Digital Commons Network^™

Identifying Key Influencing Factors Of Elderly Health Information Search Based On Meta-Ethnography, Zhumei Sun, Zhibing Wang

Journal of Scientific Information Research

[Purpose/significance] Health information search is an important way for elderly people to actively cope with aging. Identifying the key factors affecting of their health information searching and exploring the correlation among these factors are of positive significance for promoting the elderly proactive health ability.

[Method/process] This paper firstly integrated the original research through a meta-ethnographic approach to form a set of factors influencing the elderly health information search. The DEMATEL method was then used to analyze the interrelationships among the influencing factors and identify the key influencing factors.

[Result/conclusion] The study finds that, the influencing factors of elderly health information …

Spatiotemporal Modeling Of Maternal Mortality In South Carolina 2018-2023, Leah Wood, Ray Bai, Emily Mann

Senior Theses

Maternal death serves as a public health indicator due to fact that it is considered preventable with the availability of modern biomedicine, however, it persists broadly throughout the United States. Current literature outlines national trends in maternal mortality with complicating, preexisting conditions, and structural upstream factors often cited as being the largest contributors to increased risk. This study utilizes publicly available, county-level data for maternal death in addition to demographic and descriptive data in order to estimate maternal mortality rates in each of South Carolina’s 46 counties from 2018 to 2023. In order to address sparsity in the outcome variable …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda L. Killeen

School of Podiatric Medicine - Student Research

Introduction: Diabetes mellitus is the 7^th leading cause of death in the United States and is 6^th in the state of Texas. Counties from South Texas are primarily affected with higher rates of diabetes than both the state and national average. Diabetes mellitus is a complex and progressive disease which can affect multiple systems of the body, leading to serious complications if untreated, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas is a region predominantly populated by Hispanic Americans who are disproportionally …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Diabetes mellitus is the 7th leading cause of death in the U.S. and 6th in Texas. South Texas counties have higher diabetes rates than state and national averages. This complex, progressive disease affects multiple body systems and can lead to serious complications, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas, predominantly Hispanic American, is disproportionately affected. This demographic faces clinical barriers due to a lack of cultural understanding, highlighting the need for culturally sensitive healthcare workers such as promotoras. This study aimed to …

Implementing Pain Reassessment Workflow To Improve Timely Pain Management In Hospice Patients: A Quality Improvement Project, Oluremi Omodara

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely pain reassessment is a vital component of hospice care, directly influencing the quality of life for patients. Despite the high prevalence of pain, which affects 55% of hospice patients due to disease progression or adverse drug reactions, only 51% of those reporting moderate to severe pain at admission receive a documented reassessment. The gap highlights an organizational issue in pain management stemming from the absence of a clearly defined period and workflow for reassessment.

Aim of the Project: The aim of the quality improvement (QI) project was to improve compliance with pain reassessment documentation within 48 hours …

Venezuelan Migrants In Prostitution: A Personal Decision?, Yazmin Maria Lucila Cadena Camargo, Izara Maite Mondragon Moreno, Isabela Osorio Jaramillo, Paula Angélica Suárez Álvarez, Andrés Duarte Osorio, Carlos Gómez-Restrepo

Dignity: A Journal of Analysis of Exploitation and Violence

This paper explores the multifaceted experiences of Venezuelan migrant women engaged in prostitution, framed through three critical moments: the “decision to enter in prostitution,” the unique abuses faced, and the resultant consequences on mental, physical, and social health. The study highlights how socioeconomic vulnerabilities—exacerbated by migration and poverty—significantly influence the likelihood of entering prostitution. It also shows how traumatic experiences, particularly in childhood and adolescence, coupled with a lack of support networks, contribute to a heightened risk of exploitation. Eleven life stories were collected through a phenomenological approach, revealing a common narrative of abuse, poverty, and the search for survival …

Minimizing Travel Burden Of Gynecologic Cancer Surveillance Through A Unique Multidisciplinary Telehealth Program, Avni Shridhar, Suzanne Viator, Tara Castellano, Holly Provost, Navya Nair, Elizabeth Neupert, Amma Agyemang, Amelia Jernigan

School of Medicine Faculty Publications

OBJECTIVE: STEEL MAGNOLIAS (shared telehealth for multidisciplinary gynecologic cancer survivorship) is a novel gynecologic cancer surveillance care-delivery program in which rural patients see a close-by gynecologist in person with simultaneous virtual gynecologic oncology consultation. This study assesses feasibility of STEEL MAGNOLIAS by examining travel burden reduction, cancer outcomes, visit activities, guideline adherence, and patient satisfaction. METHODS: We retrospectively reviewed charts of patients with gynecologic cancer in remission under the STEEL MAGNOLIAS program in rural south Louisiana (March 2020-September 2023). Travel metrics, patient satisfaction, cancer outcomes, survival status, reasons for visit, and adherence to follow-up as per National Comprehensive Cancer Network …

Influence Of Institutional Support And Organisational Culture On Hiv And Ncd Integration, David Njuguna, Caroline Kyalo, Eunice Muthoni, Daniel Mwai, Elvis Kirui, Wesley Rotich, Joy Mugambi, James Waweru, Nelson Muriu, Easter Olwanda

Population Health, East Africa

Background: The integration of services for human immunodeficiency virus (HIV) and noncommunicable diseases (NCDs) has gained increasing attention in recent years because of the overlapping prevalence and shared risk factors between these health conditions. However, successful integration requires more than just the alignment of clinical practices. The role of institutional support and organisational culture in promoting effective integration remains an underexplored area.

Aim: This study aims to fill this gap by examining how institutional structures and organisational values influence the integration of HIV and NCD care.

Setting: The study setting was Nakuru County in Kenya.

Methods: …

Toward A Nuanced Understanding Of Health And Human Services Students' Perceptions Of Autism, Leslie A. Meskin, Annemarie Connor, Sarah Fabrizi, Ann Tilman, Joanna Salapska-Gelleri, Noelle Balsamo

Journal of Human Services: Training, Research, and Practice

Continually increasing rates of autism necessitate research-informed preparation of pre-service professionals who will work with this population. This mixed-method study examined health and human services students’ autism knowledge, bias, and interaction to inform training and education needs. Results extend the extant literature suggesting autism knowledge and interaction are necessary but insufficient in mitigating bias. Specifically, the nature of prior interaction, positive or negative, shapes both bias and proclivity for additional interaction. Lastly, self-reflection was identified as a latent and potentially impactful factor in shaping a more nuanced and less biased understanding of autism. Recommendations for education and research are discussed.

English-Spanish Bilingual Speech Language Pathologists’ Experiences Evaluating English Language Learner Students: Incorporating Conceptual Scoring, Barbara De Jesus Rivera, Raul Prezas

Journal of Human Services: Training, Research, and Practice

The number of multilingual/bilingual students has increased across schools in the United States. Assessment in both the native language and English is considered the standard for evaluating bilingual children referred for language testing. Conceptual Scoring is an evaluation approach for bilingual students that considers the students’ responses in both languages to obtain an overall language score; however, there is variability among practitioners on best practices for multilingual assessment.

Purpose: The current study (a) sought to explore the decision-making process of bilingual SLPs when evaluating bilingual students, (b) to gain a deeper understanding of how bilingual SLPs incorporate conceptual scoring in …

Recommended Best Practices For Construct-Centered Adaptation Of The Harmonized Cognitive Assessment Protocol, Emily Briceño, Darina Bassil, Pranali Khobragade, Anthony Ngugi, Martine Bejjani, Eric Ochieng, Silvia Mejia-Arango, Salima Douhou, Kazione Kulisewa, Miguel Rentería

Population Health, East Africa

Objectives The Harmonized Cognitive Assessment Protocol (HCAP) neuropsychological assessment approach aims to support the collection of harmonizable data on cognitive function for cross-national cognitive aging and dementia research. As the measurement of cognition is sensitive to differences in contextual, cultural, educational, linguistic, social, and other factors that may influence cognitive test performance, HCAP requires adaptation to be appropriate for the contexts in which it is administered. We aim to provide methodological recommendations for the adaptation and implementation of the HCAP and other cognitive data collection tools in novel settings.

Methods We drew from existing guidelines on cross-cultural psychological test adaptation …

Community Firearm Violence And Dental Care Use In Middle Adulthood, Alexander Testa, Luis Mijares, Daniel Semenza, Richard Stansfield, Ian Silver, Dylan B Jackson, Ana Neumann, Jeff R Temple, Rahma Mungia

Faculty, Staff and Student Publications

Prior research links violence inside the home to reduced dental care utilization, yet little is known about how community firearm violence affects dental care behaviors. The current study used data from wave V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health (Add Health), linked to census tract-level fatal and nonfatal shooting data from the American Violence Project for the 100 largest cities in the United States. The analytic sample included 1925 respondents aged 33-42. The primary outcome was self-reported dental care use in the past year. Firearm violence exposure was categorized as 0, 1, or 2 + …

Opportunities And Barriers To Engaging Caregivers In Firearm Suicide Prevention: Findings From Focus Groups With Caregivers Of Veterans, Katherine Macwilliams, John Marmion, Dee Blascyk, Sharon Urbina, Rachel Moyers, Gala True

School of Medicine Faculty Publications

Background: Firearms are involved in more than 70% of U.S. Veteran suicides. Caregivers, defined as family members or concerned significant others, can play an important role in firearm suicide prevention through initiating conversations about secure firearm storage with Veterans. Our objective was to explore caregivers’ experiences with lethal means safety (LMS) conversations and identify perceived barriers to caregivers discussing LMS with healthcare providers and with Veterans. Methods: We conducted focus groups with 32 caregivers with experience caring for a Veteran at risk for suicide. Qualitative data were analyzed using thematic analysis. Results: We identified three primary themes: 1) caregivers recognize …

Survival Impact And Sociodemographic Correlates Of Colon Cancer Surgery, Refusal, Paola Berrios Jimenez, Angel Aguayo Merly, Ramin Shekouhi, Berkay Demirors, Jade C. Bowers, Vishal Abhimutt Mahesh, Anjali Yadav, Bansi P. Savaliya, Reed Popp, Syeda Hoorulain Ahmed, Esinam Ekpeh, Guido Chiriboga, Emmanuel Gabriel

School of Medicine Faculty Publications

Background/Aim: Surgical treatment for colon cancer is often curative when diagnosed early. This study evaluated the sociodemographic characteristics and survival outcomes associated with refusal of surgery among patients with colon cancer. The objective was to identify disparities to improve patient outcomes. Patients and Methods: We conducted a retrospective cohort study using National Cancer Data Base (NCDB) data from 2004 to 2019, including 1,048,575 patients with colon cancer. Variables analyzed included demographics, tumor characteristics, treatment facility type, and geographic and socioeconomic factors. Descriptive statistics were assessed using Wilcoxon Rank Sum and Chi-square tests. Survival outcomes were evaluated using Kaplan–Meier analysis and …

Leading Learning Health Systems: Strategies Used To Establish And Conduct A Learning Health System, Dawn M. Bravata, Cathy C. Schubert, Amy M. Kilbourne, Scotte R. Hartronft, Ashley L. Schwartzkopf, Jennifer L. Myers, Mindy L. Flanagan, Claire E. Donnelly, Stanley E. Taylor, Mathew J. Reeves, Anthony J. Perkins, Laura E. Myers, Indrakshi Roy, Robert E. Burke, Rachael A. Beard, Marcos Montagnini, Shivani K. Jindal, Greg Arling, Caroline Madrigal, Nicholas A. Rattray

Health Services and Informatics Research

Background

Learning health systems (LHS) improve patient and provider experiences, population health, and health system performance. LHS leaders develop LHS’ social and scientific infrastructures and align the LHS with host organization’s priorities. Although researchers have examined data infrastructure and Learning Community configurations, few studies have evaluated discrete strategies leaders deploy to construct a LHS.

Objectives

We described methods used to establish the Department of Veterans Affairs (VA) Geriatric LHS (GLHS) supporting older Veterans transitioning from hospital to home and examined strategies GLHS leaders used to conduct LHS activities.

Design

Qualitative methods were employed to review notes from all meetings and …

The Relationship Between Nursing Faculty Sense Of Belonging And Faculty Intent To Stay, Heather M. Bowers

Doctoral Dissertations and Projects

The purpose of this quantitative causal-comparative and correlational study was to evaluate the relationship between workplace sense of belonging and intent to stay in the current nursing faculty role among full-time nursing faculty. The shortage of nursing faculty impacts the ability to prepare the next generation of nurses needed to meet worldwide nursing demands. Strategies to effectively recruit and retain nursing faculty are important considering the current shortage and increasing retirements of nursing faculty. While sense of belonging has been studied for student retention and studies are beginning to explore the importance of workplace belonging, the impact of organizational sense …

“Not Today”: Overcoming Prep Hesitancy, Stigma, And Adherence Barriers With Lenacapavir, Margaret Conrad, Meredith Clement

School of Medicine Faculty Publications

No abstract provided.

Occupational Health Equity: A Call To Consider Social-Structural Factors In Injury Prevention Research, Shannon Guillot-Wright, Elizabeth S Mcclure, Marizen R Ramirez, Alexis Grimes Trotter, David B Richardson

Faculty, Staff and Student Publications

Occupational health equity scholarship has been growing over the past decade, including social-structural determinants of health research that centres the voices and experiences of historically marginalised communities. In our commentary, we focus on the intersection of work-related and non-work-related factors and how they impact the health of workers, their families and their communities through community-engaged research. Case studies include the implementation of mobile clinics that are developed alongside communities, community organising to examine and reduce health disparities among racially segregated workers, the development of research instruments and measures to study racism and discrimination, and a focus on how the distribution …

Associations Between Individual And Structural Level Discrimination And Psychological And Physiological Stress Indicators During Pregnancy, Özlü Aran, Melissa Nevarez-Brewster, Kimberly D'Anna-Hernandez, Julia Dmitrieva, Curt A. Sandman, Laura M. Glynn, Elysia Poggi Davis

Psychology Faculty Articles and Research

In the United States (U.S.) pervasive health disparities in prenatal care disproportionately impact marginalized individuals. The present study investigates whether discrimination at the individual and structural levels are associated with indicators of psychological and physiological stress among pregnant Latinx people living in the U.S., including both U.S. and foreign-born individuals. Pregnant participants (n = 109) reported on birthplace, lifetime experiences of racial and ethnic discrimination, perceived levels of stress, acculturation, social support, and provided residential address data and hair samples for cortisol analysis. Regression analysis revealed that individual level discrimination was linked to higher psychological stress during pregnancy ( …

Validation Of The Jefferson Health-Related Social Needs Screener, Sara Beachy, Kristin L. Rising, Richard W. Hass, Terry Hyslop, Isabella Muti, Mackenzie Kemp, Rhea E. Powell, Cara Martino, Baligh R. Yehia, Joseph G. Cacchione, Patricia C. Henwood

Jefferson Hospital Staff Papers and Presentations

INTRODUCTION: Screening for health-related social needs (HRSN) is a growing national health priority. While multiple HRSN screening tools currently exist, none to our knowledge have been evaluated using robust statistical analyses. The goal of this work is to provide results from a validation study of the Jefferson HRSN screener conducted across inpatient and outpatient settings.

METHODS: This retrospective cross-sectional psychometric study included HRSN assessments conducted across inpatient and outpatient settings with adult patients from March 2023 to May 2024. The study was conducted across a 17-hospital academic health system serving a diverse community in a 9-county area crossing two states …

Two Essays On Health And Health Behavior In China, Jiamin Tan

Lingnan Theses (MPhil & PhD)

This thesis consists of two empirical studies on elderly mental health and on health behaviors. The first study investigates the long-term impact of childhood hunger on mental health in later life, using data from two nationally representative surveys in China. The study finds that childhood hunger exposure significantly increases the risks of depression and anxiety in later life. These effects are most pronounced among individuals exposed after age 5, suggesting that autobiographical memory formation plays an important role beyond socioeconomic and health pathways. The findings further indicate these impacts can be mitigated through economic interventions, such as welfare programs, and …

A Content Analysis Of Prison/Custodial Suicide In Bangladesh, Anisur Khan, Rasel Hussain

Journal of Social, Behavioral, and Health Sciences

Suicide is the leading cause of death in prisons and custodial settings globally. International studies have consistently shown that prisoners and detainees are at a higher risk of suicide compared to the general population. Despite Bangladesh having a large prison population, there is no scholarly work on suicide within these settings. Against this backdrop, this study explored online newspaper content analysis capturing the characteristics of prison and custodial suicide in Bangladesh from 2014–2024. A total of 20 suicide cases were identified during this period. The data were arranged based on year-wise trends, age, sex, type of custody, nature of criminality, …

Obesity Severity And Cancer Screening In Us Adults, Florina Corpodean, Michael Kachmar, Shengping Yang, Michael W. Cook, Philip R. Schauer, Vance L. Albaugh

School of Medicine Faculty Publications

No abstract provided.

Will Anyone Play With Me? Building Resilience Through Community Play With Transgender And Gender Diverse Young Adults, Lee Lebeda

Expressive Therapies Theses

The recent increase in anti-trans legislature in the United States has negatively impacted the mental health of transgender young adults nationwide. Current research suggests that creative expression in a group setting may be uniquely suited to help transgender people combat the negative mental health effects of internalized anti-trans messaging. Based on this research, a community engagement project was designed for transgender young adult participants to explore resilience building through drama therapy-informed community play. Three play-based support groups, facilitated by a drama therapy graduate student who identified as a peer to the participants, were offered to transgender young adults in their …

Staff Education About Cultural Awareness In A Healthcare Setting, Phylis Titty Tarawally

Walden Dissertations and Doctoral Studies

Summary This quality improvement project was carried out to address a practice gap in culturally responsive care among nursing staff working in a skilled nursing facility. African-American residents often face disparities in healthcare due to staff’s limited knowledge of cultural health beliefs and confidence in engaging with diverse populations. To improve this, an educational intervention was designed using the ADDIE instructional model and evaluated to see if it could enhance staff knowledge and confidence related to African-American cultural practices. The project was guided by the practice-focused question: Will a structured African-American cultural awareness program improve staff knowledge and confidence to …

The "Secret Of Seven Stones": Short-Term Efficacy Of An Online Intergenerational Sexual Health Education Game For Early Adolescents And Their Parents, Ross Shegog, Christine Markham, Melissa Peskin, Robert C Addy, Sara Dube, Diane Santa Maria, Susan Tortolero Emery, Johnny M Wilkerson, Elizabeth Baumler, Laura Armistead, Pooja Chaudhary, Hsing-Yi Song, Angela Spencer, Jeffery Mclaughlin

Faculty, Staff and Student Publications

Objectives: Intergenerational games offer a potential channel to impact parent-youth sexual health communication. The "Secret of Seven Stones" (SSS) is an 18-level online adventure game and parent website designed to engage parents and youth (11-14 years) in conversations about healthy dating relationships and sexual behavior and to provide sexual health skills training to youth. Study hypotheses were that SSS exposure would increase sexual health parent-child communication, increase youth intentions to delay sexual debut, and reduce youth exposure to situations that promote sexual activity.

Materials and Methods: SSS was evaluated in the homes of parent-youth dyads randomly assigned to intervention ( …

At Stake In Each Other’S Company: A Systems View Of Compassion Fatigue In Mental Health Work, Susan S. Standen

Journal of Conscious Evolution

Traditional research on the phenomenon of compassion fatigue (CF) in mental health work tends to include recommendations for workers to build skills in psychological detachment and self-care. This puts the burden of coping with vicarious trauma on the individual caregiver, not on the systems they operate within. Alternatively, a transformative systemic perspective suggests that Western cultural assumptions about care-giving and individual resilience need to be reassessed. By broadening the exploration of CF and comparing it with human reactions to overwhelming crises across fields and disciplines, new questions can be asked, and new solutions can be proposed. This essay details how …

Leveraging Ai To Democratize The Hidden Curriculum In Medical Education: An Implementation Framework, James Keith Martin Ii, Mercedes Byrd

Libraries Scholarship

The “hidden curriculum” in medical education—comprising unwritten rules, values, and expectations—significantly impacts student success, yet remains inaccessible to students from underrepresented backgrounds. This paper presents a theoretical framework and practical implementation strategy for using artificial intelligence (AI) to democratize access to this hidden curriculum. We analyze how cognitive load theory and the Fast/Slow Thinking paradigm explain inequities in professional integration, then propose a comprehensive implementation approach to guide equitable AI integration. This model demonstrates how AI tools, when thoughtfully implemented, can reduce cognitive burdens on disadvantaged students, accelerate professional acculturation, and contribute to building an inclusive medical workforce.

Understanding Rural Health Through Rae Garringer's Country Queers: A Love Letter, Bradley A. Firchow

Journal of Appalachian Health

Rae Garringer’s Country Queers: A Love Letter examines the experiences of queer individuals in rural America, emphasizing the relationship between place and identity. Through oral histories, the book presents perspectives on community, resilience, and healthcare access. While not centered on medical care, it highlights challenges in obtaining affirming services in rural areas. Garringer’s experience as a standardized patient provides additional context on healthcare gaps. For public health professionals, Country Queers offers insight into the structural and social factors affecting rural LGBTQ2+ populations, contributing to a broader understanding of community health and identity in Appalachia and similar regions.

The Status Of Children’S Dental Health In Rural Appalachian West Virginia, R. Constance Wiener, Gina Graziani

Journal of Appalachian Health

Introduction: Non-metro/rural Appalachian West Virginia (WV) residents have been stigmatized for poor oral health (OH), despite many advances.

Purpose: The aims of this study were to examine current OH in children in WV, as compared to children in the greater United States (U.S.), and secondarily in subgroup non-metro/rural comparisons.

Methods: This observational study involved the U.S. National Survey of Children’s Health 2022–2023 data from parents/guardians who were asked about their child’s previous 12-month OH. Rao-Scott Chi-square and logistic regression analyses were used.

Results: Nationally, the mean age was 9.7 years; for WV children, it was 9.9 years. Nationally, 12.4% of …