Maternal and Child Health Commons^™

Treatment And Interventions For Sexual Assault In Humanitarian Contexts: Addressing Gaps In Refugee And Idp Camp Care In Myanmar, Erin Nash

Capstone Experience: Master of Public Health

Sexual and gender-based violence (SGBV) remains a pervasive yet under-addressed issue in humanitarian settings. Refugee and internally displaced person (IDP) camps along the Thai– Myanmar border represent a complex nexus of protracted displacement, ethnic conflict, and limited access to medical and psychosocial care. Although the prevalence of sexual assault in these contexts is well-documented, there is a critical gap in the literature regarding effective, context-specific treatment and intervention strategies. This capstone project conducts a comprehensive review of existing research on sexual assault care in humanitarian crises worldwide and assesses its applicability to displaced ethnic minorities from Myanmar. The analysis considers …

Acceptability Of Corticosteroid Use In The Treatment Of Infant Bronchiolitis: Utilizing The Theoretical Framework Of Acceptability To Design Research Instruments, Caroline R. Smetanka

Capstone Experience: Master of Public Health

Bronchiolitis is the leading cause of hospitalization among infants under six months, yet treatment remains largely supportive due to clinical guidelines that discourage pharmacologic intervention. Recent research suggests that bronchiolitis is not a uniform condition, and a subgroup of infants (those classified within “Profile A”) may benefit from targeted corticosteroid therapy. However, these treatments remain outside current clinical guidelines, and their successful adoption depends on stakeholder acceptability. This Capstone project developed and refined four data collection instruments- two questionnaires and two interview guides- designed to assess how healthcare providers and caregivers perceive the acceptability of corticosteroid treatment for Profile A …

A Comprehensive Literature Review Of Barriers To Hormone Therapy Utilization: Strategies For Improving Menopause Management In Women Aged 40-60, Suhan Lee

Capstone Experience: Master of Public Health

Menopause is a natural transition marked by the cessation of ovarian activity, often accompanied by vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM), and psychological changes that significantly impact women’s quality of life. Hormone therapy (HT) has been the primary treatment for managing menopausal symptoms, particularly VMS, providing substantial relief when initiated within 10 years of menopause. Despite its effectiveness, HT usage has declined dramatically over the past two decades primarily due to barriers such as stigma, safety, misinformation, provider hesitancy, financial barriers, and cultural beliefs. This comprehensive literature review explores key factors influencing HT decision-making, including the media’s role …

Breaking Barriers To Smoking Cessation: Applying The Baby & Me - Tobacco Free Program To Improve Maternal And Child Health In Omaha, Nebraska, Madison Ravens

Capstone Experience: Master of Public Health

Smoking during pregnancy remains a pressing public health concern, contributing to adverse outcomes such as preterm birth, low birth weight, and developmental complications. In Nebraska, about 10% of pregnant women continue to smoke throughout pregnancy—above the national average, highlighting a critical gap in maternal health interventions. The Baby & Me – Tobacco Free (BMTF) program provides an evidence-based solution through structured counseling, carbon monoxide (CO) monitoring, and incentive-based rewards to support smoking cessation among pregnant women. This capstone project utilized the Getting to Outcomes framework to develop a detailed implementation plan to support Tobacco Free Nebraska (TFN) in launching the …

The State Of Abortion Training In Medical School And Family Medicine Residency Curricula: A Scoping Literature Review, Eric James Reece

Capstone Experience: Master of Public Health

This project aims to assess how abortion education has been integrated into medical training over the past decade, with a particular focus on understanding its current state in medical schools and family medicine residencies, including those offering specialized programs affiliated with RHEDI (Reproductive Health Education in Family Medicine) and TEACH (Training in Early Abortion for Comprehensive Healthcare). Given the ever-evolving legal landscape following the June 4^th, 2022 Supreme Court case of Dobbs v. Jackson Women’s Health Organization, this review explores how both federal- and state-level legal restrictions impact access to abortion training and attempts to identify gaps …

Transgender And Gender-Diverse Health Care Access And Availability Of Care According To Resident Leaders In The Mahoning County, Ohio, Robin A. Perry

Capstone Experience: Master of Public Health

BACKGROUND: Transgender and gender diverse health is significantly under attack in the United States and there is a continued need to further research to identify ways to increase their access to both inclusive care as well as gender affirming care. The purpose of this study was to explore barriers and supportive factors that professionals and community leaders perceive surrounding the availability and accessibility of inclusive and gender affirming care for transgender and gender diverse people in Mahoning County, Ohio.

METHODS: Key informant interviews were conducted with professionals and community leaders who could be considered “facilitators” helping transgender and gender diverse …

Promoting Adolescent Mental And Physical Health: Initiatives Focused On Connecting Public Health And Social Services To The Health Sector In Nebraska, Theresa Nguyen

Capstone Experience: Master of Public Health

This capstone focuses on the second recommendation of improving access to comprehensive, coordinated health services from the National Academies of Sciences, Engineering, and Medicine report The Promise of Adolescence: Realizing Opportunity for All Youth (2019). This proposal uses secondary data from the research project, Moving Evidence-Based Recommendations to Practice to Strengthen the Health Care System in Nebraska. Key stakeholders (n=28) were interviewed from the health care, public health, social services, and policy sectors. Each subject was asked to participate in a semi-structured interview by a trained interviewer. The interview was 1 hour long and conducted via phone call or Zoom. …

Strategies To Encourage Recall And Prevent Relapse After Full Mouth Rehabilitation Under General Anesthesia In Children, Claire Koukol

Capstone Experience: Master of Public Health

Background: Dental caries are preventable. Dentists utilize many prevention strategies in the office and provide at-home education to families. However, once a child develops Early Childhood Caries (ECC), especially in more severe cases, they may need general anesthesia (GA) to complete treatment. While this is an effective way to achieve full mouth dental rehabilitation (FMDR), this burdens the healthcare systems and families and does not come without risk to the patient. Patients with high caries experience remain at high risk of caries relapse after FMDR under GA, sometimes necessitating additional FMDR under GA. While there has been a significant amount …

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience: Master of Public Health

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …

Certified Midwives: An Exploration Of Their Impact On Maternal Health Outcomes – A Comprehensive Literature Review, Heather Hollister

Capstone Experience: Master of Public Health

Maternal health outcomes in the United States have been consistently worse than other high-income countries, with a disproportionate impact on women of color. Midwives have long played an important role in maternal health worldwide. The literature review examines the evidence for midwives as key contributors to improving maternal health outcomes. The paper reviews the existing literature on midwifery, including the impact on maternal health, labor and delivery outcomes, and patient satisfaction. Electronic searches were conducted through Cochrane Library, CINAHL, Medline and Embase. Articles were screened according to inclusion and exclusion criteria including that they must be a randomized study; participants …

The Relationship Between Congenital Heart Disease And Infant Mortality In Low- And Middle-Income Countries: A Comprehensive Literature Review, Helen Nneoma Odo

Capstone Experience: Master of Public Health

Congenital heart diseases (CHD) are conditions that are present at birth and can affect the structure of an infant’s heart and the way it works. Millions of children are born each year with congenital heart disease yet screening for CHD is not practiced in Low- and Middle-income countries (LMICs). Studies on access to healthcare for infants with congenital heart disease have not kept pace. This literature review centers on the role of congenital heart disease in infant mortality, its burden, incidence and prevalence in LMICs. The databases of PubMed, Google Scholar and Embase were searched and the selected articles for …

Early Childhood Nutrition Education Implementation Evaluation And Planning: Learn, Grow, Eat & Go!, Alyssa L. Wessling

Capstone Experience: Master of Public Health

The obesity rate among American children aged two to five years old is 12.7% (Centers for Disease Control, 2022), indicating a need for health interventions at this critical life stage. Nebraska Extension’s Nutrition Education Program has identified a need for direct education materials to reach Nebraskans in early childhood. Learn, Grow, Eat & Go! Early Childhood was identified as an appropriate curriculum to be tested in an early childhood intervention pilot. Learn, Grow, Eat & Go! Early Childhood is a newly developed program built upon the foundation of teaching children about healthful foods and physical activity through gardening. An early …

A Scoping Literature Review Of Workforce Development Strategies To Increase Indigenous Birth Workers, Danielle A. Thies

Capstone Experience: Master of Public Health

Objective/Aim: To review the literature on workforce development to increase Indigenous birth workers to improve birth outcomes in Indigenous populations.

Design: A systematic scoping review.

Data Sources: The following databases were accessed: PubMED, Embase, and CINAHL. Support relating to key words and appropriate databases was provided by a university librarian.

Review Methods: Search terms across databases were sourced identifying a total of 152 papers. Title/abstract searches were screened against the inclusion/exclusion criteria, resulting in 55 papers reaching full-text review. Of the 55 papers reviewed, 26 were eligible for inclusion in the final review.

Results/Findings: Thematic …

Identifying & Addressing Barriers To Child Care For Formerly Incarcerated Mothers, Joanne Bird

Capstone Experience: Master of Public Health

As women’s incarceration rates have risen significantly in recent decades, gender-specific programs are needed to meet the needs of formerly incarcerated mothers (FIM). Although child care can be difficult to access for many families, this marginalized population faces unique obstacles to accessing child care. In order for FIM to be employed and reintegrate, they must be able to access child care; however, FIM experience unique barriers to securing child care services. This policy brief aims to identify the special considerations FIM face, as well as to explore why existing programs are not meeting their specific needs. A literature review was …

Impact Of Coalition Building To Promote Maternal Infant Health Equity In The District Of Columbia, Maryland, And Virginia, Sydney J. Turner

Capstone Experience: Master of Public Health

The health of women and babies is critical to creating a healthy world. Stratified data shows the overwhelming rates at which Blacks are affected more than Whites. Literature has shown that leveraging partnerships and community engagement are critical components of decision-making and can positively impact the health of communities. Through a direct observational study, the Community Coalition Action Theory was used to analyze the current structure of the March of Dimes Maternal Infant Healthy Equity Coalition. The study aimed to identify strengths and gaps and subsequently provide recommendations to advance the coalition work and promote maternal and infant health equity …

Overlaps And Gaps Of Preterm Birth Programs In The Triangle Area Of North Carolina, Amber Bobbitt

Capstone Experience: Master of Public Health

Background: Preterm birth rates are a long-standing issue that has yet to be adequately addressed and prioritized. Nationally about 1 in every 10 infants are born prematurely in the United States. In the state of North Carolina, 1 in every 9 live births was preterm in the year 2020. The aim of the study was to determine the strategies organizations use in North Carolina to reduce preterm births in comparison to the CDC’s Five Strategy framework and to understand how the organizations address health equity and measure/evaluate the success of their initiatives.

Methods: Semi-structured one-on-one interviews were conducted with four …

Population-Level Prevalence Of Depression And Summary Statistics Of Women With At Least A Year Post-Final Menstruation With And Without Hysterectomy, Happiness Kingi

Capstone Experience: Master of Public Health

Background: Depression is associated with estrogen hormonal changes. There are few comparisons studies on the population-level prevalence of depression in women at least a year post final menstruation with and without hysterectomy.

Objectives: 1) To determine the population-level prevalence of depression in women with at least a year post final menstruation with and without hysterectomy and 2) to calculate the summary statistics of women with at least a year post final menstruation with and without hysterectomy

Methods: A population-based cross-sectional design was used. Respondents were female participants of the U.S. National Health and Nutrition Examination Survey (NHANES) …

Workforce Assessment: Measuring The Impacts Of Covid-19 On The Maternal And Child Health Workforce, Ashleigh M. Sutphen

Capstone Experience: Master of Public Health

Workforce assessments provide an opportunity to assess, evaluate, and identify the needs of a particular workforce. The use of workforce assessments in the field of maternal and child health (MCH) has been an ongoing and a strongly supported effort by the Health Resources & Services Administration: Maternal and Child Health Bureau (MCHB). The maternal and child health workforce is responsible for providing essential public health services to some of the most vulnerable populations such as mothers, children, and people living with disabilities. Thus, the continuation of providing these essential public health services is critical – even in the midst of …

Developing A Program Evaluation Plan For Medicaid Prenatal Care Management Programs, Shardae Sims

Capstone Experience: Master of Public Health

Prenatal care management (PNCM) is an intervention that targets women during the perinatal period to improve birth outcomes. PNCM has the potential to address social determinants of health issues and gaps or barriers to care that could lower incidences of adverse birth outcomes in Nebraska. There is currently a gap in the literature for studies that fully assess the impact of prenatal care management programs and the program’s ability to reach set goals. The purpose of this research is to develop an evaluation plan and potential implementation strategies that can be utilized by the Medicaid PNCM program in Nebraska. The …

Developing A Training Program For Omaha Metro Area Sexual Assault Nurse Examiners Caring For Individuals With Developmental Disabilities, Emily Blanchard

Capstone Experience: Master of Public Health

Individuals with developmental disabilities experience many barriers to healthcare and are at a substantially higher risk for sexual assault and trauma. There is a need for more inclusive and collaborative healthcare policies, practices, and education to guide healthcare providers during their encounters with individuals with developmental disabilities as patients, especially during forensic examinations following sexual assault and trauma. In the Omaha metro area, physical therapists at the Munroe-Meyer institute provide clinical services in a transdisciplinary program that refer victims of sexual violence to local health systems’ Sexual Health Nurse Examiners (SANEs).

There is an existing service gap for individuals with …

The Correlates Of The Maternal Fetal Attachment In The Democratic Republic Of The Congo, Orphee L. Tamba

Capstone Experience: Master of Public Health

Maternal-fetal attachment is defined as the relationship of affection that exists between the pregnant woman and her fetus during pregnancy. It increases throughout the pregnancy and predicts not only the attachment style between the mother and the child but also the chances of optimal socioemotional development during infancy. The Maternal Antenatal Attachment Scale measures the Maternal-Fetal Attachment (MFA). Several versions of this scale have been adapted in various parts of the world. However, to date no study has been conducted on the validation of this scale in sub-Saharan Africa and the identification of factors associated with the MFA. This cross-sectional …

Association Of Adverse Birth Outcomes With Maternal Exposure To Nitrate In Private Well Drinking Water: An Action Plan For Prevention, Jessyka R. Johnson

Capstone Experience: Master of Public Health

Abstract

Goal: The goal of the capstone project is to collect information required to develop an action plan focusing on minimizing exposure to nitrate in pregnant women, which, if implemented, can either prevent or reduce adverse health outcomes associated with nitrate exposure in utero.

Objective: The capstone project objective is to gain a better understanding of what programs to prevent exposure to nitrate from private well drinking water in pregnant women are already in place throughout the United States; to identify any areas of improvement in these programs; and to utilize this information to create a unique action plan in …

Trends In Childhood Elevated Blood Lead Levels In Nebraska, 2013 – 2017, Ellana Haakenstad

Capstone Experience: Master of Public Health

This project explored the exposure to lead among children in Nebraska. Using the Nebraska Department of Health and Human Services’ Blood Lead Level database, trends were investigated in screening; demographics; incidence; and prevalence of elevated blood lead levels, statewide and by census tract. The study further explored the geography of lead exposure and elevated blood lead level cases with maps. Based on these results, policy recommendations were made to the Nebraska Department of Health and Human Services’ Childhood Lead Poisoning Prevention Program, particularly about areas of Nebraska with high risk of lead incidence and exposure risk where testing should be …

Identifying The Newly Insurable Medicaid Coverage Gap Population Under The Affordable Care Act: Who They Are And Where They Live, Samuel L. Woodruff

Capstone Experience: Master of Public Health

The goal of this Capstone Project is to better define and geographically locate the potential distribution of individuals who fall within the current Medicaid Coverage Gap and those populations who would be eligible for Medicaid under the expansion of Medicaid within the state of Nebraska. Using data from multiple United States Census Bureau sources, along with available data from the Health Resources and Services Administration (HRSA), this project looks to also locate populations of these individuals that may live within established Medically Underserved Areas (MUA's) or Health Professional Shortage Areas (HPSA's) within the state. American Community Survey 5-year Public Use …

Youth Focus Groups: Design And Analysis Plan For The Bears Project, M. Renee Beacom Claborn

Capstone Experience: Master of Public Health

This capstone project produced a qualitative research design and analysis plan for youth focus groups as part of a Quality Improvement project at OneWorld Community Health Center (OWCHC) School-Based Health Center (SBHC) located at Bryan High School (BHS) in a program called BEARS. The intended use of this project is to serve as a reference guide for BEARS program planners to utilize as part of the data collection and analysis processes. The purpose for collecting qualitative data for this project is three-fold. 1. To explore adolescents’ perspectives of risk behaviors and associated health determinants common to their age group 2. …