Public Health Commons^™

Model Selection For Hierarchical Poisson Modeling In Disease Mapping, Rachel Moss Carroll

MUSC Theses and Dissertations

In disease mapping where predictor effects are to be modeled, it is often the case that sets of predictors are fixed and the aim is to choose between fixed model sets. In this dissertation, I focus on this dimension reduction objective by applying the Poisson data model commonly used for disease mapping of small area health data. I begin with a software comparison of the recently developed R package INLA (Integrated Nested Laplace Approximation) to the MCMC approach by way of the BRugs package in R, which calls OpenBUGS. This software comparison leads to choosing the appropriate platform for carrying …

Toward Enhancing Treatment For Pregnant Smokers: Laying The Groundwork For The Use Of Complementary And Alternative Medicine Approaches, Amy Michele Loree

Wayne State University Dissertations

Tobacco is the most widely used drug of abuse during pregnancy. Despite efforts to reduce perinatal tobacco use, its prevalence has remained steady over at least the past decade, suggesting that efforts to reduce smoking prevalence before and during pregnancy have not been effective. Although a range of effective treatments exist, most pregnant smokers neither seek nor receive any kind of treatment. Complementary and alternative medicine (CAM) treatments may be ideal as alternative, low-cost approaches capable of reaching and assisting a greater proportion of pregnant women with smoking cessation. This study examined characteristics and treatment utilization practices of pregnant smokers …

Undernutrition And Associated Risk Factors Among School Age Children In Addis Ababa, Ethiopia, Dawit Degarege, Abraham Degarege, Abebe Animut

Journal Articles: Epidemiology

BACKGROUND: Causes of child undernutrition are diverse and change in space and time. Investigating current determinants of undernutrition remains vital to design an effective intervention strategy. The study assessed prevalence of undernutrition and its associated factors among children living in Addis Ababa, Ethiopia.

METHODS: A community based cross-sectional study was conducted in 459 school age children and their parents or caregivers living in Lideta sub-city, Addis Ababa, Ethiopia. Participants were selected using a multi-stage simple random sampling technique. Height and weight of children was measured and their parents or care givers were interviewed for factors associated with undernutrition.

RESULTS: About …

Growing A Sustainable Community, Joseph Fulginiti, Alexander Moxam, Roderick Thompson

CwiC-PH

Poster includes: Summer Goals, Community Barriers, Fruits of Labor, Room for Growth and Community Assets.

Determining The Potential Scalability Of Transport Interventions For Improving Maternal, Child, And Newborn Health In Pakistan, Naeem Uddin Mian, Mariam Zahid Malik, Sarosh Iqbal, Muhammad Adeel Alvi, Zahid Memon, Muhammad Ashraf Chaudhry, Ashraf Majrooh, Shehzad Hussain Awan

Centre of Excellence in Women and Child Health

Background: Pakistan is far behind in achieving the Millennium Development Goals regarding the reduction of child and maternal mortality. Amongst other factors, transport barriers make the requisite obstetric care inaccessible for women during pregnancy and at birth, when complications may become life threatening for mother and child. The significance of efficient transport in maternal and neonatal health calls for identifying which currently implemented transport interventions have potential for scalability.
Methods: A qualitative appraisal of data and information about selected transport interventions generated primarily by beneficiaries, coordinators, and heads of organizations working with maternal, child, and newborn health programs …

Adolescent Oral Health In Kentucky, 2007 National Survey Of Childhood Health Analysis, Kory Brinker

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Research indicates that children raised by their grandparents can have poorer health outcomes than their peers living in mother or father based households. There is, however, little research that indicates how childhood oral health is affected by grandparents raising grandchildren. This study investigated grandparent based family structures, and how this family structure affects oral health of Kentucky children. Using data from the 2007 National Survey of Children’s Health, 113 Kentucky children were identified as living with a grandparent as a primary caregiver. Chi-Square analyses were utilized to assess the oral health status of these children, as well as what role …

Needle Stick Injuries And Blood Born Pathogen Exposures Among Health Care Workers In University Of Kentucky Health Care Facilities, Haider Sahmsulddin

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objectives:

The number of cases of needle stick and sharps-related injuries among healthcare workers are difficult to estimate due to underreporting. Multiple research studies have been done in this area but the scale of the problem is substantial and requires further attention. This study focuses on the cases of needle stick injuries and blood born pathogen exposure among health care workers at the University of Kentucky. The purpose of this study is to examine the rates of needle stick vs splash related injuries among the University of Kentucky health care workers from 2009 to 2014, and stratify the frequencies of …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

The Behavioral Impact Of Knowledge On Breast Cancer Risk Reduction, Mia Hung

Walden Dissertations and Doctoral Studies

The purpose of this study was to investigate the behavioral impact of knowledge regarding the relationship between breast cancer, vitamin D supplementation, and sunlight exposure considering levels of self-efficacy and response-efficacy. The study was based on protection motivation theory, which attributes behavior change to cognitive processes related to perceived threats and has demonstrated efficacy in promoting breast cancer risk-reducing behaviors. The study employed a quasi-experimental research design based on a survey using SurveyMonkey. Participants were New York City-residing women ranging in age from 25 to 74 who were recruited via an invitation from SurveyMonkey. Correlation analysis and linear regression analysis …

The Association Between Rheumatoid Arthritis And Type 2 Diabetes Mellitus, Magaly Perez Nieves

Walden Dissertations and Doctoral Studies

A research report from the Centers for Disease Control and Prevention (CDC) indicated that more than 50% of people with diabetes mellitus (DM) in the United States (U.S.) also have arthritis. The diabetes population is disproportionately affected by arthritis, but there has been limited and inconsistent research to confirm the association between type 2 diabetes mellitus (T2DM) and rheumatoid arthritis (RA). The current study aimed to identify an association between T2DM and RA for noninstitutionalized U.S. adults between 1999 and 2012 using a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) database (n =31,488 ). A …

Improving The Experiences Of Informal And Formal Alzheimer's Disease And Dementias Caregivers, Roxroy Anthony Reid

Walden Dissertations and Doctoral Studies

Informal and formal caregivers of persons with Alzheimer's disease and related dementias (ADRD) encounter a more difficult and unique set of challenges than do caregivers of individuals with general disabilities. If adequate caregiver supports are not provided, caregivers may experience increased strain as the disease progresses, increasing the likelihood of unnecessary institutionalization of their care recipients and increasing the cost to the public. Using rational choice theory and political systems theory, the purpose of this study was to differentiate between the phenomenological experiences of formal and informal caregivers of ADRD patients. The overall research was a qualitative design that used …

A Pilot Study To Develop A Projective Method To Understand And Measure Resilience, Tina Chen

Walden Dissertations and Doctoral Studies

Many factors affect resilience, such as personality traits and environmental support. A projective assessment has many advantages to understand a person as a whole. Up to present, there is no projective assessment for resilience. This dissertation was a pilot study to develop a projective method. Sixty-five college students participated in this study. Participants used words to describe their feelings after hearing an open-ended story with a traumatic event; they also completed the story. In this study, the resilience ratio, defined as the ratio of the number of positive responses divided by the number of total responses, reflected the resilience level …

Social Network Correlates Of Hcv And Hiv Transmission Risk Behaviors Among Injecting Drug Users, Victor Emanuel Reyes-Ortiz

Walden Dissertations and Doctoral Studies

Drug injection is an increasingly important risk factor in the transmission of blood-borne pathogens, including the hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The purpose of the study was to examine the influence of social network factors on HCV and HIV. The study was grounded in social network theory and sought to determine whether social network characteristics affect high-risk sexual and drug injection behavior as well as self-reported HIV and HCV status. The study design was a quantitative cross-sectional survey. A total of 181 participants in a needle exchange program completed a survey in Spanish assessing individual drug …

Awareness Of Diabetes Risk Associated With Individuals 18 And Older, Rebecca Jane Boone

Walden Dissertations and Doctoral Studies

The risk of developing Type 2 diabetes is increasing at epidemic proportions, and is 12-17% higher in Marion County Florida than it is across the state, based on Florida Department of Health statistics. The purpose of this DNP project was to determine if awareness of individual risk of developing Type 2 diabetes through a questionnaire would result in high-risk participants agreeing to attend a diabetes prevention program (DPP) at a local medical clinic. The health belief model and Rosswurm and Larrabee's model for change were used as frameworks. The review of the literature showed that prevention programs were highly effective …

Cultural Beliefs And Experiences Of Formal Caregivers Providing Dementia Care To American Indians, Damon Grew Syphers

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is a significant public health concern for all elders in the United States. It is a particular concern for the American Indian (AI) population, which is one of the fastest-aging populations in the United States and the smallest, most underrecognized, and most culturally-diverse group in the country. A formal caregiver understanding of AD in the AI population is scarce. This phenomenological study was designed to discern what is known about AD in the AI population by exploring the cultural beliefs and experiences of formal caregivers who provide care for AI dementia patients. Specifically, this study sought to …

Hiv Testing Among Young African American Men Who Have Sex With Men, Tayo B. Awopeju

Walden Dissertations and Doctoral Studies

Young African American men who have sex with men (AAMSM) are at greater risk of being infected with the human immunodeficiency virus (HIV) and less likely to seek HIV testing than are members of other demographic groups. This behavior results in a significant public health threat because young AAMSM with an unrecognized HIV infection are less likely to practice safer sex and, therefore, more likely to pass the infection on to their partners. This study is an examination of the social and personality factors that influence HIV testing rates among young AAMSM, using Aday's model of the social determinants of …

Health Care Seeking Behavior And Provider Responses For Hcv-Positive African Americans, Kathleen Susanna Bailey

Walden Dissertations and Doctoral Studies

Of the 3.5 million persons infected with chronic HCV in the United States, the African American population is the largest racial group with chronic HCV. Disparities in access to care and treatment involve a complex set of individual, interpersonal, socioeconomic, and environmental factors that influence the course of HCV infection in the African American population, resulting in poorer outcomes and survival. Drawing upon both the theory of reasoned action and the theory of planned behavior, this study was conducted to determine whether the seeking of health care by HCV-positive African Americans and the responses of health care providers to HCV-positive …

Promotion Of The Hospital's Patient Portal, Courtnie Jones Burrell

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services wanted to ensure that electronic health records were used in a meaningful manner to improve coordination and quality of patient care. In 2011, the federal government began offering monetary incentives to help healthcare facilities and providers adopt technology that supported patient access and increased their ability to manage their own health. The hospital where this project took place encouraged patients’ involvement in their health by providing a patient portal, yet the public has underutilized it. The purpose of this project was to develop an evidence-based strategy for future implementation at the hospital that …

Association Of Bisphenol A And C-Reactive Protein Concentrations With Cardiovascular Diseases, Hassan Salim Naji

Walden Dissertations and Doctoral Studies

Bisphenol A (BPA), a widely used chemical in plastic, has drawn wide attention due to its presence in many consumer products and the environment. The purpose of this study was to examine the association between urinary BPA and the reporting of cardiovascular diseases (CVD), and then to examine the effect of C-reactive protein (CRP) as a moderating variable. The data used in this research were extracted from the National Health and Nutrition Examination Survey collected in 2009-2010. Guided by the advanced epidemiological triangle, analysis involved 2 stepwise binary logistic regressions. The first step suggested that the controls were significant in …

The Role Of Religious Vaccination Exemptions In The Ocean County, New Jersey Pertussis Outbreak, Siobhan Bridget Pappas

Walden Dissertations and Doctoral Studies

Pertussis, also known as whooping cough, is a vaccine-preventable disease that is on the rise in the United States, a trend which has been attributed to vaccination exemption. Indeed, the pertussis outbreak that occurred in February, 2012 in Ocean County, New Jersey was associated with vaccine exemption. Considering that pertussis is deadly to young children, it is important to understand why this disease rate is on the rise. The research questions were focused on whether a relationship existed between pertussis status (no, yes) and exemption status (no, yes), sex (male, female), and county type (Middlesex, Ocean, or Other), using a …

Use Of Traditional 3-Hour Lectures In Preparing Students For The Childbearing Clinical Setting, Teresa Pohle

Walden Dissertations and Doctoral Studies

Following completion of a 4-year nursing program, some graduates have difficulty applying theories learned in the classroom to the clinical environment. This difficulty results in healthcare employers providing additional in-house training to ensure graduates' ability to safely care for their patients. The purpose of this research was to explore how traditional lecture methods have prepared students for the clinical environment. Based on a constructivist theoretical framework, a case study design was used to examine students' learning of theories delivered by traditional lecture methods. The research questions focused on student activities in the classroom and clinical setting, teaching strategies, critical thinking …

Depression And Hiv Risk Among African American Men Who Have Sex With Men, Sonya Anyaka

Walden Dissertations and Doctoral Studies

African American men who have sex with men (AAMSM) are at a greater risk of contracting HIV than any other ethnic group, subpopulation, or race. Personal, environmental, and social variables can affect risk behavior. Driven by Beck's cognitive theory of depression, this quantitative study examined the relationship between depression and HIV risk behaviors in a sample of AAMSM (n = 108). Data was gathered via the Beck Depression Inventory and the HIV Risk Behavior Questionnaire. Simple and multiple linear regression analysis were conducted to analyze the data to determine the correlation between HIV risk behavior and depression. According to study …

Planning For A Community Supported Farmers Market In A Rural Usda Food Desert, Carrie Lynn Engelbright

Walden Dissertations and Doctoral Studies

A community initiative to develop and sustain a farmer's market can address insufficient access to fresh and affordable fruits and vegetables for individuals working and residing in a United States Department of Agriculture (USDA) designated food desert. This project addressed a particular USDA food desert in South Wood County, Wisconsin. The purpose of this project was to develop and plan for implementation and evaluation of a community-supported farmers market in South Wood County, with the goal to increase access to fruits and vegetables. Project objectives included development of a sustainable community infrastructure to support the market, development of policies and …

Psychosocial Determinants Of Elective Cesarean Section Deliveries In Selected Obstetric Facilities In Nairobi, Kenya, Tom Joseph Oguta

Walden Dissertations and Doctoral Studies

Cesarean section (CS) rates have generally increased across the world in the past decade. Reducing elective cesarean section (ECS) rates is imperative as many countries aim to maintain threshold CS rates at or below 15%, the level recommended by the United States' National Institutes of Health. Women are believed to consider ECS for various interconnected psychosocial reasons, but few quantitative studies have investigated these factors. This prospective cohort study was based on the social ecological model (SEM) and the theory of planned behavior (TPB) models, and identified the psychosocial predictors of ECS among 1,268 expectant women in 2 hospitals in …

Herpes Virus Infections, Inflammatory Markers And Risk Of Developing T2dm And Cvd: An Analysis Of Nhanes With Adults, Aged 20-49, 1999-2010, Margarita Irizarry-De La Cruz

Walden Dissertations and Doctoral Studies

Herpes simplex viruses (HSVs), are among the most virulent and widespread pathogens; they affect 60-90% of the population worldwide. Substantial evidence indicates a possible association between pathogens and chronic disease. HSVs, among other viruses, have been associated with increased risk for inflammatory diseases. However, prior findings have been inconsistent on the role of infection in triggering autoimmune response and chronic disease. This study builds on the premise that pathogens can induce an inflammatory response and increase the risk for disease development. A representative U.S. sample from NHANES, a national population-based cross-sectional survey, was used to examine the relationship between HSVs …

Caregiver Status And Self-Reported Health Status Among African American, Phanta Soko Sackor

Walden Dissertations and Doctoral Studies

African American women (AAW) are at a high risk for type 2 diabetes, a debilitating and potentially fatal disease for which there is no cure. The purpose of this study was to extend the research of Mosca et al. (2012) by examining the relationship between caregiver status and self-reported health status for AAW 18 years or older diagnosed with type 2 diabetes. The chronic care model (CCM) provided the theoretical framework for this study. The CCM promoted routine care for patients with chronic illnesses to migrate from acute care to proactive, planned, and risk-based protocols. A binomial logistic regression investigated …

Disparities In Monoclonal Antibody Treatment Of Elderly Metastatic Colorectal Cancer Patients, Krista Marie Schroeder

Walden Dissertations and Doctoral Studies

Multiple research studies have demonstrated racial, socioeconomic status (SES), and neighborhood disparities in first-line treatment of colorectal cancer patients, including those with metastatic colorectal cancer. However, disparities in adjunct monoclonal antibody treatment disparities have not been explored. The purpose of this study was to assess racial, SES, and neighborhood disparities in adjunct monoclonal antibody treatment of elderly metastatic colorectal cancer patients. The research was rooted in 3 theories: the fundamental cause theory, the diffusion of innovations theory, and theory of health disparities and medical technology. Data from the SEER-Medicare database and logistic regression were used to assess the relationship between …

Evaluation Of A Mobile Health Intervention To Improve Anti-Retroviral Treatment Retention In South Africa, Ambereen Jaffer

Walden Dissertations and Doctoral Studies

South Africa has one of the highest HIV prevalence rates globally, with nearly 2.5 million people accessing antiretroviral treatment (ART) at the end of 2013. Retaining patients on ART has become a major problem in this country. When patients no longer show up for ART for unknown reasons, they are considered lost to follow-up (LTF). LTF is the highest contributor to ART attrition. This study, guided by the health belief model, evaluated the effectiveness of a technology-based, mobile health (mHealth) appointment reminder intervention on LTF among patients accessing ART services. The study ascertained differences in 6- and 12-month LTF rates …

The Association Between Online Risk Behaviors And Real Life Sexual Behaviors Among African American Female Adolescents, Nicole Rankine

Walden Dissertations and Doctoral Studies

An increased exposure to the sexual content of traditional mass media (i.e., television, magazines, movies, music) affects real life sexual behaviors among adolescents. Engaging in online risk behaviors such as sharing/posting sexual content using social networking sites, cellphones, smartphones, IPads, or other new media devices has become common among adolescents. The purpose of this quantitative, correlation study, based upon the theory of reasoned action and three pre-existing national surveys, was to determine whether significant associations exist between attitudes, intentions, and behaviors related to online risk behaviors and real life sexual behaviors among African American female adolescents in Metro Atlanta. Data …

Germline Mutations In Chek1 And Chek2 In Women With Ovarian, Peritoneal, Or Fallopian Tube Cancer, Maria Isabel Harrell

Walden Dissertations and Doctoral Studies

Ovarian cancer is the deadliest gynecological malignancy affecting women. Diagnosis often occurs late due to non-specific symptoms, but if detected early, there is excellent chance for survival. One of the most important risk factors is family history. Up to 24% of cases are due to inherited loss-of-function mutations in genes involved in the DNA damage response. The theory underlying hereditary cancers is Knudson's two-hit theory of cancer causation, where two hits are necessary for cancer to occur in an individual: one in the germline and one in the tissue. The genes, CHEK1 and CHEK2, are modulators of the DNA damage …