Public Health Commons^™

Mental Health Promotion, Early Identification & Treatment Services And Supports In Public K-12 School Districts: Three Case Studies To Explore Available Resources, Interventions, And Community Partnerships, Keenan Krick

Theses & Dissertations

Objective: This study: 1) identifies the multi-tiered efforts public K-12 school districts in a large Midwestern metropolitan area use to support mental health promotion activities and comprehensive mental health services, and 2) compares district efforts to domains defined by the National Center for School Mental Health (NCSMH). Participants: A sample of public K-12 school districts (n=12) in a large Midwestern metropolitan area participated in this study from August 2021 to October 2022. Methods: Using the Multi-Tiered Systems of Support (MTSS) intervention framework, a series of three case studies identify the resources public K-12 school districts utilize to support mental health …

Depression And Parenting: A Mixed Method Analysis Of Some Protective Factors For Depression Among African American Fathers Using A Community-Based Participatory Research Approach, Tatiana Tchouankam

Theses & Dissertations

In the United States (US), African American (AA) men often face oppression, discrimination, negative interactions with the justice system, and significant economic, neighborhood, and social hardships over their life course. These challenges increase the risk of chronic exposure to stressful events with negative mental health outcomes, such as depression. Most of the research on parenting and parental depression has focused on mothers based on the premise that women are more often primary caregivers for their children, especially during early childhood. However, a growing number of fathers take on childcare responsibilities. Despite dealing with different life stressors and negative circumstances, AA …

The State Of Oral Health In People With Disabilities And The Impact Of Family-Centered Care On The Oral Health Of Children With Special Health Care Needs, Bedant Chakraborty

Theses & Dissertations

Oral diseases are one of the most prevalent non-communicable, chronic diseases of the 21st century. Yet, dental diseases are generally neglected and are a top concern for policymakers globally. The burden of oral diseases disrupts routine activities that affect the overall quality of life, especially for those with special healthcare needs. Dental diseases have also been marked as the “silent epidemic” and are the leading secondary health condition that affects individuals with disabilities. Disabled people are less likely to receive timely and adequate dental care, which could be tied to poor oral health outcomes among them. This group of studies …

Understanding The Perceived Risk And Biopsychosocial Impact Of The Covid-19 Pandemic On People Living With Hiv And Pre-Exposure Prophylaxis Users In Nebraska: A Mixed Methods Approach, Titilola O. Labisi

Theses & Dissertations

The COVID-19 pandemic disrupted HIV care and prevention services. COVID-19 guidelines required physical and social distancing, resulting in movement restrictions and limited healthcare services. People living with HIV (PLWH) may be more vulnerable to the pandemic’s impact due to immune suppression and socioeconomic status than people without HIV. Consistent use of pre-exposure prophylaxis (PrEP), condoms, and regular sexually transmitted infection tests are critical strategies for HIV prevention. The pandemic’s impact on PLWH have not been thoroughly studied, and whether PLWH may be more impacted than PrEP users is inconclusive.

This research aimed to use an explanatory sequential mixed methods design …

Grip Characterization Of Protective Gloves, Doris Burns

Theses & Dissertations

In 2014, ASTM International (ASTM), one of the world's largest international standards developing organizations, published a new test method on glove grip performance. This method was adopted by the National Fire Protection Association (NFPA) in some of their specification standards. The method utilized hand torque instead of the pull method previously used by the NFPA to determine the Percent Bare Hand Control Value (%BHCV). The %BHCV, compares torque results of a gloved hand versus a bare hand. In developing this new test method, only four males and one female participated; therefore, it is unclear if statistical significance was attained. In …

Gender Differences In Breast Cancer Treatment Decisions And Related Survival: A Study Using The National Cancer Database, Shamim Shahi

Theses & Dissertations

Despite increasing incidence, male breast cancer (MBC) remains understudied in almost all aspects of disease management. MBC patients are more likely to be diagnosed with larger tumors, at an advanced stage, and to experience poorer survival than female patients. There is a need to identify modifiable factors that can improve MBC patients’ survival.

This dissertation aimed to investigate whether there was a difference in the refusal of recommended treatments and related survival, by gender, in breast cancer patients enrolled in the National Cancer Database. Specifically, we conducted separate analyses for four treatments: hormone therapy, chemotherapy, radiation therapy, and surgery. Then, …

Assessing The Methodology, Prevalence, And Associated Factors For Adverse Childhood Experiences (Aces) Among Children And Adolescents In The United States, Kiara L. Lyons

Theses & Dissertations

To comprehensively capture the risk and protective factors of ACE exposure and ACE-related outcomes, we propose to consider a social-ecological model framework. The concept of the Social-Ecological Model was originally introduced in the 1970s by psychologist Urie Bronfenbrenner and designed to theoretically capture the multifaceted influence different personal, social, and environmental factors have on health behaviors and outcomes. Additionally, this would help to determine what prevention and intervention methods would be more appropriate to implement. This conceptual framework had five system levels: microsystem (individual), mesosystem (interpersonal), exosystem (community context), macrosystem (societal and cultural influences), and chronosystem (internal and external elements …

Environmental Cleaning Evaluation Project For Rural Tribal Health Center, Brad Strait

Capstone Experience: Master of Public Health

This Tribal health clinic is located on reservation land and serves a community of approximately 1,550 members located over 64,000 acres located in Nevada and California. The clinic offers general health practice and podiatry at its central clinic with satellite offices located off-reservation offering dentistry, optometry, and behavioral health. The clinic is operated by Tribal staff and partners with the Indian Health Service (IHS) for environmental survey on an annual basis for compliance with Accreditation Association for Ambulatory Health Care (AAAHC) standards. While this clinic only offers outpatient services, the disinfection and cleaning protocols are an important step in limiting …

School-Based E-Cigarette Education Curriculum, “Team No Vaping”: Impact On Knowledge Of E-Cigarettes, Harm Perception, And Media Literacy Among Middle/High School Students, Niran Tamrakar

Capstone Experience: Master of Public Health

E-cigarettes are the most used tobacco products among middle/high school students. Youth e-cigarette use is at an epidemic level. While school-based vaping prevention programs exist, there is limited evidence on the effectiveness of such programs. To address vaping prevention among this vulnerable population, University of Nebraska Medical Center (UNMC) in collaboration with the Tobacco Education & Advocacy of the Midlands (TEAM) developed and implemented a school-based e-cigarette education curriculum, “TEAM No Vaping.” This study evaluated the impact of the “TEAM No Vaping” program on increasing the knowledge, harm perception, and susceptibility to e-cigarettes, and vaping media literacy for vaping prevention …

An Epidemiological Synthesis Of Emerging And Re-Emerging Zoonotic Disease Threats In Cameroon, 2000-2022 And Community Stakeholder Mapping, Nancy Tahmo

Capstone Experience: Master of Public Health

Introduction: Population factors such as urbanization, socio-economic, and environmental factors are driving forces for emerging/re-emerging diseases in Cameroon, and the effects of these are experienced differently across demographics. Indigenous rainforest communities in the Congo Basin, for example, suffer worse health outcomes compared to neighboring communities, like the Pygmies, who have a life expectancy of 22 years less than neighboring Bantus. It is important to characterize the risk of exposure of these vulnerable communities and map out, through a systematic review, descriptive epidemiological data around zoonoses, to inform preparedness and research efforts.

Methods: Following the PRISMA guidelines, a protocol was registered …

Evaluating How Physical Activity Affects The Perception Of Resilience In Box Butte County, Nebraska, Eric Pulver

Capstone Experience: Master of Public Health

Physical activity is one of the modern hallmarks for good health in individuals and the public, in general. Resiliency is a growing concentration in all levels of disaster preparedness where the focus is on how to deal with the growing number of disasters stemming from global climate change. This research project’s aim is to look at the possible relationships between physical activity and resiliency in a rural Nebraska population. This was done with the use of a cross-sectional study utilizing a fifteen-question survey to gather demographics, assess the amount of physical activity, and then apply a perception of resilience tool …

Urban/Rural Disparities Of Thyroid Cancer Using The Integrated Cancer Repository For Cancer Research (Icare2), Sunita Regmi

Capstone Experience: Master of Public Health

Abstract:

Background and objective: Multiple studies have shown that the place of residence and the distance to travel from one's residence to nearby health care providers impact cancer diagnosis and treatment. The stage of cancer at the time of diagnosis is paramount for cancer treatment and affects survival. Disparities in cancer treatment exist which affect the outcome disproportionately to certain segments of the population. To date, much of the focus has been on the racial and socioeconomic disparities in the management of thyroid cancer. The effect of geography and location (urban-rural status) on thyroid cancer stage diagnosis has …

Process Evaluation Of A Community Asset Mapping Protocol For Diabetes Prevention And Management, Andrea Peterson

Capstone Experience: Master of Public Health

Prediabetes and type 2 diabetes mellitus (DM) are highly prevalent conditions with new diagnoses occurring each year (Centers for Disease Control and Prevention, 2022a). Type 2 DM negatively impacts many aspects of life, to include social, financial, cultural, and everyday living. Asset mapping is a useful tool to build upon existing resources to help community members identify and expand services based on understanding the interconnected systems that influence type 2 DM prevention, screening, education, and care management. An Asset Mapping Protocol was created and piloted through a rural community coalition in Nebraska. The protocol includes an activity for community stakeholders …

A Systematic Literature Review On The Capability Of Sio₂-Np’S Exposure To Exacerbate Parkinson’S (Pd) Pathology And The Risk Factors For Biomedical Applications In Pd, Seth Abdallah

Capstone Experience: Master of Public Health

Silica Dioxide nanoparticles (SiO₂-NP) have become increasingly ubiquitous in industry, which has stimulated research into the potential toxicity of these compounds. Recent studies have explored the association between amorphous silica nanoparticle exposure and the potential for neurotoxicity. Additionally, research has been conducted in the application of SiO₂-NP’s in theranostics and as drug directing agents , which based on current literature may be contraindicated for individuals with conditions such as Parkinson's Disease (PD) which is characterized by neuroinflammation. The following literature review will discuss evidence for silica dioxide nanoparticle exposure to induce neurotoxicity which may exacerbate neurodegenerative diseases such as PD. …

Identifying & Addressing Barriers To Child Care For Formerly Incarcerated Mothers, Joanne Bird

Capstone Experience: Master of Public Health

As women’s incarceration rates have risen significantly in recent decades, gender-specific programs are needed to meet the needs of formerly incarcerated mothers (FIM). Although child care can be difficult to access for many families, this marginalized population faces unique obstacles to accessing child care. In order for FIM to be employed and reintegrate, they must be able to access child care; however, FIM experience unique barriers to securing child care services. This policy brief aims to identify the special considerations FIM face, as well as to explore why existing programs are not meeting their specific needs. A literature review was …

Evaluating How The Impacts Of Climate Change On Arizona's Water Supply Will Influence Public Health, Patricia Wrona

Capstone Experience: Master of Public Health

Over the last century, Arizona’s climate has increased more than 1.1 to 1.4 degrees Celsius or 2 to 2.5 degrees Fahrenheit. The temperature in Arizona is expected to increase an additional 2.2°C to 2.8°C in the next 40 years. Climate change poses various health and environmental hazards for the residents of Arizona. One of the most significant impacts is on water supply. As temperatures continue to rise in the desert, the demand for water will increase while the water supply will reduce. A literature review and program evaluation were conducted to evaluate how the impacts of climate change on Arizona’s …

Evaluation Of Human Trafficking Training/Educating Of Nursing Professionals, Emily Morris

Capstone Experience: Master of Public Health

Background: Human trafficking (HT) is a serious public health issue. Victims may present to medical facilities for a variety of health concerns, and therefore, healthcare professionals can identify and provide aid to trafficking victims. However, research shows that providers do not feel adequately trained to identify and support victims. This study evaluates the outcomes of a three hour in-person HT workshop for nurses.

Methods: We administered an online survey with closed- and open-ended questions before and after the workshop to assess improvement in knowledge, health impact, strategies for identification and assessment, and response and follow up of HT.

Results: At …

An Analysis Of Climate Factors And Their Relationship With Lyme Disease And West Nile Virus In California From 2011 To 2020, Emma Dubas

Capstone Experience: Master of Public Health

The World Health Organization estimates that approximately one-sixth of illnesses and disabilities suffered worldwide are due to vector-borne diseases, and more than half of the world’s population is at risk. Additionally, vector-borne diseases have significant socioeconomic impacts and inflate health inequities, with the greatest burden on poor populations. Lyme disease is the top tick-borne disease in the state of California and West Nile virus (WNV) is the top mosquito-borne disease in the state of California. Vector-borne diseases have a high sensitivity to climatic factors. Research shows that ongoing trends of increasing temperature and varying weather conditions will weaken recent global …

The Merit Of Inclusion: A Policy Review Examining The Convergence Of Special Education And Inclusions Policies With Compensatory Medicaid Policies In The Wake Of The Covid-19 Pandemic, Corbyn Baggett

Capstone Experience: Master of Public Health

On March 11, 2020, the World Health Organization (WHO) formally recognized the novel coronavirus (COVID-19) outbreak as a global pandemic. This global issue compelled governments to announce careful virus containing policies in order to prevent further spread and control of the disease. Although it has been proven that measures like social isolation could aid in scaling the spread of illness, the resulting extended school closures that occurred in response to an increased number of COVID-19 outbreaks posed significant challenges for all students, but especially those students with special needs. The unpredictable nature of COVID-19 at the outset of the pandemic …

Health Effects Of Neonicotinoids On An Agricultural Community, Jocelyn Rodriguez-Paar

Capstone Experience: Master of Public Health

Mead, Nebraska, a small United States agricultural community consisting of approximately 600 people, was accidentally exposed to high amounts of neonicotinoids when AltEn, an ethanol plant that used neonicotinoid coated corn and soybean seeds for biofuel, was discovered not disposing of the toxic byproduct safely. Coincidentally, there was also a leak in their wastewater system that also contaminated the nearby areas. Although neonicotinoids are not considered highly dangerous with low dose exposures, large dose exposures can cause symptoms similarly to nicotine poisonings, such as difficulty breathing, vomiting, nausea, hypertension, tachycardia, and lethargy (Imamura, T. et al., 2010). Neonicotinoid poisoning can …

The Risk Factors Of Long Covid In The Acute Covid And Solid Organ Transplant Retrospective Cohorts, Ahmed Nyandemoh

Capstone Experience: Master of Public Health

Background: Coronavirus disease 2019 (COVID-19) in solid organ transplant (SOT) patients is associated with more severe outcomes than non-immunosuppressed hosts. The risk factors for developing the long COVID in acute COVID remain unknown, and the survival outcomes of long COVID in SOT patients remain understudied.

Methods: We developed several retrospective cohorts. This project included all patients identified with acute COVID in the National COVID Collaborative Cohort Registry from July 1, 2020, to June 30, 2022.

Patients with long COVID were compared to those without long COVID in the acute COVID cohorts. Similarly, we compared the patient demographic with long COVID …

Descriptive Epidemiology Of West Nile Virus In Nebraska, 2005-2021, Luke Murphy

Capstone Experience: Master of Public Health

Objectives: West Nile virus (WNV) is a mosquito-borne flavivirus that is naturally sustained in a Culex mosquito-bird-mosquito transmission cycle and can cause disease in birds, equines, and humans. Most human infections with WNV are asymptomatic; however, West Nile fever (WNF), or West Nile neuroinvasive disease (WNND) can develop and be fatal in some circumstances. Between 2005 and 2021 there have been over 1,800 cumulative cases of WNV in Nebraska, which currently ranks as fourth in the United States for reported cases. WNV cases are a mandatory reportable disease in Nebraska through an electronic reporting system managed by the Nebraska Department …

Barriers To Healthcare Access For Refugees And Immigrants With Limited English Proficiency In Nebraska: A Systematic Review Of The Literature, Mawada Mohammed

Capstone Experience: Master of Public Health

Refugees and immigrants in the United States from a multitude of backgrounds are impacted by limited English proficiency (LEP), resulting in a health disparity. LEP in vulnerable populations can create obstacles in healthcare. In healthcare settings LEP patients experience adverse health events such as longer hospital stays, negative drug reaction, and patient dissatisfaction (Berdahl & Kirby, 2019). The following project aims to identify barriers for refugees and immigrants with limited English proficiency (LEP) in primary healthcare settings in Nebraska. The project utilized a systematic literature review using peer-reviewed and gray literature. The research was conducted utilizing databases: PsycINFO, PubMed, Google …

Impact Of Coalition Building To Promote Maternal Infant Health Equity In The District Of Columbia, Maryland, And Virginia, Sydney J. Turner

Capstone Experience: Master of Public Health

The health of women and babies is critical to creating a healthy world. Stratified data shows the overwhelming rates at which Blacks are affected more than Whites. Literature has shown that leveraging partnerships and community engagement are critical components of decision-making and can positively impact the health of communities. Through a direct observational study, the Community Coalition Action Theory was used to analyze the current structure of the March of Dimes Maternal Infant Healthy Equity Coalition. The study aimed to identify strengths and gaps and subsequently provide recommendations to advance the coalition work and promote maternal and infant health equity …

Hispanic/Latino Mothers Of Children With Developmental Disabilities: Identifying Factors Associated With Practicing Self-Care And Mental Health Outcomes, Jessica Gutierrez

Capstone Experience: Master of Public Health

Caring for a child with developmental disabilities can be challenging, exhausting, and overwhelming for many parents. The level of care that a child with disabilities requires can be intense, resulting in stress and negatively impacting caregivers' mental health. Many Hispanic/Latino mothers of children with developmental disabilities are not practicing self-care or using support services; thus, the mothers may experience high stress, depression, and anxiety. Previous research studies have found adverse psychological effects such as high levels of stress, depression, and anxiety. This quantitative study sought to identify the gaps and barriers Hispanic/Latino mothers of children with developmental disabilities encounter when …

Program Planning On Social Determinants Of Health For Rural Nebraska, Maria H. Cantu Hines

Capstone Experience: Master of Public Health

Social determinants of health (SDOH) are non-health factors that impact health in both direct and indirect ways. Research into SDOH and their effects has been extensive in recent years and has been further documented by the COVID-19 pandemic. Despite the wealth of the literature on the SDOH, awareness of these important factors is not prevalent among community residents. Rural communities are as subject to the impact of SDOH just as their urban counterparts and experience additional complexities related to geography and topography.

This capstone project aims to raise awareness, provide education, and assist with tools and resources, to empower rural …

Agrichemicals (Nitrate And Atrazine) In Drinking Water And Adverse Health Outcomes In Children In Nebraska, Balkissa S. Ouattara

Theses & Dissertations

Objectives: This research was conducted to (1) determine the concentrations of atrazine, and nitrate, in Nebraska watersheds and counties; (2) calculate the incidence of pediatric cancers and prevalence of birth defects in Nebraska counties and watersheds, respectively; (3) assess the relationship between the contaminant levels and the incidence rate of pediatric cancers and birth defects prevalence.

Methods: Pediatric cancers and birth defects data were obtained from the Nebraska Department of Health and Human Services. Water quality data were collected and retrieved from the Water Quality Portal and the Nebraska Groundwater Quality Clearinghouse. Geospatial and statistical analyses were conducted at the …

A Systematic Literature Review Of The Prevalence, Distribution, Exposure, And Human Health Risks Of Tire Microplastics And The Contribution Of Their Physicochemically Diverse Properties, Luke Glastad

Theses & Dissertations

The history of synthetic plastics dates back to their first uses in 1907, continues with their expansion through the middle of the century with a diverse array of new polymers, and are so omnipresent today that many label this age of Earth the Plasticene Era. Tire microplastics (TMPs) have been increasingly identified as one of the environment's most bountiful types of microplastics (MPs). TMPs mainly enter the environment as tire-wear particles (TWPs) and recycled tire crumb (RTC). TWPs, in particular, have a high degree of variability, which impacts their distribution, degradation, and risk for adverse human health effects. This review …

Environmental Exposures And Human Health Challenges: Evidence-Based Insights From Health Surveillance Systems, Jagadeesh Puvvula

Theses & Dissertations

Human exposure to environmental hazards is associated with a variety of preventable adverse health outcomes. As the environmental health risks result from the complex interaction between hazard, exposure, and susceptibility, these exposure-outcome associations are heterogeneous across the population. Improving environmental health literacy by advocating evidence-based environmental risk communication could play a role in reinforcing protective behavior against environmental hazards. The use of public health surveillance systems to assess the exposure-response associations is one of the effective ways to quantify the environmental health risks. However, there are several gaps in effectively quantifying environmental health risks. This dissertation aims to address a …

A Two-Part Satisfaction Evaluation Of The Recreational Therapy Department's Adult Respite And Habilitation Program At The Munroe-Meyer Institute, Hailey Humphrey

Capstone Experience: Master of Public Health

This project is a satisfaction evaluation of the Adult Night program offered to people 21+ with intellectual and/or developmental disabilities (I/DD) through the Munroe-Meyer Institute’s Recreation Therapy Department. Historically, people with I/DD face health disparities that impact all areas of their lives. Recreation therapy for I/DD populations could address and minimize access to and quality of care gaps. Current research on recreation therapy programs lacks generalizability and evaluation of non-specific recreation therapy programs for people of any age with I/DD. This project intends to fill that research gap and provide the first evaluation data of the program for the organization. …