Public Health Commons^™

Rural Residents More Likely To Be Enrolled In High-Deductible Health Plans, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd, Andrew F. Coburn Phd

Access / Insurance

Enrollment in high deductible health plans (HDHPs) has increased amid concerns about growing health care costs to patients, employers, and insurers. Prior research indicates that rural individuals are more likely than their urban counterparts to face high out-of-pocket health care costs relative to income, despite coverage through private health insurance, a difference related both to the lower income of rural residents generally and to the quality of the private plans through which they have coverage. Using the 2007-2010 National Health Interview Survey, this study examines rural residents’ enrollment in HDHPs and the implications for evolving Affordable Care Act Health Insurance …

High Deductible Health Insurance Plans In Rural Areas, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd, Andrew F. Coburn Phd

Access / Insurance

Enrollment in high deductible health plans (HDHPs) has increased amid concerns about growing health care costs to patients, employers, and insurers. Prior research indicates that rural individuals are more likely than their urban counterparts to face high out-of-pocket health care costs relative to income, despite coverage through private health insurance, a difference related both to the lower income of rural residents generally and to the quality of the private plans through which they have coverage. Using the 2007-2010 National Health Interview Survey, this study examines rural residents’ enrollment in HDHPs and the implications for evolving Affordable Care Act Health Insurance …

Integrated Care For Older Adults In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

Recognizing that traditional models of health care delivery and payment often produce fragmented and costly care and poor outcomes for those with the highest needs, many reforms under the Affordable Care Act (ACA) focus on realigning payment incentives and integrating care. These reforms presuppose the existence of supporting infrastructure and capacity, including dedicated care management staffing and health information technology and exchange. With a focus on community-dwelling older adults in need of integrated physical, behavioral health services, and long term services and supports (LTSS), this brief reviews the opportunities and challenges these reform initiatives present for rural communities: How easily …

Integrated Care Management In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

No abstract provided.

Effects On Pinniped Immune Response Upon In Vitro Exposure To The Perfluorinated Compounds, Pfos And Pfoa, Elizabeth J. Meiman

Honors Scholar Theses

This study investigated the effects of environmental toxicants on the immune system of two pinniped species, grey seals (Halichoerus grypus) and hooded seals (Cystophora cristata). The toxicants included two perfluorinated compounds (PFC), perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS), compounds commonly found in a wide variety of household consumer products, including Scotchguard and Teflon. Although corporations such as 3M curtailed the use of these chemicals in the past decade, concentrations of these chemicals are increasing in the arctic aquatic ecosystem and have been measured in the tissues and blood of arctic pinnipeds. However, the effects of …

Evaluation Of Key Components Of Draft Guidelines For The National Weather Service Tsunamireadytm Community Program, Colleen Scott

Electronic Theses and Dissertations

The National Tsunami Hazard Mitigation Program partnered with the National Weather Service (NWS) in 2000 to create the TsunamiReady^TM (TR) Community program. TR is designed to help communities in coastal areas plan and prepare for tsunamis. To achieve TR recognition communities must meet certain criteria including specific emergency planning and management actions within the categories of mitigation, preparedness, response, and recovery.

This study’s purpose was to evaluate the acceptability and usefulness of key components of a proposed revised set of TR Community program guidelines. Research was guided by the Elaboration Likelihood Model (ELM) using Community Based Participatory Research methods …

Markers And Mechanisms Of Metabolic Aging., Peter Dziewornu Ahiawodzi

Electronic Theses and Dissertations

Oxidative stress has been implicated in aging and age-related diseases. Using three distinct studies, this dissertation examines associations between lifestyle factors and oxidative stress, and their effects on advanced glycation end products, telomere length, and type II diabetes. Carboxymethyl-lysine (CML), an advanced glycation end-product, has been linked to oxidative stress, cardiovascular and other age-related diseases. The first study investigates the association between sleep disordered breathing (SDB), a source of oxidative stress, and CML. 1002 participants with sleep data from the Cardiovascular Health Study (CHS) were analyzed. SDB was not significantly associated with CML, but after stratification by gender and hemoglobin …

The Performance Of The K6 Scale In A Large Adolescent Sample., Nicholas Chalmer Peiper 1982-

Electronic Theses and Dissertations

This dissertation is an applied research study to examine the performance of the K6 scale that measures serious emotional disturbance (SED) among adolescents. As the K6 was included in the 2012 administration of the Kentucky Incentives for Prevention Survey (KIP), three specific aims are included: 1) confirm the unidimensional structure of the K6 among adolescents using factor analysis; 2) define the prevalence and correlates of adolescent SED among Kentucky students; and 3) utilize latent class analysis (LCA) to empirically derive clinically relevant subtypes of adolescents with SED. Of the 122,718 students who completed the KIP in 2012, approximately 89% provided …

Effectiveness Of Chronic Obstructive Pulmonary Disease (Copd) Management Program At The University Of Louisville., Malhar Anantbhai Jhaveri

Electronic Theses and Dissertations

Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease of the respiratory system characterized by airflow limitation that is not completely reversible and is associated with systemic effects especially of the cardiovascular system. COPD is frequently complicated by acute exacerbations that contribute to physical impairment and increased health care use. As COPD is a chronic lung disease with significant systemic manifestations, it is important to have chronic disease management programs specifically targeting individuals with COPD designed to improve their overall quality of life, reduce the burden of disease and decrease the impact of COPD on daily life. Chronic disease …

Latinas And The Traditional Genetic Counseling Model: A Qualitative Study, Stephanie Thompson

Dissertations and Theses (Open Access)

The traditional genetic counseling model reflects an individualized counseling session that includes the presentation of information about genes, chromosomes, personalized risk assessment, and genetic testing and screening options. Counselors are challenged to balance providing educational information with discussion of implications of this information in an allotted amount of time. The aim of this study was to explore the perceptions of pregnant Latinas on the benefits and limitations of the traditional prenatal genetic counseling model and to determine the specific preferences for receiving prenatal genetic counseling. Data were collected through focus groups and one-on-one, semi-structured interviews of twenty-five Spanish speaking Latinas …

The Effect Of School And Neighborhood Environmental Factors On Childhood Obesity, Yiwei Qian

Graduate Theses and Dissertations

The dissertation consists of three chapters exploring the effect of school program and neighborhood environment on childhood obesity outcome using individual panel data set of Arkansas public schoolchildren.

The first chapter (Section 2) investigates how the Fresh Fruit and Vegetable Program (FFVP), a program that provides funding for the distribution of free fresh fruits and vegetables to students in participating schools, affects childhood obesity. We combine matching methodology and difference-in-differences analysis to estimate the effect of the FFVP on childhood BMI outcomes. Estimates of the FFVP effect are sensitive to different matching methods. Methods that provide a good balance between …

Access To Supermarkets And Fruit And Vegetable Consumption, Anju Aggarwal, Andrea J. Cook, Junfeng Jiao, Rebecca A. Seguin, Anne Vernez Moudon, Philip M. Hurvitz, Adam Drewnowski

Research Collection College of Integrative Studies

Objectives: We examined whether supermarket choice, conceptualized as a proxy for underlying personal factors, would better predict access to supermarkets and fruit and vegetable consumption than mere physical proximity.Methods: The Seattle Obesity Study geocoded respondents' home addresses and locations of their primary supermarkets. Primary supermarkets were stratified into low, medium, and high cost according to the market basket cost of 100 foods. Data on fruit and vegetable consumption were obtained during telephone surveys. Linear regressions examined associations between physical proximity to primary supermarkets, supermarket choice, and fruit and vegetable consumption. Descriptive analyses examined whether supermarket choice outweighed physical proximity among …

Biomechanical And Ergonomic Impacts Of Handling In Obese Workers, Philippe Corbeil, André Plamondon, Normand Teasdale, Grant Handrigan, Jasmin Ten Have, Nancy Manzerolle

Rapports de recherche scientifique

L’obésité est un problème émergent qui a des répercussions en santé et en sécurité du travail (SST). La prévalence de blessures musculo-squelettiques chez les individus obèses et les coûts indirects (non médicaux) sont plus élevés que ceux des travailleurs ayant un poids santé. Sachant qu’une hausse soutenue du taux d’obésité chez les travailleurs est observée au Canada, il est important de s’intéresser à la problématique de l’obésité liée au travail. Les risques de blessures au dos survenues au travail sont très élevés et la profession la plus touchée est celle de manutentionnaire. On connait peu l’effet de l’obésité sur les …

Vitamin D Status Of College Students: Implications For Health Leaders, Eileen M. Cress

Electronic Theses and Dissertations

Vitamin D deficiency is considered to be a pandemic with implications for compromised bone health and other chronic diseases. Few studies have examined vitamin D status in college-aged individuals where prevention of future health consequences is still possible. Serum vitamin D 25(OH)D status and vitamin D intake were examined in 98 college students ages 18-29 years during winter. BMI was classified as < 25and 25 or greater. Race was categorized as Caucasian or other. Overall, 69.5% had suboptimal serum vitamin D levels, <30ng/mL. Only 8 students (8.2%) met the EAR (400 IU) per day for vitamin D intake. t tests were used to determine if there were significant differences in serum vitamin D level and dietary intake based on gender, race and BMI. Significant differences were found in serum vitamin D level when compared by gender and race. Females tended to have a higher serum vitamin D level than males. Those representing minorities had lower serum vitamin D levels than Caucasians; One hundred percent of the minority students had suboptimal serum vitamin D levels. Based on these findings, dietitians should increase efforts to target college-aged individuals in educational programming related to factors affecting vitamin D synthesis, vitamin D intake, and health consequences of suboptimal vitamin D status, particularly in winter. Consideration should be given to vitamin D fortification of foods that meet the preferences of today’s consumer.

Impact Of Healthy Lifestyle Choices On Smoking Behavior Among College Students Who Smoke Cigarettes, Mitchell Jenkins

Graduate Theses and Dissertations

This dissertation examines the impact certain healthy lifestyle choices had on smoking behavior among college students who smoke cigarettes. Even with continued reduction in prevalence, cigarette smoking is still the leading cause of preventable death in America. With that in mind, it is important to continue to identify factors that relate to decreased tobacco usage. Secondary data from the American College Health Association's bi-yearly National College Health Assessment was used for this study. This assessment/survey encompasses college students' habits, behaviors, and perceptions regarding prevalent health topics. The sample for this study consisted of 14,515 college students who identified themselves as …

Assessing The Impacts Of Unrestricted Pesticide Use In Small-Scale Agriculture On Water Quality And Associated Human Health And Ecological Implications In An Indigenous Village In Rural Panam[Aacute], Sarah Louise Watson

USF Tampa Graduate Theses and Dissertations

In 2014, the global pesticide industry's projected worth is $52 billion and by 2020, the developing world will make up one-third of the world's chemical production and consumption. Pesticides can have unintended negative consequences for human health and the environment, especially in the developing world where regulations are loose or nonexistent. One country with unrestricted use of pesticides is Panam[aacute], especially in Santa Rosa de Cucunatí. In this indigenous village, small-scale farmers and ranchers spray paraquat, glyphosate, picloram, and 2,4-D at higher elevations than the spring water source of a gravity-fed water system, the river, and the village. The objective …

Global Malnutrition: Challenges Associated With Current Intervention Strategies And Prevention Initiatives, Duncan Stiller

Senior Honors Projects

Few, if any, tribulations in the field of public health have managed to transcend the epidemiological transition from acute to chronic disease as malnutrition has. Officially, malnutrition is a category of diseases that includes micronutrient deficiency, under-nutrition (calories/protein), as well as excessive nutrition. The World Food Program estimates that 842 million people worldwide do not have access to enough food, approximately 146 million of which are children. The most serious types of hunger are known as Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM), with 20 million and 35 million respective cases each year occurring in children less than …

Translation, Cultural Adaptation And Field-Testing Of The Thinking Healthy Program For Vietnam, Jane Fisher, Hau Nguyen, Priya Mannava, Ha Tran, Thao Dam, Tran Huong, Thach Tran, Kelly Durrant, Atif Rahman, Stanley Luchters

Population Health, East Africa

Background: Depression and anxiety are prevalent among women in low- and lower-middle income countries who are pregnant or have recently given birth. There is promising evidence that culturally-adapted, evidence-informed, perinatal psycho-educational programs implemented in local communities are effective in reducing mental health problems. The Thinking Healthy Program (THP) has proved effective in Pakistan. The aims were to adapt the THP for rural Vietnam; establish the program’s comprehensibility, acceptability and salience for universal use, and investigate whether administration to small groups of women might be of equivalent effectiveness to administration in home visits to individual women.

Methods: The THP …

Knowledge, Attitude And Practices Regarding Hiv/Aids Among Adult Fishermen In Coastal Areas Of Karachi., Mubashir Zafar, Nighat Nisar, Masood Kadir, Zafar Fatmi, Zeeshan Ahmed, Kashif Shafique

Community Health Sciences

BACKGROUND:

Migrant populations are at high risk of Human Immuno Deficiency Virus infection (HIV) and Acquired Immunodeficiency Syndrome (AIDS). Studies of HIV/AIDS knowledge, attitudes and practices among fishermen in developing countries have shown gaps in knowledge and fear of contagion with ambivalent attitudes towards HIV/AIDS and inconsistent universal precautions adherence. The aim of this study was to determine the knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in a coastal area of Karachi, Pakistan.

METHODS:

Community based cross sectional study was conducted among fishermen in coastal area of Karachi from June to September 2012. A total of 297 adult …

A Content And Visual Analysis Of Promotional Pieces Used To Promote The Arkansas Soybean Promotion Board, Amy Hughes

Graduate Theses and Dissertations

A communications campaign was developed for a commodity promotion board in the southern region of the United States with promotional pieces produced and disseminated by a third-party communications group to reach the general public, soybean producers, and animal agriculture producers target audiences through key themes and messages. A systematic, content-driven approach assessed the potential impact on perceptions of individuals. This study utilized a content and visual analysis based on semiotic theory to analyze creative pieces and focus groups to assess content quality and impact.

Many of the creative pieces displayed too many themes, and the themes did not accurately represent …

Long-Term Mindfulness Meditation: Anxiety, Depression, Stress And Pain, Is There A Connection For Public Health?, Sara Spowart

USF Tampa Graduate Theses and Dissertations

Long-term mindfulness meditation for anxiety, depression, pain and stress has not been adequately investigated in academic literature. The majority of literature in relation to mindfulness meditation and these ailments concerns Kabat-Zinn's Mindfulness-Based Stress Reduction (MBSR) program. This is a short-term 6-8 week program that requires a licensed professional, is limited in availability, high cost, and combines other elements aside from mindfulness meditation, such as yoga, martial arts, group discussion, poetry and other teaching techniques meant to increase mindfulness concentration. Furthermore, efficacy studies, which have assessed the long-term impact of MBSR are inconclusive. Although these studies on long-term practice demonstrate a …

Physical And Mental Health Status Of Adults With Serious Mental Illness Participating In A Jail Diversion Intervention, Robin Telford

USF Tampa Graduate Theses and Dissertations

Adults with mental illnesses are at an increased risk to be diagnosed with one or more comorbid physical illnesses compared to the general population. Much of the disparities faced by adults with serious mental illnesses (SMI) can be attributed to medication side effects, increased risk for metabolic diseases, inability to communicate about severity and monitor physical health symptoms, poor health behaviors, high rates of smoking, and poor quality health care. The rate of physical illnesses for adults with mental illnesses are even higher among those who have been involved with the criminal justice system. In order to understand the relationship …

Drinking Water In The Developing World: Sources Of Fecal Contamination In Pitcher Pump Systems And Measurement Alternatives, Meghan Wahlstrom

USF Tampa Graduate Theses and Dissertations

It has been reported that globally we have achieved Millennium Development Goal (MDG) Target 7C, to halve the proportion of the population without access to safe drinking water; however, there is a major flaw with this statement. While Target 7C calls for access to `safe' drinking water, what is actually being measured and reported is access to an `improved' water source. The World Health Organization (WHO) maintains that they must use this proxy measure because the methods for water quality testing are too expensive and logistically complicated, but by doing so, they may be over reporting safe water coverage.

This …

Development Of A Molecular Method For Detecting The Causative Agent Of Swimmer's Itch (Trichobilharzia) In Freshwater Ecosystems, Heidi Mcmaster

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cercarial dermatitis, commonly known as swimmer's itch, is caused by penetration of larvae of the schistosome,Trichobilharzia, into the dermis and epidermis layers of the skin. Symptoms are characterized by painful swelling and itching at the site of penetration. The normal hosts for the life cycle of the schistosome are aquatic birds and aquatic snails. The most frequently used method of detection forTrichobilharziais microscopy. With increases in the occurrence of cercarial dermatitis outbreaks in freshwater in the Southwestern United States, it is becoming increasingly important to develop and standardize a molecular method for rapid detection that can assist health professionals and …

Strategies For Prevention Of Road Traffic Injuries (Rtis) In Pakistan: Situational Analysis., Adeel Ahmed Khan, Zafar Fatmi

Community Health Sciences

Road traffic injuries (RTIs) are one of the leading causes of death among productive age group. Using systems approach framework (SAF), current preventive strategies for RTI control were reviewed in Pakistan. A review of the literature was done using four international search engines. Only ten studies on preventive strategies for RTI stemming from Pakistan were found. The first Road Traffic Injuries Research Network (RTIRN) surveillance system for road traffic injuries was established in urban city (Karachi) in Pakistan has shown promise for injury control and should be scaled up to other cities. Enforcement of traffic laws on seat-belt and helmet …

Sentiments Of Community Stakeholders Living In Southern Nevada Neighborhoods, Erin Sheehy

UNLV Theses, Dissertations, Professional Papers, and Capstones

Community stakeholders provided insight to their local neighborhoods and shared their thoughts about the potential redevelopment of their neighborhoods. This study utilized data from the Southern Nevada Strong ethnographic research project. Ethnographic research was conducted over ten weeks in Summer 2013. Neighborhood observations and interviews with community stakeholders were conducted to understand how neighborhoods are utilized, how residents feel about potential redevelopment, and what areas of the neighborhoods residents would like to see improved in the future. Photographs were also collected to further examine the characteristics, aesthetics, and spatial landscape of the neighborhoods. The purpose of this qualitative research project …

The Impact Of Body Image On Women In Later Life: Effects On Quality Of Life And Body Perception, Rachel L. Avants

Graduate Theses and Dissertations

Physical, mental, and emotional changes can occur throughout the aging process, making it important to treat different age groups as separate populations when researching body image. Yet, very few instruments have been validated for middle-aged and older adults. An online survey was used to perform a validation of the Body Image Quality of Life Inventory (BIQLI) and examine demographic relationships, with a sample of 947 women, ages 40-79, from across the United States. A principal component analysis (PCA) and convergent validity supported the use of the BIQLI for women ages 40 to 79. A one-factor model was validated for comparing …

A Survey Of Antimicrobial Stewardship Practices In The Western United States: Successes And Challenges, Gayle Louise Allenback

UNLV Theses, Dissertations, Professional Papers, and Capstones

Antibiotics are one of the most important developments in medicine, and their ability to prevent and control infections has had a major impact in clinical medicine. However, the past three decades have shown an increase in multidrug-resistant organisms (MDROs) in both hospital patients and in the community, decreasing our ability to successfully control infection. Complicating the depletion of effective antimicrobials is the fact that, in the last 10 years, there has also been a decrease in the development of new antibacterial agents. Resistant infections have resulted in increased morbidity and mortality, with a consequential increase in healthcare costs. The utilization …

Factors Which Predict The Use Of Active Transportation To School Among Children In Clark County, Nv, Sheila G. J. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Active transportation to school (ATS) shows promise for increasing activity levels in children, but prevalence and correlates vary widely in cities and regions with different barriers and supports for active travel. Classification of ATS users is a current issue in the field. The purpose of this study was to determine the prevalence of ATS use and develop a predictive model of ATS for the novel population of children enrolled in grades K-8 in Clark County School District, a large metropolitan school district in Southern Nevada. Methods: This study used a secondary data from the National Center for Safe Routes …

The Reduction Of Central Line-Associated Bloodstream Infections In Intensive Care Units Through The Implementation Of The Comprehensive Unit-Based Safety Program, Michael Andrew Basinger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSIs) are one of the most significant healthcare-associated infections (HAIs) in the Intensive Care Unit (ICU) setting resulting in increased lengths of stay, increased healthcare costs, and higher mortality rates (Institute of Healthcare Improvement [IHI], 2012). Evidence that CLABSIs are largely preventable has created opportunities for healthcare organizations to implement evidence-based bloodstream infection prevention practices to reduce or eliminate these infections (Lissauer, Leekisa, Prease, Thom, & Johnson, 2012). Other efforts to reduce CLABSIs include implementation of safety programs to improve the safety culture in ICUs (Lissauer et al., 2012). One program, the comprehensive unit-based safety program …