Digital Commons Network^™

Enhancing Adherence To Veterans Affairs/Department Of Defense And American Psychiatric Association Clinical Guidelines For Alcohol Use Disorder, Corinna M. Trevino

Doctor of Nursing Practice

Alcohol use disorder continues to be significantly undertreated within outpatient behavioral health settings, particularly concerning pharmacological interventions. Despite the presence of robust national clinical guidelines recommending medications such as naltrexone for individuals with moderate to severe dependence, the rates of prescribing these medications remain modest owing to inconsistent screening procedures, limited referral practices, and provider follow-through barriers. This project was implemented at a substance use treatment center in a large metropolitan area to improve adherence to clinical practice guidelines. The purpose of this project was to increase prescribing of naltrexone and improve referral for patients with moderate to severe alcohol …

Hispanic Academic Leadership In The Health And Human Services, Gabriela Elizabeth Rangel

Theses and Dissertations

In the United States, there are 63.7 million Hispanics (U.S. Census Bureau, 2023), making them the largest racial or ethnic minority in the country. National data from 2019 indicates that only 6% of tenured faculty in the U.S. were Hispanic, highlighting a significant underrepresentation of leaders in academia (NCES, 2024). This study employed a phenomenological approach with purposeful sampling, utilizing semi-structured interviews with ten participants who had leadership experience in academia within Health and Human Services (H&HS). The interviews served to explore various aspects, such as what were their aspirations to become leaders, their perceptions of the characteristics and qualities …

Deficiencies In Non-Emergency Medical Transportation For Aging Rural Residents Of Iosco County, Michigan, Richard L. Douglass, Donald Stansloski, James Mortimer, Sam Purdy, Dale Evilsizer, Scott Rice

Michigan Journal of Public Health

Introduction: The rural aging population in Michigan struggles to access medical care often available only at significant distances due to limited health system resources and provider shortages. Access to routine care is challenged by lack of non-emergency medical transportation (NEMT). The Iosco County Commission on Aging provides home-delivered meals to eligible county residents. The Rural Health Group investigated the needs of home-delivered meal recipients (aged ≥60 years) for healthcare transportation access. Utilizing data from this investigation, we examined if medical care needs were hindered by problems with transportation in rural Iosco County, Michigan.

Methods: We conducted a cross-sectional survey with …

Ddt Exposure Induces Microglial Activation And Disease-Associated Microglial Signatures: Relevance To Mechanisms Of Alzheimer’S Disease, Isha Mhatre-Winters, Aseel Eid, Nicole Blum, Yoonhee Han, Ferass M Sammoura, Long-Jun Wu, Jason R Richardson

The Brown Foundation: Institute of Molecular Medicine

Background: Alzheimer's disease (AD) is characterized by the presence of amyloid-β plaques, neurofibrillary tangles, and neuroinflammation. Previously, we reported that serum levels of dichlorodiphenyldichloroethylene (DDE), the primary metabolite of the pesticide dichlorodiphenyltrichloroethane (DDT), were significantly higher in AD patients compared to age-matched controls and that DDT exposure worsened AD pathology in animal models.

Objective: Here, we investigated the effect of DDT on neuroinflammation in primary mouse microglia (PMG) and C57BL/6J mice.

Methods: DDT-induced inflammatory and disease-associated microglial (DAM) gene expression were determined in PMG by qPCR and immunocytochemistry, with and without pretreatment with the sodium channel antagonist tetrodotoxin (TTX). Furthermore, …

Combine Ebis: A Novel Collaborative Method For Building Interventions From Existing Evidence-Based Interventions, Justin Knox, Kara Portier, Christopher Magana, Maggie Denning, Christopher M Ferraris, Emily Dove-Medows, Cho-Hee Shrader, Ohemaa Poku, Phil Kreniske, Robert Remien, Efrat Aharonovich, Jennifer C Elliott, Denis Nash, Kathryn Lancaster, Till Baernighausen, Kayo Fujimoto, Adam Carrico, John A Schneider, Alida Bouris, D Scott Batey, Sheree R Schwartz, Jose Bauermeister, Patrick S Sullivan, Joseph G Rosen, Gina Wingood, Milton Wainberg, Deborah Hasin, Elvin Geng, Patrick A Wilson, Stefan D Baral

Faculty, Staff and Student Publications

Purpose: Combining evidence-based interventions (EBIs) is a discrete process from adapting EBIs, and specific guidance for how to combine EBIs could be helpful amidst the proliferation of frameworks that combine and stage EBIs and calls for services to be combined or bundled. To address this gap, we developed and applied the COllaborative Method for Building INterventions from Existing Evidence-Based Interventions (COMBINE-EBIs) approach, a five-step process for combining EBIs.

Methods: The five steps of COMBINE-EBIs are: (1) Identify and Select EBIs, (2) Develop a Shared Conceptual Model, (3) Evaluate the Conceptual Model, (4) Create a Single Combined Protocol, and (5) Refine …

School-Based Mental Health Services For Students With Disabilities: Exploring Benefits, Barriers, And The Role Of A Multi-Tiered System Of Supports, Veronica R. S. Meiners Perez

Electronic Theses, Projects, and Dissertations

Schools play a significant role in the academic, behavioral, and social-emotional development of children. Students with disabilities have legal rights to all necessary support for their educational success, including mental health supports. School-based mental health and its implementation are a work in progress, facing many barriers, but the benefits speak for themselves. Research suggests that the use of a multi-tiered system of supports ensures equal and equitable interventions for all students, especially students with disabilities. This literature review analyzes 16 studies regarding school-based mental health, special education, students with disabilities, and the MTSS framework. Support students' mental health, regardless of …

Exploring Intersectional Risks Of Substance Use Disorder, Mental Health, Hiv/Aids, And Hepatitis C Among Hispanic Adults On The Tx-Mx Border: A Mixed-Methods Study, Md Mohsin

Open Access Theses & Dissertations

Purpose: The purpose of this study was to explore intersectional risks of substance use disorders, mental health, HIV/AIDS, and HCV among Mexican-origin Hispanic adults on the Texas-Mexico border. Methods: The study employed an exploratory sequential mixed-methods approach, which involved collecting and analyzing qualitative data first, followed by quantitative data collection. Selected purposively, 15 in-depth interviews were conducted among the target population. Using convenient sampling, 106 cross-sectional surveys were conducted. Qualitative interview data were analyzed manually using thematic analysis. Quantitative data analyses included univariate descriptive analysis, bivariate, and multivariable penalized logistic regression, negative binomial, and zero-inflated negative binomial regression. Results: The …

The Him Profession And Roles: Understanding Our Path, To Plan For The Future, Kerryn Butler-Henderson, Susan H Fenton, Karima Lalani, Trixie Kemp, Salma Arabi

Faculty, Staff and Student Publications

The health information management (HIM) profession has a history spanning more than a century, with the first peak body established in Australia more than 75 years ago (Health Information Management Association of Australia [HIMAA], 2024a). While the role title of the health information manager has changed over time, its primary function has remained the same—tooversee the governance of health data and information. This chapter presents the history of the HIM profession and professional bodies, including their involvement in informing policy and systems in Australia and other countries, and international organisations. Next, the chapter draws on literature examining the roles of …

Buprenorphine Treatment During The Extended Postpartum Period: A Survey Of Patient Experiences, Bridget Galati, Heather Jacobsen, Melissa Krauss, Melissa Mills, Brittaney Vaughn, Sam Williams, Michael Wenzinger, Cynthia Rogers, Nandini Raghuraman, Jeannie Kelly

2020-Current year OA Pubs

OBJECTIVE: The late postpartum period, defined as greater than 6 weeks to 12 months, is a high-risk time for individuals with opioid use disorder (OUD). Discontinuation rates of buprenorphine treatment for OUD during this period are high. Little is known about patients' subjective experience with buprenorphine treatment during this time. We sought to assess patient treatment experience, goals, facilitators and barriers to continued buprenorphine treatment throughout the extended postpartum period.

METHODS: We performed a cross-sectional survey of postpartum patients who received buprenorphine treatment, including sublingual and long-acting injectable formulations, in an interdisciplinary, wrap-around clinic for maternal OUD between February 2022 …

Restorative Masculine Integration Theory, Todd Angelucci, Julian L. Gallegos

School of Nursing Faculty Publications

The Restorative Masculine Integration Theory (RMIT) introduces a strengths-based, systems-oriented framework for promoting healthy masculinity through healing, leadership, and relational engagement. Developed in response to the adverse effects of masculine suppression, such as emotional disengagement, burnout, and polarity collapse, RMIT outlines a five-phase Cycle of Masculine Restoration: reclaimed masculinity, emotional safety and trust, grounded leadership, rebalanced gender polarity, and healing with cultural renewal. These stages are underpinned by core concepts including psychological safety, peer mentorship, emotional literacy, and authentic masculinity. Drawing from interdisciplinary foundations in gender studies, emotional intelligence, trauma-informed practice, polarity theory, and servant leadership, RMIT offers an adaptable …

Challenges And Policies For Female Sex Workers’ Readiness To Participate In Pre-Exposure Prophylaxis Program: An Explorative Qualitative Study, Rico Januar Sitorus, Anita Rahmiwati, Diana Dewi Sartika, Elvi Sunarsih, Asri Maharani

Kesmas

The prevalence of human immunodeficiency virus is high among female sex workers (FSWs) in Indonesia, underscoring the need for integrated prevention strategies supported by strong government policies. This study aimed to investigate FSWs' willingness to participate in a pre-exposure prophylaxis (PrEP) program. This qualitative study employed semi-structured interviews with 20 participants residing in Pangkal Pinang City, Indonesia (4 stakeholders and 16 FSWs), recruited through purposive sampling. Data were collected from July to September 2024. This non-probability sampling method was adopted due to the focus on specific study objectives and a targeted population. The analysis of the interviews revealed three theme …

Prior Incarceration And Dental Insurance Trajectories Throughout Older Adulthood, A Testa, L Mijares, D B Jackson, V Maroufy, R Samper-Ternent, A C Neumann, R Mungia, K T Ganson, J M Nagata, T Oates

Faculty, Staff and Student Publications

Objectives: This study examines the relationship between prior incarceration and dental insurance trajectories throughout older adulthood.

Methods: A nationally representative sample of adults aged 55 y and older who participated in the 2012-2020 Health and Retirement Survey was analyzed (n = 6,383). Group-based trajectory modeling was used to identify distinct patterns of dental insurance coverage across the 8 survey waves. Multinomial logistic regression was used to assess the association between prior incarceration and dental insurance trajectory group membership.

Results: Four dental insurance trajectories were identified: persistent dental insurance (30.0%), intermittent high insurance (16.4%), intermittent low insurance (20.4%), and no …

Advocating For Health Equity: A Quality Improvement Project Surrounding Social Determinants Of Health Screening, Rose Anne Dela Cruz, Amanda Marquez, Madison Lemmons

2025

INNOVATION & LEADERSHIP

Background: Social Determinants of Health (SDOH) can gravely impact patient recovery. Health organizations should prioritize identifying high-risk SDOH patients to improve patient outcomes. Current research suggests SDOH screening should be standard practice in preventative care. With this awareness, healthcare team members must identify patients with complex social determinants of health needs to ensure essential resources are offered to enhance their healing process during hospitalization and sustain it post-discharge. The most straightforward approach to identifying patients from diverse backgrounds with SDOH requirements is via SDOH screening. The collaborating health system, serving a diverse pediatric population in the …

Improving Sdoh Screening Compliance In Pediatric Settings: Addressing Health Literacy In East Texas, Katie Bien

2025

QUALITY IMPROVEMENT

Background: Low parental health literacy is an under-screened social determinant of health (SDOH) that drives inequities in rural communities such as East Texas, where over 105,000 children lack access to a pediatrician, and families travel 80+ miles for care. Pediatric mortality in this region is 2.5 times the national average (UT Tyler SOM, 2023). National data indicate that one in three parents has limited health literacy (Tran et al., 2008), further exacerbating risks of missed appointments, medication errors, and poor outcomes.

Methodology: The initiative was conducted in a rural outpatient pediatric cardiology clinic within Children’s Health …

Interventions To Enhance Care Partner Performance And Participation In Alzheimer's And Neurocognitive Disorders: A Systematized Review, Ainslie Suyko, Addison Werner, Elizabeth A. Stacy, Danielle M. Westmark, Stacy Smallfield, Molly A. Whitlow

Student Systematized Reviews: Occupational Therapy

Purpose: Care partners of people with Alzheimer’s disease (AD) and related neurocognitive disorders (NCDs) often experience disrupted routines, reduced self-care, and limited participation in meaningful occupations. Occupational therapy (OT) supports care partners’ engagement in health-promoting activities and sustainable caregiving (Rhodus et al., 2023). This systematized review examined interventions that enhance care partner performance and participation.

Design: Peer-reviewed, English-language articles were included if they involved adult care partners of individuals with AD or NCDs, implemented an intervention within the scope of OT, and used quantitate research designs.

Method: A total of 319 articles from MEDLINE, CINAHL, and Scopus were screened; 61 …

The Follow-Up Gap: Racial Disproportionality And Social Determinants Of Health In New Jersey’S Hearing Detection And Intervention Program, Maryrose Mcinerney, Wendy Zeitlin

Journal of Early Hearing Detection and Intervention

Objectives. To assess how race/ethnicity and social determinants of health are related to loss to follow-up (LTF) from NJ’s Early Hearing Detection and Intervention (EHDI) program.

Methods. All infants born in NJ between June 2015 and June 2017 referring for additional hearing healthcare after hospital discharge were considered for inclusion in this study. The sample consisted of 4,141 babies, 10.7% of which received no follow-up care. Step-wise multi-level logistic regression was used to determine how race/ethnicity, family-level, and community-level social determinants of health (SDOH) were predictive of LTF.

Results. In each model, the odds of being LTF were significantly higher …

Providencia Rettgeri As An Unusual Pathogen In Diabetic Foot Osteomyelitis: A Case Report And Literature Review, Stephanie N. Campbell, Madeleine Mehaffey, Nikita Gambhir, Amanda L. Killeen

School of Podiatric Medicine Publications

Providencia rettgeri is a Gram-negative bacterium, rarely reported as a cause of diabetic wound infections. Its frequent resistance to β-lactams and carbapenems limits treatment options, especially in immunocompromised patients. We present the case of a 59-year-old unhoused male living with diabetes, peripheral artery disease, and prior bilateral transmetatarsal amputations who presented with a University of Texas 3B diabetic foot ulcer. Magnetic resonance imaging showed osteomyelitis of metatarsals 2–4, and bone biopsy grew Providencia rettgeri and Proteus mirabilis. The patient declined further surgery and was treated with 6 weeks of cefepime and metronidazole, with outpatient wound care, achieving wound closure …

Challenges In Postoperative Compliance And Follow-Up Among Trauma Patients: A Case Report Of A Trans-Scaphoid Perilunate Dislocation, Paul Bonilla, Anesu K. Murambadoro, Chloe Harris, Sergio Rodriguez

School of Medicine Publications

The wrist joint is a complex articulation that involves the distal radius, ulna, eight carpal bones (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and hamate), and the bases of the metacarpals. Trans-scaphoid perilunate fracture-dislocations are complex wrist injuries, most commonly resulting from high-energy mechanisms involving hyperextension and ulnar deviation. Prompt diagnosis and surgical management are essential in restoring wrist function and stability. This report focuses on the case of a 28-year-old male who sustained a trans-scaphoid perilunate dislocation with multiple associated fractures after an all-terrain vehicle (ATV) rollover accident. Surgical intervention included median nerve decompression, open reduction and internal fixation …

Bridging Traditions: A Mixed Methods Systematic Review Of Yoga For Trauma Recovery In Indigenous People, Andreia Schineanu, Fredrik Velander, Julaine Allan

Journal of the Australian Indigenous HealthInfoNet

Objective: The aim of this mixed methods systematic review was to explore if Yoga can alleviate mental health issues for Indigenous people, and how participants experience the effects.

Methods: Peer-reviewed primary research published in English retrieved from 2002 to March 2024 was identified using the databases Medline, Scopus, Informit, ProQuest and PsycINFO. Qualitative, quantitative and mixed method studies with Indigenous populations, where the primary intervention was Yoga or mindfulness programs with significant yoga components that reported on mental health outcomes were included.

Results: Only 5 studies met the inclusion criteria. The studies demonstrated significant improvements in mental health outcomes, including …

Increasing The Likelihood Of Using Mental Health First Aid: Applying The Theory Of Planned Behavior, Alexander E. Chan, Cheyenne Schad, Julie Slivka, Elise Young, Ghaffar A. Hurtado Choque

Journal of Extension

This study applies the Theory of Planned Behavior to examine what may drive intentions to help others after receiving Mental Health First Aid (MHFA) training. The study is unique in its application of theory to understanding MHFA outcomes, as prior studies tended to be atheoretical. Logistic regression was used to analyze the results of post-program surveys completed by MHFA participants. Results showed that participants who reported positive changes in subjective norms and attitudes were significantly more likely to report increases in intentions to help. However, when analyzed in a model containing all predictors, only attitudes remained significant.

Nursing Students As Advocates: Addressing Social Determinants Of Health Through Service-Learning, Rebekah Mullins

Nursing Theses and Dissertations

Advocacy is at the heart of nursing practice, and advocating for the social determinants of health (SDOH) is crucial when providing care to patients from vulnerable populations. Service-learning is a strategy that can be used to teach students advocacy skills. Chapter 2 of this dissertation portfolio presents a concept analysis that explores the definition of advocacy using the Walker and Avant method (2019). The concept analysis informed the development of the case study presented in Chapter 3 and the research study presented in Chapter 4. The portfolio includes original, qualitative research that was guided by the interpretive descriptive method. The …

Incorporating Behavioral Health Strategies In Primary Care To Improve Outcomes Of Depressed Patients, Amy L. Brummett

Student Scholarly Projects

Practice Problem: Depression, otherwise known as major depressive disorder, is a mood disorder characterized by persistent feelings of sadness, loss of interest, sleep disturbances, changes to weight (both gain and loss), difficulty concentrating, and in extreme cases, suicidal thoughts, and/or attempts (Mayo Clinic, 2022). An estimated 8.3% or 21.0 million adults in the United States have experienced at least one episode of depression. Primary care clinicians are often the first to recognize the symptoms of depression. Depression was very prevalent in the clinic where this DNP Scholarly project took place. The owner/nurse practitioner found that she was increasingly treating depressed …

The Impact Of Peer Mentorship In Certified Registered Nurse Anesthesia Programs: A Scoping Review, Karoline Gasque, Kelly Mcreynolds, Shelia Crump

Doctoral Projects

Abstract
Problem statement: Certified Registered Nurse Anesthetist (CRNA) programs are known for
their rigorous curriculum, which predisposes Student Registered Nurse Anesthetists (SRNAs) to
challenges such as mental health issues, stress, and isolation.
Purpose: Review the literature and assess gaps in the literature to determine if peer mentorship
programs benefit SRNAs’ well-being, promote support, reduce stress, and improve retention.
Method: Databases were searched using keywords and inclusion criteria. Studies were
considered if they discussed peer mentorship in students, healthcare professionals, or nursing.
Patterns and themes were assessed to derive conclusions from the literature available. The
Population, Concept, and Context framework was …

Introducing Neuro Sscial Work: A Brief Reflection On Neuroscience And The Profession, Priscila Llamosa

Social Work Faculty Publications

This reflection introduces and contextualizes the term Neuro Social Work, which I coin to name a specialized practice area at the intersection of social work, neuroscience, and neurodiversity. Drawing on my experience as a social work educator and practitioner, I discuss social work’s uneasy relationship with neuroscience, marked both by the opportunity to deepen our understanding of trauma, development, and healing, and by the risks of using brain‑based evidence to individualize structural harms or justify surveillance of marginalized communities. I outline, in broad strokes, what distinguishes Neuro Social Work from general neuroscience‑informed practice. The note is intended as a concept …

The Effects Of Marital Status, Partner Drinking, And Sex Differences On The Likelihood Of Remission From Alcohol Use Disorder, Christina Garasky, Alexis Duncan, Fanghong Dong, Jared Balbona, Andrey Anokhin, Emma Johnson, Arpana Agrawal, Kathleen Bucholz, Vivia Mccutcheon, Et Al.

2020-Current year OA Pubs

OBJECTIVE: Marriage is associated with improved health and alcohol outcomes, yet prior research has often combined diverse non-marital relationships, obscuring whether benefits are unique to marriage or a result of strong interpersonal relationships. This study examines whether marriage, compared to cohabitation, exclusive dating, or being single, is associated with alcohol use disorder (AUD) remission and whether this varies by sex and partner drinking.

METHOD: Participants were adults from the Collaborative Study on the Genetics of Alcoholism Lifespan Study (n = 1494; 54.4% female) who met criteria for lifetime DSM-5 AUD. Multivariate logistic regression models examined the association between marital status …

The Potential Co-Occurrence Of Perfectionism, Food Insecurity, And Gpa With Orthorexia Nervosa Risk, Samantha Kay Gould

Master's Theses

There are indeterminate risk, prevalence, and correlation data on orthorexia nervosa (ON) as shown by current literature on disordered eating (Rodgers et al., 2021). As a roughly defined disordered eating pattern, ON may be better understood after identifying associations among other attributes in a college student sample (Abdullah et al., 2020; Mavrandrea & Gonidakis, 2023; Parra-Fernández, 2019; Rogowska et al., 2021). A cooccurrence and influence of perfectionism, food insecurity, and grade point average (GPA) with ON risk was hypothesized since current literature suggests college students exhibit each of these characteristics independently (Abdullah et al., 2020; Ambwani et al., 2019; Caferoglu …

Latine Doctoral Student Experiences In U.S. Counselor Education And Supervision Programs, Nayara Aparecida Da Costa Silva Beall, Lizbeth Duran Oden, Isabel C. Farrell, Mariaimeé Gonzalez, Stephanie Thorson-Olesen

Journal of Counselor Preparation and Supervision

This study explored the experiences of Latine doctoral students in Counselor Education and Supervision programs in the United States. The consensual qualitative research yielded five domains: cultural values, representation, racialized experiences, support, and social justice. The findings are discussed with direct applications for programs and recommendations for future research.

Efficacy Of Medical-Legal Partnerships To Address Health-Harming Legal Needs: A Systematic Review Of Experimental Studies In The Field, Jemima John, Thomas Murphy, Emily Zientek, Winston Liaw, Odinakachukwu Dimgba, Thien-An Nguyen, Catherine Burnett, Mary Aitken, Shreela Sharma

Faculty, Staff and Student Publications

Background: Despite the documented success of medical-legal partnerships (MLPs), there is a dearth of robust experimental-based research on their efficacy. This review synthesizes the findings of MLP interventions and identifies opportunities for MLP expansion in vulnerable communities.

Methods: Articles were eligible if they tested the experimental effects of an MLP intervention on health-harming legal needs (HHLNs) and had full text for review. Two reviewers independently screened articles for inclusion and assessed the quality (risk of bias) of each study.

Results: Seven studies were eligible. Populations were largely women, of color, and of lower socioeconomic status. All studies demonstrated positive effects …

Book Review: "Take Your Own Advice" By Jeffrey Marsh, Kristy Carlisle

Journal of Human Services Scholarship and Interprofessional Collaboration

This review examines Take Your Own Advice by Jeffrey Marsh as a teaching tool for cultivating ethical presence, mindfulness, and professional identity in human services and counseling education. Grounded in compassion-based, trauma-informed principles, Marsh’s eight guiding rules invite readers to shift from control and perfectionism toward authenticity, acceptance, and values-based living. These concepts directly reflect mindfulness and Acceptance and Commitment Therapy (ACT) practices and expound upon self-compassion, boundary awareness, and cultural humility. Through workbook activities, students find ways to practice emotional regulation and ethical reflection. Drawing connections to the Council for Standards in Human Service Education (CSHSE) and Council for …

Using Patient Experience Data With Impact: A Framework For Healthcare Improvement, Corey Adams, Ramesh Walpola, Reema Harrison

Patient Experience Journal

Background: Despite major investment in patient experience measurement, healthcare organizations often struggle to translate patient feedback into lasting improvements. Existing knowledge translation frameworks provide useful concepts, but often lack the practical detail or contextual relevance needed to improve patient experiences. Objective: To develop and present the IMPACT Framework, an evidence-informed approach designed to bridge the gap between patient experience measurement and meaningful improvement in healthcare. Methods: This framework was informed by a systematic review of patient experience measurement and analysis of barriers to feedback use. Findings from contemporary patient experience research were combined with key principles of knowledge translation, change …