Public Health Education and Promotion Commons^™

An Explanatory Sequential Mixed Methods Nutrition And Physical Activity Intervention Study On Changes In Knowledge, Self-Efficacy, And Outcome Expectations Of Fathers, Sarah Hortman

Theses & Dissertations

Overweight and obesity rates are a continuing concern resulting in poor health outcomes and annual healthcare costs in the billions of dollars. An upstream approach of health promotion is critical to change the focus from treatment and management to prevention of chronic disease. Preventing chronic disease through evidence-based health promotion practices incorporating educational interventions aimed at dietary and physical activity behaviors will preclude negative health outcomes including cardiovascular disease, type 2 diabetes, and hypertension.

The family environment is an important consideration in the prevention of chronic disease including obesity. Parents are role models for their children, including fathers who are …

From Pipeline To Health Equity: A Case Study Of Health Profession Pipeline Students, Sonja F. Tutsch

Theses & Dissertations

Health equity arises from the social determinants of health. Access to culturally and linguistically competent health services is a major determinant of health. Despite health profession pipeline intervention efforts spanning more than 50 years, diversity in the health professions has not been achieved, and disparities in health among members of minority groups remain prevalent. Health profession pipeline programs came into existence to help grow minority representation among health professionals serving in underserved, disadvantaged, communities, where disparities in health are most prevalent. One underlying assumption was that minority students from underserved communities understand the needs of these communities best and are …

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

Capstone Experience: Master of Public Health

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

A Deeper Look: The Impacts Of Covid-19 Among Latinos In Omaha, Diana Molina

Capstone Experience: Master of Public Health

The COVID-19 pandemic has manifested worldwide distress, affecting the lives of all population groups. Racial disparities are evident as minority populations are being disproportionately affected by the impacts of COVID-19. Data indicate that the Latino population may experience more severe cases of COVID-19 and have a higher mortality rate. However, little is known about the effects that the pandemic is having on day-to-day life. Thus, the purpose of this study is to investigate COVID-19's impact on life aspects including employment situation, finances, mental health, and experiences of discrimination among the Omaha Latino community. A survey collected data from 311 participants …

Development Of A Web-Based Agriculture Health Risk Assessment Tool For Military Veteran Farmers And Ranchers, Alyssa Damke

Capstone Experience: Master of Public Health

In the U.S., significant health disparities exist among rural populations compared to their urban counterparts. These disparities can be compounded in agricultural workers due to the dangerous and unpredictable nature of their work. Agricultural producers who are also military Veterans may experience additional health pressures that are often overlooked in the healthcare setting. Over 2.5 million Veteran Health Administration (VHA) patients reside in rural areas and the healthcare infrastructure to care for these Veterans may not include an agricultural occupational approach. To address healthcare disparities in Veteran farmers and ranchers, this study, in collaboration with AgriSafe Network, will be used …

Developing A Community Innovation Grant In Response To Increasing Rural Critical Incidents In Agricultural Mental Health And Wellbeing, Community Trauma, And Natural Disasters, Chessa S. Quenzer

Capstone Experience: Master of Public Health

Spink Area Support Network (SASN) is a skilled team of community volunteers that facilitate rural critical incident response services in an effort to prevent a critical incident and offer structured support during the aftermath. SASN was developed in response to identified gaps in rural critical incident response and risk reduction through prevention in Spink County, South Dakota. SASN utilizes a collaborative team approach to fill in gaps between first responder silos and establish community interventions by providing support and resources while utilizing critical incident stress management methods. SASN requires funding to maintain response resources, training, prevention education, and follow-up services. …

Developing A Rabies Prevention Program Based On Rabies Exposure Data In Nebraska, Jill Oatman

Capstone Experience: Master of Public Health

Eighty-nine percent of Nebraska’s towns are considered rural, with populations of less than 3,000 people and with many towns having less than 1,000 residents. Rural areas consist of crop ground, livestock facilities and regions inhabited by wildlife. Nebraska has two large urban cities, Lincoln and Omaha. Animal and human health in these communities can be greatly impacted by infectious diseases that are transmitted between animals and humans, known as zoonotic diseases. One zoonotic disease of great concern is rabies. Zoonotic diseases not only impact the health of animals and humans, but the social well-being of communities and result in increased …

Planning And Facilitating The Training Of Emergency Medical Services On The Safe Transport Of Patients With Highly Infectious Diseases, Mohammed Alhallaf

Theses & Dissertations

Emergency Medical Services (EMS) personnel are the first line of treatment and are the first exposed health care workers to infectious diseases (IDs). Consequently, the EMS setting is a relatively vulnerable environment for disease transmission and cross-contamination. Also, serious and emerging IDs, such as highly pathogenic viral hemorrhagic fevers and novel Coronaviruses, in a time of increased globalization, require comprehensive EMS training and preparedness. This project had the objective of identifying best practices for the EMS transport of patients with IDs. The methods for this project were done in two phases. In the first stage, we …

Program Evaluation: Wellness For Life, Patricia Wagner

Capstone Experience: Master of Public Health

Specific Aim: The specific aim of this program evaluation is to assess the effectiveness of the employee wellness program (Wellness for Life program) at Community Hospital (CH) in McCook, Nebraska through the analysis of biometric data, personal health assessment results, and survey results.

Significance: The evaluation of this program is important to ensure CH is aiding their employees so they might lead healthy lives at a time when the health of our country is incredibly poor.

Background: CH is a small critical access hospital that employs 323 people in McCook, Nebraska. In 2013 CH decided to offer a formal employee …

A Statewide Needs Assessment Of Perspectives On Training And Certification Of Community Health Workers In Nebraska, Jessica Ern

Capstone Experience: Master of Public Health

INTRODUCTION: Community Health Workers (CHWs) are a crucial growing component of the health care field in the U.S. According to the US Bureau of Statistics (2018), the CHW workforce is expected to grow 38% in the next ten years. While research has repeatedly shown the success of CHW-led programs and the financial benefits of CHWs, little work has been done to evaluate the training and certification preferences of CHWs in Nebraska. This project aimed to gather and analyze qualitative and quantitative data through an exploratory sequential mixed-methods approach to provide policy recommendations regarding the future training and potential certification of …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Great Plains Behavioral Risk Factor Surveillance System Project, Florence G. Duran

Capstone Experience: Master of Public Health

Background: Great Plains American Indians/Alaska Natives (AI/ANs) experience higher mortality rates than Non-Hispanic Whites from the same region. The National Behavioral Risk Factors Surveillance System (BRFSS) survey can have limitations of the estimates the health risks behaviors and services from one Tribal community to another. Goals and Objectives: The goal of this project is to address the lack of Tribal specific data among AI/ANs in the Great Plains region (ND, SD, NE, IA) by using Great Plains Tribal BRFSS data that captured information for three tribes in the Great Plains region. Tribal specific data will allow tribes to access, …

Initiation Of A Roundtable Meeting To Determine Safety Hazards And Provide Education To Range Bison Herd Workers, Lucia Finocchiaro

Capstone Experience: Master of Public Health

This capstone project serves as an important piece of greater project studying bison handling. Bison production is both a growing and dangerous industry. As a new enterprise in many parts of the country and on tribal lands, significant numbers of untrained employees may be hired. This project undertakes methods to better understand the risks associated with bison handling and to thereby improve handling procedures and increase safety. Herd managers (from tribal and non-tribal sites), researchers, safety experts, and stakeholders were brought together for a roundtable meeting in Omaha. This meeting was designed to provide stakeholders a forum to discuss common …

Examining Barriers To Sexual And Reproductive Health Services For Adolescents And Young Adults In Nebraska, Marisa Rosen

Theses & Dissertations

Despite recent declines in unintended pregnancy rates among adolescent and young adult women, barriers to family planning services and contraception continue to exist for young women living in the United States. Various initiatives have been implemented over the years from programmatic interventions to enactment of policies around family planning, yet more work needs to be done to help adolescent and young adult women successfully prevent unintended pregnancy. The Contraceptive Access Project (CAP) is a multi-component initiative in Nebraska to reduce unintended pregnancy among women aged 15-24. This dissertation comprises three separate studies each of which contributes to the overall objective …

Determining The Adoption And Implementation Of Nutrition Policies At Food Pantries Across The United States, Meagan Helmick

Theses & Dissertations

Food insecurity occurs when there is a lack of access to enough food to live an active, healthy life. Current efforts to address food insecurity include developing and implementing policies, programs, and practices at the federal, state, and local levels. Specifically, local efforts target decreasing food insecurity through emergency food networks including food banks and food pantries. Over the last several years, many food banks and food pantries have worked to improve the nutritional quality of the foods they offer. However, food pantries are smaller and less formal organizations than food banks. Thus, they have limited resources to develop and …

A Characterization Of The Medical-Legal Partnership (Mlp) Of Nebraska Medicine, Jordan Pieper

Capstone Experience: Master of Public Health

This research study was completed at Legal Aid of Nebraska’s Health, Education, and Law Project through the partnership it has formed working with Nebraska Medicine and Iowa Legal Aid. Traditionally, health and disease have always been viewed exclusively as "healthcare" issues. But with healthcare consistently growing towards holistic approaches to help patients, we now know there are deeper, structural conditions of society that can act as strong driving forces of a person's poor daily living conditions that can negatively impact health. The importance of a Medical-Legal Partnership is that it considers a patient's social determinants of health (SDHs). The goal …

Identifying The Newly Insurable Medicaid Coverage Gap Population Under The Affordable Care Act: Who They Are And Where They Live, Samuel L. Woodruff

Capstone Experience: Master of Public Health

The goal of this Capstone Project is to better define and geographically locate the potential distribution of individuals who fall within the current Medicaid Coverage Gap and those populations who would be eligible for Medicaid under the expansion of Medicaid within the state of Nebraska. Using data from multiple United States Census Bureau sources, along with available data from the Health Resources and Services Administration (HRSA), this project looks to also locate populations of these individuals that may live within established Medically Underserved Areas (MUA's) or Health Professional Shortage Areas (HPSA's) within the state. American Community Survey 5-year Public Use …

Examining The Benefits And Client Satisfaction Of The Open Arms Of Minnesota Meal Service Program, Carlie Rhinehart

Capstone Experience: Master of Public Health

Chronic disease can leave individuals incapable of caring for themselves, leading to a low quality of life. Public health researchers have proven how crucial medically tailored meals are to those fighting such chronic diseases. Open Arms is a local nonprofit that started in 1986. They make and deliver meals, free of charge, to people with life-threatening illnesses.

The goal of this study is to examine the benefits of the meal services provided by Open Arms of Minnesota to clients who are chronically ill. To learn about the benefits, analysis was conducted on the client satisfaction survey data collected. The anonymous …

Public Health Perspectives On Sexual Health And Family Planning, Molly Mccarthy

Theses & Dissertations

Large bodies of evidence document the importance of sexual and reproductive health (SRH) in the lives of individuals and among populations. Of particular interest are sexually transmitted diseases (STDs), due to their potential for long-term health consequences, and unintended pregnancy because of its association with social and economic outcomes for women and families.

This dissertation addressed three distinct but related areas of reproductive health and family planning: counseling for condom use following an STD test, counseling for contraception following a pregnancy test in a clinical setting, and the effect of abortion on having and achieving long-term plans. These topics are …

Evaluation Of Adult Mental Health First Aid: Findings From 2015-2017 Post-Course Surveys, Gina Schwieger

Capstone Experience: Master of Public Health

Abstract

Introduction: Lack of knowledge about mental health, lack of access to mental health care, and stigma create substantial barriers to the overall United States adult population from seeking or helping individuals with behavioral health issues. This study evaluated Adult Mental Health First Aid (MHFA) courses, an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing the community’s confidence in helping and frequency of referring people in need.

Methods: This retrospective evaluation of 2015-2017 Adult MHFA courses, utilizes qualitative and quantitative data from post-course surveys completed by course participants. Quantitative data was measured using a five-point Likert Scale. …

Association Between Leisure Time Physical Activity Preference And Behavior: Evidence From The China Health & Nutrition Survey, 2004-2011., Junmin Zhou, Denise H. Britigan, Shireen S. Rajaram, Hongmei Wang, Dejun Su

Journal Articles: Health Promotion, Social & Behavioral Health

BACKGROUND: Previous studies have suggested that food preference is a good indicator of actual food intake and that sedentary activity preference is a significant predictor of lower physical activity level. But no studies have examined the direct relationship between leisure time physical activity (LTPA) preferences and actual LTPA behavior, especially studies using longitudinal data. This study seeks to determine the association between these two variables, and to assess whether the association differs between urban and rural areas in China.

METHODS: A total of 2427 Chinese adults were included in the analysis. Spearman correlation coefficients were used to test the association …

Sex And Sexuality Of Breast Cancer Survivors, Aja D. Kneip Pelster

Theses & Dissertations

With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the United States. A large group of this population consists of breast cancer survivors. The purpose of this research was to explore the intersection of breast cancer survivorship, at points beyond the termination of treatment, and sexuality, including expressions and performance of gender, relationships, and sexual behavior. The current study used semi-structured interviews, conducted with 21 Midwestern women at least 6-months post-treatment, to better understand the intersection of these two concepts. Following traditions of narrative and phenomenological qualitative research, the women’s own …

Epidemiologic And Clinical Profiles Of Uterine Cancer In The Gharbiah Province Of Egypt, Saad Alshahrani

Theses & Dissertations

Background: Uterine cancer is one of the top-ranking cancers of women with wide international variations in incidence rates. Egypt has a lower incidence of uterine cancer than other countries in the Middle East. In addition to the international incidence variation, there are also wide variations in incidence by rural and urban areas within countries. Therefore, this research project focused on the Gharbiah province, north of Cairo in the Nile Delta, with the aims of investigating demographic and clinical characteristics of uterine cancer, assessing rural/urban variation in incidence rates, and evaluating the possible role of hysterectomy in under-estimating the disease incidence …

Epigenetic Modifications Of Human Placenta Associated With Preterm Birth, Drissa Toure

Theses & Dissertations

Preterm birth is a complex multifactorial process. Despite the well-known role of the placenta in supporting the fetal development and maternal-fetal tolerance, the placental epigenetic modifications and preterm birth (PTB) remains poorly understood and under investigated. Various maternal and environment factors can influence epigenetic programming during fetal development to affect the functioning and structures of organs, including the placenta, which can lead to adverse pregnancy outcomes, including PTB. The understanding of the placental epigenetic alterations and maternal determinants associated with PTB are apparently indispensable for the development of actual diagnosis and methods of prevention and treatment of premature labor. The …

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

Theses & Dissertations

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

It was found that …

Leisure Time Physical Activity Preferences, Behaviors, And Hypertension: Evidence From The China Health & Nutrition Survey, 2004-2011, Junmin Zhou

Theses & Dissertations

Background: Physical activity has been continuously declining in China. At the same time, prevalence of hypertension has dramatically increased. The associations between leisure time physical activity preference, behavior, and development of hypertension in Chinese adults remained not fully understood and few studies have examined these associations using longitudinal data.

Objectives: This dissertation examined the interrelationships among leisure time activity preference, behavior, and the incidence of hypertension using longitudinal data from 2004 to 2011 in the China Health and Nutrition Survey. It also assessed the urban-rural disparities.

Methods: A total of 2,687 adults were included in the analysis. Multivariate logistic regressions …

Exploring Emergency Communication Experiences In Response To The 2010 Haiti Earthquake: Lessons Learned From International Donors And Local Government Agencies, Pierre Marie Barbara Roussel

Theses & Dissertations

Background:

In almost every disaster situation, the use of standardized communication procedures among humanitarian relief agencies has been identified as one of the efficient practices to minimize the mismanagement of resources and thus to maximize the response effort among actors to reduce the incidence impact on the public and to increase their resilience capabilities.

Agencies have access to several guidelines to follow during domestic disasters, but there have been very few manuals developed to guide relief organizations on best practices during international large and complex natural disasters such as the 2010 Haiti earthquake.

Haiti has experienced over its history several …

Factors And Outcomes Associated With Potentially Inappropriate Medication Use In Rural Community-Dwelling Older Adults, Marcia Y. Shade

Theses & Dissertations

Potentially inappropriate medications (PIMs) use in older adults is a significant public health concern. The use of PIMs to avoid may lead to negative outcomes such as adverse drug events. Prior conceptual analysis of PIMs use and observation of health-related factors in rural adults led to the design of this dissertation study. A sample was recruited from a population of rural community-dwelling older adults to examine the following specific aims: 1) Describe the use of PIMs to avoid, 2) Explore individual demographic characteristics (age, gender, income, education, and rural home location), health experience (comorbidity, number of medications and health providers), …

Understanding Access To Health Information: The Role And Measurement Of Social Location, Megan S. Kelley

Theses & Dissertations

The purpose of this research is to explore how application of social location theory may improve data collection on health information access in order to better inform and improve the effectiveness of health communication and messaging. This dissertation proposes a framework to understand how people obtain health information based on the idea of social location, Ritzer and Bell’s (1981) levels of social reality, and Dahlberg & Krug’s (2002) social ecological model. This research addressed the extent to which three studies of health information access support the use of such a framework, and if so, how its application could improve our …