Digital Commons Network^™

Loneliness And Social Isolation: Finding Connection Through Art, Elijah K. Wong

Art Therapy | Master's Theses

This study explored whether creativity might help alleviate feelings of loneliness and social isolation. The COVID-19 pandemic was an extraordinary event that significantly impacted people's emotional, physical, psychological, and social health globally. To gain insight into these impacts, the research focused on participants’ creative activities and their experiences of loneliness during and after the pandemic. The aim was to find possible links between making and viewing art and reducing feelings of loneliness and loneliness-related experiences. Ten participants were surveyed and asked about their artistry, their time during the COVID-19 pandemic, and their sense of belonging to a community. This investigation …

Shadow Garments: Costume Creation For Integrating Alienated Parts Of The Self, Mega M. Galvin

Art Therapy | Master's Theses

This study explores costume creation as a narrative-based intervention for integrating "shadow" parts, or aspects of the self that are repressed or alienated due to shame, trauma, or social pressure. Grounded in Jungian analytic psychology, narrative therapy, and expressive arts theory, the research addresses the limitations of traditional talk therapy in accessing somatic memory and proposes costume making as a pathway for externalization and re-authorship. Using a qualitative, participatory study inspired by Pat B. Allen’s Open Studio Process, four adult participants engaged in a three-session workshop to design, construct, and wear costumes representing their identified shadow aspects. Data was collected …

Nourishing Births: A Program Evaluation Proposal For Community-Based Nutrition Education, Food Access, And Garden Engagement Among Black Birthing People, Naa Deedei-Vera Hammond

Master's Projects and Capstones

Black birthing people in the United States continue to experience unequal maternal health outcomes, shaped in part by racism and barriers to nutritious food, culturally relevant health education, and supportive community spaces. While prenatal nutrition education and food assistance programs can provide important resources, information alone cannot address the challenges many people face when trying to access healthy and affordable food during pregnancy. The Nourishing Births Initiative is a proposed community-based maternal health program designed to respond to these needs by bringing together prenatal nutrition education, help connecting to food resources, community gardening, and peer support for Black birthing people …

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

The End Of Unmeasured Exploitation: How A.S.M., C.A.S., And S.I.A. Challenge Digital Attention Capitalism, Delante Clark

Graduate Scholarship and Creative Works

Digital attention capitalism generates value through the capture and monetization of human attention, yet it has historically lacked standardized mechanisms for measuring attention-related harm. This paper argues that the Attention Safeguard Models (A.S.M.), Cognitive Attentional Standards (C.A.S.), and Sociological Impact Assessment (S.I.A.) collectively challenge this system by introducing an integrated framework for classifying, measuring, and evaluating digital attention harm and its societal consequences. C.A.S. provides standardized measurement of digital attention harm, A.S.M. identifies and classifies patterns of attentional disruption and manipulation, and S.I.A. evaluates broader impacts on institutions, communities, civic engagement, education, social cohesion, and inequality. Together, these systems transform …

Teaching Medical Students To Identify Social Determinants Of Health Through Observation And Reflection, Bridget Croniger Ockunzzi, Kathleen Liu Young, Jennifer Mendez, Rima Charara

Internal Medicine Faculty Publications

Purpose: Social determinants of health (SDOH) impact 80-90% of health outcomes in the United States. To address SDOH, innovative teaching of future healthcare professionals is needed. At one large urban medical school in an area with a high population of underserved individuals, first-year medical students participated in a Service Learning curriculum, assessing community needs in local ZIP Code areas. This single-institution descriptive program evaluation describes the implementation and feasibility of this educational activity and reports students' identified community priorities and self-reported engagement.

Participants and Methods: During the 2022-2023 academic year, forty-one groups of 6--8 first-year medical students conducted neighborhood observations, …

Are Accountability Courts In Georgia A Cost-Effective Public Health Policy Alternative?, Brian D. Graves, Orion Mowbray, Leaanne Derigne, Holly Lynde, Angel Ellis, Rachel Meyer

Journal of the Georgia Public Health Association

Background: This study evaluates the cost-effectiveness of accountability courts in Georgia, presenting them as a viable alternative in public health policy.

Methods: The research utilized survey data collected from 37 court programs across 40 distinct accountability court programs; it was conducted by the University of Georgia’s Carl Vinson Institute of Government in collaboration with the Council of Accountability Court Judges. The analysis includes a comparative assessment of cost savings, benefits, and differences among various court types, specifically focusing on drug courts, DUI courts, mental health courts, family treatment courts, and veterans treatment courts.

Results: Results reveal that …

Sex-Based Disparities In Artificial Intelligence For Cardiovascular Disease: A Scoping Review, Maurgan Lee, Tarek Atasi, Michael Mclellan, Yodit Beru, Jason Booza

Population, Patient, Physician and Professionalism Projects

No abstract provided.

Intimate Partner Violence And Child Wasting Across Countries: An Ecological Cross-Sectional Study, Wanri Lumbanraja, I Ketut Kasta Arya Wijaya, Ruben Cornelius Siagian

Journal of Indonesian Health Policy and Administration

Intimate partner violence (IPV) is a public health issue that can affect the well-being of women, their families, and the child-rearing environment. Meanwhile, wasting in under-five children reflects acute malnutrition linked to food insecurity, infectious diseases, poverty, and access to healthcare services. This study aimed to analyze the relationship between the prevalence of IPV among women in the past 12 months and the prevalence of wasting in children under the age of five at the national level. This study addresses the gap in cross-national research, which remains limited in linking IPV as an indicator of social vulnerability with wasting as …

Staff Education On Teaching Evidence-Based Chronic Pain Management, Valdane Eleonu Robinson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project focused on educating providers to fill in knowledge gaps in how to effectively manage chronic pain. The lack of knowledge about the evidence-based recommendations for treating chronic pain was the practice gap. Standardized training protocols to instruct pain management professionals and address disparities in chronic pain management care should be in place to guarantee that all patients in need of chronic pain management have access to culturally appropriate education.

Harmonies Of Healing: A Secondary Data Analysis On Music Engagement And Quality Of Life In Older Adults, Theophilus Eben Nartey

Doctoral Dissertations and Projects

The purpose of this quantitative, cross-sectional secondary data analysis was to examine the relationship between music engagement and self-reported quality of life among adults aged 60 years and older, using data from the Health and Retirement Study (HRS). Guided by the Biopsychosocial-Spiritual (BPSS) framework, the study explored whether music engagement significantly predicted perceived well-being in later adulthood while accounting for chronic health conditions. Secondary data from the HRS public-use dataset were analyzed using IBM SPSS Statistics Version 29. The final analytical sample consisted of 1,582 adults aged 60 years or older with complete data on all variables included in the …

“I Was Not Wonder Woman And Required Help”: Black, Latina, And White Women’S Recovery From The Covid-19 Pandemic, J. Mitchell Vaterlaus, Colton Pierce, Harry Foster, Alison Brennan, Nicole Wanago

Journal of Social, Behavioral, and Health Sciences

The COVID-19 pandemic disproportionately affected women, particularly women of color, yet less is known about their recovery experiences following the end of the public health emergency. This exploratory mixed-methods study examined recovery from the COVID-19 pandemic among Black, Latina, and White women in the United States. Participants (N = 133) completed a survey that included a self-reported recovery measure and open-ended questions regarding their recovery experiences. A chi-square analysis indicated a significant association between race/ethnicity and recovery status, with Latina women more likely to report ongoing recovery than Black and White women. Codebook thematic analysis identified four themes: (1) …

The American Society Of Extracorporeal Technology Standards And Guidelines For Pediatric And Congenital Perfusion Practice: 2025 Update☆., Molly Elisabeth Oldeen, Carrie Whittaker Striker, Ronald Angona, Dafne Andrea Chianella, Chelsea Capone, Ashley B Walczak, Thomas Klein

Heart and Vascular Articles

Background: In 2019, the American Society of ExtraCorporeal Technology (AmSECT) approved the inaugural Standards and Guidelines for Pediatric and Congenital Perfusion Practice. These standards and guidelines were created with the intent of periodic revision to ensure continued alignment with evolving best practices. In 2023, an AmSECT subcommittee initiated this review in consideration of current literature and contemporary clinical practices.

Methods: The subcommittee, consisting of pediatric and congenital perfusionists, conducted a systematic literature review assessing each standard and guideline to determine if current evidence supports elevation of guidelines to standards, incorporation of new guidelines or standards, or whether existing standards and …

The Lived Spirituality Experiences Of Adult Diabetes Patients In Adhering To Treatment, Dwight Mahaputera Marulitua Hutapea

The Qualitative Report

This descriptive phenomenological study explored the lived spirituality experiences of adult patients with Type 2 Diabetes Mellitus (T2DM) in adhering to treatment. Prior research has indicated that spirituality may influence attitudes toward and adherence to chronic disease management; however, empirical evidence addressing the spiritual dimension among people with diabetes remains limited. Guided by Colaizzi's (1978) phenomenological method, in-depth interviews were conducted with 12 purposively selected participants, equally distributed among Christians and Muslims. All interviews were transcribed verbatim and subjected to rigorous phenomenological analysis. Seven themes emerged from the data analysis: (a) spirituality strengthens relationships; (b) spirituality affects choices and outcomes; …

Relational-Developmental Autoethnography: A Method Of Qualitative Inquiry That Fosters Personal Growth, Chris Wells

The Qualitative Report

This paper introduces relational–developmental autoethnography (RDA), a qualitative method for exploring psychological growth through personal writing and reflection. Developed through lived experience, RDA traces psychological development through sustained, recursive engagement with personal writing. Drawing on an archive of my journals, letters, clinical records, and correspondence spanning more than 30 years, I show how writing and reflection were first tools for my survival, and later became catalysts for insight, healing, and transformation. RDA is grounded in two developmental frameworks: Dąbrowski’s theory of positive disintegration, which views emotional intensity and inner conflict as signs of developmental potential, and relational-cultural theory, which …

Cultural Responsiveness: Examining Assessments Of Therapists For Ethical And Clinical Outcomes (Create Clout), Tsotso T. Ablorh

Graduate Doctoral Dissertations

The Multicultural Counseling Competencies (MCC) and Multicultural and Social Justice Counseling Competencies (MSJCC) are well-researched and supported counseling practices for decreasing microaggressions in therapy and consequent attrition, lack of satisfaction, and maltreatment (Ratts et al., 2016; Sue et al., 1982). However, scholars critique existing methods for measuring therapists’ cultural responsiveness for being disconnected from therapeutic process and outcomes (Hays, 2020; Wilcox et al., 2020). This study examined which MSJCC measures associated with variables clinically and ethically relevant to better treatment outcomes and lower microaggressive, neglectful, and stereotypical treatment for hypothetical Black, female clients by White therapists. 62 White psychologists in …

“When I’M Not Heard, I Feel Like I Don’T Matter”: Advancing Equity In Disability Policy Through Critical Participatory Action Research With People With Intellectual Disability, Cris Marchionne

Student Theses

People with intellectual disability deserve a system that offers flexible, timely, and person-centered support — one that is innovative, sustainable, and holistic in enabling them to live fulfilling lives. This qualitative study, grounded in Critical Participatory Action Research (CPAR), examines how people with intellectual disability experience participation in decision-making within New York State's disability service system. By centering lived experience, the study identifies factors that facilitate or hinder participation in decision-making and examines structural, social, and policy-related barriers that limit agency. Through six focus groups and a Photovoice project with self-advocates receiving OPWDD services, participants described systemic barriers that limited …

Artificial Intelligence And Social Equities: Navigating The Intersectionalities In A Digital Age (Editorial), Daisuke Akiba, Julie Albright

Publications and Research

This editorial article introduces and synthesizes the Special Issue, “Artificial intelligence and social equities: navigating the intersectionalities in a digital age,” which examines how AI systems intersect with race, ethnicity, and interconnected identity dimensions across global contexts. The eight contributions span healthcare, digital media, higher education, organizational communication, and speculative futures, addressing anti-racist psychiatric algorithms, AI-generated visual disinformation, epistemic injustice between the Global North and South, algorithmically mediated rural–urban divides, culturally untranslated technology transfer, accessibility auditing across the AI lifecycle, and the tension between mechanical objectivity and empathic understanding. Read together, they show that AI is neither inherently …

Advancing Paternal Perinatal Mental Health: Integrating Qualitative Evidence, Theory, And Measurement Science, Rachael Elizabeth Schmitz

Nursing and Health Sciences

Aim: To advance understanding of paternal perinatal mental health through the integration of qualitative evidence, mid-range theory, and conceptual framework development.

Background: Existing scholarship largely emphasizes prevalence and symptom identification of paternal post partum depression, with limited integration of fathers lived experiences into theory development and assessment frameworks, and mental health nursing practice. Greater integration of qualitative evidence, theory, and measurement science may strengthen the recognition and assessment of paternal distress.

Methods & results: This integrative paper synthesizes findings from a phenomenological study of fathers with postpartum depression, the Reciprocal Adaptation in Postpartum Fathers mid-range nursing theory, and the P- …

Registered Nurses’ Perceptions Of Relational Service Behaviors In Nursing Practice, Dadakpoye Tina Johnson

Walden Dissertations and Doctoral Studies

Nurses play a central role in shaping patient experiences through clinical care and relational service behaviors. However, little is known about registered nurses’ perceptions and experiences of relational service behaviors in contemporary health care settings. The purpose of this interpretive description qualitative study was to explore registered nurses’ perceptions and experiences of relational service behaviors and their role in promoting patient-centered care. Herzberg’s two-factor theory provided the conceptual framework for examining how intrinsic motivators and extrinsic workplace factors influence relational engagement. Semistructured interviews were conducted with 11 registered nurses from diverse clinical practice settings. Interview data were analyzed using Braun …

The Experience Of Wellness And Self-Care For Graduating Bsn Students, Jenny Pappas, Terri A. Clark, Tasha Ruffin, Deborah Ellison, Adrienne Wilk, Debra Rose Wilson

Journal of Social, Behavioral, and Health Sciences

The aim of this study was to explore how graduating prelicensure bachelor of science in nursing (BSN) students experience self-care and wellness, with the goal of informing future curriculum development. Nursing students face significant academic, emotional, and sociocultural pressures that heighten vulnerability to burnout. Despite widespread agreement that self-care is a professional expectation, little is known about the students’ experience within demanding programs. Guided by Orem et al.’s (2001) self-care deficit theory, a qualitative study using interpretive hermeneutic phenomenology was used to examine lived experiences of self-care and wellness. Sixteen graduating BSN students participated in in-depth, semistructured interviews. Interviews were …

Cultural Humility, A Salve For Romantic Relationship Conflict, Lena Blum

Electronic Theses and Dissertations

Conflict communication and having a relationship consisting of differing sociocultural backgrounds (DISC Couples) have been viewed as obstacles or at best hindrances of relationship satisfaction in earlier couples’ psychology literature. More recent literature makes an argument that it is not merely conflict communication or the differences of culture within a couple, but rather how couples navigate both conflict and differences that impact relationship satisfaction. The present work aims to investigate the role of cultural humility in the association between cultural conflict communication and relationship satisfaction, as well as its relationship with the frequency of cultural conflict communication among DISC couples. …

A Brief Self-Help Intervention For Anxiety And Depressive Symptoms Utilizing Cognitive Behavioral Therapy And Dialectical Behavior Therapy Within Correctional Settings, Genevieve L. Ray

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Individuals within incarcerated settings are far more likely to experience symptoms that meet criteria for a mental health disorder compared to the general population. This population is often underserved due to various financial and resource constraints. Self-help interventions have grown in popularity due to their proven effectiveness and accessibility for consumers, particularly for anxiety and depression symptoms. A self-help intervention for those in a correctional setting would not require extensive additional personnel amid financial constraints and would increase access to care. Many self-help interventions that are currently published apply to the community population, but readily accessible resources that reside in …

Clinical Considerations For Black Student Athlete Development, Jahnia Margarita Green

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Black student athletes exemplify the complexity of navigating intersecting identities at pivotal points in their development. They are also more likely to make premature commitments to their athletic identity and in turn suffer from psychological distress during times of transition (Beamon, 2012). The focus on Black collegiate athletes is informed by persistent mental health challenges associated with higher levels of competition or transitions (e.g., injury or retirement) within collegiate athletics (Brewer & Petitpas, 2017; Menke & Germany, 2019). This paper aims to develop culturally informed clinical considerations through the analysis of the Black student athlete experience and structural aspects of …

Well-Being Beyond The Binary In Perinatal Healthcare: An Application Of Reproductive Justice, Orphea D. Wright

Electronic Theses and Dissertations

Gender diverse birthing individuals face several systemic barriers to accessing affirming and empowering perinatal healthcare. The present study utilizes the term gender diverse and the abbreviation TGE to describe those who self-identify as broadly non-cisgender, an umbrella term for people whose gender identity differs from their sex assigned at birth. Gender identities that may be included in this definition include transgender/trans, gender expansive, non-binary, gender fluid, gender nonconforming, gender variant, gender queer/queer, and/or agender. Gender diverse individuals face unique barriers in perinatal healthcare due to the pervasiveness of cisnormativity in perinatal healthcare spaces. Research has documented the harm caused to …

Action Steps Toward Equity In Communication Sciences And Disorders: A Program Evaluation Of Student Self-Efficacy, Monica Bellon-Harn, Lekeitha Morris, Mark Trahan

Teaching and Learning in Communication Sciences & Disorders

Abstract

Purpose: Within communication sciences and disorders (CSD), preparing students for equitable practice requires instruction aligned with social justice principles. Because students’ confidence in engaging in these practices may influence future behavior, this study examined the effects of an asynchronous program, Action Steps toward Equity (ASE-CSD) on undergraduate and graduate CSD students’ self-efficacy for practices aligned with social justice principles.

Method: A pretest-posttest quasi-experimental design was used with undergraduate (n = 16) and graduate (n = 33) CSD students who completed ASE-CSD. Participants completed the Social Justice Scale (SJS; Torres-Harding et al., 2012), which assessed self-efficacy associated with …

Racial Trauma And Posttraumatic Growth: Implications For Counselors, Margaret M. Poandl, Nowoola Awopetu, Paul C. Harris Dr.

Journal of Counselor Preparation and Supervision

Racial trauma is ubiquitous among Black, Indigenous, and People of Color (BIPOC) and people who belong to other marginalized groups. It is likely that counselors will work with individuals who have experienced racial trauma. Aligned with the counseling profession’s values, counselors can take a strengths-based approach that incorporates facilitation of a historical trauma posttraumatic growth (HT-PTG) framework. This paper presents evidence-informed practices that can foster growth on individual and collective levels. A case example is provided that integrates individual- and collective-level interventions bidirectionally, along with implications for counselor training pedagogically, through supervision, and continuing education. Counselors can identify, encourage, and …

U.S. Service Member To Counseling Student, Nicole Marie Arcuri Sanders, Kellie Forziat-Pytel

Journal of Counselor Preparation and Supervision

This qualitative descriptive study examines the absence of military career pathways for licensed mental health counselors (MHCs) and the impact of this structural limitation on service members' career transitions. Findings indicate that both combat and non-combat veterans pursued mental health counseling due to personal service-related mental health experiences and dissatisfaction with available care while in service. Despite these challenges, many participants expressed a strong desire to continue serving their country as professional counselors. Over half of the participants reported separating from the military because no occupational role existed for licensed MHCs. At the same time, most indicated they would have …

Shared Equity Leadership In An Offshore Medical School: Distributing Responsibility For Equity, Vishal B. Surender, Sreekrishna Penna, Oluwabusola Osimosu

Journal of Comparative & International Higher Education

This essay applies the Shared Equity Leadership (SEL) framework to an offshore MD program at a private Caribbean medical school where students complete basic sciences on an island and clinical clerkships across multiple international sites. Using SEL scholarship and de-identified institutional data, we ask how equity work is currently distributed, where gaps emerge in assessment, remediation, and mobility for historically underrepresented students in medicine, and how responsibility for equity might be more deliberately shared. The Woven model of SEL provides a lens to map existing structures like curriculum committees, CQI dashboards, advising systems, and clinical site partnerships. We propose a …

Gender Disparities In Sheltered Status And Systemic Drivers Of Homelessness In Johnson City, Tennessee, Preet Patel, Dr. Opal Frye-Clark

Journal of Appalachian Health

The article examines the homelessness crisis in Johnson City, Tennessee, a mid-sized Appalachian city. First, analysis of Point-in-Time (PIT) counts from 2023 to 2025, conducted in 2025, showed persistently high unsheltered rates (35.88% – 47.17%), with men comprising 60 – 65% of the unhoused population. Men experiencing homelessness also had approximately half the odds of being counted as sheltered compared with women, indicating a gender disparity in sheltered status. Second, an interview with an experienced public health practitioner from the Appalachian Region contextualized these findings by identifying systemic drivers, including the regional housing crisis and policy restrictions, and supporting equitable …