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A chance occurrence helped to shape the path of Ashley Duff’s senior year at the University of Kentucky.

After seeing a promotion for the CPH 395 course for the Fall 2021 semester, the UK undergraduate student noticed one of the faculty mentors for the independent study course was Dr. Angela Carman.

Ashley knew that Dr. Carman, an assistant professor in the Department of Health, Behavior & Society, has research interests focused on community engagement and public health accreditation readiness. Ashley reached out for more information. The two communicated about an independent study curriculum that would expose Ashley to field work while allowing her to develop her interest in health data.

"The CPH 395 experience is so valuable for our students,” says Dr. Angela Carman. “Students work closely with dedicated faculty who are a rich source of information delivered in the context of research and practice projects. It is a ‘front-row seat’ to an invaluable learning experience."

Ashley began the College of Public Health (CPH) independent study course in mid-2021. The pre-med major’s priority was to update and maintain a database that aggregates publicly available data points.

“Our public health practice partners and their community organizations need data from which they can make decisions about health needs and ways to address those needs,” says Dr. Carman. “What we have tried to do with our database is to put many of these data points in a ‘one-stop shop’ location for ease of use. As we work with specific counties, we pull this information for them to save their time and assist their community partnerships with decision making tools leading to action.”

CPH’s oversight of the database is valuable both to end users of the information and to the students who assemble the data. Carman explains the project allows students to gain skills in finding and reporting data and saves time that practice partners would need to spend finding and reporting the same data.

UK CPH senior conducts in-the-field research

The CPH database assists public health practice partners with data needed for Community Health Assessments and Community Health Improvement Planning. Dr. Carman notes that partners have used the data to help understand the health of their communities and to determine which issues to prioritize for new interventions or policy updates.

Working with Dr. Carman, Ashley’s initial goal was to update database records for four Northern Kentucky counties.

Ashley researched and compiled county health records from the U.S. Census and the Center for Disease Control (CDC), and arrest records from the Kentucky State Police, along with locating records of population, household income, smoking rates, drug arrests, and myriad other demographic, recreational, and occupational data points. Reflecting on the project, she notes each county had special requests for data to be included in the reports shared with them.

With Dr. Carman overseeing Ashley’s work as part of the student’s CPH 395 studies, she aggregated the data in Microsoft Excel and made use of the spreadsheet’s formatting options and complex statistical formulas to present the information in accessible and useful summaries. She shared reports electronically with each public health practice partner and provided hard copies of reports as needed.

During the independent study, Ashley also accompanied Dr. Carman into the field. She attended the Kentucky River District Health Department’s (KRDHD) annual training day in December 2021. The event was held in Red Fox, Kentucky, where Ashley assisted Dr. Carman with delivery of team-building activities for the staff and a facilitated discussion of what the KRDHD had learned about the seven counties of the district during the Covid-19 pandemic.

In addition, Ashley has attended Northern Kentucky District Health Department’s (NKDHD) steering committee meetings in Covington, Kentucky, where next steps for Community Health Assessment and Community Health Improvement Planning were discussed.

Expansion of the research study’s scope

What began as a four-county project quickly expanded at the conclusion of 2021 to include all of the Commonwealth’s 120 counties. That’s when Jenni Jinright, senior strategy consultant for UK HealthCare in the office of the executive vice president for health administration (EVPHA), requested an update to statewide county-level data that Dr. Carman had first shared five years previously as part of the UK HealthCare Strategic Plan and the Healthy Kentucky Initiative.

Jinright explains the information was used for a community health needs assessment to assist in prioritizing and aligning UK HealthCare efforts with community need. “Ashley’s work combines multiple public data sources for ease of use and will be instrumental in helping us target our efforts to maximize impact and deliver equitable care to help create a healthier Kentucky,” Jinright says. “I look forward to expanding and exploring more opportunities to work together to leverage the knowledge and insight from our colleagues in the College of Public Health.”

Ashley’s comprehensive spreadsheets grew to encompass 70 to 80 health factors per county, from the Appalachian Mountains along Kentucky’s eastern borders to the Jackson Purchase counties in the state’s west side. Much of her Spring 2022 semester was spent populating the roughly 9,000 data cells in that file, allowing Dr. Carman to send the information to the EVPHA’s office in mid-March.

Additional study comparing county health departments

Dr. Carman notes Ashley had a particular interest in local health departments, especially those whose jurisdiction is a single county.

“She wanted to better understand the work done in these single-county health departments and how they were alike or different,” Dr. Carman says. “She compared them on the demographics of the people they serve, training and background of leadership, accreditation, and engagement with their communities.

“I started out by interviewing county health department directors,” Ashley recalls, noting she appreciated that the task was not spent entirely in front of computer monitors. “I was in the field; that was good hands-on experience.”

“One of the most interesting elements of her project was the level of engagement with the community. One health department had many projects in which they worked in a multi-disciplinary way with their community partners and achieved several milestones including Harm Reduction activities for the community as well as National Voluntary Public Health Accreditation status.”

Post-graduation plans

Ashley’s CPH 395 studies concluded with the Spring 2022 semester. Dr. Carman lauds the independent study course and her student’s participation in the database project.

"Finding projects which allow students to enhance their skills while providing our public health practice partners with useful information for health improvement is a win-win situation,” she says. “The work Ashley has done to update and enhance our database will be incredibly useful to many communities in Kentucky."

Ashley first began her public health studies as a sophomore, and quickly found a home in CPH. “The professors are so nice and understanding and approachable,” she says, recalling the less personal interactions of a larger program. “In pre-med, I’m one of 200 people, and professors won’t always know who you are when you reach out. In public health, everyone knows who I am and everyone is approachable. I love the kindness of the program.”

And, while Ashley will don a cap and gown in May 2022 as she concludes her undergraduate career, she won’t stay away from UK’s campus for long. The Lawrenceburg, Ky., native will return to the UK College of Public Health to get her Master of Public Health (MPH) in Fall 2022.

In the longer term, as Ashley considers medical school for her future, she sees great value in a public health background. “If I do become a doctor, I’ll be a more well-rounded doctor.”

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