Digital Commons Network^™

Promoting Maternal Health Through Community-Based Education: A Quality Improvement Initiative On Hypertension And Pregnancy Complications In An Outpatient Setting, Areli Mendez

Doctor of Nursing Practice Projects

Background

Hypertensive disorders during pregnancy remain one of the leading causes of maternal and fetal complications worldwide, particularly among underserved and minority populations. Spanish-speaking women often experience barriers related to language, limited health literacy, and reduced access to culturally appropriate education, which may delay the recognition of warning signs associated with pregnancy complications. Early education and awareness are essential to improve maternal outcomes and promote timely medical intervention.

Purpose Statement

The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the effectiveness of a culturally tailored educational intervention designed to improve maternal knowledge regarding hypertension during pregnancy …

Study Summary: Exploring Safe & Effective Interpreter Output Ofyoga Concepts In Asl, Dixie Schexnaildre Dhsc

JADARA

Yoga can support mental health, recovery, and provide positive coping strategies. Where language inequities impede access for Deaf individuals, interpreters are thought to facilitate communication. However, the percentage of interpreters trained in safe, effective, or non-triggering yoga interpretation is unknown. Using background and frequency data, this précis of a lengthy descriptive project highlights barriers to yoga programming for the Deaf community. A central finding is only 33% (n = 7) of interpreters had training to ensure emotional and physical safety to yoga participants. While results are assessed cautiously, lack of interpreter training may add to health and recovery programming inequities.

Diagnostic Trends And Service Enhancements In Deaf Mental Health: A Longitudinal Analysis, Kent Schafer, Steve Hamerdinger, Frank Wu, Rie Sakai Bizmark, Charlene Crump

JADARA

A longitudinal study investigated mental health diagnostic trends and patterns among Deaf and Hearing individuals using a comprehensive dataset from Alabama Department of Mental Health spanning 2004-2024 (Deaf=4,547; Hearing=2,056,188). Chi-square analysis revealed significant proportional differences in diagnoses between the groups. Deaf individuals showed significantly higher proportions of psychotic (12.93% vs. 8.33% Hearing), mood (20.76% vs. 18.84% Hearing), and personality (0.58% vs. 0.43% Hearing) disorders. These findings suggest that increased access to specialized and competent mental health services for individuals who are Deaf, particularly following the increase of staffing patterns for the Office of Deaf Services in 2015,contributed to more accurate …

Recognizing Structural And Social Determinants Of Health In The Diagnosis And Care Of Dementia, Shana D Stites, Sharnita Midgett, Nisha Patel, Kimberly Halberstadter, Rosalie Schumann, Marissa L Streitz, Yidan Shi, John C Morris, Jason Flatt, Crystal M Glover, Dawn Mechanic-Hamilton

2020-Current year OA Pubs

Structural and social determinants of health are environmental conditions that affect individuals' health and functioning across the life course. These determinants are salient factors at the apex of individual psychology, community variables, and larger sociological factors, exerting prominent effects on individuals' wellbeing. The National Institute on Aging seeks to understand their influence on aging and Alzheimer's disease. We propose that the benefits of doing so may reach beyond knowledge of disease mechanisms - it may also improve clinical outcomes. We describe efforts introducing structural and social determinants of health data into the national network of Alzheimer's disease research centers. We …

Quality Improvement Project: Impact Of National Culturally And Linguistically Appropriate Services (Clas) Standards Education On Behavioral Health Providers’ Self-Efficacy, Zita Anigbou

Doctor of Nursing Practice Projects

Health disparities among culturally and linguistically diverse populations continue to negatively affect access to and quality of behavioral health care. Limited provider education on the National Culturally and Linguistically Appropriate Services (CLAS) Standards contributes to communication barriers, reduced therapeutic engagement, and lower provider confidence. The purpose of this quality improvement project was to evaluate the impact of evidence-based CLAS Standards education on behavioral health providers’ self-efficacy in delivering culturally and linguistically appropriate care. Guided by Lewin’s Change Theory and the Health Equity Implementation Framework, a quantitative pre-test–post-test quasi-experimental design was used. A convenience sample of three behavioral health nurse practitioners …

Differences And Changes In Cross-Cultural Sensitivity Of German And Japanese Students Before And After Short-Term Exchange Programs, Kazumasa Nakagawa, Yuko Takahashi, Melanie Zwiorek

Journal of Educational Research and Practice

Since 2012, a Japanese and a German university have conducted exchange programs. This study examined the effects of a short-term exchange program in 2023, focusing on intercultural sensitivity. Nine Japanese students and nine German students completed a 24-item Intercultural Sensitivity Scale before and after the program using a 5-point Likert scale. We performed cross-tabulations and analyzed differences between countries and pre- and post-program changes using chi-square or Fisher’s exact tests. The results suggest that even a short-term exchange enhanced Japanese students’ confidence in intercultural interactions and encouraged German students to reflect on their own culture. However, Japanese students showed lower …

Staff Education To Improve Knowledge Of Nurse-Led Telemonitoring For Suicide Prevention, Finny Ngozi Rogers

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a staff education initiative addressing a critical practice gap: clinical staff at a mental health facility lacked the practical knowledge to implement evidence-based telemonitoring protocols for suicide prevention, despite strong supporting research. High rates of suicide attempts and readmissions underscored the urgency for this intervention. The practice-focused question was: “Will a staff education program designed to educate healthcare providers on nurse-led telemonitoring protocols increase staff knowledge?” The purpose of this project was to develop, implement, and evaluate an educational program for providers to increase their knowledge on how a telemonitoring protocol can reduce …

Evaluation Of The Consistency Of A Speech Verification System With Human Raters In Early Literacy Screening Assessments, Yaacov Petscher, Jennifer O'Sullivan, Hugh W. Catts, Ashley Edwards, Lisa Fitton Ph.D., Ccc-Slp

Faculty Publications

This study investigates the use of a speech verification system (SVS) technology, a form of automatic speech recognition (ASR), in the assessment of children's reading skills. Despite the growing integration of ASR systems in educational assessment, significant challenges persist, particularly due to the acoustic, pronunciation and dialectal variability inherent in children's speech. Our research evaluated the consistency between human rater (HR) and speech verification system (SVS) scores produced from SoapBox Labs across three linguistic tasks—phoneme blending, expressive vocabulary and word reading. Results reveal variability in agreement rates, with SVS showing lower consistency with human raters in phonologically complex tasks like …

Evaluation Of The Consistency Of A Speech Verification System With Human Raters In Early Literacy Screening Assessments, Yaacov Petscher, Jennifer O'Sullivan, Hugh W. Catts, Ashley Edwards, Lisa Fitton Ph.D., Ccc-Slp

Faculty Publications

This study investigates the use of a speech verification system (SVS) technology, a form of automatic speech recognition (ASR), in the assessment of children's reading skills. Despite the growing integration of ASR systems in educational assessment, significant challenges persist, particularly due to the acoustic, pronunciation and dialectal variability inherent in children's speech. Our research evaluated the consistency between human rater (HR) and speech verification system (SVS) scores produced from SoapBox Labs across three linguistic tasks—phoneme blending, expressive vocabulary and word reading. Results reveal variability in agreement rates, with SVS showing lower consistency with human raters in phonologically complex tasks like …

Developing Critical Thinking Skills In Undergraduate Csd Students Through A Case Study Project, Lydia R. Kruse, Windi Krok

Teaching and Learning in Communication Sciences & Disorders

Critical thinking skills are crucial for Speech-Language Pathologists to effectively assess, diagnose, and treat communication disorders. However, the optimal timing for teaching these skills to future clinicians remains an open question. Most of the current research is focused on developing critical thinking skills in graduate students, though there is some evidence to suggest that students should be working to develop critical thinking skills during their undergraduate education. This work describes the critical thinking skills demonstrated by undergraduate students in a Communication Sciences and Disorders (CSD program) through a case study project, as well as their self-perceptions. Results indicate relative weakness …

Development And Impact Of A Review Course For The Praxis Examination In Speech- Language Pathology, Miriam Baigorri, George Pagano

Teaching and Learning in Communication Sciences & Disorders

Abstract

The Praxis II: Subject Assessment in Speech-Language Pathology is a required national examination for certification and licensure in the United States. However, disparities in pass rates, particularly among culturally and linguistically diverse (CLD) test takers, create barriers to professional entry. This study examines students' perceptions of the effectiveness of an Examination Preparation Course, designed to enhance student success through structured content review, practice exams, and test-taking strategies. A total of 70 graduates (2018–2023) who completed the course participated in an online survey assessing their demographics, perceptions of the course’s effectiveness, and confidence levels before and after taking the course. …

Improving Benzodiazepine Refill Workflow And Communication Via Telehealth Using A Standardized Sbar Protocol, Hendricks Agwu

Doctor of Nursing Practice Projects

The development in telehealth operations in outpatient mental health care has enhanced access to care at the expense of creating challenges in communication and workflow, especially when it comes to dealing with high-risk substances like benzodiazepines. The role ambiguity, inaccurate refill timeline, documentation lapses and high chances of medication errors are caused by inconsistent communication during the process of telehealth refills. This quality improvement project was aimed at assessing the effects of applying a standardized Situation, Background, Assessment, Recommendation (SBAR) communication and documentation protocol to workflow efficiency, interprofessional communication, and medication safety when making benzodiazepine refills in a telehealth outpatient …

Assessment Perception: Delivery Matters, Nicole Marie Arcuri Sanders, Chelsey Simmons

Journal of Counselor Preparation and Supervision

Perception shapes how individuals experience the world and guides their actions toward personal goals. In counseling, clients’ accurate understanding of assessment results is essential for informed decision-making and effective treatment engagement. Mental health clinicians have an ethical responsibility to communicate findings in ways that safeguard client welfare and empower both clients and stakeholders to collaborate in care. This conceptual manuscript introduces the BRIEF (Brief, Relevant, Interpretive, Empathetic, and Factual) Feedback Integration Framework, a structured model for delivering assessment feedback ethically and accessibly. Integrating cognitive, developmental, and cultural considerations. BRIEF provides counselors, supervisors, and educators with a practical strategy for improving …

Perceptions Of Healthcare Access Barriers Among Eritrean, Sudanese, And Somali Refugees And Asylum Seekers In Cairo., Ayan Musa Mohamed

Theses and Dissertations

As the world witnesses an increase in different displacements of individuals for various reasons, ranging from wars, civil conflicts, human rights violations, and natural disasters, refugees and asylum seekers, who are among those forcibly displaced, continue to face challenges in access to health care services in host countries. The topic of barriers to health care has been widely researched, with a large body of literature on refugees' interactions with health care systems. However, there is limited literature on the perceptions of Eritrean, Sudanese, and Somali refugees and asylum seekers' experience with healthcare access in host countries. Therefore, this thesis aims …

Facebook Interaction As A Potential Marker Of Cognitive Decline: Pilot Study, Esraa M. Qansuwa

Theses and Dissertations

One of the critical challenges in brain disorder research is the early identification of individuals with mild cognitive impairment (MCI) who may later develop Alzheimer’s disease (AD) or other dementias. MCI in older adults is frequently associated with diminished social engagement and observable behavioral changes. With the rapid expansion of social media platforms and advances in Machine Learning (ML), digital traces from online activity present a novel and scalable avenue for mental health screening. In particular, predictive ML approaches have demonstrated strong potential in building reliable classifiers for early detection of neurocognitive decline. This study introduces an innovative framework that …

Perceptions Of Ischaemic Heart Disease Risk Among Indian Migrants In Australia: A Qualitative Study, Kunwar Kaur, Ma'en Zaid Abu-Qamar, Amineh Rashidi, Nilufeur Mckay, Rosemary Saunders

Research outputs 2022 to 2026

Background: Ischaemic heart disease (IHD) is a global health issue, with people of Indian origin facing earlier onset and more severe cases, leading to higher mortality at younger ages compared to Western countries. Indian migrants maintain similar risks post-migration. Managing modifiable risk factors and improving risk knowledge and health-seeking behaviours are essential, but research on IHD risk perceptions among Indian migrants is limited. Aim: This study explores how first-generation Indian migrants perceive their IHD risk and the factors influencing these perceptions. Methods: As a component of a mixed- method study, a qualitative descriptive study design was employed to examine study …

Validity Of The Turkish Version Of The Oral Frailty Index-8 And Its Relationship With Frailty, Malnutrition, And Sarcopenia In Older Adults, Süleyman Emre Koçyi̇ği̇t, Bi̇lal Kati̇poğlu, Yilmaz Önal, Kübra Bahar Baykan, İlknur Şeker Kaya, Fatma Sena Dost, Özge Dokuzlar, Esra Ateş Bulut, Ali̇ Ekrem Aydin, Derya Kaya, Ahmet Turan Işik

Turkish Journal of Medical Sciences

Background/aim: The Oral Frailty Index-8 (OFI-8) is a reliable screening for oral frailty. In our study, while presenting the Turkish reliability and validity study of the OFI-8, we also aimed to establish a cut-off value for oral frailty in Turkish population.

Materials and methods: Patients who presented to the outpatient clinic between January 2024 and January 2025 were evaluated. The test’s internal consistency and test–retest reliability were assessed. Divergent validity was evaluated using frailty scores, muscle strength, and nutritional status. A receiver operating characteristic (ROC) curve was generated to determine the optimal cut-off values for identifying frailty, malnutrition, and probable …

Community Participatory Co-Design And Development Of A Digital Diabetes Prevention Education Program For Hispanic Families With Obesity: Mixed Methods Study, Sandra Mihail, Marbelly Partida, Lizette Villanueva, Debbe Thompson, Teresia M O'Connor, Salma M Musaad, Maria J Redondo, Erica G Soltero

Children’s Nutrition Research Center Staff Publications

Background: Digital health interventions (DHIs) can extend the reach of disease prevention interventions; however, few are evidence-based, theoretically grounded, or developed for high-risk youth and families. Co-design approaches engage end users in the design and development of the DHI, which can lead to increased accessibility and engagement.

Objective: This study aimed to describe the adaptation of an evidence-based diabetes prevention program for remote, digital delivery.

Methods: The adaptation of the in-person intervention was guided by a modified Inclusive Digital Health Intervention Design to Promote Health Equity framework and conducted in collaboration with Hispanic adolescents (n=23) with obesity (BMI ≥95th percentile) …

Patient Characteristics Associated With Telehealth Use In A Large Federally Qualified Health Center, Priyanka Gautom, Cara L. Eckhardt, Lisa K. Marriott, Cirila Estela Vasquez Guzman, Gloria D. Coronado

OHSU-PSU School of Public Health Faculty Publications and Presentations

The COVID-19 pandemic rapidly expanded telehealth services when in-person care was limited. Using primary care data from a large federally qualified health center in Washington state, this study aimed to: 1) describe trends in telehealth use among adult patients, and 2) provide disaggregated patient characteristic data associated with telehealth use, with a focus on patients speaking Asian Indian languages.

Emerging Trends And Challenges In International Student Research: A Content Analysis Of Recent Dissertations (2022–2024), Krishna Bista, Oluwasegun Adesola Oladipo, Lin Ge, Tian Qin

Health Care Administration Faculty Research

This study presents a content analysis of 470 doctoral dissertations published between 2022 and 2024, examining emerging trends, theoretical frameworks, and research approaches related to international students. Using a qualitative content analysis approach and descriptive statistics, the study systematically analyzed the dissertations to identify recurring themes and issues. The key themes identified include teaching and learning; academic practices; acculturation and intercultural competence; career development and leadership; experiences and challenges; mobility and policy contexts; social diversity and inclusion; institutional support; and well-being. The findings show a predominant use of qualitative methods, a concentration on U.S.-based contexts, and a strong disciplinary focus …

Potential Mediators In The Relationship Between Racial Identity And Neuropsychological Performance In A Retired Nfl Cohort, Claire Stafford, Charles Golden, Ryan Bennett

Archives of Assessment Psychology

Historically, Black Americans have consistently performed more poorly than White Americans on various neuropsychological tests, with debates surrounding the causes of these differences ranging from genetic to societal factors. These differences have been documented across various cognitive domains, including memory, attention, executive function, and processing speed. Findings from previous research suggest that individuals with higher levels of education and stable marital relationships tend to exhibit better cognitive functioning, while certain football positions are linked to differences in cognitive abilities. However, the specific effects of these factors on neuropsychological performance require further investigation. The present archival study was derived from a …

Oral Health Related Quality Of Life In A Group Of Egyptian Preschool Children With Early Childhood Caries: A Cross-Sectional Study, Sara Adel Botros, Sara Magdy, Asmaa Abou Bakr, Ola Abdel Geleel

Dentistry

No abstract provided.

Protocol For Personalised Prediction Of Persistent Postsurgical Pain, Katherine J Holzer, Harutyun Alaverdyan, Ziqi Xu, Madelyn R Frumkin, Karen A Frey, Stephen H Gregory, Thomas L Rodebaugh, Chenyang Lu, Christopher R King, Denise Head, Thomas Kannampallil, Simon Haroutounian

2020-Current year OA Pubs

INTRODUCTION: Persistent postsurgical pain (PPSP) affects up to 15% of patients after major surgery, impairing physical function, quality of life and increasing risk for long-term opioid use. Current PPSP prediction models rely on static or retrospective data and fail to incorporate dynamic perioperative factors. The Personalised Prediction of Persistent Postsurgical Pain (P5) study aims to develop individualised, multimodal prediction models by integrating preoperative behavioural, psychophysical and neurocognitive assessments and high-frequency symptom monitoring.

METHODS AND ANALYSIS: P5 is a prospective, single-centre cohort study enrolling 2500 adults aged 18-75 undergoing major surgery at a tertiary academic hospital. Participants complete baseline surveys, cognitive …

Coaching In Undergraduate And Graduate Medical Education: A Scoping Review Of Success Factors, Barriers, And Outcomes Data File, Binata Mukherjee, Jenna Pfleeger, Haidee Custodio, Maria Renee Roca, Gurupreet Khalsa, Clista Clanton

University Research Data and Datasets

The data in this file support the findings of the following study.

Purpose: Wanting to implement a sustainable learner coaching program in academic medicine and prior exposure to coaching initiatives raised questions including planning, implementation and assessment, and resource allocation. This scoping review examines coaching across medical learners, reported program elements, success factors, and barriers.

Methods: Following PRISMA-ScR guidelines, informed by Levac et al. on Arskey and O’Malley’s framework and Braun and Clarke’s thematic analysis, PubMed, Scopus, and ERIC was searched through May 2024. Articles were screened, data extracted, and coded. A mixed methods analysis included descriptive statistics and thematic …

Caregivers' Experiences Of Assessment And Treatment For Their Child With Childhood Apraxia Of Speech: An International Questionnaire Study, Donna Claire Thomas, Maryane Gomez, Angela Muis, Nathan Trezise, Eliza Williamson, Julie Case, Elizabeth Murray, Maria Irene Grigos, Jenya Iuzzini-Seigel, Shelley L. Velleman

Speech Pathology and Audiology Faculty Research and Publications

Purpose: The aim of this study was to understand caregivers' preferences and experiences with diagnosis and treatment of childhood apraxia of speech (CAS).

Method: Caregivers of children with CAS completed a 70-item online survey that explored demographics, initial concerns, the CAS diagnostic process, speech therapy goals, and preferred and received speech therapy service delivery (session frequency, length, and context). Quantitative data were analyzed descriptively and with inferential statistics; qualitative data were analyzed using content analysis.

Results: One hundred sixty-one caregivers participated, mostly from the United States, Australia, and Canada. A total of 72% of caregivers had concerns about their child's …

Hootation: A Gui And Api Library For Ontology Validation And Verbalization., Muhammad Amith, Xubing Hao, Warren Manuel, Manqi Li, Shun Rao, Kirk Roberts, Hua Xu, Yang Gong, Frank Manion, Cui Tao, Licong Cui

Faculty, Staff and Student Publications

Ontology verbalization refers to the process of translating formal axioms into natural language expressions. The primary objective is to facilitate the review and validation of ontology content by subject matter experts without requiring extensive technical expertise. While previous approaches based on templates or controlled grammar have been effective, they often face limitations in scalability, fluency, and adaptability. To address these issues, we developed Hootation, an open-source software system that supports ontology verbalization through both a graphical user interface and an API library. The tool implements rule-based translation of OWL2 axioms and further incorporates optional Large Language Model (LLM) components for …

Cardiometabolic Indicators Of Cognitive Impairment In The Cameron County Hispanic Cohort, Fadi I Musfee, Seema Agarwal, Vahed Maroufy, Chelsea Liu, Joseph B Mccormick, Susan Fisher-Hoch, Sean I Savitz

Faculty, Staff and Student Publications

Background

Objective

Methods

Cultural Influences On Camouflaging And Autistic Burnout: Examining The Experiences Of Latino Autistic Young Adults, Antonio F Pagán, Katherine A Loveland, Ron Acierno

Faculty, Staff and Student Publications

The present study explored the relationship between camouflaging, autistic burnout, and cultural factors in Latino young adults with autism spectrum disorder (ASD). While autistic burnout and camouflaging have been widely studied in general ASD populations, limited research has focused on Latino individuals, who may experience unique pressures due to cultural values such as collectivism, familism, and traditional gender roles. Participants (N = 56) from the ¡Iniciando! la Adultez therapy program completed measures assessing burnout, camouflaging, acculturation, and cultural values. Results indicate that participants reported moderate to high levels of autistic burnout, with the highest levels observed in heightened self-awareness …

Back-On-Track: Protocol For Randomised Controlled Feasibility Trial Of Behavioural Activation In Farmers With Mood Problems, Alison Kennedy, Richard Gray, Martin Jones, Anna Greene, Lauren Mitchell, Meera Senthuren, Suzy Malseed, Feby Savira, Kelly Barnes, Kate Gunn, Susan Brumby

Research outputs 2022 to 2026

The mental health of people living in farming communities has been identified as an important public health issue. Cumulative exposure to a range of situational factors contributes to heightened risk of poor mental health and suicide. Access to evidence-based psychological treatments is limited by the availability of skilled mental health professionals. The aim of this trial—co-designed by members of the farming community—is to establish the feasibility of conducting randomised controlled, trial-testing, peer-worker-delivered Behavioural Activation in the farming community. We will undertake a single-blind, parallel group, randomised controlled feasibility trial in rural Australia. People living in farming communities aged over 15 …

Recommended Best Practices For Construct-Centered Adaptation Of The Harmonized Cognitive Assessment Protocol, Emily M. Briceño, Darina T. Bassil, Pranali Khobragade, Anthony Ngugi, Martine El Bejjani, Eric Ochieng, Silvia Mejia-Arango, Salima Douhou, Kazione Kulisewa

School of Medicine Publications

Objectives: The Harmonized Cognitive Assessment Protocol (HCAP) neuropsychological assessment approach aims to support the collection of harmonizable data on cognitive function for cross-national cognitive aging and dementia research. As the measurement of cognition is sensitive to differences in contextual, cultural, educational, linguistic, social, and other factors that may influence cognitive test performance, HCAP requires adaptation to be appropriate for the contexts in which it is administered. We aim to provide methodological recommendations for the adaptation and implementation of the HCAP and other cognitive data collection tools in novel settings.

Methods: We drew from existing guidelines on cross-cultural psychological test adaptation …