Honors Projects for Public Health

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    Addressing food insecurity in Hawai‘i to prevent type 2 diabetes
    (University of Hawaii at Manoa, 2022) Espinoza, Aydya ; Nelson-Hurwitz, Denise ; Public Health
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    Improving Access to Water, Sanitation, and Hygiene (WASH) in Indonesian Youth
    (University of Hawaii at Manoa, 2020) Graham, Nicole ; Nelson-Hurwitz, Denise ; Public Health
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    Increasing Language Access Services Through Policy for Health Entities in Hawai‘i
    (University of Hawaii at Manoa, 2021) Acosta, Lindney ; Tagorda, Michelle ; Public Health
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    Addressing Obesity Through Food Access and Nutritional Education Among Native Hawaiian Youth in Hawai‘i: A Policy Analysis
    (University of Hawaii at Manoa, 2019) Nieto, Robert ; Nelson-Hurwitz, Denise ; Public Health
    Obesity is an international epidemic that impacts all ethnicities and ages, and has become more prominent over the last few decades. The rise of globalization, processed foods, and a sedentary lifestyles have contributed to the rise of obesity rates, which has subsequently increased diabetes, hypertension, and cardiovascular illnesses that claim millions of lives every year. While obesity itself is a non-communicable disease, there are disparities that have disproportionately affected Native Hawaiian communities in the United States, particularly among youth in Hawai‘i. Risk factors for obesity exist at multiple levels, including at the individual level such as a physical inactivity or socio-economic status, while other factors are present at the governmental level where public policy may support a business agenda over health and wellness. Obesity is a central issue for Native Hawaiian youth. While present statistics illustrate an increase in obesity, there are potential solutions that may be implemented at the policy level. Based on policies selected, and analyzed, immediate recommendations include adoption of a policy centered on nutritious food access in after-school programming, accompanied by physical activity promotion. Policies such as this may provide a bright future for the next generation of Native Hawaiians can live and maintain a healthy weight throughout their lifetime.
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    Increasing Access to Family Planning Services Among Low Income Uninsured Women in the State of South Dakota
    (University of Hawaii at Manoa, 2020) Banks, Renee ; Nelson-Hurwitz, Denise ; Public Health
    Reproductive health is a vital component of women’s health and well-being. A woman's reproductive system is a very complex structure in the body. It is vital to take steps to protect it from infections and diseases - including long term health complications. Barriers in women’s reproductive health care access are increasing locally, regionally, and nationally through numerous institutional, legislative, and regulatory restriction levels. Lack of access to these services makes it even more difficult for women to utilize and afford reproductive health care. This lack of access can lead to serious health, social, and economic consequences for women and their families. Disproportionately low-income women are impacted prominently with these consequences as they more often than others qualify for little to no health care insurance coverage. Insurance coverage is critical for making reproductive health services affordable and accessible for low-income women as the financial burden of health care can be unreasonably high. Lack of coverage among low-income women is a prominent challenge in the United States especially in states that did not adopt the Affordable Care Act (ACA) Medicaid expansion and no longer benefit from Title X funding. South Dakota, with its high prevalence of low-income uninsured residents, has many residents who fall within the coverage gap. Through increasing provider participation, access and funding, health care clinics can connect low-income uninsured women to family planning programs and other viable reproductive health care insurance programs.
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    What I Chose: Enhancing Suicide Prevention through Young Adult (YA) Fiction
    (University of Hawaii at Manoa, 2017-05) Uekawa, Madisyn ; Schultz, Susan ; Public Health
    What I Chose is a Young Adult (YA) fictional novella that emerged from my desire to use popular literature as a tool to promote good health. I read and evaluated a series of six popular YA fiction books that contain themes of suicide, and I attempt to emulate the effective literary techniques of these best-selling authors alongside safe messaging into my work. I use my protagonist, Kiara, and Emma, her deceased twin who died by suicide, to exemplify individuals at risk for suicide. I also include supporting characters that show readers a way to reach out to those that display suicidal signs. I form my novella around Kiara’s journey as a transfer freshman at UH who is looking for a restart in life but finds herself uncovering the death and story of her twin that she had no prior knowledge of. Kiara is looked at by those who knew Emma as if she had returned from the dead, and she finds herself given a second chance at life. Similar to most of the YA novels I read in my research, What I Chose aims to hopefully illuminate the meaning in finding purpose, hope, and embracing the choices we are given in this life. Since popular culture and ideology can be influenced by successful YA literature (due to its large readership), it is essential to appropriately expand upon a YA “health promoting” subgenre that can be didactic and that can potentially improve holistic well-being and possibly reduce detrimental behavior.
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    Preventing Infant Deaths Through Safe Sleep Education
    (University of Hawaii at Manoa, 2017-05) Lam, Karolyn ; Kimura, Lisa ; Public Health
    Sudden unexpected infant death (SUID) is the death of an infant less than 1 year of age and can be reported as sudden infant death syndrome (SIDS), unknown cause, or accidental strangulation and suffocation. These reports are determined upon completion of a thorough investigation. SIDS is the leading cause of death in infants in the United States. Healthy Mothers Healthy Babies (HMHB) Coalition of Hawai‘i is a local nonprofit that provides mothers with proper education and prenatal programs. This project focuses primarily on the Hawaii Cribs for Kids Program facilitated by HMHB. The purpose of this study was to identify the demographics of mothers who attend the Cribs for Kids classes in Hawaii and identify common misconceptions about safe sleep practices. By having this information readily available, HMHB can improve class material to be more culturally appropriate and to teach recommendations and prioritize mothers at high risk when doing outreach. Results indicated that mothers learned most about pacifier use for safe sleep and how bumper pads and wedges or positioners can be hazardous when placed in an infant’s sleep environment.
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    Promoting School-Based Hearing Screenings Among Hawaiiʻs Youth
    (University of Hawaii at Manoa, 2017-05) Chow, Christopher ; Nelson-Hurwitz, Denise ; Public Health
    The hearing of a child can often be taken for granted. Hearing is not only important in day-to-day communication, but is vital in the overall development of infants and children. Although hearing loss is generally associated with aging, concerns for hearing conditions can start as early as birth. Having the ability to hear is critical in speech and language development, communication, and learning in children. Considering the difficulty in recognizing hearing impairments among youth, it is vital to provide accessible complete hearing screenings to schoolaged children. To address this need, the Hawai‘i Lions Club (HLC) has created a statewide hearing screening program that is implemented in Hawai‘i Department of Education (HDOE) schools. By providing hearing screening for students primarily in kindergarten to the third grade, the goal of the screening initiative is to achieve early identification of hearing loss or any earrelated concern. This project was designed to increase awareness of the HLC’s hearing initiatives and to compare descriptive and outcomes data from the program between the 2015-2016 academic year and 1995, when the last comprehensive report was completed. A total of 5,937 students were screened throughout the 2015-2016 academic year. The project utilized a 1995 hearing screening initiative conducted by the Hawai‘i Department of Health (HDOH) as a benchmark with which to compare HLC’s current hearing screening initiative. Recommendations include expansion of screenings to more HDOE schools, recruiting more volunteers to aid in statewide screening, and completion of an updated comprehensive report by the HDOH.
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    Association of Health Literacy with Cardiovascular Disease in Chinese Americans
    (University of Hawaii at Manoa, 2016-05) Tong, Michelle ; Nelson-Hurwitz, Denise ; Public Health
    As a leading cause of death in Americans, cardiovascular disease (CVD) is further aggravated by health disparities among ethnic minority sub-populations. In Hawaii and California, the Chinese American population is considered a minority population. Within these groups, CVD can be worsened by having low English proficiency and low health literacy. Low health literacy has been associated with CVD in other populations thus Chinese Americans may lack adequate health literacy required for protection against developing CVD or effective management of CVD after diagnosis. Having diminished understanding of disease prevention and health maintenance, such as through low health literacy (LHL), can exacerbate risk factors for developing CVD. This project was a collaborative effort between the Office of Public Health Studies at The University of Hawai’i at Mānoa and the Hawai’i State Department of Health. The aim was to gain a better understanding of the relationship between health literacy and its effects on CVD in the Chinese American sub-populations of California and Hawaii. Data was taken from three health surveys across these states, respectively. The results were analyzed using descriptive statistics and multivariate logistic models. The data collected across the surveys were compared for evidence of association between health literacy and CVD in the sample populations. While descriptive results showed a relationship with CVD and low health literacy in Chinese respondents, these relationships did not hold in multivariable models. However, other associations were found, including the relationship among health literacy and age, which sets the foundation for future research.
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    Promoting Benefits of Skin-to-Skin Contact between Mothers and Newborns
    (University of Hawaii at Manoa, 2017-12) Keliʻikuli, Jennifer ; Nelson-Hurwitz, Denise ; Public Health
    It is important to develop strong bonds between mother and child early after birth. One way this bond may be initialized is through skin-to-skin contact between mother and newborn during the first hour following birth. Benefits of instant skin-to-skin connection for newborns include enhanced biological transition following delivery, initiation of neuroprotective mechanisms, and allowing for early neurobehavioral self-regulation. For a new mother, benefits include improved recovery following delivery, the strengthening of maternal attachment to the child, and stimulation of breast milk production. This project focused on increasing awareness of benefits to mom and baby of instant skin-to-skin contact. Data were collected through a literature review and interviews of health care professionals, and were used to develop an educational pamphlet for distribution to expectant mothers. Awareness should be further promoted through distribution of materials and in-person information, particularly through pregnancy support programs, (e.g. Lamaze). Hopefully, through increased awareness, more expectant mothers will request skin-to-skin contact with their newborns following delivery to promote improved birth outcomes and long-term benefits among mothers and children.