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The Impact Of Provider Medication Reconciliation Education On Hospital Readmissions In A Skilled Nursing Facility, Vivian Nwozu Sep 2026

The Impact Of Provider Medication Reconciliation Education On Hospital Readmissions In A Skilled Nursing Facility, Vivian Nwozu

Doctor of Nursing Practice Projects

Aging causes frailty and multiple comorbidities, necessitating polypharmacy. Complicated drug regimens predispose patients to adverse drug events and hospital readmissions. The practice problem was high rates of medication-related readmissions due to inadequate provider knowledge of medication reconciliation and the lack of a standardized tool. This project aimed at evaluating the impact of provider medication reconciliation education on hospital readmissions in a skilled nursing facility. A pretest-posttest study design was utilized. The Donabedian Model of Healthcare Quality guided the translation of evidence into practice, whereas Lewin’s Change Model and Plan-Do-Study-Act models guided implementation. Eight providers were educated on medication reconciliation using …


Efficient Database Translation, Sonya Fogg, Tracy Ashby Sep 2026

Efficient Database Translation, Sonya Fogg, Tracy Ashby

Library Class: Lunch & Learn

Understand the concept and utility of database translation. Identify key differences in indexing and syntax across major biomedical databases. Apply practical strategies for translating search strategies between databases.


Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama Sep 2026

Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education evidence-based practice initiative implemented at a state-operated adult inpatient psychiatric facility in California. The practice gap was inconsistent nursing staff knowledge of early Crisis Prevention Intervention-based de-escalation strategies and available unit-based resources despite an established crisis-prevention framework. The practice-focused question asked whether a standardized staff education activity would increase staff knowledge, as measured by anonymous pre-education and immediate post-education scores. The purpose was to develop, implement, and evaluate the education using staff knowledge change as the sole measurable outcome. The Johns Hopkins Evidence-Based Practice Model guided appraisal and synthesis of 11 evidence sources …


Why Do Indonesians Travel Abroad For Medical Treatment? A Qualitative Phenomenological Study, Lucky Sarjono Buranda, Aries Wahyuningsih, Steven Busby Sep 2026

Why Do Indonesians Travel Abroad For Medical Treatment? A Qualitative Phenomenological Study, Lucky Sarjono Buranda, Aries Wahyuningsih, Steven Busby

Journal of Indonesian Health Policy and Administration

More than one million Indonesian citizens travel abroad for medical treatment each year, generating financial transactions exceeding IDR 180 trillion (USD 11.5 billion). This study aimed to explore the reasons why Indonesians seek medical treatment overseas. A qualitative phenomenological approach was employed using in-depth interviews with Indonesian citizens who had received or were currently receiving medical treatment outside Indonesia. All interviews were recorded, transcribed, and analyzed through coding to identify themes, subthemes, and related properties. Interviews were conducted with 18 participants from three major Indonesian cities (Makassar, Surabaya, and Batam), as well as individuals receiving treatment in Singapore and Malaysia. …


Differences In Mental Toughness Among Mixed Martial Artists And Physically Active Individuals, Savannah M. Calleja, Soleil Ramos, Victoria Potvin, Anthony A. Ricci, Gabriel J. Sanders, Corey A. Peacock Sep 2026

Differences In Mental Toughness Among Mixed Martial Artists And Physically Active Individuals, Savannah M. Calleja, Soleil Ramos, Victoria Potvin, Anthony A. Ricci, Gabriel J. Sanders, Corey A. Peacock

Journal for Sports Neuroscience

Mixed Martial Arts (MMA) is a physiological and psychological demanding sport. While the majority of the literature conducted in MMA regards physiological health and risk of injury, researchers are beginning to assess the psychological profiles of MMA athletes. Previous studies have evaluated mental toughness (MT) within MMA; however, no study has examined MT in MMA athletes at the professional division. Therefore, the primary purpose of this research was to evaluate the difference in mental toughness between professional MMA athletes and physically active individuals. Secondary aims are to evaluate potential variations in mental toughness within the professional level between champion and …


Quality Improvement Project: The Impact Of Self-Assessed Quality Of Sleep On Illness Experience And Job Satisfaction Among Night Shift Nurses, Eunice Ikpekpe Sep 2026

Quality Improvement Project: The Impact Of Self-Assessed Quality Of Sleep On Illness Experience And Job Satisfaction Among Night Shift Nurses, Eunice Ikpekpe

Doctor of Nursing Practice Projects

Compromised sleep quality, illness experience, and job satisfaction are important concerns among registered nurses working night shifts. The purpose of this quality-improvement project was to evaluate changes in self-assessed sleep quality, illness experience, and job satisfaction following participation in the six-week Sleep Hygiene and Recovery Program (SHRP) among night-shift registered nurses at a large, urban, Level I trauma academic teaching medical center. The project used a quantitative, quasi-experimental, single-group pretest–posttest design guided by the Plan-Do-Study-Act framework and Lewin’s Change Management Theory, with the Neuman Systems Model and Pender’s Health Promotion Model providing the theoretical foundation. SHRP was a structured, evidence-informed …


The Impact Of Unilateral Versus Bilateral Ankle Bracing On Kinematics, Kinetics, And Performance In Volleyball Players, Stephen M. Boulanger, Derek M. R. Kivi, Carlos Zerpa, Paolo Sanzo Sep 2026

The Impact Of Unilateral Versus Bilateral Ankle Bracing On Kinematics, Kinetics, And Performance In Volleyball Players, Stephen M. Boulanger, Derek M. R. Kivi, Carlos Zerpa, Paolo Sanzo

Topics in Exercise Science and Kinesiology

This study examined the effect of different types of ankle braces (Ankle Stabilizing Orthosis (ASO) vs. T2 Active Ankle(T2)) when worn unilaterally (UNI), bilaterally (BI), and with no brace worn (UB) on lower extremity kinematics and kinetics during a vertical jump and agility test. Twenty-two competitive volleyball players completed both a vertical jump test and agility T-test under five bracing conditions. Vertical jump height (VJH), ankle dorsiflexion (ADF), ankle plantarflexion (APF), knee flexion (KF), hip flexion (HF), vertical ground reaction force (vGRF), and vertical impulse were measured during the vertical jump test, while time to completion was measured for the …


Sociodemographic And Geographic Factors Underlying Breast Cancer Survival Disparities Among Women In The United States, Colletta Brabham-Orr Sep 2026

Sociodemographic And Geographic Factors Underlying Breast Cancer Survival Disparities Among Women In The United States, Colletta Brabham-Orr

Walden Dissertations and Doctoral Studies

Breast cancer-specific mortality in the United States remains higher among women in rural and socioeconomically disadvantaged areas, yet few population-based studies have been conducted to jointly scrutinize demographic and structural determinants of this disparity. Informed by the social determinants of health framework, this secondary data analysis, using records from the SEER Research Plus database, examined the association between age at diagnosis, race and ethnicity, rural/urban residence, county-level median household income, and breast cancer-specific mortality among U.S. women aged 18 and older diagnosed with malignant invasive breast cancer between 2010 and 2020 (N = 285,865). Bivariate chi-square tests and binary logistic …


Firearm Safety And Suicide Prevention In Older Adults: A Primary Care Clinical Framework., Rebecca Delp, Erik E. Langenau Sep 2026

Firearm Safety And Suicide Prevention In Older Adults: A Primary Care Clinical Framework., Rebecca Delp, Erik E. Langenau

PCOM Scholarly Works

Firearm-related injury and suicide represent a critical public health challenge in the United States, with older adults experiencing the highest rates of firearm suicide. Approximately 70 % of suicides among older adults involve a firearm, with white males over age 70 at the highest risk. Despite high household firearm access and unsecured storage, standardized screening and counseling in primary care remain underutilized. Primary care physicians are uniquely positioned to identify clinically vulnerable patients and evaluate lethal means safety through longitudinal relationships during routine encounters. This clinical practice report presents an evidence-based framework for firearm suicide risk assessment, clinical communication, and …


Turkish Translation And Cultural Adaptation Of The Evaluation In Ayres Sensory Integration (Easi), Aymen Balikci, Ayse Firdevs Aracikul Balikci, Isabelle Beaudry-Bellefeuille, Gamze Cagla Sirma, Fatos Kirteke, Zoe Mailloux, L. Diane Parham, Susanne Smith Roley, Roseann C. Schaaf Sep 2026

Turkish Translation And Cultural Adaptation Of The Evaluation In Ayres Sensory Integration (Easi), Aymen Balikci, Ayse Firdevs Aracikul Balikci, Isabelle Beaudry-Bellefeuille, Gamze Cagla Sirma, Fatos Kirteke, Zoe Mailloux, L. Diane Parham, Susanne Smith Roley, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

INTRODUCTION: Cultural sensitivity and relevance are critical components for best practice in occupational therapy assessment. The Evaluation in Ayres Sensory Integration (EASI) is a performance-based assessment designed to evaluate sensory perception, sensory reactivity, postural control, ocular control, bilateral integration, and praxis abilities in children aged 3-12 years. Before the development of this tool, no standardized performance-based assessment of sensory integration functions had included a normative Turkish sample. The objective of this study was to translate and culturally adapt the EASI for Türkiye.

METHOD: A seven-step process for translation and cross-cultural adaptation, grounded in established methodology, was applied. The steps included …


Journal Ida 2023 102 4 Sep 2026

Journal Ida 2023 102 4

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.


Journal Ida 2023 102 3 Sep 2026

Journal Ida 2023 102 3

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.


Evidence-Based Interventions For Suicide Prevention, Deepthi Gilla Sep 2026

Evidence-Based Interventions For Suicide Prevention, Deepthi Gilla

Indian Journal of Research in Homoeopathy

NA


A Retrospective Descriptive Profile Of Cancer Patients Seeking Homoeopathic Care In A Semi-Rural South African Setting, Radmila Razlog Sep 2026

A Retrospective Descriptive Profile Of Cancer Patients Seeking Homoeopathic Care In A Semi-Rural South African Setting, Radmila Razlog

Indian Journal of Research in Homoeopathy

Background: Patient profiling renders valuable information about the population's healthcare-seeking behaviours, critical for effective patient management. Khula Natural Health Centre (KNHC) in South Africa provides healthcare to rural communities, within the scope of Homoeopathy. Objective: The study aimed to create a preliminary cancer patient profile of KNHC from April 2017 to August 2024. Method: This retrospective study adopted a descriptive, exploratory design. Anonymised patient data was extracted from the KNHC database. Data that met the inclusion criteria were descriptively analysed to summarise and describe the dataset. Results: Forty-six participants' data, presenting a range of cancers, consulted at KNHC for homoeopathic …


Research Highlights, Gandham Kumuda, Monika Chandyoke Sep 2026

Research Highlights, Gandham Kumuda, Monika Chandyoke

Indian Journal of Research in Homoeopathy

NA


World Homoeopathy Day 2026: Homoeopathy For Sustainable Health, Candy Benny, Sonu Kumar, Divya Taneja, Pankhuri Misra, Renu Mittal, Subhash Kaushik Sep 2026

World Homoeopathy Day 2026: Homoeopathy For Sustainable Health, Candy Benny, Sonu Kumar, Divya Taneja, Pankhuri Misra, Renu Mittal, Subhash Kaushik

Indian Journal of Research in Homoeopathy

The World Homoeopathy Day (WHD) 2026 – a two-day interactive forum to commemorate the 271st birth anniversary of Dr. Samuel Hahnemann, founder of Homoeopathy, was held on 10th – 11th April 2026 at Vigyan Bhawan, New Delhi, India. The event was organised by CCRH, NCH, and NIH under the aegis of the Ministry of Ayush. Centered on the theme of ``Homoeopathy for Sustainable Health'', the event emphasised the role of Homoeopathy in promoting and ensuring sustainable health. The event witnessed participation from approximately 1,800 delegates comprising policy makers, practitioners, researchers, academicians, and students. There were a …


Quality Improvement Project: Electronic Consent's Influence On Consent Error Rates, Alexis Fogle Sep 2026

Quality Improvement Project: Electronic Consent's Influence On Consent Error Rates, Alexis Fogle

Doctor of Nursing Practice Projects

Surgical consent errors increase the risk of inaccurate documentation, compromise patient safety, and disrupt procedure times. Evidence indicates that adopting electronic consent can optimize workflow, support accurate and complete documentation, improve readability, and enhance record reliability. This project evaluated whether initiating electronic consent, compared with handwriting surgical consent forms, reduced the number of improper surgical consent forms completed over six weeks. Roy’s Adaptation Model guided the change process, and the Theory of the Person as an Adaptation System provided the theoretical basis. The Plan-Do-Study-Act model supported evidence-based implementation of the electronic consent intervention. The quality improvement project was conducted on …


Quality Improvement Project Stress First Aid: Equipping Nurse Leaders, Bethany Russell Sep 2026

Quality Improvement Project Stress First Aid: Equipping Nurse Leaders, Bethany Russell

Doctor of Nursing Practice Projects

Stress among nurses can negatively affect well-being, workforce stability, and the quality of patient care, highlighting the need for nurse leaders to effectively recognize and respond to stress within their teams. The purpose of this quality improvement project was to evaluate whether education on the 7 Cs of Stress First Aid (SFA) improved leadership self-efficacy among nurse leaders at an urban acute-care hospital. Watson’s Theory of Human Caring provided the theoretical foundation, while Lewin’s Change Theory guided implementation of the practice change. A one-group pretest-posttest design was used, with the Plan-Do-Study-Act framework supporting project implementation. Participating nurse leaders completed an …


Cultivating A Culture Of Feedback: Strengthening Picu Nurses Through Peer-To-Peer Feedback, Alex Ramirez, Reese Reddick, Sydney Usselman Sep 2026

Cultivating A Culture Of Feedback: Strengthening Picu Nurses Through Peer-To-Peer Feedback, Alex Ramirez, Reese Reddick, Sydney Usselman

2025

No abstract provided.


Average Performance And Performance Variability On A Brief Functional Fine Motor Test Reflect Distinct Behavioral Constructs In Aging, Chung-Fu Sun, Kyle B. Tomlin, Jennapher Lingo Vangilder, Andrew Hooyman, Alexandra M. Reed, Jessica L. Trevino, Sydney Y. Schaefer Sep 2026

Average Performance And Performance Variability On A Brief Functional Fine Motor Test Reflect Distinct Behavioral Constructs In Aging, Chung-Fu Sun, Kyle B. Tomlin, Jennapher Lingo Vangilder, Andrew Hooyman, Alexandra M. Reed, Jessica L. Trevino, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

Prior work in older adults has developed a brief functional fine motor test, which involves repeated timed trials of an upper-limb task. Performance has been associated with global and domain-specific neuropsychological tests as well as putative markers of Alzheimer’s disease when scored using variability in trial time; however, the extent to which task performance depends on motor ability has not been established nor quantified. This retrospective study examined whether mean trial time and trial time variability (measured as intrasubject standard deviation in trial time) were differentially associated with standard assessments of motor and cognitive function. Forty-eight older adults with no …


Quality Improvement Project: Impacting Clinical Competency Through Faculty Preparation: A Standardized Teaching Guide Initiative, Caroline White Sep 2026

Quality Improvement Project: Impacting Clinical Competency Through Faculty Preparation: A Standardized Teaching Guide Initiative, Caroline White

Doctor of Nursing Practice Projects

Variability in clinical teaching practices can contribute to inconsistent faculty preparation and student learning experiences. This quality improvement project addressed the absence of a standardized clinical teaching resource within an Associate Degree Nursing (ADN) program at a public technical college in the southeastern United States. The purpose was to implement a standardized, evidence-based clinical teaching guide to improve faculty confidence and clinical educator skill acquisition. Social Cognitive Theory provided the theoretical framework, and Lewin’s Change Theory guided practice change. A quantitative, quasi-experimental one-group pretest-posttest design was used. Fourteen eligible nursing faculty and clinical instructors were invited to participate; 10 participated, …


Prenatal Cannabis Exposure Is Associated With Occipitotemporal Brain Surface Area In Neonates, Alexander J. Dufford, Sun Hyung Kim, Martin Styner, Xinyi Shen, Erika Iisa, Marilyn A. Huestis, Peter Fried, Christine Conageski, Jocelyn E. Phipers, Cristina Sempio, Jost Klawitter, Pilyoung Kim, Tessa L. Crume Sep 2026

Prenatal Cannabis Exposure Is Associated With Occipitotemporal Brain Surface Area In Neonates, Alexander J. Dufford, Sun Hyung Kim, Martin Styner, Xinyi Shen, Erika Iisa, Marilyn A. Huestis, Peter Fried, Christine Conageski, Jocelyn E. Phipers, Cristina Sempio, Jost Klawitter, Pilyoung Kim, Tessa L. Crume

Institute of Emerging Health Professions Faculty Papers

IMPORTANCE: Prenatal cannabis use has been associated with neurodevelopmental consequences for the offspring beginning in childhood; however, it is unclear if neonatal brain structural morphometry is impacted shortly after birth.

OBJECTIVE: We examined differences in regional surface morphometry among neonates exposed to chronic in utero cannabis compared to unexposed neonates.

DESIGN: The Moms Helping Moms study is a prospective pre-birth cohort selected based on chronic prenatal cannabis use and an unexposed control group. Exclusion criteria included alcohol, tobacco, or other substance use. Participants included in this analysis included 18 mother-neonate pairs with prenatal cannabis exposure and 21 unexposed pairs. Chronic …


Impact Of Sexual Orientation On Syphilis Diagnosis Among African American Men In Colorado, Emmanuel Bhatti Sep 2026

Impact Of Sexual Orientation On Syphilis Diagnosis Among African American Men In Colorado, Emmanuel Bhatti

Walden Dissertations and Doctoral Studies

Syphilis remains an ongoing public health concern among African American men. Elevated rates during the COVID-19 pandemic further underscored the need for focused attention on this population. The risk factors driving syphilis diagnosis among African American men during a pandemic like COVID-19 remain poorly understood. The purpose of this quantitative cross-sectional study was to examine the association between sexual orientation and syphilis diagnosis among African American men in Colorado. Social cognitive theory was applied to understand the interaction among sexual orientation, HIV status, age, and syphilis diagnosis. Sexual orientation categories include men who have sex with men (MSM), men who …


Harmonies Of Healing: A Secondary Data Analysis On Music Engagement And Quality Of Life In Older Adults, Theophilus Eben Nartey Sep 2026

Harmonies Of Healing: A Secondary Data Analysis On Music Engagement And Quality Of Life In Older Adults, Theophilus Eben Nartey

Doctoral Dissertations and Projects

The purpose of this quantitative, cross-sectional secondary data analysis was to examine the relationship between music engagement and self-reported quality of life among adults aged 60 years and older, using data from the Health and Retirement Study (HRS). Guided by the Biopsychosocial-Spiritual (BPSS) framework, the study explored whether music engagement significantly predicted perceived well-being in later adulthood while accounting for chronic health conditions. Secondary data from the HRS public-use dataset were analyzed using IBM SPSS Statistics Version 29. The final analytical sample consisted of 1,582 adults aged 60 years or older with complete data on all variables included in the …


The Relationship Between Resiliency Scores And Nurse Educators Intent To Stay In Academia: A Predictive Correlational Study, Michele Lee Blash Sep 2026

The Relationship Between Resiliency Scores And Nurse Educators Intent To Stay In Academia: A Predictive Correlational Study, Michele Lee Blash

Doctoral Dissertations and Projects

A shortage of both clinical nurses and nursing educators exists. These shortages have a multitude of impacts on the field of nursing, both at the bedside and in academia. The shortage of clinical nurses impacts the number of nurses available to provide quality patient care. The shortage of nursing educators can impact the number of students accepted into nursing programs and, in turn, the number of new nurses available to provide direct care to patients. The purpose of this quantitative non-experimental predictive correlational design study was to examine how the resiliency of nursing educators impacts their intent to stay in …


Re-Education On Chlorhexidine (Chg) Bathing Protocol Affects Patient Chg Bathing Compliance And Surgical Site Infection (Ssi) Rates, Mary Samantha Ross Sep 2026

Re-Education On Chlorhexidine (Chg) Bathing Protocol Affects Patient Chg Bathing Compliance And Surgical Site Infection (Ssi) Rates, Mary Samantha Ross

Doctoral Dissertations and Projects

Surgical site infections (SSI) are considered a hospital-acquired infection, leading to increased hospital length of stay (LOS), readmission rates, increased cost, morbidity, mortality rates, and poor postoperative outcomes. The literature review demonstrated the benefits of preoperative Chlorhexidine (CHG) bathing, but called for standardized protocols, improved education, and patient compliance. Research and clinical experience supported the need for improved patient compliance with CHG bathing. Consistent SSI rates even after protocol changes called for re-education of nursing staff in addition to addressing patient compliance issues. Therefore, providing re-education on the updated protocol, which addresses patient compliance issues, can lead to a reduction …


Progress, Poetry, And Peace: Romantic Ideals And The Present Day, Kristen Dawn Morgan Hess Sep 2026

Progress, Poetry, And Peace: Romantic Ideals And The Present Day, Kristen Dawn Morgan Hess

Masters Theses

In the busy, technologized, and mechanized life that most people live today, it can be difficult to find true rest, comfort, and peace because the very technology and machinery that is marketed as providing these 21st-century amenities often fall short in their delivery. Taking a look backward at the Romantic era ideals presented in the poetry of William Wordsworth can offer people today the chance to gradually improve their mental, physical, and emotional health by slowing down, minimalizing, and moderating their lifestyles. This thesis talks about the historical background of three of Wordsworth’s poems— “Lines Written in Early Spring,” “The …


Novice Nurses’ Perceptions Of Caring With Empathy In An Acute Care Hospital In The Northeastern United States: A Transcendental Phenomenological Study, Haley Zurcher Sep 2026

Novice Nurses’ Perceptions Of Caring With Empathy In An Acute Care Hospital In The Northeastern United States: A Transcendental Phenomenological Study, Haley Zurcher

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the essence of the experience of empathy among novice nurses in an acute care facility in the Northeast United States. The Central Research Question (CRQ) for this study was: What was the perceived experience/understanding of empathy by novice nurses working in acute care settings in northeastern Pennsylvania, United States? The study was guided by Bandura’s (1977) self-efficacy theory to examine how confidence, environmental influences, and personal beliefs shaped the development and expression of empathy in early nursing practice. The study was conducted at a large acute care hospital. The sample …


Staff Education On Teaching Evidence-Based Chronic Pain Management, Valdane Eleonu Robinson Sep 2026

Staff Education On Teaching Evidence-Based Chronic Pain Management, Valdane Eleonu Robinson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project focused on educating providers to fill in knowledge gaps in how to effectively manage chronic pain. The lack of knowledge about the evidence-based recommendations for treating chronic pain was the practice gap. Standardized training protocols to instruct pain management professionals and address disparities in chronic pain management care should be in place to guarantee that all patients in need of chronic pain management have access to culturally appropriate education.


Barriers And Facilitators To Health Literacy Among Black Americans With Overweight And Obesity In South Carolina: A Mini-Ethnographic Study, Shelly Campbell-Timmons Sep 2026

Barriers And Facilitators To Health Literacy Among Black Americans With Overweight And Obesity In South Carolina: A Mini-Ethnographic Study, Shelly Campbell-Timmons

Doctoral Dissertations and Projects

The purpose of this qualitative mini ethnography adapted from traditional ethnography with limited time and scope, was to explore and understand perceptions of barriers and facilitators to health literacy among Black Americans with overweight and obesity in three South Carolina counties. Population data showed that approximately 40.3% of U.S. adults are obese. Moreover, Non-Hispanic Black communities are disproportionately affected by overweight and obesity despite efforts to combat the weight-related health risk. Still, limited health literacy should be the focus of public health strategies like teach-back and plain language communication, to address overweight and obesity prevalence and disparities. The study was …