Social and Behavioral Sciences Commons^™

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

Exploring The Usefulness Of Pre-Visit Materials For Children With Autism At A Public Museum, Jennifer K. Fortuna, Elaine Chamberlain, Libby Filice, Madeline Kurt, Taylor Porter, Shannon Twichell, Stephanie Ogren

Translational Science in Occupation

Abstract

Children with autism spectrum disorder (ASD) participate in community-based settings at lower rates than typically developing children. Museums provide a structured, predictable, and supportive place for children with ASD to learn. Visiting a museum may create unique challenges for children with ASD and their families. Sensory processing disorder (SPD) is a common barrier to participation that makes it difficult to process information coming in through the senses. For children who are easily overstimulated, crowds, noise, and long lines can be a source of anxiety and stress. Providing pre-visit materials such as social stories, accessibility maps, and communication books can …

The Role Of An Occupational Therapy Practitioner In Professional Advocacy: A Scoping Review, Sarah Mckinnon, Natalie Petrone, Amanda Tarbet

Translational Science in Occupation

Background: Participation in professional advocacy amongst occupational therapy practitioners (OTPs) is necessary for strengthening the profession. Although advocacy remains essential for practice, specific activities of OTPs in professional advocacy remain inconsistent and unclear.

Purpose: To examine the activities occupational therapy practitioners are engaging in related to professional advocacy. To identify key strategies and future opportunities to strengthen OT practitioner participation in professional advocacy.

Methods: We systematically searched 4 databases and 1 search engine for relevant articles- MEDLINE via PubMed, The Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete via Ebscohost, ERIC via Ebscohost, APA PsycInfo …

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …

From Vapor To Vice: Unraveling The Links Between Vaping And Traditional Substance Abuse Among Youth, Ayana Powell

Capstone Experience

ABSTRACT:

Objective: To evaluate whether vaping or using e-cigarettes is associated with the use of traditional substances, such as cigarettes, alcohol, and marijuana.

Methods: Using data from the Monitoring the Future surveys, a multivariable logistic regression model was performed, and prevalent odds ratio were calculated to evaluate the association between vaping and traditional substances.

Results: Vaping use among U.S. adolescents and teenagers was found to be an associated with use of traditional substances (cigarette use [OR]= 6.36 [CI]= 4.84, 8.38; alcohol use [OR]=5.80 [CI]= 5.28, 6.38; and marijuana use [OR]= 7.77 [CI]= 6.95, 8.70).

Conclusion: This study will assist …

Spotlight On Mental Health On A Healthcare Campus: An Assessment Of Psychological Trauma Awareness, Training, And Treatment In The University Of Nebraska Medical Center College Of Public Health Community, Jenny E. Mueller

Capstone Experience

Background: Psychological trauma has been recognized as a public health concern of epidemic proportions globally. Public health community awareness of and education in trauma is likely to be integral to preparing future public health professionals to work effectively and safely in the field. Currently, the extent of trauma awareness, training, and treatment on the University of Nebraska Medical Center College of Public Health (UNMC COPH) campus is not known.

Aims: The aims of this project are to investigate and assess the level of psychological trauma awareness, training, and treatment on the UNMC COPH campus; and to provide recommendations for actions …

Discordant Cardiopulmonary Resuscitation At An Academic Midwest Medical Center- Prevalence And Solutions, Jeremy Payne, Anne Skinner, David Gannon, Jenenne A. Geske

Graduate Medical Education Research Journal

Background: Code status orders are important features of patient-centered clinical decisions, patient autonomy, and end-of-life care. Despite proper documentation of “do not resuscitate” (DNR) code status, hospitalized patients may be subjected to cardiopulmonary resuscitation (CPR) efforts that go against their wishes.

Purpose: The objective of this study was to identify and describe the population of hospitalized patients receiving discordant resuscitation efforts at a Midwest academic medical center utilizing electronic health records (EHR).

Method: The study included EHR records between 01/01/2011 and 01/01/2021 for hospitalized patients 19 years and older who experienced cardiac arrest (ICD-10 I46) and were documented as DNR. …

Housing Is Safety: An Evaluation Of A Transitional Housing (Th), Rapid-Rehousing (Rrh), And Joint Th/Rrh Program For Survivors Of Interpersonal Violence, Bridget L. Claborn

Capstone Experience

In this capstone project, I created a program evaluation plan and conducted preliminary analysis for the Mar􏰀 Parrish Center􏰁s (MPC) transitional housing (TH), rapid-rehousing (RRH), and joint TH/RRH programs for survivors of interpersonal violence and their families. The intent of the project is: (1) to better understand the impact of MPC housing programs; (2) to inform strategies for continuous improvement in client outcomes, access, and satisfaction; (3) to further evaluation capacity for the organization; and (4) to generate practice-based evidence to inform the field at large. As a practitioner in the field of interpersonal violence and former MPC staff member, …

The Role Of Psychological Safety On Employee Satisfaction And Retention In Healthcare Delivery Settings: A Systematic Literature Review, Jamey Paul

Capstone Experience

The healthcare industry typically has a high rate of employee turnover due to higher job stresses and burnout, lower job satisfaction, and insufficient organizational support and work culture. This turnover has worsened since the onset of the COVID-19 pandemic. Psychological safety, a shared belief by organizational members that the team/unit is safe for interpersonal risk-taking, can be one of the many ingredients that contribute to employee satisfaction and reduce turnover. This systematic literature review explored the role of psychological safety on job satisfaction and retention of healthcare workers in delivery settings by synthesizing the known antecedents and outcomes of psychological …

Implementation Of A Nurse-Led Clinical Algorithm For Pressure Injury Prevention Associated With Non-Invasive Ventilation Medical Device Use, Capri Steinkuhler, Kaitlin Rogge

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Medical device related pressure injuries (PI) account for as much as 61-81% of all hospital reported wound incidents (Gefen et al., 2020) and are frequently caused by respiratory devices such as non-invasive ventilation (NIV). Use of NIV in critically ill patients dramatically increased during the pandemic. PI are one of the leading causes of injury to hospitalized patients and lengthens hospital stays (National Pressure Injury Advisory Panel [NPIAP], 2019). The NPIAP recommends routine skin assessment under devices, proper mask fit, protective barrier, moisture reduction, and interdisciplinary collaboration to prevent PIs from NIV masks. This feasibility study’s purpose …

Translating A Pediatric Weight Management Intervention Into Medically Underserved Areas, Caitlin Golden

Theses & Dissertations

Despite substantial prevention and treatment efforts, childhood obesity remains a pressing public health concern. Disparities persist in obesity prevalence among children of lower socioeconomic status, racial and ethnic minority groups, and those residing in rural areas. The vast majority of efficacious pediatric weight management interventions (PWMIs) have been based in larger cities and urban areas delivered through inter-disciplinary teams in a hospital or medical center, and the degree to which these or other efficacious PWMIs have been translated to, and are feasible in, typical rural or micropolitan areas is unclear. This dissertation describes a dissemination strategy and a systematic approach …

Program Evaluation: Utilizing Health Department’S Community Health Needs Assessment Data To Improve Emergency Preparedness Plans, Kathleen Gottschalk

Capstone Experience

Public health officials conducting emergency response plans must know how to easily identify the vulnerable populations in their community or jurisdiction. It is beneficial for access and functional needs appendices to include information and resources directed at the identified vulnerable groups before an emergency event to improve health outcomes. Community Health Needs Assessments (CHNA) can provide population-level statistics and information needed to easily identify vulnerable or at-risk groups. This report aims to evaluate the use of the CHNA data to guide the development of inclusive emergency response plans that account for vulnerable populations in local health department jurisdictions. The 2021 …

Comprehensive Literature Review: Assessing The Impact Of Covid-19 Policies, School Closures And Social Distancing, On The Mental Health Of School Age Children, Fatuma A. Hassan

Capstone Experience

Mental health is vital to the well-being of all individuals, especially children. COVID-19 unveiled a significant public health issue with poor mental health during the pandemic. There is limited literature about the mental health implications of COVID-19 policies for children and adolescents and preventive strategies for future pandemics. This comprehensive literature review seeks to further investigate the mental health impacts of school shutdowns and social distancing, which were nonpharmaceutical strategies, on school-aged children, 5-18 years old, and propose recommendations for public health officials to mitigate the mental health impacts for future pandemics. Additionally, the review aims to highlight the potential …

The Merit Of Inclusion: A Policy Review Examining The Convergence Of Special Education And Inclusions Policies With Compensatory Medicaid Policies In The Wake Of The Covid-19 Pandemic, Corbyn Baggett

Capstone Experience

On March 11, 2020, the World Health Organization (WHO) formally recognized the novel coronavirus (COVID-19) outbreak as a global pandemic. This global issue compelled governments to announce careful virus containing policies in order to prevent further spread and control of the disease. Although it has been proven that measures like social isolation could aid in scaling the spread of illness, the resulting extended school closures that occurred in response to an increased number of COVID-19 outbreaks posed significant challenges for all students, but especially those students with special needs. The unpredictable nature of COVID-19 at the outset of the pandemic …

Hispanic/Latino Mothers Of Children With Developmental Disabilities: Identifying Factors Associated With Practicing Self-Care And Mental Health Outcomes, Jessica Gutierrez

Capstone Experience

Caring for a child with developmental disabilities can be challenging, exhausting, and overwhelming for many parents. The level of care that a child with disabilities requires can be intense, resulting in stress and negatively impacting caregivers' mental health. Many Hispanic/Latino mothers of children with developmental disabilities are not practicing self-care or using support services; thus, the mothers may experience high stress, depression, and anxiety. Previous research studies have found adverse psychological effects such as high levels of stress, depression, and anxiety. This quantitative study sought to identify the gaps and barriers Hispanic/Latino mothers of children with developmental disabilities encounter when …

The Differences In Mental Well-Being For Individuals With And Without Service Dogs, Katelyn Morales

Capstone Experience

Trained service dogs can be used for many tasks, but the growing literature focuses on the benefits of the psychosocial health and well-being of individuals experiencing depression or anxiety. This study analyzes the effects of service dogs on the mental well-being of individuals with a diagnosed disability who have depression or anxiety. This quasi-experimental design assesses the mental well-being of individuals who have a service dog compared to those who do not have a service dog. Mental well-being was measured using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) and focused on individuals with a service dog and diagnosed depression or anxiety …

Analysis Of The Utilization Of Nebraska Medicine's Price Transparency Tool, Ingrid A. Olson

Capstone Experience

Healthcare costs have become a significant concern for patients, healthcare facilities, economists, and politicians within the United States. In an effort to understand and reduce health-related costs, price transparency laws were enacted at the beginning of 2021. Because of these new laws, hospitals must provide a price transparency tool for their patients. “Price transparency in healthcare makes pricing information more readily available, defines the value of services, and enables patients and other care purchasers to identify, compare, and choose providers that offer the desired level of value” (AAMC, 2022). However, research results on price transparency tools use and efficacy is …

Interrogating Race And Place-Based Inequities In Hiv And Covid-19, Rohan Khazanchi

MD Honors Theses

Over the last four years, I have developed a research focus examining the intersections of race, place, and health. My M.D. Honors Thesis reflects a snapshot of these efforts. In this collection of brief research reports, I leverage area-based measures to investigate structural inequities in three contexts: the HIV epidemic in our hyperlocal community, the early stages of the COVID-19 pandemic, and clinical trials for novel COVID-19 therapeutics. I apply novel social epidemiologic tools to measure and explore disparate outcomes. And, in reflecting upon my findings, I discuss concrete implications for clinicians, researchers, and policymakers alike.

Chapter 1: Neighborhood-Level Deprivation …

Psychological Trauma Alters T-Lymphocyte Inflammation And Redox Through Sympathetic Mechanisms, Safwan K. Elkhatib

Theses & Dissertations

Posttraumatic stress disorder (PTSD) is a devastating psychiatric disorder characterized by distinctive symptom clusters, including intrusive memories (i.e., flashbacks), avoidance of related stimuli, affective changes, and hyperarousal. Strikingly, patients with PTSD face a significantly increased risk for a number of inflammation-driven pathologies, ranging from cardiovascular to autoimmune disease. Yet, the exact etiology of this increased risk remains unknown. The immune system is known to be strongly influenced by the sympathetic nervous system, and sympathetic overactivity is a hallmark of PTSD. Lymphoid organs, such as the spleen, are richly innervated by sympathetic nerve fibers which terminate near adaptive immune …

Reflective Journaling Intervention To Impact Self-Awareness, Professional Health, And Overall Well-Being In Nurses, Brittany M. Langan, Katherine Keppen

Doctor of Nursing Practice Projects: College of Nursing

Background. Burnout among nurses has been on the rise and was exacerbated with the pandemic. Reflective journaling after work may be a strategy to decrease feelings of burnout. Reflective journaling, as an intervention, has been shown to improve self-awareness, compassion fatigue, and burnout among nurses. The purpose of this study was to pilot a 4-week reflective journaling intervention in hospital-based nurses and describe participant professional quality of life, self-awareness, and overall well-being.

Theoretical Framework. The Theory of Reasoned Action (TRA) was chosen as the theoretical framework because it identifies the belief that performing a particular behavior will lead to a …

Helping Our Heroes: An Evaluation Of Mental Health And Organizational Policies Surrounding Suicide Prevention And Postvention Strategies For Nebraska First Responders, Maria S. Mickles

Capstone Experience

Suicide is ranked as one of the leading causes of death in the United States. Over 40,000 individuals die by suicide each year (Stanley, Hom, & Joiner, 2016; Vigil et al, 2021), and, in 2020, it was ranked in the top 9 causes of death for all ages (10-64), and second for those 10-14 and 25-34 years of age (Centers for Disease Control and Prevention, 2022). These statistics disproportionately reflect first responders (i.e., firefighters, dispatchers, law enforcement, EMS, paramedics, etc.), as they die by suicide more than the general public (National EMS Management Association, 2016). Within their line of work …

Interrogating Race And Place-Based Inequities In Hiv And Covid-19, Rohan Khazanchi

EMET Projects

Over the last four years, I have developed a research focus examining the intersections of race, place, and health. My M.D. Honors Thesis reflects a snapshot of these efforts. In this collection of brief research reports, I leverage area-based measures to investigate structural inequities in three contexts: the HIV epidemic in our hyperlocal community, the early stages of the COVID-19 pandemic, and clinical trials for novel COVID-19 therapeutics. I apply novel social epidemiologic tools to measure and explore disparate outcomes. And, in reflecting upon my findings, I discuss concrete implications for clinicians, researchers, and policymakers alike.

Chapter 1: Neighborhood-Level Deprivation …

The Role Of Medical Language In Patient Care: Designing An Educational Session On The Use Of Non-Stigmatizing Language, Daniel Dooling

EMET Projects

No abstract provided.

Intention To Breastfeed: Breastfeeding Attitudes, Norms, Self-Efficacy, Social Support Network And Community Resources Of African American, Low-Income, Emerging Adult Women, Pregnant For The First Time, Sara E. Brown

Theses & Dissertations

African American (AA) women continue to have the lowest rates of breastfeeding. This continues to create a health disparity even though breastfeeding is extensively recognized in the scientific and health care communities as the optimal feeding choice for infants. This study examined the relationship between the external variables (social support network and community resources) and the explanatory variables (attitudes, norms, and perceived self-efficacy) and intention to breastfeed, for the AA, first time, low-income, emerging adult pregnant woman. The Integrated Behavior Model (IBM) was used as the theoretical framework to guide this study in better understanding the variables influencing breastfeeding intention. …

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

Factors Associated With Omani’S Schoolteachers’ Reporting Behavior Of Suspected Cases Of Child Abuse And Neglect, Zeinab N. Alazri

Theses & Dissertations

Child abuse and neglect is a global problem that can result in severe negative consequences for victims and their societies. Numerous initiatives have been launched by the United Nations Children's Fund (UNICEF) to combat this problem. Recently, Sultanate Oman, an Arab country, has mandated schoolteachers to report suspected abuse and neglect cases to comply with UNICEF's recommendations. As schoolteachers spend a great deal of their time with children, they are in a good position to recognize and report suspected abuse and neglect cases so the victims can get the needed help and treatment. There is a dearth of information about …

Evaluating Nebraska Ems Providers' Ability And Willingness To Respond To Bioterrorism Emergencies, Ryan Houser

Capstone Experience

Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack, and identify factors that predict preparedness and willingness among Nebraska Emergency Medical Service providers, who are key to resilience in the face of an attack. The survey was available for one month in 2021 during which 190 EMS providers responded to the survey. The subjects included Registered Nurses, doctors, EMTs, and paramedics. Only 10% of the respondents are both …

The Role Of Photography In Increasing Efficiency Of Dermatologic Inpatient Consulting Service, Ritu Swali, Tyler D. Evans, Dillon Clarey, Corey Georgesen, Ashley Wysong

Graduate Medical Education Research Journal

Abstract

Introduction:

Inpatient dermatology consultations can bring a mixed bag of pathologies. Due to the highly specialized nature of dermatology and the lack of dermatologic training in medical school, the dermatologic team is consulted for matters that range from non-urgent to pressing. Pictures are a critical component of dermatology and greatly aid in the diagnosis of cutaneous diseases. In the inpatient setting, pictures can help streamline diagnosis and prevent unnecessary tests or procedures. The purpose of this study was to evaluate for the presence of pictures in patients’ chart after a dermatology consult had been placed through EPIC at the …

Health Service Utilization And Expenditure In Cardio-Metabolic Conditions In The United States Adults, Kavita Mosalpuria

Theses & Dissertations

Metabolic syndrome is multicomponent risk factor for cardiovascular diseases (CVD) and type 2 diabetes that reflects the clustering of at least 3 cardiometabolic risk factors, among hypertension, impaired glucose regulations, hypercholesterolemia, and obesity. CVD are the leading cause of death in the U.S. CVD occur at earlier age and is a major cause of death and disability among people with diabetes. As compared to Japan, 13.3% to 44% of the excess CVD mortality in the U.S. can be explained by the metabolic syndrome. The prevalence of metabolic syndrome was 34.3% in 2007 to 2014 and it increases with age. Metabolic …

Evaluating A Community-Based Breastfeeding Support Organization In Nebraska, Katelyn Elaine Goodroe

Capstone Experience

Specific Aims: The aims of this evaluation plan are to investigate the role of the Nebraska nonprofit organization, MilkWorks, in promoting breastfeeding and family support programming and to identify future internal and external growth opportunities through an assessment of the organizational practices using stakeholder perspectives and marketing structure to better promote infant and parental health.

Significance: As a best practice, evaluation of MilkWorks is critical to providing proper services for promoting infant development and parental health in urban and rural Nebraska communities.

Background: MilkWorks was founded in Lincoln, Nebraska, by mothers with the intention of promoting breastfeeding by offering support …