Public Health Commons^™

Missoula Prescription Produce Program: Lessons Learned 2015-2017, Harley Fredriksen

Graduate Student Theses, Dissertations, & Professional Papers

The Missoula Fruit and Vegetable Prescription Produce program (MFVPP) started in 2015 as a partnership between Garden City Harvest (a Missoula, MT food-security non-profit) and the Providence Endocrinology Center (a local health clinic focused on diabetes care). MVFPP allows physicians, physician assistants, and dieticians to prescribe fresh produce to their patients. Patients must be of low income and suffer from chronic disease. The purpose of this paper is to evaluate the effectiveness of the MFVPP to lead to improved biometric measurements for patients. This paper also discusses the program’s limitations and complications and aims to chart a path forward for …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …

Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh

Walden Dissertations and Doctoral Studies

Infant mortality (IM) is a critical health-disparity problem in the United States. Of the 23000 infants who die each year, the highest number occurs among African Americans. Previous studies implicated a mix of health determinants and risk factors, but no study has explored the mechanisms by which IM predictably persists among African Americans. This study uncovers the complex network of risk factors that underlies racial death disparities in infants. Two theoretical lenses chosen for this study were social systems theory (SST) and critical race theory (CRT). SST explains human behavior as an intersection of interrelated systems. CRT interrogates inherent social …

Leisure Computer Usage And Perceived Body Weight, Diet, And Physical Activity, Santina Jaronko

Walden Dissertations and Doctoral Studies

Screened media platforms have been blamed for contributing to the childhood obesity epidemic. The purpose of this study was to determine if leisure computer usage, such as engaging in social media, impacted perceived body weight, dietary habits, and physical activity. The social network theory and the social cognitive theory were the theoretical frameworks of this cross-sectional study using secondary data. The data set used was the 2015 Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance Survey including a sample size of 8,241 youths between Grades 9 and 12. Chi-square test and binary logistic regression analysis were performed to …

Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann

Walden Dissertations and Doctoral Studies

The level of knowledge and awareness among patients about the concepts and implications of medical radiation is unknown. The purpose of this qualitative, case study was to explore patients' awareness and knowledge of information regarding this topic from their perspectives. The health belief model provided the framework for the study. A total of 20 individuals were recruited using purposive sampling. All participants were above the age of 18 in central North Carolina and had undergone or are currently undergoing medical radiation exams. Data were collected using semistructured interviews and analyzed using Yin's 5-phased cycle, which involved compiling, disassembling, reassembling, interpreting, …

Identifying Associated Risk With Exposure Ti Weapon Carrying Among Emerging Adults Living In Disadvantaged Urban Areas In Birmingham, Tolulope Aduroja

All ETDs from UAB

IDENTIFYING ASSOCIATED RISK WITH EXPOSURE TO WEAPON CARRYING AMONG EMERGING ADULTS LIVING IN DISADVANTAGED URBAN AREAS IN BIRMINGHAM TOLULOPE ADUROJA HEALTH EDUCATION/HEALTH PROMOTION ABSTRACT Weapon carrying is a public health concern due to its association with a serious injury, disability or death, and adverse health-related outcomes. Weapon carrying among youth is associated with both intrinsic or internalizing and extrinsic or externalizing factors (Stayton, 2011). Violence in youth and young adults is the 2nd leading cause of death (homicide) in Alabama. Health behavior theories posit that health-relevant attitudes, beliefs, and behavioral skills drive subsequent actions people take to protect themselves from …

Influencing The Positive Mental Health Of Non-Kinship Foster Children: The Lived Experiences Of Foster Parents In Alabama, Sarah Catherine Tucker

All ETDs from UAB

This Interpretive Phenomenological Analysis (IPA) qualitative study interviewed fifteen non-kinship foster parents in Alabama to explore their lived experiences of influencing the positive mental health of their foster children. This phenomenological approach allowed for a deeper understanding of the challenges foster caregivers face when facilitating improved psychological and social well-being of their foster children. In 2015, there were 427,910 children in foster care, with 45% of these children residing in a non-kinship foster home (Adoption and Foster Care Analysis and Reporting System [AFCARS], 2016). Children in foster care, especially children in non-kinship care arrangements, often have significant and complex mental …

Amyloid And White Mater Hyperintensity Burden In The Stroke Belt, Emily Carol Mckinley

All ETDs from UAB

Several large cohort studies have found associations between residence in the Stroke Belt and cognitive impairment as well as dementia mortality; however, the rela-tionship between residence in the Stroke Belt and buildup of amyloid has not been estab-lished. The current project assessed the association between residence in the Stroke Belt and amyloid burden, amyloid accumulation, or white matter hyperintensities (WMH) in a large, national cohort of older US residents. The first study used linear regression models to examine the relationship between geographic residence and Centiloid values. Residence in the Stroke Belt at the time of baseline amyloid PET assessment was …

Bayesian Hierarchical Negative Binomial And Zero-Inflated Negative Binomial Models For High-Dimensional Analyses With Applications To Human Microbiome Count Data, Amanda H. Pendegraft

All ETDs from UAB

The human microbiome was first described as an “ecological community of commensal, symbiotic, and pathogenic microorganisms that literally share our bodyspace”. These microorganisms, also known as microbes and bacteria, are known for participation in human health. For example, microbes extract energy from foods that are otherwise indigestible, synthesize vitamins and amino acids necessary for important bodily functions, and protect hosts against disease-carrying pathogens. Therefore, the pursuit of human microbiome research is important for understanding the influence of microorganisms throughout human systems. Human microbiome research is founded on advances in next-generation sequencing technology. Namely, the identification of microbes that constitute the …

Impact Of Environmental Exposures On Respiratory Health, Lawrence Rasmussen

All ETDs from UAB

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality around the world. Cigarette smoking is a leading cause of COPD; similarly, individuals exposed to secondhand smoke (SHS) are also vulnerable to COPD and other airway diseases; however, distinct molecular mechanisms involved in SHS-induced lung effects that result in COPD are poorly understood. Mucociliary clearance (MCC) is a primary lung defense against inhaled particulate matter and pathogens. Thus, understanding how inhaled irritants such as SHS disrupt MCC will promote improved scientific understanding and better public health initiatives to prevent respiratory illnesses. Using a variety of in vitro …

Increasing Living Kidney Donation Through Advocacy And Patient Navigation, Rhiannon Deierhoi Reed

All ETDs from UAB

As the prevalence of kidney disease continues to increase in the United States, the gap between the need for organs and available kidney donors is growing as well. Deceased donor organs alone are insufficient to meet this need, and transplant centers have turned their focus to living donation to address the shortage. However, the frequency of living kidney donation has been declining in the US since 2004. Changes in the health of the US population have been suggested as one possible explanation for the decline, but currently these assertions remain anecdotal. A second theory with more published evidence attributes the …

Examining Web-Based Lifestyle Interventions For Cancer Survivors, Victoria Williams

All ETDs from UAB

Diet, physical activity, and body weight status are important modifiable risk factors for many health outcomes among cancer survivors, including cancer recurrence. Face-to-face, print, and mailed lifestyle interventions have been used to promote behavior change in cancer survivors successfully. However, such approaches are costly and have limited reach. Web-based lifestyle interventions represent a promising solution to this public health concern. Therefore, this project involved first reviewing and identifying gaps in the existing literature in this area and then developing and pilot testing a web-based lifestyle intervention for cancer survivors. For this three-part dissertation, study 1 was a narrative review of …

Hpv And Hsv Associated Clinical Conditions Among People Living With Hiv-1 Infection, Yuanfan Ye

All ETDs from UAB

This dissertation research focuses on investigating health burdens of HPV- and HSV- associated clinical conditions (CC) in people living with HIV-1 infection (PLWH) in the Southeastern United States. I designed a retrospective study using the UAB 1917 HIV Clinic Cohort. Electronic health records of PLWH attending the clinic for HIV-care between January 2006 and March 2019 were obtained and reviewed. I first examined incidence rates and trends of anogenital HPV- and HSV-associated CC. Then I adopted a new algorithm to group longitudinal CD4 cell counts based on their trajectories. I compared it with nadir and median CD4 cell counts in …

Exposure Assessment Of Ultrafine Particles And Hazardous Chemicals In Electronic Cigarettes, Oluwabunmi Magret Dada

All ETDs from UAB

The widespread use of electronic cigarettes (e-cig) among youths and adolescents is a growing public health problem due to exposures to harmful byproducts formed during heating. These byproducts include particulate matter, benzene, and toluene. However, the mechanisms and variables governing their formation including the chemical content of e-cig liquid (e-liquid) are not fully understood. This study aimed to assess exposures to particulate matter, benzene, and toluene in e-cig vapors (e-vapors) and their coupling to e-liquid chemical content. A novel nuclear magnetic resonance spectroscopy method was developed to characterize e-liquids (propylene glycol, glycerol, and nicotine) and the functional content of flavorings. …

Applying Markov Processes To Model Disability In Relapsing Multiple Sclerosis Patients, Anastasia Hartzes

All ETDs from UAB

Modeling disability in multiple sclerosis (MS) is challenging due to its complexity and non-linearity, with utilized methodology having many limitations. Lack of a suitable biomarker has led to relying on statistical models to understand disease progression. Markov methodology has been limitedly applied to the clinically-assessed Expanded Disability Status Score (EDSS), but not to patient-reported Patient Determined Disease Steps (PDDS); both measure disease progression and disability, and neither have been analyzed using the Test of Lumpability (TOL). It is common practice to aggregate these scores for computational or inferential convenience; in the case of Markov Chains (MC), combining states is referred …

Designing And Implementing Inclusive Community-Based Health Promotion Intiatives, Cassandra Herman

All ETDs from UAB

Background: People with disabilities (PWDs) have poorer health outcomes, yet are they are underserved by public health initiatives. PWDs face numerous barriers to participation in community-based health programs despite mounting evidence about these barriers along with recommendations and guidelines to become more inclusive of disability. Policy, system, and environmental (PSE) changes that are inclusive of PWDs can help create access to health promotion programs for PWDs. Systematically implementing inclusive PSE changes using implementation science principles can support effective and sustainable changes are implemented for each unique community context. The purpose of this dissertation is to explore the experiences of public …

Examining The Impact Of Couple Relationship Factors On Male Engagement Pregnancy Health And Communal Coping, Pamela Musoke

All ETDs from UAB

Focusing on male partner engagement in HIV prevention is an important aspect of intervention and policy development and implementation within the sub-Saharan African context. However, engaging male partners safely and effectively to improve the impact and sustainability of HIV prevention modalities remains challenging due to continued impact of traditional gender roles that may affect the willingness and confidence to engage in pregnancy health. Additionally, the lack of knowledge of how best to engage in pregnancy health beyond financial support makes it difficult for male partners to engage. This dissertation’s overall aim is to explore aspects of male partner engagement's influences …

Role Of Primary Care Providers And Integrated Disease Surveillance In Chad, Dhoud Stave Gischel Samba

Walden Dissertations and Doctoral Studies

In the Republic of Chad, primary care physicians play a central role in the detection and control of outbreaks and are critical actors in the integrated disease surveillance system through mandatory reporting. Feedback on such surveillance must reveal the needs and perceptions of these physicians. These needs and perceptions were examined using a questionnaire survey distributed to a sampling of 20 physicians in Chad. The purpose of this qualitative study was to investigate the role of primary care providers in the integrated disease surveillance to identify factors that impact complete, quality, and timely reporting. The theory of planned behavior was …

Effects Of Neighborhood Membership And Hypertensive Disorders In Pregnancy On Adverse Birth Outcomes, Chinyere Onyebuchi

Walden Dissertations and Doctoral Studies

Infant mortality (IM) rates in the United States remains high. The higher rates of IM among specific groups in the United States is believed to be fueled by the high rates of adverse birth outcomes including low birthweight (LBW) and preterm births (PTB) among these groups. Adverse birth outcomes have also been linked to the presence of hypertensive disorders during pregnancy. The purpose of this cross-sectional study was to explore the association between hypertensive disorders during pregnancy and adverse birth outcomes and the impact of the residential neighborhood of expectant mothers on this association. The life course health development theory …

Forging Relationships Between Faith-Based And Secular Organizations To Address The Global Water Crisis A Case Study From Liberia, Kristin R. Alford, Jamison L. Koeman

University Faculty Publications and Creative Works

It is imperative to engage in interdisciplinary and multisector partnerships as we seek to develop and deliver effective solutions to address the global water crisis. These partnerships allow us to live out our Christian charge to demand justice for the vulnerable and promote human flourishing. This case study reviews the benefits and challenges of multisector partnerships between faith-based and secular organizations using the example of a multi-year water filter distribution project in Liberia. Benefits of the partnership include shared expertise, investment in students and Liberians, and results-driven research. Challenges include differing sub-goals, logistical challenges, communication difficulties, and different ways of …

Accessible Design In Rural Health Care: Usability Profile Of Outpatient Health Care Facilities In Rural West Virginia., Jordan E. Miller

Graduate Theses, Dissertations, and Problem Reports (ETD)

The Americans with Disabilities Act (ADA) became law in 1990. Since then, research has shown that people with disabilities continue to experience environmental, systematic, and structural barriers to health care. The purpose of this research is to explore the prevalence of barriers in rural West Virginia health facilities and the relationship between building characteristics (like age and purpose) and accessibility. The researcher evaluated ten rural outpatient member-sites of the West Virginia Practice-Based Research Network using a survey to understand building characteristics and a tool to measure essential features for a facility to be considered ‘usable’. Findings included a negative correlation …

Predictors And Health Outcomes Of Treatment-Resistant Depression Among Adults With Chronic Non-Cancer Pain Conditions And Major Depressive Disorder, Drishti Shah

Graduate Theses, Dissertations, and Problem Reports (ETD)

Understanding major depressive disorder (MDD) as a comorbidity in patients with chronic non-cancer pain conditions (CNPC) is of importance because of the high prevalence and well documented bi-directional relationship between MDD and pain. Furthermore, presence of CNPC among adults with MDD often reduces benefits of antidepressant therapy, thereby increasing the possibility of treatment resistance. Treatment-resistant depression (TRD) commonly defined as insufficient response to multiple antidepressant trials, often worsens depression and pain symptoms and can amplify the clinical and economic burden among adults with CNPC and MDD. Additionally, long-term opioid therapy (LTOT) may be prescribed at a higher rate to adults …

Analysis Of User Preference With N95 And Powered Air-Purifying Respirators In A Healthcare Work Environment, Brittany Renee Carver

Graduate Theses, Dissertations, and Problem Reports (ETD)

For those working in the healthcare field, personal protective equipment is vital. Healthcare workers are often first responders when it comes to dealing with patients who are infected or when a disease outbreak occurs. The Occupational Safety and Health Administration (OSHA) requires all healthcare operations to provide employee protection against blood borne pathogens. With the increase of life-threatening disease outbreaks, such as SARS in 2003 and Ebola in 2014, it is of the upmost importance to make sure respirators are best suited for users and acceptable for long term use. It has been shown through previous studies that due to …

The Children's Oncology Group: Organizational Structure, Membership, And Institutional Characteristics., Janice S. Withycombe, Todd A. Alonzo, Michele A. Wilkins-Sanchez, Maxine Hetherington, Peter C. Adamson, Wendy Landier

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The Children's Oncology Group (COG) is the only organization within the National Cancer Institute's National Clinical Trials Network dedicated exclusively to pediatric cancer research. The purpose of this article is to provide an overview of COG's organizational structure, to characterize its institutional and individual membership, and to summarize enrollments onto COG clinical trials.

METHOD: Data from 2013 to 2015 were compiled from sources internal (Network Operations, Statistics and Data Center, Chair's Office) and external (American Hospital Association, American Nurses Credentialing Center) to COG, to present a comprehensive overview of COG's structure, individual and institutional membership, and group operations.

RESULTS: …

Australian Consumer Perceptions Of Regionally Grown Fruits And Vegetables: Importance, Enablers, And Barriers, Stephanie Godrich, Katherine Kent, Sandra Murray, Stuart Auckland, Johnny Lo, Lauren Blekkenhorst, Beth Penrose, Amanda Devine

Research outputs 2014 to 2021

Fresh fruits and vegetables are a cornerstone of a balanced diet; their consumption has health, environmental, ethical, and economic implications. This pilot study aimed to: (i) measure fruit and vegetable consumption; (ii) understand consumer perceptions of the perceived importance of regionally grown fresh fruit and vegetables (RGFFV); and (iii) identify the barriers and enablers of access and consumption of RGFFV. The study took place in Tasmania (TAS) and South Western Australia (SWA). A 54-item survey included questions relating to purchasing and consumption patterns; barriers and enablers related to access and consumption of RGFFV; and sociodemographic information. Survey data were analyzed …

Mobile Technology Use And Mhealth Text Message Preferences: An Examination Of Gender, Racial, And Ethnic Differences Among Emerging Adult College Students, Kristin E. Heron, Kelly A. Romano, Abby L. Braitman

Psychology Faculty Publications

Background: Mobile health (mHealth) interventions are a potentially feasible way of targeting emerging adult college students' physical and mental health concerns, decreasing health-risk, and augmenting health promoting behaviors. However, there is limited evidence attesting to advantageous ways of designing mHealth treatments in a manner that is apt to be well-received by emerging adult college students at large, and gender, racial, and ethnic subgroups in particular. To address these research gaps, this exploratory study examined general trends, and gender (male, female), racial (White, Black), and ethnic (Latino, non-Latino) differences, in emerging adult college students' mobile technology ownership and phone plan characteristics, …

Home Childbirth Among Young Mothers Aged 15-24 Years In Nigeria: A National Population-Based Cross-Sectional Study, Emmanuel O. Adewuyi, Vishnu Khanal, Yun Zhao, Lungcit David, Olasunkanmi D. Bamidele, Asa Auta

Research outputs 2014 to 2021

Objective To estimate the prevalence and identify factors associated with home childbirth (delivery) among young mothers aged 15–24 years in Nigeria. Design A secondary analysis of cross-sectional data from the 2013 Nigeria Demographic and Health Survey (NDHS). Setting Nigeria. Participants A total of 7543 young mothers aged 15–24 years. Outcome measure Place of delivery. Results The prevalence of home delivery among young mothers aged 15–24 years was 69.5% (95% CI 67.1% to 71.8%) in Nigeria—78.9% (95%CI 76.3% to 81.2%) in rural and 43.9% (95%CI 38.5% to 49.5%, p < 0.001) in urban Nigeria. Using the Andersen’s behavioural model, increased odds of home delivery were associated with the two environmental factors: rural residence (adjusted OR, AOR: 1.39, 95% CI 1.06 to 1.85) and regions of residence (North-East: AOR: 1.97, 95% CI 1.14 to 3.34; North-West: AOR: 2.94, 95% CI 1.80 to 4.83; and South-South: AOR: 3.81, 95% CI 2.38 to 6.06). Three of the enabling factors (lack of health insurance: AOR: 2.34, 95% CI 1.16 to 4.71; difficulty with distance to healthcare facilities: AOR: 1.48, 95% CI 1.15 to 1.88; and < 4 times antenatal attendance: AOR: 3.80, 95% CI 3.00 to 4.85) similarly increased the odds of home delivery. Lastly, six predisposing factors—lack of maternal and husband’s education, poor wealth index, Islamic religion, high parity and low frequency of listening to radio—were associated with increased odds of home delivery. Conclusions Young mothers aged 15–24 years had a higher prevalence of home delivery than the national average for all women of reproductive age in Nigeria. Priority attention is required for young mothers in poor households, rural areas, North-East, North-West and South-South regions. Faith-based interventions, a youth-oriented antenatal care package, education of girls and access to health insurance coverage are recommended to speed up the reduction of home delivery among young mothers in Nigeria.

Cesarean Delivery In Nigeria: Prevalence And Associated Factors -A Population-Based Cross-Sectional Study, Emmanuel O. Adewuyi, Asa Auta, Vishnu Khanal, Samson J. Tapshak, Yun Zhao

Research outputs 2014 to 2021

Objective To investigate the prevalence and factors associated with caesarean delivery in Nigeria. Design This is a secondary analysis of the nationally representative 2013 Nigeria Demographic and Health Survey (NDHS) data. We carried out frequency tabulation, χ2 test, simple logistic regression and multivariable binary logistic regression analyses to achieve the study objective. Setting Nigeria. Participants A total of 31 171 most recent live deliveries for women aged 15–49 years (mother–child pair) in the 5 years preceding the 2013 NDHS was included in this study. Outcome measure Caesarean mode of delivery. Results The prevalence of caesarean section (CS) was 2.1% (95% …

Population Data Centre Profile - The Western Australian Data Linkage Branch, Steve Hodges, Tom Eitelhuber, Alexandra Merchant, Janine Alan

Research outputs 2014 to 2021

Established in 1995, the Western Australian Data Linkage Branch (DLB) is Australia’s longest running data linkage agency. The Western Australian Data Linkage System (WADLS) employs an enduring linkage model spanning over 60 data collections supported by internally developed and supported software and IT infrastructure. DLB has delivered, and continues to deliver, a range of significant data linkage innovations, many of which have been adopted elsewhere. A current restructure within the Western Australian Department of Health (which we will refer to as the Department of Health) will provide an improved funding model geared toward addressing issues with staff retention, capacity and …

It's Not Raining Men: A Mixed-Methods Study Investigating Methods Of Improving Male Recruitment To Health Behaviour Research, Jillian Ryan, Luke Lopian, Brian Le, Sarah Edney, Gisela Van Kessel, Ronald Plotnikoff, Corneel Vandelanotte, Tim Olds, Carol Maher

Research outputs 2014 to 2021

Background Although gender is an important determinant of health behaviour with males less likely to perform health-protective behaviours, samples in health behaviour research are heavily biased towards females. This study investigated the use of online social network, Facebook, to reach and recruit inactive males to a team-based, social, and gamified physical activity randomised controlled trial. Methods Methodological techniques included a narrative literature review, survey of inactive males (n = 34) who rated advertisement images and text captions on scales of 1–10, and trial Facebook-delivered recruitment campaigns. Advertisement effectiveness was measured by cost-per-click to the study website, number of expressions of …