Public Health Commons^™

Evaluation Of A Competency-Based Health Policy Training Program, Jim P. Stimpson, Kathleen Brandert, Brandon Grimm, Fernando A. Wilson

Reports: Center for Health Policy

An academic and practice partnership was formed to create and implement a competency-based training program for local health departments in health policy. We evaluated if the training program improved the policy knowledge and competency of participants.

Participants exhibited significant increases for self-assessed policy competency, including substantial improvements in “Critique the feasibility and expected outcomes of potential policy options”, “Identify and assess the strengths and motivations of key stakeholders and potential resistors”, and “Recommend a specific policy change”.

The policy competency instrument developed in this report could be used to measure policy knowledge and competency in future training implementations.

Evaluation Of A Competency-Based Health Policy Training Program, Jim P. Stimpson, Kathleen Brandert, Brandon Grimm, Fernando A. Wilson

Reports: Center for Health Policy

No abstract provided.

Economic Implications Of Tobacco Use For The State Of Nebraska Government, Fernando A. Wilson, Nizar K. Wehbi, Ali S. Khan

Reports: Center for Health Policy

We examine smoking-related expenditures for the state Medicaid program and for lost productivity among state government employees. The predicted number of new diagnoses of smoking-related illnesses among government employees ranged from 109 cases of kidney disease to 856 cases of arthritis and related diseases. We estimate over 6,000 lost workdays due to sick leave among currently smoking vs. non-smoking employees. Smoking-related illness is estimated to increase state budgetary expenditures on Medicaid by approximately $114.9 million annually.

A Multi-Level Assessment Of Healthcare Facilities Readiness, Willingness, And Ability To Adopt And Sustain Telehealth Services, Jamie Larson

Theses & Dissertations

Telehealth technologies are becoming more pervasive throughout the healthcare system as a way to provide services to patients that would otherwise have difficulty with access. Currently, little is known about the current state of telehealth use within clinics and hospital in the US. Most studies evaluating telehealth programs are feasibility or small patient outcome studies from one location. Utilizing a hybrid framework combining the levels of complex socio-technical systems with the theory of ready, willing and able. The theory of ready, willing, and able is founded on the basis that these three preconditions need to be met for a change …

Examining The Relationships Between School Engagement, Physical Activity, And Attention-Deficit Hyperactivity Disorder In Children Using The Ecological Model, Minh Nguyen

Theses & Dissertations

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with onset usually occurring in childhood and adolescence. During these developmental stages, social interactions and external environments can have significant impact on children’s growth and development. Few studies previously used a theoretical model to examine the effects of social and external environments on ADHD. The goal of this dissertation is to apply an ecological perspective to examine the roles of school and community in the development of childhood ADHD through school engagement and physical activity. Three studies were implemented to carry out this goal. Study 1 examined the associations of neighborhood, school, and …

Determining The Adoption And Implementation Of Nutrition Policies At Food Pantries Across The United States, Meagan Helmick

Theses & Dissertations

Food insecurity occurs when there is a lack of access to enough food to live an active, healthy life. Current efforts to address food insecurity include developing and implementing policies, programs, and practices at the federal, state, and local levels. Specifically, local efforts target decreasing food insecurity through emergency food networks including food banks and food pantries. Over the last several years, many food banks and food pantries have worked to improve the nutritional quality of the foods they offer. However, food pantries are smaller and less formal organizations than food banks. Thus, they have limited resources to develop and …

Health Professional Treatment Practices For Pediatric Sickle Cell Disease In Nigeria, Natalie Wichelt

Capstone Experience: Master of Public Health

Abstract

Sickle cell disease (SCD) is caused by a genetic defect that results in abnormal hemoglobin genes that can cause devastating health effects like chronic hemolytic anemia and vaso-occlusive crises. Additionally, sickle cell disease can cause defects in the immune system, leaving those with the disease highly susceptible to a variety of different infections. In the pediatric population specifically, the complications of sickle cell disease contribute significantly to the under-five mortality rate of Nigeria. In response to the Millennium Development Goals 4, 5 and 6, as well as with growing national concern over the challenges faced by sickle cell disease …

Perspectives, Challenges, And Oral Cancer Screening Practices Of Primary Care Providers At Nebraska Medicine, Nishitha Ponnamaneni

Capstone Experience: Master of Public Health

Background

High mortality and morbidity associated with oropharyngeal cancer (OPC) are due to delayed diagnosis. Early detection of OPC is possible by incorporating oral cancer screening (OCS) in the annual screening examination protocol of primary care providers (PCPs). The study was aimed to understand the perspectives and barriers of PCPs in screening their patients for OPC.

Objectives

1) To understand challenges PCPs’ face in performing OCS, 2) To determine the factors that influence PCPs’ decision to complete OCS, and 3) To determine if PCPs who received education on OCS are more likely to perform the screening compared to PCPs who …

Equity Of Care Analysis At Chi Health Hospitals And Clinics In The Omaha Metro Area., Lindsey Cork

Capstone Experience: Master of Public Health

The goal of the project is to identify if health disparities exist between patient groups based on race, ethnicity, language, payer type, and location of residence who received healthcare services from CHI Health system in the Omaha Metro area during January 2017 – March 2018. The health outcomes of interest are HPV vaccination rates, diabetes control rates, breast cancer screening rates, colorectal cancer screening rates, and 30-day hospital readmissions. Patient data from six Omaha area clinics and five hospitals was analyze in this study.

Among the six CHI Health clinics in this study, Lakeside had the highest rates of A1c …

Collaboration Between University Centers For Excellence In Developmental Disabilities (Ucedds) And Independent Living Networks, Sarah Swanson

Capstone Experience: Master of Public Health

In every state and U.S. Territory, there is a University Center for Developmental Disabilities (UCEDD), which is part of the state Developmental Disabilities network and an Independent Living (IL) Network, composed of Centers for Independent Living and Statewide Independent Living Councils. Each of these receive federal funding (and frequently state funding) to support people with disabilities and their families. However, each has different federal funding sources, different origins within federal legislation and different requirements. Through discussions with IL and UCEDD leadership it is clear that there are collaborations between the two, yet this is not widely recognized. This research proposal …

Protecting And Serving Yourself: The Mental Health Of Police Officers In Kaukauna, Wisconsin, Caina Weiner

Capstone Experience: Master of Public Health

The service learning hours performed at the Kaukauna Police Department served as a valuable learning experience to better understand an organization that is involved in public health. Although some may view this as non-traditional, the police department is quite involved in the community’s health. They work closely with public health officials and are also involved in certain public health programs, such as drug and alcohol programs. The health of a police officer must also be considered as a public health topic. A police officer is part of a vulnerable population of individuals that are “first responders.” These individuals are at …

Title X Family Planning Secondary Data Analysis Needs Assessment, Laura Triplett

Capstone Experience: Master of Public Health

The goal of the Title X Needs Assessment is to ‘Provide individuals the information and means to exercise personal choice in determining the number and spacing of their children', prevent unintended pregnancies, and reduce the number of abortions.’ Objectives include but are not limited to family involvement, abstinence and safer sex practice, intimate partner violence, human trafficking, contraceptive services, pregnancy testing and counseling, achieving pregnancy, basic infertility services, preconception health, STI/STD testing and treatment and HIV testing, Well Women/Men Exams; screening for breast cancer, cervical cancer, and testicular cancer in males. Sexual health education and reproductive life planning will be …

A Characterization Of The Medical-Legal Partnership (Mlp) Of Nebraska Medicine, Jordan Pieper

Capstone Experience: Master of Public Health

This research study was completed at Legal Aid of Nebraska’s Health, Education, and Law Project through the partnership it has formed working with Nebraska Medicine and Iowa Legal Aid. Traditionally, health and disease have always been viewed exclusively as "healthcare" issues. But with healthcare consistently growing towards holistic approaches to help patients, we now know there are deeper, structural conditions of society that can act as strong driving forces of a person's poor daily living conditions that can negatively impact health. The importance of a Medical-Legal Partnership is that it considers a patient's social determinants of health (SDHs). The goal …

Evaluating And Increasing Lead Poisoning Prevention Awareness In The Refugee Population Of Douglas County, Ne, Kara Albright

Capstone Experience: Master of Public Health

Background: Lead poisoning is a major public health concern. It accounted for twelve percent of the global burden for intellectual disabilities, and two and a half percent of the global burden for heart disease and stroke, as well as nearly 500,000 deaths in 2015 (World Health Organization, 2018). While everyone is at risk of lead exposure, refugee and immigrant children are at an increased risk because they have increased access and use of products from outside the United States that have been shown to contain lead (Moser, R., and Brownback, S., 2012; and New York State Department of Health, …

The Impact Of Rural-Urban Residency On Colorectal Cancer Screening, Stage At Diagnosis And Treatment In The Privately Insured Population, Mesnad Alyabsi

Theses & Dissertations

Colorectal Cancer (CRC) is the third most common and leading cause of cancer death in the United States. Although CRC screening can prevent and detect CRC at an early stage, about 35% of Americans are not screened. Despite the recent increase in screening, people with lower SES and those who live in rural areas have lowest screening. In rural areas, a common obstacle for screening is the long trips for health services which is associated with advanced CRC.

Moreover, surgery is a substantial part of CRC treatment since stages I-III and some metastatic CRC (mCRC) patients are treated with surgery. …

The Survival And Treatment Refusal Of Lung Cancer Patients: Analyses Of National Cancer Registries, Poppy Deviany

Theses & Dissertations

Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer mortality of both genders in the United States. A recent report suggests that the relative five-year survival rate of lung cancer is only 18%. Studies indicate many factors are associated with the survival of lung cancer patients, including age at diagnosis. It is widely known as a disease of older people, but the literature shows a substantial number of young people have been diagnosed with lung cancer. The literature also indicates that the refusal of recommended treatment contributes to cancer-related death and poorer survival. The …

Pandemic Planning: Estimating Disease Burden Of Pandemic Influenza To Guide Preparedness Planning Decisions For Nebraska Medicine, Angelia Wimberly

Theses & Dissertations

This year marks the 100^th anniversary of the 1918 “Spanish Flu” outbreak that killed 50-100 million people worldwide. If a pandemic of this proportion happened today, the federal pandemic influenza plan predicts that 30 percent of the population could become infected with up to 50 percent seeking outpatient care. With Nebraska Medicine currently operating at nearly full capacity (95-97%), surge capacity for hospital space, staff, and supplies would be in severe demand and would quickly overwhelm the organization. To assess the impact of pandemic influenza in Douglas County Nebraska and Nebraska Medicine, pandemic modeling tool FluAid and FluSurge 2.0 …

Healthcare Utilization For Behavioral Health Disorders: Policy Implications On Nationwide Readmissions, And Outcomes In The States Of Nebraska And New York, Rajvi J. Wani

Theses & Dissertations

The main goal of this dissertation was to estimate national-level inpatient readmissions and state-level hospital-based emergency department (ED) visits with behavioral health (BH) conditions in the states of Nebraska and New York. The dissertation aims to assess the impact of the policy mandates under the Patient Protection and Affordable Care Act on these state and national estimates. The Nationwide Readmissions Database and the State Emergency Department databases maintained by the Healthcare Cost and Utilization Project were used for this dissertation. US Adult population with high-risk of readmissions in the inpatient departments for alcohol-related disorders (ARD) and of visiting ED for …

The Effect Of Treatment Delay, Non-Adherence To Treatment Guidelines, And Never-Smoking Status On The Survival Of Lung Cancer Patients, Trisari Anggondowati

Theses & Dissertations

Despite many significant medical advances, lung cancer continues to cause more deaths than any of the other cancers in the United States (US), and worldwide. Timeliness of care and evidence-based guidelines are among the components of quality of care that are expected to improve patient outcomes. However, evidence on the effect of timeliness of care and adoption of evidence-based guidelines on patient survival remains lacking. In addition, there has been increasing concern on the fact that smokers are not the only group that suffers from lung cancer. Never-smokers comprise at least 10% of lung cancer patients in the US, or …

Transvaginal Cervical Length Surveillance Frequency And The Management Of Spontaneous Preterm Delivery In Twin Gestations, Ashley Janssen

Capstone Experience: Master of Public Health

Strategies to prevent preterm birth in multifetal gestation remain a high-priority in the United States. In women with a history of spontaneous preterm birth (sPTB) and singleton gestation, transvaginal cervical length (TVCL) surveillance and subsequent treatment is associated with a reduction in spontaneous preterm birth, however, there is limited data on the role of TVCL surveillance in twin gestation. The goal of this study is to determine if an association exists between TVCL and spontaneous preterm birth in twin gestations. Additionally, our research will assess whether TVCL surveillance impacts the timing of antenatal corticosteroids (ACS), magnesium sulfate administration, and maternal …

Massage Therapy Intervention For Pediatric Palliative Care Patients And Their Families, Taelyr Weekly

Capstone Experience: Master of Public Health

This study examined the feasibility and acceptability of a massage therapy intervention for pediatric palliative care patients and their adult caregivers to reduce their symptom impact at an urban pediatric hospital in Omaha, NE. Potential symptoms to be impacted by massage included stress for caregivers and pain, nausea, dyspnea, and anxiety for children. One hundred and thirty five massages were delivered to patients and caregivers in the PICU, NICU, and the inpatient hospital floor during the course of this non-randomized, pre-post study. Validated instruments were used to collect objective data from patients and caregivers, while observations were used to record …

A Strategic Approach To Employee Retention At Nebraska Families Collaborative, Rachel Walters

Capstone Experience: Master of Public Health

Nebraska Families Collaborative (NFC) is a nonprofit organization that supports children and families who are at risk, in eastern Nebraska. They offer a variety of services with the goal of moving children toward safety, permanency and well-being. Organizations such as NFC rely heavily on the commitment of the employees to carry out their mission, as do many other non-profit social service agencies across the country. The overall goal of the project was to identify reasons for high turnover and to identify potential solutions to reduce turnover and increase retention in the workplace at NFC. The main objectives were to analyze …

Quality Improvement: Assessing The Gaps In Education And Training Among Staff At Health, Education, And Law Project Hospital Sites In Nebraska, Michael Sauter

Capstone Experience: Master of Public Health

This research study was completed at Legal Aid of Nebraska’s Health, Education, and Law Project. The goal of this quality improvement study was to enhance the effectiveness of future Health, Education, and Law Project (HELP) training sessions for staff members of HELP sites in Nebraska. Through the use of an online survey tool, we received staff members’ input on the current training program, assessed their knowledge on relevant topics, and gave respondents an opportunity to include any appropriate suggestions. By means of this study, we were able to conclude that although staff members seemed to appreciate the training sessions overall, …

Macra Legislation (Medicare Access And Chip Reauthorization Act) And The Quality Provider Payment Program: Policy Analysis And Educational Program Evaluation, Katie Joseph-Johnson

Capstone Experience: Master of Public Health

ABSTRACT

Goal: The goal of this Service Learning/Capstone Experience is to provide an in-depth policy analysis and interpretation of the 2018 proposed changes in the Quality Payment Plan (QPP) as part of the 2015 MACRA legislation for the purpose of developing organizational training material.

Objectives: The key objectives of this project are 1) to complete a policy review of the current and proposed Quality Payment Program legislation from the Centers for Medicare and Medicaid Services (CMS), including June 2017 proposed updates and the November 2017 final rule updates; 2) to gain physician and hospital administrator’s perspective on realized …

Examining The Benefits And Client Satisfaction Of The Open Arms Of Minnesota Meal Service Program, Carlie Rhinehart

Capstone Experience: Master of Public Health

Chronic disease can leave individuals incapable of caring for themselves, leading to a low quality of life. Public health researchers have proven how crucial medically tailored meals are to those fighting such chronic diseases. Open Arms is a local nonprofit that started in 1986. They make and deliver meals, free of charge, to people with life-threatening illnesses.

The goal of this study is to examine the benefits of the meal services provided by Open Arms of Minnesota to clients who are chronically ill. To learn about the benefits, analysis was conducted on the client satisfaction survey data collected. The anonymous …

Hipaa Compliant Patient-Provider Communication: Student-Clinician Perceptions, Rachel Wenzl

Capstone Experience: Master of Public Health

Purpose: To evaluate the service learning clinical training facility’s HIPAA training by assessing student-clinician knowledge of the clinic’s HIPAA Compliance Plan and the impact of its training on student-clinician perceptions toward HIPAA-compliant patient-provider communication (PPC). For example, do student-clinicians feel it is important to be HIPAA-compliant and are they confident in discussing health-related activities and programs with patients or caregivers? The purpose of this project is not, at this time, to measure student-clinician intention to perform the behavior.

Methods: This project employed a mixed-methods, non-experimental cross-sectional study design using a retrospective post-test survey and group interview. The survey …

Mental Health Provider Perceptions On The Implementation Of Behavioral Health Interventions To Increase Access To Mental Health Care Services In Rural Nebraska, Grant Brueggemann

Capstone Experience: Master of Public Health

Abstract

Rural Nebraska communities are influenced by socioeconomic conditions and lack health care resources which contributes to the prevalence of mental health. As such, there is a need to implement effective intervention programs and evaluate current programs to reduce morbidity and mortality associated with mental health.

Goals: To assess the perceptions of mental health practitioners regarding public health programs and support services. This project also intends to gauge the effectiveness and viability of specific programs as potential solutions for increasing access and use of rural mental health care services. Furthermore, this project aims to inquire perceptions about the role …

Winnebago County Dryhootch Outreach Program, Greg Brittnacher

Capstone Experience: Master of Public Health

Abstract

Winnebago County Veterans Dryhootch Outreach Program

Aims: The Dryhootch Outreach Program focused on increasing behavioral activation through social interaction in a population of military veterans with Post Traumatic Stress Disorder (PTSD). The goals of the intervention were to reduce the prevalence of anxiety, depression, and PTSD symptoms. Additionally, the project aims to assist veterans to develop and maintain healthy relationships, assimilate with the “civilian” community, and effectively contribute to society.

Methods: Twenty-seven veterans with PTSD attended the twelve-week Dryhootch Outreach program provided by the Winnebago County Veterans Service office and partnering organizations. A pre-post interventional study format was utilized …

Identifying The Newly Insurable Medicaid Coverage Gap Population Under The Affordable Care Act: Who They Are And Where They Live, Samuel L. Woodruff

Capstone Experience: Master of Public Health

The goal of this Capstone Project is to better define and geographically locate the potential distribution of individuals who fall within the current Medicaid Coverage Gap and those populations who would be eligible for Medicaid under the expansion of Medicaid within the state of Nebraska. Using data from multiple United States Census Bureau sources, along with available data from the Health Resources and Services Administration (HRSA), this project looks to also locate populations of these individuals that may live within established Medically Underserved Areas (MUA's) or Health Professional Shortage Areas (HPSA's) within the state. American Community Survey 5-year Public Use …

Piloting An Observation Tool For The Garden To Table Program To Assess Education Of Underserved Youth In Omaha, Nebraska, Anthony Gargano

Capstone Experience: Master of Public Health

The Big Garden is a private 501-c3 organization, which utilizes multiple programs to grow healthy food, healthy kids, and healthy communities. The “Garden to Table” program helps students learn how to grow vegetables and herbs in their school garden as well as how to properly harvest, cook, and preserve these crops through various methods. This program specifically highlights STEAM education through plant science and organic gardening techniques, nutrition, and healthy lifestyles. In 2017, the “Garden to Table” program was taught after school at 5 middle schools in Omaha Public Schools: Marrs, McMillan, Monroe, Lewis and Clark, and King Science Center. …