Public Health Commons^™

Drug-Facilitated Sexual Assault At The University Of Arkansas, Barrett Weidman

Chemical Engineering Undergraduate Honors Theses

This work was written to fulfill two main purposes. First, to help survivors of Drug-Facilitated Sexual Assault (DFSA) process their experience by compiling the toxicological, pharmacological, and distribution of the three most used date-rape drugs. Second, to gauge the knowledge and interest of University of Arkansas students regarding drug impairments, sexual assault education, and bystander intervention training. A survey was conducted for the latter and revealed that 91.6% of students believe the University’s existing sexual assault prevention education and bystander intervention training have room for improvement. Also, 37.1% of students who have received this education report that the programming does …

Cyclic-Di-Gmp-Binding Proteins Regulate Acinetobacter Baumannii Motility, Gabriel Smith

Undergraduate Honors Theses

Acinetobacter baumannii is a prevalent nosocomial pathogen where, like many other infectious bacteria, A. baumannii is increasingly considered a multi-drug resistant pathogen. This research study was designed to find a way to affect the persistence of A. baumannii such that it can be applied to a hospital setting to prevent further nosocomial infections. One regulatory mechanism potentially used by A. baumannii to persist on hospital surfaces is through the use of the bacterial second messenger cyclic-di-GMP (c-di-GMP). This nucleotide signal is regulated in response to environmental conditions, and then activates c-di-GMP-binding proteins that induce phenotypic changes. One c-di-GMP-regulated phenotype is …

The Distribution Of Opioid Settlement Funds In Northeast Tennessee, Amani Patel

Undergraduate Honors Theses

Opioid Use Disorder is defined by the NIH as “the chronic use of opioids that causes

clinically significant distress or impairment.”1 Due to a number of factors, the overuse of opioids has become an epidemic in the United States. In recent years there have been a number of lawsuits against pharmaceutical companies and other parties who have benefitted from the proliferation of this issue. In most cases, it is up to the states or local governments who receive these funds to determine their best use. The purpose of this Thesis is to analyze the resources recommended by Ballad Health’s Community …

Pre-Migration To Post-Migration – Mental Health Problems In Unaccompanied Migrant Children From The Northern Triangle Of Central America, Paola Zuniga

Electronic Theses, Projects, and Dissertations

Background - The number of unaccompanied migrant children arriving at the U.S. southern border has significantly increased. Each year, children are forced to flee from their native countries of Guatemala, Honduras, and El Salvador. These countries form the Northern Triangle region of Central America, which is recognized as “one of the most dangerous places on earth” according to the United Nations High Commissioner for Refugees (UNHCR). Children from this region, experience significant trauma during their pre-migration, in-transit, and post-migration journey. This raises significant concerns about potential mental health problems. For this reason, access to mental health services for UMCs is …

Injection Drug Users (Idus), Blood-Borne Diseases, And The Role Of Needle Exchange Programs, Lilibeth Guzman

Electronic Theses, Projects, and Dissertations

Objective: Needle exchange programs are designed to educate injection drug users of healthy drug behaviors and establish a controlled environment to prevent blood-borne diseases through clean needles and provide treatment to reduce blood-borne diseases and become drug-free. This study observed the prevalence of blood-borne diseases among injection drug users as well as the general population. The study used publicly available data of drug use to assess differences by race/ethnicity, and participation in needle exchange programs.

Methods: Quantitative methods were used with the 2019 National Survey on Drug Use and Health. Analysis began with descriptive statistics, followed by regression analyses to …

From Zero To Thrive: A Model Of Cross-System And Cross-Sector Relational Health To Promote Early Childhood Development Across The Child-Serving Ecosystem, Alison L. Miller, Sara F. Stein, Rebeccah Sokol, Rachel Varisco, Phoebe Trout, Megan M. Julian, Julie Ribaudo, Joshua B. Kay, Natasha V. Pilkauskas, Nicole Gardner-Neblett, Todd I. Herrenkohl, Kara Zivin, Maria Muzik, Katherine L. Rosenblum

Articles

Early relational health between caregivers and children is foundational for child health and well-being. Children and caregivers are also embedded within multiple systems and sectors, or a “child-serving ecosystem”, that shapes child development. Although the COVID-19 pandemic has made this embeddedness abundantly clear, systems remain siloed and lack coordination. Fostering relational health amongst layers of this ecosystem may be a way to systematically support young children and families who are facing adversity. We integrate theory, examples, and empirical findings to develop a conceptual model informed by infant mental health and public health frameworks that illustrates how relational health across the …

Preventing Intimate Partner Violence Through Healthy Relationship Education, Jessica Naranjo Larios

Electronic Theses, Projects, and Dissertations

Background: Intimate partner violence (IPV) is a global public health crisis and is defined as behavior by a current or former partner who causes physical, sexual, or psychological harm (WHO, 2021). The age demographic experiencing the highest rates of IPV is those between 18-24 years old (Brewer et al., 2018). Since many college students fit this demographic, colleges must implement effective evidence-based IPV prevention programs. The purpose of this study was to examine the effects of healthy relationship education among college students using the KAP (Knowledge, Attitude, and Practice) model tool.

Methods: This study utilized quantitative research methods to assess …

Mental Health Burden Among College Students During Covid-19 Pandemic: A Cross-Sectional Study, Jeffrey Bao Truong

Electronic Theses, Projects, and Dissertations

Background: The COVID-19 pandemic is a significant public health issue and has negatively burdened the general population’s health, though assessment among vulnerable groups remain limited. The present study aimed to evaluate the mental health burden of the COVID-19 pandemic among college students.

Method:This study utilized a cross-sectional approach. Courses across multiple departments were used to collect data in order to ensure a diversity of majors. All statistical analyses were conducted using SPSS version 28 with p <.05 denoting significance.

Results: A total of 98 study participants were included in analyses. Among study participants, 32%reported feeling their mental health worsened due to COVID-19 …

Burden Of Food Insecurity Among College Students: A Cross-Sectional Study During The Covid-19 Pandemic, Saba Sami

Electronic Theses, Projects, and Dissertations

Background: Food insecurity is lack of access to proper nutrition for an individual to obtain a healthy lifestyle. The goal of this research is to determine the frequency of food insecurity among college students at a four-year college institution during COVID-19 pandemic in association to mental and physical health status.

Methods: This study was conducted among college students using cross-sectional study method. All data were collection virtually and kept anonymous. All statistical analyses were conducted using SPSS version 28 with (p<.05), denoting significance.

Results: In the study there were a total of 98 participants who were being analyzed. All the participants were …

Sleep Health And Academic Performance During The Covid-19 Pandemic: A Cross-Sectional Analysis, Rushil Gumasana

Electronic Theses, Projects, and Dissertations

Background: Sleep health is an important public health topic that is often overlooked by college students who are trying to juggle between school, work, and social life. Sleep is seen as a luxury and as a result, most often sacrificed for other activities. The purpose of this thesis is to make a connection between the factors that lead to poor sleep quality and its influence on academic performance.

Methods:The study utilized the cross-sectional approach to evaluate sleep health and identify the relationship that exists with academic performance among college students. All data were collected virtually and kept anonymous. All …

Sexual Health Services During The Covid-19 Pandemic, Thomas C. Roland

Electronic Theses, Projects, and Dissertations

Background: The COVID-19 pandemic created a unique situation for healthcare providers worldwide. The highly infectious nature of the COVID-19 virus required many countries to impose strict lockdowns and limit access to select health services such as sexual health services. The present study was designed to explore the role of the COVID-19 pandemic on healthcare services, specifically sexual health services.

Methods: A cross- sectional study design was selected to evaluate the burden of the pandemic on sexual health services. Participants responses were obtained anonymously using an online survey. Data was analyzed through descriptive statistics and bivariate analyses using IBM SPSS version …

The Effectiveness Of Best Management Practices Implemented At Lake Gregory, Crestline, Ca, Devin Darrow

Electronic Theses, Projects, and Dissertations

Water quality deterioration of recreational surface waters from excess pollution inputs is a significant concern for the health of the public and aquatic ecosystem. This study will examine the effectiveness of Best Management Practices (BMPs) in reducing pollution inputs into Lake Gregory, Crestline, CA. The effectiveness of the BMPs was examined by testing for water quality parameters including dissolved oxygen, temperature, pH, conductivity, turbidity, nitrate (NO3-), ammonium (NH4+), total coliform, and Escherichia coli on weekly to bi-weekly basis for a period of 1 year. A statistical analysis involving descriptive statistics, Pearson’s correlation, the Efficient Ratios (ER) and Percent Removal Rates …

Pandemic And Sleep Health: A Cross-Sectional Analysis Among College Students, Jasmine Mitchell

Electronic Theses, Projects, and Dissertations

Background: The purpose of this study seeks to address sleep health among college students during the COVID-19 pandemic.

Methods: The study used a cross-sectional design. Data in this study were collected from college students through a virtual survey at a public university in Southern California. Data was collected with SPSS version 28 to conduct crosstabs and chi-square, as well as descriptive statistics.

Results: The study presented key findings that call attention to college students and poor sleep health. Results showed most of the participants (62.8%) reported getting less than 7 hours of sleep on an average school night. 45.7% of …

Relationship Between University Students’ Demographics And Drinking & Driving Behaviors, Carlos Razo

Electronic Theses, Projects, and Dissertations

In the U.S. there continues to be public health concerns behind alcohol related motor-vehicle accidents, as the yearly death continues to remain high. University students are a population of interest, as the age group found in these institutions closely matches the age range of most alcohol related accidents. University students already experience health related problems with their drinking & driving behaviors. Literature supports that university students are more susceptible to drinking and driving when compared to those that don’t attend. This study focused on determining whether a relationship existed between university demographics (age, gender, and student classification) and their drinking …

Promoting Health Equity Among Racial And Ethnic Minorities During And After The Covid-19 Pandemic, Alexandra Viramontes, Deserry Salgado

Electronic Theses, Projects, and Dissertations

Racial and ethnic minorities experience disproportionate health outcomes during a pandemic, yet preparedness plans have failed to address the social determinants of health that produce the most severe impact. By examining social workers’ perspectives on the health disparities faced by racial and ethnic minorities during the COVID-19 pandemic, this study provides insight into the ways in which services can be improved in a future health crisis. In this exploratory study, a qualitative approach was utilized where social workers were asked to participate in interviews consisting of open-ended questions. The qualitative data was obtained in the form of interview transcripts, which …

Misinformation And Vaccine Hesitancy Determinants: The Significance Of Framed Public Health Messaging, Alexandra I. Todd

Capstone Experience: Master of Public Health

In 2020, the SARS-CoV-2 (COVID19) outbreak effectively disrupted worldwide operation for months, leading to tremendous economic loss and adverse health outcomes. While countries grappled to control the virus and scientists worked around the clock to deliver a vaccine in record time, a pubic health communication crisis emerged. The spread of false and misleading information, also known as misinformation, has proved to be a barrier in the fight against COVID19 and its vaccination effort. Many factors including the rise of social media, distrust of government, polarization of news sources, and fragmented media have created an environment susceptible to misinformation. Utilized correctly, …

Financial Analysis Of New Medicare And Medicaid Guidelines, Reimbursement Rates, And Increased Enrollment On Four Nebraska Clinics, Jamilah J. Abdul-Hakim

Capstone Experience: Master of Public Health

Government health insurance plans such as Medicaid and Medicare were created with the intention of providing elderly, low-income, or disabled citizens with affordable and quality health insurance through government-contracted providers (Baicker et al., 2013). Medicare is a government health insurance program that provides healthcare to United States citizens 65 years and older, regardless of their income or past medical history. Medicaid was implemented as an assistance program to provide health insurance for low-income Americans and their families. Medicaid is administered by each state independently, which creates variation in reimbursement rates, services, and structure. (Grabowski, 2007).

Providers accepting Medicare and Medicaid …

A Survey And Analysis Of Educational Materials Addressing The Health Consequences Of Drinking Nitrate Contaminated Water In Medical Clinics Located In The Most At-Risk Areas Of Nebraska: Are Healthcare Providers Equipped To Protect And Educate Their Patients?, Laura Nagengast

Capstone Experience: Master of Public Health

Background: Eighty five percent of Nebraskans rely heavily on groundwater sources, including private wells, as their primary source of drinking water. Nitrate is one of the most common chemicals found in private well water. Numerous studies demonstrated the serious human health consequences from prolonged nitrate exposure. Therefore, due to the potential health risks, this project aimed to identify and evaluate the existing knowledge and awareness among healthcare providers as well as the educational materials in medical clinics in Nebraska related to health effects of drinking nitrate contaminated water.

Methods: An 8 multiple choice question survey was developed using Microsoft Forms. …

Evaluating First Responder Personal Preparedness In Douglas County, Nebraska's Volunteer Fire And Emergency Medicine Service, Kylie Johnson

Capstone Experience: Master of Public Health

In disaster response, it is essential for first responders to focus on their disaster role. Lack of personal preparedness at home could hinder a responder’s ability to focus their attention on their response role (13). Personal conflict, such as that caused between family duties and response duties, in a disaster can be mitigated through several means. One mitigation tactic is preparedness education and support offered by the responder’s organization. While the importance of responder personal preparedness cannot be understated, there is a lack of baseline data on the topic related to Nebraska responders.

To assess the state of first responder …

Weight Gain Trajectory Over Five Years For Adult Primary Care Patients In Nebraska, Elizabeth M. Morris

Capstone Experience: Master of Public Health

INTRODUCTION: The continued rise in the prevalence of adult obesity in the United States is a public health concern. Several studies have identified the increasing rates of obesity, its impacts, and the factors leading to obesity. Some researchers have made obesity prevalence projections at the national and state levels. This study aims to fill the critical gap in real-time weight data trends among primary care adult patients in Nebraska. The main goal of this study is to determine and analyze the weight trajectory of adults in Nebraska over the past five years and determine if the trends vary among age …

Assessing Facilitators And Barriers To Enrolling In Cardiac Rehab, Michaela R. Geiser

Capstone Experience: Master of Public Health

Abstract: Heart disease has been a leading cause of death since the early 1900s (Heron & Anderson, 2016). Americans are at higher risk for heart disease if they have high blood pressure, high cholesterol, are overweight, inactive, and smoke, among other risk factors (CDC, 2019). If a person already has heart disease or has had a cardiac intervention (such as a stent), they may be referred to a local cardiac rehab program. Bryan Health in Lincoln, NE, currently offers two methods of delivering cardiac rehab: in-person or home-based. Research has not yet been done to assess enrollment facilitators and barriers …

Systematic Literature Review: Culturally Appropriate Approach To Advance Care Planning For Ponca Tribe Elders, Priscila Soto Prado

Capstone Experience: Master of Public Health

Advance Care Planning is understudied in Native American and Alaskan Natives communities. There is a strong need for further research on culturally adapting advance care planning (ACP) for indigenous communities. Specifically, for the Ponca Tribe, culturally adapting the ACP used would ideally increase the acceptance of ACP in that community. This systematic literature resulted in identifying four themes other tribes have utilized to culturally adapt their ACP, advance directive, palliative and/or end-of-life processes in an effort to increase completion rates. The four themes were involving the elders with the adaptation process, increasing education efforts and awareness of ACP and ADs, …

A Quantitative Job Satisfaction Comparison Between Certified Nursing Assistants (Cnas) Providing Care In Patients’ Homes Versus In Long-Term Care (Ltc) Facilities In The Omaha Metropolitan Area, Rusheena Shah

Capstone Experience: Master of Public Health

This capstone project looks at overall job satisfaction comparison between two groups of Certified Nursing Assistants (CNAs) – CNAs who provide home care in patients’ homes and CNAs who provide care in Long-term Care (LTC) facilities in the Omaha Metropolitan Area. In this quantitative study, a survey was sent to CNAs who provide home care to patients and CNAs who provide patient care at different nursing home facilities in the Omaha area. Prior research has indicated that even though CNAs perform similar job duties irrespective of the work environment; they experience varying degrees of job satisfaction which could be attributed …

Developing A Curriculum To Combat Loneliness As A Public Health Concern In Businesses, Sophia Yelkin

Capstone Experience: Master of Public Health

Loneliness has been considered a public health epidemic affecting people across the world. Elderly populations have historically been considered most at risk for loneliness, but it is becoming evident that loneliness is not so selective. Younger generations show more signs and symptoms of loneliness than older generations. This often overlooked condition is attributable to decreased mental and physical health and can weaken performance in the workplace.

This capstone project creates a concise curriculum addressing loneliness for dissemination in the workplace, ensuring appropriate health literacy for the priority population. Understanding the pervasive nature of loneliness, identifying symptoms, and methods to counteract …

Local Public Health Legal Landscape Report, Christina Hitz

Capstone Experience: Master of Public Health

This report provides a framework for understanding and examining local public health authority and implications of proposed legislative changes, specifically whether a shift is occurring in public health authority from the executive to the legislative branch. It compares the public health governance and legal infrastructure of states making a shift in 2021 relative to Nebraska’s current and proposed public health infrastructure and provides a synopsis of the legal context for and the scope of local public health authority currently in Nebraska. Three resources were used to create two tables to compare both states with legislative changes in 2021 indicating a …

A Comprehensive Literature Review Of Recruitment And Retention Strategies For Primary Care Providers In Rural Communities, Christian Folken

Capstone Experience: Master of Public Health

Workforce trends within the United States indicate a growing crisis in the availability and distribution of primary care providers. Rural communities have been disproportionately affected by the lack of primary care providers. The gap in available primary care services in rural areas severely affects the population health outcomes of these communities. There is a critical need for rural healthcare systems to effectively understand and implement recruitment and retention strategies of primary care providers to meet the needs of their patients and community. The goal of this paper is to provide a centralized resource of evidence-based strategies regarding the recruitment and …

Exploring Factors Related To Cancer Recurrence In Nebraska, Zenghan Tong

Capstone Experience: Master of Public Health

Currently, the studies of cancer burden are focused on the incidence, mortality, and survival of cancer. Due to the early detection and advancement of therapies, more patients can live much longer after a cancer diagnosis. Health care providers and patients want to know more about cancer recurrence, which can significantly impact cancer survivors’ quality of life. At this moment, the cancer recurrence studies are clinically based on specific treatments of particular cancers and are usually limited to small and selected populations. This study utilized the population-based cancer registry data between 1996-2015 to examine the cancer recurrence status in Nebraska. The …

A Walk In Two Worlds: An Indigenous Health Research Mentorship Model Developed From The Experiences Of Mentors And Mentees In A Cancer Research Education Program Aimed At Increasing Representation Of American Indians/Alaska Natives In Cancer Research And Healthcare Professions, Kiana Borengasser, Aislinn C. Rookwood, Joyce C. Solheim, Maurice Godfrey, Karen Taraszka Hastings, Keyonna King, Hannah Robbins, Mariah Abney, Rudy Smith Jr., Liliana Tamayo, Regina Emily Robbins

Capstone Experience: Master of Public Health

The National Cancer Institute promotes workforce development programs that aim to increase representation of American Indian/Alaska Natives in health science and research careers. One such program, Youth Enjoy Science at the University of Nebraska Medical Center, has employed American Indian/Alaska Native youth in mentored cancer research internships from 2017 to 2022. The primary purpose of this study was to examine mentor and mentee experiences of participation in Youth Enjoy Science research education internships to learn from their stories. We conducted semi-structured interviews with current and former Youth Enjoy Science mentees (n=8) and mentors (n=8). We analyzed and collectively re-storied the …

The Epidemiology Of Extended Spectrum Beta-Lactamase-Producing Enterobacterales In Nebraska, 2018 – 2021, Axel A. Vazquez Deida

Capstone Experience: Master of Public Health

Background: Extended spectrum beta-lactamase (ESBL)-producing Enterobacterales are considered a serious public health threat by the United States Centers for Disease Control and Prevention. However, surveillance of ESBL-producing Enterobacterales is currently limited to select states and the epidemiology of these antibiotic-resistant bacteria in Nebraska is still not well understood.

Objective: To describe the incidence of ESBL-producing Enterobacterales across local health department (LHD)-jurisdictions as well as at the state-level over time and assess population-specific factors associated with infection or colonization with these pathogens in Nebraska.

Methods: A retrospective, cross-sectional analysis of public health surveillance data reported to the Nebraska Department of …

Atrazine Levels In Rural Nebraska Counties And Parkinson's Disease, Muhammad Zahid

Capstone Experience: Master of Public Health

Parkinson's disease (PD) is a multifactorial disorder, connecting both genetic susceptibility and environmental risk factors. Several epidemiological and experimental studies support the evidence that pesticides exposure is positively associated with enhancing neurodegenerative diseases. The high amount of atrazine used in Nebraska and increased PD cases led us to evaluate the association between the long-lived water-soluble pesticide atrazine and PD in Nebraska counties. A person's exposure to atrazine may come from inhalation, dermal absorption, and ingestion. Three types of atrazine data covering 1992 to 2017 were used for this study: applied atrazine, atrazine in surface water, and atrazine in groundwater. In …