Public Health Commons^™

Cross-Cultural Adaptation Of An Instrument To Address The Mental Health Needs In Nepal, Dene S. Berman

Master of Public Health Program Student Publications

Nepal has had devastating earthquakes compounded by economic struggles, social and political crises. There is evidence of significant psychological distress but few mental health resources. The current project’s aim is to provide the people of Nepal who are experiencing emotional distress with information about improving their lives in a way that otherwise would not be available in rural health centers. For this purpose, a culturally sensitive and valid adaptation of Healthy Habits for Emotional Well-being into Nepali was created following World Health Organization guidelines. Implications for its use were discussed, along with possible future directions for continued outreach efforts.

Perfluoroalkyl Substances Exposure And Cancer In Nhanes 2011-2016 U.S. Population, Michael Crowder

Master of Public Health Program Student Publications

Background: Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are persistent synthetic compounds that may have associated health risks.

Purpose: To explore the association between four common detectable serum PFASs perfluorooctanoic acid (PFOA), perfluorooctyl sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) and cancer risk in United States (U.S.) adults.

Methods: Data from 4,497 participants from the 2011–2016 National Health and Nutrition Examination Survey (NHANES) were analyzed. Gender stratified adjusted logistic regression analysis was conducted to determine association between serum PFASs tertiles and risk of cancer.

Results: Median (IQR) PFASs were significantly higher in men compared to women, and among individual with …

Dichlorophenol Exposure And Chronic Kidney Disease, Karla James

Master of Public Health Program Student Publications

Purpose: To explore the relationship between the common pesticides, 2,4-dichlorophenol (2,4-DCP) and 2,5-dichlorophenol (2,5-DCP) with serum creatinine as a biomarker of kidney function. Methods: National Health and Nutrition Examination Survey (NHANES) 2013 to 2014 data (N = 2,063, 47% male and 53% female) was used to statistically analyze the relationship between either of two common pesticides 2,4-DCP or 2,5-DCP and serum creatinine levels. Gender stratified analysis was completed using multivariate adjusted linear regression. Variables adjusted were age, ethnicity and annual household income. Results: In both males and females exposure to 2,4-DCP did not elevate serum creatinine and regression results …

The Perspectives Of African American Women: Their Pregnancy Experience And Their Babies’ Birth Outcomes, Kayla M. Hairston

Master of Public Health Program Student Publications

The health disparity surrounding infant mortality has been a challenge for public health professionals for the past two decades. Today African American babies continue to die at a rate two times higher than the nation’s average rate. The purpose of this study was to explore African American mothers’ perspectives on their pregnancy experience and their babies’ birth outcomes, as a way to provide suggestions for current efforts and interventions being used to lower the rate of infant mortality in the African American population. This study examined fifteen peer reviewed articles that shared the perspectives of African American women who were …

Assessing The Social Determinants Of Health Needs Of Older Lgbt People In The Greater Miami Valley Of Ohio, Jessica L. Sokol

Master of Public Health Program Student Publications

Background: While the older LGBT population continues to grow, they remain an underserved, invisible, and under-researched segment of the population. They experience many of the same risk and protective factors of all older adults, but discrimination is one social determinant of health that is quite prevalent among this community, causing lasting impacts on health.

Objective: The purpose of this study was to assess the social determinants of health issues and needs of the aging LGBT population in Dayton, Ohio, in order to direct advocacy strategies and better targeting of local support efforts.

Methods: Data were collected through a cross-sectional survey …

Sex Differences In The Outcomes Of Mild Traumatic Brain Injury In Children Presenting To The Emergency Department, Taylor M. Yeates

Master of Public Health Program Student Publications

Mild traumatic brain injuries (mTBI) put children and adolescents at risk for short and long-term health risks. The purpose of this study was to evaluate sex differences in post-acute outcomes among children and adolescents presenting to the Emergency Department (ED) for mTBI. The study is a secondary analysis of a de-identified dataset which was drawn from a concurrent cohort, prospective, and longitudinal study design that included 8 to 16 year-old children with mTBI and a comparison group of children with mild orthopedic injuries (OI) not involving the head. Participants were recruited and completed an initial assessment during their initial visit …

The Association Of Perfluoroalkyl Substance Exposure And Lung Function In The U.S. Population, Brenna C. Heinle

Master of Public Health Program Student Publications

Background/Aim: Perfluoroalkyl substances (PFASs) are chemical compounds used in consumer products and are linked with increase in cholesterol, thyroid disease, and pregnancy-induced hypertension. However, their association with lung function is not completely understood.

Methods: Cross sectional 2011-12 U.S. population data from the National Health and Nutrition Examination Survey (NHANES) was used (N=1,450, aged 12 to 79 years, 52% men). Serum concentration of four PFASs, perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorohexane sulfonic acid (PFHxS) were assessed using mass spectrometry and were categorized into tertiles. Lung function was measured by spirometry as forced vital capacity (FVC), …

Lead Exposure And Metabolic Syndrome In U.S. Population, Nhanes 2013-2014, Khadra Gukadowr

Master of Public Health Program Student Publications

Background: Lead is a known endocrine disruptor and can impair regulation of blood glucose, blood pressure, abdominal adiposity, blood lipid levels which are risk factors for metabolic syndrome (MetS).

Objective: To study the association of lead exposure and MetS in United States (U.S.) adults.

Methods: Data from 523 male and 528 female participants aged 20 years and older from the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) were analyzed. Based on blood lead distribution in males and females, participants were categorized into low and high blood lead groups in both genders. Adjusted logistic regression analysis was used …

Who Is Testing? Demographic And Sexual Risk Factors Associated With Hiv Testing Among African American College Students, Elizabeth Gonder-Strutz

Master of Public Health Program Student Publications

Despite significant progress made in reducing HIV diagnoses, many populations are still disproportionately affected. Although African American college students tend to engage in safer sex practices than their peers, they are still at an elevated risk for contracting HIV. Therefore, it is important that HIV prevention programs understand the unique needs and risk factors among African American college students. HIV testing is an essential component of HIV prevention. This study examined the relationship between HIV testing and demographic and behavioral factors among African American college students from two universities. The study found that older students (upperclassmen) are significantly more likely …

Differences In Access To Care Of Children With Intellectual Disability Versus Children With Autism Spectrum Disorder, Kelly J. Haller

Scholarship in Medicine - All Papers

Objective: With the increase in ASD awareness and diagnosis, concerns are raised as to whether children with ID have more unmet health care needs than children with ASD. The purpose of this study was to assess the unmet health care needs of children with ID compared to children with ASD and whether inconsistent health insurance coverage is associated with any differences. Methods: The 2016-2017 NSCH identified children with diagnoses of ID and ASD (with or without ID). Caregivers were asked if the child had an unmet need for health care during the past 12 months, and the type of care …

Choosing A Second-Generation Antidepressant Using Demographic Characteristics And Clinical Symptoms Of Depression, Amanda Lin

Master of Public Health Program Student Publications

Depression is the sixth most costly health condition in the United States, and depression that does not respond to its first trial of antidepressant treatment adds an annual cost of $9,529 per person per year. Thus, choosing an effective starting antidepressant can decrease the overall cost of depression to society. A secondary analysis of data from the Collaborative Psychiatric Epidemiology Survey (CPES) was performed to create models that can predict the efficacy of second-generation antidepressants in treating sadness. Two sets of Principal Component Analyses (PCAs) and logistic regressions were performed on variables associated with patient demographics, clinical symptoms, past medical …

Description Of Race And Preterm Birth In Six Ohio Counties From 2013-2018, Kelly Trabue

Master of Public Health Program Student Publications

Objective: The purpose of this research was to describe preterm birth rates, and the risk of preterm birth among maternal race groups in Ohio, Cuyahoga County, Franklin County, Hamilton County, Lucas County, Montgomery County, and Summit County from 2013 to 2018. For the purpose of this study, preterm birth was defined as the live birth of a baby with a period of gestation less than 37 weeks. The maternal race groups were African American, White, and Other.

Methods: A descriptive analysis of retrospective data was conducted on 798,957 live births in Ohio over six years. The data was further divided …

Pharmacists’ Knowledge Of Social Determinants Of Health In Post-Graduate Pharmacy Residency Programs, Rachel N. Chandra

Master of Public Health Program Student Publications

Background: Clinical pharmacists and their training programs can play a key role in helping to address social determinants of health (SDoH) by transforming healthcare beyond the traditional clinical approaches. Pharmacists’ knowledge of SDoH in post-graduate residency programs are key skills necessary for creating an impact in healthcare outcomes.

Purpose: The purpose of this project was to assess U.S. Department of Veterans Affairs (VA) post-graduate residency program directors’ and residents’ knowledge about SDoH. Methods: An IRB exempt questionnaire was created via Survey Monkey (™) and administered to postgraduate pharmacy residents (N = 618) and residency program directors (RPDs) (N = 235) …

Health Care Provider Personal Religious Preferences And Their Perspective On Advance Care Planning With Patients, Marjorie A. Bowman, Sarah St. Cyr, Adrienne Stolfi

Population and Public Health Sciences Faculty Publications

Objective:

To understand how health-care providers’ (HCPs) religious preferences influence their willingness to undertake advance care planning (ACP) with patients and their acceptance of other HCP’s involvement.

Methods:

Online anonymous survey distributed to HCPs in hospital, ambulatory offices, and hospice settings in Dayton, Ohio. We evaluated the associations of HCP religion with their personal ACP, willingness to facilitate ACP, and acceptance of other HCPs’ ACP participation.

Results:

704 respondents: nurses (66.2%), physicians (18.8%), other HCPs (15.0%), white (88.9%), and primarily Catholic (23.3%) or Protestant (32.0%). “No religion” was marked by 13.9%. Respondents were favorable to ACP with patients. Religious respondents …

Determining The Barriers To Prenatal Care Entry Within The First Trimester By Evaluation Of Prenatal Care Surveys And Questionnaires, Joycelyn Akamune

Master of Public Health Program Student Publications

Background: Prenatal care (PNC) within the first trimester is associated with improved fetal and maternal health outcomes. Improved PNC is necessary to prevent negative birth outcomes such as low birth weight and infant mortality, which have significant impact on birth outcome rates. Improving access to PNC in the first trimester involves removing barriers to care. A brief survey distributed to expectant mothers is a simple way to define these barriers. Many small community health centers do not use surveys to gather patient information. By reaching this population, barriers to PNC can be better understood and mitigated using community resources decreasing …

The Effect Of Social Vulnerability During The 2014 Ebola Outbreak In Monrovia, Liberia, Mussa Y. Zatreh

Master of Public Health Program Student Publications

Background: Ebola virus disease (EVD) is a dangerous, often fatal disease that spreads through infected bodily fluids. In 2014, an Ebola outbreak swept through West Africa, including Liberia.

Purpose: The purpose of this study is to examine how social vulnerability affected different aspects of life during the 2014 Ebola outbreak in Monrovia, Liberia. The association between vulnerability and hardship that people experience during the outbreak was examined. This was measured by indicator variables for hardship such as availability of food, cash, or medical care. Vulnerability was also compared with EVD knowledge and vigilance.
Method: An additive index for social vulnerability …

A Tale Of Three Systems: Improving Three Emergency Communication Systems, Elizabeth M. Williams

Master of Public Health Program Student Publications

This paper examines the current state of communications between the public, first responder organizations, and hospitals during mass traumatic casualty events. While the current system that exists nationwide, the National Incident Management System (NIMS), is an effective system, there are several improvements that could be made on a community level. This paper looks at national-level plans, such as the national emergency communications plan, NIMS, Hospital Incident Command System (HICS), and national Incident Command System (ICS). This paper sets forward several cost-sensitive recommendations to add to local emergency communication plans and structures in order to make better use technology that already …

The Effect Of Urinary Triclosan On Serumthyroxine In Us Population: 2011-2012 Nhanes Data, Katie M. Clark

Master of Public Health Program Student Publications

Background: Triclosan is an antibacterial agent that is added to personal care products to prevent bacterial growth. The FDA banned the use of triclosan in soap in 2016 due to safety concerns. Triclosan is considered an endocrine disruptor and had reported effects on the body, including changes in thyroid function.

Purpose: The purpose of this study was to assess the relationship between urinary triclosan and serum thyroxine in U.S adults. Methods: Data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) were analyzed (N =1,476). Linear regression analyses were performed to assess the relationship between log transformed triclosan and …

Poor Sleep Health In American Adults: Implications For Screening In Civil Aviation, Melissa E. Gear

Master of Public Health Program Student Publications

Background: Poor sleep health is increasingly prevalent in the United States (US) adult population and contributes to fatigue. Fatigue is a significant safety hazard within civilian aviation, yet data regarding the prevalence of inadequate sleep in this population is sparse. Are there demographic characteristics which put individual at risk of not obtaining adequate sleep which should trigger screening during the medical certification process?

Methods: This cross-sectional study used National Health Interview Survey 2014-2016 data from US adults aged 18 to 65 to observe the relationship of demographic, socioeconomic, health, and behavioral characteristics with reported inadequate sleep duration and quality (trouble …

Distribution And Community Reception Of Medication Disposal Pouches Compared With Distribution Of Unintentional Overdose-Related Deaths In Montgomery County, Ohio, Parvaneh K. Nouri

Master of Public Health Program Student Publications

Introduction: Substance misuse is a significant problem nationally, where Ohio ranks within the top five states contributing to this burden. Montgomery County experiences the most deaths in the state. While illicit fentanyl and analogs are increasingly responsible for overdose-related deaths, prescription misuse is a significant risk factor for progression to illicit substance use. Methods: Survey data from a pilot medication safety campaign utilizing medication disposal pouches were evaluated by descriptive analysis and qualitative analysis. Survey findings were compared to data of all unintentional overdose-related deaths in Montgomery County from January to October, 2017. Secondary analysis of death data was performed …

Demographic Trends In Prescription Pain Reliever Misuse And Treatment-Seeking For Addiction, Megan C. Smith

Master of Public Health Program Student Publications

Opioid addiction in the United Sates has reached epidemic proportions in recent years, demanding targeted efforts in both clinical medicine and public health. This analysis outlined a demographic profile of recent prescription pain reliever (PPR) misusers and compared those characteristics to the population of individuals currently enrolled in addiction treatment. To explain the difference in numbers between these two populations, reported reasons for non-treatment seeking are analyzed by demographic characteristic. This discussion reviews existing literature profiling PPR misusers and treatment-seekers, as well as research exploring barriers to addiction treatment. A secondary analysis was performed using data from the National Survey …

Marijuana Use Among Pregnant Women In A High-Risk Population, Shanice A. Akoto

Master of Public Health Program Student Publications

Background: Marijuana is the most commonly used illicit substance in pregnancy, often used concurrently with tobacco, increasing the risk for prematurity and low birth weight. Programs such as Healthy Start and CenteringPregnancy® provide resources and prenatal care to women in underserved communities in hopes of improving birth outcomes.

Objective: Evaluate marijuana use in pregnant women living in Montgomery County, Ohio in the highest risk zip codes (45402, 45403, 45405, 45414, 45416, 45417, 45426) and determine if use at delivery is lower in women enrolled in CenteringPregnancy® compared to women who were not. Methods: A secondary analysis of previously collected de-identified …

The Association Of Perfluoroalkyl Substances Exposure And Metabolic Syndrome In U.S. Adults, David B. Leary

Master of Public Health Program Student Publications

Background: Perfluoroalkyl substances (PFASs) are persistent synthetic compounds that have been environmental contaminants since the 1950s. Exposure in the general population can be through food and water ingestion, use of non-stick cookware, and dust from stain-resistant carpet. Studies have suggested PFASs act as endocrine disrupters and to affect liver and immune function, as well as cause increases in serum lipid levels.

Objective: To explore the association between six common detectable PFASs and the metabolic syndrome (MetS) in United States (U.S.) adults. Methods: Data from 739 participants aged 20 years and older from the 2013-2014 National Health and Nutrition Examination Survey …

Wellbeing Begins With Employees: Exploring Associations Of Physical Health In A Head Start Organization, Kristin Snyder, Madelyn Hill

Master of Public Health Program Student Publications

The purpose of this research was to describe self-reported physical health status, behaviors, and wellbeing interests of teachers and other staff within a Head Start agency. Information on overall health, behaviors, demographics, and interests in wellbeing programs was collected through a 58-item questionnaire (N = 312). A majority of participants were white (66.8%), female (93.7%), and half were teachers (49.4%). Bivariate analyses and an ordinal logistic regression were performed to test the association of physical health with independent variables, health behaviors, and demographics. Associations with “very good/excellent” physical health displayed by the regression model include mental health, chronic conditions, vegetable …

Hope Center For Families: Addressing Health Needs Through A Two Generation Model, Brianna Burlock

Master of Public Health Program Student Publications

This project’s objective is to explore how the Two Generation Model of the Hope Center for Families can address the health needs of the zip code 45406 community in order to combat negative health outcomes for impoverished families. The investigator researched studies regarding the Two Generation Model and previous organizational applications of the model. Interviews were held with the partners of Hope Center for Families and with an organization that uses the Two Generation Model. The interviews were analyzed for recurring themes after listening to each of them several times and then transcribed. A logic model for the Hope Center …

Impact Of Perioperative Surgical Home On First Cases Delayed On Day Of Surgery In Colorectal Patients, Maria Sparaco

Master of Public Health Program Student Publications

Perioperative Surgical Homes (PSH) are evolving patient-centered medical home models that coordinate stream-lined care among all providers in the care process. The PSH model can serve as a solution to improve quality assurance, patient satisfaction, and reduce errors that lead to poor outcomes, many of which are preventable and can lead to higher costs. This model has many benefits, but it can be a challenge to execute in a hospital system. TriHealth chose to adopt a PSH model, the TriHealth Surgical Optimization Center (TSOC) in March 2017. It implemented a pilot program for its colorectal patients. Metrics of primary interest …

Oral Health 2020: Recommendations To Help Ohio Meet Healthy People 2020 Goals Based On States’ Oral Health Plans, Mackenzie Hunter

Master of Public Health Program Student Publications

Dental caries remains one of the largest untreated diseases in children and is one of the leading causes of poor oral health in the United States. Many states have joined forces with the Centers for Disease Control and Prevention and Medicaid to formulate a state oral health action plan that targets the Healthy People 2020 Goals for Oral Health to improve the overall oral health of children in the state. Through this plan, in connection with state oral health plans many states are comprehensively addressing these Healthy People 2020 goals. Ohio, on the other hand, has not met a number …

Conduct Disorder In Times Of Crisis In The Eastern Mediterranean Region, Ruaa A. Al-Juboori

Master of Public Health Program Student Publications

Background: The Eastern Mediterranean Region (EMR), comprising of 22 countries, has a high burden of conduct disorder (CD) and has the largest burden of displaced populations. Violence and displacement increase the need for mental health services.

Methods: Using descriptive study design, 2015 global CD burden (disability-adjusted life years DALYs per 100,000 populations) was compared to the EMR burden. Across 25 years (1990-2015) trend of CD in 22 EMR countries was graphed and compared with the global CD burden. Association of CD with a) Corruption Perception Index; b) Global Peace Index; c) Human Development Index was assessed using correlation analysis. CD …

Does Self-Efficacy Mediate The Relationship Between Parenting Style And Adolescent Fruit And Vegetable Consumption?, Sumayyah S. Shermadou

Master of Public Health Program Student Publications

Background: Inadequate fruit and vegetable (FV) consumption is a serious public health issue in children and adolescents that is influenced by the type of parenting style and one’s self-efficacy.

Purpose: The purpose of the study was to determine the association between parenting style and adolescent FV consumption and whether adolescent self-efficacy mediates this relationship.

Methods: Data retrieved from the Family, Life, Activity, Sun, Health, and Eating (FLASHE) study were used to perform statistical analyses on 1,382 parent – adolescent dyads. A mediation analysis using the causal steps approach was used to determine whether adolescent self-efficacy mediated the effect of parenting …

Consequences Of Fatigue And Sleep Deficiency In The Workplace: Implications For The Construction Industry, Karen Phegley

Master of Public Health Program Student Publications

Background: This study was a review of the (1) consequences that fatigue and sleep deficiency have on the human body, personal safety and safety in the workplace with implications for the construction industry; and (2) factors in the workplace that contribute to worker fatigue.

Methods: A systematic search and review of peer-reviewed articles and gray literature was conducted for sources describing common industry policies, standards and/or recommendations addressing sleep related problems in the workplace.

Results: The contributing factors of fatigue include work-related mental exertion, sleep deficiency and work-related physical exertion. Major work-related effects stem from circadian rhythm disruptions due to …