Master of Public Health
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Item A Measure of Food Safety Knowledge, Practices, Attitudes, And Risk Perception of Foodborne Illness Among Adult Consumers in Louisiana Region VII(2019-05) Williams, Shakera S.Foodborne illness in the United States is a costly and underreported public health burden that is largely preventable if the proper food safety steps are taken within the home environment. Approximately 3,000 deaths occur each year from foodborne infections with 128,000 hospitalizations, and 1 in 6 people will become ill. Foodborne illness is a great concern for vulnerable populations such as: pregnant women and their unborn babies, young children, individuals with weakened immune systems, and older adults. Adult consumers carry the burden to prevent foodborne illnesses when buying foods and beverages at the grocery store, storing foods at safe temperatures, safe preparation of foods, and finally cooking foods at the proper internal temperatures within the home environment. The measure of food safety knowledge, handling practices, attitudes, and risk perception of foodborne illness showed significant differences among gender, race, and educational levels. More progress is needed to protect people and reduce foodborne illness in Louisiana. A state survey administered by the Louisiana Department of Health should be completed to further measure the food safety knowledge, practices, attitudes, and risk perception of foodborne illness among adult consumers. Food safety awareness in Louisiana should be a collaborative effort between public health educators, practitioners, governmental agencies, and the food industry.Item Clinical and Molecular Epidemiology of Colonizing Group B Streptococcal Isolates in Pregnant Women of Northwest Louisiana(2019-05) Butler, KristinUnderstanding the population structure of colonizing group B Streptococcus (GBS) isolates in pregnant women is essential to enhance surveillance and inform vaccine policies. Previous GBS research in this population identified acute sexually transmitted infection and African American race as unique risk factors for GBS colonization with highly antibiotic resistant strains. This retrospective study provided epidemiological, observational, and comparative analysis by utilizing chart reviews, microbiological data, and molecular data of 333 archived GBS isolates from pregnant patients who were screened for GBS at University Health-Shreveport (UH-S) between January 1, 2013 and April 1, 2018. Of the GBS isolates studied here, statistically significant relationships were found between azithromycin exposure, chlamydia infection, and antibiotic resistance. These findings support the hypothesis that azithromycin exposure during pregnancy for Chlamydia trachomatis infection is related to increased antimicrobial resistance in colonizing strains of GBS. Serotype data for 93 of the 333 isolates included in this analysis were available for correlation with demographic, microbiological, and molecular data. Seroprevalence for this region was found to be comparable to reference populations in the U.S. and Canada. However, no relationship was found between serodistribution and any specific antibiotic resistance phenotype. Based on the findings from this study, future prospective studies are intended to further evaluate how these aspects of colonizing GBS influence pregnancy outcomesItem Improving Patients Health Literacy in Understanding Prescription Medication Labels Using Patient Centered Drug Labels and a Teach-Back Approach(2017-08) Ali, Shamsideen O.Medication adherence is recognized as an essential self-care activity performed by patients to promote their health. Misunderstanding and incorrect comprehension of directions on medication labels are often associated with low literacy and limited English proficiency. Health literacy is a significant issue related to medication adherence and misunderstanding of prescription medication labels. In this patient-randomized study, mixed method (involving the mixing of qualitative and quantitative data) evaluations are used to analyze the effectiveness of the patient-centered label (PCL) and teach-back approach (TBA) in improving patients’ health literacy in understanding medication labels. This study compares PCL plus TBA to the standard medication label. The PCL arranges information on the label from a participant’s perspective, and TBA is a communication technique used to help participants remember and understand the important information regarding their diagnosis, treatment, and medication. TBA is a communication confirmation method adopted by health care provider to improve patient medication compliance. This technique involves asking if a participant understands the medication information as explained by their provider determining if they are able to accurately “teach-back” the information to their health-care provider. Study participants were randomly assigned into a control or treatment group. The control group was given regular standard medication labels (n = 43) and the treatment group received the PCL plus TBA (n = 30). Participants underwent individual oral interviews. Three specific questions determined the accuracy of the participant’s interpretation of medication labels. Participant responses were recorded and evaluated to formulate the study results. The results of this study indicate there was no difference between the control and the treatment groups. However, the data shows that standard medication label is more difficult for participants to understand their medication instructions (p = 0.001) and participants specifically found it difficult to interpret PRN medication instructions (p = 0.033). Overall, the study shows that the treatment intervention (PCL plus TBA) is useful to enhance patient compliance with prescribed medications, especially when the instructions are complex.Item An Examination of the Staffing Needs of Respiratory Therapy Departments in Louisiana(2020-04) Danzy, Jillian N.Workforce development for the respiratory therapy profession is a growing concern with the increase in demand for respiratory therapists. Soon, there may be staffing difficulties due to retirement, respiratory therapists leaving the profession, and decreased enrollment into accredited respiratory therapy programs nationwide. The profession has potential for growth, as the number of people suffering with cardiopulmonary disease is rising and the demand for preventative services, like smoking cessation, is increasing. The purpose of this research was to assess the perceptions of staffing needs and the future of the respiratory therapy profession amongst Louisiana State respiratory therapists. This study was of cross-sectional design and utilized a modified 39-question survey tool, delivered via e-mail to 618 Louisiana members of the American Association for Respiratory Care (AARC). Descriptive statistics were used to summarize responses and inferential statistics, including Chi-square, Kruskal-Wallis, and Mann-Whitney U tests, were used to compare variables. The response rate was 19%. Understaffing was perceived by 50% of participants and those within the hospital setting, including directors, supervisors, and staff therapists, perceived understaffed work environments more often than other groups. Participants indicated that salary was most important to them as employees, followed by room for growth and scope of practice. Additionally, participants indicated the ability to assess patients and develop care plans and the ability to receive reimbursement for services as the most important factors for the future of the profession. Most (69.8%) agreed or strongly agreed that the entry-level minimum should be increased to the bachelor’s degree and 21.6% agreed that the master’s degree in respiratory therapy should be supported to increase the scope of respiratory therapy practice. Although half of participants perceived understaffed work environments, 77.6% felt it is important to remain in the respiratory therapy profession and 93.1% agreed or strongly agreed on the importance of maintaining an active membership in the AARC. These data are useful indicators that there is room for growth and Louisiana respiratory therapists are motivated to grow with the profession. There is internal support from the profession to provide a competent workforce that can and will deliver quality healthcare to those who have risk for cardiopulmonary disease. The survey results serve as an important indicator that Louisiana respiratory therapists are committed to workforce development and will continue to be a vital part of public health practice.Item Mental Health Status of Pre-Post Delivery of Minority Women in Louisiana: Findings from the Prams, 2016-2019(2021-12) Tyner, Justiss M.Pregnancy-related psychological distress was found to be common; however, the prevalence was higher among racial-ethnic minority women than Non-Hispanic White women. Apart from biological susceptibility, much of this disparity may be related to social and cultural factors such as race, socioeconomic status, and place of residence. However, Suh et al (2015), states that in the past 10-15 years, no study so far had examined pregnancy-related psychosocial/psychological distress in Louisiana. To understand this disparity better, studies examining pregnancy-related (pre-and post-delivery) mental health status (i.e., depression) of racial/ethnic minority women are needed. Using Urie Bronfenbrenner’s social ecological model, and Albert Bandura’s social learning theory and Pregnancy Risk Assessment Monitoring System (PRAMS), I examined the individual, social and environmental factors associated with the post delivery mental health status (as measured by the presence of depressive symptoms) of women living in Louisiana. PRAMS has the most recent available data for pregnant women in Louisiana. The data had specific questions related to pre-and post-delivery health status. PRAMS not only has these data but health information and references as well. It has maternal characteristics, preconception health, prenatal care and risk factors, tobacco/alcohol & drug abuse, infant and child health, postpartum health and depression, income, stressors, and much more on topic. It is a resourceful tool that will help identify women at-risk in Louisiana. For this project, I used bivariate and multivariable analysis accounting for study design-related weighting (WTANAL). First, I examined socio-demographic characteristics, means, standard deviations, and normality assumptions of the measures. Descriptive statistics was generated using frequencies/percentages and medians/ interquartile ranges (IQRs) where appropriate. Mental health status was treated as binary, and factors associated with the bivariate level was included in the multivariable model. All models were estimated with a full-information maximum likelihood estimator with robust standard errors. Software packages SPSS/STATA was used to analyze this data to make comparisons across the different ethnic groups. By using the Social Ecological Model and further examinations of individual, behavior, and environment, I identified factors related to post pregnancy mental health. Race/ethnicity was associated with post-pregnancy mental health with non-Hispanic Black women reported a decrease in depressive symptoms. Having no health insurance was another factor of depressive symptoms, those who had insurance were 42% less likely to have postpartum depressive symptoms. Abuse after pregnancy was associated with depressive symptoms, with women who experienced abuse after pregnancy were more likely (aOR = 1.46, 95%CI: 1.02-1.46; p = 0.04) to report depressive symptoms. Stress during pregnancy was another factor of postpartum depressive symptoms (aOR = 1.28, 95%CI: 1.20-1.36; p < 0.001). Women with experienced discrimination also reported increased symptoms (aOR = 1.33, 95%CI: 1.09-1.62; p < 0.001). Results identified individual as well as societal factors as predictors of post-partum depressive symptoms among women living in Louisiana. I plan to disseminate this knowledge to enable women to find resources that will help reduce pregnancy-related mental health challenges in efforts to decrease pregnancy and birthing complications amongst women.