Public Health Commons^™

Evaluation Of Services Provided To Pregnant African Refugees By Catholic Social Services Refugee Resettlement Agency In Dayton Ohio, Jessica M. Brown

Master of Public Health Program Student Publications

In 2016 Public Health - Dayton and Montgomery County declared birth outcomes the number one priority in their Community Health Improvement Plan. To improve the infant mortality rate (IMR), racial disparities must be address and considerations should be given to Dayton’s newest and most vulnerable neighbors. Dayton receives between 200 and 250 refugees each year, 70% of whom are from the Democratic Republic of the Congo. African refugees have higher infant mortally and poorer birth outcomes than native populations in the U.S. Early and regular prenatal care is protective against infant mortality, and African refugees consistently report delayed and infrequent …

Characterization Of Different Molecular Markers For Identification Of Salmonella Enterica Serovar Typhi In Pakistani Population, Faizan Muttiullah, Fida Muhammad Khan, Fakhar-I- Abbas, Sabiha Shamim

Journal of Bioresource Management

Typhoid is caused by Salmonella enterica serovar Typhi that is usually diagnosed by using serologic and immuno-chromatographic techniques in developing counties including Pakistan, which is thought to be an unreliable diagnostic method. For accurate diagnosis we used molecular techniques to amplify 204 bp StyR-36 and 498 bp flagellin gene for the identification of Salmonella enterica serovar Typhi. This study was done on 58 individuals diagnosed positive of typhoid via serologic tests and 50 healthy individuals as a control group. Success rate of amplification for flagellin gene was 77.58% while that for StyR-36 gene was 68.97% showing that flagellin gene primer …

Persistence Of Macrocytosis After Discontinuation Of Zidovudine In Hiv-Infected Patients, Inski Yu, Richard N. Greenberg, Timothy N. Crawford, Alice C. Thornton, Thein Myint

Family Medicine Faculty Publications

The duration of macrocytosis after stopping zidovudine (ZDV) is unknown. Among 104 HIV-infected patients treated with ZDV for more than 1 year, 84 patients had macrocytosis at ZDV discontinuation. The median mean corpuscular volume (MCV) was 114.6 fL (range 100-128 fL). Patients were divided into 2 groups: those who did (resolved macrocytosis, n = 36) and did not (persistent macrocytosis, n = 48) normalize MCV at 3 to 6 months after ZDV discontinuation. Alcohol use (P =.02), smoking (P =.03), and lower (but within normal range) folic acid levels (P =.05) were related to the persistence of macrocytosis. A persistence …

Mountain Biking As A Means To Encourage Public Health And Wellbeing, Scott C. Dillard

Master of Public Health Program Student Publications

Mountain biking is a popular form of outdoor exercise. There are 8.3 million riders in the U.S., 2.8% of the population (The Outdoor Foundation, 2016). The National Survey on Recreation and the Environment (https://www.srs.fs.usda.gov/trends/nsre-directory/) places the number of participants much higher at 42.7 million riders, but their definition is less restrictive (Cordell, 2012). The National Survey includes anyone who has ridden a mountain or hybrid bicycle in the last twelve months, regardless of riding surface, while Outdoor Recreation Participation Top Line Report (The Outdoor Foundation, 2016) estimates are based on riding surface. Therefore, to avoid confirmation bias, the lower Outdoor …

Complex Coordinated Terrorist Attack: Considerations For Practical Emergency Preparedness And Resiliency Exercises, Trent Elliott

Master of Public Health Program Student Publications

In today’s geopolitical environment, the emergence of religious extremism is becoming more prevalent. Justified as a holy war, jihadists are becoming more brash and calculated in attacking targets to inflict maximum damage and instill the greatest amount of fear. Coordinated, lethal, terrorist attacks against innocent targets; killing indiscriminately is a preferred tactic of extremists. Multiple attacks, coordinated either in proximity or timing, using firearms, explosive devices, or fire to inflict damage and disrupt life is the basis of a Complex Coordinated Terrorist Attack (CCTA).

City and regional emergency response plans should address mitigating efforts to a CCTA. Community strength and …

How Effective Is The Diabetes Prevention Program At Preventing Diabetes? A Survey Of Ymca’S Diabetes Prevention Program Participants Five Years Post-Completion, Rachael A. Mainord

Master of Public Health Program Student Publications

Objective: In people with prediabetes, a mere 5% weight loss can cut the risk of developing type 2 diabetes in half. In 2011, the YMCA of Greater Dayton launched the YMCA’s Diabetes Prevention Program (YMCA’s DPP) to reduce the prevalence of diabetes in Dayton, Ohio. In 2016, health data for the 2011 YMCA’s DPP prediabetic cohort, including 2016 diabetes status, were evaluated.

Methods: Using de-identified YMCA of Greater Dayton data, analysis was performed on 2011 program (N=90) and 2016 survey results (N=21). The incidence of program 5% weight loss (“success”) was determined and variables associated with success were identified. Survey …

Meeting Physical Activity Guidelines And Health Outcomes In The Elderly: Are Racial Differences Important?, R. Michael Johnson

Master of Public Health Program Student Publications

Physical activity guidelines for health improvement were recommended by the Centers for Disease Control and Prevention (CDC) in 2008. Today, data on individuals’ adherence to the CDC guidelines are collected as part of its Behavioral Risk Factor Surveillance System (BFRSS) survey. While racial disparities in health outcomes are well documented, analyses of the BRFSS data have the potential to shed light on whether there are racial differences in the relationship between physical activity and health outcomes.

The 2015 (BRFSS) dataset contained responses from 441,456 individuals, including 42,516 over the age of 65 who had complete data on the variables that …

Systematic Review Of Scientific Evidence Supporting Yoga As An Alternative Treatment For Generalized Anxiety Disorder, Alexandria Keller

Master of Public Health Program Student Publications

Background: This study was a systematic review of scientific evidence investigating yoga as a treatment for GAD. Assessing the scientific validity of alternative health practices is necessary for proposals of inclusion in public health practices.

Methods: A comprehensive search for peer-reviewed biomedical research was conducted for literature describing interventions for GAD using yoga and its practices (e.g. physical postures, meditation, breathing exercises). Systematic research was conducted on academic literature databases available through Wright State University (Web of Science, PubMed, Cochrane Library) using search terms selected based on key words for Diagnostic and Statistical Manual, 5th Edition and the Sanskrit variation …

Data-Driven Birth Outcomes Objectives For A Community Health Improvement Plan, Casey Gayheart

Master of Public Health Program Student Publications

Purpose: To identify factors associated with poor birth outcomes in four Montgomery County, Ohio zip codes identified as priority areas for public health intervention.

Methods: A cross-sectional study was conducted using data from zip codes 45415 (N=267), 45416 (N=158), 45417 (N=1,104) & 45426 (N=571) in Montgomery County, Ohio from 2013 – 2015. The outcome was birth weight. Predictor variables included maternal demographics and behavioral variables. Multiple linear regression was used to test for associations.

Results: Children of White mothers had greater mean birth weight compared to children of non-White mothers in all four zip codes; it was statistically significant in …

Screening Families For Unmet Social Needs In A Pediatric Clinic, Elizabeth Evans Peterson

Master of Public Health Program Student Publications

Background: Previous research indicates that at least 60% of preventable deaths are caused by modifiable factors. Children, especially those under the age of five, are the most at-risk population for negative social determinants of health. Identifying and mitigating these factors could break the poverty impact cycle and promote wellness into adulthood, improving community health outcomes.

Purpose: The purpose of this study was to describe trends in unmet social needs of children attending a well-child visit in Dayton, Ohio. Methods: Families attending a hospital-affiliated clinic during a well-child visit were asked to complete a simple, 10-item questionnaire. This cross-sectional study utilized …

Measurable Predictors Of Birth Outcomes: Community Health Needs Assessment Objectives, Tazeen Ahmed

Master of Public Health Program Student Publications

Purpose: The purpose of this study was to identify measurable predictors of birth weight in the four zip codes of Montgomery County, Ohio with the poorest health outcomes. Previous literature has shown that birth weight is strongly correlated with risk of infant mortality.

Methods: Multiple linear regression was used to assess the relationship between multiple predictor variables and the outcome of interest, birth weight. Separate models were fit for each zip code (45402, 45405, 45406, and 45414). Maternal and infant characteristics were analyzed to assess which variables served as the best predictors of birth weight in order to better allocate …

The Role Of Msm Status, Race, And Marijuana Use In Hiv Risk Among Adult Males In The Columbus, Oh Region, Andrea M. Hager

Master of Public Health Program Student Publications

Human Immunodeficiency Virus, or HIV, is a life-long illness that affects millions across the globe. Young adult males, especially men who have sex with men (MSM), are at significant risk for the virus. This project examined a hypothesized association between marijuana use and HIV infection, comorbidity of HIV and other STIs, and potentially confounding variables in a sample of men tested for HIV in Columbus, Ohio.

The sample included a total of 898 non-Hispanic/Latino males (294 White, 604 Black/African-American, non-Hispanic/Latino males aged 18 to 74 years. All were tested for HIV between February 2013 and April 2013 by Columbus (Ohio) …

The Opioid Epidemic In The United States With A Focus On Ohio, Timothy A. Netters Jr.

Master of Public Health Program Student Publications

The rate of deaths due to opioid drug overdoses has increased substantially in the 21st-century United States and shows no signs of slowing down. Goleman (1987) stated that opioid drugs are not inherently dangerous when used for their specified purpose of relief of moderate to severe acute pain. However, when they are abused, mixed with other drugs, or their stronger counterparts, used for chronic pain or are used without understanding of their increased strength the effects can be devastating. Ohio is unfortunately no stranger to the problem of opiate abuse and overdose. Counties throughout Ohio have had to add additional …

Association Of Cadmium Exposure With Bone Mineral Density In U.S. Adults, Joseph P. Taggart

Master of Public Health Program Student Publications

Background: Cadmium is a toxic heavy metal and environmental pollutant; general population exposure is through occupation, diet, and smoking. Cadmium is associated with lower bone mineral density (BMD) and higher risk of fractures in women. This association is not fully known in men.

Objective: Given the toxicity and global dispersion of cadmium, we explored its association with BMD in U.S. men and women.

Methods: Data from 914 participants from the National Health and Nutrition Examination Survey 2013-2014 was utilized. Multivariable regression analysis was used to determine the independent association between cadmium exposure and BMD controlling for age, body mass index, …

Post-Traumatic Stress Symptoms In Pathological Gambling: Potential Evidence Of Anti-Reward Processes, Cheryl L. Green, Ramzi W. Nahhas, Arielle A. Scoglio, Igor Elman

Population and Public Health Sciences Faculty Publications

Background: Excessive gambling is considered to be a part of the addiction spectrum. Stress-like emotional states are a key feature both of pathological gambling (PG) and of substance addiction. In substance addiction, stress symptomatology has been attributed in part to "anti-reward" allostatic neuroadaptations, while a potential involvement of anti-reward processes in the course of PG has not yet been investigated. Methods: To that end, individuals with PG (n = 22) and mentally healthy subjects (n = 13) were assessed for trauma exposure and post-traumatic stress symptomatology (PTSS) using the Life Events Checklist and the Civilian Mississippi Scale, respectively. Results: In …

Opportunity And Life-Long Health Outcomes: A Review Of The Effects And Proposed Solutions Of Hypersegregation On Health Disparities, Christen D. Johnson

Master of Public Health Program Student Publications

Hypersegregation, the overrepresentation of a racial group in a metropolitan area, is defined by evenness, exposure, concentration, centralization, and clustering. Hypersegregated communities are subjected to bias and have few resources and opportunities, which compounds the negative impact on one’s health and socioeconomic outcomes. This study aims to describe the effects of hypersegregation on health risks, chronic disease, violence, and compare the differences between hypersegregated and non-hypersegregated cities. Data were collected for Montgomery County, Ohio (MC) for low birth weight, infant mortality, diabetes, heart disease, and violent crime, and compared with data from Summit County (SC). There is a larger Black …

The American Pediatric Type 2 Diabetes Epidemic: Considerations For Targeted Diabetes Prevention Programs, Dolores Dodson

Master of Public Health Program Student Publications

Childhood obesity is an identified risk factor for several long-term health issues such as type 2 diabetes mellitus (T2DM). According to the Centers for Disease Control and Prevention (CDC), diabetes is the seventh leading cause of death within the United States. The CDC has implemented an evidence-based program, The National Diabetes Prevention Program (DPP), to prevent the development of T2DM among individuals with prediabetes. Prediabetes is defined as having elevated glucose levels glycated hemoglobin [A1C] levels between 5.7%-6.5%) that are not elevated enough to meet diabetes diagnosis criteria (A1C levels > 6.5%). The DPP is a lifestyle change program that has …

Analysis Of The 2017 Montgomery County Adult Risk Perception Of Prescription Opioid Misuse Survey Data, Lance Nussbaum

Master of Public Health Program Student Publications

Montgomery County, Ohio, has higher overdose rates than the national or state averages: approximately 50% are related to prescription opioid misuse. A community assessment was conducted to better understand Montgomery County’s adult population’s connection with, and opinions of, prescription opioid medications. Methods: Data for 284 anonymous internet surveys were compiled and subjected to a descriptive analysis of responses and trends. Response patterns were used to recommend appropriate interventions. Results: Respondents were well-educated (91.9%), employed (76.7%), Caucasian (89.8%), females (79.2%) who resided (82%) and worked (66.5%) in Montgomery County (82%). The risk from personal misuse of prescription opioids was perceived by …

Evaluation Of A Childhood Community-Based Comprehensive Asthma Management Program, Stephanie E. Welsh

Master of Public Health Program Student Publications

Background: The Dayton Children’s Hospital Comprehensive Asthma Management Program incorporates Community Health Worker (CHW) interventions to improve child asthma control and reduce urgent health resource utilization.

Methods: Children in grades two to five with parent- or physician-identified asthma received one of three levels of intervention, based on self-selection by caregivers: (1) child asthma education; (2) child and caregiver asthma education; (3) child and caregiver asthma education, plus home assessments. Child Asthma Risk Assessment Tool (CARAT) scores were collected before intervention to assess risk. Childhood Asthma Control Test (C-ACT) scores and urgent health visit numbers were collected before and after intervention. …

A Risk Factor Tool For United States Teenage Pregnancy: Adapting A Tool From The United Kingdom, Kanchen Loganathan

Master of Public Health Program Student Publications

With a population of 42 million, one out of every eight people living in the United States is an adolescent. Current data show that half of American adolescents today are engaging in sexual activity, and one in eight adolescent females will become pregnant before the age of 20. The number of teenage pregnancies have declined over the past decade due to increased contraception, and more efforts to educate adolescents on safe sex. Newer research also reports that pregnancy during an adolescent’s teenage years may not be as detrimental to their lives as once thought. However, teenage pregnancy has been linked …

Ptsd Symptom Severities, Interpersonal Traumas, And Benzodiazepines Are Associated With Substance-Related Problems In Trauma Patients, Jeffrey Guina, Ramzi W. Nahhas, Adam J. Goldberg, Seth Farnsworth

Population and Public Health Sciences Faculty Publications

Background: Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs) are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions. Methods: Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472), we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis), as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses) in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions. Results: After adjusting for multiple testing, several factors …

Trends In Contraceptive Use, Type, And Distribution Following Implementation Of The Affordable Care Act, Frank A. Catrone

Master of Public Health Program Student Publications

Background: Over half of all births in the United States are the result of unintended pregnancies. Nearly one half of those women are using contraception incorrectly, and the rest are not using it at all. A major barrier to the use of highly effective methods of contraception is cost. One of the major goals of The Patient Protection and Affordable Care Act (ACA) was to make highly effective contraceptives available to all women at no cost.

Objective: To examine the changes in utilization and methods of contraception since the ACA was effected in 2012.

Methods: Comparisons were made on summary …

Increasing Physician Awareness Of And Referral To The National Diabetes Prevention Program (Dpp) Using Continuing Medical Education (Cme), Justin T. Kelley

Master of Public Health Program Student Publications

Importance: Diabetes is a growing public health threat. One in eleven individuals have diabetes and one in three individuals have prediabetes. Without intervention, 15-30% of individuals with prediabetes will develop diabetes within five years. The National Diabetes Prevention Program (DPP) led by the Centers for Disease Control and Prevention (CDC) is proven to prevent or delay the development of diabetes in individuals with prediabetes.

Objective: A continuing medical education (CME) activity was created to increase physician awareness of and referral to the DPP. The goal was to promote the DPP among first-line treatments for prediabetes.

Methods: The types and requirements …

Factors Contributing To The "Dominican Paradox" Of Maternal Mortality, Cherissa Garcia

Master of Public Health Program Student Publications

Despite having one of the highest rates of institutionalized birth in the region, Dominican maternal mortality rates are higher than the regional average. This phenomenon is referred to as the “Dominican Paradox.” The purpose of this paper is to identify factors beyond the established healthcare system that may contribute to the “Dominican Paradox.” Literature about the “Dominican Paradox” often attempts to explain the paradox in terms of the current healthcare system alone. Over reliance on the healthcare system has likely contributed to the “Dominican Paradox.” Most of prevalent causes of maternal mortality in the Dominican Republic are strongly linked to …

Older Adults With Elevated Bmi Are At Greater Risk Of Accelerated Knee Osteoarthritis: Data From The Osteoarthritis Initiative, Kyle D. Wallace

Master of Public Health Program Student Publications

Background: Around 35% of adults with osteoarthritis (OA) have knee osteoarthritis (KOA), which generally progresses over several years; however, some individuals experience accelerated KOA (AKOA), a rapid progression to end-stage disease within 48-months. Purpose: To assess baseline differences among those who develop the different types of KOA, and to determine if baseline characteristics and measures can be used to predict an individual’s KOA status (Common KOA or AKOA) 48 months later.

Methods: Cross-sectional analysis of data from the Osteoarthritis Initiative (OAI) was completed. At baseline, 4,769 participants were enrolled. Data from individuals (n = 1,561) free of radiographic KOA (Kellgren-Lawrence …

A Set Of Smart Practices For Public Health Department Accreditation By Public Health Accreditation Board, Veer Raghava Kumar Marthy

Master of Public Health Program Student Publications

Purpose: The purpose of this research is to determine smart practices that could be used by a public health department to have an efficient, productive and successful accreditation by the Public Health Accreditation Board (PHAB).

Methodology: Accreditation coordinators of eight accredited Ohio-based public health departments were interviewed in 2016. A qualitative study was conducted using semi-structured interviews with funneling. Results were generated using a hybrid model of analysis that included a content analysis to make valid inferences from the interview data.

Results: The accreditation coordinators identified a series of smart practices. Six prominent themes that were identified and labeled as …

Best Practices: Emergency Medical Management To Hydrazine Exposure, M. Bradley Brough

Master of Public Health Program Student Publications

Objective: Hydrazine is a toxic industrial chemical with significant health risk. It is commonly used in aerospace technologies as a propellant fuel source for rockets and aircraft. The purpose of this project was to perform a comparative analysis of the emergency algorithms at United States Air Force installations where occupational hydrazine exposure may occur and then create a best practices approach for medical responders.

Methods: After review of current Occupational Safety and Health Administration standards and requirements for hydrazine, six United States Air Force Medical Group installation response protocols were analyzed and compared to each other and to current medical …

The Trend Of Communicable And Non-Communicable Diseases In East African Community (Eac) Countries: Case Study Of Burundi, Rwanda, And Uganda - 1990 To 2013, Emile Shumbusho

Master of Public Health Program Student Publications

Background: In low and middle-income countries (LMICs), non-communicable diseases (NCDs) are rapidly emerging alongside a well-documented persistence of communicable diseases (CDs) in fragile health care systems. In sub-Saharan Africa, chronic NCDs are expected to overtake CDs as the leading cause of death. The aim of this study was to compare mortality rates due to CDs and NCDs between developed countries, developing countries, Burundi, Rwanda, and Uganda from 1990 to 2013.

Methods: A descriptive study with longitudinal and cross-sectional analyses of mortality rates was conducted using the global burden of disease (GBD) study data. Tableau Public 9.3 software was utilized to …

Five Rivers Family Health Center Community Health Needs Assessment, Kara Yutzy

Master of Public Health Program Student Publications

Objectives: To conduct a community health needs assessment (CHNA) on the three zip codes around Five Rivers Family Health Center (FRFHC) in order to guide healthcare professionals in creating goals and priorities for needed health services in their health center’s targeted community.

Methods: The investigator gathered zip code specific data from the American Community Survey, Public Health - Dayton & Montgomery County, the Dayton Police Department, and other online sources for the FRFHC CHNA zip codes. Data on the targeted zip codes was compared to data from Montgomery County, Ohio, and the United States.

Results: The greatest disparities between the …

The Association Between Secondhand Smoke Exposure And Metabolic Syndrome In Children With Elevated Bmi, Alexandra Lawson

Master of Public Health Program Student Publications

Background & Purpose: The childhood obesity epidemic is associated with increased metabolic syndrome (MetS) and cardiovascular morbidity. The purpose of this study was to determine whether secondhand tobacco smoke exposure (SHSe) is associated with MetS in children with elevated body mass index (BMI).

Method: A retrospective chart review was conducted on children aged six to 11 years with elevated BMI seen in a pediatric lipid clinic from 2008-2014. Data included age, sex, race, BMI, and five MetS criteria. MetS was defined as BMI ≥85th percentile and ≥two of the following: systolic or diastolic blood pressure ≥90th percentile, HDL/dL, triglycerides >150 …