Public Health Commons^™

Disparities In Uptake Of The Primary Sars-Cov-2 Vaccine Series In A Southern Indiana Vaccine Clinic, Cassidy Padgett

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

Objective: COVID-19 is a potentially severe respiratory disease caused by infection from the SARS-CoV-2 virus. COVID-19 was first discovered in 2019 and vaccines against the virus began development in early 2020. COVID-19 vaccines are effective at preventing severe illness, hospitalizations, and death from SARS-CoV-2 infection. Clark Memorial Health is a 236-bed community health system located in southern Indiana. As one of the first four hospitals in the state of Indiana to receive the Pfizer-BioNTech’s COVID-19 vaccine in December of 2020, this health system led the area in vaccine administration. Prior to the emergency use authorization (EUA) of the COVID-19 vaccines, …

Examining The Association Between Cervical Cancer Screenings, Health Care Access, And Socio-Demographics Among Women Of Urban/Rural Status In Kentucky, Madison Penix

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

Background: This study focuses on cervical cancer screening rates (e.g., Pap testing) among women of urban/rural status in Kentucky. Specifically, this study’s primary objective is to examine the association between cervical cancer screening rates and health care access among the women of interest. Secondarily, this study aims to identify which socio-demographic variables impact cervical cancer screening rates and health care access. The purpose of doing so is to better understand what disparities and barriers might be contributing to the suboptimal screening rates observed throughout Kentucky.

Methods: An empirical analysis utilizing secondary data from the 2020 Behavioral Risk Factor Surveillance Survey …

Implementation Of Farmers Markets In Bell County, Kentucky, Rachael Schmetzer

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

This proposal addresses the link between food insecurity and obesity through the implementation of farmers markets in Bell County, Kentucky as a way to increase access and consumption of fruits and vegetables in this rural, low-income community.

Identifying Factors Associated With Syringe Reuse Among People Who Inject Drugs (Pwid) In Appalachia Kentucky, Grayson Keith Fuller

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

Aim: Syringe reuse contributes to the spread of infectious diseases. The purpose of this study is to identify factors associated with syringe reuse among people who inject drugs (PWID) in Kentucky.

Methods: PWID (n=238) completed interviewer-administered questionnaires to collect data on syringe reuse and demographic, behavioral, and clinical characteristics. Negative log binomial regression was used to model the associations.

Results: On average, people reused each syringe 9.3 times (median: 3; IQR: 2-10, range 1-95). Syringe reuse was higher among men [aOR=1.386; 95% CI: 1.041-1.845] and those who injected methamphetamine [aOR=2.122; 95% CI: 1.445-3.116]. Reuse was also higher among those who …

Effects Of Covid Prevention And Control Policies In Kentucky Schools During The Fall 2020 Semester, Ciaran Allen-Guy

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

Schools are reopening or have already reopened while implementing precautions intended to reduce the transmission of COVID-19. However, evidence on the effects of these strategies or their benefits relative to each other in the school environment is indirect or lacking. This study investigated the effects of some of these strategies as employed by Kentucky schools in the fall 2020 semester using a linear mixed effects regression model using publicly available fall 2020 school incidence data, survey data from school staff, and Kentucky Department of Education data on school faculty and primary enrollment.

Increasing Physical Activity Rates Among High School Girls In Jefferson County, Kentucky, Haley Copeland

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

Obesity rates across the U.S. are increasing, especially among adolescent females. Physical activity rates have been associated with obesity and many related health outcomes. Regular physical activity can help adolescents improve their cardiorespiratory fitness, build strong bones, control their weight, and reduce depression ¹. It can also help reduce the risk of developing health conditions like heart disease, cancer, high blood pressure, osteoporosis, type II diabetes, and obesity ¹. Thus, physical activity among youth provides a risk factor to target, with the intention of eventually decreasing obesity rates.

Recommended physical education class CDC guidelines are not being met …

An Analysis Of The Differences In Health Outcomes And Socioeconomic Factors Between Veteran Smokers And Non-Smokers In Tobacco-Growing States, Jacob Hauser

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

Tobacco usage still remains the single most preventable cause of disease, disability, and death in the United States. Service members and veterans, especially those residing in tobacco-growing states, face higher levels of societal pressure to take up the habit compared to their civilian counterparts. This research investigates why this is the case, the differences in health outcomes, and the differences in socioeconomic factors between the veteran smoking and non-smoking populations before making policy recommendations to policymakers and stakeholders to address this problem.

Covid-19 Mitigation Strategies School Staff In Indiana, Kentucky, And Ohio, Luu Le

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

Abstract

Background: This cross-sectional study aims to identify the difference in COVID-19 mitigation strategies implementation and adherence among elementary, middle, and high schools in Indiana, Ohio, and Kentucky, based on data from the School Staff Health and Wellness Study research at the University of Kentucky in 2020.

Methods: The sample size of the study was 6,794 participants who work at elementary, middle, or high schools in Indiana, Ohio, and Kentucky. Complete case analyses were performed, which included observation with no missingness in variables (N = 5,971). Descriptive statistics were generated, including a table indicating the implementation of COVID-19 mitigation strategies …

Frequency And Type Of Diabetes Screening Tests In A Sample Of Women With Polycystic Ovarian Syndrome: A Descriptive Study, Jacklyn Vollmer

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

Introduction: Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects 6-12% of United States women of reproductive age. Women with PCOS are at an increased risk of developing type 2 diabetes and fall into high-risk groups for screening guidelines put out by the American College of Obstetricians and Gynecologists (ACOG). Guidelines further suggest that an oral glucose tolerance test (OGTT) be used for diabetes screening in women with PCOS as opposed to an A1C or fasting plasma glucose test. The purpose of this study is to examine rates and type of diabetes screening used among a sample of women …

An Analysis Of The Association Between Cognitive Decline And Geographic Residence Among Women Over 65 In The Southeastern United States, Christine Invergo

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

Abstract

Introduction: The United States is an increasingly aging nation, and aging increases the risk of cognitive decline. Information on the relationship between cognitive decline and geographic residence in the U.S. is limited. Available evidence suggests that rural residents tend to suffer persistent disadvantages in cognitive functioning when compared to sociodemographically similar urban peers. This analysis focused on women over 65 years of age living in the southeastern U.S. The primary objective of this analysis was to determine if there was a significant association between geographic residence and cognitive decline. A secondary objective was to explore variables of interest that …

An Analysis Of Rural-Urban Differences In Health Care Access Among Women In The United States, Ellery Denny

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

The purpose of this project was to examine the relationship between women’s health care access and rural and urban America. Extensive review of existing literature was completed and showed that the United States ranked last out of 11 high-income countries in regard to access to care, administrative efficiency, equity, and health care outcomes (Schneider, 2021). Additionally, women in the United States faced heightened financial barriers to health care that men do not, and also faced unique disadvantages that resulted in reduced utilization of care (Cameron, 2010, p. 1649).

Results showed that rural women were significantly more likely to have one …

Comparing Governmental Communication About Covid-19 Layered Protection Strategies In Taiwan, Kenya, And The United States: A Mixed-Method Analysis Of National Health Agency Websites, Cynthia Mofunanya

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

COVID-19 is a novel coronavirus caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It can result in severe respiratory damage. Different countries have recommended different combinations of protections during the COVID-19 pandemic. Various combinations of mitigation strategies or “layered protections” against coronavirus have also been communicated differently across nations. This mixed-methods content analysis seeks to compare COVID-19 mitigation information on three national health agency websites for Taiwan, Kenya, and the United States. Availability and navigability of information was examined for each mitigation strategy. The Web Resource Rating tool was used to assess the quality of the information about …

An Analysis Of The Association Between Cognitive Decline And Geographic Residence Among Women Over 65 In The Southeastern United States, Christine Invergo

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

Abstract

Introduction: The United States is an increasingly aging nation, and aging increases the risk of cognitive decline. Information on the relationship between cognitive decline and geographic residence in the U.S. is limited. Available evidence suggests that rural residents tend to suffer persistent disadvantages in cognitive functioning when compared to sociodemographically similar urban peers. This analysis focused on women over 65 years of age living in the southeastern U.S. The primary objective of this analysis was to determine if there was a significant association between geographic residence and cognitive decline. A secondary objective was to explore variables of interest that …

Youth Who Run Away From Out-Of-Home Care In Wisconsin, 2010-2020, Sydney Shafer

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

A sample of 27,599 youth 5-17 years old who entered the child welfare system in Wisconsin between 2010 and 2020 were analyzed to examine differences in those who run away from out-of-home care and those who do not. Risk factors analyzed included age at entry into the system and measures of sexual abuse, physical abuse, emotional abuse, neglect, witness to family violence, placement restrictiveness, youth home county socioeconomic disadvantage and urbanicity, and distance from placement to home. Analyses were presented in gender- and race- specific strata. In this sample, 2434 (8.8%) ran away from their out-of-home care placement at least …

Disparities In Access To Chemotherapy Among Kentucky Stage Iv Non-Small Cell Lung Cancer Patients, Joshua Brown

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

OBJECTIVE: This population-based retrospective cohort study examines the association of sociodemographic disparities with the receipt of chemotherapy among patients with metastatic non-small cell lung cancer in the Commonwealth of Kentucky in the precision oncology and immunotherapy era.

METHODS: Kentucky Cancer Registry data from 2010 through 2017 was analyzed using univariate, bivariate, unadjusted, and adjusted multivariate regressions to assess disparities in our population (N = 9490).

RESULTS:We found no significant difference in receipt of chemotherapy between sexes (OR 0.99, P=0.90) nor races (OR 1.12, P=0.22). Patients diagnosed in an Appalachia county were significantly less likely to receive chemotherapy (OR 0.71, …

Demographic Characteristics Of Individuals Needing Treatment For Substance Use Disorder, Amber Hill

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

Introduction:

While multiple options are available for the treatment of substance use disorders (SUD), 9% of individuals reported needing treatment within the last year for illicit drug or alcohol use, according to the 2020 National Survey for Drug Use and Health (NSDUH). Despite concerns about widespread disparities in healthcare access and outcomes, there are limited current data regarding demographic characteristics of individuals that need treatment. It is crucial to identify these characteristics from population-based data in order to develop and implement targeted public health interventions.

Methods:

The NSDUH is an annual, nationwide survey that collects data about substance use and …

Recharge Moments, Scott Keel

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

Abstract Title: Recharge Moments

Background: Recent articles from the CDC and other healthcare agencies have demonstrated the detrimental effects that the COVID-19 pandemic is having on the physical and mental health of the healthcare workforce. Unfortunately, they were less informative in regard to those working for local public health departments. Pre-pandemic and concurrent publications on mindfulness-based interventions have demonstrated the positive and protective effects mindfulness-based interventions can have on burnout prevention and resilience promotion. To gain a better understanding of how the current pandemic might be affecting the public health workforce and to assess whether mindfulness-based interventions would be helpful …

The Impact On Recovery Capital Following High-Intensity Exercise Adjuvant Therapy In Opioid Addiction Treatment, Aaron M. Macdonald

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

OBJECTIVE: The Counseling Center (TCC), a substance abuse disorder (SUD) recovery facility located in Portsmouth, Ohio, began investigating alternative treatment methods that may improve long-term recovery rates through increased recovery capital (RC). RC takes into account numerous social and physical variables during the recovery phase of SUD and evidence shows a higher RC can lead to better recovery outcomes. TCC partnered with Portsmouth Spartan Kettlebell Club (PSKC), a nearby CrossFit (CF) affiliated gym, and created a partnership that allowed clients at TCC to participate in a guided CF program. The purpose of this study was to examine how this program, …

Policy Approaches To Address Childhood Obesity, Omoadoni Roseline Obielodan

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

Background: Childhood obesity continues to be a serious international public health concern. Unfortunately, there are limited treatment options for obesity. One notable intervention option is the University of Kentucky (UK) Pediatric high BMI clinic intervention for childhood obesity. The Clinic provides intervention for childhood obesity through healthy lifestyle habits. This intervention has been reported to be effective.

Even though there is evidence that public health policies that promote healthy behaviors would substantially reduce and prevent the alarming prevalence of childhood obesity, the state of Kentucky does not have well-established practical policies that promote healthy behaviors in children. Studies have shown …

Healthcare Transformation In Saudi Arabia: An Overview Since The Launch Of Vision 2030, Ahmed Ali Alasiri, Viqaruddin Mohammed

University Administration Publications

Saudi Arabia’s Vision 2030 has taken a centre stage in the development of its healthcare sector through privatization adopting Public Private Partnerships (PPPs). The objective of this study is to provide an overview of healthcare transformation in Saudi Arabia since the launch of the ambitious Vision 2030, identifying issues those need to be addressed and steps taken towards provision of health systems transformation. Literature review was based on extensive review of published and unpublished articles, where different search engines and databases searched using the key words: ‘Saudi Healthcare’, ‘Healthcare transformation’, ‘Saudi vision: 2030’, ‘Public-Private Partnerships’ and ‘Privatization’, in addition to …

Papanicolaou (Pap) Test And Human Papillomavirus (Hpv) Test Adherence: Sexual Violence Victims And Fear Of Retraumatization, Murielle Sighe Ngoumkam

CGU Theses & Dissertations

To include all vulnerable women population who faced barriers to participating in preventive cervical cancer screening, the public health community must better understand the factors that affect their decision for getting Pap and HPV tests. Public health must understand the sexual violence victims, a subgroup of women who faced the onset of trauma and explore their adherence to routine screening. This study investigated whether sexual women with a history of sexual violence (SV), likelihood to get screened for cervical cancer would be impacted given the fear of suffering from secondary trauma during conventional screening procedures. Methods: Knowledge of cervical screening …

Racial And Ethnic Disparities In Diabetes-Related Healthcare Service Use In The United States, 2016–2020, Gaole Song

CGU Theses & Dissertations

Diabetes is a serious public health issue in the United States. As one of the leading causes of death, the prevalence of diabetes has increased steadily and leads to an enormous medical and societal burden each year. Compared to non-Hispanic White adults, racial/ethnic minority adults have a higher risk to develop diabetes and its complications. Proper healthcare service use is important for reducing the prevalence of diabetes and the risk of complications. However, minority populations receive a lower quality healthcare service and have greater barriers to diabetes self-management. To get a better understanding of racial disparities in diabetes-related healthcare service …

Major Depressive Disorder And Perceived Everyday Discrimination Among The Jamaican Diaspora In The United States., Warren Williams

Walden Dissertations and Doctoral Studies

Overt racial discrimination in the United States has been supplanted by subtle forms of everyday discrimination known as microaggressions. Researchers have found perceived everyday discrimination (PED) to be associated with major depressive disorder (MDD) among African Americans but have often treated the African American subpopulation as a homogeneous group. The purpose of this cross-sectional study grounded in the theory of microaggression was to illuminate probable associations between microaggressions based on weight, age, gender, ethnicity, and race and lifetime MDD among the Jamaican diaspora in the United States. Secondary data from the Collaborative Psychiatric Epidemiologic Surveys were analyzed. Statistically significant associations …

Effectiveness Of Responsible Beverage Service Policies In Reducing Drunk-Driving In Maryland, Rhoda Makinde

Walden Dissertations and Doctoral Studies

In the State of Maryland and across the United States, driving under the influence (DUI) has led to a massive loss of lives and disability cases. Hence, responsible beverage service (RBS) policies and programs have been developed to prevent and control DUI incidence. This study sought to identify the effectiveness of these policies in addressing the DUI-related fatalities and injuries among young adults (18–30 years old) in the State of Maryland. Using program theory to evaluate the effectiveness of RBS policies and programs in reducing DUI, this qualitative research sampled bar patrons, club patrons, and alcohol servers/service staff in Baltimore. …

Accessibility To Vaping Products, Vaping, And Use Of Cigarettes Among Adolescents, Sherri Adeosun

Walden Dissertations and Doctoral Studies

There has been a continuous increase in the use of e-cigarettes among adolescents. The growth threatens to nullify the years of successfully reducing cigarette smoking among this age demographic. Additionally, the increase has been a concern for public healthcare workers due to the limited research on the effects of long-term use of e-cigarettes on adolescents. I investigated the possible side effects of exposure to e-cigarette advertisements and the use of e-cigarettes. Additionally, the study reviewed the relationship between the age e-cigarette use was initiated and the subsequent use of cigarettes. The conceptual framework was based on the multi-theory model and …

Reproductive Regrets Among A Population-Based Sample Of U.S. Women, Arthur L. Greil, Michele H. Lowry, Andrea R. Burch, Kathleen Slauson-Blevins, Nicholas Park, Julia Mcquillan

Sociology & Criminal Justice Faculty Publications

Women have many reproductive options, but little is known about their regrets regarding prior reproductive choices and outcomes. Guided by the life-course and stratified reproduction perspectives, this study draws on an open-ended question about reproductive regrets from wave I of the National Survey of Fertility Barriers, a representative telephone survey of reproductive aged U.S. women conducted from 2004 to 2006. The authors classified regrets into five broad categories: (1) none, (2) problematic fertility, (3) unfulfilled fertility desires, (4) family, and (5) pregnancy experiences. The authors conducted the analyses separately by motherhood status. Logistic regression analysis revealed that regardless of parental …

The Online Ordering Behaviors Among Participants In The Oklahoma Women, Infants, And Children Program: A Cross-Sectional Analysis, Qi Zhang, Kayoung Park, Junzhou Zhang, Chuanyi Tang

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the United States (U.S.). Participants in the program redeem their prescribed food benefits in WIC-authorized grocery stores. Online ordering is an innovative method being pilot-tested in some stores to facilitate WIC participants' food benefit redemption, which has become especially important in the COVID-19 pandemic. The present research aimed to examine the online ordering (OO) behaviors among 726 WIC households who adopted WIC OO in a grocery chain, XYZ (anonymous) store, in Oklahoma (OK). These households represented approximately 5% of WIC households who redeemed …

Vaccine Hesitancy Among Healthcare Workers In The Covid-19 Era, Gabriella Checchi

Capstone Showcase

Vaccination against harmful, deadly pathogens have been an essential tool in the scientific world and have shaped our community as we know it today. They have allowed us to live in a society where members of the community are protected from certain severe disease and can help to decrease the death toll of these diseases. Vaccines have allowed us to eradicate smallpox, a disease that ravaged the world and killed over 300 million people. They have been a one of the most useful advances in medical science so far. And yet today, as SARS-CoV-2 continues to spread rampantly throughout the …

Bodily Autonomy And Anti-Vaccine Discourse During The Covid-19 Pandemic, Haley Sherman

Capstone Showcase

This paper explores the relationship between anti-vaccine discourse and ideas about bodily autonomy. I analyze the cyclical nature of vaccine hesitancy and show that it can lead to misinformation and harmful narratives. This paper uses theories of bodily autonomy that identify a concept called moral obligation. This concept, as explored by Alberto Giubilini, is a utilitarian approach in which citizens have a responsibility to their governments to get vaccinated so that, in turn, their governments can fulfill their obligation of protecting other individuals’ health (Giubilini 2020, 54). A discourse analysis of four key players in the anti-vax movement shows that …

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …