Public Health Commons^™

Piloting An Observation Tool For The Garden To Table Program To Assess Education Of Underserved Youth In Omaha, Nebraska, Anthony Gargano

Capstone Experience: Master of Public Health

The Big Garden is a private 501-c3 organization, which utilizes multiple programs to grow healthy food, healthy kids, and healthy communities. The “Garden to Table” program helps students learn how to grow vegetables and herbs in their school garden as well as how to properly harvest, cook, and preserve these crops through various methods. This program specifically highlights STEAM education through plant science and organic gardening techniques, nutrition, and healthy lifestyles. In 2017, the “Garden to Table” program was taught after school at 5 middle schools in Omaha Public Schools: Marrs, McMillan, Monroe, Lewis and Clark, and King Science Center. …

Nebraska Wic Client Survey & Study Of Preterm Birth, Caleb Unekwu Adejoh

Capstone Experience: Master of Public Health

Background: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program provides supplemental foods, health care referrals, and nutrition education to low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children. Preterm birth remains the second leading cause of infant mortality following birth defects but there is a dearth of research on characteristics of WIC clients who are at risk of preterm birth. Objectives: The objective of the service learning was to design paper and online client satisfaction survey forms in English and Spanish for use by the Nebraska WIC program. The objective of …

Municipal Drinking Water Quality: Environmental Health And Safety Perceptions In Phoenix, Arizona, Chelsey Weaver

Capstone Experience: Master of Public Health

The goals of the Service Learning/Capstone Experience (SL/CE) project included identifying current perceptions regarding lead in municipal drinking water and related environmental health and safety concerns in the Sunnyslope community of Phoenix, Arizona; evaluating and improving the current outreach program in order to effectively target drinking water perceptions; and identifying strengths and weaknesses in the City of Phoenix Water Services Department (WSD) and Environmental Services Division (ESD) that contribute to negative public perceptions of municipally supplied drinking water. Objectives used to meet the stated goals included developing and distributing a survey to measure perceptions of the above issues through a …

The Incidence Rate, Types, And External Causes Of Traumatic Brain Injuries In Parkinson’S Disease Patients In Nebraska 2008-2014, Maher Alsaadi

Capstone Experience: Master of Public Health

Background: Parkinson’s disease (PD) patients are at higher risk of traumatic brain injury (TBI) due to disease characteristics like tremor, bradykinesia, and impaired balance. Most of the studies that have been done in the United States to investigate the incident rate and causes of TBI among PD patients have mainly focused on falls, while none of these studies have thoroughly addressed all causes of TBI among the PD population or have used a population-based database. Our study aims to investigate the incidence rate, types, and external causes of TBI stratified by age of PD diagnosis using a population-based database from …

An Assessment Of Nontuberculous Mycobacteria In Nebraska, Molly Hoffman

Capstone Experience: Master of Public Health

Background. Nontuberculous mycobacteria (NTM) are an important cause of morbidity and mortality in the U.S., yet not much is known about the prevalence and risk factors. It is thought to be increasing and most commonly found in women and older adults. The objectives of this project were to estimate the burden of NTM in Nebraska and to describe the patterns of NTM infection including location, species, specimen source, and patient demographic characteristics.

Methods. The National Electronic Disease Surveillance System was searched for all NTM infections reported from 2012-2017. Cases were classified as either pulmonary or nonpulmonary and available information was …

Assessment Of Caffeine And Sugar Sweetened Beverage Consumption Among Adult Pregnant Women In An Urban Medical Center In Nebraska, Shilpa Karanjit

Capstone Experience: Master of Public Health

Abstract

Background: Unhealthy non-alcoholic drinks for pregnant women include beverages with high caffeine and added sugar. High caffeine intake during pregnancy has been reported to be linked with adverse pregnancy outcomes such as miscarriages and stillbirth. In addition, high sugar-sweetened-beverages (SSBs) intake increases the risk of maternal obesity that is associated with many serious health problems in both mother and the fetus such as gestational diabetes, hypertension, congenital anomalies, macrosomia, childhood obesity and cardiac diseases. Maternal obesity also increases the cost of prenatal and postnatal healthcare by increasing the need of surgical and anesthetic care for mother and intensive care …

Needs Assessment And Management In Geriatric Patients Of A Federally Qualified Health Center, Nora Kovar

Capstone Experience: Master of Public Health

The purpose of this project was to identify opportunities for quality improvement in the care of geriatric patients at OneWorld Community Health Centers (OneWorld) by applying the principles of Community Oriented Primary Care (COPC) in the implementation of the Medicare Annual Wellness Visit (AWV).

Specific objectives were to better understand factors affecting geriatric health risk assessment and management (including implementation of the Medicare AWV) in federally qualified health centers (FQHCs) and to utilize data from pilot visits to better understand patient health needs in one FQHC, with emphasis on fall risk, cognitive loss, activities of daily living, and compliance with …

Symptom Clusters And Quality Of Life Trajectories In Breast Cancer Patients Before And After Chemotherapy, Gaurav Kumar

Capstone Experience: Master of Public Health

Context. Breast cancer patients experience multiple concurrent symptoms before and after chemotherapy (CTX). Physical and psychological symptoms may persist after treatment and reduce the quality of life (QOL) of survivors.

Objectives. Identify differences in prevalence and severity of symptoms at three times within 1- year of starting CTX; and identify symptom cluster and QOL trajectories over these times in breast cancer patients.

Methods. Symptoms were identified in breast cancer patients (N=219) before the start of CTX (baseline), 30 days after the last CTX, and 1-year after the first CTX. Hospital Anxiety and Depression Scale and Symptom Experience Scale …

Occupational Health Challenges In Research, Anthony Blake

Capstone Experience: Master of Public Health

ABSTRACT

Introduction: Employees working in universities and hospitals are faced with common and unique health and safety challenges. Usually, the campus Department of Health and Safety is tasked with reducing employee exposure through risk assessments. Purpose: In this study, we present a unique risk assessment case study related to a research project undertaken by the campus Department of Health and Safety (DHES). This project also describes the activities done by DHES to improve campus safety. We hypothesized that carbon monoxide, particulate matter, formaldehyde, and VOCs emitted from burning wood chips in a closed laboratory space will exceed …

Matters Of Trust: Examination Of The Patient-Provider Relationship In Cancer Care, Krista A. Brown

Capstone Experience: Master of Public Health

Background: The intangible concept of trust is critical in the patient-provider relationship. Cancer patients may experience positive and negative impacts of trust in this relationship to a higher degree due to the inherently serious nature of their disease and the level of dependence upon treatment providers.

Objective: The goal of this study was to compare colorectal cancer patients’ levels of trust in their primary care physician and oncologist, along with examining trust differences associated with demographics and other characteristics.

Methods: Colorectal cancer patients (n=158) treated at Nebraska Medicine and consented into the Integrated Cancer Repository for Cancer Research IRB …

Hearing Conservation Program On A Campus: Worker Noise Exposure Assessment And Training, Tika Nepal

Capstone Experience: Master of Public Health

Abstract

Introduction: Campus workers are exposed to loud noise from boilers, chillers, generators, snow blowers, leaf blowers, helicopters, utility vehicles, laboratory animals etc. No studies have looked at characterizing noise exposures among campus workers to see who needed to be enrolled in the Hearing Conservation Program (HCP).

Goal: The goal of this study was to determine which employees needed to be enrolled in a HCP.

Methods: This was a cross sectional study conducted among campus workers. We identified utility plant workers, comparative medicine workers, landscaping crew, security officers and facility staff who used utility vehicles as employees potentially exposed to …

Student Moves: A Mixed Methods Cross- Sectional Study Of Elementary School- Based Physical Education In Omaha Public Schools, Ashley Carroll

Capstone Experience: Master of Public Health

Childhood obesity is one of the leading pediatric health problems and a major concern among Omaha metro parents (Professional Research Consultants, 2015). While there are many inter-related factors that contribute to the development of obesity, physical inactivity is a prominent risk factor. Targeting physical activity in health promotion is desirable for its feasibility and effectiveness in balancing energy consumption and expenditure (Hill, 2012). The Student Moves research project sought to inform school district and community strategies for promoting youth physical activity by assessing current physical education practices among a random sample of third- grade students in Omaha Public Schools. Variables …

Development Of A Provider Referral Network For The National Diabetes Prevention Program In Northeast Nebraska, Carling Adams

Capstone Experience: Master of Public Health

Diabetes continues to be a significant health problem for Americans, including Nebraskans. The National Diabetes Prevention Program has designed a course for individuals with prediabetes to implement lifestyle changes and reduce their risk for developing diabetes. Although Elkhorn Logan Valley Public Health Department (ELVPHD) has offered this course for a few years, they have struggled to enroll enough participants for CDC recognition. The purpose of this project was to work with ELVPHD to develop a provider referral network for the National Diabetes Prevention Program (DPP) courses offered by the health department. In establishing this network, the goal was to increase …

The Current Burden Of Chlamydia And Gonorrhea Infections In The Three Rivers Health District, Donna Jordan

Capstone Experience: Master of Public Health

Background: The proportion of Chlamydia and Gonorrhea in Douglas County, Nebraska is significantly higher than Nebraska and the U.S. Consequently, the Douglas County Health Department has initiated numerous programs to combat STIs. However, the prevalence of Chlamydia and Gonorrhea has sharply increased in recent years. Adjacent to Douglas County is the Three Rivers Health District, including Dodge, Saunders, and Washington Counties. Few studies have assessed the burden of Chlamydia and Gonorrhea in the Three Rivers Health District.

Objectives: The objectives of the study were to 1) Compare Chlamydia and Gonorrhea by age, gender, and ethnicity for Dodge, Saunders, and Washington …

Analysis Of Food Security, Snap Benefit Duration, Income Level And The Relationship With Depression In Households With Children In Omaha., Tatiana Tchouankam

Capstone Experience: Master of Public Health

Food insecurity is defined as a lack of access to “sufficient, safe, and nutritious food that meets individuals’ dietary needs and preferences for an active and healthy life.” From 2015 to 2016, the number of people undernourished increased from 777 million to 815 million worldwide. Food insecurity affected 12.3 % of Nebraskans and 13.8% of the residents in Douglas County during the same year. There is evidence of associations between food insecurity, income level, and several adverse health outcomes, specifically with regards to mental health. The objective of this study was to examine food security, SNAP benefit duration (i.e., how …

Hpv Vaccination Of Children Among Motherse Of Mexican Origin, Bibiana M. Carvajal-Suarez

Capstone Experience: Master of Public Health

Background. The Human Papillomavirus (HPV) is a causative agent for the development of cancer which is a public health concern worldwide. In the United States (US), the highest incidence of cervical cancer is among Hispanics/Latinos. Although Hispanics/Latinos show the highest utilization rate of HPV vaccine, in general, the vaccination rates are still behind the Healthy People 2020 goal of 80%. The knowledge about this virus has been found low or nonexistent among most populations in the US, especially among minorities and populations with lower education and socioeconomic status. The knowledge and beliefs of Hispanic/Latin mothers about HPV and HPV …

Establishing An Active Reproductive Health Center And A Sliding Fee Scale At Bellevue Health Clinic, Gbadero Yerokun

Capstone Experience: Master of Public Health

Abstract

Goal

To collect preliminary data that will be used by Bellevue Health Clinic leadership to make decisions about expanding upon reproductive health services, and creating a sliding fee scale for services provided.

Objectives

To describe aspects of the scope of reproductive health care services provided by Title X-funded clinics in Lincoln, Omaha, Fremont, Grand Island, Tecumseh, Hastings, Gering, Norfolk and North Platte (14 total). The project will also compare and contrast existing sliding scale fees provided at these sites and provide subjective answers from key informants of how Title X funding and a sliding fee scale impact the population. …

Multilevel Worksite Wellness Intervention To Improve Individual Behaviors And The Worksite Environment, Mariah Morgan

Capstone Experience: Master of Public Health

Due to increasing obesity rates, public health approaches must focus on improving healthy behaviors and reducing the risk of obesity-related health problems (“Nebraska State Nutrition Profile,” 2012; “State of Obesity,” 2016). Worksites offer opportunities to stimulate behavior change through environmental supports and provide natural structures for social support; therefore, worksites are ideal locations for teaching and implementing health promotion programs (Beresford et al., 2001; Salinardi et al., 2013; Sorensen et al., 1996; Touger-Decker et al., 2008). The Social Ecological Model (SEM), which illustrates that various factors are intertwined at multiple levels to influence behaviors, has been shown to produce significant …

Youth Focus Groups: Design And Analysis Plan For The Bears Project, M. Renee Beacom Claborn

Capstone Experience: Master of Public Health

This capstone project produced a qualitative research design and analysis plan for youth focus groups as part of a Quality Improvement project at OneWorld Community Health Center (OWCHC) School-Based Health Center (SBHC) located at Bryan High School (BHS) in a program called BEARS. The intended use of this project is to serve as a reference guide for BEARS program planners to utilize as part of the data collection and analysis processes. The purpose for collecting qualitative data for this project is three-fold. 1. To explore adolescents’ perspectives of risk behaviors and associated health determinants common to their age group 2. …

Assessment Of Ems Workforce In Nebraska With Future Strategies, Matt Holt

Capstone Experience: Master of Public Health

Well-trained and fully staffed Emergency Medical Services (EMS) play a key role in improving the health of the surrounding community through rapid response, on scene care, and transportation to an appropriate facility. EMS is an integral part of the community, vital to limiting the severity of injuries, preventing morbidity, and improving the health of their populations. In order to ensure Emergency Medical Services in Nebraska are able to meet the needs of their populations and continue providing high-level care, an assessment of the State’s EMS workforce was conducted. By completing a workforce assessment, we gained a better understanding of the …

Examination Of Collaborative Efforts Of Central District To Achieve Success Of The Community Health Improvement Plan, Liene Topko

Capstone Experience: Master of Public Health

This was a quality improvement project that helped Central District Health Department (CDHD) work more closely with their community partners to identify the activities and programs that are currently in place to address priority health needs that were included in the 2016 Comprehensive Community Health Needs Assessment (CHNA). The purpose of this project is to identify the specific activities and programs that are being implemented by the health department and community partners in relation to the priority needs. These activities and programs were identified by conducting a survey of the major community partners. The findings from the survey helped to …

Primary Care Provider’S Perspectives Of Integrating Public Health Into The Prevention And Management Of Type Ii Diabetes Mellitus In Rural Nebraska, Emma Frost-Briley

Capstone Experience: Master of Public Health

Through the 2011 Community Health Needs Assessment, the Four Corners Health Department has identified type II diabetes mellitus as one of the communities top concerns within their communities. The goals of this project were: to develop a survey to assess the state of current practices of primary care providers on type II diabetes mellitus in the health department district, to identify primary care providers views on prevention, treatment, and management of type II diabetes mellitus in the health department district, and to examine primary care providers and local health department’s views on how primary care and public health can be …

The Use Of Electronic Health Records Data For Public Health: A Snapshot Of Current Practices In Nebraska’S Local Health Departments, Kushal Karan

Capstone Experience: Master of Public Health

Background: Public health issues are constantly changing and require local health departments (LHDs) to continually evolve in their approaches to address these issues. Advancements in health information technology (HIT), such as electronic health records (EHRs), play an important role in the collection of data that can be used to improve population health.

Objective: The purpose of this project was to assess the current use of electronic health records data by Nebraska’s local health departments and identify the data or tools they are using to address the health needs of the populations they serve.

Methods: In this study, a Mixed-Methods approach …

Employee Wellness At Private Clinic In Omaha, Ne: Social Marketing And Health Communications Perspective, Olivia Chambers

Capstone Experience: Master of Public Health

Midwest Gastrointestinal Associates (MGI) is a private clinic in Omaha, Nebraska that reached out to the College of Public Health for assistance in the clinic’s employee wellness program. An MPH student with a background in health and wellness provided MGI with a health promotion intervention to increase employee participation rates. A change was made to the wellness program in 2017 away from monthly health challenges and points—to small gifts distributed to all employees to increase engagement and morale. An initial program evaluation was performed to understand employee understanding and needs. Discovered was the need for an outlet employees could turn …

The Exploration Of Historical, Cultural, And Healthcare Utilization Factors When Clinically Treating Refugee Patients: Healthcare Providers’ View, Kandy Do

Capstone Experience: Master of Public Health

The objective of this project is to explore historical, cultural, and healthcare utilization factors that are significant to healthcare providers in their practice to clinically treat refugee patients holistically and equitably. Semi-structured interviews supported by a pre-interview questionnaire were conducted with 14 healthcare providers, who have experience in working with refugee patients. Purposive and snowball sampling method was used to recruit 14 healthcare providers. Thematic analysis was used to analyze qualitative data. Descriptive analysis was performed on the pre-interview questionnaire results. To our knowledge, there is limited research exploring historical, cultural, and healthcare utilization factors that are relevant for providing …

Epidemiologic And Spatial Differences In Colorectal, Lung, Breast, And Prostate Cancer Mortality-To-Incidence Ratios Between Blacks And Whites In Louisiana, Anas Almatrafi

Capstone Experience: Master of Public Health

Mortality and Incidence rates are widely used as indicators of health disparities among different racial groups. The current study used the mortality-to-incidence ratio (MIR) to provide a better population-based indicator of survival that can be used as an alternative and more accurate measure of the fatality based on incidence. This study intended to calculate and map MIRs for colorectal, lung and bronchus, breast and prostate cancers in Louisiana by race (Blacks vs Whites), sex, age groups, and geography. Age-adjusted mortality and incidence rates were calculated using the latest data release of the Surveillance, Epidemiology, and End Results (SEER) Program (1973-2014). …

Predictors Of Compliance And Predictive Values Of The Breast Cancer Screening Program Of The Oman Cancer Association (2009-2016), Sultan Al Balushi

Capstone Experience: Master of Public Health

Background: Most breast cancers in Oman are diagnosed at advanced stages and therefore early detection is important. The Oman Cancer Association (OCA) initiated a mobile mammography program in 2009 but no studies have evaluated the impact of the program. This study aimed to estimate the proportion of OCA-screened women who had repeated mammography (compliance) and the associated predictors. The sensitivity and specificity of the program were also evaluated.

Methods: Data for 13,079 women screened in the mammography clinic of OCA from 2009-2016 and medical records of all breast cancer patients seen at Royal and Sultan Qaboos University hospitals during the …

Evaluation Of Adult Mental Health First Aid: Findings From 2015-2017 Post-Course Surveys, Gina Schwieger

Capstone Experience: Master of Public Health

Abstract

Introduction: Lack of knowledge about mental health, lack of access to mental health care, and stigma create substantial barriers to the overall United States adult population from seeking or helping individuals with behavioral health issues. This study evaluated Adult Mental Health First Aid (MHFA) courses, an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing the community’s confidence in helping and frequency of referring people in need.

Methods: This retrospective evaluation of 2015-2017 Adult MHFA courses, utilizes qualitative and quantitative data from post-course surveys completed by course participants. Quantitative data was measured using a five-point Likert Scale. …

The Development Of A School Lunch Observation Measure To Assess School District Lunch Menu Implementation, Mariam Taiwo

Capstone Experience: Master of Public Health

Background: The most recent estimate of the prevalence of child and adolescent obesity in the United States is 17% (Ogden, Carroll, Lawman, & et, 2016). Based on evidence that the availability of healthy food at schools can significantly impact the nutrition behaviors of children, the Healthy and Hunger Free-Kids Act sets policy for the United States Department of Agriculture (USDA), which includes the National School Lunch Program (NSLP) and the School Breakfast Program (SBP) (USDA, 2017a). School food authorities (SFAs) are responsible for administering school feeding programs (Byker, Pinard, Yaroch, & Serrano, 2013). In other words, local school authorities (school …

Survey Of Indoor Air Quality In Residences Of Wic Participants In Lincoln, Nebraska, Eun Hee Kwon

Capstone Experience: Master of Public Health

Since 1992, Women, Infants, and Children at the Lincoln Lancaster County Health Department has provided supplemental food benefits, nutrition information, breastfeeding support, immunization referrals, and dental services to support low-income families and their children. However, statewide, the retention rate has been dropping since 2009, and if this continues, it can result in adverse health outcomes. As part of the Service Learning activities, this study aims to evaluate current services on clients’ experiences and improve their satisfaction by conducting the WIC participant-centered services survey. This cost-effective intervention program has been working successfully, however it does not provide the information of environmental …