Public Health Commons^™

Caring For Caregivers: Challenges Facing Informal Palliative Caregivers In Western Kenya, Hartlee Johnston

Independent Study Project (ISP) Collection

Chronic illnesses like cancer, HIV, and other non-communicable disease are increasing globally, especially in developing countries, necessitating development of palliative care and symptom management systems. In Kenya, the burden of care for chronically ill patients often falls to unpaid, informal caregivers like family members or friends. Thirty-five current or past informal caregivers from Kisumu, Kenya were interviewed about their experience, challenges they faced, and interventions they felt would be helpful. Major challenges identified included lack of finances for treatment and other living expenses; inadequate, unaffordable, or interrupted medical care; emotional stress exacerbated by juggling many responsibilities, pressure to emotionally support …

Hiv Harm Reduction Methods: A Comparison Between Switzerland And The United States, Erin Major

Independent Study Project (ISP) Collection

This paper explores the connections between harm reduction methods and the prevalence of HIV/AIDS in Switzerland and the United States of America, focusing primarily on the harm reduction methods of needle exchange programs, safe drug consumption spaces, and sex education. While these two countries are largely similar in their culture and geopolitical approaches, there are some key differences in how HIV is approached in each. Switzerland’s somewhat unique approach with relaxed drug policies and more pragmatic, harm reduction based response to the AIDS epidemic sets a model framework for other countries to follow, with comparatively widespread use of needle exchange …

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study …

Understanding Sanitation Preferences: An Exploratory Study In The Sirohi District Of Rajasthan, Karen Mac

Independent Study Project (ISP) Collection

Of all the countries in the world, India has the highest number of people practicing open defecation, causing adverse health outcomes from the unconfined spread of faecal matter. The Government of India is ambitiously aiming to end this practice through the construction of 12 million toilets by 2019, but historically, many toilets across India have gone unused. This study focused on understanding: (1) the reasons why people continue to openly defecate despite having toilets and (2) the requirements of a toilet that rural households would be willing to use. Along with 36 observations of household toilets, semi-structured group (n=8) and …

Effectiveness Of Breastfeeding Shift Champions On Exclusive Breastfeeding, Comfort Obi

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Purpose. This project evaluated the effect of breastfeeding support on breastfeeding and exclusive breastfeeding rates among postpartum mothers in immediate postpartum period. The breastfeeding support was provided by breastfeeding shift champions (BFSC) following childbirth.

Design. A convenience sample of BFSCs, aged between 18 and 44 years, was utilized.

Method. Pre-and post-intervention questionnaires were used to evaluate breastfeeding knowledge of BFSC. Breastfeeding and exclusive breastfeeding rates were extracted, pre- and post- intervention, from electronic medical records of newborns and their mothers.

Data analysis. Descriptive and inferential statistics were used for data analyses. Descriptive data were displayed using frequency …

Effect Of Intimate Partner Violence Education On Nurses Readiness To Screen, Felisha Dixon-Brazier

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

This quality improvement translational project was intended to increase the confidence of nurses screening for intimate partner violence, through education. The project utilized a focus group and the Physicians Readiness to Manage Intimate Partner Violence Survey to gather needs, knowledge gaps, and prior education to develop IPV education for a group of nurses at a public health department. Nurses were found to have a low level of IPV knowledge, with a mean score of 42.44 (SD= 15.13), on a 100-point scale. Six of the nurses also reported less than one hour of previous IPV training in the past. Nurses reported …

Columbia Law Experts Denounce Federal Guidance Allowing Religious And Moral Discrimination In Contraceptive Coverage, Public Rights/Private Conscience Project

Center for Gender & Sexuality Law

Columbia Law School’s Public Rights/Private Conscience Project (PRPCP) condemns the Trump administration for issuing sweeping new rules today that roll back the Affordable Care Act (ACA)’s birth control benefit, by broadening exemptions for employers who claim religious or moral objections to offering birth control to their workers. These regulations place the religious and moral views of employers above the health and wellbeing of their workers and gut the contraceptive coverage provision of the ACA by dramatically reducing access to affordable birth control. Rather than protecting religious freedom for all Americans, these regulations are part of the current administration’s ongoing effort …

Chronic Disease Prevention As An Adaptive Leadership Problem, Jean O'Connor

Journal of the Georgia Public Health Association

This is an invited editorial.

Response To “Std Services Delivery Arrangements In Georgia County Health Departments”, Kathryn Moore

Journal of the Georgia Public Health Association

This is a Letter to the editor.

Community-Based Approaches To Reduce Chronic Disease Disparities In Georgia, Latrice Rollins, Tabia Henry Akintobi, April Hermstad, Dexter Cooper, Lisa Goodin, Jennifer Beane, Sedessie Spivey, Amy Riedesel, Olayiwola Taylor, Rodney Lyn

Journal of the Georgia Public Health Association

Background: Among underserved and racial/ethnic minority populations in Georgia, there are profound health disparities and a burden of chronic diseases. Such diseases, which are preventable, are influenced by risk factors, including poor nutrition, physical inactivity, lack of quality health care, and tobacco use and exposure. Awardees of the Racial and Ethnic Approaches to Community Health (REACH) and Partnerships to Improve Community Health (PICH) are implementing community-based initiatives using evidence-based, policy, systems, and environmental approaches to reduce racial and ethnic health disparities and the chronic disease burden in underserved urban and rural Georgia communities.

Methods: Within the context of a social …

Assessing A Comprehensive Approach To Prevent Sexual Violence On Campus: Implications For Program Improvement, Chinwe Ejikeme, Kia Powell-Threets, Mosi Bayo, Kia L. Toddle, Jean O'Connor

Journal of the Georgia Public Health Association

Background: On college campuses, sexual violence (or sexual assault) is at epidemic proportions. As many as one in four college women experience sexual assaults, most of which are not reported, likely due to the adverse reactions stemming from social norms and attitudes about rape. To prevent sexual violence on college campuses, the multi-level factors influencing it necessitate implementation of a holistic approach channeled at all levels. The present multi-method study assessed the feasibility and effectiveness of a peer educator (PE)-facilitated program implemented as part of a comprehensive sexual assault prevention program in three small Georgia colleges.

Methods: Student participants (N=128) …

Efficacy Of Chronic Disease Self-Management Among Low-Income Black Males With Behavioral Health Disorders: Pilot Study, Carol Collard, Vanessa Robinson-Dooley, Frances Patrick, Kayla Farabaugh

Journal of the Georgia Public Health Association

Background: This study examined the effectiveness of Stanford University’s Chronic Disease Self-management Program (CDSMP) among men living with co-morbidities of chronic physical health disease and behavioral health disorders.

Methods: The study was conducted at a community-based, non-profit organization in partnership with a large suburban university. Two pilot studies were completed with the population of interest. Low-income adult males with behavioral health disorders were recruited to participate in the program provided by a local behavioral health agency. Facilitators trained in the CDSMP program administered it at the agency site, and participants attended weekly meetings. Descriptive data collected included health history, demographic …

Evaluation Of Trends In Diabetes Care In A Patient-Centered Medical Home, Ashley N. Saucier, Danielle Mcmechan, Julie Dahl-Smith, Carla Duffie, Denise M. Hodo, Holly E. Andrews, Joseph Hobbs

Journal of the Georgia Public Health Association

Background: The patient-centered medical home (PCMH) is a model used in primary care to achieve effective management of chronic diseases. The Augusta University Health Family Medicine Center (AUFMC), a PCMH recognized by the National Committee for Quality Assurance, has implemented strategies to manage its patient population with diabetes. The present study evaluated the effects of these interventions through trend analysis of selected diabetic core measures by use of a qualified clinical data registry, the Practice Partner Research Network.

Methods: For this retrospective study, de-identified data were abstracted for adult patients with diabetes for the period of 2013-2015. Process and outcome …

Teach Kitchen: A Chronological Review Of Accomplishments, Jung Hee Chae, Benjamin E. Ansa, Selina A. Smith

Journal of the Georgia Public Health Association

Background: The Eating and Cooking Healthy (TEACH) Kitchen was founded at the Medical College of Georgia in 2015 as a nutrition-based intervention to combat the high prevalence of obesity and obesity-related chronic diseases in the area of Augusta, Georgia. Despite the importance of diet in the management of chronic diseases, inadequate nutrition education among patients and healthcare providers presents a barrier. The purpose of TEACH Kitchen is to address this gap.

Methods: TEACH Kitchen is as a student-led initiative that promotes healthy cooking among medical students and patients with chronic diseases. Healthy nutrition and cooking classes are held during the …

The Opioid Epidemic: A Practice And Policy Perspective, Gail D'Onofrio

Center for Policy Research

I will be talking about the escalating opioid epidemic and some innovative solutions my colleagues and I at Yale University and throughout the state of Connecticut, are working on to mitigate the consequences of this public health crisis.

International Black-Market Organ Trade, Marni E. Granzow

Student Publications

The human organ trade is a global epidemic as citizens of developed-countries look to developing-countries to find organ donors, specifically exploiting the poor for their own personal gain. The impoverished organ donors are treated in an inhumane manner, as they are often left with serious medical complications and are not treated equally in the transaction.

Palliative Players: Project Development And Initial Implementation, Eliza Eager

Muskie School Capstones and Dissertations

The Palliative Players are screened and trained hospice volunteers who provide a low-cost, sustainable, role-playing resource for use teaching communication skills to healthcare workers who discuss serious illness with patients and their families. The Palliative Players project was conceived and developed in early 2017 by Dr. Lauren Michalakes, Medical Director of Palliative Care at Coastal Healthcare Alliance (CHA); Sarah Dwelley, RN; Flic Shooter, Director of Hospice Volunteers of Waldo County (HVOWC); and Eliza Eager, Project Coordinator; to provide believable, emotive simulated patients (SPs) for role-play in workshops teaching healthcare workers communication tools and skills for use in conversations with patients …

Retrospective Cohort Study Of The Efficacy Of Azithromycin Vs. Doxycycline As Part Of Combination Therapy In Non-Intensive Care Unit Veterans Hospitalized With Community-Acquired Pneumonia, Justin Spivey, Heather Sirek, Robert Wood, Kalpit Devani, Billy Brooks, Jonathan Moorman

ETSU Faculty Works

The IDSA Community-Acquired Pneumonia (CAP) Guideline recommends ceftriaxone in combination with doxycycline as an alternative to combination therapy with ceftriaxone and azithromycin for non-intensive care unit (ICU) patients hospitalized with CAP. This is an attractive alternative regimen due to recent concerns of increased cardiovascular risk associated with azithromycin. The objective of this study was to compare the clinical outcomes of azithromycin and doxycycline each in combination with ceftriaxone for non-ICU Veterans hospitalized with CAP.

The Relationship Between Obesity And Periodontal Disease, Jean Conover

Dental Hygiene Master's Papers and Projects

Obesity has been targeted as the sixth most significant risk factor worldwide that is known to contribute to both oral and other associated systemic diseases.² According to the Centers for Disease Control and Prevention (CDC), the prevalence of obesity among adults in the U.S. is 40% and 18.5% in youth with prevalence higher among middle aged adults (42.8%) than younger adults (35.7%).³ As of 2016, nearly two billion people worldwide were either overweight or obese.¹ Research indicates accumulated excessive fat from being overweight or obese contributes to serious health impairments.⁴ World-wide obesity is associated with increased …

A Social-Ecological Framework Of Theory, Assessment, And Prevention Of Suicide, Robert J. Cramer, Nester D, Kapusta

Community & Environmental Health Faculty Publications

The juxtaposition of increasing suicide rates with continued calls for suicide prevention efforts begs for new approaches. Grounded in the Centers for Disease Control and Prevention (CDC) framework for tackling health issues, this personal views work integrates relevant suicide risk/protective factor, assessment, and intervention/prevention literatures. Based on these components of suicide risk, we articulate a Social-Ecological Suicide Prevention Model (SESPM) which provides an integration of general and population-specific risk and protective factors. We also use this multi-level perspective to provide a structured approach to understanding current theories and intervention/prevention efforts concerning suicide. Following similar multi-level prevention efforts in interpersonal violence …

Hspm 7133a - Public Health Policy & Ethics, William A. Mase

College of Public Health: Faculty Syllabi (2014-2021)

The course prepares learners to understand complex health and human service-related systems in order to inform effective practice-based ethical decision-making. The primary focus of the course relates to public health policy and practice. Major content areas include health policy institutions, the health policy process, ethical political considerations, social determinants of health, workforce, health care financing, medical technology, health care organizations, the public health system, primary care systems, and other health-related issues impacting the health of the public. Strategies of implementing change through policy making and the legislative process are covered.

Pubh 3231 - Epidemiology And Biostatistics, Stuart H. Tedders

College of Public Health: Faculty Syllabi (2014-2021)

This course introduces the student to the principles and practice of epidemiology and biostatistics. Students will be exposed to the historical development of epidemiology, concepts of causality, definitions of health and disease, and sources of community health data. Current principles and practices in the cause, prevention and control of diseases in various community settings will be emphasized.

Pubh 7132, Haresh Rochani

College of Public Health: Faculty Syllabi (2014-2021)

This course explores the scientific basis of 21st century disease processes including a survey of the origins, natural history, factors influencing individual and community risk. Clinical symptoms of diseases impacting humans, both acute and chronic, as well as epidemiologic trends will be also be discussed. Students will obtain an understanding of scientific mechanisms associated with the disease processes with particular focus on using this information in health-related professions and public health decision-making. As such, emphasis will be placed on the understanding and application of proposing community-based solutions designed to break the cycle of disease..

Bios 6541 - Biostatistics, Haresh Rochani

College of Public Health: Faculty Syllabi (2014-2021)

This course examines statistics in public health and related sciences, including sampling, probability, basic discrete and continuous distributions, descriptive statistics, hypothesis testing, confidence intervals, categorical data analysis, regression, and correlation. Emphasis will be on the development of critical thinking skills and health data analysis applications with computer software.

Bios 6331 - Regression Analysis In Biostatistics, Jingjing Yin

College of Public Health: Faculty Syllabi (2014-2021)

This course introduces the methods for analyzing biomedical and health related data using linear regression models. The course will introduce the student to matrix algebra as used in linear models. The course will involve model selection, diagnosis and remedial techniques to correct for assumption violations. The students will learn how to apply SAS procedures PROC REG, PROC CORR, and PROC GLM and interpret the results of analysis. Emphasis will also be placed on the development of critical thinking skills.

Pubh 7890 Individual Study: Simulation And Analysis In R, Jingjing Yin

College of Public Health: Faculty Syllabi (2014-2021)

This course introduces R and its applications in biomedical and social media data analysis as well as in statistical simulation. The students will learn how to apply R as a statistical analysis tool using existing R packages and interpret the results of analysis. Students will learn to use R for social media data analysis in public health, primarily Twitter data. In addition to apply existing R packages and functions, students will learn how to perform statistical simulation for methodological research, primarily simulation in medical diagnostics. Emphasis will also be placed on the development of critical thinking skills.

Bios 9135 - Advanced Survival Analysis, Lili Yu

College of Public Health: Faculty Syllabi (2014-2021)

This course will be placed on the theory on survival data. Counting processes and martingale method will be introduced. Emphasis will be place on the applications of the theory on the methodologies for survival data, such as Kaplan-Meier estimate, log-rank test, Cox model, etc. The students will learn how to use R language to setup survival dataset and perform analysis.

Epid 7135a - Epidemiology Of Infectious Disease, Isaac Chun-Hai Fung

College of Public Health: Faculty Syllabi (2014-2021)

This course is designed to provide students with an overview of the principles and practices of infectious diseases epidemiology with focus on how the presence and control of communicable diseases affects public health locally, nationally and internationally. Topics to be covered include: 1) general principles of infectious diseases epidemiology, including outbreak investigation, surveillance, analysis of infectious diseases data, and laboratory testing of specimens; 2) major modes of infectious disease transmission, including airborne, food and water, zoonotic, insect vector, blood, and sexual transmission; 3) different control strategies for infectious diseases, including infection control, antimicrobial management, immunization, risk factor modification, and screening; …

Envh 7233 - Environmental Exposure And Impact Assessment, Atin Adhikari

College of Public Health: Faculty Syllabi (2014-2021)

Introduces students to appropriate design, implementation, and analysis of primary environmental exposures and how they are influenced by public health ethics, equity and disparities. Specific topics covered include designing risk profiles; evaluating dose-response relationships; assessing the contribution of public health ethics, equity and disparities to environmental exposures; and analyzing field exposures of toxins.

Pubh 6532a - Environmental Health, Atin Adhikari

College of Public Health: Faculty Syllabi (2014-2021)

This course is designed for graduate students and provides students with an introduction and overview of the key areas of environmental health. Students will gain an understanding of the interaction of individuals and communities with the environment. Impact of environmental agents on human and ecosystem health will be analyzed. This course will also introduce current topics in global environmental health and challenges faced under the changing climate and socio-economic needs and examine recent case studies and their outcomes related to environmental policy and management.