Public Health Commons^™

Forced Sexual Intercourse And Its Link To Suicide Ideation/Suicide Attempts Among Adolescent Girls: Findings From 2013 Youth Risk Behavioral Survey, Adebukola Helen Adegbite

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

Objectives. We sought to assess the association between forced sexual intercourse and suicidal ideation/attempts among adolescent girls ages 14-17.

Methods. We performed secondary data analysis of the 2013 Youth Risk Behavioral Survey, using chi-square tests to examine the association of forced sex and race/ethnicity, with suicide ideation.

Results. We found that there was an association between those who had considered suicide and those who had experienced forced sexual intercourse. Moreover, race/ethnicity was associated with those who had ever considered suicide in the past 12 months before taking the survey. Lastly, we found that there was an association of suicide ideation …

Development Of Multiple Primary Cancers In Lung Cancer Patients: Appalachian Vs. Non-Appalachian Populations Of Kentucky, Vira Pravosud

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

OBJECTIVE: This study examined whether there were differences in the development of multiple primary cancers in lung cancer patients residing in the Appalachian versus Non-Appalachian regions of Kentucky. The study also identified other factors associated with the development of another primary cancer in lung cancer patients.

HYPOTHESIS: Lung cancer patients residing in Appalachian Kentucky are more likely to develop multiple primary cancers compared to patients residing in Non-Appalachian Kentucky.

METHODS: This was a retrospective, population-based cohort study of Kentucky patients (N=26456) aged 20 years and older, diagnosed with primary lung cancer between January 1, 2000 and December 31, 2013. The …

An Examination Of Traumatic Brain Injury As A Risk Factor For Psychiatric Symptoms In Alzheimer’S Disease Patients, Jennifer F. Walch

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

Introduction:

Dementia is a major public health issue both in the United States and worldwide. Alzheimer’s disease (AD) is widely considered to be the most prevalent type of dementia. While the hallmark AD symptom is profound memory loss, patients also commonly experience changes in personality and behavior. These changes often include depression, anxiety, social withdrawal, mood swings, irritability and aggression, changes in sleeping habits, and delusions.

Background:

Several studies have established a mechanistic link between traumatic brain injury (TBI) and the development of AD. However, it is unknown whether TBI contributes to the personality/behavior changes observed in many AD patients. …

Identifying Predictors Of Functional Limitations Associated With Depression, Anxiety, And Emotional Problems In Us Adults, Jillian Richardson

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

Depressive disorders are characterized as sharing affected mood, and somatic (e.g. sleep pattern, appetite, and unintentional changes in weight) and cognitive alterations from previous normal daily functioning that are clinically significant. Anxiety disorders are characterized by excessive fear, general or specific anxiety, and related behavioral disturbances that are also clinically significant. This project attempts to identify risk factors that may predict what groups are most likely to be affected by depression and/or anxiety.

Sponsored by the CDC, the National Health Interview Survey collects general health information for non-institutionalized individuals living in the US. Variables for use in logistic regression model …

"Life Skills Training" Prescription Drug Abuse Prevention Among Youth In Bell County, Kentucky, Arveen Kaur

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

Prescription Drug Abuse (PDA) has become a serious public health concern and a major epidemic in the United States (U.S.). According to the 2014 National Survey on Drug Use and Health (NSUDH), approximately 15 million people (aged 12 or older) used prescription drugs in the past year and 6.5 million in past month. Out of these, 2 million Americans (aged 12 or older) either abused prescription drugs or were dependant on them. Almost 5% of adolescents (1.1 million) between the age group 12-17 abused prescription painkillers in 2014. Nationally, Kentucky is among the top five states with highest age-adjusted overdose …

Hispanic Agricultural Workers: The Nexus Of Demographics, Employment Characteristics, And Health, Ashley Michelle Bush

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

Agriculture, which is home to elevated occupational injury and illness rates, has a substantial demographic makeup of Hispanic workers. Hispanic farmworkers are at increased risk of poor occupational health outcomes due to the precarious nature of work and other socio-ecological influences. These adverse occupational health outcome counts are inadequate and undercounted, failing to capture the true scope of agricultural work. To gain more knowledge about agriculture, this capstone will focus on the personal and work characteristics of agricultural workers to help further understand disparities within the agricultural sector by: providing a literature review of agricultural worker health; examining missed work …

Hiv Risks, Intimate Partner Violence (Ipv), And Depression Among A Sample Of Women Who Have Sex With Men And Women (Wsmw), Krystal S. Frieson

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

Objective: The purpose of this study is to examine the associations between interpersonal partner violence (IPV), HIV risks, and depression among a sample of adolescent females who have sex with men and women.

Methods: A cross-sectional study was conducted using data from the Youth Risk Behavior Surveillance System (YRBSS). YRBSS data was obtained from representative samples of students in grades 9-12. The study sample was comprised of adolescent and young women who self-identified as having sex with men and women (WSMW)(N=526). The primary exposure was sexual behavior (having sexual intercourse with both male and female partners). The primary outcomes were …

Are There Rural-Urban Differences In Dentist Supply?, Mutlaq Alotaibi

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

The purpose of this project was to examine the supply of dentists in the Commonwealth of Kentucky at the county level. Counties with shortages in dentist supply were determined and associated factors were examined.

Several county-level variables were analyzed. These included total number of dentists, total county population, dentist to population ratio, dentist supply shortage, median household income, median age, percent of Medicaid enrollees, rurality, oral cancer crude incidence and mortality rates per 100,000 and percent of adults missing six or more teeth.

This project showed that 42 of the 120 counties in Kentucky had shortages in dentist supply. Also, …

Policy And Political Motives For Medicaid Expansion Under The Patient Protection And Affordable Care Act, Ross C. Stanton

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

Objective

This study aims to analyze policy-related and political rationales for Medicaid expansion under the Patient Protection and Affordable Care Act (PPACA). More specifically, this study seeks to discover whether states’ decisions regarding Medicaid expansion were likely based on policy implications regarding the uninsured or political motives.

Methodology

The approach is a cross-sectional/observational study of American states and the District of Columbia after the Sebelius decision in 2012. This study compares three variables: (1) whether each state decided to opt into the expansion (“Opted In”), (2) whether each state’s governor and legislature were affiliated with either the Democratic or Republican …

The Association Of Atrazine And Non-Hodgkin Lymphoma In Kentucky, Justine F. Maxwell

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

Atrazine, one of the most widely used agricultural pesticides, largely sprayed on corn. throughout the Midwest.34 The Environmental Protection Agency (EPA) has estimated 76.4 million pounds are applied annually where its usage on corn accounts for approximately 86% of total United States (US) domestic usage (in pounds).35 Approximately 75% of the field corn acreage grown in the U.S. is treated with atrazine.35 Once atrazine enters into waterways, it can persist having a half-life greater than 200 days in surface waters.34 In Kentucky, atrazine is the most heavily applied in heavy corn-producing locations, which are mostly in western regions of the …

Analysis Of Firearm Legislation And Law Enforcement Suicides In Nvdrs-Funded States, Meagan L. Hurst

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

BACKGROUND:

The purpose of this study was to evaluate firearm-related suicides among law enforcement members and identify potential differences between decedents and firearm legislation grades from National Violent Death Reporting System (NVDRS) funded states

METHODS:

Descriptive and regression analyses were conducted using suicide data from 820 decedents who worked within law enforcement at the time of death. Data were collected over a ten-year period (2003-2013) from the NVDRS. Multivariable logistic regression and Pearson’s chi-square were used to identify if differences existed among firearm-related suicides and other means using variables such as age, marital status, occupation, mental health, and firearm legislation …

Service Training And Recovery (Star) Program: An Interdisciplinary Community-Based Project To Mitigate Rr-Ptsd Among Kentucky Women, Margaret Melissa Brown

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

Background: Kentucky has greater prevalence of sexual assault compared to the US overall, 37.5% versus 35.6% of all assault crimes respectively, translating to roughly 638,000 victims within the Commonwealth [1].Research identified sexual violence as the number one factor in development of PTSD among women. There are four times the prevalence of PTSD in victims of sexual violence versus other forms of trauma. [2, 3] The STAR program utilizes skills-based training methods to empower participants through improving a sense of safety and security, self-confidence, and self-efficacy to mitigate RR-PTSD symptoms leading to negative health outcomes.

Literature Review: Existing research …

Circumstances Contributing To Suicides Among Pregnant, Postpartum And Non-Pregnant Women (15 - 54 Years) In Rural And Urban Counties In The U.S., Nvdrs 2003-2012, Akosua Korantema Adu

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

Abstract withheld upon request.

Undiagnosed Hepatitis C Infection In An Urban Emergency Department, Naseem Ansari

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

Aim: To evaluate the prevalence of previously undiagnosed hepatitis C virus and associated patient risk factors in an urban ED through a universal, integrated screening program, to contextualize results found in terms of gaps in existing HCV screening models and to inform future sustainable and effective screening models.

Methods: ED patients, ages 18-71, that were medically stable, hadn’t had a prior HCV test, and were having blood drawn as part of routine clinical care, were offered (n=2,726) an anti-HCV test, of whom 1,945 accepted. An assessment of correlates to anti-HCV positivity was completed using a binomial logistic regression …

Determinants Of An Individual's Suicide Intention In South Korea, Nam Keun Choi

MPA/MPP/MPFM Capstone Projects

This study has examined a variety of variables that influence an individual’ s suicide intention, and analyzed the impact of these variables. The data are from the 2014 wave of the Korea Welfare Panel Survey (KoWePS). I analyze data on 13,687 out of 17,134 survey participants.

The dependent variable of my study is suicide intention such as suicidal thoughts and behaviors. The independent variables are classified into three categories: socio-demographic, psychological and mental health. Socio-demographic variables are gender, age, education, marital status, and income. Psychological variables are self-esteem, satisfaction with life, and religion. Mental health variables are depression, alcohol use, …

Is There A Trade-Off? Infant Health Outcomes And Managed Care Competition, Shana L. Moore

Theses and Dissertations--Public Policy and Administration

This study offers insights into the impact of competition among Managed Care organizations (MCOs) on infant birthing charges and birth outcomes. Kentucky provides one of the nation’s first case studies to determine successes and failures of Medicaid MCOs, and by doing so, provides a prediction of the impact of Patient Protection Affordable Care Act (PPACA) competition on healthcare costs and birth outcomes. An analysis of a natural policy experiment in the state of Kentucky reveals that infants insured by a Medicaid MCO stay longer in hospitals, are less healthy, and cost more than those insured under Traditional Medicaid prior to …

Making Health A Priority: Constrained Choices At The Grocery Store, Christy F. Brady

Theses and Dissertations--Sociology

Mounting evidence of the deleterious health effects of poor diet, obesity, and correlated conditions underscore the need to understand how social factors influence food choices. A variety of factors contribute to the diets that Americans consume including limited time, limited income, lack of cooking skills, food deserts, and cheap, convenient foods in abundant portions in grocery stores and restaurants. These contextual factors serve as constraints that impact an individual’s ability to prioritize health when shopping for food. Using the three paper dissertation format, this project will utilize a Constrained Choice Theory (CCT) framework to investigate sociodemographic trends in priorities in …

Documentation Of Smoking History And Adherence To The Uspstf Recommendation For Lung Cancer Screening: A Retrospective Chart Review, Laura A. Golden

DNP Projects

Purpose: The purpose of this project was to evaluate provider compliance with documentation of smoking history and, if criteria met, referral for lung cancer screening as recommended by the United States Preventive Services Task Force in 2013.

Methods: A retrospective chart review was conducted using an electronic medical record (EMR) at a large, rural community family practice clinic. Patients meeting inclusion criteria of having a smoking history (current or past) of 30 pack years, aged 55 to 80 years, and no history of lung cancer diagnosis were included for randomization. One hundred patients were selected from 300 randomized charts; five …

Baseline Of Copd Management In A Norton Healthcare Primary Care Clinic, Angela Goldring

DNP Projects

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the United States (U.S), with rates in Kentucky among the highest in the nation. Quality care in the primary care setting is key to optimizing the health outcomes of those with COPD.

Purpose: The objective of this study was to establish a baseline of COPD patient care in a primary care clinic. The specific aims of this study were to: 1) describe the demographic and health-related characteristics of patients with COPD who have a primary care provider (PCP) at one Norton Healthcare primary care clinic; 2) …

An Evaluation Of The Screening And Management Of Childhood Overweight And Obesity In The Primary Care Setting, Diane L. Crutcher

DNP Projects

Background: Worldwide, the World Health Organization (2016) estimates that forty-two million children from two to five years of age are overweight or obese. In the United States, Kentucky ranks sixth for the highest rate of overweight youth in the nation (Partnership for Fit Kentucky, 2009). The long term consequences of overweight and obesity are early onset of adult chronic diseases as well as social and psychological issues in childhood and adulthood.

Purpose: The objective of this gap analysis was to assess BMI screening and weight management of children ages two to five who presented for a well-child check …

Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.

Methods: We follow a longitudinal cohort of …

Estimated Probability Of Becoming Alcohol Dependent: Extending A Multiparametric Approach, Olga A. Vsevolozhskaya, James C. Anthony

Biostatistics Presentations

Background: United States (US) epidemiological studies suggest that for every 5-8 who start drinking alcoholic beverages, at least one drinker will develop an alcohol dependence (AD) syndrome within the first 10 years after onset of drinking (Lopez-Quintero et al., 2011; Wagner & Anthony, 2002). Recently, we described a multiparametric functional analysis approach for new research to estimate these transition probabilities with a one-dimensional function (1D; Vsevolozhskaya & Anthony, 2015). Here, we demonstrate extension of this analysis to two-dimensional (2D) functions that combine information about number of recent drinking days and number of drinks on the typical drinking day.

Methods: Data …

Individual Responses For Muscle Activation, Repetitions, And Volume During Three Sets To Failure Of High- (80% 1rm) Versus Low-Load (30% 1rm) Forearm Flexion Resistance Exercise, Nathaniel D. M. Jenkins, Terry J. Housh, Samuel L. Buckner, Haley C. Bergstrom, Kristen C. Cochrane, Cory M. Smith, Ethan C. Hill, Richard J. Schmidt, Joel T. Cramer

Kinesiology and Health Promotion Faculty Publications

This study compared electromyographic (EMG) amplitude, the number of repetitions completed, and exercise volume during three sets to failure of high- (80% 1RM) versus low-load (30% 1RM) forearm flexion resistance exercise on a subject-by-subject basis. Fifteen men were familiarized, completed forearm flexion 1RM testing. Forty-eight to 72 h later, the subjects completed three sets to failure of dumbbell forearm flexion resistance exercise with 80% (n = 8) or 30% (n = 7) 1RM. EMG amplitude was calculated for every repetition, and the number of repetitions performed and exercise volume were recorded. During sets 1, 2, and 3, one …

Editorial: Leading People - Managing Organizations: Contemporary Public Health Leadership, James W. Holsinger Jr., Erik L. Carlton, Emmanuel D. Jadhav

Preventive Medicine and Environmental Health Faculty Publications

Effectively leading people engaged in the practice of public health has never been more critical than in the early years of the twenty-first century. Likewise, effectively managing the organizations in which these individuals practice the various professional disciplines of public health has become increasing important and difficult. Taken together, leading the people and managing public health organizations requires well educated and appropriately trained public health leaders and managers. Although leadership is often viewed as one of the key attributes of management, not every great manager will be a great leader and vice versa. While some leaders may be born with …

Accounting For Indirect Costs In Public Health Cost Analyses, Melanie D. Whittington, Adam Atherly, Lisa Vanraemdonck

Frontiers in Public Health Services and Systems Research

Background. There is a gap in research regarding the resources needed to deliver public health activities, which inhibits informed decision making around investments in public health and the allocation of funds among activities. When conducting cost analyses in public health, it is important to include costs from all cost components, including personnel, non-personnel, and indirect costs. However, defining, identifying, and measuring indirect costs is challenging and can impede studies of this type. Purpose. The purpose of this pilot study is to create a catalog of the methodologies public health researchers have used to account for indirect costs. Methods. We surveyed …

Assessment Of Quality Improvement In Ontario Public Health Units, Madelyn P. Law, J. Ross Graham, Erica Bridge

Frontiers in Public Health Services and Systems Research

Background: Quality Improvement (QI) approaches are used extensively in healthcare settings and increasingly in public health. However, the proliferation of QI in Canadian public health settings is unknown.

Purpose: The purpose of this study was to (a) assess the QI maturity in Ontario local public health units in Canada, and (b) to determine the relevance of the QI Maturity Tool in a Canadian setting

Methods: The QI Maturity Tool (Version 5) was used to conduct a cross-sectional assessment of the QI maturity of 36 local public health units in Ontario, Canada. After tool items were reviewed for relevance, individuals most …

Cross-Sector Partnerships And Public Health: Challenges And Opportunities With The Private Sector, Lee Johnston, Diane Finegood

Frontiers in Public Health Services and Systems Research

Over the past few decades, cross-sector partnerships that include the private sector have become an increasingly accepted practice in public health, particularly in efforts to address infectious disease in low and middle income countries. Now they are becoming a popular tool in efforts to reduce and prevent obesity and the epidemic of non-communicable disease. Partnering with business presents a means of acquiring resources, as well as opportunities to influence the private sector toward more healthful practices. Collaboration is a core principle of public health practice; however public-private or non-profit-private partnerships present risks and challenges that warrant specific consideration. In this …

Speaking The Language Of The Decision-Makers, Angela Carman Drph

Frontiers in Public Health Services and Systems Research

In a system experiencing dwindling resources, public health practitioners must be able to explain their goals, services, and impact via terms and concepts understood by policymakers, governmental representatives, and community members. The use of concepts such as private sector partnership development, quality improvement, expense management, and cost analysis can provide public health practitioners means for growth and improvement, as well as the ability to communicate value to decision makers.

Estimating Health & Economic Gains From Public Health Delivery System Transformation, Glen P. Mays

Health Management and Policy Presentations

Objectives: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, which we use as indicators of public health system change; and (2) the effects of these changes on preventable mortality and resource use. Methods: …

Short-Term, High-Fat Diet Accelerates Disuse Atrophy And Protein Degradation In A Muscle-Specific Manner In Mice, Steven L. Roseno, Patrick R. Davis, Lance M. Bollinger, Jonathan J. S. Powell, Carol A. Witczak, Jeffrey J. Brault

Kinesiology and Health Promotion Faculty Publications

BACKGROUND: A short-term high-fat diet impairs mitochondrial function and the ability of skeletal muscle to respond to growth stimuli, but it is unknown whether such a diet alters the ability to respond to atrophy signals. The purpose of this study was to determine whether rapid weigh gain induced by a high-fat (HF) diet accelerates denervation-induced muscle atrophy.

METHODS: Adult, male mice (C57BL/6) were fed a control or HF (60 % calories as fat) diet for 3 weeks (3wHF). Sciatic nerve was sectioned unilaterally for the final 5 or 14 days of the diet. Soleus and extensor digitorum longus …