Public Health Education and Promotion Commons^™

"They Are Who We Thought They Were": The Influence Of White Supremacist Discourse On Voter Suppression And Black Health., Tanisha Howard Lewis

Electronic Theses and Dissertations

Political systems in the United States have contributed to health outcomes in the through the historic and legal doctrine related to race and racism, segregation, housing, employment, and education. In recent years, significant attention has been given to theorizing the political determinants of health and what it means in the overall conversation about health equity. The equity implications of the political determinants of health are innumerable because they are the origin point of the structural determinants of health and the primary drivers of the social determinants of health, which span from environmental conditions to food security. The focal determinant of …

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 …

How Livelihood Change Affects Food Choice Behaviors In Low- And Middle-Income Countries: A Scoping Review, Emma Kenney Mph-Pa, Krystal K. Rampalli, Sharraf Samin, Edward A. Frongillo Ph.D., Ligia I. Reyes, Shiva Bhandari, Morgan Boncyk, Stella Nordhagen, Helen Walls, Sigrid Wertheim-Heck, Amy Ickowitz, Solveig A. Cunningham, Ramya Ambikapathi, Beatrice Ekesa, Mirriam Matita, Christine E. Blake Ph.D., Rd

Faculty Publications

Livelihoods have changed dramatically over the past decade in low- and middle-income countries (LMIC). These shifts are happening in tandem with shifts in individual and household food choice behaviors. This scoping review aimed to identify and characterize mechanisms through which livelihood changes could affect food choice behaviors in LMIC, including behaviors relating to food production, acquisition, preparation, distribution, and consumption. A literature search was conducted using 4 databases: PubMed, PsycInfo, AGRICOLA, and Embase. The search was further enhanced by expert solicitations. Studies were included if they measured or focused on a livelihood change, described or assessed a change in ≥1 …

Stopping The Bleed At Uri, Emily Lefebre

Senior Honors Projects

The number one cause of preventable death is uncontrolled bleeding from traumatic injury. From the unlikely scenario of a school shooting, to a campus car accident or an injury during a sports or club event, possessing skills to effectively stop a life-threatening bleed becomes a matter of life or death. The American College of Surgeons Committee on Trauma (ACS COT) STOP THE BLEED® program is a campaign to teach communities how to respond effectively and efficiently to life-threatening bleeding in emergencies. STOP THE BLEED® aims to empower individuals with the knowledge and skills to stop severe bleeding by tourniquet application, …

A Comparative Analysis Of Hiv/Aids In France And The United States: Historical Context And Preventative Actions, Rebecca A. Liebsack

Honors Program: Senior Projects (Public)

The HIV/AIDS pandemic is the result of transmission of a zoonotic disease known as simian immunodeficiency virus. The pandemic has had profound social and economic consequences and continues to be present today. France and the United States’ response to the discovery of HIV will be compared and the impact that HIV/AIDS had on their countries and future responses. They had rather similar responses, however, the United States had a slower initial response compared to France. Both had similar takeaways such as aiming at improving prevention and utilizing tactics developed during the start of the pandemic like frequent testing and vaccines.

Social Influences On Quitting E-Cigarette Use: A Mixed Method Analysis, Olivia Peterson, Page Dobbs

Health, Human Performance and Recreation Undergraduate Honors Theses

Social Influences on Quitting E-Cigarette Use: A Mixed Method Analysis

Page Dobbs, Olivia Peterson, Erin Arthur, Jessica Seymore, Jenn Veilleux, Robert Davis, Mance Buttram, Mufazzela Tabassum

Words: 250/250

Introduction. Young adult e-cigarette users report peers as a reason for using these products; however, it is unclear how social influences are associated with attempting to quit e-cigarettes. The purpose of this mixed-methods study was to examine the relationship between social factors and quitting e-cigarettes.

Methods. E-cigarette users from a large southern university were recruited to take part in an explanatory, sequential mixed-methods study. First, participants (n=423) completed a cross-sectional survey about …

Cost Saving And Resource Limited Public Health Interventions In Southeast Asia, Amanda Blackwelder

Electronic Theses and Dissertations

Background: Public health interventions are any activity with the objective of improving human health such as preventing or curing disease, reducing the severity or duration of a disease, or assisting in regaining function after a disease or injury. These interventions are known to be impactful; however, those living with the highest burden of disease such as individuals in low- and middle-income countries have limited money and resources to successfully implement these interventions. Southeast Asian countries are among some of the middle-income countries effected by the lack of affordable interventions. The aims of this study were to assess cost saving and …

Perceptions Of Metabolic Syndrome Management Utilization In Relation With Patient Characteristics And Health-Related Quality Of Life, Olajide Adekunle

Pharmaceutical Sciences (PhD) Dissertations

Challenges in managing MetS include untreated risk factors and ineffective management, resulting in poor health-related quality of life (HRQoL). A significant factor contributing to these challenges is the underutilization of management services, possibly due to patients' perceptions of disease management resource utilization (PMU). Therefore, understanding patients' PMU is crucial for improving health outcomes. The study investigated PMU, explored PMU predictors, and investigated the impact of PMU and patients’ demographics on HRQoL. Using a cross-sectional design, data on perceptions of healthcare, medication, and pharmacy service utilization, prior experience with pharmacy services, demographics, and HRQoL were collected from adult individuals with obesity …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Patient Understanding Of Fetal Sex Versus Gender In The Context Of Routine Cell-Free Dna Screening, Mindy Kolodziejski

Dissertations and Theses (Open Access)

Non-invasive prenatal testing (NIPT) is the current standard of care to screen for fetal aneuploidy using cell-free DNA (cfDNA). NIPT screens for sex chromosome aneuploidies (SCAs) and in doing so, can predict fetal chromosomal sex. Despite sex and gender being distinct concepts, many patients refer to NIPT as “the gender test” and elect testing in order to find out predicted fetal sex and assume gender. Our study aimed to evaluate and describe patient understanding of sex and gender in the context of receiving routine prenatal genetics education (PGE) on NIPT. A survey was developed with the goal of assessing patient …

Substantial Increases In Healthcare Students’ State Empathy Scores Owing To Participation In A Single Improvisation Session, Brian D. Schwartz, Shane L. Rogers, Nicole Michels, Lon J. Van Winkle

Research outputs 2022 to 2026

Purpose: To determine whether the 12-item state empathy scale could be modified reliably to measure empathy in healthcare professions students and to detect changes in their empathy owing to a single improvisation (improv) session. Methods: Three cohorts of students from two healthcare professions programs (total = 165 students) participated in an improv session. During the session, one of the researchers (BS) tasked the students with several improv activities. Participants’ self-reported state empathy scores were assessed at three time points (pre-improv, post-improv, and end of semester) using revised, in-class paper versions of the State Empathy Scale. Results: The exploratory factor analysis …

The Role Of Soft Infrastructure In Developing Sustainable Volunteer-Based Healthcare For Transient Migrants In The El Paso-Ciudad Juárez Border Region, Daniel Avitia

Open Access Theses & Dissertations

No abstract provided.

A Randomized Controlled Study Of The Effects Of Targeted Health Education On Uptake Of Contraceptives Among Women Of Reproductive Age In Nnewi City, South-East Nigeria, Yanmeer Tyotswam, Rosebella Iseme-Ondiek, Eliphas Makunyi

Population Health, East Africa

Objective: There is a need for contraception uptake among people to enable them to fulfil their right to determine the timing, number and spacing of their children. In regions with poor contraceptive prevalence rates, lack of effective education has been largely implicated, and Nigeria falls among such regions. Thus, the present study is designed to examine the impact of an educational intervention on uptake of contraceptives among women aged 18–49 years seeking care at the Nnamdi Azikiwe University Teaching Hospital Nnewi.

Methods: Being an interventional study to underscore the effect of targeted health education on uptake of contraceptives, …

Toward A Politics Of Care: Southeast Asian Refugee Organizing, Kinship, Care, And Reunion, James Huỳnh, Victoria Huỳnh, Mads Lê, Sheila Sy

Faculty, Staff and Student Publications

From a critical refugee studies orientation, our article redefines care within the context of myriad forms of state violence impacting Southeast Asian post-war refugee communities. Research reveals how harm is compounded at every step of Southeast Asian refugee journeys: war, forced displacement, resettlement, family separation, inherited health conditions, and generational trauma. How do we reckon with refugee trauma without conceding to it as an unchangeable fact of our lives? What knowledge might we gain by attending to the everyday work of survival in refugee communities? To answer these questions, the authors conceptualize care through (a) abolitionist organizing, (b) queer kinship …

Assessment Of Sociodemographic Status, Self-Awareness, And Risk Factors Affecting Patients With Prediabetes In Bangladesh: Cross-Sectional Study, Farhana Sultana, Muhammed Mohibul Islam, Aparajita Das, Md Hasan Shahriar Rahman, Nandita Islam Pia, Md Kayes Mahmud, Md. Saqline Mostaq, Saadullah Saadullah, Md. Saddam Hossain, Saikat Fakir, Mohammad Nurul Amin

Makara Journal of Health Research

Background: Poor glycemic control and high diabetes and prediabetes incidence are influenced by socioeconomic disparity. Raising awareness and ensuring that people with prediabetes are receiving medication, maintaining their glycemic control, and getting the proper care they need despite their socioeconomic situation are crucial in the fight against diabetes. This study aims to assess the sociodemographic status, self-awareness, and risk factors associated with prediabetes in Bangladesh.

Methods: A cross-sectional survey was carried out among 500 participants aged >18 years to evaluate and summarize their demographic data, socioeconomic status, and responses to various questionnaires about their conditions related to prediabetes …

Maternal Age And Inadequate Prenatal Care In West Virginia: A Project Watch Study, Madelin Gardner, Amna Umer, Brian Hendricks, Toni Marie Rudisill, Candice Lefeber, Collin John, Christa Lilly

Journal of Appalachian Health

Introduction: Adequate prenatal care (PNC) is essential to the overall health of mother and infant. Teen age and advanced maternal age (AMA) are known risk factors for poor birth outcomes. However, less is known about whether these age groups are associated with inadequate PNC.

Purpose: This study sought to determine the potential association between maternal age (in groups, aged 20–24, 25–29, 30–34, 35–39, and >40) and inadequate PNC (visits).

Methods: West Virginia (WV) Project WATCH population-level data (May 2018–March 2022) were used for this study. Multiple logistic regressions were performed on inadequate PNC (less than 10 visits) with maternal age …

Trilogies: Lessons From 50 Years Facilitating Community-Based Health Assessments And Planning In Appalachia, Bruce Behringer

Journal of Appalachian Health

Involvement of community and organizational groups is fundamental to most public ventures. Most social, health, economic, and educational improvements in Appalachia have been characterized by successfully integrating community input and finding ways to encourage organizational change and collaboration.

Managing group process and related facilitation skills are fundamental competencies for public health professionals and others guiding change efforts. Groups from communities and organizations can get stalled in their deliberations; a facilitator frequently must think quickly to diagnose the situation and propose alternative approaches. Creative and flexible approaches, learned through practice experiences, can blend with theories and frameworks learned in academic preparation …

Treatment At An Academic Medical Center Eliminates Survival Disparities For Appalachian Kentuckians With Pancreatic Ductal Adenocarcinoma, Emily Cassim, Hannah Mcdonald, Megan Harper, Quan Chen, Miranda Lin, Reema Patel, Michael Cavnar, Prakash Pandalai, Bin Huang, Pamela C. Hull, Joseph Kim, Erin Burke

Journal of Appalachian Health

Introduction: Rates of cancer mortality in Appalachian Kentucky is among the highest in the nation. It is unknown whether geographic location of treatment for pancreatic ductal adenocarcinoma (PDAC), one of the deadliest cancers worldwide, influences survival in Appalachian Kentuckians.

Purpose: This study compares outcomes among Appalachian Kentuckians with PDAC who received treatment at an academic medical center (AMC) or community facility (CF).

Methods: Using the Kentucky Cancer Registry, patients diagnosed with PDAC between 2003 and 2018 were identified. Patients were categorized according to treatment location (AMC v. CF) and county of residence (Appalachian v. non-Appalachian). Kaplan-Meier curves were constructed to …

Check With The Intended Audience First! Content Validation As A Method For Inclusive Research For Primary Care Engagement In Rural Appalachia, Sydeena E. Isaacs, Jennifer Schroeder Tyson, Ashley Parks, Danielle Adams

Journal of Appalachian Health

Introduction: To date, referral practices based on social determinants of health (SDOH) among primary care providers (PCPs) and clinic staff in rural regions, including Appalachian North Carolina (NC), are not well understood.

Purpose: This study aims to develop and content validate a primary care engagement (PCE) survey to assess (1) engagement and burnout; (2) referral practices; and (3) self-efficacy and confidence in making referrals based on SDOH among PCPs and clinic staff in Appalachian NC.

Methods: Using the Social-Ecological Model as a theoretical framework, researchers developed a 37-item PCE survey. Content validation was completed by a panel of experts recruited …

A Patient’S Journey: Navigating Life With Type 1 Diabetes, Maram Dalab

Patient Experience Journal

We are all patients. This article represents my views from my personal experience with type 1 diabetes for 25 years, in combination with my professional experience over the past 10 years as I have worked in patient support, health promotion and improving the patients’ experience. I aim to provide an outlook on the patient perspective, how the physician encounter translates to them and finally, what are some gaps that need to be filled in order to have a better experience and better health outcomes as a result. As I wrote the article, I shared my perspective building on my personal …

Dispelling The Malaria-Typhoid Co-Infection Myth In Nigeria. A Literature Review, Olawale Akinola

Dartmouth Library Staff Publications

Malaria and typhoid fever are public health concerns in Nigeria, with high prevalence rates. The perception of a widespread co-infection between these diseases may be misleading, due to limitations in diagnostic methods, particularly the Widal test for typhoid fever. This literature review examines the prevalence of malaria-typhoid co-infection in Nigeria and identifies factors contributing to misdiagnosis, including non-specific symptoms, limited diagnostic resources, and the diagnostic accuracy of tests employed. Additionally, the review discusses the implications of misdiagnosis, such as the overuse of broad-spectrum antibiotics leading to a rising incidence of antimicrobial resistance. Strategies to address this issue are explored, emphasizing …

Systematic Review On The Impacts Of Agricultural Interventions On Food Security And Nutrition In Complex Humanitarian Emergency Settings, Melodie Al Daccache, Berthe Abi Zeid, Leila Hojeij, Ghassan Baliki, Tilman Brück, Hala Ghattas Ph.D.

Faculty Publications

Complex humanitarian emergencies are a main driver of food and nutritional insecurity. Agricultural interventions are key to improving nutrition and food security, and their positive impacts are well-documented in stable developing countries. However, it is unclear if their positive effects on food security hold in complex emergency settings, too. In this paper, we systematically review empirical articles that apply rigorous designs to assess the causal impacts of agricultural interventions on food security, nutrition, or health outcomes in complex humanitarian emergencies. We only find six articles matching these criteria, which have mixed results on dietary diversity and food security, and little …

Sexual Health Education Scope And Sequence, Sara Wadsworth

Honors Projects

Based on a significant amount of prior research, comprehensive sexuality education (CSE) has been identified to be the most effective method of teaching sexual health education (SHAPE America, 2021; World Health Organization, 2023). Comprehensive sexual health education improves healthy behaviors and outcomes, provides useful information, and is positively perceived by students (Gardner, 2015; Kirby, 2002; Robinson et al., 2022). However, the United States’ current sexual health education has not implemented this ideal method, which is shown through state laws, students’ experiences, underdeveloped skills and flawed understanding of concepts, and – most importantly – a lack of resources for teachers (Foley, …

Messaging About Very Low Nicotine Cigarettes (Vlncs) To Influence Policy Attitudes, Harm Perceptions And Smoking Motivations: A Discrete Choice Experiment, Reed M. Reynolds, Lucy Popova, David L. Ashley, Katherine C. Henderson, Charity A. Ntansah, Bo Yang, Emily E. Hackworth, James Hardin, Jim F. Thrasher Ph.D., Ma, Ms

Faculty Publications

Background To reduce smoking and the harms it causes, countries, including the USA, are considering policies to reduce nicotine in combustible tobacco to minimally addictive levels. Effective messages about very low nicotine cigarettes (VLNCs) and this policy are crucial in combating misperceptions threatening the policy’s effectiveness.

Data and methods A discrete choice experiment assessed messages about VLNCs. Participants were 590 adults who smoked exclusively, 379 adults who both smoked and used e-cigarettes, 443 adults who formerly smoked and 351 young adults who never smoked (total n=1763). Seven message attributes were varied systematically (source, harm, chemicals, nicotine, satisfaction, addictiveness and quitting …

Family Medicine’S Role In Addressing The Intersections Of Redlining And Climate Change, Daryl O. Traylor, Eboni E. Anderson, Brianna Clark, Alex M. Smith, Cooper K. Allenbrand

Journal of Sustainable Social Impact

Redlining, the practice of discriminating against specific neighborhoods based on race and socioeconomic status, leads to persistent environmental hazards and socioeconomic inequalities that have lasting adverse health effects on their populations. Health disparities are further exacerbated through the concentration of environmental hazards, as well as the escalating impact of climate change, which poses an increased risk of respiratory illness, cardiovascular disease, mental health issues, heat-related illness, infectious diseases, food insecurity, and socioeconomic difficulties in redline neighborhoods.

This paper examines the interplay of redlining, climate change, and health disparities, with an emphasis on the enduring consequences for these marginalized communities. Through …

Evidenced-Based Strategies To Increase Cervical Cancer Screening Rates, Tuong Cat Vo Bsn-Rn, Nada Salloukh Bsn-Rn, Tatiana Elena Swanson Bsn-Rn, Xiao Mie Cindy Zhu Bsn-Rn, Laura Taylor Reed Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Cervical cancer is the fourth leading cause of cancer affecting women worldwide (Staley et al., 2021). With cervical cancer being a preventable disease, an effective method of reducing healthcare costs and mortality is primary prevention, such as screenings. Financial burdens and barriers to accessing medical care may result due to the lack of proper cervical cancer screenings. Detecting cervical cancer includes screening women 21 to 65 years old with a Papanicolaou (PAP) test every three years. Women aged 30 to 65 years old can extend the screening of cervical cancer by having a Human Papillomavirus (HPV) test along with …

Eye Infection Risks From Pseudomonas Aeruginosa Via Hand Soap And Eye Drops, Anna Gitter, Kristina D Mena, Karla S Mendez, Fuqing Wu, Charles P Gerba

Faculty, Staff and Student Publications

Eye infections from bacterial contamination of bulk-refillable liquid soap dispensers and artificial tear eye drops continue to occur, resulting in adverse health outcomes that include impaired vision or eye enucleation. Pseudomonas aeruginosa (P. aeruginosa), a common cause of eye infections, can grow in eye drop containers and refillable soap dispensers to high numbers. To assess the risk of eye infection, a quantitative microbial risk assessment for P. aeruginosa was conducted to predict the probability of an eye infection for two potential exposure scenarios: (i) individuals using bacteria-contaminated eye drops and (ii) contact lens wearers washing their hands with …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …