Increasing Organizational Value Of A Private Healthcare Education Academy, Diana Skaff

Walden Dissertations and Doctoral Studies

Amid the dynamic changes and innovations of the healthcare field, healthcare providers seek educational activities that enhance their growth and decrease their knowledge gap. Healthcare education organizations responsible for providing high-quality healthcare education, have opportunities to differentiate their programs to acquire, attract, activate, and retain healthcare providers. Grounded in the five forces of competition and the value chain theories, this mixed method formative program evaluation aimed to improve the business development program by developing a differentiation by quality strategy that will increase its competitive advantage. Participants included three decision-makers and nine leaders in a healthcare education organization in the Kingdom …

Sun Exposure And Protective Behaviors Among U.S. Hispanic Farmworkers, Claudia Marie Delgado Cebollero

Walden Dissertations and Doctoral Studies

Sun exposure increases the risk of sun-related illnesses and skin cancer among U.S. Hispanic farmworkers. Reinforced by the health belief model, the purpose of this study was to determine the association between socio-demographic factors (i.e., age, educational attainment, gender, income, and marital status) and skin cancer with the level of sun exposure (sun’s effect on skin, sunburn reported) and protective behaviors (use of cap/visor, use of sunscreen) among adult Hispanic farmworkers in the United States. The study included Hispanic farmworkers aged 21 or older (N = 112) who responded to the 2015 National Health Interview Survey. Ordinal logistic regression showed …

Experiences Of Older Adults With Hiv/Aids Enrolled In Case Management Programs In Northwest Indiana, Antoinette Cardenas

Walden Dissertations and Doctoral Studies

AbstractIn 2016, more than half of those infected with HIV/AIDS were age 50 years or older. Since the introduction of antiretroviral therapy, the survival rate of HIV patients has been on the rise with a predicted increase by 2030, but this has also contributed to early onset of comorbidities such as cardiovascular disease, osteoporosis, and kidney failure. The purpose of this generic qualitative study, driven by ecological systems theory, was to explore the experiences of older adults (age 50 and older) with HIV/AIDS who were enrolled in case management programs in Northwest Indiana. Data were collected from semi structured interviews …

Examining Engagement With And Acceptability And Usability Of Real Parenting: A Brief Online Parent-Based Intervention To Reduce Alcohol Use And Consequences Among High School Students, Shannon D. Glenn, Robert Turrisi, Michael L. Hecht, Michael A. Russell, Anne E. Ray

Health, Behavior & Society Faculty Publications

This study is a formative assessment of REAL Parenting (RP): a brief, digital intervention for parents of high school students that encourages parent-teen communication about alcohol and, in turn, aims to prevent teen alcohol use. The aims of this study were to describe engagement with, and acceptability and usability of RP; and to explore the relationship of these measures with each other and with short-term outcomes. Participants were 160 parents randomly assigned to the treatment group who received RP as part of a randomized pilot trial (Mage = 45.43[SD = 7.26], 59.3% female, 56% White, 19% Hispanic). App-based program analytics …

An Evaluation Of A Health, Wellbeing And Lifestyle Promotion Intervention Among A Cohort Of Year 1 Male Gaelic Games Student Athletes In An Irish University Setting, Anthony Casey

Theses

Background: The current research investigated the health, wellbeing and lifestyle behaviours of a cohort of 1st year male Gaelic Games student athletes (Study 1), and subsequently evaluated the impact of a bespoke intervention on these health, wellbeing and lifestyle behaviours in the same cohort (Study 2).

Methods: Participants were 1st year male Gaelic Games student athletes (mean age 18.6 ± 0.6 years, n=166) in a university in southern Ireland. Data were collected using a mixed-methods approach during the 2018/19 and the 2019/20 academic years. Data collection consisted of an online questionnaire (Bickerdike et al., 2018), which assessed health, wellbeing …

San Pedro Hospital - San Pedro La Laguna, Guatemala, Jennifer Paumen

Posters

Primary objective: to learn about the healthcare system of Guatemala including the challenges and strengths.

How Health Care Organizations Can Use The Inflation Reduction Act To Reduce Costs, Enhance Resilience, And Lower Their Environmental Footprint., Celynne Balatbat, Walt Vernon, Antonia Herzog, Terri Scannell

Ambulatory and Primary Care Articles

No abstract provided.

The Application Of Time Series Analysis To Injury Epidemiology Data, Eric Wayne Lundstrom

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Injury fatality rates in the United States (US) decreased throughout the majority of the 20th century, mostly due to declining rates of occupational and motor vehicle injuries. However, near the beginning of the 21st century, fatal injury rates in the US began to increase. This is principally due to the nation’s opioid epidemic, which has been characterized by different epidemic “waves”, each driven by overdoses associated with specific substances. Given the temporally dynamic nature of US injury trends, this study aimed to explore the application of time series analysis to injury data in the US. First, rates of non-fatal …

Beyond Gatekeeping: Building A Community For Suicide Survivors, Rebecca Thomas

DSW Capstone Projects

Suicide is a complex phenomenon, yet past attempts to change it have relied on an oversimplification that to prevent suicide, suicidal people need professional mental health treatment. Fortunately, that notion has faded. Suicide is now recognized as a public health issue; One that spans various continuums of culture, socioeconomic status, and demographics. With a better understanding and increased recognition of suicide as a public health issue, more stakeholders have engaged in suicide prevention efforts, new research has emerged, and more attention and resources are being dedicated than ever before. This capstone project explores the impact a suicide death has on …

Implementing A Mobile Saliva Rinse Screening For P16 Markers For Hpv (Human Papillomavirus) Positive Head And Neck Cancers In Central Kentucky, Madeline Brown

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

Rates of HPV-related head and neck cancers are increasing across the nation and more specifically, there has been a significant increase in the state of Kentucky. This study focuses on the implementation of a mobile clinic saliva-rinse screening program. This program will be set up at UK Athletics Men's basketball and football games in hopes of recruiting middle aged men ages 45-60, who are the target audience of the study. This is the population with highest prevalence for HPV positive head and neck cancers and also the population least likely to visit their health providers regularly. A quick saliva rinse …

Characterizing Region Iv State Health Agency - Central Office's Workforce Needs: Results From The 2021 Public Health Workforce Interest And Needs Survey (Ph Wins), Ashley Carroll

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

The purpose of this project was to examine the Region IV State Health Agency – Central Office workforce in regards to retention and reasons for leaving; workforce satisfaction levels and how that influences retention; and training gaps among non-supervisors. An extensive review of existing literature was completed and showed that since the great recession, there has been a loss of 40,000 positions at state and local governmental health agencies (Castrucci & Lupi, 2020). In addition, from 2008 to 2019, there has been a 16 percent decline in the national public health workforce, and 47 percent of public health workers plan …

A Case Study In Program Evaluation: Evaluation Of A Hypertension Self Management Program, Bailey N. Schenk

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

The CDC's program evaluation process framework is a six-step approach that guides public health practitioners in the evaluation of public health programs. The framework includes engaging stakeholders, describing the program, focusing the evaluation design, gathering credible evidence, justifying conclusions, and ensuring use and sharing of lessons learned. Each step is important in developing a comprehensive and effective program evaluation. This evaluation discusses the application of the six steps of the CDC's program evaluation process framework and how it was utilized in evaluating a hypertension self-management program at a local health department.

Changes In Severity Of Diabetes At Diagnosis Following The Onset Of The Sars-Cov-2 Pandemic, Annelise King

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

During the SARS-CoV-2 pandemic it was seen that diabetes was a risk factor for severe COVID-19. The objective of this study is to assess the severity of diabetes at diagnosis during the COVID-19 pandemic compared to pre-pandemic to see how the pandemic and SARS-CoV-2 infection impacted the severity of diabetes. This study used University of Kentucky electronic health records of 13,794 patients who developed diabetes. The majority of patients were female, white non-Hispanic, 65+, and living in an urban area. There were differences seen between the COVID-19 positive and negative cohorts in the DKA and HbA₁c variables, with …

Effect Of Medicaid Expansion On Inflammatory Bowel Disease And Healthcare Utilization, Brittany Levy

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

Inflammatory bowel disease (IBD) affects over 3 million adults in America, relaying a

need for chronic disease management. Along with 24 other states, Kentucky expanded the

Medicaid program January 1, 2014. We hypothesize, Medicaid expansion adoption results in

reduced emergency healthcare services, and increased elective healthcare services with a

reduction in overall healthcare utilization by individuals in the adult IBD population.

The Hospital Inpatient Discharge and Outpatient Services Database identify encounters

related to ulcerative colitis or Crohn’s disease from 2009-2020, in Kentucky. Patient

demographics, admission type, discharge, length of stay, and hospital charges were compared.

3386 pre-expansion and 24255 post …

Health Management And Policy Capstone: A Case Study In Program Evaluation, Kelsey R. Gatton

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

Program evaluation of a hypothetical comprehensive hypertension self-management program as directed by the CDC Framework for Program Evaluation in Public Health.

Evaluation Of Facebook Social Media Messages Following The 2022 Eastern Kentucky Floods, Delaney Bonds

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

Purpose: The goal of this study is to examine the availability of disaster-related information online from local health departments in flood-impacted counties in the month following 2022 Eastern Kentucky Floods. This study aims to evaluate Facebook messages by (1) when messages were posted (2) types of posts (3) message content.

Methods: This mix-methods environmental scan of Facebook messages posted by 8 flood-impacted Eastern Kentucky local health departments from July 26^th, 2022, to August 26^th, 2022. Messages were coded for absence or presence of a message feature. These message features were examined to identify features relevant to …

The Prepare Mobile Program For Hiv Prevention In Washington D.C., Gabrielle Cochran

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

Incidence rates of HIV have decreased in the United States in the past decade, but the southern United States has higher rates of HIV than other regions, and cities in the south, like Washington D.C., have some of the highest rates of HIV incidence in the nation. Risky sexual behavior, needle sharing, and substance use increase the risk of transmitting or acquiring HIV, and these behaviors are more common among unhoused people (CDC, 2021; CPPH, 2022).

Expansion of community resources in cities with high levels of HIV have allowed for many people at high risk for HIV to comply with …

Retrospective Analysis Of Non-Ketotic Hyperglycinemia Patients In Central And Eastern Kentucky, Shane Reeves

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

Aim: To obtain a better understanding of the non-ketotic hyperglycinemia (NKH) patient population in regards to clinical features, mortality, geographic clustering, genetics, and incidence rate within the University of Kentucky (UK) catchment area of Central and Eastern Kentucky.

Methods: Patients with ICD codes corresponding to NKH who were treated at UK between January 1, 2008, and July 1, 2022, and who had clinical documentation available for review were identified through UK’s medical records (N=15). Demographic and clinical data were obtained through review of these patient’s charts in the electronic medical record. Differences in features among patients was assessed utilizing Fisher …

Trends In Respirable Coal Mine Dust Concentration (Mg/M3) Based On Coal Miners’ Occupational Designation: An Analysis Of The Msha Coal Dust Samples Data Set (2000-2022), Aaron Blake Charles

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

Rates of Coal Workers' Pneumoconiosis (CWP) have recently increased in prevalence over the past 20 years. Recent regulation (Phase III) by the Mining Safety and Health Administration to lower the coal dust standard to 1.5 mg/m3 has been mandated to assist in reducing the burden of CWP. Occupations in the coal mining industry have different exposures to coal dust depending on their occupational responsibilities. This study examined the respirable coal dust trends for underground and surface mining occupations from 2000 to 2022. The ultimate goal is to see how respirable coal dust exposures have changed in multiple occupations over this …

Health Management And Policy Capstone: A Case Study In Program Evaluation, Bradford Brewer

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

Hypertension has risen steadily among adults in United States over the past 30 years. This increase has also been marked by a significant increase in reported prevalence rates of cardiovascular diseases. In response, the Centers for Disease Control and Prevention (CDC) funded the Lexington-Fayette County Health Department to deliver a hypertension self-management program for adults aged 35 and older. This manuscript follows the six steps of CDC program evaluation to aid Lexington citizens with uncontrolled high blood pressure (≥140/90 mmHg) in successful hypertension self-management. This evidence-based community intervention helps patients take responsibility for managing their hypertension with assistance from health …

Rapid Scoping Review Of The Epidemiological Evidence For Mercury Exposure And Prevalence Of Alzheimer’S Disease, Rebecca Mattingly

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

This rapid scoping review examines the current body of epidemiologic research evaluating the potential linkage between environmental exposure to mercury and Alzheimer's disease (AD). Alzheimer’s disease accounts for 60-80% of all neurodegenerative disease in the United States and was the seventh leading cause of death in Kentucky in 2020. The exact etiology of AD needs further investigation; however, environmental factors such as pesticides, arsenic, cadmium, lead, and mercury have been correlated with development of AD lesions, cognitive decline, and AD. Mercury is a toxic metal that can be found in air, water, and soil, both from natural and human-made sources. …

Blue Oval Sk Battery Park Environmental Impact And Community Guide, Warren Rummage

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

This Capstone Project Paper will discuss the potential effects of the BlueOval SK Battery Park being constructed in Glendale, Kentucky based on knowledge attained from open records requests and available publicly online. Based on the process of attaining said information, a Community Guide has been generated and is available to distribute to concerned community members. It is the hope that this work will enable those in Hardin County, and possibly beyond, to ensure their environment and community health are prioritized during the construction phase and eventual operation of the EV-battery manufacturing faciliities on this massive 1,500 acre plot of land.

Pfas Clinical Guidance, John Bingham

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

Introduction

A broad category of synthetic organic compounds, per- and polyfluorinated alkyl substances (PFAS), forms the impetus for this project. Known compounds in this category are numerous and diverse, with over 4700 identified molecular entities (Panieri, Baralic, Djukic-Cosic, Buha Djordjevic, & Saso, 2022). Their only commonality is the presence of at least one carbon atom that is saturated with fluoride groups. These chemical bonds are exceptionally difficult to break (Tansel, 2022), which incepts both the utility of PFAS compounds and the concerns they raise for human health (Cousins et al., 2020). While PFAS are …

The Relationship Between Maternal Depressive Symptoms And Unsafe Infant Sleep Practices In A Low-Resource Community, Rebecca D. Day, Ketrell L. Mcwhorter, Hartley C. Feld, Steven R. Bronwing

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

Objectives: To determine the relationship between maternal depressive symptoms and unsafe infant sleep intention and practices during and after pregnancy.

Methods: This study recruited 100 women from a small clinic in a low-resource community of Santo Domingo, Ecuador from 2018 to 2020. Information on intention to practice safe sleep was collected during the third trimester of pregnancy and safe sleep practices were assessed at 1 month and 6 months postpartum via survey. Depressive symptoms were measured using the Patient Health Questionnaire 2 (PHQ-2). Using log-binomial regression, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) cross-sectionally at …

Fork It, Kylee Pipgrass

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

Obesity prevalence is at an alarmingly high rate within the United States, but especially in rural areas of Kentucky. Obesity can lead to a variety of negative physical health outcomes including heart disease, diabetes, stroke, and some cancers. There are also mental disorders associated with obesity through mechanisms such as weight stigma and self-perception. Similar to obesity rates, prevalence and mortality associated of these health outcomes are also seen at disproportionately higher rates in rural, Appalachian Kentucky. Causes for increased obesity and obesity related consequences include some genetic factors as well as behavioral factors like physical inactivity, poor diet, stress, …

Epidemiology Of Angiosarcomas In Kentucky, 2000-2019, Emma Gough

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

Background/Objective: Angiosarcomas are rare, highly aggressive malignant soft-tissue sarcomas of vascular or lymphatic origin. The purpose of this study is to describe geographical distribution of angiosarcoma in Kentucky and to examine the epidemiology of angiosarcoma in Kentucky from 2000 to 2019, including the most common sites where angiosarcomas occurred and risk factors affecting survival. Methods: A sample of 246 angiosarcoma patients was received from the Kentucky Cancer Registry (KCR). Kaplan-Meier curves were produced to examine overall survival, as well as survival by age, insurance type, tumor size, and SEER site. A Cox proportional hazards regression analysis was conducted to estimate …

Roadway Density And Lung Cancer Histology In Kentucky, Mahala Pettus

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

The purpose of this article was to examine the relationship between a proxy measure of exposure to automotive exhaust – roadway density – and risk for adenocarcinoma lung cancer. Using data from the Kentucky Cancer Registry and the Kentucky Geoportal Data Clearinghouse, we conducted a cross-sectional study of the distribution of adult lung cancer cases by histological type across the state of Kentucky. The north-central region of Kentucky has a higher prevalence of adenocarcinomas and greater roadway density. Among adenocarcinoma cases in Kentucky, there are more non-smokers than other types of tobacco use. As smoking rates decrease in Kentucky, and …

Breastfeeding Promotion In The Workplace, Katie C. Nettesheim

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

Breastfeeding is one of the best things a mother can do for her baby. It has many protective qualities including a reduced risk of sudden infant death syndrome (SIDS), asthma, obesity, type 1 diabetes, respiratory infections, ear infections, and stomach bugs for the baby (CDC, 2022). There are also protective qualities for the mother as well, including a reduced risk of high blood pressure, breast and ovarian cancer, and type II diabetes. Breastfeeding exclusively, the infant only receives breastmilk and no other supplementation for 6 months, which maximizes the many benefits that breastfeeding has.

Rural areas of the United States …

Concussion Perceptions And Reporting Behaviors By Individual And Team Sport Participation Among Female Diii Student-Athletes, Bethany L. Stewart

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

Abstract

Purpose. This study aimed to analyze differences between individual and team sport participation and academic year on perception of concussion and reporting behaviors.

Methods. A cross-sectional study was conducted using original data from the Perceptions and Likeliness to Report Concussions in Collegiate Athletes survey distributed to student-athletes from April 2021 to December 2022. The study population was restricted to current residents of the United States, current enrollment in college or university, female-identifying, and between the ages of 18 and 24, yielding a final population of 135 for analysis. Statistical frequency analyses were obtained, then stratified by team and individual …

Psychosocial Outcomes Post-Concussion Of Female Collegiate Athletes, Victoria Farley

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

Concussions are traumatic brain injuries impacting upwards of 3 million athletes per year. Female collegiate athletes are an essential group of athletes to investigate as they account for 47% of all collegiate athletes and often suffer more severe concussions with worse concussion symptoms than their male counterparts. Many symptoms are associated with concussion such as dizziness nausea, headaches, and instability, however, some injury symptoms extend beyond physical symptoms. The symptoms that extend beyond physical often mimic different psychosocial factors like depression and anxiety. This study investigated the associations of injury, the duration of symptoms, and the psychosocial impacts of injury …