Public Health Education and Promotion Commons^™

Public Health Contagion Of White Supremacy: Examining The Pipeline Of Attitudes About Racism And Racial History Education Among High School Students., Trinidad Jackson

Electronic Theses and Dissertations

We are living in compounded states of upheaval. Violence and exemption from it across socioecological levels have shaped how humans survive, thrive, and die. While different violence typologies exist, the U.S., prioritizes interpersonal violence as its primary target of intervention, often through structural means that foster and reinforce interpersonal violence. The omission of structural and cultural agents and outcomes of violence allows perpetrators to infiltrate and reproduce savage, dehumanizing ideologies in perpetuity. Instead of sustaining societal pillars that oppress and destroy, we must fertilize public health research, practice, and sociopolitical activism with pillars that both inform and activate liberatory consciousness …

Understanding Public Emergency Preparedness Before And During The Coronavirus Outbreak: Implications For Effective Public Health And Risk Communication., Raphael Adjetey Fumey

Electronic Theses and Dissertations

The COVID-19 pandemic has resulted in a dramatic loss of human lives globally and presents an unprecedented challenge to public health, the world of work, and our food systems. The social and economic disruption caused by the COVID-19 pandemic is devastating, putting several millions of people at risk of falling into extreme poverty, with over 500 million people being undernourished. It is evident from the data on COVID-19 cases, deaths, and hospitalizations that the United States is the worse hit country, which can be attributed to the lack of preparedness at the individual, environmental, and government levels. This study applied …

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

Exploring The Contextual Factors And Decision-Making Process Of Risky Sexual Behavior Among Homeless Adults In Louisville, Kentucky., Sarah C. Van Heiden

Electronic Theses and Dissertations

Homelessness is a complex public health issue; individuals who experience homelessness are said to engage in risky sexual behaviors at an increased rate and experience a higher prevalence of sexually transmitted infection (STI). While the sexual behaviors of homeless adolescents are commonly studied, little is known about the sexual behaviors of the growing population of older adults, or how they make decisions to engage in sex. Three aims guided this research: 1) to describe the sexual behaviors and sexual decision-making process of homeless older adults, 2) to examine how homeless older adults evaluate the outcomes associated with engaging in risky …

“And The Next Day, You Are In Charge”: Policy Recommendations Stemming From A Qualitative Investigation Into The Professional Development Of Early Career Peer Support Specialists In Kentucky., Diane Zero

Electronic Theses and Dissertations

Over the last twenty years, the peer support segment of the behavioral health workforce has grown rapidly. However, few researchers have studied the effects on individuals from transitioning into the role. Likewise, there is limited research examining the professional development process of early career peer support specialists. To begin to fill these gaps in the literature, I conducted a qualitative research study examining workforce development experiences of peer support specialists in Kentucky. This dissertation reports on its findings and includes a policy paper with recommendations for improving policy and practice. Chapter one offers an introduction to the peer support workforce …

Tobacco Cessation Counseling Practices Amongst Dental Hygienists In Central Texas, Lacy Murray

Electronic Theses and Dissertations

Although tobacco cessation is an uphill battle for almost everyone who attempts to quit, it is important that dental hygienists do not assume that patients are not interested. Dental hygienists are in an ideal position to offer cessation help to their tobacco using patients. The purpose of this study was to gain a better understanding of the tobacco cessation practices among central Texas dental hygienists. Specifically, dental hygienists were asked about beliefs, motivation, and confidence with regard to their tobacco cessation practice. A positive significant, moderate, relationship was found between beliefs and confidence (r=0.647), beliefs and practices ( …

Economic Insecurity, Poverty, And Parental Alcohol Misuse, Joey Tucciarone

Electronic Theses and Dissertations

Because parental alcohol misuse is associated with numerous negative outcomes for drinkers and other family members, it is important to examine factors predictive of alcohol misuse patterns among parents living with at least one child under the age of 18. Two possible factors include economic insecurity and poverty. This study sought to address whether measures of economic insecurity (i.e., housing and/or food insecurity in the past 12 months) and a dichotomous measure of poverty predict parental binge drinking and parental heavy alcohol consumption in a large population-based sample. It was hypothesized that economic insecurity and poverty, analyzed separately, would predict …

Sarcopenia Screening By Registered Dietitian Nutritionists (Rdns) In The United States (U.S.), Madison Marcom

Electronic Theses and Dissertations

Sarcopenia is a disease of muscle wasting primarily seen in older adults. Although this term was first coined over three decades ago, there is a lack of consensus on a definition, screening criteria, and treatment protocol for sarcopenia. The primary purpose of this study is to determine whether registered dietitian nutritionists (RDNs) in the United States (U.S.) screen for sarcopenia. Study participants were recruited through a randomized email list and included RDNs throughout the U.S. Respondents completed a survey questioning knowledge of sarcopenia, screening tools and company protocols in place, and the need and desire for sarcopenia education. Data revealed …

Association Between Prepregnancy Obesity And Health Behaviors, Adverse Conditions, And Birth Outcomes In South Dakota, Lily Sanderson

Electronic Theses and Dissertations

Introduction: Prepregnancy obesity is associated with an increased risk for various adverse outcomes for mother and fetus. These adverse associations exist within the realms of preconception health, prenatal health, birth outcomes, and postnatal health.
Methods: This retrospective cohort study used data from the South Dakota Pregnancy Risk Assessment Monitoring System (SD PRAMS) survey, which is an ongoing statebased surveillance system of maternal behaviors, attitudes, and experiences before, during, and shortly after pregnancy. The 2017 and 2018 SD PRAMS sampled a total of 3,805 mothers who were randomly selected from birth certificate records to be representative of all South Dakota women …

A Novel Approach To Hiv Prevention: Understanding Multi-Level Influences On Hiv Pre-Exposure Prophylaxis (Prep) Uptake And Outreach Among African Americans., Suur Debrah Ayangeakaa

Electronic Theses and Dissertations

This dissertation examined and provided basis for addressing factors related to HIV pre-exposure prophylaxis (PrEP) engagement, outreach, and uptake among high-risk African American youth groups in Louisville, KY. This qualitative dissertation study was designed through the lens of an interpretive framework of social constructivism which holds that multiple realities and interpretations exist and are socially constructed through the lived experiences of individuals and their interactions with others. Thus, lived experiences of various African American youth groups in Louisville as well as key informants of AIDS service organizations (ASOs) across the U.S. (including Louisville) were explored to develop a deeper understanding …

Health And Academic Achievement In College And University Students, Amber Beane

Electronic Theses and Dissertations

The purpose of this non-experimental quantitative correlational study was to investigate the relationship between academic achievement and health in a national sample of college students using quantitative data analysis. Specifically, the researcher analyzed the relationship between three health-promoting behaviors (physical activity, strength training, and fruit and vegetable consumption), three negative health behaviors (cigarette, e-cigarette, and opioid use) and obesity with GPA.

Cross-sectional data on student health collected from the American College Health Association’s National College Health Assessment II (ACHA-NCHA-II) and completed by 426,650 college students from 650 U.S. colleges during the semesters between 2015 and 2019 formed the foundation for …

Increasing Healthy Lifestyle Behaviors In Cargo Drivers, Ronda L. Bell

Electronic Theses and Dissertations

The purpose of this project was to examine the extent to which lifestyle behaviors of transportation drivers in North Texas can be improved with health education. This research study was conducted to examine the health behaviors of transportation drivers as a result of an educational partnership between nursing and the transportation industry. The goal was to improve healthy lifestyles through education to decrease chronic illness and comorbid conditions of a significantly at-risk occupational population. The impact of this education was immediate and verified with quantitative measurement and statistical analysis. Results demonstrated that after nurse-led health education, transportation drivers reported significant …

The Effect Of Care Coordination On Hemoglobin A1c For Type 2 Diabetes Patients, Lee Ann Hinsky

Electronic Theses and Dissertations

The purpose of the study was to test the impact of care coordinator visits by primary care registered nurses on serum hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes. In the study, the researcher compared 2 groups of type 2 diabetes patients—those who had care coordinator visits from registered nurses and those who did not—through retrospective data collection and analysis from the patients’ electronic medical record from July 2018 through December 2018. An independent samples t test was used to compare the means of the intervention and control groups’ change in HbA1c levels. The intervention and control groups …

Uncovering The Stories Behind The Numbers : A Case Study Of Maternal Death Surveillance And Response In Goma, Democratic Republic Of Congo., Baraka Muvuka

Electronic Theses and Dissertations

Globally, 303 000 women die each year from preventable causes related to pregnancy, with the Democratic Republic of Congo (DRC) having the tenth highest maternal mortality rate. Maternal Death Surveillance and Response (MDSR) is a surveillance-action cycle that aims to eliminate preventable maternal mortality by linking actionable data on maternal deaths with multi-level actions. While countries are increasingly adopting MDSR, there are research gaps on its implementation, outcomes, and best practices in developing countries including the DRC. This study assessed MDSR implementation in Goma Health Zone (HZ), DRC, specifically its structure, process, quality, outcomes, and influencing factors. A qualitative case …

The Shape Study : The Survey Of Health And The Perceived Environment Study., Colette Patrice Davis

Electronic Theses and Dissertations

Introduction: Few studies have considered how an individual’s perception of their built environment may be a risk factor for being overweight or obese. Adolescents may be particularly vulnerable in the context of “impoverished environments”, which they may perceive to be difficult, dangerous, resource deficient, and unaesthetic. This study aids in clarifying how the built environment influences the risk of obesity among adolescents residing in a neighborhood in Louisville, KY. Objective: The overall objective was to conduct a cross-sectional epidemiologic pilot study among adolescents aged 12-17 years residing in West Louisville, Kentucky to evaluate the association between perceptions of …

Innovation And Equity In Public Health Research : Testing Arts-Based Methods For Trauma-Informed, Culturally-Responsive Inquiry., Tasha Golden

Electronic Theses and Dissertations

As the field of Public Health has shifted from a biomedical paradigm to a social ecological approach, focusing on health equity and social determinants of health, it has increasingly acknowledged the roles of culture and trauma in health outcomes. The field has responded by modifying some research practices, but continues to prioritize conventional methodologies—with few options designed to foreground trauma- and cultural-responsiveness. Unfortunately, to the extent that conventional approaches require health to be defined, communicated, or valued according to dominant norms, they risk perpetuating inequities. Health equity therefore requires the development of research methodologies that increase inclusivity and access, elicit …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup

Electronic Theses and Dissertations

ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …

Evaluating Socially Determined Health In Rural Appalachia: Use Of The Social Quality Theory, Paula Masters

Electronic Theses and Dissertations

People living in rural America face unique social circumstances that can prevent them from reaching optimal health status. This fact holds especially true in the rural Appalachian region of the United States where income, education, living circumstances, and lack of resources create an environment that has some of the highest rates of morbidity and mortality in the country. While the rest of the country has seen improvement in many health behaviors and health outcomes, rural Appalachian communities remain unchanged and further behind other regions. In many cases, programming and policy have failed to create a culture of health in Appalachia. …

Hiv-Related Knowledge, Attitudes, And Behaviors In Two Low Resource Settings, Candice Lynn Collins

Electronic Theses and Dissertations

Two Human Immunodeficiency Virus (HIV) outbreaks occurred almost simultaneously in the United States (US) (2014-2015) and in Cambodia (2015). Information is lacking on HIV-related knowledge, stigmatizing attitudes, and high-risk behaviors (KAB) among the general population, which may affect the transmission of HIV and lead to outbreaks. The current study aimed to: 1) assess KAB among the general population in a high-risk county in the US, 2) analyze KAB among the general population of Cambodia, and 3) compare KAB across samples from a high-risk county in Northeast Tennessee and a province in Cambodia. Tennessee data were collected in 2017 and Cambodian …

Context, Delivery, And Providers’ Perspectives Of Family Life Education In Tn, Usa, Ruby Yadav

Electronic Theses and Dissertations

In 2015, TN had the 9^th highest teen birth rate in the United States. School-based sex education programs have shown promise in curbing teen pregnancy rates. In TN public schools, sex education could be taught by teachers of subjects like biology, health education, or invited guests from ministries, or national or local nonprofit agencies. The content, rigor, and approach of sex education taught by these diverse groups of providers remains unknown. This pilot study tested a survey questionnaire and methodology, while providing information on the providers’ sex education practices and perspectives.

We adapted validated measures from past sex education …

Experimentally Investigating The Joint Effects Of Physical Activity And Sedentary Behavior On Depression: A Randomized Controlled Trial, Jeremiah Blough

Electronic Theses and Dissertations

Objective: To experimentally examine whether increasing sedentary behavior, among a young adult active population, for one week is still associated with increased depression symptomology even when allowing for a moderate engagement in physical activity (PA). Methods: Participants were confirmed as active via self-report and accelerometry during baseline and randomly assigned to one of three experimental groups. The Sedentary Intervention Group (n=19) reduced steps to less than 5000/day and were not alloto exercise for one-week; the Reduced MVPA (moderate-to-vigorous PA) Group (n=18) reduced steps to less than 5000/day but exercised for 50% of their previously reported vigorous PA for one-week; and …

Evaluating Work Place Wellness In Greater Louisville's Technology Organizations : A Case Study., Andrew L. Mccart

Electronic Theses and Dissertations

Employers in the Southern Indiana and Greater Louisville region are looking for strategies to help them become a healthier workplace. Many employers see the expense of paying for an unhealthy workforce and they are looking to limit these expenses. The purpose of the study is to determine the state of workplace wellness activities in organizations in Southern Indiana and Greater Louisville. Due to the poor health statuses of Indiana and Kentucky, 39th and 45th, respectively, this study is significant for a number of stakeholders in our area. The purpose of this case study was to understand the state of health …

The Effects Of A Supermarket Tour On Improvement Of Nutrition Knowledge And Eating Behavior, Elizabeth Hall

Electronic Theses and Dissertations

The purpose of this study was to determine if participation in a supermarket tour improves nutrition knowledge and eating behavior in adult participants. Participants were recruited in communities surrounding Food City stores, a local supermarket. Prior to completing a standardized tour, participants completed a survey to assess nutrition knowledge and eating behavior. This survey was given to participants again three months later. A program evaluation was given one time at the end of the tour. Data analysis revealed no significant findings, other than the behavior-based question: “How many meals or snacks on most days included vegetables”. Vegetable consumption appeared to …

Attending To Systemic Racism : Advancing Public Health's Approach To Youth Violence Prevention., Billie Faith Castle

Electronic Theses and Dissertations

This dissertation examines how the field of public health addresses the impact of systemic racism on health and how that informs public health’s approach to youth violence prevention. Beginning with an overview of youth violence, it breaks down the concepts of race and racism and how they are addressed within the science. It also reviews concepts that contribute to risk and protective factors of youth violence. The dissertation is written from a Critical Race Theory approach, argues that the social environment contributes to why youth violence is pervasive in certain neighborhoods, and promotes action from a macro-level approach. Seven chapters …

Reducing Tobacco-Related Health Disparities : Exploring The Barriers And Facilitators To Smoking Cessation Among Individuals Experiencing Homelessness., Bernadette Guzman Antoon

Electronic Theses and Dissertations

Although the prevalence of smoking has declined in the U.S., vulnerable populations continue to suffer from tobacco-related health disparities. An estimated 68.0-80.0% of homeless adults are current cigarette smokers compared to 15.1% in the general population. The large gap in smoking rates suggests that current tobacco cessation programs designed to reduce smoking have little impact among individuals experiencing homelessness. The purpose of this study was to explore the barriers and facilitators to smoking cessation among the homeless. The second aim of this study was to explore if the barriers and facilitators to tobacco cessation differed among male smokers experiencing homelessness …

Evaluating The Impact Of Statewide Policy Implementation On Interorganizational Collaboration At The Regional Level : An Application Of Network Analysis., Nida Moez Ali

Electronic Theses and Dissertations

One challenge to improving population health in the United States is that the systems tasked with the responsibility of providing services across the continuum of care often operate in silos, missing opportunities to provide quality, coordinated care. In 2011, Texas received approval from the Centers for Medicare and Medicaid Services (CMS) for a five-year 1115(a) Medicaid Waiver Demonstration Project. This dissertation focuses on one element of the Waiver, the Delivery System Reform Incentive Payment (DSRIP) Program, which was designed to incentivize activities that support organizations’ collaborative efforts with other organizations in addressing the Triple Aim strategies. DSRIP was implemented through …

Colorectal Cancer Fit Screening In The Hope Vi Population Of Jefferson County, Kentucky., Jeffrey D. Stone

Electronic Theses and Dissertations

Using pre-post survey data collected from 209 randomly selected African American people from the population of former residents of Clarksdale and Sheppard Square public housing areas, this study explores the relationship between individual characteristics and colorectal cancer screening behavior, measured by the uptake of the Fecal Immunochemical Test (FIT) and by prior colorectal screening, while controlling for neighborhood factors and geographic proximity to healthcare facilities. This particular public housing population is of interest because of their relocation from the downtown area, where healthcare facilities are within walking distances, to other public housing units either in large apartment complexes or scattered …

Correlates Of Human Papillomavirus (Hpv) Vaccine Acceptance In Appalachian Tennessee, Oluwatosin Ariyo

Electronic Theses and Dissertations

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the U.S., where one HPV-related cancer is diagnosed every 20 minutes. The most common HPV-related cancer is cervical cancer, with an estimated incidence of 12,000 cases annually, a third of which lead to death. Cervical cancer disparately affects women of ethnic minority groups and geographically isolated regions, such as Appalachia. Tennessee ranks third highest in cervical cancer incidence in the country. Many cases of cervical cancer could be prevented through vaccination against HPV, however, vaccination rates for females in Tennessee are among the lowest in the country. This mixed-methods …

Mammography Utilization In African American Women, April D. Kidd

Electronic Theses and Dissertations

Purpose: Breast cancer presents differently among women causing breast cancer health disparities with women of color disproportionally shouldering later-stage screening, incidence, and treatment, and greater mortality. This study assessed 10 predictors and rates of recent and long-term mammography utilization for women 43-79 years of age to better understand differences among age strata and races. This was the first study to use both the calculated Gail Risk scores (calculates absolute breast cancer risk over time intervals) from the 2010 National Health Interview Survey (NHIS) and a temporary homelessness variable in predicting mammography utilization using national-level data.

Theoretical Framework: A modified Behavioral …