Digital Commons Network^™

The Experience Of Homelessness And Its Effects On Gut Eubiosis, Kamerin Villagomez

University Honors Theses

Microorganisms which populate the human gastrointestinal tract (GIT) have a profound effect on overall human health. The relationship between host health and eubiosis, or balance, of the GIT microbiome is symbiotic and can have reciprocal relationships with quality of sleep, quality of diet, stress and mental health, and the experience of pain. These specific aspects of health are unique in populations experiencing homelessness due to the multi-dimensional and complex nature of their lived experience. Very few studies explore populations experiencing homelessness, with even fewer investigating the intersection between this population and the human GIT microbiome. It is important to do …

Impacts Of Covid-19 And Taliban Takeover On U.S. Afghan Refugee Women’S Mental Health: A Socio-Ecological Approach To Resilience Resources, Atefeh Aghaei

Theses and Dissertations

In response to the escalating global refugee crisis, intensified by ongoing conflicts and environmental changes, this dissertation research focuses on the mental health of Afghan refugee women in the United States (U.S.), particularly in the context of the COVID-19 pandemic and the 2021 Taliban takeover. With over 114 million people displaced globally, Afghan refugees, notably women, encounter heightened mental health risks due to violence, deprivation, systemic persecution, and the challenges of migration. This vulnerability is exacerbated by recent mass traumatic events, including the pandemic and political upheaval in Afghanistan. Our study, conducted through semi-structured interviews with Afghan refugee women and …

The Effect Of Covid-19 Restrictions On The Social Support Experiences Of Black Women Giving Birth In South Carolina Hospitals During The First Year Of The Covid-19 Pandemic (2020) As Compared To A Previous Birth, Tiffany Eva Byrd

Theses and Dissertations

The United States is experiencing a maternal health crisis, which disproportionately affects Black women. Black women die from pregnancy-related causes two to three times as often as their White counter parts, and the majority of maternal death are preventable. In recent years, public health and national governing authorities have devoted resources to monitoring the health crisis and raising the public’s knowledge of warning signs; however, maternal mortality rates continue to rise. Noted contributors to Black maternal mortality include, but are not limited to, racism, delayed treatment and response to health emergencies, and lack of social and emotional support during childbirth, …

Recruitment And Retention Of Physician Assistants In Rural Medicine: A Novel Approach, Sean Grabbe

Theses and Graduate Projects

Improving the health of patients requires having access to well trained medical providers. This is one of the main goals of the physician assistant profession. For many years research has documented how to recruit and retain physician assistants in the rural areas of the United States. Although created to fill the gaps in primary care medicine physician assistants have moved as all of medicine has into specialization. This gap in primary care has not closed and is most significant in rural areas. This paper reviews the plethora of research and elaborates on the known and best methods for recruitment and …

Personalized Nutrition: Tailoring Dietary Recommendations Through Genetic Insights, Saiful Singar, Ravinder Nagpal, Bahram H. Arjmandi, Neda S. Akhavan

Kinesiology and Nutrition Sciences Faculty Research

Personalized nutrition (PN) represents a transformative approach in dietary science, where individual genetic profiles guide tailored dietary recommendations, thereby optimizing health outcomes and managing chronic diseases more effectively. This review synthesizes key aspects of PN, emphasizing the genetic basis of dietary responses, contemporary research, and practical applications. We explore how individual genetic differences influence dietary metabolisms, thus underscoring the importance of nutrigenomics in developing personalized dietary guidelines. Current research in PN highlights significant gene–diet interactions that affect various conditions, including obesity and diabetes, suggesting that dietary interventions could be more precise and beneficial if they are customized to genetic profiles. …

Novel Applications Of Syndemic Theory For Global Public Health: Considerations For Gender Based Violence And Mixed Methods Research, Luissa Vahedi

Brown School Graduate Student Theses and Dissertations

Syndemic theory highlights that epidemics do not occur in isolation. Due to harmful political inequalities, epidemics can co-occur and interact with one another to magnify the overall burden of disease. Certain contexts and populations are more prone to syndemic vulnerabilities. Gender based violence (GBV) has been labeled as an epidemic in low- and middle-income countries (LMICs). Epidemiological evidence has demonstrated that GBV co-occurs alongside other epidemics such as HIV and substance use. This dissertation extends the application of syndemic theory to GBV in LMIC for the purpose of improving methodological and analytical approaches as well as global health applications. Three …

Association Between High Health Literacy, Doctor's Recommendation, And Prostate Cancer Screening Among Men In The United States, Felicia Njideka Akunna

Walden Dissertations and Doctoral Studies

To efficiently identify and prevent the advancement of prostate cancer and decrease mortality rates, it is crucial to examine the impact of health literacy. Despite potential advantages associated with enhanced health literacy and early detection, the United States continues to witness a significant rise in both new prostate cancer cases and mortality rates, emphasizing the severity of the condition. However, it is unclear if those with high health literacy are discouraged from participating in prostate cancer screening due to the risks associated with screening. Based on the stimulus organism response model, 2016 Behavioral Risk Factor Surveillance System data were analyzed …

Empowering The Biomedical Research Community: Innovative Sas Deployment On The All Of Us Researcher Workbench, Izabelle Humes, Cathy Shyr, Moira Dillon, Zhongjie Liu, Jennifer Peterson, Chris St Jeor, Jacqueline Malkes, Hiral Master, Brandy Mapes, Bassent Abdelbary

Physician Assistant Studies Faculty Publications

Objectives: The All of Us Research Program is a precision medicine initiative aimed at establishing a vast, diverse biomedical database accessible through a cloud-based data analysis platform, the Researcher Workbench (RW). Our goal was to empower the research community by co-designing the implementation of SAS in the RW alongside researchers to enable broader use of All of Us data.

Materials and methods: Researchers from various fields and with different SAS experience levels participated in co-designing the SAS implementation through user experience interviews.

Results: Feedback and lessons learned from user testing informed the final design of the SAS application.

Discussion: The …

A Social Media Game To Increase Physical Activity Among Older Adult Women: Protocol Of A Randomized Controlled Trial To Evaluate Challenge, Michael C Robertson, Maria Chang Swartz, Karen M Basen-Engquist, Yisheng Li, Kristofer Jennings, Debbe Thompson, Tom Baranowski, Elena Volpi, Elizabeth J Lyons

Faculty, Staff and Student Publications

BACKGROUND: Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits …

Integrated Delivery Of Health Care And Continuity Of Care For Older Mississippians With Mental And Behavioral Health Concerns, Tockie V. Hemphill

Journal of Public Health in the Deep South

The mental health of older adults is of national concern. There is some uncertainty regarding access to care and whether mental and behavioral health care will be readily available in primary care settings. This paper explores the concepts of integrated delivery of care and continuity of care for older adults. The definitions of the two concepts vary in detail, but are similar in purpose. There is an array of strategies presented that outline a continuity of care that involves an integrated delivery system. Relationship development is the core of this system, as well as older adults’ ability and willingness to …

Caregiver To Caregiver: An Exploratory Case Study In Adult Family Caregiving Experiences, Tamara Brocks, Kaye Bender

Journal of Public Health in the Deep South

Adult family caregiving is a national public health issue which is more prominently recognized since the COVID pandemic. The National Strategy to Support Family Caregivers (2022) highlights more than three hundred federal government actions in support of family caregivers and more than 150 actions that can be addressed at other levels of government with their partnerships to build a caregiver support system. A partnership between the Mississippi State Department of Health (MSDH), the Mississippi Public Health Association (MPHA) and AARP MS is working to address many of the issues related to the heathy aging ecosystem in Mississippi. This case study …

Implementing Policy To Increase Health Literacy In Falls Prevention: A Teach-Back And Show-Back Intervention, Yalanda M. Barner, Lollie Vaughan-Robinson, Jazmin Adjei

Journal of Public Health in the Deep South

Background: Although falls are preventable, falls among older adults remain a public health concern. Research indicates that over one-third of persons over 65 fall. Approximately 3 million report to emergency rooms due to falls annually. Falls are attributed to health conditions such as cognitive impairment, poor eyesight, arthritis, and polypharmacy.

Purpose: This study adapted the Teach-Back/Show-Back method for older persons in adult daycare and faith-based settings to assess their understanding of falls prevention techniques. Therefore, the purpose of this study was to examine the risk factors, prevention strategies, and policy recommendations of falls prevention among older adults.

Methods: A survey …

The Mississippi Healthy Aging Data Report: Tools To Advance Health Equity, Elizabeth Dugan, Taylor Jansen, Chae Man Lee, Nina M. Silverstein, Yan-Jhu Su

Journal of Public Health in the Deep South

Introduction. This article describes the Mississippi Healthy Aging Data Report, which includes 125 indicators reported at the county and state level.

Methods. Data sources include the American Community Survey from the U.S. Census, the Behavioral Risk Factor Surveillance Survey, the Centers for Medicaid and Medicare Services, and other sources. Small-area estimation techniques are used to calculate age- and gender-adjusted county rates. Data visualizations illustrate health disparities.

Results. Mississippi is home to 663,581 people age 60 or older – 22% of the state’s total population. Approximately 12.9% of Medicare beneficiaries in Mississippi have Alzheimer’s disease or a related …

Strategic Advocacy: Doula Care, Liminality, And Reproductive Justice, Julie Johnson Searcy, Ellen Block, Angela N. Castañeda

Sociology Faculty Publications

No abstract provided.

Unveiling Healthcare Disparities By Addressing Historical Traumas To Build Inclusive Spaces For Marginalized Communities: An Autoethnographic Study, Helena Humphreys

Theses and Graduate Projects

This paper delves into the pervasive disparities within the healthcare system, rooted in historical injustices that are perpetuated by systemic biases, particularly affecting Black, Indigenous, and People of Color (BIPOC) communities, as well as the LGBTQIA2S+ community. Through a comprehensive literature review and autoethnographic study, the paper examines the deep-seated issues faced by these marginalized groups, including access barriers, discrimination, mistrust of healthcare providers, and the enduring impact these have on health outcomes. Historical traumas such as the Tuskegee Syphilis Study and the use of HeLa cells underscore the enduring impact of past injustices on present-day healthcare experiences. Moreover, the …

Addressing Rural Food Insecurity: A Flexible Approach Using Evidence-Based Practices, Alison Clayshulte

Master's Projects and Capstones

Food insecurity is a major public health problem in the United States that can lead to worse physical and mental health outcomes for millions of Americans. Rural communities struggle with food insecurity at a higher rate, leading to disproportionately higher levels of chronic conditions, obesity, and stress. Food insecurity is a symptom of many factors including underlying social, economic, and institutional obstacles that affect the quantity and quality of available food. Examples of evidence-based programs implemented to address these factors abound, however rural communities have unique challenges that must be considered to ensure programmatic success. This paper explores these challenges …

Association Between Agrichemical Mixtures And Pediatric Health Outcomes: Evidence From A Nebraska Population-Based Surveillance, Jabeen Taiba

Theses & Dissertations

Human exposure to environmental contaminants is associated with various pediatric health outcomes. Agrichemicals are a significant environmental risk factor for childhood cancers and congenital anomalies, and reduced exposure could improve pediatric health outcomes. Previous studies in Nebraska have explored the association between single pollutants and pediatric cancers and birth defects. However, it is important to estimate the overall effect of the agrichemical mixture on these pediatric health outcomes. In addition to environmental risk factors, several social vulnerability factors also contribute to increased agrichemical exposure and show disparities in pediatric cancers and birth defects. The objectives of this dissertation are to …

Telehealth For Healthy Aging: A Multi-Level, Multi-Methods Approach, Vaibhavi Mone

Theses & Dissertations

Telehealth, rapidly adopted during the pandemic, has shown its usefulness and limitations, yet was not designed with older adults in mind. This dissertation encompasses three interconnected studies exploring telehealth utilization for Medicare Annual Wellness Visits (AWVs) among older adults, provider perspectives on telehealth AWVs, and the impact of teleconferencing on primary care providers' knowledge and confidence in geriatric care. The objectives are to determine patient characteristics using telehealth AWV (study 1), understand provider perspectives on telehealth AWV (study 2), and evaluate the effectiveness of geriatrics education through telehealth (study 3). Study 1 investigates the changes in AWV utilization among 18,405 …

Respiratory Syncytial Virus In The United States: A Research Proposal For A Prospective Cohort Study Of Rsv Vaccines, Kenneth D. Chiu

Master's Projects and Capstones

Objective

This paper proposes a phase IV study to estimate the effectiveness of Abryvso and Arexvy in older adults against severe RSV disease. Additionally, the study aims to assess factors involved with low vaccine uptake for these RSV vaccines.

Methods

For the background literature review of this proposal, I conducted a search of the PubMed and CINAHL Ultimate databases for articles on older adults and RSV. I filtered out results within the period of 2020 to 2024 that were publicly available and focused on RSV burden, vaccinations, or knowledge in the United States.

The proposed phased IV study is a …

The Dissemination And Implementation Of N95 Fit Testing Capacities For Nebraska Long-Term Care Facilities: A Mixed-Methods Analysis Using The Re-Aim Framework, Anthony Blake

Theses & Dissertations

Background: Ensuring the proper fit of N95 respirators used by healthcare workers in long-term care facilities (LTCF) is essential for their safety. The Nebraska Department of Health and Human Services launched a LTCF strike team project (STP) in the summer of 2022, focused on increasing the number of staff trained in infection control and building internal capacity for LTCFs to fit test their employees. This study describes the N95 fit-testing initiative for Nebraska LTCFs.

Methods: Staff from all 19 local health departments (LHD) received “train-the-trainer” training to prepare LTCF staff to perform qualitative fit testing. LTCF administrators were requested to …

Improving Patient Care: Expansion Of Access To Free Clinics, Anahis H. Davidian, Gail M. Bloom

Patient Experience Journal

Free clinics provide free or reduced-fee healthcare services for uninsured, underserved, and marginalized populations. Free clinics may be the only source of primary care for socioeconomically disadvantaged individuals lacking health insurance. However, consistently understaffed and underfunded free clinics are struggling to meet growing needs. The demand for services results in long waitlists with long wait times. Most free clinics rely on volunteer providers and staff due to limited financial resources. This case study proposes recommendations that can address the challenges of funding limitations while improving free clinics' ability to offer more accessible and equitable care to serve a greater proportion …

Foundational Patient Experience: Analyzing 10 Years Of Patient Experience Research, Geoffrey A. Silvera Phd, Mha, Courtney Haun Phd, Mph, Varun Natarajan

Patient Experience Journal

In this study, we seek to provide a critical examination of the field of Patient Experience (PX) by using citation analysis to determine the foundational keystones of the PX knowledge base. This study will employ a systematic citation analysis to evaluate the articles published in the Patient Experience Journal (PXJ), focusing on citation frequency as evidence of impact on the field. To achieve this, we examine the entire corpus of article citations published in the PXJ from 2014–2023 (Volumes 1–10). By examining a corpus consisting of 515 independent articles (N=515) that include over 12,000 references (n=12,712) over the course of …

Accompanying People Affected By Cancer In Their Return To Life After Treatment: A Report On An Experiment Conducted In Canada, Christine Arsenault, Saskia Hazout, John Calogerinis, Françoise Poirier, Louise Normandin, Cécile Vialaron, Monica Iliescu Nelea, Marie-Pascale Pomey

Patient Experience Journal

This study aims to assess family doctors' perceived needs for improved patient follow-up post-acute treatment in oncology departments, specifically focusing on the Patient Oriented Discharge Summary (PODS) for individuals living with cancer. A cross-sectional quantitative survey targeted family doctors, and a before/after exploratory study was conducted with patients to measure their needs pre- and post-PODS implementation. Twenty-one out of 42 family doctors participated in the survey (50%). Patient data was collected at three points in time: prior to PODS implementation (T1, n = 20/30; 77%), one month later (T2, n = 20/26; 77%), and six months later (T3, n = …

Investigating The Perceived Impact Of Surgeons' Burnout On Surgical Physician Associates' Wellness In United States Ambulatory Surgery Centers, Rhionna J. Smith, Lihua Dishman, John W. Fick, Kathleen M. Thomas

Patient Experience Journal

Surgeons are the de facto leaders of surgical teams with surgical physician associates (SPAs) as integral members who function in all areas of the peri-operative environment. Surgeons often supervise SPAs. Ambulatory surgery centers (ASCs) provide patients with same-day diagnostic and preventive procedures as more convenient alternatives to hospital-based outpatient procedures. This qualitative, national, and cross-sectional study explored the perceived impact of surgeons' burnout on SPAs' wellness in U.S. ASCs during global health crises. Primary demographic and qualitative data were collected using a self-developed, three-section survey instrument: (1) information regarding informed consent; (2) 10 short demographic questions; and (3) two open-ended …

Primary Care Productivity And Patient Satisfaction Community Practice: What Is The Relationship?, Thomas G. Howell Jr.

Patient Experience Journal

Research has shown a consistent positive association between patient and provider experience and improved patient outcomes and safety. There is a belief that patient satisfaction and physician productivity are competing interests. The relationship for primary care physicians, in a Midwest Health system was evaluated as part of this project. Data from Press Ganey patient satisfaction surveys on likelihood of recommending the practice and the physician were compared between primary care physicians in the top quartile of average monthly patient visits and those that were in the three lower quartiles. A secondary analysis of patient satisfaction scores related to continuous years …

The Perceived Usefulness Of Patient Narrative Feedback In Primary Care Settings, Sasmira Matta, Yuna S.H. Lee, Rachel Grob, Mark Schlesinger, Ingrid Nembhard

Patient Experience Journal

Research suggests that insights from patient narratives – stories about care experiences in patients' own words – contain information that can be used to improve care. However, assessments of narratives reported by clinical personnel have been mixed. This is the first study, to our knowledge, to systematically measure how useful personnel in primary care perceive patient narratives to be. We surveyed 276 clinical and administrative personnel in nine primary care clinics in a large health system in the United States. We found that perceived usefulness of patient narratives is generally high, but varies by individual characteristics such as level of …

Research Imitates Life: Researching Within Your Lived Experience, Bethany Donaghy, Delane Linkiewich

Patient Experience Journal

This personal narrative article seeks to bring awareness to and provide an overview of the various aspects that come with being a lived experience researcher including the host of benefits and challenges that come with conducting research within one's own area of lived experience. Throughout this narrative, we (Bethany Donaghy, an autistic person, and Delane Linkiewich a person living with chronic pain) share our perspectives on what it is like to be lived experience researchers. Our narratives discuss how the many identities we hold both improve the impact and relevance of our research while also posing challenges for us like …

Evaluating The Effectiveness Of Hiv/Aids Interventions In Lesotho, Maya Gomez Velardez

Master's Projects and Capstones

Lesotho faces a severe HIV/AIDS epidemic, with one of the highest prevalence rates globally, impacting its public health, economy, and society. Despite numerous efforts, the country continues to struggle with persistently high infection rates, highlighting the need to thoroughly evaluate current interventions. This review examines the effectiveness of various HIV/AIDS interventions in Lesotho, focusing on multi-level strategies within the Social Ecological Model. The paper synthesizes literature from 2013 to 2023, concentrating on antiretroviral therapy (ART) coverage, community initiatives, and efforts targeting high-risk groups. Key strategies involve expanding ART coverage, strengthening community-based healthcare through community health workers (CHWs), and enhancing initiatives …

Effects Of Misinformation And Disinformation On Vaccine Hesitancy And Routine Vaccine Uptake, Cindy Chen

Master's Projects and Capstones

This literature review was conducted to identify the role misinformation and disinformation plays on the rates of vaccine hesitancy and vaccine uptake for routine immunization among the child and adult populations of the United States. Fifteen articles between 2018-2024 were extracted from PubMed and Google Scholar databases. As shelter-in-place and social distancing protocol wanes, the risk of common vaccine preventable diseases (VPDs) reemerges, especially in populations that have not kept up with routine immunization schedules. Current efforts to restore mass vaccination campaigns are underway, but do not provide the necessary modifications to include social, behavioral, and cultural factors that influence …

Health For All: Evaluating The Impact Of Equity-Centered Approaches On U.S. Healthcare Delivery, A Review Of Literature, Angela Leung

Master's Projects and Capstones

This literature review examines the impact of equity-centered approaches on issues affecting U.S. healthcare delivery—multiple databases to identify relevant literature that discussed equity-centered care, associated health disparities, and implementation strategies. Of the 490 search results, ten articles remained after refining the search results to include papers published between 2014-2024 and fit the specific inclusion and exclusion criteria. The key findings highlight the benefits of equity-centered approaches in improving the quality and accessibility issues affecting the U.S. healthcare system. Presently, the status of equity work is siloed between healthcare systems in the U.S., creating an unprecedented roadblock. Nonetheless, the findings suggest …