Digital Commons Network^™

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …

Life In Laughter: Comedy’S Impact On Student Health And Success, Julia Weinstein

Honors Undergraduate Theses

College students face rising rates of anxiety, depression, and stress, highlighting the need for accessible, stigma-free wellness interventions. While comedy is often seen as entertainment, research indicates laughter produces measurable psychological and physiological benefits, including reduced cortisol and increased endorphins. Life in Laughter, a creative-research hybrid project, investigates how live and digital comedy experiences affect college students’ mood, stress, and sense of belonging. Using mixed methods, data were collected through anonymous audience surveys, app-based reflections via JoyScroll, and interviews, supplemented by a mini-documentary. Findings suggest humor functions as both an emotional regulation tool and a means of fostering …

Colorectal Cancer Screening In Carceral Settings: Barriers And Opportunities To Improve Early Detection Among Incarcerated Individuals, Daven K. Sarikonda Ba, Elijah Marquez Bs, Alexander Seidel Ba, Christine Larrea Bs, Jack S. Gurwin Bs, Maria Karla Bermúdez Piñero Ba, Suraj Suresh M.D., Laura Benjamins Md, Mph, Faap, Aahivs

Population, Patient, Physician and Professionalism Projects

Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related death in the United States, with screening shown to significantly reduce mortality. However, incarcerated individuals experience substantially lower CRC screening rates and often present with more advanced disease than non-incarcerated individuals. Our project’s objective was to review the state of CRC screening in U.S. carceral settings, along with exploring possible alternatives to address the substantial disparity in CRC screening rates experienced by the incarcerated population.

Covid And The Great Retrenchment, Samuel R. Bagenstos

Articles

The past six years have seen two dramatic shifts in federal health and benefits policy. First, during the COVID pandemic, the government dramatically expanded public benefits. These expansions had incredibly positive effects, and recipients were largely satisfied with them. But after a relatively short time, Congress rolled back nearly all of the expansion. Worse, the immediate pullback set the stage for even more significant retrenchments in the second Trump Administration. Where in 2023 the United States came closest to universal health care in its history—with a record low uninsured rate of 7.7%—the Trump Administration’s Medicaid cuts and failure to extend …

Poct Hgb A1c And Patient Satisfaction In Adult Patients With Diabetes, Kelly Galvin

West Chester University Graduate Theses, Dissertations, and Final Projects

Point-of-care testing (POCT) is used to measure a variety of healthcare data rapidly at the bedside. It can be particularly useful when laboratory data is not available at the time a patient sees their healthcare provider (HCP). Patients living with diabetes frequently do not obtain laboratory data prior to their visit with their HCP. This quality improvement projected aim to assess if use of POCT to measure an Hgb A1c level in patients with diabetes affected patient satisfaction in an endocrinology clinic. Eligible participants were asked to complete an anonymous survey, with three questions asking if having their Hgb A1c …

Photovoice Exploration Of Afghan Refugee Background Women's Food-Related Well-Being, Eileen C. Lindemann

Graduate Research Theses & Dissertations

More than 117,000 Afghans have been relocated to the United States following the U.S. military withdrawal in August 2021. Research indicates that Afghan refugees resettled in the U.S. are at increased risk of psychological distress, with Afghan women particularly susceptible compared with Afghan men, and diet-related chronic disease. However, research also shows that traditional food and eating customs foster cultural identity, social support, integration, and well-being. The purpose of this study was to collaboratively explore the food-related well-being and daily life contexts of resettled refugee participants through the photovoice method, a participatory research strategy in which participants photograph aspects of …

Seeing Public Health In Color: Phenomenological Perspectives Of Bipoc Women In Leadership, Jasmyn Spicer

All Graduate Theses, Dissertations, and Other Capstone Projects

Public health is a complex, ever-changing industry that holds pivotal capacity to impact society on a larger scale. For the United States, disparities and inequity in public health have had significant consequences for Black, Indigenous, and People of Color (BIPOC) communities. Effective leadership in public health has the potential to impact roles, policy development, and the overall scope of oversight regarding the quality of care that communities are provided in the industry. While BIPOC women are underrepresented in public health leadership roles, they have the capacity to advance equity in the field and contribute to culturally responsive care in foundational …

The Limits Of Daca: Affordability- And Access-Related Barriers To Health Professions Education, Nicole Perez, Laura Hirshfield

Journal of College Access

The U.S. is currently facing a shortage of health professionals from underrepresented backgrounds. One potential pathway to decrease this shortage is through the Deferred Action for Childhood Arrivals (DACA) program, a policy that provides temporary relief from deportation for individuals who migrated to the U.S. before age 16. This study, using 15 life-history narrative interviews, investigates the experiences of Latinx young adults who were pursuing health professions education or working as health professionals. Nine of the participants were DACA recipients, while the remaining six were second-generation (i.e., children of immigrants). An iterative, inductive approach to data analysis was used to …

Understanding Risk And Protective Factors Of Intimate Partner Violence: A Public Health And Social Advocacy Approach, Mangai Natarajan, Yasemin Irvin-Erickson, Brittany Suh, Susan Nembhard, Lindsay Smith, Yi-Fang Lu

Sociology & Criminal Justice Faculty Publications

Intimate partner violence (IPV) is a recurring social problem that has individual, interpersonal, community, and societal level consequences necessitating interdisciplinary knowledge and a holistic, systemic approach for prevention. Recent research on IPV indicates the need to identify the implications of the COVID-19 pandemic for IPV risk and subsequent consequences to inform mitigation solutions. Using a mixed-methods design, this rapid assessment research aims to address an existing gap by gathering primary data on the perceived risk and protective factors in addressing IPV through interviews, focus group discussions (n = 102), and surveys (n = 324) from a purposive sample of victim …

Effects Of Differential Stress And Mental Health On Substance Use Among College Students, Avdi S. Avdija, Arif Akgul

Sociology & Criminal Justice Faculty Publications

Substance use among college students is often seen as a coping mechanism for some students who are prone to extreme stress, depression, or anxiety. Multiple forms of stress become the leading factors that push students toward substance use. This study tests the effects of college stressors, depression, and anxiety on substance use among college students. The results are based on the data that were collected using a 101-item questionnaire administered to 302 college students at a public university in the Midwest U.S.A. Using Logistic Regression as the primary data analysis technique, the findings of this study show that social stressors …

Maintaining Trust In Uncertain Times: Funding Pauses And The Ethical Cost To Community-Engaged Research, Brynn E. Sheehan

Department Psychiatry & Behavioral Science Faculty Publications

Federal funding pauses, once considered rare, are increasingly disrupting the stability and continuity of community‐engaged research. Even projects with active, awarded grants are experiencing the strain of funding uncertainty, raising substantive concerns among research teams and community partners. These disruptions extend beyond operational delays; they jeopardize the continuity of relationships developed through sustained, collaborative engagement. In the absence of clear information about a project's future, uncertainty undermines trust and challenges the ethical principles that guide human subjects research, particularly beneficence and justice. This paper draws on direct experience and insights from the broader field to examine the practical and ethical …

Exploring Microaggressions Experienced By Students Of Color In Occupational Therapy Programs: Fostering A Climate Of Belonging, Laurie Knis-Matthews Ph.D., Ot, Sara Frommer Otd, Otr/L, Jacquelyn Pierre Otd, Otr/L, Geena Santomo Otd, Otr/L, Corrine Pineda Msot, Otr/L, Jackeline Artiles Otd, Shaniqua Bradley Ph.D., Lcsw

Journal of Occupational Therapy Education

Microaggressions, which are subtle and often unintentional acts of bias, continue to shape the educational experiences of students from marginalized backgrounds, yet their nuanced nature makes them difficult to define and address. This phenomenological qualitative study investigated the lived experiences of occupational therapy graduate students of color regarding microaggressions within their academic programs. Using purposeful sampling, five occupational therapy graduate students from various United States institutions participated in individual, semi-structured interviews. Thematic analysis revealed four key themes: It’s Hard to Describe a Microaggression without Using Examples and Explaining the Emotions Behind It; These Microaggressions Had Immediate and Long-Term Consequences on …

Toward A Critical Occupational Therapy Education: A Discrit-Informed Framework, Robert Niewiadomski, Chia-Yang Chiang

Journal of Occupational Therapy Education

Occupational therapy has long articulated commitments to equity, inclusion, and occupational justice, yet its dominant educational approaches often remain focused on interpersonal competence rather than structural analysis. This conceptual paper argues that contemporary occupational therapy education is insufficiently equipped to prepare practitioners to address the sociopolitical forces shaping occupational participation. Drawing on disability critical race theory (DisCrit), critical pedagogy, intersectionality, and occupational justice scholarship, the authors propose the Critical Occupational Therapy Education (COTE) framework as a structural, justice-oriented reorientation for occupational therapy education. COTE positions racism and ableism as interlocking systems that shape professional norms, knowledge production, and access to …

Collaboration Between Occupational Therapy Doctorate And Doctor Of Osteopathic Medicine Students: Interprofessional Education In Fall Prevention, Linda Frasier, John V. Rider

Journal of Occupational Therapy Education

Falls among older adults are a pervasive public health concern that requires coordinated interprofessional strategies. Interprofessional education (IPE) can enhance collaboration and role clarity among students in health professions, particularly in geriatric care, where complex medical, functional, and environmental factors intersect. The purpose of this study was to examine the impact of an IPE event involving entry-level Doctor of Occupational Therapy (OTD) and Doctor of Osteopathic Medicine (DO) students focused on fall prevention in older adults. A retrospective cross-sectional design was employed to analyze written reflections from 125 students following their participation in a standardized patient IPE event. Small interprofessional …

How Do Students Come Across Occupational Therapy And What Makes Them Want To Study Occupational Therapy? Implications For Recruitment, Mette Eg Bruun, Mette Krohn, Sofie Balle Riis, Lene Tanggaard, Tina Helle

Journal of Occupational Therapy Education

Recruitment challenges in occupational therapy education vary globally. To address workforce needs, it is necessary to examine the factors influencing students’ decisions to pursue occupational therapy. This study investigated how students discovered occupational therapy, what they found appealing about the profession, the influence of study location, and demographic differences between students enrolled in an urban university city and a rural district. Three focus group interviews with 15 occupational therapy students were conducted, supplemented by descriptive statistics comparing student characteristics across urban and rural programs. Qualitative analysis identified five categories: (1) discovering occupational therapy by chance, (2) the power of occupational …

A Rasch Analysis Of The Self-Assessment Scale Of Clinical Reasoning In Occupational Therapy (Sa-Crot) For Continuing Professional Development, Sho Maruyama, Reiko Miyamoto, Takuya Hirose, Takao Kaneko, Peter Bontje

Journal of Occupational Therapy Education

The purpose of this study was to establish structural validity, internal reliability, and concurrent validity of the Self-Assessment scale of Clinical Reasoning in Occupational Therapy (SA-CROT) when used in continuing professional development. We conducted a cross-sectional survey of 513 occupational therapists with ≤5 years of experience. Rasch analysis was applied to assess structural validity (rating scale functioning, monotonicity, dimensionality, item/person fit) and reliability (item/person reliability, strata). Additionally, concurrent validity was examined by Spearman’s correlation with clinical experience. The Rasch rating scale analysis supported the structural validity of the SA-CROT. Categories showed ordered thresholds with outfit mean-square (MnSq) values ranging from …

Perceived Impacts Of Confucianism On Placement Experiences Of Hong Kong Pre-Registration Occupational Therapy Students In The United Kingdom, Hin Yuet Li, Sarah Louise Mcginley, Rachel Dadswell, Rachel Houweling

Journal of Occupational Therapy Education

This study explored the views of Hong Kong pre-registration occupational therapy (OT) students in the United Kingdom (UK) about how Chinese culture influenced their practice placement experiences. Students from diverse cultural backgrounds may encounter various challenges during OT placements, but little is known about how OT students from Hong Kong—where Confucianism traditionally shapes workplace expectations and the hierarchical teacher‑student relationship—experience placements in the UK. Two online focus groups to collect qualitative data were conducted in November 2022 with four participants who were UK-based OT students from Hong Kong (N=8 in total), two facilitators (OT students from Hong Kong, based in …

Hospitality As A Philosophy Of Care, Freddy Clark

Antioch University Dissertations & Theses

This study examines hospitality as a philosophy of care and a practice of social justice, particularly within marginalized communities. While hospitality is often understood as a gesture of kindness or a function of the service industry, this research reframes it as an ethical and relational practice grounded in human dignity, mutuality, and community formation. It explores how hospitality extends beyond transactional exchanges to become a transformative expression of care that challenges exclusion and affirms belonging. Drawing on interdisciplinary frameworks, the study integrates biblical narratives, including the Good Samaritan and Matthew 25:35–40, philosophical perspectives from Emmanuel Levinas and Jacques Derrida, and …

Impact Of Social Determinants Of Health On Perioperative And Interstage Outcomes In Congenital Heart Surgery A Systematic Review, Sara Sakowitz, Jennifer S. Nelson, Justin Robinson, Camilla S. Rossi, David M. Shahian, David T. Cooke, Jeffrey P. Jacobs, Shelby Aughtman, Megan Schultz, Meena Nathan, Claude Beaty, Michal Shafer, Deborah Kozik, Glenn J. Pelletier

Department Surgery Faculty Publications

Importance: Social determinants of health (SDoH)- conditions in which patients live, grow, and age, - are increasingly recognized to influence the health of patients with congenital heart disease (CHD).

Objective: To explore the impact of SDoH on short-term mortality and morbidity, interstage outcomes, and resource utilization, among patients following congenital heart surgery.

Evidence Review: A systematic review was completed according to PRISMA guidelines. Relevant studies evaluating the association of SDoH with surgical outcomes of pediatric and adult CHD patients were identified from five databases queried including PubMed, SCOPUS, CINAHL, PYSCINFO, and Cochrane between January 1999 and February 2024. Inclusion criteria …

Dental Professionalism In A Changing World: Challenges & Opportunities, Robert P. Iovino, Dds, Ma Dds, Ma

Journal of the American College of Dentists

This manuscript examines the erosion of traditional dental professionalism amid rising educational costs, declining membership in professional associations, and the growing influence of corporate ownership and private equity in dentistry. Drawing perspectives from economics, sociology, philosophy, law, and ethics, it traces the historical development of professional licensure and its role in safeguarding clinical autonomy, ethical integrity, and public trust. The analysis highlights how deregulation and profit-driven practice models challenge the profession’s social contract. The manuscript argues that preserving strong civic institutions, restrictive licensure standards, and humanities-informed education is essential to sustaining dentistry as a learned profession rather than a commodified …

The Personal, Professional, And Practice: Integrating Health Humanities Into Dental Education, Margie Hodges Shaw Jd, Ma, Phd, Michael Yunker Dds, Nicholas Mercado Drph, Ms

Journal of the American College of Dentists

Dentistry’s evolution as a profession reflects both scientific progress and enduring tensions between commercial and service-oriented models of care. Despite long-standing commitments to ethical education, dental training continues to privilege technical mastery over professional identity formation, leaving some future practitioners underprepared for the ethical and relational complexities of clinical practice. This paper situates these challenges within the historical separation of dentistry and medicine and argues that integrating the health humanities into dental education can strengthen professional identity formation and clinical ethics competency. Using a case study, we demonstrate how biases, professional obligations, and patient trust intersect in practice. We introduce …

Negotiating Health: A Qualitative Analysis Of Home Smoking Rules Among Families With Medically Vulnerable Infants, Yolanda R Villarreal, Thomas F Northrup, Stephen M Fischer, Jackson S Norwood, Angela L Stotts

Faculty, Staff and Student Publications

Introduction: Approximately 5000 child deaths are attributed to secondhand smoke exposure (SHSe) annually, which is three times the number of childhood cancers combined. Infants, medically fragile infants, are highly vulnerable to the harmful effects of SHSe, including respiratory infections and sudden infant death syndrome. While having a home smoking ban may mitigate these risks, implementation remains a challenge for many families. Our primary aim was to explore the familial and sociocultural factors associated with smoking-ban initiation and maintenance in households with medically fragile infants.

Methods: Qualitative interviews were conducted with 20 mothers participating in a behavioral intervention from 2015 to …

The Psychiatric Burden Of Hidradenitis Suppurativa: A Trinetx Analysis Of Sex-Specific Disparities In Mental Health And Medication Use, Emily Sheetz, Julia Feord, Collette Sholi, Parker Adams, Tamas Gal, Susan G. Kornstein, Arturo Saavedra

Department of Medicine Faculty Publications

Background:

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with physical and psychological burden. Prior research has shown increased rates of depression and anxiety among individuals with HS; however, sex-based disparities in the prevalence of these mental health conditions in patients with HS remain underexplored.

Objective:

To evaluate sex-based differences in the prevalence of major depressive disorder (MDD), generalized anxiety disorder (GAD), and the prescribing of antidepressants and anxiolytics among patients with HS.

Methods:

Using the TriNetX database, we identified patients over the age of 18 who had a recorded diagnosis of HS. Propensity score matching based on …

Addressing Professional Tensions Through Intellectual Candour And Stewardship, Thoughtful Dialoguing As A Duoethnographic Collaborative Exploration, Sarah Barradell, Narelle Lemon

Research outputs 2022 to 2026

Using duoethnography, we explore our experiences of physiotherapy practice and education and argue that the profession’s desire for credibility is at the expense of vulnerability, risk and intellectual candour–of imagining the profession and education of its graduates differently. We identified key themes around: alignment/misalignment, reflection/reflexivity and professional scope. This methodology models risk and questioning through the juxtaposition of different perspectives. Through our contrasting narratives, we remain open to new forms of learning, modelling what intellectual candour demands from us: facing the problems of the past so that we might learn from our history and change our future. This can be …

The Nurse's Role In Curative-To-Palliative Transitions In Advanced Cancer: A Theory Synthesis Using Turner's Method, Geya George, Deborah Kirk, Davina Porock

Research outputs 2022 to 2026

Aim: This paper aims to explain the process of formulating a robust theory that comprehensively explains the nurse's role during the transition from curative to the palliative phase in advanced cancer care. Design: A qualitative theory synthesis approach was applied, utilising Turner's 9-step theory synthesis method to integrate five grounded theories and 10 qualitative studies. The Walker and Avant method of concept development and analysis further ensured rigour. Methods: Turner's theory synthesis was used to formulate a more comprehensive, testable theory from five existing grounded theories and 10 other qualitative studies that explain the nurse's role in supporting and facilitating …

Early-Life Pathways To Inequalities In Child Mental Health: Evidence From Eight Birth Cohorts, Demetris Avraam, Gabriella Melis, Tim Cadman, Jennie Carson, Marie Aline Charles, Yu Wei Chua, Ahmed Elhakeem, Joaquín Escribano, Veit Grote, Dariusz Gruszfeld, Kathrin Guerlich, Rae-Chi Huang, Jennifer R. Harris, Jesus Ibarluzea, Jordi Julvez, Berthold Koletzko, Ashleigh Lin, Unai Martin, Rosemary Mceachan, Maria Melchior, Phillip Melton, Johanna Thorbjornsrud Nader, Angela Pinot De Moira, Maja Popovic, Simona Porru, Lorenzo Richiardi, Blanca Sarzo, Daniela Schlüter, Jordi Sunyer, Morris Swertz, Elvira Verduci, John Wright, Annick Xhonneux, Tiffany Yang, Daniela Zugna, Anne-Marie Nybo Andersen, Katrine Strandberg-Larsen, David Taylor-Robinson

Research outputs 2022 to 2026

Background: Socioeconomic inequalities in children's emotional and behavioural problems are already present at school entry. We examined associations between early-life socioeconomic conditions and children's externalising and internalising problems and assessed whether early-life risk factors mediated these associations.

Methods: We analysed harmonised individual participant data from eight birth cohorts within the EU Child Cohort Network. Maternal educational level during pregnancy was used as an indicator of early-life socioeconomic conditions (SECs). Scores of children's externalising and internalising problems around school entry age were used as the outcome variables. Inequalities were quantified using the Slope Index of Inequality which captures the difference in …

Overview Of Aboriginal And Torres Strait Islander Health Status 2025, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

This Overview provides a summary of the most recent indicators of the health and wellbeing of Aboriginal and Torres Strait Islander people (of all ages, where data are available). The topics included in the Overview cover chronic health conditions which are featured on the HealthInfoNet website. Over the years as additional funding has been obtained and in consultation with HealthInfoNet networks, more topics have been covered on the website and are now included in the Overview. The topics aim to reflect the status of Aboriginal and Torres Strait Islander health over this period and going forward.

The Lived Experience Of Tenders Of Community Grief Rituals, Margaret Y. Wilson

Antioch University Dissertations & Theses

The purpose of this research study is to gain an understanding of the lived experience of tenders of community grief rituals, and how tenders make meaning of their experiences. This study utilized photo elicitation and a reflexive thematic analysis. Participants (N = 11) provided one to three photographs that captured their experience of grief and/or tending grief rituals. The results identified 10 themes supported by subthemes: (a) Grief Tender Wisdom About the Nature of Grief, (b) Life’s Many Experiences are Sources of Grief, (c) The Multifaceted Impacts of Grief-Body, Anger, Compassion, Empathy, Resilience, Gratitude, Joy, and Love, (d) The Nuances …

Navigating Family, Culture, And Well-Being: A Qualitative Study Of First-Generation Adult Children Of Middle Eastern Immigrants In The United States, Ramona Amely

Antioch University Dissertations & Theses

The purpose of this study is to explore the lived experiences of first-generation adult children of Middle Eastern immigrant parents/caregivers living in the United States. This was a phenomenological study with reflexive thematic analysis. Participants (N=10) were interviewed via Zoom, and transcripts were analyzed using Reflexive Thematic Analysis (RTA). The results included four themes: (1) Migration Contact and Cultural Formation, (2) Bicultural Identity Development, (3) Family System Adaptation, and (4) Emotional Socialization and Psychological Impact. This study highlights how first-generation adult children of Middle Eastern immigrants navigate complex, interwoven processes of bicultural identity development, family adaptation, and emotional socialization shaped …

Bi+ Cismale Experiences With Straight Cismale Friends, Taylor M. Hardock

Antioch University Dissertations & Theses

Minority Stress Theory (2006) posits that individuals with a marginalized sexual identity have unique challenges and stressors. Bisexual+, or bi+, individuals have particular stressors related to not holding a monosexual identity, including specific mental health challenges. Research has shown that friendship can have many positive benefits on individuals, though the literature looking at friendship among bi+ identifying people is very limited. This qualitative study investigates the experiences of friendship between bi+ and straight cis men, especially as they may relate to minority stress and experiences of resilience and community belongingness. A thematic analysis was utilized to understand the personal experiences …