Public Health Commons^™

Summary Of: Clinician Experiences And Comfort With Providing Harm Reduction Resources To People Who Use Drugs, Amanda Cahn, Melissa Calica, Erin Mooz, Malia Haddock, Wendy Craig, Tania D. Strout

Northern New England Clinical & Translational Research

Drug overdose deaths continue to rise in the United States, including in Maine, which has high rates of overdose mortality, viral hepatitis, and a recent HIV outbreak among people who use drugs. Harm reduction strategies such as naloxone distribution, safer use supplies, and linkage to syringe service programs are well established in research and improve patient safety and engagement. Despite strong evidence, clinical adoption remains inconsistent.

Study found @ "Clinician Experiences and Comfort with Providing Harm Reduction Resour" by Amanda Cahn, Melissa Calica et al.

State-Level Variations In School Physical Activity Policies And Their Impact On Student Physical Activity In Arkansas And Oklahoma, Sydney K. Crees, Erin Howie Hickey

2026 Honors Symposium

Regular physical activity is critical for children's health and development, yet most U.S. children fall short of recommended daily activity levels. Schools represent a key opportunity to address this gap through PE and recess, though state policies governing these vary widely. This cross-sectional study compared school-based physical activity in Arkansas and Oklahoma, two states with distinct policies. Arkansas mandates 40 minutes of daily recess and 40 minutes of PE per week, while Oklahoma requires 60 minutes of weekly PE and 60 minutes of additional weekly physical activity but does not mandate recess. Surveys were distributed to principals and PE teachers …

Exploring Acculturation And Its Role In Substance Abuse Behaviors Among Refugee Populations In Bowling Green, Ky: An Interactive Learning Experience Through Provider’S Perspectives., Aishwarya Potluri

College of Graduate Studies: Theses & Dissertations

Substance use among refugee populations is an emerging public health concern shaped/influenced by cultural, social, and structural factors associated with resettlement. This qualitative study explored providers’ perspectives on substance use behaviors among refugees in Bowling Green, Kentucky. Using Health Behavior Theory with acculturation as a contextual construct, semi-structured interviews were conducted with 10 providers working with refugee-serving organizations. Data collected through the interviews was analyzed using thematic analysis in NVivo. The findings indicate that substance use is being influenced by peer exposure, occupational stress, and the increased availability of substances in the United States. Providers identified cultural stigma surrounding mental …

Trends Among Suspected Opioid Overdose Emergency Medical Service (Ems) Incidents In Georgia From 2019-2023, Ashton Harris

College of Graduate Studies: Theses & Dissertations

Opioid overdoses remain a problem in the United States, underscoring the need for additional surveillance tools to monitor trends in opioid overdoses. Emergency Medical Services (EMS) data is a timely surveillance method that captures more potential overdoses than hospitals by representing the pre-hospital setting. Research questions in the study assess EMS responses to suspect opioid overdose incidents from 2019-2023 in Georgia to encompass the following characteristics: timeframe (pre, during, post-pandemic), urban versus rural counties, race/ethnicity, categorical type of first responder, mean dosage of naloxone in milligrams administered, and death. 84,359 records meeting the inclusion criteria were initially retrieved from the …

On Burden Of Diseases, Prevention, Medical Research And Health Service Delivery: Grampian Case Study, Seshadri S. Vasan, Sudarshan Anand, Miae Lee, Nicholas C. Fluck

Research outputs 2022 to 2026

Burden of diseases measured as disability-adjusted life years (DALYs) per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions, and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified that selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias …

Purchasing A Healthier Future: A Nutrition-Focused, Community-Centered Approach To Reduce Obesity And Diabetes In Graves County, Kentucky, Marissa Stephens

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

Obesity and type 2 diabetes are among the most significant public health challenges in the United States, with Kentucky consistently ranking among the states with the highest prevalence of both conditions. Together, these conditions contribute to reduced quality of life, rising healthcare costs, and increased morbidity and mortality, underscoring the need for targeted, community-centered interventions. The disease burden of obesity and diabetes is particularly pronounced in rural areas, including the state’s westernmost region, the Jackson Purchase. Among rural populations, chronic disease risk is driven by a combination of factors, including low socioeconomic status, limited access to healthcare/supermarket options, and food …

Enhancing Breast Cancer Screening Uptake In Hispanic Women Residing In Rural Texas Through A Quality Improvement Project, Bianca Batchelor-Salazar

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Breast cancer remains a leading cause of cancer-related mortality among women in the United States. Despite the effectiveness of mammography in early detection, Hispanic women in rural communities experience lower screening rates due to socioeconomic, cultural, and access-related barriers. At a rural South Texas clinic, the baseline screening rate among Hispanic women aged 50–74 years was 70.6%, below national benchmarks.

Purpose: To increase breast cancer screening compliance among Hispanic women aged 50–74 years in a rural South Texas family practice clinic.

Methods: Guided by the Lean A3 quality improvement framework, this project implemented a multifaceted intervention bundle that included …

Increasing Oral-Gut Axis Health Literacy In Underserved Communities With Community-Involved, Pantry-Accessible Nutrition Education: A Conceptual Framework And Program, Audrey Kho, Yinon Gankin, Polina Pine

Chemistry: Faculty Publications and Other Works

In metropolitan U.S. areas, health inequities caused by socioeconomic disparity continue to influence oral health, nutritional status, and the risk of chronic diseases. Diets heavy in added sugars and poor in fiber and vital micronutrients are especially harmful to the oral–gut axis, which connects diet, microbial balance, inflammation, and systemic and neurological health. Due to institutional hurdles to health literacy, limited access to preventive health education, and food poverty, these eating habits are more common among low-income individuals. Only 36% of low-income parents in Chicago report being in good health, compared to 75% of parents with better incomes, underscoring the …

Long-Lasting Impact Of Public Health Dentistry, Michal Herman Dds, Facd

Journal of the American College of Dentists

This article reflects on the enduring impact of public health dentistry through the author’s 25-year professional journey serving underserved and marginalized communities. It examines persistent barriers to equitable oral health care, including workforce shortages, inadequate insurance coverage, racial disparities, and limited access in rural and low-income populations. Drawing on experiences in nonprofit and community dentistry, the article highlights the importance of mentorship, advocacy, leadership, and community engagement in addressing oral health inequities. It argues that public health dentistry represents a form of professional altruism grounded in service and social responsibility, and calls on dental professionals to expand access, support workforce …

What Is The Evolving Role Of Nurses In Telehealth As Future Healthcare Professionals?, Emma G. Lowry

Honors College Theses

Telehealth has evolved into an essential component of healthcare delivery in today's world, something that occurred alongside the COVID-19 pandemic. As healthcare professionals, nurses must be adequately prepared and equipped to use the tools for telehealth. This paper examines the evolving role of nurses in telehealth by assessing undergraduate nursing students’ and practicing nurses’ knowledge, attitudes, and perceived competencies. Data will be collected through a Qualtrics survey utilizing the Awareness, Knowledge, Attitude, and Skills (AKAS) Scale for Telemedicine, supplemented by interviews with telehealth practitioners to provide qualitative context. It is expected that variations in proficiency and attitudes, from previous biased …

J Am Coll Dent 2026 92 2b

Journal of the American College of Dentists

This special issue of the Journal of the American College of Dentists responds to a growing but long-underrecognized demand for humanities and ethics in dental education, practice, and scholarship. It emerges from the work of the National Collaborative on Humanities and Ethics in Dentistry (NCHED), a multi-institutional partnership formed in 2023 to address the persistent exclusion of dentistry from broader health humanities conversations. Through national webinars and scholarly collaboration, NCHED has demonstrated substantial interest in ethical reflection, historical analysis, narrative inquiry, and the arts as essential to understanding oral health and dental care.

The unexpectedly strong response to the call …

Between Tradition And Transition: Cultural Negotiations And Contraceptive Perceptions Among Ghanaian Students In The United States, Beatrice Amissah

Theses and Dissertations

As global mobility continues to rise, international students often encounter new cultural norms and health practices that differ from those in their home countries. While some studies have focused on contraception within the context of gender and types, less focus has been placed on diasporic populations, especially how students navigate tensions surrounding contraception within new cultural environments. This study explores how Ghanaian students in the United States interpret, negotiate, and respond to contraceptive messaging while navigating the cultural transition between their heritage and host societies. Drawing on Berry’s (1980)  Acculturation Theory, the study examines the tensions students experience, the strategies …

Preventing Teen Pregnancy Through Expanded Contraceptive Access In Mccreary County, Kentucky, Dacey B. Chitwood

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

This capstone project proposes a school-based Condom Availability Program to reduce teen pregnancy risk by expanding discreet contraceptive access for adolescents in McCreary County, Kentucky. Teen pregnancy remains a persistent public health concern in rural communities where stigma, privacy concerns, transportation barriers, and limited healthcare access can prevent adolescents from obtaining reproductive health resources. McCreary County faces elevated teen birth rates, socioeconomic disadvantage, and limited maternal healthcare infrastructure, making teen pregnancy prevention an important local priority. The proposed program would place free latex and non-latex condoms in student restrooms at McCreary Central High School, with QR-code-linked information connecting students to …

Environmental Predictors Of Human Lyme Disease Incidence Across Appalachian Counties In Kentucky, Virginia, And West Virginia, 2000-2019, Karlie D. Rennison

Theses and Dissertations--Epidemiology and Biostatistics

This ecological study examined county-level environmental, landscape, and host-related predictors of Lyme disease incidence across Kentucky, Virginia, and West Virginia from 2000-2019. Lyme disease is an emerging public health concern in the Appalachian region, where geographic expansion and shifting ecological conditions may influence disease risk.

Lyme disease case rates (per 10,000 population) were analyzed in relation to climate variables, land cover metrics, host density measures, and rurality using publicly available data sources. Descriptive and regression analyses were conducted to evaluate associations between candidate predictors and disease incidence.

Substantial geographic variation in Lyme disease incidence was observed, with higher case rates …

Wastewater Surveillance For Sars-Cov-2 In Rural Kentucky, 2021–2023, James W. Keck, Reuben Adatorwovor, Ann Noble, Savannah Tucker, William Strike, Soroosh Torabi, Mohammad Dehghan Banadaki, Blazan Mijatovic, Steven K. Roggenkamp, Donna Mcneil, Lindell Ormsbee, Scott M. Berry

Family and Community Medicine Faculty Publications

Wastewater testing for SARS-CoV-2 provided useful public health information during the COVID-19 pandemic yet was underutilized in rural communities. We addressed this gap by implementing wastewater surveillance and assessing its performance in 10 communities in Eastern Kentucky. We collected wastewater samples 1–2 times weekly at 10 wastewater treatment plants (WWTPs) from May 2021 until April 2023 and measured SARS-CoV-2 RNA concentrations using polymerase chain reaction testing. We calculated time-lagged correlations between wastewater concentrations and county-level reported COVID-19 cases by site. We developed a generalized linear model to estimate COVID-19 incidence from wastewater SARS-CoV-2 concentrations. The 10 participating WWTPs served 2430 …

Perceptions Of The Proposed Food And Drug Administration Graphic Cigarette Warnings Among Adults Who Smoke On A Nondaily Or Daily Basis: A Within-Subjects Experiment, Bethany Shorey Fennell, Renee E. Magnan, Jennifer I. Vidrine, Damon J. Vidrine

Family and Community Medicine Faculty Publications

Introduction: People who smoke nondaily represent nearly one third of U.S. adults who smoke and experience significant smoking-related morbidity and mortality, yet they are rarely considered when evaluating the efficacy of graphic cigarette warnings.

Method: In October 2019, U.S. adults who smoked nondaily ( n =59) and daily ( n =183) evaluated 13 Food and Drug Administration–proposed graphic warnings and 13 equivalent text-only warnings on the extent to which they elicited understanding, perceived new knowledge, worry about smoking, and discouragement to smoke and were believable. Repeated-measures ANOVA and planned comparisons tested for between-subjects (smoking status) and within-subjects (warning type) effects. …

From Vision To Impact: Strategic Planning For The South Health District, Jason D. Butler Jr

College of Graduate Studies: Theses & Dissertations

This study presents a community health assessment and strategic planning process for the South Health District (SHD), a rural, multi-county public health district.  Using a mixed-methods approach, quantitative surveys and qualitative data from County Nurse Managers, County Boards of Health, and internal staff were integrated with secondary sources to identify community health priorities and organizational gaps.  Broad stakeholder engagement through surveys, SWOT workshops, and town-hall meetings ensured credibility and contextual relevance.

Findings revealed challenges in behavioral health, substance abuse, chronic disease, access to preventive services, transportation, workforce capacity, communication, and infrastructure.  Four strategic issues—Communication, Workforce Development and Retention, Purpose-Driven District, …

Ask Me 3® In Action: Advancing Health Literacy In Pediatric Acute Care, Yaseming Medina

2026

This evidence-based practice project evaluated the implementation of the Ask Me 3® health literacy tool in a pediatric perioperative setting to improve caregiver understanding of medical information and communication with healthcare providers. Findings suggest that Ask Me 3® supports health literacy and caregiver engagement, while patient experience measures related to nurse communication, listening, and caregiver comfort improved following implementation.

Responding To Social Isolation: The Tole Of Chaplaincy In Addressing Social Determinants Of Health (Sdoh) In Pediatric Contexts, Adam Lubbers, Forest Melton, Simbarashe Sigauke, Sophie Le

2026

This poster describes a pilot program that integrated chaplaincy services into the care pathway for pediatric patients and families who screened positive for low social support, a key social determinant of health. The findings suggest chaplain-led interventions provide effective emotional, spiritual, and practical support, helping address social isolation, caregiver burden, financial insecurity, and other health equity concerns while offering culturally responsive care.

Fitness To Work Evaluation In A Combined Physical And Office Working Activity With Piriformis Syndrome: A Case Report, Arif Prasetya, Nuri Purwito Adi

Occupational and Environmental Medicine Journal of Indonesia

Background Piriformis syndrome (PS) is a neuromuscular disorder with significant impact on workforce productivity. This case report presents a comprehensive evaluation of fitness for work and job modification strategies for a patient with PS in a combined physical and sedentary working environment. A 44-year-old male medical facility supervisor presented with left buttock pain, radiating to the left leg, diagnosed with left gluteal piriformis syndrome. Despite undergoing multiple conservative therapies by Physical Medicine and Rehabilitation Specialist, the patient showed minimal improvement.

Methods A seven-step fitness for work assessment approach was implemented following Indonesian Association of Occupational Medicine Specialists guidelines. The evaluation …

Factors Associated With The Atherogenic Index Of Plasma Among Workers At A National Respiratory Hospital In Jakarta, Muhammad Abror Rizani Fahmi, Herqutanto Herqutanto, Iqbal Mochtar, Dewi Yunia Fitriani, Marsen Isbayuputra, Resultanti Resultanti, Ariningsih Ariningsih

Occupational and Environmental Medicine Journal of Indonesia

Background Cardiovascular diseases (CVD) represent the primary cause of mortality globally. The atherogenic index of plasma (AIP) can predict the risk of CVD more accurately than other indices. Hospital workers are at risk of developing CVD. There are several factors that can influence the AIP. No studies have specifically investigated these associations in Indonesia, particularly regarding the AIP in hospital workers. This study aims to determine factors associated with the AIP among workers at a national respiratory hospital in Jakarta.

Methods This cross-sectional study collects data from the medical check-up records of workers at Persahabatan Hospital in 2024, who met …

Health Matters: Advancing Pediatric Health Equity Through Accessible And Engaging Health Literacy Activity Books, Lorraine Sheldon

2026

This poster describes the development and implementation of the Health Matters activity book series, a health literacy initiative designed to provide engaging, accessible, and developmentally appropriate health education for pediatric patients and their families. Through multidisciplinary collaboration, audience-centered design, and distribution across more than 30 departments, the project demonstrates how interactive educational materials can advance pediatric health equity, support family engagement, and improve health literacy outcomes.

Improving Sdoh Screening Compliance In Pediatric Settings: Addressing Health Literacy In East Texas, Katie Bien, Shannon Blalock, Donna Procell

2026

This poster focuses on efforts to improve compliance with social determinants of health (SDOH) screening in pediatric healthcare settings, with a particular emphasis on addressing health literacy challenges in East Texas. The project examines how health literacy considerations may influence the effectiveness and consistency of SDOH screening practices among pediatric patient populations.

Scaling Up Health Literacy Practices Through A Champion Program, Cameron Stine, Kelli Williams, Diana Montoya, Leslie Moore, Carol Howe

2026

This poster describes the development and expansion of a Health Literacy Champion Program designed to improve the consistent use of health literacy best practices across a healthcare organization. The program successfully expanded from ambulatory nursing to 13 disciplines, using champion training, newsletters, clinical observations, and peer influence to promote plain language communication, information chunking, and teach-back techniques that support patient understanding and safety.

The Correlation Between 25(Oh)D, Blood Lead Levels, And Delta-Aminolevulinic Acid Dehydratase Activity Among Indonesia Male Workers, Ratih Fadhillah, Muhammad Ilyas, Liem Jen Fuk, Levina Chandra Khoe, Muchtaruddin Mansyur

Occupational and Environmental Medicine Journal of Indonesia

Background Lead exposure disrupts the heme synthesis pathway by modifying the activity of Delta-Aminolevulinic Acid Dehydratase (ALAD), contributing to oxidative stress. Vitamin D has been suggested as an antioxidant to influence oxidative balance, but evidence regarding its association with ALAD activity in lead-exposed populations remains limited. This study aimed to analyze the associations between blood lead levels (BLL), serum 25-hydroxyvitamin D [25(OH)D], ALAD activity, and the 25(OH)D/BLL ratio among Indonesian male workers.

Methods A cross-sectional study was conducted among 90 male workers exposed to lead as part of either their occupation or living environment in Java, Indonesia. Serum 25(OH)D, BLL …

Return To Work After Percutaneous Coronary Intervention In Employee With Metabolic Comorbidities: An Evidence-Based Case Report, Bramantyo Eko Wahyudi Mr, Levina Khoe

Occupational and Environmental Medicine Journal of Indonesia

Background This evidence-based case report examines whether metabolic comorbidities independently predict return to work (RTW) after percutaneous coronary intervention (PCI) for myocardial infarction. A 52-year-old male senior manager with type 2 diabetes, hypertension, dyslipidaemia, and central obesity underwent PCI and required structured occupational assessment.

Methods A systematic literature search identified five eligible studies—one national registry cohort, three prospective cohort studies, and one narrative systematic review—critically appraised using Oxford Centre for Evidence-Based Medicine criteria.

Results Metabolic comorbidities showed consistent directional associations with reduced RTW probability in bivariate analyses and independently predicted longterm labour-market exit. However, in multivariate models across three of …

Unpacking And Re-Imagining Dental Ethics With Anti-Oppressive And Interdisciplinary Praxis, Eleanor Fleming Phd, Dds, Mph, Ficd, Facd

Journal of the American College of Dentists

Dental ethics are assumed to be neutral in their intent. With a social contract grounded in liberalism and assumptions centering whiteness, the resulting ethics reinforce hierarchy, otherness, and inequities. Because concepts and practices are rarely neutral, dental ethics is embedded with biases, which results in it falling short of the demands of the 21st century and exacerbating health inequities rather than supporting efforts for health justice. This manuscript invites the reader to reflect critically and re-imagine dental ethics using anti-oppressive and interdisciplinary praxis. For the improvement of public health, the narrowing of inequities, and a functioning oral health system, the …

Caregiver Training: Improving Social Determinants Of Health, Patient Safety, Empowerment Through Improving Elder Care Education And Skills, Kathleen Thimsen

Nursing Faculty Research

Caregiver training (CaGi TRaining) is a time-tested intervention aimed at improving safety in elders living and aging in place in the community. While elder abuse and maltreatment was the intial purpose of the project, with over 3500 Caregivers graduated from this program since 2009, the course has addresses social determinants of health, and improved workforce pipelines by providing stable employment, improved self-efficacy, and confidence demonstrated by self-reports at graduation and in follow up surveys. Previously learners without a high school diploma retruned to school to obtain a GED (40%), with an additional return to school for bacalaureate and degrees (27%) …

One-Stop-Shop (Oss): Community Health Nursing: (For Undergraduate Nurses), Sarmad Muhammad Soomar

Books

No abstract provided.

Facilitating Shared Reading Exposure To Promote Health Outcomes In A Rural Pediatric Primary Care Clinic, Meredith L. Longino

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this scholarly project was to address a gap in early literacy promotion for rural children by incorporating the Reach Out and Read program. This program bolsters foundational literacy by providing a book and anticipatory guidance at every well-child visit from birth through age 5. This project was expected to decrease no-show well-child attendance rates and improve provider morale.

Background

The project was implemented in an established rural pediatric primary care clinic in Northeast Texas. 

Methodology

Process implementation was measured through books distributed and EHR documentation of the intervention. Process objectives were measured by no-show rates for …