Digital Commons Network^™

Assessing Indoor Heat Vulnerability And Cooling Strategies In Three Mobile Home Communities In Boulder, Colorado, Usa, Mehdi P. Heris, Skye Niles, Alana Wilson, Megan Mccurdy, Amy Lacourse, Nick Lankau

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Extreme heat is an increasing public health and environmental threat shaped by both physical and social factors. This study assesses the vulnerability of mobile homes and their residents at three mobile home parks in Boulder, Colorado. We examined indoor temperature, housing conditions, and social and personal risk factors of the households. We monitored indoor and outdoor temperatures using 27 indoor and 5 outdoor temperature data loggers, comparing mobile homes with air conditioning, swamp coolers, and passive cooling designs. This work provides a detailed analysis of indoor temperature patterns and demonstrates how evaluating trends yields insights into the performance and effectiveness …

It's (Not) Raining Men: Exploring The Themes Surrounding Low Male Presence In Pediatric Nursing, Marcin Janczak

Honors Projects

Background: Men remain underrepresented in nursing, with an even smaller presence in pediatric nursing. Purpose: To examine pediatric-specific themes that may contribute to the low presence of men in pediatric nursing, and strategies to counteract these potential barriers. Methods: CINAHL Ultimate and Google Scholar were searched for primary research published from 2015 to 2025 related to male nurses, male nursing students, gender bias, pediatric care, and clinical experiences. Findings: Four major themes emerged: gender stereotypes and the feminization of pediatric nursing, sociocultural barriers and gender bias, fear and distrust toward male nurses, and psychological and professional impacts on men in …

Understanding And Enhancing Suicide Prevention Strategies In The Military: The Roles Of Culture, Leadership, And Command Climate, Kelly Johanna Pires

Dissertations

Military service members are shaped and molded to fit a military culture that emphasizes mission readiness and continuous preparedness. Countless hours are spent training for various situations that can arise. Many trainings are geared toward worst-case scenarios that can cause an increase in stressors and traumatic events. They are expected to demonstrate resilience and overcome adversity to remain mission-ready. This expectation to be mission-ready creates the space for mental health difficulties as well as stigma and avoidance of help-seeking behaviors. In many cases, the desire to stay mission-ready creates a barrier for conversations around mental health. The military emphasizes qualities …

Socioeconomic Inequalities In Health-Related Quality Of Life During The Covid-19 Pandemic: A Six-Country Comparison Using The Eq-5d-5 L, Joëlle Eijkens, Joshua M. Bonsel, You-Shan Feng, M. F. Bas Janssen, Erica I. Lubetkin, Juanita A. Haagsma

Publications and Research

Purpose

Despite the growing attention to health inequalities, there is no global consensus on how to measure socio-economic status. This study examined inequalities in health-related quality of life (HRQoL) during the early phase of the COVID-19 pandemic across six countries—China, Italy, the Netherlands, Sweden, the United Kingdom (UK), and the United States (US)—using three SES indicators: education level, income, and work status.

Methods

Between April and June 2020, individuals aged 18–75 years old completed a web-based survey. HRQoL was measured using the EQ-5D-5L Level Sum Score (LSS), where higher scores indicate poorer health. Country-specific differences in LSS across SES groups …

Socio-Ecological Models As A Framework For 21st-Century Genetic Counseling, Shana L. Merrill, Rebecca Mueller

College of Life Sciences Faculty Papers

Socio-ecological models and the related concepts of micro-, meso-, and macro-level practice are commonly used in the fields of social work and public health yet have not been thoroughly conceptualized for application to genetic counseling practice, research, and training. The field of genetic counseling is currently undergoing significant expansion with more genetic counseling training programs, greater variation in genetic counselor job roles, and genetic counselors practicing in more globally dispersed regions. It is therefore a critical time to conceptualize and tailor relevant theoretical frameworks to unify and guide the evolving field of genetic counseling. In this paper, we posit that …

Structured Telehealth Community Health Worker-Clinician Feedback And Diabetes Outcomes: A Randomized Clinical Trial, Elizabeth Vaughan, Xiaoying Yu, Amber Amspoker, Aanand Naik, Ashok Balasubramanyam, Craig Johnston, Christi Ballantyne, Salim S. Virani, Shelton Brown, Kristina Mena

Population Health, East Africa

Importance  Community health workers (CHWs) improve chronic disease management in underserved populations, but scalable integration strategies are limited.

Objective  To evaluate whether a multidimensional intervention incorporating telementored CHWs and a structured participant-CHW-clinician feedback loop can improve diabetes outcomes.

Design, Setting, and Participants  This 12-month randomized clinical trial was conducted at 3 institutionally and geographically diverse community clinics in Texas between September 1, 2023, and April 30, 2025, and included low-income, uninsured White Hispanic adults with type 2 diabetes identified through clinic databases. Data were analyzed between May 1 and July 31, 2025.

Intervention  Individuals were randomized 1:1 to the intervention …

Assessing Family Planning Progress In Exemplar Countries: Development Of A Conceptual Framework And Case Study Methodology, Zahid Memon, Hina Najmi, Abeer Mian, Sacha Ahmad, Muhammad Islam, Kevin Samuel, Marleen Temmerman, Ali Mohammad Mir, Zeba Sathar

Centre of Excellence in Women and Child Health

Family planning (FP) is a critical component of reproductive health, enabling individuals to plan the number and timing of children through various contraceptive methods.

We outline the conceptual framework and country case study methodology used by the Exemplars in Family Planning (EFP) project. This was based on the wider Exemplars in Global Health programme, which uses mixed-methods to examine determinants of FP progress in countries that exceed expectations for health outcomes. The EFP project integrates findings from case studies on six such countries, including quantitative analyses of trends and drivers of modern contraceptive prevalence, systematic reviews, policy, programme and financing …

An Attachment Perspective For Help-Seeking Intentions Among Emerging Adult Women Child Sexual Abuse Survivors, Dominique Giroux

Dissertations

Child sexual abuse (CSA) is an adverse childhood experience and a global health issue. Approximately one in four girls encounter CSA per year. Research evidence suggests approximately 50% of CSA survivors encounter sexual revictimization during adulthood (Walker & Wamser-Nanney, 2023), but formal help and intervention can mitigate further psychosocial harm experienced by CSA survivors (Widom et al., 2008). Attachment theory has provided a theoretical framework for identifying individuals at risk for revictimization and help-seeking patterns, such that individuals who have insecure attachment styles report more revictimization frequency, but the literature is mixed about attachment styles and help-seeking (Brenner et al., …

Rethinking Ethics For An Era Of Trusted Computational Tools, Kristin M Kostick-Quenet, Meghan Hurley, John Herrington, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Computer perception (CP) technologies are poised to deliver near real-time behavioral insights with high precision. As technical barriers recede, our field's ethical focus must shift from "Can we trust the data?" to "Should we use it here, and how?" We propose a contextual ethics framework that: (1) defines the appropriate scope of CP integration; (2) advocates codesigned roadmaps to manage expectations and epistemic conflict; (3) expands evaluation beyond performance metrics to humanistic outcomes; and (4) anticipates future high performance systems to safeguard dignity, empathy, and shared decision-making in clinical care.

Moving Beyond Traditional Cost Containment For Glp-1 Coverage Within Oregon's Proposed Universal Health Plan, Manoj Rajesh

University Honors Theses

In 2022, Oregon voters passed Measure 111, constitutionally mandating access to affordable health care. As the Universal Health Plan Governance Board (UHPGB) designs the state's proposed single-payer system, it faces an unprecedented financial vulnerability: the clinical demand for GLP-1 receptor agonists. These high-cost, indefinite-use medications for obesity and metabolic syndrome threaten to overwhelm fixed public budgets. Historically, both the Oregon Health Plan's Medicaid framework and commercial private insurers have relied on static cost-containment models—categorical exclusions, step therapy, and aggressive utilization management—that achieve short-term fiscal solvency at the expense of comprehensive preventative care. This thesis argues that to fulfill the mandate …

Narrative Roots - What We Inherit, What We Tell, What We Become: Intergenerational Storytelling, Meaning-Making, And Mental Health, Adam Sholder

Critical and Creative Thinking Capstones Collection

This capstone synthesis explores how the family stories we inherit and the stories we tell across generations shape who we become, with particular attention to their impact on identity and mental health. Drawing on narrative identity theory, reflective practice, and relational understandings of family life, it introduces the Recursive Narrative Integration Model, which positions intergenerational storytelling as both a method of inquiry and a mechanism of meaning-making. Informed by a recursive process of creative and reflective writing, this synthesis approaches storytelling not only as an object of study, but as a lived and generative practice through which experience and narrative …

A Literature Review Of Burnout And Associated Tools In Residency Programs, Foluso Obisanya, Fatima Mncube-Barnes, Kudiratu A. Proctor, Charles A. Mcdaniel, Donna M. Alexander, Tyrece D. Hunter

Graduate Medical Education Research Journal

Background. Burnout poses considerable challenges in workplaces, particularly for resident physicians. This intricate phenomenon stems from a myriad of factors that include, but are not limited to, staff shortages, excessive workloads, specific job responsibilities, work environments, and individual psychological factors. The Accreditation Council for Graduate Medical Education encourages institutions to incorporate wellness as a fundamental component of residency training programs.

Methods. The aim of this review was to investigate burnout among resident physicians via a comprehensive literature review to elucidate this significant issue and identify potential preventative intervention strategies. We analyzed the issue of burnout across various residency specialties, providing …

A Call To Action: Towards A Compendium For Culturally Responsive And Inclusive Pain Management, Arvie Vitente, Rob Sweet, Lester Jones

Philippine Journal of Physical Therapy

Introduction: Pain is a pervasive global health problem, yet its assessment and management remain shaped by biomedical, monolingual, and culturally narrow assumptions that do not fully reflect the lived realities of diverse populations. Although contemporary pain science recognizes pain as a personal experience influenced by biological, psychological, and social factors, inequities persist across racial, ethnic, linguistic, and cultural groups.

Main Body: These inequities affect how pain is expressed, interpreted, documented, and treated, particularly among Indigenous peoples, migrants, refugees, and patients with limited English proficiency. In this perspective, we call for the development of a comprehensive compendium on culturally responsive and …

Navigating Trust: The Impact Of Social Media Influencers On Gen Z Health Behaviors, Abigail Stelling

Honors Thesis

Social media plays a defining role in the daily lives of Gen Z, influencing how people communicate, access information, and make decisions. More than a form of entertainment, social media is a powerful source that shapes identity, perceptions, and behaviors. As the first generation to grow up fully immersed in a digital world, Gen Z is uniquely impacted by the content and interactions that occur on social media platforms. Within this digital landscape, social media influencers have emerged as powerful figures. These individuals use large online platforms to promote lifestyles, products, and behaviors. Influencers often have the ability to shape …

Internalized Homophobia As An Influence On Participation In Hiv Prevention Among Young Men Who Have Sex With Men (Ymsm), Kasey I. Brazee

Honors Scholar Theses

Stigma is a known barrier to accessing preventative services for human immunodeficiency virus (HIV), however, the types of stigmas involved in this relationship remain not well defined. Homophobia, or negative attitudes directed towards homosexuality, is a particularly important type of stigma considering the disproportionate effect of HIV on men who have sex with men (MSM). Young MSM (YMSM) are especially impacted, making them a key population in the context of HIV prevention research.  Internalized homophobia, which refers to homophobia that one directs towards themselves, is under researched regarding its role in participating in HIV prevention. In this study, we aimed …

Caring For The Carers: Exploring The Mental Wellbeing Of Informal Palliative Caregivers Of Cancer Patients In Kenya, James Kariuki, Rose Njiraini

Journal of Global Awareness

Cancer cases have been on the increase globally, and this has led to economic burden on the affected households. One way of reducing the cost of care is through home-based care by informal palliative caregivers who include family members, friends, and other people assigned by the family members to take care of the patient. The objectives of this study were to assess the status of the mental wellbeing of palliative caregivers of cancer patients; to examine the relationship between the ability of the patient to cope with cancer diagnosis and the mental wellbeing of the caregiver; and to investigate the …

Soft Power, Arab Media And Sports Mega Events: Coverage Of Fifa 2022 And Lessons For Future Arab Hosting, Lynne Kennedy, Maaira Shahbaz, Ala Al Rajabi

All Works

Sport mega-events (SMEs) increasingly transcend athletic competition, functioning as strategic instruments for national identity formation, statecraft, and soft power projection. This dynamic is particularly pronounced in the Gulf, where Qatar’s successful hosting reignited regional rivalries and attracted unprecedented global scrutiny. While existing scholars have extensively examined Western media portrayals of SMEs, a notable gap remains for academic engagement with Gulf media. Dismissed as state-controlled and analytically lacking, we contend that such media offer a rich site for exploring how small states use media as soft power, to construct and contest legitimacy, identity, and global influence. This analysis suggests how state-aligned …

Postpartum Depression: A National Crisis Calling For Federal Support, Sarah A. Stallsworth

Doctor of Nursing Practice Final Manuscripts

Postpartum depression (PPD) is the leading cause of maternal mortality in the United States, yet it remains significantly underdiagnosed and undertreated. Despite decades of research illuminating its prevalence and detrimental consequences, federal intervention has been limited.  States retain responsibility to address the issue and possess inconsistent and limited legislation.  The purpose of this paper is to propose adding PPD screening as a National Performance Measure (NPM) within the Title V Maternal and Child (MCH) block grant. MCH is a longstanding and resourceful program that provides states funds to address maternal mental health needs. This proposal suggests leveraging a PPD NPM …

The Relationship Between Mentorship And Career Longevity For New Clinicians In Emergency Medical Services, Katherine Elizabeth Contreras

Doctoral Dissertations and Projects

The purpose of this qualitative descriptive phenomenological study was to understand how mentorship assisted a new Emergency Medical Services (EMS) clinician in navigating the challenges of the first year at an EMS agency in Central Texas. Guiding the study was Lev Vygotsky’s theory of social constructivism, which focuses on knowledge gained through human activities, social interactions, and behavior modeling. Twelve study participants completed one-on-one interviews, two participants completed a single focus group interview, and the researcher conducted naturalistic observations, during which the participants shared personal, firsthand experiences that answered the study’s central research question: How does mentorship help new EMS …

Perceptions Of The Effects Of Launch Control Center Environmental Exposures And Alert Schedules Among Missile Operations Officers: A Mixed Methods Phenomenological Study, Dawnie Rae Ramie

Doctoral Dissertations and Projects

This mixed methods hermeneutic phenomenological study focused on an investigation of the perceptions of missile operations alert duty and the effects on health and sleep hygiene among Air Force missile operations officers. Questionnaires, interviews, and surveys were all used to gather data on subjects’ experiences and perspectives, including methods to mitigate the effects of poor sleep. Driving questions of research included how missile alert schedules affect sleep habits, as well as how missileers perceived alert duties may impact their health. Data was collected through a web-based Qualtrics Likert questionnaire (N=139), open-ended interviews with purposively selected subjects (N=17), and web-based Qualtrics …

Exploring The Impact Of Cultural Beliefs On Death Anxiety: A Qualitative Study To Inform Healthcare Education And Practices, Sharon Sonnilal

Doctoral Dissertations and Projects

A hermeneutic phenomenological approach framed this qualitative study, examining how cultural beliefs, spiritual traditions, and relational contexts shape death anxiety and meaning-making among adults from diverse backgrounds. Terror Management Theory and Culturally Sensitive Grief Treatment guided the conceptualization of death anxiety as a culturally mediated and relational phenomenon rather than an isolated psychological response. A purposive sample of 13 adults aged 18 and older represented diverse cultural, racial, gender, and spiritual identities. Recruitment occurred via Instagram, and participants completed an open-ended demographic and narrative survey. Participants who provided rich survey narratives received invitations to complete semi-structured Zoom interviews to deepen …

Health-Seeking Behaviors Of Ethiopian Women In The United States: A Pilot Qualitative Study, Hanna Belay, Felicia Leammuda, Ahmed Ugbad, Beamlak Kebede

InnovateHER Meeting 2026

This study explores how Ethiopian immigrant women understand health and navigate healthcare in the United States. Using qualitative interviews with two participants, findings show that health is viewed holistically, with strong reliance on traditional remedies. Participants engage with the U.S. healthcare system selectively, often seeking care only when symptoms become severe. Barriers such as system complexity, fear, and time delays influence healthcare decisions.

Awareness And Attitudes Toward Female Genital Mutilation At A Mid-Sized Midwestern University, Kaafiya Salad

InnovateHER Meeting 2026

This study utilized a confidential survey to examine awareness, knowledge, and attitudes toward Female Genital Mutilation (FGM) among the Saint Cloud State University community. Participants were recruited through campus outreach methods, and responses were collected voluntarily. The survey included questions assessing familiarity with FGM, sources of information, knowledge of associated health risks, and perceptions of the importance of awareness and public education.

Beyond The Ban: Chhaupadi Abolition And The Governance Of Menstrual Autonomy In Western Nepal, Nikita Paudel

Master in Public Policy Theses

This thesis examines how two decades of efforts to abolish chhaupadi have shaped the everyday conditions under which women and girls experience menstruation in western Nepal. Chhaupadi, commonly understood as menstrual seclusion, has been addressed through Supreme Court directives, national policy, criminal law, municipal implementation instruments, hut demolition campaigns, public health programming, and rights-based advocacy. Yet the practice has persisted, adapted, and in some cases moved into less visible spaces. Rather than treating this as a simple gap between law and practice, this thesis asks how abolition efforts themselves have become part of the regulatory regime through which menstruation is …

Rehabilitation Belief And Engagement Transformation (Rbet) Model: A Grounded Theory Approach, Jade Ibhar V. Cuambot, Marc Eric S. Reyes, Karen Katrina V. Trinidad

Makara Human Behavior Studies in Asia

Competitive sports injuries have significant physiological and psychological consequences for athletes. While rehabilitation medicine effectively addresses the physical aspects of injury recovery, the psychological and emotional journey of injured athletes remains neglected. Thus, the current study addresses this gap by examining athletes’ transforming belief systems and emotional experiences during injury rehabilitation. A qualitative research design grounded in grounded theory principles was conducted with professional athletes to understand how their beliefs toward rehabilitation evolved over time. Findings revealed a dynamic process of belief transformation consisting of seven interconnected stages, captured in the Rehabilitation Belief and Engagement Transformation (RBET) Model: (1) Pre-rehabilitation …

Thoughts From The Pit: Can Raving Change The World? A Literature Review Exploring Rave Culture As Expressive Arts Healing, Marissa Rose Renella

Expressive Therapies Theses

This literature review examines the structural and philosophical commonalities between expressive arts therapy (EXA) and rave culture. Drawing on scholarship from anthropology, cultural studies, health sciences, transpersonal psychology, neuroscience, and expressive arts therapy, this review identifies five core principles shared between the two fields: transformational experiences, multimodality, entrainment and flow, containment and ritual, and community and social action values. Across each principle, the literature reveals not surface-level similarity but deep convergence — two fields that have, independently and through different lineages, arrived at the same understanding of what human beings need in order to heal, grow, and connect. To the …

From Worry To Invention: Developing The Lunch Bunch As A Multimodal Expressive Arts Model For Regulation, Collaboration, And Peer Connection In Elementary Schools, Pascale Lauren Mimran-Ugbabe

Expressive Therapies Theses

This thesis documents the development of the Multimodal Expressive Arts Lunch Bunch, a small group intervention for elementary students delivered during the school lunch period at a public elementary school in Boston, Massachusetts. Grounded in multimodal expressive arts therapy, intermodal transfer theory, polyvagal-informed co-regulation, and principles of externalization, the intervention was designed as a low-barrier creative support group accessible regardless of diagnosis, referral status, or family pursuit of clinical services. Two cohorts of teacher-nominated students, one group of fourth-grade girls and one mixed-gender third-grade group, participated in a sequenced arc moving from worry externalization through collaborative invention, prototype construction, and …

Whiny Women: How Medical Gaslighting Becomes Medical Trauma, Neena Marcus

Honors Projects

Background: The idea of “medical gaslighting” has been present since 1969, but it has increased in popularity in the recent century. Women in particular are at increased risk of being dismissed by their healthcare providers, as throughout history they have been deemed “hysterical” or untrustworthy when recounting their symptoms.

Methods: Articles were compiled from CINAHL Complete, Google Scholar, and the University of Washington library. A total of 33 articles were chosen and reviewed.

Results: Medical gaslighting results in lasting medical trauma, a decreased quality of life and detachment from standard healthcare. Six themes were recurrent in the papers utilized: sexism, …

Conflict, Climate, And Child Health: Evidence From Sub-Saharan Africa, Brian C. Thiede, Nigel C. James

Health Studies Faculty Publications

Many parts of the world are experiencing social and political instability, as well as ongoing climatic changes that are expected to accelerate in the years ahead. These changes can undermine children's health through multiple pathways, and the growing frequency of sociopolitical and environmental stressors increases the likelihood that individuals are exposed to multiple risks simultaneously. Few studies have quantified the effects of such concurrent shocks despite conceptual motivations for doing so. We address this gap by measuring the independent and compounding effects of conflict and climate exposures on the weight-for-height of 0–23 month-old children across 32 countries in sub-Saharan Africa. …

“There Was Nothing Left To Give”: Experiences Of Compassion Fatigue Among Former In-Patient Psychiatric Clinicians, Katie Ladner

Counseling and Psychology Dissertations

Compassion Fatigue (CF) is a state of emotional and physical exhaustion resulting from prolonged exposure to stressful or traumatic experiences, specifically among healthcare workers, and it negatively impacts their ability to provide care to their patients and perform their jobs effectively (Singh et al., 2020). The purpose of this qualitative study is to explore the lived experiences of compassion fatigue in mental health clinicians who previously worked in in-patient psychiatric hospitals and their subsequent resignations. This phenomenological research explored participants' understanding and descriptions of their CF experiences in their roles within psychiatric hospitals and how CF contributed to their leaving …