Other Public Health Commons^™

Analysis Of The Hospital Medical Surge Preparedness Index In Relation To Hospital Characteristics And Social Determinants Of Health, Philipp Lirk

Capstone Experience: Master of Public Health

Objective

Substantial investments have been made in hospital emergency preparedness. The Hospital Medical Surge Preparedness Index (HMSPI) has been proposed as a metric to assess health system readiness. This index summarizes hospital system characteristics, space and facilities, staff availability, and supply planning.

Methods

The primary objective was to evaluate the relationship between the HMSPI and characteristics of the respective hospitals, including size, type, location, performance on the Hospital Resilience Index (HRI), and Social Determinants of Health (SDoH).

Results

Higher HMSPI scores were found in suburban compared to rural hospitals, a higher HMSPI in larger hospitals with greater patient volumes and …

The Impact Of Public Health Authority On Emergency Response In State Health Departments, Jessica L. Baggett

Dissertations: Doctor of Public Health

Background

Public health authority plays a crucial role in enabling state health officials to implement emergency response measures such as isolation, quarantine, and vaccination campaigns. However, legislative changes following the COVID-19 pandemic have significantly curtailed these authorities in many states, raising concerns about the ability of public health officials to respond effectively to future health crises. The erosion of public health authority has highlighted gaps in the legal literacy of health officials and underscored the need for enhanced training in navigating political and legal challenges.

Purpose

The purpose of this study is to assess legal literacy among state health officials, …

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 …

Active Shooter And Radiological Contamination Full-Scale Exercise, Elise M. Lowe

Capstone Experience: Master of Public Health

Planning and conducting exercises in rural settings highlights the unique features and challenges of emergency preparedness in rural America. Exercise designers must employ creative solutions to plan for player/controller contingencies, limited resources, and patient management across large geographical areas. This paper outlines the process by which a full-scale mass casualty exercise was conducted in a small Wyoming town. It analyzes some of the major problems encountered in rural exercise development and the solutions employed. The focus is on the success and failures of the exercise design based on direct observation/participation, hotwash forms, the after-action review, and direct feedback from participants. …

Surge Scramble: An Evaluation Of Combining The Medical Response And Surge Exercise With The Centers For Disease Control And Prevention’S Pan Flu Scramble, Rebecca L. Thompson

Capstone Experience: Master of Public Health

This report analyzes how Hospital Preparedness Program funding recipients in Nebraska adapted the Center for Disease Control’s Pan Flu Scramble format to meet Medical Response and Surge Exercise (MRSE) requirements in the 2023-2024 fiscal year. By combining the MRSE and Pan Flu Scramble, the recipients created an in-person functional exercise format for the six Nebraska health care coalitions to test their respective chemical plans and the Health Care Crisis Protocol for the State of Nebraska. The report explains the design and conduct of the exercises and provides a comprehensive evaluation of the exercise design and conduct. This report will outline …

Understanding And Mitigating The Potential Effects Of Postpartum Depression On Fathers And Male Support Persons, Rachel Norton-Turk

Capstone Experience: Master of Public Health

Background. During the postpartum period, best practices dictate that medical professionals screen new mothers or birthing persons for anxiety and depression and direct them to the appropriate resources and services they may need. This qualitative study explored the steps being taken to identify depression and anxiety concerns in male support partners during the postpartum period and to understand what resources are being brought to their attention if depression and anxiety are identified. Methods. A convenience sample of male support persons participated in semi-structured, one-on-one interviews either in-person or over Zoom between September and October 2024. Interviews were recorded, transcribed, …

Phase 0 Feasibility And Design Of Mobile Health Applications For Use In Rural Settings, Aubree C. Honcoop

Theses & Dissertations

Background. Mobile Health (mHealth) interventions, when meant to serve as decision support, require an in-depth investigation of current workflows and decisional needs to ensure future usability and acceptability. Rural groups were prioritized due to their limited healthcare access, and therefore, their increased need for interventions like mHealth apps that address health disparities.

Objective. To assess the decisional needs of parents/caregivers and/or Healthcare Providers (HCPs) in rural areas regarding emergencies with children with medical complexity (CMC, Project 1), COVID-19 vaccination (Project 2), and HPV and COVID-19 vaccination (Project 3).

Methods. Parents and HCPs were approached through various methods for participation, primarily …

Optimizing Malaria Control In Nigeria: A Comprehensive Review Of Llin Effectiveness And Policy Frameworks, Jash Mehta

Capstone Experience: Master of Public Health

This comprehensive literature review examines the effectiveness of Long-Lasting Insecticidal Nets (LLINs) and the policy frameworks governing their use in Nigeria, with the goal of optimizing malaria control strategies in the country. The review explores the scientific underpinnings of LLINs, evaluates their effect on malaria incidence, and examines the operational, sociocultural, and economic aspects that affect their use. It also examines Nigeria's policy environment, assessing the creation, application, and efficacy of policies pertaining to LLIN. The summary of research results from several studies emphasizes the importance of LLINs in preventing malaria and the challenges associated with implementing policies in different …

Examining The Impact Of Racial And Ethnic Disparities In Colorectal Cancer Screening Compliance In The United States And The Potential Of Targeted Interventions., Jessica Ware

Capstone Experience: Master of Public Health

Objectives:

Examine Colorectal cancer (CRC) screening compliance among racial and ethnic groups in the United States (US) based on the US Preventive Services Task Force (USPSTF) recommendations.

Identify targeted interventions to promote screening compliance, early diagnosis, and CRC survivorship.

Methods: This cross-sectional study utilized 165,878 selected participant responses from the 2022 Behavioral Risk Factor Surveillance System. We modeled and investigated CRC screening compliance based on the USPSTF recommendations as inclusion criteria between racial/ethnic groups in the US while adjusting for covariates using a weighted stepwise logistic regression.

Results: With covariates adjustment, Hispanics (POR 1.16 95%CI 1.04-1.29), Asian …

Examining The Relationship Between Deafness And Mental Health Status: An Analysis Of The Behavioral Risk Factor Surveillance System (Brfss) 2022, Brianna Stroud-Williams

Capstone Experience: Master of Public Health

Objective: The objective of the research is to examine the association between mental health status as measured by number of mentally healthy days in the past month and deafness and binge drinking.

Methods: The Behavioral Risk Factor Surveillance System (BRFSS) study was conducted via telephone survey in 50 states, including the District of Columbia and US territories. The sample size is 402,156 participants. Univariate, bivariate, and multivariate regressions, odds ratio, and 95% confidence interval were used to measure the data.

Results: Deaf respondents have 1.56 times the odds of having poor mental health than those who are not deaf. (95% …

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 …

Reducing Burnout Using Emergency Planning: A Literature Review, Taylor Vaughn

Capstone Experience: Master of Public Health

Objective

The objective of this capstone is to gain knowledge on what burnout is, what causes it, what can be done to prevent it, and what can be added to public health emergency plans to reduce burnout in local emergency preparedness workforces.

Methodology

A literature review was completed through peer-reviewed articles, and documents from professional and governmental organizations. The results were used to search current plans to determine whether burnout-related recommendations were present.

Results

Burnout prevention at the personal level includes a good diet, routine exercise, and mindfulness activities. At the organizational level it should include providing emotional support, emphasizing …

Depression And Parenting: A Mixed Method Analysis Of Some Protective Factors For Depression Among African American Fathers Using A Community-Based Participatory Research Approach, Tatiana Tchouankam

Theses & Dissertations

In the United States (US), African American (AA) men often face oppression, discrimination, negative interactions with the justice system, and significant economic, neighborhood, and social hardships over their life course. These challenges increase the risk of chronic exposure to stressful events with negative mental health outcomes, such as depression. Most of the research on parenting and parental depression has focused on mothers based on the premise that women are more often primary caregivers for their children, especially during early childhood. However, a growing number of fathers take on childcare responsibilities. Despite dealing with different life stressors and negative circumstances, AA …

The Patient-Centered Medical Home And The Value Of Heightened Care Coordination: A Systematic Literature Review, Garrett L. Vetter

Capstone Experience: Master of Public Health

Health care spending in the United States continues to increase at a pace that far exceeds inflation. Representing a greater proportion of the nation’s gross domestic product (GDP) than any other country, costs associated with health care services in the U.S. lend support to growing concern regarding the sustainability of current systems. Furthermore, the fragmented nature of the current landscape often presents challenges to the provision of high-quality and efficient care. Satisfaction among both patients and health care providers, alike, suffers under the weight of increasing regulatory burden, the lack of integrated medical records systems, and growing complexity among health …

1-Check Unmc Mobile App Usage: A Quantitative Analysis Of The Data, Molly Pofahl

Theses & Dissertations

As COVID-19 cases continued to rise in Nebraska, universities and colleges were faced with unique challenges in the effort to continue providing quality education for students. The University of Nebraska Medical Center (UNMC) took on especially difficult challenges due to its status as an academic medical center. By the Fall of 2021, students, faculty, and staff were beginning to return to campus. The 1-Check UNMC app was created to help keep sick people from coming to campus. The UNMC community was expected to screen themselves for COVID-19 using this app each day before coming to campus. This thesis is an …

A Quantitative Job Satisfaction Comparison Between Certified Nursing Assistants (Cnas) Providing Care In Patients’ Homes Versus In Long-Term Care (Ltc) Facilities In The Omaha Metropolitan Area, Rusheena Shah

Capstone Experience: Master of Public Health

This capstone project looks at overall job satisfaction comparison between two groups of Certified Nursing Assistants (CNAs) – CNAs who provide home care in patients’ homes and CNAs who provide care in Long-term Care (LTC) facilities in the Omaha Metropolitan Area. In this quantitative study, a survey was sent to CNAs who provide home care to patients and CNAs who provide patient care at different nursing home facilities in the Omaha area. Prior research has indicated that even though CNAs perform similar job duties irrespective of the work environment; they experience varying degrees of job satisfaction which could be attributed …

Point Of Care Spirometry Assessment For Pediatric Asthma Prevalence In A Family Homeless Shelter In Omaha, Nebraska, Nathaniel Mattison, Dale Agner, Breanne Parets, Haley Mathews, Emily Saliga, Maria Vacha, Jamicah Harris, Ryan Saliga

Graduate Medical Education Research Journal

Abstract:

Introduction: The few studies on pediatric asthma in US homeless shelters describe a 27.9 – 39.8% prevalence, and historically Omaha has had a high incidence of fatal pediatric asthma. Thereby, Clarkson Family Medicine (CFM) residency began a pediatric asthma outreach to a local family-homeless shelter to assess the prevalence of pediatric asthma and follow-up appointment attendance.

Methods: We obtained a voluntary parent-child assessment of the child’s respiratory history and an Asthma Control Test (ACT) between ages 4-18 for children residing at the family-homeless shelter. We obtained a pre-albuterol and post-albuterol mobile spirometer assessment using the Global Initiative for …

Fire Service Covid-19 Infection Prevention And Control Policy Comparison, Saaddedine Dichari

Theses & Dissertations

To date, there have been over 2.7 million deaths and more than 126 million cases attributed to the COVID-19 pandemic (JHU, 2021). This pandemic has affected nearly every aspect of daily life. Among those impacted are U.S. firefighters, as they provide many services beyond simply extinguishing structure fires and are frequently dual certified as emergency medical technicians. Many of the victims of this pandemic have relied on first responders to provide them with emergency medical care and hospital transport. When caring for these infected patients, firefighters have an increased risk of exposure and must be provided with adequate …

The Epidemiology Of Clostridioides Difficile In Nebraska - A Descriptive Study Between 2018-2020, Storm Keffer

Capstone Experience: Master of Public Health

Objectives: Clostridioides difficile (C. diff) is a common but challenging infection both financially and medically. Due to these difficulties, Clostridioides difficile infection (CDI) caused by C. diff is a mandatory reportable disease in Nebraska and as such has been a priority disease targeted by various disease control practices across many hospitals. All CDI laboratory results are reported electronically through the Nebraska Electronic Disease Surveillance System (NEDSS). However, capturing and conceptualizing the true burden of CDIs in Nebraska has not been adequately accomplished since monitoring of CDIs began. The objective of this study is to examine the trends of …

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 …

The Escape Pod: Utilizing Escape Room Methodologies To Train Public Health Volunteers On Open Point-Of-Dispensing Operations, Melanie R. Thompson

Theses & Dissertations

Mobilizing Points-of-Dispensing (PODs) during a mass dispensing of medication event at a local health department will require a large amount of personnel, both staff and volunteers. Training the volunteers prior to this type of event is ideal to ensure that POD operations flow quickly and properly. This project aimed to create an affordable and fun training that engaged volunteers and other interested stakeholders while increasing their knowledge of POD operations. Methodologies used in commercial escape rooms were employed in this training to enhance the participants’ understanding of POD operations. Participants to worked in groups to solve puzzles and challenges in …

God, I Hope This Part Of My Life Is Over: A Focused Ethnography Of A Correctional Youth Facility’S Therapeutic Climate, Eric Meyer

Theses & Dissertations

Although all prisons have the same goal of isolating offenders from society, the precise strategies used vary from one jurisdiction to the next. Some prisons use means of punishment to gain inmate compliance. Other prisons concentrate their limited resources on rehabilitation. Contained within the following pages are details of a focused ethnography that was completed in a state correctional youth facility that housed males between the ages of 15 and 21 years, all of whom were convicted of violent crimes. This study had the objective of exploring the climate of therapy in this correctional youth facility where rehabilitative programs were …

Potentially Reduced Exposure Products, Occupational Variations In Smoking, And Hardcore Smokers: Examining Important Elements In The Tobacco Use Spectrum, Raees A. Shaikh

Theses & Dissertations

The purpose of this research was to examine three important aspects of the smoking phenomenon that are, and will remain, important for the future of tobacco control research and policy. First and currently one of the most debated and researched topics in the tobacco research field relates to the group of products regarded by some as the potentially reduced exposure products (PREPs). We studied determinants of use of these products. Second aspect was to examine the socioeconomic subgroup of smokers based on their occupations who might potentially benefit from the use of PREPs and the third stage involved studying the …

Common Areas For Improvement From After Action Reports (Aars) Generated After Exercises Or Actual Disasters, As Reported By A National Sample Of U.S. Hospitals, Abdoulaye Abdoulaziz

Theses & Dissertations

Many hospitals conduct exercises every year, and they conclude the process with an After-Action Report and Improvement Plan. Therefore, there are thousands of AAR/IP’s across the country with limited opportunity to compare them or to learn from them collectively. Our project has gathered Improvement Plans (IP’s) and conducted a qualitative analysis which determined whether the “lessons learned” can be categorized into common themes.

Pandemic Planning: Estimating Disease Burden Of Pandemic Influenza To Guide Preparedness Planning Decisions For Nebraska Medicine, Angelia Wimberly

Theses & Dissertations

This year marks the 100^th anniversary of the 1918 “Spanish Flu” outbreak that killed 50-100 million people worldwide. If a pandemic of this proportion happened today, the federal pandemic influenza plan predicts that 30 percent of the population could become infected with up to 50 percent seeking outpatient care. With Nebraska Medicine currently operating at nearly full capacity (95-97%), surge capacity for hospital space, staff, and supplies would be in severe demand and would quickly overwhelm the organization. To assess the impact of pandemic influenza in Douglas County Nebraska and Nebraska Medicine, pandemic modeling tool FluAid and FluSurge 2.0 …

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 …

Hospital Based Emergency Department Visits With Dental Conditions: Outcomes And Policy Implications In The States Of California, Nebraska And New York, Sankeerth Rampa

Theses & Dissertations

The purpose of this dissertation was to present state-level estimates of hospital-based emergency department (ED) visits with dental conditions across all ages in the states of California, Nebraska, and New York. Also, this dissertation examined the outcomes and impact of changes in Medicaid policies on the utilization of ED with dental problems. State Emergency Department Databases (California, Nebraska, and New York), a component of the Healthcare Cost and Utilization Project (HCUP) was used for this dissertation. Dental conditions were identified by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. High-risk groups visiting EDs with dental conditions were …

Barriers To Pediatric Triage Guideline Compliance: A Survey Of Nebraska Emergency Departments, Jonathon J. Gruba

Theses & Dissertations

Nebraska emergency departments may be underprepared for a mass casualty event involving a large number of children, as indicated by the results from the 2013 Emergency Medical Services for Children’s (EMSC) Pediatric Readiness Project (PRP) report. This was primarily evident by the lack of existence of a pediatric triage policy among Nebraska emergency departments. Utilizing a survey, this study attempted to identify the emergency departments in Nebraska that followed the EMSC guideline of having a pediatric triage policy, as well as to identify possible barriers to guideline adherence among those that did not have the policy.

It was found that …

Behavioral Care For Children In Urban And Rural Integrated Primary Care, David I. Taylor

Theses & Dissertations

Mental, emotional, and behavioral issues in children are a significant concern for the children, their families, and society. Despite the existence of evidence-based treatments, the success of behavioral healthcare to meet the needs of these families will require high quality communication and relationships across a wide range of stakeholders. Integration of care represents a patient-centered strategy to unify these stakeholders into a single cohesive care team. The purpose of this dissertation is to define the behavioral healthcare team in integrated primary care for children in terms of the functional roles involved and to evaluate the quality of relationships and communications …

Assessing Change In Baseline Preparedness Knowledge In Long-Term Care Facilities, Heidi L. Wheeler

Theses & Dissertations

With much of the focus and federal resources in recent history going to support hospital preparedness, long-term care facilities have been left behind even though they house one of our most vulnerable populations. Few regulations and standards have required these facilities to keep pace with preparing for an increasingly volatile environment and aging society. This is changing with the proposal of new federal standards and regulations requiring more thorough and robust preparedness planning. These new requirements do not have to be overwhelming or burdensome to facilities but can be included quite simply into routine planning and training. This study looks …