Digital Commons Network^™

Queering Healthcare Equity: Exploring How Two Community Health Centers That Specialize In Lgbtq Healthcare Frame Cultural Competence, Tommy Royston

Dissertations

Despite increased advocacy and funding, significant inequities in healthcare access, quality of care, and health outcomes have continued to persist for lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) communities. Intersecting marginalized identities such as race, gender, and disability compound health inequities faced by LGBTQ folx. These inequities are not random; rather, they result from deeply embedded homophobia, transphobia, ableism, and racism that pervade the U.S. healthcare system. An exploratory comparative case study was completed using qualitative data collection methods (i.e., key informant interviews, focus groups, and document analysis) to investigate how two California-based Federally Qualified Health Centers (FQHCs) that specialize in …

Growing In Grief: A Meaning-Making Expressive Arts Therapy Method Developed For Bereaved Youth, Jessica Wilson

Expressive Therapies Capstone Theses

Approximately 5.3 million youth in the United States have experienced the death of a sibling or parent. They face challenges such as an increased risk of depression, anxiety, substance use, and other detrimental effects on adjustment. A small subset of this population experiences significant emotional and behavioral difficulties, characterized by an inability to function in major life roles, a preoccupation with the loss, and separation distress. Modern grief literature describes meaning-making as an adaptive coping process contributing to a sense of renewed hope and self-efficacy and a reduction in distressing grief symptomology. Expressive arts therapy is an effective way to …

The Effect Of Neurologic Music Therapy On Speech Intelligibility In Children With Cerebral Palsy, Paulina Perez-Curiel

Yale School of Medicine Physician Associate Program Theses

Cerebral palsy is the most common motor disability in children and is caused by abnormal development of or damage to the brain. Children with cerebral palsy often have speech disorders, most commonly dysarthria, due to deficits in speech-motor control. The inability to communicate effectively can lead to needs not being met, self-isolation, and an overall decrease in self-perception and quality of life. In this randomized control trial, we will evaluate whether Neurologic Music Therapy improves word-level speech intelligibility in children with Cerebral Palsy. Fifty children will be exposed to Neurologic Music Therapy and fifty children will receive standard speech therapy. …

Quehry: A Question Answering System To Query Electronic Health Records, Sarvesh Soni, Surabhi Datta, Kirk Roberts

Faculty, Staff and Student Publications

OBJECTIVE: We propose a system, quEHRy, to retrieve precise, interpretable answers to natural language questions from structured data in electronic health records (EHRs).

MATERIALS AND METHODS: We develop/synthesize the main components of quEHRy: concept normalization (MetaMap), time frame classification (new), semantic parsing (existing), visualization with question understanding (new), and query module for FHIR mapping/processing (new). We evaluate quEHRy on 2 clinical question answering (QA) datasets. We evaluate each component separately as well as holistically to gain deeper insights. We also conduct a thorough error analysis for a crucial subcomponent, medical concept normalization.

RESULTS: Using gold concepts, the precision of quEHRy …

Exploring The Perceptions Of English-Speaking West African Born Registered Nurse Graduates From United States Entry Level Nursing Programs Regarding Academic Factors That Contribute To Retention And Success In United States Nursing Programs, Afua Ampiaw

Seton Hall University Dissertations and Theses (ETDs)

Background: The United States (U. S.) population is becoming more racially and ethnically diverse. To ensure equity in healthcare access and outcomes between majority and majority populations, there is need for minority representation in the health professions including nursing to reflect their representation in the general population. Nevertheless, ethnic minorities are underrepresented in the nursing profession. One of the many issues identified to compound this problem is the lack of retention and success of ethnic minority people in U.S. nursing programs. While the English-Speaking West African (ESWA) population in the U.S. forms about 5% of the 45 million immigrant population …

How Pediatric Emergency Department Nurses Initiate And Provide Care To Children And Families With Limited English-Proficiency, Caroline Meza

Seton Hall University Dissertations and Theses (ETDs)

Effective pediatric emergency care requires ongoing communication between the pediatric patient and their family. There may be additional challenges for pediatric emergency nurses (PENs) to consider in their efforts to provide safe quality nursing care to pediatric patients and families with limited English proficiency. The purpose of this study was to explore and describe the experience of PENs who are engaged in providing care to pediatric patients and families with limited-English proficiency (LEP) in a pediatric emergency department. Using an interpretive description method, semi-structured interviews conducted with 15 PENs and five certified professional medical interpreters (CPMIs) were analyzed. The study …

Exploring Community College Health Science Adjunct Faculty's Perception Of Culturally Responsive Teaching Practices And Implementation Readiness, Catherine Sirangelo

Seton Hall University Dissertations and Theses (ETDs)

Introduction. Millions of students enroll in public community colleges in the United States. They are often first-generation or first in their family to go to college. They are often culturally and linguistically diverse, with English not being their first language. They often choose a community college because of its high-quality, lower cost, and successful implementation of programs to assist and acclimate them to post-secondary education. Students look to community college as a first step into a professional healthcare career. Health Science faculty teaching at community colleges are either full-time or part-time (adjunct) contingency faculty. Adjunct faculty are often content experts …

Post-Resettlement Food Insecurity: Afghan Refugees And Challenges Of The New Environment, Zahra Goliaei, Mariaelena Gonzalez, Karina Diaz Rios, Mamata Pokhrel, Nancy J Burke

Faculty Publications & Research of the TUC Public Health Program

BACKGROUND: Lack of access to adequate, safe, and nutritious food is a major concern for the Afghan population due to ongoing war and humanitarian crises. Recently resettled Afghan refugees in the US continue to face challenges securing adequate, nutritious food resources in new environments. This study examined Afghan refugees' food access and insecurity in the San Joaquin Valley, California.

METHODS: Semi-structured, in-depth interviews were conducted to collect the perspectives and experiences of key informants and newly arrived Afghan refugees.

RESULTS: This study highlights environmental and structural factors (availability and accessibility of grocery stores; availability of religious-appropriate items in the stores; …

Servant Leadership: A Powerful Paradigm For Effective Leadership In Africa, Franklin Ezeorah

Journal of Vincentian Social Action

Lack of good leadership is the greatest undoing of African progress. Unfortunately, good leadership for Africans is not just mirroring the western leadership system but adapting to a style of leadership that is attractive to African people’s way of life and effective for African people’s development and wellbeing. Because leadership is a crucial determining factor for the success of all economic, political, and organizational structures, determining an essential leadership style for a nation-state largely depends on how suitable the style can fit into the complex challenges facing such a nation-state. Considering the viability and profitability of the servant leadership style …

Experiences Of People With Serious Mental Illness Seeking Services At Community Mental Health Centers During The Covid-19 Pandemic, Emily Leickly

Dissertations and Theses

Community mental health centers (CMHCs) have been underfunded and overburdened since Reagan-era disinvestment and the United States' move toward neoliberalism. Rates of mental illness have been rising consistently, particularly in Oregon, as CMHCs face continuing financial pressures and staff retention issues. This was before the COVID-19 pandemic. Today, we are still trying to understand the ongoing pandemic's impact on people with serious mental illnesses (SMI). Most of the studies in this area thus far are quantitative, and first-hand accounts of the pandemic from people with SMI are largely absent. Additionally, research in this area fails to draw on critical alternative …

Review Of Gynaecological Cancer Among Aboriginal And/Or Torres Strait Islander People In Australia, Aime Powell, Ami Morseu-Diop, Maya Morton Ninomiya, Uday Narayan Yadav, Emily Phillips, Devendra Raj Singh, Tamara Butler, Emma Allanson, Lisa J. Whop

Journal of the Australian Indigenous HealthInfoNet

Gynaecological cancers bear a significant burden on the health of Australians. Whilst Australia has made great strides in reducing the overall gynaecological cancer burden nationally, Aboriginal and/or Torres Strait Islander women continue to experience disproportionately high rates of gynaecological cancers.

This review focuses on the social, cultural, and historical contexts that contribute to inequitable gynaecological cancer rates among Aboriginal and/or Torres Strait Islander women. An in-depth discussion on cervical cancer, ovarian cancer, and uterine cancer are described; including the incidence, mortality, survival, and management of these diseases for Aboriginal and/or Torres Strait Islander women.

It highlights both the persistent barriers …

Implementation Of A Decision Aid To Increase The Rate Of Routine Breast Cancer Screening Among Women Between 50 To 74 Years Old At A Federally Qualified Health Center, Dana Mars

Doctor of Nursing Practice Scholarly Projects

Background: Breast cancer is the most prevalent form of cancer in the U.S. Cancer screenings can result in prompt treatments and positive health outcomes. Disparities in screening rates are prevalent among vulnerable populations. At a Federally Qualified Health Center (FQHC), where the project occurred, the rate of breast cancer screening in 2021 (64%) was lower than the target set by the Healthy People 2030 (77%). This quality improvement project aimed to increase the rate of routine breast cancer screening among women aged 50-74 years old in the FQHC.

Methods: Previous studies have reported that decision aids on breast cancer screening …

Eco-Interoception: What Plants, Fungi And Protista Have Taught My Body, Sara Riley Dotterer

Art Theses and Dissertations

To me, ecology is the relational, full-body awareness that I am made up of and deeply connected to everything around me; and for better or worse, this is reciprocal. I form ecotones, an ecological transitional zone between two ecosystems, with the world around me. I use this ecotonal lens to blur binaries and dissolve boundaries between me and the world “outside my body.” During my Masters of Fine Arts at Southern Methodist University, I have continuously explored and represented the lives of various more-than-human species outside of my body, including plants, fungi and protista through an ecotonal lens. Although these …

An Examination Of The Research Addressing Evidence-Based Communication Approaches For Students With Autism, Sydni Kaye Mcatee

Honors Theses

The meta-analysis examines scholarly articles regarding research on evidence-based communication for students with Autism Spectrum Disorder. More specifically, this research involves different forms of Alternative and Augmentative Communication. This form of communication is used without a voice. A variety of interventions for Manual Signing (MS), Speech Generating Devices (SGD), and Picture Exchange Communication Systems (PECS) are reviewed within the research study. The purpose of this research is to define which evidence-based Alternative and Augmentative Communication (AAC) interventions are most effective for children with Autism. More specifically, determining which form of communication can help lead children to more expressive language and …

Verb Tense Production Differences Across Various Discourse Tasks In People With Fluent And Nonfluent Aphasia, Madeline Ann Zurbrugg

Honors Theses

Background: Fluent and nonfluent aphasia are both seen to exhibit varying degrees of morphosyntactic difficulties, with particular difficulties in verb tense production. There is disagreement regarding why tense is particularly impaired, which type of aphasia is more impaired and why, and whether some tense forms are more impaired than others. There is also evidence that language elicitation tasks affect language production measures because they require different linguistic and cognitive processes. This is likely also true for verb tense production. To date, no studies have examined discourse elicitation task effect on verb tense production in both fluent and nonfluent aphasia. The …

The Existence Of Stuttering-Like Disfluencies In American Sign Language, Katherine King

Honors Theses

For over a century, data have documented fluency disorders and stuttering-like disfluencies (SLDs) in multiple expressive modalities outside of speech, including musical expression, writing, and American Sign Language (ASL). The presence of SLDs in multiple expressive modalities presents the argument that SLDs are not limited to speech. This study specifically surveys fluent ASL signers relative to SLDs, analyzes SLD manifestations, and documents specific examples of stuttering behaviors in ASL.

This study analyzes SLD manifestations in ASL by conducting a survey developed from all known research within the SLD paradigm. Based on all previous research, SLD manifestations are categorized and represented …

Structural Barriers To Health Care Access And Ipv Disclosure In First-Generation Latina Immigrants, Donna L. Schminkey, Deborah Elkins, Karen Jagiello, Sandra Annan, Jamie Robinson, Erika Metzler Sawin

Virginia Journal of Public Health

Background: This study aimed to describe the unique structural barriers faced by Latina women in rural areas of Virginia as they attempt to access the health care system, and, once they have gained access, to identify barriers to intimate partner violence (IPV) disclosure.

Methods: Semi-structured in-depth individual interviews with first-generation Latina immigrants were conducted after initial purposeful convenience sampling and concomitant snowball recruiting. A thematic content analysis using a phenomenological approach was employed to interpret participants' experiences. Initial findings were validated through additional interviews.

Results: The overarching theme expressed by these women was their search for dignity. Emergent sub-themes related …

A Rapid Review Of The Literature: Cardiovascular Disease Preventive Practices And Rural Black Women, Modjadji M. Choshi, Maria Devalpine

Virginia Journal of Public Health

Cardiovascular disease (CVD) is the leading cause of death among Black/African American women. Rural Black women have the highest CVD prevalence and are more likely to have modifiable risk factors such as high blood pressure, diabetes, and obesity than any other race. Accessible evidence-based culture-appropriate self-care programs for risk reduction and CVD prevention can address these disparities. This rapid review aims to provide a comprehensive collection of such programs. Methods. Searches were performed in PubMed, CINAHL, Web of Science, Psychinfo-Embase, and Scopus for studies reporting CVD prevention programs for rural Black women. Three articles met the inclusion criteria, with …

How To Be An Anti-Racist Educator: A Book Review Through An Educational Perspective, Maria Cristina F. Soares, Melanie Morales

Journal of Multicultural Affairs

The authors reviewed the book How to be an Antiracist by Ibram X. Kendi (2019) while reflecting on how Kendi’s brilliant dismantlement of racism and discrimination would help educators become conscious of how racism operates in our society, their schools, and their communities. Kendi’s book could motivate teachers to self-reflect on intrinsic feelings and misconceptions about race and culture built over time, allowing them to adopt new attitudes towards their students and school community. The authors considered the need to reevaluate systemic racism in schools as research has, for instance, found evidence of discriminatory practices towards African American boys (Gregory …

Development And Validation Protocol For An Instrument To Measure Household Water Insecurity Across Cultures And Ecologies: The Household Water Insecurity Experiences (Hwise) Scale, Sera L. Young, Shalean M. Collins, Godfred O. Boateng, Torsten B. Neilands, Zeina Jamaluddine, Joshua D. Miller, Alexander A. Brewis, Edward A. Frongillo Jr., Wendy E. Jepson, Hugo Melgar-Quiñonez, Roseanna C. Schuster, Justin B. Stoler, Amber Wuitch, Hwise Research Coordination Network

Faculty Publications

Introduction A wide range of water-related problems contribute to the global burden of disease. Despite the many plausible consequences for health and well-being, there is no validated tool to measure individual- or household-level water insecurity equivalently across varying cultural and ecological settings. Accordingly, we are developing the Household Water Insecurity Experiences (HWISE) Scale to measure household-level water insecurity in multiple contexts.

Methods and analysis After domain specification and item development, items were assessed for both content and face validity. Retained items are being asked in surveys in 28 sites globally in which water-related problems have been reported (eg, shortages, excess …

Medical Interpreters' Work Impact On Their Lives: Understanding Medical Interpreters' Work Experience, Nicholas M. Herrarte Smith

Senior Honors Projects, 2020-current

Medical interpreters in the US are crucial health workers that specialize in facilitating communication between non-English-speaking patients and English medical professionals. Although much research has been done regarding the positive impact of professional medical interpreters on LEP (limited English proficient) patients' health, it is less known how medical interpreters’ lives are impacted in this line of work. Thus, this study was aimed at gaining a better understanding on the impact that this line of work has on the lives of medical interpreters. For this study, a survey was created with questions regarding demographics, interpretation’s certification process, interpreter’s satisfaction/experience, and mental …

A Modified Dbt-Informed Art Therapy Group Curriculum With A Focus On Neurodiversity Acceptance, Megan Moyer

Art Therapy Counseling Final Research Projects

Historically, therapy methods made to support neurodivergent individuals have been focused on reducing “challenge behaviors” and modifying behavior to societal standards. Simultaneously, many behavior modification therapies neglect the emotional well-being of the individual. As neurodiversity grows to be accepted as an aspect of diversity, so too must therapy methods change to promote skill building in line with the cultural values and strengths of neurodivergent individuals and promote social-emotional well-being. This group therapy curriculum poses as one such possibility to this change by utilizing DBT and Art Therapy in a group psychoeducation format.

Age-Related Decline In Neural Synchrony And The Ffr, Haley Szabo

Dissertations, 2020-current

It is a known phenomenon that speech understanding in background noise declines with advancing age. Although there is ample evidence of behavioral measures declining with age, there is less physiologic evidence. This study hypothesizes that the FFR will be degraded with advancing age, consistent with poorer phase locking. This is hypothesized to be present even in people with audiograms within normal limits. A second hypothesis is that middle-aged adults will have degraded neural representation as frequency increases, compared to a younger normal hearing group which will have better high frequency neural representation than the middle-aged group. Subjects were divided into …

Implementing Cultural Competency Training Among Advanced Practice Providers At An Academic Medical Center: A Quality Improvement Project, Kierah Barnes

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Racial health disparities, inequities, and healthcare bias are long considered concerns for the healthcare community.Cultural competency training (CCT) is one solution that is gaining recognition as an effective intervention to address bias among healthcare providers, resulting in improved patient outcomes and assisting with reducing health disparities among minority populations. This quality improvement project was implemented at an academic medical center and designed for Advanced Practice Providers who completed the training to demonstrate an increase in their cultural competency post-test compared to the pre-test. The increase in CCT will hopefully impact the delivery of culturally conscious/competent healthcare and positive experiences to …

Du Undergraduate Showcase: Research, Scholarship, And Creative Works, Caitlyn Aldersea, Justin Bravo, Sam Allen, Anna Block, Connor Block, Emma Buechler, Maria De Los Angeles Bustillos, Arianna Carlson, William Christensen, Olivia Kachulis, Noah Craver, Kate Dillon, Muskan Fatima, Angel Fernandes, Emma Finch, Colleen Cassidy, Amy Fishman, Andrea Francis, Stacia Fritz, Simran Gill, Emma Gries, Rylie Hansen, Shannon Powers, Jacqueline Martinez, Zachary Harker, Ashley Hasty, Mykaela Tanino-Springsteen, Kathleen Hopps, Adelaide Kerenick, Colin Kleckner, Ci Koehring, Elijah Kruger, Braden Krumholz, Maddie Leake, Lyneé Alves, Seraphina Loukas, Yatzari Lozano Vazquez, Haley Maki, Emily Martinez, Sierra Mckinney, Audrey Mitchell, Kipling Newman, Audrey Ng, Megan Lucyshyn, Andrew Nguyen, Stevie Ostman, Casandra Pearson, Alexandra Penney, Julia Gielczynski, Tyler Ball, Anna Rini, Christina Rorres, Simon Ruland, Helayna Schafer, Emma Sellers, Sarah Schuller, Claire Shaver, Kevin Summers, Isabella Shaw, Madison Sinar, Claudia Pena, Apshara Siwakoti, Carter Sorensen, Madi Sousa, Anna Sparling, Alexandra Revier, Brandon Thierry, Dylan Tyree, Maggie Williams, Lauren Wols

DU Undergraduate Research Journal Archive

DU Undergraduate Showcase: Research, Scholarship, and Creative Works

Functional And Location Context Effects On Reading Sentences In Healthy Young Adults: Evidence From Eye Tracking Methods, Elizabeth Baird

Honors Theses

Spreading activation theory proves the way our brains are semantically wired to accept outside information and understand it. Previous studies have demonstrated the effects of spreading activation theory in different settings and activities. These effects are important to understand because they can be used in therapy and assessment for communication disorders. This study explores how the context of sentences affects reading time on noun targets in healthy young adults using an eye tracking method. Specifically, we compared functional and location context types and manipulated the context to be incongruent or congruent to the targets. Our research questions were (1) whether …

Spanish Club For Healthcare Professionals, Sophie Stallings

Honors Theses

Spanish Club for Healthcare Professionals was registered as an approved student organization in January of 2023, and the first meeting was January 30. The objective of this club is to educate students entering different healthcare fields on how to communicate with Spanish speaking patients. During my time serving as the founder and president of this organization, I strived to provide a resource that would help lower the language barrier that is present in today’s society with regards to a lack of Spanish- speaking healthcare professionals. The goal is not for students to be fully fluent in Spanish but simply learn …

Layperson Perception Of Reflux-Related Symptoms, Jakob L. Fischer, Anthony M. Tolisano, Alvaro I. Navarro, Lily Trinh, Waleed M. Abuzeid, Ian M. Humphreys, Nadeem A. Akbar, Sharan Shah, John S. Schneider, Charles A. Riley, Edward D. Mccoul

2020-Current year OA Pubs

OBJECTIVE: To assess for differences of intended meaning in the description of reflux-related symptoms among otolaryngology patients and clinicians.

STUDY DESIGN: Cross-sectional survey-based study.

SETTING: Five tertiary, academic otolaryngology practices.

METHODS: Between June 2020 and July 2022, a questionnaire consisting of 20 common descriptors of reflux-related symptoms within four domains (throat-, chest-, stomach-, and sensory-related symptoms) was completed by patients. Attending otolaryngologists at five academic medical centers then completed the same survey. The primary outcome was to assess differences in patient and clinician perceptions of reflux-related symptoms. Differences based on geographic location was a secondary outcome.

RESULTS: A total of …

Coda Identity - Why Our Stories Are Important: A Qualitative Look At The Personal Narratives Of Adult Hearing Children Of Deaf Adults, Emma Tripp

Undergraduate University Honors Capstones

Children of Deaf adults (Coda) possess bicultural identities which may play a significant role in their mental health journeys. Bicultural identities can be a source of both stress and pride. Harmony between multiple cultural identities is associated with more positive mental health outcomes (Tikhonov et al., 2019). Codas belong to an under researched population of Deaf communities, further mystifying the inner worlds of Codas. This preliminary study aims to document the personal narratives of Codas’ lived experiences and perceptions as individuals with bicultural identities by thematic analysis of qualitative interviews with five Codas in hopes to identify areas of future …

Perspectives On Non-Prescription Antibiotic Use Among Hispanic Patients In The Houston Metroplex, Lindsey Laytner, Patricia Chen, Susan Nash, Michael K Paasche-Orlow, Richard Street, Roger Zoorob, Barbara Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

BACKGROUND: Non-prescription antibiotic use includes taking an antibiotic without medical guidance (e.g., leftovers, from friends/relatives, or purchased without a prescription). Non-prescription use contributes to antimicrobial resistance, adverse drug reactions, interactions, superinfection, and microbiome imbalance. Qualitative studies exploring perspectives regarding non-prescription use among Hispanic patients are lacking. We used the Kilbourne Framework for Advancing Health Disparities Research to identify factors influencing patients' non-prescription use and organize our findings.

METHODS: Our study includes Hispanic primary care clinic patients with different types of health insurance coverage in the Houston metroplex who endorsed non-prescription use in a previous survey. Semistructured interviews explored the factors …