Public Health Education and Promotion Commons^™

Preventing Teen Pregnancy Through Expanded Contraceptive Access In Mccreary County, Kentucky, Dacey B. Chitwood

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This capstone project proposes a school-based Condom Availability Program to reduce teen pregnancy risk by expanding discreet contraceptive access for adolescents in McCreary County, Kentucky. Teen pregnancy remains a persistent public health concern in rural communities where stigma, privacy concerns, transportation barriers, and limited healthcare access can prevent adolescents from obtaining reproductive health resources. McCreary County faces elevated teen birth rates, socioeconomic disadvantage, and limited maternal healthcare infrastructure, making teen pregnancy prevention an important local priority. The proposed program would place free latex and non-latex condoms in student restrooms at McCreary Central High School, with QR-code-linked information connecting students to …

Determinants Of Routine Childhood And Adolescent Vaccine Hesitancy And Uptake Among Parents In The United States: A Scoping Review, Precious Johnson

Theses and Dissertations

Routine childhood and adolescent vaccination is an essential public health strategy for preventing disease and protecting communities. However, parental vaccine hesitancy and barriers to vaccine uptake continue to affect vaccination decisions in the United States. This scoping review examined factors associated with routine childhood and adolescent vaccine hesitancy and uptake among U.S. parents. A comprehensive literature search of PubMed and EBSCO identified peer-reviewed studies published in English between 2016 and 2026. Studies focusing on parents, guardians, or caregivers of children and adolescents in the United States were screened according to predefined eligibility criteria. Of 69 records identified, 52 remained after …

Ask Me 3® In Action: Advancing Health Literacy In Pediatric Acute Care, Yaseming Medina

2026

This evidence-based practice project evaluated the implementation of the Ask Me 3® health literacy tool in a pediatric perioperative setting to improve caregiver understanding of medical information and communication with healthcare providers. Findings suggest that Ask Me 3® supports health literacy and caregiver engagement, while patient experience measures related to nurse communication, listening, and caregiver comfort improved following implementation.

Fitness To Work Evaluation In A Combined Physical And Office Working Activity With Piriformis Syndrome: A Case Report, Arif Prasetya, Nuri Purwito Adi

Occupational and Environmental Medicine Journal of Indonesia

Background Piriformis syndrome (PS) is a neuromuscular disorder with significant impact on workforce productivity. This case report presents a comprehensive evaluation of fitness for work and job modification strategies for a patient with PS in a combined physical and sedentary working environment. A 44-year-old male medical facility supervisor presented with left buttock pain, radiating to the left leg, diagnosed with left gluteal piriformis syndrome. Despite undergoing multiple conservative therapies by Physical Medicine and Rehabilitation Specialist, the patient showed minimal improvement.

Methods A seven-step fitness for work assessment approach was implemented following Indonesian Association of Occupational Medicine Specialists guidelines. The evaluation …

Factors Associated With The Atherogenic Index Of Plasma Among Workers At A National Respiratory Hospital In Jakarta, Muhammad Abror Rizani Fahmi, Herqutanto Herqutanto, Iqbal Mochtar, Dewi Yunia Fitriani, Marsen Isbayuputra, Resultanti Resultanti, Ariningsih Ariningsih

Occupational and Environmental Medicine Journal of Indonesia

Background Cardiovascular diseases (CVD) represent the primary cause of mortality globally. The atherogenic index of plasma (AIP) can predict the risk of CVD more accurately than other indices. Hospital workers are at risk of developing CVD. There are several factors that can influence the AIP. No studies have specifically investigated these associations in Indonesia, particularly regarding the AIP in hospital workers. This study aims to determine factors associated with the AIP among workers at a national respiratory hospital in Jakarta.

Methods This cross-sectional study collects data from the medical check-up records of workers at Persahabatan Hospital in 2024, who met …

The Correlation Between 25(Oh)D, Blood Lead Levels, And Delta-Aminolevulinic Acid Dehydratase Activity Among Indonesia Male Workers, Ratih Fadhillah, Muhammad Ilyas, Liem Jen Fuk, Levina Chandra Khoe, Muchtaruddin Mansyur

Occupational and Environmental Medicine Journal of Indonesia

Background Lead exposure disrupts the heme synthesis pathway by modifying the activity of Delta-Aminolevulinic Acid Dehydratase (ALAD), contributing to oxidative stress. Vitamin D has been suggested as an antioxidant to influence oxidative balance, but evidence regarding its association with ALAD activity in lead-exposed populations remains limited. This study aimed to analyze the associations between blood lead levels (BLL), serum 25-hydroxyvitamin D [25(OH)D], ALAD activity, and the 25(OH)D/BLL ratio among Indonesian male workers.

Methods A cross-sectional study was conducted among 90 male workers exposed to lead as part of either their occupation or living environment in Java, Indonesia. Serum 25(OH)D, BLL …

Return To Work After Percutaneous Coronary Intervention In Employee With Metabolic Comorbidities: An Evidence-Based Case Report, Bramantyo Eko Wahyudi Mr, Levina Khoe

Occupational and Environmental Medicine Journal of Indonesia

Background This evidence-based case report examines whether metabolic comorbidities independently predict return to work (RTW) after percutaneous coronary intervention (PCI) for myocardial infarction. A 52-year-old male senior manager with type 2 diabetes, hypertension, dyslipidaemia, and central obesity underwent PCI and required structured occupational assessment.

Methods A systematic literature search identified five eligible studies—one national registry cohort, three prospective cohort studies, and one narrative systematic review—critically appraised using Oxford Centre for Evidence-Based Medicine criteria.

Results Metabolic comorbidities showed consistent directional associations with reduced RTW probability in bivariate analyses and independently predicted longterm labour-market exit. However, in multivariate models across three of …

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

Examining The Barriers To Healthcare Among Native Hawaiian And Pacific Islander Populations Living In Hawaii, Gracie L. Kaye

Honors Undergraduate Theses

The state of Hawaii was annexed by the United States in 1898, and served as a starting point from which the U.S. influenced Hawaii's socioeconomic conditions and healthcare access. The literature review examines healthcare views and outcomes among Native Hawaiian and Pacific Islander residents, utilizing various tools and resources to investigate how these factors have impacted overall health statistics and the reasons behind these trends. Results found that the western colonization of the island and the disease outbreaks led to an initial mistrust of “western ideas.” Additionally, due to long-standing cultural beliefs, there is a natural preference for traditional cultural …

Between Tradition And Transition: Cultural Negotiations And Contraceptive Perceptions Among Ghanaian Students In The United States, Beatrice Amissah

Theses and Dissertations

As global mobility continues to rise, international students often encounter new cultural norms and health practices that differ from those in their home countries. While some studies have focused on contraception within the context of gender and types, less focus has been placed on diasporic populations, especially how students navigate tensions surrounding contraception within new cultural environments. This study explores how Ghanaian students in the United States interpret, negotiate, and respond to contraceptive messaging while navigating the cultural transition between their heritage and host societies. Drawing on Berry’s (1980)  Acculturation Theory, the study examines the tensions students experience, the strategies …

Rare Manifestation Of Scapular Cutaneous Larva Migrans Infection Among Sand Porters In Warm Climate: A Case Report, Prio Hangudi Sampurno, Tri Wisesa Soetisna

Occupational and Environmental Medicine Journal of Indonesia

Background Cutaneous larva migrans is a serpiginous helminthic infection common among certain occupations dealing with contaminated soil especially in warm climate. Most common predilections include the feet, legs, and buttocks with only a fraction of cases found on the trunk and upper extremities.

Case Presentation A rare scapular cutaneous larva migrans manifestation on a thirty-six years old sand porter with high occupational exposure was described. Physical examination revealed progressive pruritic and warm rash in a serpiginous pattern on the left shoulder.

Results Diagnosis was established based on characteristic serpiginous rash physical findings supported by history of contact. This case needed …

Incident Of Sensorineural Hearing Disorder In Toll Road Workers Exposed To Noise And Lead, Fitria Rimadhanty Setyaningtyas, Muhammad Ilyas, Dewi Yunia Fitriani, Suryo Wibowo

Occupational and Environmental Medicine Journal of Indonesia

Background Toll road workers are exposed to traffic noise and lead, both of which may increase the risk of sensorineural hearing loss (SNHL). This study aimed to examine the association between noise and lead exposure and the occurrence of SNHL among toll road workers.

Methods A cross-sectional study was conducted using secondary data derived from medical check-up records of 1,445 toll road workers in 2022. Study variables included age, sex, length of employment, past medical history, smoking status, job position, blood lead levels and SNHL incidence. Descriptive analyses were performed, followed by bivariate analysis using the chi square test and …

Systematic Review And Meta‑Analysis Of United States Childhood Obesity Public Policy Interventions, Marilyn Frenn, Maharaj Singh, Julia A. Snethen, Leigh Small, Nancy Browne, Cindy Smith Greenberg, Emily Horner, Sharon Y. Irving, Eric A. Hodges

College of Nursing Data

No abstract provided.

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

From Vision To Impact: Strategic Planning For The South Health District, Jason D. Butler Jr

College of Graduate Studies: Theses & Dissertations

This study presents a community health assessment and strategic planning process for the South Health District (SHD), a rural, multi-county public health district.  Using a mixed-methods approach, quantitative surveys and qualitative data from County Nurse Managers, County Boards of Health, and internal staff were integrated with secondary sources to identify community health priorities and organizational gaps.  Broad stakeholder engagement through surveys, SWOT workshops, and town-hall meetings ensured credibility and contextual relevance.

Findings revealed challenges in behavioral health, substance abuse, chronic disease, access to preventive services, transportation, workforce capacity, communication, and infrastructure.  Four strategic issues—Communication, Workforce Development and Retention, Purpose-Driven District, …

Exploring Acculturation And Its Role In Substance Abuse Behaviors Among Refugee Populations In Bowling Green, Ky: An Interactive Learning Experience Through Provider’S Perspectives., Aishwarya Potluri

College of Graduate Studies: Theses & Dissertations

Substance use among refugee populations is an emerging public health concern shaped/influenced by cultural, social, and structural factors associated with resettlement. This qualitative study explored providers’ perspectives on substance use behaviors among refugees in Bowling Green, Kentucky. Using Health Behavior Theory with acculturation as a contextual construct, semi-structured interviews were conducted with 10 providers working with refugee-serving organizations. Data collected through the interviews was analyzed using thematic analysis in NVivo. The findings indicate that substance use is being influenced by peer exposure, occupational stress, and the increased availability of substances in the United States. Providers identified cultural stigma surrounding mental …

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 …

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 …

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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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 …

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 …

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% …