A Dual-Angle Exploration Towards Understanding Lapses In Covid-19 Social Responsibility, Sean T. H. Lee, Jerome J. X. Mah, Angela K. Y. Leung

Research Collection School of Social Sciences

Breaking infection chains requires not just behaviours that allow individuals to stay healthy and uninfected (i.e. health protective behaviours) but also for those who are possibly infected to protect others from their harboured infection risk (i.e. socially responsible behaviours). However, socially responsible behaviours entail costs without clear, immediate benefits to the individual, such that public health-risking lapses occur from time to time. In this important yet understudied area, the current exploratory study sought to identify possible psychological factors that may affect people's likelihood of engaging in socially responsible behaviours. Assuming that self-perceived infection should provide an impetus to engage in …

Life-Space Mobility, Transportation, And The Companionship Network Of Members Of A Hispanic Senior Center, Rebecca L Mauldin, Rupal Parekh, John P Connolly, Stephen P Mattingly, Aiman Mushtaq, Kayo Fujimoto

Faculty, Staff and Student Publications

Objectives: Companions (i.e., friends who spend time together) are important for the well-being of older adults. Senior centers in the United States are places for older adults to participate in group activities and form and maintain companionships. However, differences in mobility and transportation may affect the ability of older adults to leverage senior center activities into actual companionships.

Methods: This social network analysis was conducted to characterize the companionship network among members of a senior center in relation to their life-space mobility and transportation resources. An exponential random graph model was estimated to identify mobility- and transportation-related correlates of the …

Dyadic Yoga For Head And Neck Cancer Patients Undergoing Chemoradiation And Their Family Caregivers, Kathrin Milbury, David I Rosenthal, Yisheng Li, An Thuy Ngo-Huang, Smitha Mallaiah, Sania Yousuf, Clifton D Fuller, Carol Lewis, Eduardo Bruera, Lorenzo Cohen

Faculty, Staff and Student Publications

Objectives: Concurrent chemoradiation to treat head and neck cancer (HNC) may result in debilitating toxicities. Targeted exercise such as yoga therapy may buffer against treatment-related sequelae; thus, this pilot RCT examined the feasibility and preliminary efficacy of a yoga intervention. Because family caregivers report low caregiving efficacy and elevated levels of distress, we included them in this trial as active study participants.

Methods: HNC patients and their caregivers were randomized to a 15-session dyadic yoga program or a waitlist control (WLC) group. Prior to randomization, patients completed standard symptom (MDASI-HN) and patients and caregivers completed quality of life (SF-36) assessments. …

Excess Risk Of Chronic Health Conditions In Hispanic Survivors Of Adolescent And Young Adult Cancers, Amy M Berkman, Eunju Choi, John M Salsman, Susan K Peterson, Christabel K Cheung, Clark R Andersen, Qian Lu, J A Livingston, Michelle A T Hildebrandt, Susan K Parsons, Michael E Roth

Faculty, Staff and Student Publications

Purpose: There is a growing population of survivors of adolescent and young adult (AYA) cancers (age 15-39 years at diagnosis). Studies in AYA cancer survivors have identified racial and ethnic disparities in long-term outcomes. To understand the extent to which a cancer diagnosis exacerbates pre-existent health disparities within a minoritized population, comparisons should be made to those of the same race or ethnicity without a cancer history.

Methods: Self-reported data from the National Health Interview Survey (2009-2018) were used to identify Hispanic AYA cancer survivors and Hispanic age- and sex-matched controls. SES factors (marital status, income, education, insurance) and prevalence …

Challenges And Implications For Substance Use And Mental Healthcare Among Under-Resourced Women In The Covid-19 Era, Maria C Mejia, Alicia Kowalchuk, Sandra J Gonzalez, Muktha Nair, Lisa Webb, Nadine Scamp

Faculty, Staff and Students Publications

BACKGROUND: The COVID-19 pandemic exacerbated disparities in mental healthcare and substance use disorder (SUD) treatment access, especially in under-resourced communities. This study aimed to comprehend the experiences of under-resourced women with SUD during the pandemic, their knowledge and attitudes toward it, and its impact on substance use and treatment access.

METHODS: A cross-sectional study included 66 under-resourced women receiving medically managed withdrawal treatment at a community residential SUD center. Data collection occurred between November 2021 and August 2022, utilizing a 75-item instrument covering COVID-19 exposure and its impact on health, substance use, treatment access, vaccination status, beliefs, and knowledge. Descriptive …

Current Practices In Clinical Supervision In Primary Care, Stacy A. Ogbeide, Cory Knight, Alex Young, Deepu George, Brittany Houston, Maribeth Wicoff, Yajaira Johnson-Esparza, Gabriela Gibson-Lopez

School of Medicine Publications

The purpose of this study was to examine current clinical supervision practices within primary care settings. We used a descriptive survey design, which blends quantitative and qualitative data, and examined the current state of clinical supervision practices and approaches in primary care and the type of training the behavioral health consultants received to provide supervision to pre-licensure level behavioral health trainees. Ninety-four participants completed the survey in 2022. Seventy-one percent of respondents felt they had adequate training to be an effective integrated behavioral health (IBH) supervisor; however, most training came from sources, such as workshops, continuing education, or supervision of …

Once, I Was Very Very Scared And More: An Exploration Into Depictions Of Interpersonal Trauma In Children's Literature, Emma K. Siepmann

University Honors Theses

This thesis examines the ways in which experiences of interpersonal trauma are depicted in English-language contemporary literature for elementary-aged children (6-11 years). A review of academic literature suggests that interpersonal trauma can have devastating and ongoing repercussions for individuals and their communities, although establishing a sense of relational safety can help mitigate these effects and facilitate healing after a traumatic experience. This research explores age-appropriate literature as a therapeutic tool for developing relational safety and providing critical skills to children at risk for and recovering from interpersonal trauma. This study analyzes the depictions of interpersonal trauma found in 11 picture …

Family Fragments: Pressure And Proximity In First-Episode Psychosis, Cassandra B. Seltman

Dissertations, Theses, and Capstone Projects

This study explores the value of assuming a position that decenters the identified patient in families with a member with schizophrenia. Instead, a systemic view of the family is taken, as subject to pressures from without and within, and utilizing observable processes for the management and discharge of tension. It attempts the difficult balance of thinking dynamically without sacrificing scientific rigor, considering the social without discounting the biological, and exploring the functionality of the family without collapsing into blame, reductive cause-and-effect thinking, and the search to prioritize one true origin.

When treating family members as discrete units around an identified …

Determining Factors For Improved Uptake Of Harm Reduction Services In The United States: A Study Of Inclusive, Culturally Sensitive Messaging, Lauretta Ekanem Omale

Dissertations

Harm reduction refers to public health policies and programs aimed at decreasing the adverse consequences associated with drug use. While harm reduction services (e.g., syringe exchange programs) can mitigate health risks, marginalized groups face barriers to service access and utilization, partially due to ineffective messaging approaches that fail to align with cultural values and experiences. A one-size-fits-all approach to messaging can negatively impact service utilization, health outcomes, and health disparities. Ineffective communication can lead to poor adherence to treatment, poorer health outcomes, and increased adverse events.

Culturally insensitive communication contributes to stigma, mistrust, and lack of perceived relevance, discouraging service …

Online Mental Health Help Seeking Behaviors Among College Students, Rachel Johnson, Monica Nandan, Brian Culp, Dominic Thomas

Faculty Articles

Even before the pandemic, utilization of online mental health resources continues to grow among young adults. There is limited research on online help seeking behaviors, let alone specific research on college students’ online mental health help seeking behaviors. This study aims to identify which terminology college students utilize on online search engines to seek assistance related to mental health. A cross-sectional survey design was used during the 2019-2020 academic year. The respondents consisted of 259 college students at one of the 50 largest public institutions of higher education in the Southeastern United States. Overall, the sample data suggests that college …

Conceptualizing Recovery From Mental Illness In Indonesia: A Scoping Review, Flora Cohen, Agus Sugianto, Hans Pols, Clement Bayetti

Makara Human Behavior Studies in Asia

Understanding how recovery is defined and realized across different cultural contexts is vital to upholding the dignity and rights of people with mental illnesses. Within the Indonesian context, there is a dearth of research on conceptualizations of recovery from mental illnesses. Questions remain regarding the extent to which service users and providers share common definitions of recovery. We conducted a scoping review to interrogate current definitions of recovery from the perspectives of the various actors working with people with lived experiences of mental illness and extreme mental distress. We found that definitions of recovery differ across multiple domains and include …

Charting A Path To The Quintuple Aim: Harnessing Ai To Address Social Determinants Of Health, Yash Shah, Zachary Goldberg, Erika Harness, David Nash

College of Population Health Faculty Papers

The Quintuple Aim seeks to improve healthcare by addressing social determinants of health (SDOHs), which are responsible for 70-80% of medical outcomes. SDOH-related concerns have traditionally been addressed through referrals to social workers and community-based organizations (CBOs), but these pathways have had limited success in connecting patients with resources. Given that health inequity is expected to cost the United States nearly USD 300 billion by 2050, new artificial intelligence (AI) technology may aid providers in addressing SDOH. In this commentary, we present our experience with using ChatGPT to obtain SDOH management recommendations for archetypal patients in Philadelphia, PA. ChatGPT identified …

Psychological Safety Of Pre-Licensure Nursing Students: A Longitudinal, Qualitative Study, Laura Butler

Theses and Dissertations

Background: Previous studies have explored the concept of psychological safety among pre-licensure nursing students; however, the literature is notably sparse on personal descriptions of pre-licensure nursing students' experiences of psychological safety in clinical settings. Individual descriptions of psychological safety will provide added insight and understanding about the elements that shape psychological safety in pre-licensure nursing students. Objectives: This research aimed to longitudinally explore pre-licensure nursing students' experiences of psychological safety during clinical rotations and how their experiences of psychological safety change over time. Methods: This study used a longitudinal, qualitative, descriptive approach. Participants were recruited from a nursing program in …

Improving Obesity And Related Chronic Disease Outcomes: Developing Nurse Practitioner Competence In Motivational Interviewing, Jodi Wilson

Doctor of Nursing Practice Final Manuscripts

Background: Despite America’s persistent focus on health, over 40% of the US population is obese. A significant obstacle to mitigating disease in those with obesity is inspiring lasting behavioral change. Motivational Interviewing (MI) is highly effective yet under-utilized for catalyzing personal change inertia. Recent meta-analyses demonstrated statistically significant improvement in BMI, A1C, and blood pressure. Objectives: This evidenced-based project (EBP) aimed to develop nurse practitioner (NP) skills in deploying fidelity-based MI, resulting in increased adherence to lifestyle interventions. Implementation: This EBP project implemented MI into routine primary care through a self-paced healthcare provider MI certification and a 45-minute skill …

Honoring Veterans’ Wishes: Efficacy Of An Evidence-Based Shared Decision-Making Tool In Va Icu Goals-Of-Care Discussions, Stephanie Alexander, Anna Astashchanka Md, Venktesh Ramnath Md

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This Doctor of Nursing Practice project aimed to enhance the knowledge and confidence of the San Diego Veterans Health Administration’s (VASD) Intensive Care Unit (ICU) medical providers in goals-of-care discussions (GOCD). Additionally, this project aimed to improve the documentation of these discussions.

Background: Delays in GOCD can lead to futile medical and surgical interventions, inappropriate antibiotic use, and higher rates of mental health conditions in patients and their loved ones. Earlier GOCD are associated with lower ventilation and resuscitation rates, earlier hospice enrollment, reduced ICU admissions, lower financial costs, and better patient and caregiver quality of life. However, …

Covid-19 Vaccine Motivation And Hesitancy Among A Sample Of African American, Afro-Caribbean, And African Respondents In The United States, Shauna K. Elbers, Denise A. Vaughan, Yordanos M. Tiruneh

School of Medicine Faculty Publications and Presentations

Understanding the motivations and decisions behind COVID-19 vaccine acceptance is crucial for designing targeted public health interventions to address vaccine hesitancy. We conducted a qualitative analysis to explore COVID-19 vaccine acceptance among diverse ethnic subgroups of Black Americans in the United States. This study investigates the 2021–2022 responses of 79 African American, Afro-Caribbean, and African respondents over the age of 18 in Washington State and Texas. Respondents were asked “Do you plan to get the COVID-19 vaccination?” Qualitative responses were analyzed by content category and ethnic subgroup. Of the 79 responses, 60 expressed favorable perceptions, 16 expressed unfavorable perceptions, and …

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

Mentorship Matters: Promising Results From Vpha’S Pilot Mentorship Program, Ashley Tharpe, Stacey B. Plichta, Anna R. Robertson, Kim Baskette

Virginia Journal of Public Health

Purpose

The Virginia Public Health Association (VPHA) Pilot Mentorship Program seeks to support public health students, early career professionals, and career switchers throughout the Commonwealth of Virginia in their growth as public health professionals. The program provides opportunities for participants to gain job-seeking and professional communication skills through live webinars, to connect with each other through online networking events, to manage stress through wellness webinars, and to interact with experienced public health professionals.

Methods

VPHA formed a volunteer committee to develop and implement the program in Fall 2022. Initially, the program was envisioned as a traditional one-to-one mentoring program; however, …

Assessing Health Needs In A Dominican Republic Community During An Interprofessional Service-Learning Trip, Gabriela Andonie, Hanna Rotundo, Ashanti Jones, Logan Dugas, Shylon Francis

Journal of Interprofessional Practice and Collaboration

Purpose: International medical missions may increase access to medicines and care, but international teams must understand local needs to implement appropriate services. In 2023, a multidisciplinary team from our institution partnered with a nonprofit organization in the barrio of Cienfuegos, Dominican Republic with the goal of strengthening local health services. The primary objective of this study was to identify health-related needs in Cienfuegos from the perspective of community members and local health care workers.

Methods: A qualitative study was conducted as part of a service-learning initiative. After obtaining informed consent, the investigators conducted individual semi-structured interviews facilitated by multi-lingual interpreters. …

Some Kind Of Unfolding: A Micro- To Macrosystemic Exploration Of The Emic Experiences Of Formerly Incarcerated Mothers, Mary Anne Gunter Phd Lpc Lmft

Journal of Interprofessional Practice and Collaboration

Problem

The incarceration of women has increased exponentially in the past 40 years. Over 80% of incarcerated women are mothers separated from their children. A mother’s incarceration can impose a destabilizing influence upon an already fragile family system.

Significance

Incarcerated mothers have been inconsistently provided supportive rehabilitative programs, which have demonstrated a correlation to decreased recidivism.

This qualitative study conducted semi-structured interviews that explored the phenomenological experiences of eight disenfranchised incarcerated mothers who were separated from their children, as well as of their experiences of a carceral setting and involvement with prison programs.

Implications

Thematic analysis of the data revealed …

Why Spiritual Leadership Matters In A New Physical Therapist Education Program, Ondrell S. Moore

Journal of Interprofessional Practice and Collaboration

Abstract

Physical therapists (PTs) function with a set of core values established to guide these rehabilitation specialists in providing person-centered care to diverse populations. Spiritual leadership aligns with the core values for the physical therapist. As community leaders and advocates, PTs are positioned to address health disparities that disproportionately affect rural communities and racial and ethnic minority groups. Physical therapist education programs that train student physical therapists to provide equitable care across cultures should reflect the diversity espoused by the American Physical Therapy Association (APTA). This article examines the impact of leadership in building a culture of belongingness and discusses …

Initiating Access To Palliative Care Earlier In Pediatric Oncology Patients, Anita Sharma

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Pediatric oncology patients should be referred to palliative care early but despite research indicating the clear benefits, there is still a delay in referring patients. One of the reasons include lack of understanding amongst providers on what palliative care is. Palliative care provides symptom management, emotional support and helps the patient and family with difficult decision making.

Objectives: This project aimed to increase the number of early referrals to palliative care. The Pediatric Palliative Care Screening Tool (PaPas) was utilized to help identify the triggers which should prompt the referral.

Methods: A chart review of patients diagnosed with …

A Trauma-Informed Socially Just Approach To Working With Juvenile Justice-Involved Youth Utilizing Expressive Arts Therapy, Ciara Carr

Expressive Therapies Capstone Theses

Youth involved with the juvenile justice system often have a history of trauma and oppression resulting from their positionality and circumstances. Most juvenile justice-involved youth are boys, youth of color, low-income, LGBTQIA2S+, disabled, and traumatized. This literature review explores the history of the juvenile justice system, issues with the present-day model, and trauma-informed and transformative justice approaches to practice. The implementation of socially just, trauma-informed expressive arts therapy programs is proposed as a more equitable practice to replace commonly used punitive practices across the United States. More research is needed to understand the impact of such programs on this population …

Art Therapy Meets Dungeons And Dragons: Supporting The Development Of Social Skills In High School Students, Ben Li

Expressive Therapies Capstone Theses

This arts-based research explores the current literature on the clinical uses of Dungeons and Dragons (D&D) using art and play therapies. Previous studies that intersect with D&D and expressive arts interventions have been traditionally focused on drama and play therapies while this study focused on open studio practices based on art therapy methodologies. D&D in clinical settings has been effective in developing social connection between peers and emotional regulation. A 10-week art therapy group was conducted in a school setting with adolescents with academic anxiety, socioemotional disabilities, and developmental disabilities. The author provided a space for participants to create art …

Tap Dance Therapy For Children With Medical Complexity: A Literature Review, Beth Calabrese

Expressive Therapies Capstone Theses

Although various genres of dance and movement have been studied to serve as therapeutic tools for individuals, research on tap dance for children with serious illnesses and complex medical needs is near non-existent. This thesis aims to analyze the available literature on tap dance and dance/movement therapy for children, as well as identify gaps in research in service of improving the quality of lives and mental health of children with medical complexity (CMC). Additionally, a discussion of a possible tap dance therapy (TDT) program for children with special needs related to medical complexities will be introduced, which will include evidence-based …

Utilizing Flow Arts Movement As An Expressive Arts Therapy Tool To Treat Trauma: A Literature Review And Autoethnography, Shannon Mcgrail

Expressive Therapies Capstone Theses

This expressive arts-based autoethnography research explores the effectiveness of using flow arts movement as a tool of expressive arts therapy to treat symptoms of trauma for individuals who experienced a traumatic event in their lifetime. While research on the use of flow arts movement to treat mental illness is in its early stage, much can be drawn from the literature on expressive arts therapy and dance/movement therapy research with a range of populations addressing trauma. Through exploration of trauma through neuroscience, mind, body, and integrated mindfulness through flow, this work aims to bring an understanding of using intermodal expressive arts …

Re-Member Selfhood A Drama Therapy Intervention, Option 1, Angelique Beauchêne

Expressive Therapies Capstone Theses

Re-member Selfhood is a specific trauma-informed, drama therapy, intervention designed to meet the needs of adults with exposure to trauma and traumatic stress, who have pertinent adverse childhood experience scores and/or experience persistent trauma cycles over the lifespan concurrent with somatization. The aim of this thesis was to introduce an intervention which could function as indirect exposure and assist in the integration process taking the whole being of trauma sufferers into account, including body, mind, and soul. Additionally, the hope of this intervention is to decrease perceived physical pain, assist in the integration of the rejected aspect of self, and …

Playing With International Students From Asia: An Exploration Of Cultural Commonalities And Differences In Developmental Transformations (Dvt), Hazuki Okamoto

Expressive Therapies Capstone Theses

Asian international students in the United States face a multitude of challenges such as language barriers, differences in cultural norms and behaviors, and identity confusion while navigating a foreign landscape. Developmental Transformations (DvT), a form of drama therapy, may apply to these challenges by enabling participants to explore different identities and express themselves creatively beyond the language barrier. This community engagement project was designed for Asian international students to be seen and heard by utilizing DvT. Within an in-person workshop, five participants played with their shared stories, and explored international and cultural roles in group DvT. Key takeaways from the …

This (Dis)Abled Person: Professional Receptiveness Towards Future Slps With Disabilities, Billy Allen

Theses & Honors Papers

With increasing levels of diversity within the United States, having the field of speech-language pathology better reflect and represent the changing demographic shifts in society is critically important. Little attention has been given toward the prospect of individuals with disabilities serving in the field despite focused efforts to increase the presence of professionals from racial, ethnic, and cultural backgrounds. This study investigated the receptiveness of practicing speech-language pathologists (SLPs) or communication sciences and disorders (CSD) graduate faculty towards the prospect of individuals with disabilities working as SLPs within the field or entering graduate-level CSD programs. A survey collecting quantitative data …

Raising The Bar: Optimizing Peripartum Handoff Through Standardized Nurse Knowledge Exchange (Nke), Kimberly Martinez Rn

Master's Projects and Capstones

Problem Hospital X’s peripartum microsystem has no policy guiding the Nurse Knowledge Exchange (NKE) process. Variability in handoffs during patient transfers could lead to medical errors and adverse events. This quality improvement (QI) project aims to pilot a standardized handoff guide to improve nurse communication and avoid adverse patient outcomes following patient transfers. Context The setting for this QI project was a peripartum mesosystem at an urban hospital located in Northern California with 21 postpartum rooms and nine labor rooms. Intervention The project employed a systematic approach that involved engaging stakeholders, analyzing microsystems, reviewing literature, and analyzing data to identify …