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Beyond Fentanyl Test Strips: The Need To Decriminalize All Drug Checking Equipment In Tennessee, Jeremy C. Kourvelas Mph

SMART Policy Briefs

KEY POINTS

• In 2022, Tennessee decriminalized fentanyl test strips (FTS) through Public Chapter 764. Thousands have since been distributed by the state and nonprofit coalitions as a key harm reduction strategy. As of the end of 2023, 44 other states and D.C. had also decriminalized FTS.

• Research indicates that people who use drugs are five times as likely to change their behaviors (including reducing drug use overall) in response to a test result that is positive for fentanyl. People who use methamphetamine are especially likely to change their behaviors.

• However, the law only applies to “narcotic testing equipment used to …

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Unveiling The State Of Loneliness: An Investigation Of Loneliness Patterns In Generation Z Undergraduates Across Tennessee, Arwen Rolinitis, Alden Laborde, Jordan Osborne

Belmont University Research Symposium (BURS)

The current study seeks to investigate the prevalence of loneliness in Generation Z undergraduates currently attending universities in Tennessee. Loneliness has been identified as a growing worldwide problem (United States Office of the Surgeon General, 2021), and given the continuing increase of loneliness in young adults (Buecker, 2021), it is evident that there is much left to learn regarding the personal experience of loneliness in modern undergraduates. To investigate the experience and prevalence of loneliness in Generation Z undergraduates, we conducted a survey with participants from one private and one public university in Tennessee. Participants completed a survey on Qualtrics …

Full Practice Authority: Policy Review And Recommendation For Regional Nurse Practitioner Practice In The Southeastern Region Of The United States, Tambra Ratledge

Student Scholarly Projects

This policy analysis examines the limited practice authority for advanced practice registered nurses (APRN) in the Southeastern United States, focusing on Tennessee while drawing comparisons to Georgia and Alabama. The PICO question that guided this policy analysis is: For advanced practice registered nurses within the southeast region of the United States (P), how does the development of a comprehensive policy recommendation for full practice authority (I), compared to existing reduced or restricted practice authority in the southeast region of the United States (C) affect access to care as endorsed by literature (O)? The literature suggests that despite being equipped with …

Association Between Chronic Disease And Substance Use Among Older Adults In Tennessee, Manik Ahuja, Jessica Stamey, Johanna Cimilluca, Kawther Al Skir, Mary K. Herndon, Kathleen Baggett, Thiveya Sathiyasaleen, Praveen Fernandopulle

ETSU Faculty Works

Background:

Design and methods:

Leptospira Seroprevalence In Companion Animals In Tennessee, Kellie Anne Mccreight

Masters Theses

Leptospirosis is a re-emerging zoonotic disease in humans and animals. The bacteria Leptospira spp. causing this disease is maintained in the kidneys of animals such as rodents and cattle as well as in the environment. Animals harboring Leptospira spp. in the kidneys frequently shed the bacteria in their urine, contaminating the environment. Contact with contaminated soil and water may result in infection. Animals and humans may develop serious life threatening disease from Leptospira infection. Approximately 1 million new human cases and over 50,000 deaths are reported worldwide. Numerous animal species including rodents, cattle, and dogs may serve as reservoir …

Ballad Health: Understanding Appalachia’S Regional Healthcare Monopoly, Meredith A. Bailey

Baker Scholar Projects

The Ballad Health merger of 2018, which combined the now 21 hospitals in the region under one organization, has impacted the healthcare landscape in Northeast Tennessee and Southwest Virginia. Historically, Appalachia has had to persevere through primary physician shortages, a lack of specialty care, geographic obstacles to accessing healthcare, challenges related to substance abuse, and much more. Since the merger of Mountain States Health Alliance and Wellmont Health System, little research has been done to assess the perceived impact the aggregation of providers has had on the population it serves. This study utilizes an online survey to better understand the …

The Pink Tax: A Comparative Case Study Between Tennessee And Washington State, Megha Chitturi

Baker Scholar Projects

The imposition of an additional luxury tax on menstrual health products, otherwise referred to as the “Pink Tax” or the “Tampon Tax”, is present in some states while absent in others. The decision to repeal such a tax is one that has proven to be critical, as it removes the connotation that such products are of “luxury” and make them more accessible to menstruators throughout the state. As of 2023, twenty-three states have eliminated the tax. The state of Washington falls under that parameter while Tennessee does not. The purpose of this undergraduate honors thesis is to explore the potential …

Extending Immunity For Drug Overdoses, Dixie R. Tabet, Maggie G. Spadaro, Kaylie E. Moss

Belmont University Research Symposium (BURS)

The Tennessee Code 63-1-156 provides immunity to those who suffer from a drug overdose that seek medical assistance, only for the first overdose. After the first overdose, individuals who seek medical assistance do not receive immunity and are subject to criminal charges. Over the past 5 years, drug overdose deaths have increased significantly and in 2021 3,814 Tennesseans died from a drug overdose. In addition, individuals incarcerated for drug-related offenses make up about 20% of the state’s prison population. The state of Tennessee has had a significant increase in drug abuse rates, leading to a rise in overdose deaths and …

Retention Of Foster Parents For At-Risk Youth In Tennessee, Marvin Amos

Walden Dissertations and Doctoral Studies

Federal legislation with the Family First Prevention Service Act (FFPSA) of 2017 required Tennessee to increase foster parent retention strategies. Tennessee does not have enough available foster homes for adolescents. The purpose of this generic qualitative study was to explore foster parent retention in Tennessee and to inform policymakers on how to adapt policy to increase the retention. The theoretical foundation for this study was based on the policy feedback theory, to identify the policy scope in Tennessee, and the two-factor theory, to guide the data analysis in the context of employee satisfaction and retention measures. Purposive sampling techniques were …

Predicting Immunization Status At Arrival In Tennessee Stocker Calves, Claire E. Hunkler

Masters Theses

Bovine respiratory disease is a multifaceted disease with agent, host, and environmental factors. Stocker calves are at high risk of contracting the disease through many stressors like weaning, transportation, commingling, etc. The purpose of this project was to test if externally observed physical characteristics of calves on arrival at a stocker facility can be used to predict calfhood vaccination status determined based on antibody titer levels. Knowledge of highly correlated characteristics could allow stocker operators to reduce the occurrence of BRD through targeted management strategies, thus lowering morbidity, mortality, and treatment costs. Ear notches, blood, and visual characteristics were collected …

The Interaction Of Children Living In Single-Parent Households With Healthcare In Tennessee, Molly Balcer

Scholarship in Medicine - All Papers

The objective of this paper is to examine how a child living in a single-parent home is able to interact with healthcare in the state of Tennessee in 2020. Family structure in the United States trends away from the nuclear family, with 32% of households containing children headed by single-parents in 2018 as recorded by the United States Census Bureau. Given the knowledge that children in single-parent families are at higher risk for unmet healthcare needs, it is prudent to determine whether these trends are mirrored in Tennessee. Tests of statistical analysis were conducted on publicly available data collected from …

Factors Affecting The Rates Of Childhood Poverty In Tennessee, Aleeya F. Shareef

Scholarship in Medicine - All Papers

Objective: The goal of this investigation is to analyze data to determine the factors that influence childhood poverty in Tennessee. Specifically, I am examining how child poverty has changed over the past years, as well as determining its associations with residential segregation (Black/white), food insecurity, teen births, low birthweights, child and infant mortalities, drug overdose deaths, access to healthy foods, premature deaths, and uninsured children. Data was used from the County Health Rankings website. Their data has been collected from surveys. Paired t-tests, unpaired t-tests, Pearson correlations, and stepwise linear regressions were performed. Results indicated that Tennessee has had decreased …

Analyzing The Investment Potential To Increase Prenatal Care Utilization As A Tactic To Decrease Preterm Birth Costs In Tennessee, Michael S. Wiggins

Doctoral Dissertations and Projects

Preterm birth contributes significantly to health care costs in the United States (Frey & Klebanoff, 2016). Certain components of prenatal care reduce preterm birth incidence (Newnham et al., 2014). Tennessee’s preterm birth rate ranks 35th among the 50 United States (National Center for Health Statistics, 2019). This study analyzed the investment potential to reduce preterm birth cost through increasing prenatal care utilization in Tennessee. Based on 2018 data, the study identified a significant relationship between prenatal care utilization and preterm birth incidence in Tennessee. The study also identified a significant opportunity to increase prenatal care utilization in Tennessee when compared …

Examining Health Disparities Among Lesbian, Gay, Bisexual, Transgender, And Queer/Questioning Adults In Davidson County, Tennessee, Samantha Anticuar

DNP Scholarly Projects

Background: Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals experience increased risks for health disparities and discrimination compared to non-LGBTQ individuals, yet there is limited research in southern populations. Purpose: The purpose of this scholarly project was to examine if LGBTQ individuals had increased health disparities compared to non-LGBTQ individuals in Davidson County, Tennessee (TN). Methods: A quasi-experimental design (N = 1,704) used the 2019 Nashville Community Health and Well-being Survey for analysis. Results: Findings suggested LGBTQ individuals had increased odds of not having health insurance (p = .009, adjusted odds: 6.84), poor mental health (p …

Better Broadband For Better Health, Jeremy Kourvelas, Katie Cahill, Carole Myers Phd, Jennifer Tourville, Sreedhar Upendram

SMART Policy Briefs

No abstract provided.

Telehealth Improves Access To Treatment For Substance Use Disorder, Jeremy Kourvelas, Carole Myers Phd, Katie Cahill Phd, Stephen Loyd Md, Jennifer Tourville Dnp

SMART Policy Briefs

No abstract provided.

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

Evaluation Of A Tennessee Statewide Initiative To Reduce Early Elective Deliveries Using Quasi-Experimental Methods, Michael P. Thompson, Ilana Graetz, Caitlin N. Mckillop, Peter H. Grubb, Teresa M. Waters

Health Management and Policy Faculty Publications

Background: Concerted quality improvement (QI) efforts have been taken to discourage the practice of early elective deliveries (EEDs), but few studies have robustly examined the impact of directed QI interventions in reducing EED practices. Using quasi-experimental methods, we sought to evaluate the impact of a statewide QI intervention to reduce the practice of EEDs.

Methods: Retrospective cohort study of vital records data (2007 to 2013) for all singleton births occurring ≥36 weeks in 66 Tennessee hospitals grouped into three QI cohorts. We used interrupted-time series to estimate the effect of the QI intervention on the likelihood of an EED birth …

Control Efforts And Serologic Survey Of Pseudorabies And Brucellosis In Wild Pigs Of Tennessee, Lisa I. Muller, Neelam C. Poudyal, Roger Applegate, Chuck Yoest

Human–Wildlife Interactions

European wild pigs (Sus scrofa) are an introduced invasive species that now constitute a major threat to agriculture and the natural ecology of the environments they now inhabit. Wild pigs also carry many diseases known to infect wildlife, humans, and livestock. Two of these diseases, pseudorabies (PRV) and brucellosis, constitute major diseases in the United States. Better data are needed regarding the prevalence of these diseases in wild pigs to understand and manage the potential risks to wildlife, humans, and livestock. From July 1, 2011 to June 30, 2017, Tennessee Wildlife Resources Agency personnel trapped and euthanized 4,727 …

Political Astuteness In Tn Nurse Practitioners: Strategies To Inform, Tracie Gooch, Tracie Herrell

Doctoral Projects

Abstract

Political astuteness among nurse practitioners practicing in states like Tennessee where their scope of practice is restricted needs evaluation to promote policy and scope of practice change to increase access to quality healthcare in rural and underserved areas to decrease healthcare disparities in vulnerable populations. There is a scant amount of literature that specifically addresses political astuteness in nurse practitioners. The purpose of this project is to assess and provide strategies to inform nurse practitioners on political astuteness and activity. A cross sectional survey included the administration of an online version of the Political Astuteness Inventory (PAI), compared results …

Concussion Protocols For Youth Sport In Tennessee, Corinne C. Oliphant

Chancellor’s Honors Program Projects

No abstract provided.

Context, Delivery, And Providers’ Perspectives Of Family Life Education In Tn, Usa, Ruby Yadav

Electronic Theses and Dissertations

In 2015, TN had the 9^th highest teen birth rate in the United States. School-based sex education programs have shown promise in curbing teen pregnancy rates. In TN public schools, sex education could be taught by teachers of subjects like biology, health education, or invited guests from ministries, or national or local nonprofit agencies. The content, rigor, and approach of sex education taught by these diverse groups of providers remains unknown. This pilot study tested a survey questionnaire and methodology, while providing information on the providers’ sex education practices and perspectives.

We adapted validated measures from past sex education …

Promoting Health Education And Literacy In Rural Tennessee: The Go-Packs Pilot Project, Taylor Cox, Claire Gleadhill, William Seagrave, Coty Cooper, Alantis Hunt, Kelly Mitchell, Anthony Delucia, Randy Byington

Appalachian Student Research Forum

Little Milligan Elementary School in rural Carter County, Tennessee was provided with health literacy resources in the form of health education Go-Packs––easily implementable lessons contained in a small storage tote––as part of the community project requirement of the James H. Quillen College of Medicine Rural Primary Care Track Curriculum. These Go-Packs included detailed lesson plans and accompanying materials that were designed to facilitate health education in the classrooms by providing easily deployable lessons for the teachers to utilize. Four Go-Packs were provided for hygiene, oral health, tobacco use, and nutrition that teachers used to augment instruction during teachable moments that …

Improving Tennessee Health Care Providers Understanding Of Neonatal Abstinence Syndrome, Ivy Click, Nicholas E. Hagemeier

Nicholas E. Hagemeier

No abstract provided.

Evaluation Of Increased Targeted Enforcement And Community-Based Outreach And Education Programs To Increase Nighttime Seatbelt Use In East Tennessee, Kwaku Frimpong Boakye

Doctoral Dissertations

According to the National Highway Traffic Safety Administration (NHTSA), motor vehicle crashes are the leading cause of death among people aged 1-54 in the United Sates. In 2015, the number of motor-vehicle deaths on U.S. roadways totaled 35,092, a 7% increase from 2014 (32,744). Though lower gas prices and increased vehicle mileage combined with risky driving behaviors (e.g. speeding, driving while texting) account for the increased fatality rate, seatbelt non-use has been a significant contributory factor. It is estimated that nearly half (48%) of passenger vehicle occupants involved in fatal crashes each year are unrestrained.

In a recent 2014 report …

Trends And Determinants Of Up-To-Date Status With Colorectal Cancer Screening In Tennessee, 2002-2008, Sreenivas P. Veeranki, Shimin Zheng

Shimin Zheng

BACKGROUND: Screening rates for colorectal cancer (CRC) are increasing nationwide including Tennessee (TN); however, their up-to-date status is unknown. The objective of this study is to determine the trends and characteristics of TN adults who are up-to-date status with CRC screening during 2002-2008. METHODS: We examined data from the TN Behavioral Risk Factor Surveillance System for 2002, 2004, 2006 and 2008 to estimate the proportion of respondents aged 50 years and above who were up-to-date status with CRC screening, defined as an annual home fecal occult blood test and/or sigmoidoscopy or colonoscopy in the past 5 years. We identified trends …

Prevalence Of And Risk Factors For Adolescent Obesity In Tennessee Using The 2010 Youth Risk Behavior Survey (Yrbs) Data: An Analysis Using Weighted Hierarchical Logistic Regression, Shimin Zheng, Nicole Holt, Jodi L. Southerland, Yan Cao, Trevor Taylor, Deborah L. Slawson, Mark Bloodworth

Shimin Zheng

Background: The rate of adolescent overweight and obesity has more than quadrupled over the past few decades, and has become a major public health problem [1]. In 2011, 55% of 12-19 year olds in the United States (U.S.) were overweight or obese [2]. Adolescence is a pivotal time in which many health risk behaviors such as tobacco, alcohol, and drug use are initiated. Such health risk behaviors have been significantly associated with overweight and obesity among adolescents. Objective: The purpose of this study is to evaluate the relationship between obesity and the health risk behaviors most commonly associated with premature …

Proper Prescribing Of Controlled Drugs: A Pilot Study Of A Web-Based Learning Modules’ Impact On Knowledge, Attitude, And Practice In New Graduate Nurse Practitioners, Shelly Duckett

DNP Scholarly Projects

Controlled substance abuse is a global epidemic. Several factors that influence health care providers prescribing habits have been presented in recent literature. However, the existing evidence primarily reflects the prescribing habits of physicians, while relatively little is known about the prescribing habits of nurse practitioners. The purpose of this project is to evaluate the impact of a brief web-based continuing education module targeting appropriate prescribing of controlled substances for recent graduate nurse practitioners. The project served to assess the provider’s knowledge, attitude, and practice compared to current integrated curriculum on prescribing and assess change in knowledge. Two online educational modules …

Construction Fatalities In Kentucky, Tennessee And West Virgina Between 2005 And 2014, Jacob Petrey

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

Background: The construction industry involves many hazards and accounts for the greatest number of work related fatalities in the United States. The objective of this study was to characterize the demographics of people involved in construction fatalities and the causes of these fatalities in Kentucky, Tennessee and West Virginia between 2005 and 2014.

Methods: The Bureau of Labor Statistics Census of Fatal Occupation Injuries (CFOI) was the source of data about the number of fatalities, rates and characteristics about fatalities for each state. The U.S. Census Bureau was also used to find the average annual construction population for each state …

Prevalence Of And Risk Factors For Adolescent Obesity In Tennessee Using The 2010 Youth Risk Behavior Survey (Yrbs) Data: An Analysis Using Weighted Hierarchical Logistic Regression, Shimin Zheng, Nicole Holt, Jodi L. Southerland, Yan Cao, Trevor Taylor, Deborah L. Slawson, Mark Bloodworth

ETSU Faculty Works

Background: The rate of adolescent overweight and obesity has more than quadrupled over the past few decades, and has become a major public health problem [1]. In 2011, 55% of 12-19 year olds in the United States (U.S.) were overweight or obese [2]. Adolescence is a pivotal time in which many health risk behaviors such as tobacco, alcohol, and drug use are initiated. Such health risk behaviors have been significantly associated with overweight and obesity among adolescents.

Objective: The purpose of this study is to evaluate the relationship between obesity and the health risk behaviors most commonly associated with premature …