Public Health Commons^™

Measuring The Impact Of Rise Vt: Evaluating Community-Based Obesity Prevention Initiatives With A Standardized Intensity Score, Brianna K. Johnson Bsn, Rn, Ocn, Dnpc

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background. Obesity is a leading cause of morbidity and mortality in the US. Rise VT is a multilevel community-based initiative to reduce obesity. The Community Programs and Policies Intensity Score (CPPI) is a standardized metric to evaluate multisector efforts over time, which has correlated with reductions in childhood obesity.

Purpose. The purpose of this project was to quantify the impact of Rise VT using the CPPI score. A secondary aim was to assess the feasibility of using the CPPI score for ongoing program planning and evaluation statewide.

Methods. Interviews with program managers were conducted to gather data related to …

Evaluation Of Clinician Prescribing Practices For Contraceptive Care: A Quality Improvement Collaboration, Julie Desrochers

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Primary care providers (PCPs) have the training and opportunity to provide contraceptive care. Unplanned pregnancy is a major public health issue for which up to 50% of the population is at overall lifetime risk. Reproductive life planning during healthcare visits can reduce rates of unintended pregnancy, prompting contraception or preconception planning. Studies suggest contraceptive counseling protocols and reproductive intent screening are effective tools. This project compares clinician behaviors with best practices. The purpose is to evaluate preventive reproductive healthcare practices in primary care, identifying opportunities to meet the contraceptive healthcare needs for people of reproductive age.

Methods: PCPs and …

Development Of Hospital-Wide Policy For Pediatric Needle Procedures At An Academic Medical Center, Katherine J. Rose

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Needle procedures are traumatic experiences for pediatric patients, and have been linked to formation of phobias and lifelong decreased healthcare utilization.^1,2 Pain management during needle procedures and hospital wide standardization of needle procedures are known to increase patient satisfaction, while decreasing long-term adverse outcomes related to seeking health care.^3,4 The purpose of this project was to develop a hospital-wide standardized policy for pediatric needle procedures at an academic medical center.

Methods: Those performing pediatric needle procedures were electronically surveyed to identify full spectrum issues regarding adoption of a pediatric needle policy. Based on survey findings …

Physical Activity Levels And Depressive Disorder: A Cross-Sectional Sample Of Vermont Adults, Paige Stefanak, Obichukwu Ezennia, Marley Jurgensmeyer, Jessica Dubetsky, Elise Carlson

Master of Public Health Culminating Projects

Objective: To investigate the association between meeting physical activity (PA) recommendations and having ever been told of having a depressive disorder in a cross-sectional sample of Vermont adults.

Methods: Study participants (n = 11,429) were Vermont residents that had answered all required questions from 2015 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) telephone surveys. Descriptive and binary logistic analyses were run with PA as the exposure variable and depression as the outcome variable.

Results: Study participants were 44.5% males; 93.2% white/non-Hispanic; 67.6% with some college or more; 46% age 60 or over; 45.8% employed for wages and retired. A …

Electronic Vapor Product Usage And Its Relationship To Suicidality In Vermont Youth, John Paul Grogan, Bonnica Zuckerman, Frezette Ackah, Melissa Ackley, Margaret Cameron, Kelsey Gleason

Master of Public Health Culminating Projects

Objective: To examine the association between the use of electronic vapor products (e-cigarettes) and suicidal ideation.

Methods: This study explored the association between e-cigarettes usage and suicidal ideation among 16,733 Vermont high school respondents of the 2017 Youth Risk Behavior Survey (YRBS). Bivariate logistic regression was used to predict the odds of suicidal ideation with current electronic vapor product (EVP) use as the main predictor while controlling for current cigarette, alcohol, and marijuana use, age, gender, sexual orientation, and a history of bullying or sexual violence.

Results: The odds of suicidal ideation are 5.86% lower for students using EVPs than …

Personal Health And Community Safety Perceptions And Their Association With Meeting Physical Activity Guidelines, Jordan J. Keene, Alexandra Piccione, Christian Taylor, Gail Regan, Vicki C. Hart

Master of Public Health Culminating Projects

Objective: To examine whether Vermonters’ perceptions of physical health, mental health, and community safety are associated with meeting Healthy Vermonters’ (HV) 2020 goals.1,2,3 Data was collected in 2017 and utilized for the present study, completed May 2020.

Methods: Predictor variables for logistic regression analysis were the 4,393 respondents’ selfreported 1) physical health, 2) mental health, and 3) community safety for walking. Outcome variables were achievement of the HV 2020 goals for 1) aerobic and muscle-strengthening activity and 2) engagement in leisure-time physical activity (LTPA).

Results: The odds of meeting the HV 2020 guidelines for aerobic and muscle strengthening activity for …

Assessing The Effect Of Cold Weather On Rural Cardiovascular Disease Deaths In Vermont, Alex V. Sherbrook, Madison M. Freeman, Cody A. Aspril, Jennifer A. Tomczak, Emily C. Pareles, Timothy B. Plante

Master of Public Health Culminating Projects

Objective: To study Vermont mortality and temperature data to determine if there is an increased incidence of cardiovascular disease related death on categorically cold streak days among rural residents.

Methods: A retrospective study was conducted using a cohort of Vermont CVD deaths between 2009-2017 subset with corresponding daily temperature data. CVD deaths that occurred on a categorical cold streak day were then identified and analyzed using a Poisson Regression to assess the relationship between ambient temperature changes, CVD mortality, and rurality.

Results: As compared to non-cold streak days, risk of CVD mortality was 4% higher on cold …

High School Students Who Experienced A Concussion Are More Likely To Report Indicators Of Depression: A Cross-Sectional Examination Using The 2017 Vermont Youth Risk Behavior Survey, Zoe Adams, Elizabeth Morris, Amelia Trello, Rachel Cummings, Lexi Naylor, Thomas Delaney, Kelsey Gleason

Master of Public Health Culminating Projects

Objective: To examine the relationship between a history of concussions and depressive indicators in high school students.

Methods: 2017 Vermont Youth Behavior Risk Survey data (n = 26,962) was used to evaluate a potential association between concussions and depressive indicators in 20,653 eligible high schoolers using a multivariate logistic regression analysis, controlling for covariates.

Results: Multivariate logistic regression analysis using a dichotomous concussion variable revealed that the odds of reporting one or more depression indicators were greater for individuals reporting at least one concussion in the past year compared to individuals who did not report any concussions, controlling for all …

Screening For Palliative Care Services In An Assisted Living Facility, Maria Delia Crosby

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Palliative care services remain under-utilized, even as evidence suggests that early palliative care leads to positive health outcomes, reduced ED visits, and substantial cost savings. Barriers include a lack of knowledge of palliative care services in the community, and under-utilization of validated assessment tools, including a symptom checklist. Aims of this project: 1. To determine whether the integration of validated community-based palliative care screening tool in an assisted living setting will identify older adults with unmet palliative care needs. 2. To determine if tool implementation could lead to a referral for palliative care consultation.

Methods: A screening tool developed …

From Evidence To Practice: Promoting Continued And Exclusive Breastfeeding In Rural Eastern Uganda, Katherine Judge

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Malnutrition is responsible for about one third of deaths globally among children under age five. Over 65% of these deaths, often associated with inappropriate feeding practices, occur during the first year of life and disproportionately affect those living in resource poor countries. Breastfeeding has been established as uniquely effective in providing infants with nutrients for healthy growth and development. Ugandan demographic surveys (2016) indicate less than 43% of infants age 4-5 months are breastfed.

Methods: The objective was to equip Community Health Educators (CHEs) with evidence-based practice guidelines for promoting continued exclusive breastfeeding to postpartum women. This project was …

The Association Of Maternal Obesity And Race With Pregnancy Weight Gain And Small For Gestational Age Infant Birth: The Effect Of Prenatal Care, Charles E. Mercier, Ariel Carter, Tori Dobbs, Jeralyn T. Bradford-Keel, Emily Dickinson, Victoria Hart

Master of Public Health Culminating Projects

Objective: To examine the association of maternal obesity, race/ethnicity, and prenatal care on high gestational weight gain (GWG) and small for gestational age (SGA) infant birth.

Methods: This was a retrospective cohort study of births included in the PRAMS Phase 8 dataset (2016-2017). The study population was 53,893 non-diabetic women with a singleton in-hospital birth between 37 and 42 weeks gestational age.

Results: Only obese non-Hispanic white and Hispanic women showed a consistent decrease in adjusted odds of high GWG as prenatal care visit category increased. Only non-Hispanic white women showed a lower increase in adjusted odds of an …

Employee Burnout And Job Retention Scores Among Ems Workers In Vermont, Caitlin Eckert, Andrew Gross, Chris Haines, Deanna Kish, Jacob Porter, Thomas Delaney

Master of Public Health Culminating Projects

Objective: To assess whether shift length and employment status were positively associated with increased burnout and retention among emergency medical service (EMS) workers in the state of Vermont.

Methods: We conducted a secondary analysis of cross-sectional data using the Vermont EMS Retention Survey from the Vermont Department of Health. 545 participants provided data from August to November 2019. Measures included burnout and retention using the Maslach Burnout Inventory.

Results: In an adjusted model, the 24-hour shift length was associated with higher burnout compared to the eight-hour shift. Volunteer workers displayed lower instances of burnout and had higher retention rates than …

On The Dynamics And Structure Of Multiple Strain Epidemic Models And Genotype Networks, Blake Joseph Mitchell Williams

Graduate College Dissertations and Theses

Mathematical disease modeling has long operated under the assumption that any one infectious disease is caused by one transmissible pathogen. This paradigm has been useful in simplifying the biological reality of epidemics and has allowed the modeling community to focus on the complexity of other factors such as contact structure and interventions. However, there is an increasing amount of evidence that the strain diversity of pathogens, and their interplay with the host immune system, can play a large role in shaping the dynamics of epidemics.

This body of work first explores the role of strain-transcending immunity in mathematical disease models, …