Digital Commons Network^™

A Pill Too Expensive: A Comprehensive Review For Exploring Medical Non-Adherence In The Age Of Rising Drug Prices, Vidhani Goel, Roberto Sagaribay

Undergraduate Research Symposium Lightning Talks

Prevalence & Health Disparities:

• Medication non-adherence is a major public health issue.
• High prescription drug costs are a significant barrier.
• Affects chronic conditions like diabetes, hypertension, and mental health disorders.

Potential Solutions:

• Patient assistance programs.
• Use of generic drugs.
• Policy reforms to reduce medication costs.

Future Directions & Solutions:

• Address research gaps in long-term outcomes.
• Explore broader policy interventions.
• Improve accessibility and awareness of assistance programs.

Contributing Factors:

• Leads to worse health outcomes.
• Increases hospitalizations and long-term healthcare costs.
• Affects vulnerable populations (i.e., elderly, uninsured, racial minorities)

Analyzing Healthcare As A Right, Instead Of A Privilege, Saidt Gutierrez

Undergraduate Research Symposium Podium Presentations

Healthcare is a fundamental necessity, yet in many countries including the United States, it remains a privilege rather than a right. This research examines the benefits of universal healthcare by analyzing its impact in countries that have successfully implemented healthcare such as Canada, the United Kingdom, and Germany. This study evaluates the healthcare accessibility, cost efficiency, and health outcomes in these countries against the U.S. This finding will suggest that universal health care leads to lower overall healthcare costs, improve public health, and reduce financial burdens on individuals. By ensuring healthcare as a right, rather than a privilege, the U.S …

Costing Care: Unpacking The Drivers Of Medicaid Spending For Nicu Admissions In Nevada, Vidhani Goel, Ana L. Reyes, Bertille Assoumou, Dodds P. Simangan, Farooq Abdulla, Deborah A. Kuhls

Undergraduate Research Symposium Podium Presentations

Overview This study examines how maternal and neonatal factors influence Medicaid spending for NICU admissions in Nevada, with an emphasis on identifying cost-driving health disparities. Approach: A retrospective analysis was conducted using linked data from Nevada’s Birth Registry and Medicaid claims (2015–2021). Infant records were analyzed using univariate and bivariate statistics, and logistic regression models identified associations between maternal/neonatal characteristics and above-median Medicaid spending. Cost trends were assessed using NICU case costs, annual growth rates, and year-to-year fluctuations. Key Objectives: Analyze trends in NICU-related Medicaid spending over a seven-year period. Identify maternal and neonatal characteristics linked to higher NICU costs. …

Challenges Individuals With Mental Illness Encountered With Reasonable Accommodation After The Implementation Of Title I Of The Americans With Disabilities Act, Kristie Demarco

Walden Dissertations and Doctoral Studies

Policy makers often lack information associated with the perspective of those living with mental illness as to whether Title I of the Americans with Disabilities Act is working as intended. When considering requests for workplace accommodations, the research literature has focused on the perspective of employers, and the impact on those with physical disabilities, yet few studies considered the impact on individuals with mental illness. The purpose of this generic qualitative study was to obtain the perspective of individuals with mental illness who have requested reasonable accommodations. Using a conceptual framework comprised of narrative policy framework and critical disability theory, …

Heartache In The Heartland: Unraveling The Social Roots Of Deaths Of Despair In Kentucky, Lyndsey K. Blair, Madeline M. Tomlinson, Michele Abee-Biskis, Jessica Hume, Gabri Warren

Journal of Appalachian Health

Introduction: Deaths of despair (DoD), encompassing suicides, drug overdoses, and alcohol-related liver diseases, have emerged as a critical public health crisis in the United States, with their rise particularly pronounced from 1995 to 2013 and exacerbated by the COVID-19 pandemic. Kentucky, grappling with high rates of substance use disorder, poor mental health, and economic hardship, is at the forefront of this issue, particularly in its rural and Appalachian regions.

Purpose: This study explores the social determinants contributing to DoD in Kentucky, focusing on economic and social factors that influence rising rates of suicide, drug overdose, and alcohol-related liver disease. The …

The Political Economy Of Namibian Development, William A. Lindeke

Journal of African Policy Studies

No abstract provided.

Un Treatment Of Multiple Oppressions: A Black Feminist Perspective, Stanlie James

Journal of African Policy Studies

No abstract provided.

South African Land Policy: The Legacy Of History And Current Options, Hans P. Binswanger, Klaus Deininger

Journal of African Policy Studies

No abstract provided.

State Capacity And Integrity At The Local Level: A Case Study Of Business And Trade Associations In Kano, Nigeria, John Lucas

Journal of African Policy Studies

No abstract provided.

Hiring Preferences Of Federally Recognized Tribes: Survey And Analysis, Kristen Gutierrez Livoti

Master of Public Administration

In the United States, there are currently 574 federally recognized Tribal nations. Both employers and applicants face challenges in the hiring process. Tribes may face challenges finding qualified applicants with the necessary skills for specific roles. A less-qualified employee may result in less impactful program outcomes, lower revenue, discouraged employees, and higher turnover rates. In addition, hiring an employee who doesn’t understand Tribal culture may result in ineffective programs, policies, and/or miscommunication. For those looking to work for a Tribal government, applicants often find challenges in that hiring preferences/policies (P&Ps) are different from Tribe to Tribe and not posted in …

Municipal Solid Waste Reduction Through Food Waste Diversion And Recycling Initiatives, Gosia Stolarska

Master of Public Administration

The report evaluates how Massachusetts municipalities are working toward the goals set in the MassDEP 2030 Solid Waste Master Plan, focusing on waste reduction, recycling initiatives, and especially food waste diversion. It identifies barriers, highlights successes, and makes policy recommendations, drawing on statewide and local examples. Primary methods include a literature review of articles covering the challenges municipalities face in waste reduction and some successful approaches. However, there is a literature gap regarding the impact of local staffing and implementation of waste reduction strategies. Data and case examples from Massachusetts are used to illustrate the benefits of dedicated staffing for …

Hope After Grief And Loss: A Needs Assessment Of Peer-Led, Non-Denominational Bereavement Support Services At Laurel’S Grief Center, Julia A. Lange

Public Administration Master’s Projects

This needs assessment examines the grief support services provided by Laurel’s Grief Center (LGC), a nonprofit organization in Buffalo, New York, and identifies opportunities to expand tailored services for grieving adults in Western New York. Using a convergent mixed-methods design, this study collected data through semi-structured interviews with LGC board members and surveys with clients and peer volunteers. Key findings highlight the importance of peer-led, non-denominational grief support and creative approaches, such as art therapy, while identifying barriers, such as stigma, limited awareness, and fragmented regional services.

Based on these findings, this study recommends expanding healing arts programs, enhancing outreach …

Increasing Voter Engagement Through Participatory Action Research With A Community Health Lens In The City Of Worcester, Engle Torres

Master of Public Administration

Worcester, the second-largest city in New England, has undergone significant changes throughout its history. Although it is diverse, it is still segregated by race and income, with disparities evident across various data sets. Non-clinical factors significantly influence a person's health, and voting is a right that may not be accessible to everyone for several reasons. Local elections generally impact residents more than Presidential elections, but voter participation in Worcester's local elections is declining. This research project will investigate the factors contributing to voter apathy in Worcester and outline the process for identifying these issues and addressing them effectively. This project …

Challenges Threatening The Sustainability Of School Meal Programs, Anca Tughin

Master of Public Administration

The sustainability of school meal programs is increasingly threatened by procurement challenges, including regulatory constraints, supply chain disruptions, and budgetary pressures. This capstone project examines how values-based procurement (VBP)—which prioritizes local, sustainable, and nutritionally rich food—can be integrated into school meal programs despite these challenges. Worcester Public Schools (WPS) serves as a case study to illustrate the obstacles districts face in implementing VBP and the opportunities available for improving procurement models.

Key findings from this research highlight the following:
• Regulatory Constraints: Federal procurement policies, while intended to ensure fairness, often create barriers for schools trying to source locally or …

Creating The 15-Minute City: Public Engagement Strategies To Move People Away From Cars And Towards A More Walkable Worcester, Sarah Mount

Master of Public Administration

The study of urban planning there has recently been a resurgence in the idea of a 15-minute city. A 15-minute city is a city where vital destinations are within a 15- minute walk or cycle from any resident. These cities flip the current car-centric method of transportation planning on its head, and instead ask planners to prioritize pedestrians and cyclists when designing streets. Previous studies show that 15-minute cities don’t just exist, they will take planning, infrastructure implementation, and possibly most importantly, resident buy-in. It is hard to achieve change in cities without having the support of your residents. Becoming …

Assessing The Recall Of Traffic Safety Campaigns In Arkansas, Pratik Babu Pokharel

Graduate Theses and Dissertations

This study estimates the degree to which drivers recall traffic safety campaigns based on sociodemographic characteristics including driving frequency, vehicle type, education, income, age, household composition, race, and gender. Traffic safety campaigns are efforts to educate, persuade, and inspire individuals to adjust their attitudes and behaviors for improved road safety, utilizing planned communications over a set time period. They aim to encourage safe driving using slogans shown on television, radio, social media, billboards, and variable message signs. Two years of a mail-based survey conducted in Arkansas were used to estimate binary logistic regression models for each of four safety campaigns. …

Front Line Innovation In Federal Agencies: U.S. Department Of State Passport Services Innovation Portal Engagement Program, Bill Langer

Creativity and Change Leadership Graduate Student Master's Projects

This project explores strategies for enhancing front-line innovation within federal agencies through employee engagement with the U.S. Department of State's Passport Services Innovation Portal. Rooted in the principles of creative leadership and intrinsic motivation, the project addresses persistent barriers to innovation in federal settings, such as bureaucratic inertia and a lack of feedback mechanisms for idea submissions. Utilizing the Creative Problem Solving (CPS) model and a modified 21st-century facilitation framework, the project team designed and implemented an engagement program that included informational briefings and targeted newsletters. Quantitative data from website analytics and idea submissions were analyzed using paired t-tests and …

Differentiated Instruction For Students With Special Needs: “How Can We Better Equip Students, School Systems, And Society For Differentiated Instruction For Students With Special Needs In Career And Technical Educational Environments?”, Mikala A. Highsmith

Creativity and Change Leadership Graduate Student Master's Projects

Career and Technical Education (CTE) plays a vital role in preparing students for the demands of the modern workforce by providing essential knowledge, technical skills, and industry-recognized certifications. As the number of students with disabilities, including neurodivergent learners, continues to rise, CTE programs face increasing pressure to adopt innovative, inclusive educational practices. Integrating creative teaching strategies and leveraging technology are now critical tools in addressing diverse learning needs that promote effective classroom management and enhance student engagement. Moreover, CTE programs emphasize the development of professional competencies, workforce protocols, and transferable skills that strengthen students’ employability across industries. This paper examines …

The Fraught Path To Residency For International Medical Graduates, Fatima Mossolem, Nidhi Chaudhary, Kate Whelihan, Venkat Venkataraman

Rowan-Virtua Research Day

Background:

International medical school graduates (IMGs) are a vital part of the physician workforce in the United States helping to combat the ongoing physician shortage. The Association of American Medical Colleges reported that 42.3% of hospitalists were IMGs, physicians that also comprise a significant part of primary care physicians in rural underserved areas. Students in a gray area of immigration statuses such as those in DACA or those that have lived in the US for years waiting to attain citizenship are automatically considered “international students” and have typically received less residency interviews, and have had a harder time matching into …

Seven Themes About Substance Use Among Asian Americans, Carolyn Wong, Sun S. Kim Phd, Aprn-Bc

Institute for Asian American Studies Publications

This research brief summarizes the findings from a study on improving services for Asian Americans at risk for substance use problems that was conducted by the Institute for Asian American Studies in collaboration with the Bureau of Substance Addiction Services at the Massachusetts Department of Public Health. The full report, Exploring Substance Use Among Asian Americans: Seven Themes from Interviews with Service Providers and Community Residents by Drs. Carolyn Wong and Sun S. Kim is available here: https://scholarworks.umb.edu/iaas_pubs/51/

Air And Missile Defense Threat Scenario Variation To Reduce Pretest Sensitization, Video Games As A Case Study, Julie Renee Szekerczes

All-Inclusive List of Electronic Theses and Dissertations

This study uses fixed and variable video game types to measure pretest sensitization as a proxy for repeated and varied threat test scenarios in system performance testing of air and missile defense systems. The pretest sensitization phenomenon exists when repeated exposure to a test condition influences the participant's response. Research shows air and missile defense development correlates with video games, resulting in similar interfaces and computer operating environments. Department of Defense acquisition test and evaluation results must reflect system performance without prior knowledge of the threat scenarios confounding the results. System performance results inform acquisition decisions, such as further funding …

Enhancing The Eden Alternative Model With Well Standards: A Case Study Analysis, Mariah Stoner

Architecture Masters of Science Program: Theses

This thesis investigates the potential for improving the Eden Alternative Model, a person-centered approach to elder care that emphasizes creating a homelike environment and meaningful relationships, using WELL Standards, a building certification system focused on enhancing human health and well-being through improvements in environmental quality. Through a mixed-methods approach involving quantitative data analysis and qualitative case studies, this research examines how WELL Standards, which cover aspects such as air quality, water quality, lighting, and thermal comfort, can improve environmental quality and resident satisfaction within the Eden Alternative Model. This research introduces a tailored approach to elder care by combining these …

Stop Design: Rethinking The Approach To Public Transit's Architecture, Elizabeth M. Nielsen

Architecture Masters of Science Program: Theses

Public spaces are the foundation of our social health and wellbeing, but are often designed without considering the needs of the public, creating spaces that people do not feel encouraged to use. Just as public space design as a whole often falls short of serving the public, the same can be said for a subset of public space design, public transit stops. While they are public spaces created for the purpose of waiting, their design rarely reflects this.

Well-designed public transit stops are capable of both maintaining existing ridership and drawing in new riders. Most commonly, this design occurs at …

Recognizing Injustice, Reclaiming Voices: Establishing A Missing Persons Database For Missing And Murdered Indigenous Women And Children In Nebraska, Bayly W. Watson

Department of Anthropology: Theses and Student Research

Indigenous people have been the victims of harsh persecution since the time of colonization; this has negatively impacted Native communities and has contributed significantly to the ongoing crisis of Missing and Murdered Indigenous Women and Children (MMIWC) across the United States and Canada. Under Legislative Bill 154, Richards et al. (2021) conducted an initial study to identify missing Native cases in Nebraska and in 2023, the Attorney General appointed a Missing and Murdered Indigenous People (MMIP) Liaison to help combat the number of missing Indigenous in the state. This thesis contributes to previous research by analyzing 20,049 reports from three …

Indirect Cost Cap: Perspectives On Efficiency, Waste, And Equity, Neel B. Patel, Lakshman Segar

Rowan-Virtua Research Day

Background: On February 10, 2025, the NIH enacted a 15% cap on indirect costs, reallocating $4 billion from institutional overhead to direct research within a $35 billion funding framework. The policy follows longstanding concerns about unchecked growth and inefficiencies in indirect cost reimbursements, which rose from 15% in the 1950s to over 70% at some institutions by the 1990s. Notable examples include a $200 million overcharge at Stanford and millions in questionable expenditures identified in federal audits.

Objective: To evaluate the financial, operational, and equity-related impacts of the NIH’s indirect cost cap on U.S. research institutions.

Methods: …

The Repercussions Of Race-Based Egfr On The Morbidity & Mortality Of Black Children With Renal Disease, Angelina Siino

Rowan-Virtua Research Day

This study investigates the implications of race-based adjustments in estimated glomerular filtration rate (eGFR) calculations on the health outcomes of Black children with renal disease. Historically, a race coefficient has been added to eGFR calculations for patients identified as Black, resulting in an artificial inflation of kidney function by approximately 16%. This inflation can delay the classification of chronic kidney disease (CKD), postpone eligibility for essential interventions like preemptive kidney transplantation, and prolong reliance on maintenance dialysis. Through a comprehensive literature review of peer-reviewed U.S. medical journal articles published between 2000 and 2023, this work explores how these clinical delays …

Addressing Gaps In Clinical Trial Access For African Americans, Vanessa Veltre, Michael Acevedo, Alexandra Stone, Lydell Lettsome, Brian Stone

Rowan-Virtua Research Day

Background: Clinical trials are essential for generating evidence on the safety and efficacy of new treatments. However, Black Americans remain underrepresented in clinical research, particularly for conditions that disproportionately affect them. This underrepresentation compromises the generalizability of findings and perpetuates health disparities. This study aimed to identify barriers and facilitators to African American participation in clinical trials and to inform culturally sensitive strategies to improve enrollment of diverse populations.

Methods: We developed a 38-question web-based survey, divided into three domains: (1) cultural affinity, (2) trust, and (3) background information. The survey was administered using Jotform, a HIPAA-compliant platform. Participants—Black adults …

Child Sex Trafficking In Pediatrics: From Screening To Comprehensive Care, Victoria Shwe, Tracy Lin, Nicole M. Leopardi

Rowan-Virtua Research Day

Child sex trafficking is a significant issue in New Jersey, with minors making up 22% of trafficking victims in 2023. While screening tools exist to identify at-risk youth, there is a major gap in understanding the steps healthcare providers should take after identification to ensure appropriate care, support, and referrals. Current research highlights the lack of data on the use of trafficking screening tools and the absence of standardized post-screening protocols. Most pediatricians rely on referrals to social services or law enforcement, yet limited coordination between healthcare providers and these agencies complicates effective care. The shortage of child abuse pediatric …

Disparities In Demographics Of Patients Presenting To A Student-Run Free Clinic In South Jersey, Kirsten Carlberg, Sabah Iqbal, Christian Moya Gamboa, Daliza Diaz, Cerena Moreno, Rebecca Moore

Rowan-Virtua Research Day

Medical schools around the country have established free clinics to better serve the underserved patient populations. In this study, we aimed to evaluate demographic characteristics in the patient population at our free clinic, Rowan-Virtua Community Health Clinic (RVCHC), compared to the general population of Camden County. We found a disproportionately higher percentage of black patients at our clinic when compared to the county overall. Addressing these disparities would require targeted outreach to specific patient populations and improved transit access. Future studies should aim to identify RVCHC health outcomes through the management of chronic disease and understanding emergency room utilization.

Quality Considerations In The Pedestrian Realm: Dead Space Intervention And Prevention, Alycia Ramage

Masters in Architecture Program: Theses

What if every space deemed “unadmirable” was reimagined as a stage for community life? Efforts to find solutions to this question prompted a more complex question: how can new construction promote interaction between architecture and the pedestrian realm?

This thesis is conducted in three main parts: 1) understanding dead space, 2) reinventing dead spaces in existing conditions, and 3) creating a design handbook that works to minimize dead spaces in new design.

Using Lincoln, Nebraska as a case study, part one begins with observation- looking for spaces that could be deemed unadmirable by a pedestrian. Utilizing research and observation, the …