Digital Commons Network^™

Impact Of Long-Term Doula Services On Maternal And Fetal Health Outcomes In Women In Treatment For Opioid Use Disorder, Saloni Parikh, Meghan Gannon, Phd, Msph

Phase 1

This study analyzed the impact of doula services on maternal and fetal health outcomes in pregnant women seeking treatment for opioid use disorder. Understanding the impact of doula services is critical in reducing inequities in health outcomes experienced by this vulnerable population. Retrospective and prospective data was collected from surveys, focus groups, and maternal and infant birth data from 100 women in treatment for opioid use disorder, with fifty utilizing doulas and fifty not utilizing doulas. Standardized data abstraction of quantitative and qualitative measures were collected into an SPSS database and Nvivo, respectively, and analyzed using SPSS. Measures of importance …

Maternal Stress And Breastfeeding Intention In Pregnant Women With Opioid Use Disorder, Yassamin Jamshidian, Vanessa Short, Phd, Mph, Diane J. Abatemarco

Phase 1

Introduction: Breastfeeding rates are low among women in treatment for opioid use disorder (OUD). Information on determinants of breastfeeding intention can help inform the design of breastfeeding promotion interventions for this population. The objective of the study was to examine associations between maternal characteristics, including stress, and breastfeeding intention among pregnant women in treatment for OUD.

Methods: Fifty-six pregnant women who were receiving treatment for OUD at Thomas Jefferson University’s Maternal Addiction Treatment Education & Research (MATER) program completed a survey, which included questions on demographics, psychosocial characteristics, breastfeeding history, and breastfeeding intention. Maternal stress was measured using the Perceived …

Medicaid Expansion’S Importance To Mental Health Care, Cameron Blazoski, Vittorio Maio, Pharmd, Ms, Msph

Phase 1

Introduction: The 2010 Patient Protection and Affordable Care Act established the Medicaid expansion, which incentivized states to expand their Medicaid programs to include individuals with incomes up to 138% of the federal poverty level. A significant population that stood to benefit from this health care expansion were Americans who suffer from a mental health disorder. This study was conducted to analyze the impact of Medicaid expansion on individuals with mental health and substance abuse disorders.

Methods: This political commentary was based on statistics on mental health in the United States derived from research studies and publications from federal …

Retrospective Chart Review Of Metastatic Solid Tumor Discharges To Subacute Rehab, Sarah Svetec, Molly Hanson, Crnp, Brooke Worster, Md

Phase 1

Introduction: Regaining strength through rehabilitation as a mechanism to return cancer patients to therapy is poorly understood and therefore realistic advice cannot be given to patients when cancer-directed therapy must be stopped. This research examines what cancer patients are able to accomplish following referral to subacute rehabilitation (SAR). It was hypothesized that the majority of patients would not return to cancer-directed therapy following SAR and that a high functional status at discharge would be the best predictor of this return.

Methods: A retrospective chart review was completed for 112 metastatic solid tumor patients discharged to SAR (2018-2020). The primary outcome …

Attitudes And Practices Of Providers Towards Continuity Of Care With Patients Prescribed Contraception, Jennifer Sachs, Grace Styklunas, Caroline King, Rebecca Mercier, Md

Phase 1

Introduction: The primary objective of this study is to evaluate provider attitudes and practices for follow-up counseling regarding patients prescribed contraception at women's health and primary care offices. As prescription contraception (oral contraceptive pills (OCPs), the patch, NuvaRing) are the most widely used reversible form of birth control in the United States, understanding provider practices and attitudes towards the necessity of follow-up for prescription contraception management is crucial.

Methods: An anonymous 16-item cross-sectional online Qualtrics survey queries providers for specialty and position, years in practice, as well as attitudes and practices regarding follow-up counseling for prescription contraception. The study cohort …

Nutritional Intervention In Concussion Treatment And Analysis Using Mri And Eeg, Jideofor Okafor, Namdi Nwasike, Andrew Newberg, Md

Phase 1

Traumatic brain injuries (TBI) occur in over one million Americans annually, leading to thousands of deaths, hospitalizations, and individuals with long term disability. The most common causes of TBI which result in hospitalization primarily affect middle-aged to older adults and contribute to the annual economic burden of billions of dollars. The goal of this study is to determine if baseline EEG scans predict responsiveness to supplemental treatment in TBI patients experiencing chronic symptoms, which could improve their care.

Subjects recruited from the greater Philadelphia area were randomly separated into 3 groups—Control, N-acetylcysteine (NAC), or Nutrition—and either received standard treatment for …

Immigrant Health Literacy Initiative, Yuliya Goykhman, Kelsey Salazar, Mph

Phase 1

Introduction: Low health literacy in immigrant and refugee patients contributes to reduced health access and overall poorer quality of life in these patient populations. Community-Based Organizations (CBOs) provide necessary health navigation services for immigrant populations, but their role is often overlooked by large healthcare institutions. This project aims to illustrate the unique needs of both immigrant and refugee clients in navigating the healthcare system and CBO staff in assisting them with navigation, and to demonstrate to hospital partners how their services are crucial to adequate care of these communities.

Methods: As part of the Pennsylvania Health Literacy Coalition (PAHLC), four …

Differences In Hypertension And Obesity Levels Between High School Students In Philadelphia Urban And Suburban Areas, Joseph Gonnella, Jeremy Close, Md, Michael Bozzi, Md, Peri Levey, Kyle Prochno

Phase 1

Introduction: The prevalence of childhood obesity remains high, putting millions of children at risk of developing certain illnesses, such as diabetes and cardiovascular diseases. Therefore, it is vital to determine the true scope of the issue and reveal the risk factors associated with this condition. Since the objective of this study is to compare the obesity and hypertension levels between adolescents in Philadelphia urban and suburban high schools, these risk factors can be highlighted and analyzed.

Methods: Biometric and demographic data of Philadelphia urban students was collected from the Athlete Health Organization (AHO) pre-participation evaluations (PPEs) from 2016-2018. It was …

Diabetes Distress, Daily Functioning, And Hemoglobin A1c In Older Black Individuals With Diabetes And Mild Cognitive Impairment, Navajyoti R. Barman, Robin J. Casten, Phd, Barry W. Rovner, Md

Phase 1

Objective: The purpose of the cross-sectional study was to identify associations between diabetes distress, physical functioning, and cognition with hemoglobin A1c in older Black individuals with diabetes and mild cognitive impairment.

Methods: The investigators analyzed previously collected data from 101 older Black individuals with diabetes and mild cognitive impairment. Participants were administered surveys at baseline to assess diabetes distress, physical functioning, and cognitive functioning, and had hemoglobin A1c testing.

Results: Participants with higher hemoglobin A1c showed worse self-reported daily function (r = -0.279, p < .01). Three of four diabetes distress factors were positively correlated with hemoglobin A1c – emotional (r = .276, p < .01), regimen-related (r = .330, p < .01), and interpersonal distress (r = 0.266, p <.01). In a multivariate regression with hemoglobin A1c as the dependent variable, only regimen-related diabetes distress (beta = .282, p = .012) and self-reported daily function (beta = -0.294, p = .027) were significant.

Conclusion: The main finding of this study is that regimen-related diabetes distress and self-reported daily …

An Assessment Of Quality Improvement Strategies For The Implementation Of Certified Recovery Specialists In Treating Opioid Use Disorder At The Emergency Department At Jefferson, A. Cosmo Annese, Rickie Brawer, Phd, Mph, Ches

Phase 1

Introduction: Opioid overdose mortality rate in the U.S. has seen a staggering upward trend lately, more than tripling between the years 2000-2017. Although the use of Certified Recovery Specialists (CRSs) has been shown to improve overdose rates, relapse rates, and treatment completion rates for people with opioid use disorder (OUD), the optimal specialization of CRSs in healthcare settings has yet to be clearly defined. This project seeks the perspectives of CRSs and healthcare workers to gain insight into how CRSs can be most effectively implemented in the ED at Jefferson to treat OUD.

Methods: The study population includes CRSs and …

Improving The Implementation Of Home Blood Pressure Monitoring, Joshua Mairose, Geoffrey Mills, Md

Phase 1

Introduction: Home blood pressure monitoring (HBPM) has been shown to outperform traditional office readings in its association with cardiovascular disease (CVD) risk and ability to identify patients with white coat or masked hypertension. For these reasons, the 2017 ACC/AHA Guidelines included HBPM as part of its recommendations for hypertension management. Our project focused on improving the implementation of HBPM in an urban primary care practice with an end goal of increasing the number of patients that actively use home blood pressure cuffs and have access to them for future telemedicine visits.

Methods: A patient outreach process to increase HBPM uptake …

Exploring Political Awareness And Civic Engagement Among Women Utilizing Mater Services, Cathy Lu, Meghan Gannon, Phd, Msph

Phase 1

Introduction: High levels of civic engagement by United States citizens sustains the integrity of the democratic system. Health organizations, such as The Maternal Addiction Treatment Education and Research (MATER) program, are in a position to help marginalized voting-eligible individuals overcome barriers to voting.

Methods: The target population was women utilizing MATER services. The study design consisted of a survey collecting data including demographic information, political engagement, perceived barriers, and interest in future advocacy. Following the survey, participants were offered more voting resources.

Results: One hundred percent of participants reported utilizing public assistance. Forty-eight percent reported a social network as their …

Race And Disordered Eating: A Narrative Review Of Current Literature, Casey Swann, Msed, Lee Pachter, Do, Elizabeth Liveright, Md, Meghan Gannon, Phd, Msph

Phase 1

Research Problem: Eating disorder literature has well-established a correlation between childhood trauma and development of eating disorder symptomology. One type of trauma that is often overlooked in eating disorder research is that of racial stress faced by ethnic minorities. The literature on racism and eating disorders tends to focus on the transdiagnostic construct of disordered eating behavior rather than specific DSM-5 diagnoses. As such, the current literature review examined the findings regarding associations between racial stressors and disordered eating behavior.

Methods: The current literature review between Nov 2007 and August 2020 searched 3 databases, PubMed, CINAHL, and PsycInfo for …

The Impact Of Doula-Supported Care On Stress Levels Of Women Receiving Opioid Addiction Treatment, Mariel Becker, Meghan Gannon, Phd, Msph

Phase 1

Introduction: Mothers suffering from opioid addiction are at high risk for experiencing extreme stress levels which prevents them from providing a healthy and nurturing environment for their family. The aim of this project is to explore if a doula-supported care team alleviates the parenting stress of new mothers participating in opioid addiction rehabilitation.

Methods: A total of 35-40 women in treatment at the Montair program for substance use disorder rehabilitation were recruited to participate in the City of Philadelphia’s Community Doula project. The Parenting Stress Index Score (PSI) was recorded and compared to a control group composed of women …

Strategic Design Development For Malawian Public Health Center Labor & Delivery Suites, Kayla Holston, Mph, Meghan Gannon, Phd, Msph, Christopher Harnish, March, Zayithwa Fabiano, Mbbs, Luis Gadama, Mbbs, Mmed

Phase 1

Introduction: Maternity ward pre-, peri-, and postnatal room sharing creates concerns regarding maternal privacy (particularly confidentiality and dignity), paternal involvement in birthing process, and staff workflow efficiency. This study aimed to understand the current state of the aforementioned concerns and their impact on maternal child bonding and maternal mental health at Queen Elizabeth Central Hospital (QECH).

Methods: At discharge, mothers of birth (MOBs) were surveyed on pre-, peri-, and postnatal experience with regard to privacy and paternal involvement in the birthing process, and then assessed using the Mother to Infant Bonding Scale and Edinburg Depression Scale. Father of births (FOBs) …

Assessing The Role Of Virtual Social Networks In The Treatment Progress Of Mothers Recovering From Opiate Addiction, Marisa Wu, Meghan Gannon, Phd Msph, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Social engagement is a significant contributor to the treatment success of individuals with prior substance use. This project aims to determine if social engagement improves the progression through and experience of treatment of mothers with prior opioid use at an inpatient recovery facility. We hypothesize that increased social engagement will improve treatment progress and experience.

Methods: The project is centered on mothers seeking treatment for opioid use at an urban inpatient treatment facility. The study obtains qualitative and quantitative data through interviews and therapy sessions. The data informs the extent and quality of social engagement and individual perspectives of …

Public Perceptions Of Opioid Use Disorder (Oud) In Rural Pennsylvania: Opportunities, Challenges, And Barriers, Josiah Miller, Duane Donmoyer, Md, James Plumb, Md, Mph

Phase 1

Introduction:

Opioid Use Disorder (OUD) has significantly impacted rural communities nation-wide. This study adds information to what is currently known about OUD and its effects on small towns through examining how OUD has, and is currently, affecting a rural community (~7,000 population) in central Pennsylvania. The main aim of this study was to better understand how OUD affects this small town through interviewing individuals involved in local public health.

Methods:

This qualitative study consisted of key stakeholder interviews with ten individuals involved in local government, law enforcement, or healthcare. Questions centered around how OUD affects the local area, how current …

Patient Evaluation Of Medication-Assisted Treatment For Opioid Dependency, Francesca Ciocco, Lara Weinstein, Md

Phase 1

Introduction: Although primary care settings are a promising setting for expansion of medication-assisted treatment (MAT) for opioid use disorder (OUD), currently there is not an established primary care model for MAT. While creating a primary care MAT model, traditional treatment success measures (TSMs), like abstinence, may not be effective for vulnerable populations. This study aims to identify patient-important TSMs and compare their relative importance to traditional TSMs.

Methods: Traditional TSMs for MAT programs were identified with a literature review, while potential patient-important TSMs were identified from qualitative analysis of intake interviews for a MAT program in Philadelphia. Traditional and …

Comparing The Quality Of An In-Person Versus Virtual Diabetes Education Course Due To Covid 19 Pandemic, Allie Hamilton, Rickie Brawer, Phd

Phase 1

Introduction: Group diabetes education courses are proven to improve patients’ diabetes knowledge and metabolic control. Due to the COVID19 pandemic, Stephen Klein Wellness Center (SKWC) shifted their diabetes education course to an online format over Zoom. This study aimed to investigate difference in patient experience and course effectiveness between the in-person and online courses.

Methods: The population for this study includes 89 patients at SKWC that completed either the in-person or online diabetes education course. Participant satisfaction was measured with phone interviews and a survey. Course effectiveness was measured using surveys to assess the change in patients’ weight, amount of …

Patient Characteristics Of A Primary Care-Based Medication-Assisted Treatment Program For Opioid Use Disorder In Philadelphia, Zoe Wong, Lara Weinstein, Md

Phase 1

Introduction: The opioid crisis is a persistent national public health concern, with Philadelphia at its epicenter. Medication-assisted treatment (MAT) programs for opioid use disorder in primary care settings afford greater access to marginalized groups and integration of healthcare services. This study describes patient characteristics of a low-threshold, primary care-based MAT program in Philadelphia.

Methods: 134 patient interviews between February 12, 2019 and March 14, 2020 were retrospectively analyzed. Key characteristic measures included drug and alcohol use history, co-occurring health conditions, history of violence or trauma, and quality of life. The results from the two program locations, Stephen Klein Wellness Center …

Training Toolkit For Caregivers At Residential Care Centers In Peru, Elizabeth Stratton, Stephen Didonato, Wayne Centrone

Phase 1

Introduction:

Health Bridges International (HBI) is developing a training toolkit for caregivers working with marginalized youth in residential care centers (RCCs) in Peru. The toolkit represents an amalgamation of best practices, evidence informed research, and the results of our QI survey tool. We predicted that current Peruvian caregivers will identify topics of interest that differ from current literature.

Methods:

Surveys were distributed to over 150 RCCs throughout Peru using email and WhatsApp messages in a snowball format, starting at the administration level. The survey required 20-30 minutes to complete and was completely voluntary. All preliminary data was de-identified and imputed …

Pattern Of Sexual Partner Violence And Health In Young Adult College Students Ages 18-24, Alice Renaud, Allison Casola, Phd

Phase 1

No abstract provided.

Identifying Health Topics For Elementary-Aged Children In Delaware, Kayla Morrell, Denise Hughes

Phase 1

Introduction: Health literacy involves understanding health-related information to make educated decisions regarding an individual’s needs. Low health literacy is associated with poorer health outcomes, which can be minimized by early introduction to accurate health information. Currently, elementary schools in Delaware have no health curriculum, leaving students at risk for low health literacy.

Methods: Interviews were conducted with Delaware elementary school teachers to identify a series of topics that would allow students to learn health information via incorporation into existing curriculum. Teachers were divided into focus groups by school and grade level. The resulting discussions were qualitatively analyzed by two independent …

Racial Discrepancies In Interpregnancy Intervals And Postpartum Contraception Receipt In Centering Pregnancy Prenatal Care, Amulya Raju, Ms, Dennis Hand, Phd

Phase 1

Non-Hispanic black women are disproportionately affected by higher rates of shorter interpregnancy intervals. The purpose of this study is to identify whether the Centering Pregnancy model of group prenatal care (GPC) can reduce this health disparity by increasing postpartum contraception receipt.

This retrospective chart analysis measures consistency in contraception intent versus actual postpartum receipt in populations of women who received either individual or GPC. The main predictors were: race, insurance type (public or private), marital status, and type of prenatal care. The main outcomes were: type of contraception received, consistency with contraception intent, and presence of a short interpregnancy interval. …

Pediatric Group Well Care Within The Maternal Treatment Education & Research (Mater) Program, Elizabeth Franko, Neera Goyal, Vanessa Short, Aditi Kale

Phase 1

Introduction:

This project aims to develop and implement group well care for mothers and infants receiving care for opioid use disorder (OUD). Groups would be composed of 5-7 mothers and infants of similar age with extension of sessions to allow group activities and parenting discussions. To evaluate acceptability and feasibility of this care model, we sought to examine attitudes and beliefs from these mothers, in particular the impacts of the COVID-19 pandemic.

Methods:

A qualitative interview study of women receiving treatment for OUD at Maternal Addiction Treatment Education and Research at Thomas Jefferson University from October – December 2020 was …

Effectiveness Of Enrichment Programs Such As Step Up In Increasing The Matriculation Of Urim Students To Medical Schools, Jessica Amoako, Traci Trice, Md

Phase 1

Introduction: Diversity in healthcare can improve access to healthcare for racial/ethnic minorities. However, barriers such as lack of educational opportunities have hindered URiM (underrepresented in medicine) students from matriculation to medical school. Enrichment programs such as STEP UP Medicine seek to break down these barriers. It provides its participants with MCAT preparation, advising, medical skills sessions, clinical shadowing experiences, and networking opportunities. Thus, the goal of this project is to assess if this program is effective in improving the medical school matriculation rates of URiM students.

Methods: Data was collected through a self-administered online survey using Google forms. The link …

Assessing Food Quality And Regulations At Homeless Shelters In Philadelphia, Emily Casaletto, Rickie Brawer, Phd, Mph, Mches

Phase 1

Introduction: Nutritional diseases such as hypertension, diabetes, and cholesterol disorders are particularly high among individuals experiencing homelessness in comparison to the general United States population, leading the propagation of chronic health conditions and overuse of expensive healthcare resources. In addition, the food served in homeless shelters is the main source of nutrition for those living in these shelters, most notably when there is no option for food storage available. Despite the disproportionate prevalence of nutrition-related diseases among the homeless population, there is limited research on the quality of the food provided in homeless shelters and there are few policies to …

Menstrual Management In Adolescent Transgender Males, Julia Eisenberg, Sarah Felleman, Benjamin Bear, Mph, Arielle Effron, Md, Anne Kazak, Phd, Abpp, Anthony Alioto, Phd, Evan Graber, Do, Vanessa Short, Phd, Mph, Meghan Gannon, Phd, Msph, Beth Schwartz, Md

Phase 1

Introduction: Gender dysphoria is associated with increased rates of anxiety, depression, and suicidal ideation in adolescents. There is anecdotal evidence that menstruation increases the occurrence of gender dysphoria in adolescent transgender males. We hypothesize that menses are distressing to transgender males and this population would benefit from menstrual management.

Methods: We conducted a retrospective chart review of all transgender male patients seen in the Nemours Gender Wellness Program (GWP) and limited our population to those who have reached menarche. Data was extracted from the encounters at the GWP clinic and recorded in REDCap. We compared self-reported symptoms of gender dysphoria …

The Number And Types Of Procedures Performed At Jeffhope Clinics, Jeremy Heard, James Plumb

Phase 1

Introduction: Procedures performed as part of the urgent care medical services provided at JeffHOPE Clinics (JHCs) are common in daily operations, but the number and types of procedures performed at each JHC have not yet been reported. The goal of this research was to provide JHCs the data needed to ensure clinic-specific evidence-based training for incoming procedures committee members, and thus ensure the highest quality patient care. The inquiry question was what are the number and types of procedures performed at each JHC?

Methods: An IRB waiver of authorization was obtained. A chart review of patients 18 years or older …

Net Therapy Effect On Chronic Pain Patients: An Fmri/Pet Imaging Study, Layla Annous, Andrew Newberg

Phase 1

Chronic pain is pain that lasts longer than 3 months or lasts longer than tissue healing should naturally take, which can limit patients’ daily activities. Chronic pain impacts 20% of people worldwide, preferentially affecting vulnerable and marginalized populations. We aimed to use fMRI/PET imaging of the brain to determine the efficacy and therapeutic use of Neuro-emotional Technique (NET) therapy for chronic pain patients. We anticipated that NET Therapy would result in decreased activity in areas of the brain associated with pain and decreased perception of pain. Patients who have been suffering chronic pain conditions were used as the experimental group …