Public Health Education and Promotion Commons^™

Refining Computerized Physician Order Entry Initiatives In An Adult Intensive Care Unit, Chevita Fuller

Walden Dissertations and Doctoral Studies

Computerized physician order entry (CPOE) is used in healthcare organizations to improve workflow processes and transcription, as well as to prevent prescribing errors. Previous research has indicated challenges associated with CPOE for end-users that predispose patients to unsafe practices. Unsafe CPOE practices can be detrimental within the intensive care unit (ICU) setting due to the complexity of nursing care. Consequently, end-user satisfaction and understanding of CPOE and electronic health record (EHR) functionality are vital to avoid error omissions. CPOE initiatives should be refined post system implementation to improve clinical workflow, medication processes, and end-user satisfaction. The purpose of this quality …

Perceived Attitudes And Staff Roles Of Community Based Outpatient Clinics In Disaster Management, Pauline Antoinette Hodge-Hilton

Loma Linda University Electronic Theses, Dissertations & Projects

Objective: Natural and manmade disasters have claimed the lives of thousands of individuals in the US and caused billions of dollars in property damage. First responders carry the responsibility of disaster management, leaving other health care professionals such as medical clinic staff underutilized to support the clinic staff. We explored how medical and support staff in Community-based Outpatient VHA Clinics (CBOC) perceive their roles in disaster response, their attitudes about clinic readiness and continuity of care during disasters, and their ability to function in a post disaster environment.

Methods: A mixed method study was conducted to answer questions related to …

Overcoming Shortage Of Pharmacists To Provide Pharmaceutical Services In Public Health Centers In Indonesia, Yuyun Yuniar, Max Joseph Herman

Kesmas

Indonesia masih menghadapi keterbatasan jumlah apoteker di puskesmas, sehingga pihak pemerintah daerah dan puskesmas harus berupaya mengatasi permasalahan tersebut. Penelitian ini bertujuan untuk menggambarkan ketersediaan dan distribusi tenaga pelayanan kefarmasian di puskesmas serta permasalahan dan alternatif pemecahannya. Data diambil dari hasil Riset Fasilitas Kesehatan (Rifaskes) tahun 2011I. Data kuantitatif tentang tenaga pelayanan kefarmasian di puskesmas dianalisis secara deskriptif berdasarkan regional. Data kualitatif sebagai pendukung diperoleh melalui wawancara mendalam dengan bagian kepegawaian dinas kesehatan dan apoteker empat puskesmas di Kota Bogor dan Bekasi, 3 kemudian dianalisis dengan metode analisis tema. Hasil analisis menunjukkan bahwa Sulawesi memiliki persentase puskesmas dengan tenaga apoteker …

Maternal Smoking, Weight Status And Preecalmpsia And Eclampsia Risk Among Women Living In San Bernardino County, Fiona Bedelia Lewis

Loma Linda University Electronic Theses, Dissertations & Projects

Preeclampsia is defined as pregnancy-induced hypertension affecting between 2% and 8% of pregnancies and accounting for about 10-15% of maternal deaths worldwide. Eclampsia is defined as the occurrence of one or more episodes of seizures in a pregnant woman related only to a preeclampsia diagnosis. Preeclampsia, if poorly managed, can progress to eclampsia resulting in injury and death to both mother and infant. The etiology of preeclampsia is not completely understood. Oxidative stress leading to abnormal placenta development and endothelial dysfunction are thought to be key components in the biological mechanism of preeclampsia.

Modifiable risk factors include maternal body weight …

Fearless: Kevin Lugo, Kevin B. Lugo

SURGE

This summer, recent graduate Kevin Lugo will bike over 4,000 miles across the country to benefit the Ulman Cancer Fund for Young Adults. His choice to bike for seventy days from Baltimore to Seattle makes him fearless! His goal is to raise $7,476 for the organization, and he reached that goal last night (although more donations are always welcome in support of fighting cancer)! Kevin explains that when he studied abroad in Denmark in the fall of 2011, he “fell in love with sustainable transportation, especially cycling.” Not only does his fearless endeavor raise money to fight cancer, but he …

The Association Of Diet And Physical Activity With Stroke Mortality Results From The Adventist Health Study-1, Tahereh Zamansani

Loma Linda University Electronic Theses, Dissertations & Projects

Stroke is one of the leading causes of death and disability, with major global public health implications. Stroke ranks No. 4 among all causes of death, behind heart disease, cancer, and chronic lower respiratory disease (CLRD). Stroke accounts for almost 1 of every 18 deaths in the United States. Women accounted for 60.6% of stroke deaths. Death certificate data show that the mean age at stroke death was 79.6 years; males had a younger mean age (76.3) than females.

There is still a great scientific uncertainty among researchers and epidemiologists about the magnitude of any preventive effect, mechanisms of action …

Los Agroquímicos Usados En Las Plantaciones Bananeras Y Sus Efectos En El Agua, La Gente, Y El Ambiente En La Comunidad De Changuinola, Bocas Del Toro, Panamá., Daniela Rossi

Independent Study Project (ISP) Collection

Esta investigación analiza los efectos de los químicos que se usan en forma de fertilizantes, nematicidas, insecticidas, y pesticidas en las plantaciones bananeras en Changuinola, Panamá. Esta investigación analiza la relación entre estos químicos y la salud de la gente de la comunidad que vive adentro de las bananeras, la salud de los trabajadores de los bananales, y los efectos en el ambiente, específicamente el agua. Este estudio se realizo por medios de entrevistas informales y por analices de muestras de agua en fincas bananeras en el laboratorio de IDAAN. Los posos de agua analizados fueron de Fincas 03, 04, …

Functional Data Analysis To Guide A Conditional Likelihood Regression In A Case-Crossover Study Investigating Whether Social Characteristics Modify The Health Effects Of Air Pollution, Juana Maribel Herrera Hernandez

Open Access Theses & Dissertations

In this study we are focused on exploring whether social characteristics modify the relationship between air pollution and hospitalizations due to asthma or chronic pulmonary obstructive disease (COPD) in El Paso, Tx. The case-crossover design with conditional regression analysis was used, here the controls and the case are the same subject at different

times and has the advantage of removing confounding by permanently confounding factors. Social characteristics are included in the models as interactions with the pollutants, variables included are age, sex, ethnicity and insurance status as indicator for the socio-economic status. The pollutant's lags were chosen using the historical …

The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HR_{β_biockers}= 0.64, 95% CI 0.26-1.56 and HR_ACEi/ARB=0.50, …

The Efficacy Of An Audio Program And Discussion Guide In Promoting Exclusive Breastfeeding In Cameroon, Africa, Kathryn R. Reinsma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In the Northwest Region of Cameroon, approximately 90% of women initiate breastfeeding; however, only 34% continue exclusive breastfeeding for the recommended six months (Kakute, et al., 2005; WHO, 2008). Entertainment-education is a mass-media communication strategy of placing educational information into media such as television programs, movies, and radio programs (Siegel & Lotenberg, 2007). This form of behavioral change communication has proven effective in addressing health-related issues in developing countries.

Purpose: The aim was to design an audio program and discussion guide to test the hypothesis that an audio program and discussion guide improves exclusive breastfeeding knowledge, beliefs, benefits, self-efficacy, …

Racial Disparities In Cancer Screening Among Women With Chronic Joint Pain, Edith M. Williams, Laurene Tumiel-Berhalter, Christopher Purdy, Adrianne Ransom, Judith Anderson

Journal of Health Disparities Research and Practice

Chronic pain related disorders and breast and cervical cancer are more prevalent among African-American women compared with non-Hispanic White women. However, few studies address how racial differences in the context of comorbidity may compound these disparities. This study used secondary analysis of the National Health Interview Survey (NHIS) to assess racial differences in breast and cervical cancer screening and patient education among adult women with chronic joint pain conditions. Statistical analyses included chi-square and independent samples t-tests. African-American women compared with non-Hispanic White women were less likely to receive a pap smear or mammogram within the last two years and …

Breast Cancer Screening Practices Among American Indians And Alaska Natives In The Midwest, Christine M. Daley, Melissa Filippi, Aimee S. James, Sarah Brokenleg, Stacy Braiuca, K. A. Greiner, Won S. Choi

Journal of Health Disparities Research and Practice

American Indian and Alaska Native (AI/AN) women currently have some of the highest mortality rates from breast cancer for any racial/ethnic group in the United States and some of the lowest screening rates. However, current data are not available for regional differences in screening, which can result in dramatically different stage at diagnosis and mortality. We conducted surveys with 120 focus group participants in a needs assessment of mammography among AI/AN in the greater Kansas City metropolitan area and parts of Northeast Kansas. We found that among women under age 40, for whom recommended screenings include only annual clinical breast …

Disparities In Park Availability, Features, And Characteristics By Social Determinants Of Health Within A U.S.-Mexico Border Urban Area, Amir Kamel

Open Access Theses & Dissertations

Background: Parks have been shown to be a key feature in the built environment that promote physical activity and positively influence health. However, a number of studies have highlighted that park availability, park features (e.g., park facilities, amenities, and aesthetic features), and park characteristics (e.g., quality/safety concerns of the park and surrounding neighborhood) are not equally distributed across neighborhoods in the U.S, specifically areas of low socioeconomic status and diverse racial/ethnic composition. The overall aim of this study was to examine and describe park availability, park features, and park characteristics, and determine their association with two social determinants of health …

An Occupational-Based Experimental Study Of Collective Vs. Personal Efficacy To Encourage Sun Protective Behaviors In Head Start Preschool Teachers, Elizabeth A. Holzhauser

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Skin cancer is one of the most common types of cancers in the United States. An analysis of literature shows that skin cancer can be partially mitigated through personal behavior changes (Glanz, Buller, & Saraiya; 2007, Canadian Centre of Occupational Health and Safety [CCOHS], 2010). Currently national sun-safety educational campaigns promote sun-protective behaviors to individuals who receive exposure due to their work environment (Task Force on Community Preventive Services, 2004). Preschool teachers employed with San Bernardino County Head Start are inadvertently exposed to sunlight during mandatory recess periods posing risks to their health.

Purpose. This study evaluated two instructional …

Impact Of An Online Support System On Health Related Quality Of Life Among Men Diagnosed With Prostate Cancer, Daniel K. Osei

Loma Linda University Electronic Theses, Dissertations & Projects

Prostate cancer is a major public health issue worldwide and a significant cause of male cancer death in the USA. Though early screening and treatment has greatly enhanced the outcome, men diagnosed with prostate cancer face problems that compromise quality of life after treatment. Online support for prostate cancer clients is a convenient way to help because it is anonymous, inexpensive, and can be used at clients’ convenience. Yet few studies have explored how these supports impact these clients. This study used a longitudinal randomized experimental design to examine the impact of online services on quality of life of prostate …

Factors That Inhibit Or Enhance Maternal Coping With Stillbirth In Chhattisgarh, India, Lisa R. Roberts

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Over half of the known stillbirths occur in four highly populated countries—India among them. While acknowledged as a significant public health issue in western societies, little is known about maternal coping with stillbirth in developing countries. The purpose of this mixed methods study is to explore how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India.

Methods: In Phase 1 of this mixed methods study, grounded theory methods were used to explore perceptions regarding stillbirth. A de-identified medical records review of 536 deliveries at Christian …

Optimal Control Applied To A Discrete Time Influenza Model, Paula Andrea Gonzalez Parra

Open Access Theses & Dissertations

For the last decades, mathematical epidemiological models have been used to understand the dynamics of infectious diseases and guide public health policy.

In particular, several continuous models have been considered to study influenza outbreaks and their controls policies. However, most epidemiological data is discrete; therefore, a discrete formulation is more convenient to compare collected data with the output of the model. We introduce a discrete time model in order to study optimal control strategies for influenza transmission.

In our model, we divide the population into four classes: susceptible, infectious, treated, and recovered individuals.

In particular, we evaluate the potential effect …

Application Of The Water Poverty Index In Border Colonias Of West Texas, Marcelo Korc

Open Access Theses & Dissertations

This study applied the Water Poverty Index (WPI) in border colonias and other rural areas of west Texas. The colonias are mostly unincorporated communities located primarily in New Mexico and Texas along the border with Mexico and are characterized by high poverty rates and substandard living conditions. In Texas, access to drinking water and sanitation services has been identified as one of the most significant determinants of health in over 350 colonias with about 50 thousand residents.

The WPI is a multidimensional measure that links household welfare with water availability. WPI components were identified and prioritized by a wide range …

Assessment Of Intra-Urban Traffic-Related Air Pollution On Asthmatic Children's Exposure At Schools In The Paso Del Norte Region, Amit Ugamraj Raysoni

Open Access Theses & Dissertations

Traffic-related air pollution can be a major public health concern in any urban area. This problem is compounded in the Paso del Norte region that has experienced rapid economic growth, and a substantial number of people living in close vicinity of major roadways. The desert surroundings, arid weather, frequent temperature inversions, heavy border traffic at the international ports of entry between El Paso and Ciudad Juárez, and poorly maintained vehicle fleet further exacerbates this problem. A growing body of air quality and epidemiologic research has discerned the linkage between traffic emissions and respiratory disorders.

Initial health investigations in the Paso …

Effects Of Acculturation On Hiv/Aids Sexual Risk Behaviors Among Asian And Pacific Islander (Api) Women, Margaret Cabotage Salud

Loma Linda University Electronic Theses, Dissertations & Projects

Background. In the US women are the fastest growing group for sexually transmitted infections (STIs), including HIV and AIDS. In addition, the estimated AIDS cases among female adults and adolescents, aged 13-19, increased from 7% in 1985 to approximately 26% in 2002. Most infections occur by heterosexual transmission with 53% occurring through contact with a high-risk sexual partner. While overall HIV/AIDS rates in the Asian Pacific Islander (API) community remain low, they are rising and HIV testing rates, one of the major prevention strategies for HIV, are lower than that of other populations. Furthermore, very little is known about APIs …

A Pda Intervention To Sustain Smoking Cessation In Clients With Socioeconomic Vulnerability, Lynne Buchanan, Deepak Khazanchi

Information Systems and Quantitative Analysis Faculty Publications

This article describes a pilot study to explore use of a personal digital assistant (PDA) to sustain smoking cessation after discharge in clients with socioeconomic vulnerability. The major aim is to describe technology acceptance (perceived ease of use, usefulness, and attitude), portability, technical difficulty, satisfaction, and use time. The sample includes 31 medical surgical clients with average age of 47.35 (±13.3), average household income of $13,629 (±8,204), average number in the household of 2.67 (±2.22), and average education of 11th grade. The results demonstrate mean use time of 9.28 (±3.23) hr, or about 1 hr over 8 weeks. Technology acceptance …

Culturally-Adapted And Audio-Technology Assisted Hiv/Aids Awareness And Education Program In Rural Nigeria: A Cohort Study, Ighovwerha Ofotokun, Jose Nilo G. Binongo, Eli S. Rosenberg, Michael Kane, Rick Ifland, Jeffrey L. Lennox, Kirk A. Easley

Faculty Articles

Background: HIV-awareness programs tailored toward the needs of rural communities are needed. We sought to quantify change in HIV knowledge in three rural Nigerian villages following an integrated culturally adapted and technology assisted educational intervention.

Methods: A prospective 14-week cohort study was designed to compare short-term changes in HIV knowledge between seminar-based education program and a novel program, which capitalized on the rural culture of small-group oral learning and was delivered by portable digital-audio technology.

Results: Participants were mostly Moslem (99%), male (53.5%), with no formal education (55%). Baseline HIV knowledge was low (< 80% correct answers for 9 of the 10 questions). Knowledge gain was higher (p < 0.0001 for 8 of 10 questions) in the integrated culturally adapted and technology-facilitated (n = 511) compared with the seminar-based (n = 474) program.

Conclusions: Baseline HIV-awareness was low. Culturally …

Identifying Influential Observations Through The Intraclass Correlation Coefficient, Angel De Jesus Davalos

Open Access Theses & Dissertations

In this thesis, we analyze the performance of adapting the DFBETA statistic for identifying influential observations on the intraclass correlation coefficient under the assumptions of the one-way random effects model. Additionally, we introduce an approach for transforming negative intraclass correlation coefficient estimation values using the method of moments estimator. We apply this method on a data set of repeated blood pressure measurements, after which we will investigate implications of identifying influential observations.

The Use Of Human Patient Simulators To Enhance The Clinical Decision Making Of Nursing Students, Sharon Kay Powell-Laney

Walden Dissertations and Doctoral Studies

One of the newest teaching modalities in nursing education is the use of human patient simulators (HPS). An HPS simulation scenario creates a software program vignette in which students interact with a manikin to practice caring for critical patients in a risk-free environment. Although used extensively in schools of nursing, there is little research that examines if these expensive simulators improve the clinical decision-making ability of nursing students. The purpose of this experimental differentiated treatment study was to assess if HPS technology leads to increased clinical decision-making ability and clinical performance more than the teaching modality of a paper and …

The Prevalence And Determinants Of Health Risk Behaviors Among High School Students In Mexico, Nellie León

Loma Linda University Electronic Theses, Dissertations & Projects

The Centers for Disease Control and Prevention report that despite health promotion efforts, adolescents continue to engage in behaviors that put them at risk for morbidity and mortality. Alcohol consumption, illicit drug use, smoking, and risky sexual behaviors are among the behaviors that contribute to leading causes of morbidity and mortality in youth; these four behaviors were explored in this study. An observational cross-sectional design was utilized. The Youth Risk Behavior Survey from the Centers for Disease Control and Prevention was utilized to assess the prevalence of the four risk behaviors among high school students in Jalisco, Mexico. Items constructed …

Health Literacy In The Mathematics Classroom: The Iowa Core Curriculum As An Opportunity To Deepen Students’ Understanding Of Mathematics, Elana Joram, Susan Roberts-Dobie, Nadene Davidson

Faculty Publications

By 2012, all high schools in Iowa will be required to incorporate the new Iowa Core Curriculum, followed by elementary and middle schools in 2014 (Iowa Department of Education, 2009). The Iowa Core Curriculum addresses the question: "How is Iowa's educational system preparing our youth for successful lives in the 21st-century global environment?" (Davidson, 2009). It consists of core content standards, and identifies essential concepts and skills for content areas. The Iowa Core Curriculum also includes the ―21st Century Skills‖ of ―health, financial, technology, and civic literacy, and employability skills. These skills are to be infused into existing subject matter …

The Influence Of Familism On Descriptive And Injunctive Norms In Predicting The Intention To Eat A Vegetarian Diet Among Chinese Seventh-Day Adventists, See Wei Toh

Loma Linda University Electronic Theses, Dissertations & Projects

According to the theory of planned behavior (TpB), one determinant of intention to engage in a behavior is the subjective norm. Various studies have found that subjective norm is often the weaker predictor of intention compared to perceived behavioral control and attitude. This study examined whether familism (emphasis on the family rather than the individual) would contribute positively to the predictive power of the TpB model through interactions with the family portion of descriptive and injunctive norms. Descriptive and injunctive norms are component variables of the subjective norm. A sample of 284 adult Chinese Seventh-day Adventists 18 years and older …

The Association Of Maternal Intention To Breastfeed, Early Skin-To-Skin Mother/Infant Contact, And Exclusive Breastfeeding During The Maternity Hospital Stay, Leslie Mary Bramson

Loma Linda University Electronic Theses, Dissertations & Projects

Breastfeeding is the optimal method to nourish and nurture an infant. Exclusive breastfeeding rates in the United States have reached the goal of Healthy People 2010 that 75% of mother's breastfeed in the immediate postpartum period. Yet, less than 35% of San Bernardino county mothers and 47.7% of Riverside county mothers are exclusively breastfeeding during their maternity hospital stays, with as many as 50% of the infants being weaned from the breast in the first 14 days of life.

This prospective study examined archived data collected by Perinatal Services Network (PSN) of Loma Linda University Medical Center/Children's Hospital for the …

Knowledge, Perceptions, Beliefs And Behaviors Related To The Prevention Of Hypertension Among Black Seventh-Day Adventists Living In London, Maxine A. Newell

Loma Linda University Electronic Theses, Dissertations & Projects

This study was a cross-sectional survey of the hypertension (HTN) knowledge and risk behaviors of Black Seventh-day Adventists (SDA) in London. Recruitment took take place in 17 predominantly Black SDA churches in London. A questionnaire assessed knowledge and lay-beliefs about HTN and perceptions towards HTN using the health belief model (HBM) constructs of susceptibility, severity, benefits, barriers, and self-efficacy. Cohen’s Perceived Stress Scale was incorporated into the questionnaire. Blood pressure, height, weight and waist circumference were and current lifestyles practices were evaluated for the presence of HTN risk factors.

Of the 312 volunteers, ages 25 to 79, 55% were born …

Fighting Nuclear Waste At Skull Valley, Margene Bullcreek

Native American Forum on Nuclear Issues

Abstract:

-Reasons We Oppose Nuclear Waste

-Sovereignty

-Traditional values must be protected

-Protect sacredness of our culture, plants,

animals, air, and water

-Affects on community health

-Protect reservation and homeland

-To protect the air and water

-To protect future generations

-Environmental Justice