Public Health Commons^™

Factors Affecting School Health Scores: Wellsat Scores, School Policy, And The School Environment, Alicia Baker

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

A recent trend in school health intervention has been through policy creation and development. Studies have shown that changes in school health policy can improve student health behaviors, particularly in physical activity and nutrition. This study looked at how potential factors could affect the scores of a school policy assessment tool called the Wellness School Assessment Tool (WellSAT). Using a combination of t-tests, chi-square tests, and logistic regression, schools’ strength and comprehensiveness nutrition scores from the WellSAT were analyzed when compared to Free and Reduced Lunch Rates, type of school, and whether schools had separate policies from their school district. …

Effects Of Locality And Risk Of Late Stage Breast Cancer Diagnosis In Kentucky Females, 2001-2011, Michael Jacob Sither

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

Breast cancer survival is heavily dependent on stage at diagnosis. Recent evidence supports rural women are more likely than urban women to be diagnosed with advanced stage disease but historically these findings have been mixed when investigated at the state level. Cancer surveillance in the Appalachian region suggests Kentucky females are at significantly greater risk of premature breast cancer mortality due to consistently lower prevalence of screening mammography utilization. In the literature, disparities in breast cancer outcomes have been largely explained by population demographics, areabased measures of socioeconomic deprivation, shortages of referring providers as well as differences in spatial access …

Evaluating Oral Health Trends In Kentucky, 2006-2012, Briana Michelle Forsythe

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

According to the former US Surgeon General, C. Everett Koop, “You’re not healthy without good oral health.” Poor oral health, comprising of the presence of caries and/or periodontal disease, can lead to edentulism, which in turn can yield poor physical health, inability to communicate properly, poor mental health, and a lesser quality of life. In Kentucky, over one quarter of the adult population has lost six or more teeth due to decay or gum disease, a figure 10% higher than the national average. Objectives: The purpose of this study was to examine: a) Kentucky’s Statewide Oral Health Strategic Plan, implemented …

Factors Influencing Differential Oral Health Care Use Between Hispanics And Non-Hispanic Whites In The U.S., Nathalie Astudillo

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

Oral health is often considered merely the absence of disease. However, oral health involves much more. Good oral health facilitates very basic functions like eating and speaking; a healthy smile is also associated with good self-esteem and productivity.1 Most oral health diseases are largely preventable. Despite this, a large portion of the population in the United States still suffer from untreated dental decay.2 Poor oral health has a direct effect on systemic health, quality of nutrition, digestion, phonetics, selfimage and self-esteem.5 Whether considered individually or combined, each of these factors has a direct impact on the quality of life of …

Antipsychotic Prescriptions For Children Aged 5 Or Younger: Do We Need Policy Oversight Standards?, Ana Lopez-De Fede, Medha Vyavaharkar, Jessica D. Bellinger

Publications

The use of antipsychotics in very young children is of concern given the lack of empirical evidence in their efficacy and long-term impact on children’s health. This study examined the prescription of antipsychotics among children aged ≤5 years enrolled in a state Medicaid program. Secondary data analysis was conducted using the Medicaid administrative data of a southeastern state. Using SAS 9.3, descriptive statistics were performed to examine socio-demographic characteristics, psychiatric diagnoses, off-label use, receipt of medications from multiple psychotropic drug classes, and receipt of non-pharmacologic psychiatric services among children aged ≤5 years who received antipsychotic prescriptions in calendar year (CY) …

Injuries Among Miners In Kentucky During 2010-2012 From Workers Compensation Data, Evelyn Thomas

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

Introduction: Coal miners in Kentucky have higher rates of injury morbidity and mortality than national rates. In order to understand better what is happening in this area, we not only analyzed the injuries and deaths, but also identified common characteristics between these nonfatal and fatal injuries. The objectives of this study were to 1) Identify injuries among coal miners in Kentucky; 2) Determine if there are any other risk factors for injuries other than working in a mine; and 3) Determine the different health effects on coal mine workers. Methods: Data from Kentucky Workers’ Compensation First Reports of Injuries and …

Influence Of Marianismo On Colorectal Cancer Screening Behavior Among Hispanic Women In The United States, Robin Thompson

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

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer death in the United States (U.S).1 Although early detection and treatment can reduce CRC-related morbidity and mortality, almost twothirds of patients are diagnosed with advanced stage disease indicating non-adherence to recommended screening guidelines.1 Indeed, less than half of individuals over 50 years of age get screened at recommended intervals.2 More specifically, lower rates of CRC screening exist among these groups: those identifying as being of Hispanic origin, the uninsured, disabled individuals, and women.3 In a 2011 report from the National Center on Health …

An Exploration Of Empowerment, Sexual Violence, And Hiv Among Indian Women, Brigid Kyung-Hwa Cecil

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

Empowerment plays a major role in sexual violence and HIV among women worldwide. Findings on empowerment in relation to domestic violence or HIV are scarce and are conflicting. The purpose of this study was to examine the relationship between empowerment and HIV status by means of sexual violence, and to compare this relationship between previously married women (N = 2,658) and currently married women (N = 37,539) living in India. The Baron and Kenny mediated regression model was used, involving simple logistic and multiple logistic regression, drawing from the National Family Health Survey 2005-2006 (NFHS-3). Sexual violence was not found …

Association Of Hiv Testing, Educational Attainment, And Age Among Black And Non-Black Men, Ashley N. Martell

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

Human Immunodeficiency Virus (HIV) infection can lead to a chronic condition, Acquired Immunodeficiency Syndrome (AIDS), but can be well managed with a combination of medications, treatments, and remedies.1 The emergence of HIV in the United States in 1981 created an atmosphere unlike any other at that time. Overtime, the science community has worked diligently to combat this disease through research, practice, and intervention. Although many efforts have been put forth over the past thirty years, millions of Americans still remain infected with HIV.2 Among those who are infected with HIV/AIDS we see disproportionate rates among specific races and gender. Research …

Breast Health And Access To Care In The Kentucky Women's Health Registry, Sarah Yeiser

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

Breast cancer is the second leading cause of death (14%) among all cancers in women in Kentucky.1 In 2010 the United States incident rates of breast cancer in white women were 122.6 per 100,000, and 118 per 100,000 in black women.2 Although breast cancer is diagnosed more in white women, black women are more likely to die from breast cancer and usually have more advanced stages of breast cancer upon diagnosis.2 In Kentucky from 2003-2007 the age-adjusted breast cancer mortality rate was 23.6 per 100,00 in white women and 32.8 per 100,000 black women. Black women die from breast cancer …

The Effect Of Television Watching On Condom Use Among 9th-12th Graders, Rashidat Mohammed

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

Abstract: At least one out of every three youth will acquire a Sexually Transmitted Infection (STI) by the time they reach 25 years old. Although this may be caused by a variety of factors, sexually-charged media are believed to play a significant role. In television, there are more sexually inaccurate messages than there are portrayals of sexually responsible behaviors. These messages are not only unrealistic, but they could potentially have negative effects on adolescent sexual behavior. Among these negative effects is failure to use condoms. When used correctly, male condoms are about 98% effective. Recommendations are presented to help address …

Improvement Of Tobacco-Free Policy Enforcement At The University Of Kentucky, Muchen Bai

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

Smoking has been known as the leading preventable cause of death and premature disease in the United States (DHHS, 2014). Every year, cigarette smoking causes more than 480,000, approximately, one in five deaths (DHHS, 2014). According to the Centers for Disease Control and Prevention (CDC), "smoking causes more deaths each year than all of the listed combined: Human immunodeficiency virus (HIV), Illegal drug use, Alcohol use, Motor vehicle injuries, and Firearm-related incidents" (CDC, 2014). Since 1964, 31 Surgeon General's Reports have revealed the causal relationship between health outcomes and tobacco smoke exposure (DHHS, 2014). The report, The Health Consequences of …

Association Between Co-Sleeping And Breastfeeding: Does Prenatal Care Make A Difference?, Brynne Kathleen Adams

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

Prenatal care is important to ensure a healthy pregnancy for both a woman and her baby. According to the Mayo Clinic, prenatal care should start as soon as there is a positive pregnancy test and should continue throughout the pregnancy.1 The more prenatal care visits a woman attends, the more opportunities to detect potential problems and offer health education materials to help ensure a healthy pregnancy. Prenatal care visits are also used to discuss what may happen after the woman delivers particularly early infant care and breastfeeding. Mothers who do not receive adequate prenatal care are three times more likely …

The Relationship Between Perceived High Levels Of Stress And Non-Condom Usage Among College Students At The University Of Kentucky, Samantha Bearman

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

Introduction: Due to the paucity of research that specifically examines the non-use of condoms, during sexual encounters, as a maladaptive coping strategy for stress among college students; the purpose of my study, is to determine if there is an association between perceived high levels of stress and the decreased likelihood of condom use during sex among students at the University of Kentucky. Method: The cross-sectional descriptive study investigated health behaviors and attitudes towards health behaviors in a sample of 7,000 University of Kentucky students enrolled in courses for fall 2013. Participants were randomly selected to partake in an anonymous online …

Impact Of Routine Immunization Coverage In Controlling Measles And Progressing Toward The Introduction Of Rubella Containing Vaccine: A Comparison Study Between Rwanda And Uganda, Carmen Kupangi Dibaya

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

Despite the existence of safe and effective vaccines, measles and rubella present a major public health problem in many developing countries, disproportionally affecting low-income populations.1-3 Indeed, measles and rubella remain two of the leading causes of death and congenital defects in children worldwide.4-6 In 2008, an estimated 10 million new cases and 164,000 deaths were reported from measles alone.3 During the same time period, the United Nations International Children's Emergency Fund (UNICEF) reported an estimated 110,000 cases of Congenital Rubella Syndrome (CRS) in developing countries, with the continent of Africa shouldering 38% of the disease burden.7 Measles is a highly …

An Evaluation Of Three Positive Parenting Practices And Their Combined Impact On Developmental, Social, Or Behavioral Delays In Children Ages 1-5 In The United States, Sarah Cprek

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

Objectives: (1) Determine whether three individual positive parenting practices (PPP) – reading to children, engaging in storytelling or singing, and eating meals together as a family – decrease the risk of developmental, behavioral, or social delays among children between the ages of 1-5 years in the United States. (2) Determine if a combination of these parenting practices has an additive effect on the outcome. Methods: Multiple logistic regression and chi-square analyses were used to analyze data from the National Survey of Children’s Health 2011/2012 in regards to the relationship between each of the three individual PPP as well as a …

Distribution Of Wildlife Rabies In Central Appalachia And Analysis Of Factors Influencing Human Exposure, Sara J. Reilly

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

Abstract Background: The rabies virus is a Lyssavirus of the family Rhabdoviridae which affects all mammals and causes progressive encephalomyelitis that is fatal in nearly one hundred percent of untreated cases. In the United States, wildlife act as the primary reservoir for rabies and prevention, surveillance, and control costs remain high. The purpose of this study is to understand the current distribution of wildlife rabies in Central Appalachia, as well as identify any demographic or geographic factors which may affect the risk of human exposure at the county level. Methods: A spatial statistical analysis using StatScan was performed to identify …

Narrative And Qualitative Analyses Of Workers' Compensation-Covered Injuries In Short-Haul Vs. Long-Haul Trucking Industries, Mark D. Chandler

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

ABSTRACT

Problem: Trucking transportation remains one of the most dangerous industries in the US. The aims of the current study were to (1) identify and characterize differences in injury types between workers in short-haul and long-haul trucking; (2) analyze and code narrative text to identify and characterize the on-the-job activities associated with injuries within each trucking industry group; and (3) identify areas for targeted improvement of safety interventions. Method: Quantitative and narrative analyses of 2012 Kentucky short-haul and long-haul truck transportation workers’ compensation first reports of injury and narrative text data were performed. Chi-square tests assessed differences in demographics, injuries, …

Examination Of The Prevalence And Mediating Factors Of Diabetes Diagnoses In Kentucky Women With A History Of Gestational Diabetes, Courtney Danielle Ryan

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

Diabetes mellitus (DM) is an overwhelming health issue in the United States affecting 25.8 million people, which is equivalent to 8.3% of the population.1 It is the seventh leading cause of death and a major cause of serious complications such as heart disease, stroke, kidney failure, nontraumatic lower limb amputations, and new causes of blindness among adults in the U.S.1 Paralleling the obesity epidemic, the rates of DM incidence and prevalence continue to rise each year.2 One particularly troubling public health issue related to DM is that over a quarter of the people who have this disease are unaware, even …

Connecting The Supply And Need For Buprenorphine Treatment In Kentucky Counties, Ellen Lavonne Parker

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

Abstract Background: Prescription opioid drug overdose mortality rates have surpassed those of motor vehicle accidents in Kentucky. While opioid overdose plagues the state, buprenorphine is an FDA approved medication that has proven effective in treating opioid dependence. Objectives: This study examined the supply of licensed buprenorphine providers and community treatment centers in each county of Kentucky along with the need for treating opioid use disorder in each county. Methods: Licensed buprenorphine physicians and community treatment centers prescribing buprenorphine were identified through the Substance Abuse and Mental Health Services Administration online treatment locator. The need for treatment was measured by calculating …

Cultural Factors Associated With Utilization Of Antenatal Care Services In Rural India, Anjali Om

Undergraduate Research Posters

Despite vast economic growth in developing countries in the past few years, infant mortality continues to plague underdeveloped regions, particularly rural regions of India. Many of these deaths are caused by a lack of education and motivation in regard to utilization of antenatal and neonatal care services to prevent and treat consequences of unhygienic umbilical cord care.

For years, high incidences of neonatal tetanus have plagued rural areas of India as a result of cultural practices that encourage topical applications of cow dung to cut umbilical stumps either directly or by using ghee heated with cow dung to warm umbilical …

Aftermath Of The Hobby Lobby Decision: Implications For Women In The Workforce, Hirsh Shah

Undergraduate Research Posters

Burwell v. Hobby Lobby Stores, Inc. is a landmark Supreme Court case in which it was ruled that the contraceptive mandate from the Affordable Care Act was an unnecessary and substantial burden on Hobby Lobby’s corporate exercise of religious freedom. This is the latest of many court cases that have expanded corporation’s rights to equal those of humans, giving them individual status without the responsibilities that come along with it. By citing religious liberty rights, closely held corporations such as Hobby Lobby can impose their religious viewpoints on their employees, specifically by not providing certain contraceptive care coverage. Other corporations …

Tick Toxic: The Failure To Clean Up Tsca Poisons Public Health And Threatens Chemical Innovation, Kristen Ekey

William & Mary Environmental Law and Policy Review

No abstract provided.

Public Health Research Implementation And Translation: Evidence From Practice-Based Research Networks, Glen P. Mays, Rachel A. Hogg, Doris M. Castellanos-Cruz, Anna G. Hoover, Lizeth C. Fowler

Health and Clinical Sciences Faculty Publications

BACKGROUND: Research on how best to deliver efficacious public health strategies in heterogeneous community and organizational contexts remains limited. Such studies require the active engagement of public health practice settings in the design, implementation, and translation of research. Practice-based research networks (PBRNs) provide mechanisms for research engagement, but until now they have not been tested in public health settings.

PURPOSE: This study uses data from participants in 14 public health PBRNs and a national comparison group of public health agencies to study processes influencing the engagement of public health settings in research implementation and translation activities.

METHODS: A cross-sectional network …

New Health Delivery Networks: Merging Public Health And Health Care Systems, Glen P. Mays

Health Management and Policy Presentations

Incomplete coordination between medical care and public health delivery systems can result in significant missed opportunities for improving population health and constraining overall resource use. This lecture uses insight from the field of public health services and systems research (PHSSR) to examine: (1) why medical care and public health systems often fail to connect; (2) what are the potential health and economic consequences of these failures; and (3) what are the opportunities for connecting medical care and public health delivery to improve population health.

Recessions, Risks And Reforms: Changes In Inter-Organizational Activities To Improve Public Health, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new incentives for hospitals, insurers, employers, public health agencies, and others to contribute to activities designed to promote health and prevent disease an injury. At the same time, the economic recession has constrained government and private sector spending on health and health care, necessitating changes in the scope and scale of public health delivery. This study uses data from the 1998-2012 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, with a focus on hospitals, insurers, employers, and primary …

Who Benefits From Public Health Spending And How Long Does It Take: Estimating Community-Specific Spending Effects, Glen P. Mays

Health Management and Policy Presentations

Objectives: Spending on public health and prevention strategies varies widely across states and communities. The Patient Protection and Affordable Care Act of 2010 (ACA) authorized the largest expansion in federal public health spending in decades, with the goals of improving population health and helping to moderate growth in medical care spending. To produce evidence needed to inform these investments, this study (1) estimates the effects of public health spending patterns within communities on preventable mortality and subsequent medical care spending; and (2) uses the methods of local instrumental variables developed by Heckman and Vytlacil and Basu to estimate how the …

A Case For Refining The Who Global Strategy On Food Safety: Perspectives From India., Subbarao M Gavaravarapu, Katherine C Smith, Rajiv N Rimal

Prevention and Community Health Faculty Publications

No abstract provided.

Public Perceptions On Family Planning And Birth Spacing In The Cultural And Religious Context Of Senegal: A Case Study In Dakar, Senegal, Heidi Kahle

Independent Study Project (ISP) Collection

Much prior research has examined the prevalence rates of family planning and contraceptive use in Senegal, as well as the importance of family planning for reducing maternal and infant mortality, improving the well being of families, and improving the national economy. Few studies, though, have captured the perspectives of Senegalese persons and their attitudes and beliefs toward family planning, rumors and stigmas that surround it, and how different actors can work together to dispel rumors and encourage the use of family planning. I conducted my research in Dakar, Senegal, where I interviewed a variety of persons – two gynecologists, a …

Nurturing The Whole Body: The Benefits Of Supplementing Tuberculosis Chemotherapy With Traditional Chinese Medical Practices, Rachel Levine

Independent Study Project (ISP) Collection

Although modern medicine has found a cure for Tuberculosis (TB), it remains a worldwide health threat. Due to poor adherence to TB chemotherapya multi-drug resistant strain of the TB bacteria (MDR-TB) has been created.It has been found that poor adherence is caused by many factors, two of which include the high cost of treatment and the many uncomfortable side effects. Through a month of research based in Kunming, China including interviews, observations and surveys,this project hoped to compare Western biomedicine and Traditional Chinese Medicine (TCM) to determine the potential benefits TCM holds for TB patients. TCM improves a TB patient’s …