Public Health Commons^™

Program Evaluation: Utilizing Health Department’S Community Health Needs Assessment Data To Improve Emergency Preparedness Plans, Kathleen Gottschalk

Capstone Experience: Master of Public Health

Public health officials conducting emergency response plans must know how to easily identify the vulnerable populations in their community or jurisdiction. It is beneficial for access and functional needs appendices to include information and resources directed at the identified vulnerable groups before an emergency event to improve health outcomes. Community Health Needs Assessments (CHNA) can provide population-level statistics and information needed to easily identify vulnerable or at-risk groups. This report aims to evaluate the use of the CHNA data to guide the development of inclusive emergency response plans that account for vulnerable populations in local health department jurisdictions. The 2021 …

A Review Of Nebraska Public School Active Shooter/Armed Intruder Preparedness Requirements Compared To Other States, Anna Hansen

Capstone Experience: Master of Public Health

Approximately 17% of mass shootings which occurred between 2000 and 2013 took place in the public school K-12 setting. The incidence of school shootings is on the rise, with a particularly concerning increase in annual incidents beginning around 2010. A review of legal requirements for public school active shooter preparedness in FEMA Region VII, which includes the states Nebraska, Iowa, Kansas, and Missouri, was conducted. While Iowa clearly requires an emergency operations plan including provisions for the active shooter scenario, Nebraska and Kansas do not clearly require such provisions in school emergency operations plans, and Missouri does not appear to …

Utilization Of Community Health Workers In Emergency Preparedness And Response: A Literature Review, Amelia P. Stoltman

Capstone Experience: Master of Public Health

As the frequency and magnitude of disasters worldwide continues to rise, so too does the devastation that follows. This devastation extends to the whole community. In guidance put forward by the Federal Emergency Management Agency (FEMA), emergency preparedness must be represented in and reflective of the whole community, but marginalized groups or segments of the population may be left out of the conversation. Community Health Workers (CHW)s serve as a trusted liaisons and community advocates within the health care landscape. That landscape, as recent events demonstrate, includes emergency preparedness and response. This literature review is designed to assess available publications …

Longitudinal Trends In Body Mass Index And Risk Of Obesity Among Blue Cross & Blue Shield Of Nebraska Insured Sample Population During 2017-2022, Devi Venkata Naga Akshay Dwarabandam

Capstone Experience: Master of Public Health

Objective: To estimate and compare the longitudinal trends in the crude prevalence of obesity in the Blue Cross and Blue Shield of Nebraska (BCBSNE) sample of the adult population with the Behavioral Risk Factor Surveillance System (BRFSS) of Nebraska during the pre-pandemic period (2017-2019) and COVID-19 pandemic period (2020-2022) using standardization methods.

Background: Studying the obesity disease burden in a commercial insurance company's administrative claims data can provide critical insights that can inform policy, practice, and interventions aimed at improving health outcomes, managing costs, and reducing the burden of obesity at the population level.

Methods: This study utilized a cohort …

Assessing The Impact Of Ebola Virus Inoculum Size On Likelihood Of Infection, Joseph Lukowski

Capstone Experience: Master of Public Health

Background: Indirect transmission of Ebola virus disease (EVD) is not uncommon but is poorly understood. Improving the understanding of the potential risk of EVD transmission from fomites should result in new or updated prevention or control measures for suspected or confirmed EVD cases or outbreaks.

Objective: This study aims to compile and understand pertinent data from peer-reviewed literature, establish the dose-response relationship between inoculum doses introduced to mucous membranes, and finally estimate the risk of EVD transmission from fomites.

Methods: A literature search was conducted through PubMed to obtain relevant data. This study employed this data to perform Poisson regression …

Rural/Urban Differences In Five-Year Survivorship In Pediatric Cancer In United States, Hong Li

Capstone Experience: Master of Public Health

Background: In the United States, five-year survival rates for pediatric (ages 0-19 years) cancer have improved since the mid-1970s due to treatment improvement. Research on adult cancer patients suggested rural patients have worse survival than urban patients. However, there is a dearth of research on survivorship among children and adolescents diagnosed with cancer.

Aims: The aims of the study were to: 1) examine differences in five-year relative survival rates of pediatric cancer in the United States between children living in urban and rural areas from 2000-2014 and 2) examine differences in a risk of dying from pediatric cancer between children …

A Scoping Literature Review Of Workforce Development Strategies To Increase Indigenous Birth Workers, Danielle A. Thies

Capstone Experience: Master of Public Health

Objective/Aim: To review the literature on workforce development to increase Indigenous birth workers to improve birth outcomes in Indigenous populations.

Design: A systematic scoping review.

Data Sources: The following databases were accessed: PubMED, Embase, and CINAHL. Support relating to key words and appropriate databases was provided by a university librarian.

Review Methods: Search terms across databases were sourced identifying a total of 152 papers. Title/abstract searches were screened against the inclusion/exclusion criteria, resulting in 55 papers reaching full-text review. Of the 55 papers reviewed, 26 were eligible for inclusion in the final review.

Results/Findings: Thematic …

A Retrospective Analysis Of Rabies Lyssavirus Animal Testing In Nebraska, 2012 Through 2021, Elijah Theye

Capstone Experience: Master of Public Health

Background: Rabies is a zoonotic disease caused by a neurotropic virus that has been a public health issue for over 4,000 years, killing roughly 59,000 humans globally each year. This study examined the seasonality of bat-human exposures, the association between animal-human exposure types and animal rabies positivity, and using skunk monthly positivity rates to predict all non-skunk non-bat animal positivity rates with a lag time of six months, in Nebraska.

Methods: Animal rabies testing data from 2012-21 were extracted from Nebraska’s Electronic Disease Surveillance System. Animal tests that had a valid animal rabies test were included in the analyses. To …

Environmental Cleaning Evaluation Project For Rural Tribal Health Center, Brad Strait

Capstone Experience: Master of Public Health

This Tribal health clinic is located on reservation land and serves a community of approximately 1,550 members located over 64,000 acres located in Nevada and California. The clinic offers general health practice and podiatry at its central clinic with satellite offices located off-reservation offering dentistry, optometry, and behavioral health. The clinic is operated by Tribal staff and partners with the Indian Health Service (IHS) for environmental survey on an annual basis for compliance with Accreditation Association for Ambulatory Health Care (AAAHC) standards. While this clinic only offers outpatient services, the disinfection and cleaning protocols are an important step in limiting …

School-Based E-Cigarette Education Curriculum, “Team No Vaping”: Impact On Knowledge Of E-Cigarettes, Harm Perception, And Media Literacy Among Middle/High School Students, Niran Tamrakar

Capstone Experience: Master of Public Health

E-cigarettes are the most used tobacco products among middle/high school students. Youth e-cigarette use is at an epidemic level. While school-based vaping prevention programs exist, there is limited evidence on the effectiveness of such programs. To address vaping prevention among this vulnerable population, University of Nebraska Medical Center (UNMC) in collaboration with the Tobacco Education & Advocacy of the Midlands (TEAM) developed and implemented a school-based e-cigarette education curriculum, “TEAM No Vaping.” This study evaluated the impact of the “TEAM No Vaping” program on increasing the knowledge, harm perception, and susceptibility to e-cigarettes, and vaping media literacy for vaping prevention …

An Epidemiological Synthesis Of Emerging And Re-Emerging Zoonotic Disease Threats In Cameroon, 2000-2022 And Community Stakeholder Mapping, Nancy Tahmo

Capstone Experience: Master of Public Health

Introduction: Population factors such as urbanization, socio-economic, and environmental factors are driving forces for emerging/re-emerging diseases in Cameroon, and the effects of these are experienced differently across demographics. Indigenous rainforest communities in the Congo Basin, for example, suffer worse health outcomes compared to neighboring communities, like the Pygmies, who have a life expectancy of 22 years less than neighboring Bantus. It is important to characterize the risk of exposure of these vulnerable communities and map out, through a systematic review, descriptive epidemiological data around zoonoses, to inform preparedness and research efforts.

Methods: Following the PRISMA guidelines, a protocol was registered …

Evaluating How Physical Activity Affects The Perception Of Resilience In Box Butte County, Nebraska, Eric Pulver

Capstone Experience: Master of Public Health

Physical activity is one of the modern hallmarks for good health in individuals and the public, in general. Resiliency is a growing concentration in all levels of disaster preparedness where the focus is on how to deal with the growing number of disasters stemming from global climate change. This research project’s aim is to look at the possible relationships between physical activity and resiliency in a rural Nebraska population. This was done with the use of a cross-sectional study utilizing a fifteen-question survey to gather demographics, assess the amount of physical activity, and then apply a perception of resilience tool …

Urban/Rural Disparities Of Thyroid Cancer Using The Integrated Cancer Repository For Cancer Research (Icare2), Sunita Regmi

Capstone Experience: Master of Public Health

Abstract:

Background and objective: Multiple studies have shown that the place of residence and the distance to travel from one's residence to nearby health care providers impact cancer diagnosis and treatment. The stage of cancer at the time of diagnosis is paramount for cancer treatment and affects survival. Disparities in cancer treatment exist which affect the outcome disproportionately to certain segments of the population. To date, much of the focus has been on the racial and socioeconomic disparities in the management of thyroid cancer. The effect of geography and location (urban-rural status) on thyroid cancer stage diagnosis has …

Process Evaluation Of A Community Asset Mapping Protocol For Diabetes Prevention And Management, Andrea Peterson

Capstone Experience: Master of Public Health

Prediabetes and type 2 diabetes mellitus (DM) are highly prevalent conditions with new diagnoses occurring each year (Centers for Disease Control and Prevention, 2022a). Type 2 DM negatively impacts many aspects of life, to include social, financial, cultural, and everyday living. Asset mapping is a useful tool to build upon existing resources to help community members identify and expand services based on understanding the interconnected systems that influence type 2 DM prevention, screening, education, and care management. An Asset Mapping Protocol was created and piloted through a rural community coalition in Nebraska. The protocol includes an activity for community stakeholders …

A Systematic Literature Review On The Capability Of Sio₂-Np’S Exposure To Exacerbate Parkinson’S (Pd) Pathology And The Risk Factors For Biomedical Applications In Pd, Seth Abdallah

Capstone Experience: Master of Public Health

Silica Dioxide nanoparticles (SiO₂-NP) have become increasingly ubiquitous in industry, which has stimulated research into the potential toxicity of these compounds. Recent studies have explored the association between amorphous silica nanoparticle exposure and the potential for neurotoxicity. Additionally, research has been conducted in the application of SiO₂-NP’s in theranostics and as drug directing agents , which based on current literature may be contraindicated for individuals with conditions such as Parkinson's Disease (PD) which is characterized by neuroinflammation. The following literature review will discuss evidence for silica dioxide nanoparticle exposure to induce neurotoxicity which may exacerbate neurodegenerative diseases such as PD. …

Identifying & Addressing Barriers To Child Care For Formerly Incarcerated Mothers, Joanne Bird

Capstone Experience: Master of Public Health

As women’s incarceration rates have risen significantly in recent decades, gender-specific programs are needed to meet the needs of formerly incarcerated mothers (FIM). Although child care can be difficult to access for many families, this marginalized population faces unique obstacles to accessing child care. In order for FIM to be employed and reintegrate, they must be able to access child care; however, FIM experience unique barriers to securing child care services. This policy brief aims to identify the special considerations FIM face, as well as to explore why existing programs are not meeting their specific needs. A literature review was …

Evaluating How The Impacts Of Climate Change On Arizona's Water Supply Will Influence Public Health, Patricia Wrona

Capstone Experience: Master of Public Health

Over the last century, Arizona’s climate has increased more than 1.1 to 1.4 degrees Celsius or 2 to 2.5 degrees Fahrenheit. The temperature in Arizona is expected to increase an additional 2.2°C to 2.8°C in the next 40 years. Climate change poses various health and environmental hazards for the residents of Arizona. One of the most significant impacts is on water supply. As temperatures continue to rise in the desert, the demand for water will increase while the water supply will reduce. A literature review and program evaluation were conducted to evaluate how the impacts of climate change on Arizona’s …

Evaluation Of Human Trafficking Training/Educating Of Nursing Professionals, Emily Morris

Capstone Experience: Master of Public Health

Background: Human trafficking (HT) is a serious public health issue. Victims may present to medical facilities for a variety of health concerns, and therefore, healthcare professionals can identify and provide aid to trafficking victims. However, research shows that providers do not feel adequately trained to identify and support victims. This study evaluates the outcomes of a three hour in-person HT workshop for nurses.

Methods: We administered an online survey with closed- and open-ended questions before and after the workshop to assess improvement in knowledge, health impact, strategies for identification and assessment, and response and follow up of HT.

Results: At …

An Analysis Of Climate Factors And Their Relationship With Lyme Disease And West Nile Virus In California From 2011 To 2020, Emma Dubas

Capstone Experience: Master of Public Health

The World Health Organization estimates that approximately one-sixth of illnesses and disabilities suffered worldwide are due to vector-borne diseases, and more than half of the world’s population is at risk. Additionally, vector-borne diseases have significant socioeconomic impacts and inflate health inequities, with the greatest burden on poor populations. Lyme disease is the top tick-borne disease in the state of California and West Nile virus (WNV) is the top mosquito-borne disease in the state of California. Vector-borne diseases have a high sensitivity to climatic factors. Research shows that ongoing trends of increasing temperature and varying weather conditions will weaken recent global …

The Merit Of Inclusion: A Policy Review Examining The Convergence Of Special Education And Inclusions Policies With Compensatory Medicaid Policies In The Wake Of The Covid-19 Pandemic, Corbyn Baggett

Capstone Experience: Master of Public Health

On March 11, 2020, the World Health Organization (WHO) formally recognized the novel coronavirus (COVID-19) outbreak as a global pandemic. This global issue compelled governments to announce careful virus containing policies in order to prevent further spread and control of the disease. Although it has been proven that measures like social isolation could aid in scaling the spread of illness, the resulting extended school closures that occurred in response to an increased number of COVID-19 outbreaks posed significant challenges for all students, but especially those students with special needs. The unpredictable nature of COVID-19 at the outset of the pandemic …

Health Effects Of Neonicotinoids On An Agricultural Community, Jocelyn Rodriguez-Paar

Capstone Experience: Master of Public Health

Mead, Nebraska, a small United States agricultural community consisting of approximately 600 people, was accidentally exposed to high amounts of neonicotinoids when AltEn, an ethanol plant that used neonicotinoid coated corn and soybean seeds for biofuel, was discovered not disposing of the toxic byproduct safely. Coincidentally, there was also a leak in their wastewater system that also contaminated the nearby areas. Although neonicotinoids are not considered highly dangerous with low dose exposures, large dose exposures can cause symptoms similarly to nicotine poisonings, such as difficulty breathing, vomiting, nausea, hypertension, tachycardia, and lethargy (Imamura, T. et al., 2010). Neonicotinoid poisoning can …

The Risk Factors Of Long Covid In The Acute Covid And Solid Organ Transplant Retrospective Cohorts, Ahmed Nyandemoh

Capstone Experience: Master of Public Health

Background: Coronavirus disease 2019 (COVID-19) in solid organ transplant (SOT) patients is associated with more severe outcomes than non-immunosuppressed hosts. The risk factors for developing the long COVID in acute COVID remain unknown, and the survival outcomes of long COVID in SOT patients remain understudied.

Methods: We developed several retrospective cohorts. This project included all patients identified with acute COVID in the National COVID Collaborative Cohort Registry from July 1, 2020, to June 30, 2022.

Patients with long COVID were compared to those without long COVID in the acute COVID cohorts. Similarly, we compared the patient demographic with long COVID …

Descriptive Epidemiology Of West Nile Virus In Nebraska, 2005-2021, Luke Murphy

Capstone Experience: Master of Public Health

Objectives: West Nile virus (WNV) is a mosquito-borne flavivirus that is naturally sustained in a Culex mosquito-bird-mosquito transmission cycle and can cause disease in birds, equines, and humans. Most human infections with WNV are asymptomatic; however, West Nile fever (WNF), or West Nile neuroinvasive disease (WNND) can develop and be fatal in some circumstances. Between 2005 and 2021 there have been over 1,800 cumulative cases of WNV in Nebraska, which currently ranks as fourth in the United States for reported cases. WNV cases are a mandatory reportable disease in Nebraska through an electronic reporting system managed by the Nebraska Department …

Barriers To Healthcare Access For Refugees And Immigrants With Limited English Proficiency In Nebraska: A Systematic Review Of The Literature, Mawada Mohammed

Capstone Experience: Master of Public Health

Refugees and immigrants in the United States from a multitude of backgrounds are impacted by limited English proficiency (LEP), resulting in a health disparity. LEP in vulnerable populations can create obstacles in healthcare. In healthcare settings LEP patients experience adverse health events such as longer hospital stays, negative drug reaction, and patient dissatisfaction (Berdahl & Kirby, 2019). The following project aims to identify barriers for refugees and immigrants with limited English proficiency (LEP) in primary healthcare settings in Nebraska. The project utilized a systematic literature review using peer-reviewed and gray literature. The research was conducted utilizing databases: PsycINFO, PubMed, Google …

Impact Of Coalition Building To Promote Maternal Infant Health Equity In The District Of Columbia, Maryland, And Virginia, Sydney J. Turner

Capstone Experience: Master of Public Health

The health of women and babies is critical to creating a healthy world. Stratified data shows the overwhelming rates at which Blacks are affected more than Whites. Literature has shown that leveraging partnerships and community engagement are critical components of decision-making and can positively impact the health of communities. Through a direct observational study, the Community Coalition Action Theory was used to analyze the current structure of the March of Dimes Maternal Infant Healthy Equity Coalition. The study aimed to identify strengths and gaps and subsequently provide recommendations to advance the coalition work and promote maternal and infant health equity …

Hispanic/Latino Mothers Of Children With Developmental Disabilities: Identifying Factors Associated With Practicing Self-Care And Mental Health Outcomes, Jessica Gutierrez

Capstone Experience: Master of Public Health

Caring for a child with developmental disabilities can be challenging, exhausting, and overwhelming for many parents. The level of care that a child with disabilities requires can be intense, resulting in stress and negatively impacting caregivers' mental health. Many Hispanic/Latino mothers of children with developmental disabilities are not practicing self-care or using support services; thus, the mothers may experience high stress, depression, and anxiety. Previous research studies have found adverse psychological effects such as high levels of stress, depression, and anxiety. This quantitative study sought to identify the gaps and barriers Hispanic/Latino mothers of children with developmental disabilities encounter when …

Program Planning On Social Determinants Of Health For Rural Nebraska, Maria H. Cantu Hines

Capstone Experience: Master of Public Health

Social determinants of health (SDOH) are non-health factors that impact health in both direct and indirect ways. Research into SDOH and their effects has been extensive in recent years and has been further documented by the COVID-19 pandemic. Despite the wealth of the literature on the SDOH, awareness of these important factors is not prevalent among community residents. Rural communities are as subject to the impact of SDOH just as their urban counterparts and experience additional complexities related to geography and topography.

This capstone project aims to raise awareness, provide education, and assist with tools and resources, to empower rural …

A Two-Part Satisfaction Evaluation Of The Recreational Therapy Department's Adult Respite And Habilitation Program At The Munroe-Meyer Institute, Hailey Humphrey

Capstone Experience: Master of Public Health

This project is a satisfaction evaluation of the Adult Night program offered to people 21+ with intellectual and/or developmental disabilities (I/DD) through the Munroe-Meyer Institute’s Recreation Therapy Department. Historically, people with I/DD face health disparities that impact all areas of their lives. Recreation therapy for I/DD populations could address and minimize access to and quality of care gaps. Current research on recreation therapy programs lacks generalizability and evaluation of non-specific recreation therapy programs for people of any age with I/DD. This project intends to fill that research gap and provide the first evaluation data of the program for the organization. …

Examining Mental Health Disparities In A Rural County: A Community Health Needs Assessment Analysis, Dustin M. Schulz

Capstone Experience: Master of Public Health

Over 20% of adults in the United States experience some form of mental illness each year. Those residing in rural areas can see increased prevalence of mental illness, and typically face disparities in access and availability of services for mental health. The goal of this project was to examine the impact of mental health in Woodford County, Illinois using data collected through the 2022 Community Health Needs Assessment (CHNA) process, with the intent of identifying areas of improvement that could be implemented at the local level. Analysis of the CHNA data was conducted using frequency analysis in SAS 9.4 through …

Assessment Of Ems Response And Hospital Arrival Times In Nebraska, Tina Vu

Capstone Experience: Master of Public Health

Timely EMS response and ground transport to the appropriate hospital are essential to patients’ survival and health outcomes during emergencies. This study utilizes interactive Geospatial Information System (GIS) mapping to assess emergency medical service (EMS) response and hospital arrival times in rural and urban Nebraska counties. The goal is to determine if there are underserved areas in the State and to propose potential interventions if identified. 2018 Social Vulnerability Index Scores (SVI) collected from Census Data were also reviewed for these areas to see possible correlations. The interactive GIS map revealed the Western and Central regions of Nebraska to be …