Digital Commons Network^™

Perceptions And Roles Of Genetic Counselors In Perinatal Palliative Care: Where Are We Now?, Amanda Chamberlain

Dissertations and Theses (Open Access)

After the identification of a life-limiting fetal diagnosis, a perinatal palliative care (PPC) team can provide specialized medical care and emotional support for the family throughout the pregnancy and after delivery. Although the growth of the field of PPC over the last ten years is well-documented, there is only one study to date that explores the experiences of genetic counselors with regards to PPC. This study seeks to further the understanding of genetic counselors’ current perceptions of, experiences with, and roles in the delivery of PPC.

An edited version of the Perinatal Palliative Care Perceptions and Barriers Scale was used …

“…You Can't Unknow It, It's A New Reality": A Case Study Exploring A Social Justice Public Health Intervention's Impact On Critical Consciousness Development In Youth., Monique Williams

Electronic Theses and Dissertations

Even though public health purports to be rooted in social justice, it is not clear how social justice frameworks are integrated in public health research and intervention. The discipline focuses on groups/populations on the margins, without integrating the social and political factors that cause marginalization into the intervention. Seeing communities, and individuals, as assets and experts in their own experiences is key to population-level health improvement. Particularly for public health youth intervention, how youth are labeled and engaged in social change is critical to their healthy development. While public health lags in practically applying asset-based approaches to youth intervention, research …

Exploring Feasibility Of Mhealth To Manage Hypertension In Rural Black Older Adults: A Convergent Parallel Mixed Method Study, Danice B. Greer, Willie M. Abel

Nursing Faculty Publications and Presentations

Objective: The purpose of this study was to explore perceived ease of use, usability, and the feasibility of using mobile health applications to manage hypertension self-care in rural Black older adults with hypertension.

Methods: A convergent parallel mixed method design was used to study a purposeful sample of 30 Black older adults (29 females, 1 male) from rural East Texas. Quantitative data included demographic characteristics and measured blood pressure, height, and weight, along with questionnaires: the Hill-Bone Compliance to High Blood Pressure Therapy Scale, the Krousel-Wood Medication Adherence Scale-4, and the Technology Acceptance Model Questionnaire (adapted). Qualitative data …

Quantifying Inequities In Covid-19 Vaccine Distribution Over Time By Social Vulnerability, Race And Ethnicity, And Location: A Population-Level Analysis In St. Louis And Kansas City, Missouri, Aaloke Mody, Cory Bradley, Salil Redkar, Branson Fox, Ingrid Eshun-Wilson, Matifadza G. Hlatshwayo, Anne Trolard, Khai Hoan Tram, Lindsey M. Filiatreau, Franda Thomas, Matt Haslam, George Turabelidze, Vetta Sanders-Thompson, William G. Powderly, Elvin H. Geng

2020-Current year OA Pubs

BACKGROUND: Equity in vaccination coverage is a cornerstone for a successful public health response to COVID-19. To deepen understanding of the extent to which vaccination coverage compares with initial strategies for equitable vaccination, we explore primary vaccine series and booster rollout over time and by race/ethnicity, social vulnerability, and geography.

METHODS AND FINDINGS: We analyzed data from the Missouri Department of Health and Senior Services on all COVID-19 vaccinations administered across 7 counties in the St. Louis region and 4 counties in the Kansas City region. We compared rates of receiving the primary COVID-19 vaccine series and boosters relative to …

Estimating The Health Effects Of Adding Bicycle And Pedestrian Paths At The Census Tract Level: Multiple Model Comparison, Ross J. Gore, Christopher Lynch, Craig Jordan, Andrew Collins, R. Michael Robinson, Gabrielle Fuller, Pearson Ames, Prateek Keerthi, Yash Kandukuri

VMASC Publications

Background: Adding additional bicycle and pedestrian paths to an area can lead to improved health outcomes for residents over time. However, quantitatively determining which areas benefit more from bicycle and pedestrian paths, how many miles of bicycle and pedestrian paths are needed, and the health outcomes that may be most improved remain open questions.

Objective: Our work provides and evaluates a methodology that offers actionable insight for city-level planners, public health officials, and decision makers tasked with the question “To what extent will adding specified bicycle and pedestrian path mileage to a census tract improve residents’ health outcomes over time?” …

Stepped Care Versus Standard Care For Children After Trauma: A Randomized Non-Inferiority Clinical Trial, Alison Salloum, Yuanyuan Lu, Henian Chen, Troy Quast, Judith A Cohen, Michael S Scheeringa, Kristen Salomon, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Objective: Trauma-focused cognitive-behavioral therapy (TF-CBT) is an evidence-based therapist-led treatment for children after trauma. Parents often experience barriers to treatment engagement, including cost. Stepped care TF-CBT (SC-TF-CBT) was developed as an alternative delivery system. Step One is a parent-led therapist-assisted treatment. Step Two provides therapist-led TF-CBT for children who did not benefit from Step One and require more intensive treatment. This study compared SC-TF-CBT to standard TF-CBT in a community-based non-inferiority trial.

Method: A total of 183 children (aged 4-12 years) experiencing posttraumatic stress symptoms (PTSS) and their caregivers were randomly assigned to SC-TF-CBT or standard TF-CBT within 6 community …

Sexual Orientation And Gender Identity Data Collection In Oncology Practice: Findings Of An Asco Survey, Charles S Kamen, Mandi L Pratt-Chapman, Stephen C Meersman, Gwendolyn P Quinn, Matthew B Schabath, Janette K Merrill, Melinda Kaltenbaugh, Caroline Schenkel, Shine Chang

Faculty, Staff and Student Publications

Purpose: Lack of collection of sexual orientation and gender identity (SOGI) data in oncology practices limits assessment of sexual and gender minority (SGM) cancer patients' experiences and restricts opportunities to improve health outcomes of SGM patients. Despite national calls for routine SOGI data collection, individual-level and institutional barriers hinder progress. This study aimed to identify these barriers in oncology.

Methods: An online survey of ASCO members and others assessed SOGI data collection in oncology practices, institutional characteristics related to SOGI data collection, respondents' attitudes about SOGI data and SGM patients, and respondent demographics. Logistic regression calculated adjusted odds ratios (ORs) …

Emergency Department Communication In Persons Living With Dementia And Care Partners: A Scoping Review, Ryan M Carnahan, Eric D Isaacs, Deborah Jobe, Kathleen Kelly, Nancy Morrow-Howell, Beth Prusaczyk, Bob Savage, Joe Suyama, Allan S Vann, Kristin L Rising, Ula Hwang, Manish N Shah

Faculty, Staff and Student Publications

OBJECTIVES: To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research.

DESIGN: Systematic scoping review.

SETTINGS AND PARTICIPANTS: PLWD and their care partners in the ED setting.

METHODS: Informed by 2 Patient-Intervention-Comparison-Outcome (PICO) questions, we conducted systematic electronic searches of medical research databases for relevant publications following standardized methodological guidelines. The results were presented to interdisciplinary stakeholders, including dementia researchers, clinicians, PLWD, care partners, and advocacy organizations. The PICO questions included: How does communication differ for …

“My Attitude On Telehealth Has Completely Changed.”: Facilitators And Barriers To Implementing Technology For Care Delivery In Community Mental Health Centers, Suzanne Meller, Justin Tauscher, Dror Ben-Zeev

Journal of Technology in Counselor Education and Supervision

The purpose of this study was to explore facilitators and barriers aiding community mental health centers in implementing technology-assisted care during the COVID-19 pandemic. Six key informants were interviewed and 28 clinicians were surveyed from three community mental health centers. Interviews focused on technology-assisted care implementation efforts and factors that facilitated adoption. Surveys focused on clinician beliefs and experience with technology-assisted care in addition to training needs. Barriers to technology-assisted care implementation included beliefs about the quality of virtual services and a lack of technology access. An increase in service utilization was reported. Technology-assisted care facilitators included reimbursement policy changes …

Examining P3 And N2 Amplitudes Following Social Exclusion And Provocation In College Students With High And Low Narcissistic Traits, Kathleen Ramsey

Dissertations

Adults with narcissistic traits are prone to reacting aggressively following provocation due to elevations in emotional reactivity and perceived threat to their grandiose self-views. Prior studies have examined event-related potentials (ERPs) measures in college students with narcissistic traits in the context of risky decision making and facial emotion processing; however, no known studies have examined how those with narcissistic traits react to rejection and provocation at the neurophysiological level during an externally valid social rejection task (i.e., Cyberball). For the purposes of this study, it was predicted that participants with higher levels of narcissistic traits (both total narcissism and grandiose …

Evaluation Of An Australian Neurological Nurse-Led Model Of Postdischarge Care, Judith Dianne Pugh, Kathleen Mccoy, Merrilee Needham, Leanne Jiang, Margaret Giles, Elizabeth Mckinnon, Kym Heine

Research outputs 2014 to 2021

Neurological disorders are a leading cause of disease burden worldwide, placing a heavy demand on health systems. This study evaluated the impacts and cost savings of a community-based nursing service providing supported discharge for neurological patients deemed high-risk for unplanned emergency department presentations and/or hospital readmissions. It focused on adult patients with stroke, epilepsy, migraine/headache or functional neurological disorders discharged from a Western Australian tertiary hospital. An observational design was used comprising prospective enrolment of patients receiving nurse-led supported discharge and follow-up (Neurocare), 21 August 2018 to 6 December 2019 (N = 81), and hospital administrative data, 1 February …

The Role Of Community Factors In Predicting Depressive Symptoms Among Chinese Workforce: A Longitudinal Study In Rural And Urban Settings, Wanlian Li, Guanghan Gao, Fei Sun, Lin Jiang

School of Social Work Faculty Publications

Background: The dual urban-rural division system in China has led to distinguishes in economic development, medical services, and education as well as in mental health disparities. This study examined whether community factors (community cohesion, supportive network size, foreseeable community threat, and medical insurance coverage) predict the depressive symptoms of Chinese workers and how community factors may work differently in rural and urban settings.

Methods: This secondary data analysis was conducted using data from the 2014 and 2016 China Labor-force Dynamics Survey (CLDS). The sample of this study includes 9,140 workers (6,157 rural labors and 2,983 urban labors) who took part …

Social Life Of Females With Persistent Covid-19 Symptoms: A Qualitative Study, Atefeh Aghaei, Ran Zhang, Slone Taylor, Cheuk-Chi Tam, Chih-Hsiang Yang, Xiaoming Li Ph.D., Shan Qiao Ph.D.

Faculty Publications

Persistent COVID-19 symptoms (long COVID) may bring challenges to long haulers' social lives. Females may endure more profound impacts given their special social roles and existing structural inequality. This study explores the effects of long COVID on the social life of female long haulers. We conducted semi-structured interviews via Zoom between April and June 2021 with 15 female long haulers in the United States, purposely recruited from Facebook and Slack groups and organization websites related to long COVID. Interviews were audio-recorded and transcribed verbatim with consent. The interview data were managed using MAXQDA and examined by thematic analysis. Long COVID …

Comparing Substance Use Outcomes By Sexual Identity Among Women: Differences Using Propensity Score Methods, Katherine J. Karriker-Jaffe, Laurie Drabble, Libo Li, Cat Munroe, Amy A. Mericle, Karen F. Trocki, Tonda L. Hughes

Faculty Research, Scholarly, and Creative Activity

Background: Differences in alcohol, tobacco, and other drug (ATOD) use by sexual identity vary across samples of women recruited using different sampling methods. We used propensity score (PS) weighting methods to address two methodological questions: (1) Do disparities between sexual minority women (SMW) and heterosexual women persist when differences in risk and protective factors are similarly distributed between groups, and (2) Does accounting for SMW-specific resiliency factors impact differences between non-probability samples of SMW? Methods: Four samples included SMW from a longitudinal study with a nonprobability sample (n = 373), a national general population panel sample (n = 373), …

Examining Demographic And Environmental Factors In Predicting The Perceived Impact Of Cancer On Childhood And Adolescent Cancer Survivors, Nazan Cetin

Dissertations and Theses

Cancer survivors' perceptions on how cancer has impacted their lives has been identified as a "critical predictor" of psychosocial well-being and quality of life outcomes. Given the dramatic increase in survival rates and the long-term health and psychosocial challenges, as well as survivorship care barriers, this study focuses special attention on childhood and adolescent cancer survivors and is guided by Tedeschi and Calhoun's theory of posttraumatic growth and Hammond's theory of distinctiveness. This study aims to examine the influence of demographic (i.e., age at diagnosis, biological sex, race/ethnicity, type of cancer) and environmental factors (i.e., geographical location and insurance type), …

Professional Development In Nursing Starting At The Bedside: An Evidence-Based Study, Annette Joyce Carlisle-Spotts

Graduate Theses, Dissertations, and Capstones

Frontline nurses are faced with a host of responsibilities requiring clinical skills to care for complex, and often, chronically ill patients. Nurses need leadership skills to communicate effectively with the interdisciplinary and multidisciplinary teams they are increasingly required to work alongside. The Institute of Medicine’s recommendation is to prepare bedside nurses with the advanced skills needed to collaborate with others to revolutionize healthcare (Institute of Medicine, 2010). With more than four million nurses in the United States serving a variety of patients and families and levels of need; the urgency for gaining advanced skills has never been greater. We also …

The Root Of The Growing Mental Illness Epidemic In Elementary Children, Rayanne Brown

University Honors Program

This research determined important contributions to the mental illness epidemic in elementary children to find if mental illness in current American society is based on bias or science. Some of the researched contributions include use of technology, family dynamics, proper use of medical terminology, physical health, and the diagnosis process, and more. Many recent articles supported the possibility that mental health awareness has become too common, resulting in overdiagnosis and unnecessary treatment in elementary children. In all, society views mental illness through a different lens to encourage victims of mental illness to reach out for treatment, but the added attention …

The Effect Of Transfer Of Care Protocol On The Rehospitalization Rates In Psychiatric Patients, Fernando Guillen Msn, Cnp, Pmhnp-Bc

Student Scholarly Projects

Practice Problem: The problem involved the transition of psychiatric care from long psychiatric hospitalizations to community-based psychiatric treatment which has developed into shorter inpatient psychiatric hospitalizations, which in turn has developed into a significantly higher number of individuals being readmitted within one year of inpatient discharge.

PICOT: In adult patients undergoing inpatient acute psychiatric care (P), how does the use of a transfer of care protocol (I), compared to current transfer of care practice (C), affect the rate of readmission within 30 days for inpatient acute psychiatric care (O), in 10 weeks?

Evidence: The evidence from an extensive literature review …

Sars-Cov-2 (Covid-19) Vaccine Intentions In Kentucky, Kevin A. Pearce Md, Mph, Emily Messerli Dnp, Aprn, Mary E. Lacy, Brittany L. Smalls, Diane B. Francis, Sukruthi Yerramreddy, Marc Kiviniemi

Journal of Appalachian Health

Background: At the time of our writing, the COVID-19 pandemic continues to cause significant disruption to daily lives. In Kentucky, the burdens from this disease are higher, and vaccination rates for COVID-19 are lower, in comparison to the U.S. as a whole. Understanding vaccine intentions across key subpopulations is critical to increasing vaccination rates.

Purpose: This study explores COVID-19 vaccine intentions in Kentucky across demographic subpopulations and also investigates the influences on vaccine intention of attitudes and beliefs about COVID-19.

Methods: A population-based survey of 1,459 Kentucky adults was conducted between January 26 and March 20, 2021, with over-sampling of …

Supporting Children Impacted By Parental Addiction: A Toolkit For Kinship Caregivers, Nicole Mueller, Jaimee Kudrle

Nursing DNP Projects

Kinship caregiving has become increasingly common in the United States, specifically due to parental substance use disorder. These kinship caregivers (KC) have unique needs that are largely unmet. Often, there is no comprehensive resource for KCs specific to their community. KC’s greatest needs are financial, legal, and mental health assistance, as well as educational information about care of children for the kinship caregivers. The objective of this project was to develop a KC resource toolkit to meet priority needs within the community. The project design utilized an EBP framework and followed a community-based participatory research approach. Project leads worked with …

Examination Of The Interaction Between Parental Military-Status And Race Among Non-Hispanic Black And Non-Hispanic White Adolescents With Overweight/Obesity, M K Higgins Neyland, Denise E Wilfley, Et Al.

2020-Current year OA Pubs

OBJECTIVES: Adolescent military-dependents experience distinct risk and protective factors, which may necessitate additional clinical considerations. In civilian youth, overweight/obesity is associated with eating, internalizing, and externalizing difficulties, with some studies reporting more difficulties among non-Hispanic White (vs. non-Hispanic Black) youth. It is unknown if these disparities exist among adolescent military-dependents, or between civilian and military-dependent youth.

METHODS: Non-Hispanic Black (187 civilian, 38 military-dependent) and non-Hispanic White (205 civilian, 84 military-dependent) adolescents with overweight/obesity (14.7 ± 1.6 years; 73.9% girls; body mass index adjusted for age and sex 1.9 ± 0.5) completed a disordered-eating interview; parents completed a measure assessing their …

A Path Towards Digital Equity

Thomas Jefferson University Research Magazine

Telemedicine is a vital tool in health care, but it’s leaving some patients behind. Jefferson researchers are on a mission to improve ‘digital readiness’ in under-resourced communities to bridge inequities.

Congregational Leaders And Covid-19: Human Flourishing And Future Directions For Research, Isaac Voss

Essays

No abstract provided.

From Isolation To Connection: A Cross-Sectional Analysis Of Older Adults’ Social Participation Using The Cov19-Qol Scale, Kathleen Melei, Jill Linder

The Open Journal of Occupational Therapy

Background: Social isolation during COVID-19 has the capacity to impact older adults’ physical health, mental health, and quality of life. Using an occupational therapy perspective of social participation as an occupation, the current study explores (a) the extent to which social participation (habits/routines) has changed following the onset of the COVID-19 pandemic, (b) differences in perceptions of social participation in relation to the COVID-19 pandemic, and (c) differences in scores on the COVID-19 Quality of Life (COV19-QoL) scale by demographics, access to health care, and lifestyle routine.

Method: Community-dwelling adults (N = 230) 65 years of age or …

Occupational Therapy’S Psychosocial Role For Young Children Transitioning Out Of Foster Care, Patrick J. Walker, Bryan M. Gee, Sharon Leonard

The Open Journal of Occupational Therapy

Background: Unmet needs for children in the foster care system lead to hardships with social participation, healthy relationships, and occupational engagement. Despite an understanding of these needs, there is minimal research on occupational therapy’s role for young children transitioning from foster care back to their biological parents.

Method: A single case report was completed via occupational-based interventions focused on psychosocial development, such as emotional regulation and appropriate social skills. All nine interventions were intended to be provided via 45-min individual treatment sessions followed by biological parent coaching for 15 min with strategies such as role-playing, sensory techniques, and trauma-informed …

Intimate Partner Violence In Plastic Surgery Practice: Perceptions And Preparedness Amongst Practicing Plastic Surgeons, Sophie L. Cemaj, Collin J. Macdonald, Bria R. Meyer, Erin M. Shriver, Sean Figy

Graduate Medical Education Research Journal

INTRODUCTION

It is estimated that 4 of 10 women in the United States have experienced one or more forms of intimate partner violence (IPV) in their lifetime. The US Preventative Service Task Force recommends that clinicians screen women of reproductive age for IPV and refer women who screen positive to ongoing support services (B recommendation). We aim to identify the perceptions, attitudes, and preparedness of plastic surgeons regarding intimate partner violence

METHODS

An IRB approved survey was sent to members of the American Society of Plastic Surgeons. The survey contained three sections: (1) surgeon and practice demographics, (2) surgeon experience …

Social Determinants Of Health In Pulmonary Arterial Hypertension Patients In The United States: Clinician Perspective And Health Policy Implications, Vijay R. Nadipelli, Jean M. Elwing, Willie H. Oglesby, Karim El-Kersh

College of Population Health Faculty Papers

Social determinants of health (SDoH) can impact the vulnerable pulmonary arterial hypertension (PAH) population, especially during the COVID-19 pandemic. Providers' understanding of SDoH at the point of care and their impact is unknown. We conducted semi-structured virtual interviews with US clinicians at 17 pulmonary hypertension (PH) centers and one patient advocate from the Pulmonary Hypertension Association. We sought participants' perspective on SDoH in PAH and their impact. Transcripts were developed and analyzed for key themes to assess potential policy implications. Participants served a large PAH population and demonstrated high awareness of SDoH and its impact on treatment and outcomes. They …

Screening For Social Determinants Of Health In A Comprehensive Pediatric Sickle Cell Disease Clinic, Marie Turner

Dissertations

Problem: Social determinants of health (SDOH) affect health outcomes across the lifespan. The American Academy of Pediatrics recommends routine screening for SDOH. Poverty is a SDOH affecting health outcomes in children, especially in children with a chronic disease such as sickle cell disease (SCD). Children with sickle cell disease have a high burden of SDOH. This project sought to describe the SDOH barriers experienced by pediatric patients with SCD.

Methods: A descriptive survey/observational design, using a convenience sample of pediatric patients ages 0-19 years old in a comprehensive SCD clinic at a large, urban, Midwestern academic medical center was utilized …

Evaluating Mindfulness On Loneliness In An Older Adult Population, Jessica Tieskoetter

Dissertations

Problem: Loneliness is a widespread public health concern and has negatively impacted mortality and health outcomes among older adults. This quality improvement project’s purpose was to evaluate mindfulness on loneliness and quality of life among adults aged 65 years and older, participating in a weekly befriending socialization program.

Methods: A descriptive cohort design was utilized to assess loneliness pre-and post-implementation of a mindfulness telephone line over three months. A convenience sample of 22 older adults enrolled in a befriending socialization program was used. The Iowa Model of Evidence-Based Practice framework was applied to guide the implementation of a practice change …

Palliative Care Screening For Persons Living With Dementia In A Nursing Home, Shanika S. Pruitt

Dissertations

Problem: Dementia is rapidly increasing as the people of the world mature and life expectancy increases. As the world ages and the prevalence of dementia increases, nursing home placement will and is the most sought place for care of this population. Dementia is under recognized as a terminal illness and palliative care is underutilized for nursing home residents with advanced symptoms of dementia.

Methods: This quality improvement (QI) initiative utilized a prospective, descriptive design. The Palliative Care Screening for the Elderly tool was administered to a purposive sample of persons living with dementia residing in the nursing home. Qualitative data …