Public Health Commons^™

The Impact Of Doulas On Breastfeeding In Black Women: A Literature Review, Delaney C. Holland

Capstone Experience: Master of Public Health

This literature review was conducted to explore the impacts doulas have on breastfeeding initiation and continuation in the Black population. Black women’s breastfeeding and continuation is exceptionally low compared to white women and other races and ethnicities. Six journal articles were used to examine the relationships that doulas have on breastfeeding initiation and continuation in black communities. There was an array of study designs found throughout the articles to help support the doula and breastfeeding relationship in Black women. The results of this literature review were preliminarily positive, but more evidence is required to firmly establish the positive impact of …

Understanding Gendered Risks For Severe Covid-19 Through Surveying The Gender Diverse Community, Arden Tyree

Capstone Experience: Master of Public Health

Early on in the pandemic, the medical community began noticing that men were more likely to be hospitalized, require admission to the ICU, and die of COVID-19 than women but few studies of COVID-19 make mention of gender diverse people, an often-overlooked population who may have vastly different experiences than non-gender diverse men or women. Their variations in gender and sex characteristics may also help provide further insight into which traits are protective or risk factors for this disease. This project used Poisson regression in order to analyze self-reported survey data. The major associations of interest will be between disease …

The Risk Factors Associated With Personal Protective Equipment Usage Rates In The Central States By Generalized Multilevel Models, Carter E. Vogel

Capstone Experience: Master of Public Health

Background: Agriculture producers in the United States face some of the highest rates of fatal and non-fatal injuries among all occupations. This includes a high risk of respiratory damage when working in dusty environments, chemical and health hazards when working with pesticides or other dangerous chemicals, and hearing damage when working in noisy environments. These risks can be reduced using personal protective equipment (PPE). While some workplaces are required by the Occupational Safety and Health Administration (OSHA) to provide necessary PPE and monitoring according to the risks of a job, many small farms are not required by OSHA to provide …

Early Childhood Nutrition Education Implementation Evaluation And Planning: Learn, Grow, Eat & Go!, Alyssa L. Wessling

Capstone Experience: Master of Public Health

The obesity rate among American children aged two to five years old is 12.7% (Centers for Disease Control, 2022), indicating a need for health interventions at this critical life stage. Nebraska Extension’s Nutrition Education Program has identified a need for direct education materials to reach Nebraskans in early childhood. Learn, Grow, Eat & Go! Early Childhood was identified as an appropriate curriculum to be tested in an early childhood intervention pilot. Learn, Grow, Eat & Go! Early Childhood is a newly developed program built upon the foundation of teaching children about healthful foods and physical activity through gardening. An early …

A Qualitative Analysis Of Candida Auris Laboratory Surveillance In Nebraska, Lissa M. Young

Capstone Experience: Master of Public Health

Objectives: Candida auris is an emerging pathogenic yeast that was first identified in Japan in 2009 and detected in the United States in 2015. As of 2020, C. auris has been reported in cases throughout 41 countries, including the United States. The ability of this species of yeast to spread rapidly and survive for long periods of time on surfaces, the high mortality rate of those infected, and its multidrug resistant phenotype, have rendered it a urgent public health threat (the highest threat level) by the United States Centers for Disease Control and Prevention beginning in 2019 (CDC, 2019). Since …

Evaluating The Impact Of Culturally Informed Interventions On Nebraska's Refugees: A Pilot Study With Healthcare Workers, Falah Nayif Rashoka

Capstone Experience: Master of Public Health

Background: Refugees in the US are at increased risk of poor health outcomes, spanning mental health and general well-being, compared with American-born individuals. With the rapid growth of the refugee population in Nebraska, the need to train healthcare providers to provide culturally competent care has never been greater. A common point of access to healthcare for the refugee population after resettlement is via local health departments and the primary healthcare network. Recent estimates show close to five thousand Yazidi refugees living in Nebraska, most of whom moved after 2009 based on federal legislation admitting those who served in the …

Operation Wasatch: Scenario Based Planning To Assess The Cold Weather Preparedness Of The National Disaster Medical System, Alison Matthews

Capstone Experience: Master of Public Health

Background: The National Disaster Medical System has little experience with sustained mission operations under anything other than temperate environmental conditions. Extreme weather events increase the complexity of disaster response by presenting significant logistic, operational, and safety challenges. Identifying gaps and vulnerabilities in response capabilities can promote improved Disaster Medical Assistance Team preparedness.

Methods: This discussion based exercise utilized a scenario involving a 7.0 magnitude earthquake along the Wasatch Fault in winter. This exercise was conducted with members of the Wisconsin-1 Disaster Medical Assistance Team. Team members provided oral and written feedback in response to exercise objectives and prompts. This feedback …

Association Of Socioeconomic Status And Mental Health Characteristics And Participant Attrition In A Cohort Study, Mathews Thampi

Capstone Experience: Master of Public Health

The cohort study is an essential design for investigating associations between a variety of risk factors or exposures and a plethora of health outcomes. However, one of their biggest weaknesses is participant attrition, which can introduce bias and impact validity. Understanding whether this attrition is related to exposure and outcome is a critical aspect of assessing the potential for selection bias. The Women and Their Children's Health (WaTCH) study is a prospective cohort study designed initially to examine the health impacts of exposure to the Deepwater Horizon oil spill. The study has undergone two waves of data collection and is …

Housing Is Safety: An Evaluation Of A Transitional Housing (Th), Rapid-Rehousing (Rrh), And Joint Th/Rrh Program For Survivors Of Interpersonal Violence, Bridget L. Claborn

Capstone Experience: Master of Public Health

In this capstone project, I created a program evaluation plan and conducted preliminary analysis for the Mar􏰀 Parrish Center􏰁s (MPC) transitional housing (TH), rapid-rehousing (RRH), and joint TH/RRH programs for survivors of interpersonal violence and their families. The intent of the project is: (1) to better understand the impact of MPC housing programs; (2) to inform strategies for continuous improvement in client outcomes, access, and satisfaction; (3) to further evaluation capacity for the organization; and (4) to generate practice-based evidence to inform the field at large. As a practitioner in the field of interpersonal violence and former MPC staff member, …

The Relationship Between Congenital Heart Disease And Infant Mortality In Low- And Middle-Income Countries: A Comprehensive Literature Review, Helen Nneoma Odo

Capstone Experience: Master of Public Health

Congenital heart diseases (CHD) are conditions that are present at birth and can affect the structure of an infant’s heart and the way it works. Millions of children are born each year with congenital heart disease yet screening for CHD is not practiced in Low- and Middle-income countries (LMICs). Studies on access to healthcare for infants with congenital heart disease have not kept pace. This literature review centers on the role of congenital heart disease in infant mortality, its burden, incidence and prevalence in LMICs. The databases of PubMed, Google Scholar and Embase were searched and the selected articles for …

Effects Of Hospital Interventions On Maternal Mortality Rates Of African American Women: A Literature Review, Oluwatosin A. Soyege

Capstone Experience: Master of Public Health

Maternal mortality is a serious health concern and harms society’s economic, physical, and psychological well-being. It is tragic for the woman’s family and community when a woman passes away during pregnancy, at delivery, or shortly after delivery. Hospital interventions are needed to mitigate the social impact of maternal mortality. In the U.S., several initiatives have been enacted to reduce maternal mortality. Fighting racism would also help African American women’s rates of maternal mortality as they are subject to stigma in everyday contexts, during pregnancy and obtaining healthcare, and when obtaining resources and services during pregnancy. This paper reviews the literature …

Assessing Meatpacking Worker's Perceptions Of Supervisors' Concern For Safety And Supervisors' Support, Sara Reyes

Capstone Experience: Master of Public Health

Occupational safety is a major public health issue, given that failure to meet safety regulations can lead to incidents and death. Meat processing facilities have some of the highest rates of non-fatal and fatal injuries compared to other industries. A reported 5.9 incidents per 100 full-time occupied within meat processing industries. The majority of workers within meat processing plants are people of color and immigrants, leading to a disproportion in reports of incidents and safety concerns. Immigrant workers frequently occupy positions within the kill floor and fabrication departments. Supervisors are often at the forefront of safety, yet workers often report …

The Role Of Psychological Safety On Employee Satisfaction And Retention In Healthcare Delivery Settings: A Systematic Literature Review, Jamey Paul

Capstone Experience: Master of Public Health

The healthcare industry typically has a high rate of employee turnover due to higher job stresses and burnout, lower job satisfaction, and insufficient organizational support and work culture. This turnover has worsened since the onset of the COVID-19 pandemic. Psychological safety, a shared belief by organizational members that the team/unit is safe for interpersonal risk-taking, can be one of the many ingredients that contribute to employee satisfaction and reduce turnover. This systematic literature review explored the role of psychological safety on job satisfaction and retention of healthcare workers in delivery settings by synthesizing the known antecedents and outcomes of psychological …

A Twin Study Of Genetic Heritage And Environmental Influences On Tobacco Susceptibility And Initiation On Early Age, Yadi Liu

Capstone Experience: Master of Public Health

Purpose: Tobacco product susceptibility is defined as the interest a person has to start smoking. Tobacco product initiation refers to whether a person has ever used tobacco products. We aim to understand and explain how genetic and environmental factors affect tobacco products' susceptibility and initiation in children. Methods: The classical twin model estimates three sources of variance: additive genetic (A), shared environmental (C), and unique environments (E). Each source of variance is latent and is calculated from the similarity in the correlations of twin pairs on a phenotype. The magnitude of difference in the correlation of a particular …

Utilization Of Routine And Recommended Preventive Care Among Individuals With Disabilities In Nebraska, Snehal Jadhav

Capstone Experience: Master of Public Health

Background: Healthcare access disparities exist among individuals with and without disabilities (IWD, IWoD). There is a scarcity of studies focused on Nebraskans living with disabilities.

Methods: Access to Care Nebraska surveyed adults (age 19+) in Oct 2020-Mar 2021. We used Andersen’s model of healthcare utilization to group risk factors for non-compliance with routine care and recommended cancer screening. A multivariate log-binomial regression compared the non-compliance between IWD and IWoD to compute adjusted prevalence ratios (aPR) for risk factors.

Results: Of the 1101 participants,96(8.7%) were IWD. IWD had a higher proportion of non-compliance to routine preventive care (61.7% vs 54.1%) and …

A Systematic Literature Review On Long-Term Care Quality Improvement Initiatives In The United States, Daisy D. Pang

Capstone Experience: Master of Public Health

As the number of people 65 and older increases due to the baby boomer population, there will be a greater demand for long-term care (LTC) services. Quality improvement in LTC is essential to ensure positive health outcomes, patient satisfaction, and reduction in healthcare costs. The purpose of this systematic literature review is to identify the current quality initiatives for LTC in the United States and evaluate the outcomes, effects, and values of each quality initiative identified to support the claim that current the quality initiatives have a limited effect on quality improvement in LTC settings. The Preferred Reporting Items for …

Cultivating A Robust Safety Culture Through Identifying And Overcoming Barriers Within Organizations, Morgan Shradar

Capstone Experience: Master of Public Health

The hierarchical power structure within healthcare and response teams may impede communication about safety risks and violations. In developing or enhancing the safety culture within the emergency response to infectious disease events in healthcare organizations, the hierarchy of controls can be utilized to evaluate successful transmission prevention or further harm to responding teams. Within the tool, administrative controls focus on policies, procedures, and practices that minimize the risk of exposure/transmission. The idea of a safe culture emerged following the Chernobyl Disaster, in which a combination of human and system failures led to this emergency. Safety culture has been integrated into …

Reducing Burnout Using Emergency Planning: A Literature Review, Taylor Vaughn

Capstone Experience: Master of Public Health

Objective

The objective of this capstone is to gain knowledge on what burnout is, what causes it, what can be done to prevent it, and what can be added to public health emergency plans to reduce burnout in local emergency preparedness workforces.

Methodology

A literature review was completed through peer-reviewed articles, and documents from professional and governmental organizations. The results were used to search current plans to determine whether burnout-related recommendations were present.

Results

Burnout prevention at the personal level includes a good diet, routine exercise, and mindfulness activities. At the organizational level it should include providing emotional support, emphasizing …

Comprehensive Literature Review: Assessing The Impact Of Covid-19 Policies, School Closures And Social Distancing, On The Mental Health Of School Age Children, Fatuma A. Hassan

Capstone Experience: Master of Public Health

Mental health is vital to the well-being of all individuals, especially children. COVID-19 unveiled a significant public health issue with poor mental health during the pandemic. There is limited literature about the mental health implications of COVID-19 policies for children and adolescents and preventive strategies for future pandemics. This comprehensive literature review seeks to further investigate the mental health impacts of school shutdowns and social distancing, which were nonpharmaceutical strategies, on school-aged children, 5-18 years old, and propose recommendations for public health officials to mitigate the mental health impacts for future pandemics. Additionally, the review aims to highlight the potential …

Exploring How Social Determinants Of Health Affects Rates Of Chronic Obstructive Pulmonary Disease (Copd) In The Des Moines Metro, Kyla Winkelman

Capstone Experience: Master of Public Health

Chronic Obstructive Pulmonary Disease (COPD) is consistently in the top ten leading causes of death and most recently ranked fourth in the United States (Heron, 2021). Research on health disparities and SDOH has increased recently as investigators learn their importance in diagnosing chronic conditions. Several studies show that a person’s life and environment can determine their risk of exposure, susceptibility, course, and disease outcome. UnityPoint Health (UPH) clinics were utilized for this project to explore how the social determinants of health and health disparities affect COPD rates in Des Moines, Iowa. Initial data was obtained surrounding COPD statistics in the …

The Association Of Apgar Score Outcomes With The Number Of Midwife Antenatal Care Visits Among Infants Born To Rohingya Refugees In Cox’S Bazar, Bangladesh, Vickie Doss

Capstone Experience: Master of Public Health

A cross-sectional study was conducted at the HOPE Foundation for Women and Children of Bangladesh Field Hospital in Cox’s Bazar, Bangladesh, to examine the relationship between the number of antenatal care visits (ANCV) and Apgar scores. This study aims to explore the association between the number of ANCV and Apgar scores in neonates born to Rohingya refugee women. The medical records at HOPE Field Hospital of 182 post-delivery Rohingya women in the Mhodhurchora refugee camp were collected through a medical chart review to

obtain the number of ANCV and 1-minute and 5-minute Apgar scores. The Apgar scoring system is a …

Examining The Effects Of Experiencing A Tornado On Rates Of Suicide, Jessica Lowder

Capstone Experience: Master of Public Health

Background: Suicide rates in the United States have been on the rise in recent years. As of 2020, suicide was the 12^th leading cause of death in the country. Climate change has also contributed to an increase in tornadoes. Studies have found that experiencing a natural disaster is associated with an increase in suicide rates. Studies examining suicide rates and tornadoes, specifically, are virtually nonexistent.

Methods: The exposure groups were those living in three different tornado-affected regions. The comparison group consisted of those living in the larger geographical region. Mortality data was obtained from the CDC, tornado-related data was …

A Qualitative Survey Research Study: The United States Department Of Agriculture Commodity Supplemental Food Program: An Examination Of Operational Challenges And Recommendations, Brianna Cochran

Capstone Experience: Master of Public Health

Background

The United States Department of Agriculture (USDA)’s Commodity Supplemental Food Program (CSFP) has been nationally adopted in 60 states or Indian Tribal Organizations (ITOs) to improve the health of low-income persons at least 60 years of age by supplementing their diets with nutritious USDA Foods. Despite the potential effectiveness of the program, less is known about the operational challenges in the program implementation at the state and local health department. The goal of the study is to identify factors related to program operations including facilitators and barriers of implementation of the USDA CSFP under a national lens.

Methods

An …

Quality Improvement Intervention To Improve Hpv Immunization Rates In Rural Primary Care Settings: Policy Recommendations From Post Intervention Survey, Isabel Stock

Capstone Experience: Master of Public Health

It is estimated that 8 billion dollars annually fund the prevention and treatment of Human Papillomavirus (HPV) associated cancers in the U.S. The HPV vaccine is the most effective way in preventing associated cancers when administered on-time, during adolescence. With HPV vaccination rates remaining low across the country, organizations have been researching effective interventions to improve uptake of the vaccine. In this paper we conducted a descriptive analysis of a survey completed by clinicians upon completion of an eighteen-month quality improvement (QI) intervention to increase HPV vaccination rates in rural primary care settings. New research indicates that differences in HPV …

Associations Between Demographic, Social Determinant, And Health Factors And Self-Management Measures Among Insured Individuals With Type 2 Diabetes, Shari Bowers-Dueker

Capstone Experience: Master of Public Health

Background: Ensuring that individuals with type 2 diabetes properly manage their chronic condition is a nation-wide challenge, even among individuals who have health insurance coverage and access to the treatment they need. There exist several literature sources that suggest various factors that may influence an individual’s lack of self-management of type 2 diabetes. This study investigated some of these factors by determining whether various demographic, social determinant, and health factors were associated with three self-management measures among individuals with type 2 diabetes.

Methods: The self-management measures of interest included (i) whether the annual recommended two primary care visits were attended …

Food Insecurity And Child Development In Nebraska: The Role Of Income, Home Learning Environment, And Family Socio-Demographic Factors, Marlette Grace Dulcinee Mabiala-Maye

Capstone Experience: Master of Public Health

Food insecurity is a well-known risk factor for delayed child development. Still, the contribution of other factors, such as income, home learning environment (HLE), and family socio-demographic factors, remains to be determined. Therefore, the study aimed to determine the association between food insecurity and child development and assess the role of income, HLE, and family socio-demographic factors in that association. We used secondary data from the Nebraska Early Childhood Study, a cross-sectional study of caregivers of children under five years old in Omaha and Lincoln. Child development, food insecurity, and HLE were measured using a caregiver report of child development. …

A Scoping Review Of The Predictive Values And Use Of The Oraquick In-Home Hiv Test, Mariah Zinn

Capstone Experience: Master of Public Health

The OraQuick In-Home HIV Test was FDA-approved for over-the-counter use for people aged 17 years and older in 2012. The FDA reported on the sensitivity and specificity of the test, which looks at the accuracy of a test relative to a reference standard. However, the predictive values that account for prevalence still need to be thoroughly examined among tests distributed through community-based means. In this review, we looked at the predictive values for the OraQuick In-Home HIV Test for people aged 15 years and older when the test is distributed through community-based means. We calculated the predictive values for each …

Association Between Socioeconomic And Behavioral Characteristics With Urinary Neonicotinoid Levels In The United States, 2015-2016, Komi Nomessi Akliku

Capstone Experience: Master of Public Health

Neonicotinoids are a class of pesticides developed in the 1980s and widely used in agriculture and households. They are sources of health damage in mammals, as identified in experimental studies in rats. The health effects identified were acetamiprid: memory dysfunction, respiratory failure, and digestive troubles; imidacloprid: liver and brain cell necrosis through Nitric Oxide formation: Thiacloprid induces an increase of cytokine proinflammation and causes cell division disturbance and genotoxicity; thiamethoxam is incriminated in reproductive system toxicity and cardiotoxicity; clothianidin is found to be associated with fertility troubles affecting spermatozoids’ motility. They have been said to be associated with thyroid cancer …

Assessing Occupational Exposure Risk And Covid-19 Incidence Rates In Nebraska By Industry And Occupation, 2020, Christopher Austin

Capstone Experience: Master of Public Health

Occupational outbreaks of COVID-19 have been described during the pandemic, yet the epidemiology of COVID-19 across a larger workforce population is currently not well characterized in the United States. Describing COVID-19 incident rates by industry and occupation will elucidate how the pandemic affected the workforce in Nebraska. However, nonresponse bias occurs in the employment information when participants are unwilling or unable to respond to contract tracer questions, thus affecting the results. Nonresponse bias will be analyzed, and appropriate statistical approaches will be utilized to adjust for any bias in the data. Adjusting for bias, incidence rates by detailed industry and …

Planning A Multiple Myeloma Needs Assessment For Omaha Nebraska, Judith Ngozi Obodougo

Capstone Experience: Master of Public Health

Literature Review

Worldwide, approximately 176,404 people had Multiple Myeloma in 2020, which caused about 117,077 deaths in the same period. Multiple Myeloma is a rare type of blood cancer currently considered a curable malignancy.

Objectives

This public health capstone aims to create a plan for a community needs assessment for multiple Myeloma in Omaha, Nebraska.

Methods

This capstone project modified the Centers for Disease Control and Prevention (CDC) community needs assessment guidelines to create a Multiple Myeloma needs assessment plan for Omaha, Nebraska.

Results

All seven steps outlined in the CDC community needs assessment planning steps were relevant. Omaha, Nebraska, …