Medicine and Health Sciences Commons^™

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 …

Evaluation Of Anemia In Communities Served By Shoulder To Shoulder Global: A Cross-Sectional Study In Santo Domingo, Ecuador, Kevin Mercer

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

BACKGROUND: Shoulder to Shoulder Global (STSG) recognizes anemia as a cause of morbidity among patients in Santo Domingo, Ecuador. Little research has been done to assess targetable anemia risk factors to serve as a foundation for future pharmacotherapeutic interventions. This study sought to identify risk factors for anemia in this population.

METHODS: Data obtained from existing patient records from January 1, 2010 to August 31, 2016 included hemoglobin/hematocrit, age, sex, pregnancy status, and presenting community. Chi-square tests compared means to examine risk factors associated with anemia. Poisson regression and incidence rate ratios (IRR) were used to estimate risk factors associated …

Statistical Analysis Of Rabies Submissions In Kentucky And Weather As A Potential Predictor Of Positive Cases, Hannah Free

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

Background

The rabies virus is a zoonotic pathogen that is nearly 100 percent fatal once symptoms occur. Because it is still active in wildlife populations in Kentucky, the need for preventive measures and surveillance is critical. Temperature and precipitation have been shown to affect rabies. This study examined rabies submissions in Kentucky, weather and geographical distribution to both describe and predict cases.

Methods

Data from the University of Kentucky Veterinary Diagnostics laboratory were used to assess rabies submissions from 2005 through 2015. These submissions were anonymously submitted by the public and the Florescent Antibody Test was used to determine infection …

The Relationship Between Early Pregnancy Dietary Intakes And Subsequent Birthweight And Neonatal Adiposity, R.A.K. Kennedy, Laura Mullaney, A.C. O'Higgins, A. Doolan, Daniel Mccartney, M.J. Turner

Articles

Background: Maternal nutrition intakes may influence neonatal birthweight and adiposity; however, inconsistencies within the literature exist. The relationships between maternal dietary intakes in early pregnancy and both birthweight and neonatal adiposity requires elucidation. This study examined the relationship between early pregnancy dietary intakes and subsequent birthweight and neonatal adiposity.

Methods: Women were recruited at their convenience after sonographic confirmation of a singleton pregnancy. Women completed a Willet food frequency questionnaire evaluating habitual food and nutrient intakes at their first antenatal visit. Neonatal body composition was measured using air-displacement plethysmography.

Results: Of the 385 mother-neonate dyads, mean maternal age was 30.8 …

Beyond Weight Loss: A Qualitative Exploration Of Participant Expectations And Strategies For Measuring Progress During A Weight Management Program, John Spencer Ingels, Adam Hansell, Sam Zizzi

Faculty & Staff Scholarship

Objectives:

Previous research with participants in weight management has primarily focused on participant weight-loss expectations. The purpose of this study was to explore participant expectations and strategies for measuring progress during a community-based weight management program.

Methods:

Semi-structured interviews were completed with 22 participants with overweight or obesity, who were currently enrolled in a 2-year weight management program in order to understand their expectations and strategies for measuring their progress.

Results:

Aside from weight loss, participants’ expectations included improved health, fitness, and mood, gaining support, and developing new habits. Participants discussed measuring their success by focusing on weight loss and …

The Relationship Between Access To Healthcare And Heart Disease Mortality In Kentucky, 2012-2014, Nima Farsi

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

Cardiovascular disease is the cause for a large portion of the mortalities in the United States. Furthermore, Kentucky has one of the highest heart disease mortality rates out of all 50 U.S. States. This study hypothesized that heart disease mortality in Kentucky counties has a positive relationship with lack of accessibility to healthcare. Furthermore, this ecological study hypothesized that because there is no available usual source of a healthcare providers and ultimately a lack of accessibility to receive diagnostic/preventative services for this population, the high rate of cardiovascular disease mortality in Kentucky is dependent on access to healthcare services.

This …

Consultation Experience In Public Health, Hannah Bellamy

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

The following portfolio is an overview of my consulting experience in public health. My experiences include making frequency tables, producing summary statistics, conducting Chi- Square and T-Test, and reproducing a demographics table. Working with investigators, I have conducted a power analysis for a pilot study, assisted with a study design consultation, used the Kappa coefficient to test for inter-rater reliability, presented survey results with answer distributions, and produced summary statistics for an investigator’s research poster.

Working in the Applied Statistics Laboratory and with investigators has taught me the process of consulting. It begins by meeting with an investigator and determining …

An Ecologic Study Of Access To Acute Stroke Care, Mortality And Its Correlates In The Stroke Belt, Jeffrey E. Levy

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

Importance: Stroke is leading cause of death in the United States, but quick access to treatment has been shown to result in better outcomes and improved mortality. Among the many barriers to access, geographic proximity to hospitals certified in stroke care may also play a role.

Objectives: To calculate county-level measures of accessibility to certified stroke hospitals using GIS, and to examine its relationship with county stroke mortality while controlling for other county-level potential confounders.

Methods: Ecologic study using county mortality rates and census data to recreate stroke death counts for use in traditional, and a geographically …

Implementing The National Diabetes Prevention Program In Mason County, Kentucky, Cassandra Yelton

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

The National Diabetes Prevention Program (DPP) is sponsored by the Centers for Disease Control and Prevention (CDC). The program’s goal is to reduce the incidence of diabetes through dietary modification and physical activity. On one hand, the DPP is currently offered by various organizations through the country. On the other hand, the DPP is mostly unavailable in rural areas, especially the Diabetes Belt. The Diabetes Belt is in the eastern Appalachian region of the United States. People who live in this area of the country are more likely to develop diabetes than those who do not. Mason County, Kentucky has …

Wayne County Board Of Education Adaptation Of Love Notes Curriculum For Adolescent Pregnancy Prevention, Allison Shea Merritt

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

West Virginia has the 8^th highest rate of adolescent pregnancy in the United States and the rate in Wayne County is significantly higher. Adolescent pregnancies cause negative health outcomes for both the baby and the mother. Adolescent mothers are at an increased risk of anemia, preeclampsia, and preterm labor and babies born to adolescent mothers are more likely to have a low birth weight and to have cognitive impairment. To address this burden, the school board has decided to use the ADAPT-ITT framework on the evidence-based Love Notes adolescent pregnancy prevention curriculum to adapt it to be more culturally …

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 …

Increasing Colorectal Cancer Screening In Kentucky’S Buffalo Trace Area Development District With A Mailed Fit Program, Carrie Anne Burt

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

This program involves a partnership among eight primary care clinics in the Buffalo Trace Area Development District (BTADD) of Kentucky and proposes implementing a mailed Fecal Immunochemical Test (FIT), or FIT Pack, program to increase colorectal cancer screening (CRCS) rates in this region. Mailing FIT tests to eligible patients is an evidence-­‐based program that has been shown to increase CRCS among patients included in studies. The program will occur at the clinic level. Clinics will mail FITs and information leaflets to patients based on patient eligibility criteria identified in clinic electronic health records. The program’s short-­‐term goals are to increase …

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 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% …

Reducing Stigma Associated With Mental Illness And Mental Health Treatment Services In Racial And Ethnic Minority College Students, Joseph Christodoulou

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

Depression and Suicide

Mental health is a determining factor in how individuals function throughout their daily lives, encompassing an individual’s physical, emotional, and social well-being (U.S. Department of Health and Human Services, 2013). Mental illnesses such as depression, hinder daily functioning and lead to a range of negative outcomes. These include increased risk of mortality from suicide, chronic diseases such as heart disease, other conditions/behaviors such as anxiety and substance use disorders, and high economic burden (Centers for Disease Control and Prevention, 2016b). Depression is a major contributor to disability and burden of disease in the U.S., contributing to 3.7% …

Prospective Policy Analysis Of The Kentucky Health Demonstration Waiver, Keahna Akins

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

In January 2018, the Centers for Medicare & Medicaid Services approved Kentucky’s Section 1115 Medicaid demonstration waiver, which gave the state approval to require work/community engagement as a condition of Medicaid eligibility, charge premiums of up to 4% household income, and add an incentive account for dental and vison services. The waiver projected nearly 100,000 fewer enrollees and $2.4 billion less in spending over the five-year demonstration period. Two days short of the waiver July 1st implementation date a federal judge ruled the waiver invalid. This finding held that the Health and Human Services Secretary’s judgement was arbitrary and capricious. …

The Effect Of Rescheduling Of Hydrocodone On Prescription Writing Among University Of Kentucky Dentists, Robert Taylor

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

Opioid abuse has become a public health crisis over the last two decades. Hydrocodone is the most frequently prescribed opioid to patients whose deaths are related to prescription drug abuse. On October 6, 2014, Federal law changed hydrocodone, an opioid-based analgesic, from Schedule III to Schedule II. This limits the number of ways it can be prescribed, including eliminating refills. This study examined hydrocodone and oxycodone prescriptions written across all dental clinics associated with the University of Kentucky College of Dentistry and analyzed three different dental disciplines that perform procedures that require pain management. Prescription data was obtained through axiUm, …

Impact Of The School Health Innovations Grant Act On Healthcare Access, Outcomes, And Cost In The District Of Columbia, Robert West

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

This paper provided a prospective policy analysis of the Washington, D.C. School Health Innovations Grant Act. This act establishes a grant program to facilitate the formation of school-based telehealth centers to provide mental health services to District school children. The purpose of this act is to improve access to mental health services for children, especially children in disadvantaged populations, such as those low-income, predominantly African American neighborhoods in eastern Washington, D.C., where a high burden of need is compounded by a shortage of health professionals.

This analysis was guided by the Bardach framework of policy analysis. The various factors affecting …

Bronchiolitis In The Bluegrass: Epidemiology, Disease Burden And Resource Utilization At Kentucky Children’S Hospital, Ashwin Krishna

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

Background: Every year Kentucky Children’s Hospital (KCH) admits infants and toddlers with respiratory disease due to viral bronchiolitis. This disease is characterized by viral-induced inflammation and edema of the lower airways. The resulting disease is characterized by increasing mucus production, acute bronchospasm, necrosis of the respiratory epithelium and functional obstructive lung disease. Patients usually present with symptoms consistent with an upper respiratory tract infection, but can progress to marked respiratory distress and ultimately respiratory failure, as well as poor oral intake and dehydration. While Respiratory Syncytial Virus (RSV) is the pathogen classically described cause of viral bronchiolitis, other viruses have …

Modeling The Impact Of 13rs-Hb358: Hpv Vaccination For School Entry In A High-Prevalence State, Stacy Lee Ware

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

Prophylactic cancer vaccination presents novel opportunities to improve the health and well-being of populations. Since the approval of a cervical cancer vaccine against human papillomavirus (HPV) in 2006, only three states have passed legislation adding it to their school-entry schedules of required vaccinations. Despite ample evidence of its safety and efficacy, the vaccine remains controversial, and national vaccination rates among both girls and boys remain low. Risk for HPV-related cancers varies by population, and Appalachian Kentucky has among the highest HPV-related morbidity and mortality in the nation. Annual attempts to pass HPV vaccine legislation in Kentucky have so far failed …

Commercial Driver License Examinees’ Misreport On Their Federal Motor Carrier Safety Administration Certification Evaluation, Adam Pascoe

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

Commercial Driver’s License (CDL) examinees report their medical history during their Federal Motors Carriers Safety Administration (FMCSA) medical certification exams ≤2 years. When the examinees report diagnoses which may impact the control and operation of commercial motor vehicles (CMV), they face scrutiny with decreased medical certification or may be Adam PascoePascoe Page 2 7/18/2018 considered unfit to control and operate a CMV. Medical examiners may have access to the examinees’ electric medical records (EMRs) to generate a deeper appreciation, independent from the examinees’ self-report, of their risk for sudden and/or gradual incapacitation. We do not know how often diagnoses are …

Latino Worker Reported Respiratory Symptoms And Stall Bedding On Thoroughbred Horse Farms, Lacy Jinks

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

Objective: The purpose of this study is to assess the association between self-reported respiratory symptoms in Latino workers and bedding type used in stalls on thoroughbred horse farms.

Methods: Self-reported community-based questionnaire data from 225 Latino horse farm workers in the southeastern US collected from October 2013-April 2014 were used to investigate associations between upper and lower respiratory symptom prevalence and the type of bedding used in stalls (straw, sawdust, or straw plus wood shavings or sawdust). Analysis was performed by chi-square to compare frequencies of symptoms and demographic and exposure risk factors. Logistic regression was used to adjust …

Socioeconomic Characteristics Of Farmers And Agrochemical Use In Grenada, Lindonne Marcia Glasgow

Walden Dissertations and Doctoral Studies

The World Health Organization classified carbaryl, glyphosate, and paraquat as hazardous to human health. In the Agriculture Health Study in the United States, health problems were associated with the use of these 3 agrochemicals 12 or more times per year. These 3 agrochemicals were commonly used in Grenada. The purpose of this quantitative cross-sectional study was to investigate the relationship between the social and economic characteristics of the farmers who participated in the 2012 agriculture survey and the use of agrochemicals at frequencies that could pose health risks. Five constructs of the social cognitive theory were used as the premise …

Perceptions Of Chiropractors In Mississippi Regarding Obesity, Phelesia Nakita Foster

Walden Dissertations and Doctoral Studies

Obesity continues to be a growing problem across the United States. Chiropractors have made claims of providing health promotion services within their treatment protocol; however, there is a lack of empirical research regarding a need for the chiropractic profession to train chiropractors to address Healthy People 2020 public health initiatives. The purpose of this qualitative study was to examine the perceptions of Mississippi Delta Region chiropractors regarding their role in obesity management as nonmedical practitioners that implement public health objectives in their practice. The research questions aimed at addressing possible barriers and limitations that influenced chiropractors' perceptions regarding their role …

The Effect Of Fast Food Restaurants On Type 2 Diabetes Rates, Grace Bailey

CMC Senior Theses

This paper conducts an analysis of county level data to determine the effect of fast food restaurants on type 2 diabetes rates. Due to endogeneity concerns with respect to the location of fast food restaurants, this paper follows the work of Dunn (2010) and uses the number of interstate exits in a given county to serve as an instrument for fast food restaurants. The strength of the instrument, which is theoretically and empirically tested in this paper, imposes some restraints on the interpretation of the findings. Using the Two-Stage Least Squares estimation method, I find that the presence of fast …

Public Health Providers' Perceptions Of Electronic Health Records In A Disaster, Sherhonda Yvette Harper

Walden Dissertations and Doctoral Studies

The introduction of federal initiatives and incentives regarding health information technology fostered a movement towards the adoption of electronic health records (EHR). Implementation of EHRs sparked discussions among healthcare providers, patients, and others about the benefits or challenges of the move from the traditional paper method to the electronic version in healthcare settings. A knowledge gap in research involving the usefulness of EHRs and their impact to the delivery of care in other settings exists. The purpose of this qualitative study was to explore public health providers' perceptions of the meaningful use of EHRs in a disaster setting. Study participants …

Sexual Coercion, Drinking To Cope Motives, And Alcohol-Related Consequences Among Self-Identified Bisexual Women, Michelle L. Kelly, Sarah J. Ehlke, Robin J. Lewis, Abby L. Braitman, Wendy Bostwick, Kristin E. Heron, Cathy Lau-Barraco

Psychology Faculty Publications

Background: Given higher sexual victimization and greater alcohol use among bisexual women, a critical public health challenge is to understand within-group variation that may heighten or explain these associations in bisexual women. Objectives: The present study tested a moderated-mediation model in which sexual coercion was hypothesized to be associated with alcohol-related consequences via drinking to cope motives in self-identified bisexual women who reported at least occasional binge drinking. Negative affect was hypothesized to moderate the sexual coercion-drinking to cope motives association. Methods: Participants were a community sample of 107 self-identified bisexual women (age M = 20.97, SD = 2.11) who …

Measuring Sexual Minority Stressors In Lesbians Women's Daily Lives: Initial Scale Development, Kristin Heron, Abby L. Braitman, Robin J. Lewis, Alexander T. Shappie, Phoebe T. Hitson

Psychology Faculty Publications

Lesbian women face unique sexual minority stressors (SMS) because of their stigmatized and marginalized status in society. Existing studies of SMS are primarily cross-sectional and use global measures of SMS. The goal of the present study was to develop a brief daily measure of SMS for use in daily diary or ecological momentary assessment studies. Existing retrospective measures of SMS were reviewed, resulting in an initial pool of 29 items. Thirty-eight lesbian women (Mage = 24.3 years, range: 19–30 years) completed a daily web-based survey including the SMS items for 12 days. Two response scales were tested; participants were randomized …

Indoor Air Quality In Schools, Clint Pinion Jr.

EKU Faculty and Staff Scholarship

An indoor air quality study was conducted on a ‘net-zero energy’ school using a TSI Velocicalc Model 9555-p with probe model 982, passive radon monitors, visual inspection protocol, and an indoor environmental quality survey of school faculty and staff. Average indoor temperature, relative humidity, and carbon dioxide levels in several areas within the school were not within IAQ guidelines. Three rooms on the school’s grounds had radon levels exceeding the action level. Recommended solutions included installing return and supply air ducts in hallways and relative humidity and temperature monitors in classrooms with high-pitched ceilings.

The Epidemiology And Economic Burden Of Obesity And Related Cardiometabolic Disorders In The United Arab Emirates: A Systematic Review And Qualitative Synthesis, Hadia Radwan, Rami A. Ballout, Hayder Hasan, Nader Lessan, Mirey Karavetian, Rana Rizk

All Works

Copyright © 2018 Hadia Radwan et al. Background. Noncommunicable diseases (NCDs) are considered as a global health problem and considered as a public health priority with the more considerable increasing trend of obesity and cardiometabolic disorders rates in the Middle Eastern countries. This systematic review aims at assessing the prevalence, incidence rates, and trends, as well as the cost of obesity and related cardiometabolic disorders in the United Arab Emirates (UAE). Methods. A highly sensitive strategy was used to retrieve original observational studies, addressing the epidemiology and cost of obesity and related cardiometabolic disorders in the UAE, irrespective of nationality …