Public Health Commons^™

Alcohol Use And Church Attendance Among Seventh Through Twelfth Grade Students, Dominican Republic, 2011, Michael N. Dohn, Santa Altagracia Jimenez Mendez, Maximinia Nolasco Pozo, Elizabet Altagracia Cabrera, Anita L. Dohn

Population and Public Health Sciences Faculty Publications

Excessive alcohol consumption increases the years of life lost to premature death and disability worldwide. Religion is a mitigating factor in alcohol consumption. A survey in the Dominican Republic showed increasing church attendance by middle and high school students (N = 3,478) was associated with a delay in age at first alcoholic drink, fewer students who had consumed alcohol in the past month (current drinkers), lower alcohol consumption levels, fewer episodes of inebriation, and less heavy episodic alcohol consumption (all P < 0.0001). The results suggested that it may be useful to conceive of church-attending youth as a subset of the adolescent social network when planning primary alcohol prevention programs for young people.

From Sea To Shining Sea: Force Health Management Of Infectious Diseases In A Cross-Global Deployment Flux Toward Tropical Environments, Joanna M. Nelms

Master of Public Health Program Student Publications

Infectious diseases in fighting armies are a pestilence as old as war itself. The history of the United States military is rich in successes of innovation and lessons learned in failure in the prevention and treatment of infectious diseases. Over the nearly two and a half centuries of American warfare, military research and development have contributed greatly to advancements in vaccines, medical treatments, and other control and prevention strategies for tropical and other infectious diseases. Current deployments in desert environments have provided continued research and progress in infectious disease control, treatment, and prevention, despite a relative decrease in civilian medical …

Project Parenthood: Efficacy Of Evidence-Based Parenting And Safer Sex Education Program In An At-Risk Adolescent Population, Jasmin Scott

Master of Public Health Program Student Publications

Objective: Project Parenthood was developed to support the growth of adolescent parenting education and to provide a resource for adolescent safer sex education and repeat pregnancy prevention.

Methods: Through the use of pre- and post-surveys, three key variables were measured: (1) knowledge, (2) perspective, and (3) skill. Survey questions were categorized as measuring one of the variables. Survey data was aggregated to create a pre- and post-composite score for each question. The percentage of questions that resulted in an increase, decrease, or no change was calculated for each variable. A Paired t-Test analysis was run to evaluate whether or not …

Adverse Health Effects Of Intestinal Parasitic Infections In Rural Peruvian Clinic Patients, Jonathan M. Stofer

Master of Public Health Program Student Publications

Intestinal Parasitic Infections (IPIs) pose a significant global health concern. IPIs annually contribute to 3.5 billion infections and 450 million illnesses worldwide. In hyperendemic countries, IPIs pose a significant economic and health burden, especially in rural areas. IPIs have many routes of transmission and cause a wide range of symptoms associated largely with poor health, impeded growth, and worsening of secondary infections. Such diseases are widespread in poor communities living in the Peruvian Amazon. This study aims to describe common chief complaints, diagnoses, treatments, as well as behaviors and practices associated with IPIs presenting in clinic patients. As part of …

Safety Policy And Procedure In Ohio High School Basketball, Issa Walker

Master of Public Health Program Student Publications

There are projected to be seven million high school adolescents from roughly 20,000 high schools who partake in local sports programs annually. Children and adolescents are increasingly participating in sports, and this expanding involvement brings forth issues regarding possible risks of sports-related injury (Vanderlei et al. 2013). Although the involvement in sports is proven to be advantageous for the physical and mental well-being of human beings, injury rates are a public health concern. In the United States, young athletes are responsible for more than two million injuries, 500,000 physician visits, and 30,000 hospitalizations per year (Centers for Disease Control & …

Assessing Multicultural Knowledge, Attitudes, Skills And Comfort: Medical Education For A Changing World, Seth Vanzant

Master of Public Health Program Student Publications

Objectives: To assess the knowledge, skills, comfort and attitudes pertaining to cultural competency of first and fourth year medical students at Wright State University’s Boonshoft School of Medicine in Dayton, Ohio.

Study Design: The Cross Cultural Competency Questionnaire (CCCQ) was distributed to first and fourth year medical students. The CCCQ provided demographic information, as well as the students’ perceptions of their cross cultural knowledge, skills, comfort and attitudes. IBM’s Statistical Package for the Social Sciences (SPSS) was used to analyze the data, in an attempt to identify potential predictive factors for higher levels of cultural competency among entry level students, …

Qualitative Analysis On Reintegration Needs Of Formerly Incarcerated Women In Clark County, Ohio, Londa E. Holliday

Master of Public Health Program Student Publications

There has been a significant increase in the rate of incarceration among women. Since 1995, women’s incarceration rate has increased by about 203%. With this growing trend it is important to explore the unique needs of women, particularly those that relate to community reintegration. It has been found that women reported their needs differently than men. This study examines some of those needs reported by women in the Clark County Jail through a pilot focus group conducted in January 2012. The women in this study discussed what they felt would be needs they would face once they were released from …

Selecting Valid Questionnaires For A Longitudinal Study Of African-American College Student Health, Matthew Collins

Master of Public Health Program Student Publications

Purpose: To create a modular public health questionnaire that can be used to conduct longitudinal academic research in the areas of sleep habits, dietary habits, cardiovascular disease risk, and physical activity and sedentary behavior in an African American collegiate population. Methods: A literature search for questionnaires used in collegiate studies was conducted separately for each category via PubMed. Valid questionnaires were identified and critically reviewed.

Results: Questionnaires recommended for use were the Munich Chronotype Questionnaire, Rate Your Plate Questionnaire, and the International Physical Activity Questionnaire Short Form. For the category of cardiovascular disease risk, no calculators provide a result for …

Analysis Of Barriers To The Successful Prevention And Management Of Pediatric Obesity And Their Relationship To Care At Community Health Centers, Rebecca Beesley, Nicole Craker

Master of Public Health Program Student Publications

Despite international attention, pediatric obesity continues to burden healthcare. Much research has been done to identify barriers to the successful reduction of childhood overweight and obesity, however, a more condensed and accessible compilation of these barriers was lacking. A literature review was done to identify the barriers healthcare providers perceive to the prevention and management of pediatric obesity. It was performed in Fall of 2013 from the following databases: PubMed, PsycINFO, CINAHL, ERIC, and SocIndex. Two independent reviewers selected relevant articles, developed a coding template, and extracted themes. Barriers to the prevention and management of pediatric obesity fell into three …

Leveraging Practice-Based Research Networks To Accelerate Implementation And Diffusion Of Chronic Kidney Disease Guidelines In Primary Care Practices: A Prospective Cohort Study, James W. Mold, Cheryl B. Aspy, Paul D. Smith, Therese M. Zink, Lyndee Knox, Paula Darby Lipman, Margot Krauss, D. Robert Harris, Chester Fox, Leif I. Solberg, Rachel Cohen

Family Medicine Faculty Publications

Background

Four practice-based research networks (PBRNs) participated in a study to determine whether networks could increase dissemination, implementation, and diffusion of evidence-based treatment guidelines for chronic kidney disease by leveraging early adopter practices.

Methods

Motivated practices from four PBRNs received baseline and periodic performance feedback, academic detailing, and weekly practice facilitation for 6 months during wave I of the study. Each wave I practice then recruited two additional practices (wave II), which received performance feedback and academic detailing and participated in monthly local learning collaboratives led by the wave I clinicians. They received only monthly practice facilitation. The primary outcomes …

State Zoonotic Disease Program Structure In The United States: Implications For Local Public Health, Dustin W. Ratliff

Master of Public Health Program Student Publications

Objective: The purpose of this research was to assess to current status of zoonotic disease biosurveillance in the United States.

Methods: A questionnaire was administered to 53 state zoonotic disease program representatives in the United States and Puerto Rico. The questionnaire assessed the structure of zoonotic disease biosurveillance in the respective states, current biosurveillance activities such as testing arthropods for pathogens, information provided to local public health on zoonotic disease, and opinions of the current state of zoonotic disease surveillance. A website assessment was conducted to identify fact sheets that are provided by states on vectors of diseases of public …

One Health: Veterinary Involvement And Zoonoses In Humans, Jasmine Cheeks

Master of Public Health Program Student Publications

Introduction: As veterinarians are often first to identify zoonotic disease events in animals, their involvement in One Health should be facilitated and strengthened by support from zoonotic disease surveillance systems and health regulations specific to zoonotic disease surveillance.

Objectives: To identify relatable trends between the relationship of the number of active veterinary professionals and the incidence of zoonotic diseases in the developed countries of Australia, Brazil, Czech Republic, Denmark, Ireland, Israel, Netherlands, Spain, and the United States of America. Another objective was to illustrate potential barriers current health regulations place on veterinary contributions to One Health surveillance. Methods: Data were …

The Importance Of The Young Invincibles To The Success Of The Affordable Care, Ethel K. Ishimwe

Master of Public Health Program Student Publications

Health care reform in the United States, as codified in the Affordable Care Act (ACA), includes an individual mandate to insure that all citizens are participants in public or privately funded health insurance programs. Universal participation insures that the national risk pool of insured persons will include the broadest spectrum of patient utilizers from the very healthy, who are low utilizers, to the very sick who are high utilizers of health care services. It is only through this high level of participation that the increased services and cost savings of health care reform can be realized. Key to this comprehensive …

Polish Healthcare System In Transition - Perceptions Of The Old And New Systems, Paul Puchta

Master of Public Health Program Student Publications

Poland is the largest country in central Europe. During the Second World War (WWII) Poland lost 39% of its physicians. After WWII, Poland fell under Soviet influence. Socialist parties dominated its government until 1989. Poland was the first country from the Soviet block to adopt economic reforms and turn away from centrally planned system.

Poland is presently a stable democracy with a growing economy, and was accepted to the European Union as a full –fledged member in May 2004. Startling results of the population perception of national healthcare system were published in 2013. Polish customers rated current system poorly, giving …

Is Public Health - Dayton & Montgomery County's Level One Food Safety Certification Training Effective?, Matthew M. Tyler

Master of Public Health Program Student Publications

The objective of the culminating experience was to evaluate the effectiveness of Public Health – Dayton & Montgomery County’s (PHDMC) Level One Food Safety Certification class. Pre-training and post-training quiz score data from approximately 692 participants were examined. Paired t-tests were used to evaluate change in scores, overall, on individual questions, and by job responsibility. There was significant improvements in quiz scores both aggregately (20.6%) and also by individual questions, except for question one which assessed how people could become ill from improper food safety. The temperature related questions were answered incorrectly the most but also showed the most improvement. …

Increasing Chlamydia Retesting Rates In Std Clinics, Michelle L. Bellando

Master of Public Health Program Student Publications

Background: Chlamydia is the most common STD in the United States (Mishori, McClaskey, & WinklerPrins, 2012). Due to the high reinfection rate of Chlamydia, the CDC recommends retesting three months after initial treatment (Park, Amey, Creegan, Barandas, & Bauer, 2010).

Objective: The purpose of this study is to investigate strategies that might improve STD follow-up rates in a clinic setting.

Methods: Public Health - Dayton and Montgomery County STD clinic patients 18 years and older who tested positive for NonGonococcal Urethritis (NGU) or Mucopurulent Cervicitis (MPC) and who agreed to participate were given an opinion survey.

Results: Of the 31 …

The Association Between Autism Spectrum Disorders And Secondhand Tobacco Exposure, Bhupinder Kaur

Master of Public Health Program Student Publications

Second hand tobacco smoke exposure has been associated with neurobehavioral disorders among children. The objective of this study was to evaluate the relationship between second hand smoking and autism spectrum disorders (ASD) in children in the United States. Parent-reported postnatal tobacco exposure inside and outside the house and ASD diagnosis was examined in children younger than 12 years using the 2011-2012 National Survey on Children's Health. The physician diagnosis of current ASD as reported by the parents was used as the outcome variable. Univariate and multivariate logistic regression models adjusted for potential confounders were used to assess the associations. Of …

No Shows: Effectiveness Of Termination Policy And Review Of Best Practices, Maalinii Vijayan

Master of Public Health Program Student Publications

The primary objective of the study was to identify whether the implementation of Patient No Show and Termination policy at Five Rivers Health Centers (FRHC) is associated with a significant reduction of its no show rate. The secondary objective was to perform the best practices review on other strategies to reduce no shows. The data for this study was obtained retrospectively from the electronic medical records of the seven clinical centers of FRHC. Individual clinic's no show rates and cumulative no show rates for pre-implementation and post-implementation period were calculated. Chi-squared test were used to detect statistical significance between pre- …

Smarter Lunchrooms - Ohio: Using Production And Sales Records To Measure Change In Food Selection, Roopsi J. Narayan

Master of Public Health Program Student Publications

Background: The 2010 Healthy, Hunger-Free Kids Act (HHFKA) updated the national school meals standards from the 1995 to the 2010 Dietary Guidelines for Americans. The HHFKA are the most comprehensive changes to the national school meal standards in 15 years. Measurement of food selection is essential to determine the impact of the new rules. This study develops an indicator, using production records, to track food selection in school cafeterias. Methods: Participating Ohio school districts applied interventions from The Smarter Lunchrooms Movement to cafeterias. Using MyPlate as a model and production records from two school districts, a coding system was developed …

Fruit And Vegetable Consumption Patterns Among Children During School Lunch, Haley R. Riegel

Master of Public Health Program Student Publications

Background: As the United States suffers from a childhood obesity epidemic, more attention has been given to school lunch nutrition. Federal requirements on school lunch are evolving to include a variety of fruits and vegetables, whereas other programs study ways to increase healthy food consumption during school lunch. This project categorizes fruits and vegetables by the United States Department of Agriculture (USDA) and Cornell University’s Smarter Lunchrooms school lunch categories in order to gain a better understanding of fruit and vegetable waste during school lunch.

Methods: Visual estimations of tray waste were collected across four school districts. Averages of fruit …

Impact Of Poor Retention In Hiv Medical Care On Time To Viral Load Suppression, Timothy N. Crawford, Wayne T. Sanderson, Alice Thornton

Family Medicine Faculty Publications

Objective: The purpose of this study was to evaluate how poor retention in HIV care impacts time to viral suppression after initiating highly active antiretroviral therapy. Methods: A retrospective cohort study design, employing a medical chart review, was conducted at an academic infectious disease clinic at the University of Kentucky. Patients seeking care between 2003 and 2011 were included in the study. A log-normal model was employed to determine the factors associated with time to viral suppression. Results: Of the 532 patients in the study, 426 (80.1%) patients were virally suppressed. Controlling for insurance status, race, baseline CD4 counts, and …

Flipping The Global Health Challenge To The Classroom, Cristina Redko

Population and Public Health Sciences Faculty Publications

Much of the debate concerning global health education remains focused on building effective training programs. This paper emphasizes the development of teaching strategies specific to global health education. Inspired by the active learning process of “flipped classrooms” where critical thinking happens in the classroom and fact finding happens outside, this paper describes the experience of bringing the real global health challenge of high maternal mortality in Somaliland directly into the North American classroom in a public health graduate program.

The Likelihood Of Khat Chewing Serving As A Neglected And Reverse ‘Gateway’ To Tobacco Use Among Uk Adult Male Khat Chewers: A Cross Sectional Study, Saba Kassim, Nikki Lynn Rogers, Kelly Leach

Population and Public Health Sciences Faculty Publications

Background

Chewing khat leaves is often accompanied by tobacco use. We assessed aspects of tobacco use and explored factors associated with tobacco use patterns (frequency of use per week) among khat chewers who used tobacco only when chewing khat (“simultaneous tobacco and khat users”, STKU).

Methods

A sample of 204 male khat chewers was recruited during random visits to khat outlets. Data collected included socio-demographic items, tobacco use and khat chewing behaviours. Both psychological and physical dependence on khat were assessed using the Severity of Psychological Dependence on Khat (SDS-Khat) Scale, the Diagnostic Statistical Manual IV (DSM-IV) and adapted items …

Best Practices: A Network Approach Of The Mandatory Influenza Vaccination Among Healthcare Workers, Greg Attenweiler, Angie Thomure

Master of Public Health Program Student Publications

A network simulation was applied to hospital social networks improve the influenza vaccination rate of healthcare workers in a healthcare system. Social network methods can be used to develop an understanding of structures of social relations. Over 200,000 U.S. patients are hospitalized annually for influenza, which attributes to 36,000 deaths and is the sixth leading cause of death in adults. The best way to prevent influenza each year is by receiving the influenza vaccination. The typical influenza vaccination rate among healthcare workers is 40- 50%. A Healthy People 2020 objective is to increase the percentage of healthcare workers who are …

Key Influences Of Patient Satisfaction Measurement As A Quality Indicator In Inpatient Facilities, Mitila Arasu

Master of Public Health Program Student Publications

Patient Satisfaction remains a focal point in overall healthcare experience. Satisfaction of patients has become a priority for hospital administrators because of the ties to improve organization performance, increase reimbursement schedules, prevent claims, and gain return to provider reputation. This study examines the key influences of patient satisfaction and how it is measured in an inpatient facility. A literature search was done through PubMed and Google Scholar to determine specific areas needing improvement. Out of 30 articles that met all search criteria (published in the year 2000 or later, survey administered in United States, published in English, administered in an …

Integration Of Early Clinical Experience And Population Health In Undergraduate Medical Education, Thang N. Vu, Josephine Mensah-Dapaah

Master of Public Health Program Student Publications

Objective: In order to better prepare physicians to face the challenges in health care delivery today, educators have pushed for the integration of core population health competencies into undergraduate medical education. The goal is to equip future physicians with the necessary skills to not only improve the health of an individual, but also be able to advocate for a community and meet the health needs of a population. The purpose of this research study is to propose a plan to evaluate the pilot program Early Meaningful Clinical Experience (EMCE) at the Boonshoft School of Medicine at Wright State University.

Methods: …

A Description Of Snack Foods In Select Ohio Schools: A Baseline Prior To Usda New Competitive Food Guidelines, Chukwudubem C. Obianagha

Master of Public Health Program Student Publications

Background: The proliferation of snack foods in school lunch programs has necessitated the USDA to regulate its consumption by implementing policies regarding its use. The competitive food guidelines were enacted in June 2013 through the Healthy, Hunger-Free Kids Act. This required development of federal nutritional guidelines snack foods had to meet in order to be considered a competitive food and thus sold in school lunchrooms.

Objectives: The purpose of this study is to describe the current snack food offerings in select Ohio high schools, and to determine how these snack foods affect the consumption of healthier free and reduced meal …

Complexity Of Breastfeeding Health Policy In Tanzania, Africa, Theresa Thompson

Master of Public Health Program Student Publications

Background: The purpose of this study was to investigate Tanzanian health policy regarding the protection and promotion of breastfeeding.

Country Profile: Tanzania is a United Republic composed of the mainland and also the islands of Zanzibar. Tanzania is located in east Africa with a population of approximately 46 million. About 1.6 million babies are born each year in Tanzania, however only approximately 140,000 are registered annually. Tanzania’s infant mortality rate is 68 infant deaths per 1000 live births. Tanzania makes up for approximately 0.5% of the world population but 2% of the global infant death.

Approaches: In this study, the …

Diabetes And The Uninsured In Montgomery County, Ohio: Effects Of A County-Funded Health Services Program On Hemoglobin A1c Values, Mark Feighery

Master of Public Health Program Student Publications

Montgomery County Care (MCC) was a county-funded, limited benefit health services program launched in 2010 as a bridge to expanded Medicaid and the health insurance marketplaces for the uninsured of Montgomery County, Ohio. A principal goal was to help manage chronic disease, particularly diabetes. Approximately 20% of the MCC members assigned to a community health center were diagnosed with diabetes. Paired sample t-tests of Hemoglobin A1c values were compared for diabetic members enrolled in the program for a minimum of one year. Among 188 members for whom initial and subsequent values were recorded, HA1c values declined (showed an improvement) from …

Association Of Demographic Characteristics With Gestational Diabetes Mellitus And Gestational Hypertension In Ohio During 2012, Jared D. Klein

Master of Public Health Program Student Publications

Background: Gestational Diabetes Mellitus (GDM) and Gestational Hypertension (GHTN) are serious conditions that can arise during pregnancy. Both of these disorders can cause detrimental health effects to both mother and newborn. Methods: Ohio vital statistics birth data was obtained from Public Health- Dayton and Montgomery County. The data set included 137,268 women who gave birth during 2012 in Ohio and had a known GDM and/or GHTN status. IBM Statistical Package for Social Sciences for Mac Version 20 (SPSS, IBM, 2011) was used to analyze the data. Descriptive statistics, odds ratios, chi-square analyses, and multivariate logistic forward stepwise regressions were calculated …