Public Health Commons^™

The College Of Health & Human Services [Annual Report], Wku College Of Health & Human Services, Dr. John Bonaguro, Dean

College of Health & Human Services Publications

No abstract provided.

Prevalence Of Metabolic Abnormalities In Children With Varying Degrees Of Obesity, Leah Sabato

Master of Public Health Program Student Publications

As the prevalence of obesity among children has risen, metabolic syndrome, a cluster of abnormalities which includes obesity, altered glucose metabolism, hypertension, and dyslipidemia, has increasingly become recognized in the pediatric population. Metabolic syndrome has been studied extensively in adults, and there is increasing interest to understand the condition in adolescents; however, studies of metabolic syndrome in younger children are limited. The purpose of this study is to examine the prevalence of metabolic syndrome and its individual components among children aged 6-10 years. Demographic, anthropometric, and biochemical data were gathered retrospectively from the medical records of 222 obese children aged …

The Association Between Neighborhood Walkability, Type 2 Diabetes, And Socioeconomic Status In Residents Of Eight Ohio Counties, Dawn L. Ebron

Master of Public Health Program Student Publications

Objective: Regular physical activity is beneficial in preventing type 2 diabetes. Walking, either for recreation or to travel to a destination, is an inexpensive way to meet physical activity guidelines. Disadvantaged populations with low socioeconomic status (SES) have a higher prevalence of type 2 diabetes and are more likely to live in unwalkable neighborhood. The purpose of this study was to determine the association between SES and neighborhood walkability in eight Ohio counties with highest prevalence of type 2 diabetes in the state.

Methods: Using data from the 2010 Ohio Behavioral Risk Factor Surveillance System (BRFSS) survey and Walk Score …

Colorectal Cancer In Montgomery County, Ohio: A Descriptive Analysis, Ursula Turner

Master of Public Health Program Student Publications

In the United States colorectal cancer (CRC) is one of the most common malignancies, and is the third leading cause of cancer deaths (Sharma & O’Keefe, 2007). Approximately 270,000 cases of colorectal cancer were diagnosed in 2008 with 81,900 cases resulting in death. There were 16,520 cases diagnosed in African Americans and 7,120 resulted in death or significant illness (American Cancer Society, 2008). Mortality as the result of CRC is greater among the African American population with 27% and 38% higher death rates for African American males and females when compared with Caucasian males and females (Agarwal, 2005). CRC is …

A Geospatial Analysis Of The Role Of Urban Forestry In Outdoor Ambient Air Pollution Reduction In Dayton, Ohio, Nicholas P. Clemens

Master of Public Health Program Student Publications

Objective: Air pollution is associated with negative respiratory and cardiovascular health outcomes. According to the American Lung Association listing for 2011, the Dayton-Springfield-Greenville, OH area ranks 22 out of 277 US cities for year round particulate pollution. The tree canopy cover plays a significant role to reduce air pollution. The purpose of this analysis was to quantify the role of urban forestry in the Dayton, Ohio metropolitan area in reducing air pollution.

Methods: Using a peer-reviewed model designed by the US Forest Service, the imagery data was analyzed to create a descriptive analysis of the canopy cover in the Dayton, …

Nation's Future: Preparedness For Burn Victims, Jacqueline Tippett

Master of Public Health Program Student Publications

Natural and manmade disasters have occurred throughout the decades, within the United States and around the globe. Increased incidence and awareness of terrorist attacks have caused the US to re-evaluate its safety and preparedness efforts to prevent such events from happening and to develop an adequate response plan if such unfortunate events do occur. Therefore, the purpose of this research is to (1) review and discuss the American Burn Association’s (ABA) paradigm for emergency planning in burn disasters, (2) give recommendation about the National Response Framework (NRF) guidelines on “all hazards” response as they pertains to burns, and (3) give …

An Examination Of Ohio’S Physical Education Academic Content Standard 4, Benchmark A For Grades 9-12, Gabriel Jones

Master of Public Health Program Student Publications

Objective: The purpose of this study was to describe select physical education teachers’ perceptions of the effectiveness and accuracy of the assessments for Ohio's Physical Education Academic Content Standard 4 Benchmark A in determining the fitness and physical activity levels of high school students. A secondary purpose was to describe the fitness levels of high school physical education students, based on assessment data.

Methods: Participants were forty-one physical education teachers and ninety high school students from southwest Ohio. Data were collected from the teachers through an online questionnaire and from students with FITNESSGRAM testing. FITNESSGRAM data from one local school …

Acl Injuries In Montgomery County, Oh: Moving Toward The Development Of A Prediction Model, Kelly Estes

Master of Public Health Program Student Publications

Anterior cruciate ligament (ACL) tears are one of the most frequent soft tissue injuries of the knee. A torn ACL leaves the knee joint unstable and at risk for further damage to other soft tissues manifested as pain, dislocation, and osteoarthritis. A better understanding of the dimensional details of knee joints suffering ACL tears and a prediction model for individuals susceptible to tears is needed. Using a cross-sectional study design, magnetic resonance images (MRIs) of 72 patients with knee injuries were evaluated from an orthopedic surgery group practice. The status of the ACL was the main variable of interest, creating …

Impact Of Congestive Heart Failure Discharge Planning On Congestive Heart Failure Re-Admission Rates, Sula E. Mazimba

Master of Public Health Program Student Publications

Background: Congestive Heart Failure (CHF) is the most common diagnosis accounting for more healthcare costs than any diagnosis. CHF readmissions contribute significantly to this expenditure. Quality of care in heart failure is linked to process based performance measures. This study evaluated the relationship between adherence to performance metrics and 30 day readmission rates.

Methods: This was a single center case-control study that evaluated 6063 consecutive patients admitted with CHF from December 2001 through December 2008. Data was collected for readmission to the hospital within 30 days and compliance to the heart failure performance measures at discharge.

Results: The rate of …

State Preparedness: A Study Of State Plans, Zachary Fehrman

Master of Public Health Program Student Publications

Non-pharmaceutical interventions (NPIs) have been used since the early years of public health. The Centers for Disease Control and Prevention (CDC) provides a standard definition for NPI and what NPI strategies are contained within the definition. This paper seeks to discover if state pandemic influenza plans use the term NPI and its strategies, and if states’ use of NPI strategies in their state pandemic plans is consistent with the CDC definition. To determine how states were defining and using the term NPI and NPI strategies a survey of forty-eight (48) state plans was conducted using each respective states’ pandemic plan. …

Assessment And Management Of Adult Obesity In A Primary Care Practice, Sherry M. Adkins

Master of Public Health Program Student Publications

Purpose: The purpose of this project was to describe primary care physician adherence to National Heart Lung and Blood Institute (NHLBI) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (1998) and to explore patient characteristics associated with physician assessment and management behaviors. Patient characteristics included age, sex, race, BMI, associated disease risk, and Medicaid coverage.

Methods: A chart abstraction of 99 randomly selected adult patients with at least one visit to a particular primary care practice during a 12-month period was completed. Patients were not pregnant during the year of review, and had a …

The Influence Of School Eating Environment On Children's Eating Behaviors: An Examination Of The Snda-Iii, Sabrina M. Neeley

Master of Public Health Program Student Publications

The prevalence of childhood overweight and obesity in the United States has prompted researchers to examine the factors that contribute to children’s food choices and consumption. Schools provide ample opportunities to teach children healthy eating habits, as well as create eating environments that are conducive to healthy eating behaviors. The National School Lunch Program (NSLP) provides federally assisted meals to millions of children every day and the assessment of the NSLP provides an opportunity to examine the school-eating environment. Hierarchical and logistic modeling of the SNDA-III, the USDA assessment of the NSLP, was conducted to determine relationships between environmental factors …

Using The Commons To Facilitate Health Communication, Anna Liebzeit, Karen Adams, Mat Jakobi

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Prevalence, Knowledge, And Concern About Bed Bugs, Mary Beth Kaylor

Master of Public Health Program Student Publications

Recent research suggests that the United States and the world are on the verge of a bed bug pandemic. Assumptions have been made that socioeconomic status is not an indicator and that bed bugs are not competent disease vectors. However, little information is available at the local level about the prevalence of bed bugs in private homes. This study aimed to identify prevalence, knowledge, and concern about bed bugs in one village in Ohio. Responses from 96 individuals who completed the Prevalence, Knowledge, and Concern about Bed Bugs (PK CABB) survey were utilized for data analysis. The majority of the …

Worksite Wellness: An Administrative Perspective, Neha Kumar

Master of Public Health Program Student Publications

Objective: To develop a better understanding of businesses’ goals and purpose for offering worksite wellness opportunities and the level of administrative support for worksite wellness programs.

Method: Human resource directors, benefit managers, or other administrators of 76 businesses that have contracted with Premier Community Health in the past 2 years were contacted by e-mail to complete a standardized online survey on SurveyMonkey®. The survey included questions about the businesses worksite wellness current programs and future interests. In addition, data on how often businesses have utilized each of the PCH worksite offerings over the past 2 years was collected from the …

Situation Analysis Of Disability Resources And Needs Of Shantytowns Near Lima, Peru, Jessica Hunt

Master of Public Health Program Student Publications

Individuals in shantytowns of Lima, Peru experience unique challenges due to socioeconomic status and perceived inabilities. A situation analysis using qualitative ethnographic interviews of key participants (n=15) and one focus group (n=7) was conducted to explore life with disability in a shantytown of Lima, Peru. Findings showed that individuals with disability face physical and attitudinal barriers that limit social inclusion through the avenues of rehabilitation, education, and employment. The familial complex is expected to provide care for the individual with disability. The adult family member often chooses between providing income for the household and providing care and safety for their …

The Effect Of Prenatal Care And Other Factors On Preterm Births In Montgomery County 2007-2009, Leslie A. Schmieder

Master of Public Health Program Student Publications

Introduction Preterm birth is defined as a baby who is born before 37 weeks of pregnancy. Problems with preterm birth include an increased risk for health complications throughout life as well as having significantly more medical expenses compared to a full term infant. Prenatal care has shown to decrease the risk for preterm birth nationally. The objective of this project was to analyze prenatal care and other risk and demographic factors to determine their association with preterm birth in Montgomery County.

Method Data used included the 2007-2009 Montgomery County Birth Certificate Data for mothers who had singleton births. The Kessner …

Pertussis In Ohio: A Descriptive Analysis Of The 2010 Columbus Outbreak And Patterns Of A Reemerging Childhood Disease, Christopher Rohde

Master of Public Health Program Student Publications

Objective: In 2010, Columbus, Ohio experienced the largest outbreak of pertussis that it has had in the past 25 years. Similar outbreaks are occurring across the nation on an increasing basis. This descriptive study examines the 2010 outbreak and describes the demographics of the affected population. Comparison is made to previous and current pertussis incidence in Ohio and outbreaks elsewhere in the United States. Contributing factors to the increasing occurrence of pertussis outbreaks are discussed.

Methods: Raw data was obtained from the Columbus Public Health epidemiology department and is gathered through the Ohio Disease Reporting System (ODRS). Pertussis cases are …

Prevalence Of Obesity Among Head Start Preschoolers In Western Ohio, Angela Sims

Master of Public Health Program Student Publications

Objective: The intent of this study was to examine low income Head Start overweight and obese preschoolers, ages 3-5, in 8 western Ohio counties. Variables of interest included: obesity status, rural versus metropolitan location, home versus center-based Head Start, and access to physicians.

Methods: Data was collected retrospectively from the host Head Start site located in Piqua, Ohio. All Head Start enrolled preschoolers (N=1,181) ages 3 to 5 within the 8 western Ohio counties and 43 programs were studied. All children were considered of low income based on their acceptance into the Head Start program.

The data was retrieved from …

Evidence-Based Public Health Practices For Screening For Postpartum Depression, Roula Hilli

Master of Public Health Program Student Publications

Background: Five to 20 percent of the women worldwide suffer from Post Partum depression (PPD) which has serious negative impacts on the mother and her newborn. Although PPD is a preventive disease thorough screening using different tools, half of its cases are left undetected.

Purpose of the study: Is to find the best practice for PPD screening, which includes the best screening tool, best setting for screening, best administration period and the best cut-off score.

Methods: It is an Evidence-based Public Health (EBPH) review through a comparative study of 82 studies since 2005 that screened women for PPD in the …

Gaps And Strengths In Us Policies On Infant And Young Child Feeding: An Analysis Based On The Global Strategy On Infant And Young Child Feeding, Linda J. Smith

Master of Public Health Program Student Publications

This research project reviews the evidence on the significance of infant and young child feeding to public health goals, analyzes US policy documents in relationship to the Global Strategy using the World Breastfeeding Trends Initiative (WBTi) to quantify the findings into a national score, and then summarizes the gaps and strengths in US policies and makes recommendations. Using the WBTi scoring system, strengths for the US exist in national policy, Baby-Friendly Hospital Initiative, monitoring and evaluation, and complementary feeding. Mother support and community outreach, information and support were moderate. Gaps exist in policies on infant feeding in emergencies and for …

Determining Evidence-Based Practices In Asthma Management, Erin Smiley

Master of Public Health Program Student Publications

Objective: One aim of this study will focus on determining what are evidence-based studies in asthma control. A second aim focuses on determining which asthma interventions, self-monitoring tools and asthma management programs have shown to be the most significant in improving outcomes in patients with asthma. Recommendations will be made to future asthma self-management programs based on the findings.

Methodology: The review of 15 evidence-based research studies is used to identify and analyze the best asthma self-management practices to be implemented in a community health education program. Using the Brownson framework a weighting schema was created based on the level …

Mathematical Model To Assess The Relative Effectiveness Of Rift Valley Fever Countermeasures, Holly Gaff, Colleen Burgess, Jacqueline Jackson, Tianchan Niu, Yiannis Papelis, David Hartley

Biological Sciences Faculty Publications

Mathematical modeling of infectious diseases is increasingly used to explicate the mechanics of disease propagation, impact of controls, and sensitivity of countermeasures. The authors demonstrate use of a Rift Valley Fever (RVF) model to study efficacy of countermeasures to disease transmission parameters. RVF is a viral infectious disease that propagates through infected mosquitoes and primarily affects animals but also humans. Vaccines exist to protect against the disease but there is lack of data comparing efficacy of vaccination with alternative countermeasures such as managing mosquito population or destroying infected livestock. This paper presents a compartmentalized multispecies deterministic ordinary differential equation model …

Norovirus Epidemiology And Duration Of Shedding In Michigan, 2007-2008, Nodira A. Abdujamilova, David Dixon, Laura Mosher, Patricia Somsel, Anthony Muyombwe, Patricia A. Clark, Jeffrey Massey, Brenda Brennan, Paul C. Bartlett

Michigan Journal of Public Health

Background: In the United States, an estimated 23 million cases of norovirus (NoV) are reported each year, and although mortality is low, the morbidity and economic impact are substantial. Methods: RT-PCR and sequencing were used for identification of NoV genotypes obtained from outbreak and sporadic cases. RT Quant PCR was used to determine the viral load in fecal specimens. In order to rule out bacterial infection as the cause for acute gastroenteritis (AGE), bacterial culture for Salmonella, E.coli O157, Shigella, Campylobacter and Clostridium difficile was performed by standard laboratory procedures. The duration of NV shedding was investigated with longitudinal sampling …

Factors Associated With Prescribing Antiviral Medications For Treatment Of Influenza Among Primary Care Physicians In The United States, Payal Patel

All ETDs from UAB

Influenza is a contagious respiratory illness that affects millions each year. The illness, if not contained, can be a paramount public health threat in the U.S. and the world. Primary care physicians play an essential role in administering antiviral medications as a treatment for influenza yet the factors that influence their prescribing of these medications remain unclear. The present study aims to identify factors associated with physicians' prescribing of antiviral medications in the ambulatory care setting. The data utilized for this study were obtained from the National Ambulatory Medical Care Survey for each influenza season between the years of 2005-2008. …

Building Capacity For Public And Population Health Research In Africa: The Consortium For Advanced Research Training In Africa (Carta) Model, Alex C. Ezeh, Chimaraoke O. Izugbara, Caroline W. Kabiru, Sharon Fonn, Kathleen Kahn, Lenore Manderson, Akinyinka Omigbodun, Margaret Thorogood, Ashiwel S. Undieh

Publications and Research

Background: Globally, sub-Saharan Africa bears the greatest burden of disease. Strengthened research capacity to understand the social determinants of health among different African populations is key to addressing the drivers of poor health and developing interventions to improve health outcomes and health systems in the region. Yet, the continent clearly lacks centers of research excellence that can generate a strong evidence base to address the region’s socio-economic and health problems. Objective and program overview: We describe the recently launched Consortium for Advanced Research Training in Africa (CARTA), which brings together a network of nine academic and four research institutions from …

Put Your Money Where Your Butt Is: A Commitment Contract For Smoking Cessation, Xavier Giné, Dean Karlan, Jonathan Zinman

Dartmouth Scholarship

We designed and tested a voluntary commitment product to help smokers quit smoking. The product (CARES) offered smokers a savings account in which they deposit funds for six months, after which they take a urine test for nicotine and cotinine. If they pass, their money is returned; otherwise, their money is forfeited to charity. Of smokers offered CARES, 11 percent took up, and smokers randomly offered CARES were 3 percentage points more likely to pass the 6-month test than the control group. More importantly, this effect persisted in surprise tests at 12 months, indicating that CARES produced lasting smoking cessation. …

Injury In Nevada, Michelle Chino, Jonathon Lavalley, Darlene R. Haff, Deborah A. Harris, Andrea R. Rivers

School of Public Health Faculty Research

Injury is a major threat to health and safety. In a typical day in the US, 400 people will die as the result of an injury, 7,500 will be hospitalized due to an injury, and more than 150,000 will suffer an injury severe enough to restrict activities and seek medical attention. Many of these deaths, hospitalizations, and disabling events will be the result of motor vehicle crashes. Others will result from vio­lence, falls, drowning, and poisoning – all of which are considered injuries.

The costs of injury are high. In the United States, the cost of injuries is estimated to …

Cardiovascular Risk Assessment - From Individual Risk Prediction To Estimation Of Global Risk And Change In Risk In The Population, John A. Batsis, Francisco Lopez-Jimenez

Dartmouth Scholarship

Cardiovascular disease is the most common cause of death and risk prediction formulae such as the Framingham Risk Score have been developed to easily identify patients at high risk that may require therapeutic interventions. Using cardiovascular risk formulae at a population level to estimate and compare average cardiovascular risk among groups has been recently proposed as a way to facilitate surveillance of net cardiovascular risk and target public health interventions. Risk prediction formulas may help to compare interventions that cause effects of different magnitudes and directions in several cardiovascular risk factors, because these formulas assess the net change in risk …

Latin America And The Caribbean: Assessment Of The Advances In Public Health For The Achievement Of The Millennium Development Goals, Amal K. Mitra, Gisela Rodriguez-Fernandez

Faculty Publications

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN …