Indiana University-Purdue University Indianapolis (IUPUI)

Lyme disease is a multisystemic, infectious disease caused by the tick-borne spirochete Borrelia burgdorferi. The CDC designated LD as a reportable disease in 1990 and evidence suggests underreporting of the disease in Indiana. Local health department nurses have a major role in the areas of disease recognition, reporting, and education about LD. The present study assessed local health department nurses' knowledge of LD to determine their competence as LD educators.The study consisted of 428 nurses in 92 counties and three cities with independent health departments who were mailed a questionnaire containing 30 multiple-choice and/or true/false questions. Twenty-four nurses participated in a pilot study to establish the reliability of the instrument.The results were: (1) nurses did not differ in knowledge regardless of their duties, (2) urban and rural counties did not differ in knowledge, (3) experience did not make a difference in knowledge, and (4) less educated nurses were more knowledgeable. The nurses were least knowledgeable about LD reporting criteria, late stage symptoms, and and description of EM and most knowledgeable about prevention. The following are some of the recommendations suggested: more research with nurses on vector- borne diseases, better dissemination of information from CDC and ISDH, inservice programs for nursing personnel, and educational materials to distribute to the public. / School of Nursing

The focus of the study was to examine the extent to which pharmacies in Indiana are currently selling cigarettes and alcohol, the current opinions of pharmacists, to compare findings with the previous 1996 Indiana study and to determine pharmacists' familiarity with available public health resources. A survey questionnaire was designed based on previous studies. It was reviewed by a jury of experts and subsequently administered to the randomly selected pharmacies in Indiana. Of those pharmacies that were included in the study, 74.4% were returned. Collected data were analyzed and compared to findings from 1996 using descriptivestatistical methods.Findings revealed that fewer pharmacies sold cigarettes in 2001 (58.1%) than in 1996 (63.7%). Alcohol sales continued at 206 (43.7%) of pharmacies currently selling alcoholic beverages, which is relatively the same level as in 1996, 202 (41.9%) of pharmacies. There is an increasing trend in pharmacists that believe pharmacies should be selling neither cigarettes (+7.2%) nor alcohol (+4.7). Most pharmacists' (64%) agree that they play asignificant role in health promotion/disease prevention to the public, yet only 42.6% involve themselves with publichealth promotion activities. The capability of pharmacists to refer people to outside resources for educational needsis limited. Over three-fourths of pharmacists are either completely unfamiliar with or have no opinion about thethree most well-funded public health programs in the state of Indiana. / Department of Physiology and Health Science

This study explored and described the experiences of Eritrean immigrants regarding utilisation of healthcare services in Indianapolis. Qualitative descriptive phenomenological design was utilised. Data were collected using a semi-structured interview format, on eight conveniently selected Eritrean immigrants, living in Indianapolis. Data were analysed using Interpretive Phenomenological Analysis Framework for data analysis. Three superordinate themes emerged from data analysis: Healthcare financing system, Positive side of healthcare services and Challenges related to utilisation of healthcare service. All these factors have an impact on the utilisation of the Healthcare services by Eritrean immigrants. Recommendations have been put forward to advocate for policy change regarding financing of healthcare services for immigrants and improved healthcare services to accommodate cultural diversity. Further research should be conducted on ways of improving utilisation of healthcare services by Eritrean immigrants in Indianapolis. / Public Health / M.A. (Health Studies)

This study explored and described the experiences of Eritrean immigrants regarding utilisation of healthcare services in Indianapolis. Qualitative descriptive phenomenological design was utilised. Data were collected using a semi-structured interview format, on eight conveniently selected Eritrean immigrants, living in Indianapolis. Data were analysed using Interpretive Phenomenological Analysis Framework for data analysis. Three superordinate themes emerged from data analysis: Healthcare financing system, Positive side of healthcare services and Challenges related to utilisation of healthcare service. All these factors have an impact on the utilisation of the Healthcare services by Eritrean immigrants. Recommendations have been put forward to advocate for policy change regarding financing of healthcare services for immigrants and improved healthcare services to accommodate cultural diversity. Further research should be conducted on ways of improving utilisation of healthcare services by Eritrean immigrants in Indianapolis. / Public Health / M.A. (Health Studies)

Indiana University-Purdue University Indianapolis (IUPUI) / Consistent under-reporting of autism cases by Indiana physicians to the Indiana Birth Defects and Problems Registry (IBDPR) has made quality autism-related data very difficult to obtain (Indiana Birth Defects and Problems Registry [IBDPR], 2011). As a result, the Indiana State Department of Health (ISDH) currently also utilizes data from billing information that it receives from hospital discharges. However, such cases must be investigated further because autism is often merely suspected as a possibility in the discharge data. A chart auditor must therefore review the child’s chart to determine if the condition is confirmed. Meanwhile, the Indiana Department of Education (IDOE) has a different diagnostic procedure from physicians for determining whether a student has an Autism Spectrum Disorder (ASD), which qualifies him or her for special education. A physician diagnosis of autism does not guarantee that a child will receive special education from public schools. With all of these current complications surrounding autism, announced changes in the definition of autism by the American Psychiatric Association (APA) will likely have effects on both the special education field and the public health field. There is a possibility that children who had previously received special education could cease to maintain their eligibility and may find it difficult to obtain benefits. The IDOE may find it necessary to reevaluate their criteria for determining special education eligibility. Additionally, public health officials may see the definition changes affect the number of autism cases they perceive their populations to have, thus impacting community and policy decisions. This study was performed as an attempt to investigate and compare the sources used by the IBDPR to obtain autism data, and determine whether or not the resulting data creates an accurate depiction of the autistic population of Indiana. It was also performed to speculate whether a stricter definition of autism will result in a higher quality of data for the IBDPR and a more consistent view on the disorder between the ISDH and the IDOE. Perhaps from such consistency and simpler definitions, future recorded data will more closely resemble that of reality, enabling the ISDH to utilize the IBDPR to its full extent. Using current definitions for an exploratory analysis of data from the past five years, a discrepancy clearly exists between the IBDPR and the reality of the population of Indiana.

Indiana University-Purdue University Indianapolis (IUPUI) / The Charity Organization Society of Indianapolis experienced founding, maturing, and corporate phases between 1879 and 1922. Indianapolis provided the ideal setting for the organized charity movement to flourish. Men and women innovated to act on their civic ideal to make Indianapolis a desirable city. As charity leaders applied the new techniques of scientific philanthropy, they assembled data one case at a time and based solutions to social problems on reforming individuals. The COS enjoyed its peak influence and legitimacy between 1891 and 1911. The organization continually learned from its work and advised other charities in Indianapolis and the U.S. The connected men and women engaged in organized charity learned that it was not enough to reform every individual who came to them for help. Industrialization created new socioeconomic strata and new forms of dependence. As the COS evolved, it implemented more systemic solutions to combat illness, unemployment, and poverty. After 1911 the COS stagnated while Indianapolis diversified economically, culturally, ethnically, and socially. The COS failed to adapt to its rapidly changing environment; it could not withstand competition, internal upheaval, specialization, and professionalization. Its general mission, to aid anyone in need, became lost in the shadow of child saving. Mid-level businessmen, corporate entities, professional social workers, service club members, and ethnic and racial minorities all participated in philanthropy. The powerful cache of social capital enervated and the civic ideal took on different dimensions. In 1922 the COS merged with other agencies to form the Family Welfare Society. This dissertation contributes to the scholarship of charity organization societies and social welfare policy. The scientific philanthropy movement did not represent an enormous leap from neighborhood benevolence. COSs represented neither a sinister agenda nor the best system to eradicate poverty. Organized charity did not create a single response to poverty, but a series of incremental responses that evolved over more than four decades. The women of Indianapolis exhibited more agency in their charitable work than is commonly understood. Charitable actors worked to harness giving and volunteering, bring an end to misery, and make Indianapolis an ideal city.