Public Health Commons^™

An Exploratory Study Of Generational Differences In Health Information Seeking And Smoking Behaviors In Bulgaria, Iva Stoyneva

Communication & Theatre Arts Theses

Smoking is a serious global public health threat that causes more than 6 million deaths annually (WHO, 2013). Smoking is also the single, most preventable cause of death (CDC, 2014). According to a recent study, Bulgaria was ranked as one of onlyl 1 countries in the world, in which half of the adult male population smokes, as well as one of 11 countries in which more than one-quarter of the adult female population smokes. Research suggests that the most significant predictors of smoking behavior in Bulgaria were age and geographic location (Balabanova, Bobak & McKee, 1998). Contributing to these finings, …

The Proliferation Of Diabetes: A Cultural Epidemiological Review Of Type 2 Diabetes In The Global Community, Kelly Heuer

Renée Crown University Honors Thesis Projects - All

Global diabetes is a serious and growing problem, which has quickly turned into a public health crisis. The rapid spread of type 2 diabetes can be contributed to several different factors, including genetics, environmental influences, poor nutrition habits, and sedentary lifestyle. A large part of the proliferation of this diease is the spread of western culture, specifically diet.

A problem faced when addressing this disease from a global standpoint of prevention, control, and treatment is that type 2 diabetes affects different cultures in different manners around the globe due to differences in risk factors (including genetics, age, race, sex, education, …

Substance Abuse Trends In Maine: State Epidemiological Profile 2014, Tim Diomede

Muskie School Capstones and Dissertations

This report takes into account the primary objectives of the Office of Substance Abuse and Mental Health Services (SAMHS): to identify substance abuse patterns in defined geographical areas, establish substance abuse trends, detect emerging substances, and provide information for policy development and program planning. It also highlights all the prevention priorities identified in the SAMHS strategic prevention plan: underage drinking, high-risk drinking among 18-25 year olds, misuse of prescription drugs among 18-25 year olds, and marijuana use in 12-25 year olds; as well as monitors the progress being made to address these priorities. This report includes data available through December …

Integrated Care For Older Adults In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

Recognizing that traditional models of health care delivery and payment often produce fragmented and costly care and poor outcomes for those with the highest needs, many reforms under the Affordable Care Act (ACA) focus on realigning payment incentives and integrating care. These reforms presuppose the existence of supporting infrastructure and capacity, including dedicated care management staffing and health information technology and exchange. With a focus on community-dwelling older adults in need of integrated physical, behavioral health services, and long term services and supports (LTSS), this brief reviews the opportunities and challenges these reform initiatives present for rural communities: How easily …

Integrated Care Management In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

No abstract provided.

Vitamin D Status Of College Students: Implications For Health Leaders, Eileen M. Cress

Electronic Theses and Dissertations

Vitamin D deficiency is considered to be a pandemic with implications for compromised bone health and other chronic diseases. Few studies have examined vitamin D status in college-aged individuals where prevention of future health consequences is still possible. Serum vitamin D 25(OH)D status and vitamin D intake were examined in 98 college students ages 18-29 years during winter. BMI was classified as < 25and 25 or greater. Race was categorized as Caucasian or other. Overall, 69.5% had suboptimal serum vitamin D levels, <30ng/mL. Only 8 students (8.2%) met the EAR (400 IU) per day for vitamin D intake. t tests were used to determine if there were significant differences in serum vitamin D level and dietary intake based on gender, race and BMI. Significant differences were found in serum vitamin D level when compared by gender and race. Females tended to have a higher serum vitamin D level than males. Those representing minorities had lower serum vitamin D levels than Caucasians; One hundred percent of the minority students had suboptimal serum vitamin D levels. Based on these findings, dietitians should increase efforts to target college-aged individuals in educational programming related to factors affecting vitamin D synthesis, vitamin D intake, and health consequences of suboptimal vitamin D status, particularly in winter. Consideration should be given to vitamin D fortification of foods that meet the preferences of today’s consumer.

Global Malnutrition: Challenges Associated With Current Intervention Strategies And Prevention Initiatives, Duncan Stiller

Senior Honors Projects

Few, if any, tribulations in the field of public health have managed to transcend the epidemiological transition from acute to chronic disease as malnutrition has. Officially, malnutrition is a category of diseases that includes micronutrient deficiency, under-nutrition (calories/protein), as well as excessive nutrition. The World Food Program estimates that 842 million people worldwide do not have access to enough food, approximately 146 million of which are children. The most serious types of hunger are known as Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM), with 20 million and 35 million respective cases each year occurring in children less than …

Strategies For Prevention Of Road Traffic Injuries (Rtis) In Pakistan: Situational Analysis., Adeel Ahmed Khan, Zafar Fatmi

Community Health Sciences

Road traffic injuries (RTIs) are one of the leading causes of death among productive age group. Using systems approach framework (SAF), current preventive strategies for RTI control were reviewed in Pakistan. A review of the literature was done using four international search engines. Only ten studies on preventive strategies for RTI stemming from Pakistan were found. The first Road Traffic Injuries Research Network (RTIRN) surveillance system for road traffic injuries was established in urban city (Karachi) in Pakistan has shown promise for injury control and should be scaled up to other cities. Enforcement of traffic laws on seat-belt and helmet …

Factors Which Predict The Use Of Active Transportation To School Among Children In Clark County, Nv, Sheila G. J. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Active transportation to school (ATS) shows promise for increasing activity levels in children, but prevalence and correlates vary widely in cities and regions with different barriers and supports for active travel. Classification of ATS users is a current issue in the field. The purpose of this study was to determine the prevalence of ATS use and develop a predictive model of ATS for the novel population of children enrolled in grades K-8 in Clark County School District, a large metropolitan school district in Southern Nevada. Methods: This study used a secondary data from the National Center for Safe Routes …

The Reduction Of Central Line-Associated Bloodstream Infections In Intensive Care Units Through The Implementation Of The Comprehensive Unit-Based Safety Program, Michael Andrew Basinger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSIs) are one of the most significant healthcare-associated infections (HAIs) in the Intensive Care Unit (ICU) setting resulting in increased lengths of stay, increased healthcare costs, and higher mortality rates (Institute of Healthcare Improvement [IHI], 2012). Evidence that CLABSIs are largely preventable has created opportunities for healthcare organizations to implement evidence-based bloodstream infection prevention practices to reduce or eliminate these infections (Lissauer, Leekisa, Prease, Thom, & Johnson, 2012). Other efforts to reduce CLABSIs include implementation of safety programs to improve the safety culture in ICUs (Lissauer et al., 2012). One program, the comprehensive unit-based safety program …

Health Care In The Motor City: Thriving Or Surviving?, Sally Coberly, William J. Scanlon

National Health Policy Forum

This site visit explored the forces shaping the delivery of health care in Detroit. Health care providers in Detroit face the twin challenges of controlling costs and serving a bifurcated metropolitan area that includes large numbers of uninsured, low-income, and vulnerable residents as well as more prosperous residents of a reviving inner core and the surrounding suburbs and counties. The program looked at the underlying economic, social, and physical conditions that make improving the health of the city's residents extremely challenging. Efforts to contain costs through payment innovations such as the Blue Cross Blue Shield of Michigan's Physician Group Incentive …

The Effects Of The Changes In Section 317 Rules For Administration Of Federally Purchased Vaccines, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Section 317 of the Public Health Services Act is a federal program that provides funds for the purchase of vaccines. These annual Congressional allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2013, Section 317 rules redefined the population eligible for immunization with Section 317 purchased vaccines. In Tennessee, the response was a policy change …

The Baby Friendly Hospital Initiative, Kathryn E. Brackett

Senior Honors Theses

Abstract

The Baby-Friendly Hospital Initiative (BFHI) is a worldwide movement started by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that is aimed at providing hospitals with a certification that guarantees the best possible patient-centered care for mothers and infants. It focuses on breastfeeding as optimal infant nutrition, and implements strategies to encourage and support mothers to breastfeed their infants exclusively for six months after birth. The Ten Steps to Successful Breastfeeding are a set of 10 simple, easy to understand guidelines developed by WHO and UNICEF for implementing this initiative in the hospital setting and …

Childhood Obesity And Familial Hypercholesterolemia: Genetic Diseases That Contribute To Cardiovascular Disease, Alyssa Caudle

Senior Honors Theses

Childhood obesity occurs as the result of an imbalance between caloric intake and energy expenditure. Genetic risk factors for obesity have become an area of research due to its permanency. Mutated genes such as Fat Mass and Obesity Associated (FTO), Leptin (LEP), Leptin Receptor (LEPR), Melanocortin 4 Receptor (MC4R), Adiponectin C1Q and Collagen Domain Containing (ADIPOQ), Proprotein Convertase Subtilisin/Kexin Type 1 (PCSK1), and Peroxisome Proliferator-Activated Receptor Gamma (PPARG) all contribute to the development of childhood obesity. In the presence of high cholesterol caused by obesity, the genetic condition known as familial hypercholesterolemia is exacerbated. Familial hypercholesterolemia is caused by a …

Trends In The Use, Sociodemographic Correlates, And Undertreatment Of Prescription Medications For Chronic Obstructive Pulmonary Disease Among Adults With Chronic Obstructive Pulmonary Disease In The United States From 1999 To 2010, Earl S. Ford, David M. Mannino, Anne G. Wheaton, Letitia Presley-Cantrell, Yong Liu, Wayne H. Giles, Janet B. Croft

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: The extent to which patients with COPD are receiving indicated treatment with medications to improve lung function and recent trends in the use of these medications is not well documented in the United States. The objective of this study was to examine trends in prescription medications for COPD among adults in the United States from 1999 to 2010.

METHODS: We performed a trend analysis using data from up to 1426 participants aged ≥20 years with self-reported COPD from six national surveys (National Health and Nutrition Examination Survey 1999-2010).

RESULTS: During 2009-2010, the age-adjusted percentage of participants who used any …

Blood Pressure Monitoring Of Hypertensive Patients In Primary Care: Barriers And Facilitators To Ambulatory, Office, And Home Blood Pressure Monitoring In The Context Of The Triple Aim, Elizabeth Andrews

Muskie School Capstones and Dissertations

Hypertension represents a population health issue in that many patients are misdiagnosed and over-or-under medicated. Research has indicated that overestimating the true blood pressure by 5 mmHg leads to over 30 million Americans being inappropriately treated with blood pressure medication (Handler, 2009). Blood pressure measurements taken in the office are often inaccurate due to patient behaviors, improper technique, and observer errors, yet providers are still using this method to diagnose hypertension. Therefore, considering other methods of blood pressure for the diagnosis and management of hypertension is important to the healthcare quality for millions of Americans.

The main objective of this …

Assessing The Readiness Of Nairobi Deaf Youth To Accept A Best-Practice Hiv/Aids Intervention, Ke'ala Morrell

Annual Undergraduate Conference on Health and Society

After nearly forty years of HIV/AIDS research in the global community, data on HIV/AIDS in the Deaf population is still disproportionately neglected. No surveillance system is in place to monitor prevalence, awareness or mode of HIV infection in the Deaf community. Additionally, prevention and education interventions have yet to be tailored to meet the specific needs of this highly vulnerable population.

Purpose: This project attempted to assess the readiness of the Nairobi Deaf youth community to accept a best-practice HIV/AIDS intervention. The broad objective of this research was to assess HIV awareness, perceptions and behaviors of Deaf youth in regards …

Understanding Hiv Care Delays In The Us South And The Role Of The Social-Level In Hiv Care Engagement/Retention: A Qualitative Study, Courtenay Sprague, Sara E. Simon

Center for Peace, Democracy and Development Publications

Introduction: In a significant geographical shift in the distribution of HIV infection, the US South - comprising 17 states - now has the greatest number of adults and adolescents with HIV (PLHIV) in the nation. More than 60% of PLHIV are not in HIV care in Alabama and Mississippi, contrasted with a national figure of 25%. Poorer HIV outcomes raise concerns about HIV-related inequities for southern PLHIV, which warrant further study. This qualitative study sought to understand experiences of low-income PLHIV on the AIDS Drug Assistance Program in engagement and retention in continuous HIV care in two sites in Alabama. …

Lhds Increase Their Use Of Ebdm Practices From 2010 To 2013, Kay A. Lovelace, Gulzar H. Shah, Carolyn J. Leep, Robert Aronson

Health Policy & Community Health: Faculty Presentations (1993-2023)

Background: An evidence-based approach is needed to effectively address the gap between population health goals in the United States and current morbidity and mortality rates. Recently, the authors developed an index to allow researchers to assess the frequency of evidence-based decision making (EBDM) practice in LHDs. The first descriptive analysis was conducted with data from the NACCHO 2010 Profile Study of Local Health Departments (LHDs). The current research was designed to assess changes in the percentage of LHDs using EBDM practices from 2010 to 2013.

Research Objective: To identify changes in the frequency with which LHDs carried out EBDM practices …

The Effect Of Early Head Start On Child Welfare System Involvement: A First Look At Longitudinal Child Maltreatment Outcomes, Beth L. Green, Catherine Ayoub, Jessica Dym Bartlett, Adam Von Ende, Carrie Jeanne Furrer, Rachel Chazen-Cohen, Claire Vallotton, Joanne Klevens

Center for Improvement of Child and Family Services Publications

The high societal and personal costs of child maltreatment make identification of effective early prevention programs a high research priority. Early Head Start (EHS), a dual generational program serving low-income families with children prenatally through age three years, is one of the largest federally funded programs for infants and toddlers in the United States. A national randomized trial found EHS to be effective in improving parent and child outcomes, but its effectiveness in reducing child maltreatment was not assessed. The current study used administrative data from state child welfare agencies to examine the impact of EHS on documented abuse and …

Implementing A Community-Based Intervention For African American Mothers And Daughters, Teri Aronowitz, Nandini Sengupta

Office of Community Partnerships Posters

Adolescents represent one of the fastest growing risk groups for HIV. Inner-city, minority youth are at highest risk because of concentration of HIV in inner-city areas, higher rates of STDs, and early sexual initiation. Mothers are the primary sex educator of daughters, and girls state their relationship with their mother was an important influence on their delaying sexual activity. With 70% of adolescent HIV seroconversions occurring among African American (AA) females, studies are urgently needed to enhance mother-daughter sexual communication. The purpose of this poster is to offer insights on the logistics of carrying out a manualized program.

Two Community Collaborations With Sexual Minority Women’S Ngos In Shanghai & Hong Kong, Connie Chan, Hsin-Ching Wu

Office of Community Partnerships Posters

Based on research with sexual minority communities in the United States, Connie Chan, professor of public policy and public affairs, conducted comparative research with community groups in Hong Kong and Shanghai, China. She provided capacity building training and resources directly to the organization which provides outreach and service to sexual minority women and girls in Shanghai, China. Professor Chan also supported Queer Sisters – an NGO that provides advocacy and community outreach to sexual minority girls and women in Hong Kong – by co-creating a needs assessment survey and helping them to interview their membership in Hong Kong.

Connie Chan …

Annual Report 2013, Forum Staff

National Health Policy Forum

This annual report describes the activities of the Forum during the 2013 calendar year, and provides a snapshot of our participants and resources.

Translational Nutrition: A Review Of The Application Of Nutrition Science, Regulation, And Outreach Case Study: Farm Fresh Rhode Island, Eliza Zalis

Public & Community Service Studies Student Scholarship

This project examines the avenues by which nutrition science impacts individuals in society. It examines the factors that influence consumer behavior and food choice and the importance of health literacy in guiding nutrition and health. It elucidates the role of the Food and Drug Administration (FDA) in regulating food labeling and the implications that such regulation has on consumer perception and possible health outcomes. Further, this project outlines recently proposed changes to the “Nutrition Facts” panel. In investigating nutrition education and outreach programs, this project includes a case study of Farm Fresh Rhode Island and the organization’s nutrition initiatives.

Grappling With Gatekeepers: Addressing Gender Hindrances To Mhealth, Jack O’Rourke

Independent Study Project (ISP) Collection

This study was conducted in order to understand the social and economic problems associated with Ugandan women’s usage of mobile phones and the ways in which different mHealth groups are approaching these problems. Seeing how these different groups approach this issue added new information and analysis to a relatively unexplored topic

The qualitative methodology undertaken was two pronged. First, single sex focus groups in rural Mukono District were assembled. Men, women without phones and women and with phones were all talked to in Luganda with the use of a translator. In addition to these focus groups in rural Mukono District, …

Development Of An Evidence‐Based Implementation Plan For A System‐Wide Anticoagulation Management Service, Sarah Varney

Muskie School Capstones and Dissertations

The Mercy Health System of Maine (MHSM) is a large healthcare system located in Southern Maine. It consists of three inpatient campuses, one level II Emergency Department, four Express Care centers, seven Primary Care locations and an array of specialist practices. The organization has identified a need for improved management of anticoagulation therapy within the system as a large number of patients are receiving anticoagulation therapy throughout all of the various healthcare access sites. In order to address this need, MHSM seeks to implement a system‐wide, standardized approach for managing patients receiving anticoagulation therapy.

Injection, Ingestion, & Misconception: Drug Use & Rehabilitation In Indonesia, Elena Silvestrini

Independent Study Project (ISP) Collection

When developing countries begin to work their way towards a more recognizable and first world standpoint, there are always certain social issues that must be worked out and addressed. While Indonesia is still considered a third world country, the nation is developing through its gradually increasing economy and booming tourism industry. As any other nation does in its initial stages of expansion, Indonesia has reached a major turning point in which the social issues that have plagued the country for decades must finally be attended to. Politicians, public officers, and local citizens are speaking out against injustices, inequalities, and concerning …

Smoking Behaviors Among Pregnant Women: A Romanian Case Study, Katherine Lemasters

Independent Study Project (ISP) Collection

Smoking behavior during pregnancy is one of few preventable factors associated with poor health outcomes for both women and children. The post-communist countries in Central and Eastern Europe face many challenges in this realm, as tobacco control efforts have not adequately addressed this behavioral health issue that has arisen since 1989. To better inform these efforts in Romania, this study categorizes the determinants of pregnant women’s prior smoking, current smoking, and current smoke exposure by using both quantitative and qualitative analysis. We find that those living with other smokers, exposed to smoke on a daily basis, and experiencing stress during …

National Spending For Long-Term Services And Supports (Ltss), 2012, Carol O'Shaughnessy

National Health Policy Forum

Long-term services and supports (LTSS) for the elderly and younger populations with disabilities are a significant component of national health care spending. In 2012, spending for these services was $219.9 billion (9.3 percent of all U.S. personal health care spending), almost two-thirds of which was paid by the federal-state Medicaid program. This publication presents data on LTSS spending by major public and private sources.

2014 Massachusetts Family Impact Seminar: A Lot On Our Plate; Chronic Health Threats In Massachusetts, Ira S. Ockene M.D., Christina D. Economos Ph.D, Barbara Goldoftas Ph.D, Denise A. Hines Ph.D., Caitlin Alcorn, Jacqueline A. Daigneault, Jordan R. Daley, Maura A. Flanagan, Carsten-Hendrik Rasche, Heather Rios, Julia Tran, Liam Kelly Fleming

Mosakowski Institute for Public Enterprise

A Lot on Our Plate: Chronic Health Threats in Massachusetts is the fifth Massachusetts Family Impact Seminar, and is designed to emphasize a family perspective in policymaking on issues related to childhood obesity, cardiovascular disease, and type 2 diabetes. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.