Community Health and Preventive Medicine Commons^™

Translating Evidence Into Action: Understanding How Community- Based Practitioners Make Intervention Implementation Decisions In Practice, Kristin C. Bennett

Dissertations and Theses (Open Access)

This study examined how community-based practitioners implement public health interventions in practice settings to identify gaps between existing implementation frameworks and real-world practice. Six farmers' markets in Southeast Texas served as cases to understand implementation decision-making by community-based practitioners addressing food access challenges. A qualitative case study approach was employed, using semi-structured interviews with program adopters and key stakeholders to examine how practitioners addressed food access problems, selected interventions, and navigated implementation decisions. This methodology captured the contextual nature of implementation decision-making in community settings. The findings revealed that program adopters recognized health problems through lived experience rather than formal …

From Medical Check-Ups To Risk-Based Health Governance: Reframing Fitness-For-Work And Preventive Health In Modern Health Systems, Kasyunnil Kamal, Iqbal Mochtar

Occupational and Environmental Medicine Journal of Indonesia

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Health Risk Assessment (Hra) In Home-Based Ironing Businesses: Risk Identification, Intervention, And Evaluation In Johar Baru District, Central Jakarta, Heru Alfares, Irawadi Darmaputra, Marsen Isbayuputra, Muhammad Ilyas

Occupational and Environmental Medicine Journal of Indonesia

Background Home-based ironing businesses in Johar Baru District, Central Jakarta, are part of the informal sector, vulnerable to health risks due to suboptimal working conditions. This study aims to identify, assess, and control health risks through a Health Risk Assessment (HRA) approach.

Methods Research methods include direct observation, interviews, environmental measurements, health screenings, and ergonomic surveys using the BRIEF (Baseline Risk Identification of Ergonomic Factor) instrument.

Results The results indicate that the temperature in the ironing area reaches 33°C, exceeding the comfort standard, and that 80% of workers have dark yellow urine, indicating a high risk of dehydration. Risk assessment …

Returning To Work On Chef With Graves’ Disease: A Case Report, Izzatul Abadiyah, Dewi Sumaryani Soemarko

Occupational and Environmental Medicine Journal of Indonesia

Background Graves’ disease has adverse effects on quality of life, because of somatic psychiatric symptoms and an inability to work. Chefs face many occupational hazards that can aggravate certain medical conditions, worsen the disease, and pose safety risks at work. This case report aims to assess the returning-to-work evaluation and program for a chef with Graves’ disease.

Case Description A forty-seven-year-old Indonesian male who was diagnosed with Graves’ disease from characteristic clinical features and biochemical abnormalities was admitted to the hospital with shortness of breath. TSH concentration was 0.001mU/L, FT4 concentration was 2.85 ng/dL, hemoglobin level was 10.6 g/dL, and …

Efikasi Diri Dalam Melakukan Diet Sehat Pada Masyarakat Desa Cipacing, Sumedang, Hilmi Khairun Nisa, Neti Juniarti, Adelse Prima Mulya

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. Noncommunicable diseases (NCDs) account for 57 million deaths (71%) worldwide and 73% of all deaths in Indonesia. Eating habits are one of the factors contributing to the incidence of NCDs. In the process of improving a healthy lifestyle, including a healthy diet, self-confidence or self-efficacy in maintaining a healthy diet is necessary.

Objective. This study aims to identify the level of self-efficacy in maintaining a healthy diet among the community in Cipacing Village, Sumedang.

Methods. This study was conducted using a quantitative descriptive research design among the community of Cipacing Village, Sumedang Regency, West Java. The sample was …

Hurricane Helene, One Year Later: Lived Experience, Geraldine A. Miller

Journal of Appalachian Health

Ashe County is located in the northwestern corner of North Carolina (NC), bordered by Virginia and Tennessee. The county is isolated, mountainous, and historically has lacked good highway access. Hurricane Helene, a category 4 hurricane at landfall, struck Western NC on September 27, 2024, resulting in flooding and wind damage that destroyed local communities in terms of land, homes, bridges, water, electricity, etc. with a damage of $59.6 billion.⁶ One year later, the recovery from the hurricane continues draining individuals and communities of their time, energy, and money. Geri Miller reflects on her hurricane impact experiences a year later. …

Impact Of West Virginia Abortion Ban On West Virginia Physician Trainee Practice Intentions, Rebecca Wald, Kristy Ward, Sarah Dotson

Journal of Appalachian Health

In June 2022, the Dobbs v Jackson Women’s Health Organization overturned the constitutional right to abortion established by Roe vs. Wade. Shortly after, West Virginia (WV) began enforcing a near total ban on abortion. Statewide restrictions on access to reproductive health care have important implications for the recruitment and retention of physicians. This project aimed to determine overall awareness of the 2022 changes in abortion laws among physician trainees, and whether the law influenced the intention of resident/fellow physicians to practice medicine in the state following completion of their medical training. A total of 178 resident and fellow physicians at …

Leveraging Community Health Worker’S Deep Community Knowledge To Address Food And Nutrition Security In Appalachia, Alexis Kimbro Scott, Melissa D. Olfert, Dawn Brewer, Makenzie Barr, Julie Plasencia

Journal of Appalachian Health

Introduction: Community health workers (CHWs) are trusted professionals in communities because of the deep understanding and cultural insights learned from their lived experiences. In Appalachia, CHWs are embedded in the community, giving them a unique understanding of how social determinants, like food and nutrition security, impact health outcomes.

Purpose: This study aimed to examine the professional characteristics and knowledge of CHWs while identifying culturally sensitive practices around food insecurity.

Methods: This cross-sectional, mixed-methods study used an online survey and in-depth phone interviews with CHWs in the Appalachian Region to examine their professional characteristics and knowledge on food security in their …

Stigmatization And Healthcare Inequity Perceived By Individuals Served By Homeless Shelters In An Appalachian City, Molly Powney, James M. Mears, Reagan Sharp, Lisa Calderwood

Journal of Appalachian Health

Introduction: People experiencing homelessness are medically vulnerable and suffer disproportionately from chronic physical and mental health conditions. Evidence-based standards to inform decisions surrounding care would be valuable for this population. Studies exploring how homeless individuals in Appalachia perceive their interactions with the healthcare system remain limited, however.

Purpose: The purpose of this study is to assess perceptions of the healthcare system among homeless individuals served by temporary housing shelters in an Appalachian city.

Methods: A voluntary anonymous survey was administered to residents at three shelters in Charleston, West Virginia (WV) from September 2023 – March 2024. Responses were collected utilizing …

Geospatial Analysis Of Breast Cancer Incidence, Mortality, And Access To Screening In Rural And Appalachian Virginia, Jennifer Osher, Caleb Brown, Phillip Nichols, Tariq Ayubi, Jeremy Powers

Journal of Appalachian Health

Introduction: Breast cancer is the most common malignancy among women in the United States (U.S.), despite recent survival rates improving nationally. However, rural and Appalachian regions have experienced slower mortality declines. These communities face unique health care-related challenges that may contribute to observed disparities.

Purpose: The purpose of this study is to assess differences in breast cancer incidence, mortality, and mortality-to-incidence ratio (MIR) between Appalachian and non-Appalachian counties, as well as rural and non-rural counties in Virginia (VA). Furthermore, we aim to evaluate whether availability of mammography is associated with these differences.

Methods: County-level breast cancer incidence and mortality data …

Influence Of Family Health History And Parental Education On Body Mass Index, Blood Pressure, And Lipid Levels In 5th Grade Children: A Secondary Data Analysis Of The Cardiac Project, Madha Rani Das, Lee A. Plyes, Eloise Elliott, Christa L. Lilly

Journal of Appalachian Health

Introduction: Childhood obesity and related cardiovascular risks reflect the interplay of genetic predispositions and socioeconomic adversity. Appalachia’s poverty, limited health care, and educational gaps worsen family health risks, driving early cardio-metabolic problems in children, highlighting the need for effective interventions.

Purpose: The purpose of this study is to examine the association of family health history and parental education with BMI, BP, and lipid profiles among 5^th grade children in West Virginia (WV).

Methods: The study used WV CARDIAC data from 2006–2009. Outcomes were BMI, SBP/DBP, and fasting lipids (HDL, LDL, TG). Predictors were parental education and family health history …

Association Of Abo Blood Groups With Dengue Fever And Its Severity: A Study In Surabaya, Indonesia, Sulistiawati Sulistiawati, Linda Dewanti, Ronald Pratama Adiwinoto, Raissa Manika Purwaningtias, Bilqis Inayatillah, Jan Nouwen

Journal of Health Research

Background: Indonesia, a dengue-endemic country, has high morbidity and mortality rates. Dengue infection manifestations vary from asymptomatic to mild to severe. One of the risk factors for infection that plays a role in this severity is blood type. A better understanding of the risk factors for dengue infection is required to prevent and control it.

Methods: This analytical observational cross-sectional study was conducted at three hospitals in Surabaya from March to May 2013. Consecutive sampling included 95 patients aged >12 years with confirmed dengue infection (IgM/IgG positive) and without comorbid severe illness. Data were collected using questionnaires, interviews, and checklists, …

Evaluating The Impact Of A Community-Based Prostate Cancer Screening Program, Amy Leader, Kristine Pham, Nicola Cianci, Hannah Knapp, Fatuma Doka, Suzanne Barron, Oleksandr Kolesnikov, Jordan Dehoratius, Katie Bradley, Le'ann Robles, Robert Giamboy, Olivia Dahlgren, Leonard G. Gomella

Kimmel Cancer Center Faculty Papers

BACKGROUND: One out of eight men in the U.S. will be diagnosed with prostate cancer during his lifetime. Black men are more likely to be diagnosed with and die from prostate cancer than other males, contributing to significant prostate cancer disparities. Early detection, often by routine screening, allows for more options for treatment and an increased chance of survival. Barriers to screening contribute to prostate cancer disparities, particularly among those who lack regular access to health care. Community based screening programs may overcome barriers to prostate cancer screening.

METHODS: An urban, NCI-designated cancer center collaborated with a national prostate cancer …

The Implementation Of Indoor Urban Gardening: A Microgreens Pilot Study In A University Setting, Kathryn Chang, Samantha Brink, Annette Gadegbeku

Transformative Medicine

Introduction: “Food deserts” are geographical areas that lack affordable full-service grocery stores and have higher densities of unhealthy or “fast food” options. These deserts not only exist in communities such as Philadelphia, but also on college campuses. One solution to creating access to fresh vegetables is urban farming, which refers to green areas (i.e. community gardens) that provide places for food to be grown by local residents. Microgreens Health Outreach Project (HOP), aimed to build and implement a small, indoor community garden cart within the Health Sciences Building (HSB) at Drexel University; the organization hoped that this cart would be …

Impact Of Community Health Needs Assessments As Barriers To Chronic Disease Prevention: A Comparative Study, Marissa E. Woelm Ms.

Honors Thesis

Community health needs assessments (CHNAs) are vital tools for identifying population health priorities through monitoring chronic diseases and conditions; however, their effectiveness in preventing chronic diseases remains debated. This comparative study examines CHNAs from sixteen South Dakota hospitals across Avera, Sanford, Monument Health, and independent systems to evaluate their role in preventing chronic diseases. Analysis reveals significant challenges, including biased data sampling, limited community engagement, small survey samples, and inconsistent implementation strategies. While CHNAs effectively identify mental health, cancer, and obesity as the top community concerns alongside several other diseases like diabetes and kidney disease, most reports lack specific timelines …

Barriers To Neglected Tropical Disease Service Accessibility: Challenges And Solutions For Reaching Mobile And Migrant Populations In Uganda., Victor Lambongang, Wuraola R. Awosan

Montview Journal of Research & Scholarship

Neglected Tropical Diseases (NTDs) remain a significant public health challenge in Uganda, disproportionately affecting mobile and migrant populations, including refugees, internally displaced persons (IDPs), and cross-border workers. Despite ongoing efforts by the Ugandan government and global health organizations, these populations face barriers to accessing NTD services, including geographic inaccessibility, weak healthcare infrastructure, socio-cultural misconceptions, and policy gaps. These challenges hinder early diagnosis, treatment adherence, and prevention efforts, leading to increased disease burden and reinfection risks in high-mobility settings. This study aims to identify barriers to NTD service accessibility among migrant populations in Uganda and propose evidence-based solutions to improve healthcare …

Public Perception About Covid-19 Vaccine Hesitancy In South Central Nebraska, Rita Nnenne Oparaocha

Biology Theses, Dissertations, and Student Creative Activity

The COVID-19 pandemic created a shift in the trajectory of vaccination hesitancy, altering risk perceptions and vaccination attitudes among individuals in rural communities. The 5C framework highlights confidence, complacency, constraints, calculation, and collective responsibility as influencing factors of vaccine hesitancy. This study assessed the proportion of adults who refused COVID-19 vaccination and identified the individual reasons for hesitancy among those who refused the COVID -19 vaccines in South Central Nebraska. Data was analyzed from a local cross-sectional public health survey administered to 2,034 adult participants over a six-month period (March-August 2024), including 91 respondents who were from outside the seven-county …

Enhancing Public Health Strategies: Addressing The Rsv Burden In Alabama Through Clinical Treatment, Community Prevention, And Surveillance Approaches, Martha K. Findley Roper, Jennifer S. Dawson

Journal of Public Health in the Deep South

Introduction: Respiratory Syncytial Virus (RSV) is a highly contagious pathogen driving morbidity, hospitalizations, and economic burden. This review uses the epidemiological triad and National Wastewater Surveillance System data to assess transmission, viral load spikes in Alabama, and strategies for treatment and prevention.

Methods: A review of literature on supportive care, vaccination, monoclonal antibodies, and emerging nanomedicine was reviewed to evaluate strategies for reducing viral burden and complications.

Results: Trends from December 2024–January 2025 were assessed with National Wastewater Surveillance System data. Primary prevention includes immunization, hygiene, air quality maintenance, and early diagnostics. Tertiary care addresses complications such as secondary …

Dual-Task Exercise Protects Healthy Older Adults Against In-Creased Risk For Dementia: A Controlled Trial, Helen Tatiane Santos Pontes, João Bento-Torres, Naina Yuki Vieira Jardim, Victor Oliveira Da Costa, Josilayne Patricia Ramos Carvalho, Cristovam Wanderley Picanço-Diniz, Natáli Valim Oliver Bento-Torres

Baltic Journal of Health and Physical Activity

Background: Functionality in aging is closely linked to the ability to divide attention during multitasking activities, which are essential for activities of daily life. However, coordination between motor and cognitive simultaneous tasks decreases with age, impairing functional ability and restricting older adults' participation and healthy aging. This study aimed to assess the effects of a multimodal dual-task exercise intervention on motor and cognitive dual-task costs and its potential to mitigate age-related declines in healthy older adults. Materials and Methods: A controlled trial was conducted with community-dwelling older adults assigned to either the Dual-Task Exercise group, which participated in a 24-session …

A Cross-Sectional Study On Patient Safety Attitudes And Their Determinants Among Medical Staff In Malaysian Public Specialist Hospitals, Sharifah Balqis Sayed Abdul Hamid, Aniza Ismail, Saperi Sulong

Makara Journal of Health Research

Introduction: This study aimed to assess the baseline level and mean scores of patient safety attitude domains among doctors and nurses in Malaysian public hospitals and to identify determinants associated with these attitudes across six domains: teamwork, safety climate, working conditions, job satisfaction, stress recognition, and perception of management.

Methods: A cross-sectional study was conducted using the Safety Attitudes Questionnaire (SAQ) among 142 doctors and 231 nurses from three public tertiary hospitals. Participants were selected through proportionate stratified random sampling. Data were analyzed using descriptive, bivariate, and multivariate methods.

Results: The study achieved an 81% response rate. …

Lycopene, Race And Periodontitis: Disparities In Older Adults, Katherine Kwong, You Lu, Zhuo Huan Li, Susu Luo, Zhaoyu Huang, Zhong Chen, Na Zhao, Tung Sung Tseng

School of Public Health Faculty Publications

Background Periodontitis is a severe gum disease that can be an indicator of other health conditions such as cardiovascular disease and diabetes. Lycopene has been suggested as an adjunct therapy for periodontitis. This study aims to investigate the association between insufficient lycopene intake and the risk of Periodontitis among non-Hispanic White (NHW) and non-Hispanic Black (NHB) older adults. Methods The study included 1,227 adults aged 65–79 years from the National Health and Nutritional Examination Survey (2009–2014). Total lycopene intake from daily diet was studied with age, race, marital status, smoking status, BMI, diabetes, sex, and education as independent variables in …

Improving Staff Satisfaction And Flu Vaccine Uptake Through Standardized Workflow Tools, Salma Adriana Blanco

Master's Projects and Capstones

Objective: Insufficient workflows can cause documentation to be confusing, which ultimately

limits staff engagement. This has led to staff dissatisfaction and a low vaccination uptake in

outpatient clinics. The implementation of a standardized workflow tool and proper staff

education and training can improve staff satisfaction and vaccination adherence, as indicated by

a review of literature. Aim: The purpose of this quality improvement project is to implement a

change in workflow in the electronic health record and staff training in an urban community

health clinic primarily serving low income and Latino patients. This intervention seeks to

increase medical assistant user satisfaction …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

Food, Fitness, And Filipino Culture: Evaluating And Reimagining Chronic Disease Interventions For Filipino Americans Through The Pen-3 Framework, Juliana Mastro

Master's Projects and Capstones

Filipino Americans experience high rates of chronic diseases such as diabetes and hypertension. This paper reviews nutrition and exercise interventions targeting this population through the strengths-based PEN-3 cultural framework, focusing on cultural identity, relationships and expectations, and cultural values. It identifies effective strategies that engage these cultural components, and highlights gaps such as limited research on Filipino-American health outcomes. Recommendations include family-centered approaches, culturally relevant activities like tinikling dance, and community-driven online healthy recipe archives to promote positive health behaviors. These culturally informed strategies aim to improve self-efficacy, support lasting health behavior change and reduce chronic disease prevalence nationwide.

Standardizing The Use Of The Sinc Screening Tool In A Rural Clinic, Madison Foss

DNP Projects

Unmet contraceptive need represents a persistent quality gap in rural primary care, where reproductive health discussions are often inconsistently addressed. A rural primary care clinic in Shelbyville, Tennessee lacked a standardized, evidence-based process for screening women of childbearing age (15–44 years) for contraceptive needs. This quality improvement project evaluated the feasibility and effectiveness of implementing the Self-Identified Need for Contraception (SINC) screening tool to support routine, patient-centered care. The SINC tool consists of a single validated question designed to identify patients who wish to discuss contraception or pregnancy prevention during clinical visits. Plan–Do–Study–Act cycles were used to integrate the tool …

Challenges And Strategies For Hypertension Control In The Young Generation In Indonesia: A Bibliometric Review, Gina Maratus Solihah, Dwi Prijatmoko, Novia Luthviatin

Preventia: The Indonesian Journal of Public Health

Hypertension among young people in Indonesia has become an increasingly alarming public health problem due to lifestyle changes, low awareness, and limited access to preventive health services. This review aims to analyze the challenges and strategies for controlling hypertension in young populations based on national and international literature, supported by bibliometric analysis. Data were obtained from the Web of Science (WOS) database and analyzed using VOSviewer to map research trends, keyword relationships, and collaboration networks related to hypertension in youth. The 2018 Riskesdas data showed that 34.1% of Indonesian adults aged ≥18 years had hypertension, with major risk factors including …

The Influence Of Health Students' Attitudes On Tobacco Control And Tobacco Education On Family Smoking Cessation, Lies Permana, Riza Hayati Ifroh, Annisa Nurrachmawati

Preventia: The Indonesian Journal of Public Health

Health students are aware of how smoking affects people's health. They are typically well-equipped to help smokers quit and play a significant role in tobacco control. The purpose of this study was to determine the role that students have in encouraging their families to quit smoking both before and after studying in health faculty, as well as the impact that health students' attitudes and tobacco control education have on these inquiries. In March and April of 2024, a cross-sectional survey was conducted using the GHPSS questionnaire, with 123 student in Universitas Mulawarman, grade 2nd public health faculty. The findings showed …

Evaluating Fall Prevention Outcomes: Fall Rates, Staff Fall Knowledge, And Perceptions On Safety Culture, Priscilla Greco

Student Scholarly Projects

Practice Problem: The practice problem addressed in this project was the elevated fall rates on a 46-bed medical–surgical unit with a reported sentinel fall event, prompting the need to evaluate the current fall prevention program.

PICOT: The PICOT question that guided this project was: In nursing staff on a medical–surgical unit (P), how does the implementation of an evidence-based fall prevention program evaluation using AHRQ tools (I), compared with no formal program evaluation (C), influence staff knowledge, perceptions of safety culture, and fall rates (O) over 8-weeks (T)?

Evidence: Evidence supporting this project emphasized that structured staff education, strong communication, …

Healthy Living As A Critical Part Of Emergency Preparedness, Callahan K. Ward, April Litchford

All Current Publications

This resource presents practical, health-focused actions that individuals and caregivers can take to strengthen resilience before, during, and after emergencies. By integrating long-term wellness habits and short-term readiness strategies, it supports a more comprehensive and inclusive approach to disaster preparedness, enhancing not only personal outcomes but also community-wide response capacity.

Epidemiology, Presentation, And Diagnosis Of Type 2 Diabetes Mellitus In Children And Adolescents, Bisher Alsabbagh, Whard Alsabbagh

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents has increased substantially over recent decades, paralleling rising rates of pediatric obesity and metabolic risk. Youth-onset T2DM is characterized by significant insulin resistance accompanied by an inadequate compensatory insulin response, resulting in progressive hyperglycemia and early beta-cell dysfunction. Incidence varies widely among racial and ethnic groups, with the highest rates observed in non-Hispanic Black, Hispanic, Native American, Asian American, and Pacific Islander youth. Risk factors include obesity, family history, high-risk ethnicity, pubertal insulin resistance, prenatal metabolic exposures, and comorbid conditions such as polycystic ovary syndrome. Clinical presentation ranges …