Digital Commons Network^™

Patient-Centered Education In Fall Risk And Prevention Decreases The Number Of Falls On The Orthopedic Unit, Kaitlyn Chan, Amparo Guzman Garcia, Tran Huynh

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Inpatient falls are a major patient safety concern, particularly in orthopedic units where mobility limitations, comorbidities, and postoperative factors elevate risk and contribute to preventable injury, longer hospital stays, and increased costs. At Sutter Medical Center Sacramento’s orthopedic unit, an annual rate of 16 falls and persistent gaps in patient and staff education highlight the need for a targeted quality improvement initiative despite use of an EPIC predictive fall-risk model. Guided by the Plan-Do-Study-Act framework, this project implements a comprehensive fall-prevention education program modeled on the Fall T.I.P.S. toolkit, including a standardized bedside brochure, visual cues (wristbands, door signage, bedside …

Empowering Dietary Change: A Culturally Competent Nutrition Intervention For Hispanic Patients At The Agape Clinic, Ariana N. Smith

DNP Research Projects

Abstract 

Type 2 diabetes disproportionately affects Hispanic adults and may be more difficult to manage among uninsured and underserved populations experiencing barriers to healthcare, nutrition education, and culturally appropriate resources. The purpose of this Doctor of Nursing Practice quality improvement project was to implement and evaluate a brief, culturally tailored nutrition education intervention for Hispanic adults with elevated A1C receiving care at The Agape Clinic in Dallas, Texas. A quantitative, quasi-experimental, within-subject design was used. The intervention provided bilingual, low-literacy education focused on A1C, portion control, added sugars, and culturally familiar foods. Thirty-eight participants enrolled in the project, and 11 …

Utilizing Youth Mental Health First Aid: A Community-Based Prevention Strategy To Increase Teh Confidence Levels Of Seventh-Day Adventist Adults In Assisting Youth With Mental Health Distress, Sarah Hillebert

DNP Research Projects

Abstract 

Objective: Youth Mental Health First Aid (YMHFA) is an initiative from the National Council for Mental Wellness that trains adults in identifying and responding to adolescents exhibiting mental health distress. This DNP project evaluated the effectiveness of YMHFA in increasing the mental health literacy and confidence scores of Seventh-day Adventist (SDA) adults. Method: quality improvement, pretest-posttest quasi-experimental design was used. Participants were SDA adults aged 22 to 74 who work with youth in school, church, or camp settings (n=19; Mean age = 48.5 years, SD = 10.5). The quantitative MHFA 2.1 measured mental health literacy and confidence to intervene, …

Cognitive Load Classification Using Functional Near-Infrared Spectroscopy, Pratham Shah

Theses and Dissertations (Comprehensive)

This thesis investigates the classification of cognitive load using functional near-infrared spectroscopy (fNIRS) signals recorded during an N-back working memory task. The study introduces a novel short-channel correction layer designed to suppress superficial physiological noise adaptively, addressing limitations of traditional General Linear Model (GLM) based regression. A single participant dataset comprising 69 validated sessions was analyzed using both conventional machine learning and deep learning approaches. Traditional classifiers: Linear Discriminant Analysis (LDA), Support Vector Machines (SVM), Random Forests, and Gradient Boosting were first evaluated using statistical features (mean, variance, peak, and slope). Among these, Gradient Boosting achieved the highest accuracy (55.6%), …

Dual Language Learner Status In Relation To Cortisol For Children In Head Start Preschool, Keala Bratsch

West Chester University Graduate Theses, Dissertations, and Final Projects

Early childhood education (ECE) has well documented school readiness benefits, especially for children facing economic hardship. Yet preschool context poses challenges that are associated with elevated stress levels and potential long-term tax on physiological systems that respond to stress. The present study examined dual language learner (DLL) status in relation to levels of the stress hormone cortisol among low-income children attending Head Start Preschool programs. Participants included 207 children ages 3- 5 years who attended preschool in 2021-22 (60.9% attending a dual-language learning school, 39.1% attending an English-instruction-only preschool; all participants meeting the criteria for low-income), and their parents or …

The Experiences Of Black Women’S Maternity Care And Its Effects On Pregnancy Outcomes, Joy O. Osaghae

West Chester University Graduate Theses, Dissertations, and Final Projects

Health disparities in maternal health are a significant challenge to the public health of the United States, and Black women have double the morbidity and mortality rates of maternal illnesses in comparison with White women. These inequalities persist across socioeconomic levels, highlighting systemic inequities within the healthcare system. Some published studies have focused on quantitative outcomes, but few have examined Black women's lived experiences and their impact on pregnancy outcomes. This paper fills this gap by discussing the maternity care experiences of Black women in Philadelphia, Pennsylvania. Drawing on Critical Race Theory and Intersectionality Theory, this qualitative phenomenological study explored …

Assessing The Mentorship Role In Neonatal Outcomes, Patricia Juhline Brunner

West Chester University Graduate Theses, Dissertations, and Final Projects

The complex environment of neonatal intensive care requires a skilled, engaged nursing workforce to maintain high‑quality outcomes. Structured mentorship is an evidence‑based strategy shown to enhance professional engagement and support improved clinical outcomes. This Doctor of Nursing Practice quality improvement project aimed to evaluate the impact of a structured clinical mentorship program on evidence‑based practice beliefs, nurse engagement, and selected neonatal outcomes in a Level III academic intensive care nursery.

Guided by the Donabedian model, the project evaluated structure through mentorship design and preparation, process through mentor–mentee interactions and workflow integration, and outcomes through nursing and patient metrics. Lewin’s change …

How Autistic Children Define Novel And Real Words, Henry James Tomiser

Graduate Research Theses & Dissertations

Word knowledge is highly valuable to Autistic individuals, and although much research has characterized Autistic children’s vocabulary breadth (i.e., the number of lexical entries), less attention has been paid to vocabulary depth (i.e., the richness with which one understands a given word). In this exploratory post-hoc study, 11 Autistic children (one assigned female at birth) participated in novel and real word learning paradigms in which child-friendly referents were paired with CVCV word forms. Participants were then asked to provide open-ended definitions of the words. Definitions were parsed into meaningful subunits, or semantic features. Semantic features were coded by type of …

Geospatial Disparities In Adolescent Mental Health Resources: School- And Community-Level Evidence From Travis County, Texas, Sharon V Munroe, Jingjing Gao, Gayla Ferguson, Muinat Abolore Idris, Eric C Jones

Faculty, Staff and Student Publications

Background: Adolescents in the United States face growing mental health challenges, with nearly one in three high school students reporting poor mental health in the past 30 days. Schools increasingly serve as key access points for mental health care. However, geographic disparities in access to school-based mental health services remain underexplored.

Purpose: This study examines the spatial distribution of adolescent mental health resources in Travis County, Texas, and evaluates how school- and community-level factors are associated with the presence of on-site school social workers.

Methods: School locations, enrollment data, and the presence of on-site social workers were mapped and analyzed …

A Qualitative Examination Of Human Papillomavirus Vaccine Access, Beliefs, And Behaviors Among Adult Males Aged 18–35: Applying The Health Stigma And Discrimination Framework, Jacquelin I Cordero, Louis D Brown, Jesús M Alemán, María E Fernández, Serena A Rodríguez, Eva M Moya

Faculty, Staff and Student Publications

Background: Males, who disproportionately account for 83% of oropharyngeal cancer cases, are underrepresented in health promotion research, including human papillomavirus (HPV) vaccination studies. The initial exclusion of males in HPV vaccine research, policies, and interventions has negatively affected male vaccine uptake. Furthermore, stigma, a well-documented barrier to healthcare engagement, has been overlooked in HPV vaccination behaviors. This study aimed to provide a more contextualized understanding of HPV vaccine disparities among adult males by applying the Health Stigma and Discrimination Framework (HSDF) to examine how stigma is produced, enacted, and sustained across social systems, which may impact male vaccine uptake.

Methods: …

Survivors Of Historical Intergenerational And Familial Trauma Scale For Black American Descendants Of Enslaved People: A Development And Initial Validation Study, Loryn Chás Kimbrough

Graduate Research Theses & Dissertations

Despite extensive research documenting cultural and racialized trauma, no validated assessment tool had previously captured the intrafamilial mechanisms of trauma transmission specific to the BADEP population, whose trauma lineage is rooted in slavery. The present study addresses this gap through the development and initial validation of the Survivors of Historical Intergenerational and Familial Trauma Scale (SHIFTS), a culturally grounded instrument designed to measure the transmission of historical trauma (HT) and ongoing intergenerational trauma (IGT) among Black American Descendants of Enslaved People (BADEPs). The SHIFTS examines how HT gives rise to the continued transmission of two interrelated legacies: survival-based and trauma-rooted …

A Structured Review Of Emerging Prompt Instability Indices (Piis) To Evaluate The Reproducibility Of Prompt-Driven Image Segmentation Models., Adib Shafipour, Deevakar Rogith, Zulfiia Ditto, Hien V Tran, Katie Stinson, Toufeeq Ahmed Syed

Faculty, Staff and Student Publications

Prompt-aware image segmentation has introduced new flexibility by allowing models to incorporate user-provided cues, such as points, boxes, or text prompts, to guide object delineation across diverse imaging domains. This flexibility introduces a fundamental challenge: ensuring segmentation results remain reproducible when prompts are altered. Minor variations in prompts produce substantially different outputs, raising concerns about the reliability and scientific validity of research and clinical applications. This paper conducts a structured review of emerging Prompt Instability Indices (PIIs), quantitative measures developed to assess the reproducibility of prompt-driven segmentation models. A systematic search of PubMed and arXiv (2020-2025) identified relevant studies, analyzed …

Integrating Hippotherapy Into Interprofessional Aphasia Rehabilitation: A Feasibility Pilot Study, Bethany H. Wenger

Graduate Student Theses, Dissertations, & Professional Papers

Background and Significance: Stroke remains a leading cause of disability in the United States, affecting over 2.5 million individuals annually. Stroke-related motor and communication deficits often co-occur, increasing challenges for recovery, increasing social isolation, depression, and dependency. Hippotherapy has emerged as a novel treatment approach for neurorehabilitation; however, its application within interprofessional models for individuals with stroke-related motor and communication impairments remains underexplored. This study examines the feasibility, fidelity, and acceptability of an interprofessional intervention using hippotherapy for adults with chronic post-stroke aphasia, the purpose of which is to generate methodological guidance for future controlled trials.

Methods: A non-randomized, single-group …

Postpartum Depression Screening Among Hispanic Women: Insights From Epds Literature, Gabriella A. Irizarry Negron, Sara Moyer

UROP Posters

Postpartum depression screening among Hispanic women remains an important but complicated issue, as differences in how the EPDS is used and current barriers to care may affect early identification and treatment. This poster, Postpartum Depression Screening Among Hispanic Women: Insights from EPDS Literature, explores how the Edinburgh Postnatal Depression Scale (EPDS) has been evaluated across studies involving Hispanic populations. Using a literature review approach, eight peer-reviewed articles were organized into an annotated bibliography and matrix to identify key trends in screening practices and outcomes.

Findings revealed three major themes: (1) EPDS cut-off scores for postpartum depression vary widely across …

The Limits Of Daca: Affordability- And Access-Related Barriers To Health Professions Education, Nicole Perez, Laura Hirshfield

Journal of College Access

The U.S. is currently facing a shortage of health professionals from underrepresented backgrounds. One potential pathway to decrease this shortage is through the Deferred Action for Childhood Arrivals (DACA) program, a policy that provides temporary relief from deportation for individuals who migrated to the U.S. before age 16. This study, using 15 life-history narrative interviews, investigates the experiences of Latinx young adults who were pursuing health professions education or working as health professionals. Nine of the participants were DACA recipients, while the remaining six were second-generation (i.e., children of immigrants). An iterative, inductive approach to data analysis was used to …

Integrating Fieldwork Educators Into Didactic Coursework: Impact On Occupational Therapy Students’ Readiness For Level Ii Fieldwork, Tara Mansour, Victoria Denovellis

Journal of Occupational Therapy Education

Level II fieldwork represents a critical transition from didactic learning to clinical practice in occupational therapy education, yet students frequently report challenges related to applying knowledge, managing expectations, and navigating complex clinical environments. Many of these challenges reflect aspects of the “hidden curriculum,” including implicit expectations related to communication, professional behaviors, and feedback that are often not explicitly addressed in coursework. This study examined the impact of integrating fieldwork educator–led sessions into a didactic seminar to support student readiness. A mixed-methods survey using a retrospective pre–post design was administered to 33 students (97% response rate). Quantitative analyses demonstrated significant improvements …

Equity-Oriented Mentoring For Occupational Therapy Students In Canada: A Narrative Assessment, Kaarina Valavaara, Tara Pride, Chris Mcwilliam, Jaime Blenus, Stephanie R. Bizzeth, Brenda Beagan

Journal of Occupational Therapy Education

In the health professions, mentoring has emerged as a key strategy for reducing the isolation and exclusion of students from equity-denied groups – including students who identify as Indigenous, racialized, disabled and/or queer. Mentoring often focuses on academic and professional skills, which implies students from these groups are somehow lacking. In contrast, ‘equity-oriented’ mentoring focuses on learning in the context of on-going, everyday isolation, exclusion, discrimination and even hostility. Mentors from the profession, who are also members of the same equity-denied groups, provide role models for thriving in the face of oppression. They may provide psychosocial support while helping students …

Assessing Supports And Barriers To Equitable Participation In Occupational Therapy Fieldwork For Students From Minoritized Backgrounds: A Mixed Methods Analysis, Kristin M. Nxumalo, Coalition Of Occupational Therapy Advocates For Diversity Cotad, Alexia Rebne, Janis Yue, Ryan Thomure, Ricardo D. Ramirez

Journal of Occupational Therapy Education

Fieldwork experiences in occupational therapy (OT) and occupational therapy assistant (OTA) education introduce students to novel environments that they must successfully navigate. When examining the experiences of OT and OTA students from minoritized backgrounds, it is critical to understand their fieldwork experiences so that fieldwork educators and partners can create inclusive, supportive environments that promote success for all students. Within this study, a needs assessment was conducted to explore factors that impacted the OT and OTA fieldwork experiences of students from minoritized backgrounds. Using a mixed methods design, a cross-sectional survey was completed by non-faculty OT practitioners (n=48), Academic Fieldwork …

Toward A Critical Occupational Therapy Education: A Discrit-Informed Framework, Robert Niewiadomski, Chia-Yang Chiang

Journal of Occupational Therapy Education

Occupational therapy has long articulated commitments to equity, inclusion, and occupational justice, yet its dominant educational approaches often remain focused on interpersonal competence rather than structural analysis. This conceptual paper argues that contemporary occupational therapy education is insufficiently equipped to prepare practitioners to address the sociopolitical forces shaping occupational participation. Drawing on disability critical race theory (DisCrit), critical pedagogy, intersectionality, and occupational justice scholarship, the authors propose the Critical Occupational Therapy Education (COTE) framework as a structural, justice-oriented reorientation for occupational therapy education. COTE positions racism and ableism as interlocking systems that shape professional norms, knowledge production, and access to …

Validity And Reliability Of The Professional Belonging Scale For Occupational Therapy Students Version 2, Sarah Corcoran Otd, Otr/L, Pooja Patel Drot, Otr/L, Izabela Dubiel Drot, Otr/L, Theresa Rhett-Davis Edd, Otr/L, Nancy Green Ms, Drot, Otr/L, Emily Pasqualetto Drot, Otr/L, Amanda Carter Drot, Otr/L

Journal of Occupational Therapy Education

A strong sense of belonging supports student engagement, motivation, clinical competency, retention, and overall well-being; yet few tools specifically assess this construct in occupational therapy (OT) and occupational therapy assistant (OTA) programs. To address this gap, Corcoran et al. (2025) developed the Professional Belonging Scale for Occupational Therapy Students (PBSOTSv1). The current study aimed to revise the PBSOTSv1 for clarity, inclusivity, and alignment with emerging theoretical frameworks and to evaluate the revised version (PBSOTSv2) for content validity and internal consistency reliability. Revisions involved expert cognitive interviews and Content Validity Index (CVI) ratings, guided by Allen et al.’s framework of belonging, …

Perceived Impacts Of Confucianism On Placement Experiences Of Hong Kong Pre-Registration Occupational Therapy Students In The United Kingdom, Hin Yuet Li, Sarah Louise Mcginley, Rachel Dadswell, Rachel Houweling

Journal of Occupational Therapy Education

This study explored the views of Hong Kong pre-registration occupational therapy (OT) students in the United Kingdom (UK) about how Chinese culture influenced their practice placement experiences. Students from diverse cultural backgrounds may encounter various challenges during OT placements, but little is known about how OT students from Hong Kong—where Confucianism traditionally shapes workplace expectations and the hierarchical teacher‑student relationship—experience placements in the UK. Two online focus groups to collect qualitative data were conducted in November 2022 with four participants who were UK-based OT students from Hong Kong (N=8 in total), two facilitators (OT students from Hong Kong, based in …

Mental Health First Aid Training In The Community, Vester Agbley Gideon

Doctor of Nursing Practice Projects

Mental health issues impact one in five adults in the United States; however, many individuals lack the requisite knowledge and skills to effectively respond to mental health crises. Mental Health First Aid (MHFA) training empowers individuals to recognize and address mental health concerns, thereby fostering early intervention and support. This review analyses the efficacy of MHFA training, best practices for its implementation, and its influence on mental health outcomes. Empirical evidence indicates that MHFA training enhances mental health literacy, diminishes stigma, and encourages supportive behaviors. Customized approaches for targeted populations, such as youth and older adults, have also shown significant …

Role-Differentiated Ai Competencies And Curriculum Implications For Health Professions Education: Qualitative Study, Yuyi Park, Yejin Han, Hyeongjo Kim, Solmoe Ahn, Frederick William Kron, Jihyun Lee

Department of Family and Community Medicine Faculty Publications

Background: As AI fundamentally transforms the healthcare landscape, medical education curricula have struggled to keep pace with these technological shifts. While current research has established a foundation for general AI literacy, less attention has been given to the role-specific competencies required for the diverse functions that healthcare professionals perform in an AI-integrated environment. Although existing tiered and domain-based competency models have clarified general AI competency requirements, they offer limited guidance on how such competencies should be differentiated according to the roles healthcare professionals perform in practice.

Objective: This study aimed to explore how AI-driven changes in healthcare shape competency requirements …

A Quality Improvement Project To Enhance Early And Consistent Prenatal Care In The Spanish Speaking Female Population At The Fqhc West Ashley Fetter Clinic, Ana Martinez Conde, Sophia Zia, Joye Fordham, Dennis Besong

South Atlantic Division GME Research Days 2026

No abstract provided.

A Preliminary Investigation Of Research Collaboration Through Scientific Paper Co-Authorship In The Gulf Of Mexico, Juliet Vallejo, Evelyn Roozee, Dongkyu Kim, Andrew M Song, Christopher A Gabler, Jasper De Vries, Antonia Sohns, Gordon M Hickey, Owen Temby

Faculty, Staff and Student Publications

It is well known that publications with collaborators from external institutions increase citations. This effect scales with spatial distance. There are also many barriers to long-distance collaborations, including linguistic differences, funding constraints, and the incremental costs of remote collaboration. This paper uses the Gulf of Mexico as a case study to examine long-distance research collaboration because it consists of three countries with diverse development levels and two prominent diplomatic languages, within a singular regional ecosystem of tremendous natural and economic value. This paper uses bibliometric network analysis to examine scientific research article co-authorship in the Gulf of Mexico from 2000 …

Digital Communication Strategies For Culinary Medicine In Cancer Prevention And Survivorship: Information-Seeking Habits And Content Preferences Of Online Cooking Media Among Adults Participating In Four Cancer Prevention And Control Cohort Studies, Margaret Raber, Sara Fares, Maria Vazquez, Larkin Strong, Carrie Daniel-Macdougall, Lorna Mcneill, Karen Basen-Engquist

Faculty, Staff and Student Publications

Introduction

Poor diet and excess weight have been linked to increased risk for at least 13 types of cancer. Culinary medicine utilizes experiential cooking skill development to improve individuals’ capacity for healthy eating. Digital communication strategies offer pathways for scalable culinary medicine interventions, but little research has explored how online cooking tools could be leveraged for cancer prevention messaging. We conducted a cross-sectional survey study exploring online cooking information-seeking habits and content preferences among participants in four cancer prevention and control cohorts to inform future digital culinary medicine interventions.

Methods

A cross-sectional survey study was conducted with a convenience sample …

Knowledge Distillation And Dataset Distillation Of Large Language Models: Emerging Trends, Challenges, And Future Directions, Luyang Fang, Xiaowei Yu, Jiazhang Cai, Yongkai Chen, Shushan Wu, Zhengliang Liu, Zhenyuan Yang, Haoran Lu, Xilin Gong, Yufang Liu, Terry Ma, Wei Ruan, Ali Abbasi, Jing Zhang, Tao Wang, Ehsan Latif, Wei Liu, Wei Zhang, Soheil Kolouri, Xiaoming Zhai, Dajiang Zhu, Wenxuan Zhong, Tianming Liu, Ping Ma

Faculty, Staff and Student Publications

The exponential growth of Large Language Models (LLMs) continues to highlight the need for efficient strategies to meet ever-expanding computational and data demands. This survey provides a comprehensive analysis of two complementary paradigms: Knowledge Distillation (KD) and Dataset Distillation (DD), both aimed at compressing LLMs while preserving their advanced reasoning capabilities and linguistic diversity. We first examine key methodologies in KD, such as task-specific alignment, rationale-based training, and multi-teacher frameworks, alongside DD techniques that synthesize compact, high-impact datasets through optimization-based gradient matching, latent space regularization, and generative synthesis. Building on these foundations, we explore how integrating KD and DD can …

Using Text Messages To Reduce Pediatric No-Show Rates In Primary Pediatric Care, Kelly A. Rexford-Hudson

West Chester University Graduate Theses, Dissertations, and Final Projects

Pediatric appointment no-show rates lead to fragmented care, missed preventative services, delayed immunizations, and reduced clinic efficiency. Children who miss well-child and follow-up visits are at increased risk for unmanaged chronic conditions and gaps in developmental surveillance. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether bilingual text message reminders would decrease no-show rates in a pediatric primary care clinic. Led by the Plan-Do-Study-Act framework and Bronfenbrenner's Ecological Model, this intervention consisted of two manual text message reminders, delivered in English and Spanish, at 7 days and 2 days before scheduled appointments during a …

"Why Don't I Talk To A Therapist?": Motivations And Reflections Of Female-Identifying Chinese Immigrants Seeking Psychotherapy For Depression, Qiuyi Wei

Antioch University Dissertations & Theses

This phenomenological study explored the lived experiences of Chinese immigrants and temporary residents struggling with depressive symptoms and their process of seeking and accepting psychotherapy support. The study aimed to describe the factors that motivated participants to enter therapy for depression while also addressing their internal concerns about treatment. Nine female-identified Chinese immigrant adults with such experiences were recruited. Participants’ perceptions of their depressive symptoms and the factors contributing to their decision to seek professional therapy were explored through in-depth, semi-structured qualitative interviews conducted in Mandarin. The interview transcripts were analyzed in Mandarin using interpretative phenomenological analysis, through which four …

Enhancing Mri Accessibility Through Community Engagement For Autistic Young Adults, Antonio F Pagán, Grace Gogola, Ashley Huang, Katherine A Loveland

Faculty, Staff and Student Publications

The present study, a community-engaged research initiative, was specifically designed to enhance MRI accessibility and optimize the overall experience for autistic Latino young adults. Crucially, we employed a Community-Based Participatory Research (CBPR) approach, ensuring that the voices and perspectives of the target community were central to every stage of inquiry. Insights were gathered from Community Scientist meetings and 18 autistic Latino young adults (ages 18-25) through focus groups with nine MRI-naïve individuals and individual interviews with a separate cohort of nine individuals who had prior MRI experience. Transcripts from these sessions underwent thematic analysis to identify key patterns related to …