Digital Commons Network^™

Navigating The Maternal Health Crisis: Enhancing Maternal Health Outcomes In New Jersey, Nyrobi Barnes

Doctoral Dissertations and Projects

The purpose of the study was to better understand the implications of race and ethnicity on perinatal health experiences and maternal health outcomes in non-Hispanic Black women (nHBw) in New Jersey and mitigate the maternal health crisis. A secondary outcome was to propose an evidence-based initiative to elicit equitable care in New Jersey via grant-funded programs at the New Jersey Department of Health. Although New Jersey has made progress in improving maternal and infant health outcomes, racial disparities continue to persist. The research aims to further understand implications of race and ethnicity on adverse perinatal health experiences and maternal health …

Exploring Social Cognitive Learning In Simulation-Enhanced Interprofessional Education: A Case Study, William Nicholas Vasios Iii

Doctoral Dissertations and Projects

The purpose of this single-case design study is to explore the impact of observational and vicarious learning during simulation-enhanced interprofessional education (Sim-IPE) on the confidence and perceived self-efficacy of nursing students and IM residents at a southeastern university. Guided by Bandura’s social cognitive learning theory, which addresses the personnel, behavioral, and environmental factors of Sim-IPE, while answering the central research question: How does observational and vicarious learning during Sim-IPE impact participant confidence and perceived self-efficacy? This qualitative single-case study was conducted at a university in the southeastern United States, using data collected through visual confidence analog scale surveys, interviews, and …

Comparing The Difference In Nurses’ Knowledge And Attitudes Toward Near-Death Experiences (Ndes) Before And After Receiving Nde Education, Renata B. Mcallister

Doctoral Dissertations and Projects

Near-death experiences (NDEs) have been reported in approximately 6.3% to 39.3% of patients who survived death or critical illness. Research indicated that health care professionals, of whom nurses are the largest group, received little education or training on NDEs. Nurses' responses to a disclosure could help the patient integrate the experience or contribute to stress and isolation. National nursing standards do not address education or competencies specific to NDEs, and few studies have examined educational programs on the topic. This quasi-experimental study examined changes in nurses' knowledge and attitudes before and after a three-part asynchronous training on NDEs, measured with …

Promoting Scientific Impact At The Nih, Fred D. Ledley M.D.

CISI Publication

We are honored to offer our comments on Promoting Scientific Impact at the NIH in response to NOT-OD-26-087: Request for Information on Measuring and Rewarding Scientific Impact.

These comments are informed by my professional experience as the founding director of the Center for Integration of Science and Industry at Bentley University, which has a mission to “advance the translation of scientific discoveries for public value by engaging science, business, and policy in transdisciplinary dialogue, scholarship, and education.” Our approach is to bring together the perspectives of natural science, business, analytics, economics, law, and policy to better understand, and advance, the …

Implementation Readiness For National Cancer Survivorship Care Standards, Christiane J. El Khoury, Meera Gupta, Maryem Shirzadi, Heidi Dowst, Martha Mims, Maysa Abu-Khalaf, Hoda Badr

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Cancer survivorship care is a growing public health priority, yet delivery remains variable across health systems. The National Standards for Cancer Survivorship Care provide a framework for high-quality care, but little empirical evidence exists regarding health system readiness to implement these standards in routine practice.

OBJECTIVE: To assess implementation readiness for the National Standards for Cancer Survivorship Care and identify perceived barriers to implementation.

DESIGN, SETTING, AND PARTICIPANTS: This real-time Delphi survey study was conducted from January to March 2025 at a National Cancer Institute-designated comprehensive cancer center. Participants were multidisciplinary experts involved in cancer survivorship care delivery, care …

2026 Focused Update Of The Saudi Heart Association Guidelines On Best Practices In The Management Of Chronic Coronary Syndromes, Owayed Alshammeri, Halia Alshehri, Shukri Alsaif, Mirvat Alasnag, Fatema Qaddoura, Fahad Alqahtani, Yosra Abdulahad A Turkistani, Walid Alharbi, Adel Tash, Mohammad Alshehri, Khalid Al Faraidy, Waleed Alhabeeb

Journal of the Saudi Heart Association

Background: Chronic coronary syndromes (CCS) continue to impose a substantial clinical and economic burden in Saudi Arabia. Since publication of the 2022 Saudi Heart Association (SHA) CCS guidelines, important advances have emerged in diagnosis, pharmacotherapy, cardiometabolic risk reduction, antiplatelet management, and revascularization. This 2026 focused update selectively revises and clarifies key recommendations to reflect these advances within the Saudi context.

Methods: A multidisciplinary SHA expert panel conducted a structured review of randomized trials, meta-analyses, and relevant international guidance published since 2022. Updates were restricted to areas with substantive new evidence or evolving clinical practice. Recommendations were formulated through expert consensus …

Action Steps Toward Equity In Communication Sciences And Disorders: A Program Evaluation Of Student Self-Efficacy, Monica Bellon-Harn, Lekeitha Morris, Mark Trahan

Teaching and Learning in Communication Sciences & Disorders

Abstract

Purpose: Within communication sciences and disorders (CSD), preparing students for equitable practice requires instruction aligned with social justice principles. Because students’ confidence in engaging in these practices may influence future behavior, this study examined the effects of an asynchronous program, Action Steps toward Equity (ASE-CSD) on undergraduate and graduate CSD students’ self-efficacy for practices aligned with social justice principles.

Method: A pretest-posttest quasi-experimental design was used with undergraduate (n = 16) and graduate (n = 33) CSD students who completed ASE-CSD. Participants completed the Social Justice Scale (SJS; Torres-Harding et al., 2012), which assessed self-efficacy associated with …

Equity In Evaluation: Examining Grading Practices And Student Experiences In Speech-Language Pathology Education, Jennifer Essig

Teaching and Learning in Communication Sciences & Disorders

Traditional grading practices remain the norm in communication sciences and disorders (CSD) education, despite evidence these systems may exacerbate inequities and affect motivation and perceptions of learning. This study examined how traditional and alternative grading practices are experienced by undergraduate and graduate students enrolled in CSD programs. Using a convergent mixed-methods design, survey data were collected from 73 students regarding perceptions of grading, motivation to learn, and emotional responses to assessment. Quantitative analyses indicated that students in alternatively graded classrooms reported significantly higher perceptions of fairness, clarity, and learning than those in traditionally graded settings. Qualitative analysis revealed contrasting emotional …

Supporting Neurodivergent Students In Communication Sciences And Disorders: Best Practices Integrating Udl And Tilt In Academic Courses, Jacqueline A. Towson, Nancy Mcintyre, Alexis Cunha

Teaching and Learning in Communication Sciences & Disorders

In this tutorial, we explore effective andragogical strategies to support neurodivergent students in higher education programs, specifically within academic course in the field of communication sciences and disorders (CSD). By integrating the evidence-based education practices of Universal Design for Learning (UDL) and the Transparency in Learning and Teaching (TILT) framework, faculty can create inclusive and supportive learning environments in academic courses to better support neurodivergent students in CSD programs. We discuss practical applications of these frameworks through two sample assignments, supported by recent research, and provide actionable recommendations for faculty in higher education. The goal of this tutorial is to …

Csdeep Learning Seminar: Connecting Students, Faculty, And Alumni To Promote A Creative Path To Success, Chao-Yang Lee, Emily Jones

Teaching and Learning in Communication Sciences & Disorders

What do the best college students do to cultivate their intellectual and personal development? How does learning type lead to professional success and personal fulfillment? We report the design and implementation of a seminar in which undergraduate students in Communication Sciences and Disorders collaborated with peers, faculty, and alumni to explore the meaning and application of deep learning. Participants examined how learning type shapes college experience through book discussions and conversations with alumni. Feedback from participants suggests that the book discussions and alumni conversations broadened the students’ perspective on learning type, purpose of college education, and success and failure. The …

Simulated Participant Engagement In Communication Sciences & Disorders Programs: A Scoping Review, Jason Konzelmann, Richard I. Zraick

Teaching and Learning in Communication Sciences & Disorders

Introduction. Simulated participants (SPs) are widely used in medical and nursing education, but their application in allied health, including Communication Sciences and Disorders (CSD), remains limited. Despite accreditation standards supporting simulation in CSD training, student engagement with SPs is still uncommon.

Objectives. This scoping review examined recent literature on SP use in CSD programs involving speech-language pathology or audiology students or providers. We explored how SPs were integrated and identified gaps for future research.

Methods. Guided by PRISMA-ScR, we searched six databases and an internet search yielded one additional article. Studies published between 2019 and 2025 were included if they …

Two-Thirds Return But Performance Suffers: Acl Reconstruction Outcomes Across Elite European Women's Soccer Leagues, Haneef Khan, Forest Rodriguez, Amina Khan, Ashley Rosenberg, Stephen Marcaccio

Student Papers, Posters & Projects

PURPOSE: To analyse return-to-play (RTP) rates, timing and performance outcomes following anterior cruciate ligament (ACL) reconstruction (ACLR) in elite European women's soccer players across the top five leagues.

METHODS: We reviewed ACL injuries sustained by female professional soccer players across the Bundesliga, Women's Super League, Primera División Femenina, Serie A Women and Première Ligue between 2007 and 2025. Players were included if they had a confirmed ACL injury requiring ACLR and one season of performance data pre- and post-injury. Players were excluded if the injury occurred during their rookie season or after the 2023 season. Data were collected from Soccerdonna.de …

Improving Advanced Care Planning Conversations And Documentation Through App Education And Standardized Epic Workflow: A Quality Improvement Initiative, Michelle N. Rutter, Emily Goldstein

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Advance care planning (ACP) is essential for ensuring (GOC), particularly in acute care settings, defined in this paper as inpatient hospital environments, including critical and intensive care units (ICU), where a patient’s decision-making capacity could become impaired. ICU patients are often critically ill and may lose the ability to make health care decisions. Family uncertainty regarding patient preferences frequently exacerbates psychological distress regarding GOC. Restricted access to ACP may result in non-concordant medical care, as well as elevated healthcare expenditures driven by the underutilization or inappropriate allocation of critical resources. Despite the recognized importance of ACP and …

Understanding Factors Associated With 911 And 988 Use In Mental Health Crises Original Paper Open Access, Michiko Ueda, Colleen M. Heflin, Yanhong Liu, Qingyi Yu, Seethalakshmi Ramanathan

The Lender Center for Social Justice

The 988 Suicide and Crisis Lifeline was launched in July 2022 as an alternative to 911 for mental health crises. However, little is known about the factors influencing decisions to use 911 or 988 among individuals most likely to benefit from 988, including those with suicidal ideation. This study analyzes individual characteristics associated with the likelihood of calling 911 during a mental health crisis and examines awareness of, willingness to use, and concerns about 988. An anonymous online survey was conducted in early 2024 with 1,894 U.S. adults aged 18–50, oversampling racial minorities. Logistic regression models were estimated for four …

Expressive Arts For Women Experiencing Homelessness, Theresa G. Karman, Susan Macdermott, Amy Lyons-Brown

Summer 2026 OTD Capstone Symposium

Background: Women experiencing homelessness due to domestic violence face significant occupational disruptions, including challenges related to emotional regulation, identity, social participation, and engagement in meaningful occupations. Occupational therapy (OT) can support recovery by addressing these occupational needs through trauma-informed and occupation-centered interventions.

Purpose: This doctoral capstone project developed and implemented Express & Empower Studio, a six-week expressive arts program designed to promote emotional expression, self-efficacy, social participation, and engagement in meaningful occupations among women residing in a domestic violence shelter.

Methods: Program development was guided by the Model of Human Occupation (MOHO) and the Expressive Therapies Continuum (ETC) within …

Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron

Walden Dissertations and Doctoral Studies

African American women experience a disproportionate burden of Type 2 diabetes, and limited evidence exists regarding the relationship between diabetes knowledge and self-care behaviors, particularly among African American female veterans. The purpose of this quantitative, cross-sectional study was to examine the relationship between diabetes knowledge and diabetes self-care among African American women with Type 2 diabetes, including a subsample of African American female veterans, and to evaluate whether the COVID-19 pandemic (2017–2019 vs. 2021–2023) moderated this relationship. Additional variables included age, marital status, physical health, and mental health. Guided by the social-ecological model, de-identified data from the Behavioral Risk Factor …

Relationship Between Hospital Case Management Leadership Style And Employee Engagement, Malinda Ellis

Walden Dissertations and Doctoral Studies

Employee engagement among hospital-based nurse case managers is important because these nurses support discharge planning, utilization management, care coordination, and safe patient transitions. Although leadership style has been studied in nursing, limited research has examined its relationship to engagement among nurse case managers. The purpose of this quantitative, nonexperimental, correlational study, using House’s path-goal theory, was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and employee engagement among hospital-based nurse case managers. Data were collected from 89 registered nurse case managers in acute care settings in the United States, who completed the Multifactor Leadership Questionnaire, Short Form, …

Knowledge Of Parents About Thalassemia In Tabuk City: A Cross-Sectional Study, Sawsan Mohammed Alblewi, Amirah M. Alatawi, Ehab Mahmoud Hanafy, Faisal Mayudh Althobaiti, Abdulelah Hamad Al-Balawi, Faisal Mohammed Alamrani, Yazeed Mahmoud Ajwah, Omar Muslih Albalawi, Mohammed Majed Alquayr, Sultan Ibrahim Alhamdi

Makara Journal of Health Research

Background: Thalassemia is a common inherited blood disorder and remains a significant public health concern in Saudi Arabia. Parental knowledge is essential for effective prevention, screening, and early intervention. This study aimed to assess the knowledge of thalassemia among parents in Tabuk City, Saudi Arabia, and identify factors associated with knowledge levels.

Methods: A cross-sectional study was conducted among 392 parents residing in Tabuk City between March and May 2025. Data were collected using a validated Arabic questionnaire distributed online. Knowledge was assessed using 21 items covering general thalassemia knowledge, thalassemia major, carrier status, and prevention. Knowledge levels …

Internet Use And Decision-Making Processes Among Pregnant Women: A Cross-Sectional Study, Ayça Balmumcu, Endam Çetinkaya Ak, Sabriye Uçan Yamaç

Makara Journal of Health Research

Background: The coronavirus disease 2019 (COVID-19) pandemic restricted access to in-person health services, especially in rural areas. This increased reliance on the internet for health information and decision-making was particularly notable among pregnant women. This study aimed to investigate the role of internet use in decision-making among pregnant women.

Methods: This analytical, cross-sectional study examined 384 pregnant women living in a rural district of Turkey who attended family health centers for prenatal care. Data were collected using the Internet Decision-Making Scale in Pregnancy and a questionnaire assessing internet use patterns during the pandemic.

Results: Pregnant women demonstrated …

E-Health Literacy And Cyberchondria Severity Among Adolescent High School Students: A Cross-Sectional Study, Seyda Çavmak, Adem Bilgin

Makara Journal of Health Research

Background: Amid rapid digitalization and the growing use of artificial intelligence-based search engines, adolescents increasingly seek health information online. This study examined the relationship between high school students' e-health literacy and their cyberchondria tendencies.

Methods: This quantitative, cross-sectional study included 683 students from public high schools in Mersin, Türkiye. Data were collected using a Demographic Information Form, the e-Health Literacy Scale (eHEALS), and the Cyberchondria Severity Scale Short Form (CSS-12). Descriptive statistics, comparative tests, and Pearson correlation were applied (p < 0.05).

Results: Students' e-health literacy and cyberchondria severity were moderate. Significant positive correlations emerged between e-health literacy …

Needlestick Injury Risk And Preventive Behaviors Among Nursing Students, Angga Wilandika, Riandi Alfin, Rosa Intan Khoerunnisa

Makara Journal of Health Research

Background: Needlestick injury (NSI) remains a persistent occupational safety risk for nursing students during clinical practice, with implications for worker safety, patient care, and healthcare safety systems. Understanding preventive safety behavior within clinical training environments is essential for improving workplace safety in healthcare settings.

Methods: A cross-sectional study was conducted among nursing students undertaking hospital-based clinical placements. Using a purposive sampling, participants completed a structured self-administered questionnaire assessing NSI exposure, preventive safety behaviors, clinical supervision, safety training, and perceived safety within the clinical learning environment. Data was analyzed to identify patterns of NSI risk and associated preventive behaviors. …

Assessing Healthcare Access Among Overweight And Obese Individuals In Türkiye Using Latent Variable Modeling, Banu Beyaz Sipahi

Makara Journal of Health Research

Background: Overweight and obesity are critical determinants of healthcare access, yet evidence on how the COVID-19 pandemic reshaped these dynamics in Türkiye remains limited. This study investigates whether the early post-pandemic recovery period altered healthcare access patterns for individuals with excess weight.

Methods: Using nationally representative microdata from the 2014, 2016, 2019, and 2022 Turkish Health Surveys, we constructed a latent Healthcare Access Index based on six indicators of unmet care needs. Probit models were estimated to assess associations between BMI categories and healthcare access, controlling for socioeconomic and demographic factors. The 2022 wave serves as the early …

Staff Education On Improving Medication Adherence, Oneil Dobgima Galega

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a practice gap in an outpatient behavioral health setting involving inconsistent use of structured communication strategies to support medication adherence among psychiatric patients. Although nurses routinely provided medication instructions, approaches such as motivational interviewing and psychoeducation were underutilized, limiting patient engagement, understanding, and adherence, and ultimately affecting care continuity and outcomes. The purpose of the project was to improve psychiatric nurses’ knowledge and intent to use motivational interviewing and psychoeducation to enhance medication adherence. The guiding practice-focused question examined whether a structured educational intervention could strengthen nurses’ competencies in these communication strategies. …

Staff Education To Improve Behavioral Health Integration In Primary Care, Nelly Endah Atu

Walden Dissertations and Doctoral Studies

This staff education project addressed a persistent gap in the delivery of integrated physical and mental healthcare for patients with co-occurring conditions. Fragmented care in primary care contributes to untreated mental health needs, increased patient distress, higher costs, and poor outcomes. The aim of this project was to develop, deliver, and evaluate a staff education program equipping nurses, nurse practitioners, and interdisciplinary team members with the knowledge, skills, and practical strategies needed to improve behavioral health integration in primary care. The practice question was, among interdisciplinary staff in a community health setting, did the implementation of an evidence-based, ADDIE-designed staff …

Sbirt Staff Education To Registered Nurses In The Emergency Department, Rosemary Thuet

Walden Dissertations and Doctoral Studies

Summary The project hospitals have, on average, 2,400 emergency department (ED) visits a month. Although patients receive a social screening, there are no specific assessments to determine if the person is at risk for alcohol use disorder (AUD). The lack of screening is a missed opportunity to provide a Screening, Brief Intervention and Referral to Treatment (SBIRT) assessment of over 2,400 patients a month or 48,000 people annually. Although several screening tools could be used for an SBIRT assessment, the recommendation of ED nursing leadership is to implement the tool known as the CAGE Questionnaire (Cut down, Annoyed, Guilty, and …

Racial Trauma And Posttraumatic Growth: Implications For Counselors, Margaret M. Poandl, Nowoola Awopetu, Paul C. Harris Dr.

Journal of Counselor Preparation and Supervision

Racial trauma is ubiquitous among Black, Indigenous, and People of Color (BIPOC) and people who belong to other marginalized groups. It is likely that counselors will work with individuals who have experienced racial trauma. Aligned with the counseling profession’s values, counselors can take a strengths-based approach that incorporates facilitation of a historical trauma posttraumatic growth (HT-PTG) framework. This paper presents evidence-informed practices that can foster growth on individual and collective levels. A case example is provided that integrates individual- and collective-level interventions bidirectionally, along with implications for counselor training pedagogically, through supervision, and continuing education. Counselors can identify, encourage, and …

The Safe Fishbowl Model: Psychological Safety By Design In Counseling Skills Training, Mike Mariska

Journal of Counselor Preparation and Supervision

Skills training in counselor education can be constrained by performance anxiety, which may reduce participation, limit deliberate practice repetitions, and shift demonstrations to the instructor. This applied-practice manuscript introduces the SAFE (Structured Avatar and Feedback Experience) Fishbowl model, a simulation architecture designed to address performance anxiety while scaling participation. SAFE Fishbowl integrates rotating counselor roles, a real-time coaching loop, structured observation grounded in experiential learning theory, and purposeful debriefing. An implementation example for group counseling leadership skills is provided, along with adaptation guidance across multiple skill domains and delivery modalities. Descriptive course-evaluation feedback illustrates feasibility and perceived usefulness. Implications include …

Integrating Consensual Non-Monogamy In Counselor Education: Practical Guidelines And A Pilot Descriptive Study, Yun-Zhuo (Zoey) Liu, Lena Salpietro

Journal of Counselor Preparation and Supervision

Consensual non-monogamy (CNM) is a prevalent and diverse relationship structure, yet mononormative assumptions persist in counselor training and practice, contributing to stigma and inadequate care. Research indicates that counselors’ CNM-specific knowledge and attitudes are critical to positive therapeutic outcomes (Schechinger et al., 2018), highlighting the need for clear guidance. In response, this paper presents Guidelines for Incorporating CNM in Counseling Curricula. Three domains are grounded in multicultural and social justice principles: foundational knowledge and terminology, challenging bias and promoting self-reflection, and application informed by attachment theory. Additionally, findings from a survey of counselor educators (N = 54) are presented. Results …

U.S. Service Member To Counseling Student, Nicole Marie Arcuri Sanders, Kellie Forziat-Pytel

Journal of Counselor Preparation and Supervision

This qualitative descriptive study examines the absence of military career pathways for licensed mental health counselors (MHCs) and the impact of this structural limitation on service members' career transitions. Findings indicate that both combat and non-combat veterans pursued mental health counseling due to personal service-related mental health experiences and dissatisfaction with available care while in service. Despite these challenges, many participants expressed a strong desire to continue serving their country as professional counselors. Over half of the participants reported separating from the military because no occupational role existed for licensed MHCs. At the same time, most indicated they would have …

Modernizing Career Counseling In Counselor Education: A Conceptual Exploration, Yuhyun Park, Se Hoon Kim, Rasheed Adeyemo, Sarah Ebner, Mallory Redmond, Breeana Donayre, Carly Steves

Journal of Counselor Preparation and Supervision

Career development is often confined to a single course despite its relevance across counseling practice. This conceptual article reframes it as an integrative foundation for counselor preparation, supervision, and professional identity. It examines connections among work, mental health, education, disability, relationships, and social context across counseling specializations. The article also considers doctoral training and the ethical use of artificial intelligence in career-related practice. Recommendations address curriculum design, supervision, and future research on integrated career preparation.