Community Health and Preventive Medicine Commons^™

Evidence-Based Hazmat Medical Surveillance, Michael D. Jacobson

Master of Public Health Program Student Publications

Background: Hazardous materials (HAZMAT) teams are tasked with neutralizing substances that pose a dire threat to human health. As a result, communities invest substantially in medical surveillance to protect first responders. Yet, little is known as to the actual exposures, consequent injuries, and cost-effectiveness of medical surveillance.

Objective: The purposes of this study were: 1) Determine actual HAZMAT threats. 2) In light of these threats, evaluate current regulatory requirements, recommendations and practices for their basis in evidence.

Methods: National HAZMAT data was analyzed for trends and compared with local response records from 2008 through 2011. Regulations applicable to medical surveillance …

Rights Of Ohio Mothers: Best Practices For The Pediatric Patient With A Life-Threatening Illness, Kelly Peekstok

Master of Public Health Program Student Publications

The purpose of this paper is to evaluate and review current best practices with regards to a minor’s refusal of life-sustaining medical treatment. The policies of other developed countries and states within the United States serve as a guide for developing evidence-based guidelines for Ohio healthcare professionals. Four specific cases were identified and then analyzed. The results showed that in three of the four cases, the wishes of the minor were followed. While each case contains its own set of complexities, creating a developmental guideline for healthcare organizations will ensure protection of the minor’s capacity to make autonomous decisions.

The Efficacy Of Abstinence Only Education, Jennie Watt Mcadams

Master of Public Health Program Student Publications

Chlamydia, Gonorrhea and unplanned teen pregnancies cost the United States billions of dollars every year in various forms of government aid. Why are the numbers of teenage incidences of these health indicators higher than almost every other industrialized nation? Why are the youth in the United States so far behind their peers in sexual health? This paper proposes that one cause is that government funding goes to abstinence only education curriculum which is taught in many schools across the nation. These curricula many times do not teach youth about sexual protection or health and other times contain false information. If …

Chronic Disease Prevalence Of A Refugee Population In Dayton, Oh, Sandeep Palakodeti

Master of Public Health Program Student Publications

Introduction: This study aimed to understand the chronic disease burden of anemia, cancer, diabetes mellitus, hypertension, overweight/obesity, stroke, and tobacco use in the domestic as well as a refugee population. It also aimed to examine the current literature on appropriate screening for those conditions.

Methods: 348 refugee screening intake exams from Public Health - Dayton & Montgomery County were analyzed for presence of the conditions stated. Screening intake recommendations from the CDC, the Minnesota Public Health Department, the Canadian Collaboration for Immigrant and Refugee Health, and the Ohio Department of Job and Family Services were examined and compared in order …

Analysis Of An Improved Cook Stove Intervention In Rural Guatemala, Chad Graven

Master of Public Health Program Student Publications

An estimated three billion people cook and heat their homes using open fires and nearly two million people die prematurely from illness attributable to indoor air pollution from solid fuel use. According to the World Health Organization, “every year, indoor air pollution is responsible for the death of 1.6 million people...one death every twenty seconds.” Various international groups, government initiatives, and communities have attempted to improve this indoor air pollution problem around the world by implementing various improved cook stove models. In July, 2011, Partners In Health (PIH) and Equipo Técnico de Educación en Salud Comunitaria (ETESC) co-directed the delivery …

Obesity: The Anthropometric And Demographic Characteristics Of Insured And Uninsured Individuals, Terra Fox Williams

Master of Public Health Program Student Publications

Objectives. This study evaluates the association between Body Mass Index (BMI) and health insurance status in attendees at a local health fair. BMI was also compared among ages, gender, and races.

Methods. Descriptive analysis conducted using data collected at the “Celebrating Life and Health” health fairs between the years 2008 and 2011. Data for this study were collected at the BMI booth staffed by Wright State Boonshoft School of Medicine students.

Results. The results of this particular study do not demonstrate a statistical difference between obesity and health insurance status. Consistent with other research articles this study does show that …

The Role Of Supermarkets In Community Nutrition, Staci Gruber

Master of Public Health Program Student Publications

Background: Chronic diseases related to nutrition are a serious threat to public health. Supermarkets offer an important and promising venue to improve diet quality and overall health. The purpose of this study is to evaluate the supermarkets’ community nutrition focus and interest in public health.

Methods: This study emphasis’s a triangulated qualitative study design. It employs various methods and taps various sources for data. Twenty face-to-face, semi-structured key informant interviews were conducted with five full service supermarket chains in Montgomery County, Ohio; Wal-Mart, Kroger, Meijer, Cub Foods, and Dorothy Lane Market. Qualitative sources of information collected include store observation and …

Evaluation Of Cancer From Exposure To Cyanotoxins In Drinking Water At Grand Lake Saint Marys, Timothy Edward Soward

Master of Public Health Program Student Publications

Background: The Celina Water Department treats and supplies surface water contaminated by cyanotoxins from Grand Lake Saint Marys (GLSM) to approximately 12,000 customers in Celina, Ohio. Cyanotoxins are a biochemically and bioactively diverse group of extremely potent natural toxins in water. A common cyanotoxin called microcystin-LR found in GLSM has been associated with acute liver damage and potentially liver and colorectal cancer.

Methods: In this observational study, the city of Celina (Mercer County) Ohio that had a contaminated surface water supply, the cancer incidence was compared with two control cities, St. Marys, and Wapakoneta (Auglaize County) in Ohio, both served …

Are Student Nurses Ready For Disasters? An Analysis Of Emergency Preparedness Content In Nursing School Textbooks Used In The Miami Valley, Kimberly Caudill

Master of Public Health Program Student Publications

Results of an analysis of nursing textbooks used in the Miami Valley, indicate that there is minimal emergency preparedness content included. The research was based on the textbooks used in the Introduction to Nursing, Psychiatric Nursing, and Community Health Nursing classes at four local nursing schools: Sinclair Community College, Kettering College of Medical Arts, Cedarville University, and Wright State University. The Community Health Nursing classes have the most prepared content, and include extra content in the form of tables and pictures .The analysis indicates that Wright State University does the best job at preparing student nurses to be ready to …

Assessment Of Refugees’ Health In Montgomery County: A Case Study Of Refugees From Rwanda And Burundi, Jean De Dieu Mukunzi

Master of Public Health Program Student Publications

The purpose of this research study was to identify health needs and health problems experienced by a refugee/asylee population in Montgomery County. Montgomery County hosts a large number of refugees, asylees and asylum seekers from countries such as Iraq, Ethiopia, Eritrea, Soudan, Rwanda, Burundi and Congo.

A public health challenge is limited demographic data about this population. The scarce data on their health needs slows down not only their successful resettlement but also limits community organizations, health and human services agencies to improve the delivery of health care services and health promotion programs to refugees and immigrants in Montgomery County. …

Comparing Cognitive Functioning And Adverse Metabolic Effects Of Consumers Taking Type 1 Or Type 2 Antipsychotic Medications With Un-Medicated Consumers, Muhammad Puri

Master of Public Health Program Student Publications

Obesity and metabolic side effects such as diabetes mellitus are major concerns in public health. Mentally ill people are a high risk subgroup for obesity and metabolic syndrome because of behavior, non treatment, and medication side effects. In this research, I conducted a retrospective chart review to compare the weight and body mass index of consumers who were prescribed antipsychotic Type 1 or Type 2 medications. The sample was drawn from consumers attending the Consumer Advocacy Model (CAM) program which is an outpatient substance abuse and mental health treatment program in the Wright State University Boonshoft School of Medicine Department …

Toxic Chemicals Transported By Rail And Public Health Safety Using Gis In Montgomery County, Ohio, Jason Lipiec

Master of Public Health Program Student Publications

Hazardous chemicals transported by rail pass directly through urban cities and pose a safety and health threat to the community. Some of these chemicals can be in large quantities, extremely toxic, devastating to the environment and have the potential to cause mass casualties and death. Thousands of people could be in harm’s way. While there is always the possibility for accidental chemical release, they also have the potential to be used in acts of sabotage and terrorism. Evaluation of the rail line in Montgomery County, Ohio using standards in the 2008 Emergency Response Guidebook using geographic information systems (GIS) at …

The Non-Infectious Disease Implications Of Bed Bug Infestations, Christopher T. Balster

Master of Public Health Program Student Publications

The purpose of this study was to determine the prevalence of bed bug infestations throughout Ohio, whether the non-infectious disease implications of infestations are public health concerns, and also determine the perceived ability of public health departments to respond to outbreaks within their jurisdiction. A descriptive study was performed using survey data obtained from 79 local public health departments throughout Ohio. Overall, 79.05% of individuals surveyed agreed that bed bug outbreaks are a public health concern. The mode of responses regarding whether or not the non-infectious disease concerns of infestations are a public health concern was 4 on a scale …

Smoking During Pregnancy: Its Effects On The Prevalence Of Low Birth Weight Infants, Lynda M. Colussi

Master of Public Health Program Student Publications

Objective: The purpose of this research was to determine what impact demographic characteristics and the smoking status of mothers had on the prevalence and risk for LBW births. Methods: Birth certificate data from Montgomery County, Ohio from 2006-2009 was analyzed. Among the information collected were the infant's birth weight, the mother's age, marital status, education level, race, payer status at time of delivery, WIC status, and smoking status. The impact demographic characteristics and smoking status had on the prevalence of LBW births was determined by a logistic regression model. The effect of when women smoked during pregnancy had on the …

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 …