Digital Commons Network^™

Identifying Barriers And Place-Based Solutions To Physical Activity For Older Adults In East Tennessee, Lydia Hoskins, Jodi Southerland

Journal of Appalachian Health

Introduction: Older adults in East Tennessee (TN), the fastest growing demographic, face significant health challenges, with 44% reporting four or more chronic conditions. The state ranks 45th in physical inactivity among older adults, exacerbating chronic disease risks, fall-related injuries, and mental health issues. Urban-rural disparities in East TN further complicate efforts to promote active living, particularly for rural residents.

Purpose: This qualitative study explored socioecological barriers and solutions to increase physical activity (PA).

Methods: In April 2024, two focus group were conducted in East TN, with a total of 11 participants composed of six community partners and five older adults. …

Radon Environmental Health Literacy Among Health Council Participants In Northeast Tennessee, Kawther Al Ksir, Stacy Stanifer, Hadii M. Mamudu, Megan Quinn, Deborah L. Slawson

Journal of Appalachian Health

Introduction: Radon, a radioactive gas, poses significant health risks, including lung cancer, and is prevalent in indoor environments. Understanding radon testing behavior and Environmental Health Literacy (EHL) is crucial for individuals to take appropriate preventive measures.

Purpose: This study assessed radon-related EHL among Health Council participants in seven Northeast Tennessee (NETN) counties and examined associations between sociodemographic factors and EHL levels. Understanding radon knowledge and behaviors within this influential group is critical, as they often serve as trusted public health advocates.

Methods: A cross-sectional survey was conducted from September – November 2023 among Health Council participants across seven counties in …

Prevalence Of Screening Patients For Alcohol Use In West Virginia: A Cross-Sectional Observational Study, Bayan Abuhalimeh, Christopher Waters, R. Constance Wiener

Journal of Appalachian Health

Introduction: Consequences of alcohol consumption are well-established and compounded by physiological changes of aging (increased sensitivity; medication interactions; etc.). Alcohol screening for all ages is recommended, especially as most Americans believe moderate drinking is acceptable. Screening is important in high alcohol use regions, such as rural areas where isolation is more likely, especially for older adults. The Appalachian Region has a significant rural population of older adults. West Virginia (WV) is representative of Appalachia. It is a rural state, has many older adults, and all counties are Appalachian.

Purpose: The purpose of this cross-sectional study is to determine the likelihood …

Finding Community: A Thematic Analysis Of Resilience During The Pandemic, Myles Kwitny, Quinn Richards, Grace Digirolamo, Shannon Freedman, Sophie Wenzel

Journal of Appalachian Health

Introduction: The Covid-19 pandemic impacted those within rural Appalachian communities, particularly people with marginalized identities.

Purpose: Through interviewing 44 participants from New River Valley, an Appalachian community in Virginia, this study sought to understand how resilience impacted individuals' experiences during the pandemic.

Methods: Participants belonged to one of the following groups: African American, Hispanic, older adults, or people who use drugs. Participants were required to reside in the New River Valley and be older than 18. Each participant was interviewed either in person, by phone, or over video call. Interviews were recorded, transcribed, then thematically analyzed for themes of resilience. …

Addressing The Root Causes Of Population Health In Central Appalachian Virginia, David L. Driscoll, Kol Gold

Journal of Appalachian Health

Introduction: The Southwest Virginia Health Authority (SWVHA) recently commissioned a community health needs assessment (CHNA) to reduce the high rate of preventable health problems in Virginia’s (VA) Appalachian Region. The CHNA took place over a two-year period from 2023 – 2025.

Purpose: This iterative, mixed-method CHNA informed the development of a new iteration of the regional Blueprint for Health Improvement and Health-Enabled Prosperity identifying and prioritizing health issues and develop strategic planning to address them in VA’s three westernmost regional health districts.

Methods: The CHNA followed a sequential mixed methods design to assess the regional health status, the contextual factors …

Align Appalachia’S Opioid-Settlement Spending With Evidence And Emerging Threats, Bradley Firchow

Journal of Appalachian Health

State and local governments across Appalachia are allocating opioid-settlement dollars over the coming years. This funding opportunity can support lasting public health infrastructure or be spent on short-term programs anchored in the opioid crisis of the past. Evidence indicates that emerging synthetic drugs such as nitazenes and xylazine are altering overdose risk patterns in ways that require urgent policy attention.

An Evolutionary Preamble Towards A Multilevel Framework To Understand Adolescent Mental Health: An International Delphi Study, Federica Sancassiani, Vanessa Barrui, Fabrizio Bert, Sara Carucci, Fatma Charfi, Giulia Cossu, Arne Holte, Jutta Lindert, Simone Marchini, Alessandra Perra, Samantha Pinna, Antonio Egidio Nardi, Alessandra Scano, Cesar A Soutullo, Massimo Tusconi, Diego Primavera

Faculty, Staff and Student Publications

Background/objectives: Adolescence is a sensitive developmental window shaped by both vulnerabilities and adaptive potential. From an evolutionary standpoint, mental health difficulties in this period may represent functional responses to environmental stressors rather than mere dysfunctions. Despite increasing interest, integrative models capturing the dynamic interplay of risk and protective factors in adolescent mental health remain limited. This study presents a holistic, multi-level framework grounded in ecological and evolutionary theories to improve understanding and intervention strategies.

Methods: A two-round Delphi method was used to develop and validate the framework. Twelve experts in adolescent mental health evaluated a preliminary draft derived from the …

Assessing The Psychological Wellbeing And Resilience Of Frontline Health Workers In Uganda: A Cross-Sectional Study, Ahmed Sarki, Joseph Atukwatse, Gideon Mbithi, Sabina Odero, Mary Namuguzi, Bernard Mutwiri, Lestine Bitakwitse, Peninah Wachira, Kevinson Mwangi, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Health workers in the frontline are the major drivers of health systems in low- and middle-income countries. However, these health workers face both chronic and acute shocks and stressors that expose them to mental health problems which are often overlooked. We examined the prevalence of mental health problems, correlates of psychological functioning, and resilience of frontline health workers in Uganda.

Methods: We conducted a cross-sectional study comprising 1800 frontline health workers across all regions of Uganda from August through October 2023. We used tools such as the PC-PTSD-5, PHQ9, PSS, GAD-7, Oldenburg Burnout Inventory, and CD-RISC-10 to assess PTSD, …

Parent Needs, Recommendations, And Systemic Challenges Affecting Pediatric Hypertension Detection, Abbas H. Zaidi, Erica D. Sood, Sarah De Ferranti, Samuel Gidding, Varsha Zadokar, Jonathan M. Miller, Anne E Kazak

Department of Pediatrics Faculty Papers

Pediatric hypertension (HTN) affects 3%-5% of children in the United States, yet only 25% are diagnosed and 60% lack recommended follow-up care. Skepticism about elevated blood pressure (BP) readings and reluctance to use antihypertensive medications by parents and clinicians highlight the need for stakeholder-informed strategies to address these challenges. This study examined parents' perceived needs, their recommended strategies to improve HTN detection, and contextual health system challenges. Parents and clinicians from 10 pediatric primary care clinics participated in semi-structured qualitative interviews. Only parents of children with documented stage 2 BP readings and a HTN diagnosis, but with gaps in care …

Strategies And Considerations For Forming And Managing Community Advisory Boards From Health Research With Transgender And Nonbinary Communities, Mannat Malik, Anushka Aqil, Jennifer L. Glick, Jean Michel Brevelle, Anthony Black, Kellan Baker, Arjee Restar, Molly Gribbin, Colin Flynn, Danielle German

School of Public Health Faculty Publications

Purpose: There is limited research on the use of community advisory boards (CABs) in health research with transgender and nonbinary communities. Transgender communities are navigating challenging histories of health researcher exploitation and research distrust alongside exponential research growth. We explored strategies for forming and managing CABs when conducting transgender community-informed health research. Methods: We used purposive and snowball sampling to identify key informants (KIs): research leaders, implementing staff, and community partners engaging in transgender health research. Between October 2018 and December 2020, we conducted 30 semi-structured in-depth interviews. We used coding followed byiterative thematic analysis and memoing to identify themes. …

Is Our Assessment Of Bias In Academics … Biased?, Sunil A Sheth, Ashutosh P Jadhav, Tudor G Jovin

Faculty, Staff and Student Publications

No abstract provided.

Restricted Social Engagement Is Associated With Depressive Symptoms In Older Chinese Adults: A Nationwide Cross-Sectional Study, Zheng Guo, Yulu Zheng, Yahong Zhu, Huacheng Wang, Jian Geng, Hengrui Liu, Piyong Ma, Lois Balmer, Xingang Li

Research outputs 2022 to 2026

Background and Aims: Social isolation has been linked to depressive symptoms in older adults. Previous studies have shown that greater engagement in social activities is associated with better mental health. However, it remains unclear whether restricted social engagement is related to poorer mental health outcomes. This study examined the association between reduced social activities/networking and the presence of depressive symptoms among community-dwelling older Chinese adults. Methods: During the COVID-19 pandemic, people chose to minimize going out to reduce the risk of infection, creating a natural setting that mimicked a passive intervention of restricted social engagement for community-based individuals. Data were …

Public Support For And Reactive Behavior Toward Technological Risk Interventions: An Extension Of Secondary Risk Theory, Hye Kyung Kim, Rui Gu, Fiona Goh, Sonny Rosenthal, Shirley S. Ho

Research Collection College of Integrative Studies

Project Wolbachia is a dengue control initiative in Singapore. Guided by Secondary Risk Theory, this study examined how primary (dengue) and secondary (Wolbachia) threat and coping appraisals shape public support and reactive behavior toward the project. A nationally representative survey of 1,000 Singaporeans showed that support was positively linked to the perceived primary risk, the efficacy of the project and the government, while negatively related to the perceived secondary risk. Reactive behavior was positively associated with perceptions of both primary and secondary risk. Media attention and trust in the government indirectly influenced support and behavior moderated by knowledge.

Towards A New Health Politics In Kenya: Labor Organizing And Strikes By Health Workers In The Public Health Sector, Michael Scanlon

Graduate Doctoral Dissertations

There has been insufficient attention by global health scholars to labor organizing by health workers, including when and why organizing occurs, what forms and strategies it takes and its implications for governance and policy. These questions are critical but largely absent in research on what has been called the “global health workforce crisis.” Kenya represents an important case study. A new constitution in 2010 expanded institutional spaces for labor organizing and decentralized governance of the health system. Both reforms had significant implications for the health workforce and strikes by health workers have been pervasive. In 2017, nationwide strikes by public …

Institutionalized Bullying In Tertiary Institutions In Nigeria And Perceived Mental Health Impacts: A Phenomenological Qualitative Study, Chika Bosah, Casey Mace Firebaugh, Tara R. Zolnikov

The Qualitative Report

Institutionalized bullying is when bullying moves beyond individual instances of bullying and is culturally embedded in an institution, such as a school or workplace. This type of bullying has not been thoroughly examined in tertiary school settings in Nigeria. This phenomenological qualitative study examined the experiences of tertiary students (from four different institutions in Nigeria) and their experiences of institutionalized bullying to determine if and to what extent this practice is occurring. There were (n=48) tertiary students engaged in open-ended, semi-structured interviews in Nigeria in 2022. Interviews were transcribed, coded, and thematically analyzed. Overall, this study found that institutionalized bullying …

Quality Of Life Among Type Ii Diabetes Mellitus Patients, Duaa Dhia Hameed Al-Baghdadi, Rajha Abdul Hassan Hamza

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Background: Type 2 diabetes mellitus (T2DM) is a significant public health concern Approximately 90% of people with diabetes worldwide have diabetes mellitus type 2. Methods: A cross-sectional study was conducted from October 23, 2023, to March 2, 2025, in Al-Najaf Al-Ashraf City to assess the quality of life among individuals with T2DM. A non-probability sampling technique (purposive sampling) was used to select 167 T2DM patients. Data were collected through a questionnaire, which consisted of three parts: Part I covered sociodemographic information, Part II focused on clinical data, and Part III addressed the quality of life among T2DM patients by using …

Hurricane Katrina Archive: E-Books And E-Journals A To Z Bibliography 2020-2025, Lsu Health Sciences Center - New Orleans Libraries, Elizabeth H. Holt

LSUHSC Hurricane Katrina Archive: Bibliographies

This bibliography includes 43 electronic books and edited collections created on the topic of Hurricane Katrina by authors and others affiliated with LSU Health Sciences Center - New Orleans between September 2005 and August 2025.

Evaluating Inclusion Rates Of Oral-Systemic Health Connection Coursework In Dental And Medical Professional Programs' Admissions Requirements, Wendy Marie Carry

Doctoral Dissertations and Projects

Oral systemic health connections (OSHC) are bidirectional, life-threatening, and a significant public health concern. Studies have identified over 200 OSHCs; however, the prevalence of foundational OSHC education in dental and medical professional programs remains unknown. This quantitative descriptive comparative pilot study aimed to explore the prevalence of predictor variables, dental and medical professional programs in the United States, and the criterion variable, including an OSHC admissions requirement for the 2025 academic year. The point-in-time count methodology served as the theoretical framework guiding this study and the development of the PiT-PARCI instrument. The proposed testing was replaced with alternative testing based …

Experiences Of First-Generation Nursing Students After Their First Year At An Hbcu: A Transcendental Phenomenological Study, Ari L. Cuffee

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to explore the lived experiences of first-generation nursing students (FGNS) after their first year at a Historically Black College or University (HBCU). The central research question asked, “What are the lived experiences of first-generation nursing students who have completed one year at a Historically Black University?” The theoretical framework that guided this study was Banks’ theory of multicultural education. This theory demonstrated how educators taught FGNS using the multicultural education paradigm with strategies and procedures to make provisions for culturally, racially, and ethnically diverse students. Data were analyzed using Moustakas’ interpretive phenomenological …

Associations Between Factors Of Unhealthy Lifestyle, Mental Health Issues, Chronic Illnesses, Environmental Health Risks, And Infertility In Females: A Cross-Sectional Study, Richard L. Huang

Doctoral Dissertations and Projects

Infertility has risen rapidly in recent decades and has become the third-largest public health concern in the world. It has significantly threatened individuals’ psychological, physical, and social well-being, and it could be an early sign of severe health problems in the future. Furthermore, it also threatens the continuation of life and human civilization. The purpose of this study was to examine the relationship between individuals’ daily lifestyle behaviors, mental health status, chronic conditions, environmental health factors, and infertility by using cross-sectional quantitative methods. It benefits the public as the study raised awareness of potential risks and provided guidance to avoid …

An Analysis Of Sport Science Practices And Standards In Collegiate Football, Corey F. Fitzgerald

Doctoral Dissertations and Projects

This dissertation presents the findings of a survey that identifies the sport science practices and standards utilized in National Collegiate Athletic Association (NCAA) football programs. In total a fifty-two item survey instrument was administered that examines seven sections, including (i) demographics, (ii) current sport science practices, (iii) advanced technology, (iv) decision-making processes, (v) health and wellness, (vi) budget and resources, and (vii) comments. All generated numerical data was organized into a statistical analysis program, SPSS Statistics v 29.0.2.0 (© IBM Corporation). Correlations were conducted on data gathered from Likert Scale questions, using Spearman test. Additionally, comprehensive non-numerical subjective data was …

Educational Use Of Artificial Intelligence In Doctor Of Health Sciences Programs, G. Zipp, Christina B. Gunther, Douglas Kuperman, Jill Moore, Lori Rainchuso

Journal of Innovation in Health Sciences Education

Introduction: Artificial intelligence (AI) has gained increased attention in higher education with the identification of several strengths, weaknesses, opportunities, and threats regarding its utility. The aim of this study was to ascertain how doctoral programs in health sciences utilize AI as academicians and instructors.

Methods: An electronic survey was distributed to all Association of Doctoral Programs in Health Science (ADPHS) members on the mailing list (n=51), with n=19 (37.3%) voluntarily responding.

Results: The findings revealed both enthusiasm and caution regarding the use of AI in doctoral health sciences education, reflecting similar broader trends identified in the literature. Despite institutional …

Sleep, Emotion Regulation, And Relationship Satisfaction: A Moderation Analysis, Lakyn Boone

Doctoral Dissertations

Sleep plays a pivotal role in overall health and well-being, influencing mental health, cognitive abilities, memory, emotional balance, and physical well-being (Luyster et al., 2012; Mukherjee et al., 2015). Emotions constitute a natural and indispensable element of human existence but necessitate proper regulation, as any disruption in emotion control has been associated with various mental health disorders (Gross & Jazaieri, 2014; Kring & Gordon, 1998; Phelps, 2006). Furthermore, human connections and relationships are fundamental aspects of the human experience, contributing to emotional support, personal growth, a sense of belonging, and even influencing one's physical health outcomes (Baumeister & Leary, 1995; …

Is There An Association Between Food Literacy And Diet Quality In Young Adult College Men?, Morgan Claire Mayeux

Master's Theses

Food literacy skills can improve dietary intake in young adults as it provides them with the tools they need to make healthier food-related decisions. The benefits of improving food literacy includes the reduction in the risk of prevalent, preventable dietrelated diseases such as obesity, T2DM, heart disease, and other chronic diseases that plague the Unites States today. Previous literature reports primarily on college female samples. Because a large proportion of the samples in the available studies are female, the current literature may not reflect young adult men’s food literacy and its comparison to their overall diet quality. The purpose of …

Proposed Theoretical Model Of Pediatric Onset Multiple Sclerosis And Restrictive Eating Behaviors, Anna L. Smith

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Multiple Sclerosis (MS), a chronic, demyelinating, autoimmune disease that causes an array of physical and cognitive symptomatology, is commonly diagnosed in adulthood. Pediatric Onset Multiple Sclerosis (POMS) is characterized by diagnosis of the disease before age 18 and accounts for about 5% of MS cases. While there is a growing body of literature examining the impact of adult-onset multiple sclerosis on psychosocial functioning, research specifically addressing POMS remains limited. Moreover, there is a notable gap in the literature regarding the risk of eating disorders among individuals with POMS. This paper will explore a constellation of potential risk factors that may …

Building An Interdisciplinary Workforce In Geroscience: Aligning Perspectives And Educational Goals, Iman M Al-Naggar, Miranda E Orr, Et Al.

2020-Current year OA Pubs

The National Institute on Aging-funded Geroscience Education and Training Network held the "Building an Interdisciplinary Workforce in Geroscience: Aligning Perspectives and Educational Goals" preconference workshop at the 2023 Gerontological Society of America's Annual Meeting. Parties involved in geroscience education and interested stakeholders addressed the development of didactic educational materials, training, and career development opportunities to equip learners with the skills to meet the demands of the emerging field of geroscience, from research to clinic and industry. Recent successes were presented, existing opportunities, gaps, and challenges identified and discussed, and solutions and future directions described.

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

The Residual Impact Of Slavery On How Enslaved Black Females Defined And Made Meaning Of Sexual Violence: A Content Analysis, Suzanne R. Bates

Dissertations

Thompson-Miller & Picca (2016) and Feimster (2023) argued that enslaved African American women, and even free African Americans after the Civil War were victims of non-consensual sexual activity and rape. The NISVS report revealed that before the age of 18 years old, 35.5% of African American women experienced contact sexual violence, 29.5% experienced non-contact unwanted sexual encounters, and 20.7% experienced rape (Basile et al., 2022). Researchers of slave scholarship have made the case for the importance of including discourse on slavery and enslaved Black females’ experiences when discussing present day sexual violence among Black women in the US today (Balfour, …

Enhancing Interprofessional Competence Among Speech Pathology, Nursing, Social Work, And Psychology Students Using Simulated Case Presentations, Elizabeth Oommen, Emily Helder, Kayla Johnson, Stacia L. Hoeksema, Laura Schipper

University Faculty Publications and Creative Works

Background: This study assesses the impact of an Interprofessional Education (IPE) program (which included simulated case presentations), on the perceived competence and quality of interprofessional (IP) work products of undergraduate social work, nursing, psychology students, and graduate students in speech-language pathology.

Methods: Participants included 123 students who participated in IP colloquiums through reviewing clinical cases, developing IP assessment and treatment goals, and presenting these to fellow students and faculty. Pre- and post-testing using IPEC Competency Self-Assessment Tool was used for assessment. For each colloquium, the students from all disciplines also submitted a single worksheet for their assigned case, …

Psychosocial Challenges As Predictors Of Transactional Sex Among Undergraduates In Ondo State, Nigeria, Ifeoluwa Blessing Michael, Oyedotun Dolapo Ilori, Patrick O. Akerele

Buletin Konseling Inovatif

The study investigated the psychosocial challenges predictive towards engaging in transactional sex among undergraduates within Ondo State, with the moderating role of demographic variables weighed heavily. Employing a descriptive survey design, data were gathered from 404 undergraduates by means of a validated questionnaire (reliability = 0.86) randomly sampled from two public and two private universities. Amongst the findings from descriptive statistics and multiple regression analyses were that peer pressure, financial instability, family dysfunction, and emotional health challenges had significant correlations with involvement in transactional sex while jointly explaining 46.6% of the variance. Financial instability was the strongest predictor, followed by …