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.
2023 Capstone Abstracts - Utah Campus, Salt Lake City (*Utah Asia Campus projects forthcoming)
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
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.