Public Health Commons^™

Examining Intersectional Factors In Infant Mortality: The Role Of Race, Geography, And Socioeconomic Status In Ohio, Catherine Tran, Rebekah Murray

Scholarship in Medicine - All Papers

Background: Aspects of a mother’s identity such as race, socioeconomic status, and geographical location can impact healthcare access and outcomes, especially infant mortality.
Objective: The aim of this study is to identify how different variables relating to a mother’s identity intersect with one another to impact infant mortality rate in Ohio.
Methods: Data for infant mortality rate, racial residential segregation index, patient race by percentage, and median household income was collected from County Health Rankings, and data was analyzed using IBM SPSS Statistics.
Results: A linear regression found that the best fitting model including median household income and percent Black …

The Opioid Crisis: Analyzing Access To Resources, Mental Health And The Influence On Overdose Deaths In Urban And Rural Communities, Katharina Johnson, Maggie Obourn

Scholarship in Medicine - All Papers

Background: Opioid use contributes significantly to deaths throughout the United States. Opioid overdose deaths have increased in recent years and the opioid crisis has far reaching effects on many communities. There are several factors that contribute to opioid overuse and death, including access to resources and social factors.
Objective: In this study we aimed to assess how social factors affect overdoses by examining the differences between rural and urban communities over time.
Methods: We utilized data from County Health Rankings and conducted a retrospective review of data from 2016 and 2023 to compare several factors that we hypothesized affected opioid …

Access To Exercise Opportunities And Food Security: Mediators In The Prevalence Of Chronic Diseases In Ohio, Anidya Soni, Lisa Victor

Scholarship in Medicine - All Papers

Background: Obesity remains a leading public health issue in the United States, with 40.3% of adults classified as overweight, underscoring the need to understanding the environmental and social determinants of health1. The neighborhood food environment, including access to healthy food and recreational spaces in one's community, plays a critical role in shaping dietary behaviors and physical activity levels.

Objective: This study examines the relationship between neighborhood food environments including access to healthy food and exercise opportunities, socioeconomic factors, and health outcomes like obesity, and diabetes in Ohio from two-time points: 2016 to 2023 using data from the County Health Rankings …

A Program Evaluation Case Study, Madelyne G. Culbertson

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

This case study presents a program evaluation of a physical activity intervention implemented in Bourbon County, Kentucky, guided by the Centers for Disease Control and Prevention’s Framework for Program Evaluation in Public Health.

A Case Study In Program Evaluation, Alexis Strottman

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

This paper presents a comprehensive evaluation plan for the Bourbon County Physical Activity Improvement Program, as prompted in the University of Kentucky's 2025 MPH-Health Management and Policy Capstone Case Study. The case study outlines a program developed in response to high obesity and inactivity rates in Bourbon County, Kentucky. Utilizing the CDC's 6-step program evaluation framework, the plan outlines engagement of a diverse group of stakeholders to assess the program's effectiveness in increasing physical activity among residents. The evaluation focuses on both process and outcome measures, examining the implementation of exercise facilities, community events, and an app designed to track …

A Case Study In Program Evaluation: Evaluation Of A Program Designed To Increase Activity Levels In Bourbon County Residents, Brooke M. Woodburn

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

This paper provides recommendations to eliminate possible barriers in a program developed to reduce inactive levels across Bourbon County.

Increasing Hpv Vaccination Adherence In Floyd County, Ky: Give Teens Vaccines, Taylor M. Stumbo

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

Cervical cancer remains a pressing public health issue, particularly in underserved and rural areas where access to preventive care is limited. This capstone addresses the urgent need to increase human papillomavirus (HPV) vaccination adherence in Floyd County, Kentucky—part of the central Appalachian region that experiences disproportionately high cervical cancer incidence and mortality. Despite the proven effectiveness of HPV vaccines in preventing the virus strains most responsible for cervical cancer, uptake in this region remains below national targets due to socioeconomic barriers, limited healthcare access, and lack of awareness. Give Teens Vaccines is a two component intervention leveraging existing healthcare systems …

A Case Study In Program Evaluation Evaluation Of A Physical Inactivity Program In Bourbon County, Kentucky, Carine N. Malekera

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

This paper evaluates a physical activity program by the Bourbon County Health Department aimed at increasing physical activity among local residents. Using the CDC’s Framework for Program Evaluation, the study includes both process and outcome evaluations to assess program implementation and impact on health outcomes. Key findings indicate success in urban areas but challenges in rural regions due to limited access to resources. Recommendations include improving access to exercise opportunities in rural areas and offering virtual classes. This evaluation emphasizes the importance of continuous assessment for effective public health interventions.

A Case Study In Program Evaluation, Kaitlyn E. Lee

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

This capstone project evaluates a fictious online MRSA education program developed by the Lexington-Fayette County Health Department and Fayette County Public Schools after a suspected outbreak among student athletes. Using the CDC’s 6-Step Framework for Program Evaluation, the project focuses on how stakeholders were engaged, how the program was described and mapped, how the evaluation questions were developed, what evidence was collected, and how conclusions were formed. The goal of the evaluation is to understand whether the program’s structure, delivery, and implementation support clear infection-control education for the different school personnel who use it. This project emphasizes the overall evaluation …

Customary Corruption, Ani B. Satz, Liza Vertinsky

Faculty Articles

For over a hundred years, it has been well-accepted among tort scholars that physicians—as one of the legally recognized professions— determine their own customary practices. Within tort law, and medical malpractice more specifically, customary practice establishes whether physicians breach or uphold the required standard of care toward their patients. The results of our hand-coded examination of decided cases and statutes show a more complex picture. While some states have endeavored to shift the standard away from professional custom, it continues to play a critical, and in many cases a determinative, role in establishing physician liability in most states.

Using illustrative …

Tort Liability For Failure To Age Gate: A Promising Regulatory Response To Digital Public Health Hazards, Matthew B. Lawrence, Brett Frischmann, Avi Sholkoff

Faculty Articles

Tort liability for failure to “age gate” is a promising legal response to the public health hazards of AI, social media, sports gambling, and other digital spaces. Tort liability for failure to “age gate” hinges liability for harms to minors on an app’s failure to take reasonable steps to prevent minors from gaining access or otherwise to apply appropriate governance rules, such as privacy-protective default settings or ensuring genuine parental consent. While no one legal response is a panacea, tort liability for failure to age gate carries several distinctive advantages that make it a particularly promising option at this stage …

Constitutionalizing Climate Rights, Mark P. Nevitt

Faculty Articles

This Essay proceeds in three Parts. In Part I, I describe and analyze which states have climate and environmental amendments within their state constitutions. Here, I focus on three states (Hawaii, Montana, and Pennsylvania) that have comparably strong Green Amendments and have experienced litigation in recent years enforcing these constitutional provisions. I describe and analyze three cases: Navahine F. v. Hawaii Department of Transportation (Hawaii), Held v. Montana (Montana), and Robinson Township (Pennsylvania). I argue that these three decisions—all of which enjoyed varying degrees of success—will spur greater efforts to constitutionalize state environmental rights. Indeed, there are grassroot efforts within …

Association Of Out-Of-Pocket Expenditures With Continuation And Type Of Treatment Among New Adult Cancer Cases At Ahsania Mission Cancer And General Hospital In Bangladesh (2023-2024) : A Secondary Data Analysis, A K M Shahriar

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background and Objective: Bangladesh faces a heavy cancer burden, with about 167,000 new cases annually and 68% of health spending paid out-of-pocket (OOP). High OOP costs cause financial toxicity, forcing patients to abandon treatment. This study examined associations between patient OOP expenditures and prescribed treatment continuation and treatment modality (others versus chemotherapy/radiotherapy) among adult cancer patients at a hospital in Dhaka. Methodology: We conducted a cross-sectional analysis of existing hospital records for all adult cancer patients (age ≥18) at Ahsania Mission Cancer and General Hospital between 01 January 2023 and 31 December 2024 (N = 12,907). Data included each patient’s …

Association Of Biomarker And Cardiovascular-Kidney-Metabolic Syndrome Among Older Chinese Adults : Findings From A Nationwide Study, Jiahao Shi

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: CKM syndrome poses a growing burden in aging populations, but early detection remains limited by the lack of integrated biomarkers. The C-reactive protein–triglyceride glucose index (CTI), which reflects inflammation and insulin resistance—two core drivers of CKM—has not yet been evaluated for its association with CKM status in large, aging Asian cohorts. This study addresses this gap.Objective: To investigate the association of C-reactive protein–triglyceride–glucose (CTI) index with cardiovascular-kidney-metabolic (CKM) syndrome in older Chinese adults.Methods: This cross-sectional study analyzed data from 10,318 participants aged ≥45 years in the 2015 China Health and Retirement Longitudinal Study (CHARLS). CKM syndrome was operationalized as …

Exploration Of The Mechanisms Of Benjakul’S Anti-Rheumatoid Arthritis Actions Through Network Pharmacology, Hongxiang Duan

Chulalongkorn University Theses and Dissertations (Chula ETD)

Rheumatoid arthritis (RA) is driven by chronic inflammation and matrix degradation; traditional Thai formula Benjakul (BJK) is empirically used for inflammatory conditions, but its mechanisms are not well defined. To assess the antioxidant capacity of BJK and to elucidate potential anti-inflammatory targets and signaling pathways relevant to RA. BJK and its five constituent herbs were extracted with 99% ethanol and evaluated for TPC, TFC, FRAP, and DPPH assays. LC–MS/MS was used to profile key bioactive compounds, which were further filtered by SwissADME and subjected to target prediction using SwissTargetPrediction. Overlapping targets with RA-related genes were analyzed by GO and KEGG. …

"Factors Associated With Knowledge, Attitude And Practice (Kap) Towards The Prevention Of Type 2 Diabetes Mellitus Among The Middle-Aged Group Adults In Dhaka City, Bangladesh : A Cross-Sectional Study", Sabrina Rahman

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Type 2 Diabetes Mellitus has emerged as a critical public health challenge in Bangladesh, particularly in urban areas, like Dhaka city, due to rapid urbanization, sedentary lifestyles, dietary transitions, and increasing obesity rates. However, there is limited research related to influencing factors of knowledge, attitude, and practice towards diabetes prevention in Bangladesh. Objective: This study aims to identify the level of knowledge, attitude, and practices (KAP) towards the prevention of Type 2 Diabetes Mellitus and their associated factors among middle-aged adults in Dhaka City, Bangladesh. Methods: A cross-sectional study design was conducted in participants aged 30–64 years, with a …

Association Between Knowledge, Attitude, Risk Perception, Expectancies And Cannabis Use Among International University Students In Thailand : A Cross-Sectional Study, Yueting Liu

Chulalongkorn University Theses and Dissertations (Chula ETD)

The global increase in cannabis use, particularly among young individuals, poses a serious public health risk. Thailand decriminalized cannabis in 2022, under this situation, international students are experiencing changes in social attitudes toward cannabis use and have increasing access to sources of cannabis. There is currently lack of research on cannabis use among this group in Thailand. This study aimed to analyze the associations between knowledge, attitudes, risk perceptions, and expectancies and cannabis use among international university students in Thailand. This cross-sectional study was conducted among international university students aged 18 years and older in Thailand. Participants were collected through …

Impacts Of Physical Inactivity Models On Endothelial Function: A Systematic Review, Joel E. Harden, J. David Branch, Leryn J. Reynolds

Exercise Science Faculty Publications

Background

Endothelial dysfunction is associated with cardiovascular disease and cardiac events. Numerous studies demonstrate that a reduction in physical activity/exercise levels are associated with poor endothelial function. Yet, these studies use a plethora of models to mimic reduced activity levels which may have widely different results on endothelial function. It is pertinent to collectively review these articles to provide a comprehensive understanding of the impact of reduced activity on vascular health, as endothelial function is one of many factors that influences vascular tone.

Objective

The purpose of this systematic review is to examine and synthesize the current literature regarding the …

Exploring Lgbtq+ Competency In Healthcare, Jordan Whiteman

Honors College Theses

Marginalized groups such as the LGBTQ+ community are known to face healthcare disparities that negatively affect their process of navigating healthcare systems. This project explores the perceived lack of representation and understanding of the LGBTQ+ community within healthcare settings, exposing the deficits in knowledge for unique challenges and inequalities these patients may face. By viewing the literature, a myriad of complications faced by LGBTQ+ people in clinical settings can be identified. They possess a generalized feeling of mistrust towards the healthcare system. Healthcare staff overall describe low confidence with caring for this demographic. Heteronormativity’s presence in the field of healthcare …

Educational Interventions To Improve Pediatric Emergency Care: A Qualitative Assessment Of The Perspectives Of African Healthcare Workers, Emily A. Hartford, Chris A. Rees, Isaac Kihurani, Raana Hussain, Elena Seifert, Alexis Schmid, Tigist Bacha, Carol C. Chen, Megan L. Schultz

Paediatrics and Child Health, East Africa

Pediatric emergency care (PEC) training for health care workers (HCWs) is commonly offered in the form of short courses. This study gathers the perspectives of HCWs from eight African countries on how to best deliver and implement short training courses in PEC. This is a qualitative study using semi-structured key informant (KI) interviews. Utilizing the African Federation for Emergency Medicine (AFEM) member list serve, we identified African HCWs who had previous experience participating in and/or delivering short training courses in PEC. From this cohort, four interviewers were selected. These interviewers all received training in qualitative interviewing and then each recruited …

Developing A Culturally Sensitive Nursing Framework For Muslim Patients Practicing Ramadan: Focusing On Fasting Benefits And Islamic Dietary Recommendations, Amreen Mahmood Munshi

Nursing | Student Research Posters

Background: Muslims practice Ramadan, a month-long period of fasting from dawn to dusk, yet many healthcare providers lack knowledge of its principles and practices. Hospitals lack formal education on caring for fasting Muslim patients, leading to a knowledge deficit in cultural competence and sensitivity of Islamic practices. Purpose: This paper proposes a research design for a nurse education program on Ramadan fasting to promote cultural competence and sensitivity in nursing care. The proposed research aims to educate nurses on Islamic practices, particularly Ramadan, to bridge the cultural competency gap. The literature review also explores the health benefits of …

Culturally Sensitive Nursing Care And Its Impact On Abuse Disclosure Among Immigrant-Origin Populations​, Jaspal Uppal

Nursing | Student Research Posters

Background: Immigrant-origin patients often face many systemic barriers when accessing healthcare. Factors such as language barriers, fear of deportation, limited trust in healthcare providers, and lack of culturally sensitive care make it hard for patients to disclose abuse. These challenges contribute to poor health amongst vulnerable populations which highlights the importance of using culturally sensitive and trauma-informed care. Objective: This research aims to test whether culturally adapted, trauma-informed nursing care improves disclosure of abuse and access to support services. The objective is to strengthen safety and trust between healthcare providers and patients through culturally sensitive care. Method: A quantitative quasi-experimental …

The Impact Of Diabetes Education & Post Discharge Interventions For African American Adults At Risk For & After Myocardial Infarction, Trinity L. Billingsley

Nursing | Student Research Posters

Cardiovascular disease or CVD refers to a multitude of conditions that affect both the heart and blood vessels. Being the leading cause of death in the United States, heart disease claims 919,032 lives; the risk of death becomes more likely when accompanied with comorbidities like diabetes (CDC, 2024). While heart disease is a leading cause of death across all populations, it accounts for a larger proportion of deaths in African American, or AA, adults at 22.6% compared to White adults at 18.0% and Hispanic adults at 11.9%, highlighting persistent racial disparities in cardiovascular outcomes (CDC, 2024). Diabetes as a comorbidity …

Exploring Dominican University Nursing Student’S Perceptions Of Economic Barriers To Accessing Essential Women’S Health Products, Annabelle E. Burke

Nursing | Student Research Posters

Access to essential feminine hygiene products, including menstrual supplies and hygiene items, is a growing economic and public health issue. Rising product prices and reliance on costly disposable products contribute to financial strain for many women. Period poverty is the lack of access to menstrual products, education, and hygiene facilities due to financial constraints, and it negatively affects women’s physical and mental health, particularly among students and low-income populations. Research shows that limited access to menstrual products affects dignity, sanitation, and emotional well-being and is compounded by social stigma and cultural silence surrounding menstruation (Brinkley & Niebuhr, 2023). Findings from …

Educating Nurses On Culturally Competent Intimate Partner Violence Care, Nicole Lee

Nursing | Student Research Posters

No abstract provided.

The Effects Of Medical Misinformation About Vaccines On Parents Of Pediatric Patients, Mya Izabela B. Emelia

Nursing | Student Research Posters

No abstract provided.

Empowering Birth: Comparing Nurse-Led Holistic And Pharmacologic Pain Relief Approaches​, Jessica C. Moore

Nursing | Student Research Posters

Childbirth is often described as one of the most meaningful experiences in a woman’s life. During this time, effective pain management is essential not only for reducing discomfort, but also for improving maternal satisfaction and minimizing unnecessary obstetric interventions. While childbirth is frequently approached as a purely physical process, it is inherently holistic, influenced by cultural, social, psychological, and emotional factors.

Growing evidence highlights the value of incorporating and educating patients and providers on non-pharmacologic strategies such as breathing techniques, massage, aromatherapy, hydrotherapy, positioning ,ambulation, and continuous emotional support.

For example, a study in Sweden that found that a group …

Knee Health Is A Major Determinant Of Mobility Across The Healthspan, Brandon M. Peoples, Kenneth Harrison, Michael A. Samaan, Christopher B. Mobley, David T. Redden, Jaimie A. Roper

Kinesiology and Health Promotion Faculty Publications

Knee health constitutes a pivotal determinant of locomotor function and overall mobility throughout the healthspan. Impairments in knee function lead to a series of biomechanical and physiological alterations that pose substantial public health challenges and economic burdens worldwide. This review synthesizes evidence that delineates the complex and multifaceted relationship between knee health and mobility, emphasizing the interplay across various domains in adult populations. Knee health is conceptualized as a dynamic, interconnected system whereby structural integrity, neuromuscular mechanisms, biomechanical adaptations, and functional mobility are intricately interrelated through cascades of mechanistic processes operating across different temporal stages. A comprehensive understanding of these …

The Impacts Of Dietary And Educational Intervention In Addressing Adult Obesity In The Mexican Population, Matthew C. Servin

CMC Senior Theses

Mexico’s obesity epidemic has been an ongoing issue for the past few decades, with multiple studies attributing this to the disparities in accessing healthy food and health education. Designing a solution to Mexico’s adult obesity crisis will focus on studying the effects of an intervention plan that addresses these obesogenic factors. This proposed study will assess how a token system and health education sessions may impact the risk of obesity in the adult Mexican population. This study also will consider any limitations that arise when only one of the two intervention methods are used. As these interventions are implemented over …

Adapting A Mobile Health Intervention To Improve Prep Adherence Among Young Black Msm In Fulton County, Georgia, Kassidy Maust

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

Young Black men who have sex with men (YBMSM) in the southern United States, particularly in Fulton County, Georgia, face disproportionately high rates of HIV and unique structural barriers to pre-exposure prophylaxis (PrEP) uptake and adherence. Sustained adherence among YBMSM remains low due to intersecting structural, social, and behavioral barriers. To address these disparities, this paper presents an adapted implementation of the evidence-based M-Cubed (Mobile Messaging for Men) mHealth intervention. Prior studies of M-Cubed and similar mHealth interventions have shown promising outcomes in increasing PrEP adherence among Black MSM populations. The adapted intervention integrates culturally tailored messaging specific to behaviors …