Digital Commons Network^™

"I Feel Like People Would Look At Me Like I'M Dirty Or Like I'M A Thief:" A Qualitative Exploration Of Interpersonal And Intrapersonal Experiences That Influence Recovery Among Adults At Risk Of Opioid-Related Overdose, Hannah S Szlyk, Sara Jones, Jordan Michener, Zhuoran Zhang, Nina Kaiser, Heidi Holtz, Melody Rachel Konadu Frempong, Husain Lateef, William Hutson, Patricia Cavazos-Rehg

2020-Current year OA Pubs

OBJECTIVE: Due to the nature of early termination of treatment and the transient lifestyles of many people who use substances, many providers are unaware of the factors that may have contributed to their client's engagement in treatment. Treatment providers and researchers need a better understanding of intrapersonal and interpersonal factors that impact recovery from the clients' perspective. This study uses qualitative methods to explore these factors.

METHODS: Eligible participants were adults who had used opioids and/or stimulants and were receiving treatment at a consenting facility. Participants completed one-month follow-up interviews after using a mobile health intervention. Transcripts were analyzed using …

Disability Awareness And Inclusion, Claudia C. Gonzalez, Raquel C. Vasquez, Bruce J. Reed

School of Rehabilitation Services & Counseling Faculty Publications

The Centers for Disease Control and Prevention (2021) reported an increase in the prevalence of persons with disabilities affecting one in four people in the United States. Disability awareness and inclusion describe how a combination of understanding, acknowledgment, compassion, and acceptance can allow persons with disability the same opportunities as those without disabilities. This can be seen with the increase in persons with a disability graduating from postsecondary institutions, about 14% from 2012 to 2022 of persons over 25. This chapter covers foundational material regarding disability awareness and inclusion, including the prevalence of disability in general and in educational settings, …

An Examination Of Harm During The Real-Life Experience, Michelle E. Balch

Antioch University Dissertations & Theses

The Real-Life Experience (RLE) has been described as a coercive and arbitrary requirement without evidence of validity or reliability. This can cause more harm than it prevents for a significant subset of transition-seeking transgender clients. For these reasons the RLE was dropped from the WPATH Standards of Care after version six. However, the RLE has been adopted by a number of health insurance companies as a measure of readiness to receive transition services. An Interpretative Phenomenological Analysis (IPA) and semi-structured interviews of five individuals were conducted to evaluate their perceptions of RLE and the meaning they attach to their broader …

Beyond Strong: A Phenomenology Of Women Executives And The Connection Between Leadership And Fitness, Nozomi Bullock

Antioch University Dissertations & Theses

Senior-level executive leaders’ work in a dynamic, competitive, 24/7 business environment can be physically rigorous, mentally demanding, and emotionally isolating. The same holds true for women pursuing senior-level leadership roles in corporate America. Women who achieve and succeed in such roles remain the minority: Outsiders in elite spaces who are held to higher standards and overly scrutinized. Among senior-level executive women leaders, those committed to a fitness and training regimen including weightlifting constitute an even smaller minority. Senior-level executive roles require stamina, resilience, and courage—qualities that make up the foundation of the mindset of fitness and strength training (Foyster et …

Federal Laws And On-Campus Supports For Students With Disabilities In Postsecondary Education, Bruce J. Reed, Raquel C. Vasquez, Claudia C. Gonzalez

School of Rehabilitation Services & Counseling Faculty Publications

In the United States, the attainment of a postsecondary degree is seen as an important milestone that leads to a financially rewarding career. College graduates can expect an increase of 75% in lifetime earnings compared to non-college graduates (Kumok & Hahn, 2023). It is estimated that in 2022, 54% of American adults had earned at least a bachelor's degree (Welding, 2023). Estimates vary as to the number of students with disabilities (SWD) attending postsecondary education ranging from 9-19% (Blasey et al., 2023). The true number of college SWD at any one time is unknown as students must self-report and seek …

Disparities In Maternal Healthcare: Examining The Impact Of Social Determinants Of Health On Provider Care Quality, Rishita Anumukonda

Honors Undergraduate Theses

Poor maternal health outcomes among racially and socioeconomically marginalized populations are a major public health concern in the United States. Effective clinician discussions during prenatal and postpartum care play an essential role in promoting maternal and infant well-being. However, the content of provider-patient discussions in maternal care and how it varies for patients exposed to different social determinants of health has not yet been well explored. This study aims to examine whether healthcare provider discussions about key maternal health topics, including preventative health tips, risk factors, and available resources, differ based on social factors such as income level and race. …

Emotions And Cognition, Krystal D. Becks

Theses and Dissertations

Background: Cognitive functioning is linked to emotional processes, with this relationship shaped by various biological (e.g., age, sex, diseases, and genetics), psychological (e.g., emotional well-being, coping strategies, mental health), and sociological (e.g., income and education) factors. Understanding these interactions is critical for advancing research on cognitive-emotional health across diverse populations. Purpose: To examine the relationship between positive and negative emotions and cognitive functioning among healthy adults. Methods: This was a cross-sectional analysis of data from the Aging Brain Cohort (ABC) study (n=434). The independent variables were subsets from the NIH toolbox emotional battery. The dependent variables were from the NIH …

Check Your Data Before You Wreck Your Model: The Impact Of Careless Responding On Substance Use Data Quality, Abby L. Braitman, Anna M. Petrey, Jennifer L. Shipley, Rachel Ayala Guzman, Emily Renzoni, Alison Looby, Adrian J. Bravo

Psychology Faculty Publications

Background: The accuracy of survey responses is a concern in research data quality, especially in college student samples. However, examination of the impact of removing participants from analyses who respond inaccurately or carelessly is warranted given the potential for loss of information or sample diversity. This study aimed to understand if careless responding varies across a number of demographic indices, substance use behaviors, and the timing of survey completion.

Method: College students (N = 5809; 70.7% female; 75.7% White, non-Hispanic) enrolled in psychology classes from six universities completed an online survey assessing a variety of demographic and substance use-related information, …

Understanding The "Paradox" In Black-White Alcohol Outcomes: Examining High-Effort Coping And Health Behaviors With A Focus On Black Populations And College Students, Rachel Ayala Guzman, Abby L. Braitman

Psychology Faculty Publications

Despite experiencing more physical health disadvantages and psychosocial stressors, Black Americans consistently report better mental health outcomes compared to White Americans—a phenomenon commonly referred to as the Black-White health paradox. Alcohol research has identified another racial paradox suggesting Black Americans are at greater risk for alcohol-related problems despite drinking less than White Americans, which is known as the Black-White alcohol paradox. While both paradoxes are well-documented, few studies have examined their potential overlap or how insights from one might inform understanding of the other. Although the alcohol paradox is usually examined among older adults, it may be important to consider …

Journey To Well-Being: An Exploration Of Thrivership Post-Domestic Violence, Kader Gumus

Antioch University Dissertations & Theses

Domestic violence profoundly affects multiple facets of a survivor’s life. While most existing literature on survivorship addresses the immediate aftermath of domestic violence, this study delves into the extended process following the trauma of abuse to attain “thrivership,” a new concept in the scholarly and practice literature that emphasizes enduring well-being and flourishing. This dissertation examines the journeys from surviving to thriving for 13 women who transformed themselves and their lives to achieve well-being after traumatic domestic violence. Bronfenbrenner’s ecological systems theory was applied to examine the multiple layers of environmental influences on an individual’s development, including the micro, meso, …

Post-Migration Living Distress And Suicidal Behavior In Refugee Populations Resettled In Vermont, Phoebe K. Lewis

Antioch University Dissertations & Theses

The study of refugee psychology and suicidal distress is a comparatively nascent field when compared with the body of research concerning non-refugee populations. Over the past fifty years, however, the post-migration refugee experience has been the subject of growing clinical interest. In particular, the construct of post-migration living distress (PMLD) has been identified as a salient factor contributing to psychological distress in refugee populations. This dissertation explores the relationship between PMLD and suicidality in a sample of refugees resettled in a New England city. Guided by the Interpersonal Theory of Suicide (IPTS), this dissertation considers how elements of the post-migration …

Black Birth Work As Radical Praxis: A Hermeneutic Phenomenological Inquiry Of Leadership Among Black Birth Workers, Lesa C. Clark

Antioch University Dissertations & Theses

This hermeneutic phenomenological study explores the leadership experiences of Black birth workers (BBWs), revealing critical insights into leadership dynamics within maternal healthcare. Through a theoretical framework integrating African feminism, Black feminism, and anti-racist feminism, the research examines how BBWs conceptualize and enact leadership through embodied, relational, and liberatory approaches. This study addresses a significant gap in leadership literature, particularly regarding generational knowledge and practices of BBWs, which remain understudied despite their vital role in Black maternal healthcare. This study reveals distinct leadership perspectives and methodologies through in-depth interviews with eight BBWs and a detailed interpretive analysis. The findings contribute to …

The Importance Of Accessibility, Self-Advocacy, And Affirming Care: An Interpretive Phenomenological Analysis Of Transgender And Gender Diverse Older Adults’ Primary Care Experiences, Jason Vaught

Antioch University Dissertations & Theses

The present study explored the lived experiences of Transgender and Gender Diverse (TGD) older adults when receiving primary care. The methodology utilized for this study was Interpretive Phenomenological Analysis (IPA). Three participants completed individual, semi-structured interviews. The themes that emerged included “Lack of Accessibility to Services,” “Need for Self-Advocacy,” and “Value of Affirming Care from Providers.” These results illustrated the multifarious needs that arise for TGD older adults when accessing primary care. The findings provided recommendations for healthcare organizations, primary care physicians, and other healthcare professionals. Specifically, the recommendations emphasized two key practices for physicians treating TGD older adults: (1) …

Frozen: A Grounded Theory Of Transgenerational Trauma Cycles In The Evangelical Slavic Diaspora Of Former Soviet Union Refugees, Yulia Shtareva

Antioch University Dissertations & Theses

This dissertation builds on historical and scientific assertions that Former Soviet Union immigrants survived distinct political traumas, resulting in unique, culturally adaptive behaviors and beliefs. Using constructivist grounded theory, it examined how these behaviors manifest in the evangelical Slavic community (ESC) of former Soviet Union Refugees (FSURs) in the U.S. The researcher asserts that (a) adaptations are generationally preserved in the ESC through a “cycle of authoritarianism,” and (b) survival strategies became maladaptive in new social environments. Narratives from eight young adults raised in the ESC were analyzed alongside a literature review and lived experience. Findings show that coping strategies …

Loneliness Associates With Endothelial Dysfunction In A Community-Based Cohort: A Pilot Study And Translational Approach, Yvonne Baumer, Brian A. Tirado, Lola R. Ortiz-Whittingham, Andrew S. Baez, Cristhian A. Gutierrez-Huerta, Laurel G. Mendelsohn, Abhinav Saurabh, Joshua A. Jacobs, Marcus R. Andrews, Valerie M. Mitchell, Billy S. Collins, Antwan Jones, Danielle M. Schwartz, Anca D. Dobrian, Michael V. Stanton, Tiffany M. Powell-Wiley

Department of Biomedical and Translational Sciences Faculty Publications

Loneliness is known to be an important contributor to cardiovascular disease (CVD). However, little is known about the impact of loneliness on endothelial barrier integrity, a crucial hallmark of CVD development and progression. In this study, we aimed to investigate how loneliness might impact the endothelium. We found greater perceived loneliness associated with the product of circulating epinephrine and TNFα (E/T), which, in turn, associated with lower VE-cadherin on endothelial cells in an ex vivo experiment. Additionally, circulating plasma levels of soluble VE-cadherin were associated significantly with subclinical CVD. To explore the mechanistic aspects of these associations, we measured the …

Association Of Mean Arterial, Systolic, And Diastolic Blood Pressure Trends In Early Pregnancy With Superimposed Preeclampsia With Severe Features In Pregnancies Complicated By Chronic Hypertension, Tetsuya Kawakita, Justin M. Leach, George R. Saade, Kim Boggess, Lorraine Dugoff, Brenna L. Hughes, Joseph Bell, Kjersti Aagaard, Rodney K. Edwards, Kelly Gibson, David M. Haas, Lauren Plante, Torri Metz, Brian Casey, Sherri Longo, Matthew K. Hoffman, Kara K. Hoppe, Methodius Tuuli, Michelle Y. Owens, Heather Frey, Todd Rosen, Uma M. Reddy, Wendy Kinzler, Emily Su, Iris Krishna, Mary E. Norton, Daniel Skupski, Yasser Y. El-Sayed, Ronald Librizzi, Mounira Habli, Shauna Williams, Gabriella Pridjian, David S. Mckenna, Sarah Osmundson, Joanne Quinones, Zorina Galis, Lorie Harper, Namasivayam Ambalavanan, Jeff M. Szychowski, Alan T.N. Tita

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE: To evaluate the association of longitudinal systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in early pregnancy with later development of superimposed preeclampsia with severe features in pregnancies complicated by mild chronic hypertension.

METHODS: This secondary analysis used data from the CHAP (Chronic Hypertension and Pregnancy) trial, a multicenter randomized controlled trial that involved pregnant individuals with chronic hypertension. Participants were categorized based on the development of superimposed preeclampsia with severe features. Longitudinal blood pressure measurements from enrollment to the development of superimposed preeclampsia with severe features or delivery were assessed using regression models. …

Active Learning In Respiratory Care Education: A Narrative Review, Tisha Ann Skariah, Udaya Kumar Rao, Manjush Karthika

Health Professions Education

Purpose: This study evaluates the effectiveness of active learning strategies in respiratory care (RC) education, specifically examining their impact on student engagement, critical thinking, and clinical competency to address limitations inherent in traditional passive instructional methods.

Methods: A comprehensive narrative review of peer-reviewed literature was conducted using databases such as PubMed, Web of Science, and Scopus. Thematic analysis was utilized to explore the influence of key active learning methodologies, including simulation-based learning (SBL), flipped classroom (FC), problem-based learning (PBL), and team-based learning (TBL).

Results: The findings demonstrate that active learning approaches significantly enhance clinical decision-making, collaborative skills, and knowledge retention …

The Association Between Obstetric Violence And Postpartum Depression Among Latina Women In The United States: An Integrative Review, Natalia Alameda

Scripps Senior Theses

Obstetric violence, a structural form of gender-based violence, involves abuse, mistreatment, or neglect by healthcare providers during obstetric care. It is often associated with childbirth trauma and may result in physical and psychological harm to mothers and children, including postpartum depression. Postpartum depression is a major depressive episode occurring during pregnancy or within four weeks following delivery. While these concepts are often studied independently, few studies examine their intersection, particularly among Latina women in the United States. To address this gap, an integrative literature review was conducted to explore the association between obstetric violence and postpartum depression among Latina women. …

Exploring Lgbtq+ Competency In Healthcare, Jordan Whiteman

Honors College Theses

Marginalized groups such as the LGBTQ+ community are known to face healthcare disparities that negatively affect their process of navigating healthcare systems. This project explores the perceived lack of representation and understanding of the LGBTQ+ community within healthcare settings, exposing the deficits in knowledge for unique challenges and inequalities these patients may face. By viewing the literature, a myriad of complications faced by LGBTQ+ people in clinical settings can be identified. They possess a generalized feeling of mistrust towards the healthcare system. Healthcare staff overall describe low confidence with caring for this demographic. Heteronormativity’s presence in the field of healthcare …

Racial And Ethnic Disparities In Longitudinal Trajectories Of Cardiovascular Risk Factors In Us Middle-Aged And Older Adults, Matthew E Dupre, Radha Dhingra, Hanzhang Xu, Scott M Lynch, Qing Yang, Cassie Ford, Michael D Green, Ying Xian, Ann Marie Navar, Eric D Peterson

Faculty, Staff and Student Publications

Background: Racial and ethnic disparities in cardiovascular disease (CVD) risk factors are well-documented. However, racial and ethnic differences in the longitudinal changes among multiple CVD risk factors are unknown.

Methods: We used prospective cohort data of U.S. adults aged ≥50 in the 2006-2016 Health and Retirement Study. Group-based multi-trajectory models characterized age-related trajectories of systolic blood pressure ([BP] mmHg), non-HDL cholesterol (mg/dL), diabetes mellitus (DM), and smoking. Racial and ethnic differences in the multi-trajectory profiles were examined using multinomial logistic regression. Karlson-Holm-Breen methods were used to assess factors contributing to these associations.

Results: Among 10,292 participants (median age: 61), approximately …

How Do Young Adults With Drug Use Disorder (Dud) Utilize Treatment? Exploring And Examining Lived Experiences Towards Treatment Completion In Indonesia, Dewi Kartikawatiningsih

Electronic Theses & Dissertations (2024 - present)

In Indonesia which has the highest rate of drug addiction in Southeast Asia, there is currently little knowledge about how young adults perceive the barriers faced when completing treatment or how treatment providers' perspectives influence their treatment completion. Understanding and identifying barriers to treatment completion is essential to making drug treatment more effective. The purpose of this study is to explore the perspectives and live experiences of young adults with DUD and their addiction counselors to develop a deeper understanding of treatment needs. This study interviewed 33 clients and 15 counselors from the rehabilitation center of the Badan Nasional Narkotika …

Challenge Based Learning For Social Entrepreneurship Education, Koen Depryck, Ilse Wambacq

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Challenge Based Learning (CBL) provides a promising educational framework for teaching social entrepreneurship, addressing the persistent gap between theoretical knowledge and practical implementation. Through a comprehensive analysis of existing literature and theoretical frameworks, this paper demonstrates how CBL’s seven key elements-authentic challenges, stakeholder involvement, interdisciplinary approaches, student agency, work and life skills development, entrepreneurial mindset cultivation, and impact focus-directly align with and support core social entrepreneurship competencies. The integration of Kolb’s experiential learning theory, Santos’ social entrepreneurship framework, and Rogers’ innovation diffusion theory provide a basis for understanding how CBL can enhance social entrepreneurship education. Evidence suggests that CBL particularly …

Sex Work Patterns Among Transgender And Gender Diverse People: A Latent Class Analysis, Madeline Stenersen, Anjum Umrani, Irelan Fricke, Jessica L. Zemlak

College of Nursing Faculty Research and Publications

Sex work is a diverse profession encompassing a broad range of people, and services. Though overrepresented in sex work communities, transgender and gender diverse (TGD) individuals are underrepresented in sex work literature. Further, sex work literature continues to underrepresent the heterogeneity evident in the sex work community and the practices that occur within it. The present study utilized data from the 2015 United States Transgender Survey (USTS) to conduct a latent class analysis (LCA) to identify patterns of different types of sex work among TGD adults (N = 2,153) and understand the demographic characteristics associated with engagement in different types …

Resilience As Accusation: A Critical Examination Of Individual Resilience Training For Burnout Mitigation, Jacqueline Christianson, Bonnie Sommers-Olson, Jessica Leiberg, Dana Kaminstein

College of Nursing Faculty Research and Publications

Burnout, a syndrome of work-related exhaustion and cynicism, is prevalent among nurses and is associated with workplace stressors. Resilience training programs are a prevalent method of burnout mitigation employed by healthcare institutions that aim to improve or alter how individuals respond to chronic stressors. Through the lens of General Systems Theory, we describe resilience training as a method of individualizing a systemic problem by problematizing a response to chronic stress exposure. Resilience training may furthermore serve as a mechanism which allows subversion of institutional responsibility for nurses’ well-being in the workplace. We describe several suggestions for nurses to resist being …

Defining Knowledge Gaps In Preterm Birth Research: Can Biomarkers Fill The Gaps?, Scott M Williams, Kevin P Rosenblatt, Sandra Reznik, Dawn P Misra, Shajila Siricilla, Nardhy Gomez-Lopez, Brandie D Taylor, Kristina M Adams Waldorf, Ramkumar Menon, Prebic North America 2024

2020-Current year OA Pubs

Preterm birth (PTB) is a syndrome arising from multiple etiologies that manifest as a final common phenotype, delivery before full term. Current knowledge gaps in epidemiologic, basic science, and clinical fields have limited our understanding of this complex pregnancy syndrome. Lack of insight into the cellular and molecular pathways underlying spontaneous PTB (PTB) has thus limited effective clinical management and restricted the investigation of novel treatments or druggable targets. Here, we examine several areas of domain-driven research that may lead to a better understanding of PTB, including infection and inflammation that drive early labor, social factors and their biological consequences …

Identifying Factors Associated With Time To Diagnosis For Symptomatic Intestinal Malrotation In Pediatric Patients, Katie E. Corcoran

Graduate Theses, Dissertations, and Problem Reports (ETD)

Intestinal malrotation is a rare condition in which the intestines rotate improperly during embryonic development. Intestinal malrotation is typically diagnosed in pediatric patients with an upper gastrointestinal imaging (UGI) series. Longer time to diagnosis of intestinal malrotation increases the risk of mortality and severe morbidity. While the need for timely diagnosis is well-established in the literature, the correlates of time to diagnosis are largely unknown. The classic medical presentation for intestinal malrotation is an infant presenting with green bilious emesis. I hypothesize that time to diagnosis of intestinal malrotation will be longer in symptomatic pediatric patients when they present differently …

Improving Hpv Vaccine Rates For Aboriginal Young People Through A Social Media Campaign: An Interrupted Time Series, Natalie A. Strobel, Jocelyn Jones, Kim Gates, Simon L. Turner, Joanne E. Mckenzie, Daniel R. Mcaullay

Research outputs 2022 to 2026

Human papillomavirus (HPV) is a common sexually transmitted infection that can lead to HPV-related cancers such as cervical cancer and other cancers such as anal, vaginal, and penile cancer. HPV rarely produces symptoms and cannot be cured or treated; therefore, vaccination is essential to protect against HPV and HPV-related diseases. However, young Aboriginal and Torres Strait Islander (hereafter, respectfully, ‘Aboriginal’) people are not receiving their HPV vaccine dose, resulting in missed opportunities to be protected from HPV-related cancers. Health promotion is a critical way to empower people to take ownership over and control their health and is a core function …

Male Involvement Interventions Influencing Maternal Reproductive Health Outcomes: A Narrative Synthesis Using Re-Aim With Implications For Maternal Mortality In Africa, Onyekachukwu Anikamadu, Ucheoma Nwaozuru, Nkiruka Obodoechina, Olufunto Olusanya, Temitope Ojo, Juliet Iwelunmor

2020-Current year OA Pubs

INTRODUCTION: Male involvement is crucial in optimizing maternal reproductive health outcomes, offering the potential to bolster reproductive health outcomes for mothers. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework can describe the implementation of interventions focused on promoting male involvement in maternal reproductive health. This study aims to (1) examine the implementation of male involvement interventions that influence maternal reproductive health outcomes and (2) report the implementation outcomes as conceptualized in the RE-AIM framework.

METHODS: This protocol followed the preferred reporting items for systematic review and meta-analysis. We searched PubMed, CINAHL, PsycINFO, and Web of Science utilizing a systematic …

Healthcare Utilization Unchanged In The Control Arm Of A Randomized Clinical Trial, Pratik Gongloor, Saad Nadeem, Xiaoying Yu, Mukaila Raji, Kristina D Mena, Elizabeth M Vaughan

Faculty, Staff and Students Publications

including among control groups. Increased access to care and heightened health awareness during trial enrollment could lead to altered behaviors, a phenomenon known as the Hawthorne effect, which may obscure true intervention impacts; however, this effect remains poorly studied in low-income environments.

Aim: To conduct a secondary exploratory analysis of healthcare utilization among control participants of a randomized clinical trial (RCT).

Methods: We retrospectively analyzed electronic medical records from the control arm (n = 26) of an RCT involving low-income Hispanic adults with type 2 diabetes receiving care at a community clinic. Before randomization to a 12-month diabetes education intervention …

Differences In Mental Health Outcomes In Immigrant Vs. U.S.-Born Populations In Urban Vs. Rural Areas In The United States, Zoë Gentles

Electronic Theses & Dissertations (2024 - present)

Background

The immigration process to the United States creates distinct mental stressors. These stressors are influenced by socioeconomic factors including income, education level and insurance status. In rural America, these factors are intensified due to a poor healthcare infrastructure that is limited. This study examines the relationship between urban-rural residence and mental health outcomes among immigrants vs. native-born residents in the United States.

Methods

Data from the National Health Interview Survey (NHIS) from 2019 and 2022 were used to examine the relationship. The exposure of interest was place of birth, and the outcome of interest was the presence of clinically …