Public Health Commons^™

“Greening” Worcester: Municipal Best Practices For Sustainability, Erin Mckeon, Charline Kirongozi, Jared Duval, Antannia Greene, Qianshu Sun, Zewei Yao

School of Professional Studies

In response to the urgent threat posed by climate change, more and more cities, including Worcester, are attempting to become more environmentally responsible and sustainable. Worcester is attempting to develop ways to become more sustainable; both to strengthen their communities and to protect the planet. The Green Worcester Working Group (GWWG) tasked the Clark Capstone Team with researching best practices for municipal sustainability. The GWWG has set the following priorities: climate change mitigation, resilience, open spaces, sustainable resource management, education and awareness. Taking these into account, the Clark Capstone Team researched the sustainability practices of cities in New England, across …

Worcester Chamber Of Commerce: Recruiting Minority Business Owners, Ryan Dimaria, Alexander Hull, Xikun Lu, Haopeng Wang, Jiacheng Hou, Danning Zhao

School of Professional Studies

Our capstone project was to help the Worcester Regional Chamber of Commerce identify how to re-frame their marketing so it would be appealing to immigrant and minority owned businesses. Based on interviews and external research, our group was able to create a tangible and resourceful data set that provided justified recommendations and ideas on how the Chamber could make adjustments to their marketing plan to attract more businesses of this particular demographic in the city of Worcester. By implementing these recommendations, we believe the Chamber has the opportunity to create a more diverse group of Chamber members, add value to …

Service Now: Cmdb Research, Monika Patel, Smita Patil, Katerina Tzanavara, Manish Chauhan, Yuhao Wang, Houmin Xie, Lei Shi

School of Professional Studies

The MAPFRE Capstone team has been tasked with reviewing and recommending roadmap on the existing CMDB configuration. Paper discusses the team’s overall research on ServiceNow CMDB, Client’s deliverables and introduction to the latest technological innovations. Based on given objectives and team’s analysis we have recommended key solutions for the client to better understand the IT environment areas of business service impact, asset management, compliance, and configuration management. In addition, our research has covered all the majority of the technical and functional areas to provide greater visibility and insight into existing CMDB and IT environment.

For One Child, Zion Bereket, Xin Huang, Yitong Lin, Ruobing Pei, Rachel White, Ziyuan Li

School of Professional Studies

The entirety of this project was completed on the foundation of the three focus areas, which were identified by our client as areas of high need. The client wanted to prioritize these three areas as they believed that these three areas were the most integral to the successful achievement of their mission, as well as to the overall health and longevity of the organization.

Hiv/Aids In The Latino Community Of San Francisco: Past And Present, Jessica Da Silva

School of Professional Studies

There are approximately 122,000 people of Latino origin in San Francisco, which account for 15% of the total population (Census, 2010). Historically, Latinos have and still face several barriers to access healthcare and improvements in health (Aguirre-Molina, Molina & Zambrana, 2001). When the world was exposed to the spread of a new and unknown virus, the broader population suffered from the epidemic. The Latino community in San Francisco was and still is one of the hardest hit by the virus.

Changing The Current Perception Of Affordable Housing In Worcester, Simone Mcguinness, William Roberts, Vaske Gjino, Tong Zhou, Mengxin Ma, Sarawadee Sonpuak

School of Professional Studies

One of Worcester Interfaith’s goals is to eradicate the stigma of affordable housing in Worcester. Currently, the perception of affordable housing is of an image of unkept and old residences filled with destitute citizens who cannot afford basic needs to live in a city, let alone housing. This image is perpetuated by media, stigma, and a lack of education of the true reality of affordable housing and who its recipients are. Affordable housing-qualified citizens represent a range of educations, professions, age, race, and income levels. Affordable housing units, too, represent a variety of homes, many of which are extremely well-kept …

The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd

Disability & Aging

This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse.

Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs.

The Effects Of A Dementia Simulation Experience On Attitudes Towards People With Dementia, Micah Huckabee

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: The neurodegenerative effects of dementia resulting in cognitive and behavioral impairments is plausibly one of the reasons for a societal stigma towards individuals with dementia. Societal stigmas are associated with decreased life satisfaction, depressive symptoms, and decreased psychological well-being for stigmatized individuals. In an effort to improve attitudes towards individuals with dementia, this study utilized a dementia simulation to measure attitudinal changes after a dementia simulation. Methods: There were 33 participants in this study (13 male and 20 female) between the ages of 18 and 25. Participants completed a Dementia Attitudes Scale (DAS) survey, and then they dressed in …

It's Not Easy - Impacts Of Suicide Prevention Research On Study Staff, Jason I. Chen, Ginnifer L. Mastarone, Lauren M. Denneson

Communication Faculty Publications and Presentations

Suicide prevention researchers who work with individuals at high risk of suicide or are exposed to details of suicide attempts and deaths may experience negative impacts on their own well-being. This is not unlike the experiences of mental health providers, where repeated exposure to clients' difficult experiences gas long been identified as an occupational risk (Molnar et al., 2017). however, there have been few studies evaluating how exposure to details of suicide-related behavior impacts researcher well-being. This gap in the literature is worrisome, as researcher' mental health and well-being might be negatively impacted by repeated exposure to graphic details of …

Assessing Hospitalizations Due To Assaults At Dell Seton Medical Center (2015-2018), Stephani L. Curry

Dissertations and Theses (Open Access)

Physical assaults are a major public health concern in the United States, with rates being on the rise during the last couple of years (WISQARS Nonfatal Injury Reports, n.d.). In Austin at the Dell Seton Medical Center [DSMC], physical assaults are a main reason for hospitalization, making up nearly 10% of their hospitalizations, with around 250 patients per year. No subgroup of the population is risk free from physical assaults; however, national data suggest some sociodemographic groups are at higher risk than others (“Injury and Violence Prevention”, n.d.). Given the diversity of Austin, TX, it was unclear whether local sociodemographic …

Epidemiology Of Tuberculosis In Internationally Displaced Children Resettling In Harris County, Gabriella S. Lamb

Dissertations and Theses (Open Access)

Background More than 300,000 refugees arrived in the United States (U.S.) from 2010-2015, and Texas accepts the 2nd highest number of refugees. Texas also accepts large numbers of asylees, parolees, and special immigrant visa holders. Additionally, a large proportion of trafficked persons in the U.S. live in or pass through Texas. Foreign-born children are disproportionately affected by tuberculosis (TB) and account for two-thirds of U.S. childhood TB cases. Children are at greater risk for progression from TB infection to disease and experience greater morbidity and mortality from TB disease. This makes screening for and treatment of TB infection in children …

The Association Of Cell Phones With Adolescents' Academic Performance, Sleep, Time Spent With Friends, And Cyberbullying Exposure, Johanna E. Peyton

Dissertations and Theses (Open Access)

This study examined the association between owning or having access to a cell phone with/without internet access and adolescent academic performance, whether they met the guidelines for recommended nightly sleep, the amount of time spent with friends outside of school and the presence and frequency of cyberbullying experienced by 8th and 11th grade participants in the 2015-2016 SPAN study in Texas. This study also examined the association between gender of the adolescent and the above-mentioned outcomes.

The study group consisted of 5,421 adolescents from 8th grade and 3,635 from 11th grade. The 8th grade sample contained 51.48% males(48.6% females) and …

Exploring Prenatal Risk Factors Among Hispanic Children With Autism Spectrum Disorders. – A Pilot Study In The Rio Grande Valley, Lauren Tien

Dissertations and Theses (Open Access)

Background: Peer-reviewed studies suggest that a hostile gestational environment is associated with delayed neurological development in infants. Autism spectrum disorder (ASD) is estimated to affect 1 in 59 children in the United States; however, few studies have specifically investigated risk factors for autism in Hispanic children. Purpose: The University of Texas RGV Hispanic Autism Research Center (HARC) studied Hispanic children with ASD and their biological mothers to identify potential environmental exposures and prenatal risk factors that could impact the risk for ASD through preliminary research in the Rio Grande Valley. Methods: This pilot study recruited 25 Hispanic mothers and their …

Trends In Advanced Hiv Disease And Long-Term Outcomes Of Hivinfected Children Treated With Antiretroviral Therapy In Eastern And Southern Africa: 2003-2017, Peter James Elyanu

Dissertations and Theses (Open Access)

Despite the over 10-years’ experience providing pediatric antiretroviral therapy(ART) and implementing different WHO guidelines, data on updated trends (after 2010) in advanced disease at ART start, and on long-term survival of children receiving ART are scarce. Without these data, the impact of recent WHO guidelines on early treatment initiation and long-term survival remains unclear. First, we examined trends in advanced disease at ART start, then described 10-year survival and investigated risk factors of early mortality in children treated with ART and lastly examined the association between rapid ART initiation and outcomes (mortality and loss to follow-up) of HIV infected. We …

Cost-Effectiveness Of Collegiate Recovery Programs, Sierra Castedo De Martell

Dissertations and Theses (Open Access)

The prevalence of substance use disorders (SUDs) is greater among full-time college students and young adults regardless of enrollment status than it is among any other age group (1,2). These disorders represent substantial costs to both society and to institutions of higher education, both in terms of life years lost and in lost tuition revenue. The recent proliferation of collegiate recovery programs (CRPs) – supportive communities and resource centers for students seeking to maintain SUD recovery while pursuing a higher education – have the potential to help ameliorate some of these costs. While these CRPs are typically low-cost compared to …

Diagnostic Coding Of Physical Abuse Among Patients Evaluated By A Multidisciplinary Child Protection Team In A Pediatric Level I Trauma Center, Holly Hughes Garza

Dissertations and Theses (Open Access)

Child abuse is a substantial public health problem. Numerous studies have used hospital discharge data coded using the International Classification of Diseases, 9th and 10th Editions, Clinical Modification (ICD-9 and ICD-10) to identify cases of physical abuse seen in hospitals. Published studies on the sensitivity and specificity of ICD coding for physical child abuse are limited using ICD-9, and non-existent with ICD-10. This study examined the accuracy of ICD coding for physical child abuse, among patients less than 18 years of age, who were evaluated due to concern for physical abuse by a Multidisciplinary Child Protection Team (MCPT) during 2012-2013 …

The Prevalence Of Practicing Safety Professionals’ Knowledge, Involvement, And Competency Associated With Workplace Wellness Programs: Gauging The Safety Profession’S Engagement With The Total Worker Health Initiative, Jennifer C. Laine

Dissertations and Theses (Open Access)

The morbidity and mortality burden of occupational injuries and illnesses in the United States became such a public health concern that in 1970 the Occupational Safety and Health Act was signed into law. This law requires employers to provide workplaces “free from recognized hazards” and spurred the development of specific regulations along with the creation of academic and professional training programs to educate individuals about the safety sciences and careers in safety fields. Today there are an estimated 26,000 professionally trained and board certified safety professionals supporting workplace programs across the country, alongside numerous non-certified, but degreed, practicing safety professionals. …

Predictors Of On-Treatment Mortality Of Patients Undergoing Palliative Radiation Therapy: Improving The Quality Of End-Oflife Cancer Care, Matthew Stephen Ning

Dissertations and Theses (Open Access)

PURPOSE: Excessive medical treatment at end-of-life is an indicator of poor quality care. While radiation therapy (RT) is effective for palliation, some patients die shortly after or even during treatment. Any treatment that requires terminal patients to spend significant time in the hospital setting contradicts palliative goals. This study investigates patterns of end-of-life RT to inform quality improvement initiatives.

METHODS: All patients who died within 6 months of starting RT at a single large academic cancer center between 2015 through 2018 were identified through our institutional databases on an Institutional Review Board-approved protocol. Clinical factors including age, treatment service, number …

Measuring Goal Attainment In Chronic Disease Self-Management Within Clinical And Research Contexts: Development And Initial Testing Of The Goal Attainment Outcome Measure For Stroke (Gam-S), Barbara Kimmel

Dissertations and Theses (Open Access)

Background and Aims: Self-management (SM) skills help stroke survivors achieve behavior risk factors control. Goal setting and attainment are fundamental for SM. The most salient elements of SM effectiveness and measurements are just beginning to be understood. Investigation of measurement of goal attainment of SM risk factors has been the major aim of the study. My dissertation explores research questions concerning the goal attainment measure using data collected at the Veterans hospital.

Methods and Results: Introductory Chapters 1 and 2, include the background on stroke prevention through self-management interventions and a preliminary literature review of goal attainment in the context …

Social Capital And Health Services Utilization In Msm, Edward Tsai

Dissertations and Theses (Open Access)

While incidence of HIV has decreased overall and in most population subgroups, men who have sex with men (MSM) continue to remain at disproportional risk for new infection. In particular, MSM of color experience HIV incidence rates that continue to rise and represent the overwhelming majority of new cases each year. Evidence suggests greater risk among MSM may not be attributable primarily to individual behavioral level factors, but instead to structural and social environmental level factors such as access to health services. Access to health services represents a critical link in HIV and STI prevention, as health services provide serological …

Addressing Barriers To Preventative Health Care For Transgender Populations: A Systems Approach To Improving Access To Gynecological Care, Meghan N. Flynn

Master's Theses

The current study addresses the lack of research exploring the individual and systemic barriers to accessing gynecological care for transgender populations. An integrated mixed-methods needs assessment was designed to explore the individual and systemic barriers to gynecological health care for transgender and gender diverse populations. Participants of the study included established community providers known to serve the transgender community through advocacy or research efforts, as well as clinical psychologists and medical professionals working in gynecological settings. The study includes a brief quantitative survey, which measured “Perceptions of Inclusivity Importance” among key stakeholders. Following the survey, participants were invited to engage …

The Perception Of Iron-Deficient Anemia In Bolgatanga, Ghana Among Women Of Childbearing Age, Sydney Albrecht

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Objective: To understand the perception of anemia among the women of childbearing age in Bolgatanga, Ghana, and to correlate the reasoning with the high incidence of anemia in the area.

Method: This research was a qualitative study consisting of 67 interviews over the course of the three weeks that were spent in Bolgatanga. 50 of these interviews were women of childbearing age (15-49), 6 were health professionals, and 11 were women older than the age range provided. Interviews were taken from the maternity clinics nearby as well as from women in a rural area that was a 10-minute taxi ride …

Increasing Low-Income Residents’ Access To Fresh Produce Through A Local Mobile Pantry, Laura Wasson

Human Nutrition and Hospitality Management Undergraduate Honors Theses

Seeds that Feed (STF) is a mobile food pantry located in Fayetteville, Arkansas. STF receives produce from local farmers to distribute to residents in low-income housing sites throughout Northwest Arkansas. According to Feeding America, food insecurity affected 14.3% Washington County, Arkansas’ population in 2016. The purpose of this study was to determine if STF’s model is an effective way to increase individuals’ access to fresh fruits and vegetables and increase their potential to meet the United States Department of Agriculture’s Food Patterns (USDA-FP) for to fruit and vegetable consumption. Twenty-three participants from three sites completed the study. A survey was …

Reducing The Risk: Psychological And Technological Approaches For Improving Handwashing Practices In The Foodservice Industry, Jeffrey Allan Clark

Graduate Theses and Dissertations

As Americans are spending greater portions of their dollar on food consumed outside the home, the foodservice industry plays more of an integral part of daily existence compared to previous generations. Given the numerous annual foodborne illness outbreaks that threaten human lives while undermining confidence in the food supply, food safety is a pertinent issue for industry stakeholders, government regulators, and consumers. Food worker handwashing reduces the risk of foodborne illness transmission, yet compliance with this simple behavior is a complex problem. This dissertation addresses, predominantly, the issue of sub-optimal handwashing practices through applying psychology and technology, including wearable computers …

Alcohol Use, Dietary, And Exercise Behaviors: A Latent Profile Analysis Of Young Adult Lifestyle Behaviors, Ryan Wesley Grant

Graduate Theses and Dissertations

As individuals enter adulthood, their lifestyles and lifestyle behaviors begin to change drastically. These lifestyle behavior changes in emerging adulthood provide a foundation for future health behaviors that often persist through all of adulthood. The aim of this study was to use Latent profile analyses (LPA) to discover distinct profiles of homogenous groups of young adults based on alcohol, diet, and exercise behaviors. Overall, five distinct profiles for both males and females were identified: Moderates, Unhealthy Eaters, Medium Drinkers, Healthier Eaters and Exercisers, and Heavy Drinkers. Heavy Drinkers and Unhealthy Eaters were the highest risk groups and reported the highest …

Crumbling Foundations: The Case For Prioritizing Self-Care Among Educational Leaders, Joshua Brent Ray

Graduate Theses and Dissertations

There is a potentially dangerous disassociation between human behavior, decision-making, and ethics and the notion that these fundamental aspects of what it means to be human originate simply as the functions of an organ. A deeper knowledge of the operation and limitations of the brain suggests biological input could possess the ability to unknowingly alter human behavior and effectiveness. This study utilizes a research-based understanding of the implications of human health and self-care habits on neurological, psychological, and behavioral function to examine the current practices of educational administrators across Arkansas while exploring systemic and job-based factors within the profession that …

The Shape Study : The Survey Of Health And The Perceived Environment Study., Colette Patrice Davis

Electronic Theses and Dissertations

Introduction: Few studies have considered how an individual’s perception of their built environment may be a risk factor for being overweight or obese. Adolescents may be particularly vulnerable in the context of “impoverished environments”, which they may perceive to be difficult, dangerous, resource deficient, and unaesthetic. This study aids in clarifying how the built environment influences the risk of obesity among adolescents residing in a neighborhood in Louisville, KY. Objective: The overall objective was to conduct a cross-sectional epidemiologic pilot study among adolescents aged 12-17 years residing in West Louisville, Kentucky to evaluate the association between perceptions of …

Innovation And Equity In Public Health Research : Testing Arts-Based Methods For Trauma-Informed, Culturally-Responsive Inquiry., Tasha Golden

Electronic Theses and Dissertations

As the field of Public Health has shifted from a biomedical paradigm to a social ecological approach, focusing on health equity and social determinants of health, it has increasingly acknowledged the roles of culture and trauma in health outcomes. The field has responded by modifying some research practices, but continues to prioritize conventional methodologies—with few options designed to foreground trauma- and cultural-responsiveness. Unfortunately, to the extent that conventional approaches require health to be defined, communicated, or valued according to dominant norms, they risk perpetuating inequities. Health equity therefore requires the development of research methodologies that increase inclusivity and access, elicit …

A Framework For Learning During An Honors Internship: Embold Health Inc., Haley Haldeman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Embold Health Inc. is a health care analytics start-up company that identifies top performing providers using large data sets and clinically nuanced measurement. A comprehensive assessment of quality, appropriateness, and cost is what Embold Health delivers. Embold allows payers more control in choosing providers within their region. Being able to identify top provider behaviors through rigorous data driven measurement is significant both clinically and commercially; it provides the opportunity to increase value of care, decrease waste, and drive down cost.

Over the past year as an intern, I’ve had a first-hand look into the complexity that surrounds data driven health …

Comparative Analysis Of Early And Late Tracheostomy Among Patients With Acute Heart Failure Exacerbation, Trends, Clinical And Economic Outcome Assessment, From 2005 To 2014 Nationwide, Min Ji Kwak

Dissertations and Theses (Open Access)

Heart failure is one of the leading causes of high morbidity and mortality. Acute exacerbation of heart failure may result in acute respiratory failure, which requires mechanical ventilator support. Despite supportive management, patients can fail extubation of the endotracheal tube and need a tracheostomy to continue mechanical ventilator support. However, optimal timing of tracheostomy has been controversial. Systemic study to assess the clinical and economic outcome of early tracheostomy among patients with acute heart failure exacerbation is lacking. The purpose of the study was to assess the national trend of tracheostomy among those who are admitted for acute respiratory failure …