Master of Public Health
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Browsing Master of Public Health by Subject "Health Education"
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Item Assessing Factors for Dental Decay using NHANES Survey in the United States(2022-08) Gallardo, LauraThe purpose of this research was to study the factors affecting oral health in the residents of the United States. This study examined if there were significant differences in the examination of dental decay concerning the last dental visit and age. The study analyzed secondary data National Health and Nutrition Examination Survey 2017-2018. This study examined a sample of 9,254 residents aged 1 – 80 years old. The Chi-Square Test of Independence was used to test the association among the variables of the last visit to the dentist and age. The researcher of the study found significant difference in dental decay and age, but no significant difference was found between dental decay and last visit to the dentist. However, the researcher recommends that future studies review other factors affecting oral health in regard to oral health behaviors, high sugar intake, and full integration across all levels of the health system will likely lead to optimal benefit for population health and reduction in oral health inequities.Item A Comparison of Advance Care Directive Attitudes and Completion Rates Amongst Medicaid Population in Inland Empire Pre and Post-COVID-19 Pandemic(2020-12) Manley, Ethel P.The passage of the Patient Self Determination Act in 1990 gave patients the legal right to express their wishes for future medical care and end of life treatment wishes. Yet, despite the benefits of executing an advance directive, most people do not have one executed. Few studies have been done that focus on the Medicaid population and their attitudes about completing an advance directive during a pandemic. This study aimed to determine if the COVID-19 pandemic is enough to influence attitudes and readiness in the Medicaid population about advance directives. A cross-sectional study was conducted using a modified version of Porter Novelli’s HealthStyles end of life items and the four-item version of Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey to obtain information about exposure to health information, health promotion, and communication about advance directives. The population sample consisted of 63 adult Medicaid recipients, 13 males and 49 females living in San Bernardino and Riverside counties in California. A paired samples t-test and a one-way analysis of variance (ANOVA) were performed. Based on these results, the COVID-19 pandemic was not a large enough motivator to influence advance directive completion in the Medicaid population.Item Determinants of Type II Diabetes among Native Americans in the United States: An Analysis of the 2015 Behavioral Risk Factor Surveillance(2020-05) Snowball, Kandis DevenThe purpose of this study is to examine the relationship between type II diabetes and mental health status, alcohol/tobacco use, sleep disorders, and healthcare coverage within the Native American population. The aim of this study is to answer these questions: (1) Is mental health status, sleep disorders, tobacco use and alcohol abuse significantly associated with self-reported type II diabetes in the Native American Population? (2) Is health care coverage significantly associated with self-reported type II diabetes in the Native American Population? METHOD: using data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS). After reviewing the 2015 questionnaire, 6-questions were classified as dependent variables and were examined to determine if there was a significant relationship with self-reported type two diabetes in the Native American population (measured using BRFSS question-7). The design was a cross-sectional design using secondary data. RESULTS: no significant relationship between the variables sleep or energy and having type-II diabetes. There was a significant relationship between the variables: alcohol, reported being a current/former smoker, and mental health concerns (including stress, depression and problems with emotions) and having type-II diabetes. Also, the results found that having health care coverage was significantly associated with participants that reported having type-II diabetes. CONCLUSION: Findings from this study are beneficial in understanding the Native American/Alaska Native population and type II diabetes relationships.Item Eating Behaviors and Physical Activity among Registered Nurses in Riverside County(2020-11) De Leon, MelissaNurses are critical to the United States healthcare system, as there are more than 3.8 million registered nurses. Supporting the well-being of nurses is fundamental since they are frequently in contact with patients and work daily to improve the health of patients. The purpose of this study was to determine if there was a relationship between health habits and working as an RN within Riverside County, California. A total of 174 participants completed the Nurses’ Health Survey consisting of 24 questions. Participants were asked demographic questions that included gender, age, ethnic background, height, weight, hospital affiliation, and work setting. A weak positive correlation was found between the number of years of employment as an RN and BMI (rho (148) = .203, p = .014), indicating a significant relationship between the two variables. No significant relationship was found between perceived stress level and fast food consumption (X2 (1) = .068, p = .79). No significant relationship was found between the amount of vigorous physical activity and shift work among RNs working in Riverside County (X2 (1) = .000, p = .99. The results of these findings have public health implications for implementing health-promoting activities for nurses.Item The Effect of Food Insecurity on Fruit/Vegetable Consumption and Body Mass Among Low Income and Minority Adults(2022-08) Barahona, JackieFood insecurity is a public health concern across the United States. It is rooted in poverty and can have long-lasting health consequences on communities (U.S. Agency for International Development, 2021). In 2020, California’s food insecurity rate was 20%, demonstrating that one-fifth of the state’s residents lack access to healthy, nutritious foods (California Association of Food Banks, 2020). This study aimed to examine the effect of food insecurity, specifically cutting, or skipping meals, on variables such as fruit/vegetable consumption and body mass index (BMI) in low income, minority adults, using the 2020 California Health Interview Survey (CHIS) data. The results showed a significant relationship between cutting or skipping meals and fruit consumption (t (-2.81) = 2381, p = .005). There was also a significant relationship between cutting or skipping meals and BMI (t (3.525) = 2381, p < 0.001). The findings from this study suggest health educators and community agencies should promote food assistance programs in minority communities. Furthermore, interventions need to be tailored to promote healthy eating to different cultures. Public health professionals must advocate for programs that support access to healthy food in underserved communities.Item An Evaluation of the Differences in HPV Vaccination Status and Providers Recommendation between Genders and Maternal Educational Levels(2020-08) Martinez Luna, DulceHuman Papillomavirus (HPV) vaccination rates have remained low among adolescents in the United States over the last decade, persevering as a public health concern. The purpose of this study was to evaluate differences in HPV vaccination status and provider recommendation between genders and maternal educational levels. First, this study addressed if there were differences in HPV vaccination status between female and male adolescents 13-17 years of age. Secondly, this study sought to determine if there were differences in HPV vaccination status based on adolescents’ mothers’ educational levels (mothers of high vs. low educational levels). The study further examined the difference in provider HPV vaccine recommendations to adolescents based on adolescents’ mothers’ educational levels. Lastly, the study explored if there were differences in the likelihood of teens receiving the HPV vaccine in the next 12 months based on the adolescents’ mothers’ educational levels. This study employed a cross-sectional design using data from the 2018 National Immunization Survey-Teen (NIS-Teen). Chi-square tests of independence and an independent samples t-test were used to analyze the four research questions. The findings of this study determined a significant difference in HPV vaccination status between genders (p = .002). This study also identified a significant difference in provider recommendations between high and low maternal educational levels (p = .001). However, no difference was found in the likelihood of teens receiving the HPV vaccine in the next 12 months between adolescents whose mothers had high or low educational levels. Further research is needed to better understand reasons for lack of provider HPV recommendations.Item Evaluation of the Keepin' it REAL Drug Prevention Program(2022-08) Bernal, Nancy GuadalupeAlcohol, tobacco, and other drug (ATOD) use among adolescents is a severe public health problem in the United States. ATOD prevention programs have been implemented in schools to reduce the adverse health and social consequences of youth ATOD use. This study examined the effectiveness of the keepin’ it REAL (kiR) drug prevention program among 118 adolescents from two different high schools in Southern California. A quasi-experimental design was utilized to determine the impact of the program on adolescents’ ATOD use behaviors. It was hypothesized that students who received the kiR program would report a decrease in ATOD use behaviors and an increase in intention to abstain from ATOD use, intention to avoid ATOD use, intention to use ATOD resistance skills, and self-efficacy to refuse ATOD offers compared to students who did not receive the kiR program. A series of two-way repeated-measures ANOVAs were used to examine changes in outcome variables between the treatment and comparison groups. Results indicate that there was no effect of the kiR program on any of the outcome variables of interest. Future research is warranted to examine the impact of kiR on ATOD use behaviors and whether health educators should continue to use the kiR program to reduce ATOD use among adolescents in high school.Item Examining Differences in CVD Knowledge and Body Image Perceptions in Racial/Ethnic Groups(2021-08) Richard, Evynn C.Females with low-income levels are disproportionally affected by both obesity and cardiovascular disease, with Non-Hispanic Blacks as the leading ethnic group. Despite representing significantly higher levels of obesity than other racial groups, black females still hold positive views of their body image- which may indicate a normalization of their overweight circumstances. The purpose of this study is to examine influences on obesity and CVD knowledge amongst racial groups. A sample of 225 participants were asked to participate in a cross-sectional study. After receiving consent, a 42-question survey comprised of demographic information, Heart Disease Fact Questionnaire created by Wagner, and the Body Shape Questionnaire created by Cooper was used to measure overall CVD knowledge and perceived body image. An Analysis of Variance (ANOVA) test was conducted to find differences between test groups. The results of the ANOVAs showed no differences in CVD knowledge among females. In addition, no differences were found in CVD knowledge amongst Non-Hispanic Black males and females. Significant differences were found in body image perceptions between obese African American females and both other BMI groups (F(2,52) = 6.69, p = .03).Item Examining Race and Socioeconomic Status as Predictors of Cervical Cancer Screening and Human Papillomavirus Vaccination in Women(2022-08) Ochoa, Marlene ElizabethMore than 4,000 women die from cervical cancer annually, even though 93% of cervical cancers are preventable with HPV screenings and vaccinations (Centers for Disease Control and Prevention [CDC], 2020). In 2012, women ages 21 to 65 in the United States reported they had not been screened for cervical cancer (CDC, 2020). This study aimed to examine the relationships of between ethnicity/race, income, education, HPV screening, and HPV vaccine uptake of cervical cancer. The 2020 Behavioral Risk Factor Surveillance System (BRFSS) data were used to determine if there was a significant relationship between sociodemographic factors, specifically race, ethnicity, household income, and education, with disparities in HPV screenings and vaccines among women. A cross-sectional research design was utilized. The study revealed a significant relationship between HPV screening across race/ethnicity categories, income level, and education. The findings showed a significant relationship between HPV screening across race/ethnicity categories (H (5) = 43.846, p <.001), within income levels (X2(1) =12.077, p <.001), and for educational attainment (X2(1) = 52.220, p < .001). There also was a significant relationship between HPV vaccination across race/ethnicity categories (H (5) = 36.367, p <.0010), income level (X2(1) = 2.145, p >.143), and education (X2(1) = 14.490, p <.001). The findings from this study are beneficial in identifying the disparities among women residing in underserved communities for cervical cancer screenings and acquiring the HPV vaccination series. This study demonstrates that race/ethnicity, income, and education may be factors that make a woman more susceptible to cervical cancer. Therefore, health educators must be conscious of a community's cultural background and its impacts when addressing the disparities in HPV vaccine uptake and cervical cancer screenings. It is vital for public health and healthcare professionals to implement more efforts to promote HPV screening and HPV vaccination at the state and national levels to decrease cervical cancer incidence.Item Examining the Relationship Between Mental Health Status and Alcohol Consumption Among College Aged Adults(2018-08) Kozam, Narjs OmarMental health disorders and alcohol use have been identified as public health issues. Research indicates that young adults have relatively high rates of mental health disorders and alcohol use. The main purpose of this study is to examine the relationship between mental health status and alcohol consumption among college-aged adults living in California, using the 2016 Behavioral Risk Factor Surveillance System (BRFSS). It was also examined whether race/ethnicity, gender, and income variables affect the relationship. A random sample of 1,087 male and female college-aged adults living in California was used. Using a cross-sectional design, participants completed a phone survey containing demographics and health questions. The dependent variable was alcohol consumption, and the independent variables were race/ethnicity, gender, income, and mental health. A Chi-Square test of independence and a binary logistic regression model were used to answer the research questions. The result of the study indicated that there is no significant relationship between mental health status and alcohol consumption among college-aged adults. Also, race/ethnicity, gender, and income did not predict or modify the relationship between alcohol consumption and mental health.Item Exploration of Factors that Influence Workforce Development Needs for a Local Public Health Department(2019-08) Cheema, KirndeepHealth disparities cause a significantly impact public health employees. Some public health employees have a better understanding of why health disparities exist and are interested in reducing them. It is important that public health staff work together in order to understand why disparities occur. The Improved Health for All discussion series helped determine if public health employees had an interest in addressing health disparities. The discussion series took place at a local public health training session during the sixth and final module. The IHA intervention was designed to educate the staff on the relationship between inequities and health disparities Participants were asked to participate by taking a survey, which measured their behavioral intentions on health disparities and length of employment and the completion of formal public health training. The study used a retrospective pretest design to collect pretest and posttest data from staff at a local health department. In this study, a partial correlation was calculated to determine if length of employment influenced public health employees’ behavioral intentions. This was conducted after controlling for pretest responses, which showed that there was no significant relationship between length of employment and behavioral intention. An Independent Samples t-test was conducted to determine if there was an association between employee age and completion of formal public health training. The results showed that there was a statistically significant difference in age and formal public health training.Item Hospital Workers Readiness to Adapt Health Improving Behaviors to Reduce Stress(2020-08) Fuentes, Sindy MaricelaHigh levels of stress are prevalent among hospital workers (Dyrbye, Shanafelt, Sinsky, Cipriano, Bhatt, Ommaya, West, & Meyers, 2017), but although stress is high, not many studies have investigated healthy behaviors among hospital workers to reduce stress. Therefore, the purpose of this research study was to investigate the relationship between perceived stress levels and stages of change for healthy behaviors among hospital workers. A volunteer sample of 123 hospital employees was collected in 2018 upon their approval from a hospital in Southern California. Results show that levels of stress were inversely related to stages of change for exercise. In addition, gender found to be not a significant factor in determining the level of stress among hospital workers. However, the level of stress across different demographic factors, such as ethnicity and gender, were reported to be slightly higher than that of average scores in the general population (Cohen, Kamarch, & Mermelstein, 1983).Item The impact of breakfast intake on BMI in high school teenagers in California(2022-08) Herrera, Arlene NavarroSkipping breakfast is an unhealthy eating habit that commonly occurs in teenagers and has become a public health concern for the youth population in the state of California. The literature indicates a relationship between skipping breakfast and overweight/obesity, which may result from unhealthy dietary behavior and skipping other meals. This study aimed to assess the impact of skipping breakfast and breakfast eating frequency (low, moderate, and high breakfast intake) on body mass index. We hypothesized that skipping breakfast will result in higher BMI and higher consumption of sugar-sweetened beverages (SSB), while high breakfast intake will lower BMI. An independent samples t-test was used to compare the mean BMI between breakfast-skippers and breakfast eaters. Further, the breakfast eaters were categorized into low, moderate, and high breakfast intake groups to assess the impact of breakfast frequency on BMI. A one-way ANOVA was used to determine the differences in BMI between breakfast-skippers and the above breakfast intake categories. Similar analyses were performed in males, females, and in different ethnic/race groups using the split file function in SPSS. A significant difference was observed between the mean BMI of breakfast eaters and skippers (p = 0.005). The frequency of breakfast intake impacted BMI. High school teenagers who did not eat breakfast had a higher BMI (p = <0.001) compared to teenagers who had high breakfast consumption (5-7 days breakfast intake). Specifically, only the high breakfast intake group (p = <0.001) had a significantly lower BMI, but not those who had low (1-2 days breakfast intake) (p = 1.00), or moderate (3-4 days breakfast intake) (p=0.868) compared to breakfast skippers. A similar trend was observed in females, males, non-Hispanic, and black African Americans when our dataset was split by gender and ethnicity. In summary, this study shows that skipping breakfast has a negative impact on high school teenagers’ BMI. The study also revealed the importance of eating breakfast almost daily (5-7 days) to improve body weight; therefore, effective strategies to promote the daily consumption of breakfast are warranted to combat obesity in high school teens in California.Item The Impact of Socioeconomic Status on the Mental Health of Children(2021-08) Orr, Mackenzie L.The rate of mental illness diagnoses is increasing across the U.S. population. The impact of mental illness is not limited solely to adults, but also has a dramatic effect on adolescents in their formative years. Given the prevalence of mental illness in American society, an analysis was done to determine if there is a relationship between socioeconomic status and mental health diagnoses in children. Using parental education level and markers of poverty (measured as federal poverty level and qualification for cash assistance, free or reduced-cost breakfast or lunches, and food stamps) as the indicators for socioeconomic status, a cross-sectional analysis was performed using data from the Data Resource Center (DRC) for Child & Adolescent Health: A project of the Child and Adolescent Health Measurement Initiative (CAHMI) National Survey for Children’s Health (NSCH). The mental health diagnoses utilized were anxiety and depression. The chi-square tests of independence found relationships between the following variables: parental education and depression; poverty level and anxiety; qualification for food stamps and anxiety; poverty level and depression; qualification for free or reduced-cost breakfast or lunches and depression; and qualification for food stamps and depression. The strongest relationship was found between qualification for food stamps and diagnoses of depression in the children.Item Measuring the Impact of a Mental Health Intervention on Perception of Stigma and Help-Seeking Behaviors(2018-08) Berrios, Eileen JMental illness is a condition that alters an individual’s thoughts, feelings, and behaviors. Within the United States, the stigma associated with mental illness is highest among the African American community. African Americans are less likely than other groups to acknowledge the seriousness of a mental illness. The aim of this study was to determine the relationship between perceived mental health stigma and help-seeking behaviors before and after the implementation of a faith-based mental health intervention among African American females. Additionally, income was explored as a possible influence on the relationship between the perception of stigma and help-seeking behaviors. Program participants completed paper-based pre-and post-tests administered by program evaluators during Week 1 and Week 8 of the program. The survey instrument used to collect the pre- and post-test data consisted of a combination of questions mandated by the California Department of Public Health Office of Health Equity and questions developed by the program evaluators. A paired-samples t-test was used to answer the first research question, while a multiple linear regression was used to answer the second question. The findings of the study indicated that participant scores remained closer to “Probably Willing” to socialize, make friends, work, and live with someone who has a mental illness. In addition, neither perceived stigma nor income was found to be a significant predictor of help-seeking behaviors.Item Obesity and Academic Outcomes Among Hispanic/Latino Adolescents: An Analysis of the National Survey of Children’s Health(2019-12) DiYorio, Katie MarieOver the last thirty years in the United States, obesity rates among children ages 2 to 19 have doubled, with even higher rates among ethnic minorities. The purpose of this study is to determine if school-related disciplinary problems, repeating grades, free or reduced school meals, and parent/caregiver engagement were significantly associated with overweight or obesity among the Hispanic/Latino children population. This study used 553 Hispanic/Latino female and male children aged 17 and below from the 2016 National Survey of Children’s Health (NSCH) dataset. A chi square test of independence was used to determine the effect size of any established association between the dependent variables and overweight and obesity. This study does not entirely concur with the findings of previous studies, which state that a child’s overweight status is associated with poorer educational outcomes, such as school reported problems, repeated grades, and little to no parent/caregiver engagement. However, the current study presented an established association between Hispanic/Latino children who receive free or reduced school meals and overweight or obesity. Because of this finding, there is a clear need to restructure the National School Lunch Plan (NSLP). It is suggested for this population that future studies review other ethnicities to determine similarities and differences. Information from this study is beneficial for improving academic outcomes among Hispanic/Latino children.Item An Observation of Access to Substance Abuse Treatment Facilities and the Effect on Opioid Overdose Deaths(2021-04) Lancaster, AmberThis study examines the accessibility of opioid use disorder (OUD) facilities in Riverside and San Bernardino Counties zip codes that experience high rates of fatal opioid overdose. This study also aimed to investigate the types of communities (rural or urban) that experience the highest rates of fatal opioid overdose in the two counties. This descriptive study used geographic information system (GIS) software and crosstabulation analyses to compare the rates of opioid overdoses that occur in each zip code of these counties and substance abuse treatment facilities available in these same zip codes in their respective counties. Results showed that rural communities within these counties experienced some of the highest rates of fatal opioid overdose deaths while simultaneously lacking access to treatment facilities that were abundant in urban areas of these same counties. The findings of this research suggest that there are inadequate resources available for those suffering from OUD that live in the rural communities of Riverside and San Bernardino Counties. Policy reforms are recommended at the county government levels in order to increase access to treatment for residents of these areas, including access to medication assisted treatment (MAT).Item Polycystic Ovarian Syndrome (PCOS), Type 2 Diabetes Risk Factors and Environmental Influences on PCOS(2019-05) Frost, Rebecca GaylePolycystic Ovarian Syndrome (PCOS) is an endocrine condition that affects nearly 4-21% percent of women of reproductive age (Azziz, Carmina, Dewailly, Diamanti-Kandarakis, Escobar-Morreale, Futterweit, Jannsen, Legro, Norman, Taylor, & Witchel, 2006). Symptoms of the syndrome include insulin resistance (IR), infertility, hirsutism, and obesity (Sivanandy, Zuuren, & Aird, 2018). The etiology and cause of the condition remain largely unknown (Roe & Dokras, 2011). The purpose of this study is to examine possible connections between PCOS and Type 2 Diabetes (T2D) by investigating behavioral, obesogenic, and other risk factors associated with T2D. This study also investigates environmental and behavioral exposures experienced by individuals in their daily lives, as well as if these environmental factors correlated with adverse effects on the PCOS condition. Little is known about the environment and its affect, if any, on women diagnosed with PCOS. Two research questions were posed for this study: first, if there is a relationship between PCOS and T2D and second, if there are environmental factors that have any adverse effects on the PCOS condition. The study design was cross-sectional and observational in nature, using a survey administered via social media. Risk factors for T2D include obesity and a higher body mass index (BMI). The results of this study found a statistical association between some areas related to T2D risk factors and an increased likelihood for a selfreported diagnosis of PCOS. On the other hand, this study found no statistical association between environmental factors and adverse effects on the PCOS condition. The public health and future implications of the study are vast. Future analysis could include clinical studies on A1C levels of women with PCOS. This could further define the association between IR and PCOS.Item A Qualitative Analysis of Lessons Learned and Application to Professional Practice among Graduate Students Participating in an Interprofessional Education Simulation(2020-08) Davee, Briana MarieThroughout many years of examination and evidential research of the practice of healthcare workers and their effect on patient health outcomes, it has been determined that Interprofessional Education is effective and necessary for enhancing positive health outcomes. This claim is widely recognized by well-known health institution such as the World Health Organization. The purpose of this study is to examine the common takeaways that students felt they could carry on into their professions. This research project uses a qualitative, cross-sectional design used to identify common themes learned by students participating in the university-wide emergency simulation. 144 students participated in the simulation, 16 students from Athletic Training, 23 students from Speech Language pathology, 41 students from Graduate Nursing, 18 students from Public Health, 30 Physician Assistants, and 16 students from Behavioral and Social Sciences. Participants were randomly assigned to work together through the simulation. Students were given a disaster scenario to work through in randomized groups at designated session times to participate in the one-day simulation assignment. After students completed this simulation, they were asked to complete an anonymous short- answer survey to reflect on this experience to evaluate student learning, level of enjoyment, and how they would use what they have learned in their professional practice. The analysis is descriptive using frequencies of common themes identified among respondents. Six common themes were identified are teamwork/ collaboration, preparedness for emergencies, understanding other disciplines, skill application, communication, and remaining calm and focused in the event of an emergency. Lastly, a crosstabulation analysis was also used to categorize the data and, different themes were found across the various professions.