Psychiatric disorders, primarily those such as Generalized Anxiety Disorder, Social Phobia, Depression and Post-Traumatic Stress Disorder, affect a large amount of the population. It is approximated that 1 in 5 individuals suffer from conditions that can be classified as mental disorders. Current treatment for a range of these psychiatric disorders is centered around approaches such as Cognitive Behavioral Therapy, as well as are often supplemented by the use of pharmaceuticals. This method has not been proven to be particularly effective in treating such disorders, particularly ones such as PTSD, anxiety and depression.The possession of such disorders tends to have co-morbid effects, such as lowered self-esteem, social skill deficits, and underachievement, both academically and professionally. Due to the multitude of negative outcomes for those with these conditions, research has been facilitated in order to propose new approaches to provide solutions with higher efficacy in the treatment of patients suffering from such conditions. Equine Facilitated Psychotherapy is one such method that is beginning to receive support from both the traditional medical, and holistic medicine, communities. EFP is centered around utilizing traditional Cognitive Behavioral Therapy approaches in conjunction with specifically developed activities to incorporate equine animals into the treatment plan. This approach is beginning to acquire an evidence base to support the practice, and a higher number of patients are beginning to choose this method, due to its' numerous benefits and potentially long-lasting effects.
Diet-related chronic diseases are among the leading causes of death in America. Many of these conditions are preventable and reversible through changes in diet, particularly by increasing the consumption of fresh fruits and vegetables. As these diet-related chronic diseases affect lower socio-economic classes disproportionately, many organizations employ strategies to influence fresh produce consumption among these populations. One such strategy is the Double Up Food Bucks (DUFB) program developed by the “Fair Food Network,” which incentivizes the purchase of fresh produce by Supplemental Nutrition Assistance Program (SNAP) recipients. The aim of this study is to examine the literature on the effectiveness of DUFB programs on increasing healthy food consumption and improving health. This study is a narrative literature review. The methods include a search of relevant articles and an examination of incentivized nutritional programs as compared to nutritional education efforts and to restrictions on purchases. The review also seeks to summarize the progress and results of the many nationwide DUFB programs. Search terms included SNAP, DUFB, healthy food incentives, food access, and effects of incentives on health/nutrition. This review includes three randomized controlled trials, six reviews and longitudinal analyses, two longitudinal quasi-experimental studies, one mixed- method study, one case study, one cross-sectional survey, and one graduate thesis, as well as data reported by the “Fair Food Network” in their annual reports. This paper also highlights obstacles and barriers to reaching target populations. The review summarizes opportunities for future research on the impact of incentive programs on health behaviors and exposes gaps in program outcomes. Analyses suggest that incentivized nutritional programs are effective in increasing the purchase and consumption of fresh produce among SNAP recipients, but also that this strategy may have limited impact on improving the overall health of this population.
Underage drinking and tobacco use are prevalent in the United States. This is an issue because of the marketing techniques used to entice underage youth to want to try alcohol and tobacco before they are of legal purchasing age. Some policies to restrict large corporations from marketing exist, but stores have latitude. The goal of this study was to assess stores in the Yancey, Mitchell and Avery County. This study includes 27 items generated by CounterTools to focus on the marketing techniques in stores. Some of these items include alcohol or tobacco products within 12 in of children items, are any of these items 3 feet of the floor, which product has the most stock, as well as what is the least price of these items. These items were given to a group of 4 students. The 4 students were given 60 stores to collect data from. The students will then take the collected data and enter the data into graphs to determine frequencies for each of the item in question. Students will present the findings to the Board of Health to show why it is pertinent to raise the legal purchase age of tobacco to 21 and to make sure all stores are following the marketing guidelines of these products so the youth are not wanting to start these habits.
Despite various efforts, the Native American community is severely affected by substance abuse. Research suggests that one in ten Native American deaths are alcohol related, indicating the need for interventions. Interventions have usually included laws or policies put in place by the Federal Government limiting alcohol sales on Native American reservations. Since most of these laws have been changed with time, tribes now have the power to enforce their own laws on alcohol sales. Although this has made many Native communities give up on their efforts of prohibition, some Native Tribes are still hesitant to allow alcohol to be sold within the community. Employing a literature review on substance abuse control within Native communities, this study examines the health implications of prohibition on Native American populations, particularly in Cherokee, NC. The findings of the research suggest mixed results.Overall, communities that did not allow the sell of alcohol appeared to have fewer alcohol-related incidents. The negative implications included an increase in crime related to alcohol and the income lost to the neighboring communities that take advantage of the prohibition. Although some positive benefits have come out of prohibition in Native lands, it is clear that it would be more beneficial of Native American communities to avoid prohibition and progress in other methods of substance abuse care. Approaches, including policies that align with the culture and that are more natural, such as medical marijuana, should be considered.
Despite quantitative and qualitative research revealing the high prevalence and serious consequences of physician burnout in the United States, little is known about the approaches for reducing or eliminating burnout. While burnout reduction programs are vital for providing support, services, and informations to physicians who are experiencing burnout, the effects of the programs are temporary and limited by participation. This study aims to explore the causes of burnout, program successes, and institutional changes through a narrative review of the literature. The methods of this study include a collection of literature from relevant public health database searches using keywords followed by an analysis of the recent and historical changes in medicine, and examination of the successes, failures, and limitations of burnout reduction programs and applied institutional change. Results of this study suggest burnout reduction programs are successful in short-term burnout reduction within physicians who attend, through training of mindfulness, coping strategies. These findings indicates establishing that institutional and policy change is necessary to ensure lasting burnout reduction and prevention. These findings may have implications for for-profit medical systems, insurance companies, and policy initiatives.
Childhood obesity and other diet-related health issues are of concern for American Indians. American Indian children and adolescents are about thirty percent more likely to develop and suffer from obesity when compared to White children and adolescents. The American Indian population, on average, is twice as likely to be diagnosed with Diabetes than any other population in the United States. A promising intervention is in early childhood education centers, including the Dora Reed Center in Cherokee, North Carolina. The purpose of this project was to create a professional development program for the kitchen staff to help increase their knowledge surrounding cultural appropriate and nutritious dishes for the 266 children at the Dora Reed Center. Our methods included: a literature review to understand contributing factors for nutrition-related behaviors; a visit and conversations with center staff; visit to and learning about Rainbow in My Tummy in Black Mountain, and searching for culturally-relevant information. Through this process, our team learned about US Department of Agriculture Food Guidelines for Child Care Facilities, curriculum for preparing foods in child care settings, school-based programs, and cultural issues, such as Colonization’s effect on foods, food access issues, and different Tribal foods. Recommendations include requiring teachers to model healthy eating behaviors, offering alternatives and different food options, purchasing Rainbow in My Tummy and shadowing of the on-site chef, and distribution of calendars and recipes featuring seasonal foods and culturally appropriate dishes. If implemented, these efforts could result in a decrease in childhood obesity and prevention of future diagnoses of Diabetes across the American Indian populations.
The long-term consequences of overuse injuries can impact both academic and athletic performance of collegiate athletes. Over the course of my research I have identified and summarized the determinants leading to high rates of overuse injury. To prevent chronic health consequences resulting from untreated injuries, I will propose a series of strategies to implement with NCAA Collegiate Athletes. Using evidence based data I will discuss the use of acquiring proper technology to track athlete training, combined with implementing correct periodization models. Using these data collection methods will allow coaches to identify and adjust training before a decline in performance occurs.
People often care for their physical health more than their mental health. Stigma holds people back from talking about their mental health issues. Even when they are ready to discuss these issues, lack of education and high cost limits where and who they can contact to receive the necessary help. This talk will examine the use of outreach programs and organizations specializing in mental health to better educate community members and bridge the accessibility gap between medical providers. Establishing more collaborative care between mental health specialists and primary care physicians can improve accessibility, coordinate care and cut cost through reducing payment to a single bill. Another important method this talk will examine is the elimination of stigma for future generations through increased mental health awareness and education beginning at the elementary school levels. Increasingly, many programs and organizations utilizing these methods have found positive reports, such as patients reporting a higher quality of care, lowered cost in bills, a better understanding of mental health issues, and becoming more knowledgeable of local, qualified facilities capable of treating their needs. With these findings and new approaches to care, it becomes clear that the mind and body are equally important for one’s health and overall well-being. One cannot care for just a single part of the body and expect to thrive while the rest of their body is neglected. In fact, that expectation would be madness.
The purpose of this study is to assess how various exercises generate muscle activity in the hip abductor and hip flexor muscles. We are recruiting healthy subjects above the age of 18 to participate in this study. Participants will complete a demographic questionnaire and will be asked to perform 12 exercises, three times while muscle activity is recorded. These exercises include: bridge, mountain climber, rope/elastic band clam flexors, TRX lateral balance lunge with rotation, TRX single leg hinge with rotation, TRX rear foot elevated foot lunge, lateral band walk, side-lying wall, single-leg forward reach, skater hop, side plank leg raise, and hip drops. Participants will be fitted with surface electromyographic (EMG) equipment to measure their muscle activity. Their body fat and lean mass will be measured using a dual energy x-ray absorptiometer (iDXA) scan. This information will be useful for developing exercise routines to prevent falls in older adults.
I am reviewing the most culturally competent approaches to improving food access in immigrant communities. The goal of this research is to identify the purchasing, cooking and dietary choices, as well as to recognize the most advantageous approaches to improving food access, in ways that are appropriate for these populations. Food is at the heart of identity for people around the world. Our country also has a precedent set as a melting pot of cultures and identities. Our immigrant population is steadily increasing every year; the US Census anticipates, that within the next 25 years, population growth will result in over half of our population identifying as non-white, and that by 2060, 20% of Americans will be born outside of the country. In order to accommodate this population, we need to find new approaches to improving food access in immigrant communities. The “food desert” metric measures distance between supermarkets, which are a characteristically Western means of interacting with food. People of Latin, Asian and other backgrounds have dietary lifestyles that cannot be (nutritiously) accommodated by the selection in the average supermarket. Supermarkets perpetuate the Standard American Diet, which is associated with higher risk for heart disease, diabetes and obesity. Ethnic food markets have the capacity to bridge the gaps in food access for these communities. In the Asheville area, we are collecting data on the availability of fresh fruits and vegetables at Ethnic Food Markets. This will help to gain perspective on what is available regionally for nutrient dense options, as well as where opportunities lie for improvement.
Ethnic food markets or ethnic food stores (defined as one that meets two of the three criteria, (a) ethnic name (b) prominently displayed ethnic symbols and/or (c) noticeably high presence of diverse food items associated with a particular ethnic cuisine) are often overlooked by food surveys nationwide. Research on healthy food access often focus on supermarkets/chain companies and their role in healthy eating, however, ethnic food markets are invaluable in that they provide healthy produce and products that are culturally acceptable to their target populations. In our research project, Ethnic Food Landscape in Asheville, we will investigate what the ethnic food market landscape in Asheville looks like overall, and whether the landscape is wide spread through the city or concentrated in a certain area. This research is led by Professor Jennifer Sanchez-Flack, and includes Harper Gande, Anniina Hirvonen, Joceline Rosas, and Leah Fagan in the Health and Wellness Promotion 499 undergraduate research course. Along with this research we will be surveying the fresh produce offered at these food stores, looking at both quantity and price of produce. This research will allow us to see whether or not the produce is affordable, readily available, and the variety of produce in the store. We will organize the data we find and create a clear and concise set for others to access.
Thanks to the internet and social media, living in 2018, humans are now exposed to more harmful, and at times significantly more stressful, news than someone who lived in 1980. Current studies show that one in four freshmen report experiencing mental health struggles, which can lead to a host of concerns including academic struggles. More alarming is that NCAA colligate athletes are reported to suffer from mental health issues at higher rates than their non-athlete peers. Current research has shown that the gut microbiome, the vast array of microorganisms in the gut, has a direct connection to the brain, and thus may have a significant, bidirectional impact on mental health. More research is needed to investigate how the microbiome of students and student-athletes changes over the course of their first semester in college, given the new environment and increased stress that many students face. A pilot study that would consist of 5 student-athletes and 5 traditional students will complete a pre and post semester microbiome analysis, dual-energy x-ray absorptiometry scan, heart rate variability analysis, and demographic and psychosocial questionnaires to help identify potentially related changes in mental health, physical health, and body composition. Participants will also be responsible for keeping a daily food log for the duration of the study. The study will serve as a basis for further research in hopes of furthering our understanding of gut health and its relationship to mental health. The link between depression specifically and the makeup of the microbiome would be the key focus. Studying student-athletes’ and traditional student’s microbiomes in relation to student life and performance will allow for the possibility of improving sport and academic performance and alleviate possible symptoms depression these groups frequently face.
Poor communication between health care providers and patients can lead to significant deleterious consequences, ranging from heart disease, stroke, cancer, type 2 diabetes, and obesity. Conditions such as these are among the most costly, and preventable of all health problems. As such, programs that aim to improve this communication may lead to heightened early diagnosis and the prevention of chronic condition. One possible solution may include modifying the preliminary intake forms patients are asked to submit before the doctor visit. My model will be grounded on the Clinical/Community Population Health Intervention Model. I plan to create a new format for the current form that will inquire about health, improve assessment of priority health issues, and enable the patient to take action. Outcomes of the new form will become a collective database for future prevention, diagnosis, and technique or improved communication.
Nearly 440,000 children are currently in the foster care system. Most children in foster care have been exposed to a multitude of adverse experiences, including maltreatment and neglect, which can make these children more susceptible to socioemotional challenges. Previous research suggests that summer camps have a positive impact on youth development, therefore it is important to see whether foster children experience similar positive benefits from such experiences. I will be conducting a comparative analysis of how summer camp impacts foster kids compared to those that come from stable homes. Specifically we will be assessing the effects of participation in YMCA’s Camp Watia on self-esteem, socioemotional status, and self-worth. Both parents and children will complete a battery of assessments before and after each week long camp session. I predict that both groups of kids will display a positive correlation between camp attendance and socioemotional outcomes; however, I think the difference between the pre and post assessments of the foster kids will yield more growth. If the results support my hypothesis, this study could be used to gain increased support and funding for programs that promote camp attendance among children in the foster care system. This would allow more foster kids the opportunity to obtain the rich and positive impacts that camps can have on these children’s lives.
Asthma and exercise-induced asthma seem to be a prevalent issue for many athletes. Numerous college and professional athletes suffer from asthma and have to find ways to cope with it on a daily basis. Heart Rate Variability Biofeedback has been shown to decrease the symptoms of asthma in studies done in general groups. It has also been shown to increase the peak performance of many athletes by helping them recover more quickly. Since HRV biofeedback could decrease the symptoms of asthma and increase peak performance for athletes, there may be a dual benefit to the use of HRVB with athletes who experience symptoms of asthma. This study will look at two groups; athletes that suffer from asthma and athletes that do not suffer from asthma. Both groups will receive HRV training to attempt to increase their HRV but to also see if it effects those with asthma differently. By comparing the two group’s peak performance, it could be seen that those with asthma may see a better performance outcome due to increased peak performance and reduced symptoms.
Asheville Middle School (AMS) strives to excel in academics, athletics, and involvement in the community, and recently the school has started to incorporate mindfulness into students’ everyday activities. The objective of this public service project was to extend this practice into athletics and shift mindfulness from a required activity to something the students could enjoy and benefit from in an extra-curricular context. The methods undertaken as part of the project included weekly visits to AMS to lead mindfulness practices with the girls’ soccer team. Prior to the beginning of each practice, a new mindfulness technique circling the idea of visualization and breathing was explained. Following the completion of the technique, an explanation was given on how the athletes could individually implement the practices into their athletic performance. Based on this work, we are developing a manual for coaches. The manual includes a list of mindfulness activities, directions on how to implement each activity, a page of extended resources, and guidance for coaches to move forward with their players. The manual will also emphasize athletics as a whole in hopes to extend this positive movement throughout all athletics and reduce any further negative connotations around mindfulness. Following the completion of the gathered feedback and results on certain exercises and research, all AMS coaches will have the ability to access the created manual to use with their teams so they can cultivate a more stable mind in their athletes and better cooperation overall.
America is facing an epidemic that killed over 33,000 people in 2015 across all ages. Substance abuse among teenagers and adults are only increasing due to the widespread addiction to over the counter drugs and prescription painkillers. Healthy People 2020 has made substance abuse a very high priority, particularly among youth. Rates have increased since reports in 2005 for nonmedical use of prescription drugs. The thought that pain relievers are less harmful to ingest and both increasing availability and access to these drugs has created an epidemic. The opioid crisis has a top down, and bottom up effect. Meaning doctors are prescribing medications to patients with chronic disease allowing the patient to be addicted to the medication. The bottom up aspect is in reference to the lack of knowledge or awareness that individuals have with taking medication. This paradox creates an unfair and problematic cycle in the distribution and abuse of prescribed medication. Millions are impacted by this every year, and it is only becoming more prevalent. I believe the approach to a solution should be multidimensional. First we must build an awareness in the community. This could be done by health educators through seminars, posters, and media. The other direction should come from health care providers. They should be required to educate about the possible effects of taking a medication and also possible alternatives to the medication. They should also be required to follow up with the patient after a week of being on the medication to look for alternatives to the prescription drug. This both verifies the appropriate use, as well as gives the patient a healthy more holistic alternative.
Most college students share at least one commonality: the lack of sleep. The goal of this product is to increase the number of hours of quality sleep in order to holistically improve the lives of students whether that be mentally, emotionally, academically, or physically. Hence, providing safe, comfortable spaces in the community “hubs” of campus for both the residential and commuter student bodies to rest is a goal within the Healthy Campus Initiative's grasp of being achieved. Many chemical, and biological factors play a role in the definition of ""quality sleep"" and are used throughout this project to both increase awareness and standards of rest. Other universities and companies across the country have provided information regarding certain methodologies in which to accomplish this mission of creating safe sleeping spaces across a university campus.
Despite the social barriers, inequality, and economic pressures from the ever-growing population; the Shiloh area of Asheville, NC has maintained its sense of community. One important part of this sense of community involves the meticulous record-keeping of the Shiloh Community Association (SCA). The SCA members, along with the African-American residents of Shiloh, show great commitment: promoting healthy lifestyles, supporting small businesses, recognizing youth education, cultivating diversity, pushing for safe environments, and creating recreational programs, etc.-within their community. With the increasing urban-white population, the inequality and economic gain is on the rise; putting the Shiloh community and its residence at constant risk for displacement. The purpose of this public service project was to assist the SCA in transferring nearly 15 years of archival documents from hard copies to electronic files. The methods undertaken included scanning of documents from many binders, labeling of over one thousand files, organizing the files by year and according to type of file, and training SCA members and residents in how to access and navigate the electronic archive. While the product is a shared electronic folder, the results include greater access to community documents, a living history of the community, and a mode for future documentation. This project represents a community’s effort to keep a sense of community while showcasing commitment. As the student working on this project, I have appreciated the look at a collective product that may provide insight into any disparities between an African-American community and the surrounding urban population, which might also affect its sustainability.
College athletes are exposed to high injury risk. Research previously conducted suggests sport injuries can be reduced with psychological and Biofeedback skill training. This presentation will use comparative soccer positions to find the effects correlated to biofeedback and heart rate variability to measure overall peak performance compared to injury reports. Biofeedback examines the body to make determinations about physiology, skeletal trauma, nutritional imbalances, as well as emotional states that can affect the body or mind. The focus of a biofeedback analysis on UNCA soccer players is to promote deep breathing skills, muscle relaxation, emotion regulation, and increased reaction time; these skills can be an indicator of decreased injury risk. The expenditure data will be evaluated using Heart Math and BioPak Software. This presentation will propose a research design in a forthcoming study.
For centuries, the universal language of music has been understood to have healing effects. In the last two centuries, humans have invented and utilized electronic music synthesis or the production of sound via transmission of electronic signals. Electronic music synthesis has given humans the capability to produce pure sound waves (i.e., sine, triangle, square, and sawtooth waves), introducing new ways for sound to be experienced. Research has shown that sound, principally pure sound, can have notable effects on physiological functioning. The method called binaural beats involves two sine waves, less than 1500hz and less than 40hz apart played, played in opposite each using stereo headphone. Binaural beat technology has been studied in terms of brainwave entrainment. This works by synchronizing brainwaves to the internal beat pulse created by binaural beats. Studies prove this has effect, but the degree to which it is effective for each individual has been debated. This research project will center around the effects of sound on the autonomic nervous system, specifically stimulation of the parasympathetic nervous system. My goal is to produce and test a more effective method of achieving desired results. Combining the binaural beat technology with heart-rate variability biofeedback, I hope to achieve desired results, altering brainwaves and moving the participants into a relaxed, parasympathetic state.
Bystander intervention education is a topic of growing importance on college campuses across the United States. This education encourages students to be active bystanders in situations of potential harm or violence against others by equipping students with the knowledge and tools necessary to intervene. Stand Up, Speak Out (SUSO) is UNC Asheville’s bystander intervention program. Unlike most college bystander intervention programs, Stand Up, Speak Out focuses on a wide array of topics including bullying, discriminatory language, sexual violence, peer pressure and more. Traditionally, each workshop is instructed by a student intern, based in the belief that students will be more receptive to student-led presentations. This poster presentation will explore aspects of the SUSO curriculum, based in the experiences of the Student Coordinator Intern for the program.
A large population within the United States of America has fallen to the grips of a growing health crisis, opioid addiction. According to recent data, during 2015 there were approximately 52,404 overdose deaths in the United States, with 33,091 as a result of opioids. Not only is the tragedy of death rampant, but also even more disconcerting is the economic and social toll impacting families across the nation. The purpose of my research is to examine and better understand the application medical marijuana may have in combating this crisis. Traditionally, due to education and government policies, medical professionals have often prescribed opioids for pain management, with little consideration for alternative approaches. After reading over 12 scholarly articles and peer reviewed journals I have found a promising potential for medical marijuana in relation to the opioid crisis. The least psychoactive cannabinoids present in cannabis is CBD, meaning it does not get users “high”, unlike the more commonly known cannabinoid Tetrahydrocannabinol (THC). This fact gives CBD the highest potential for medical application and use in treating substance abuse. Many experimental studies that have indicated support for the application of CBD in treating behaviors associated with addiction. Clinical research applied to cannabis in regards for managing chronic pain has extensively indicated that cannabis is safe and effective as a treatment option. One drug can rarely treat all aspects of a condition, including chronic pain; this opens the door for the potential of using cannabis in conjunction with opioids to treat pain. Research has indicated that the introduction to cannabis for treating chronic pain has the potential to result in reduction or even complete termination of opioid use. I believe that the medical and social potential of cannabis should be further discussed in regards to the opioid crisis.
From 2000 to 2011, diagnoses of ADHD rose 42 percent. One in 10 children in the US are currently diagnosed with ADHD, and this number is increasing. I would like to explore the link between ADHD diagnosis and early use of electronics in childhood. Contributing factors to this problem could be a trend towards allowing children access to TV, computers, video games, and cell phones more frequently and at younger ages. The primary treatments for ADHD are medication and therapy. Medication for chronic behavioral disorders in early childhood is problematic, and I would like to explore an intervention that prevents attention deficit disorders from the beginning by reducing screen time for young children at home and in schools. None of the current treatments are preventative or holistic. Through encouraging outdoor and creative play in place of screen time we may be able to effectively “slow down” kids’ brains in a constructive way so as to encourage calmer and more focused behavior. I am proposing an intervention for elementary school aged children that would stem from an in-school program and be carried out at home to reduce the amount of time they spend in front of a screen and encourage them to come up with new forms of creative entertainment. The intervention would engage students in a competition to prove which student could spend the least amount of time in front of a screen over the course of the school year. A large incentive prize would be presented to the student who most successfully reduced media time by the end of the year. I believe a program like this could empower children and change lifelong habits of media use.