Public Health Commons^™

Reduction Of Fecal Coliform Bacteria Through The Elimination Of Sewage Discharges In West Virginia Streams, Kady Rogers

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

Background and Objectives

Early environmental regulations such as the Federal Water Pollution Control Act of 1948, and the 1972 amendments—which would later become known as the Clean Water Act—have improved the quality of the drinking and recreational waters here in the United States. This has been achieved as a result of strict regulations on discharges, proper management strategies, as well as thorough sampling and testing for contaminants. One such contaminant is fecal waste; these materials are a public health concern because of the potential risk of gastrointestinal diseases. Scientists have used fecal coliforms as an indicator of the presence of …

Characterization Of Foreign-Born Vs. U.S. Native-Born Worker Fatalities In Kentucky, 2001-2014, Yailet Cruz Galardy

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

Background: Foreign-born workers may be more vulnerable to fatal and nonfatal work injuries. Available information on the differences that exist between foreign-born and U.S. native-born worker fatal injuries is scarce. This study aims to describe and characterize occupational fatal injuries in foreign-born and U.S. native-born workers in Kentucky.

Methods: A retrospective descriptive analysis of foreign-born vs. U.S. native-born worker fatalities was performed over a 14-year period from 2001-2014 using Kentucky Fatality Assessment and Control Evaluation (FACE) program worker fatality surveillance data.

Results: From 2001-2014, there were a total of 87 foreign-born and 1,361 native-born worker fatalities. The average age of …

Social Network Analysis Of Cellphone Surveillance Data For Ebola In Sierra Leone, Jia B. Kangbai

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

Aim: To explore and visualize the connectivity of suspected Ebola cases and surveillance callers who used cellphone technology in Moyamba District in Sierra Leone for Ebola surveillance, and to examine the demographic differences and characteristics of callers who make more calls as well as more likely to make at least one positive Ebola call.

Methods: Surveillance data for 393 suspected Ebola cases (192 males, 201 females) were collected from October 23, 2014 to June 28, 2015 using cellphone technology. UCINET and NetDraw were used to explore and visualize the social connectivity between callers and suspected Ebola cases. Poisson and logistic …

Self Center: Addressing Teen Pregnancy In Wolfe County, Ky, Lindsey Smith

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

Teen pregnancies and births are at an all-time low across the United States. Despite this decline in rates within the last decade, the teen pregnancy rate in Kentucky remains significantly higher than that of the overall United States. Additionally, teen pregnancy still has significant economic and health impacts on both teen parents and their children. In rural communities, such as Wolfe County, KY, teen birth rates are approximately one-third higher than the rest of the country. Self Center is an evidence-based teen pregnancy prevention program that involves school-linked reproductive health services and provides participants with education, counseling, and healthcare services. …

Hiv/Sti And Teen Pregnancy Prevention Within Mclennan County Texas, Kayla M. Storrs

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

In response to the Center for Disease Control and Prevention (CDC) funding announcement, the McLennan County Health Department proposes to implement Be Proud! Be Responsible!, an evidence-based HIV/STI and teen pregnancy prevention program into the pre-existing health curriculum of the sixth grade classes within the county. With the highest rates of chlamydia and gonorrhea within the state of Texas, and $7 million per year of teen pregnancy related costs spent in Waco, Texas alone, this intervention aims to increase HIV/STI knowledge, increase positive perceptions of safe sexual behaviors, increase parent-student communication about safe sexual behaviors, prolong first sexual initiation, and …

An Investigation Of The Influence Of Current Public Health Policies In The United States On The Prevalence Of Rural Health Professional Shortage Areas, Hayne Noh

Undergraduate Research Posters

The healthcare professional shortage or maldistribution severely limits access to sufficient health care, affecting many Americans, particularly in rural areas. There is a range studies that agree that the health professional shortage is a pressing issue, but none that specifically evaluate the overall effectiveness and improvements to be made to government funded programs, such as Loan repayment and scholarship programs aimed at attracting primary care physicians to these rural underserved areas. This study analyzes both quantitative and qualitative data from 21 peer-reviewed journals about rural primary Health Professional Shortage Areas, Title-VII funded schools, and rural primary health care. Although effective …

Comparison Of Small-Area Deprivation Measures As Predictors Of Chronic Disease Burden In A Low-Income Population, Ana Lopez-De Fede, John E. Stewart, James W. Hardin, Kathy Mayfield-Smith

Publications

Background: Measures of small-area deprivation may be valuable in geographically targeting limited resources to prevent, diagnose, and effectively manage chronic conditions in vulnerable populations. We developed a census-based small-area socioeconomic deprivation index specifically to predict chronic disease burden among publically insured Medicaid recipients in South Carolina, a relatively poor state in the southern United States. We compared the predictive ability of the new index with that of four other small-area deprivation indicators. Methods: To derive the ZIP Code Tabulation Area-Level Palmetto Small-Area Deprivation Index (Palmetto SADI), we evaluated ten census variables across five socioeconomic deprivation domains, identifying the combination of …

Correlates Of Antibiotic Diversion In The Philippines: Misconceptions And Community-Level Access To Nonmedical Sources Of Antibiotics, Daniel Alexander Barber

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

Aim: To identify sociodemographic, knowledge, and attitudinal correlates to antibiotic diversion among a community-based sample of adults (age 18 and older) in a low-income setting of the Philippines and to explore community-level data on informal antibiotic distribution in sari-sari stands.

Methods: Participants (n=307) completed self-administered surveys. Correlates to antibiotic diversion were assessed using logistic regression with Firth’s bias-adjusted estimates. Availability and characteristics of antibiotics in the sari-sari stands (n=106) were observed through site visits.

Results: A majority (78%) had shared antibiotics in their lifetime, most often with family members. In multivariable analysis, agreement with the belief that it is safe …

Self-Rated Diet Health: Socioeconomic And Health Related Correlates, Emily B. Bell

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

BACKGROUND: Two-thirds of Americans are overweight or obese, increasing their risk for multiple chronic diseases. Self-rated diet health may be useful in public health efforts to prevent the negative consequences of overweight/obesity. This study aims to identify sociodemographic and health-related correlates of the NHANES self-rated diet health question.

METHODS: The 2009-2010 NHANES data for adults 20 years and older were used. Sociodemographic and health-related variables were investigated with selfrated diet health as the outcome. First, bivariate analyses determined associations of each variable with self-rated diet health. Those associated with pvalues ≤.25 were included in two multiple ordinal logistic regression models. …

Correlates Of Hepatitis C Serostatus Disclosure In Rural Appalachian Kentucky, Megan G. Hofmeister

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

Aim: To identify demographic, behavioral, and interpersonal characteristics associated with hepatitis C (HCV) serostatus disclosure among adult, rural, high-risk people who use drugs (PWUD) in Appalachian Kentucky.

Methods: Laboratory confirmed HCV antibody-positive participants (n=243), drawn from the fifth follow-up assessment of a longitudinal study of rural PWUD, completed interviewer-administered questionnaires eliciting demographic and interpersonal characteristics, risk behaviors, and information on HCV disclosure. Correlates of HCV disclosure were assessed using logistic regression.

Results: Most (69.1%) reported disclosing their HCV-positive status to at least one of their social referents (current or past sex partners, current or past injection drug use (IDU) partners, …

Equine Leptospirosis Seroprevealence In The Central And Bluegrass Regions Of Kentucky From 1993 - 2015, Charlene Siza

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

BACKGROUND

Leptospirosis is a worldwide zoonotic bacterial disease of significant importance for both human and animal health. There are many sources of infection and shedding of the bacteria, including horses. There is a known occupational hazard for leptospirosis, especially in occupations that work directly with animals or animal products. This study examined the prevalence of equine leptospirosis in Kentucky in relation to trends over time and geographical distribution.

METHODS

Data was obtained from the University of Kentucky Veterinary Diagnostic Laboratory(UKVDL) on equine leptospirosis from 1993 through September 2015. Overall seropositive prevalence and prevalence stratified by serovar were calculated. Furthermore, distribution …

Birth Cohort Effects In Risk Factors For Alzheimer’S Disease, Kingsley Uzodinma

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

Background and Objectives: The purpose of this study was to assess the presence of birth cohort effects by exploring differences in established risk factors of Alzheimer’s disease (AD) and dementia using case-control designs and also estimate the AD risk among women with respect to their number of biological children.

Methods: This is a case control study design of participants born in 1896 – 1955 and were enrolled in one of the designated Alzheimer’s disease centers (ADCs). The uniform Data Set of the National Alzheimer’s Coordinating center (NACC) include those who had Alzheimer’s disease or mild cognitive impairment (cases) and were …

Increasing Colorectal Cancer Screening Rates In Shelby County, Tennessee Through The Implementation Of Flu-Fit In Community Clinics And Pharmacies, Samantha Wang

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

The Shelby County Health Department (SCHD) proposes implementing of Flu-FIT in community clinics and pharmacies to increase colorectal cancer screening (CRCS) rates in Shelby County, Tennessee. Flu-FIT is an evidenced-based program that involves health care providers offering patients between 50 and 75 years of age the fecal-immunochemical test at the time the patients receive their annual influenza vaccine along with counseling on colorectal cancer and reminder phone calls. Flu-FIT aligns with the mission of SCHD to “promote, protect, and improve the health and environment of all Shelby County residents.” The project’s short term outcomes include increasing CRCS rates in patients …

The Utilization Of Models Of Care Transition To Reduce Medicare Beneficiaries’ Hospital Readmission Rates In Kentucky: A Case Study, Audra Putt

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

Problem: Unsuccessful care transitions for Medicare beneficiaries have resulted in high health expenditures and a diminished quality of care as the 30-day hospital readmission rate has increased. This has prompted the Centers for Medicare and Medicaid Services to require hospitals with high readmission rates to pay penalties. As a result, the Community-based Care Transitions Program was established under Section 3026 of the Affordable Care Act to provide health organizations funding to utilize models of care transition to improve the care transition process. The purpose of this capstone project was to identify whether two community-based organization programs, the Kentucky Appalachian Transition …

Drink Switch Program In South La Schools, Lauren Barker

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

Sugary drinks, including sports and energy drinks, are the number one source of added sugar in the American diet.1 Excess sugar consumption can lead to health complications such as overweight and obesity, and obesity-related chronic diseases such as diabetes, high blood pressure, and cardiovascular disease.2 Sugary drink consumption among youth in Los Angeles is particularly high, and teenagers in Service Planning Area (SPA) 6 of Los Angeles have some of the highest consumption rates in the county, with one out of two reporting consuming at least one sugary drink per day.3 Based on the correlation between sugar consumption and health, …

Identification Of Leishmania Spp. And Trypanosoma Cruzi In Sylvatic Animals In El Paso County, Texas, Mariel Christina Matamoros

Open Access Theses & Dissertations

Background Leishmaniasis and Chagas's Disease are two of the seventeen diseases considered as Neglected Tropical Diseases (NTF) by the CDC. Ten million people worldwide are at risk of being infected by Leishmaniasis and Chagas' disease affects six million people in the world; however, these are mostly cases in Latin America. The vector for Chagas' disease, triatomine, has been identified near El Paso, Texas region to be positive for Trypanosoma cruzi. Recent studies have also shown positive results for Chagas' disease and Leishmaniasis in sylvatic animals in El Paso.

Objective To determine the prevalence of Trypanosoma cruzi and/or Leishmania spp. infection …

Forced Migration, The Human Face Of A Health Crisis, Lawrence O. Gostin, Anna E. Roberts

Georgetown Law Faculty Publications and Other Works

Nearly 60 million refugees, asylum-seekers and internally displaced persons (IDPs) fled their homes in 2014, predominately from war-torn Syria, Afghanistan and Somalia. The global response to assisting this vulnerable group has been wholly incommensurate with the need given the profound health hazards faced by forced migrants at each stage of their journey. The majority of forced migrants are housed in lower-income countries that do not have the infrastructure to assist the significant numbers of individuals who are crossing their borders and the humanitarian organizations who seek to assist in the response are grossly underfunded and under-resourced.

Countries have varying responsibilities …

Perceptions Of Safety Among Adolescents In Jordanian Host Communities: A Pilot Study Conducted In Housing Communities In Baqa’A And Ramtha, Katie Stevenson

Independent Study Project (ISP) Collection

The purpose of this research was to understand how refugee and Jordanian adolescents perceive safety by answering the following three questions: 1) How do adolescents in host communities define safety? 2) How do they perceive the safety of their community? 3) What is being done, within their communities, to address the safety needs of adolescents? By answering these questions, this research aimed to increase the understanding of how safety should be defined, assessed, and addressed in regards to adolescents living in Jordanian host communities. Due to resources limitations, this research was only conducted with Syrian adolescents refugees. Four interviews were …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern Models the Effect of School Closures
• Georgia Southern Researcher Examines Racial Differences in the Utilization of Bone Marrow Transplantation and Participation in Survey and Biospecimen Research

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern Researchers Use CBPR to Extend Prostate Cancer Education, Counseling and Screening to Inner-City Men
• Georgia Southern Assesses Call to Integrate Healthcare and Public Health
• Georgia Southern Assistant Professor Implements a Community Empowerment Center
• Georgia Southern Investigates Perfomance of Stratified biviraite Ranked Set Sampling

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Assesses Call to Integrate Healthcare and Public Health

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• U.S. Undergraduate Education in Public Health

By Word Of Mouth: A Qualitative Approach To Understanding The Integration Of Preventive Dental Health In Primary Care Settings, Joni D. Nelson

Theses and Dissertations

Childhood and adolescence are sensitive periods in the lifespan when oral and craniofacial appearances can help determine social interactions and lifetime outcomes. In this respect, oral health can be viewed as more than just brushing or flossing for healthy teeth; children’s oral health can influence their social development and behaviors, impact their academic growth, affect their guardian’s responsibility for healthcare cost and create a potential pathway for negative impacts on quality of life. Access to quality oral healthcare is vital for the prevention of unwanted diseases and to avoid the burden of oral health complications. Oral health disparities may not …

Association Between Electronic Prescribing Among Ambulatory Care Providers And Adverse Drug Event Hospitalizations In Older Adults, Grishma Patel Bhavsar

Theses and Dissertations

Purpose.

This dissertation research sought to determine whether the proportion of physicians using electronic prescribing (e-prescribing) was associated with the hospitalization rate for adverse drug events (ADEs) among patients aged 65 and older in 2011. Additionally, we sought to determine whether increases in the proportion of e-prescribing physicians in a county were associated with decreases in the hospitalization rate for ADE among older adults.

Methods.

Two study designs were used, a cross-sectional study using 2011 data and a pre-post- study using 2008 and 2011 data. Data from the 2008 and 2011 State Inpatient Databases, the Office of the National …

Ecpat: Development And Testing Of Mobile Technology To Engage Youth In Active Living Policy, Systems, And Environmental Health Promotion Efforts, Gina M. Besenyi

Theses and Dissertations

Modifying the built environment is a promising way to promote youth physical activity and reduce obesity. Parks, in particular, are key intervention venues given their low cost and legislated ubiquity. Creating healthy communities, including better parks, will require the interest and participation of multiple constituencies, including youth. Creation of mobile technology environmental audit tools can provide a more interactive way for youth to engage with communities and facilitate participation in participatory action research (PAR) and health promotion efforts.

The purpose of the first study was to describe the development and validity and reliability testing of an electronic version of the …

Spatial Analysis And Correlates Of Waterpipe Tobacco Smoking Among College Students In The United States, Frederick Richard Kates

Theses and Dissertations

Introduction: In the United States, young adults have the highest prevalence of waterpipe tobacco smoking (WTS) according to National Adult Tobacco Surveys (NATS) published by the Center for Disease Control (CDC). Experimentation of different tobacco products is highest among 18-24 year olds. Most recently, WTS has surged in popularity among this demographic group. The rapid diffusion of WTS among this population has been accelerated by marketing efforts on the Internet. There are misperceptions that WTS is less harmful than smoking cigarettes and there is a proliferation of WTS establishments due to tobacco retail exemptions. Presently, WTS establishments are almost completely …

Smoking Cessation In Pregnancy And Gestational Weight Gain In South Carolinian Mothers, 2009-2011, Laquenta Latreese Weldon

Theses and Dissertations

Purpose: To determine if smoking cessation during pregnancy is associated with excessive gestational weight gain (GWG).

Methods: Data came from the 2009-2011 Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing population-based survey of live births in South Carolina (n=2,603). Participant smoking status was classified as nonsmoker (did not smoke before or during pregnancy), persistent smoker (smoked before and throughout pregnancy), or quitter (smoked before but quit during pregnancy). Multinomial logistic regression model was estimated to examine the association between smoking status and meeting the 2009 Institute of Medicine guidelines, while linear regression model was used for the continuous outcomes such …

Longitudinal Study Of The Effectiveness Of The South Carolina Medicaid Policy For The Application Of Fluoride Varnish For Children Age Three And Under, Christine N. Veschusio

Theses and Dissertations

In South Carolina, the burden of dental decay disproportionately affects disadvantaged children enrolled in Medicaid (Dye et al., 2012; Martin et al., 2012; Ayers et al., 2013). To address this oral health disparity, South Carolina’s Medicaid Program initiated payment to physicians for the delivery of fluoride varnish (FV), an evidence-based preventive dental service at the well-child visit, to children up to thirty-six months of age. Fluoride varnish has been found to reduce dental decay by thirty-seven percent when applied two to four times a year (Weyant et al., 2013; Marinho et al., 2013).

Two retrospective cohort studies were undertaken to …

Connecticut's Elderly Population: An In-Depth Analysis Of Current And Future Trends In Elder Care, With A Focus On Dementia And Cognitive Decline, Emily J. Snodgrass

Honors Scholar Theses

The aging population in Connecticut currently represents ~15% of the state’s population but is anticipated to rapidly increase over the next 20 years. My thesis is an examination of the types of interventions and programs currently available for elderly persons with memory impairment and cognitive decline, as well as the challenges associated with caring for a larger elderly population. Data collected from interviews with CT healthcare and research professionals representative of the diverse specialties of aging together with an analysis of current research literature are used to demonstrate the importance of continued research and expansion of appropriate and accessible services …

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Laying the Groundwork for Evidence-Based Public Health