Public Health Commons^™

Breast Health And Access To Care In The Kentucky Women's Health Registry, Sarah Yeiser

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

Breast cancer is the second leading cause of death (14%) among all cancers in women in Kentucky.1 In 2010 the United States incident rates of breast cancer in white women were 122.6 per 100,000, and 118 per 100,000 in black women.2 Although breast cancer is diagnosed more in white women, black women are more likely to die from breast cancer and usually have more advanced stages of breast cancer upon diagnosis.2 In Kentucky from 2003-2007 the age-adjusted breast cancer mortality rate was 23.6 per 100,00 in white women and 32.8 per 100,000 black women. Black women die from breast cancer …

The Effect Of Television Watching On Condom Use Among 9th-12th Graders, Rashidat Mohammed

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

Abstract: At least one out of every three youth will acquire a Sexually Transmitted Infection (STI) by the time they reach 25 years old. Although this may be caused by a variety of factors, sexually-charged media are believed to play a significant role. In television, there are more sexually inaccurate messages than there are portrayals of sexually responsible behaviors. These messages are not only unrealistic, but they could potentially have negative effects on adolescent sexual behavior. Among these negative effects is failure to use condoms. When used correctly, male condoms are about 98% effective. Recommendations are presented to help address …

Improvement Of Tobacco-Free Policy Enforcement At The University Of Kentucky, Muchen Bai

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

Smoking has been known as the leading preventable cause of death and premature disease in the United States (DHHS, 2014). Every year, cigarette smoking causes more than 480,000, approximately, one in five deaths (DHHS, 2014). According to the Centers for Disease Control and Prevention (CDC), "smoking causes more deaths each year than all of the listed combined: Human immunodeficiency virus (HIV), Illegal drug use, Alcohol use, Motor vehicle injuries, and Firearm-related incidents" (CDC, 2014). Since 1964, 31 Surgeon General's Reports have revealed the causal relationship between health outcomes and tobacco smoke exposure (DHHS, 2014). The report, The Health Consequences of …

Association Between Co-Sleeping And Breastfeeding: Does Prenatal Care Make A Difference?, Brynne Kathleen Adams

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

Prenatal care is important to ensure a healthy pregnancy for both a woman and her baby. According to the Mayo Clinic, prenatal care should start as soon as there is a positive pregnancy test and should continue throughout the pregnancy.1 The more prenatal care visits a woman attends, the more opportunities to detect potential problems and offer health education materials to help ensure a healthy pregnancy. Prenatal care visits are also used to discuss what may happen after the woman delivers particularly early infant care and breastfeeding. Mothers who do not receive adequate prenatal care are three times more likely …

The Relationship Between Perceived High Levels Of Stress And Non-Condom Usage Among College Students At The University Of Kentucky, Samantha Bearman

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

Introduction: Due to the paucity of research that specifically examines the non-use of condoms, during sexual encounters, as a maladaptive coping strategy for stress among college students; the purpose of my study, is to determine if there is an association between perceived high levels of stress and the decreased likelihood of condom use during sex among students at the University of Kentucky. Method: The cross-sectional descriptive study investigated health behaviors and attitudes towards health behaviors in a sample of 7,000 University of Kentucky students enrolled in courses for fall 2013. Participants were randomly selected to partake in an anonymous online …

Impact Of Routine Immunization Coverage In Controlling Measles And Progressing Toward The Introduction Of Rubella Containing Vaccine: A Comparison Study Between Rwanda And Uganda, Carmen Kupangi Dibaya

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

Despite the existence of safe and effective vaccines, measles and rubella present a major public health problem in many developing countries, disproportionally affecting low-income populations.1-3 Indeed, measles and rubella remain two of the leading causes of death and congenital defects in children worldwide.4-6 In 2008, an estimated 10 million new cases and 164,000 deaths were reported from measles alone.3 During the same time period, the United Nations International Children's Emergency Fund (UNICEF) reported an estimated 110,000 cases of Congenital Rubella Syndrome (CRS) in developing countries, with the continent of Africa shouldering 38% of the disease burden.7 Measles is a highly …

An Evaluation Of Three Positive Parenting Practices And Their Combined Impact On Developmental, Social, Or Behavioral Delays In Children Ages 1-5 In The United States, Sarah Cprek

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

Objectives: (1) Determine whether three individual positive parenting practices (PPP) – reading to children, engaging in storytelling or singing, and eating meals together as a family – decrease the risk of developmental, behavioral, or social delays among children between the ages of 1-5 years in the United States. (2) Determine if a combination of these parenting practices has an additive effect on the outcome. Methods: Multiple logistic regression and chi-square analyses were used to analyze data from the National Survey of Children’s Health 2011/2012 in regards to the relationship between each of the three individual PPP as well as a …

Distribution Of Wildlife Rabies In Central Appalachia And Analysis Of Factors Influencing Human Exposure, Sara J. Reilly

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

Abstract Background: The rabies virus is a Lyssavirus of the family Rhabdoviridae which affects all mammals and causes progressive encephalomyelitis that is fatal in nearly one hundred percent of untreated cases. In the United States, wildlife act as the primary reservoir for rabies and prevention, surveillance, and control costs remain high. The purpose of this study is to understand the current distribution of wildlife rabies in Central Appalachia, as well as identify any demographic or geographic factors which may affect the risk of human exposure at the county level. Methods: A spatial statistical analysis using StatScan was performed to identify …

Narrative And Qualitative Analyses Of Workers' Compensation-Covered Injuries In Short-Haul Vs. Long-Haul Trucking Industries, Mark D. Chandler

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

ABSTRACT

Problem: Trucking transportation remains one of the most dangerous industries in the US. The aims of the current study were to (1) identify and characterize differences in injury types between workers in short-haul and long-haul trucking; (2) analyze and code narrative text to identify and characterize the on-the-job activities associated with injuries within each trucking industry group; and (3) identify areas for targeted improvement of safety interventions. Method: Quantitative and narrative analyses of 2012 Kentucky short-haul and long-haul truck transportation workers’ compensation first reports of injury and narrative text data were performed. Chi-square tests assessed differences in demographics, injuries, …

Examination Of The Prevalence And Mediating Factors Of Diabetes Diagnoses In Kentucky Women With A History Of Gestational Diabetes, Courtney Danielle Ryan

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

Diabetes mellitus (DM) is an overwhelming health issue in the United States affecting 25.8 million people, which is equivalent to 8.3% of the population.1 It is the seventh leading cause of death and a major cause of serious complications such as heart disease, stroke, kidney failure, nontraumatic lower limb amputations, and new causes of blindness among adults in the U.S.1 Paralleling the obesity epidemic, the rates of DM incidence and prevalence continue to rise each year.2 One particularly troubling public health issue related to DM is that over a quarter of the people who have this disease are unaware, even …

Connecting The Supply And Need For Buprenorphine Treatment In Kentucky Counties, Ellen Lavonne Parker

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

Abstract Background: Prescription opioid drug overdose mortality rates have surpassed those of motor vehicle accidents in Kentucky. While opioid overdose plagues the state, buprenorphine is an FDA approved medication that has proven effective in treating opioid dependence. Objectives: This study examined the supply of licensed buprenorphine providers and community treatment centers in each county of Kentucky along with the need for treating opioid use disorder in each county. Methods: Licensed buprenorphine physicians and community treatment centers prescribing buprenorphine were identified through the Substance Abuse and Mental Health Services Administration online treatment locator. The need for treatment was measured by calculating …

Study On Private Health Insurance Coverage For Adults Under 65: 34 States From 2003 To 2010, Weisheng Gu

MPA/MPP/MPFM Capstone Projects

Objectives: The analysis in this paper is designed to find out what factors contributed to the change of uninsured rate of people aged between 18 and 65 from 2003 to 2010.

Method: A fixed-effect analysis with panel data is conducted. The analysis unit is state. The main independent variable is the private health insurance cost per enrollee per year. The private insurance cost data covered 34 states sampled in Medical Expenditure Panel Survey from 2003 to 2010.

Key finding: The private insurance cost per enrolled adult below 65, private insurance cost per enrolled adult below 65 as a proportion of …

Social Networks, Drug Use, And Drug Abuse Help-Seeking: A Test Of The Network Episode Model Among African American Women, Erin L. Pullen

Theses and Dissertations--Sociology

Untreated substance use disorders are a major public health concern that has costly consequences at both the societal and individual level. Identifying the characteristics and resources of those who seek help for substance abuse problems in order to inform more effective intervention and treatment techniques is therefore an important research objective. Using the Network Episode Model (NEM) as a theoretical framework, this dissertation examines both substance abuse help-seeking (i.e. inpatient/outpatient treatment and 12-Step meeting attendance) and patterns of drug use over time among low-income African American women, with a special focus on the role of the social network system in …

The Public Health Pbrn Program: A Summative Report, Center For Public Health Systems And Services Research

UKCPHSSR Research Briefs and Reports

This program seeks to expand the volume and quality of evidence on how best to organize, finance, and deliver public health services by: (1) helping to organize and develop practice-based research networks (PBRNs) comprised of public health agencies and skilled research institutions; (2) selecting grantees to receive funding and technical assistance for PBRN research projects; and (3) facilitating the successful development, implementation, and translation of research projects through PBRNs by providing technical assistance, fostering peer learning, and leading selected multi-network research activities.

Evaluating Quality Improvement To Improve Hiv Reporting, Nandi A. Marshall, William C. Livingood, Angela Peden, Gulzar H. Shah, Russ Toal, Dayna Alexander, Alesha Wright, Sandra Jump, Shelby Freeman, Kay Davis, Lynn Woodhouse, Kellie Penix

Frontiers in Public Health Services and Systems Research

The incorporation and evaluation of Quality Improvement into Georgia’s public health systems continues to be a focus of the Georgia Public Health Practice Based Research Network. This report describes the process, preliminary results and lessons learned from incorporating Quality Improvement into one of Georgia’s public health districts.

Online Social Networks To The Rescue: Fulfilling The Ten Essential Public Health Services, Melanie D. Mason, Maureen P. Bezold

Frontiers in Public Health Services and Systems Research

Budget cuts and shortages in the public health workforce have contributed to the reduction of public health services in 91% of state health departments (SHDs). To adjust for these changes, health departments must discover novel ways to deliver essential public health services to their constituents. Researchers conducted a retrospective analysis of the content published on SHDs’ Twitter pages to determine if online social networks were used to fulfill the ten essential public health services. While 42 SHDs had a Twitter page, the volume and content of tweets varied. Although tweets were posted that related to all ten of the essential …

Efficiency In Public Health Service Delivery: An Analysis Of Clinical Health Services Provided By Local Health Departments In Florida, Simone R. Singh

Frontiers in Public Health Services and Systems Research

The ability of local health departments (LHDs) to provide public health services to improve the health of their communities depends to a large extent on their financial resources. More money by itself, however, does not necessarily translate into better population health. LHDs also have to use their resources in an efficient manner to achieve the best possible outcomes. This article first describes two techniques that LHDs can use to assess their efficiency at providing public health services: process costing, a technique used by management accountants, and stochastic frontier analysis, a technique used by economists. Using data for LHDs in Florida, …

Evidence Use In New York City Public Health Policymaking, Miriam J. Laugesen, Kimberley R. Isett

Frontiers in Public Health Services and Systems Research

New York City Mayor Michael R. Bloomberg has attracted national attention for his public health policy reforms. The policy process behind the reform program has received less scrutiny, especially the use of research by policymakers. We show that the process used to develop, promote, and evaluate polices is heavily based on five types of data and research. New York Department of Health and Mental Hygiene staff conducted in-depth appraisals of existing published research, used local health surveys and private laboratory surveillance data, engaged in “shoe-leather” field research, formed research collaborations within and outside government, and disseminated research to legitimize policy …

Commentary: Moving Beyond The Numbers, Effectively Using Research To Influence Policy, F. Douglas Scutchfield, Marylou Wallace

Frontiers in Public Health Services and Systems Research

This seventh issue of Frontiers reflects the variety of PHSSR. One emerging theme, however, is the notion of public health and its role in policy and policy development. PHSSR focuses on several potential users, researchers, practitioners and policy makers. As it concerns policy makers, PHSSR delivers research that allows them to make decisions about policy change that not only influences public health status, but creates healthy conditions. In this way, PHSSR essentially influences decisions about support for public health services.

Initial Impact Of Tailored Web-Based Messages About Cigarette Smoke And Breast Cancer Risk On Boys' And Girls' Risk Perceptions And Information Seeking: Randomized Controlled Trial, Chris G. Richardson, Laura L. Struik, Kenneth C. Johnson, Pamela A. Ratner, Carolyn Gotay, Jasmina Memetovic, Chizimuzo T.C. Okoli, Joan L. Bottorff

Nursing Faculty Publications

BACKGROUND: Recent evidence indicates a causal link between both active smoking and secondhand smoke (SHS) exposure and breast cancer (BC).

OBJECTIVE: The objective of the present study was to evaluate the initial reactions of girls and boys to tailored Web-based messages that describe the relationship between SHS and BC, using a parallel, single-blinded cluster randomized controlled trial.

METHODS: This trial was nested within a cycle of an ongoing longitudinal study of 1498 students from 74 secondary schools. Self-reported assessments were used to evaluate the impact of study messages on participants' risk perception and interest in obtaining additional information after participants …

The National Longitudinal Survey Of Public Health Systems: Selected Findings And Applications, Glen P. Mays

Health Management and Policy Presentations

This presentation reviews the National Longitudinal Survey of Public Health Systems and its applicability for monitoring the effects of the Affordable Care Act on public health delivery within the U.S.

Public Health Research Implementation And Translation: Evidence From Practice-Based Research Networks, Glen P. Mays, Rachel A. Hogg, Doris M. Castellanos-Cruz, Anna G. Hoover, Lizeth C. Fowler

Health and Clinical Sciences Faculty Publications

BACKGROUND: Research on how best to deliver efficacious public health strategies in heterogeneous community and organizational contexts remains limited. Such studies require the active engagement of public health practice settings in the design, implementation, and translation of research. Practice-based research networks (PBRNs) provide mechanisms for research engagement, but until now they have not been tested in public health settings.

PURPOSE: This study uses data from participants in 14 public health PBRNs and a national comparison group of public health agencies to study processes influencing the engagement of public health settings in research implementation and translation activities.

METHODS: A cross-sectional network …

Occupational Injuries On Thoroughbred Horse Farms: A Description Of Latino And Non-Latino Workers' Experiences, Jennifer E. Swanberg, Jessica M. Clouser, Susan C. Westneat, Mary W. Marsh, Deborah B. Reed

Health, Behavior & Society Faculty Publications

Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries. However, limited known research has examined the experiences of the industry's workers, including immigrant workers, despite their prominence and increased vulnerability. Using data collected from thoroughbred farm representatives via a phone-administered survey, a 2-hour face-to-face semi-structured interview, and farm injury logs, this article identifies …

Estimating The Costs Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medicine recommended in 2012 that the federal government undertake work to identify the components and costs of a "minimum package" of public health programs, services, and capabilities that should be available in every American community. This presentation summarizes work that is currently underway through the Robert Wood Johnson Foundation-supported Public Health Practice-Based Research Networks (PBRN) Program to estimate the costs of public health delivery.

Truck Driver Dies When Tractor-Trailer Leaves The Road And Plunges Into A Creek-Bed, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the early morning hours of a fall day, exact time unknown and the length of time driving unknown, a 28-year-old male truck driver was driving north on an interstate transporting 30,000 lbs. of blue plastic injection molding pellets. The truck driver exited the highway behind a guardrail and traveled 1,320 feet, striking a wire fence and several trees before plummeting into a creek bed, shearing the cab open. At 10:27 a.m., a citizen called in to the fire department to report a mysterious blue substance observed in the creek a couple of miles down from the accident. The fire …

New Health Delivery Networks: Merging Public Health And Health Care Systems, Glen P. Mays

Health Management and Policy Presentations

Incomplete coordination between medical care and public health delivery systems can result in significant missed opportunities for improving population health and constraining overall resource use. This lecture uses insight from the field of public health services and systems research (PHSSR) to examine: (1) why medical care and public health systems often fail to connect; (2) what are the potential health and economic consequences of these failures; and (3) what are the opportunities for connecting medical care and public health delivery to improve population health.

Recessions, Risks And Reforms: Changes In Inter-Organizational Activities To Improve Public Health, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new incentives for hospitals, insurers, employers, public health agencies, and others to contribute to activities designed to promote health and prevent disease an injury. At the same time, the economic recession has constrained government and private sector spending on health and health care, necessitating changes in the scope and scale of public health delivery. This study uses data from the 1998-2012 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, with a focus on hospitals, insurers, employers, and primary …

Who Benefits From Public Health Spending And How Long Does It Take: Estimating Community-Specific Spending Effects, Glen P. Mays

Health Management and Policy Presentations

Objectives: Spending on public health and prevention strategies varies widely across states and communities. The Patient Protection and Affordable Care Act of 2010 (ACA) authorized the largest expansion in federal public health spending in decades, with the goals of improving population health and helping to moderate growth in medical care spending. To produce evidence needed to inform these investments, this study (1) estimates the effects of public health spending patterns within communities on preventable mortality and subsequent medical care spending; and (2) uses the methods of local instrumental variables developed by Heckman and Vytlacil and Basu to estimate how the …

Update On Public Health Financing & Economic Studies From The Phssr And Pbrn Programs, Glen P. Mays

Health Management and Policy Presentations

As part of the Public Health Financing Roundtable at APHA, this session provides an update on public health financing and economics studies underway through the Public Health Services and Systems Research (PHSSR) Program and the Public Health Practice-Based Research Networks (PBRN) Program, supported by the Robert Wood Johnson Foundation.

Arborists Die After Falling, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To Prevent Arborists Injuries:

• Never allow an aerial lift to be used as a crane or material lifting device.
• All trees and limbs should be inspected for structural weakness such as rot, before work starts.
• Arborists should wear appropriate personal protective equipment while performing tree trimming activities.

Special Factors for Aerial Lifts:

• Do not exceed the boom and basket load limits specified by the manufacturer.
• When working from an aerial lift, use a body harness that is properly attached.