University of Utah Division of Public Health, Master of Public Health Program
Masters of Public Health Capstone
Master of public health students complete a culminating project to demonstrate mastery of selected competencies based on student interest and track. Capstone projects result in scholarly resources useful to public health practice such as health status reports, secondary data analyses, health information, education, or communication (IEC) products, policy briefs/analyses, program/intervention design, program evaluation, community health assessments, grant proposals, literature reviews, white papers, quality improvement strategies, health system strengthening proposals, and more.
2024
Lilah Brophy
Bridging the Gap for Individuals 65+ in Utilizing Telehealth and Virtual Care
As the global population ages, there is an increasing need to address the challenges faced by individuals aged 65 and above in adopting and utilizing telehealth and virtual care services. This white paper outlines a comprehensive approach to bridge the gap for older adults in accessing modern healthcare technologies. Drawing on principles from Behavior Change Theory, Diffusion of Innovation, and social marketing techniques, the proposed strategies aim to enhance the adoption and effective utilization of virtual care among this demographic. The aging population necessitates a focus on facilitating access to modern healthcare technologies for individuals aged 65 and above. This white paper explores best practices, recommendations, and strategies to encourage increased usage of virtual care, considering the unique challenges faced by older adults.
Kamryn L. Broschinsky
Bridging Health Divides and Promoting Equity: The Power of Inclusive Communication in Healthcare
In the evolving landscape of healthcare, effective patient-provider communication is pivotal for positive health outcomes. This white paper examines the role of inclusive communication in enhancing healthcare delivery and promoting health equity. Inclusive communication encompasses linguistic competence, cultural sensitivity, and the strategic use of technology to cater to diverse patient backgrounds. Studies, such as Hsueh et al. (2019), demonstrate the benefits of language-concordant care, showing significant improvements in patient satisfaction and healthcare outcomes. Moreover, Bhatt & Bathija (2018) emphasize that inclusive strategies are crucial for engaging underserved and vulnerable populations, ensuring equitable healthcare access. This paper outlines the principles of inclusive communication, discusses technological advancements aiding communication, and presents actionable strategies for healthcare organizations. By adopting these inclusive practices, healthcare providers can improve patient engagement, enhance outcomes, and reduce disparities, solidifying inclusive communication as a cornerstone of effective healthcare.
Grace Broussard
Barriers and Facilitators to the Implementation of an Opioid and Alcohol Co-use Medication Management Intervention
A significant risk for overdose among patients prescribed opioid medications is co-use of alcohol. The barriers and facilitators that promote or impede the adoption of universal alcohol screening and intervention at point of opioid medication dispensing are unknown. Community pharmacies are underutilized as a resource to prevent and address co-use. This capstone project involved drafting a manuscript as part of an ongoing study with faculty supervision. In this mixed methods study, pharmacy staff perceptions towards the implementation of a pharmacy-based screening/intervention for the co-use of opioids and alcohol was conducted using key informant interviews and a structured survey to inform pharmacy system/practice-level barriers and facilitators for universal screening. Participants were recruited from Utah and Tennessee who had an interest and opinion on a co-use intervention for alcohol and opioids within community pharmacies. The interviews used the Consolidated Framework for Implementation Research (CFIR) and the Organizational Readiness for Implementing Change (ORIC) assessment. While community pharmacies are strongly motivated to provide this service, proper development and implementation will be paramount to the success of the intervention, its impact, and long-term sustainability. Full results will be published in a forthcoming peer-reviewed journal.
Marissa Burton Ho
Refugee Mental Health Educational: A Framework for a Mental Wellness Curriculum – Sample Example Lesson Plan, course materials, and Infographic
This Capstone project aimed to build a mental health education curriculum with a lesson plan and mental health awareness infographic. The curriculum is designed for Utah’s refugee populations and targeted to stakeholders who would implement the curriculum. The infographic is targeted to Utah’s healthcare professionals that may be providing mental health services to patients that have experienced trauma. The project included gathering background information on the needs for mental health education in Utah Refugee populations, identifying major stakeholders, and reviewing what programs/materials already existed. The project involved applying awareness of cultural competency practices to build the resources and communicating through the audience appropriate tools. Overall, this project addresses a need for mental health educational resources that are culturally relevant and accessible to Utah’s Refugee populations.
Lindsay Butrum
Increasing Practical Evaluation Skills in Public Health Graduate Students
The 10 Essential Public Health Services include improving functions through evaluation and building a skilled public health workforce. These services unite in the training of students in program planning and evaluation to engage in quality improvement. Restricted academic timeframes and resource burdens of the evaluation process limit opportunities for practical evaluation experience. Evaluability assessment (EA) is a component of the evaluation process that determines a program’s readiness for evaluation. EA can offer practical skills in program evaluation with fewer resource demands than full-scale evaluation. A lesson plan was developed and implemented with public health graduate students in a program planning and evaluation course. Students had prior education in evaluation principles, but most had no previous assessment experience. After learning about the EA process, student groups applied an existing tool to assess program materials for evaluation readiness. After the EA activity, students improved their knowledge of evaluation principles. They reported increased confidence in their ability to conduct a program evaluation, and many commented on the tool's usefulness in better understanding the evaluation process. The findings suggest that incorporating EA training into public health curricula can contribute to building a proficient workforce and improving public health interventions. This is achievable without imposing significant resource burdens on faculty or students.
Laura Byl
Utah's Struggle with Compliance: The Prison Rape Elimination Act (PREA)
The Prison Rape Elimination Act (PREA) was enacted in 2003 to combat sexual violence in correctional facilities by establishing a zero-tolerance policy along with comprehensive standards for prevention, reporting, and response. Despite federal mandates, Utah has been slow to adopt PREA standards, leaving incarcerated individuals vulnerable to ongoing risks of sexual abuse. This policy brief examines Utah's resistance to PREA implementation, highlighting the gaps in policies, procedures, and inmate education. Through a thorough analysis of Utah's correctional system, it becomes evident that transparency and accountability are lacking, further solidifying a culture of silence. Despite recent legislative efforts, Utah continues to struggle with PREA compliance, leading to ongoing risks for incarcerated individuals. Recommendations include enhancing staff training, strengthening investigative protocols, increasing oversight, implementing prevention programs, and improving victim support services. By leveraging facilitators such as advocacy organizations and community stakeholders, Utah can overcome these Barriers to PREA compliance, ensuring transparency, survivor support, and accountability. The full implementation of PREA in Utah is crucial for transparency, survivor support, accountability, and, ultimately, the protection of fundamental human rights within the state's correctional system.
Yunah Cho
Trends in Korean Medical Device Development For ADHD and ASD: Scoping Review
This capstone comprised of a scoping literature which was submitted for a peer reviewed publication. Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are some of the most prevalent mental disorders among school-aged youth in Korea and as such, may play a role in the increasing pressures on teachers and school-based special education programming. New innovations in technology to screen and treat ADHD and ASD may offer some relief to students, parents, and teachers through earlier and efficient diagnosis, access to treatment options, and ultimately, better-managed care and expectations. This scoping review provides a review of medical device use and development in Korea for the diagnosis and management of ADHD and ASD and highlights research gaps. This review used the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist as a methodology. The trends in Korean medical device development were categorized into 2 major groups: “digital therapeutics” and “traditional therapy.” Digital therapeutics have 5 subgroups: “virtual reality (VR) & artificial intelligence (AI),” “machine-learning & robot,” “gaming & visual contents,” “eye-feedback & movement intervention,” and “EEG & neurofeedback.” Traditional therapy has 3 subgroups: “cognitive behavioral therapy & working memory,” “diagnosis & rating scale,” and “musical, literary therapy & MBSR.” Future development of medical devices for ADHD and ASD is predicted to heavily rely on digital technologies, such as those that sense people’s behaviors, eye movement, and brainwaves.
Rebekah Clark
Supporting Women in Remote and In-Person Work: Lessons from the Pandemic
The COVID-19 pandemic and shifts to remote work have changed the work experience for many university staff. We conducted interviews with university leadership and focus groups with staff at three Utah universities to explore differences for women working remotely versus in-person. Our objective was to determine the unique ways these changes impact women staff and how employers can support their staff going forward. We identified benefits of remote work for women, including improved work-life balance, decreased workplace sexism, and increased support for physical and mental health. We also identified cautions in regard to work-life balance, caregiving burdens, and the increased strain and resentment from staff who must work on campus toward those who were able to work remotely. Informed by the benefits and cautions we found, we suggest practices that provide support for women staff working in both remote and onsite settings. Through utilizing staff choice, creative problem-solving, and collaboration, employers can improve the work experience for their women staff based on lessons learned during the pandemic.
Nicole Codd
Utah Title V Block Grant Summary Progress Report 2020-2024: Women’s Health Domain
As a part of the MCH Title V Block Grant, Utah Department of Health and Human Services (UDHHS) conducts a Utah State MCH Community Health Needs Assessment (CHNA) every five years. To assist UDHHS with the preparation for the upcoming CHNA, this white paper serves as a background report on the progress towards Utah’s Strategic Plan. The Title V Block Grant has 5 domain areas – Women, Infant, Children, Adolescents, and Children with Special Healthcare Needs. This white paper focuses on the “Women” domain. This report includes an analysis of seven recent needs assessment reports with a women’s health lens, women’s health status trends from the past five year queried in IBIS, and an in-depth analysis of two high priority areas; 1) women’s mental health and 2) healthcare access. The white paper concludes with a discussion of how Utah’s strategic maternal health priorities relate to progress to date.
CC Cook
Preventing Prolonged Grief Disorder Among Bereaved Parents Through Art
Bereaved parents may be three to five times more likely to experience prolonged grief disorder after losing a child than those who have experienced different losses. Prolonged grief disorder occurs when a bereaved individual is unable to regain normative functioning after a period of time that is considered typical for grieving, and it is associated with increased risk of multiple poor health outcomes. This pilot program will aim to prevent prolonged grief disorder among bereaved parents through art and the meaning-making process of grief therapy. Parents who participate in this program will attend a grief workshop where they will learn about grief and create a collage honoring their child. They will then send their collage to a professional artist who will create a professional portrait based on the elements of the collage. This program is an example of how healthcare can be individualized and how health and art spaces can coincide.
Katie Davis
Social determinants of homelessness in Alaska, a public policy review
Homelessness in Alaska has been on a consistent rise over the last several years. Social determinants of health are non-medical factors that impact health, and include where people are born, where they live, their age, race, and other important factors. This report analyzes social determinants of homelessness in Alaska which include race, geography, rental costs, and wages. Geography impacts access to supportive services and infrastructure available to support housing development and resources. Race impacts homelessness due to the overrepresentation of Alaska Natives amongst the homeless population in Alaska and the ethnic discrimination they face in predominantly white urban areas. Rental costs and wages impact state residents’ ability to obtain affordable housing. In analysis of these determinants, recommendations were drafted to address each of these issues. These included increasing minimum wage, restructuring zoning to create more population dense housing, supporting private/public partnership to reduce building costs, and addressing stigma amongst policymakers and the public to encourage support of community solutions.
Alyssa de St. Jeor
Civic Engagement and Refugee Integration: A Comprehensive Systematic Review
This project aimed to complete a systematic literature review of current research on the role of civic engagement in refugee integration in the United States. The objective was to address what has been documented about civic engagement in the literature up to this point. The definition and documentation of civic engagement were systematically identified using The Home Office Indicators of Integration Framework 2019. Through the review process, it was found that only six articles met the inclusion criteria. These articles offer valuable insights into the current research about civic participation. The findings suggest civic engagement involves developing social relationships with individuals, communities, and institutions. These connections can facilitate successful interventions and be a key component in adapting to life in the United States. Moving forward, further research is needed to explore the dynamics of civic engagement further and deepen the understanding of the integration process.
Emma Erwin
Concurrent Disaster Preparedness and Response: A Communication Strategy for the National Environmental Health Association (NEHA) Concurrent Disasters Online Readiness Simulator
When disaster strikes, local health departments must be prepared to coordinate, cooperate, and collaborate with their internal programs and external partners, regardless of the type, scale, or severity of the event. The goal of the NEHA Online Readiness Simulator is to help local health departments and their community partners prepare for and respond to concurrent public health and environmental health disasters. The purpose of this project was to develop a theory-based communication strategy for the simulator and its associated campaign materials. The strategy was based on the Action Model (Shannon-Weaver Model of Communication (1963)) adapted specifically for healthcare marketing and utilized both digital and print materials.
Patrick Fowler
Dietary Management of Crohn’s and Ulcerative Colitis through Evidence-Based Cookbook
Crohn’s disease (CD) and Ulcerative Colitis (UC) are chronic inflammatory bowel diseases that affect the gastrointestinal tract. Genetics can play a part in developing CD and UC as well as environmental and behavioral factors including diet. The average diet today contains many processed foods with high fat and additives which can be toxic to the microbiota health of the gut and could lead to the development and progression of IBD. In the United States IBD is estimated to affect one third percent of U.S. adults (approximately 3 million) with about 70,000 new cases per year. Presently medical literature reviewed is communicating that diet is being realized as an important tool in therapy in providing support in the remission and flareups of UC and CD. This project aimed to analyze how diets can support UC and CD symptom management and provide recipes based on the analysis. A review of the literature using PubMed and key terms “anti-inflammatory diets”, “Crohn’s Disease”, “Ulcerative Colitis”, and “anti-inflammatory foods.” An anti-inflammatory cookbook was developed using anti-inflammatory ingredients found in the literature review. Individuals with UC and CD and a physician assistant with a specialty in gastroenterology provided input and feedback on dietary approaches. A cookbook with recipes that includes anti-inflammatory ingredients followed.
Anna Gallegos and Jack Veverka
Transforming Primary Care in Utah: Adapting Existing CMS Innovation Models to Address Population Health Challenges
Utah's current healthcare infrastructure is unable to meet the needs of its expanding population, leading to ongoing health disparities. Among the most concerning wellbeing trends in Utah are frequent mental distress, racial disparity with premature death, and access to primary care providers. We report here on potentially adaptable innovative care models under development by the Centers for Medicare and Medicaid Services (CMS) Innovation Center, designed to enhance quality of care, foster health equity, improve population health, and curb the rising cost of healthcare. We selected six models and performed qualitative analysis of their purpose, interventions, and implementation strategies to determine which may be adapted to address Utah’s population health challenges. We recommend 1) developing infrastructure to support population-based payments through the Making Care Primary model, 2) implementing aspects of the Primary Care First model to improve care for Utah’s most vulnerable patients, and 3) applying to participate in the Innovation in Behavioral Health model to harness primary care and mental health integration. Policymakers can implement existing innovations developed by CMS to help transform a system which is currently inadequate into one which is integrated, coordinated, equitable, and suited to Utah’s individualized needs.
Victoria Gonce
Community Representation in Public Leadership Opportunities within Salt Lake County: A Descriptive Analysis of Salt Lake County’s Boards and Commissions
This study explores the demographic composition and representation patterns of the Salt Lake County Boards and Commissions compared to the adult population across the six-county council districts. Analysis of age, race/ethnicity, and gender demographics highlighted potential disparities in community representation, particularly among younger age groups and certain racial/ethnic identities. The findings emphasize a need for targeted strategies to promote diversity and equity within advisory bodies to ensure inclusive governance and representation of all community voices. Furthermore, the analysis serves as a critical step towards addressing systemic imbalances and fostering greater inclusivity in Salt Lake County’s leadership opportunities.
Samuel Hernandez Salazar
Assessment of water quality for total coliforms and E. coli in point source drinking water in Spiti Valley through a field-testing protocol
This study aims to develop a field-testing protocol to assess total coliforms (TC) and Escherichia coli in point-source drinking water in rural communities located in Spiti Valley, India, located at 14,009 feet in the Himalayas. The area is characterized by mountainous terrain with a heavy reliance on agriculture, which the Spiti River and its tributaries sustain. Recent challenges include reduced glacier melt influenced by climate change, significantly impacting approximately 12,500 residents. Though often commensal, enteric bacteria, such as E. coli, can consist of pathogenic serotypes and frequently include antibiotic resistance that poses severe health risks, like enterohemorrhagic symptoms and potentially fatal conditions like hemolytic-uremic syndrome in vulnerable populations. The project also addresses the broader issue of antimicrobial resistance (AMR), exacerbated by India's unregulated use of antibiotics—contributing significantly to global health challenges. Providing a reliable protocol for water quality assessment aims to improve water safety and mitigate risks associated with bacterial pathogens and the spread of AMR within community settings.
Hannah Hurley
Advocacy for Mental Health Access: Interstate Social Work Licensure Compact
This paper advocates for the adoption of H.B.44: Social Work Licensure Compact to ameliorate the mental health disparities of rural areas. Recent data reveals that 7.7 million adults in rural communities grapple with mental illness, compounded by factors like geographic isolation, workforce shortages, and cultural stigma. The COVID-19 pandemic has worsened these issues, prompting a surge in telehealth usage as a vital solution. The proposed compact seeks to facilitate the movement of mental health professionals across state lines, reducing regulatory hurdles and enhancing access to care. By bolstering the availability of behavioral health providers and maintaining states' regulatory control, the compact holds promise for mitigating mental health gaps in rural regions. Implementation could lead to tangible improvements in well-being for millions in need.
Ronak Iqbal
An Interdisciplinary Educational Training Program in Early Detection and Management of Melanoma in Utah Veterans
Veterans have an increased melanoma risk and are more likely to be diagnosed at later stages than non-veterans. Timely detection is crucial because undetected melanoma can be fatal, and prompt early disease intervention is more effective and less expensive. We developed a weeklong educational program to improve the early detection of melanoma in US veterans, which appears feasible for faculty and has resulted in expanded clinical services to veterans. The program was well-received by learners, and we plan to offer it quarterly to health professional education (HPE) trainees from a broad range of disciplines e.g. internal medicine residents, nurse practitioners, and physician assistants. The Primary Care Derm clinic in the VA is being developed as a sustained weekly experience incorporating HPE trainees. Long-term plans include analysis of patient-level data for program impact on rates of early- and late-stage melanoma diagnoses in veterans.
Oti Langi
Curriculum for Healthcare Workers: Using Storytelling and Creative Writing for Healing from Trauma
In a medically underserved area, one of the many challenges for patients is receiving mental health services. Currently in the US, getting in to see a mental health provider can take weeks (if not months). Thus, creating a gap in care. This is where Mental Health First Aid (MHFA) and Creative Writing Kits (CWK) can be a helpful tool in bridging care. MHFA is a validated method of giving care to someone who is experiencing distressing feelings as a way to assess, refer, and give support. In this project provides a Creative Writing Kit based on the MFHA method. CWK comprises of a journal filled with writing prompts, a pen/pencil, a stress ball, and touchstone. CWK hopes to help patients engage in healthy coping skills as they wait for care. With the rising need for mental health services, low cost yet effective solutions like MHFA and CWK aim to improve outcomes.
Tayler Lundell
Increasing Awareness for Skin Cancer Screening and Management: The Integration of Dermatology into Primary Care
The purpose of this capstone is to raise awareness on the importance of skin cancer screening and an early diagnosis to promote positive patient health outcomes. Background research on the global burden of skin cancer and the pathway for attaining dermatological care in various countries was conducted to gain an understanding on the current country-specific dermatology systems. The countries with the highest incidence rates of skin cancer, Australia and New Zealand, currently integrate dermatology into their primary care physician (PCP) training and visitations. Australia and New Zealand’s approach to dermatology has alleviated many of the challenges associated with their high incidence rates of skin cancer and increasing shortages of specialized dermatologists. The United States deals with similar challenges in relation to dermatology, therefore, this paper proposes that these countries could serve as a model to the United States to improve dermatological access and patient outcomes. This paper is targeted to PCPs as they would benefit from more thorough dermatology-related training in medical school and upon completion of medical school. Patients would also benefit from the integration of dermatology into primary care, as the cost and lengthy referral times for a dermatology appointment would be greatly reduced. This research will also be conveyed to PCPs through the means of a podcast.
Heather Morgan
Understanding the Current Health Needs of Utah Youth
Every five years Utah state conducts a statewide Maternal and Child Health (MCH) needs assessment. As part of this assessment the priority health concerns are identified for the adolescent population and an action plan is created to address these concerns. Using data from the 2020 MCH needs assessment, local community health needs assessments (CHNA), and specific indicators, the current health trends and priority needs of Utah adolescents can be identified. Mental health, substance abuse, and obesity were the most common adolescent health concerns mentioned in recent needs assessments. Mental health indicators show that poor mental health and suicide risk has increased among Utah adolescents. Substance use has improved overall; however use of electronic vapor products has increased. The LGBTQ+ and Hispanic populations are at a higher risk of substance use when compared to heterosexual or White/non-Hispanic populations. LGBTQ+ youth are also at greater risk of mental health concerns. Mental health efforts should remain a priority, and substance abuse efforts should focus on reducing the use of electronic vapor products. Additional attention should be given to the LGBTQ+ and Hispanic populations in both data collection and program creation. Focusing efforts on understanding and addressing the higher risk facing these groups is an important part of reducing health concerns among Utah adolescents.
Kari Pedersen
Improving Worker Health and Safety by Utilizing Total Worker Health Competencies
Many workplaces shifted procedures and management methods to adapt to the COVID-19 pandemic. This qualitative research study and manuscript used thematic analysis of focus group transcripts to investigate how these shifts aligned with the NIOSH Total Worker Health ® (TWH) competencies, determined how they impacted staff, and outlined best practices for workplaces to improve work conditions and employee health and safety. Utilizing the six TWH competencies and the positive practices identified when implementing workplace policies, changes, and leadership techniques can improve overall worker health, well-being, and safety, thereby enhancing employee engagement and workplace satisfaction.
Leslie Salamanca
Act Today, Protect Your Heart Tomorrow: A Health Communication Guide for Heart Disease Prevention among Latina Women in Salt Lake County
Research has concluded that heart disease is more prevalent in diverse communities comprised of people of color. Among Latina women, heart disease is the second leading cause of death, just behind cancer, and Latina women are more likely to develop heart disease ten years earlier than their non-Latina counterparts. Latinas face various challenges that make them vulnerable to developing heart disease comorbidities, such as higher rates of diabetes, obesity, and hypertension. Only 1 in 3 Latina women are aware of the threat that heart disease poses to women in the United States, compared to 1 in 2 for all women in the United States. This capstone project aims to design a culturally appropriate health communication guide and develop a campaign strategy to educate Latina women in Salt Lake County about heart disease risk and prevention. Objectives include: 1) develop a heart disease education guide with the goals of increasing health literacy about heart disease, raising knowledge about heart disease risk and action items, and promoting heart-healthy lifestyles; and 2) Disseminate the materials developed for the campaign strategy plan during Heart Disease Prevention Month in February via community-based organization partnerships and social media marketing.
Cameron Smelcer
Increasing Trends in Syphilis Rates and Considerations for Sexual Health Education in Utah
Syphilis continues to be an issue throughout Utah. Syphilis is a sexually transmitted infection (STI) that is highly contagious and presents itself in multiple stages. Besides primary and secondary syphilis, congenital syphilis is also a concern. Syphilis rates have been on the rise throughout Utah over the past few years. In 2022, Utah experienced a spike in rates for females and males in certain age categories. As rates go up, policy regarding Utah’s sexual health education courses is a point of concern. Utah has an abstinence-based policy regarding sexual health education courses for middle and high school students. Abstinence is highly stressed over all other preventative measures when discussing STI, HIV, and pregnancy prevention. Surveys to young college students in Utah has provided insight on how effective these courses are. As syphilis rates continue to rise, Utah sexual health education courses can help increase the knowledge for people throughout Utah to reduce incidences of syphilis.
Lauren Studiner
Cervical Cancer and HPV Primary Screening: Literature review and a call for the US to join the global shift
The World Health Organization states, “No woman should die from cervical cancer. We have the technical, medical, and policy tools and approaches to eliminate it. The burden of cervical cancer falls on the women who lack access to health services, mainly in low-and middle-income countries” (WHO, 2024). In many countries, HPV testing is the new standard in place of pap smears. This opens up the opportunity to test earlier for the HPV virus itself instead of waiting for cellular precancerous changes to the cervix. HPV testing also provides the opportunity for home testing. The rollout of home screening self-collection kits has brought new access for patients to this screening and for rural healthcare workers to facilitate pap smears without bringing individuals into a clinic. This approach has the potential to not only increase the reach of screening but also be seen as empowering for women and reduce a portion of the fear and discomfort associated with these screenings. This review focused on strategies to meet these targets and tackle barriers to screening access, particularly among rural populations in areas struggling to reach goals of cervical cancer prevention/early detection. The review describes successful global health programs that address barriers to cervical cancer screening, particularly the use of self-collection kits for HPV testing and implementation strategies. Additionally, this presentation examines knowledge, attitudes, and beliefs surrounding cervical cancer and utilizes this information to create educational materials to increase knowledge around cervical cancer prevention and early screenings.
David Suisse
Housing Impact on Refugee Health and Integration: Distributed Resettlement versus ethnic Enclaves: A Scoping Review
This paper considered the health implications of refugee resettlement techniques, specifically the creation of ethnic enclaves, or concentrated grouping of refugees from a single location or ethnicity, and distributed resettlement—when refugees are spread evenly across a community, generally rural, in an attempt to facilitate integration. Reasons for support or disdain were determined for either approach and analyzed through the lens of Ager & Strang’s 2004 Indicators of Integration (more recently updated in 2019 by the UK Home Office to include 14 indicators rather than 10). Ethnic enclaves were found to form either through explicit resettlement design or through secondary migration of individuals congregating near family and friends. Enclaves were found to be associated with increased crowdedness, concentration of poverty, and accompanying negative health outcomes. Distributed resettlement reduces crowdedness and improves English language acquisition, but may not be an effective approach if individuals are cut off from co-ethnic support. Social bonds within an ethnic group and social bridges between groups are both important, and a lack of either may result in negative health outcomes. Community partnerships may aid in nurturing social bonds while avoiding the negative health outcomes associated with ethnic enclaves.
Maria von Ellm-McKenna
Community Health Needs Assessment of Children with Mental and Behavioral Health Conditions in Salt Lake County, Utah
Salt Lake County, Utah, with its diverse population exceeding 1.2 million, faces significant disparities in accessing mental and behavioral health services. The primary objective of this initiative is to examine existing data to better understand and contextualize mental and behavioral health issues faced by children in Salt Lake County. The methodology involved a thorough examination of existing data, including reports from the Utah Behavioral Health Assessment & Master Plan. National comparisons underscore the urgency of this issue, with data from the Annie E. Casey Foundation and the Centers for Disease Control, emphasizing the prevalence and impact of childhood mental and behavioral health disorders. This community health needs assessment focuses on children aged 3 to 17 residing in Salt Lake County, Utah, and acknowledges their unique mental and behavioral health challenges. Results revealed that substantial barriers hinder effective delivery of mental and behavioral health services to children. Key challenges include limited access to care, inadequate training and resources for primary care providers, and workforce capacity issues. Utah ranks 18th out of the nation for its Health domain, emphasizing the need for change. Recommendations include enhancing training for primary care providers, broadening their scope of practice, and promoting integrated care delivery models. Through collaborative efforts and innovative approaches, this assessment sought to create a more resilient and responsive healthcare system capable of meeting the diverse needs of the pediatric population.
Valerie Wendell
Safe Gun Storage in Utah
In Utah, 49% of registered voters own a gun. Because firearms are so easily accessible, 84% of suicides in 2019 were performed by a gun and half of all suicides were done by a firearm. To combat this harrowing statistic and those that are similar throughout the U.S., eight states have set up an easily accessible safe storage gun map online showing gun owners the options they have to store their firearms offsite if they or a loved one at home feel unsafe with a gun in the house. Utah still has some hesitations about a gun map advertising gun storage away from the home. Instead, legislation is trying to push for a requirement to have safe gun storage inside the home. There were a couple bills that were brought to the house and the senate in the past couple years that haven’t been passed yet. As I did my research on safe gun storage here in Utah, I have learned that until safe gun storage becomes a requirement, and we hold firearm owners more responsible for the carrying of such a lethal weapon, it is important that we educate as many as possible about the risks associated with owning a gun and the importance of storing them safely and securely.
Alena Wilson
Student Perspectives of Global Health Learning Abroad Programs
Historically, global health service trips were introduced as emotionally based neocolonial “missions” with participants from higher resourced countries who had uprooted themselves to “help” or “serve” individuals they perceived as less fortunate. This capstone project examined ethics and concepts of neo-colonialism with regard to global health learning abroad programs. University of Utah students who participated in Global Health Learning abroad were interviewed to document their experiences and perspectives. The purpose of the project was to explore ethical concerns and best practices that should be considered when assessing the value of short term experiential global health (STEGH) programs.
D. Ginger Zamora
Selfies and Scrolling: Using Branding and Social Media as Public Health Tools
Public health messaging is a critical way to engage and educate communities. After the COVID‐19 pandemic, trust is continuing to be re‐established between public health and the general public. The goal of health communications is to illuminate the success of public health and how the public can collectively contribute to healthier communities. Social media presents the potential for immense distribution of verified health education. While the threat of misinformation is expected, it can be countered with prepared participation from experts and authorities. Late adopters of social media may feel hesitant to enter a new platform. My capstone project focused on increasing self‐efficacy in public health professionals to use social media and branding in their organizations. My capstone resulted in creating an infographic for public health communication tips on best utilizing their organization’s social media and training at the Utah Public Health Association Conference on branding and social media as public health tools.
2023
Nikita Abraham
Art and Communications in Public Health: A Review of Historical and Theoretical Perspectives, Public Health Implications, and Practical Tips for Public Health Workers
Visual communication is an important aspect of public health communication that is often overlooked. This review outlines how art and visual communication relate to public and community health. This review focuses on static visual communications; and culminates in practical recommendations for public health workers to better communicate information with others in health and the general public. An original art piece was designed. For this art piece, the artist created a draft mural for a hospital or community clinic featuring flora and fauna native to Utah. The intention of this piece was to create something that patients and their families could look at and feel a little bit of reprieve and comfort during what can be a stressful experience.
Layne Adams
Overcoming Cultural and Linguistic Barriers: Improving Completion of Preventive Care Referrals for Limited English Proficient Patients
Preventive care, such as cancer screenings, diabetes prevention, depression screening, etc., is essential to maintain good health and prevent chronic diseases. However, limited English proficient (LEP), minority, and underserved populations often face barriers to completing referrals for preventive care. These include language and cultural barriers, lack of access to healthcare services, and mistrust in healthcare systems and providers. This literature review explores the strategies to improve the completion of referrals for preventive care for these populations. The focus will be on culturally and linguistically appropriate interventions and programs.
Kayli Brown
Gender Diverse Public Health Leadership: Voices from the Workforce, Current Practices, and What to do Next
Leaders possess the ability and influence to make decisions that affect society, communities, organizations, and individuals. By evaluating how organizations within public health approach gender equity and their health promotion outcomes a new understanding of how programs function within the gender construct can be realized. This paper will use current research to determine the impact of gender parity on global health organizations and programs. Accomplishing this will be possible through analysis of gender equity using the Global 50/50 index framework and a series of interviews with female-identifying leaders of diverse backgrounds in global public health. Vital to this project are the actionable items discussed by interviewees and academic research that have the potential to lead to change. Organizations have a responsibility to seek new ideas in hopes of improving equity. There are models within the workforce that give insight into innovative ways that equity can be at the forefront of global health change. Combining all aspects of this project produced the conclusion that gender equity in leadership and organizations has a positive impact on global health and overall well-being
Ariana Callahan
Introduction to Data Literacy: A Workshop for Community Health Workers and Public Health Professionals
Data literacy is defined as the ability to collect, manage, evaluate, and apply data in a critical manner. This includes competencies in statistics, data visualization, and problem-solving. Social sector organizations such as public health are increasingly using “Big Data” and Big Data analysis is being seen as an essential skill in government, humanitarian, and social change contexts. When using data in a public health context, it is important to pay attention to outliers and minorities who are often missed in aggregate analysis. Data literacy includes the ability to read, work with, analyze, and argue with data. While many public health professionals are not data analysts, it is important for them to have the knowledge and skills to understand and work with data in their field. This project resulted in the development and delivery of 1.5 hour introductory data literacy class for public health and community health workers. Materials include instructional slides, an exercise to interpret SDOH-related articles, and a lesson plan.
Madelyn F. Carter
Rural for Rural: A Rural Health Equity Podcast
Living and working in a rural area has many positive attributes. Rural communities are often close-knit, housing can be more affordable compared to urban areas, and there are other benefits. However, rural America is plagued with significant health disparities. These health disparities are characterized by differences in health status, such as higher incidence of disease and/or disability, higher mortality rates, lower life expectancies, and higher rates of chronic pain when compared to the overall population. Lower socioeconomic status, geographic isolation, limited access to healthcare and health education, limited job and educational opportunities, and a lack of employer-provided health insurance. To address this issue, the Rural for Rural podcast was created. This 5-part podcast series is focused on promoting health equity in rural areas by informing and linking people to health resources. Each podcast features an interview with a health professional who has resources for rural community members. Topics include women's health, mental health, STEM in K-12 education, telehealth, and recruitment of rural physicians. Rural for Rural is an important public health project that aims to address the health disparities in rural populations. Providing longitudinal programming to every rural area in Utah is challenging due to the remote nature of many of these communities. However, podcasting offers a solution to the geographic barriers that exist in Utah, making it an effective tool to promote health equity in rural areas
Claudia Charles
Evaluation of Cancer Screening at the Urban Indian Center in Salt Lake City
Preventative cancer screenings have been historically lower for American Indians and Alaska Natives (AI/AN) versus the general population. AI/AN often lack the resources and tools for routine preventive care. 44% of AI/AN versus 63% of the general population of Utah have received mammograms in the past two years. 60% of AI/AN versus 76% of the general population of Utah have completed a recommended colon cancer screening. These numbers indicate fewer AI/AN individuals who do not receive preventative cancer screenings are at higher risk of a later cancer diagnosis stage. The Urban Indian Center – Salt Lake (UICSL) is the leading healthcare facility for AI/AN in the urban area of the Wasatch front. The UICSL offers cancer screenings for the urban Indian community, including breast examinations, fecal immunochemical tests (FIT), pap exams, and HPV vaccinations for adolescents. The UICSL have provided input through a SWOT analysis of their cancer screening program's strengths, weaknesses, opportunities, and threats. This analysis will evaluate the Urban Indian Health Programs (UIHP) methods and interventions on how the program increases the rates of cancer screenings to detect cancers at earlier stages and reduce the cost of treatment that impact the AI/AN community.
Stephanie Cheng
Digital Media Literacy for Middle School-Aged Children
Digital media literacy is lacking in the United States, especially for children. Internet use has made information available at rates never seen in history and children in particular are accessing technology and online programs at younger ages and with less adult supervision. Misinformation and disinformation are rampant online and the techniques used to mislead online are getting more sophisticated. The goal of this capstone project was to research the current literature regarding techniques to combat misinformation, research and create online resources for middle school-aged children and make a website that allows these resources to be utilized. The site is meant to be entertaining and educational, teaching children to spot information that is false, misleading or inflammatory online. The site includes images, videos, games and different modules to click on and explore, as well as a glossary. A proposal was also crafted to send to school districts, pediatricians’ offices and other interested stakeholders in order to provide the website link so children and/or parents may access the website directly.
Mary Katherine Curcio Stoddard
Policy Analysis of Utah Support and Diagnosis Services for Autistic Young Adults
Young adults, ages 18 to 25, are in a period of extreme transition as they navigate new responsibilities, career and educational systems, friendships and relationships, and familial structures. For autistic individuals, this can be especially stressing as lower education-based treatment and long-term support services dependent on age or grade level are lost. Many young adults also explore the diagnosis process as their self-identified and implemented coping techniques become vulnerable, their traits are exemplified from stress, and individuals require more formal services. It is imperative to analyze existing policy to improve support for this population, especially as most current autism educational materials use child-focused language that is aimed towards caregivers and data collection is centered around elementary-aged children. This project utilized a socio-ecological approach, analyzing current access and barrier systems in Utah at the personal, organizational, environmental, and policy levels. Key findings showed that there are disparities present in language use, accessibility services, insurance coverage and therapy service acceptance, and research focus for this population. It is evident that national and state policy influences the support and acceptance of autistic young adults from a top-down perspective. Research often neglects adult, or “late”, diagnosed autistic individuals, which skews the data and improperly influences comprehensive policy and funding. As the body of research for autistic adults grows, it is important that the state is prepared to support, both in culture and policy, the ever-changing experience of autism throughout their lives. It is also necessary that systems are in place to support autistic adults, regardless of diagnosis status, as it is a dynamic experience for every individual.
Stephanie Cheng
Digital Media Literacy for Middle School-Aged Children
Digital media literacy is lacking in the United States, especially for children. Internet use has made information available at rates never seen in history and children in particular are accessing technology and online programs at younger ages and with less adult supervision. Misinformation and disinformation are rampant online and the techniques used to mislead online are getting more sophisticated. The goal of this capstone project was to research the current literature regarding techniques to combat misinformation, research and create online resources for middle school-aged children and make a website that allows these resources to be utilized. The site is meant to be entertaining and educational, teaching children to spot information that is false, misleading or inflammatory online. The site includes images, videos, games and different modules to click on and explore, as well as a glossary. A proposal was also crafted to send to school districts, pediatricians’ offices and other interested stakeholders in order to provide the website link so children and/or parents may access the website directly.
Dylan Freston
Opioid Use Disorder (OUD) in rural areas: Telemedicine options and an introductory training for providers in rural Utah
The incidence of Opioid Use Disorder (OUD) has increased significantly in recent years, particularly in rural areas, where access to healthcare services may be limited. The standard of care for OUD is Medication Assisted Treatment (MAT), which utilizes one of several opioid analogs along with the use of behavioral therapies. However, less than 50% of counties in the US have a provider that can prescribe buprenorphine, one of the key medications used in MAT, and many rural patients have limited access to healthcare services. Telemedicine offers several benefits for the treatment of OUD in rural populations, including increased access to care, reduced need for travel, potential reduction in stigma, and improved access to overdose prevention training. However, the use of telemedicine in rural areas is also is met with several limitations, including access to a reliable internet connection and patients preferring an in-person visit. This synthesis concludes that telemedicine is an immensely useful tool for treating OUD, and more work needs to be done to improve awareness of telemedicine programs and increase social support for their uptake. This project includes a literature review of OUD in rural areas, intervention options, and an introductory training module for rural providers.
Elena Gardner
Developing a new model for predicting and assessing long-Covid in primary care: an NIH R21 proposal and comparative analysis
Today, more than 93 million Americans have been infected with SARS-CoV-2, and an estimated 10-30% of those individuals will experience unpredictable long-term symptoms across the body and mind, known as Post Covid-19 Conditions (PCC) or “long-Covid”. To prevent further death, disability, and their related socioeconomic consequences, there is an urgent need to support the identification and assessment of this debilitating and life-altering condition. The purpose of this project was to prepare an NIH R21 funding application to develop an electronic health record (EHR)-based PCC screening tool for primary care providers (PCPs). This innovative study will advance our understanding of PCC predictors by analyzing patient symptoms in primary care settings, validating the prediction model with EHR data, and has the potential to become a PCC management tool for PCPs. In collaboration with the principal investigator, I drafted the proposal which includes specific aims, research strategy, innovation, and approach. Additionally, a comparative analysis of how PCC is being addressed in high income countries (HICs) and low- and middle-income countries. Through this analysis, stark differences were found in the amount of literature from low-income countries compared to high or middle income countries. Despite this disparity, literature from low-income countries support findings in high and middle income countries that PCC is impacting working age adults. PCC may be of special concern to low-income nations who rely on this section of the population to drive economic development, but high-income nations should also consider the economic impacts of PCC. In the future, researchers could consider adapting the PCC screening tool to limited resource settings. Before then, more research is needed to understand manifestations of PCC in different contexts.
Lia Ghozati
Proposal for a multilevel health promotion campaign to increase HPV vaccinations in Mozambique utilizing behavior change models
Mozambique has one of the highest rates of cervical cancer in the world (Soi et al., 2018). Despite this, cervical cancer is highly preventable with the Human papillomavirus (HPV) vaccine. Current HPV vaccine coverage in Mozambique is slightly above 50%, which is well below the goal set by the WHO of 90% of girls vaccinated worldwide (IARC, 2023; WHO, 2022). In recent years, progress on HPV vaccinations in Mozambique have been stalled due to the COVID-19 pandemic and the rising young population (UNICEF, 2022; IS Global, 2019). The purpose of this capstone project is to develop a proposal for a multilevel campaign to increase HPV vaccinations in Mozambique. The aim of this proposal is to recommend a campaign strategy by utilizing behavior change models and adapting its elements to fit the context of Mozambique and HPV vaccinations. Methods included performing a literature review on contextual factors of Mozambique, the existing barriers among the national HPV vaccination strategy in Mozambique, and lessons learned from countries that have been successful at increasing HPV vaccination coverage. Additionally, suggestions for campaign strategies and activities to be implemented in Mozambique are presented with input from several behavior change models, including the Theoretical Domains Framework and the Health Belief Model. Aside from the campaign proposal, included are a mock radio script and draft of a billboard to be used during a campaign.
Kathryn Graham
Obsessive Compulsive Disorder Awareness Toolkit for Higher Educational Institutions in the United States
Obsessive compulsive disorder (OCD) is a debilitating mental health disorder characterized by persistent intrusive thoughts (obsessions) and ritualistic behaviors (compulsions). In 2019, the World Health Organization (WHO) ranked OCD tenth in the WHO’s ten leading causes of disability. OCD is estimated to affect 2-3 million adults (1 in 100) and around 50,000 children and teens (1 in 200) in the United States. However, because OCD is commonly misdiagnosed by health care providers, OCD is likely more common than current estimates. OCD most commonly presents during childhood (ages 8-12) or early adulthood (ages 18-25). Despite how common OCD is, many affected individuals go undiagnosed for an average of ten years which leads to unnecessary suffering. While many national OCD awareness campaigns exist, there is a lack of OCD awareness efforts targeted primarily toward young adults on college and university campuses. For my capstone, I created an OCD awareness toolkit for higher education students as well as other important stakeholders on higher educational campuses: professors, university/college leadership members, residential and housing services staff, mental health professionals, and college/university health clinic staff. My capstone produced a detailed literature review about OCD signs, symptoms, stigma, proper treatment, and relevant advocacy and policy solutions. I also produced a 3-episode podcast called “So OCD” which includes podcasts on OCD awareness and education, an interview with a young adult college student with OCD, and an interview with an OCD-trained therapist.
Katie Hale
Green Space Policies, Access, and Associated Public Health Implications in Salt Lake City, Utah
Green space access is a growing topic in the Public Health sphere. The importance of green space access to health and wellness continues to be researched and backed by new evidence. Disparities in access to green space across demographics is a growing concern as research becomes available. This study aimed to reveal any green space access disparities in Salt Lake County through collecting park data from arcGIS and demographic data from the US Census. This study also examines green space policy and trends, which has a strong influence on urban planning and green space development, maintenance, and placement, as well as an influence on the social determinants of green space use.
Maura Hughes
Social Determinants and Resource Mapping for the University of Utah Medical Campus Expansion into West Valley City, Utah
With the proposition of expanding the University of Utah Medical Campus to West Valley, an assessment of the health status and social determinants of health among residents will help planners, public health officials and involved parties in determining the value of expanding this campus. Furthermore, an assessment of community health and social service assets in the area will further inform the plan for expansion. Community data and information, along with the Utah Health Places Index were used to describe population health indicators, social determinants of health, childcare, pharmacies, access to healthy eating, and other health resources in the area. The report includes asset maps and an interactive map of social determinants of health.
Maclane Jorgensen
Current Status and Trends of HIV/AIDS in Utah
HIV/AIDS is a public health issue that remains consistent throughout Utah. HIV is both a bloodborne pathogen and an STD that directly attacks the host's immune system, ultimately diminishing the immune system and making opportunistic pathogens deadly. Recent developments from programs, such as Pre-Exposure Prophylaxis (PrEP), were introduced to reduce the likelihood of transmission, primarily for individuals at risk of acquiring HIV. However, it is open to all with approval from their healthcare provider. In the case of a diagnosis of HIV, patients are referred to beginning a treatment program recognized as Antiretroviral Therapy (ART). ART ultimately appears to be more effective the sooner the treatment begins after diagnosis. Analysis is provided to show details of the demographics at highest risk and the treatment status to reduce HIV severity. While Utah is lower than the national average in diagnostic rates, there are recognized opportunities for improving the diagnostic rates to lower levels with improvement in treatment. Regarding treatment, Utah is notably absent in providing early treatment after HIV diagnosis, which needs to be suggested and offered earlier in the post-diagnostic stage. Regarding transmission, the two main methods are sexual intercourse and drug usage via injections. Providing resources and educating risk behavior the population will provide awareness of the situation and risks of HIV. Reducing the stigma for all demographics and the overall concept of HIV/AIDS is essential in reducing HIV in Utah.
Ariel Keklac
COVID-19 Trends and Positivity Among Pac-12 Student-Athletes
Non-pharmaceutical measures and extensive surveillance testing were implemented in University athletic programs during the COVID-19 pandemic. This study used PAC-12 athletic program data across 12 western Universities to describe testing, positivity rates, incidence, and time to quarantine by team and sport for two academic years (2020 – 2022). Stata/BE 17.0 and Microsoft Excel were used for analysis. There were 445,616 COVID-19 tests conducted from July 1, 2020 to June 30, 2022, with 266,449 (59.79%) of those being PCR tests and 5,536 positive tests total. Overall, there was an 82% decrease in tests, 5% increase in the raw number of positives, and an 83% increase in positivity rate from year one to year two and 3,1 27 unique quarantine episodes. Average time from exposure or start of quarantine to positive test was 3.64 days. Percent positivity and incidence rates increased from year one to year two for almost all sports and teams. Across all student-athletes, there were 51.3 tests per roster member with 0.7% positivity, and 0.36 incidence in year one, and 9.5 tests/roster member, 4.2% positivity, and 0.40 incidence in year two. Understanding trends in testing and positivity, positivity rates by sport and team, and time from exposure or start of quarantine to a positive test result can help inform future COVID-19 mitigation policies and determine the efficacy of existing measures that may currently be in place.
Sarah Lopez
Establishing a Center of Excellence in Stillbirth Research at the University of Utah
Stillbirth in the United States (US) affects 1 in 175 births, or about 21,000 families yearly. Globally a baby is born still every 16 seconds. This amounts to 1.9 million babies each year, or 1 in 72 births. Stillbirth is a key public health challenge that leaves families devastated and often without answers, as about half of all stillbirths still go unexplained. Clinicians are left frustrated with a lack of evidence-based interventions, prevention guidelines, and policies while having virtually no evidence-based bereavement care to support their patients. There is no current academic Center of Excellence in Stillbirth in the US, and there is a lack of leadership in Stillbirth globally as a whole. The US has an opportunity to fill this role and share its stillbirth data and research findings to help understand the underlying causes, develop novel prevention techniques, and implement health policies and educational material to reduce stillbirth rates in the US and globally. This project included drafting a grant proposal with colleagues in the Department of Obstectrics and Gynecology to establish the University of Utah Center of Excellence in Stillbirth (UUCES).
Shanna Loughmiller
Engaging Communities with Clinical Health Systems for Improved Health: Review and Practical Recommendations
Traditional health systems and patient care models often overlook community-level and systemic factors that have widespread and significant effects on health. Clinical care tends to focus on individual patient-level diagnoses and medical interventions, with less consideration for factors stemming from the physical, social, cultural, political, and economic environments. These factors help shape every person’s health and well-being differently, especially for minority populations who are particularly vulnerable to experiencing negative health outcomes. Clinical health systems must integrate collaborative, sustainable, population health approaches focusing on community engagement to see beyond individual interventions and address other factors to improve health. Health systems must actively engage with the populations they serve from beginning to end. A comprehensive literature review was conducted of scholarly and gray article sources published in English within the past ten years and were available either free or with the University of Utah institutional access. Articles were identified through PubMed, ResearchGate, Wiley, Sage, Springer, Elsevier, and NCBI databases, as well as through the Google search engine for gray literature. Chapters from a physical published text were included as well. Articles were included based on or around the keywords of patient/user/consumer/community and activation/engagement associated with clinical health. Copies of PDFs for all included articles were uploaded and coded using Dedoose, which is a qualitative and mixed methods data analysis software.
Erin Mclaughlin-Tutton
Expanding School-Based Mental Health Through Community Partnerships and Universal Screenings
The rising number of mental health challenges due to adverse childhood events (ACEs) including stress and trauma highlight a desperate need for better access and quality of mental health services. Utah has a higher prevalence of both mental health disorders, and lack of treatment in children compared to most states. Significant barriers such as stigma, cost, time, and access often prevent children from receiving the care they need. Developing comprehensive school-based mental health care is an excellent opportunity to improve the health, wellness, and equity of our children. While schools in Salt Lake City School District have initiated several key practices such as trauma-informed education and social-emotional learning, the implementation is not comprehensive. Educators are expected to not only teach, but recognize the signs and symptoms of child trauma, as well as mitigate its effects. This tremendous strain diminishes their ability to teach. The state of the mental health of children is a public health crisis. Health professionals must take responsibility and find creative solutions. School-based mental health teams and screening can improve the health and future of our children.
Elizabeth Michie
Trauma-Informed Care: Recommendations for Sexual and Reproductive Care Providers
In sexual and reproductive healthcare, individuals with a history of trauma face significant health disparities due to an increased likelihood of adverse physical and mental health outcomes, an underutilization of preventative care, and uninformed care providers. Previous research has established that trauma is extremely widespread and has real and lasting effects on individual physical, mental, and emotional health. In response to this issue, the American College of Obstetricians and Gynecologists recommends that providers adopt universal trauma precautions by implementing universal screenings and trauma-informed approaches in their practices. Other institutions and current research advocate for the implementation of trauma-informed care. Despite this, there is a lack of standardized guidelines and recommendations for the implementation of trauma-informed care in the field of sexual and reproductive healthcare. The goal of this project was to synthesize current research on trauma and trauma-informed care to inform practical recommendations for providers of sexual and reproductive healthcare, gaps in knowledge in the current research, and the direction of future research.
Katherine Suwannee Miller
Advocating for Solutions to Non-Emergency Medical Transportation (NEMT) Access for Urban Medicaid Populations in Utah
Social determinants of health, such as transportation, have major impacts on a person’s health, well-being, and quality of life. Barriers to transportation to healthcare services can worsen chronic diseases and increasing future emergency department visits. The white paper will educate and advocate Utah legislators on urban non-emergency medical transportation (NEMT) solutions for Utahn's who are eligible for a state Medicaid plan. The main findings in the white paper are that Medicaid individuals with low-income, no internet at home, and/or have mobility issues are less likely to have access to NEMT services. A communication plan will provide individuals with the information necessary to communicate this topic and solution recommendations with their representatives or in public comment. In conclusion, recommendations for this population include implementing free statewide UTA fare, creating more public transit stops and routes, and improving the conditions of transit facilities near or at public transit stops and stations.
Abby Novinska-Lois
Building Resilience and Community Health Through Climate-Smart Healthcare
Climate change, caused by the burning of fossil fuels, has been declared the largest threat to human health in the 21st century by the World Health Organization, and in 2021, over 200 medical journals issued an unprecedented joint statement calling on health professionals and the health sector to act. Health harms include heightened cardiovascular and respiratory mortality, increased preterm birth risk, and worsened chronic conditions from rising heat stress and air pollution, increased spread of vector-borne illness, lengthened allergy seasons, rising food insecurity and water-borne diseases, injuries from exacerbated extreme weather, and more. The US healthcare system has a unique responsibility and role within this challenge, considering it accounts for approximately 9% of the US greenhouse gas emissions, and 25% of global health sector emissions. This capstone focused on building out a Climate-Smart Healthcare Program for the Wisconsin Health Professionals for Climate Action, centered around reducing the pollution generated by hospitals, clinics, and health organizations. To expand engagement, education, and the advocacy capacity of their team, a grant was written with structured goals, timelines, and support for staffing. As part of that advocacy, a letter was also organized to call for the re-opening of the HHS/White House Health Sector Climate Pledge. Outreach to stakeholders led to the formal support of 46 organizations and catalyzed the successful re-opening of the national program on March 9, 2023. Since this is an exciting announcement, additional materials to raise awareness of the program were constructed, including a video and infographic.
Kamala Poudyel
Oral Health Education and Promotion Communication Campaign for the Bhutanese Refugees in Salt Lake City, Utah
Refugees have unique healthcare needs, including oral health, which is often overlooked in the vulnerable community. Poor oral health can impact overall health and quality of life. Refugees face several barriers to accessing dental care, such as language barriers, cultural differences, lack of transportation, and financial limitations. This literature review aims to summarize research on the oral health of refugees and interventions to improve outcomes. It also seeks to raise awareness among Bhutanese refugees in Salt Lake City, Utah, on the importance of good oral hygiene and promote oral health through a communication campaign. The goal is to reduce health disparities and improve oral health outcomes through awareness and education for Bhutanese refugees.
Yihao Qin
Male Perspectives of Public Space Harassment in South Asia
This study aimed to explore the male perspective on public space harassment (PSH) in South Asia, focusing on the roles of men as victims, perpetrators, and bystanders and their perceptions. A descriptive and cross-sectional online survey was conducted with men in India, Bangladesh, and Pakistan through a research team at the University of Utah and researchers in partner countries. Data were analyzed descriptively in STATA16 and Excel. A total of 235 men, primarily young, well educated, and of modest means, participated. Most participants disagreed with restricting women's movements or blaming them for harassment they may experience in public spaces. Most participants agreed that men who engage in harassment should face legal punishment and community-level action. However, mixed opinions were observed on whether women should interact with male strangers in public spaces, dress modestly, or stay out after dark.
While most male participants recognize the need for action against harassment, some still hold traditional or conservative views on women's behavior in public spaces. Further research, including female perspectives and exploring the cultural and societal factors influencing public space harassment, is recommended. Engaging men as allies in addressing PSH in South Asia is essential for creating safer and more inclusive communities.
Tuilua'ai-Ofa Roberts
Pacific Islander Health: Identifying Gaps & Linking Resources
Utah ranks fifth on the list of states with the largest Native Hawaiian/Other Pacific Islander population. A great percentage of this population identifies as Samoan or Tongan, and between 2010-2020 the number of Pacific Islanders in Utah increased by 50%. Compared to the rest of Utah, NHOPIs have higher rates of stroke, diabetes, obesity, and cancer (including breast, colorectal, and prostate cancer), and NHOPI women are also burdened with higher rates of preterm birth and are 30% less likely to access prenatal care. This literature review and report includes a gap and asset analysis for the Pacific Islander community in Utah. Gaps are defined as any issues or disparities that are overlooked or need to be addressed within the community. Assets are defined as community strengths, resources, and also cover the current efforts being made to address issues. First, secondary data was collected in order to gain a background understanding of the current demographic, health, and disease trends of Pacific Islanders and secondly, interviews with six community leaders were conducted to gather information on current issues, resources, and the important work being done to improve health within PI communities.
Nathan L Rolling
PTSD Treatment and Education Guide for Veterans and Families
Post-traumatic stress disorder (PTSD) is a mental disorder that generally occurs when an individual experiences frightening events or trauma and undergoes physical or psychological harm. Veteran families need to be educated on how to address PTSD and what organizations are in their area that can aid besides just VA facilities. Events leading to PTSD include accidents, war, and physical, mental, or sexual assault. Among these, war is considered the most intense stressor, leading soldiers to have a high prevalence of depression, alcohol abuse, anxiety disorders, and the development of PTSD. The number of U.S. veterans with PTSD has increased significantly since 2001 due to the war on terror. This was mainly due to combat experiences and non-honorable discharge status, which were also found to indirectly affect PTSD symptoms through their impact on social connectedness. Since there is no cure for PTSD, the main form of treatment is to reduce negative feelings or symptoms, allowing for an increase in an individual’s daily life. This is usually paired with serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and mood stabilizers. This project includes a literature review and resource guide for veterans and their families.
Nahoa Romo
Fostering Diversity in Public Health Departments: an introductory training module
Diversity is a concept that refers to the variety of differences that exist among individuals, including race, ethnicity, gender, age, sexual orientation, religion, socioeconomic status, and cultural background. It is an important aspect of organizations, including public health departments, because it allows for a more comprehensive approach to problem-solving and decision-making. Homogeneity, on the other hand, refers to the absence of diversity within a group or organization. This lack of diversity can lead to a narrow perspective, reduced creativity and innovation, and the reinforcement of biased attitudes and beliefs. In public health, diversity is critical to addressing health disparities and achieving health equity. This includes understanding the unique health needs and challenges different populations face and promoting cultural competence and sensitivity among healthcare providers. This project aimed to review best practices in diversity training and develop a training module tailored to public health department employees. This training module aimed to increase awareness of the importance of diversity in public health, promote cultural competence, and provide tools and strategies for addressing diversity-related challenges in the workplace. By promoting diversity and inclusion, public health departments can better serve their communities and advance health equity for all.
Grant Russum
Project Mountain Dentist: A Promising Program for Oral Health Outreach in Rural Bhutan
Oral health in Bhutan remains inadequate, with 80.5% of children having tooth decay, with this percentage akin to adults. Bhutan supports oral health for all and has agreed with the WHO to provide universal access, yet gaps remain in rural/remote areas. The universal health care system structure covers around 90% of the population, who live within about two hours' travel distance. Project Mountain Dentist (PMD) works to accommodate the 10 percent of the population living outside of the two-hour travel distance. Additional funding is needed to keep the program going, and further funding will support the addition of further staff. PMD is an emerging nonprofit that supports three sustainable development goals of Bhutan and continues to educate through citizen interaction. This project focused on documenting needs and designing donor materials.
James Smith
The State of the State's School Vision Screening in Utah
Vision health significantly influences all aspects of a child’s life and is critical to their development. Untreated vision issues can cause physiological alterations in the visual pathway and are associated with lower literacy rates, poorer self-esteem, and delayed functional skills. Vision impairment in children can have lasting impacts into adulthood and is associated with a higher prevalence of mental and chronic health conditions and poor employment opportunities. Early identification and diagnosis of these vision disorders are essential as treatment is more successful and cost-effective when detected earlier. School-based vision programs (SBVP) are invaluable in identifying children’s vision disorders. There is no federal requirement for vision screenings in schools, and all mandates are managed by each state individually. Each state is responsible for creating its mandates, policies, and procedures for SBVP, causing vast differences in school-based vision screening methodology and frequency between states. The Utah Department of Health and Human Services is mandated by Utah State law Section 53G-9- 404 to create and provide instruction for an SBVP that can be used by schools and school districts across the state. This report provides a description of the current SBVP efforts in Utah.
Mckaylee Smith
Racial and socioeconomic differences in Utah mothers’ behaviors associated with sleep-related infant deaths
In 2022, 3,279 sleep-related infant deaths (SRIDs) occurred in the United States. Studies have shown that there may be racial and socioeconomic disparities in the incidence of SRIDs and SRID-associated behaviors, including incorrect infant sleep position, bed-sharing, and lack of room-sharing. However, few studies about SRIDs have been performed with data from the Utah Pregnancy Risk Assessment Monitoring System (PRAMS). In this study, the Utah PRAMS data from 5,397 mothers between 2018 and 2021 were analyzed to determine if differences existed in SRID-associated behaviors between racial and socioeconomic groups. The prevalence of various behaviors in the sample was calculated. Using logistic regression, odds ratios of racial and socioeconomic groups were calculated for selected behaviors. SRID-associated behaviors were common among surveyed mothers, and putting the infant to sleep with a blanket was the most prevalent behavior (58.0%). All odds ratios of selected SRID-associated behaviors were statistically significant for non-white mothers as compared to white mothers and for mothers of all socioeconomic levels as compared to mothers who had a household income level 185% of the federal poverty line or higher. When adjusted for socioeconomic status, age, education, and marital status, the odds ratio of incorrect sleep position remained significant for non-white as compared to white mothers (OR: 2.15; 95% CI: 1.68-2.75). Further research is needed to know if these differences are a result of inadequate prenatal counseling and care and/or cultural practices and beliefs.
Jennifer Nicole Luckau Specchiale
Burn Out: A Wildfire Tabletop Exercise Toolkit
Nearly 700 Utah communities are at-risk for catastrophic wildfire. The immediate and long-term impact of wildfire events have devastating social, economic, and health consequences. Wildfire victims often experience long-term financial and housing repercussions, in addition to physical and mental health consequences. Many communities across Utah have Community Wildfire Preparedness Plans (CWPP) in place. Emergency planners test and validate these plans by conducting emergency exercises. The purpose of this project was to develop a wildfire tabletop exercise toolkit for Duchesne County. A tabletop exercise with a scenario and injects was developed and presented to community stakeholders at the county and state level. Duchesne county’s communities are among the highest risk areas for wildfires in Utah and magnified by the county’s relatively rural location, drought conditions, and a lack of resources, including funding for emergency personnel, equipment and mitigation. This project provides an emergency planning toolkit tailored for Duchesne County and could be adapted to communities with similar characteristics.
Jared Staheli
Exclusionary Zoning, its Impact on Health, and Remediations in Utah
This project examined the effects of exclusionary zoning on health through a review of the scientific literature. Secondly, the project conducted a geographic survey and policy analysis of the actions being taken by Utah cities to address exclusionary zoning and advance health-promoting housing policy under bills recently passed by the Utah legislature on housing affordability. It also included a discussion of the political landscape surrounding these types of changes and paths to coalition building that advance these policy goals. The final piece of this capstone is a Tableau dashboard that can be used to further explore the data around which actions Utah cities have taken.
Kimberly Stocco
“We Grow Together” A Model Curriculum for Nutrition Education in Uruguayan Schools
The project “We Grow Together” is a school-based nutrition promotion intervention tailored to elementary schools in an urban setting in Uruguay. The program promotes nutrition through a curriculum than can be implemented across subjects and ages and developing sustainable gardens at each school. The importance of healthy foods and healthy eating habits are reinforced with journals, recipe books, and other materials for children and families. A pre-post evaluation is incorporated with the curriculum. This program will not only provide the children with hands-on experience growing their own fruits and vegetables, but it will also provide them with an educational understanding of its significance which they can hopefully spread to their distinct communities.
Rabina Thapa
Assessment of Sexual & Reproductive Health (SRH) Among Adolescent Girls in Rural Nepal
Adolescent girls in rural Nepal face challenges like poverty, early marriage, early childbearing, lack of educational opportunities, limited familial decision-making power, menstrual seclusion, and deep-rooted social norms that limit their growth. Compared to the rural population, the urban population has shown improvement in empowering women through higher education, restricting early marriage practices, and shifting norms in traditional gender roles. There are programs addressing adolescents, but policies and interventions specifically targeting rural adolescent girls still need to be implemented in those areas where it is most needed. Multilevel factors limit adolescent girls' access and utilization of SRH services. The strategies that address individual, interpersonal, community, and health system levels are critical. This report describes the social context of norms & cultural practices. It identifies the gaps in the sexual and reproductive health and rights (SRH) of girls in urban and rural communities.
Linda Loyda Ida Tovar
Use of the World Café in a Community Based Participatory Research Approach to Evaluating the Circle of Health Tool with Community Health Workers in Utah
The Circle of Health (CoH) survey tool explores seven health domains— emotional, environmental, financial, intellectual, physical, social, and spiritual. This novel, holistic tool was developed by the Center of Excellence in Women’s Health at the University of Utah and originally used for health research and assessment among women. The purpose of this project is to explore relevance of this tool for use among community healthcare workers (CHWs) in Utah. The Utah Community Health Worker Association (UCHWA) has emphasized the need for health assessment tools to identify gaps in care for both CHWs and the individuals they serve in their communities. The Circle of Health tool was identified as a potential health evaluation tool that CHWs could use in both personal and professional settings. This project included gathering feedback on the tool from CHWs in World Café discussion groups to assess CHW needs and get feedback on the tool for use in personal and professional settings and analyzing and reporting qualitative data.
Cindy Turner
Online health misinformation: A public health response and policy recommendations
The World Health Organization defines an infodemic as too much information including false or misleading information that causes confusion and risk-taking behaviors that can harm health… [and] leads to mistrust in health authorities. As social media usage and online health information seeking behaviors increase, more people than ever are at risk for harmful health impacts resulting from exposure to social media health misinformation (SMHM). Exacerbating concerning levels of SMHM is Section 230 of the Communications Decency Act, which protects social media companies from being liable for information posted on their platforms. Medical and behavioral scientists have proposed solutions for mitigating health misinformation while information technology and law scholars have been more concerned with policy targeting social media content regulation. A public health response is necessary to bridge the gaps between these two disparate disciplines. This project included a literature of social media trends as well as SMHM prevalence, susceptibility, and spread. It also briefly summarizes the history of Section 230 and legal scholarship related to first amendment implications for regulating online content and recommendations for public health interventions. A companion Op Ed article is included.
Logan Wechtler
Perinatal depression trends in Utah and the role of nurses and integrated behavioral health professionals
Perinatal depression is a serious condition that many women experience in Utah. Women with this challenge may not receive adequate treatment even when they are screened. This study evaluated the needs of Utah women who are perinatally depressed and identified recommendations for addressing this public health concern. Data collected from the Utah PRAMS survey on 8,491 women were analyzed. Of these women, 307 had depressive symptoms and provided substantive comments to the open-ended question. Multivariate logistic regression analysis was performed and the results were expressed as adjusted odds ratios. A qualitative analysis of the open-ended responses was also executed to identify various thematic categories. Women from a non-white background, women who were not married, and women with lower socioeconomic status had higher odds of experiencing depressive symptoms. In the thematic analysis, most women wished they had received better medical care during pregnancy or at delivery and several described an unmet need related to their depressive symptoms. Many women experienced diseases during the perinatal period while others had a positive pregnancy experience or delivery. Race, marital status, and socioeconomic status are risk factors for women in Utah with postpartum depression. In addition, Utah women with perinatal depression continue to have unmet needs for diagnosis and treatment. Though screening services for postpartum depression have improved, Utah should increase the frequency and consistency of screening, provide more training about identifying perinatal depression to nurses, and support integrated behavioral healthcare models to treat perinatally depressed mothers.
Emily Harrell Wilson
Analysis of the Economic Impact of Single Payer Healthcare
The U.S. is behind other developed countries in most health outcomes and spends nearly double the average of these countries. Research from the U.S. and other high-income countries show that single payer healthcare consistently results in economic benefits over the current multi payer system. The purpose of this project was to outline these benefits for consideration of legislative bodies to be informed on voting on behalf of their constituents. A literature review and analyses were conducted to determine if sufficient evidence had been gathered to support a position paper. Topics included physician pay in Canada, a meta-analysis of multiple single payer effects on cost-benefits, research on bankruptcy, immigrant contribution to GDP, and the rising cost of healthcare in comparison to rise in wages. In addition to evidence-based research, political statements and explanations were reviewed to be included in the paper. In a review of the literature, physicians are able to make the same or more in a single payer system. With our shortage of healthcare workers, training for these jobs will replace insurance jobs. Employees will receive higher wages and premiums will switch to taxes hence no greater cost to individuals. All people will have healthcare coverage and all bills will be paid to providers. There will be increased productivity in the workforce as they will be healthier and won’t carry the stress and burden of how to pay for their healthcare.