Public Health Commons^™

Healthy, Fit, & Strong: A Parent-Child Physical Activity Program For Families With Obese And Overweight Adolescents, Patrick Maloney

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

Over 20% of Kentucky children between the ages of 10-17 are obese, the third highest prevalence in the nation. The Healthy, Fit, & Strong Program works with children with a BMI above the 85th percentile and their parents to improve behaviors related to physical activity (PA) and nutrition. The intervention is a 12-week program which features tri-weekly physical activity sessions and nutrition classes. Both children and parents participate in activities in order to build knowledge and confidence related to healthy behaviors. The goal of this intervention is to improve upon baseline physical activity levels and diet as well as to …

Alcohol Excise Taxes And Their Effects On The Community, Christopher R. Watts

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

Objectives: This study examines the association of an additional excise tax on alcoholic beverages in Georgetown, Kentucky with alcohol-related motor vehicle accidents. Evaluate the additional benefits of the excise tax on the community of Georgetown, Kentucky.

Methods: Using an interrupted time series design, this study compares alcohol-related crash statistics from two similar cities based on 126 months of data from the Kentucky State Police. Analyses included linear regression and Poisson models to evaluate the data in each city to determine population-wide results.

Results: Alcohol-related motor vehicle crashes immediately declined (-12.5%) in Georgetown following the implementation of the excise tax and …

Mitigating Opioid Related Healthcare Use In Kentucky: An Assessment Of The Impact Of Kentucky Revised Statute (Krs) Changes To Opioid Prescribing On Opioid Related Prescribing And Healthcare Utilization, Drew Speer

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

The opioid epidemic has impacted few other places more than the state of Kentucky. In 2018, data from the Centers of Disease Control and Prevention (CDC) and the National Institute on Drug Abuse (NIDA) ranked Kentucky as being in the top ten for rate of drug overdose deaths and opioid-involved overdose deaths per 100,000 persons.^1,2 These rankings exist even though prescription opioid dispensing rates have fallen from 102.6 per 100 persons in 2015 to 72.3 per 100 persons in 2019.³ Aligning with this trend, while research shows this problem began with prescription opioids in the late 1990’s, it …

Risk Factors Of Carbapenem-Resistant Enterobacteriaceae Acquisition Among Adult Intensive Care Unit Patients At A Kentucky Academic Medical Center, Jason Eric Wilson, Jason Wilson

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

Background: This study aimed to identify risk factors of carbapenem-resistant Enterobacteriaceae (CRE) acquisition among adult intensive care unit (ICU) patients at a Kentucky academic medical center and to evaluate sink drains as a possible environmental reservoir of carbapenem-resistant organism (CRO) transmission.

Methods: A retrospective cohort study was conducted from October 1, 2013 through October 31, 2016. Intensive care unit patients were screened for CRE at admission and weekly until discharge. Cases were defined as patients who tested positive for CRE on ICU admission day 3 or greater. Sink drains were sampled for CROs in selected units from January 2018 through …

Assessment Of The University Of Kentucky's Nutrition Education Program's Smarter Lunchrooms Pilot Plate Waste Project In Three Kentucky Schools, Natalie Jones

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

School-based approaches utilizing policy, systems, and environmental strategies are needed to address the complex factors driving childhood obesity. The purpose of this pilot study is to implement Smarter Lunchroom strategies in three participating Kentucky middle schools in 2019 and then assess two outcomes: (1) determine the impact of the intervention on fruit and vegetable purchases and waste, and (2) determine how purchases or waste varied by interventions selected for each setting. After the 6-week intervention, combined we found no statistical significant increases in fruit and vegetable purchasing from pre to post-intervention. No statistical significant decreases in fruit and vegetable plate …

An Evaluation Of Injurious Falls And Fall-Risk-Increasing-Drug (Frid) Prescribing Behaviors In A Nationally Representative Sample & The Pharmacist’S Role In Fall Prevention, Taylor Elliott, Susan Westneat, Shama Karanth, Erin Abner, Anna Kucharska-Newton, Daniela C. Moga

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

Background: Falls are a major public health problem affecting millions of older adults each year. Little is known about FRID prescribing behaviors after injurious falls occur.

Objective(s): The primary objective of this study was to investigate whether an injurious fall impacts the odds of being prescribed a new FRID.

Methods: We conducted a cross-sectional analysis using data from the 2016 National Ambulatory Medical Care Survey to investigate whether an injurious fall impacts the odds of being prescribed a new FRID. We included patients age >/= 65 years and classified visits based on presence of an injurious fall. The outcome of …

Occupational Health Practices Among Dental Care Professionals Before And During The Covid-19 Pandemic, Sean Banaee, Denise M. Claiborne, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

BACKGROUND: The COVID-19 pandemic has posed a substantial burden on dental care professionals. While dentistry is known as one of the most exposed and high-risk professions, dental care professionals are indeed at even greater risk.

OBJECTIVE: The aim of this study was to assess knowledge, attitudes, occupational health practices, personal protective equipment usage, and mental stressors during COVID-19 pandemic among dental care professionals.

METHODS: A cross-sectional study was conducted among dental care professionals who were subscribers to a dental hygiene journal using a self-administered online survey (n = 1047 respondents). Cross-tabulations were performed to determine differences in the responses to …

Data On Breastfeeding And State Policies In The United States, Chun Chen, Hong Xue, Qi Zhang

Community & Environmental Health Faculty Publications

Breastfeeding is critically important to maternal and child health in the United States. Examining the relationship between breastfeeding outcomes and state policies requires multidisciplinary efforts to link data from various sources. This article describes an integrated dataset that was used to understand the relationship between participation in a nutrition assistance program and low-income children's breastfeeding outcomes [1]. This dataset merged public health information from the National Immunization Surveys Data from 2006 to 2016 and matching state policy data from the Correlates of State Policy Project (CSPP), the U.S. Department of Agriculture/Economic Research Services (USDA/ERS) Supplemental Nutrition Assistance Program (SNAP) Policy …

Influence Of The Inherent Safety Principles On Quantitative Risk In Process Industry: Application Of Genetic Algorithm Process Optimization (Gapo), Mehdi Jahangiri, Abolfazl Moghadasi, Mojtaba Kamalinia, Farid Sadeghianjahromi, Sean Banaee

Community & Environmental Health Faculty Publications

Inherent safety (IS) refers to a set of measures that enhance the safety level of processes and equipment, rendering additional equipment and/or add-ons. The early design phase of processes is suited best for implementation of IS strategies as some of such strategies either are impossible to be implemented at the operation phase or substantially increase costs. The purpose of this study is to present a new approach called genetic algorithm process optimization (GAPO), by which processes can be made inherently safer even at the operation phase. This study simulates the IS principle, assessing its impact on quantitative risk and the …

Income-Related Health Inequality Among Chinese Adults During The Covid-19 Pandemic: Evidence Based On An Online Survey, Peng Nie, Lanlin Ding, Zhou Chen, Shiyong Liu, Qi Zhang, Zumin Shi, Lu Wang, Hong Xue, Gordon G. Liu, Youfa Wang

Community & Environmental Health Faculty Publications

BACKGROUND: Partial- or full-lockdowns, among other interventions during the COVID-19 pandemic, may disproportionally affect people (their behaviors and health outcomes) with lower socioeconomic status (SES). This study examines income-related health inequalities and their main contributors in China during the pandemic.

METHODS: The 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media in China. A national sample of 10,545 adults in all 31 provinces, municipalities, and autonomous regions in mainland China provided comprehensive data on sociodemographic characteristics, awareness and attitudes towards COVID-19, lifestyle factors, and health outcomes during the lockdown. Of them, 8448 subjects provided data for …

African Environmental Ethics: Keys To Sustainable Development Through Agroecological Villages, Charles Verharen, Flordeliz Bugarin, John Tharakan, Enrico Wensing, Bekele Gutema, Joseph Fortunak, George Middendorf

Center for Global Health Publications

This essay proposes African-based ethical solutions to profound human problems and a working African model to address those problems. The model promotes sustainability through advanced agroecological and information communication technologies. The essay's first section reviews the ethical ground of that model in the work of the Senegalese scholar, Cheikh Anta Diop. The essay's second section examines an applied African model for translating African ethical speculation into practice. Deeply immersed in European and African ethics, Godfrey Nzamujo developed the Songhaï Centers to solve the problem of rural poverty in seventeen African countries. Harnessing advanced technologies within a holistic agroecological ecosystem, Nzamujo's …

Exploring The Covid-19 Experience Of Young Adult Latinos In Rural California: Insights Into Mental Health & The Immigrant Health Paradox, Vivianna Plancarte

Pomona Senior Theses

This study expands the COVID-19 and Latino Immigrants in Rural California (CLIMA) Study at UC Merced by exploring how the mental health of young adult Latinos in rural CA has been affected by the COVID-19 pandemic and comparing the experiences of US-born Latinos to those of Latino immigrants to investigate an Immigrant Health Paradox. A convergent mixed methods design was first employed whereby qualitative and quantitative data was collected concurrently, and then merged. Then, the data collected from young adult Latinos was compared to that from Latino immigrants collected by CLIMA Study to explore the Immigrant Health Paradox in the …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Perceptions And Health Effects Of Electronic Cigarettes Among College Students, Safia Centner

Honors Undergraduate Theses

Electronic cigarettes, or e-cigarettes, are devices that allow users to inhale an aerosol, which contains chemical additives. E-cigarettes are becoming common for nicotine delivery in addition to traditional cigarettes. The goal of this study was to determine how college students perceive e-cigarettes, how often college students use e-cigarettes, and how they view e-cigarettes compared to tobacco cigarettes. This was accomplished through sending a survey built on Qualtrics to UCF students via Knights Email. This survey included questions about demographics, perceptions, and usage of e-cigarettes. The collected data was downloaded into SPSS and analyzed to compare data among different groups. The …

A Mixed Methods Study On Food Insecurity Screening And Patient-Centered Care: Perspectives Of Patients And Healthcare Providers On Practices And Barriers To Effective Screening In Outpatient Medical Settings, Christina Bernhardt

Electronic Theses and Dissertations, 2020-2023

The purpose of this study was to better understand the relationship between elements of patient-centered care and patient/provider comfort with conversing about food insecurity and related social determinants of health. A mixed methods study was conducted. Patients and healthcare providers were surveyed on their experiences with patient-centered care and comfort discussing food insecurity and related social concerns. Telephone interviews were conducted to gain a richer understanding of the concepts under investigation. In the survey and telephone interviews, both samples were also asked about changes in communication during COVID-19 times. Quantitative findings show that patient involvement in care and cultural sensitivity …

Health Literacy, Knowledge, Attitudes, And Opioid Use Behavior Among College Students, Khristen Holmes

Electronic Theses and Dissertations, 2020-2023

Opioid-related deaths have increased rapidly over the last couple of decades due to the overprescribing of prescription opioids and the availability of illicit drugs from family members, friends, or street dealers. To address this crisis, this research will attempt to identify how health literacy levels affect knowledge, attitudes, and behaviors. Hence, this study is informed by the Knowledge-Attitude-Behavior (KAB) Model. The KAB model is used to determine the influence of knowledge and attitudes on behaviors, which includes prescription drugs, illicit drugs, and fentanyl. This dissertation aims to explore the relationships between health literacy, knowledge, attitude, and behavior for opioids (prescription …

The Impact Of The 2018 Kentucky Cigarettes Taxes On Tobacco Use Among Youth, Claire W. Mampunza

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

Introduction: In the Commonwealth of Kentucky, cigarette smoking results in 1.92 billion dollars spent every year on medical costs, the death of approximately 9,000 Kentuckians, and 34 percent of all cancer cases. In 2017, 14.3 percent of high school students in Kentucky declared being current cigarette smokers, compared to 8.8 percent nationally. Tobacco use among youth is a public health concern because 88 percent of adult smokers initiate smoking before age 18. Youth nicotine use can damage the growing brain, which continues to develop until 25 years of age. In July 2018, the excise tax on cigarettes increased from …

Assessing Changes In The Epidemiology Of Cutaneous Leishmaniasis In Southwest Colombia Following The Peace Accord With Fuerzas Armadas Revolucionarias De Colombia (Farc), Matthew Stephen Benczkowski

Public Health Theses

The Colombian Conflict persisted for over 50 years, recently coming to an end in November 2016 after the signing of Colombia’s Peace Agreement between the government and FARC guerrilla group. Internal armed conflict is often entangled with the exacerbation of health outcomes, including promoting the spread of infectious diseases like cutaneous leishmaniasis (CL). CL is a vector-borne parasitic disease localized to the human tegument that decreases quality of life through lesions leading to scars and associated stigmatization. This study assessed changes in demographic and clinical characteristics of patients with CL in Southwest Colombia before and after the signing of the …

The Utility Of A Maximum Entropy Species Distribution Model For Ixodes Scapularis In Predicting The Public Health Risk Of Lyme Disease In Ontario, Canada, Holly Alexandra Burrows

Public Health Theses

Introduction: Lyme disease is an emerging public health threat in Ontario, Canada due to the range expansion of the tick vector, Ixodes scapularis. Tick abundance and density are important predictors of human Lyme disease risk and are typically measured using active tick surveillance (dragging). New cost-effective tools are needed to augment current surveillance activities.Objective: The objective of this study was to evaluate the ability of a Maximum entropy species distribution model to predict I. scapularis density and abundance in three regions of Ontario – Ottawa, Kingston, and southern Ontario – in order to determine its utility in predicting the public …

Exploring Thai Physicians’ Perceptions Of And Willingness To Prescribe Pre-Exposure Prophylaxis (Prep), Brandi E. Moore

Public Health Theses

Background: Oral pre-exposure prophylaxis (PrEP) is a daily medication that can prevent HIV infection. PrEP may further support HIV prevention initiatives in Thailand, particularly as it becomes more accessible in the country’s government clinics and hospitals. While studies have explored perceptions of PrEP for at-risk people in Thailand, there has been limited investigation into Thai physicians’ opinions of and willingness to prescribe PrEP. Methods: Using convenience sampling, this cross-sectional study recruited 132 Thai physicians to complete an anonymous, online survey. The survey assessed physicians’ concerns about PrEP, experience with PrEP, and willingness to prescribe PrEP. Bivariate and multivariable logistic regressions …

Covid Mitigation Strategies And Safety Perceptions Among Workers During Spring 2020 Shutdown, William Mciver

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

A novel coronavirus pandemic radically shifted the working environment of the population in the United States in the spring of 2020. Studies have examined the difference between healthcare workers and the general population, but there exists a gap when looking at mitigation strategies between healthcare workers and other workers that continued working outside the home. This study surveyed workers and asked about employment status, employment field, COVID safety precautions taken in the workplace, and feelings of safety. This study examined that and found statistically significant differences in the mitigation strategies used by healthcare workplaces and all other non-healthcare workplaces. This …

Educational Intervention To Change Knowledge And Attitudes Regarding Sexual Behaviors To Reduce Rates Of Sexually Transmitted Infections Among University Of Kentucky’S Sorority Life Students., Julianna Maita

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

Sexually transmitted infections disproportionally affect young adults. Within this age group, women are at an increased risk for contracting and STI and face more severe long-term adverse consequences than men. College aged individuals are at an increased risk for contracting an STI due to risky sexual behaviors such as unprotected sex with multiple partners. College students involved in Greek Life have been found to engage in risker sexual behaviors than non-Greek life students. These individuals perceive themselves to be at a higher risk for contracting an STI and have an increased number of unprotected sexual encounters under the influence of …

Diabetes Management And Self-Perception Of Health Among Adults In The United States, Moses Ajoku

Walden Dissertations and Doctoral Studies

The burden and complications of diabetes have been a public health concern and societal challenge for decades, and the rate of prevalence is projected to increase in the future. The study aims to examine the association between blood glucose monitoring, glycated hemoglobin test, and self-perceived health status among diabetic adults in the United States. Guided by the chronic care model, the study used data from the 2019 Behavioral Risk Factor Surveillance System to investigate diabetes management practices among diabetic adults in the United States. Quantitative and cross-sectional methods were used to assess the associations between diabetes management practices and self-perceived …

Association Between Food Insecurity And Influenza Outcome In The United States., Sabrina Fiona Pink

Walden Dissertations and Doctoral Studies

AbstractThe influenza virus is one of the most commonly occurring respiratory viral infections in the world. The outer capsule of the virus contains 18H proteins and 11N proteins, which allows the virus to reform in over 100 different strands and outperform the vaccine. Despite efforts to improve access to care and reduce vaccine inequities; the Center for Disease Control and Prevention estimates 9-45 million documented influenza-related illnesses, 140,000 to 810,000 hospitalization, and 64,000 deaths yearly. The purpose of this study is to investigate whether food insecurity, access to care and other social determinants of health such as age, race, and …

The Predictive Relationship Of Allostatic Load In Asthma, Mohamed Mustafa Hassan

Walden Dissertations and Doctoral Studies

Research on populations emphasizes the influence of allostatic overload, a marker of biophysical and biochemical stress, in driving adverse health outcomes. Unknown is the impact of allostatic load and its cardiovascular, metabolic, and inflammatory components as they pertain to asthma prevalence in U.S. populations. Specifically, there is a need to understand the nature of the relationship between allostatic load and asthma in light of confounders such as socioeconomic status, race, education, and gender. Using Bronfenbrenner’s bioecological model as a theoretical underpinning and binary logistic regression as a statistical modality, the predictive relationship between allostatic load and asthma was examined in …

Food Insecurity In Community College Students In The Central Valley Of California, Leah Carter

Walden Dissertations and Doctoral Studies

AbstractMany college students struggle with having enough money to pay for the costs of college and basic necessities, such as adequate food, which leads to food insecurity. Food insecurity results in a more challenging time focusing on studying and less success in school. This study addressed the lack of a profile of a food-insecure California community college student at Hiker’s Community College (HCC; pseudonym) in the Central Valley of California. The purpose of this quantitative study was to determine the profile of a food-insecure student and to determine relationships between food insecurity and ethnicity, gender, being a first-generation college student, …

The Importance Of Staff Education About Implementing Ketogenic Diet In Prediabetic Patients, Clarissa L. Dorsey

Walden Dissertations and Doctoral Studies

Diabetes, a chronic disease that can lead to many complications, is one of the leading causes of death. Obesity tends to increase the risk of diabetes. Nutritional therapy can not only control diabetes but also prevent it in some cases by decreasing weight. The ketogenic diet is a low-carbohydrate, high-fat diet that can prevent and control diabetes. The purpose of this study was to examine the recommendations of medical providers before and after the presentation of educational content on the ketogenic diet as nutritional therapy in prediabetic and diabetic patients. The practice-focused question addressed whether educating medical staff at a …

Relationship Between Media Coverage And Child Measles Vaccination Uptake, Tanika Ward

Walden Dissertations and Doctoral Studies

Childhood vaccines have been a source of heated debates between both opponents and proponents of vaccination. Childhood immunizations have proven to be effective and save lives, but antivaccine movements continue. The purpose of this retrospective cross-sectional quantitative study was to determine if there was a significant difference in child measles vaccine uptake based on provider facility type and census region, after adjusting for age and education of mother, for the years 2003–2012, pre-and-post 2007 media coverage deeming vaccines unsafe, and for the years 2013–2017, pre-and-post exposure to measles at Disneyland in 2014–2015 for children aged 19–35 months. The social ecological …

Social Media And Physical Activity Among African American College Women, Carmen Brown

Walden Dissertations and Doctoral Studies

Among African American (AA) college women, physical activity (PA) is decreasing, with less than 20% participating in moderate-intensity cardio or aerobic exercise. Physical inactivity can lead to increased morbidity and mortality from chronic conditions. There is a need for more research on AA women’s health practices to develop interventions that can lead to sustainable behavior change among this population. More than 70% of AA college women reported using some form of social media (i.e., Facebook, Twitter, Instagram, TikTok, and Snapchat) daily. Social networking sites (SNS) in particular can provide health information, advice, and an open forum for individuals with health …

Understanding Perspectives Of Clinical And Non-Clinical Healthcare Administrators On Culture And Diversity In The Healthcare Workplace, Katherine Counts

Theses and Dissertations--Community & Leadership Development

The racial and ethnic composition of the U.S. population is becoming increasingly more diverse. The 2010 U.S. Census reported a 29% increase in minority groups other than non-Hispanic Whites. In response to these changing demographics, healthcare organizations have struggled to keep pace with these trends in their hiring of a diverse staff. Healthcare leaders appear to be lagging in their efforts to make adequate changes to increase diversity in their organizations. What factors may be contributing to this inequity? One possible explanation is a limited knowledge of healthcare leaders regarding culture and diversity within the workplace. To this end, this …