M.S. - Public Health

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    A demographic profile of the Cook Islands
    ( 1972) Phillips, James F. ; Public Health
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    The Determinants and Disparities of Gout within the Multiethnic Cohort
    ( 2019) Thompson, Mika Daniel ; Wu, Yan Yan ; Public Health
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    "Dump the Plump": A 5-year Hawaii Department of Health Worksite Wellness Program, A Pilot Study.
    ([Honolulu] : [University of Hawaii at Manoa], [December 2016], 2016-12) Calimlim, Precilia
    The increased prevalence of obesity and overweight in the United States and Hawaii are just some of the underlying factors leading to catastrophic death rates due to heart disease. Hence, a worksite wellness Program entitled “Dump The Plump” (DTP) was conceptualized, implemented, and sustained at the State Laboratories Division (SLD) for a period of five years, 2010-2015 to reverse or prevent these risk factors. With the University of Hawaii Institutional Review Board approval, SLD employees were recruited and self-identified as a Player or Cheerleader into the DTP intervention which initially lasted for 1 year then shortened to six months thereafter. The objective of this study was to determine whether or not participation in DTP lead to weight loss in SLD employees decreasing obesity and overweight prevalence at SLD. In 2014, a prospective cohort study was implemented at SLD. DTP participants who consented to receive the DTP intervention were defined as “cases”, while other SLD employees who consented not to receive the DTP intervention were defined as “controls”. A paired t-test was investigated to determine if there was significant weight loss in study subjects after the DTP intervention by comparing their before weight (M=153.73, SD=34.04), and after weight (M=152.33, SD=34.37). The paired t-test indicated a t (24) =1.3807 p= 0.1801 and a 95% confidence interval (CI) for weight loss (-0.6947, 3.5027). This indicated an average weight loss of 1.38 pounds by study subjects, since the p-value was greater than the alpha value of 0.05, the weight loss was not significant. A Fisher’s exact test indicated that weight loss was not significantly associated with study status (cases vs. controls), gender (male vs. female) or DTP status (Player vs. Cheerleader) p=1.0. Also, a two sample t-test for independent groups was performed on the cases (N=23) to determine if their weight loss (M=1.3826, SD=5.2624) was associated with DTP intervention, compared to the controls (N=2) who didn’t receive DTP intervention (M=1.6500, SD=3.3234). The independent samples t-test was not associated with a statistically significant effect of weight loss with cases compared to controls, t (1.48) = -0.10, p=0.930. This indicated that there was no significant difference in weight loss in the cases compared to the controls. Lastly an odds ratio (OR) was computed to estimate the association between DTP intervention (case vs. control status) and weight loss and showed an OR=1.88 (0.10,34.13). The odds of weight loss was 1.88 times greater in cases compared to controls, since the CI includes 1, the results are not statistically significant. In 2015, a longitudinal study was approved for retrospective data for years 2010-2015 of SLD employees who participated in DTP during the five year period. Several variables were investigated to determine if a linear relationship existed in determining weight loss in study subjects. Data analysis exploring a linear model, Model 1, showed no significant linear relationship between weight loss and gender p=0.06 or weight loss and DTP status p= 0.14. Moreover, a linear mixed-effect model, Model 2, showed there was no significant linear relationship between weight loss and the fixed effects of gender p= 0.21 or DTP status p= 0.25, when coupled with the random effect of subject id. However, a paired t-test was performed to compare DTP participants before weight (M=160.35, SD=39.97), to their after weight (M=157.24,SD=37.85) to determine if weight loss did not occur after DTP intervention. Results indicated an average weight loss of 4.6011 pounds of study subjects with a p-value<0.0001 with 95% confidence intervals of weight loss (1.7725, 4.4510). The results suggest that the DTP intervention resulted in significant weight loss in DTP participants at the SLD and Maui District Health Lab.
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    Fall Prevention and Risk Factors - Hawai‘i 2014
    ([Honolulu] : [University of Hawaii at Manoa], [May 2016], 2016-05) Romero Romero, Yesid
    This study is based on self reported information from the Behavioral Risk Factor Surveillance System – Hawai‘i 2014. A perspective of current prevention measures is presented and the association to demographics, behavioral and health conditions were unveiled to determine risk groups to target for prevention. The study examined current status of fall prevention programs, behavioral, demographic, and health factors associated with falls and fall-related injuries in adults 45 years of age and older. A total of 4614 respondents 45 years of age and older participated in the fall prevention measures survey. The year 2014 BRFSS – Hawai‘i survey indicates an overall survey’s response of 84.1% for landline and cell phones. Results of the study indicate that the prevalence of falls and injuries related to fall were higher for the following groups: women, age groups 55-64 and 45-54, White and Japanese ethnic groups, those with income equal or higher than $75,000 or less than $35,000, college 1 to 3 years, and those with specific health conditions or behavior. The increased odds for falling for certain health conditions or behaviors can increase as high as 6.2 times (95% CI 4.3-8.8) and as high as 2.9 times (95% CI 1.8-4.7) for injury related to fall. Older groups had increasingly higher odds for falls after adjusting for sex, ethnicity, education level, and annual household income while 65-74 and 85 and older age groups had higher adjusted odds for injuries related to fall. Other information useful to guide and help better customize combination of evidence-based preventive intervention to the local population of Hawai‘i is also presented. Results on specific preventive measures of the program indicate that about 90% of the respondents selected at least one prevention intervention to reduce the risk of falls emphasizing the interest of the community in general in the fall prevention program but also showing warning signs for disparities in knowledge translation.