Digital Commons Network^™

Dental Care Utilization Among U.S. Children Participating In Early Head Start Programs, Ahlam Ibraheem Joufi

Health Services Research Dissertations

Early childhood caries (ECC) remains one of the most common preventable diseases among children under the age of 6 years. Several national stakeholders recommend establishing a continuous collaboration of individuals involved with receiving oral health services (dental home) and routine dental care for the child by 12 months. Despite this recommendation, disparities exist among young, low-income children in preventive dental service utilization. The Early Head Start (EHS) program serves low-income children aged 0-3 years and their families and promotes oral health practices and service utilization within the program. This study aims to examine predictors of dental care utilization among children …

The Influence Of Minority Stress, Coping, And A Pandemic On The Relationship Between Sexual Orientation And Mental Health: A Mixed Methods Study, James Michael Macchia

Psychology Theses & Dissertations

For decades, scientific literature has shown that sexual minority individuals across populations are disproportionately affected by negative mental health outcomes when compared to their heterosexual counterparts. These disparities are largely attributable to minority stress. Coping is a significant factor that can impact the content and severity of mental health outcomes and coping behaviors have been shown to vary based on sexual orientation. Mental health outcomes may also differ between sexual minority subgroups due to additional factors such as double discrimination and bisexual invisibility/erasure. Moreover, factors such as internalized homophobia and community connectedness have demonstrated strong associations with sexual minority mental …

Exploring Methods To Reduce Stress In College Students: Dog-Assisted Therapy, Ashley A. Green

Psychology Theses & Dissertations

Many young adults find their college years to be highly stressful. The American College Health Association (2021) found 48% of college students reported moderate to severe levels of psychological stress. Research has found that chronic stress, commonly found in the college population, can adversely affect the health and academic performance of college students (Campbell & Svenson, 1992). Universities have begun experimenting with and adopting a variety of strategies to help students manage stressors associated with college attendance. These initiatives have included relatively well-researched procedures such as meditation and yoga as well as emerging practices. Recently, some colleges have begun testing …

The Mediation Effects Of Adaptive Blindness Strategies On The Relation Between Institutional Betrayal From Military Sexual Assault And Mental Health Symptoms, Rachel L. Davies

Psychology Theses & Dissertations

Military sexual assault is a serious and prevalent issue. The frequency with which military sexual assault occurs and the nature of the response to these events within the military system may contribute to institutional betrayal. Institutional betrayal is the failure of an institution, such as the military, to prevent sexual assault from occurring and/or the failure to support a survivor after sexual assault. Adaptive blindness strategies are forms of coping strategies that help individuals navigate a relationship they depend on when there is a betrayal. Two adaptive blindness strategies are self-blame and minimization. Although the adaptive blindness strategies may allow …

Teaching Social Determinants Of Health In Physical Therapist Professional Education Programs: Exploring Curricular Approaches And Examining An Assessment Tool, Emily Jordan Hawkins

Rehabilitation Sciences Theses & Dissertations

There is a growing emphasis and need for physical therapists (PTs) to serve not only as clinicians but also as advocates to pursue health equity. Clinical practice for preventing and rehabilitating injuries and promoting physical activity will not eliminate health disparities resulting from the social determinants of health (SDH). Leaders in the field of physical therapy have charged physical therapist professional education programs to teach future PTs to address SDH, however, as of August 2023, the Standards and Required Elements for Accreditation of Physical Therapist Education Programs does not specifically require curricular content regarding SDH. The purposes of this dissertation …

Examining The Experience And Impact Of Teen-To-Teen Crisis Line Work For Youth Volunteers: A Pilot Study, Taylor Kalgren

Psychology Theses & Dissertations

For young people, suicide is a leading cause of death. In addition, suicidal thoughts and behaviors begin during adolescence, and rates are high during this developmental period. Crisis lines are one of the oldest suicide prevention strategies used today. Crisis line work is challenging, and therefore, examining the health and safety of these operators is critical. Teen-to-teen (t2t) crisis lines are a unique resource where adolescent volunteers help their similarity aged peers. The goal of this pilot study was to begin to evaluate the impact of t2t crisis lines for youth volunteers. Twenty youth crisis line volunteers (ages 15-20) were …

Providing Family Centered Care Within Pediatric Integrated Care Settings, Emily D. Bebber

Counseling & Human Services Theses & Dissertations

Parent engagement remains critical to pediatric care. Both pediatric medical and mental health care remains dependent upon parent/guardian engagement to support successful outcomes for children and adolescents. Efforts to enhance Family Centered Care (FCC) has been spotlighted within pediatric care since the 1950s and the inclusion of counselors within integrated behavior health (IBH) teams ushers a need for an evolved understanding of the implementation of FCC, including parent/guardian engagement across professional roles. Using an explanatory mixed-method design, I examined team implementation of Family Centered Care (FCC) among different provider types (e.g., physicians, nurses, licensed mental health providers, social workers, technicians) …

Tobacco Smoking Among Saudi College Students: Validation Of An Arabic Health Belief Model Instrument, Saad Abdullah S. Alotaibi

Health Services Research Dissertations

This dissertation intended to learn more about Saudi college students' behavior in relation to the use of tobacco smoking. Multiple interrelated projects have been carried out in order to achieve this ambitious goal. The goal of the first study was to evaluate the scope of the existing smoking issue as indicated by research, by systematically estimating the prevalence of tobacco use among higher education students in Saudi Arabia. The second study aimed to systematically analyze and integrate the existing information on the determinants of smoking among Saudi college students. The last project aimed to develop a psychometric instrument to evaluate …

The Effect Of Minority Stress On Sexual Minority College Students' Mental Health: The Role Of General Social Support And Sexuality-Specific Social Support, Lee A. Golembiewski

Psychology Theses & Dissertations

Sexual minority (SM) college students continue to face greater mental health problems relative to their heterosexual peers (Woodford et al., 2014; Wilson & Liss, 2022). According to minority stress theory, SM individuals face distal (e.g., heterosexist discrimination) and proximal (e.g., expectations of rejection, internalized homophobia, and concealment) stressors related to their SM identity which can have negative effects on their mental health (Douglass & Conlin, 2020; Meyer, 2003). However, social support has been hypothesized to help protect against the effects of minority stress experienced by SM individuals (Cohen & Wills, 1985; Moody & Smith, 2013). Most of the existing research …

Predicting E-Cigarette Use Among Emerging Adults Using Perceived Social Norms And Outcome Expectancies, Stephen N. Hanson

Psychology Theses & Dissertations

Despite low rates of combustible tobacco use rates among adolescents and young adults, e-cigarettes continue to gain popularity. A few factors have been shown to be related to e-cigarette use based on prior research. One such example is social enhancement expectancies. Additionally, greater perceptions of harm have been found to be inversely related to e-cigarette use such that those that expect increased risk to their health are less likely to report using e-cigarettes. I hypothesized that social enhancement expectancies would mediate the relationship between perceptions of social norms and e-cigarette dependence. I also hypothesized that perceived harm, such as greater …

Impact Of Culturally Tailored Shared Medical Appointments On Diabetes Self-Care Ability And Knowledge In African Americans, Adrienne L. Reddick, Deborah C. Gray

Nursing Faculty Publications

Background: Type 2 diabetes mellitus (T2DM) continues to disproportionately affect African Americans, significantly impacting morbidity and mortality. Research suggests that addressing barriers that stem from socioeconomic circumstances, systemic inequalities, biological factors, and cultural factors may positively influence biometric indicators of health and diabetes control. Objective: The aim of this study was to evaluate a diabetes shared medical appointment (SMA) model program that has been culturally tailored to address the unique social determinants of health barriers faced by an inner city African American population in Norfolk, Virginia. Methods: A pilot study using a within-group pretest–posttest design was conducted. Information was collected …

Architectural Design Of A Blockchain-Enabled, Federated Learning Platform For Algorithmic Fairness In Predictive Health Care: Design Science Study, Xueping Liang, Juan Zhao, Yan Chen, Eranga Bandara, Sachin Shetty

VMASC Publications

Background: Developing effective and generalizable predictive models is critical for disease prediction and clinical decision-making, often requiring diverse samples to mitigate population bias and address algorithmic fairness. However, a major challenge is to retrieve learning models across multiple institutions without bringing in local biases and inequity, while preserving individual patients' privacy at each site.

Objective: This study aims to understand the issues of bias and fairness in the machine learning process used in the predictive health care domain. We proposed a software architecture that integrates federated learning and blockchain to improve fairness, while maintaining acceptable prediction accuracy and minimizing overhead …

The Shortfalls Of Vulnerability Indexes For Public Health Decision-Making In The Face Of Emergent Crises: The Case Of Covid-19 Vaccine Uptake In Virginia, Lydia Cleveland Sa, Erika Frydenlund

VMASC Publications

Equitable and effective vaccine uptake is a key issue in addressing COVID-19. To achieve this, we must comprehensively characterize the context-specific socio-behavioral and structural determinants of vaccine uptake. However, to quickly focus public health interventions, state agencies and planners often rely on already existing indexes of "vulnerability." Many such "vulnerability indexes" exist and become benchmarks for targeting interventions in wide ranging scenarios, but they vary considerably in the factors and themes that they cover. Some are even uncritical of the use of the word "vulnerable," which should take on different meanings in different contexts. The objective of this study is …

Examining The Impact Of De-Escalation Training Among Emergency Department Nurses, Jonathan Recchi, Jeffrey N. Doucette, Janice E. Hawkins

College of Health Sciences Posters

Workplace violence is a growing concern for US nurses, especially in the context of COVID-19 and patient incivility. De-escalation training can help mitigate high-risk incidents, but its psychological benefits are not well understood. This study aimed to determine if de-escalation training for emergency department nurses provided psychological benefit. This pre-experimental pre-test, post-test study evaluated nurse confidence in coping with patient aggression, caregiver resiliency, professional quality of life, and intention to stay with the organization. Participants completed a pretest survey, attended a two-hour verbal de-escalation training via zoom, and then completed the posttest survey. The study showed that attending the two-hour …

Use Of The Rasch Model For Fit Statistics And Rating Scale Diagnosis For The Student Perception Appraisal- Revised, Robert J. Hawkins, Janice Hawkins, Beth Tremblay, Lynn Wiles, Karen Higgins

Nursing Faculty Publications

Background and Purpose: Nursing student retention is essential to meet workforce demands. Jeffrey's Nursing Student Retention Student Perception Appraisal-Revised (SPA-R1) has been used extensively to understand factors that impact retention. Psychometric testing of the SPA-R1 contributes to greater confidence in the instrument's reliability and validity.

Methods: Item response theory and specifically, the single parameter polytomous Rasch model was used as a framework for fit statistic testing and rating scale diagnostics of the SPA-R1. This was a secondary analysis of a convenience sample of undergraduate prelicensure nursing students. The setting for the previous study was virtual, and the study period was …

Role Of Nativity In Mental Health Service Utilization Among Asian Americans: A Weighted Analysis Of Complex Survey Data, Anne Dumadag, Hadiza Galadima

College of Health Sciences Posters

Asian Americans represent both the fastest-growing population and the smallest group of consumers of mental health services (MHS) in the United States. The current study aimed to identify factors associated with MHS use and explore differences in MHS use by nativity among Asian Americans. Data from the 2015-2018 National Health and Nutrition Examination Survey (NHANES) were used to examine past-year MHS use among Asian Americans ages 18 and older. Weighted analyses were used to determine the distribution of the population by nativity and other covariates, and Rao-Scott Chi-Square tests were used to explore the association between past-year MHS use and …

Refining An Ecological Momentary Assessment Study Of Binge Eating Among Sexual Minority And Heterosexual Young Women: A Mixed Methods Pilot Study, Kristin E. Heron, Charlotte A. Dawson, Cassidy M. Sandoval, Lauren V. Butler, Abby L. Braitman, Alison Cerezo, Robin J. Lewis

Psychology Faculty Publications

Background: Ecological momentary assessment (EMA) is used to capture daily lived experiences, states, and environments. Although EMA is commonly used in behavioral health research, there remains a dearth of literature on how researchers account for design considerations of EMA techniques when designing studies. The goal of this formative mixed methods study was to elicit feedback on EMA study procedures and materials from the target populations for a larger study about binge eating among sexual minority and heterosexual young women, in which data are collected entirely remotely.

Methods: Sexual minority (n=12) and heterosexual (n=9) women ages 18–30 who binge ate took …

The Influence Of Internalized Heterosexism On Life Satisfaction: Comparing Sexual Minority Women In Belgium And Turkey, Esra Ummak, Ezgi Toplu-Demirtaş, Amber L. Pope, Jeffry Moe

Counseling & Human Services Faculty Publications

To date, the majority of research studying lesbian, gay, bisexual, transgender, and queer (LGBTQ) health has been conducted in Westernized, predominantly individualistic countries. Building on minority stress theory and models of LGBTQ health, we explored how sexual orientation and nationality moderated the association between internalized heterosexism and life satisfaction for lesbian and bisexual (LB) women living in two countries (Turkey and Belgium) with contrasting social contexts. The results of two-way MANOVA, in a sample of 339 Turkish and 220 Belgian LB women, revealed main effects but no interaction effects. LB women in Belgium reported less internalized heterosexism and more life …

Heightened Technology In The Care Of Type 1 Diabetes: An Ethical Symbiosis?, Susanna Larsen

OUR Journal: ODU Undergraduate Research Journal

This paper explores the common negative consequences and ethical issues associated with the evolving medical technology used in the care of Type 1 diabetes. In this paper, I will discuss the ethical impacts of technology on diabetic youth: their view of self, their mechanical requirements, and their health priorities. In order to define the scope of the issues, I will use the following intellectual tools: feminist theory, care ethics, and philosophical discussions of control. This paper will also outline some possible solutions to these ethical issues.

Prevalence Of Gastrointestinal Symptoms Among Autistic Individuals, With And Without Co-Occurring Intellectual Disability, Calliope Holingue, Danika Pfeiffer, Natasha N. Ludwig, Rachel Reetzke, Ji Su Hong, Luther G. Kalb, Rebecca Landa

Communication Disorders & Special Education Faculty Publications

Gastrointestinal symptoms (GI) are very common among individuals on the autism spectrum. Prior research reports mixed findings regarding whether individuals with autism and co-occurring intellectual disability (ID) have elevated risk of gastrointestinal symptoms relative to individuals with autism alone. GI symptoms can be challenging to assess in individuals with autism spectrum disorder (ASD) and/or ID given challenges with language, communication, and interoception. Prior research has tended to only include individuals with documented presence or absence of GI symptoms or conditions, that is, to exclude observations in which there is uncertainty regarding presence of GI symptoms. Therefore, none of the prior …

A Comparison Of Chief Complaints, Specific Diagnoses, And Demographics Of Pediatric Urgent Care Visits Before And During The Covid-19 Pandemic: A Retrospective Study, Zaharoula A. Viennas, Julie Martin, Benjamin Klick, Tammy Speerhas, Turaj Vazifedan, Danielle Millspaugh, Jennifer Ferris, Margret Bedle, Lauren Paluch, Theresa Guins

Nursing Faculty Publications

There was an increased incidence of pediatric patients who presented with injuries caused by falls not related to sports or other recreational activities, as well as for animal bites, during the early pandemic period of April 2020. Education of parents and caregivers of young children is warranted to raise awareness of the even greater potential for falls and animal bites when children are confined at home for longer than typical periods of time, as occurred with the stay-at-home government orders during the initial period of the COVID-19 pandemic.

Family Structure And Child Behavior Problems In Australia, The United Kingdom, And The United States, Nina A. Stoddard-Bennett, Jordan Coburn, Mikaela J. Dufur, Jonathan A. Jarvis, Shana L. Pribesh

Educational Leadership & Workforce Development Faculty Publications

A large body of literature suggests that children living with two married, biological parents on average have fewer behavior problems than those who do not. What is less clear is why this occurs. Competing theories suggest that resource deficiencies and parental selectivity play a part. We suggest that examining different contexts can help adjudicate among different theoretical explanations as to how family structure relates to child behavior problems. In this paper, we use data from the Growing Up in Australia: Longitudinal Study of Australian Children (LSAC), the UK Millennium Cohort Study (MCS), and the US Early Childhood Longitudinal Study (ECLS-K) …

Protecting Low-Income Consumers In The Era Of Digital Grocery Shopping: Implications For Wic Online Ordering, Qi Zhang, Priyanka Patel, Caitlin M. Lowery

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is now expected to allow participants to redeem their food benefits online, i.e., via online ordering, rather than only in-store. However, it is unclear how this new benefit redemption model may impact participants’ welfare since vendors may have an asymmetric information advantage compared with WIC customers. The WIC online ordering environment may also change the landscape for WIC vendors, which will eventually affect WIC participants. To protect WIC consumers’ rights in the new online ordering model, policymakers need an appropriate legal and regulatory framework. This narrative review provides that …

Psychometric Properties Of The Persian Version Of Consideration Of Future Safety Consequence (Cfsc) Scale, Fazel Rajabi, Hamidreza Mokarami, Payam Farhadi, Sean Banaee, Mehdi Jahangiri

Community & Environmental Health Faculty Publications

Background: Personality traits, due to having a relative stability, are important factors for predicting employees’ safety behavior. Consideration of Future Safety Consequence (CFSC) is a personality trait that was recently introduced to predict the safety behaviors. The purpose of this study was to translate and assess the psychometric properties of the Persian version of the CFSC scale.

Methods: In the first stage of this cross-sectional study, the instrument was prepared by the forward-backward forward translation technique and evaluated by 487 employees of a gas refinery. The validity of the scale was evaluated through face, concurrent, validity, and construct validity. The …

Unraveling Controversies Over Civic Honesty Measurement: An Extended Field Replication In China, Qian Yang, Weiwei Zhang, Shiyong Liu, Wenjin Gong, Youli Han, Jun Lu, Donghong Jiang, Jingchun Nie, Xiaokang Lyu, Rugang Liu, Mingli Jiao, Chen Qu, Mingji Zhang, Yacheng Sun, Xinyue Zhou, Qi Zhang

Community & Environmental Health Faculty Publications

Cohn et al. (2019) conducted a wallet drop experiment in 40 countries to measure "civic honesty around the globe," which has received worldwide attention but also sparked controversies over using the email response rate as the sole metric of civic honesty. Relying on the lone measurement may overlook cultural differences in behaviors that demonstrate civic honesty. To investigate this issue, we conducted an extended replication study in China, utilizing email response and wallet recovery to assess civic honesty. We found a significantly higher level of civic honesty in China, as measured by the wallet recovery rate, than reported in the …

Comparison Of Physics-Based Deformable Registration Methods For Image-Guided Neurosurgery, Nikos Chrisochoides, Yixun Liu, Fotis Drakopoulos, Andriy Kot, Panos Foteinos, Christos Tsolakis, Emmanuel Billias, Olivier Clatz, Nicholas Ayache, Andrey Fedorov, Alex Golby, Peter Black, Ron Kikinis

Computer Science Faculty Publications

This paper compares three finite element-based methods used in a physics-based non-rigid registration approach and reports on the progress made over the last 15 years. Large brain shifts caused by brain tumor removal affect registration accuracy by creating point and element outliers. A combination of approximation- and geometry-based point and element outlier rejection improves the rigid registration error by 2.5 mm and meets the real-time constraints (4 min). In addition, the paper raises several questions and presents two open problems for the robust estimation and improvement of registration error in the presence of outliers due to sparse, noisy, and incomplete …

Forming The Perception Of Wic Infant Feeding Recommendations: A Qualitative Study, Emily Fisher, Kathryn Wouk, Priyanka Patel, Chuanyi Tang, Qi Zhang

Community & Environmental Health Faculty Publications

Nearly half of newborns in the United States are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Promoting breastfeeding is a programmatic priority, although formula vouchers are provided for those who do not exclusively breastfeed. Previous literature suggests that participant perception of WIC’s breastfeeding recommendations is a significant factor predicting breastfeeding initiation, duration, and exclusivity outcomes. However, little is known about how participants’ perceptions of WIC’s breastfeeding recommendations are formed. To address this knowledge gap, we conducted a qualitative pilot study in Nevada, interviewing 10 postpartum WIC mothers and 12 WIC staff who had interacted …

The Effectiveness Of An Ehealth Family-Based Intervention Program In Patients With Uncontrolled Type 2 Diabetes Mellitus (T2dm) In The Community Via Wechat: Randomized Controlled Trial, Yuheng Feng, Yuxi Zhao, Linqi Mao, Minmin Gu, Hong Yuan, Jun Lu, Qi Zhang, Qian Zhao, Xiaohong Li

Community & Environmental Health Faculty Publications

Background: Intervention based on family support and risk perception can enhance type 2 diabetes mellitus (T2DM) patients’ self-care activities. In addition, eHealth education is considered to improve family members’ support for patients with T2DM. However, there is little evidence from rigorously designed studies on the effectiveness of an intervention combining these approaches.

Objective: This randomized controlled trial (RCT) aimed to assess the effectiveness of an eHealth family-based health education intervention for patients with T2DM to improve their glucose control, risk perception, and self-care behaviors.

Methods: This single-center, 2-parallel-group RCT was conducted between 2019 and 2020. Overall, 228 patients were recruited …

Obesity During Adolescence And Feeding Practices During Infancy: Cross-Sectional Study, Reem Sharaf-Alddin, Radhia Almathkoori, Hara Kostakis, Ahmed N. Albatineh, Abdullah Al-Taiar, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Background: Breastfeeding is proposed to play a role in reducing the risk of obesity throughout life. Kuwait has an extremely high prevalence of childhood obesity (45% of adolescents are overweight/obese) and extremely low breastfeeding indicators, particularly exclusive breastfeeding. In fact, little is known about the association between breastfeeding and obesity from Kuwait and the broader Middle East.

Aims: To estimate the prevalence of overweight/obesity in female adolescents in Kuwait and assess its association with breastfeeding during infancy.

Methods: This is a cross-sectional study that included 775 girls randomly selected from public and private high schools in Kuwait. The primary exposure …

Experiences With Covid-19 Stress Among Hispanic/Latino Farmworkers, Brenda Berumen-Flucker, Hadiza Galadima, Sylvia Shangani, Michele Kekeh, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

BACKGROUND: Hispanics/Latinos, particularly those that identify as foreign-born, are overrepresented in the agricultural sector in the U.S. Over the course of the COVID-19 pandemic, this subpopulation of farmworkers was recognized as an invaluable group of essential workers unable to implement COVID-19 protections.

METHODS: Previously validated COVID-19 stress scale measures were identified, adapted, and translated to collect COVID-19 stress data from Hispanic/Latino agricultural workers in two heavily agricultural counties in northeastern North Carolina. Participants were recruited using purposive convenience sampling. Data collection took place from June to November of 2021.

RESULTS: The majority of Hispanic/Latino agricultural workers surveyed reported experiencing worries …