Public Health Commons^™

Improving Chronic Pain Management Processes In Primary Care Using Practice Facilitation And Quality Improvement: The Central Appalachia Inter-Professional Pain Education Collaborative, Roberto Cardarelli, Sarah Weatherford, Jennifer Schilling, Dana King, Sue Workman, Wade Rankin, Juanita Hughes, Jonathan Piercy, Amy Conley-Sallaz, Melissa Zook, Kendra Unger, Emma White, Barbara Astuto, Bobbi Stover

Journal of Patient-Centered Research and Reviews

Purpose: With the increasing burden of chronic pain and opioid use, provider shortages in Eastern Kentucky and West Virginia have experienced many challenges related to chronic pain management. This study tested a practice facilitator model in both academic and community clinics that selected and implemented best practice processes to better assist patients with chronic pain and increase the use of interdisciplinary health care services.

Methods: Using a quasi-experimental design, a practice facilitator was assigned to each state’s clinics and trained clinic teams in quality improvement methods to implement chronic pain tool(s) and workflow processes. Charts for 695 patients with chronic …

Contingency Management For Smoking Cessation In Pregnancy, Jacob Miller, Brady Reynolds, Courtney Crain, Hisham Keblawi, Lynne J. Goebel

Marshall Journal of Medicine

This pilot study examined the feasibility of applying Contingency Management (CM), where the woman receives financial compensation for abstinence from smoking. Eleven subjects were recruited from Marshall’s OB clinic for the program. CO levels were measured daily using online video recording. Quit rates were determined at the end of pregnancy. Birth outcomes were measured at delivery. 21 pregnant smokers from Marshall’s OB clinic were used as the control group. The results demonstrated a trend toward improved rates of smoking abstinence in CM participants as compared with the control group. Our study also showed a trend towards improved birth outcomes in …

Marketing Strategies To Encourage Rural Residents Of High-Obesity Counties To Buy Fruits And Vegetables In Grocery Stores, Emily Liu, Tammy Stephenson, Jessica Houlihan, Alison Gustafson

Dietetics and Human Nutrition Faculty Publications

Introduction

Obesity rates in Appalachia are among the highest in the United States, and knowledge of upstream approaches to decrease prevalence among this vulnerable population is limited. The primary aim of this study was to examine the association between healthy, diet-based, social marketing interventions in grocery stores and frequency of fruit and vegetable intake.

Methods

A social marketing campaign was conducted among 17 grocery stores (N = 240 participant surveys) over 4 months in 5 rural Kentucky counties. Interventions included providing food samples, recipe cards, and promotional discounts on fruits and vegetables and moving high-calorie foods to side aisles.

Results …

Social Support For Physical Activity For High Schoolers In Rural Appalachia, Pooja M. Shah

Undergraduate Honors Theses

The purpose of the present study is to conduct a secondary qualitative analysis to examine parent, teacher, and high school adolescents’ perceptions of social support for physical activity (PA) for high schoolers in Southern Appalachia. Social support for PA is linked to higher rates of PA participation in adolescents. Parents, siblings, and peers provide key sources of support. Social support for PA may be even more important in under-resourced communities such as Appalachia, where geographic, economic, and environmental barriers negatively impact PA engagement. During 2013-2014, focus groups and semi-structured interviews were conducted with parents of adolescents (n=39), high school teachers …

Self-Reported Tobacco Use And Correlation With Umbilical Cord Blood Cotinine Levels At Delivery Among Appalachian Gravidas, Jesse Cottrell, Brenda L. Mitchell, Pooja N. Sangani, D'Andrea S. Thomas, Monica A. Valentovic

Marshall Journal of Medicine

The detrimental effects of cigarette use during pregnancy are well documented. Studies have shown that cigarette smoking while pregnant is associated with multiple adverse outcomes including: pre-term birth, placental abruption, placenta previa, fetal growth restriction, stillbirth, increased rate of birth defects, and increased risk of sudden infant death syndrome. Cotinine is the primary metabolite of nicotine and allows for measurement of active as well as passive exposure. Cotinine freely cross the placental barrier and maternal concentrations are closely correlated with newborn plasma levels. The aim of this study was to compare maternally reported rates of tobacco use to fetal umbilical …