role playing actors.

Results: Of the 386 articles reviewed only 18 met inclusion criteria. The literature is primarily descriptive in nature with regards …

Needs Assessment For The Mobile Health Clinic Of The Sukhdev Raj Soin Hospital, Luke Rothermel

Master of Public Health Program Student Publications

India has an established system of medical and public health services to provide care to all citizens through a government‐run network of providers and infrastructure. That system, though, is constrained by socio‐economic limitations, a booming population, and the cultural variations of its population. In addition to the public efforts to provide health care, the private sector has grown to serve a large portion of the population. Many of these private initiatives are found in urban areas where the potential for financial gain are great, but others have spread into semi‐urban areas and villages to serve the more rural populations. The …

Pregnancy Management Strategies And Childbirth Experiences Of Internally Displaced Women In Barranquilla, Colombia, Bre Bolivar

Master of Public Health Program Student Publications

This ethnographic study aims to illuminate the experiences of pregnant and new mothers in poor areas of Colombia with respect to pregnancy and childbirth. Ethnographic observations including key informant qualitative interviews were performed by the primary investigator in four different neighborhoods in and around the city of Barranquilla, Colombia, over the course of 3 months. A total of 24 women were interviewed, and additional interviews were held with Colombian medical students, religious workers and not-for-profit healthcare leaders. I seek to better understand the perspectives of these internally displaced women in terms of contraception use including the sense of necessity of …