Public Health Education and Promotion Commons^™

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

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

Capstone Experience: Master of Public Health

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

Beyond The Bruise: Understanding Injury Risk Factors Among Livestock Workers In Cattle Feedyards And Animal Handling Farms And Ranches, Rishad Ahmed

Theses & Dissertations

Cattle feeding and livestock production are central to U.S. agriculture and represent some of the most hazardous occupational environments. Workers in feedyards and on cattle farms and ranches face elevated risks of injury due to physically demanding labor, frequent animal handling, and exposure to environmental and ergonomic hazards. Many feedyard workers are Hispanic/Latino immigrants who may experience additional barriers related to language, healthcare access, and job security. Similarly, injury risks among cattle producers are compounded by seasonal workload fluctuations, limited rest opportunities, and psychosocial stressors. Beyond individual impacts, agricultural injuries also pose a substantial economic burden. Recent estimates indicate that …

Kansas City Health Department – Childhood Lead Poisoning Prevention Program – Quality Improvement, Hanh Pham

Capstone Experience: Master of Public Health

This capstone manuscript evaluates the Kansas City Health Department's Childhood Lead Poisoning Prevention Program’s effectiveness. Through comprehensive data analysis of grant utilization, return-on-interest (ROI) and participant satisfaction evaluation, the project will provide actionable recommendations for improving sustainable long-term outcomes in lead poisoning prevention.

Evaluating Surge Capacity In The Emergency Department: A Comprehensive Literature Review On Preparedness And Response Frameworks, Tanner J. Riscoe

Capstone Experience: Master of Public Health

Medical surge capacity in emergency departments is influenced by four critical factors: staff, stuff, space, and systems. Understanding these factors and the interplay between them is critical. Emergency departments are increasingly encountering issues with overcrowding, patient boarding, and medical surge events causing interruptions in care and depleting critical resources. Coordination of medical surge is challenging during normal operations but is intensified during times of crisis. This comprehensive literature review seeks to better understand the current state of the literature surrounding surge preparedness and response in emergency departments across the United States, identify gaps in the current literature, and ultimately recommend …

Utilizing The Health Belief Model To Design A Community-Based Program To Increase Cervical Cancer Screening Rates Among 21 To 25-Year-Olds In The Omaha Metro Area, Karli Baker

Capstone Experience: Master of Public Health

The 2021 Douglas County Community Health Needs Assessment found that cervical cancer screening rates have been on a downward trend since 2011. Previous studies on cervical cancer screening interventions have examined refugee populations, and current programs in Douglas County offer assistance to uninsured women, typically aged 40 and older. However, interventions have overlooked young women aged 21 to 25 in the Omaha metro area, who exhibit the lowest cervical cancer screening rates. We will use the PRECEDE-PROCEED Model as a framework to design an educational program for young women aged 21 to 25, guided by the theoretical underpinnings of the …

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, …

Ensuring Safe Mri Examinations And Earlier Detection Of Recurrent Cancer: A Scoping Review To Identify Breast Tissue Expanders That Are Safe For High-Risk Breast Cancer Survivors, Kristin E. Westmore

Capstone Experience: Master of Public Health

Purpose

This capstone project aims to conduct a scoping review to identify breast tissue expanders that are safe for high-risk breast cancer survivors, ensuring safe magnetic resonance (MR) examinations. The goal is safe MR examinations for early detection of recurrent cancer, post-operative evaluation, monitoring, and reducing preventable morbidity and mortality.

Background

The MR safety of manufacturers' tissue expanders is defined according to the United States Food and Drug Administration (FDA) guidelines and regulations as MR Conditional or MR Unsafe. Before 2023, there was a safety concern about using tissue expanders containing a magnetic port during the first stage of breast …

Cardiovascular Disease Risk Reduction Program For Hispanics In The Us Midwest: A Culturally Adapted Intervention, Armando De Alba

Theses & Dissertations

Cardiovascular disease (CVD) represents the second leading cause of death in Nebraska (NE), accounting for approximately one in every five deaths. In the state, there are marked ethnic and rural-urban disparities in the prevalence of chronic diseases and resultant deaths. For instance, while the rates in NE of coronary heart disease and myocardial infarction between 2001 and 2010 decreased among non-Hispanic Whites, the rates for Hispanics almost tripled. There is little evidence of CVD risk factor reduction strategies being implemented in Midwestern areas and Hispanic populations.

One promising approach for reducing CVD risk involves health education and lifestyle modification programs …

From Survivors To Care Providers: A Multi-Dimensional Study On Physical Activity In Cancer Care, Gaurav Kumar

Theses & Dissertations

As the population of cancer survivors grows, understanding the dynamics of physical activity (PA) engagement is critical due to its potential benefits in reducing adverse health outcomes and mortality associated with cancer. Despite known benefits, both adherence to and promotion of PA among cancer survivors face significant challenges. This comprehensive study examines PA levels, barriers, facilitators, and perceptions among cancer survivors and oncology care providers over a ten-year period. The objectives are to assess adherence levels to PA among cancer survivors, explore the perceived barriers and facilitators to PA engagement from the survivors' perspectives, and understand the barriers, facilitators, and …

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience: Master of Public Health

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

Evaluation Of Community Healthcare Workers Of Faith-Based Workers In Northern Omaha, Ashley Piwkiewicz

Capstone Experience: Master of Public Health

The University of Nebraska Medical Center (UNMC) developed a training and certificate program for Community Health Workers (CHWs) in faith-based organizations in Northern Omaha. Each recruited trainee developed an experimental program they implemented in their faith-based community. This research study aims to explore and analyze the implementation of these programs in the community, the effects that these programs have on the community, and the extent to which the goals of the CHWs' implemented programs were met.

To achieve this, data was collected through a 41-question survey administered via REDCap to 12 CHW trainees. Descriptive statistics of this data were analyzed …

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 …

Inequality In Opportunities And Outcomes: Indicators To Inform Data-Driven Community Systems For Youth Physical Activity, Ann Essay

Theses & Dissertations

Indicators illuminating whole-of-community and setting system physical activity (PA) outcomes and drivers are needed to inform population health improvement efforts. This multi-study dissertation examines inequalities in PA resources, opportunities, and outcomes and the factors influencing inequalities across multiple temporal and geospatial scales (e.g., community, setting). First, a scoping review examined community-level variability in PA resource and opportunity availability by community sociodemographic characteristics (e.g., race). Across 46 included studies, 41 unique indicators characterizing community PA systems were identified, and 29.8% of relationships assessed indicated greater resource/opportunity availability in communities of higher socioeconomic status or lower minority population prevalence. The indicators synthesized …

A Community-Based Participatory Research Approach To Addressing Pediatric Asthma Disparities In Douglas County, Nebraska, Aislinn Rookwood

Theses & Dissertations

Pediatric asthma is the leading chronic disease among children in the United States, and the incidence of pediatric asthma is increasing every year. Nebraska has an asthma prevalence comparable to the United States average; however, the state has significant disparities by county, race, and geographic location, with prevalence rates much higher than the national average. Douglas County is a hot spot for increased pediatric asthma rates, with further differences in rates by race and geographic location within the county. The University of Nebraska Medical Center, in partnership with Healthy Housing Omaha and the Nebraska Asthma Coalition, collaborated to conduct this …

Spotlight On Mental Health On A Healthcare Campus: An Assessment Of Psychological Trauma Awareness, Training, And Treatment In The University Of Nebraska Medical Center College Of Public Health Community, Jenny E. Mueller

Capstone Experience: Master of Public Health

Background: Psychological trauma has been recognized as a public health concern of epidemic proportions globally. Public health community awareness of and education in trauma is likely to be integral to preparing future public health professionals to work effectively and safely in the field. Currently, the extent of trauma awareness, training, and treatment on the University of Nebraska Medical Center College of Public Health (UNMC COPH) campus is not known.

Aims: The aims of this project are to investigate and assess the level of psychological trauma awareness, training, and treatment on the UNMC COPH campus; and to provide recommendations for actions …

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 …

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

Capstone Experience: Master of Public Health

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

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

Capstone Experience: Master of Public Health

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

Translating A Pediatric Weight Management Intervention Into Medically Underserved Areas, Caitlin Golden

Theses & Dissertations

Despite substantial prevention and treatment efforts, childhood obesity remains a pressing public health concern. Disparities persist in obesity prevalence among children of lower socioeconomic status, racial and ethnic minority groups, and those residing in rural areas. The vast majority of efficacious pediatric weight management interventions (PWMIs) have been based in larger cities and urban areas delivered through inter-disciplinary teams in a hospital or medical center, and the degree to which these or other efficacious PWMIs have been translated to, and are feasible in, typical rural or micropolitan areas is unclear. This dissertation describes a dissemination strategy and a systematic approach …

Planning A Multiple Myeloma Needs Assessment For Omaha Nebraska, Judith Ngozi Obodougo

Capstone Experience: Master of Public Health

Literature Review

Worldwide, approximately 176,404 people had Multiple Myeloma in 2020, which caused about 117,077 deaths in the same period. Multiple Myeloma is a rare type of blood cancer currently considered a curable malignancy.

Objectives

This public health capstone aims to create a plan for a community needs assessment for multiple Myeloma in Omaha, Nebraska.

Methods

This capstone project modified the Centers for Disease Control and Prevention (CDC) community needs assessment guidelines to create a Multiple Myeloma needs assessment plan for Omaha, Nebraska.

Results

All seven steps outlined in the CDC community needs assessment planning steps were relevant. Omaha, Nebraska, …

Mental Health Promotion, Early Identification & Treatment Services And Supports In Public K-12 School Districts: Three Case Studies To Explore Available Resources, Interventions, And Community Partnerships, Keenan Krick

Theses & Dissertations

Objective: This study: 1) identifies the multi-tiered efforts public K-12 school districts in a large Midwestern metropolitan area use to support mental health promotion activities and comprehensive mental health services, and 2) compares district efforts to domains defined by the National Center for School Mental Health (NCSMH). Participants: A sample of public K-12 school districts (n=12) in a large Midwestern metropolitan area participated in this study from August 2021 to October 2022. Methods: Using the Multi-Tiered Systems of Support (MTSS) intervention framework, a series of three case studies identify the resources public K-12 school districts utilize to support mental health …

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 …

Program Planning On Social Determinants Of Health For Rural Nebraska, Maria H. Cantu Hines

Capstone Experience: Master of Public Health

Social determinants of health (SDOH) are non-health factors that impact health in both direct and indirect ways. Research into SDOH and their effects has been extensive in recent years and has been further documented by the COVID-19 pandemic. Despite the wealth of the literature on the SDOH, awareness of these important factors is not prevalent among community residents. Rural communities are as subject to the impact of SDOH just as their urban counterparts and experience additional complexities related to geography and topography.

This capstone project aims to raise awareness, provide education, and assist with tools and resources, to empower rural …

Evaluating How Physical Activity Affects The Perception Of Resilience In Box Butte County, Nebraska, Eric Pulver

Capstone Experience: Master of Public Health

Physical activity is one of the modern hallmarks for good health in individuals and the public, in general. Resiliency is a growing concentration in all levels of disaster preparedness where the focus is on how to deal with the growing number of disasters stemming from global climate change. This research project’s aim is to look at the possible relationships between physical activity and resiliency in a rural Nebraska population. This was done with the use of a cross-sectional study utilizing a fifteen-question survey to gather demographics, assess the amount of physical activity, and then apply a perception of resilience tool …

Evaluation Of Awareness, Knowledge, And Preventive Intervention Of Nonalcoholic Fatty Liver Disease Among Chinese Young Adults, Yi Du

Theses & Dissertations

The prevalence of nonalcoholic fatty liver disease (NAFLD) among Chinese young adults (CYA) aged 18-25 years ranges from 4.7% to 15.1% and has kept increasing in recent years. Previous studies reported limited awareness and knowledge of NALFD among middle-aged and older Chinese populations, however, they have not investigated awareness in CYA, for which there is no well-validated questionnaire. There is currently no efficacious educational intervention on NAFLD for CYA.

The objectives were 1) to develop and validate a questionnaire which can be used to assess the awareness and knowledge of NAFLD among CYA; 2) to assess the awareness and knowledge …

Association Of Health Literacy And Provider Education With Knowledge Of Breast And Cervical Cancer Screening In An Underserved Female Population, Mallory Gandy, Karly A. Meyer, Jennifer Liu, Jenenne Geske

EMET Projects

No abstract provided.

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Intention To Breastfeed: Breastfeeding Attitudes, Norms, Self-Efficacy, Social Support Network And Community Resources Of African American, Low-Income, Emerging Adult Women, Pregnant For The First Time, Sara E. Brown

Theses & Dissertations

African American (AA) women continue to have the lowest rates of breastfeeding. This continues to create a health disparity even though breastfeeding is extensively recognized in the scientific and health care communities as the optimal feeding choice for infants. This study examined the relationship between the external variables (social support network and community resources) and the explanatory variables (attitudes, norms, and perceived self-efficacy) and intention to breastfeed, for the AA, first time, low-income, emerging adult pregnant woman. The Integrated Behavior Model (IBM) was used as the theoretical framework to guide this study in better understanding the variables influencing breastfeeding intention. …

Evaluating A Community-Based Breastfeeding Support Organization In Nebraska, Katelyn Elaine Goodroe

Capstone Experience: Master of Public Health

Specific Aims: The aims of this evaluation plan are to investigate the role of the Nebraska nonprofit organization, MilkWorks, in promoting breastfeeding and family support programming and to identify future internal and external growth opportunities through an assessment of the organizational practices using stakeholder perspectives and marketing structure to better promote infant and parental health.

Significance: As a best practice, evaluation of MilkWorks is critical to providing proper services for promoting infant development and parental health in urban and rural Nebraska communities.

Background: MilkWorks was founded in Lincoln, Nebraska, by mothers with the intention of promoting breastfeeding by offering support …