Digital Commons Network^™

Quality Improvement Project: Improving Interdisciplinary Care In Nursing Education Through Simulation, Anna Williams

Doctor of Nursing Practice Projects

Interprofessional education (IPE) is essential in preparing nursing students for effective teamwork and communication in clinical practice and is supported by the literature as improving these outcomes. However, limited faculty training in interprofessional simulation design contributes to reduced IPE opportunities within nursing curricula. A needs assessment at the project site identified a lack of structured, hands-on training for simulation faculty, resulting in decreased faculty confidence and limited implementation of IPE simulations. The purpose of this quality improvement project was to evaluate whether a structured training intervention improved simulation faculty self-efficacy in developing and implementing IPE simulations. Bandura’s Self-Efficacy Theory guided …

Quality Improvement Project: Evaluating The Impact Of Provider Education On Sbirt On Screening For Suds, Faith Ogala

Doctor of Nursing Practice Projects

Substance use disorder (SUD) is a serious public health issue in people with psychiatric disorders. However, diagnosis and treatment are often delayed, leading to poor treatment outcomes and increased social and economic costs. The purpose and aim of this Doctor of Nursing Practice (DNP) project was to educate providers on the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model to facilitate the timely diagnosis of SUDs in patients with dual diagnoses. The key outcomes were provider knowledge and SBIRT implementation rates. The Donabedian Model of Healthcare Quality assessed the outcomes, whereas Lewin’s Change Model guided implementation. The project employed …

Assessing The Feasibility Of Integrating Occupational Therapy Services Within A Pediatric Primary Care Setting For Children 0-3 Years Old., Amanda L. Wilbert, Cristina Dumitrescu, Kim Karr

Post Professional Occupational Therapy Doctoral (PPOTD) Student Capstone Projects

The objective of this capstone project was to assess the feasibility of implementing occupational therapy (OT) services within a pediatric primary care office using a manualized service delivery approach. Occupational therapy is inherently grounded in parent coaching and education, positioning the profession to play a critical role in supporting families and promoting early identification of developmental risk. This project aimed to address a documented gap in the inclusion of OT within pediatric primary care by exploring how OT services can support parenting skills and monitor children identified as at risk for developmental, behavioral, or psychosocial concerns. The project was conducted …

Prenatal Care Access And Pregnancy Outcomes Among Black Women Ages 15–44 In Cook County, Illinois, Deandrea Heggins

Walden Dissertations and Doctoral Studies

Maternal health disparities affecting Black women in the United States remain a persistent public health concern due to inequities in prenatal care access and adverse birth outcomes. Prior research has shown that socioeconomic conditions, insurance coverage, and systemic barriers influence prenatal care utilization and maternal outcomes; however, limited research has examined how Medicaid coverage, household income, preterm birth, and birth weight are collectively associated with prenatal care access among Black women in Cook County, Illinois. The purpose of this quantitative correlational study was to examine the relationships among these factors and access to prenatal care among Black women ages 15–44 …

Beyond Symptoms: A Narrative Counseling Interpretation Of First-Year Student Anxiety In Indonesian Higher Education, Azizah Abdullah, Rizky Andana Pohan, Ramtia Darma Putri, Triyono Triyono, Marimbun Marimbun, Rahmi Dwi Febriani

Buletin Konseling Inovatif

The transition to higher education is a critical period in which first-year students face new academic demands, financial pressures, social adjustment challenges, and uncertainty about the future. However, limited research has examined how freshmen make sense of and narrate their anxiety, particularly in the Indonesian context. This study aimed to explore the main domains of anxiety among first-semester students in Indonesian public universities and to interpret these experiences through a narrative counseling lens. The study employed a qualitative online survey design with an interpretivist orientation. Data were collected from 199 first-semester students through open-ended questions addressing anxiety-provoking situations, sources of …

Implementing A Self-Administered Crafft Screening Tool In A Pediatric Mental Health Setting, Michael Nguyen

Doctoral Dissertations & Projects

Background: Adolescent substance use disorders (SUDs) require early identification in inpatient psychiatric settings, but inconsistent screening workflows limit systematic detection.

Aims: This quality improvement project evaluated implementation of the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) 2.1 screening tool to improve identification of adolescents at risk for SUDs and support multidisciplinary communication.

Methods: CRAFFT 2.1 screening was embedded into admission workflows for adolescents admitted to two inpatient psychiatric units. Admission nurses distributed self-administered forms during admission. Completed screenings were scored and entered into the electronic medical record. Scores were categorized as low (0), medium (1), or high (≥2). High-risk results …

Barriers Asian Adoptees Face In Screening For Inheritable Conditions Due To A Lack Of Family Medical History, Anna Shea

Honors Projects

Adoption has been increasingly common in the United States, with more than 7.8 million people in the United States adopted (Wexler et al., 2025) and over 280,000 children in the United States adopted internationally (Orr et al., 2024). Despite this, those who are adopted, especially internationally, often face medical disadvantages compared to those biologically related to their family. The differences in treatment between adoptees and those who are biologically related are largely due to the knowledge, or lack of knowledge, of the individual’s family medical history and genetic information. Genetic or inherited disease screening is often only completed or covered …

Food Reintroduction After Negative Ofcs In Pediatrics: Dietary Frequency And Caregiver Attitudes, Olivia Pietrantozzi

Honors Projects

Food allergies in pediatric populations have been gradually increasing in prevalence and present significant nutritional risks requiring strict dietary management and psychosocial challenges. Oral food challenges (OFCs) serve as a gold standard in diagnosing food allergies and determining whether allergenic foods can be safely reintroduced to an individual's diet. However, caregivers of children may still experience anxiety and barriers that delay the reintroduction of foods, which can limit diet diversity and increase the child's risk of future allergy development. This study looked to evaluate the dietary frequency of allergenic food reintroduction following negative OFCs, as well as to assess changes …

Questionnaire For Eudaimonic Well-Being: Psychometric Validation Among Malaysian Youth, Mohd Ahsani A. Malek, Nurulwahida Saad, Suzana Mohd. Hoesni, Muhamad Ariff Ibrahim, Nurul Shafira Adi, Mohd Nazir Mohd Nazori

Makara Journal of Health Research

Background: The rising prevalence of mental illness underscores the need to understand how individuals can live and flourish under such conditions. In Malaysia, research has largely emphasized diagnosis and treatment, with limited focus on positive psychology and few validated instruments. This study aimed to translate and validate the questionnaire for eudaimonic well-being (QEWB) among Malaysian youth.

Methods: The QEWB was translated into Malay using back-to-back translation and administered to undergraduates from four public universities through a cross-sectional survey design. Convenience quota sampling was used, resulting in 229 respondents completing the online form to measure sociodemographic characteristics, eudaimonic well-being, …

Relationships Between Adolescents With Substance Use Disorders, Their Guardians, And Expressive Arts Therapy: A Literature Review, Sarah K. Unkefer

Expressive Therapies Theses

This literature review collects the comprehensive, current research around effective treatment of adolescents with substance use disorder (SUD) and explores ways to provide psychoeducation for the adolescent and their guardians to foster healthy relationships and open communication. This author explores the ways that expressive arts therapy influences treatment and long-term recovery of adolescents with substance use disorders (SUDs) by addressing familial communication and internalized stigma. Previous studies have shown that the current primary reaction from guardians is forcing abstinence, which often damages the adolescent-guardian relationship. Since this is one of the most important relationships in an adolescent’s projected recovery journey, …

Evaluating An Lgbtq+ Adolescent Sexual Health Toolkit: Boosting Confidence And Provider Knowledge, Joslyn Lypka

Doctoral Dissertations & Projects

When leveraged correctly, sexual health education empowers youth to build resilience, deepen self-understanding, and confidently navigate gender and sexual identities. However, many school-based programs emphasize cisgender and heterosexual norms, leaving LGBTQ+ adolescents with limited access to inclusive and affirming sexual health information. This project aimed to develop and evaluate an online sexual health education toolkit designed to increase knowledge and support self-advocacy among LGBTQ+ adolescents, parents/caregivers, and healthcare providers. In collaboration with a Midwest nonprofit organization serving sexual and gender-diverse individuals, an online toolkit was developed and evaluated using two sequential Plan–Do–Study–Act (PDSA) cycles. During the first cycle, subject matter …

Quality Improvement Project Enhancing Maternal Health Outcomes: Evaluating The Impact Of Universal Social Determinants Of Health (Sdoh) Screening In An Interdisciplinary Pregnancy Care Model, Shannon Morgen

Doctor of Nursing Practice Projects

Social determinants of health (SDOH), including housing instability, food insecurity, transportation barriers, and interpersonal violence, significantly influence maternal outcomes and contribute to disparities such as preterm birth and maternal morbidity. Despite national recommendations for universal SDOH screening, implementation in prenatal care remains inconsistent, limiting opportunities to identify and address social needs. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement and evaluate a standardized SDOH screening and documentation process to improve referral completion and examine its impact on hospital readmissions among obstetric patients. Guided by Bronfenbrenner’s Socio-Ecological Model and the Plan-Do-Study-Act framework, the project …

From Browsing To Building: Navigating Your Google Resource Space (Drive & Site), Libby Cunningham

Capstone Projects

This capstone project aimed to develop a trauma-informed, evidence-based support hub for Court Appointed Special Advocates (CASA) working with children involved in the foster care system. CASA advocates are frequently exposed to secondary trauma, burnout, and compassion fatigue, which can impact their effectiveness and overall well-being. Additionally, trauma exposure significantly affects children’s emotional regulation, behavior, and participation in daily occupations. The primary objective of this project was to design, develop, and organize a comprehensive digital resource platform tailored to the needs of Kalamazoo CASA and their active cases. Utilizing evidence-based literature on trauma-informed care and secondary trauma, relevant resources were …

The Missing Link Between Occupational Therapy And Hemodialysis: Program Development And Implementing Intradialytic Ot In A Rural Hospital Setting, Madison Maki

Capstone Projects

Occupational therapy (OT) has demonstrated effectiveness in supporting individuals undergoing hemodialysis, a life‑altering yet lifesaving treatment for end‑stage renal disease (ESRD) and chronic kidney disease (CKD). Despite this, hospitalized patients who require dialysis often receive reduced rehabilitation services due to the time‑intensive nature of dialysis and the productivity demands placed on therapists. Additionally, gaps in therapist knowledge regarding the unique functional deficits and educational needs of this population further limit service delivery.

This doctoral capstone project (DCE), conducted at Upper Peninsula Health System (UPHS), a hospital in rural Northern Michigan, addressed these barriers through the development of a comprehensive resource …

Exploring Occupational Therapy’S Role In Addressing Mental Health Disparities And Emergency Service Utilization Among Homeless Populations: A Comprehensive Review, Megan Darnell

Capstone Projects

Occupational Therapy (OT) is a healthcare profession focused on enabling individuals to engage in meaningful activities and roles through a client-centered approach. This doctoral capstone experience (DCE) was completed in the Emergency Department (ED) at Bronson Methodist Hospital, where individuals experiencing homelessness frequently present with unmet mental health needs. A gap was identified in the accessibility and utilization of community-based mental health and social resources, contributing to repeated ED utilization. The purpose of this DCE was to examine how resource provisions impact the frequency of ED visits and engagement with community mental health services among this population. Objectives include developing …

Exploring Systemic Challenges In The Western North Carolina Dental Safety Net: A Qualitative Analysis, Blaire Mirmow, Bill Milner, Nadia Laniado

Journal of Appalachian Health

Introduction: Despite statewide growth, rural communities in Western North Carolina (WNC) face persistent barriers to oral health care driven by chronic dental workforce shortages and systemic geographic disparities. Within this Appalachian region, the dental safety net serves as a vital yet strained support system, struggling with limited financial resources and a lack of provider participation that leaves many underserved populations without essential oral health services.

Purpose: This study aims to explore the experiences of individuals working within the WNC dental safety net to identify barriers and strategies required to strengthen the delivery of oral health care in high-need rural settings. …

From Stories To Speech: Cultivating Cultural Competence And Linguistic Awareness In Future Slps, Alexis Lawton

Teaching and Learning in Communication Sciences & Disorders

This manuscript reports on a pilot study examining how storytelling and linguistic diversity may cultivate cultural competence in graduate students in speech-language pathology (SLP). Through engagement with traditional folk tales, students explored the cultural significance of narratives and the linguistic features that shape them. The assignment emphasized adapting stories for diverse audiences while highlighting culturally relevant vocabulary, dialectal variations, and the complexities of language use. Facilitated discussions following student presentations prompted reflections on how these elements influence communication and understanding. Preliminary findings suggest that narrative exploration can foster both cultural and linguistic awareness, equipping students with emerging skills to provide …

The Development Of The Retire Well Program For First Responders, Boguslawa T. Syrotiak, Noralyn Davel Pickens, Cynthia Evetts

The Open Journal of Occupational Therapy

Background: First responders experience challenges during retirement transition because of exposure to stress and trauma on the job and a high level of identification with their work. Our objective was to develop a client-centered retirement transition program for first responders and their families.

Method: Using a participatory research approach, data were collected from two focus groups of health care providers and retired first responders and analyzed using a content analysis approach.

Results: Data yielded themes and subthemes leading to the development of an outline of a retirement transition program: The Retire Well program, an occupation-based program that …

Innovations In Developing Behavioral Health Care Managers Within Collaborative Care Programs, Jesse K. Allen-Dicker, Virginia Kelly Arlt Mutch, Derek M. Tate

The Journal of Integrated Primary Care

The collaborative care model is an effective method to treat adults with depression and other psychiatric symptom presentations within primary care settings. Research suggests that patients treated by more experienced behavioral health care managers receiving consistent supervision experience greater symptom relief. Supervision is an essential and widely accepted component of the collaborative care model, though minimal guidance has been offered on how to best implement supervision and foster behavioral health care manager development within these programs. The present paper highlights the approach developed by a collaborative care program with an emphasis placed on consistent and frequent consultation and supervision and …

Six Departments Move Into New Building, Una Alumni Association

Documents

Alumni News article discussing the early stages of Stevens Hall, then known as the Education and Nursing Building, and its impact on the School of Nursing, School of Education, and Departments of Social Work, Sociology, Foreign Languages, and Political Science.

New Building Houses Education And Nursing, University Of North Alabama

Documents

Article from the 1979 Resume of UNA discussing the Education and Nursing Building, now known as Stephens Hall, as well as the accreditation of the Schools of Nursing and Education.

Life Skills For Individuals In A Juvenile Detention Center, Carrington Brown

Student Capstone Papers

This capstone project involved the development, implementation, and evaluation of a life skills program for justice-involved youth in a juvenile detention setting. Guided by a needs assessment, the program targeted financial literacy, job readiness, professionalism, and soft skills through structured sessions incorporating education, interactive activities, and group discussion. Findings from pre- and post-surveys and qualitative feedback indicated improved knowledge, confidence, and readiness for community reintegration, supporting the value of rehabilitative, occupation-based programming.

Predictors Of Stress Among Bsw And Msw Students At Fhsu, Octavio Ramirez, Annette Clarke Jones

SACAD: Scholarly Activities

Chronic stress leads to severe health consequences, including anxiety, depression, burnout, and physical issues like fatigue and sleep disturbances. This study examined factors predicting stress among a sample (n = 101) of BSW and MSW students attending FHSU. The findings showed that sexual orientation, academic grade point average, and marital status were significant predictors of stress among this sample.

Exploring The Role Of Cine-Virtual Reality In Empathy And Awareness Of Social Determinants Of Health Among Occupational Therapy Students, Leah M. Stade, Madison Mckeever, Emma Gardner, Jana L. Wardian Phd

Innovations in Health Sciences Education Journal

Understanding social determinants of health (SDOH) is crucial for Occupational Therapy students to develop empathy and deliver optimal healthcare. This study explores using web-based 360° cinematic virtual reality (cine-VR) simulations in Level I fieldwork to address SDOH education and occupational engagement before community-based exposure.

This mixed methods study involved surveys and thematic analysis of written reflections from fifty students in a distance-based program at a Midwest university. Students viewed 12 web-based immersive cine-VR modules about a client experiencing multiple SDOH impacts. Surveys were conducted at baseline, post-intervention, and 6-weeks post-intervention, measuring empathy using the Jefferson Empathy Scale and attitudes toward …

Can The Implementation Of The Pause Decrease Death Anxiety And Poor Mental Health In Practicing Nurses?, Lilli Meyer

Undergraduate Theses

Practicing nurses are frequently exposed to patient death, placing them at increased risk for death anxiety and compromised mental health. Despite this, there remains a lack of structured, in-the-moment interventions to support emotional processing within clinical settings. This study evaluates whether the implementation of “The Pause,” a brief moment of silence following a patient’s death, may reduce death anxiety and improve mental health outcomes among practicing nurses. A quantitative survey consisting of eight questions was distributed to nurses in the Louisville, Kentucky area over a three-month period, yielding 26 responses. Findings indicated that 80.8% of participants reported no improvement or …

Community As Coping: Mental Illness And Homelessness Within A Tent Camp, Karen A. Snedker, Jennifer Mckinney

Sociology Faculty Articles and Research

"Drawing from interview data with residents of Tent City 3, a sanctioned homeless camp, we illustrate the complex connections between mental illness and homelessness from the residents’ perspectives to understand how living in this tent city helps residents manage mental health."

Using Somatic Experiencing To Mitigate Symptoms Of Secondary Traumatic Stress In Female Helping Professionals, Jillian Christie Guinta

Doctoral Dissertations and Projects

This phenomenological and quantitative study explored the lived experiences of a dozen women within the veterinary, social work, and nursing communities and how secondary traumatic stress impacts their lives. Faced with unanticipated patient illnesses, facilitating compassionate end-of-life procedures, and rapidly moving from one emotional state to the next between patients, professionals are carrying tremendous unprocessed emotional burdens that can affect them physiologically and psychologically. Somatic Experiencing (SE) indicates tremendous promise in rehabilitating practitioners’ trauma-impacted nervous systems by offering techniques to release emotional stress and re-regulate the nervous system (Kuhfuß et al., 2023). This mixed-methods study explored the world of these …

Mental Health Rates Across Ethnic Groups In A Small Midwestern Christian University, Arianna Torres

Honors Theses

This study aims to find if there is a significant difference in depression, anxiety, trauma, and suicidality among students of different ethnic backgrounds at Andrews University. By focusing on ethnic disparities, this research aims to target the mental health issues rising among college students and bring to light the importance of cultural competency in relation to mental health. Results from this study may aid Andrews University in developing more inclusive and culturally responsive mental health services and inform broader discussions about mental health equity in higher education. It can also add insight into how mental health rates may vary by …

Implementing Measurement-Based Care In Virtual Mental Health Services For Rural Veterans: Provider Insights From A Pre-Implementation Evaluation, Amanda Heeren, Kimberly Mccoy, Lindsey Fuhrmeister, Natalie Suiter, Jan A Lindsay, Chloe Hoang, Laura Marsh, John Fortney, Carolyn Turvey

Faculty, Staff and Students Publications

Background

Measurement-Based Care (MBC) uses repeated standardized psychological assessments to monitor treatment progress and guide clinical decision-making. Although MBC improves outcomes when results are discussed collaboratively, adoption across the Veterans Health Administration (VHA) remains below 50%, particularly in virtual and rural settings. This pre-implementation evaluation explored provider perspectives to inform development of a digital MBC workflow for rural tele-mental health settings.

Methods

Using the Alacrity Center’s Discover, Design, Build, and Test model and User Centered Design, we conducted a pre-implementation survey of mental health providers at a VHA Medical Center providing care to rural and highly rural Veterans in South …

The Role Of Community Health Workers In Rural South Carolina, Sarah W. Haselden

Senior Theses

This paper aims to explore the role of Community Health Workers (CHWs) in rural South Carolina through a literature review as well as the data supplied from the Community Health Alignment Initiative (CHAI) and Community Health Workers Changing Outcomes in SC (CCOSC). Through reviewing the collection of materials and data, the effectiveness of CHWs can be studied. Community Health Workers (CHWs) provide a unique aspect to primary care within communities through their aid in prevention of health conditions. CCOSC and CHAI collected data throughout South Carolina to determine the needs of communities and how CHWs can work to address those …