Digital Commons Network^™

Letter From The President, Suzanne Keep

Michigan Journal of Public Health

No abstract provided.

After-Hours, Severity, And Distance Are Associated With Non-Vha Emergency Department Use For Older Veterans: Insights From A Regional Health Information Exchange, Elina Kurkurina, Kimberly M. Judon, Ula Hwang, Kenneth S. Boockvar, Juan Wisnivesky, Matthew R. Augustine

Journal of Geriatric Emergency Medicine

Background: Older adults treated in emergency departments (EDs) are at higher risk for adverse outcomes. Using multiple facilities can worsen this issue through service duplication and poor care transitions. Veterans with dual insurance coverage can access both Veterans Health Administration (VHA) and non-VHA EDs. This study aimed to identify factors associated with non-VHA ED use among veterans.

Methods: We conducted a retrospective observational study of patients aged ≥ 65 who had primary care at the James J Peters VA Medical Center and at least one VHA or non-VHA ED visit between October 2017 and February 2020. Data were collected from …

Effectiveness Of An Improved Leprosy Lakar Training On Knowledge And Skills Among Healthcare Workers In Primary Healthcare In Pahang Malaysia., Nuraihan Zafirah Zainal Abidin

Student Works (2020-2029)

Leprosy, a neglected chronic tropical disease caused by Mycobacterium leprae, poses significant health challenges due to its potential for irreversible disabilities and disfigurement. Adequate leprosy training for healthcare workers (HCWs) is crucial for early detection and prompt treatment, thereby preventing complications and reducing transmission risks. This study aimed to revise and evaluate the effectiveness of leprosy LaKAR* training on knowledge and skills of leprosy among HCWs in primary healthcare in Pahang, Malaysia. The study employed a sequential exploratory, mixed-method design consisting of two phases. Phase 1a was a qualitative study identifying gaps in current LaKAR training among HCWs at …

The Living Document: Medical Records As A Malleable Presence, Camilla Lyckblad

Proceedings from the Document Academy

Understanding why individuals might safeguard information or keep secrets in working documents such as medical records is essential for the development of good quality care, fostering an environment where both patients and staff feel secure to part with sensitive information, encouraging more honest and open communication as well as improved quality of care. This ongoing research aims to deepen comprehension of information behavior in clinical contexts, where the contemporary medical record, with its increasing properties such as open record access for patients, can be viewed as an entity that both listens and influences. This examination sheds light on the complex …

Infant Mortality Data: Missing Pieces To Prevention In Lesotho, Jacinda Croissant

Master's Projects and Capstones

Lower-middle-income countries (LMICs) like Lesotho lack complete and quality infant mortality data. Without infant mortality data, it can be challenging to develop public health education, programming, and policies to address preventative infant deaths in specific populations (Rao et al., 2004). A literature review identified strategies to improve infant mortality data in LMICs. Through a community engagement model and digital storytelling, community members can gain awareness, begin an ongoing conversation about local public health issues, and participate in an improved data collection system. Infant mortality is often used as an indicator of health for a population; improved infant mortality data can …

Improving Health Equity: Integrating Mental Health Services Into Mobile Health Clinics For Unhoused And Low-Income Populations In The United States, Tiffany Lynn Wong

Master's Projects and Capstones

Mental health disparities among homeless and low-income populations in the United States highlight significant challenges in access and quality of care. This literature review explores the integration of mental health services into Mobile Health Clinics (MHCs) as a promising recommendation to address these disparities. I used various search engines, extracting 10 articles published from 2013 to 2023 focused on the U.S. MHCs show its effectiveness in improving healthcare access and quality of care, covering different services like mammography, reproductive health, COVID-19 testing, and diabetes care. Building on these successful models, this paper proposes extending MHCs to include mental health screenings, …

Food Security And Its Impact On Hypertension In Urban Communities, Lauren M. Nobriga

Master's Projects and Capstones

The Quality Improvement Team proposed an intervention to increase enrollment in the Food Security Program, a six-month initiative that provides vouchers redeemable for fruits and vegetables. Long-term impacts of this Program include an improved food economy and enhanced patient disease management autonomy. This project aimed to increase the percentage of eligible adult medicine clinic patients enrolled in the Food Security Program by 25%, or 11 patients per month, based on the mean enrollment for the first four months of the Program (May to August) of nine patients. The intervention was based on bi-monthly performance reports, making the goal include enrolling …

Improving Food Security To Decrease Hypertension At An Urban Community Clinic, Christine S. Villalta

Master's Projects and Capstones

Diet and lifestyle changes have been proven to reduce blood pressure in patients with hypertension, and a key dietary approach aligned with this recommendation is the DASH diet, which includes consuming fruits and vegetables. Food insecurity, defined as lacking enough safe, nutritious food to maintain an active and healthy life, is a growing crisis in the United States, affecting 13.5% of U.S. households in 2023. This is especially significant for those whose chronic disease management depends on the accessibility of healthy food. An urban community clinic implemented a Food Security Program to decrease food insecurity and reduce hypertension among their …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

Chronic Disease Screening And Detection In Vulnerable Populations, Courtney J. Seman, Hussein Hadid, Tania Jaimes, Robert Walls

Master's Projects and Capstones

This quality improvement project aims to address gaps in chronic disease screening by implementing standardized protocols for diabetes, hypertension, vision impairment, and scoliosis within the University of San Francisco (USF) Nurse-Led Clinic in Orange County. Problem: The clinic identified a lack of screening practices, which limited early detection and intervention for two specific vulnerable populations. Context: The clinic serves two high-risk groups: older adults, including formerly homeless individuals, and children in two local grade schools. These populations face significant healthcare disparities, making early detection of chronic conditions critical. Interventions: Guided by Kotter’s Change Theory, the project developed and implemented evidence-based …

A Supervised Machine Learning Statistical Design Of Experiment Approach To Modeling The Barriers To Effective Snakebite Treatment In Ghana, Eric Nyarko, Edmund F. Agyemang, Ebenezer Kwesi Ameho, Louis Agyekum, José María Gutiérrez, Eduardo Alberto Fernandez

School of Mathematical & Statistical Sciences Faculty Publications

Background

Snakebite envenoming is a serious condition that affects 2.5 million people and causes 81,000–138,000 deaths every year, particularly in tropical and subtropical regions. The World Health Organization has set a goal to halve the deaths and disabilities related to snakebite envenoming by 2030. However, significant challenges in achieving this goal include a lack of robust research evidence related to snakebite incidence and treatment, particularly in sub-Saharan Africa. This study aimed to combine established methodologies with the latest tools in Artificial Intelligence to assess the barriers to effective snakebite treatment in Ghana.

Method

We used a MaxDiff statistical experiment design …

Msw Portfolio, Andrea E. Anderson

Graduate Student Portfolios, Professional Papers, and Capstone Projects

The portfolio narrative includes a brief introduction to my academic journey including field related work. The ten social work competencies are used as a guide while I reflect on the required appendices, theoretical frameworks and orientation to practice throughout the narrative.

Assessing The Reach Of Health Access Resources In Indianapolis For Populations With Low Income, Kyler A. Casbon, Kai J. Gatting, Simran Nadig, Isabella K. Peckinpaugh, Alexandre A. Sauquet, Kourtney A. D. Byrd, Megan E. Conklin, Gicella Garcia, Mitchell L. Struewing, Omolola A. Adeoye-Olatunde

Purdue Journal of Service-Learning and International Engagement

Two public health crises that the United States are contending with are diabetes and the prevalence of opioid overdoses, both of which have a significant impact on communities nationwide. Inequities in social conditions contribute to health disparities amidst these diabetes and opioid overdose public health crises nationally and locally. To address these health inequities in Indianapolis, Indiana, the the Purdue University Center for Health Excellence, Quality and Innovation (CHEQI) shaped relationships through their CHAMP (Community Health Access Model Partnerships) services with local food pantries and homeless shelters, providing Indianapolis residents pre-diabetes screening and resources and convenient access to and education …

Jovial Family Farm Facilitates Intergenerational Learning Opportunities Through Urban Farming, Maera Williams

Purdue Journal of Service-Learning and International Engagement

Maera Williams is a sophomore in Environmental and Ecological Engineering at Purdue University. She joined the Engineering Projects in Community Service (EPICS) Urban Farming team as a freshman and now serves as project manager of ten undergraduate students collaborating with Jovial Family Farm to design and develop three indoor hydroponics systems for a laboratory space on their property in Broad Ripple, IN. Jovial Family Farm is a nonprofit organization founded by Drs. Bobbie and Brian Jellison with the mission to provide senior citizens, their families, and their communities with meaningful engagement opportunities on an intergenerational scale through urban agricultural activities. …

Take Charge Of Your Health: Start With Your Smile, Jordan L. Lacey, Brizette O. Owusu, Sophia Gardner, Madeline Whitehead, Haeun Park, May Ligno

Nursing Leadership in Community Engagement Projects

Take Charge of Your Health: Start with Your Smile

Oral health is a fundamental component of overall health, yet it is often neglected-particularly among vulnerable populations like houseless individuals (Freitas et al., 2019). Houseless individuals face numerous barriers to accessing healthcare, with dental services being limited. This lack of access contributes to a higher prevalence of oral diseases, which if left untreated, can lead to severe complications. Poor oral health doesn’t just affect the mouth; it negatively impacts one’s overall systemic health, psychosocial well-being, and quality of life (Csikar et al., 2019).

As nursing students engaged in a Community Health …

The Impact Of Adverse Childhood Experiences On The Eating Behaviors Of Black American Women, Teshia Stovall Dula

Doctoral Dissertations and Projects

This dissertation explores the impact of behaviorism on understanding adverse childhood experiences (ACEs) and their effects on eating behaviors, particularly emotional overeating, and satiety responsiveness, in Black women. It highlights the importance of addressing ACEs to promote holistic well-being, especially given racial health disparities. The study investigates various factors shaping the behavior of Black women, including individual traits, environments, and behavioral patterns, focusing on an under-researched area. It calls for standardized definitions in this context and advocates for more extensive and diverse sample sizes for future research. Ultimately, the research aims to empower Black women by translating insights into effective …

Mexican Health And Aging Study Biomarker And Genetic Data Profile, Rafael Samper-Ternent, Jesús Daniel Zazueta-Borboa, Alejandra Michaels-Obregon, Dolly Reyes-Dumeyer, Sandra Barral, Giuseppe Tosto, Rebeca Wong

Faculty, Staff and Student Publications

The Mexican Health and Aging Study (MHAS) is one of the largest ongoing longitudinal studies of aging in Latin America, with six waves over 20 years. MHAS includes sociodemographic, economic, and health data from a nationally representative sample of adults 50 years and older in urban and rural Mexico. MHAS is designed to study the impact of diseases on adults' health, function, and mortality. As Mexico is experiencing rapid population aging, providing adequate information to study this phenomenon is vital for designing and implementing public policies. The availability of biomarker and genetic data and longitudinal survey data elevates opportunities for …

The Work-Life Balance Of Higher Education Faculty In Light Of Constant Access To Technology: A Case Study, Giordana Morales-Spier

Doctoral Dissertations and Projects

The purpose of this instrumental case study was to explore the perception of constant access to technology for faculty members in the university setting. Constant access to technology was defined as the majority of work tasks taking place in front of the computer, the expectation of quick email responses, and the pressure for continual student interaction, particularly outside of regular business hours. Burnout theory guided this study, which provided views of faculty’s efficiency, stress levels, and personal time. The central research question that guided the study was: How do higher education faculty at CVU guard against burnout while experiencing constant …

Review Of Epidemiology, Prevention And Management Of Blood-Borne Viruses Experienced By Aboriginal And Torres Strait Islander Peoples, Katiska Davis, Eliza Lock, Laura Thum, Gemma Crawford, Roanna Lobo, Odette Aung Thein, Shane Kavanagh, Jonathan Hallett

Journal of the Australian Indigenous HealthInfoNet

This review examines the epidemiology, prevention, and management of blood-borne viruses (BBVs) experienced by Aboriginal and Torres Strait Islander peoples in Australia with a focus on hepatitis B, hepatitis C, and HIV. The review highlights the disproportionate burden of BBVs among Aboriginal and Torres Strait Islander peoples in Australia, influenced by historical, social, and cultural factors stemming from colonisation. Key findings include higher prevalence rates of hepatitis B and C compared to non-Indigenous Australians, with some progress in reducing new infections through vaccination and treatment programs. However, significant gaps remain in screening, linkage to care, and treatment uptake. The review …

An Exploration Of Telemedicine Application Service Quality And Its Relevance With Patient Satisfaction, Victoria Olguin

Honors Program Theses and Research Projects

When the world experienced a pandemic due to the SARS-CoV-virus (COVID-19) in 2019, a lockdown quickly took place and travel restrictions were applied, placing a barrier to in- person healthcare access. This made the healthcare settings practice alternate ways in delivering healthcare that did not necessarily have to be in-person. The evolvement of a remote setting took place, and the development and usage of telemedicine quickly accelerated. This form of healthcare has transformed the way care is delivered to patients, with many key elements shaping their experience and outcomes. Now that the COVID-19 pandemic has ended, the practice of telemedicine …

Examining The Effects Of Language Barriers For Non-Native English Speakers In The Healthcare System In Northwest Ohio, Sarah Witt

Honors Projects

Hundreds of thousands of people in the state of Ohio speak a language other than English, and communication in a predominantly English-speaking state can prove not only cumbersome, but dangerous as well. Patients who have difficulties communicating with their healthcare providers experience higher rates of medical error, adverse medical reactions because of improper drug use, longer hospital stays, and more hospital readmissions than the general population. Additionally, they experience high rates of anxiety and frustration when receiving medical care, which causes resentment and mistrust of the healthcare system. This study investigated language barriers in healthcare systems across Northwest Ohio by …

Covid For One: Identifying Obstacles To Self-Management Of Covid-19 For Single Adults, Linda A. Treiber, Christie Emerson, Jenna Shackleford

Faculty Articles

Given the complexities of healthcare provision, it is imperative to understand how single adults experience their interactions with medical professionals and health care organizations, manage care and treatment, and navigate the barriers encountered. This study’s purpose is to understand physical and mental health experiences in consideration of social determinants of health, barriers, and coping strategies for single adults diagnosed with COVID-19. An interpretive phenomenology study design was used with 12 individuals who were single and living alone during the COVID-19 pandemic. Semi-structured, open-ended interviews revealed important aspects of the COVID-19 illness experience. Interviews were transcribed for coding and thematic analysis. …

Effect Of School Hpv Vaccination Requirements On Pediatricians' Recommendations, Ashley Hedrick Mckenzie, Lara S Savas, Ross Shegog, Dale S Mantey, Erica L Frost, Paul Gerardo Yeh, C Mary Healy, Stanley Spinner, L Aubree Shay, Sharice M Preston, Sally W Vernon

Faculty, Staff and Student Publications

Background/objectives: Pediatrician recommendations are highly influential in parents’ decisions to vaccinate their children against HPV. Unqualified, presumptive, and bundled recommendations (UPBRs) are associated with increased HPV vaccine uptake and are considered best practice. This study analyzes pediatricians’ self-reported data to assess changes in UPBR use and the psychosocial determinants of UPBR use as a result of the implementation of a multi-level intervention, the Adolescent Vaccination Program (AVP).

Methods: We surveyed pediatricians across 51 clinics in the Houston area. Baseline surveys (n = 137) were distributed in 2015, and follow-ups (n = 120) in 2019.

Results: Pediatrician UPBR use …

Perceived Patient-Centered Care In Marching Band Artists, A L. Merrill, Z K. Winkelmann, N A. Uriegas

Bakerman Student Research Awards

Objective: Approximately 27,000 college marching band (MB) artists in the United States could benefit from access to healthcare services and patient-centered clinicians. The purpose of this study was to explore HCPs MB artists have access to and their perceptions of patient-centered care (PCC). Methods: We used a cross-sectional web-based survey of MB artists (n=751, age=20±8 years). MB directors from 242 colleges were emailed a survey link to forward to MB artists. Participants indicated which HCPs they could access. Those who reported no access or unsure were prompted to describe what they would do if an injury or illness occurred. Participants …

Public Health Implications Of State-Level Public Health Organizational And System Structures, Cameron Ferguson Hays

Dissertations

Public health thought leaders such as the Institute of Medicine and National Academies of Science, Engineering, and Medicine have long been concerned about the lack of standardization among state-level public health systems (IOM, 1988; NASEM, 2023). However, little research studies these systems, their structures, and whether structural constructs affect population health outcomes.

This study attempted to examine the structural constructs that make up these systems and the impact of those constructs using an exploratory sequential mixed-methods design. Variables from management science were qualitatively extracted from materials describing all 50 state-level public health systems. Those variables were then analyzed using a …

Building Community Resilience Through Community Participatory Asset Mapping For Emergency Preparedness, Cassandra Y. Davila

2024 Fall Honors Capstone Projects - Archive

A community's capacity to prepare, manage, and recover from a disaster determines its level of resilience. The Federal Emergency Management Agency recommends engaging community members in resilience planning to ensure sustainable strategies are implemented. This project uses community-based asset mapping to identify how community participatory methods influence community resilience to combat emergency events. An asset map documents a community’s existing resources, highlighting its strengths. Focus group discussions in the urban area will be conducted to obtain feedback about existing assets and suggestions for additional resources to include. The expected result of this project is to build a comprehensive map of …

Exposing The Disaster Disparities And Experiences On College Campuses, Deleanor Kirkpatrick Murray

All-Inclusive List of Electronic Theses and Dissertations

Challenges in higher education continue to arise, providing administrators with insights into how prepared—or unprepared—their institutions may be for future crises. The purpose of the study is to examine how mid-level leadership, staff, and students perceived the disaster response to Hurricane Ida during the 2021–2022 academic year. Using the theoretical frameworks of the Four-Frame Model (Bolman & Deal, 2021), Critical Race Theory (Delgado & Stefancic, 2017), and Institutional Theory (Manning, 2018), this case study employed interviews with 8 participants. Data analysis resulted in the emergence of 7 major themes and 11 sub-themes. The findings from the study suggest that participants …

The Benefits Of Telehealth Among Disadvantaged Communities, Anoosh Arshad

Honor’s College Freeman Research Journal

This study aims to understand how the widespread integration of telehealth services affects underserved communities, helping reduce health disparities in this group. Telemedicine includes various technologies and applications, supported by extensive research, public health, administrative, and patient-care benefits, to adapt to different fields. It involves clinical applications that focus on patient care, like making health decisions, and nonclinical applications like arranging board meetings. Telehealth is a health platform that uses communication technologies that allow doctors and patients to meet online through video and telephone visits, ensuring that patients receive high-quality care. It increases access to healthcare by removing geographical and …

Promoting Adolescent Mental And Physical Health: Initiatives Focused On Connecting Public Health And Social Services To The Health Sector In Nebraska, Theresa Nguyen

Capstone Experience: Master of Public Health

This capstone focuses on the second recommendation of improving access to comprehensive, coordinated health services from the National Academies of Sciences, Engineering, and Medicine report The Promise of Adolescence: Realizing Opportunity for All Youth (2019). This proposal uses secondary data from the research project, Moving Evidence-Based Recommendations to Practice to Strengthen the Health Care System in Nebraska. Key stakeholders (n=28) were interviewed from the health care, public health, social services, and policy sectors. Each subject was asked to participate in a semi-structured interview by a trained interviewer. The interview was 1 hour long and conducted via phone call or Zoom. …

Cybersecurity Vulnerabilities And Considerations In U.S. Healthcare Facilities: A Scoping Review, Rebecca J. Campbell

Capstone Experience: Master of Public Health

Robust cybersecurity measures are essential for business continuity of U.S. healthcare institutions which is to maintain care standards for all patients. Hackers seek to disrupt healthcare delivery for financial and political means, to disrupt services in retaliation, or simply for malicious intent (Wasserman & Wasserman, 2022). The COVID-19 pandemic further accelerated innovation and digitization in healthcare, including wearable and implanted medical devices, telehealth care delivery options, artificial intelligence, and cloud-based data management (Kioskli, Fotis, & Mouratidis, 2021). This progress in innovation continues today but also brings new vulnerabilities and challenges to stay ahead of cybersecurity threats.

Given that cyberattacks have …