Public Health Commons^™

Teeka Tehreek: Increasing Epi Vaccinations In Khyber Pakhtunkhwa, Pakistan, Narjis Fatima Hussain

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

Abstract

Globally, Pakistan ranks third among countries with the most unvaccinated and under-vaccinated children. Within the country, there are huge regional disparities, and the Khyber Pakhtunkhwa region (KPK FATA) has one of the lowest vaccination rates in the country. Low vaccination rates contribute to the high burden of childhood infectious diseases in Pakistan that cause 70% of childhood deaths. Addressing the issue requires an understanding of the barriers towards vaccinations; 30% of refusals are due to religious reasons and other misconceptions that are compounded by low literacy rates. Since religion has a critical authority in shaping the population’s beliefs, attitudes, …

Nurse Home Visitation Program In Hamilton County, Oh To Increase Maternal And Child Health Outcomes, Hannah Widner

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

Hamilton County Ohio currently has poor outcomes related to maternal and infant health, specifically among African Americans. Compared to the Healthy People 2020 goals, Hamilton County has higher rates of infant mortality, preterm birth, neonatal infant mortality, and conception within 18 months of previous pregnancies. These rates are disproportionate among African Americans. For instance, African American babies born in Ohio have higher infant mortality rate (14.3 per 1,000) prematurity as a cause of death (4 per 1,000) and neonatal mortality rate (9.2 per 1,000). These are compared to White babies in Ohio with infant mortality rate (5.1 per 1,000), prematurity …

Implementing The Mothers And Babies Program To Reduce Preterm And Low Birth Weight Deliveries, Tan Frison

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

Georgia ranks fourth (4th) in the nation for the highest low birth weight rate at 10%, and sixth (6th) in the nation for preterm birth rate at 11.7%, among the states. Based on statistical data Bulloch county has maintained an average low birth weight statistic of 10% for over a decade. In 2019, there were 107 preterm and 79 low weight births in Bulloch county, Georgia. These numbers confirm there is a need for more preventive resources for mothers and children within this community. To address this burden, the Bulloch County health department has decided to implement the Mothers and …

Farmer Suicide: Rates, Trends, And Associations To Commodity Production Among States Reporting Violent Deaths, 2003-2017, Paul Norrod

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

Occupational studies show that farmers are at higher risk for suicide with rates at least two-fold those of the U.S. population.2-4 Therefore, the purpose of this study was to (1) determine age- and sex-specific farmer suicide rates, (2) evaluate rate trends, and (3) assess the relationship between commodity production and farmer suicide using the National Violent Death Reporting System (NVDRS) and quinquennial Census of Agriculture. We identified 1,652 farmer suicide cases from the NVDRS. Age-specific rates showed the highest rates among male farmers over 64 at 14.03 per 100,000. Annual rates for the 15-year study period peaked during 2013 at …

Recovery Housing In The United States And The Importance Of Data Collection, Maanasa Manchikanti

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

Substance use disorder (SUD) has been a prevalent issue in both the clinical and public health sectors for some time. Substance use disorder can be defined as a disease that affects an individual’s brain and behavior, causing them to develop an inability to control the use of legal or illegal drugs and substances (Mayo Clinic, 2021). Substances include but are not limited to alcohol, marijuana, opioids, and other controlled substances (Mayo Clinic, 2021). Substance misuse is a large topic of focus in public health because it not only deteriorates the quality of health in individuals and society, but also comes …

Rates Of Diabetes Screening In Kentucky Before And After Implementation Of The Affordable Care Act (Aca), Cory Reinert

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

Diabetes mellitus, commonly referred to as “diabetes”, is currently at epidemic proportions in the United States as its prevalence has drastically increased over the past several decades. The percentage of Americans with diagnosed diabetes has risen from 0.93 percent of the population in 1958 to 10.5 percent in 2018 (ADA, 2021). Diabetes also impacts record numbers of Kentucky residents.

Regular screening for those considered at-risk can encourage patients to implement lifestyle modifications, pharmacological therapy, or other interventions earlier in the course of disease. This can help prevent or delay onset of T2D and can reduce diabetes-related complications in those who …

Implementing The Textme Cardiovascular Mobile Health Intervention In Detroit, Michingan, Melissa Horton

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

Cardiovascular disease is currently the leading cause of death in the United States. One of the cities with the highest rates of cardiovascular disease is Detroit, Michigan. Those diagnosed with cardiovascular disease are encouraged to make lifestyle modifications to improve their health. However, if cardiovascular disease is not managed, it can lead to serious health outcomes such as stroke, heart disease, and death. The TEXTMe program is designed to send randomized text messages to participants to encourage lifestyle changes around diet, exercise, and smoking cessation. Participants in the program will be recruited from three health clinics located in the city …

The Impact Of The 2018 Kentucky Cigarettes Taxes On Tobacco Use Among Youth, Claire W. Mampunza

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

Introduction: In the Commonwealth of Kentucky, cigarette smoking results in 1.92 billion dollars spent every year on medical costs, the death of approximately 9,000 Kentuckians, and 34 percent of all cancer cases. In 2017, 14.3 percent of high school students in Kentucky declared being current cigarette smokers, compared to 8.8 percent nationally. Tobacco use among youth is a public health concern because 88 percent of adult smokers initiate smoking before age 18. Youth nicotine use can damage the growing brain, which continues to develop until 25 years of age. In July 2018, the excise tax on cigarettes increased from …

Covid Mitigation Strategies And Safety Perceptions Among Workers During Spring 2020 Shutdown, William Mciver

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

A novel coronavirus pandemic radically shifted the working environment of the population in the United States in the spring of 2020. Studies have examined the difference between healthcare workers and the general population, but there exists a gap when looking at mitigation strategies between healthcare workers and other workers that continued working outside the home. This study surveyed workers and asked about employment status, employment field, COVID safety precautions taken in the workplace, and feelings of safety. This study examined that and found statistically significant differences in the mitigation strategies used by healthcare workplaces and all other non-healthcare workplaces. This …

Educational Intervention To Change Knowledge And Attitudes Regarding Sexual Behaviors To Reduce Rates Of Sexually Transmitted Infections Among University Of Kentucky’S Sorority Life Students., Julianna Maita

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

Sexually transmitted infections disproportionally affect young adults. Within this age group, women are at an increased risk for contracting and STI and face more severe long-term adverse consequences than men. College aged individuals are at an increased risk for contracting an STI due to risky sexual behaviors such as unprotected sex with multiple partners. College students involved in Greek Life have been found to engage in risker sexual behaviors than non-Greek life students. These individuals perceive themselves to be at a higher risk for contracting an STI and have an increased number of unprotected sexual encounters under the influence of …

Adverse Childhood Experience And Undergraduate Student Success: A Longitudinal Investigation Into The Relationship Between Childhood Stress And Success In Higher Education, Sarah E. Cprek

Theses and Dissertations--Educational Policy Studies and Evaluation

Institutions of higher education have long worked to understand factors that influence or predict student success and degree completion. Childhood experiences including potential exposure to toxic stress have been found to impact student success in K-12 schools yet have rarely been evaluated among undergraduates. Therefore, the purpose of this study is to investigate the relationship between Adverse Childhood Experiences (ACEs) and undergraduate degree completion among a random sample of 1,894 students at a state-funded university in the US. Participants completed a web-based survey assessing ACEs in spring 2015. Results from the survey were linked to student academic records for each …

Understanding Perspectives Of Clinical And Non-Clinical Healthcare Administrators On Culture And Diversity In The Healthcare Workplace, Katherine Counts

Theses and Dissertations--Community & Leadership Development

The racial and ethnic composition of the U.S. population is becoming increasingly more diverse. The 2010 U.S. Census reported a 29% increase in minority groups other than non-Hispanic Whites. In response to these changing demographics, healthcare organizations have struggled to keep pace with these trends in their hiring of a diverse staff. Healthcare leaders appear to be lagging in their efforts to make adequate changes to increase diversity in their organizations. What factors may be contributing to this inequity? One possible explanation is a limited knowledge of healthcare leaders regarding culture and diversity within the workplace. To this end, this …

Multiple Proteinopathies And Their Role In Cognitive Impairment And Neurodegenerative Diseases, Shama D. Karanth

Theses and Dissertations--Epidemiology and Biostatistics

Most age-related neurodegenerative disorders are associated with the aggregation of misfolded and aberrant proteins. Alzheimer’s disease (AD) is one of the most common neurodegenerative disorders and is highly prevalent in older adults. Neuropathologically, AD is characterized by the accumulation of amyloid-β (Aβ) plaques and neurofibrillary tangles (NFTs). Other misfolded proteins, including α-synuclein and transactive response DNA-binding protein 43 (TDP-43), are also commonly observed in aged brains. Aberrant α-synuclein has been associated with Parkinson's disease, Dementia with Lewy bodies, and multiple system atrophy, whereas TDP-43 has been associated with multiple neurological diseases, the most common of which was designated as limbic-predominant, …

Enhancing Drug Overdose Mortality Surveillance Through Natural Language Processing And Machine Learning, Patrick J. Ward

Theses and Dissertations--Epidemiology and Biostatistics

Epidemiological surveillance is key to monitoring and assessing the health of populations. Drug overdose surveillance has become an increasingly important part of public health practice as overdose morbidity and mortality has increased due in large part to the opioid crisis. Monitoring drug overdose mortality relies on death certificate data, which has several limitations including timeliness and the coding structure used to identify specific substances that caused death. These limitations stem from the need to analyze the free-text cause-of-death sections of the death certificate that are completed by the medical certifier during death investigation. Other fields, including clinical sciences, have utilized …

Environmental Respiratory Exposures And Pulmonary Function Among Residents Of Rural Appalachia, Kentucky, John C. Flunker

Theses and Dissertations--Epidemiology and Biostatistics

Introduction

Resource extraction exposures are hypothesized to promote adverse respiratory health outcomes among residents of rural Appalachia, yet no studies to date have simultaneously quantified small-scale geographic variation in residential exposure, individual level health factors, and respiratory health outcomes.

Methods

The Mountain Air Project (MAP) is a community engaged cross-sectional study based in Harlan and Letcher counties of Southeastern Kentucky. MAP utilized a novel small-scale method to define residential exposure boundaries: hydrologic unit code (HUC), which represents distinct drainages (AKA “hollows”) where residents cluster. We assigned the HUC level density of active and abandoned surface and underground mining, oil/gas wells, …

Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell

Theses and Dissertations--Family Sciences

The World Health Organization (WHO; 2002) has indicated that sexual violence is a serious public health concern, and both the WHO and the United Nations (UN) have declared that violence against women, in particular, is a profound violation of human rights (UN General Assembly, 1993; WHO, 2017). Although the systemic and negative impact of trauma on family and intimate relationships have been well documented, the empirical literature regarding the effects of adult sexual trauma on relationship satisfaction is less robust. These studies are designed to address this gap and will do so with analyses centered on an understudied population: the …

Equine West Nile Virus In Kentucky: Characteristics Of Historical Testing And Analysis Of Causal Factors, Kaelyn Short

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

As the arbovirus with the highest incidence in both humans and horses in the United States, West Nile Virus (WNV) presents a significant risk to the equine population of Kentucky. Widespread infection has the potential to cause a significant economic impact to the state and long-term health complications for the horses. To better understand the burden of equine WNV, historical diagnostic testing archives the University of Kentucky Veterinary Diagnostic Lab were analyzed along with environmental and census data collected from additional sources. A total of 2146 test results were analyzed utilizing descriptive statistics, chi-square tests of independence, and binary logistic …

Secular Trends In Low Birth Weight And Preterm Birth Disparity Between Infants Born To Teenage And Adult Mothers: An Exploratory Analysis, Elizabeth Edwards

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

Introduction. Increased risk of preterm birth and low birthweight for infants born to teenage mothers (15-19), when compared to infants born to adult mothers (20-29), is well documented in the United States. Trends in preterm birth and low birthweight are also well documented over time. Examination of the difference in incidence of preterm birth or low birthweight between infants born to teenage mothers and to adult mothers over time is not present in the literature. This study aimed to fill this gap in the literature and determine how preterm birth and low birthweight differences have changed over time.

Methods. Natality …

Colorectal Cancer Differences In Staging And Survival: Appalachian And Non-Appalchian Kentuckians, Ripley Lucas

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

Colorectal cancer is the third most commonly diagnosed cancer in the United States. Historically, the Appalachian region of Kentucky has experienced disparities in colorectal cancer screening and survival as compared to both the non-Appalachian region of the state and the United States. The aim of this paper is to investigate the differences in cancer staging and survival after diagnosis in Appalachian and non-Appalachian Kentuckians. The present time period of study is a retrospective, population-based cohort with data taken from the Kentucky Cancer Registry. Binomial logistic regression and Cox proportional hazards models were used to estimate unadjusted and adjusted odds ratios …

Applying Mixed-Effects Modeling To Behavioral Economic Demand: An Introduction, Brent A. Kaplan, Christopher T. Franck, Kevin Mckee, Shawn P. Gilroy, Mikhail N. Koffarnus

Family and Community Medicine Faculty Publications

Behavioral economic demand methodology is increasingly being used in various fields such as substance use and consumer behavior analysis. Traditional analytical techniques to fitting demand data have proven useful yet some of these approaches require preprocessing of data, ignore dependence in the data, and present statistical limitations. We term these approaches “fit to group” and “two stage” with the former interested in group or population level estimates and the latter interested in individual subject estimates. As an extension to these regression techniques, mixed-effect (or multilevel) modeling can serve as an improvement over these traditional methods. Notable benefits include providing simultaneous …

Introduction To Special Issue Of Plant Virus Emergence, Michael M. Goodin, Jeanmarie Verchot

Plant Pathology Faculty Publications

No abstract provided.

Prevalence And Correlates Of Secondary Syringe Exchange (Sse) Among People Who Inject Drugs (Pwid) In Rural Kentucky, Jordan R. Wilson

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

Aim: To describe the prevalence of secondary syringe exchange (SSE) in a sample of syringe service program (SSP) clients in rural Appalachian Kentucky and to identify the correlates of SSE.

Methods: Participants (n=338) completed interviewer-administered questionnaires. Only those who reported having ever exchanged syringes at a SSP (n=140) were included in analysis. SSE was measured through self-report of obtaining syringes for someone else at a SSP in the past 6 months. Prevalence and correlates of SSE were examined using bivariate analysis and multiple logistic regression.

Results: Overall, 30% of participants reported SSE. Participants in the second [aOR= 3.83; 95% CI: …

The Relationship Between Health Insurance Literacy, Health Insurance Coverage, And Health Insurance Utilization In The United States, Elizabeth Graves

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

The Affordable Care Act (ACA) made health insurance more accessible but that does not mean that individuals understand their health insurance or are more confident in using it. The knowledge and confidence that individuals have in health insurance impact their health insurance literacy. Health insurance literacy (HIL) is defined as the ability and capacity to seek, obtain, understand, and potentially use health insurance information and plans.

This capstone study assesses how having HIL, which includes having a knowledge of health insurance terms and confidence in utilizing health insurance services, is related to having health insurance and having a usual source …

Impact Of Smoking And Hpv Status On Cervical Cancer Survival In Women Living In Kentucky, 2004-2005 And 2014-2015, Brittany M. Mckinley

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

BACKGROUND/ OBJECTIVE: Cervical cancer is the fourth most commonly occurring malignancy in women worldwide, with an estimated 530,000 new cases and 270,000 new deaths each year (Small et al, 2017). While the incidence of cervical cancer has decreased by approximately 1.9% per year between 2007 and 2011, the death rate has remained stable (Bernard et al, 2014). Studies have shown that nearly all cervical cancer cases are associated with the Human Papilloma Virus (HPV). Many studies support the association of smoking with increased risk of invasive cervical cancer in women with high-risk HPV (Castle et al, 2002; Fang et al, …

Prevalence And Exacerbation Of Asthma Within Two Counties In Eastern Kentucky, Rachid Souleye

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

Background: Central Appalachia residents have one of the highest rates of serious respiratory diseases in the nation. Appalachian Kentuckians are 50% more likely to be diagnosed with adult asthma compared to the overall U.S. population. Yet, few epidemiologic studies have assessed risk factors for respiratory disease in this population. Using a community-based approach, the investigators of the Mountain Air Project (MAP), one of the largest adult cohorts from two disadvantaged communities in Central Kentucky, collected data to estimate the prevalence of asthma and assess various socioeconomic and environmental risk factors to determine their effect on asthma.

Methods: A cross-sectional epidemiologic …

Impact Of Mental Health And Financial Status Of Essential And Non-Essential Workers That Continued Working Outside The Home During The Spring 2020 Covid-19 Shutdown, Adrianne Deveira

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

Objective: A global pandemic caused businesses in the United States to shutdown based on essential vs. non-essential criteria. There has been a lot of research discussing the impact of the shutdown on healthcare frontline workers. Little is known about other essential and non-essential workers, that continued working outside the home during the shutdown. The purpose of this paper is to examine the financial and mental health issues encountered by essential and non-essential workers that continued working outside the home during the Spring 2020 shutdown.

Methods: Snowball sampling of an online survey that was available from May 8 – June 6, …

Methenamine Prophylaxis For Recurrent Urinary Tract Infections In A Tertiary Referral Center, Cameron A. Wade

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

Purpose: Methenamine hippurate (MH) is a urinary antiseptic, indicated for prophylaxis of recurrent urinary tract infections (UTIs) but with only few and limited studies regarding its efficacy. To help address this knowledge gap we reviewed our experience with MH for UTI prophylaxis, focusing on women with recurrent uncomplicated UTIs.

Materials and Methods: The University of Kentucky electronic health record was queried to identify adults who were prescribed MH from the Urology clinic between January 2013 and January 2019. Charts were reviewed to assess patient-reported UTI frequency, demographics and relevant health factors. Treatment success was defined as 0-1 UTI in 6 …

Injuries Among Distillery Workers: Workers' Compensation First Reports Of Injury, 2010-2019, Mira Hali Mirzaian

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

AIMS: To identify the most frequent type, nature, and cause of work-related injury amongst distillery workers as well as contributing factors to the injurious event in an effort to inform potential intervention.

METHODS: Workers’ Compensation First Reports of Injury (FROI) from the years 2010-2019 (N=974) were obtained. Variables were created for ‘occupational category’ and ‘accident description’ to assist in the elucidation of the injurious event. The Ratchet Circular Scan Test was used to assess seasonal variation in injury. Kernal Density Analysis was conducted to assess rates of injury by calendar year.

RESULTS: Amongst injured distillery workers, 908 of the injuries …

Healthy Living People: A Hiv Transmission Intervention In Four Chicago Communities, Angela Wuerger

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

The transmission of HIV within the city of Chicago has been established as a major health concern: however, the lack of adequate resources has created gaps within current programming available for people living with HIV. Healthy Living People (HLP) is an evidence-based program focused on reducing the transmission of HIV through strengthening adherence to antiretroviral therapy and decreasing number of higher risk sexual encounters. The Chicago Department of Public Health will provide the HLP program, which includes fifteen 90-minute sessions over the course of one year. The HLP program will be offered for people living with

HIV in four Chicago …

Can Treatment Of Social Isolation And Loneliness Reduce Healthcare Utility? An Analysis Of Social Prescribing, Matthew Mattingly

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

The paper focuses on the practice of social prescribing as it is currently implemented through the National Health Service (NHS) of the United Kingdom. Social Prescribing is an emerging healthcare intervention aimed at referring patients to community-based activities. NHS promotes social prescribing as a method of reducing healthcare utilization in chronically ill patients. Current evidence on social prescribing is subject to significant variation and has not supported NHS’s claims. The potential link between feeling of social isolation, loneliness and chronic illness was further investigated through data from the National Social Life, Health & Aging Project (NSHAP). Data was tested for …