Community Health and Preventive Medicine Commons^™

Cardiovascular Risk Factors Associated With Venous Thromboembolism, John Gregson, Stephen Kaptoge, Thomas Bolton, Lisa Pennells, Peter Willeit, Carlos J. Crespo, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Importance It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE).

Objective To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism.

Design, Setting, and Participants This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731 728 participants; 75 cohorts; years of baseline surveys, February 1960 to June 2008; latest date of follow-up, December 2015) and the UK Biobank (421 537 participants; years of baseline surveys, March 2006 to September 2010; latest date of follow-up, February …

Accessible Design In Rural Health Care: Usability Profile Of Outpatient Health Care Facilities In Rural West Virginia., Jordan E. Miller

Graduate Theses, Dissertations, and Problem Reports (ETD)

The Americans with Disabilities Act (ADA) became law in 1990. Since then, research has shown that people with disabilities continue to experience environmental, systematic, and structural barriers to health care. The purpose of this research is to explore the prevalence of barriers in rural West Virginia health facilities and the relationship between building characteristics (like age and purpose) and accessibility. The researcher evaluated ten rural outpatient member-sites of the West Virginia Practice-Based Research Network using a survey to understand building characteristics and a tool to measure essential features for a facility to be considered ‘usable’. Findings included a negative correlation …

Determinants Of Physical Activity For Latino And White Middle School-Aged Children, Aileen Garcia, Shinya Takahashi, Mindy Anderson-Knott, Dipti Dev

Department of Child, Youth, and Family Studies: Faculty Publications

Background: Physical activity (PA) has long been acknowledged to contribute health benefits among children. However, research has consistently shown that PA declines as children grow older. Thus, this study examined the factors which are associated to children’s PA in order to identify potential barriers to PA.

Methods: Using data from the KidQuest Program, we conducted bivariate and multivariate analyses on survey data collected from fifth to seventh grade students in a small Midwestern city.

Results: We found that food knowledge, eating breakfast, and talking with family about eating healthy foods, are positively related to PA. On the

other hand, screen …

Kangaroo Mother Care And Traditional Care, Arianna Smola, Kirsten Lawson

Williams Honors College, Honors Research Projects

Prematurity and low birth weight are leading causes of infant death. Throughout recent years care methods for this population have evolved from incubator care to Kangaroo Mother Care (KMC). The purpose of this systematic review was to answer the following PICO question: in the case of preterm and low birth weight (LBW) infants, how does the technique of Kangaroo Mother Care (KMC) compare to traditional incubator use, regarding long and short-term outcomes of preterm and LBW infant recovery. Methods of this study included the selection of twenty peer-reviewed articles that studied the effect of incubators and KMC on premature and …

Association Of Food Deserts And Pediatric Hospitalization Rates, Laura Plencner, Matthew Hall, Molly Krager, Henry T. Puls, Jessica L. Markham, Ellen Kerns, Jessica L. Bettenhausen

Posters

Retrospective cross-sectional study describes differences in hospitalization rates for children based upon their residence within a food desert and describes any differences among reasons for hospitalization.

Determining The Instructional Effectiveness Of An Online Resident Vaccine Curriculum, S. Elizabeth Williams, Shannon Clark, Barbara A. Pahud, Sharon Humiston, Donald Middleton, Kadriye O. Lewis

Posters

We developed four online modules through the Collaboration for Vaccine Education and Research (CoVER) project. The objective of this qualitative study is to determine the instructional effectiveness of the CoVER curriculum from the perspectives of medical residents.

Predictors Of Experimental And Control Group Attendance: Findings From An Hiv/Std Prevention Rct With Pregnant Women At Risk For Substance Use, Jaclyn S. Sadicario

Theses and Dissertations

Efforts to improve inclusion in research have included mandating the recruitment of ethnic minorities and women into NIH funded studies. However, little research has been completed on who attends such interventions. This is particularly worrisome in populations for which attendance to interventions can have dire consequences. HIV is a public health concern for pregnant women in substance using communities, as pregnant women are much less likely to use condoms during intercourse to prevent HIV. Group modular HIV prevention interventions have long been the standard for HIV prevention. However, little attention in research on HIV prevention interventions RCTs has been focused …

Association Of Health Departments’ Completion Of A Community Health Assessment, Community Health Improvement Plan, And Strategic Plan With Better Population Health Outcomes, Kelora T. Cofer

College of Graduate Studies: Theses & Dissertations

Promoting health and well-being requires a strong public health infrastructure. This study examined the association of engagement of local health departments (LHDs) in accreditation and its pre-requisites with health outcomes in LHD jurisdictions such as the prevalence of premature death and tobacco use in the counties they serve. Two data sets, The 2016 National Profile of Local Health Departments and 2018 Community Health Rankings were linked using deterministic linkage approach, based on county FIPS codes as a unique identifier. Descriptive and multinomial logistic regression analyses were performed using SPSS Version 25. The results showed that having recently completed a community …

The Effect Of Narrative Medicine Combined With Medication Assisted Treatment On Decreasing The Desire To Use Intravenous Substances In Hospitalized Patients With Infective Endocarditis, Paula Works

DNP Projects

Substance abuse is a significant problem that spans the nation. Of particular concern is the growing population of patients at UK HealthCare who have endocarditis as a complication from IV substance abuse.

PURPOSE: The aims of this study were

1. To assess the effect of narrative medicine combined with MAT, compared to MAT alone, on desire to use in hospitalized patients with a history of IV substance use
2. To examine the changes in quality of life before and after the introduction of narrative medicine in hospitalized patients with a history of IV substance abuse using The Quality of Life Scale (QOLS). …

The Effect Of A School Nurse Intervention Program On Student Absenteeism In Jefferson County Public Schools: A Pilot Study, Eva Stone

DNP Projects

Background: School attendance has a significant impact on student achievement. In early grades, students who miss 10% or more of school are considered chronically absent and at risk to be behind in reading. High school students with similar attendance patterns are less likely to enroll and stay in college after graduation. Evidence shows that the presence of school nurses can result in improved school attendance.
Purpose: The purpose of this pilot project was to implement a targeted school nurse intervention at an elementary, middle and high school in Jefferson County. The intervention included assessment by a registered nurse for children …

Provider Adherence To National Heart, Lung, And Blood Institute’S Guidelines On Screening, Diagnosis, And Treatment Of Hypercholesterolemia In The Pediatric Population Aged 9-11 Years, Alanna Cox

DNP Projects

Purpose: High cholesterol levels have been directly linked to atherosclerosis, which is a leading cause of cardiovascular disease (CVD). Risk factors that accelerate the development of atherosclerosis, such as high cholesterol can begin in childhood. The purpose of this project was to evaluate provider adherence to the National Heart, Lung, and Blood Institute’s (NHLBI) Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, specifically the guidelines on universal lipid screening in children aged 9-11 years. The objectives were: 1) determine the rate of lipid screening in children 9-11 years old; 2) determine the number of children who …

Tobacco Screening Among Adults In Primary Care: Evaluation Of The Use Of The 5a’S Framework For Treating Tobacco Dependence, Alexis Owens

DNP Projects

Abstract

Background: Tobacco use in the United States is the chief cause of preventable disease and death. Preventing and identifying tobacco use through screening and education is essential to assist users to quit and to decrease overall tobacco associated health risks.

Purpose: The purpose of this study was to assess the integration of the 5A’s tobacco engagement framework into the workflow at one Primary Care Center. Study objectives included determining baseline tobacco screening data prior to 5A’s education, providing providers and support staff education on the 5A’s process, reviewing and interpreting pre/post data of the 5A’s process, and identification of …

Increasing Smoking History Documentation And Lung Cancer Screening Orders In A Primary Care Clinic, Tabitha M. Caudill

DNP Projects

BACKGROUND: In 2018, there were approximately 234,030 new lung cancer diagnoses and 154,500 lung cancer deaths in the United States. Kentucky leads the nation in new lung cancer cases each year. The USPSTF estimates that 10% to 12% of lung cancers detected by routine screening would not have been detected until the cancer advanced; therefore, the USPSTF recommends yearly lung cancer screenings using low dose CT (LDCT) scans of the chest for patients 55 to 80 years old who have a 30 pack-year smoking history and are currently smoking or have quit within the last 15 years.

PURPOSE: …

Motivational Interviewing In A Team-Based Wellness Clinic: Perceptions And Fidelity, Jodi M. Winship

Theses and Dissertations

INTRODUCTION: Motivational Interviewing (MI) is an evidenced based counseling style to elicit health behavior change. Team-based student clinics are an ideal climate for students to learn and practice team-based care, yet little is understood as to how client-centered communication styles such as MI are implemented in a team setting.

PURPOSE: The purpose of this dissertation was to conduct an exploratory study using mixed methods to better understand how an MI training translates to team-based communication with clients, the factors impacting team-based implementation of MI, and how team-based MI impacts clients’ perceived autonomy at a student-led, interprofessional, team-based wellness clinic for …

Experiences Of Formal Caregivers Providing Dementia Care To American Indians, Damon Grew Peter Syphers, C.J. Schumaker, Ronald P. Hudak

Journal of Sustainable Social Impact

Alzheimer’s disease (AD) is a significant public health concern for all elders in the United States. It is a particular concern for the American Indian (AI) population, which is one of the fastest aging populations in the United States and the smallest, most underrecognized, and most culturally diverse group in the country. A formal caregiver understanding of AD in the AI population is scarce. This phenomenological study was designed to discern what is known about AD in the AI population by exploring the cultural beliefs and experiences of formal caregivers who provide care for AI dementia patients. Specifically, this study …

Youth Study Recruitment Using Paid Advertising On Instagram, Snapchat, And Facebook: Cross-Sectional Survey Study, Kelsey Lynett Ford, Tashuna Albritton, Tara A. Dunn, Kacy Crawford, Jessica Neuwirth, Sheana Bull

Publications and Research

Background:The use of paid social media advertising for targeted study recruitment is an effective strategy in health research and evaluation, specifically to reach diverse youth participants. Although the literature adequately describes the utility of Facebook in recruitment, limited information exists for social media platforms that are more popular with youth, specifically Instagram and Snapchat.

Objective:This paper outlines a paid advertising approach using Instagram, Snapchat, and Facebook to evaluate a statewide youth marijuana prevention campaign. The objective of this study was to compare recruitment metrics across Instagram, Snapchat, and Facebook for two surveys documenting youth knowledge, attitudes, and behaviors related to …

Mobile Technology Use And Mhealth Text Message Preferences: An Examination Of Gender, Racial, And Ethnic Differences Among Emerging Adult College Students, Kristin E. Heron, Kelly A. Romano, Abby L. Braitman

Psychology Faculty Publications

Background: Mobile health (mHealth) interventions are a potentially feasible way of targeting emerging adult college students' physical and mental health concerns, decreasing health-risk, and augmenting health promoting behaviors. However, there is limited evidence attesting to advantageous ways of designing mHealth treatments in a manner that is apt to be well-received by emerging adult college students at large, and gender, racial, and ethnic subgroups in particular. To address these research gaps, this exploratory study examined general trends, and gender (male, female), racial (White, Black), and ethnic (Latino, non-Latino) differences, in emerging adult college students' mobile technology ownership and phone plan characteristics, …

Needs Assessment Regarding Occupational Health And Safety Interventions Among Textile Workers: A Qualitative Case Study In Karachi, Pakistan, Numan Hussain, Muhammad Masood Kadir, Asaad Ahmed Nafees, Rozina Karmaliani, Tanzil Jamali

Community Health Sciences

Objective: To determine the perceived health and safety needs identified by textile workers, managers and experts as well as direct observation of the prevailing health and safety practices in the textile industry.
Methods: The qualitative study using the needs assessment conceptual framework was conducted in July-August 2015 in Karachi, and comprised focus group discussions with textile workers, in-depth interviews with factory managers and health and safety officers, and key informant interviews with relevant stakeholders and experts. A walk-through survey was also conducted in selected mills for which the Checklist of hazards in textiles was used.
Results: A total of 6focus …

Sexual Behaviours Of Adolescents In Creek Town, Cross River State, Nigeria, Kabiru K. Salami, Rowland E. Edet

Department of Sociology: Faculty Publications

Risky sexual behaviors of adolescents in Creek Town have not been fully profiled. This study investigated the sexual behaviors of adolescents and their various dimensions in Creek Town, in Cross River State, Nigeria. This cross-sectional survey design adopted multi-stage sampling procedure to administer a 112-items questionnaire to 422 adolescents, to elicit information on their sexual behaviors and practices. Four focus group discussion sessions were also conducted with in-school and out-of-school adolescents. The mean age of adolescents was 17 years. Majority (65.4%) of the adolescents were sexually active. The mean age at sexual debut was 15 years for both male and …

Malaria Care-Seeking Behaviour Among Hiv-Infected Patients Receiving Antiretroviral Treatment In South-Eastern Nigeria: A Cross-Sectional Study., Uchechukwu M Chukwuocha, Gregory N Iwuoha, Geoffrey C Nwakwuo, Peter K Egbe, Chidinma D. Ezeihekaibe, Christopher P Ekiyor, Ikechukwu N S Dozie, Sahai Burrowes

This study assesses malaria prevention and treatment behaviour among people living with HIV/AIDS (PLWHA) in Owerri, South Eastern Nigeria. Although Nigeria bears one of the world's largest burdens of both malaria and HIV, there is almost no research studying how co-infected patients manage their care. We systematically sampled 398 PLWHA receiving care at Imo State Specialist Hospital and the Federal Medical Centre in Owerri to complete a structured, pre-tested questionnaire on malaria care-seeking behaviour. Descriptive statistics were reported and chi-square tests and multivariate logistic regressions were also used. The majority of HIV-infected patients (78.9%) reported having had an episode of …

Spirit Checklist, Myopia Outcome Study Of Atropine In Children (Mosaic): Design And Methodology, Saoirse Mccrann, Daniel Ian Flitcroft, John S. Butler, James Loughman

Articles

Purpose

The Myopia Outcome Study of Atropine in Children (MOSAIC) aims to explore the efficacy, safety, acceptability and mechanisms of action of 0.01% atropine for myopia control in a European population.

Methods

MOSAIC is an investigator-led, double-masked, placebo-controlled, randomised clinical trial (RCT) investigating the efficacy, safety and mechanisms of action of 0.01% atropine in myopia progression management. During Phase 1 of the trial, 250 children aged 6-16 years with progressive myopia apply eye drops once nightly in both eyes from randomisation to month 24. No treatment is given during Phase 2 from month 24 to 36 (washout period) for those …

Elbow Injury Prevention In Youth Dominican Baseball Players: A Training Intervention Pilot Study, Chelsey Erbaugh Franz, Dawn Hall-Bibb, Myra Stockdale, Aliya Thompson, Bailey Biggs

Internet Journal of Allied Health Sciences and Practice

Background: Research suggests deficits in shoulder and elbow strength and flexibility may explain the role of elbow injuries in overhead athletes, specifically ulnar collateral ligament (UCL) injury in baseball players. Significant damage to this ligament typically requires operative care for continued activity in the sport. Several studies have demonstrated the success of rehabilitation programs post-surgery; however, few studies have examined the role of UCL injury prevention programs. A recognized upper extremity (UE) injury prevention method is the Thrower’s Ten Program. This program may create elbow stability when pitching and throwing, theoretically reducing the risk of UCL injury. Purpose: The purpose …

Relationship Of Sociodemographic Factors With Serum Levels Of Vitamin D In A Healthy Population Of Pakistan, Khalida Iqbal, Najmul Islam, Naseema Mehboobali, Ali Asghar, Saleem Perwaiz Iqbal, Mohammad Perwaiz Iqbal

Department of Biological & Biomedical Sciences

High prevalence of vitamin D deficiency has been reported from Pakistan. Association of sociodemographic factors with vitamin D status has received little attention in this region. Therefore, we embarked on investigating the relationship of sociodemographic factors with vitamin D levels in a healthy Pakistani population. Venous blood from 226 healthy participants (age range 19-69 years) was collected and analyzed for serum concentrations of 25(OH) vitamin D [25(OH)D] and other related biomarkers. Demographic characteristics of the study participants were collected. Vitamin D deficiency (25(OH)D levels less than 20 ng/ml) was found to be 75% in this cohort. Gender, sunlight exposure and …

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

College of Graduate Studies: Theses & Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …

Quality Of Life And Stigma Among People Living With Hiv/Aids In Iran, Mohammad Ebrahimi Kalan, Jian Han, Ziyad Ben Taleb, Kristopher P. Fennie, Mohammad Asghari Jafarabadi, Maryam Dastoorpoor, Nima Hajhashemi, Mitra Naseh, Shahnaz Rimaz

School of Social Work Faculty Publications and Presentations

Background: Stigma against HIV profoundly affects the quality of life (QOL) of people living with HIV/AIDS (PLWHA). We aimed to assess the factors associated with QOL in PLWHA in Iran, specifically HIV-related stigma, sociodemographic and clinical characteristics.

Methods: Two hundred PLWHA participated in this cross-sectional study. Data were collected using sociodemographic, stigma, and WHO-QOL-BREF questionnaires. Correlations, ANOVAs, and Student’s t-distribution tests were performed as bivariate analyses. We employed stepwise multiple linear regression analysis to explore the main factors associated with QOL domains.

Results: Six domains of QOL were negatively correlated with three domains of stigma (p < 0.001 for all). Stepwise multiple linear regression revealed that, after adjusting for con-founders, lack of healthcare insurance, having no basic knowledge of HIV/AIDs prior to diagnosis, low monthly income of participants and family, and stigma (blaming and distancing, discrimination, and fear) were associated with low mean score of different domains of QOL.

Conclusion …

Randomised Study Demonstrates Sustained Benefits Of A Pre-School Intervention Designed To Improve Nutrition And Physical Activity Practices, Diewerke De Zwarte, John Kearney, Clare A. Corish, Corina Glennon, Lorraine Maher, Charlotte Johnston Molloy

Articles

Background: Health-promoting programmes must demonstrate sustained efficacy in order to make a true impact on public health. This study aimed to determine the effect of the Healthy Incentive for Pre-schools project on health-promoting practices in full-day-care pre-schools 18 months after a training intervention.

Methods: Thirty-seven pre-schools completed the initial study and were included in this follow-up study. The intervention consisted of one training session with either the pre-school 'manager-only' or 'manager and staff' using a specifically developed needs-based training resource pack comprised of written educational material and a validated health-promoting practice evaluation tool. Direct observation data of health-promoting practices were …

Missoula Prescription Produce Program: Lessons Learned 2015-2017, Harley Fredriksen

Graduate Student Theses, Dissertations, & Professional Papers

The Missoula Fruit and Vegetable Prescription Produce program (MFVPP) started in 2015 as a partnership between Garden City Harvest (a Missoula, MT food-security non-profit) and the Providence Endocrinology Center (a local health clinic focused on diabetes care). MVFPP allows physicians, physician assistants, and dieticians to prescribe fresh produce to their patients. Patients must be of low income and suffer from chronic disease. The purpose of this paper is to evaluate the effectiveness of the MFVPP to lead to improved biometric measurements for patients. This paper also discusses the program’s limitations and complications and aims to chart a path forward for …

The Impact On Cost, Quality, And Patient Satisfaction When Delivering Care To Acutely Ill Adults In An At-Home Care Model Versus An Inpatient Hospital Setting., Franchesca M. Adams

Honors Theses and Capstones

The impact on cost, quality, and patient satisfaction when delivering care to acutely ill adults in an at-home care model versus an inpatient hospital setting. Hospital level care for certain acute conditions can be safely delivered in the patient’s home while lowering the cost per episode of care, maintaining or improving patient experience, and improving safety and patient/care giver education as well as care coordination, at the Critical Access Hospital (CAH) level.

Drivers Of International Variation In Prevalence Of Disabling Low Back Pain: Findings From The Cultural And Psychosocial Influences On Disability Study, David Coggon, Georgia Ntani, Keith T. Palmer, Vanda E. Felli, Florencia Harari, Leonardo A. Quintana, Sarah A. Felknor, Marianela Rojas, Anna Cattrell, Muhammad Masood Kadir

Community Health Sciences

Background: Wide international variation in the prevalence of disabling low back pain (LBP) among working populations is not explained by known risk factors. It would be useful to know whether the drivers of this variation are specific to the spine or factors that predispose to musculoskeletal pain more generally.
Methods: Baseline information about musculoskeletal pain and risk factors was elicited from 11 710 participants aged 20-59 years, who were sampled from 45 occupational groups in 18 countries. Wider propensity to pain was characterized by the number of anatomical sites outside the low back that had been painful in …

A Systematic Review Of Observational Studies, Demonstrating Smoking Among School Going Adolescents, Shafquat Rozi, Gillian Lancaster, Sadia Mahmud, Zahid Ahmad Butt, Talat Roome, Nida Zahid

Community Health Sciences

Objective: To characterize the methods of design and analysis currently adopted in survey research of school-based observational studies for smoking, and to identify the common pitfalls made by researchers.
Methods: The systematic review was conducted in 2009 and consisted of observational studies in school settings published between January 2005 and January 2009. Smoking status was the main outcome of interest. Following Cochrane style, five steps were followed: setting selection criteria for studies and conducting a literature search; review of abstracts; review of complete articles; data extraction and quality assessment of included studies; and, finally, synthesis of studies.
Results: Of the …