Community Health and Preventive Medicine Commons^™

The Reduction Of Central Line-Associated Bloodstream Infections In Intensive Care Units Through The Implementation Of The Comprehensive Unit-Based Safety Program, Michael Andrew Basinger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSIs) are one of the most significant healthcare-associated infections (HAIs) in the Intensive Care Unit (ICU) setting resulting in increased lengths of stay, increased healthcare costs, and higher mortality rates (Institute of Healthcare Improvement [IHI], 2012). Evidence that CLABSIs are largely preventable has created opportunities for healthcare organizations to implement evidence-based bloodstream infection prevention practices to reduce or eliminate these infections (Lissauer, Leekisa, Prease, Thom, & Johnson, 2012). Other efforts to reduce CLABSIs include implementation of safety programs to improve the safety culture in ICUs (Lissauer et al., 2012). One program, the comprehensive unit-based safety program …

Factors Which Predict The Use Of Active Transportation To School Among Children In Clark County, Nv, Sheila G. J. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Active transportation to school (ATS) shows promise for increasing activity levels in children, but prevalence and correlates vary widely in cities and regions with different barriers and supports for active travel. Classification of ATS users is a current issue in the field. The purpose of this study was to determine the prevalence of ATS use and develop a predictive model of ATS for the novel population of children enrolled in grades K-8 in Clark County School District, a large metropolitan school district in Southern Nevada. Methods: This study used a secondary data from the National Center for Safe Routes …

Strategies For Prevention Of Road Traffic Injuries (Rtis) In Pakistan: Situational Analysis., Adeel Ahmed Khan, Zafar Fatmi

Community Health Sciences

Road traffic injuries (RTIs) are one of the leading causes of death among productive age group. Using systems approach framework (SAF), current preventive strategies for RTI control were reviewed in Pakistan. A review of the literature was done using four international search engines. Only ten studies on preventive strategies for RTI stemming from Pakistan were found. The first Road Traffic Injuries Research Network (RTIRN) surveillance system for road traffic injuries was established in urban city (Karachi) in Pakistan has shown promise for injury control and should be scaled up to other cities. Enforcement of traffic laws on seat-belt and helmet …

Health Care In The Motor City: Thriving Or Surviving?, Sally Coberly, William J. Scanlon

National Health Policy Forum

This site visit explored the forces shaping the delivery of health care in Detroit. Health care providers in Detroit face the twin challenges of controlling costs and serving a bifurcated metropolitan area that includes large numbers of uninsured, low-income, and vulnerable residents as well as more prosperous residents of a reviving inner core and the surrounding suburbs and counties. The program looked at the underlying economic, social, and physical conditions that make improving the health of the city's residents extremely challenging. Efforts to contain costs through payment innovations such as the Blue Cross Blue Shield of Michigan's Physician Group Incentive …

The Effects Of The Changes In Section 317 Rules For Administration Of Federally Purchased Vaccines, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Section 317 of the Public Health Services Act is a federal program that provides funds for the purchase of vaccines. These annual Congressional allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2013, Section 317 rules redefined the population eligible for immunization with Section 317 purchased vaccines. In Tennessee, the response was a policy change …

The Baby Friendly Hospital Initiative, Kathryn E. Brackett

Senior Honors Theses

Abstract

The Baby-Friendly Hospital Initiative (BFHI) is a worldwide movement started by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that is aimed at providing hospitals with a certification that guarantees the best possible patient-centered care for mothers and infants. It focuses on breastfeeding as optimal infant nutrition, and implements strategies to encourage and support mothers to breastfeed their infants exclusively for six months after birth. The Ten Steps to Successful Breastfeeding are a set of 10 simple, easy to understand guidelines developed by WHO and UNICEF for implementing this initiative in the hospital setting and …

Childhood Obesity And Familial Hypercholesterolemia: Genetic Diseases That Contribute To Cardiovascular Disease, Alyssa Caudle

Senior Honors Theses

Childhood obesity occurs as the result of an imbalance between caloric intake and energy expenditure. Genetic risk factors for obesity have become an area of research due to its permanency. Mutated genes such as Fat Mass and Obesity Associated (FTO), Leptin (LEP), Leptin Receptor (LEPR), Melanocortin 4 Receptor (MC4R), Adiponectin C1Q and Collagen Domain Containing (ADIPOQ), Proprotein Convertase Subtilisin/Kexin Type 1 (PCSK1), and Peroxisome Proliferator-Activated Receptor Gamma (PPARG) all contribute to the development of childhood obesity. In the presence of high cholesterol caused by obesity, the genetic condition known as familial hypercholesterolemia is exacerbated. Familial hypercholesterolemia is caused by a …

Trends In The Use, Sociodemographic Correlates, And Undertreatment Of Prescription Medications For Chronic Obstructive Pulmonary Disease Among Adults With Chronic Obstructive Pulmonary Disease In The United States From 1999 To 2010, Earl S. Ford, David M. Mannino, Anne G. Wheaton, Letitia Presley-Cantrell, Yong Liu, Wayne H. Giles, Janet B. Croft

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: The extent to which patients with COPD are receiving indicated treatment with medications to improve lung function and recent trends in the use of these medications is not well documented in the United States. The objective of this study was to examine trends in prescription medications for COPD among adults in the United States from 1999 to 2010.

METHODS: We performed a trend analysis using data from up to 1426 participants aged ≥20 years with self-reported COPD from six national surveys (National Health and Nutrition Examination Survey 1999-2010).

RESULTS: During 2009-2010, the age-adjusted percentage of participants who used any …

Blood Pressure Monitoring Of Hypertensive Patients In Primary Care: Barriers And Facilitators To Ambulatory, Office, And Home Blood Pressure Monitoring In The Context Of The Triple Aim, Elizabeth Andrews

Muskie School Capstones and Dissertations

Hypertension represents a population health issue in that many patients are misdiagnosed and over-or-under medicated. Research has indicated that overestimating the true blood pressure by 5 mmHg leads to over 30 million Americans being inappropriately treated with blood pressure medication (Handler, 2009). Blood pressure measurements taken in the office are often inaccurate due to patient behaviors, improper technique, and observer errors, yet providers are still using this method to diagnose hypertension. Therefore, considering other methods of blood pressure for the diagnosis and management of hypertension is important to the healthcare quality for millions of Americans.

The main objective of this …

Assessing The Readiness Of Nairobi Deaf Youth To Accept A Best-Practice Hiv/Aids Intervention, Ke'ala Morrell

Annual Undergraduate Conference on Health and Society

After nearly forty years of HIV/AIDS research in the global community, data on HIV/AIDS in the Deaf population is still disproportionately neglected. No surveillance system is in place to monitor prevalence, awareness or mode of HIV infection in the Deaf community. Additionally, prevention and education interventions have yet to be tailored to meet the specific needs of this highly vulnerable population.

Purpose: This project attempted to assess the readiness of the Nairobi Deaf youth community to accept a best-practice HIV/AIDS intervention. The broad objective of this research was to assess HIV awareness, perceptions and behaviors of Deaf youth in regards …

Lhds Increase Their Use Of Ebdm Practices From 2010 To 2013, Kay A. Lovelace, Gulzar H. Shah, Carolyn J. Leep, Robert Aronson

Health Policy & Community Health: Faculty Presentations (1993-2023)

Background: An evidence-based approach is needed to effectively address the gap between population health goals in the United States and current morbidity and mortality rates. Recently, the authors developed an index to allow researchers to assess the frequency of evidence-based decision making (EBDM) practice in LHDs. The first descriptive analysis was conducted with data from the NACCHO 2010 Profile Study of Local Health Departments (LHDs). The current research was designed to assess changes in the percentage of LHDs using EBDM practices from 2010 to 2013.

Research Objective: To identify changes in the frequency with which LHDs carried out EBDM practices …

Understanding Hiv Care Delays In The Us South And The Role Of The Social-Level In Hiv Care Engagement/Retention: A Qualitative Study, Courtenay Sprague, Sara E. Simon

Center for Peace, Democracy and Development Publications

Introduction: In a significant geographical shift in the distribution of HIV infection, the US South - comprising 17 states - now has the greatest number of adults and adolescents with HIV (PLHIV) in the nation. More than 60% of PLHIV are not in HIV care in Alabama and Mississippi, contrasted with a national figure of 25%. Poorer HIV outcomes raise concerns about HIV-related inequities for southern PLHIV, which warrant further study. This qualitative study sought to understand experiences of low-income PLHIV on the AIDS Drug Assistance Program in engagement and retention in continuous HIV care in two sites in Alabama. …

The Effect Of Early Head Start On Child Welfare System Involvement: A First Look At Longitudinal Child Maltreatment Outcomes, Beth L. Green, Catherine Ayoub, Jessica Dym Bartlett, Adam Von Ende, Carrie Jeanne Furrer, Rachel Chazen-Cohen, Claire Vallotton, Joanne Klevens

Center for Improvement of Child and Family Services Publications

The high societal and personal costs of child maltreatment make identification of effective early prevention programs a high research priority. Early Head Start (EHS), a dual generational program serving low-income families with children prenatally through age three years, is one of the largest federally funded programs for infants and toddlers in the United States. A national randomized trial found EHS to be effective in improving parent and child outcomes, but its effectiveness in reducing child maltreatment was not assessed. The current study used administrative data from state child welfare agencies to examine the impact of EHS on documented abuse and …

Implementing A Community-Based Intervention For African American Mothers And Daughters, Teri Aronowitz, Nandini Sengupta

Office of Community Partnerships Posters

Adolescents represent one of the fastest growing risk groups for HIV. Inner-city, minority youth are at highest risk because of concentration of HIV in inner-city areas, higher rates of STDs, and early sexual initiation. Mothers are the primary sex educator of daughters, and girls state their relationship with their mother was an important influence on their delaying sexual activity. With 70% of adolescent HIV seroconversions occurring among African American (AA) females, studies are urgently needed to enhance mother-daughter sexual communication. The purpose of this poster is to offer insights on the logistics of carrying out a manualized program.

Two Community Collaborations With Sexual Minority Women’S Ngos In Shanghai & Hong Kong, Connie Chan, Hsin-Ching Wu

Office of Community Partnerships Posters

Based on research with sexual minority communities in the United States, Connie Chan, professor of public policy and public affairs, conducted comparative research with community groups in Hong Kong and Shanghai, China. She provided capacity building training and resources directly to the organization which provides outreach and service to sexual minority women and girls in Shanghai, China. Professor Chan also supported Queer Sisters – an NGO that provides advocacy and community outreach to sexual minority girls and women in Hong Kong – by co-creating a needs assessment survey and helping them to interview their membership in Hong Kong.

Connie Chan …

Annual Report 2013, Forum Staff

National Health Policy Forum

This annual report describes the activities of the Forum during the 2013 calendar year, and provides a snapshot of our participants and resources.

Translational Nutrition: A Review Of The Application Of Nutrition Science, Regulation, And Outreach Case Study: Farm Fresh Rhode Island, Eliza Zalis

Public & Community Service Studies Student Scholarship

This project examines the avenues by which nutrition science impacts individuals in society. It examines the factors that influence consumer behavior and food choice and the importance of health literacy in guiding nutrition and health. It elucidates the role of the Food and Drug Administration (FDA) in regulating food labeling and the implications that such regulation has on consumer perception and possible health outcomes. Further, this project outlines recently proposed changes to the “Nutrition Facts” panel. In investigating nutrition education and outreach programs, this project includes a case study of Farm Fresh Rhode Island and the organization’s nutrition initiatives.

Grappling With Gatekeepers: Addressing Gender Hindrances To Mhealth, Jack O’Rourke

Independent Study Project (ISP) Collection

This study was conducted in order to understand the social and economic problems associated with Ugandan women’s usage of mobile phones and the ways in which different mHealth groups are approaching these problems. Seeing how these different groups approach this issue added new information and analysis to a relatively unexplored topic

The qualitative methodology undertaken was two pronged. First, single sex focus groups in rural Mukono District were assembled. Men, women without phones and women and with phones were all talked to in Luganda with the use of a translator. In addition to these focus groups in rural Mukono District, …

Injection, Ingestion, & Misconception: Drug Use & Rehabilitation In Indonesia, Elena Silvestrini

Independent Study Project (ISP) Collection

When developing countries begin to work their way towards a more recognizable and first world standpoint, there are always certain social issues that must be worked out and addressed. While Indonesia is still considered a third world country, the nation is developing through its gradually increasing economy and booming tourism industry. As any other nation does in its initial stages of expansion, Indonesia has reached a major turning point in which the social issues that have plagued the country for decades must finally be attended to. Politicians, public officers, and local citizens are speaking out against injustices, inequalities, and concerning …

Smoking Behaviors Among Pregnant Women: A Romanian Case Study, Katherine Lemasters

Independent Study Project (ISP) Collection

Smoking behavior during pregnancy is one of few preventable factors associated with poor health outcomes for both women and children. The post-communist countries in Central and Eastern Europe face many challenges in this realm, as tobacco control efforts have not adequately addressed this behavioral health issue that has arisen since 1989. To better inform these efforts in Romania, this study categorizes the determinants of pregnant women’s prior smoking, current smoking, and current smoke exposure by using both quantitative and qualitative analysis. We find that those living with other smokers, exposed to smoke on a daily basis, and experiencing stress during …

Development Of An Evidence‐Based Implementation Plan For A System‐Wide Anticoagulation Management Service, Sarah Varney

Muskie School Capstones and Dissertations

The Mercy Health System of Maine (MHSM) is a large healthcare system located in Southern Maine. It consists of three inpatient campuses, one level II Emergency Department, four Express Care centers, seven Primary Care locations and an array of specialist practices. The organization has identified a need for improved management of anticoagulation therapy within the system as a large number of patients are receiving anticoagulation therapy throughout all of the various healthcare access sites. In order to address this need, MHSM seeks to implement a system‐wide, standardized approach for managing patients receiving anticoagulation therapy.

National Spending For Long-Term Services And Supports (Ltss), 2012, Carol O'Shaughnessy

National Health Policy Forum

Long-term services and supports (LTSS) for the elderly and younger populations with disabilities are a significant component of national health care spending. In 2012, spending for these services was $219.9 billion (9.3 percent of all U.S. personal health care spending), almost two-thirds of which was paid by the federal-state Medicaid program. This publication presents data on LTSS spending by major public and private sources.

2014 Massachusetts Family Impact Seminar: A Lot On Our Plate; Chronic Health Threats In Massachusetts, Ira S. Ockene M.D., Christina D. Economos Ph.D, Barbara Goldoftas Ph.D, Denise A. Hines Ph.D., Caitlin Alcorn, Jacqueline A. Daigneault, Jordan R. Daley, Maura A. Flanagan, Carsten-Hendrik Rasche, Heather Rios, Julia Tran, Liam Kelly Fleming

Mosakowski Institute for Public Enterprise

A Lot on Our Plate: Chronic Health Threats in Massachusetts is the fifth Massachusetts Family Impact Seminar, and is designed to emphasize a family perspective in policymaking on issues related to childhood obesity, cardiovascular disease, and type 2 diabetes. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

The Burden Of Influenza-Like Illness In The Us Workforce, Y. Tsai, F. Zhou, I. K. Kim

United States Public Health Resources

Background -- The disease burden of influenza-like illnesses (ILIs) on the working population has been documented in the literature, but statistical evidence of ILI-related work absenteeism in the USA is limited due to data availability.

Aims -- To assess work absenteeism due to ILIs among privately insured employees in the USA in 2007–8 and 2008–9.

Methods -- We used the 2007–9 MarketScan® research databases. Full-time employees aged 18–64 years, with the ability to incur work absence and continuously enroled in the same insurance plan during each season were included. We identified ILI episodes using ICD-9 codes for influenza and …

Telehealth: Into The Mainstream?, Lisa Sprague

National Health Policy Forum

Teleheath, and its subset telemedicine, extend across a range of technologies allowing patients to seek diagnosis, treatment, and other services from clinicians by electronic means. Telephone, videoconferencing, iPads, and apps are all employed. In its most established form, hospitals and medical centers use telehealth to reach patients in underserved rural areas. Proponents of telehealth suggest it can relieve medical workforce shortages; save patients time, money, and travel; reduce unnecessary hospital visits; improve the management of chronic conditions; and improve continuing medical education. But telehealth also faces ongoing challenges. States require physicians to be licensed in each state where they treat …

Differences In The Delivery Of Health Education To Patients With Chronic Disease By Provider Type, 2005-2009, Tamara S. Ritsema, Jeffrey Bingenheimer, Patty Scholting, James F. Cawley

Prevention and Community Health Faculty Publications

Introduction
Health education provided to patients can reduce mortality and morbidity of chronic disease. Although some studies describe the provision of health education by physicians, few studies have examined how physicians, physician assistants, and nurse practitioners differ in the provision of health education. The objective of our study was to evaluate the rate of health education provision by physicians, physician assistants, and nurse practitioners/certified midwives.

Methods
We analyzed 5 years of data (2005–2009) from the outpatient department subset of the National Hospital Ambulatory Medical Care Survey. We abstracted data on 136,432 adult patient visits for the following chronic conditions: asthma, …

Faith And Hiv Prevention: The Conceptual Framing Of Hiv Prevention Among Pentecostal Botswana Teenagers, Elias Mpofu, Fidelis Nkomazana, Jabulani A. Muchado, Lovemore Togarasei, Jeffrey Bingenheimer

Prevention and Community Health Faculty Publications

Background

There is a huge interest by faith-based organizations (FBOs) in sub-Saharan Africa and elsewhere in HIV prevention interventions that build on the religious aspects of being. Successful partnerships between the public health services and FBOs will require a better understanding of the conceptual framing of HIV prevention by FBOS to access for prevention intervention, those concepts the churches of various denominations and their members would support or endorse. This study investigated the conceptual framing of HIV prevention among church youths in Botswana; - a country with one of the highest HIV prevalence in the world.

Method

Participants were 213 …

The Effects Of The State Of Tennessee Immunization Policy Change Of 2011 - 2012 On Vaccination Uptake In East Tennessee, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

In the United States, funding for the purchase of vaccines depend on annual Congressional allocations. These allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2012, the loss of funds allocated from the American Recovery and Reinvestment Act required action by states to ensure appropriate use of remaining funds. In Tennessee, the response was a …

Chhs March/April 2014 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

U-54 Building Infrastructure Leading To Diversity (Build) National Institutes Of Health: Enhancing Cross-Disciplinary Infrastructure Training At Oregon, Carlos J. Crespo

Community Health Faculty Publications and Presentations

This presentation focuses on the NIH Building Infrastructure Leading to Diversity (BUILD) Initiative (U54) that was awarded to Portland State University.