Public Health Commons^™

Evaluating Knowledge Of Emergency Procedures For Top Hazards Among Hospital Staff, Aisha Zahid

Capstone Experience: Master of Public Health

Hospitals serve as frontline responders during public health emergencies, but the effectiveness of their response relies heavily on staff awareness and engagement with emergency preparedness training. This capstone project assesses hospital staff’s baseline knowledge of procedures for responding to the top emergency hazards. These hazards were selected based on Nebraska Medicine’s biannual Hazard Vulnerability Analysis (HVA), which identifies fire, severe weather events, and winter storms as high-priority risks requiring consistent staff readiness. Despite the existence of emergency procedures and training materials, literature reveals limited data on staff knowledge of these procedures across different hazards. This study, conducted at a large …

The Road To Regulation: A Literature Review Of The Influences On The Updated Silica Standards, Skye M. Medcraft

Capstone Experience: Master of Public Health

Silica is a hazardous compound that poses a risk to human health resulting from dust creating activities across various industries. Several agencies, including OSHA (Occupational Health and Safety Administration) and MSHA (Mine Safety and Health Administration) have adopted regulatory oversight of silica exposure in the workplace. As more research has been conducted on silica exposure, the health effects are becoming better described, which has led to the creation and updating of exposure regulations to protect worker health. The objective of this literature study is to review the data presented to the Department of Labor and discuss how the factors that …

Acceptability Of Corticosteroid Use In The Treatment Of Infant Bronchiolitis: Utilizing The Theoretical Framework Of Acceptability To Design Research Instruments, Caroline R. Smetanka

Capstone Experience: Master of Public Health

Bronchiolitis is the leading cause of hospitalization among infants under six months, yet treatment remains largely supportive due to clinical guidelines that discourage pharmacologic intervention. Recent research suggests that bronchiolitis is not a uniform condition, and a subgroup of infants (those classified within “Profile A”) may benefit from targeted corticosteroid therapy. However, these treatments remain outside current clinical guidelines, and their successful adoption depends on stakeholder acceptability. This Capstone project developed and refined four data collection instruments- two questionnaires and two interview guides- designed to assess how healthcare providers and caregivers perceive the acceptability of corticosteroid treatment for Profile A …

Utilization Of Tricare’S Childbirth And Breastfeeding Support Demonstration: Access To Lactation Services Among Military Families, Holly Johnson

Capstone Experience: Master of Public Health

In January 2022, the Department of Defense launched a five-year pilot program called the TRICARE Childbirth and Breastfeeding Support Demonstration. This demonstration aimed to cover lactation services for Tricare beneficiaries. This project included an electronic survey and was created and completed by 577 participants. Eligible participants needed to have given birth in the last 24 months and have TRICARE as their primary insurance. Participants completed this survey to help understand if they were aware of lactation benefits, if they utilized the service, and if it improved their breastfeeding experience.

Out of the 577 participants, 485 were eligible for the project. …

Influence Of Food Insecurity On Adolescent Mental Health: A Comprehensive Literature Review, Sarah Foss

Capstone Experience: Master of Public Health

Food insecurity is a growing public health concern with significant implications for adolescent mental health. This literature review provides an overview of current research on the relationship between food insecurity and adolescents’ mental health in the United States. A literature review was completed to identify studies examining the association between food insecurity and anxiety, depression, or attention deficit disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD). Evidence shows that the experience of food insecurity in adolescence is associated with a higher risk of developing or experiencing an exacerbation of anxiety, depression, or ADD/ ADHD. This review utilizes the socioecological model to explain …

Creating Actionable, Culturally Appropriate Interventions From Survey Data: A Community-Driven Capstone Pilot Project, Nicole Placke

Capstone Experience: Master of Public Health

The Community-Driven Capstone Track is a pilot program designed as an alternative to the traditional capstone track. With this track, students are able to engage with community partners through an integrative learning experience. The goal is to address real organizational needs in a way that demonstrates the mastery of foundational and concentration competencies.

Unlike the traditional capstone track, the CDC offers flexibility in both project type and deliverables. Rather than one formal written report, students might produce a series of products or tools. Deliverables are decided collaboratively between the student, community partners, and the faculty committee to ensure they are …

A Literature Review: Back Injuries Affecting Certified Nursing Assistants In Nursing Facilities, Nesta Nsembene-Ntoutoume

Capstone Experience: Master of Public Health

Certified nursing assistants (CNAs) are at a higher risk of back injuries in healthcare, particularly in long-term care settings. This literature review assessed the primary causes of these injuries and the efficacy of current interventions, particularly Safe Patient Handling and Mobility (SPHM) programs. A total of 26 peer-reviewed articles were published between 2014 and 2025, including experimental simulations, cross-sectional and longitudinal studies, quasi-experimental training interventions, and evaluations of SPHM programs. Across the literature, the primary contributors to back injuries included high physical workload, inadequate ergonomic design, limited access to assistive devices, and staff shortage.

Experimental and biomechanical studies have demonstrated …

Infectious Disease Crisis Communication After The Covid-19 Pandemic, Macy Lloyd

Capstone Experience: Master of Public Health

Since the COVID-19 pandemic, the United States has experienced a proliferation of mis- and disinformation, an increasing politicization of health and science, and growing distrust in government, science, and institutions. While these trends present challenges for normal public health communications, during a public health emergency, such as an infectious disease outbreak, these challenges are even more acute. To address challenges at the local level, health departments need plans, products, and tools that adapt health crisis communications to the current media environment and meet community members where they are across the trust continuum. To develop an infectious disease incident communication plan, …

The Effectiveness Of Interventions In Reducing Sexually Transmitted Infections Among African American Adolescents: A Comprehensive Literature Review, Brandy M. Leaver

Capstone Experience: Master of Public Health

In the United States, an estimated 20 million new sexually transmitted infections occur annually, with half of the cases occurring in adolescents. The infection rate among African American adolescents is four times higher than that among white adolescents. Although many types of interventions exist, few are specifically designed for African American adolescents. In conducting this comprehensive literature review and synthesis, I examined the effectiveness of existing interventions in creating behavioral change among African American adolescents by applying the health belief model to interpret and organize the findings. The databases PubMed, Embase, and Google Scholar were searched on October 1, 2025. …

Linking Training To Confidence: A Literature Review On Advancing Nutrition Environments In Child Care Programs, Jeanne M. Vanorsdal

Capstone Experience: Master of Public Health

This comprehensive literature review examined child care nutrition training interventions using the Health Belief Model (HBM) to understand how to increase providers’ ability to serve nutritious food. By analyzing HBM constructs such as perceived severity, benefits, and barriers, the review assessed how training influences provider abilities and identified barriers and facilitators to consistently offering healthy meals and snacks. Studies were 1) published in English; 2) research conducted in the United States; 3) population involved home-based or center-based child care providers caring for children from birth to age 5; 4) articles published from January 1, 2015, to October 5, 2025; 5) …

Reducing Sleep-Related Infant Deaths In Douglas County, Lauren J. Maskin

Capstone Experience: Master of Public Health

Douglas County, including the city of Omaha, covers 339.6 square miles along the border of the Missouri River in Nebraska with a population of 517,110 (https://www.douglascounty-ne.gov/) and is one of seven large urban counties in the state. There are approximately 8,000 infants born in Douglas County annually (Nebraska Vital Statistics Birth Dashboard). The Douglas County Health Department (DCHD), established in 1854, is one of the oldest county health departments in the state and manages multiple public health projects annually. In 2024-2025, a renewed focus for DCHD has been its infant mortality rate (IMR). In 2024, 44 infant mortalities occurred in …

Beyond The Bruise: Understanding Injury Risk Factors Among Livestock Workers In Cattle Feedyards And Animal Handling Farms And Ranches, Rishad Ahmed

Theses & Dissertations

Cattle feeding and livestock production are central to U.S. agriculture and represent some of the most hazardous occupational environments. Workers in feedyards and on cattle farms and ranches face elevated risks of injury due to physically demanding labor, frequent animal handling, and exposure to environmental and ergonomic hazards. Many feedyard workers are Hispanic/Latino immigrants who may experience additional barriers related to language, healthcare access, and job security. Similarly, injury risks among cattle producers are compounded by seasonal workload fluctuations, limited rest opportunities, and psychosocial stressors. Beyond individual impacts, agricultural injuries also pose a substantial economic burden. Recent estimates indicate that …

Symptom Clusters And Their Association With Health-Related Quality Of Life In Pediatric Cancer Survivors After Treatment Completion, Krishtee Napit

Theses & Dissertations

A critical area of cancer research, symptom management, has evolved from focusing on individual symptoms to recognizing the complexity of co-occurring symptoms, commonly referred to as symptom clusters. However, most studies on pediatric cancer symptom clusters have focused primarily on the treatment phase or long-term survivorship, overlooking the early post-treatment period. This dissertation examines the prevalence of multiple symptoms and symptom clusters in pediatric cancer survivors post-treatment; factors associated with the total number of symptoms and symptom clusters; and the association of the total number of symptoms and symptom clusters with health-related quality of life (HRQoL). We developed and tested …

Analyzing Food Access: An Investigation Of Food Insecurity Amongst Latinos In Rural Nebraska, Natalia Santos

Theses & Dissertations

Background: Food insecurity is a public health issue in the United States, with disproportionately higher rates among Latino/Hispanic households. Rural communities face unique geographical, socioeconomic, and systemic barriers that often exacerbate food access disparities. Despite the growing Latino population in rural areas, particularly in Midwestern states like Nebraska, there remains a critical gap in comprehensive research that integrates both objective and subjective understandings of their food environments. Understanding these multifaceted influences is crucial for developing effective, culturally sensitive interventions.

Problem Statement: This dissertation aims to answer the central question: How does food access and food insecurity manifest amongst Latinos in …

The Relationship Between Total Serum Cholesterol And Hypertensive Outcomes Among Women 50-60 Years Old: Findings From The Framingham Heart Study, Sierra Smith

Capstone Experience: Master of Public Health

Objective: To assess whether total serum cholesterol (TSC) among middle-aged women is associated with subsequent hypertension while accounting for potential confounders.

Methods: A sample of 853 adults who identify as women, aged 50-60, from the Framingham Heart Study 1948-1972 cohort was selected for this study. Participants' TSC was measured at baseline, and they were followed for 24 years for cardiovascular disease outcomes or death. The outcome of interest in this study was hypertension. A multivariable logistic regression was used to analyze the relationship between TSC and hypertension while controlling for age, glucose, systolic, and diastolic blood pressure.

Results: Compared to …

Analysis Of The Clinical, Socioeconomic, And Sociodemographic Characteristics Of Virally Unsuppressed Children Aged 2-14 Living With Hiv/Aids In The Region Of Abidjan 2 – Côte D’Ivoire (Region Supported By Usaid), Maman Fathim Kamagate

Capstone Experience: Master of Public Health

Background: Viral suppression among children living with HIV (CLHIV) remains suboptimal in Côte d’Ivoire. This study assessed clinical, socioeconomic, and demographic characteristics associated with viral non-suppression among CLHIV aged 2–14 years in Abidjan 2 to inform targeted interventions under the U.S. Agency for International Development (USAID)-supported Reaching Impact, Saturation, and Epidemic Control (RISE) project.

Methods: A retrospective analysis was conducted using routine program data from 1,203 CLHIV across 73 health facilities. Descriptive, bivariate, and multivariate analyses were performed to examine associations with viral load suppression status. Findings guided the development of a multi-level implementation plan using Kotter’s Change Management Framework, …

Evaluation Of The Zanesville-Muskingum County Ohio’S Mosquito And Tick Disease Vector Control Program, Samantha Wantz

Capstone Experience: Master of Public Health

This project aimed to evaluate the Zanesville – Muskingum County Health Department’s (ZMCHD) Vector Control Program based on performance measures, program indicators, and customer satisfaction. A secondary goal of the project is to evaluate and revise the existing policies and procedures of the program in regards specifically to the safety of the intern. Based on information from the Ohio Department of Health infectious disease dashboard, in the last 10 years (2014-2024) Muskingum County has reported 12 total cases of La Crosse virus, one case of West Nile Virus, and one case of Malaria (Ohio Department of Health, 2024a). ZMCHD has …

Supporting Autistic Students' Mental Wellness: A Community Readiness Model Approach, Cady Walker

Capstone Experience: Master of Public Health

Autism spectrum disorder or difference (ASD) is a lifelong neurodevelopmental disability, usually identified during childhood. However, many adults miss the opportunity for diagnosis during childhood due to previous misunderstandings about autism presentation, camouflaging behaviors, and misdiagnoses. While current diagnostic tools for assessing autism in children are more robust, similar measures are lacking for adults who were not diagnosed in childhood. This gap poses risks for poor mental health outcomes among adults who missed a timely ASD diagnosis, which can be especially challenging for autistic college students. Although some higher education institutions offer support programs for autistic students, most do not, …

Evaluating The Impact Of The Occupation-Centered Intervention Assessment On Client-Centered Care In Inpatient Brain Injury Rehabilitation: A Pilot Study, Vanessa D. Jewell, Katherine Lally, Melinda Schultze, Yongyue Qi, Kendra Schnack, Madeline Mcgill, Rachel Vaughn

Translational Science in Occupation

Background: Occupational therapy practitioners (OTPs) recognize the value of evidence-based practice, however, incorporation of client-centered practice as a component of evidence-based practice is challenging, despite the known advantages. This pilot study evaluated the use of the Occupation Centered Intervention Assessment (OCIA) in increasing practitioner ability to provide client-centered care in inpatient rehabilitation facilities with adults with an acquired brain injury (ABI).

Method: A mixed methods design was employed, using four forms of data collection (OCIA, The Measure of Processes of Care for Service Providers [MPOC], MPOC- Service Providers [MPOC-SP], and interviews) to determine changes in observed and perceived …

Enhancing Diversity In Occupational Therapy Through A High School Internship Program, Alexis M. F. Morin, Brittany Adams, Vianni Gomez

Translational Science in Occupation

Abstract

The United States (US) is projected to become an increasingly diverse nation over the decades ahead, but there is a lack of racial, ethnic, and gender diversity in occupational therapy (OT). While the job outlook for occupational therapy practitioners continues to be strong and is expected to rise, OT education programs are facing enrollment crises nationally. It is crucial for academic programs to develop and implement innovative and methodical strategies to recruit and retain a diverse student body to promote diversity, inclusion, and equity within the profession. To promote diversity, inclusion, and equity in occupational therapy, a university partnership …

Implementation Of An Adolescent Women’S Health And Wellness Education Program, Lauren Acker, Laynee Conner, Jennifer Cera

Doctor of Nursing Practice Projects: College of Nursing

Objectives: The goal of this research study was to provide scientific evidence supporting the importance and effectiveness of implementing a women’s health and wellness education course and its effect on (1) adolescent knowledge of sexual health and hygiene, (2) self-efficacy in menstrual management, and (3) self-empowerment in managing their own reproductive health.

Design: This was a mixed methods pilot study utilizing a pre/post-test single intervention efficacy trial. Quantitative and qualitative data were obtained.

Setting: The setting included two different sites including one outpatient ambulatory obstetrics/gynecology clinic and one community outreach center. Both sites were located within a midwestern metropolitan …

Identification And Preclinical Assessment Of Novel Therapeutic Modalities In Environmental Exposure-Induced Lung Disease, Aaron D. Schwab

Theses & Dissertations

Environmental lung diseases are preventable respiratory conditions either caused or made worse by inhaled environmental exposures. Contemporarily, environmental lung diseases are most associated with workplace exposures given specific occupational processes aerosolize inflammatory agents that can be inhaled at high concentrations. Although a considerable amount is known regarding immunoglobulin (Ig)E-mediated responses to environmental exposures, little is known about non-IgE mediated respiratory conditions resulting from lipopolysaccharide (LPS)-enriched organic dust exposure(s). Chronic respiratory diseases such as asthma, hypersensitivity pneumonitis, chronic obstructive pulmonary disease (COPD), and pulmonary fibrosis have all been identified as environmental lung diseases caused or exacerbated by such environmental dusts. Therapeutic …

From Vector To Consequence: Integrating Vector Surveillance, Environmental Drivers, And Public Health Impact Into Lyme Disease Risk Management, Kathleen E. Angell

Theses & Dissertations

Lyme disease is the most common vector-borne disease in North America. This dissertation examines (1) how crowd-sourced compares to active vector surveillance and whether they are associated with Lyme disease, (2) how ecological factors relate to tick abundance and whether they can predict high disease years, and (3) estimated health and economic burden of Lyme disease and savings when interventions are applied. Tick abundance data from active and passive surveillance were compared and tested for association with Lyme disease in the first aim. We found differences in tick life-stage, species, and seasonality. Tick observations were positively correlated with Lyme disease. …

Schistosoma Haematobium Infection In Ethiopian Children: Evaluating Praziquantel Efficacy, Nutritional Effects, And Diagnosis Using Flukecatcher, Louis Fok

Theses & Dissertations

Urogenital schistosomiasis continues to impact the wellbeing of hundreds of millions of people worldwide and remains a significant public health challenge across Ethiopia. Despite existing knowledge on the disease, there remain significant unanswered questions with regard to its treatment and diagnosis. This dissertation evaluated the efficacy of praziquantel at treating urogenital schistosomiasis, improving nutritional parameters among children and the performance of FlukeCatcher at detecting and determining the intensity of infection. In effecting this, a total of 977 children aged 5 through 15 from the Afar and Gambella regions of Ethiopia were screened for S. haematobium infection using urine filtration microscopy …

The Impact Of Public Health Authority On Emergency Response In State Health Departments, Jessica L. Baggett

Dissertations: Doctor of Public Health

Background

Public health authority plays a crucial role in enabling state health officials to implement emergency response measures such as isolation, quarantine, and vaccination campaigns. However, legislative changes following the COVID-19 pandemic have significantly curtailed these authorities in many states, raising concerns about the ability of public health officials to respond effectively to future health crises. The erosion of public health authority has highlighted gaps in the legal literacy of health officials and underscored the need for enhanced training in navigating political and legal challenges.

Purpose

The purpose of this study is to assess legal literacy among state health officials, …

Assessing And Addressing The Needs Of Socially Vulnerable Populations To Enhance Community Emergency Preparedness And Resilience: A Mixed Methods Study, Jennifer E. Harris

Dissertations: Doctor of Public Health

Background: A robust understanding of the needs of individuals and communities can help reduce the impact of a disaster, especially on those communities that already have associated health disparities. By strategically including these populations into mitigation, preparedness, response, and recovery planning, emergency management plans can be enhanced to be more inclusive and effective by identifying targeted resources during a crisis. Additionally, understanding and improving upon individual resiliency can potentially bolster a community’s resiliency level and reduce overall susceptibility to a disaster event, and expedite the recovery phase. Purpose: The purpose of this study is to assess the emergency …

Demographic Groups’ Use Of Agency Intimate Partner Violence (Ipv) Services: A Quality Improvement Project To Identify And Engage Local Underserved Populations, Mia Parker

Capstone Experience: Master of Public Health

This quality improvement project intended to identify populations of adult intimate partner violence (IPV) survivors in Spokane County, Washington, by race/ethnicity and sex who are underserved by a local victim service agency and provide action-oriented, evidence-informed recommendations that the agency may utilize to increase engagement with these local underserved populations. Methods used include secondary data analysis, timeline creation, literature review, and interpretation of quantitative and qualitative data analysis. This was a capstone project designed to demonstrate multiple public health competencies.

Ocular Surface Squamous Neoplasia (Ossn) Risk Factors In Lusaka, Zambia: The Role Of Hiv And Socioeconomic Status, Stepfanie N. Siyumbwa, Peter Julius, Tabitha Nkhata, Obvious N. Chilyabanyama, Abraham Mengist, Gleb Haynatzki, Charles Wood

Capstone Experience: Master of Public Health

Objective

To identify and evaluate potential risk factors for OSSN at the University Teaching Hospital (UTH) in Lusaka, Zambia.

Methods

Data from 475 patients were analyzed retrospectively, and it included 390 with OSSN and 85 with benign biopsies. Variables with significance values

Results

Several key predictors of OSSN were identified after controlling for confounders in the household cooks sub-population, these were, a lower household income (adjusted odds ratio [aOR] = 0.64, 95% CI: 0.46–0.90, p = .009), a Lab confirmed HIV-positive status (aOR = 3.56, 95% CI: 1.72–7.21, p = .001) and exposure to biomass smoke (aOR = 2.47, 95% …

Is Diabetes A Predictor Of A Diagnosis Of Hypertension In The Population Of 32- To 70-Year-Olds In A Cohort Study? A Multivariate Logistic Regression Analysis Of A Subset Of Data Obtained From The Framingham Study, Walter Marquez-Lavenant

Capstone Experience: Master of Public Health

Objective: Assess the independent role of diabetes on hypertension using logistic regression, while adjusting for covariates such as age, sex, BMI

Methods: A subset of data from the Framingham Cohort study, with 5,209 participants and collected across three periods from 1956 to 1968, was analyzed. The dataset includes laboratory, clinic, questionnaire, and event data from 4,434 individuals and was analyzed using SAS software for logistic regression.

Results:In the adjusted model, diabetes was not associated with hypertension (aOR:1.1, 95% CI:0.67-1.81, p=0.7). Females had 26% higher odds of hypertension than males (aOR=1.26, 95%CI:1.09-1.25, p=0.00). Participants aged 51 or older (aOR=2.86, 95%CI:2.37-2.47, …

Restoring Trust In Public Health: An Analysis Of The Lasting Implications Of The Covid-19 Pandemic Response On Community Trust In Public Health In Nebraska, Kerri Dittrich

Capstone Experience: Master of Public Health

Background and Significance

Public trust is essential for effective public health efforts. In Nebraska, as in many regions, the pandemic response exposed strengths and vulnerabilities in the public health system. Misinformation, political discourse, inconsistent messaging, and poor communication contributed to growing mistrust, threatening the long-term success of public health programs and initiatives. While national trends have been studied, Nebraska-specific research remains limited.

Methods

An original descriptive survey was designed and administered to public health professionals in Nebraska to assess their perceptions of public trust in the local public health system before and after the COVID-19 pandemic. The survey also explored …