Digital Commons Network^™

Effectiveness Of Cognitive Behavioral Therapy Versus Therapeutic Play For Hospitalized Children Diagnosed With Cancer: An Integrative Systematic Review, Dianne Kong

Theses and Dissertations

Psychotherapy provides essential coping mechanisms and strategies for children who are diagnosed with cancer, as they experience the extraordinary burden of physical, emotional, and mental strains. While many medical advancements have been made within the past few decades, progress related to psychotherapy for pediatric cancer patients has not been commensurate, evidenced by the limited current literature. Given the sparsity of relevant research, it is presently difficult to compare and evaluate the various psychotherapeutic interventions available for pediatric oncology patients. Additionally, there are significant challenges in providing psychotherapeutic care for patients and their families, including lack of consistency, disruption of care, …

The Use Of Dance And Movement For The Embodied Healing Of Interpersonal Trauma In Women And Girls: A Systematic Review, Catherine Xinyu Liang

Theses and Dissertations

Interpersonal trauma is a serious and devastating problem for women and girls from all walks of life. Research has shown that there are physiological consequences for experiencing trauma, and as such, treatment for trauma may need to target the body. Dance/Movement Therapy (DMT) has been emerging in the current literature as one body-oriented treatment approach that is effective in helping women and girls heal from interpersonal trauma. This review examines how practitioners are currently using DMT for this population, what treatment outcomes have been observed, and what the racial/ethnic identities and international contexts are for survivors who have benefited from …

Application Of Third-Wave Cognitive-Behavioral Interventions In The Treatment Of Obsessive-Compulsive Disorder, Emily Hanna

Theses and Dissertations

Obsessive-compulsive disorder (OCD) has a high comorbidity rate, with substantial risks for anxiety, mood, and substance use disorders. Exposure and response prevention (ERP) is considered the first-line psychotherapy treatment for OCD. While highly efficacious, not all patients achieve full remission with ERP, and given the chronicity of OCD and its sensitivity to stress-related events, many patients struggle with ongoing symptoms. A growing area of research has been the use of third-wave behavioral and cognitive therapies that potentially enhance patients’ willingness to engage with exposure-based treatment and provide strategies to cope with residual symptoms. This integrative systematic review summarizes and synthesizes …

Trust In Integrated Medical Care Using A Population-Based Normative Approach, Heather Summers

Theses and Dissertations

The role of integrated care partnerships in addressing health care and social needs to achieve whole person care is important as health care costs rise and quality of care outcomes are incentivized. Medicaid reform and 1115 Medicaid waiver programs are implemented statewide as innovative programs aimed at achieving cost savings and improved clinical quality of care outcomes. Understanding how cross sector partnerships can meet the needs of individuals through integrated care cross sectoral coordination between government, social services and managed care is needed. This research study examined the role of normative care values, vision, trust, shared care, and leadership. The …

Medication Initiation, Patient-Directed Discharges, And Hospital Readmissions Before And After Implementing Guidelines For Opioid Withdrawal Management, Jillian Zavodnick, Md, Nicolette M. Heinsinger, Angelo C. Lepore, Robert C. Sterling

Department of Medicine Faculty Papers

OBJECTIVES: Rising rates of hospitalization for patients with opioid use disorder (OUD) result in high rates of patient-directed discharge (PDD, also called "discharge against medical advice") and 30-day readmissions. Interdisciplinary addiction consult services are an emerging criterion standard to improve care for these patients, but these services are resource- and expertise-intensive. A set of withdrawal guidelines was developed to guide generalists in caring for patients with opioid withdrawal at a hospital without an addiction consult service.

METHODS: Retrospective chart review was performed to determine PDD, 30-day readmission, and psychiatry consult rates for hospitalized patients with OUD during periods before (July …

Training In Eight Low-And Middle-Income Countries: Lessons Learned From A Pilot Study Using The Who-Tdr Dissemination And Implementation Massive Open Online Course, Ashlin Rakhra, Victor Davila-Roman, Ana A Baumann, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Non-communicable diseases (NCDs) are a leading cause of morbidity and mortality in low-and middle- income countries (LMICs). Despite this, a lack of funding, training and mentorship for NCD investigators in LMICs exists. In an effort to gain knowledge and skills to address these gaps, participants from the Global Research on Implementation and Translation Science (GRIT), a consortium of studies in eight LMICs and their networks, attended the dissemination and implementation (D&I) massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases at the World Health Organization to strengthen D&I capacity building. Here, …

A Novel Approach For Assessing Bias During Team-Based Clinical Decision-Making, Natalie Pool, Megan Hebdon, Esther De Groot, Ryan Yee, Kathryn Herrera-Theut, Erika Yee, Larry A Allen, Ayesha Hasan, Joann Lindenfeld, Elizabeth Calhoun, Molly Carnes, Nancy K Sweitzer, Khadijah Breathett

2020-Current year OA Pubs

Many clinical processes include multidisciplinary group decision-making, yet few methods exist to evaluate the presence of implicit bias during this collective process. Implicit bias negatively impacts the equitable delivery of evidence-based interventions and ultimately patient outcomes. Since implicit bias can be difficult to assess, novel approaches are required to detect and analyze this elusive phenomenon. In this paper, we describe how the de Groot Critically Reflective Diagnoses Protocol (DCRDP) can be used as a data analysis tool to evaluate group dynamics as an essential foundation for exploring how interactions can bias collective clinical decision-making. The DCRDP includes 6 distinct criteria: …

Introducing Sonhr-Reporting Guidelines For Social Networks In Health Research, Douglas A. Luke, Edward Tsai, Bobbi J. Carothers, Sara Malone, Beth Prusaczyk, Todd B. Combs, Mia T Vogel, Jennifer Watling Neal, Zachary P. Neal

2020-Current year OA Pubs

OBJECTIVE: The overall goal of this work is to produce a set of recommendations (SoNHR-Social Networks in Health Research) that will improve the reporting and dissemination of social network concepts, methods, data, and analytic results within health sciences research.

METHODS: This study used a modified-Delphi approach for recommendation development consistent with best practices suggested by the EQUATOR health sciences reporting guidelines network. An initial set of 28 reporting recommendations was developed by the author team. A group of 67 (of 147 surveyed) experienced network and health scientists participated in an online feedback survey. They rated the clarity and importance of …

Development Of A Social And Environmental Determinants Of Health Informatics Maturity Model, Juan C Espinoza, Shruti Sehgal, Jimmy Phuong, Neil Bahroos, Justin Starren, Adam Wilcox, Daniella Meeker

2020-Current year OA Pubs

INTRODUCTION: Integrating social and environmental determinants of health (SEDoH) into enterprise-wide clinical workflows and decision-making is one of the most important and challenging aspects of improving health equity. We engaged domain experts to develop a SEDoH informatics maturity model (SIMM) to help guide organizations to address technical, operational, and policy gaps.

METHODS: We established a core expert group consisting of developers, informaticists, and subject matter experts to identify different SIMM domains and define maturity levels. The candidate model (v0.9) was evaluated by 15 informaticists at a Center for Data to Health community meeting. After incorporating feedback, a second evaluation round …

A Randomized Implementation Trial To Increase Adoption Of Evidence-Informed Consent Practices, Erin D Solomon, Jessica Mozersky, Melody Goodman, Meredith V Parsons, Kari A Baldwin, Annie B Friedrich, Jenine K Harris, James M Dubois

2020-Current year OA Pubs

INTRODUCTION: Several evidence-informed consent practices (ECPs) have been shown to improve informed consent in clinical trials but are not routinely used. These include optimizing consent formatting, using plain language, using validated instruments to assess understanding, and involving legally authorized representatives when appropriate. We hypothesized that participants receiving an implementation science toolkit and a social media push would have increased adoption of ECPs and other outcomes.

METHODS: We conducted a 1-year trial with clinical research professionals in the USA (

RESULTS: Participants who engaged more with the toolkit were more likely to have tried to implement an ECP during the trial …

Situating Implementation Science (Is) In Res(Is)Tance: A Conceptual Frame Toward The Integration Of Scholarship From The Black Radical Tradition, Cory D Bradley, Whitney C Irie, Elvin H Geng

2020-Current year OA Pubs

This manuscript undertakes a disciplinary self-critique of the field of implementation science, a field which attempts to bridge the gap between evidence-based interventions and their practical application. Despite the heightened emphasis on health equity and racial disparities, the field's current discourse is limited by key epistemic shortcomings. First, even though prevalence of implementation gaps between racialized groups in the United States necessitates a comprehensive understanding of the systems perpetuating these disparities, the field does not operate with a general explanation for disparities not as a failure of systems, but a system historically and structural designed to produce disparities. Second, the …

Achieving The Sdgs Targets: Women’S Autonomy And The Continuum Of Maternal And Child Health Services Utilization In Indonesia Using Idhs 2017, Izzun Nafiah, Omas B. Samosir, Prani Sastiono

Journal of Environmental Science and Sustainable Development

A reduction of child and maternal mortality is among the targets of the Sustainable Development Goals (SDGs), namely the third goal. An important determinant of child and maternal mortality risk is the utilization of maternal and child health (MCH). This study aims to analyze the relationship between women's autonomy and the continuum of MCH services utilization in Indonesia using IDHS 2017. The unit of analysis was women of childbearing age who were married or living together, gave birth to at least one child in the five years before the survey, and had the last child aged 1 to 3 years, …

A Prospective Analysis Of Sources Of Referral To A Student Run Free Clinic In Camden, Nj, Samir Shah, Anjali Desai, Behjath Jafry

Cooper Rowan Medical Journal

Background: A center for learning and a haven for minority, marginalized, and medically indigent patients, the student run free clinic (SRFC) has emerged as a cornerstone of care at many academic medical centers (AMC). However, little is known regarding the demographics of patients who utilize SRFC and the manner in which they come to know of the free and quality care available at SRFC .

Methods: Participants were administered a survey wherein they were asked their ethnicity, how they came to know of the clinic, and how long they have remained a patient at the Cooper Rowan Clinic (CRC) – …

Caregivers Of Elderly With Moderate To Total Dependence In Activities Of Daily Living In Yogyakarta Indonesia: Correlation Of Burden And Quality Of Life, The Maria Meiwati Widagdo, Lise Insani Gulo, Herose Cendrasilvinia, Widya Christine Manus

Makara Journal of Health Research

Background: Aging is accompanied by a functional decline leading to the loss of independence in conducting activities of daily living. The dependence of the elderly can cause burden that affects the quality of life of caregivers. This study aimed to assess the correlation between the burden and quality of life of caregivers looking after moderately to totally dependent elderly.

Methods: This research is a cross-sectional study that used Zarit Burden Interview to assess caregiver burden and World Health Organization Quality of Life to measure the quality of life of people caring for elderly with moderate to total dependence …

Promoting Rigor And Sustainment In Implementation Science Capacity Building Programs: A Multi-Method Study., Amy G Huebschmann, Shelly Johnston, Rachel Davis, Bethany M Kwan, Elvin Geng, Debra Haire-Joshu, Brittney Sandler, Demetria M Mcneal, Ross C Brownson, Borsika A Rabin

2020-Current year OA Pubs

BACKGROUND: The field of Implementation science (IS) continues to evolve, and the number and type of IS capacity building Programs (ISCBPs) are in flux. These changes push the field to revisit the accepted IS competencies and to guide sustainment of ISCBPs. Our objectives were: (1) compare characteristics of current ISCBPs; (2) identify recommendations to support ISCBP sustainment; (3) measure how often ISCBPs address IS competencies; (4) identify novel and important IS competencies for the field.

METHOD: This multi-method study included ISCBPs delivering structured, longitudinal IS training, excluding single courses and brief workshops. We used three complementary methods to meet our …

Hiv-Seropositive Patients’ Experiences With Social Workers: A South African Hiv+ Social Worker’S Reflective Log, Delarise Maud Mulqueeny

The Qualitative Report

Social workers play a pivotal role in HIV-seropositive patients’ treatment and care within South African public antiretroviral treatment (ART) programs. This article is a reflective log of an HIV-seropositive social worker’s observations and reflections on her positionality during a study on HIV-seropositive patients’ experiences of the public ART program in eThekwini, KwaZulu-Natal, South Africa. The primary investigator (PI) utilized various tools and techniques including reflexive bracketing, participatory action research and a reflexive diary to navigate a sensitive study. This was while being cognizant of the fluidity of her insider/outsider positionality. The disclosure of the PI’s HIV-seropositive status culminated in all …

Sodium Content And Labelling Of Packaged Foods And Beverages In Nigeria: A Cross-Sectional Study, Adedayo E Ojo, Mark D Huffman, Et Al.

2020-Current year OA Pubs

Increased consumption of unhealthy processed foods, particularly those high in sodium, is a major risk factor for cardiovascular diseases. The nutrition information on packaged foods can help guide consumers toward products with less sodium and support government actions to improve the healthiness of the food supply. The aims of this study were to estimate the proportion of packaged foods displaying nutrition information for sodium and other nutrients specified by Nigerian nutrition labelling regulations and to determine the amount of sodium in packaged foods sold in Nigeria using data from the nutritional information panel. Data were collected from November 2020 to …

Patient-Centered Outcomes Of An Emergency Department Social And Medical Resource Intervention, Rohit Gupta, Anthony Wang, Daniel Wang, Daniela Ortiz, Karen Kurian, Thiago Halmer, Michael S Jaung

Faculty, Staff and Students Publications

INTRODUCTION: Few studies have examined the impact of emergency department (ED) social interventions on patient outcomes and revisits, especially in underserved populations. Our objective in this study was to characterize a volunteer initiative that provided community medical and social resources at ED discharge and its effect on ED revisit rates and adherence to follow-up appointments at a large, county hospital ED.

METHODS: We performed a cross-sectional analysis of ED patients who received medical and social resources and an educational intervention at discharge between September 2017-June 2018. Demographic information, the number of ED return visits, and outpatient follow-up appointment adherence within …

Ensuring A Knowledgeable Geriatric Workforce: Interdisciplinary Education In Long-Term Services And Supports, Gina Tucker-Roghi

Occupational Therapy | Faculty Scholarship

In this symposium, we describe five interdisciplinary educational programs to enhance the geriatric workforce in long-term services and supports (LTSS): Skilled nursing facilities (SNFs), assisted living, and home health and hospice. The interdisciplinary teams that came together to offer the programs leveraged technology to maximize access to experts in both the curriculum development process and the delivery of the educational programs for a wide range of target learners. The first program, an interdisciplinary telementoring series on dementia care for therapists in SNFs, was developed by a team of experts from occupational, physical and speech therapy. The program included asynchronous online …

Rewriting Kendra’S Law: A More Ethical Approach To Mental Health Treatment, James Diven

Pace Law Review

Michelle Go was pushed in front of a subway car by a man suffering from schizophrenia that had fallen through the cracks of New York’s mental health care system. Michelle’s death was imminent because the severely ill man had every right to be on the streets under present law. This note will discuss the problems with New York’s mental hygiene laws that prevent courts from mandating treatment even when treatment is in the state’s best interest.

Michelle’s death is not unique. Historically, New York has struggled to enact effective legislation governing the treatment of mentally ill individuals. As a result, …

Interdisciplinary Telementoring For Therapists In Snfs To Improve Dementia Care Knowledge And Skills, Gina Tucker-Roghi

Occupational Therapy | Faculty Scholarship

Occupational, physical, and speech therapists possess knowledge and skills that have the potential to reduce the burden of care and improve the quality of life of skilled nursing facility (SNF) residents living with dementia. Despite this opportunity to impact the well-being of residents with dementia, many therapy practitioners lack specialized training on the management of dementia. Therapy practitioners (n=31) from 22 SNFs participated in eight weekly interdisciplinary educational sessions using the Project ECHO (Extension for Community Health Outcomes) tele-mentoring model. An interdisciplinary team of therapy experts collaborated on the development of the curriculum, which included didactic content on dementia-care best …

The Evaluation Of A Clinical Decision Support Tool Using Natural Language Processing To Screen Hospitalized Adults For Unhealthy Substance Use: Protocol For A Quasi-Experimental Design, Cara Joyce, Talar W. Markossian, Jenna Nikolaides, Elisabeth Ramsey, Hale M. Thompson, Juan C. Rojas, Brihat Sharma, Dmitriy Dligach, Madeline Oguss, Richard S. Cooper, Majid Afshar

Biostatistics Collaborative Core: Faculty Publications and Other Works

Background: Automated and data-driven methods for screening using natural language processing (NLP) and machine learning may replace resource-intensive manual approaches in the usual care of patients hospitalized with conditions related to unhealthy substance use. The rigorous evaluation of tools that use artificial intelligence (AI) is necessary to demonstrate effectiveness before system-wide implementation. An NLP tool to use routinely collected data in the electronic health record was previously validated for diagnostic accuracy in a retrospective study for screening unhealthy substance use. Our next step is a noninferiority design incorporated into a research protocol for clinical implementation with prospective evaluation of clinical …

Mental Health Services: Improving Utilization In Homeless Populations, Gurdeep Mann

DNP Qualifying Manuscripts

Emergency shelters provide a unique location to offer easily accessible services for unhoused individuals experiencing mental distress and serious mental illness. Housing First interventions do not improve mental health or social integration. It is important to consider alternative approaches to providing care for homeless individuals. This integrated review was undertaken to evaluate existing evidence of interventions that improve mental health awareness and utilization of mental health services among unhoused populations living in shelters. Assertive outreach is an important strategy that was shown to improve effectiveness of mental health programs in shelters; reconnect individuals with family; and help with psychological integration. …

Engaging Rural Providers About The Potential Of Low-Earth Orbit Internet Satellite Supported Rural Telehealth Programs, Joshua M. Cleary

Doctor of Nursing Practice (DNP) Projects

Abstract

This paper describes a DNP project that was designed to address the issue of rural mental telehealth implementation barriers. One of the main barriers to rural telehealth programs has been a technical infrastructure incapable of adequately hosting the telehealth programs. Low-Earth orbit (LEO) internet technology has emerged as a way to solve the rural telehealth conundrum by offering an improved rural technical infrastructure. An integrated review was completed based on the following PICOT question: In rural providers, how does an educational outreach compared to no educational outreach affect provider adoption of new technologies? The evidence showed educational sessions as …

Impact Of Montessori-Based Dementia Programming On Engagement And Affect Of Older Adults With Dementia, Meredith S. Sheppard

Master's Projects and Capstones

The COVID-19 pandemic has profoundly impacted the Adult Day Services program and Adult Day programs across the country. As the Adult Day Services program transitions to an in-person format, goals within the organization include developing appropriate programming, increasing group size, and keeping clients entertained. The framework guiding this quality improvement project is Montessori-Based Dementia Programming ® (MBDP). This project aims to increase client engagement, decrease client anxiety, and decrease staff workload. This will be measured by a self-developed staff workload survey, the Menorah-Park Engagement, and the Affect rating scale. Implementation of MBDP at the Adult Day Center did not meet …

The Health And Health Care Needs And Experiences Of Mexican Heritage Individuals In A Nonmetro Location: An Ethnonursing Study, Karla Adu

Electronic Theses and Dissertations

Introduction: The population of Mexican heritage individuals has grown significantly in nonmetro, emerging communities. The purpose of this study was to explore the health and health care needs and experiences of this population in the Midwest. Methods: Leininger’s Culture Care Theory and Ethnonursing Research Methods were used as the guiding theory and methodology for the qualitative study. Interviews were conducted with 27 informants. Recordings were transcribed and analyzed according to Leininger’s phases of data analysis. Results: Three themes emerged from the data: 1. living a better life in a nonmetro community with and for family, 2. barriers to understanding …

A Process Evaluation On The Health Care Transition Process For Youth With Osteogenesis Imperfecta With Special Health Care Needs, Janet Amirkhanian

Doctor of Nursing Practice (DNP) Manuscripts

With medical, surgical, and technological advances, children with childhood diseases with special health care needs (SHCNs) are surviving and living into adulthood (Cohen et al., 2014). Health care transition (HCT) should be a process through which youth are expected to achieve the skills necessary to manage their health as adults (Sawicki et al., 2017). HCT should be a purposeful, organized, and coordinated process involving the youth, family, and health care team (Stringer et al., 2015; Gabriel et al., 2017; White et al., 2018). Evidence supports that adolescents and young adults with SHCNs are often unprepared for transition (Jensen et al., …

Home Health Workplace Safety During The Covid-19 Pandemic: A Cross-Sectional Descriptive Analysis Of Home Health Agencies In Arkansas, Kelly M. Neal Taylor

ATU Theses and Dissertations 2021 - Present

Abstract

Workplace safety is a continual concern for home healthcare workers that provide medical care in a patient’s home environment. Healthcare workers, such as registered nurses, licensed practical nurses, and nursing aides, make up the largest group of home care providers. Before the COVID-19 Pandemic, home healthcare providers had to navigate job safety issues related to clutter in the home, unsanitary conditions, pest infestations, fumes, pets, and aggressive family members (Gershon et al., 2008). The pandemic brought about additional safety concerns, such as the implementation of isolation policies and limited supplies of personal protective equipment, to name a few. This …

The Mediating Effect Of Caregiving Relationship Quality On The Association Between Caregiving Stressors And Mental Health Problems Among Older Spousal Caregivers, Fei Wang, Elliane Irani

Faculty Scholarship

Providing care to a spouse can be especially challenging for older adults given their compounding stressors resulting from aging and caregiving. This cross-sectional study examines the relationships between caregiving stressors and caregiver mental health problems and the potential mediator (i.e., caregiving relationship quality) of these associations. A total of 431 Americans (≥65 years) were selected from the National Study of Caregiving. Path analysis shows that care assistance was positively associated with caregiver mental health problems, and this association was mediated by negative relationship quality (Indirect effect =.14, p =.016). Moreover, role overload was positively associated with caregiver mental health problems, …

Topics And Sentiment Surrounding Vaping On Twitter And Reddit During The 2019 E-Cigarette And Vaping Use-Associated Lung Injury Outbreak: Comparative Study, Dezhi Wu, Erin Kasson, Avineet Kumar Singh, Yang Ren, Nina Kaiser, Ming Huang, Patricia A. Cavazos-Rehg

Publications

BACKGROUND: Vaping or e-cigarette use has become dramatically more popular in the United States in recent years. e-Cigarette and vaping use-associated lung injury (EVALI) cases caused an increase in hospitalizations and deaths in 2019, and many instances were later linked to unregulated products. Previous literature has leveraged social media data for surveillance of health topics. Individuals are willing to share mental health experiences and other personal stories on social media platforms where they feel a sense of community, reduced stigma, and empowerment. OBJECTIVE: This study aimed to compare vaping-related content on 2 popular social media platforms (ie, Twitter and Reddit) …