Public Health Commons^™

Overlaps And Gaps Of Preterm Birth Programs In The Triangle Area Of North Carolina, Amber Bobbitt

Capstone Experience: Master of Public Health

Background: Preterm birth rates are a long-standing issue that has yet to be adequately addressed and prioritized. Nationally about 1 in every 10 infants are born prematurely in the United States. In the state of North Carolina, 1 in every 9 live births was preterm in the year 2020. The aim of the study was to determine the strategies organizations use in North Carolina to reduce preterm births in comparison to the CDC’s Five Strategy framework and to understand how the organizations address health equity and measure/evaluate the success of their initiatives.

Methods: Semi-structured one-on-one interviews were conducted with four …

Analysis Of The Utilization Of Nebraska Medicine's Price Transparency Tool, Ingrid A. Olson

Capstone Experience: Master of Public Health

Healthcare costs have become a significant concern for patients, healthcare facilities, economists, and politicians within the United States. In an effort to understand and reduce health-related costs, price transparency laws were enacted at the beginning of 2021. Because of these new laws, hospitals must provide a price transparency tool for their patients. “Price transparency in healthcare makes pricing information more readily available, defines the value of services, and enables patients and other care purchasers to identify, compare, and choose providers that offer the desired level of value” (AAMC, 2022). However, research results on price transparency tools use and efficacy is …

Exploring Stakeholder Attitudes Towards Tobacco 21 Implementation, Enforcement, And Outcomes, Summer L. Woolsey

Capstone Experience: Master of Public Health

Objectives: This qualitative study seeks to assess the impact of the federal Tobacco 21 (T21) law by analyzing data collected from a nationwide sample of key tobacco control stakeholders towards the implementation, enforcement, and outcomes of the T21 law. Methods: A series of five focus groups were conducted in December 2021 with stakeholders (n=31) who were asked about T21 implementation and enforcement measures used in their own communities. Participating stakeholders included tobacco policy experts, tobacco evaluation experts, subject matter experts, and implementation personnel. Results: We conducted a thematic analysis of the data resulting in eight themes found under four broad …

The Patient-Centered Medical Home And The Value Of Heightened Care Coordination: A Systematic Literature Review, Garrett L. Vetter

Capstone Experience: Master of Public Health

Health care spending in the United States continues to increase at a pace that far exceeds inflation. Representing a greater proportion of the nation’s gross domestic product (GDP) than any other country, costs associated with health care services in the U.S. lend support to growing concern regarding the sustainability of current systems. Furthermore, the fragmented nature of the current landscape often presents challenges to the provision of high-quality and efficient care. Satisfaction among both patients and health care providers, alike, suffers under the weight of increasing regulatory burden, the lack of integrated medical records systems, and growing complexity among health …

An Analysis Of Demographics And Risk Factors Associated With Increasing Syphilis Cases In Iowa, Eleanore H. Nelson

Capstone Experience: Master of Public Health

Background:

Syphilis is easily detectable and treatable with the appropriate medical attention, yet national incidence rates have been on the rise since reaching an all-time low in 2000 (Shockman et al, 2014). Similar to HIV, men who have sex with other men (MSM), represent most syphilis transmission, yet in recent years, syphilis rates have concerningly increased among both genders and among all racial/ethnic groups (CDC, 2019).

Methods:

Surveillance data was collected on all syphilis cases reported to the Iowa Department of Public Health (IDPH) regarding demographics and risk factors of cases. Variables were analyzed using chi-square and Fisher’s exact tests, …

The Differences In Mental Well-Being For Individuals With And Without Service Dogs, Katelyn Morales

Capstone Experience: Master of Public Health

Trained service dogs can be used for many tasks, but the growing literature focuses on the benefits of the psychosocial health and well-being of individuals experiencing depression or anxiety. This study analyzes the effects of service dogs on the mental well-being of individuals with a diagnosed disability who have depression or anxiety. This quasi-experimental design assesses the mental well-being of individuals who have a service dog compared to those who do not have a service dog. Mental well-being was measured using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) and focused on individuals with a service dog and diagnosed depression or anxiety …

Beyond The Plant: Facing Systemic Barriers As A Meatpacking Community During The Covid-19 Pandemic, Shannon Barrientos

Capstone Experience: Master of Public Health

The COVID-19 pandemic has revealed and magnified health disparities and social inequities that disproportionately burden racial and ethnic minorities. These disparities are readily seen within meatpacking communities, considering a lack of protections offered by the meatpacking industry have heightened COVID-19 susceptibility. These conditions have aggravated health inequities within rural communities throughout the span of the pandemic. Despite significant advances in research investigating the effect of COVID-19 on essential workers within the meatpacking plants, this research remains isolated within the meat processing industry. Moreover, research has focused predominantly on the pandemic’s impact on rural communities and the institutional barriers that hinder …

Trends Of Human Papilloma Virus- Related Cancers And Hpv Vaccination In Nebraska From 2010 To 2018, Christelle Massumbu

Capstone Experience: Master of Public Health

Background:

Approximately 46,143 human papillomaviruses (HPV) related cancers are diagnosed annually in the United States. Although the HPV vaccine has been available in the United States since 2006, more than half of adolescents have not completed the HPV vaccine series. In Nebraska, the incidence rates of HPV-related cancers have increased from 2006 (5.7%) to 2018 (6.3%). Although cervical cancer has been highly studied, there is limited research and surveillance on head and neck, vaginal, vulvar, anal, and penile cancers in a state such as Nebraska, which experiences limited access to healthcare in its rural areas. Clarity about these aspects could …

Disparities And Attitudes Toward Sars Cov2 Vaccine Among People With Disabilities, Ahmed A. Omar

Capstone Experience: Master of Public Health

The pandemic caused by SARSCOV2 that began in late 2019 posed a significant public health challenge for communities worldwide. The pandemic negatively impacted people's health, economy, and living conditions. Pharmaceutical companies worldwide have begun a race against time to invest in vaccine development to control and eliminate the worst outcomes of the COVID 19 associated disease. Scientific research resulted in several effective vaccines being developed and authorized for use in people (Salmeron Ríos S et al.).

Public health agencies like the Center for Disease Control and Prevention (CDC) prioritized high-risk populations for vaccination. This process is meant to accomplish the …

Misinformation And Vaccine Hesitancy Determinants: The Significance Of Framed Public Health Messaging, Alexandra I. Todd

Capstone Experience: Master of Public Health

In 2020, the SARS-CoV-2 (COVID19) outbreak effectively disrupted worldwide operation for months, leading to tremendous economic loss and adverse health outcomes. While countries grappled to control the virus and scientists worked around the clock to deliver a vaccine in record time, a pubic health communication crisis emerged. The spread of false and misleading information, also known as misinformation, has proved to be a barrier in the fight against COVID19 and its vaccination effort. Many factors including the rise of social media, distrust of government, polarization of news sources, and fragmented media have created an environment susceptible to misinformation. Utilized correctly, …

Financial Analysis Of New Medicare And Medicaid Guidelines, Reimbursement Rates, And Increased Enrollment On Four Nebraska Clinics, Jamilah J. Abdul-Hakim

Capstone Experience: Master of Public Health

Government health insurance plans such as Medicaid and Medicare were created with the intention of providing elderly, low-income, or disabled citizens with affordable and quality health insurance through government-contracted providers (Baicker et al., 2013). Medicare is a government health insurance program that provides healthcare to United States citizens 65 years and older, regardless of their income or past medical history. Medicaid was implemented as an assistance program to provide health insurance for low-income Americans and their families. Medicaid is administered by each state independently, which creates variation in reimbursement rates, services, and structure. (Grabowski, 2007).

Providers accepting Medicare and Medicaid …

A Survey And Analysis Of Educational Materials Addressing The Health Consequences Of Drinking Nitrate Contaminated Water In Medical Clinics Located In The Most At-Risk Areas Of Nebraska: Are Healthcare Providers Equipped To Protect And Educate Their Patients?, Laura Nagengast

Capstone Experience: Master of Public Health

Background: Eighty five percent of Nebraskans rely heavily on groundwater sources, including private wells, as their primary source of drinking water. Nitrate is one of the most common chemicals found in private well water. Numerous studies demonstrated the serious human health consequences from prolonged nitrate exposure. Therefore, due to the potential health risks, this project aimed to identify and evaluate the existing knowledge and awareness among healthcare providers as well as the educational materials in medical clinics in Nebraska related to health effects of drinking nitrate contaminated water.

Methods: An 8 multiple choice question survey was developed using Microsoft Forms. …

Evaluating First Responder Personal Preparedness In Douglas County, Nebraska's Volunteer Fire And Emergency Medicine Service, Kylie Johnson

Capstone Experience: Master of Public Health

In disaster response, it is essential for first responders to focus on their disaster role. Lack of personal preparedness at home could hinder a responder’s ability to focus their attention on their response role (13). Personal conflict, such as that caused between family duties and response duties, in a disaster can be mitigated through several means. One mitigation tactic is preparedness education and support offered by the responder’s organization. While the importance of responder personal preparedness cannot be understated, there is a lack of baseline data on the topic related to Nebraska responders.

To assess the state of first responder …

Assessing Meat Processing Workers’ Attitudes And Concerns Regarding Covid-19 Vaccination, Karen Schmeits

Capstone Experience: Master of Public Health

The COVID-19 pandemic has impacted industries across the globe. Specifically, for meat processing (meatpacking) facilities, the pandemic has changed the way facilities operate, how the workers perform tasks, and how workers perceive their health. The development of an FDA approved COVID-19 vaccine brought hope to meat processing employers and workers. However, little research has been conducted to know how meat processing workers feel about vaccines generally and how they perceive the COVID-19 vaccine. The purpose of this cross-sectional study was to investigate preventive vaccine determinants and attitudes and concerns specifically regarding the COVID-19 vaccine. Surveys were conducted with 128 meat …

Weight Gain Trajectory Over Five Years For Adult Primary Care Patients In Nebraska, Elizabeth M. Morris

Capstone Experience: Master of Public Health

INTRODUCTION: The continued rise in the prevalence of adult obesity in the United States is a public health concern. Several studies have identified the increasing rates of obesity, its impacts, and the factors leading to obesity. Some researchers have made obesity prevalence projections at the national and state levels. This study aims to fill the critical gap in real-time weight data trends among primary care adult patients in Nebraska. The main goal of this study is to determine and analyze the weight trajectory of adults in Nebraska over the past five years and determine if the trends vary among age …

Assessing Facilitators And Barriers To Enrolling In Cardiac Rehab, Michaela R. Geiser

Capstone Experience: Master of Public Health

Abstract: Heart disease has been a leading cause of death since the early 1900s (Heron & Anderson, 2016). Americans are at higher risk for heart disease if they have high blood pressure, high cholesterol, are overweight, inactive, and smoke, among other risk factors (CDC, 2019). If a person already has heart disease or has had a cardiac intervention (such as a stent), they may be referred to a local cardiac rehab program. Bryan Health in Lincoln, NE, currently offers two methods of delivering cardiac rehab: in-person or home-based. Research has not yet been done to assess enrollment facilitators and barriers …

The Perception Of Technology On Continuous Health And Environmental Monitoring For Professional Drivers, Troy Suwondo

Capstone Experience: Master of Public Health

Due to the sedentary nature of professional truck driving (among other high-risk behaviors and hazardous exposures) many suffer from acute and chronic health conditions. There are many potential hazards in the professional driving profession. Many of these hazards come from those that transport hazardous materials. Figuring out what health and environmental indicators are important to measure can be a way to minimize hazards. Continuous health monitoring technology may be an option to detect disease and alert professional drivers when vital signs indicate impending health crises. Before this can be implemented, it will be important to evaluate the perception of wearable …

Systematic Literature Review: Culturally Appropriate Approach To Advance Care Planning For Ponca Tribe Elders, Priscila Soto Prado

Capstone Experience: Master of Public Health

Advance Care Planning is understudied in Native American and Alaskan Natives communities. There is a strong need for further research on culturally adapting advance care planning (ACP) for indigenous communities. Specifically, for the Ponca Tribe, culturally adapting the ACP used would ideally increase the acceptance of ACP in that community. This systematic literature resulted in identifying four themes other tribes have utilized to culturally adapt their ACP, advance directive, palliative and/or end-of-life processes in an effort to increase completion rates. The four themes were involving the elders with the adaptation process, increasing education efforts and awareness of ACP and ADs, …

A Quantitative Job Satisfaction Comparison Between Certified Nursing Assistants (Cnas) Providing Care In Patients’ Homes Versus In Long-Term Care (Ltc) Facilities In The Omaha Metropolitan Area, Rusheena Shah

Capstone Experience: Master of Public Health

This capstone project looks at overall job satisfaction comparison between two groups of Certified Nursing Assistants (CNAs) – CNAs who provide home care in patients’ homes and CNAs who provide care in Long-term Care (LTC) facilities in the Omaha Metropolitan Area. In this quantitative study, a survey was sent to CNAs who provide home care to patients and CNAs who provide patient care at different nursing home facilities in the Omaha area. Prior research has indicated that even though CNAs perform similar job duties irrespective of the work environment; they experience varying degrees of job satisfaction which could be attributed …

Effect Of Climate Variability On Lyme Disease Cases In The United States – A Retrospective Study, Larissa Mark

Capstone Experience: Master of Public Health

Vector-borne illnesses are a growing serious global public health threat. According to the CDC, Lyme disease (LD) is the most common vector-borne disease in the United States. It is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of an infected black-legged tick. Since the discovery, LD has increased in both incidence and geographical distribution. Vector life cycles and disease transmission are highly sensitive to abiotic conditions; as such, it is expected that climate change will alter the geographic distribution and magnitude of vector-borne illnesses. Certain facets of climate change like precipitation patterns, greater climate …

Randomizer Utilizing R Shiny, Cali R. Savage

Capstone Experience: Master of Public Health

Currently, many published animal experiments fail to include concise information regarding randomization (Festing, 2014). By not including randomization efforts in published research, the ability for one to accurately reproduce a study’s results is greatly diminished. This can be seen in randomization efforts that may be difficult to reproduce, such as poor randomization techniques and lack of documentation. Therefore, the creation of the Randomizer utilizing software R to create a user-friendly program that can enable University of Nebraska Medical Center (UNMC) researchers, among others, to create randomization schemes for research involving mice, other animal, or human subjects, and enhance documentation and …

Developing A Curriculum To Combat Loneliness As A Public Health Concern In Businesses, Sophia Yelkin

Capstone Experience: Master of Public Health

Loneliness has been considered a public health epidemic affecting people across the world. Elderly populations have historically been considered most at risk for loneliness, but it is becoming evident that loneliness is not so selective. Younger generations show more signs and symptoms of loneliness than older generations. This often overlooked condition is attributable to decreased mental and physical health and can weaken performance in the workplace.

This capstone project creates a concise curriculum addressing loneliness for dissemination in the workplace, ensuring appropriate health literacy for the priority population. Understanding the pervasive nature of loneliness, identifying symptoms, and methods to counteract …

Local Public Health Legal Landscape Report, Christina Hitz

Capstone Experience: Master of Public Health

This report provides a framework for understanding and examining local public health authority and implications of proposed legislative changes, specifically whether a shift is occurring in public health authority from the executive to the legislative branch. It compares the public health governance and legal infrastructure of states making a shift in 2021 relative to Nebraska’s current and proposed public health infrastructure and provides a synopsis of the legal context for and the scope of local public health authority currently in Nebraska. Three resources were used to create two tables to compare both states with legislative changes in 2021 indicating a …

A Comprehensive Literature Review Of Recruitment And Retention Strategies For Primary Care Providers In Rural Communities, Christian Folken

Capstone Experience: Master of Public Health

Workforce trends within the United States indicate a growing crisis in the availability and distribution of primary care providers. Rural communities have been disproportionately affected by the lack of primary care providers. The gap in available primary care services in rural areas severely affects the population health outcomes of these communities. There is a critical need for rural healthcare systems to effectively understand and implement recruitment and retention strategies of primary care providers to meet the needs of their patients and community. The goal of this paper is to provide a centralized resource of evidence-based strategies regarding the recruitment and …

Exploring Factors Related To Cancer Recurrence In Nebraska, Zenghan Tong

Capstone Experience: Master of Public Health

Currently, the studies of cancer burden are focused on the incidence, mortality, and survival of cancer. Due to the early detection and advancement of therapies, more patients can live much longer after a cancer diagnosis. Health care providers and patients want to know more about cancer recurrence, which can significantly impact cancer survivors’ quality of life. At this moment, the cancer recurrence studies are clinically based on specific treatments of particular cancers and are usually limited to small and selected populations. This study utilized the population-based cancer registry data between 1996-2015 to examine the cancer recurrence status in Nebraska. The …

Respiratory Syncytial Virus (Rsv) Laboratory Surveillance And Mortality In Nebraska, 2016 – 2021, Derek Bumgardner

Capstone Experience: Master of Public Health

Respiratory syncytial virus (RSV) is a common respiratory virus affecting children and adults. The United States RSV peak season occurs regularly between October to May, but in April 2021, an unexpected United States interseason RSV epidemic ensued. RSV laboratory testing has changed in the United States due to increased use of nucleic acid amplification testing (NAAT) rather than antigen-based testing, affecting how RSV seasonal epidemics are determined. Nebraska linked RSV laboratory and death certificate data (2016-2021) were used to calculate crude, specific and adjusted RSV case and mortality rates by age, sex, race, and ethnicity. A Cochran – Armitage test …

A Walk In Two Worlds: An Indigenous Health Research Mentorship Model Developed From The Experiences Of Mentors And Mentees In A Cancer Research Education Program Aimed At Increasing Representation Of American Indians/Alaska Natives In Cancer Research And Healthcare Professions, Kiana Borengasser, Aislinn C. Rookwood, Joyce C. Solheim, Maurice Godfrey, Karen Taraszka Hastings, Keyonna King, Hannah Robbins, Mariah Abney, Rudy Smith Jr., Liliana Tamayo, Regina Emily Robbins

Capstone Experience: Master of Public Health

The National Cancer Institute promotes workforce development programs that aim to increase representation of American Indian/Alaska Natives in health science and research careers. One such program, Youth Enjoy Science at the University of Nebraska Medical Center, has employed American Indian/Alaska Native youth in mentored cancer research internships from 2017 to 2022. The primary purpose of this study was to examine mentor and mentee experiences of participation in Youth Enjoy Science research education internships to learn from their stories. We conducted semi-structured interviews with current and former Youth Enjoy Science mentees (n=8) and mentors (n=8). We analyzed and collectively re-storied the …

The Epidemiology Of Extended Spectrum Beta-Lactamase-Producing Enterobacterales In Nebraska, 2018 – 2021, Axel A. Vazquez Deida

Capstone Experience: Master of Public Health

Background: Extended spectrum beta-lactamase (ESBL)-producing Enterobacterales are considered a serious public health threat by the United States Centers for Disease Control and Prevention. However, surveillance of ESBL-producing Enterobacterales is currently limited to select states and the epidemiology of these antibiotic-resistant bacteria in Nebraska is still not well understood.

Objective: To describe the incidence of ESBL-producing Enterobacterales across local health department (LHD)-jurisdictions as well as at the state-level over time and assess population-specific factors associated with infection or colonization with these pathogens in Nebraska.

Methods: A retrospective, cross-sectional analysis of public health surveillance data reported to the Nebraska Department of …

Atrazine Levels In Rural Nebraska Counties And Parkinson's Disease, Muhammad Zahid

Capstone Experience: Master of Public Health

Parkinson's disease (PD) is a multifactorial disorder, connecting both genetic susceptibility and environmental risk factors. Several epidemiological and experimental studies support the evidence that pesticides exposure is positively associated with enhancing neurodegenerative diseases. The high amount of atrazine used in Nebraska and increased PD cases led us to evaluate the association between the long-lived water-soluble pesticide atrazine and PD in Nebraska counties. A person's exposure to atrazine may come from inhalation, dermal absorption, and ingestion. Three types of atrazine data covering 1992 to 2017 were used for this study: applied atrazine, atrazine in surface water, and atrazine in groundwater. In …

A Systematic Literature Review Of The Use Of Technology As An Emergency Preparedness Tool To Control And Contain The Covid-19 Pandemic, Alyssa Spartz

Capstone Experience: Master of Public Health

Various tools and strategies have been utilized in response to the COVID-19 pandemic. In addition to preexisting measures, novel mechanisms and methods have also been developed since the COVID-19 pandemic began to address several different needs worldwide. Technology, for example, has served as a unique and multifunctional tool to aid with controlling and containing the pandemic. While studies and reviews have been conducted to analyze specific types of technology, such as digital applications, a gap in the literature currently exists that fails to comprehensively understand and compare how multiple types of technology were implemented to address the COVID-19 pandemic. This …