Public Health Education and Promotion Commons^™

Marketing Strategies To Encourage Rural Residents Of High-Obesity Counties To Buy Fruits And Vegetables In Grocery Stores, Emily Liu, Tammy Stephenson, Jessica Houlihan, Alison Gustafson

Dietetics and Human Nutrition Faculty Publications

Introduction

Obesity rates in Appalachia are among the highest in the United States, and knowledge of upstream approaches to decrease prevalence among this vulnerable population is limited. The primary aim of this study was to examine the association between healthy, diet-based, social marketing interventions in grocery stores and frequency of fruit and vegetable intake.

Methods

A social marketing campaign was conducted among 17 grocery stores (N = 240 participant surveys) over 4 months in 5 rural Kentucky counties. Interventions included providing food samples, recipe cards, and promotional discounts on fruits and vegetables and moving high-calorie foods to side aisles.

Results …

Understanding And Promoting Parent-Child Sexual Health Communication, Shannon Phelps

Theses and Dissertations--Education Sciences

Parent-child sexual health communication (PCSHC) can have a positive impact on adolescents’ sexual health choices, outcomes, and capabilities for communicating with others about sexual health. Many parents are hesitant and feel unprepared for and uncomfortable with communicating about sexual health with their children. Other parental factors as well as child factors can impact the quality, frequency, coverage, and effectiveness of PCSHC. Some adolescent sexual health outcomes have improved, however, teen birth rates in the United States are elevated compared to other developed countries and half of all sexually transmitted infection (STI) diagnoses are made to adolescents and emerging adults. This …

Riding Through Life: A Lifespan Study Of The Attitudes, Behaviors, And Areas Of Educational Opportunity For Female Equestrians Toward Bra Use And Health Outcomes When Engaged In Equestrian Sports, Karin Pekarchik

Theses and Dissertations--Community & Leadership Development

Equestrian sport is a popular exercise choice for females of all ages, although the links between this exercise choice, health outcomes, and risk to health have not been thoroughly examined. These issues are of particular interest because the female equestrian has the opportunity to ride and/or compete for decades, from early to very late in life, covering almost the full sequence of the female lifespan. Equestrian sports provide physical activity through riding and caring for the horse, and promote positive mental outcomes through tangible practices, such as engaging in physical activity and hard work, goal-setting, acquisition of skills, and participation …

Utilizing The Social Ecological Model To Address Drinking Behaviors Among College Students Participating In Ncaa Division I Non-Revenue Generating Sports, Andrew M. Smith

Theses and Dissertations--Educational Policy Studies and Evaluation

College students between the ages of 18 and 24 are considered high-risk for alcohol-related negative consequences due to drinking at high-risk levels (Barry, Howell & Salaga, 2015). Within that population, varsity student athletes are considered at even greater risk for those issues (Druckman, 2015; Wechsler, 2002).

With football and men’s basketball being considered the only revenue-generating NCAA Division I sports, non-revenue-generating sports consist of the majority of student athletes (NCAA, 2016). This study is designed to examine high-risk drinking as well as alcohol-related consequences among non-revenue-generating student athletes attending a National Collegiate Athletic Association (NCAA) Division I school.

The sample …

A Secondary Analysis Of Survey Data Evaluating The Lifelines Suicide Prevention Program Among Middle School Students, Nicki Sullivan

DNP Projects

PURPOSE: The purpose of this study was to evaluate student feedback of the 2015 Lifelines Suicide Prevention Program at Jessie Clark Middle School. Student feedback was examined by assessing students’ knowledge of suicide, attitudes toward suicide, knowledge of when and from whom to seek help if feeling suicidal or told by a friend that they are suicidal, and impressions of the educational presentation following participation in the Lifelines Suicide Prevention Program.

METHODS: In this secondary analysis, anonymous student responses (N=269) from a 2015 middle school survey were examined by using a mixed method design with the quantitative study measures being …

Understanding The Links Of Mindfulness, Relationship Satisfaction, And Sexual Satisfaction, Elizabeth N. Greer

Theses and Dissertations--Kinesiology and Health Promotion

The purpose of the present study was to examine the relationship between mindfulness and its link to sexual satisfaction and relationship satisfaction. Data were collected from 809 individuals (18.8% bisexual, 60.7% straight, 19.2% gay/lesbian) in romantic relationships. Participants completed an online survey to measure mindfulness (five facets: observing of experience, describing with words, acting with awareness, non judging of inner experience, non reactivity to inner experience), sexual satisfaction, and relationship satisfaction. Results from two multivariate analyses (predicting sexual satisfaction and relationship satisfaction) revealed that relationship satisfaction is significantly predicted by three of the five facets of mindfulness – acting with …

The Effects Of A Worksite Wellness Program On Prescription Claims, Carrie Deann Davidson

Theses and Dissertations--Kinesiology and Health Promotion

The purpose of this study was to determine the effectiveness of the worksite wellness weight loss program called Weight Loss Matters (WLM) for employees at the University of Kentucky. The three main objectives were to measure the effect of Weight Loss Matters for employees from June 2006 to December 2011 in the following areas (1) prescription claims for hypertension, diabetes, and dyslipidemia, (2) weight loss, and (3) food diary compliance. Participants included 591 employees who participated in WLM for at least one session from 2006 to 2011 for whom there were data. This study employed a Quasi-experiment, longitudinal design. Data …

Using Process Mining To Assess The Fidelity Of A Home Visiting Program, Riyad Haq, Sofia Campos Vidal Pires, Julie M. Kapp, Sara Schlemper, Eduardo J. Simoes

Frontiers in Public Health Services and Systems Research

Background: The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program is a federal public health initiative which supports at-risk families through evidence-based programs and promising approaches for pregnant women, and childhood development for children aged 0 to 5. These public health program funding mechanisms commonly include process evaluation mandates.

Purpose: The use of process mining was explored as a methodology to assess the fidelity of the MIECHV programs’ actual workflow to that of their intended models.

Methods: Research Electronic Data Capture (REDCap) data files that were populated with program process data elements from the local implementing agencies were …

A Tool To Cost Environmental Health Services In North Carolina Local Health Departments, Nancy L. Winterbauer, Simone Singh, Ashley Tucker, Lisa M. Harrison

Frontiers in Public Health Services and Systems Research

Introduction: The cost of providing a basic set of public health services necessary not been well-described. Recent work suggests public health practitioners are unlikely to have the empirically-based financing information necessary to make informed decisions regarding practice. The purpose of this paper is to describe the development of a costing tool used to collect primary data on the number of services provided, staff employed, and costs incurred for two types of mandated environmental health services: food and lodging inspections and onsite water services.

Methods: The tool was iteratively reviewed, revised, and piloted with local health department (LHD) environmental health and …

Evidence For The Role Of Resource-Sharing Networks In Coalition Development, Margaret Mcgladrey, Angela Carman Drph

Frontiers in Public Health Services and Systems Research

Background: Accreditation bodies and sponsors of community health projects increasingly require the use of health coalitions in community health planning efforts to ensure buy-in, leverage resources, and distribute health information. Despite a substantive body of research documenting the characteristics of successful health coalitions, little is known about how team dynamics in these coalitions evolve.

Purpose: The goal of this study was to employ social network analysis techniques to evaluate whether coalitions’ relative stages in Tuckman’s stages of team development model were associated with specific patterns of advice-, information-, and resource-sharing among the eight coalitions participating in a region-wide …

Polytobacco Use Among College Students, Karen M. Butler, Melinda J. Ickes, Mary Kay Rayens, Amanda T. Wiggins, Ellen J. Hahn

Nursing Faculty Publications

INTRODUCTION: Use of more than one tobacco product among college students is increasing in popularity, leading to nicotine addiction and additional health risks. The study (1) examined polytobacco use patterns among college students who had ever used tobacco; and (2) assessed the sociodemographic and personal factors associated with current polytobacco use, compared to current single product use and former tobacco use among college students.

METHODS: Of 10,000 randomly selected college students from a large public university in the Southeast, a sample of 1593 students age 18 or older completed an online survey assessing tobacco use and attitudes. Ever tobacco users …

Promoting Healthy Eating And Physical Activity: A Qualitative Examination Of Community-Based Obesity Interventions In Rural Kentucky, Brooke F. Butterworth

Theses and Dissertations--Nutrition and Food Systems

Rural Americans are medically underserved groups and are at greater risk of becoming obese than urban Americans. The purpose of this qualitative study was to determine the perceived causes of obesity in six counties of rural Kentucky and to determine how to customize strategies to reduce obesity in these areas. University of Kentucky Cooperative Extension Service Agents formed coalitions in each of the six counties to assess their communities’ needs and assets to inform plans for implementing evidence-based obesity interventions. Between February and August of 2015, the coalitions were convened for a total of 11 meetings. Each of the coalition …

Promoting Culturally Respectful Cancer Education Through Digital Storytelling, Melany Cueva, Regina Kuhnley, Anne Lanier, Mark Dignan, Laura Revels, Nancy E. Schoenberg, Katie Cueva

Internal Medicine Faculty Publications

Cancer is the leading cause of mortality among Alaska Native people. Over half of Alaska Native people live in rural communities where specially trained community members called Community Health Aides/Practitioners (CHA/Ps) provide health care. In response to CHA/Ps’ expressed desire to learn more about cancer, four 5-day cancer education and digital storytelling courses were provided in 2014. Throughout each course, participants explored cancer information, reflected on their personal experiences, and envisioned how they might apply their knowledge within their communities. Each course participant also created a personal and authentic digital story, a methodology increasingly embraced by Indigenous communities as a …

Comprehensive Sexuality Education In Kentucky, Luciana D. Hockersmith

Theses and Dissertations--Community & Leadership Development

Discussions of sex education of any kind can be controversial in a given setting. Traditional approaches to sex education prompt debate regarding effectiveness. Key indicators central to the effectiveness of sex education continue to be rates of teen pregnancy and transmission of sexually transmitted diseases (STDs). With discontentment surrounding the effectiveness of “traditional approaches,” a more wide-ranging method is worthy of being explored. The curriculum approach of Comprehensive Sexuality Education (CSE) includes six key concepts, and subsequent sub-concepts, intended to provide a broad and even all-inclusive range of topics for a similarly broad and even all-inclusive range of ages of …

Competitive Food Policy Implementation In Kentucky Schools, Paula Gisler

Theses and Dissertations--Nursing

This study was designed to explore the literature on competitive food policy implementation (CFPI); examines demographic and school factors associated with CFPI; and explores the experiences of school leaders and staff in CFPI using a proposed theoretical framework to guide the research. Competitive foods are those sold in vending machines, a la carte settings, fundraisers, class parties and other venues which compete with foods offered through the national school lunch and breakfast programs. Competitive foods have traditionally been of low nutritional value and high energy density. CFPI may be effective in reducing student calorie intake and BMI. However, evaluation of …

Promoting Healthy Home-Cooked Family Meals: Evaluation Of A Social Marketing Program Targeting Low-Income Mothers, Mollie Y. Dawahare

Theses and Dissertations--Nutrition and Food Systems

Objective: Evaluate how a social marketing approach compares to traditional nutrition education curriculum for promoting behavioral changes related to eating and food.

Design: Nonequivalent comparison group, entry-exit design. Participants from 12 Kentucky counties assigned either comparison or pilot group. Comparison group received traditional nutrition education curriculum and pilot group received the social marketing program, Cook Together, Eat Together (CTET) curriculum. EFNEP’s Behavior Checklist and 24-Hour Dietary Recall were administered at entry and exit of the 8-week programs.

Participants: Females (18-72 years of age) from families eligible to receive SNAP benefits (n=64 comparison group participants, n=60 pilot group participants).

Intervention: …

Testing Multi-Theory Model (Mtm) In Predicting Initiation And Sustenance Of Physical Activity Behavior Among College Students, Vinayak K. Nahar, Manoj Sharma, Hannah Priest Catalano, Melinda J. Ickes, Paul Johnson, M. Allison Ford

Kinesiology and Health Promotion Faculty Publications

Background: Most college students do not adequately participate in enough physical activity (PA) to attain health benefits. A theory-based approach is critical in developing effective interventions to promote PA. The purpose of this study was to examine the utility of the newly proposed multi-theory model (MTM) of health behavior change in predicting initiation and sustenance of PA among college students.

Methods: Using a cross-sectional design, a valid and reliable survey was administered in October 2015 electronically to students enrolled at a large Southern US University. The internal consistency Cronbach alphas of the subscales were acceptable (0.65-0.92). Only those who did …

How Feedback And Goal-Setting Impact Children's Recess Physical Activity, Ryann Koufoudakis, Heather Erwin, Aaron Beighle, Michelle L. Thornton

Kinesiology and Health Promotion Faculty Publications

In recent years, schools desire to promote physical activity (PA) for their students but are restricted due to resources being expended in other areas of their curriculum, including standardized testing preparation. Recess/lunch periods have potential to contribute important amounts of PA to youth’s overall levels. Interventions to maximize PA during recess are warranted. The purpose of this study was to demonstrate the impact of feedback and goal-setting on students’ PA during recess. A sample of 136 (67 females, 69 males) 4^th and 5^th grade students in the Southeast United States wore unsealed Walk4Life pedometers during recess for one …

The Role And Impact Of School Nurses And Intentions To Delegate Diabetes-Related Tasks Amidst Budget Cuts And Legislative Changes, Michelle J. Lineberry

Theses and Dissertations--Kinesiology and Health Promotion

As the percentage of school children with chronic conditions such as diabetes continues to rise, funding for school nurses to keep those students healthy and safe is decreasing. This dissertation includes three studies: (1) a systematic review of the literature on the role and impact of American elementary school nurses, (2) a focus group study that further examined the role of Kentucky school nurses and described their reaction to a new regulation that necessitates delegation of diabetes-related nursing tasks to unlicensed assistive personnel (UAP), and (3) a quantitative study that examined Kentucky school nurses’ past behaviors and future intentions regarding …

Individual Responses For Muscle Activation, Repetitions, And Volume During Three Sets To Failure Of High- (80% 1rm) Versus Low-Load (30% 1rm) Forearm Flexion Resistance Exercise, Nathaniel D. M. Jenkins, Terry J. Housh, Samuel L. Buckner, Haley C. Bergstrom, Kristen C. Cochrane, Cory M. Smith, Ethan C. Hill, Richard J. Schmidt, Joel T. Cramer

Kinesiology and Health Promotion Faculty Publications

This study compared electromyographic (EMG) amplitude, the number of repetitions completed, and exercise volume during three sets to failure of high- (80% 1RM) versus low-load (30% 1RM) forearm flexion resistance exercise on a subject-by-subject basis. Fifteen men were familiarized, completed forearm flexion 1RM testing. Forty-eight to 72 h later, the subjects completed three sets to failure of dumbbell forearm flexion resistance exercise with 80% (n = 8) or 30% (n = 7) 1RM. EMG amplitude was calculated for every repetition, and the number of repetitions performed and exercise volume were recorded. During sets 1, 2, and 3, one …

Short-Term, High-Fat Diet Accelerates Disuse Atrophy And Protein Degradation In A Muscle-Specific Manner In Mice, Steven L. Roseno, Patrick R. Davis, Lance M. Bollinger, Jonathan J. S. Powell, Carol A. Witczak, Jeffrey J. Brault

Kinesiology and Health Promotion Faculty Publications

BACKGROUND: A short-term high-fat diet impairs mitochondrial function and the ability of skeletal muscle to respond to growth stimuli, but it is unknown whether such a diet alters the ability to respond to atrophy signals. The purpose of this study was to determine whether rapid weigh gain induced by a high-fat (HF) diet accelerates denervation-induced muscle atrophy.

METHODS: Adult, male mice (C57BL/6) were fed a control or HF (60 % calories as fat) diet for 3 weeks (3wHF). Sciatic nerve was sectioned unilaterally for the final 5 or 14 days of the diet. Soleus and extensor digitorum longus …

A Cost Analysis Of The 1-2-3 Pap Intervention, Kristina M. Rabarison, Rui Li, Connie L. Bish, Robin C. Vanderpool, Richard A. Crosby, Mehran S. Massoudi

Frontiers in Public Health Services and Systems Research

Background: Cervical cancer places a substantial economic burden on our healthcare system. The three-dose human papillomavirus (HPV) vaccine series is a cost-effective intervention to prevent HPV infection and resultant cervical cancer. Despite its efficacy, completion rates are low in young women aged 18 through 26 years. 1-2-3 Pap is a video intervention tested and proven to increase HPV vaccination completion rates.

Purpose: To provide the full scope of available evidence for 1-2-3 Pap, this study adds economic evidence to the intervention’s efficacy. This study tested the economies of scale hypothesis that the cost of 1-2-3 Pap intervention per number of …

Designing For Dissemination: Lessons In Message Design From "1-2-3 Pap", Elisia L. Cohen, Katharine J. Head, Margaret J. Mcgladrey, Anna G. Hoover, Robin C. Vanderpool, Colleen Bridger, Angela Carman, Richard A. Crosby, Elaine Darling, Mary Tucker-Mclaughlin, Nancy Winterbauer

Communication Faculty Publications

Despite a large number of evidence-based health communication interventions tested in private, public, and community health settings, there is a dearth of research on successful secondary dissemination of these interventions to other audiences. This article presents the case study of "1-2-3 Pap," a health communication intervention to improve human papillomavirus (HPV) vaccination uptake and Pap testing outcomes in Eastern Kentucky, and explores strategies used to disseminate this intervention to other populations in Kentucky, North Carolina, and West Virginia. Through this dissemination project, we identified several health communication intervention design considerations that facilitated our successful dissemination to these other audiences; these …

The Role Of Kentucky State-Supported Postsecondary Education In Creating A Healthier Citizenship, Julia K. Buchanan

Theses and Dissertations--Educational Leadership Studies

Citizens within the United States of America (USA) and the Commonwealth of Kentucky exhibit indicators of lessened health status in a variety of areas. Many chronic diseases and conditions are due to individual lifestyle behaviors, which can be modified through the implementation of dedicated health and wellness programming. Such programs, often housed within institutions of higher education, have the ability to impact many individuals including students, faculty, staff, and community members. This dissertation is a report of a mixed-methods study that begins to explore how state-supported postsecondary institutions may be able to impact individual behavior and thus, resulting health outcomes. …

Development, Implementation, And Evaluation Of Refugee Health Literacy Program (R-Help), Cecilia A. Boateng

DNP Projects

Problem Statement: United States refugees often encounter significant barriers when adapting to their new host country; such as cultural and language barriers, and difficulty in navigating through the American healthcare system. For example, navigating through the American Pharmacy system to buy or refill medications is a great challenge for most refugees. To make matters worse, most refugees have difficulty understanding medications instructions which puts them at risk for making medication errors.

Purpose: The purpose of this study was to develop, implement, and evaluate the feasibility of delivering an evidence based health literacy medication educational program for all newly-arrived refugees attending …

Global School-Based Childhood Obesity Interventions: A Review, Melinda J. Ickes, Jennifer Mcmullen, Taj Haider, Manoj Sharma

Kinesiology and Health Promotion Faculty Publications

Background: The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies.

Methods: A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and …

Construction Flagger Struck And Killed In Two-Lane Highway Work Zone, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Construction

On a clear, cold, Monday, January 20, 2014, a 36-year-old married flagger entered a two-lane highway with his back toward oncoming traffic and was struck by a 2010 red Toyota Corolla, driven by a 53 year-old motorist. The seven-man crew had finished setting up a construction zone on a two-lane highway to repair damaged guardrails along the westbound side of the roadway. The crew had placed alert signs in each direction of travel in preparation to stop all traffic prior to completely closing the westbound lane and had just dropped off the victim, who was designated as the flagger for …

Tanker Truck Involved In Deadly Crash On Interstate, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

February 17, 2014, on a cloudy Monday, around 4:40 p.m., a 40 year-old male tanker truck driver (victim) was driving down a straight level 3-lane interstate headed north bound to a neighboring state going approximately 70 m.p.h., to deliver his 45,000 lbs. of liquid sodium sulfate when he came upon a slow moving vehicle in the right lane, the victim swerved to the left to avoid the vehicle and his 2001 Kenworth tractor trailer left the road. The victim then overcorrected and his semi flipped landing on its top in the right side of the roadway in a grassy area …

Hispanic Laborer Killed When Struck By Falling Plywood On A Commercial Construction Site, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Construction

On a clear windy Wednesday, around 11:50 a.m., a 24 year-old Hispanic laborer was helping his brother-in-law load trusses on the ground, when a gust of wind ripped an 8 foot by 4 foot sheet of plywood from another Hispanic laborer’s hands as he was handing the plywood to a co-worker 60 feet above on a commercial construction site roof. The co-worker on the roof tried to grab the sliding plywood by jumping onto it, but could not stop it. The co-worker’s life line prevented him from falling over the edge of the roof. As the plywood reached the edge …

Grain Truck Driver Killed At Train Crossing, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

On a clear fall Wednesday afternoon, at 3:45 p.m., a 69 year-old driver of a semi-trailer loaded with soybeans was killed when he turned off a two lane state highway and into a farm driveway, directly into the path of an oncoming freight train. The train and truck were both travelling west on parallel pathways; the truck driver was struck on the blind spot of his cab’s passenger side by the train. The truck driver was not wearing his seatbelt and was ejected from the cab. The train finally came to a stop at the next intersection, approximately a half …