Digital Commons Network^™

Mitigating Disparities In Diagnosis Of Dementia, Lycia Tramujas Vasconcellos Neumann, Simin Mahinrad, Erin L. Abner, Soo Borson, Goldie S. Byrd, Maria Carrillo, Lindsay Clark, Anthony N. Correro Ii, Kacie D. Deters, Gladys E. Maestre

School of Medicine Publications

The field of Alzheimer's disease and related dementias (AD/ADRD) is undergoing a transformative shift with a better understanding of disease biology, biomarker-based diagnostics, and disease-modifying therapies. Yet, these advancements risk exacerbating existing disparities in diagnosis and care. The 2024 Alzheimer's Association International Conference (AAIC) Advancements: Exploring Equity in Diagnosis convened interdisciplinary experts to address these inequities and chart a path toward population-generalizable research and practice. This article synthesizes key insights from the conference, highlighting considerations for inclusive and representative research design, ethical approaches in diagnostic disclosure, as well as challenges and solutions at individual, community, and systemic levels to advance …

Treatment Of Obsessive-Compulsive Disorder Via Mental Health Technology, Erika S Trent, Nisha Jagannathan, Eric A Storch

Faculty, Staff and Students Publications

Obsessive-compulsive disorder (OCD) is a debilitating neuropsychiatric disorder that remains chronic unless intervened with evidence-based intervention. Cognitive behavioral therapy (CBT) with exposure and response prevention is the gold-standard psychological intervention for OCD, but many individuals do not receive this intervention due to barriers to accessing treatment. Mental health technology tools such as telehealth, computerized programs, internet-delivered CBT, and mobile applications have been adopted to expand the accessibility of CBT. An up-to-date summary of the evidence base of technology-mediated formats of CBT for OCD treatment is provided. Clinical benefits offered by such approaches, current limitations, and future research directions are discussed.

Birth Satisfaction, As Measured By The Birth Satisfaction Scale–Revised (Bss-R), And Its Role In Predicting Breastfeeding Duration, Maternal-Infant Attachment, And Postpartum Depression, Molly Parker

University Honors Theses

Birth satisfaction has been consistently associated with improved maternal outcomes such as reduced postpartum depression (PPD), stronger maternal-infant attachment, and longer breastfeeding duration. However, the extent to which birth satisfaction independently predicts these outcomes remains unclear. This study examined whether birth satisfaction, as measured by the Birth Satisfaction Scale–Revised (BSS-R), predicts postpartum depression, maternal-infant attachment, and breastfeeding duration in a longitudinal cohort.

Data were drawn from the Prenatal Environmental And Child Health (PEACH) study. Birth satisfaction was assessed at 12 months postpartum using the BSS-R. Postpartum depression was measured using the Edinburgh Postnatal Depression Scale (EPDS), maternal-infant attachment using the …

Geographic And Systemic Disparities In Maternal Health: A Systems Analysis Of Prenatal Care Access Across Rural Oregon, Cecelia Petrik

University Honors Theses

Objectives: In Oregon, 51% of hospitals providing labor and delivery services are located in rural areas. Consolidation of these hospitals and provider shortages has created severe geographic and systemic disparities in maternal healthcare. This thesis explores how geographic isolation and inadequate prenatal care access contribute to widening disparities in severe maternal morbidity (SMM) and mortality across Oregon's rural and frontier counties.

Methods: This study utilizes data from the Oregon Health Authority (OHA) Center for Health Statistics (2024) and analyzes spatial correlations across all 36 Oregon counties. A bivariate choropleth map was constructed to examine the structural intersection between health infrastructure …

Moving Beyond Traditional Cost Containment For Glp-1 Coverage Within Oregon's Proposed Universal Health Plan, Manoj Rajesh

University Honors Theses

In 2022, Oregon voters passed Measure 111, constitutionally mandating access to affordable health care. As the Universal Health Plan Governance Board (UHPGB) designs the state's proposed single-payer system, it faces an unprecedented financial vulnerability: the clinical demand for GLP-1 receptor agonists. These high-cost, indefinite-use medications for obesity and metabolic syndrome threaten to overwhelm fixed public budgets. Historically, both the Oregon Health Plan's Medicaid framework and commercial private insurers have relied on static cost-containment models—categorical exclusions, step therapy, and aggressive utilization management—that achieve short-term fiscal solvency at the expense of comprehensive preventative care. This thesis argues that to fulfill the mandate …

Functional Genomics Studies Of Psychiatric Disorders In Individuals Of Latin American Populations: A Scoping Review, Luz M Porras, Isabelle Rodríguez-Lausell, Gabriel Iglesias-Maldonado, Emily Val F Tuliao, Gabriela Martínez, Chelsey Leveque, Julian Tobon, Rachel Eloy, Sintia Belangero, Cynthia M Bulik, Camila M Loureiro, Carolina Muniz Carvalho, Vanessa Ota, Diego Luiz Rovaris, Eric A Storch, Eva Maria Trujillo-Chi Vacuan, Maria M Velasquez, Latin American Genomics Consortium, Marcos L Santoro, Humberto Nicolini, Elizabeth G Atkinson, Janitza L Montalvo-Ortiz, Paola Giusti-Rodríguez

Faculty, Staff and Students Publications

Over the past 15 years, genetic studies of psychiatric disorders have provided important insight into the contribution of both common variants of small effect, as well as rare exonic and copy number variants with large effect sizes. Genome-wide association studies (GWAS) allow us to understand the intricate polygenicity characteristic of many psychiatric disorders. However, a considerable proportion of single nucleotide polymorphisms (SNPs) implicated in these disorders localize to the non-coding regions of the genome. Unraveling the molecular mechanisms that underlie the etiology of psychiatric illnesses requires integration using functional genomics approaches. Functional genomics methods are critical for developing a mechanistic …

Understanding And Enhancing Suicide Prevention Strategies In The Military: The Roles Of Culture, Leadership, And Command Climate, Kelly Johanna Pires

Dissertations

Military service members are shaped and molded to fit a military culture that emphasizes mission readiness and continuous preparedness. Countless hours are spent training for various situations that can arise. Many trainings are geared toward worst-case scenarios that can cause an increase in stressors and traumatic events. They are expected to demonstrate resilience and overcome adversity to remain mission-ready. This expectation to be mission-ready creates the space for mental health difficulties as well as stigma and avoidance of help-seeking behaviors. In many cases, the desire to stay mission-ready creates a barrier for conversations around mental health. The military emphasizes qualities …

Addressing Mental Health Issues And The Effectiveness Of Cognitive Behavioral Therapy And Mindfulness-Based Interventions Among Athletes, Shelby Jones-Stachnik

Dissertations

This literature review identifies mental health concerns among competitive athletes and evaluates psychological interventions to address these challenges. Specifically, the review explores the mental health concerns experienced by athletes engaged in high-level sport. It examines whether cognitive behavioral therapy and mindfulness-based interventions are effective approaches for improving psychological outcomes in this population. A systematic review of peer-reviewed research was conducted, and findings were synthesized to evaluate the effectiveness of cognitive behavioral therapy and mindfulness-based interventions. The review included randomized controlled trials, quasi-experimental studies, and meta-analyses examining psychological interventions in athletic populations. Findings across the literature indicate that both cognitive behavioral …

Diverse Families Navigating Mental Health At The Pediatrician’S Office: A Mixed Methods Exploration Of The Interplay Of Stress, Culture, And Child Mental Health In The Primary Care Setting, Sara B. Budowsky

Dissertations

Low-income and ethnic minority youth experience high psychiatric need but persistently low participation in traditional mental health care. General pediatricians are often the first and only healthcare providers with whom many families engage around their child’s emotional and behavioral development. Using both quantitative analysis of retrospective secondary data and Interpretative Phenomenological Analysis (IPA) of in-depth interviews with diverse caregivers, this project explored influencers of child mental health and family utilization of pediatric primary-care-based mental health services in the context of a uniquely multicultural clinic serving a predominantly Medicaid population. Three key findings include: 1) Caregiver Stress was a highly significant, …

Music Appreciation In Cochlear Implant Users: A Questionnaire, Hanna Davidson

Dissertations, Theses, and Capstone Projects

Cochlear implants provide significant benefits for speech perception in individuals with severe to profound hearing loss; however, music perception and appreciation remain challenging due to limited spectral and temporal resolution. This study examined music appreciation in post lingually deafened adult cochlear implant users, focusing on changes in enjoyment, listening behaviors, and subjective experiences following implantation. Sixteen adults completed a 36-item questionnaire assessing pre- and post-implant music engagement, perceived sound quality, and emotional responses to music. Quantitative data were analyzed using descriptive statistics and inferential statistics, and qualitative responses were analyzed thematically.

Results indicated a moderate decline in music enjoyment following …

Neural Correlates Of Recognition Memory And Metamemory In Breast Cancer Survivors: An Event-Related Potential Study, Dishari Zaman Azad

Dissertations, Theses, and Capstone Projects

Breast cancer survivors (BCS) often report noticeable cognitive difficulties despite showing limited impairment on standardized neuropsychological tests. Some have theorized that this is simply an insensitivity of standardized testing to subtle cognitive changes (test-insensitivity hypothesis), whereas others have suggested there are early neural changes that are detected by patients but precede detection by these tests (early signal hypothesis) or that when they achieve normal performance, it is through saliently effortful compensatory processes (compensation hypothesis). The present study tested these theories by assessing metamemory and recognition memory retrieval in BCS and non-cancer controls (NCC) using both behavioral and event-related potential (ERP) …

Implicit Attitudes Toward Hearing Aid Visibility: Conspicuous Versus Inconspicuous Hearing Aid Colors, Orly R. Ames

Dissertations, Theses, and Capstone Projects

Hearing aid stigma remains a significant barrier to treatment uptake, with device visibility frequently identified as a contributing factor. Although prior research has examined visibility in relation to hearing aid size and style, the role of color as a distinct aesthetic dimension has not been systematically investigated. The present study assessed whether hearing aid color affects implicit and explicit attitudes toward hearing aids and whether such evaluations differ across contexts. Twenty-six adults who were not current hearing aid users participated in an online quantitative multi-method study consisting of an Implicit Association Test (IAT) and self-report questionnaires. The IAT measured implicit …

Enhancing Ecological Validity In Speech-In-Noise Testing: Integrating Virtual Reality For A Multisensory Audiological Experience, Paulina Lee

Dissertations, Theses, and Capstone Projects

Despite the remarkable advances in hearing healthcare technology, the speech recognition tests used in routine clinical audiological assessment have remained essentially the same for decades.  Monosyllabic word recognition tests in quiet, such as the Northwestern University Auditory Test No. 6 (NU-6; Tillman & Carhart, 1966), have served as the audiology field’s default measure of speech understanding.  Modern speech-in-noise (SIN) tests, such as the QuickSIN (Killion et al., 2004), have emerged, yet they remain auditory-only, leaving an unignorable gap between what clinical tests measure and how patients communicate in daily life.  The present study examined whether pairing a standard SIN test …

A Comparison Of Manufacturers’ Claims Of Attenuation Rates In Non-Custom Earplugs, Skyler M. Shipley

Dissertations, Theses, and Capstone Projects

Recreational and social environments frequently expose individuals to high intensity noise environments; however, the use of hearing protection devices (HPDs) remains limited. This study evaluated whether non-custom, over-the-counter musicians’ earplugs provide attenuation consistent with manufacturers’ claims and whether cost is associated with performance. Six commercially available earplug models were tested using both human participants and a KEMAR manikin system. Attenuation was measured across frequencies from 250–8000 Hz (octave and inter-octave frequencies) and were tested using different ear tip sizes. Results indicated that several earplugs achieved attenuation levels comparable to or exceeding their advertised noise reduction ratings (NRR), though consistency varied …

A Predictive Coding Account Of Spatial Working Memory Following Prophylactic Levetiracetam Administration Prior To Traumatic Brain Injury, Omeima Mutwali

Dissertations, Theses, and Capstone Projects

Traumatic brain injury (TBI) symptom prevention and remediation is an important area of research that would benefit vulnerable groups, including active-duty and veteran soldiers. These patients can sustain penetrative forces in fields of combat or in training, which result in focal lesions that trigger inflammatory and degenerative processes in the brain. Both primary and secondary injuries are associated with changes to cognition, behavior and affective state. This disease poses increased risk of epileptogenesis, as well. Given these outcomes, prior research has evaluated levetiracetam (LEV) as a prophylactic treatment for seizures, cognitive deficits and negative emotionality. LEV acts as a presynaptic …

Early Neurodevelopmental Outcomes In Children With Congenital Heart Disease., Mike Seed, Dawn Ilardi, Valerie Rofeberg, Cynthia Ortinau, Caren Goldberg, Garrett Reichle, Lauren Bush, Justin Elhoff, Amy Jo Lisanti, Jennifer Butcher, Caitlin Rollins, Andrew Van Bergen, Shabnam Peyvandi, Emily Bucholz, Stephanie Cox, Lyla Hampton, Jacqueline Sanz, Sonia Monteiro, Shruti Tewar, Kiona Allen, Caroline Lee, Kristi Glotzbach, Nneka Alexander, Laurel Bear, Corinne Anton, Renee Sananes, Linh Ly, Gina Boucher, Kelly Wolfe, Lindsay Edwards, Elizabeth J. Willen, Alexander Tan, Christina Ortega, Erica Sood, Anjali Sadhwani, Kari Crawford Plant, Lauren Quigley, Jessica Pliego, Elizabeth Valles, Abbey Hines, David Wypij, Thomas Miller

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Neurodevelopmental impairments are common in children with congenital heart disease.

OBJECTIVES: To compare neurodevelopmental outcomes by cardiac diagnosis and identify associations between medical and social factors and early neurodevelopmental outcomes among children with congenital heart disease.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional analysis used neurodevelopmental follow-up data obtained between May 1, 2019, and June 30, 2022, and entered into the Cardiac Neurodevelopmental Outcome Collaborative (CNOC) registry, with linkage to the Pediatric Cardiac Critical Care Consortium registry. Children younger than 30 months from 25 CNOC sites were studied. Data analysis was performed between January 2023 and December 2024.

EXPOSURES: Patients …

Incidental Colorectal Adenomas In Adolescents: Clinical Management, Genetic Evaluation, And Surveillance., Brett J. Hoskins, Shlomi Cohen, Colleen B. Flahive, Isabel Rojas, Aparajita Singh, Thomas M. Attard

Manuscripts, Articles, Book Chapters and Other Papers

The rising incidence of early-onset colorectal cancer has renewed attention to colorectal adenomas in adolescents and young adults (AYA), although these lesions remain rare and poorly characterized in adolescents. Lack of age-specific guidance creates uncertainty regarding genetic evaluation, surveillance intervals, and long-term management when these lesions are identified in adolescents. This narrative review synthesizes current evidence and expert perspective on epidemiology, evaluation, endoscopic management, surveillance, genetic considerations, and psychosocial implications of incidentally identified colorectal adenomas across the AYA spectrum, with emphasis on adolescents as a distinct clinical population. Available data largely derive from adults aged 20-49 years but suggest that …

Initial Injury Type And Violent Reinjury, Nicholas Szoko, Daphne Lew, Taylor Kaser, Zoe M Miller, Matt Vogel, Michael A Mancini, Lindsay M Kranker, Christopher Behr, Vicki Moran, Rachel Ancona, Kristen Mueller

2020-Current year OA Pubs

IMPORTANCE: Violent injuries are the leading cause of death among children and young adults in the United States. Violent injury may increase the risk of subsequent injury (ie, violent reinjury), but it is unclear how this risk varies across different injury types (eg, blunt assault, stabbing, firearm).

OBJECTIVE: To describe patterns of violent reinjury across different injury types to inform tailored prevention strategies.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter cohort study included patients who presented with violent injuries to 2 adult and 2 pediatric level I trauma centers in St Louis, Missouri, from January 2016 to December 2023.

EXPOSURES: Violent …

New Graduate Nurses' Experiences Of Leaving The Emergency Department, Gemma John

Walden Dissertations and Doctoral Studies

No abstract provided.

Early Neurodevelopmental Outcomes In Children With Congenital Heart Disease, Mike Seed, Cynthia Ortinau, Caroline Lee, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Neurodevelopmental impairments are common in children with congenital heart disease.

OBJECTIVES: To compare neurodevelopmental outcomes by cardiac diagnosis and identify associations between medical and social factors and early neurodevelopmental outcomes among children with congenital heart disease.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional analysis used neurodevelopmental follow-up data obtained between May 1, 2019, and June 30, 2022, and entered into the Cardiac Neurodevelopmental Outcome Collaborative (CNOC) registry, with linkage to the Pediatric Cardiac Critical Care Consortium registry. Children younger than 30 months from 25 CNOC sites were studied. Data analysis was performed between January 2023 and December 2024.

EXPOSURES: Patients …

Remote Hr-Guided High-Intensity Interval Training With Weekly Health Monitoring In Breast Cancer Patients During Chemotherapy: A Moderation Analysis Of Physiological Predictors, Madara Ketlīna Štarka-Rantiņa, Rudolfs Ceseiko, Martins Campa, Maksims Zolovs, Greta Franceska Jermolenko, Kristaps Eglitis, Alicia Llorente, Aija Linē, Aija Klavina

Baltic Journal of Health and Physical Activity

Background: The study aimed to investigate the effects of a six-month remotely monitored heart rate – guided high-intensity interval training (HIIT) program on aerobic capacity, functional performance, and weekly self-reported health outcomes in women with stage II–III breast cancer undergoing neoadjuvant chemotherapy. Materials and methods: Fifty-six women (mean age 47 ± 8 years) were randomly assigned (1:1) to a HIIT group or a control group (CG). Thirty-five participants were included in analyses (HIIT group = 17; CG = 18). HIIT group performed 4 × 4-minute HIIT sessions at the intensity of 85–95% of the peak heart rate, two to three …

Effects Of Garden Exposure On Physician Assistant Students, Richard Gilbert Jr., Anne Schempp, Daniel Martin

Inquiry: The Journal of the Virginia Community Colleges

Introduction: Stress and burnout within the physician assistant student population has been an evolving topic in physician assistant education. Greenspaces have been utilized for the reduction of stress and improvement of overall well-being.

Methods: Using a mixed methods survey methodology, participating physician assistant students were evaluated on their perceived stress levels both pre and post-exposure to a garden area. Both quantitative and thematic qualitative data was synthesized to evaluate the garden’s effect on the physician assistant student stress levels.

Results: A linear mixed effects model revealed that participants significantly improved stress outcomes from pre-test to post-test (ꞵ = 3.83, CI95% …

Improving Antihypertensive Medication Adherence Through Education And Follow- Up Phone Calls In A Primary Care Setting, Sarah Peterson

Doctor of Nursing Practice Final Manuscripts

Hypertension affects nearly half of adults and significantly increases the risk of stroke and cardiovascular disease; however, poor medication adherence remains a primary barrier to effective blood pressure management. The purpose of this evidence-based practice (EBP) project was to improve antihypertensive medication adherence among adult patients in a primary care setting. Guided by the Iowa Model of Evidence-Based Practice to Promote Quality Care, the project utilized a pre-test/post-test design at a private practice clinic. The sample included adults with a hypertensive diagnosis and active prescriptions. Medication adherence was defined as the Morisky Medication Adherence Scale (MMAS-8) scores, measured before and …

Closing The Gap: Integrating A Standardized Depression Screening In Primary Care, Cyndy Marie Oreas

Doctor of Nursing Practice Final Manuscripts

Objective: The purpose of this evidence-based practice (EBP) project is to implement the routine use of the Patient Health Questionnaire-9 (PHQ-9) screening instrument in the primary care setting to improve early diagnosis, treatment, and referrals to mental health.

Background: Depression is frequently underdiagnosed in primary care despite its significant impact on health outcomes. Inconsistent screening practices and a lack of standardized workflows contribute to missed opportunities for early identification and intervention. Routine PHQ-9 screening has been shown to improve detection and facilitate timely referral to behavioral health services.

Methods: A standardized PHQ-9 screening was implemented for adult patients aged 18 …

Reducing Preoperative Anxiety In Patients Undergoing Gynecologic-Oncology-Related Surgeries, Iman Sean Lavine-Richardson

Doctor of Nursing Practice Final Manuscripts

Elevated levels of preoperative anxiety are associated with adverse effects in the postoperative period. Evidence demonstrates the effectiveness of incorporating multimedia into preoperative education to alleviate preoperative anxiety. This project aims to decrease preoperative anxiety levels and increase satisfaction and feelings of preparedness in patients scheduled to undergo gynecologic-oncology-related procedures through the implementation of an evidence-based practice (EBP) informational video. The San Diego 8A’s EBP model was utilized to guide this project. Data was collected, anonymously, through online questionnaires which included the Anxiety Specific to Surgery Questionnaire (ASSQ) to assess anxiety levels and Likert-scale questions to assess satisfaction and feelings …

Implementation Of Comprehensive Checklist For Opioid Use Disorder Treatment In Primary Care, Sophia R. Madden

Doctor of Nursing Practice Final Manuscripts

Background: The escalating opioid crisis demands a comprehensive approach to Opioid Use Disorder (OUD) management. Patients often face comorbid mental illnesses, infectious diseases, concurrent substance use, and social determinants of health (SDOH)—all of which increase the risk of treatment attrition. Standardizing care through evidence-based clinical practice guidelines and tools is essential for improving treatment quality and consistency.

Purpose: This project aimed to increase comorbidity screenings and improve resource access for OUD patients at a San Diego Internal Medicine primary care office by implementing a comprehensive care checklist based on the American Society of Addiction Medicine (ASAM) guideline.

Methods: The ASAM …

Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …

Innovating Adhd Care: A Doctoral Capstone On A Pilot Adult Adhd Diagnostic Clinic Implementation, Fozia Aman

Doctor of Nursing Practice Final Manuscripts

Objective: To evaluate whether an APRN-led pilot Adult ADHD Diagnostic Clinic within a large academic healthcare system in the San Diego area improves timely access to diagnostic evaluation and optimizes care disposition for adults with suspected ADHD.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention and/or hyperactivity-impulsivity that interferes with functioning in daily life. It often emerges in childhood and persists into adulthood, affecting approximately 360 million adults globally. Despite its prevalence and associated functional and psychiatric burden, adult ADHD remains underdiagnosed and undertreated due to limited primary care training, stigma, and reduced access to psychiatric services, resulting in delayed …

Sleep Tight: A Sleep Hygiene Bundle For Adults To Improve Sleep Quality In A Skilled Nursing Facility, Meaghan Corbin

Doctor of Nursing Practice Final Manuscripts

Abstract

Nearly two thirds of skilled nursing facility (SNF) residents report poor sleep. Negative consequences of poor sleep are depressed mood, anxiety, pain, cognitive impairment, increased risk for dementia, fatigue, decreased concentration, and lower activity participation. A review of literature has shown that implementation of non-pharmacological sleep interventions can significantly improve sleep quality. The aim to screen SNF residents on current self-reported sleep quality and provide non-pharmacological sleep interventions. The evidence-based project utilized the 8 A’s Model. Using the Pittsburg Sleep Quality Index (PSQI), a resident with a score above 0, received the non-pharmacological sleep hygiene bundle: eye mask, earplugs, …