Public Health Commons^™

Increasing Hpv Vaccination In Two Appalachian Counties, Autumn Rice

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

In response to the Funding Opportunity Announcement (FOA), the evidence-based Making Effective HPV Vaccine Recommendations training program will be implemented in the Southeast Kentucky AHEC region over the course of three years. The implementation of the Making Effective HPV Vaccine Recommendations program has three specific aims:

Aim 1: Effectively implement and deliver the Making Effective HPV Vaccine Recommendations program to immunization providers in the Southeast Kentucky AHEC region

Aim 2: Increase provider self-efficacy for making strong recommendations for HPV routinely

Aim 3: Increase the number of recommendations for the HPV vaccine among adolescents of Bell and Harlan Counties in Kentucky …

Patient Access To Glp-1 Ra’S: A Medicare Part D Policy Analysis, Celine Hummer

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

This policy analysis examines the evolving landscape of GLP-1 receptor agonists (GLP-1 RAs) and their implications for Medicare Part D coverage. Initially developed for managing type 2 diabetes, GLP-1 RAs have rapidly gained popularity due to their efficacy in treating obesity and reducing cardiovascular events, leading to broader therapeutic applications. However, access to these medications under Medicare Part D is limited by high costs and coverage restrictions, particularly when used for obesity without diabetes. This analysis evaluates current Medicare Part D policies, including specialty drug tier placement, formulary restrictions, and the potential impact of recent legislative initiatives such as the …

Family Structure, Family Transitions, And Child Overweight And Obesity: Comparing Australia, The United Kingdom, And The United States, Sadie A. Slighting, Kirsten Rasmussen, Mikaela J. Dufur, Jonathan A. Jarvis, Shana Pribesh, Alyssa J. Alexander, Carolina Otero

STEMPS Faculty Publications

Growing rates of childhood obesity globally create concern for individuals' health outcomes and demands on health systems. While many policy approaches focus on macro-level interventions, we examine how the type of stability of a family structure might provide opportunities for policy interventions at the micro level. We examine the association between family structure trajectories and childhood overweight and obesity across three Anglophone countries using an expanded set of eight family structure categories that capture biological relationships and instability, along with potential explanatory variables that might vary across family trajectories and provide opportunities for intervention, including access to resources, family stressors, …

Breastfeeding Perceptions And Decisions Among Hispanic Participants In The Special Supplemental Nutrition Program For Women, Infants, And Children: A Qualitative Study, Emily Fisher, Priyanka Patel, Kathryn G. Wouk, Bidusha Neupane, Futun Alkhalifah, Marilyn M. Bartholmae, Chuanyi Tang, Qi Zhang

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the U.S. WIC served 2.5 million eligible Hispanic women, infants, and children under the age of five in 2021, which is WIC's largest racial/ethnic group. However, limited research has been conducted to understand Hispanic WIC participants' perceptions of WIC breastfeeding recommendations and their breastfeeding decisions. For this qualitative study, we interviewed 18 of these pregnant and postpartum WIC participants on their experiences and decision-making processes related to breastfeeding. Hispanic cultures and home country norms were identified as prominent influences on breastfeeding decisions, along …

Navigating New Normals: Student Perceptions, Experiences, And Mental Health Service Utilization In Post-Pandemic Academia, Hadiza Galadima, Anne Dumadag, Cara Tonn

Community & Environmental Health Faculty Publications

This study explores the profound impacts of the COVID-19 pandemic on higher education, focusing on shifts in learning experiences and students’ intentions to utilize mental health services post-pandemic. Utilizing Andersen’s Behavioral Model of Health Services Use, this study assesses perceptions from a stratified random sample of college students on post-pandemic learning experiences and mental health service utilization intentions. Findings reveal a positive reception to university initiatives and a preference for ongoing virtual classes. There is an evident increase in, and varying intentions for, using mental health services, shaped by demographics, employment, and prior service utilization. Younger and female students showed …

The Association Of Skin Cancer Prevention Knowledge, Sun-Protective Attitudes, And Sun-Protective Behaviors In A Navy Population, Rachel Newnam, Uyen Le-Jenkins, Carolyn Rutledge, Craig Cunningham

Ellmer School of Nursing Faculty Publications

Introduction: U.S. Navy service members are primarily between the ages of 18 and 30 years and often required to be outside for extended periods of time in geographical locations with increased and often unfamiliar ultraviolet indexes that collectively increase their risk for skin cancer. Skin cancer is the country's most common form of cancer, yet there is a paucity of skin cancer prevention literature, especially within the U.S. Navy. The purpose of this study was to describe skin cancer risk and skin cancer prevention "cues-to-action" and to determine if skin cancer prevention knowledge was associated with sun-protective attitudes (e.g., prevention …

Unraveling The Complex Interactions Among Lung Cancer, Copd, Cardiovascular Disease, And Pulmonary Fibrosis: Overlapping Risks, Converging Pathways, And Integrated Care Approaches, Daisy Umutoni, Mayowa Soloman Owolabi, Sakariyau Adio Waheed

Chemistry & Biochemistry Faculty Publications

Background: The coexistence of lung cancer, chronic obstructive pulmonary disease (COPD), cardiovascular disease (CVD), and pulmonary fibrosis poses significant challenges in clinical management due to shared risk factors, overlapping pathogenic mechanisms, and the complexity of co-managing multimorbid conditions. Smoking, environmental exposures, and genetic predispositions are critical shared risk factors, while common molecular mechanisms such as oxidative stress, chronic inflammation, and aberrant tissue remodeling contribute to the pathogenesis of these diseases. This review comprehensively examines the prevalence, shared mechanisms, and clinical implications of these comorbid conditions, emphasizing the importance of integrated management strategies to improve patient outcomes. We further highlight research …

Vegetarian Diet And Health Outcomes, Shabana Masood

CGU Theses & Dissertations

Introduction: Vegetarian diet is one of the most consistent diets which has shown long-term health benefits. According to a nationwide survey of adults 18+, 4% of Americans were vegetarians. The dissertation was divided into 3 separate studies and assessed the effect of vegetarian diet in the association between (Study1) childhood ADHD symptoms and young adult weight status; (Study 2) health behaviors and depression in young adults; (Study 3) comparison of weight perception and weight control strategies among vegetarians and non-vegetarians.

Methods: The National Longitudinal Study of Adolescent to Adult Health (Add Health) dataset is a national dataset spanning decades and …

Answering The “Now What?”: The Development Of A Transdisciplinary Breast Cancer Survivorship Nonprofit Organization, Vir-Iaesta Maniquiz Vergel De Dios

CGU Theses & Dissertations

Although patients are living longer or are surviving breast cancer, the side effects of treatment still leave patients struggling with quality-of-life issues. The lack of whole-person care leaves patients unequipped after treatment is complete, searching for answers and a way to survive on their own. The unintended consequence becomes a dramatic shift from the weekly/daily medical appointments during active treatment to a silence that can be daunting for many to navigate. Living Your Truth Empowered, shortened to LYTE Foundation, is an antiauthoritarian minded and anti-hierarchal nonprofit created to address the needs of the growing breast cancer survivor population. LYTE is …

The Formation And Operationalization Of Charter(S) For The Lyte Foundation, Inc. (Living Your Truth Empowered), Through The Creation Of Policies, Roles, And Responsibilities Of Charter Leaders, Identification Of Resources, And Identification Of Community Needs, Charles Ngoc Tran

CGU Theses & Dissertations

This study aimed to develop policies and procedures needed for the operationalization of LYTE's charters. Employing a dual-methodology approach in document review and qualitative study, the study addressed two main objectives. The first is through document review and analysis of successful charters and nonprofit organizations in the US. With the insights gained from document analysis, drafts of policies required for LYTE’s charters operationalization were developed. The second is through interviews with organizational leaders and stakeholders such as breast cancer survivors and advocates. This provided perspectives and thematic insights crucial for tailoring policies specific to LYTE’s charters. The resulting deliverables include …

An Impedance Tube Technique For Estimating The Insertion Loss Of Earplugs, K. Carillo, O. Doutres, F. Sgard

Études primaires

This paper proposes a quick and straightforward technique for estimating the insertion loss (IL) of earplugs measured on an acoustical test fixture (ATF) using a commercial impedance tube. In this method, the earplug's acoustic properties (i.e., its transmission loss and the reflection coefficient of its medial surface) are determined from its transfer matrix measured using the three-microphones impedance tube method modified here for the current application. The IL is then estimated using a one-dimensional analytical model of open and occluded earcanals based on the wavefield decomposition theory. The method is evaluated numerically and experimentally from 50 Hz to 6.5 kHz. …

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

Assessing The Value And Knowledge Gains From An Online Tick Identification And Tick-Borne Disease Management Course For The Southeastern United States, Catherine A. Lippi, Holly D. Gaff, Alexis L. White, Sadie J. Ryan

Biological Sciences Faculty Publications

Background

Tick-borne diseases are a growing public health threat in the United States. Despite the prevalence and rising burden of tick-borne diseases, there are major gaps in baseline knowledge and surveillance efforts for tick vectors, even among vector control districts and public health agencies. To address this issue, an online tick training course (OTTC) was developed through the Southeastern Center of Excellence in Vector-Borne Diseases (SECOEVBD) to provide a comprehensive knowledge base on ticks, tick-borne diseases, and their management.

Methods

The OTTC consisted of training modules covering topics including tick biology, tick identification, tick-borne diseases, and public health, personal tick …

Early Onset Colorectal Cancer: Research, Trends & Challenges, Sarah E. Smith

Capstone Showcase

Early onset colorectal cancer (EOCRC) incidence and mortality are rising in a global trend, contrasting with improvements seen in late-onset colorectal cancer (LOCRC). EOCRC appears to differ in presentation, histology, and pathology from LOCRC painting concerns of a more aggressive tumor profile. With incidence steadily climbing, there is still lacking awareness and guidance on screening for EOCRC. This article aims to provide background on EOCRC including epidemiology, risk factors, and traits, as well as to explore methods for adjusting provider screening criteria to combat this concerning trend.

Introducing Comprehensive Sexuality Education And Hiv Prevention And Treatment Methods Through Pop-Up Clinics To Secondary School Girls In Kwazulu-Natal, South Africa, Eliza I. Tobin, Joaquin Carlos Pinga, Caitlyn Stanya

Capstone Showcase

Human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system leading to people living with HIV (PLHIV) immunodeficient and more susceptible to other infections or diseases (UNAIDS, 2023b). This can lead to acquired immunodeficiency syndrome (AIDS) within 8-10 years of infection (UNAIDS, 2023b). HIV does not always present symptoms, making it hard for people to identify their HIV status without proper screening. The lack of awareness around a person’s status has led HIV to spread worldwide. In addition to the worldwide spread of HIV, there is no cure for the disease, however, antiretroviral therapy (ART) is mainly used …

Reducing The Prevalence Of Overweight And Obesity In Children Ages 10-13 In Charleston, West Virginia Through A School-Based Nutrition Education And Physical Activity Program, Isabella Tullio, Emma Heffley, Natalie Scardino

Capstone Showcase

Childhood overweight and obesity, the excessive or abnormal accumulation of fat causing a health risk, is primarily caused by lifestyle issues including inadequate physical activity and too many calories from food and drinks (WHO, 2020; Mayo Clinic, n,d). Key determinants of health for childhood obesity include physical environment, socioeconomic status or occupation, education level, and school environments. Children with parents who have low socioeconomic status, live in a food desert, (a neighborhood with limited access to fresh fruits, vegetables, and whole grains), or a food swamp, (a neighborhood with a saturation of fast-food outlets, convenience stores, and corner stores), or …

New York City’S Health Governance And Activism From The 1950s To The 1970s, Andres Valcarcel

Theses and Dissertations

New York City's expansive network of hospitals and preventative health services has an intense history outside of the popular narratives of biomedical and technological advancement. This thesis will discuss the period between the 1950s and 1970s and the various movements and parties that shaped the city's health and hospital system. During this period, New York City's healthcare delivery system became increasingly privatized and commercialized; processes that improved the quality of healthcare yet simultaneously barred the poorest from accessing it. Communities, healthcare workers, and civil rights organizations worked to address perceived faults and extend their agency in health and hospital policy; …

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

Improving Discharge Education Quality In Urgent Care Settings: A Quality Improvement Project, Brielle N. Patscheider

Master's Theses and Capstones

BACKGROUND:

Effective discharge education is vital for improving patient care by enhancing health outcomes and reducing hospital readmission. When patients receive thorough and personalized discharge instructions, they are better able to manage their health, follow treatment plans, and identify symptoms needing further attention. This not only boosts patient satisfaction and safety but also reduces the strain on healthcare systems by decreasing preventable readmissions.

LOCAL PROBLEM:

Urgent care facilities serve diverse populations with a range of common, non-emergency ailments. The rapid service and walk-in availability often lead to a high volume of patients with diverse and complex medical needs. To eliminate …

Health Vulnerability Mapping For Drought: A Case Study In A Predominantly Rural, Agricultural State, Babak Jalalzadeh-Fard, Jagadeesh Puvvula, Kelly Smith, Michael Hayes, Rachel Lookadoo, Rezaul Mahmood, Sharon J. Medcalf, Clinton Rowe, Martha Durr, Jesse E. Bell

Journal Articles: Environmental, Agricultural & Occupational Health

No abstract provided.

Predictive Power Of Wastewater For Nowcasting Infectious Disease Transmission: A Retrospective Case Study Of Five Sewershed Areas In Louisville, Kentucky., Fayette Klaassen, Rochelle H. Holm, Ted Smith, Ted Cohen, Aruni Bhatnagar, Nicolas A. Menzies

Faculty and Staff Scholarship

Background: Epidemiological nowcasting traditionally relies on count surveillance data. The availability and quality of such count data may vary over time, limiting representation of true infections. Wastewater data correlates with traditional surveillance data and may provide additional value for nowcasting disease trends. Methods: We obtained SARS-CoV-2 case, death, wastewater, and serosurvey data for Jefferson County, Kentucky (USA), between August 2020 and March 2021, and parameterized an existing nowcasting model using combinations of these data. We assessed the predictive performance and variability at the sewershed level and compared the effects of adding or replacing wastewater data to case and death reports. …

A Scoping Review Of Perceptions And Fears Experienced By Families With Children With Developmental Disabilities In Sub-Saharan Africa., Isaac Twum Boamah

Theses and Dissertations

The prevalence of perception and fear surrounding families with children with developmental disabilities in Sub-Saharan Africa reveal a complex interplay of cultural, social, economic, and healthcare factors. This interplay of factors results in stigma, which often leads to societal misconceptions and discrimination, exacerbating the challenges faced by affected families. This study seeks to identify the individual and family perception of developmental disabilities, document the stigma experienced by the individual and their families, and document the resources available to help alleviate the plight faced by the individuals and their families. It further seeks to find gaps in the literature on developmental …

Preparing Healthcare Education For An Ai-Augmented Future, Jiajie Zhang, Susan H Fenton

Faculty, Staff and Student Publications

Artificial intelligence (AI) fundamentally transforms healthcare education as a knowledge enterprise, creating a distributed cognitive system composed of the human brain, which remains relatively unchanged, and AI-based knowledge and cognitive functions, which have accelerated exponentially in scale and power. Education must focus on developing skills to collaborate with AI and on achieving outcomes like problems solved and discoveries made. Curriculum and education policies also need to adapt to this transformation.

Systemic Treatment Of Patients With Metastatic Breast Cancer: Asco Resource-Stratified Guideline Q And A, Sana Al Sukhun, Bogda Koczwara, Sarah Temin, Banu K Arun

Faculty, Staff and Student Publications

The Systemic Treatment of Patients with Metastatic Breast Cancer: @ASCO Resource-Stratified Guideline Q and A presents takeways, rationale, and key recommendations based on #JCOGO full guideline for patients by menopausal and marker status.

Human Equilibrative Nucleoside Transporter 1: Novel Biomarker And Prognostic Indicator For Patients With Gemcitabine-Treated Pancreatic Cancer, Jianchun Xiao, Fangyu Zhao, Wenhao Luo, Gang Yang, Yicheng Wang, Jiangdong Qiu, Yueze Liu, Lei You, Lianfang Zheng, Taiping Zhang

Faculty, Staff and Student Publications

AIM: This article aimed to find appropriate pancreatic cancer (PC) patients to treat with Gemcitabine with better survival outcomes by detecting hENT1 levels.

METHODS: We collected surgical pathological tissues from PC patients who received radical surgery in our hospital from September 2004 to December 2014. A total of 375 PC tissues and paired adjacent nontumor tissues were employed for the construction of 4 tissue microarrays (TMAs). The quality of the 4 TMAs was examined by HE staining. We performed immunohistochemistry analysis to evaluate hENT1 expression in the TMAs. Moreover, we detected hENT1 expression level and proved the role of hENT1 …

Modernizing And Harmonizing Regulatory Data Requirements For Genetically Modified Crops-Perspectives From A Workshop, Nicholas P Storer, Abigail R Simmons, Jordan Sottosanto, Jennifer A Anderson, Ming Hua Huang, Debbie Mahadeo, Carey A Mathesius, Mitscheli Sanches Da Rocha, Shuang Song, Ewa Urbanczyk-Wochniak

Faculty, Staff and Student Publications

Genetically modified (GM) crops that have been engineered to express transgenes have been in commercial use since 1995 and are annually grown on 200 million hectares globally. These crops have provided documented benefits to food security, rural economies, and the environment, with no substantiated case of food, feed, or environmental harm attributable to cultivation or consumption. Despite this extensive history of advantages and safety, the level of regulatory scrutiny has continually increased, placing undue burdens on regulators, developers, and society, while reinforcing consumer distrust of the technology. CropLife International held a workshop at the 16th International Society of Biosafety Research …

Hpv Vaccination In Africa In The Covid-19 Era: A Cross-Sectional Survey Of Healthcare Providers' Knowledge, Training, And Recommendation Practices, Joel Fokom Domgue, Issimouha Dille, Sharon Kapambwe, Robert Yu, Freddy Gnangnon, Lameck Chinula, Gad Murenzi, Nomonde Mbatani, Mala Pande, Fatoumata Sidibe, Joseph Kamgno, Bangaly Traore, Hicham El Fazazi, Mamadou Diop, Pierre-Marie Tebeu, Mohenou Isidore Diomande, Fabrice Lecuru, Isaac Adewole, Marie Plante, Partha Basu, Jean-Marie Dangou, Sanjay Shete

Faculty, Staff and Student Publications

INTRODUCTION: Although the burden of cervical cancer in Africa is highest, HPV vaccination coverage remains alarmingly low in this region. Providers' knowledge and recommendation are key drivers of HPV vaccination uptake. Yet, evidence about providers' knowledge and recommendation practices about the HPV vaccine against a backdrop of emerging vaccine hesitancy fueled by the COVID-19 pandemic is lacking in Africa.

METHODS: A cross-sectional study was conducted in 2021-2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior training, the availability of the HPV vaccine in their practice, whether they recommended the HPV vaccine, …

Secondhand Tobacco Smoke Exposure In Homes And Vehicles In Youth: Disparities Among Racial, And Sexual And Gender Minorities, Rajesh Talluri, Sahil S Shete, Surendra S Shastri, Sanjay Shete

Faculty, Staff and Student Publications

BACKGROUND: Secondhand smoke exposure (SHSe) among youth is a serious public health concern, leading to an increased risk of conditions such as asthma and respiratory infections. However, there is little research on SHSe among vulnerable populations, such as racial and sexual minorities. Understanding the factors associated with youth SHSe in homes and vehicles is crucial to developing better protective policies.

METHODS: This study utilized 2020 data from the National Youth Tobacco Survey, a representative sample of middle- and high-school students in the US. The primary outcomes were youth SHSe at home and while riding in a vehicle. Multinomial regression models …

Exploring Measurement Tools Used To Assess Knowledge, Attitudes, And Perceptions Of Pregnant Women Toward Prenatal Screening: A Systematic Review, Lea Sacca, Yasmine Zerrouki, Sara Burgoa, Goodness Okwaraji, Ashlee Li, Shaima Arshad, Maria Gerges, Stacey Tevelev, Sophie Kelly, Michelle Knecht, Panagiota Kitsantas, Robert Hunter, Laurie Scott, Alexis Piccoli Reynolds, Gabriela Colon, Michele Retrouvey

Faculty, Staff and Student Publications

There is a lack of standardized measurement tools globally to assess knowledge, attitudes, and perceptions of expecting women toward prenatal screening. The purpose of this systematic review was to identify reasons women pursue or decline prenatal screening and compare the strengths and limitations of available measurement tools used to assess pregnant women's perceptions, knowledge, and attitudes toward prenatal screening. This review followed the five-step York methodology by Arksey and O'Malley and incorporated recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist for the extraction, analysis, and presentation of results. The five steps consisted of: (1) identification of …

Fitness Consequences Of Depressive Symptoms Vary Between Generations: Evidence From A Large Cohort Of Women Across The 20th Century, Christopher I Gurguis, Renée A Duckworth, Nicole M Bucaro, Consuelo Walss-Bass

Faculty, Staff and Student Publications

Depression has strong negative impacts on how individuals function, leading to the assumption that there is strong negative selection on this trait that should deplete genetic variation and decrease its prevalence in human populations. Yet, depressive symptoms remain common. While there has been a large body of work trying to resolve this paradox by mapping genetic variation of this complex trait, there have been few direct empirical tests of the core assumption that there is consistent negative selection on depression in human populations. Here, we use a unique long-term dataset from the National Health and Nutrition Examination Survey that spans …