Digital Commons Network^™

Early Mental Health Screening In The Gi Patient Population: A Quality Improvement Project, Jacqueline Sagala

Loma Linda University Electronic Theses, Dissertations & Projects

Aims

This quality improvement project aimed to increase awareness and better integrate mental health screening in a GI clinic by educating staff and providers. The project evaluated changes in depression literacy, attitudes toward mental illness assessment, perceived training effectiveness, use of the training in clinical practice, and referrals to the Resiliency Clinic.

Background

Patients with chronic GI disorders commonly experience anxiety and depression, yet mental health concerns are often overlooked in specialty care. Although annual depression screening was already a part of the standard care at the Digestive Disease Center at Loma Linda University Faculty Medical Clinics, staff education and …

Implementing A Noise Reduction Protocol To Reduce Perceived Noise In The Icu – An Evidence-Based Practice Project, Soh Jeon

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims:

This project aims to reduce perceived noise in the ICU and promote a healing environment through a multi-interventional noise-reduction protocol and nursing staff education.

Rationale/Background:

The World Health Organization (WHO) recommends that hospital noise levels remain below 35 decibels during the day and 30 decibels at night. However, ICU noise often exceeds 50-70 decibels. Increased noise levels are primarily caused by conversations, monitoring alarms, and routine care activities, such as cleaning and procedures. These high noise levels directly affect patients’ sleep, which is essential to recovery. Insufficient rest can lead to immunosuppression, prolonged mechanical ventilation, and elevated stress …

Setting Research Priorities For The Use Of Digital Technology In The Self-Management Of Heart Health: The Results Of The James Lind Priority Setting Partnership, Lis Neubeck, Simon Nichols, Nicola Straiton, Louise J. Dunford, Amitava Banerjee, Susan Dawkes, Donna Fitzsimons, Maria Hayes, Alistair Lawson, Abigail A. Lyons, Mary Mcauley, Jill Mclaggan, Richard Mindham, Nicholas L. Mills, Rakesh Modi, Alice Pearsons, Amanda Pitkethly, Fiona E. Strachan, Coral L. Hanson

Research outputs 2022 to 2026

Aims: There are wide inequalities in access to cardiovascular care, and risk factors such as obesity, high blood pressure, and physical inactivity are often not well managed. We aim to identify the most important questions about how digital technologies can help people and their carers prevent cardiovascular disease and improve access to care. Methods and results: A priority setting partnership that aimed to generate a top 10 list of research priorities for the use of digital technology in the prevention and management of heart disease and heart conditions in the UK and Ireland, with equal input by people with lived …

Impact Of Plasma Ptau181 Levels On Clinician Diagnostic Confidence And Management In Memory And Cognition Clinics: A Multi-Site Before-And-After Study, Johannes C. Michaelian, Azadeh Feizpour, James C. Vickers, Jane E. Alty, Jessica M. Collins, Vincent Doré, Catriona Ireland, Anna E. King, Ralph N. Martins, Michael Woodward, Sharon L. Naismith, Christopher C. Rowe

Research outputs 2022 to 2026

Introduction: Recent advances allow blood tests to detect key proteins linked to Alzheimer's disease (AD). Methods: In this before-and-after study across three Australian memory and cognition clinics, we evaluated the impact on clinicians' diagnostic confidence and management following disclosure of routine patients' AD probability, using predefined plasma phosphorylated tau 181 (pTau181) thresholds set at 90% sensitivity and 90% specificity for amyloid-beta (Aβ) positron emission tomography (PET) positivity. Results: One hundred thirteen participants (mean age: 71.2 ± 8.4; mean Mini-Mental State Examination score: 27.7 ± 2.5) with dementia (n = 17, 15.0%), mild cognitive impairment (n = 48, 42.5%), and subjective …

The Effect Of Midwife-Led Continuous Labor Support Care On Delivery Mode And Timely Initiation Of Breastfeeding In Primigravida Women In Northwest Ethiopia: A Hybrid Type I Implementation Study, Mengstu Melkamu Asaye, Aragaw, Eden Bishaw Taye, Kihinetu Gelaye Wudineh, Sara Bayes

Research outputs 2022 to 2026

Midwife-led continuous labor and childbirth support reduces the episiotomy rate and increases the rates of vaginal delivery and early initiation of breastfeeding. However, no studies have yet been conducted in Ethiopia. This study aimed to evaluate the effect of midwife-led continuous labor and childbirth support. A quasi-experimental study involving 419 primigravida women compared an intervention given by trained midwives at two hospitals to routine at two others. Data were collected from July to December 2024 through interviews and record reviews. The McNemar test was used to compare changes, with a p-value of less than 0.05. Midwife-led continuous labor support increased …

An Evidence-Based Educational Intervention To Enhance Nurses' Knowledge Of Metabolic Syndrome In Residential Care Facilities, Marie Tanyi

Doctor of Nursing Practice Scholarly Projects

The project addresses a critical gap in nursing education by implementing a structured, evidencebased educational intervention led by an Advanced Practice Registered Nurse (APRN) to improve nurses’ knowledge of metabolic syndrome in residential care facilities. The purpose was to determine whether this intervention could significantly enhance nurses’ understanding and management of metabolic syndrome, a complex cluster of disorders present in adult populations. Nine nurses participated in targeted educational sessions focusing on definition, diagnosis, complications, and evidence-based prevention and management strategies. Each participant completed the Metabolic Syndrome Knowledge Scale (MSKS) questionnaire before and after the intervention to assess changes in knowledge. …

Developing A Pediatric Pain Curriculum For Pediatric Anesthesia Fellows In Sub-Saharan Africa: A Delphi Study, Anisa Bhettay, Rebecca Gray, Romy Parker, Nikki Allorto, Abigail Amponsah, Brian Anderson, Lillian Baranzila, Charles Carapinha, Susan Carolus, O' Brien Kyololo

School of Nursing & Midwifery, East Africa

Background Comprehensive pain management in children requires a specialized skillset, with a limited number of clinicians possessing the level of expertise required to successfully navigate the complexities of holistic care. The emergence of pediatric anesthesia fellowship programs in sub-Saharan Africa presents an opportunity to embed a pediatric pain curriculum for trainees, improving the availability of specialist skill and knowledge in the field. Existing pain curricula fall short in addressing the sociocultural aspects of pediatric pain identified through research as being unique to the African context, and do not include elements of leadership and advocacy training required to navigate the complexities …

Implementing And Evaluating A Mental Health Education And Mindfulness Program For Police Officers, Patricia Lynn Young

Doctor of Nursing Practice

Background: Police officers are routinely exposed to occupational stress and trauma, contributing to an increased risk of anxiety, depression, substance misuse, and post-traumatic stress disorder (PTSD). Targeted mental health interventions are needed to proactively address their mental health. Purpose: This Doctor of Nursing Practice (DNP) project implemented and evaluated a mental health education and mindfulness program designed to reduce operational stress and increase knowledge and use of departmental mental health resources and mindfulness techniques among police officers. Methods: A pre–post intervention design was used over a 10-week period. Participants (n = 14) completed the Operational Police Stress Questionnaire (PSQ-Op) and …

Evaluation Of The Prevention And Management Of Assaultive Behaviors (Pmab) Training For Outpatient Ambulatory Care Staff, Michaela Bowles

Doctor of Nursing Practice

Background: Workplace violence (WPV) disproportionately affects healthcare workers and harms both staff well-being and the healthcare organization. Despite growing attention to WPV prevention, effective solutions remain limited. The purpose of this project was to evaluate the Prevention and Management of Assaultive Behaviors (PMAB) training in an outpatient ambulatory care setting and to assess staff’s confidence and ability to respond to escalating situations. Methods: A pre/post observational survey using Likert-scale, multiple choice, yes/no questions and narrative responses measured confidence before, immediately after, and 3 to 12 months following PMAB training. A retrospective review of WPV incident reports three months before and …

Mindbodystrong: A Pilot To Address Nursing Burnout & To Promote Wellness, Leilah Hunt

Doctor of Nursing Practice

Background: Nursing burnout rates have increased significantly since the Covid-19 pandemic, not only within the United States but throughout the world. As burnout is multifaceted in nature, identifying and addressing the root cause of burnout has been challenging. One approach to remedy burnout effects is by enhancing wellness through daily practice of healthy habits. Purpose: The purpose of this DNP project was to pilot and evaluate the effects of the MINDBODYSTRONG Cognitive Behavioral Skills Building Program on self-rated anxiety, stress, depressive symptoms, and burnout symptoms in a sample population of nurses at a large psychiatric hospital. This program has …

Measuring Provider Confidence In Using Long-Acting Injectable Antipsychotics In Hospitalized Adults With Schizophrenia Spectrum Disorders, Rachel Mccluskey

Doctor of Nursing Practice

Background: Schizophrenia spectrum disorders are severely disabling conditions requiring ongoing pharmacological management. Rates of medication nonadherence among individuals with schizophrenia spectrum disorder are high and strong evidence exists for the benefits of long-acting injectable antipsychotics (LAI) over oral antipsychotics. Despite this, only 10% of patients in Washington State with schizophrenia spectrum disorders are administered longacting injectable antipsychotics. Purpose: The purpose of this project was to measure change in provider’s confidence in prescribing LAI for hospitalized patients with schizophrenia spectrum disorders following one-on-one motivational information (MI) style informational/discussion sessions coupled with a prescribing reference. Methods: This quality improvement project surveyed provider’s …

Assessing The Association Between Musculoskeletal Injury And Mental Health In Rugby Players-A Cross-Sectional Study, Mordicai Atinga, Jasmit Shah, Sarah Karanja, Mark Lumbasi, Miriam Ndungu, Sarah Kiburi, James Ondiege, Njalalle Baraza

Internal Medicine, East Africa

Background: Musculoskeletal injuries are common among athletes and can negatively affect both physical and psychological wellbeing. Beyond physical disability, injuries have been linked to poor mental health, loss of athletic identity, and increased substance use. In low- and middle-income countries (LMICs), where awareness and management of mental health remain limited, the psychological burden of sports injuries may be underrecognized. Rugby, a physically demanding contact sport, has one of the highest rates of injury, but little is known about how such injuries influence mental health and related outcomes in African contexts. This study explored the relationship between musculoskeletal injuries and health …

The Role Of Leadership Style In Team And Individual Performance In Collegiate Athletics, Luke Mulkey

Posters - 2026

• Measuring the effectiveness of leadership is important because strong leaders can bring significant contributions to both organizations and individuals

• Previous studies have said that intrinsic motivation of the individual plays a larger role than the leadership style of a coach

• Studies also show that leadership style has an influence on team success and cohesion

• This study aimed to determine the extent to which transformational leadership played a role in team success, measured in win percentage

• This study went further into the individual perception of their coach’s impact on the athlete’s performance compared to the extent …

Advancing The Understanding Of Palliative Care In Singapore: Knowledge, Attitudes, Receptiveness, And The Moderating Role Of Media Information-Seeking Preferences, Su Lin Yeo, Angel Lee, Raymond Han Lip Ng, May O. Lwin, Yumin Lin

Research Collection Lee Kong Chian School Of Business

Introduction: Despite the growing demand for palliative care, this specialized medical care remains severely underutilized, with almost 50% of countries worldwide lacking access. Given that misperceptions and stigma continue to hinder progress in healthcare policy, this study aims to examine the relationships between palliative care knowledge, attitudes, and receptiveness to better understand how public health communication can enhance awareness and understanding of the topic in Singapore. Applying the adapted knowledge-attitude-practice (KAP) model, it further extends theory by examining the moderating role of media information-seeking between knowledge and receptiveness.Methods: Mixed-mode surveys involving 1,226 participants (926 online and 300 in-person respondents), representing …

Preoperative Health During A Pandemic: An Observational Study Assessing Lifestyle Changes In Patients Associated With Covid-19 In Western Australia, Nadine Radin, Dana Hince, Jim Codde, Paola Chivers, Dale W. Edgar

Research outputs 2022 to 2026

Background and Aim: Healthcare service disruptions resulting from the COVID-19 pandemic led to substantial changes in surgical pathways across public hospitals in Western Australia (WA). These disruptions, compounded by restrictions and containment measures, influenced the health and lifestyle behaviours of the WA community, including patients awaiting surgery. This study aimed to assess changes in self-reported modifiable lifestyle risk factors among patients during COVID-19. Methods: This observational study analysed hospital patient data across three seasonally matched calendar periods: Period 1 (January–March 2019 vs 2020), Period 2 (March–July 2019 vs 2020), and Period 3 (July–December 2019 vs 2020). Multivariable regression models were …

Influence Of Simulator Physical Fidelity And Immersion On Decision-Making Skill, Presence, And Cognitive Load, Zachariah G. Hoyne, Morris-Binelli, Sean Müller, Benjamin Piggott, Paola Chivers, Evan Dekker

Research outputs 2022 to 2026

In a variety of domains such as law enforcement and sport, virtual reality is being explored to simulate field-based decision-making contexts. 360-degree video virtual reality (360VR) is innovative as it can immerse the user in a simulated environment, present egocentric, stereoscopic vision and allows for head movements to perceive visual information. However, it is unknown whether physical, rather than psychological fidelity, is crucial for performance, and its impact upon cognitive load, relative to immersion. This study investigated simulator fidelity, presence, and cognitive load across immersion (two-dimensional video and 360VR) in an exemplar sport-specific decision-making task. Thirty skilled Australian Rules Football …

Self-Management Challenges And Psychosocial Support Needs In Clean Intermittent Catheterization: A Qualitative Study Of Individuals With Neurogenic Bladder And Caregivers, Lianyu Zou, Xiaomei Wu, Shun Chen, Shuluan Feng, Xiaohua Huang, Weiting Liu

Research outputs 2022 to 2026

Background – Clean intermittent catheterization (CIC) is widely regarded as the preferred approach to bladder management for individuals with neurogenic bladder (NB). Nevertheless, a considerable gap persists between evidence and clinical practice: patients and caregivers frequently encounter self-management barriers that compromise clinical outcomes during CIC. This qualitative study explores these barriers to provide an empirical foundation for developing tailored strategies that improve quality of care. Design – A descriptive qualitative study. Methods – From August to October 2025, a convenience sampling method was employed to recruit 16 participants individuals with NB or their long-term caregivers from the Department of Rehabilitation …

Caregiver Challenges And Health Access For Individuals With Developmental Disabilities In Mississippi, Kirsten Cunningham

Honors Theses

Current literature has highlighted the health disparities faced by individuals within the disability community and how it affects the care they receive. However, for many individuals with developmental disabilities, they require caregivers to make medical decisions for them. The purpose of this study is to focus on the caregiver’s perspective of caregiver stress, physical access to care, and health literacy to combat the challenges faced when getting access to healthcare resources for individuals with developmental disabilities in Mississippi. The researcher hypothesized, based on the literature review, that caregivers with higher levels of educational attainment would have less caregiver stress, more …

Dnp Final Report: An Evidence-Based Project To Decrease Stress In Undergraduate Nursing Students, Elaine Wallace

DNP Final Reports

Stress among undergraduate nursing students is a well-documented concern that negatively affects academic performance, clinical readiness, well-being, and program retention. Stress levels are often heightened before clinical skills check-offs, highlighting the need for practical, evidence-based interventions. This Doctor of Nursing Practice quality improvement project examined whether mindfulness-based mandala coloring could reduce perceived stress in undergraduate nursing students. Using the PICOT framework, the project evaluated whether undergraduate nursing students (P) who participated in mindfulness-based mandala coloring (I), compared with no intervention (C), experienced reduced perceived stress levels (O) over a 12-week implementation period (T).

A comprehensive search of the literature supported …

Wellness In Action: Implementation Of An Experiential Wellness Elective For Occupational Therapy Students, Heather Short

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Wellness In Action: Implementation of an Experiential Wellness Elective for Occupational Therapy Students

Graduate student mental health is a growing concern in higher education, highlighted by the student experience of high levels of stress, burnout, and declining well-being that impair academic and daily functioning (SenthilKumar et al.,2023; Bullock et al.,2017). Research highlights the need for proactive, holistic interventions that provide education and support skill development (Henrico, 2021; Van Oss et al., 2025). To address this need, this capstone project aimed to design, implement, and evaluate an experiential wellness elective for occupational therapy (OT) doctoral students within a graduate health professions …

Justice, Autonomy, Beneficence, And Non-Maleficence: The Global Failure To Heed Ethical Mandates In Birth Spaces, Julia Dees

Richard T. Schellhase Essay Prize in Ethics

Respectful and safe care in all birthing spaces has long been an ideal that global communities fail to meet. Birthing people are disrespected, physically or emotionally harmed, or left to completely fend for themselves during a period of extreme emotional and medical vulnerability. Historically, autonomy especially has been ignored in birthing spaces with medical trends like the twilight sleep, where women were drugged into a state of unconsciousness during birth (Taylor, 2023), demonstrating the desire of western medicine, in particular, to reduce birthing people to bystanders in their own birth. While birth trends and medical treatments have changed throughout time, …

Exploring Student Academic And Grief Functioning After Loss: Perceptions And Influence Of Faculty Responses To Student Bereavement, Vivian Hale

Honors Theses

Bereavement is a common yet underrecognized experience among college students, with many experiencing the death of a loved one during their academic careers. The university environment can present unique challenges that may impede the grieving process. Thus, faculty members may play an important role in shaping students’ academic and emotional outcomes following a loss. Understanding how students are affected by their faculty’s response to loss is critical for identifying strategies to support bereaved students within the academic environment. This study builds on previous research demonstrating that bereaved college students experience academic and emotional challenges while specifically examining the role of …

Exploring Adolescents’ Social, Cultural, And Health Experiences To Inform Culturally Responsive Interventions, Bria D. Singleton

Theses and Dissertations

This study examined adolescents’ perceptions of their social, cultural, and health-related experiences, assessing constructs related to identity formation, digital exposure, belonging, and safety among Generation Alpha. Using a mixed-methods design, data were collected from students aged 11 to 14 enrolled at a public middle school in South Carolina using a structured survey and qualitative group discussions. Survey findings indicated primarily positive perceptions of school safety and a sense of self-efficacy in caring for their mental health and well-being. However, qualitative findings disclosed the adolescents’ acute awareness of environmental threats, such as gun violence and school shootings, resulting in emotional dysregulation …

Vaccination Coverage And Factors Associated With Covid-19 Vaccination In The Adult African American Community In South Carolina: A Cross-Sectional Survey, Brittany Divon Smith

Theses and Dissertations

The COVID-19 pandemic has disproportionately affected African American communities, revealing longstanding disparities in healthcare access and outcomes. In South Carolina, where these inequities are particularly evident, understanding the determinants of COVID-19 vaccine uptake among African Americans is crucial for advancing health equity. This thesis examines vaccination coverage and explores social, economic, and psychological predictors of vaccine uptake in a sample of 305 African American adults through a cross-sectional survey conducted in 2023.

Vaccination status was categorized as unvaccinated, partially vaccinated, and fully vaccinated (with or without a booster). Ordinal logistic regression analyses were performed to examine associations between vaccination status …

Wright State University's Celebration Of Student Research, Scholarship & Creative Activities From Wednesday, April 1, 2026, Wright State University

Celebration of Undergraduate & Graduate Research, Scholarship, and Creative Activities Materials

The student abstract booklet is a compilation of abstracts from students' oral and poster presentations at Wright State University's Celebration of Student Research, Scholarship & Creative Activities on April 1, 2026.

Navigating End-Of-Life Decisions: Cultural Considerations For Latine Patients, Michelle Carbajal Hernandez

Honors Capstones

Healthcare professionals face many challenges when communicating terminal illness prognoses for individuals. This responsibility to address a terminal prognosis is further complicated when communicating with Latine patients who may face multiple barriers within the healthcare system and whose cultural preferences influence end-of-life care planning (Carrion, 2010). For example, Latines are less likely to enroll in end-of-life (EOL) care services (e.g., hospice) (Barragan-Carrillo et al., 2022). As well as engage in end-of-life care planning than White Non-Latines (Shen et al., 2016). To understand this hesitancy towards EOL care options, this literature review aims to explore how terminally ill Latine and …

Heroes Of Medicine In The Rio Grande Valley: Documentary Interview With Dr. Cynthia Cavazos Gonzalez, Cynthia Cavazos Gonzalez, Raquel Elena Orellana

Heroes of Medicine in the Rio Grande Valley

Cynthia Cavazos Gonzalez PhD is an Associate Professor of Clinical Practice at UTRGV in Edinburg, Texas and she is the clinic director of the UTRGV Psychology training clinic. She completed a doctoral degree in Clinical Psychology from California School of Professional Psychology in Fresno, California. Her doctoral degree is in Clinical Psychology with a major specialization in Neuropsychology and minor specialization in Health Psychology. She completed an APA-accredited pre-doctoral internship at UTMB in Galveston with a major emphasis in hospital consultation, outpatient psychotherapy, and psychological and neuropsychological evaluations with diverse populations. She completed an informal neuropsychology post-doctoral residency in Texas …

Resilience Factors For Physical Activity After Completion Of Intensive Interdisciplinary Pain Treatment: A Qualitative Analysis., William R. Black, Lora L. Black, Jennifer Christofferson, Liesbet Goubert, Cara M. Hoffart, Dustin Wallace

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: This study explored potential resilience factors that facilitate engagement in physical activity (PA) among adolescents with chronic musculoskeletal pain after completing intensive interdisciplinary pain treatment.

METHODS: Ten adolescents aged 13 to 17 years with a history of chronic musculoskeletal pain from a mid-western pediatric hospital in the United States participated in this qualitative study. Participants provided demographic information and completed semistructured virtual interviews. The interviews focused on their pain experiences, resilience, and engagement in PA. Transcripts were analyzed using primarily directed content analysis based on a pain resilience framework.

RESULTS: Participants highlighted several key resilience factors that influenced their …

Proximal And Distal Factors Associated With Obesity In Childhood: An Exploratory Structural Equation Model., Joseph A. Skelton, Erinn T. Rhodes, Sarah Hampl, Ihuoma Eneli, Edward H. Ip, Sit Study Research Group

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Obesity in childhood is complex; structural equation modeling (SEM) offers an approach to ascertain complicated relationships between weight and proximal (health behaviors, child health) and distal (family/household, community) variables. The objective of the study was to use SEM to map the influence of different etiological clusters on obesity in childhood.

METHODS: Secondary analysis of baseline data from patients and parents enrolled in a multi-site study of pediatric weight management was conducted. The primary outcome was weight status (utilizing percentage above the 95th percentile BMI, %95BMI). SEM was used to evaluate the influences of variables proximal and distal to child …

Pastoral Listening Skills Training In The Black Baptist Church: Equipping Clergy To Better Support Congregants, Regina Pair Allen

Doctor of Ministry Projects and Theses

This study engages a historical survey of qualitative studies of perspectives of Black pastors regarding pastoral care, examining various avenues for training in pastoral listening and the role of ministers as theological clinicians in supporting church ministries and community needs. The findings highlight the ongoing need for professional development among pastors as primary educators and theological clinicians. The study underscores the importance of equipping Black Baptist pastors to address the clinical pastoral needs of African American congregants. The significance to this field of study is providing Black Baptist clergy with practical skills and tools, grounded in theological principles, to better …