Community Health and Preventive Medicine Commons^™

Cardiovascular Disease And Post Traumatic Stress Disorder In Adults Exposed To The Terrorist Attacks On The World Trade Center, Katie C. Imhof

Master of Public Health Program Student Publications

Following events of terrorism communities and individuals are subject to the cumbersome responsibilities associated with rescue and recovery efforts. In addition to the loss of life and direct injuries sustained during the incident, long term health outcomes among the exposed population are often seen. Both physical and mental health can be affected as a result of the exposure, and some outcomes do not immediately present themselves. The population exposed to the September 11, 2001 terrorist attacks on the World Trade Center in New York City is no different, and the World Trade Center Health Registries database has been established by …

Prevalence Of Metabolic Abnormalities In Children With Varying Degrees Of Obesity, Leah Sabato

Master of Public Health Program Student Publications

As the prevalence of obesity among children has risen, metabolic syndrome, a cluster of abnormalities which includes obesity, altered glucose metabolism, hypertension, and dyslipidemia, has increasingly become recognized in the pediatric population. Metabolic syndrome has been studied extensively in adults, and there is increasing interest to understand the condition in adolescents; however, studies of metabolic syndrome in younger children are limited. The purpose of this study is to examine the prevalence of metabolic syndrome and its individual components among children aged 6-10 years. Demographic, anthropometric, and biochemical data were gathered retrospectively from the medical records of 222 obese children aged …

The Association Between Neighborhood Walkability, Type 2 Diabetes, And Socioeconomic Status In Residents Of Eight Ohio Counties, Dawn L. Ebron

Master of Public Health Program Student Publications

Objective: Regular physical activity is beneficial in preventing type 2 diabetes. Walking, either for recreation or to travel to a destination, is an inexpensive way to meet physical activity guidelines. Disadvantaged populations with low socioeconomic status (SES) have a higher prevalence of type 2 diabetes and are more likely to live in unwalkable neighborhood. The purpose of this study was to determine the association between SES and neighborhood walkability in eight Ohio counties with highest prevalence of type 2 diabetes in the state.

Methods: Using data from the 2010 Ohio Behavioral Risk Factor Surveillance System (BRFSS) survey and Walk Score …

Colorectal Cancer In Montgomery County, Ohio: A Descriptive Analysis, Ursula Turner

Master of Public Health Program Student Publications

In the United States colorectal cancer (CRC) is one of the most common malignancies, and is the third leading cause of cancer deaths (Sharma & O’Keefe, 2007). Approximately 270,000 cases of colorectal cancer were diagnosed in 2008 with 81,900 cases resulting in death. There were 16,520 cases diagnosed in African Americans and 7,120 resulted in death or significant illness (American Cancer Society, 2008). Mortality as the result of CRC is greater among the African American population with 27% and 38% higher death rates for African American males and females when compared with Caucasian males and females (Agarwal, 2005). CRC is …

A Geospatial Analysis Of The Role Of Urban Forestry In Outdoor Ambient Air Pollution Reduction In Dayton, Ohio, Nicholas P. Clemens

Master of Public Health Program Student Publications

Objective: Air pollution is associated with negative respiratory and cardiovascular health outcomes. According to the American Lung Association listing for 2011, the Dayton-Springfield-Greenville, OH area ranks 22 out of 277 US cities for year round particulate pollution. The tree canopy cover plays a significant role to reduce air pollution. The purpose of this analysis was to quantify the role of urban forestry in the Dayton, Ohio metropolitan area in reducing air pollution.

Methods: Using a peer-reviewed model designed by the US Forest Service, the imagery data was analyzed to create a descriptive analysis of the canopy cover in the Dayton, …

Nation's Future: Preparedness For Burn Victims, Jacqueline Tippett

Master of Public Health Program Student Publications

Natural and manmade disasters have occurred throughout the decades, within the United States and around the globe. Increased incidence and awareness of terrorist attacks have caused the US to re-evaluate its safety and preparedness efforts to prevent such events from happening and to develop an adequate response plan if such unfortunate events do occur. Therefore, the purpose of this research is to (1) review and discuss the American Burn Association’s (ABA) paradigm for emergency planning in burn disasters, (2) give recommendation about the National Response Framework (NRF) guidelines on “all hazards” response as they pertains to burns, and (3) give …

An Examination Of Ohio’S Physical Education Academic Content Standard 4, Benchmark A For Grades 9-12, Gabriel Jones

Master of Public Health Program Student Publications

Objective: The purpose of this study was to describe select physical education teachers’ perceptions of the effectiveness and accuracy of the assessments for Ohio's Physical Education Academic Content Standard 4 Benchmark A in determining the fitness and physical activity levels of high school students. A secondary purpose was to describe the fitness levels of high school physical education students, based on assessment data.

Methods: Participants were forty-one physical education teachers and ninety high school students from southwest Ohio. Data were collected from the teachers through an online questionnaire and from students with FITNESSGRAM testing. FITNESSGRAM data from one local school …

Acl Injuries In Montgomery County, Oh: Moving Toward The Development Of A Prediction Model, Kelly Estes

Master of Public Health Program Student Publications

Anterior cruciate ligament (ACL) tears are one of the most frequent soft tissue injuries of the knee. A torn ACL leaves the knee joint unstable and at risk for further damage to other soft tissues manifested as pain, dislocation, and osteoarthritis. A better understanding of the dimensional details of knee joints suffering ACL tears and a prediction model for individuals susceptible to tears is needed. Using a cross-sectional study design, magnetic resonance images (MRIs) of 72 patients with knee injuries were evaluated from an orthopedic surgery group practice. The status of the ACL was the main variable of interest, creating …

Impact Of Congestive Heart Failure Discharge Planning On Congestive Heart Failure Re-Admission Rates, Sula E. Mazimba

Master of Public Health Program Student Publications

Background: Congestive Heart Failure (CHF) is the most common diagnosis accounting for more healthcare costs than any diagnosis. CHF readmissions contribute significantly to this expenditure. Quality of care in heart failure is linked to process based performance measures. This study evaluated the relationship between adherence to performance metrics and 30 day readmission rates.

Methods: This was a single center case-control study that evaluated 6063 consecutive patients admitted with CHF from December 2001 through December 2008. Data was collected for readmission to the hospital within 30 days and compliance to the heart failure performance measures at discharge.

Results: The rate of …

State Preparedness: A Study Of State Plans, Zachary Fehrman

Master of Public Health Program Student Publications

Non-pharmaceutical interventions (NPIs) have been used since the early years of public health. The Centers for Disease Control and Prevention (CDC) provides a standard definition for NPI and what NPI strategies are contained within the definition. This paper seeks to discover if state pandemic influenza plans use the term NPI and its strategies, and if states’ use of NPI strategies in their state pandemic plans is consistent with the CDC definition. To determine how states were defining and using the term NPI and NPI strategies a survey of forty-eight (48) state plans was conducted using each respective states’ pandemic plan. …

Assessment And Management Of Adult Obesity In A Primary Care Practice, Sherry M. Adkins

Master of Public Health Program Student Publications

Purpose: The purpose of this project was to describe primary care physician adherence to National Heart Lung and Blood Institute (NHLBI) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (1998) and to explore patient characteristics associated with physician assessment and management behaviors. Patient characteristics included age, sex, race, BMI, associated disease risk, and Medicaid coverage.

Methods: A chart abstraction of 99 randomly selected adult patients with at least one visit to a particular primary care practice during a 12-month period was completed. Patients were not pregnant during the year of review, and had a …

The Influence Of School Eating Environment On Children's Eating Behaviors: An Examination Of The Snda-Iii, Sabrina M. Neeley

Master of Public Health Program Student Publications

The prevalence of childhood overweight and obesity in the United States has prompted researchers to examine the factors that contribute to children’s food choices and consumption. Schools provide ample opportunities to teach children healthy eating habits, as well as create eating environments that are conducive to healthy eating behaviors. The National School Lunch Program (NSLP) provides federally assisted meals to millions of children every day and the assessment of the NSLP provides an opportunity to examine the school-eating environment. Hierarchical and logistic modeling of the SNDA-III, the USDA assessment of the NSLP, was conducted to determine relationships between environmental factors …

Prevalence, Knowledge, And Concern About Bed Bugs, Mary Beth Kaylor

Master of Public Health Program Student Publications

Recent research suggests that the United States and the world are on the verge of a bed bug pandemic. Assumptions have been made that socioeconomic status is not an indicator and that bed bugs are not competent disease vectors. However, little information is available at the local level about the prevalence of bed bugs in private homes. This study aimed to identify prevalence, knowledge, and concern about bed bugs in one village in Ohio. Responses from 96 individuals who completed the Prevalence, Knowledge, and Concern about Bed Bugs (PK CABB) survey were utilized for data analysis. The majority of the …

Worksite Wellness: An Administrative Perspective, Neha Kumar

Master of Public Health Program Student Publications

Objective: To develop a better understanding of businesses’ goals and purpose for offering worksite wellness opportunities and the level of administrative support for worksite wellness programs.

Method: Human resource directors, benefit managers, or other administrators of 76 businesses that have contracted with Premier Community Health in the past 2 years were contacted by e-mail to complete a standardized online survey on SurveyMonkey®. The survey included questions about the businesses worksite wellness current programs and future interests. In addition, data on how often businesses have utilized each of the PCH worksite offerings over the past 2 years was collected from the …

Situation Analysis Of Disability Resources And Needs Of Shantytowns Near Lima, Peru, Jessica Hunt

Master of Public Health Program Student Publications

Individuals in shantytowns of Lima, Peru experience unique challenges due to socioeconomic status and perceived inabilities. A situation analysis using qualitative ethnographic interviews of key participants (n=15) and one focus group (n=7) was conducted to explore life with disability in a shantytown of Lima, Peru. Findings showed that individuals with disability face physical and attitudinal barriers that limit social inclusion through the avenues of rehabilitation, education, and employment. The familial complex is expected to provide care for the individual with disability. The adult family member often chooses between providing income for the household and providing care and safety for their …

The Effect Of Prenatal Care And Other Factors On Preterm Births In Montgomery County 2007-2009, Leslie A. Schmieder

Master of Public Health Program Student Publications

Introduction Preterm birth is defined as a baby who is born before 37 weeks of pregnancy. Problems with preterm birth include an increased risk for health complications throughout life as well as having significantly more medical expenses compared to a full term infant. Prenatal care has shown to decrease the risk for preterm birth nationally. The objective of this project was to analyze prenatal care and other risk and demographic factors to determine their association with preterm birth in Montgomery County.

Method Data used included the 2007-2009 Montgomery County Birth Certificate Data for mothers who had singleton births. The Kessner …

Pertussis In Ohio: A Descriptive Analysis Of The 2010 Columbus Outbreak And Patterns Of A Reemerging Childhood Disease, Christopher Rohde

Master of Public Health Program Student Publications

Objective: In 2010, Columbus, Ohio experienced the largest outbreak of pertussis that it has had in the past 25 years. Similar outbreaks are occurring across the nation on an increasing basis. This descriptive study examines the 2010 outbreak and describes the demographics of the affected population. Comparison is made to previous and current pertussis incidence in Ohio and outbreaks elsewhere in the United States. Contributing factors to the increasing occurrence of pertussis outbreaks are discussed.

Methods: Raw data was obtained from the Columbus Public Health epidemiology department and is gathered through the Ohio Disease Reporting System (ODRS). Pertussis cases are …

Prevalence Of Obesity Among Head Start Preschoolers In Western Ohio, Angela Sims

Master of Public Health Program Student Publications

Objective: The intent of this study was to examine low income Head Start overweight and obese preschoolers, ages 3-5, in 8 western Ohio counties. Variables of interest included: obesity status, rural versus metropolitan location, home versus center-based Head Start, and access to physicians.

Methods: Data was collected retrospectively from the host Head Start site located in Piqua, Ohio. All Head Start enrolled preschoolers (N=1,181) ages 3 to 5 within the 8 western Ohio counties and 43 programs were studied. All children were considered of low income based on their acceptance into the Head Start program.

The data was retrieved from …

Evidence-Based Public Health Practices For Screening For Postpartum Depression, Roula Hilli

Master of Public Health Program Student Publications

Background: Five to 20 percent of the women worldwide suffer from Post Partum depression (PPD) which has serious negative impacts on the mother and her newborn. Although PPD is a preventive disease thorough screening using different tools, half of its cases are left undetected.

Purpose of the study: Is to find the best practice for PPD screening, which includes the best screening tool, best setting for screening, best administration period and the best cut-off score.

Methods: It is an Evidence-based Public Health (EBPH) review through a comparative study of 82 studies since 2005 that screened women for PPD in the …

Gaps And Strengths In Us Policies On Infant And Young Child Feeding: An Analysis Based On The Global Strategy On Infant And Young Child Feeding, Linda J. Smith

Master of Public Health Program Student Publications

This research project reviews the evidence on the significance of infant and young child feeding to public health goals, analyzes US policy documents in relationship to the Global Strategy using the World Breastfeeding Trends Initiative (WBTi) to quantify the findings into a national score, and then summarizes the gaps and strengths in US policies and makes recommendations. Using the WBTi scoring system, strengths for the US exist in national policy, Baby-Friendly Hospital Initiative, monitoring and evaluation, and complementary feeding. Mother support and community outreach, information and support were moderate. Gaps exist in policies on infant feeding in emergencies and for …

Determining Evidence-Based Practices In Asthma Management, Erin Smiley

Master of Public Health Program Student Publications

Objective: One aim of this study will focus on determining what are evidence-based studies in asthma control. A second aim focuses on determining which asthma interventions, self-monitoring tools and asthma management programs have shown to be the most significant in improving outcomes in patients with asthma. Recommendations will be made to future asthma self-management programs based on the findings.

Methodology: The review of 15 evidence-based research studies is used to identify and analyze the best asthma self-management practices to be implemented in a community health education program. Using the Brownson framework a weighting schema was created based on the level …

Unmasking The Moving Threat: Reckless Driving, Borderline Personality Disorder, And The Impact On Motor Vehicle Accidents, Charlene Lam

Master of Public Health Program Student Publications

Background: Motor vehicle accidents (MVAs), a leading cause of mortality in the United States have an enormous impact on public health. Researchers contend that approximately 90% of all MVAs are, to some extent, a result of driver characteristics and behavior (Lewin, 1982). One of the least researched driver characteristics is psychiatric comorbidity, especially borderline personality disorder (BPD), a disorder that is characterized by impulsivity and emotional volatility.

Objective: The purpose of this study is to examine the relationship between BPD and driving citations.

Method: Using two measures for BPD, we surveyed a consecutive sample of patients who were being seen …

Assessment Of Support Service Needs Of Primary Caregivers Of Hiv And Aids Infected Children: A Review Of Literature And Suggestions For Practice, Barry Eneh

Master of Public Health Program Student Publications

Summary: With the advent of highly active antiretroviral treatment, routine screening and treatment options for pregnant women for perinatally acquired HIV and AIDS, infection is on dramatic decline in the U.S. In spite of the declines and the medical advances, primary and informal caregivers of infected children continue to face innumerable challenges with regard to the availability, access and utilization of non-medical supportive service care needs. HIV/AIDS continues to create unique challenges for infected children and the non-infected family caregivers at multiple levels; impacting their relationships, resources and resilience.

Objective: This literature review identifies and assesses the unique and critical …

Maternal Characteristics And Infant Birth Weight In Dayton, Ohio, Matthew Pellerite

Master of Public Health Program Student Publications

Objective: To better understand and identify modifiable maternal risk factors that are driving the increased incidence of low birth weight (LBW) in Montgomery County.

Background Information: LBW has lifelong effects on growth and development. These medical and social implications are coupled with an enormous economic burden. In the US, over 5.8 billion dollars are spent annually to care for LBW babies. Despite the recognition of these medical and economic challenges and the implementation of public campaigns to decrease rates, LBW trends have continued to increase. Between 1995 and 2005 the LBW rates in the US incrementally increased from 7.3% to …

Environmental Influences On Pediatric Obesity: An Examination Of The 2007 National Survey Of Children's Health (Nsch), Donny Dunfee

Master of Public Health Program Student Publications

Obese children are more likely to become obese as adults; hence, they are at increased risk for a number of adult diseases. As with adult obesity, several variables contribute to the increasing prevalence of childhood obesity. The intent of this report is to illustrate the connection between childhood obesity and the social environmental interactions of populations. With the increasing prevalence of obesity in adults and children, healthcare and public health professionals view childhood overweight and obesity as one of the most serious public health concerns of our time. This research conducts a secondary analysis of the National Survey of Children’s …

Demographic Factors That Predict Cervical Cancer Screenings In Ohio Women With Disabilities, Shari Mae Martin

Master of Public Health Program Student Publications

Background: Cervical cancer screening (CCS) rates are lower for women with disabilities than for the general population. The purpose of this project was to describe cervical cancer screening rates in women with disabilities, living in Ohio, and explore the relationship of select demographic factors to cervical cancer screening participation.

Methods: A chart audit of 350 randomly selected women with disabilities, ages 20-80, enrolled in a statewide home care waiver program was completed.

Results: Less than half of the women (45.4%) had obtained a CCS within the last 3 years, compared to a rate of 82% for the general population of …

Diabetes Obesity-Wellness Opportunity Program (Dowop) Evaluation, Francis Banahene

Master of Public Health Program Student Publications

The aim of the study was to evaluate Diabetes Obesity - Wellness Opportunities Program (DOWOP) for overweight and obese adolescents aged eight to 14 years.

The study was conducted over 14 weeks at Victor J. Cassano, Sr. Health Center in Dayton, Ohio. Thirteen weekly nutrition, exercise and cognitive presentations were held. Cooking class was held on week thirteen. Participants completed food and activity diaries. The program sessions focused on healthy eating, increasing physical activity, decreasing sedentary behavior and supporting participants maintain healthy lifestyle.

Nurses recorded BMI and waist circumference at baseline, week 7 and week 14. Program administrators were interviewed …

Gender Differences In Risk Behaviors Of Adolescents Enrolled In An Inner City Charter High School, Kimbra Dent

Master of Public Health Program Student Publications

Adolescents engage in health risk behaviors (Grunbaum, 2001). Persons engaging in high‐risk behaviors during adolescence have disproportionally poor health as adults (Grunbaum et al., 2003; Resnick et al., 1997). Adolescents comprise a target group for health promotion and education programs to establish healthy lifestyle choices that transcend into adulthood. The purpose of this descriptive research study was to identify, analyze, and compare the health interests and health risk behaviors between male and female inner city, adolescent, charter high school students. The study served as a needs assessment before a health promotion and education program was implemented into the high school. …

Barriers To Accessing Primary Dental Care For The Uninsured/ Underinsured Population In The City Of Cincinnati, Kiana R. Trabue

Master of Public Health Program Student Publications

Despite federal, state and local efforts to provide access to dental services to vulnerable populations such as the uninsured and underinsured, many people still do not receive adequate dental care. This study seeks to identify barriers to primary dental care in the City of Cincinnati. The Cincinnati Health Department (CHD) operates five safety net health centers which provide dental care for the citizens of the Cincinnati service area. Surveys conducted in these centers found that cost was the main reason individuals do not see the dentist regularly. Even in those with dental insurance cost was a major barrier, although most …

The Relationship Of Maternal Age, Trimester Of Entry Into Prenatal Care, Maternal Postpartum Depression, And Race With Birth Weight Of Infants Born In Cincinnati, Ohio, Kelli Kohake

Master of Public Health Program Student Publications

Healthcare, resources, and technology in the United States (U.S.) has improved, yet the U.S. ranks 29th in the world for the highest infant mortality rates – behind other less developed countries. Within the U.S., Ohio (and Hamilton County in particular) has high rates of infant mortality. Low birth weight and preterm births are a major cause of infant mortality. Data analysis was done consisting of descriptive statistics and Analysis of Variance of the prenatal patients served at the Cincinnati Health Department health centers who delivered in 2009, with dependent variables of birth weight and postpartum depression. Independent variables included maternal …