Digital Commons Network^™

Impact Of Employment Status And Housing Stability On Tuberculosis Treatment Adherence In Virginia, Samuel Deapeh Worgee

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) cases have resurged in Virginia, yet the structural determinants shaping treatment completion among socioeconomically marginalized populations remain unquantified locally, leaving public health programs without state-specific predictive evidence. Grounded in the World Health Organization's social determinants of health framework, this quantitative, ex post facto study examined how employment status, housing stability, and social risk factors predicted TB treatment completion. De-identified surveillance records for N = 898 adult TB cases reported from 2020 through 2024 were extracted from the Virginia Electronic Disease Surveillance System and analyzed using a multivariable binary logistic regression, controlling for age, sex, race/ethnicity, and radiographic severity …

Building Health Resilience Against The Threat Of “Jakarta Sinking”: A Scoping Review, Risky Kusuma Hartono, Dewi Shinta

Journal of Indonesian Health Policy and Administration

In Jakarta, land subsidence amplifies flood risks—often described as the city “sinking”—which increases exposure to waterborne and vector-borne diseases, disrupts essential health services, and undermines health system resilience. This review examines how subsidence-induced flood amplification impacts health and its implications for system resilience. This study employs a literature review approach that combines narrative synthesis with scoping-oriented evidence mapping. Peer-reviewed articles in English or Indonesian (2015–2025) were searched across PubMed, Scopus, ScienceDirect, Google Scholar, and Portal Garuda using the following terms: flooding, Jakarta land subsidence, health impacts, and health system resilience. Data on hazards, populations, health outcomes, and resilience functions were …

Evaluation Of Disaster Mitigation Policy Implementation And Public Health Integration Through The “Sipatokkong” Program In Strengthening Tourism Village Resilience, Nurul Azisah Sahrani, Andi Alif Raihan Analta

Journal of Indonesian Health Policy and Administration

Disaster risks in tourism villages are increasing, generating multidimensional impacts on environmental, economic, institutional, and public health. In late 2024, Mattabulu Tourism Village experienced an 83% decline in tourist visits following a series of disasters, disrupting tourism activities and weakening local governance capacity. This study uses a qualitative case study design to evaluate disaster mitigation policy implementation through the “Sipatokkong” Program. Evaluation applied four Organisation for Economic Co-operation and Development–Development Assistance Committee (OECD-DAC) criteria: relevance, effectiveness, impact, and sustainability, operationalized through policy implementation, street-level bureaucracy, and collaborative governance frameworks. Data were obtained from five documents and non-participatory field observations conducted …

Perceived Susceptibility And Automatic Compliance In Indonesia's Triple Elimination Screening: A Mixed-Methods Study, Ratna Dewi Puspita Sari, Josef Maria Seno Adjie

Journal of Indonesian Health Policy and Administration

Despite global commitments to eliminating mother-to-child transmission of human immunodeficiency virus, syphilis, and hepatitis B, gaps remain in understanding the behavioral and systemic drivers of screening coverage in decentralized health systems such as Indonesia. This study aimed to analyze individual behavioral determinants and structural health system barriers affecting triple elimination screening coverage among pregnant women, focusing on perceived susceptibility and automatic compliance. A mixed-methods sequential explanatory study was conducted in Central Jakarta, Surabaya, and Karawang. The quantitative phase involved a cross-sectional survey of 1,224 pregnant women, with Health Belief Model variables analyzed using logistic regression. The qualitative phase comprised three …

Healthcare System Barriers To Somali Refugees In Kenya, Zahra Sharif Hashim

Walden Dissertations and Doctoral Studies

Access to health care is a fundamental right of every refugee, yet gaps in implementing Kenya's Refugees Acts of 2006 and 2021 continue to limit access for Somali refugees in Dadaab camp. Existing research has documented resource constraints, movement restrictions, and other barriers to refugee health care, but how policy implementation gaps shape access in Dadaab has not been well explored. The purpose of this qualitative descriptive study was to understand barriers to health care access for Somali refugees resulting from gaps in implementing Kenya's refugee health policies. The narrative policy framework guided the study. Data from semistructured interviews with …

Socioeconomic Determinants Of Malaria Infection Among Pregnant Women In Cameroon, Sub-Saharan Africa, Arnold Akosah Muluh

Walden Dissertations and Doctoral Studies

Malaria during pregnancy is a significant public health issue in Cameroon, affecting maternal health and birth outcomes. Despite preventive measures, disparities exist among socioeconomic groups and between urban and rural areas. The study was guided by the social-ecological model and explored how socioeconomic factors and geographic location influence malaria infection in pregnant women. Specifically, the impact of wealth index, maternal education, and healthcare access on infection rates, considering maternal age, parity, and residence, was examined. Quantitative data from the Cameroon DHS Phase 8 were used (N=1204). The sample included pregnant women with valid malaria test results. Chi-Square tests and binary …

Post-Pandemic Telebehavioral Health: Sustaining And Regulating Remote Mental Health Care As A Core Modality, Weiqiao Dong

Dartmouth College Master’s Theses

The United States continues to face a persistent mental health crisis after the COVID-19 pandemic, raising a policy question about the long-term role and regulation of telebehavioral health as a core modality of care. This thesis examines that question through a case study of New York State, an early center of the pandemic and a leader in telehealth policy reform.

Guided by the Health Policy Triangle framework, this thesis integrates longitudinal data from all 62 New York counties for 2010-2025 with a 2025 cross-sectional dataset covering 61 counties. Seventeen standardized indicators are organized into four dimensions: geographic, economic, demographic, and …

Theology Of The People As Modernity’S Alternative: A Review Essay, William J. Collinge

The Journal of Social Encounters

In Modernity’s Alternative, Rocco Buttiglione presents the Argentinian theology of the people as an alternative to modernity as it has developed in Europe and North America. After an introduction, the first main part of this review essay discusses Buttiglione’s account of the development of the theology of the people and the major figures in it and how the apparition of Our Lady of Guadalupe marks the beginning of an alternative modernity. The second section considers Buttiglione’s parallel between Christian Platonists’ inculturation of Christian faith into Greek culture and Guadalupe’s inculturation of Christian faith into Mesoamerican culture. The third section …

Essays On Opioid Prescription Limit Policy Diffusion, Evaluation, And Opioid Use Disorder Treatment Utilization, Md Ashiqur Rab

All Dissertations

The drivers of the opioid epidemic in the United States include the oversupply of prescription opioids, the availability of illicit drugs, under-resourced healthcare settings, and several socio-economic factors. Federal and state-level initiatives, including policy interventions to curb the oversupply of prescription opioids, providing access to healthcare, prevention and recovery support services, and community-level engagement, have been adopted to combat the opioid epidemic. Motivated by the need to better understand the policy and recovery efforts to address the epidemic, this dissertation examines opioid prescription limit policy diffusion, evaluation, and treatment utilization patterns. This dissertation comprises three manuscripts that offer a comprehensive …

Paying For Participation: Equitable Compensation Models For Community Co-Researchers, Jamie Zimmerman, Prabhneet Girn

The Foundation Review

Community-engaged research is increasingly central to philanthropic practice, yet funders rarely provide guidance for compensating community members who participate as co-researchers. This gap is especially pronounced for youth, who often face administrative, legal, and developmental constraints that complicate what “fair pay” looks like in practice.

This article presents findings from a mixed-methods comparative case study of three youth participatory action-research projects involving 44 youth ages 16–24 across varied organizational settings. Data were collected through youth surveys, focus groups, staff interviews, financial analysis, and document review.

Findings show that each model carries distinct trade-offs related to feasibility, transparency, and administrative capacity, …

Optimizing Vitamin A Intervention: Strengthening Supplementation With Targeted Biscuit Fortification, Mayfa Yemima Simanjuntak, Nadia Amanda, Yuli Berliana Simanjuntak, Carissa Wityadarda, Lesta Livolina Simamora

Journal of Indonesian Health Policy and Administration

Vitamin A deficiency (VAD) remains a persistent public health challenge in Indonesia, particularly among children under five and breastfeeding mothers. This study aimed to analyze the distribution of vitamin A interventions and assess the potential of biscuit fortification as a complementary strategy. This study employs a literature review using the Health Policy Triangle (HPT) framework, examining policy context, content, key actors, and implementation processes related to vitamin A interventions. The analysis was conducted using secondary data from government reports, international agencies, and peer-reviewed literature published between 2018 and 2025, with comparative evidence from Vietnam, Bangladesh, and Ghana. The findings show …

Referral Patterns From Primary Care To Referral Care By Icd-10 Codes In Indonesia: Cross-Sectional Analysis Of National Claims Data (2017–2024), Della Dwi Ayu, Syarif Rahman Hasibuan, Putu Erma Pradnyani, Nisrina Widyasanti

Journal of Indonesian Health Policy and Administration

Primary health care (PHC) facilities serve as gatekeepers within Indonesia’s tiered health system. However, PHC referral patterns to hospitals still show substantial variation and remain insufficiently characterized by disease groupings based on the International Classification of Diseases, 10th Revision (ICD-10). This study aimed to identify the most frequently referred diagnoses from PHC to secondary or tertiary care facilities and to determine the participant characteristics associated with referrals. This observational study employed a cross-sectional design using secondary data from the National Health Insurance (Jaminan Kesehatan Nasional – JKN) claims database for the period 2017–2024. The unit of analysis was each …

Global Health Financing Of Diagonal Interventions: Building Resilient And Sustainable Health Systems In Sub-Saharan Africa, Lucy Kim

Master in Public Policy Theses

Background: Global health financing has historically prioritized disease-specific “vertical” programs over broader “horizontal” strengthening of general health systems. Vertical programs in HIV have led to unprecedented reductions in mortality worldwide, but HIV remains a significant public health threat in sub-Saharan Africa, where vertical strategies have long been criticized for creating fragmented health systems. In response, global health strategies have shifted towards combining vertical investments with broader horizontal activities, commonly referred to as “diagonal” programming. While evidence suggests that diagonal programming has the potential to create more resilient and sustainable health systems, evaluating its value for money is challenging due to …

Cracks In The Great Wall: Zero-Covid Protests And The Reassertion Of Political Security In China, Khannia Zhafira Ronaulli Pandjaitan, Arfin Sudirman

Jurnal Wacana Politik

The protests of the zero-COVID policy in 2022, which led to the issuance of Ten New Measures in China, are an interesting political phenomenon to study. This phenomenon raises questions about the dynamics of China’s political security during the zero-COVID policy period and how the government responded to the social pressures that arose. Applying political security theory that emphasizes national objectives, threat perceptions, and political freedom of action, this article analyzes China’s political dynamics during that period. This article concludes that political security for a country is often realized through various actions justified to protect national interests and maintain social …

Food For Thought: Community Perspectives On Access To Produce In The Mississippi Delta Region, Mckenzie S. Cox

Honors Theses

Historically, MS has struggled to provide access to nutritious food for its residents. Approximately 15.3% of households in the state were classified as food insecure between 2018 and 2020, which is significantly higher than the national food insecurity rate of 10.7% for the same year (USDA Economic Research Service, 2023). According to the National Park Service (2022), between 55% and 60% of all land area in the MS Delta region is used for agricultural purposes. However, there appears to be a missing link in the chain connecting individuals and local communities to these crops.

This qualitative study focuses on food …

The Response Of Child Protection Services To Prenatal Substance Exposure, Cierra Hassel

Dissertations, Theses, and Projects

Prenatal Substance Exposure (PSE) is a growing public health concern that requires Child Protection Services (CPS) involvement. CPS is a government agency that investigates child safety to determine whether child removal is necessary. Due to the increase of substance use during pregnancy, often linked to the opioid epidemic, more mandated reporters are submitting reports for positive drug tests at birth, which are screened in as neglect by the mother. PSE has significant implications for developing fetuses, potentially causing both short- and long-term behavioral, medical, and developmental challenges.  

Pregnant women with substance use disorder may often neglect prenatal care, as they …

How The U.S. Virgin Islands Government Responded To The Covid-19 Crisis: A Leadership Perspective, Erica Dover

Walden Dissertations and Doctoral Studies

No abstract provided.

Gme As A Healthcare And Economic Driver In Southern Nevada, Tripp Umbach

Policy Briefs and Reports

In early 2025, the Nevada Health and Bioscience Corporation (NHBC) commissioned Tripp Umbach to conduct a comprehensive study examining the current state and future expansion of physician training and retention in Southern Nevada. The approach recommended in this report is rooted in strategic partnerships among medical institutions, proven funding approaches, and needed policy changes. Tripp Umbach, a nationally renowned private consultancy specializing in medical education expansion strategies, reviewed data, conducted interviews, and developed recommendations to expand GME, highlighting its profound economic impact in Southern Nevada.

Exploring The Biocultural Profile Of The Undocumented Populations Of The Sonoran Corridor: A Skeletal Assessment Of The Prevention Through Deterrence Strategy, Mary A. Vaughn

Department of Anthropology: Theses and Student Research

Over the last thirty years the mortality rate of the undocumented population at the US-Mexico border has risen, requiring methods distinguishing US-born individuals from immigrants to improve the likelihood of identification and repatriation through foreign consulates. Forensic anthropologists with the Pima County Office of the Medical Examiner (PCOME) have advocated for the use of the biocultural profile, combining the biological profile with factors including oral health, osteological stress, and personal effects. The biocultural profile serves two purposes, functioning both as a tool for identification and with which to document structural inequality within communities of origin.

This study examines changes in …

Colonialism, Conflict, Capital, And Coups: Drivers Of Médecins Sans Frontières Operations In Mali Post-2022, Gina T. Fiorenza

Honors Capstones

Previous research has indicated that an NGO’s funding stream can limit its organizational decision making and inadvertently cause NGOs to place the priorities of donors over that of their beneficiaries. Additionally, Western-international NGOs operating in the Global South have been accused of engaging and perpetuating imbalanced power structures, often facing accusations of racism. To analyze these issues, I conducted a quantitative analysis of financial reports in conjunction with a qualitative analysis of activity reports in Mali in the past 20 years.  My findings indicate that MSF’s past collaboration with the Malian government and decision to reject state funding allows the …

Building Community Resilience In The Wabash Valley Region, Abby Chappell, Jacob Harmon, Corbyn Irwin, Aiden Askins

2026 Spring Reports (Terre Haute)

The focus of this project is investigating how to improve community resilience against disasters among citizens of the Wabash Valley from an interdisciplinary perspective. Chandra, et al. (2011) defines community resilience as “the ongoing and developing capacity of the community to account for its vulnerabilities and develop capabilities that aid that community in (1) preventing, withstanding, and mitigating the stress of a health incident; (2) recovering in a way that restores the community to a state of self-sufficiency and at least the same level of health and social functioning after a health incident; and (3) using knowledge from a past …

Sequencing Dengue Control Policy In Singapore: An Evolutionary Perspective For Policy Design, Ishani Mukherjee, Panchali Guha

Research Collection School of Social Sciences

About half the global population is now at risk of contracting dengue, a mosquito-borne viral infection that can cause severe morbidity and fatalities. Effective dengue control depends on controlling the mosquito vector, but finding the right mix of vector control policies has proved challenging. Using a content analysis of 208 Hansard records from parliamentary proceedings in Singapore, where dengue outbreaks have significantly increased in both frequency and magnitude since the early 1990s, we trace the processual evolution of Singapore’s anti-dengue policy mix from 1960 to 2023 and conclude that the evolution of dengue control policies is consistent with a customized …

Assessing Stakeholders’ Perceptions Of Organizational Effectiveness Through A Multidimensional Theoretical Model: An Interpretive Phenomenological Qualitative Case Study, Andrea M. Paul

School of Public Service Theses & Dissertations

Nonprofit organizations play a fundamental role in meeting community needs when government resources are limited or nonexistent. For decades, scholars and practitioners have recognized the importance of nonprofit-government partnerships for effective public service delivery. This study examines faith-based organizations as a specific type of hybrid nonprofit organization. As social, economic, and environmental challenges intensify, the need for community-based programs led by faith-based organizations also increases. These organizations are working to combat several of society's wicked problems, including but not limited to homelessness, food insecurity, drug addiction, youth and family services, and climate change. Nonprofit sector performance measurement is often recognized …

Frontline Medicine During War In Sudan: Confronting Health System Collapse, Mogahed Halaly

The Journal of Social Encounters

Since the outbreak of war in Sudan in April 2023 between the Sudanese Armed Forces and the Rapid Support Forces, the country’s fragile health system has deteriorated rapidly. As hospitals closed, medical supplies vanished, and millions were displaced, frontline health workers were forced to make impossible choices. This essay recounts my experience as a young physician during the collapse of Sinnar Teaching Hospital, my displacement to White Nile State, and the creation of a community-led humanitarian initiative that provided clinical care, shelter, food, and livelihood support to thousands. It reflects on the intersection of war, displacement, public health collapse, and …

The Disproportionate Impact Of Hiv On Young Women In Durban: Exploring Gendered Vulnerabilities And Socioeconomic Barriers, Adrian A. Nolasco

Capstone Collection

South Africa has a high rate of HIV, with young women in Durban especially affected due to social, economic, and cultural challenges. This study looks at the experiences of young women living with HIV and the views of healthcare professionals caring for them in KwaZulu-Natal. Using a qualitative, phenomenological approach, semi-structured interviews were conducted with five women and three medical professionals to explore how HIV affects their lives, the challenges they face, and how they cope.

The findings show that both structural and personal barriers make it hard for young women to stick to treatment. Long waits at clinics, limited …

Private Sector Healthcare Investment In Indonesia: Leveraging Australia-Indonesia Partnerships For Health System Transformation, Susan Josephine Neuhaus

Journal of Indonesian Health Policy and Administration

Australia and Indonesia are strategic partners with expanding bilateral trade valued at AUD 26.7 billion (2022-23). Health care partnerships between the two countries offer significant opportunities for private sector engagement. Indonesia’s large population, rapidly growing middle class, and implementation of Universal Health Coverage (UHC) through the Jaminan Kesehatan Nasional (JKN) present partnership opportunities to strengthen health system capacity, address infrastructure gaps and workforce shortages, and contribute to shared economic and prosperity goals. This study explores how Australian private healthcare investment can complement government initiatives in supporting Indonesia’s UHC while advancing Australia’s regional engagement. A descriptive qualitative analysis was conducted using …

Analysis Of Coverage Of Tuberculosis Prevention Therapy (Tpt): Literature Review, Septia Rahmalina, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

Tuberculosis Preventive Therapy (TPT) is a crucial intervention for tuberculosis (TB) control, particularly among high-risk groups such as household contacts of TB patients and people living with Human Immunodeficiency Virus (HIV). Despite being recommended by the World Health Organization (WHO), TPT implementation still faces challenges at the primary care level. This study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to review 11 articles published between 2021 and 2025 that were relevant to TPT implementation in various high-TB burden countries, including Indonesia. The main barriers identified were input (logistics, training), process (tracing, education, monitoring), and output …

Prophylactic Antibiotic Analysis In Obs-Gyn, Orthopedics, Gastrointestinal Surgery At A South Tangerang Hospital, January-March 2024, Evelina Endang Nurjaman, Helen Andriani

Journal of Indonesian Health Policy and Administration

Inappropriate use of prophylactic antibiotics (PAs) remains a primary driver of antimicrobial resistance (AMR); however, global adherence to established prescribing guidelines remains suboptimal. This study aimed to analyze the compliance and rationality of PA prescription and to evaluate the underlying causes of physician non-adherence in obstetrics, orthopedic, and gastrointestinal surgeries at a hospital in South Tangerang City, Indonesia. Adopting a mixed-methods approach, this investigation combined a quantitative assessment of 208 surgical patient records (January–March 2024) with qualitative exploratory interviews conducted with three specialist peer group heads. This design allowed the triangulation of prescribing data with underlying clinical perspectives. PA rationality …

Deterrence Without Peace: Nuclear Weapons And The Rising Threshold Of Warfare, Catie Clarke

CISLA Senior Integrative Projects

Nuclear weapons fundamentally changed the international political landscape, leading to the emergence of deterrence theory and the notion of the Long Peace. This paper challenges these claims, arguing that nuclear weapons facilitated a more violent and volatile international system rather than stability. Drawing on constructivist theory, this paper develops the Threshold of Violence framework – a normative model which asserts that nuclear weapons elevated the perceived upper limit of tolerable violence in international politics. This raised threshold generated three trends in the nuclear era: increased frequency of proxy wars, escalating levels of benefactor involvement, and greater severity of conflicts fought …

Grant-O-Thon: A Designathon-Informed Grant Writing Program To Enhance Research Grant Writing Skills In Low- And Middle-Income Countries, Yusha Tao, Gifty Marley, Lauren Fidelak, Bin Yu, Yusuf Babatunde, Anita N. Walker, Anthony A. Attama, Andrea L. Conroy, Esther K. Afolabi, Dimitrios N. Vatakis, Iheanyi Omezuruike Okonko, Shyngle K. Balogun, Hongyun Fu, Xin Peng, Ijeoma M. Ifeorah, Patience Kukundakwe, Alexandra Cossio, Ifeoma M. Obionu, Ángela Patricia Beltrán López, Matthew Idowu Olatubi, Ucheoma C. Nwaozuru, Yuanyi Chen, Huachun Zou, Eneyi E. Kpokiri, Daniil Wu, Oliver Ezechi, Juliet Iwelunmor, Meredith Labarda, Jason J. Ong, Weiming Tang, Joseph D. Tucker

Department of Pediatrics Faculty Publications

Problem

Early career researchers in low- and middle-income countries (LMICs) face substantial barriers when writing research grants and have limited writing support. A designathon approach was applied to organize a grant writing workshop (grant-o-thon) tailored for early-career LMIC researchers. This study describes the planning, implementation, and participant-reported outcomes of the grant-o-thon as a participatory training approach.

Approach

Grant-o-thons were organized in 2023, 2024, and 2025. Consistent with the designathon model, the grant-o-thon was structured in three stages: preparation using co-creation with end-users, intensive collaborative teamwork supported by mentor feedback and weekly writing deliverables, and structured follow-up. Each grant-o-thon consisted of …