Public Health Commons^™

Factors Associated With The Dental Attendance Among Elderly Patients In Faculty Of Dentistry, Chulalongkorn University: A Secondary Data Analysis, Narongrit Nampikul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Objective: To identify the predisposing factors, enabling factors, and need factors related to dental attendance of elderly patients at dental hospitals, Faculty of Dentistry, Chulalongkorn University using the conceptual framework of the Anderson model. Materials and methods: this study was a secondary analysis study. The participants were 402 elderly patients who were both males and females. Data was collected from telephone questionnaires and dental records of dental hospitals. Faculty of Dentistry Chulalongkorn University. Data were analyzed using chi-square statistics and binary logistic regression analysis. Results: age was the only predisposing factor that was statistically significantly associated with dental attendance among …

Medical Service Utilization Among International Tourists In Bangkok, Thailand, Ken Lin

Chulalongkorn University Theses and Dissertations (Chula ETD)

Medical service utilization is an important concern for international travelers during their trip, especially after the serious COVID-19 pandemic worldwide. In this study, we aim to investigate the medical service utilization and satisfaction among international tourist in Bangkok after the country reopening for international tourist in October 2022.The international tourist in Bangkok was interviewed using the validated questionnaire related to travel information, medical services utilization, and satisfaction. Google form was sent out through social medica platforms, as well as face-to-face interviews at tourist gathering places. In total, 422 participants answered the questionnaire. Taiwan, China, Malaysia, Japan, and South Korea were …

Treatment-Seeking Time Of Patients With Malaria At Private General Practitioners In Myanmar: A Secondary Data Analysis Of Routine Surveillance Data (2018-2022), Pyi Thein Khine

Chulalongkorn University Theses and Dissertations (Chula ETD)

Malaria is a significant global health burden, and prompt treatment is essential for optimum results. Due to their accessibility and convenience, populations in high-risk areas of malaria commonly seek treatment in the private health sector. This study aimed to investigate the factors associated with the delayed treatment-seeking time of patients with malaria at private general practitioners in Myanmar. The secondary data analysis of routine surveillance data included a sample of 4,939 patients with malaria who sought treatment from private quality general practitioners under the Myanmar Medical Association Malaria Project. Nearly 80% of patients sought treatment later than 24 hours and …

Dental Health Expenditure And Associated Factors Among Elderly Patients In Faculty Of Dentistry, Chulalaongkorn University, Rawitsara Suwannimit

Chulalongkorn University Theses and Dissertations (Chula ETD)

The affordability has been one of the barriers to access dental care for elderly. However, In Thailand and among the elderly, there were very few studies about dental health expenditure and the factors related to it. This study aimed to investigate and identify the factors that are related to dental health expenditure for patients who are over 60 years old and receive treatment at the Faculty of Dentistry, Chulalongkorn University. This study used secondary data from an initial survey and the Medical Record System for oral treatments, among the patients who were over 60 years and received treatments at the …

The Utilization Of Physical Literacy To Understand Physical Activity In Individuals With A History Of Anterior Cruciate Ligament Reconstruction, Rachel Renee Kleis

Theses and Dissertations--Rehabilitation Sciences

Injury to the anterior cruciate ligament (ACL) is common in physically active populations. Anterior cruciate ligament reconstruction (ACLR) is commonly performed after injury in order to restore joint stability and knee function and return patients to desired levels of physical activity. However, not everyone will return to their pre-injury levels of sport after surgery and recent evidence reveals that individuals with a history of ACLR are less likely to meet the recommended physical activity guidelines. Specifically, previous literature has reported that individuals with a history of ACLR take fewer daily steps and participate in less moderate-to-vigorous physical activity compared to …

Implementation Of Physical Activity In Kentucky Public Schools: From Theory To Policy, Nancy Kearns

Theses and Dissertations--Rehabilitation Sciences

Physical activity in schools improves academic performance and fitness measures in children. However, state policy supporting implementation of physical activity remains poor. Identifying specific barriers to implementing physical activity minutes in Kentucky public schools is pivotal in preserving the cognitive and physical health of our children. This is of particular interest as physical activity minutes remain low despite the positive effects of exercise on cognition. The purpose of this dissertation is to provide policymakers and school administrators a method of identifying current policies, attitudes and infrastructure that inhibit the implementation of physical activity minutes in public schools. Thus, the findings, …

Stemming The Shadow Pandemic: Integrating Sociolegal Services In Contact Tracing And Beyond, Medha D. Makhlouf

Faculty Scholarly Works

The COVID-19 pandemic has shed light on the challenges of complying with public health guidance to isolate or quarantine without access to adequate income, housing, food, and other resources. When people cannot safely isolate or quarantine during an outbreak of infectious disease, a critical public health strategy fails. This article proposes integrating sociolegal needs screening and services into contact tracing as a way to mitigate public health harms and pandemic-related health inequities.

A Game Theoretical Model Of Radiological Terrorism Defense, Shraddha Rane, Jason Timothy Harris

International Journal of Nuclear Security

Radiological dispersal devices (RDD) pose a threat to the United States. Healthcare facilities housing high-risk radioactive materials and devices are potentially easy targets for unauthorized access and are vulnerable to malevolent acts of theft or sabotage. The three most attractive candidates for use in RDD considered in this study are: ⁶⁰Co (radiosurgery devices), ¹³⁷Cs (blood irradiators) and ¹⁹²Ir (brachytherapy high dose radiation device). The threat posed by RDDs has led to evaluating the security risk of radioactive materials and defending against attacks. The concepts of risk analysis used in conjunction with game theory lay the foundations of …

Nuclear Security Awareness Survey At A University, Marcia P. Robinson, Naomi German, Destiny B. White, Shraddha V. Rane, Jason Timothy Harris

International Journal of Nuclear Security

The concept of assessing safety culture in an organization emerged with its application at the nuclear power industry and has expanded since then. An assessment of nuclear security, on the contrary, is still under-developed, especially at non-nuclear facilities, such as academic institutions and medical facilities. To identify the level of the awareness and understanding of credible nuclear and radiological threats, response preparedness, security culture, and the integrity of nuclear security systems among non-radioactive material users at a university setting; a campus-wide survey was deployed. A total of 3,336 non-radioactive material users, including students, faculty, and staff participated in the survey. …

Project Spraoi: The Implementation And Outcomes Of A Process Evaluation Of A School-Based Health Promotion Intervention, Yvonne Larrissa O’Byrne

Theses

Large multi-site school-based interventions are challenging to implement and difficult to evaluate due to the complex adaptive nature of schools as a research setting. This study focused on implementing a comprehensive process evaluation of a multicomponent primary school-based health promotion called Project Spraoi (PS), alongside intervention delivery, to aid the translation of outcomes and understand the moderating role of contextual factors on intervention delivery. PS is led by a physical activity (PA) specialist known as an Energizer and aims to improve children’s PA levels and reduce sedentary time by delivering 20 minutes extra daily moderate to vigorous PA (MVPA) during …

Healing Sanctuary, Kammy Downs

Master's Theses or Doctor of Nursing Practice

The natural world has hidden wisdom and resources that are disregarded as we misuse our responsibility to care for them. The benefits of being in tune with nature have been traded for a culture that manipulates nature on the altar of expediency, waste, and unquenchable desire. Healing Sanctuary presents a duality. My work speaks about the relationship between the seen and unseen, represented by ten larger-than-life drawings of medicinal herbal plants that have had a profound physical healing effect on me. At the same time, plants, roots, and seeds create visceral metaphors for mental health. Our accomplishments, outlook on life, …

Disparities In Uptake Of The Primary Sars-Cov-2 Vaccine Series In A Southern Indiana Vaccine Clinic, Cassidy Padgett

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

Objective: COVID-19 is a potentially severe respiratory disease caused by infection from the SARS-CoV-2 virus. COVID-19 was first discovered in 2019 and vaccines against the virus began development in early 2020. COVID-19 vaccines are effective at preventing severe illness, hospitalizations, and death from SARS-CoV-2 infection. Clark Memorial Health is a 236-bed community health system located in southern Indiana. As one of the first four hospitals in the state of Indiana to receive the Pfizer-BioNTech’s COVID-19 vaccine in December of 2020, this health system led the area in vaccine administration. Prior to the emergency use authorization (EUA) of the COVID-19 vaccines, …

Examining The Association Between Cervical Cancer Screenings, Health Care Access, And Socio-Demographics Among Women Of Urban/Rural Status In Kentucky, Madison Penix

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

Background: This study focuses on cervical cancer screening rates (e.g., Pap testing) among women of urban/rural status in Kentucky. Specifically, this study’s primary objective is to examine the association between cervical cancer screening rates and health care access among the women of interest. Secondarily, this study aims to identify which socio-demographic variables impact cervical cancer screening rates and health care access. The purpose of doing so is to better understand what disparities and barriers might be contributing to the suboptimal screening rates observed throughout Kentucky.

Methods: An empirical analysis utilizing secondary data from the 2020 Behavioral Risk Factor Surveillance Survey …

Implementation Of Farmers Markets In Bell County, Kentucky, Rachael Schmetzer

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

This proposal addresses the link between food insecurity and obesity through the implementation of farmers markets in Bell County, Kentucky as a way to increase access and consumption of fruits and vegetables in this rural, low-income community.

Identifying Factors Associated With Syringe Reuse Among People Who Inject Drugs (Pwid) In Appalachia Kentucky, Grayson Keith Fuller

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

Aim: Syringe reuse contributes to the spread of infectious diseases. The purpose of this study is to identify factors associated with syringe reuse among people who inject drugs (PWID) in Kentucky.

Methods: PWID (n=238) completed interviewer-administered questionnaires to collect data on syringe reuse and demographic, behavioral, and clinical characteristics. Negative log binomial regression was used to model the associations.

Results: On average, people reused each syringe 9.3 times (median: 3; IQR: 2-10, range 1-95). Syringe reuse was higher among men [aOR=1.386; 95% CI: 1.041-1.845] and those who injected methamphetamine [aOR=2.122; 95% CI: 1.445-3.116]. Reuse was also higher among those who …

Effects Of Covid Prevention And Control Policies In Kentucky Schools During The Fall 2020 Semester, Ciaran Allen-Guy

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

Schools are reopening or have already reopened while implementing precautions intended to reduce the transmission of COVID-19. However, evidence on the effects of these strategies or their benefits relative to each other in the school environment is indirect or lacking. This study investigated the effects of some of these strategies as employed by Kentucky schools in the fall 2020 semester using a linear mixed effects regression model using publicly available fall 2020 school incidence data, survey data from school staff, and Kentucky Department of Education data on school faculty and primary enrollment.

Increasing Physical Activity Rates Among High School Girls In Jefferson County, Kentucky, Haley Copeland

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

Obesity rates across the U.S. are increasing, especially among adolescent females. Physical activity rates have been associated with obesity and many related health outcomes. Regular physical activity can help adolescents improve their cardiorespiratory fitness, build strong bones, control their weight, and reduce depression ¹. It can also help reduce the risk of developing health conditions like heart disease, cancer, high blood pressure, osteoporosis, type II diabetes, and obesity ¹. Thus, physical activity among youth provides a risk factor to target, with the intention of eventually decreasing obesity rates.

Recommended physical education class CDC guidelines are not being met …

An Analysis Of The Differences In Health Outcomes And Socioeconomic Factors Between Veteran Smokers And Non-Smokers In Tobacco-Growing States, Jacob Hauser

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

Tobacco usage still remains the single most preventable cause of disease, disability, and death in the United States. Service members and veterans, especially those residing in tobacco-growing states, face higher levels of societal pressure to take up the habit compared to their civilian counterparts. This research investigates why this is the case, the differences in health outcomes, and the differences in socioeconomic factors between the veteran smoking and non-smoking populations before making policy recommendations to policymakers and stakeholders to address this problem.

Covid-19 Mitigation Strategies School Staff In Indiana, Kentucky, And Ohio, Luu Le

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

Abstract

Background: This cross-sectional study aims to identify the difference in COVID-19 mitigation strategies implementation and adherence among elementary, middle, and high schools in Indiana, Ohio, and Kentucky, based on data from the School Staff Health and Wellness Study research at the University of Kentucky in 2020.

Methods: The sample size of the study was 6,794 participants who work at elementary, middle, or high schools in Indiana, Ohio, and Kentucky. Complete case analyses were performed, which included observation with no missingness in variables (N = 5,971). Descriptive statistics were generated, including a table indicating the implementation of COVID-19 mitigation strategies …

Frequency And Type Of Diabetes Screening Tests In A Sample Of Women With Polycystic Ovarian Syndrome: A Descriptive Study, Jacklyn Vollmer

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

Introduction: Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects 6-12% of United States women of reproductive age. Women with PCOS are at an increased risk of developing type 2 diabetes and fall into high-risk groups for screening guidelines put out by the American College of Obstetricians and Gynecologists (ACOG). Guidelines further suggest that an oral glucose tolerance test (OGTT) be used for diabetes screening in women with PCOS as opposed to an A1C or fasting plasma glucose test. The purpose of this study is to examine rates and type of diabetes screening used among a sample of women …

An Analysis Of The Association Between Cognitive Decline And Geographic Residence Among Women Over 65 In The Southeastern United States, Christine Invergo

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

Abstract

Introduction: The United States is an increasingly aging nation, and aging increases the risk of cognitive decline. Information on the relationship between cognitive decline and geographic residence in the U.S. is limited. Available evidence suggests that rural residents tend to suffer persistent disadvantages in cognitive functioning when compared to sociodemographically similar urban peers. This analysis focused on women over 65 years of age living in the southeastern U.S. The primary objective of this analysis was to determine if there was a significant association between geographic residence and cognitive decline. A secondary objective was to explore variables of interest that …

An Analysis Of Rural-Urban Differences In Health Care Access Among Women In The United States, Ellery Denny

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

The purpose of this project was to examine the relationship between women’s health care access and rural and urban America. Extensive review of existing literature was completed and showed that the United States ranked last out of 11 high-income countries in regard to access to care, administrative efficiency, equity, and health care outcomes (Schneider, 2021). Additionally, women in the United States faced heightened financial barriers to health care that men do not, and also faced unique disadvantages that resulted in reduced utilization of care (Cameron, 2010, p. 1649).

Results showed that rural women were significantly more likely to have one …

Comparing Governmental Communication About Covid-19 Layered Protection Strategies In Taiwan, Kenya, And The United States: A Mixed-Method Analysis Of National Health Agency Websites, Cynthia Mofunanya

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

COVID-19 is a novel coronavirus caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It can result in severe respiratory damage. Different countries have recommended different combinations of protections during the COVID-19 pandemic. Various combinations of mitigation strategies or “layered protections” against coronavirus have also been communicated differently across nations. This mixed-methods content analysis seeks to compare COVID-19 mitigation information on three national health agency websites for Taiwan, Kenya, and the United States. Availability and navigability of information was examined for each mitigation strategy. The Web Resource Rating tool was used to assess the quality of the information about …

An Analysis Of The Association Between Cognitive Decline And Geographic Residence Among Women Over 65 In The Southeastern United States, Christine Invergo

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

Abstract

Introduction: The United States is an increasingly aging nation, and aging increases the risk of cognitive decline. Information on the relationship between cognitive decline and geographic residence in the U.S. is limited. Available evidence suggests that rural residents tend to suffer persistent disadvantages in cognitive functioning when compared to sociodemographically similar urban peers. This analysis focused on women over 65 years of age living in the southeastern U.S. The primary objective of this analysis was to determine if there was a significant association between geographic residence and cognitive decline. A secondary objective was to explore variables of interest that …

Youth Who Run Away From Out-Of-Home Care In Wisconsin, 2010-2020, Sydney Shafer

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

A sample of 27,599 youth 5-17 years old who entered the child welfare system in Wisconsin between 2010 and 2020 were analyzed to examine differences in those who run away from out-of-home care and those who do not. Risk factors analyzed included age at entry into the system and measures of sexual abuse, physical abuse, emotional abuse, neglect, witness to family violence, placement restrictiveness, youth home county socioeconomic disadvantage and urbanicity, and distance from placement to home. Analyses were presented in gender- and race- specific strata. In this sample, 2434 (8.8%) ran away from their out-of-home care placement at least …

Disparities In Access To Chemotherapy Among Kentucky Stage Iv Non-Small Cell Lung Cancer Patients, Joshua Brown

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

OBJECTIVE: This population-based retrospective cohort study examines the association of sociodemographic disparities with the receipt of chemotherapy among patients with metastatic non-small cell lung cancer in the Commonwealth of Kentucky in the precision oncology and immunotherapy era.

METHODS: Kentucky Cancer Registry data from 2010 through 2017 was analyzed using univariate, bivariate, unadjusted, and adjusted multivariate regressions to assess disparities in our population (N = 9490).

RESULTS:We found no significant difference in receipt of chemotherapy between sexes (OR 0.99, P=0.90) nor races (OR 1.12, P=0.22). Patients diagnosed in an Appalachia county were significantly less likely to receive chemotherapy (OR 0.71, …

Demographic Characteristics Of Individuals Needing Treatment For Substance Use Disorder, Amber Hill

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

Introduction:

While multiple options are available for the treatment of substance use disorders (SUD), 9% of individuals reported needing treatment within the last year for illicit drug or alcohol use, according to the 2020 National Survey for Drug Use and Health (NSDUH). Despite concerns about widespread disparities in healthcare access and outcomes, there are limited current data regarding demographic characteristics of individuals that need treatment. It is crucial to identify these characteristics from population-based data in order to develop and implement targeted public health interventions.

Methods:

The NSDUH is an annual, nationwide survey that collects data about substance use and …

Recharge Moments, Scott Keel

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

Abstract Title: Recharge Moments

Background: Recent articles from the CDC and other healthcare agencies have demonstrated the detrimental effects that the COVID-19 pandemic is having on the physical and mental health of the healthcare workforce. Unfortunately, they were less informative in regard to those working for local public health departments. Pre-pandemic and concurrent publications on mindfulness-based interventions have demonstrated the positive and protective effects mindfulness-based interventions can have on burnout prevention and resilience promotion. To gain a better understanding of how the current pandemic might be affecting the public health workforce and to assess whether mindfulness-based interventions would be helpful …

The Impact On Recovery Capital Following High-Intensity Exercise Adjuvant Therapy In Opioid Addiction Treatment, Aaron M. Macdonald

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

OBJECTIVE: The Counseling Center (TCC), a substance abuse disorder (SUD) recovery facility located in Portsmouth, Ohio, began investigating alternative treatment methods that may improve long-term recovery rates through increased recovery capital (RC). RC takes into account numerous social and physical variables during the recovery phase of SUD and evidence shows a higher RC can lead to better recovery outcomes. TCC partnered with Portsmouth Spartan Kettlebell Club (PSKC), a nearby CrossFit (CF) affiliated gym, and created a partnership that allowed clients at TCC to participate in a guided CF program. The purpose of this study was to examine how this program, …

Policy Approaches To Address Childhood Obesity, Omoadoni Roseline Obielodan

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

Background: Childhood obesity continues to be a serious international public health concern. Unfortunately, there are limited treatment options for obesity. One notable intervention option is the University of Kentucky (UK) Pediatric high BMI clinic intervention for childhood obesity. The Clinic provides intervention for childhood obesity through healthy lifestyle habits. This intervention has been reported to be effective.

Even though there is evidence that public health policies that promote healthy behaviors would substantially reduce and prevent the alarming prevalence of childhood obesity, the state of Kentucky does not have well-established practical policies that promote healthy behaviors in children. Studies have shown …