Digital Commons Network^™

Sustaining Substance Use Recovery Housing For People Taking Medications For Opioid Use Disorder: Diverse Funding, Strategic Partnerships, And Charging Rent, I Niles Zoschke, Kathryn R Gallardo, Danielle Gillespie, Hannah L N Stewart, Serena A Rodriguez, Sheryl A Mccurdy, J Michael Wilkerson

Faculty, Staff and Student Publications

Introduction: Opioid use disorder is a U.S. epidemic, and recovery housing plays a critical role by providing stable, supportive environments that promote long-term recovery. However, little is known about the sustainability of recovery homes, particularly those serving people taking medications for opioid use disorder.

Methods: We applied thematic analysis to interviews with 29 staff and operators from 10 recovery homes serving people taking medications for opioid use disorder across five Texas cities.

Results: Operators relied on diverse funding sources, leveraged strategic partnerships and professional certifications, and planned to charge rent when public funding ended. Staff and operators balanced financial sustainability …

Recovery Housing And On-The-Ground Research Priorities: A Scoping Study Through The Lens Of Community Based Participatory Research, Patrick F Hibbard, Cameron W Tice, Jodie M Dewey, Kathryn R Gallardo, James Tompkins, Justin S Bell, Jasleen Sandhu, Michelle A Cruz, Kathryn Babbitt, Amy A Mericle, Ashli J Sheidow

Faculty, Staff and Student Publications

Introduction: Though communities have featured recovery housing (RH) for several decades, the base of evidence for best practices continues to grow - especially evidence needed by, and known to, those who operate and receive these services. The Initiative for Justice and Emerging Adult Populations (JEAP) engaged with three community boards (CBs) - consisting of young adults with experience in recovery from substance use issues, people who have a history of criminal legal system involvement and recovery, and payers and provider of substance use services and harm reduction - to understand on-the-ground priorities for research into recovery support services.

Methods: JEAP …

Community-Involved Economic Evaluation And Development Of A Cost-Effectiveness Calculator For Two Peer-Driven Substance Use Interventions, Sierra Castedo De Martell, Margaret B Moore, Hannah Wang, Lori Holleran Steiker, J Michael Wilkerson, Sheryl A Mccurdy, Nalini Ranjit, H Shelton Brown

Faculty, Staff and Student Publications

Introduction: While peer-driven substance use interventions have proliferated across the U.S., economic evaluations of these interventions have lagged behind. A key characteristic of these interventions is the centrality of the "nothing about us without us" ethos, which should extend into economic evaluation research. To that end, this study sought to take a community-based participatory research (CBPR) approach to conducting a cost-effectiveness analysis (CEA) of peer recovery support services (PRSS) and turning that CEA and a CEA of bystander naloxone distribution (BND) into components of a free, web-based calculator for use by recovery community centers (RCCs).

Methods: We engaged staff and …

Disposition Outcomes Following Prehospital Use Of Naloxone In A Large Metropolitan City In The United States, James R Langabeer, Christine Bakos-Block, A Sarah Cohen, Ishmam Alam, Bhanumathi Gopal, Marylou Cardenas-Turanzas, Arlo F Weltge, David Persse, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

Objectives: During a drug overdose, research suggests individuals may not call 9-1-1 out of fear of criminal justice concerns. Of those that call, research is inconclusive about the disposition of the emergency transport. We evaluated transport outcomes for adults with opioid-related overdose in the Emergency Medical Services (EMS) of a large metropolitan city in the United States.

Methods: We reviewed the EMS incident report database from the patient care record system for years 2018 to 2022. We queried all records, searching for relevant terms, and two reviewers cross-checked the database to identify cases that did not result in death at …

Community-Level Factors Influencing The Duration Of Buprenorphine Treatment In Individuals With Opioid Use Disorder: A Cohort Study Using Us Longitudinal Claims Data, Paula A Jaimes-Buitron, Kehe Zhang, Yanmin Gong, Yuanxiong Guo, Cici Bauer, Carolina Vivas-Valencia

Faculty, Staff and Student Publications

Introduction: Buprenorphine is effective in reducing opioid-related morbidity and mortality; however, many patients discontinue treatment prematurely. While previous research has focused on individual-level predictors of retention, the influence of community context remains underexplored. This study aims to examine how community-level factors, such as social vulnerability, availability of buprenorphine-waivered providers and access to behavioural health services, affect the duration of buprenorphine treatment episodes for individuals with opioid use disorder (OUD).

Methods: We conducted a retrospective cohort study using longitudinal claims data from 2006 to 2022. Adults aged 18 and older who initiated buprenorphine treatment for OUD and maintained continuous enrolment were …

Factors Affecting The Quality Of Life Of Residents In The United States: Lessons From Virginia, Daniel K. Pryce

Sociology & Criminal Justice Faculty Publications

Evaluating community members' views about their quality of life is important for improving quality of well-being in society, as most societies are interested in the collective well-being of the people. Moreover, quality-of-life research helps public officials to understand how well they are meeting the needs of the electorate. Using the theoretical framework of Maslow's Developmental Perspective, which argues that the higher the need satisfaction of the majority in a given society the greater the quality of life of that society, I explore the effects of multiple variables on quality of life in the Hampton Roads region of Southeast Virginia (this …

Is The Defendant Mad Or Bad? The Association Between Mental Health, Race And Sex In Sentencing In Federal Courts, Tracy Sohoni, Sylwia Piatkowska, Briana Paige

Sociology & Criminal Justice Faculty Publications

Although US courts regularly sentence individuals with mental health problems, to date, there has been little research on whether mental health indicators are related to sentencing decisions. The focal concerns perspective suggests that sentencing decisions reflect perceptions of the blameworthiness of the defendant, concerns about protecting the community, and practical considerations. Potentially, mental health issues could serve as a mitigating factor in sentencing decisions by making defendants seem less culpable for their actions and more deserving of assistance rather than punishment, and/or due to concerns about practical considerations related to higher costs of incarceration or of exacerbating current mental health …

Impact Of An Educational Workshop On Occupational Therapy Student Perceptions Of People With Justice System Involvement, Emily K. Simpson, Sara Engimann, Jamie N. Deal, Sydney M. Sabbagha, Lexi Frazier

Journal of Occupational Therapy Education

The United States has the highest number of people per capita in detention centers when compared to all other nations in the world. Stigma exists against people with justice system involvement, resulting in discrimination by healthcare providers and students and ultimately health inequities. This convergent mixed-methods study aimed to impact occupational therapy students’ (N=25) knowledge, attitudes, and beliefs about the criminal justice system and people with justice system involvement. The workshop included education, a panel of people with lived experience, and an occupational therapist with experiences in the criminal justice system. Significant changes were seen in the number of correct …

Trauma-Informed Care In Occupational Therapy Education, Cristina H. Scionti, Mary Shotwell, Donnamarie Krause

Journal of Occupational Therapy Education

Students bring their life histories, including traumatic experiences, to their learning and education. Potentially up to 75% of the student body of occupational therapy programs may have experienced a traumatic event, which often leads to occupational disruption and challenges in academic performance. Thus, it is critical for occupational therapy educators to mitigate the impact of trauma by identifying the barriers and facilitators to occupational participation in education for occupational therapy students affected by trauma. Despite the high prevalence of adverse childhood experiences (ACEs), research shows that few health professions education programs, such as occupational therapy, attend to ACEs or utilize …

The Impact Of Socioeconomic Status On Substance Use Amongst The Hispanic Maternal Population, Emily C. Olivo

Honors Undergraduate Theses

Aim: To explore and synthesize existing research that focuses on the relationship between socioeconomic status and the use of substances amongst the maternal Hispanic population. By examining research and these factors, interventions can be identified to lower reported substance use rates amongst Hispanic mothers of childbearing ages.

Background: Minorities such as Hispanic women deal with a myriad of struggles, especially during motherhood. Socioeconomic status and substance use can contribute to a large part of the struggles faced by this population. Hispanic and Latina will be used interchangeably throughout this review of literature.

Method: A comprehensive electronic review of 3 databases …

Educational Sessions On Opioid Use Disorder In A Rural Community: A Faith-Based Approach, Tarrelle Reade

Doctor of Nursing Practice Projects

This scholarly project aimed to evaluate the effectiveness of a faith-based community education program regarding opioid use disorder (OUD) in a rural area of Person County, North Carolina. Through 4 weekly sessions hosted at Lattisville Grove Missionary Baptist Church, the program provided education on the signs and symptoms of opioid misuse, associated risks, available treatment options, support resources, and the use of Narcan. A pre- and post-survey design using a Likert scale measured changes in knowledge and confidence across five key domains. Data from participants (n = 54 total) showed statistically significant improvements in awareness and self-efficacy in most areas, …

Championing Reproductive And Perinatal Health With The Recovery Community: Improving Access To Healthcare And Health Promotion Resources To Support Recovery, Hartley C. Feld, Alex Elswick, Jeremy Byard, Whitney Beckett, Amanda Fallin-Bennett

Nursing Faculty Publications

Peer recovery support services are instrumental in the promotion of long-term recovery primarily by focusing on building the recovery capital of people with substance use disorders. Women may have specific health-related needs that are not generally part of recovery support staff training. Our team co-created a model by training people with lived experience as coaches to promote the health of women with SUD during the critical period of their reproductive years when mortality from overdose risk is high and can be compounded by issues surrounding pregnancy. We explored the outcomes of a small pilot test of this model to promote …

Caretaker Of Captors: The Experience Of Role Conflict Among State Correctional Officers, Camille M. Botticelli-Pohl

Antioch University Dissertations & Theses

A variety of policies at the national level over the last 70 years have resulted in the mass incarceration of various marginalized populations, inclusive of individuals with mental health problems or severe mental illness. Although Constitutional mandates require that psychology staff be available at all state and federal facilities, these providers spend a fraction of the time with incarcerated people than correctional officers do. Correctional officers seem to play an important, if often overlooked, supporting role in the management of the day-to-day lives of people in custody, including elements of their mental health care. They are also, theoretically, tasked with …

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

Antioch University Dissertations & Theses

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

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

Antioch University Dissertations & Theses

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

Geriatric Care In Corrections: An Exploratory Study Of Cross-Disciplinary Perspectives On The Needs Of An Aging Prison Population, Cynthia A. Scheiderer

Antioch University Dissertations & Theses

The incarcerated population in the United States is aging. The proportion of adults 55 or older in prison rose from 3% in 1993 to 16% at year-end 2022 (Carson & Sabol, 2016; Carson & Kluckow, 2024). Researchers have consistently found evidence that the prevalence of disabilities and functional impairment is higher among older adults who are incarcerated than among those in the community. As the incarcerated population ages, corrections professionals responsible for providing safety, housing, and health care must respond to the needs of the population. In this qualitative study, 21 corrections professionals from the disciplines of custody, classification, medical, …

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

Graduate Theses, Dissertations, and Problem Reports (ETD)

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

Exploration Of Coping And Mental Health In West Virginia Farmers, Jodi Meadows Richmond

Graduate Theses, Dissertations, and Problem Reports (ETD)

Compared nationally, West Virginia currently ranks lowest for life expectancy, highest for drug related deaths and 35^th for access to adequate health (WV DHHR Organization Assessment & Strategic Plan, 2022). The state also ranks first in the nation for depression with one in four adults experiencing some form of depressive condition each year (CDC, 2020). The rurality of the state may limit social interaction and availability of medical treatment facilities (Brew et al., 2016).

The situation is even more dire for those in farming-related occupations. Farmers often struggle with management stress, utilizing appropriate coping strategies, and accessing mental health …

Health Equity And Children With Medical Complexity/Children And Youth With Special Health Care Needs: A Scoping Review, Elizabeth A. Flasch

College of Nursing Faculty Research and Publications

Children with medical complexity (CMC) and children and youth with special health care needs (CYSHCN), compared with the general population, engage with the health care system at increased rates, at multiple life stages, and for a myriad of reasons (Berry et al., 2015). Operational definitions of CMC and CYSHCN are very limited, with the terms conflated and differentiated across the literature. Because of the lack of standardized definitions and general conflation of the two terms across the literature, CMC and CYSHCN will be used interchangeably for this review. Allshouse et al. (2018) defined CMC as a subset of CYSHCN “as …

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

College of Nursing Faculty Research and Publications

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

Lived Experience Of Middle School Science Teachers During The Covid-19 Pandemic, David E. Abbott Jr.

Theses and Dissertations

The COVID-19 pandemic significantly disrupted education worldwide, compelling schools to adopt remote teaching and learning. This phenomenological study examined the lived experiences of six middle school science teachers in an Alabama school district during this period. Data were collected through interviews and reflective journals maintained for 2 weeks following the interview. The research investigated how teachers navigated shifting instruction to remote settings, engaged students, assessed and monitored their progress, and managed challenges. Guided by the technological pedagogical and content knowledge (TPACK) framework, findings revealed that teachers leveraged a combination of technological, pedagogical, and content knowledge to adapt their instruction. Despite …

Factors Contributing To Teacher Attrition From The Perspectives Of Teachers Who Left The Profession, Malik Padgett

Theses and Dissertations

This applied dissertation examined teacher attrition, a persistent challenge in K–12 education. Nearly 20% of teachers leave by their third year, with up to 50% departing by the fifth year. High turnover disrupts learning, strains resources, and diminishes educational quality, particularly in under-resourced communities. Addressing these issues is crucial for improving retention and fostering stability.

The study explored key factors driving attrition, including inadequate compensation, excessive workload, insufficient professional development, and limited administrative support, especially in the post-COVID era. Grounded in transformational leadership theory, the research highlighted the role of leadership in fostering morale and ethics rather than merely transactional …

Differences In Mental Health Care Use Between Urban And Rural Populations In New York State, 2017-2022, Anna J. Papa

Electronic Theses & Dissertations (2024 - present)

Objective

This study aimed to determine whether rural New York State residents receive mental health care at the same rate as urban residents, how poverty rates in New York State relate to rurality and mental health care use, and how pre-pandemic mental health care use rates compare to 2022 use rates. The goal was not to estimate the burden of disease, nor to estimate the number of patients engaged in care in each zip code, but to highlight the potential differences in service use between urban and rural New York State Office of Mental Health clients.

Methods

A secondary analysis …

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

Electronic Theses & Dissertations (2024 - present)

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

Sample Ascertainment And Recruitment Sources In The Accelerating Medicines Partnership Schizophrenia Program, Jean Addington, Daniel Mamah, Et Al.

2020-Current year OA Pubs

BACKGROUND: This paper presents the recruitment sources of clinical high-risk (CHR) and community controls (CC) from the Accelerating Medicines Partnership Schizophrenia (AMP SCZ) program, which aims to study various clinical variables and biomarkers in 2040 CHR and 652 CC participants.

METHODS: A total of 1640 CHR and 514 CC had recruitment source data. The Positive Symptoms and Diagnostic Criteria for the Comprehensive Assessment of At-Risk Mental States Harmonized with the SIPS was utilized to assess CHR criteria and severity of attenuated psychotic symptoms (APSs), and the Global Functioning: Social Scale was used for social functioning. Participants were recruited through various …

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

2020-Current year OA Pubs

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

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

Mitigating The Risk Of Qtc Prolongation When Using Haloperidol For Acute Treatment Of Cannabinoid Hyperemesis Syndrome In Adolescents And Young Adults, Sandra Merino, Lissette Tordera, Allison Jun, Sun Yang

Pharmacy Faculty Articles and Research

Background/Objectives: Cannabinoid Hyperemesis Syndrome (CHS), associated with long-term cannabinoid use, has been increasingly observed in emergency room visits as more states in the U.S. have legislatively permitted medical and recreational marijuana use. The acute management of CHS primarily focuses on antiemetic treatment and supportive care. However, both the condition itself and the antiemetic drugs, such as haloperidol, may cause QTc prolongation. Methods: We reported two adolescent cases admitted to the emergency department for acute antiemesis management of CHS who received haloperidol treatment. A literature review was performed through October 2024 for previously published cases of QTc prolongation and/or …

Factors Affecting Waiting Times To Enter Opioid Use Disorder Treatment In The United States With A Particular Focus On Potential Biological Sex Disparity, Stanley Nkemjika, Kenneth Oforeh, Connie Olwit, Olaniyi Olayinka, Terence Tumenta

Department of Psychiatry and Human Behavior Faculty Papers

AIM: Opioid use disorder (OUD) is the problematic use of licit or illicit opioids. Thus far, the literature on biological sex differences in accessing treatment is scarce. Hence, we hypothesize that biological sex has a moderating effect on OUD treatment accessibility. We aim to explore biological sex differences in treatment disparities and its role in wait time to enter OUD treatment.

METHOD: Using the 2018 Treatment Episode Data Set Discharge, the national sample representative of OUD patients in the substance use disorder treatment facilities within the 50 states of the United States was 382,547. Univariate and multivariable logistic analysis of …

"Does Anyone Believe Me"?: The Traumatization Of Domestic Violence Survivors In The Criminal Justice System, Olivia Depalma

Master of Arts in Human Services

Survivors of domestic violence are often subject to chronic trauma as well as a heightened risk of injuries and mental health problems and disorders. The intention of the author is to focus on how trauma impacts a survivor’s ability to maneuver and interact with the criminal justice system (CJS). Prior studies have shown how survivor’s behaviors, usually the result of trauma, can lead to misconceived notions and beliefs in court officials and those involved in the CJS. Survivors will often face judgment, doubt, and criticism in the CJS, and this can impact their willingness to come forward, report the abuse, …

The Role Of Camaraderie In The Moods Of African American U.S. Military Veterans With Ptsd: A Qualitative Phenomenological Study, Virginia K. Thompson

Doctoral Dissertations and Projects

The purpose of this qualitative phenomenological study was to understand the essence of the collective lived experiences of United States military veterans of African American ethnicity who were diagnosed with posttraumatic stress disorder (PTSD) and the role that camaraderie plays in their moods. Veterans are a marginalized group who often feel they are rejected by society, but as Christians, we should be interested in human beings, promoting their well-being, and practicing psychology as an act of love. Guided by social identity theory and social justice theory, this study was aimed to gain understanding of how group memberships and social categorization …