Public Health Education and Promotion Commons^™

A Case Study In Program Evaluation: Evaluation Of The Bourbon County Physical Activity Initiative, Michaela D. Amburgey

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This evaluation examines the Bourbon County Physical Activity Initiative, which aims to increase physical activity levels in Bourbon County, Kentucky. The initiative includes increased access to exercise opportunities, community events, and an incentive-based activity tracking system. This evaluation assesses the program’s implementation, effectiveness, and provides recommendations for improvement. By utilizing evaluation findings, public health practitioners can enhance decision-making, optimize resource allocation, and improve population health outcomes.

Psychosocial Factors, Stress And Sleep Among Rural Appalachian Kentucky Residents With Type 2 Diabetes Mellitus, Blake Dipaola, Zoe Taylor, Eric Hennemann, Brittany L. Smalls, Philip M. Westgate, Nancy Schoenberg

Journal of Appalachian Health

Introduction: Rural Appalachian residents experience higher rates of most chronic diseases, including type 2 diabetes mellitus (T2DM). Stress and sleep deficiency also are common in the region.

Purpose: To better understand these associated health burdens, the relationship among these conditions and psychosocial factors—such as depressive symptoms, distress, empowerment, and social support—was examined among Appalachian residents with T2DM.

Methods: Using data collected from a community-based sample of Appalachian adults with T2DM, the study examined whether psychosocial factors were associated with perceived stress (Cohen Perceived Stress Scale) and self-reported sleep deficiency (Epworth Sleepiness Scale). Multilevel linear mixed effects regression modeling was used …

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 …

Examining The Feasibility Of Implementing Farm To School Programs In Rural Kentucky Schools: Barriers And Successes Of Initiating Programming As Identified Through Teacher’S Observations, Christina Wilson

Theses and Dissertations--Nutrition and Food Systems

Farm to School (FTS) programs provide experiential learning opportunities to children that have the potential to shape eating patterns and, in turn, improve health and learning outcomes. Participation in FTS programs in Kentucky is growing. However, programming varies widely across schools, and few have an edible school garden. This study examined the feasibility of establishing an edible school garden while incorporating FTS programming by evaluating teachers' observations and experiences. Six rural Kentucky schools were selected to receive a $5,000 grant to initiate an edible school garden and incorporate FTS programming. A Qualtrics survey measured six categories regarding implementation. The results …

Disparities In Mortality Between Appalachian And Non-Appalachian Regions Of Kentucky, Sonali S. Salunkhe, Sahal Alzahrani, Beatrice Ugiliweneza

Journal of Appalachian Health

Introduction: In the opioid epidemic, the U.S. faces a significant public health crisis, with some areas of the country, such as rural and Appalachian regions, suffering more than others. The differential regional impact of the crisis in Kentucky—a state with both non-metropolitan/metropolitan and Appalachian/Non-Appalachian statuses—has not yet been documented despite such knowledge being essential to the success of overdose prevention efforts.

Purpose: This study compares all-cause, drug- and opioid-related mortality between counties in different regions of Kentucky: Appalachian non-metropolitan, Appalachian metropolitan, non-Appalachian non-metropolitan, and non-Appalachian metropolitan.

Methods: Age-adjusted mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online …

Carbapenem-Resistant Enterobacterales—Kentucky, 2013–2020: Challenges And Successes, Mary Issac, Andrea Flinchum, Kevin Spicer

Journal of Appalachian Health

Introduction: Carbapenem-resistant Enterobacterales (CRE) are considered urgent, antibiotic-resistant threats in the U.S. and are of global concern. Active collaboration between public health authorities and healthcare facilities and providers will be necessary to prevent and contain these organisms.

Purpose: To describe the epidemiology of CRE in Kentucky and to discuss challenges and successes with building and sustaining an effective prevention and containment program.

Methods: Retrospective descriptive summary of CRE isolates reported by healthcare providers, facilities, and laboratories in Kentucky from 2013 through 2020. Data available from case reporting forms and laboratory testing are summarized.

Results: From 2013 through 2020, 1805 CRE …

Examining The Utility Of A Kentucky Fcs Cooperative Extension Curriculum On Community Members’ Healthy And Sustainable Diet-Related Behaviors, Catharine Pickford

Theses and Dissertations--Nutrition and Food Systems

Experts recommend individuals adopt healthy and sustainable dietary behaviors to improve human and environmental health. The objective of this study was to pilot a sustainable eating Family and Consumer Sciences (FCS) Cooperative Extension curriculum and evaluate the effectiveness of the lesson series by measuring participants’ changes in knowledge, perceptions, and intentions towards healthy and sustainable dietary behaviors as well as overall satisfaction with lessons. A five-lesson sustainable eating curriculum was developed with topics focused on: reducing food waste; eating more seasonal, local plant-based foods; varying protein sources; maintaining energy balance; and consuming fewer highly processed and packaged foods. To assess …

Through The Lens: Youth Experiences With Cancer In Rural Appalachian Kentucky Using Photovoice, Katie Gaines, Courtney Martin, Chris Prichard, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Rural Appalachian Kentucky experiences disproportionately high cancer incidence and mortality rates. This cancer burden is due to social determinants of health and cultural factors prominent in the region. The firsthand experiences of community members—especially young people—can highlight these factors and identify areas for improvement. The purpose of this study was to encourage Appalachian Kentucky youth to consider determinants of cancer and visualize the effects that cancer has on their families or communities by asking them to take photographs of cancer-related objects around them. Content analysis was performed on 238 photographs submitted by 25 students, and photographs were organized into themes, …

Physical Activity Barriers And Assets In Rural Appalachian Kentucky: A Mixed-Methods Study, Natalie Jones, Deirdre Dlugonski, Rachel Gillespie, Emily M. Dewitt, Joann Lianekhammy, Stacey A. Slone, Kathryn M. Cardarelli

Sports Medicine Research Institute Faculty Publications

Obesity is an increasing public health concern in the U.S. and a contributor to chronic illness, with trends revealing a rise in adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations, including those in rural communities. A mixed-methods approach was used to examine perspectives on perceived physical activity barriers, resources, and level of community support. Researchers utilized the socioecological model to examine the multiple domains that support physical activity in rural Appalachia. The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and five …

Spatial Analysis Of Health Care Utilization Among Medicare Beneficiaries With Coal Workers’ Pneumoconiosis And Other Related Pneumoconiosis, Ahmed A. Arif, Claudio Owusu, Rajib Paul, Christopher M. Blanchette, Ripsi P. Patel, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• The states with the highest number of Medicare beneficiaries with coal workers’ pneumoconiosis (CWP) were Kentucky, West Virginia, Virginia, and Pennsylvania.
• Significant clustering of health care utilization rates for Medicare beneficiaries with CWP was observed in the central Appalachian states of Kentucky, West Virginia, and Virginia.
• Significant clustering of health care utilization rates for Medicare beneficiaries with Other Related Pneumoconiosis was observed in Appalachia and the southeast parts of Texas and Louisiana. This clustering merits additional research to understand underlying disease etiology.

Prevalence And Correlates Of Secondary Syringe Exchange (Sse) Among People Who Inject Drugs (Pwid) In Rural Kentucky, Jordan R. Wilson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Aim: To describe the prevalence of secondary syringe exchange (SSE) in a sample of syringe service program (SSP) clients in rural Appalachian Kentucky and to identify the correlates of SSE.

Methods: Participants (n=338) completed interviewer-administered questionnaires. Only those who reported having ever exchanged syringes at a SSP (n=140) were included in analysis. SSE was measured through self-report of obtaining syringes for someone else at a SSP in the past 6 months. Prevalence and correlates of SSE were examined using bivariate analysis and multiple logistic regression.

Results: Overall, 30% of participants reported SSE. Participants in the second [aOR= 3.83; 95% CI: …

A Brief Educational Intervention Enhances Basic Cancer Literacy Among Kentucky Middle And High School Students, Lauren Hudson, Kerrigan M. Samons, Haley E. Dicken, Chris Prichard, L. Todd Weiss, Jean Edward, Robin C. Vanderpool, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Kentucky experiences the highest overall cancer incidence and mortality rates in the USA with the greatest burden in the eastern, Appalachian region of the state. Cancer disparities in Kentucky are driven in part by poor health behaviors, poverty, lack of health care access, low education levels, and low health literacy. Individuals with inadequate health literacy are less likely to participate in preventive measures such as obtaining screenings and making healthy lifestyle choices, thus increasing their chances of developing and dying from cancer. By increasing cancer literacy among youth and adults, it may be possible to decrease cancer disparities across Kentucky. …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …

Promotion Of Fruit And Vegetable Intake Through Recipe Card Distribution And Sampling At Farmers’ Markets Throughout Kentucky, Umaima Sidra Afsheen Syeda

Theses and Dissertations--Nutrition and Food Systems

The Center for Disease Control and Prevention (CDC) reports indicate that 8% and 6.3% of Kentuckians consume enough fruits and vegetables, respectively. The Plate It Up! Kentucky Proud (PIUKP) project is a recipe-development project that aims to boost produce consumption by incorporating local fruits and vegetables. The purpose of this study was to implement promotional strategies using PIUKP recipes at farmers’ markets and determine their effects on consumers’ intent of purchasing and preparing the produce. The study was conducted at nine farmers’ markets across Kentucky (n=300) in collaboration with Cooperative Extension agents/assistants.

The consumers’ impression of the sample was positively …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …

Refugee Health And The Kentucky Global Health Center, Rahel Bosson, Ruth M. Carrico

Journal of Refugee & Global Health

In this University of Louisville Grand Rounds lecture, Drs. Rahel Bosson and Ruth Carrico give an overview of the real struggle of the refugee population and provide an update of the current state of refugee health in Kentucky.

They also provide an overview of the Global Health Initiative at University of Louisville, which includes the follow programs: HIV/AIDs, Refugee Health and Immunization, Vaccine and International Travel and Global Health Research Support.

The talk concludes looking to the future with a comprehensive Global Health Center composed of improving refugee orientation and EMR, healthcare worker education, developing guidelines, and bettering our surveillance …

Hpv Vaccination Among Young Adult Women: A Perspective From Appalachian Kentucky, Laurel A. Mills, Katharine J. Head, Robin C. Vanderpool

Health, Behavior & Society Faculty Publications

INTRODUCTION: Few studies have assessed barriers to human papillomavirus (HPV) vaccination uptake and adherence, particularly among women of Appalachian Kentucky, a population with higher rates of cervical cancer, lower rates of HPV vaccination, and lower socioeconomic status compared with the rest of the nation. The objective of this study was to address women's reasons for declining the HPV vaccine and, among women who initiated the vaccine series, barriers to completion of the 3-dose regimen.

METHODS: We recruited 17 women aged 18 to 26 from a Federally Qualified Health Center who participated in in-depth, semistructured telephone interviews. All interviews were audio-recorded …

Drivers Killed Due To Tire Failures, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To Prevent Tire Failures,

Employers should:

• Ensure that routine maintenance is performed on work vehicles
• Implement and enforce an employer seat belt safety program

Employees should:

• Be properly trained in safe work vehicle operation
• Perform routine pre-trip and post-trip inspections, including inspection of the tires
• Ensure that tires do not run below 80% of the recommended pressure

Workers Die From Heat Stroke, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent heatstroke, employers should:

• Train supervisors and employees to recognize symptoms of heat stroke
• Give frequent breaks and provide drinking water
• Adjust work hours to accommodate work conditions such as high heat index and/or high humidity
• Monitor workers who are at risk of heat stroke

Employees should:

• Report unusual behavior
• Know how to treat co-workers for heat stroke
• Monitor your physical condition and that of your coworkers

Workers Killed After Being Electrocuted, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent electrocutions, employers should:

• Provide non-conductive ladders
• Conduct a jobsite survey to identify potential hazards
• Provide electricity awareness training
• Provide onsite automated external defibrillators (AEDs)

• Use non-conductive ladders
• De-energize lines before beginning work
• Make sure all equipment is properly grounded
• Know how to use automated external defibrillators (AEDs)

Workers Killed During Tree Trimming/Removal, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent tree trimming and removal fatalities, workers should:

• Perform a hazard assessment of the work area before starting work
• Appropriate personal equipment should be worn at all times while trimming or removing trees
• Determine the tree’s felling direction. Address forward lean, back lean, and/or side lean issues
• All trees and limbs should be inspected for structural weakness before work commences
• Have an escape route planned

Workers Killed While Working With Forklifts, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent forklift injuries:

• Do not operate a forklift without being certified and trained.
• Forklift operators should wear their safety belts.
• Do not jump from an overturning forklift. Keep your body inside the forklift frame. Ride it out and lean in the opposite direction of the overturn.
• Do not place yourself between two forklifts.
• Do not handle loads that are heavier than the load capacity of the forklift.
• Make sure that the travel path of the forklift is clear from the floor to the height of the load being moved.
• Do not step on elevated loads.
• It is a violation …

Workers Killed While Working With Granite, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent injuries while working with granite:

• A job hazard analysis should be conducted each day before work commences.
• Employees should be trained in proper material handling procedures that include handling and transport of granite slabs.
• Use slab carts or slab racks to transport granite slabs and use tie-downs to secure the granite slabs to the forklift.
• Work should only be performed when the general contractor has a competent person on the job site.

Workers Electrocuted While Working In Elevated Buckets, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent worker electrocutions while working near over-head power lines:

• Employers should implement and enforce a formal written electrical safety training program that includes work around overhead lines.
• An observer should be designated by the employer to perform an electrical hazard
• evaluation prior to commencing new work activities.
• A hazard assessment of the job site and route of travel, including aerial and ground hazards and obstacles, within the job site should be performed by a competent person before work commences.

Hansen, Gregory Alfred (Fa 396), Manuscripts & Folklife Archives

Folklife Archives Finding Aids

Finding aid and full-text of paper (click on "Additional File" below) for Folklife Archives Project 396. Paper: "[Nautilus Center at Lovers Lane Racquetball Club]" written by Gregory Alfred Hansen for a Western Kentucky University folk studies class.

Truck Drivers In Fatal Crashes After Substance Use, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent truck crashes due to substance use:

• Employers should implement and enforce a policy that prohibits commercial drivers who are ill or taking over-the-counter medications with potential side effects for impaired driving from operating a commercial vehicle.
• Employers should implement and enforce a “reasonable suspicion” drug testing policy if a driver is suspected to be under the influence of drugs.
• Companies should conduct comprehensive new-hire prescreening and after-hire random drug testing for substance abuse.
• A nationwide data- base containing a record of all commercial driver positive drug tests in the last two years should be developed.

Workers Struck By Trains While Driving, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent injuries while driving vehicles across railroad tracks:

• A hazard assessment should be performed before crossing railroad tracks.
• Safety belts should be used while driving.
• Commercial vehicles should not be stopped on railroad tracks.
• Braking mechanism checks should be performed before commercial vehicles enter roadways.
• Cell phones should not be utilized while driving.
• Employers should provide employees training on railway traffic safety.

Fatal Aerial Lift Injuries, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent injuries while working in aerial lifts:

• A “pre-job safety plan” should be developed for each job site and reviewed prior to each day on the job site.
• Mechanical checks should be performed on all equipment at each job site prior to each use.
• There should be communication between the worker in the elevated lift and ground control crew.
• Ensure that appropriate fall protection equipment is available and correctly used when working from elevations.
• Employees should work within job qualifications and job limits.

Amputation Injuries Due To Forklifts, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent injuries from forklifts while working:

• Before you operate a forklift, make sure that you are trained and certified.
• Remember if you are on a sit-down type forklift, and it starts to over-turn, lean in the opposite direction, stay with the forklift; don’t jump.
• When operating a forklift on site, slow the truck and sound the horn at cross aisles, exits, and other employee traverse points.
• Before dismounting, set the parking brake, lower the forks or lifting carriage, and neutralize controls.

Working Drivers Killed In Motor Vehicle Collisions Were Not Wearing Safety Belts, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent motor vehicle injuries while working:

• Employers should implement a comprehensive employee driver safety training program.
• Employees should wear seat belts at all times.
• Employees should be aware of distractions and pay attention at all times.