APUS ePress: Public Health

Cynthia Herlihy
Program: Public Health: Capstone-Thesis: Master of Public Health (MPH)
Awarded: February 2018
Capstone Instructor: Dr. Carol A. Hoban
Abstract: The older adult population presents significant challenges to public health and dental professionals where good oral health is essential to maintaining overall health and general wellness. Access to oral care and oral hygiene in older adults residing in Georgia, the United States and world-wide is recognized as inadequate. The purpose of this study is to examine the oral health status of adults 65 years of age and older residing in assisted and independent (LTC) living facilities in Cobb County, Georgia, investigate factors that act as facilitators or barriers to access to oral health care, and analyze archival findings to outcomes from this research. Using a quasi-experimental and correlational design, an 8-item multiple choice questionnaire with a pre/post evaluation was administered to 89 older adults (75 women, 14 men). The survey data and archival data were analyzed as separate components. The findings indicated that there was not a significant relationship between visiting a dentist within the past 12 months and having dental insurance (χ2(1) = 0.28, p = .598). In addition, the results revealed oral health education significantly increased the likelihood of individuals to seek oral healthcare (Z = -4.20, p < .001). Oral health education appears a primary driver of perceived oral health need and significantly increases the likelihood of older adults in LTC facilities to seek oral health care. While no significant difference was noted between having dental insurance and visiting a dentist, this may be due to older adults in LTC facilities having a disproportionately greater need to visit a dentist and do so regardless of cost. Tackling obstacles to oral care in this older adult population will require a multi-interventional approach to increase oral health awareness, improve access to affordable services, and promote good oral care outcomes.

Kelly Bowman
Program: Public Health: Capstone-Thesis: Master of Public Health (MPH)
Awarded: August 2015
Capstone Instructor: Dr. Carol Hoban
Abstract: Since 1980, the prevalence of obesity in the United States has increased dramatically with the largest increases seen in children and adolescents. Although a number of school-based prevention programs have produced promising results, a consensus has yet to be reached as to which programs and/or program components are most effective. Purpose: To determine whether participation in a Nutrition Advisory Council Program lesson lead to increased knowledge of lesson-specific nutrition concepts Methods: Using a quasi-experimental design, a 9-item multiple choice pre/post-evaluation was administered to 255 elementary students in grades three through five who were participating in the Nutrition Advisory Council Program in one southern California school district. A paired samples t-test was conducted to determine whether total test scores increased significantly from pre to post and McNemar’s exact tests were conducted to determine whether there were significant percentage increases in the number of correct responses provided for each question. The significance level was set at p<0.05 for all analyses. Results: Significant increases in the percentage of correct responses from pre to post were identified on eight of the nine test questions, p<0.05. Conclusion: The Nutrition Advisory Council Program may be an effective component in school-based obesity interventions; however, further research is needed to determine the impact of the program on dietary intake behaviors and weight status of program participants.

Christopher L. Chandler
Program: Public Health: Capstone-Thesis: Master of Public Health (MPH)
Awarded: August 2015
Capstone Instructor: Dr. Carol Hoban
Abstract: The study shall review the critical issues that relate to the Human Immunodeficiency Virus in the South East Region of the United States. More precisely these regions incorporate the states of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia. More intently, the study shall scrutinize the aspects of access care and effective treatment plans, financial and housing assistance that is available and applicable, and prevention through awareness and education. Most importantly, the study shall scrutinize the existent programs and their effectiveness. The methodologies that will be applicable in the data collection process incorporate Literature review, focus groups, and observation. The HIV programs in the Southeast region of the United States operate in line with authoritative objectives, but they face challenges in eliminating and minimizing the HIV virus in the area. An all-inclusive framework is essential, and this will nurture new and robust HIV programs in Southeast region of the US while enhancing the existent initiatives of the current HIV programs in the region.

Cara L. Leitch
Program: Public Health: Capstone-Thesis: Master of Public Health (MPH)
Awarded: August 2015
Capstone Instructor: Dr. Carol Hoban
Abstract: The 2014 Ebola outbreaks demonstrated the need for better procedures in controlling the spread of infection among healthcare workers. Not only did other countries experience the inadequacies with infection control procedures, but even in the United States, procedures have been found to be insufficient for safely treating patients with highly infectious agents such as Ebola. As a result, biosafety professionals began reaching out to provide assistance to the healthcare community. The purpose of this study is to analyze infection control measures and biosafety practices to identify similarities and differences to make recommendations for future improvements for protecting healthcare workers. A grounded theory approach was employed as the research method, and data was collected through a survey from participants who practice infection control and biosafety. Data was analyzed through comparative analysis and inductive reasoning. Participants and relevant literature indicated areas in need of improvement for protecting healthcare workings from exposure and how the biosafety community can assist in mitigating the risks when working with patients who have highly infectious diseases. The study found that use of personal protective equipment and training, engineering improvements, and following protocols were the top three areas in need of improvement.

Terry M. Rauch
Program: Public Health: Capstone-Thesis: Master of Public Health (MPH)
Awarded: February 2015
Capstone Instructor: Dr. Samer Koutoubi
Abstract: The purpose of this study is to present an argument for the expansion of the Emergency Use Authorization beyond the current scope of threats that cover chemical, biological, radiological, or nuclear agents and to include instruments of war or terrorism (explosive devices or agents), or hazards which cause or threaten to cause massive physical trauma. A literature search using PubMed, the Defense Technical Information Center, and Google Scholar identified 26 articles from January 1982 to December 2014 that examined the effects of blast as an instrument of war on combat casualty care. An assessment was made of each article that included a medical product in either pre-clinical or clinical trial status, a medical product that the Food and Drug Administration approved for another indication other than a particular trauma indication, or a product approved by a foreign regulatory entity. The results show a major gap in the Emergency Use Authorization that requires expansion to allow the Food and Drug Administration to grant authorization for an unapproved medical product (or unapproved use of an approved product) that is the best available medical countermeasure for trauma care.