Digital Commons Network^™

Examining The Relationship Between Patient Engagement With Digital Inhaler Technology And Asthma Control, Tanisha D. Hill

Walden Dissertations and Doctoral Studies

Asthma is a chronic lung disease that has significant public health and economic impact. Nonadherence to asthma medications can lead to poor treatment response and poor asthma outcomes. Digital health technologies have been shown to improve asthma medication adherence as well as asthma outcomes. The purpose of this quantitative research study was to examine the relationship between patient characteristics and mobile app engagement and the relationship between patient engagement with a digital inhaler app and asthma control in adult patients with uncontrolled asthma who were assigned to use a digitally enabled asthma medication and accompanying app for asthma therapy. Several …

Impact Of Diabetic Education On Reducing Hospital Readmission Rates: A Literature Review Of Adults With Diabetes, Frank Camarda

Rowan-Virtua Research Day

According to 2018 data from the Diabetes Institute Foundation, adults in the U.S. diagnosed with diabetes accounted for 17 million emergency department visits. The readmission rate for patients with diabetes far exceeds the general readmission rates for hospitalized patients. While there is recognition of the need for diabetic education to reduce hospital readmissions, optimizing long-term self-management of diabetics remains a focus of ongoing research.

A Case Of Hhv-6 Viral Meningitis, Mohammad A. Rattu, Wayne Tamaska

Rowan-Virtua Research Day

Meningitis is the inflammation of the meninges and associated with abnormal cell count in the cerebrospinal fluid (CSF). The lack of bacterial growth in cultures, most commonly referred to as aseptic meningitis, is frequently caused by viruses [2]. Viruses have become more common as the prevalence of bacterial meningitis has decreased secondary to vaccination use, with viral meningitis being the most common form among countries. Viral meningitis will present with fever, headache, photophobia, neck stiffness and nausea and vomiting. Younger children however may not show any signs of meningeal irritation. Viral meningitis is usually self-limiting and with good prognosis; however, …

The Impact Of The Covid-19 Mask Mandate On Effective Communication Between Healthcare Providers And Deaf/Hoh Patients, Antonia J. Conti, Alexa Gingerich

Rowan-Virtua Research Day

During the peak of the COVID-19 pandemic, many countries mandated the use of facial masks in public environments, especially in healthcare settings.[3] While this was beneficial in reducing the spread of the coronavirus disease, it created many challenges for the deaf/HoH community.[4] In particular, it limited effective communication between healthcare providers and deaf/HoH patients. It was found that masks limit word recognition for both deaf/HoH and non-deaf/HoH individuals. Additionally, both surgical and N95 masks hinder word recognition for deaf/HoH individuals and significantly impact communication during medical appointments.

Investigating Risk Factors Contributing To The High Incidence Of Covid-19 Among The Diné People Of The Navajo Nation, Elizabeth Lila Reynolds

Rowan-Virtua Research Day

Background: COVID-19 became international news in December 2019 and subsequently impacted global health. The research shows that the Diné people of the Navajo Nation were one of the most severely impacted populations¹. The Navajo Nation is a region spanning Arizona, New Mexico, and Utah that is composed of North American indigenous people known as the Diné. Purpose: To explore the risk factors contributing to the increased rates of COVID-19 infection and severity of infection among the Diné people. Methods: This literature review research process utilized PubMed and JAMA to find scholarly articles on this topic. Search terms …

Lep Prevalence In Southern New Jersey And The Use Of Interpreting Services In Healthcare Settings, Katherine Chavarria, Ariana Blake, Marlyn Valentin

Rowan-Virtua Research Day

Language barriers pose a great challenge to populations of Limited English Proficiency (LEP) in understanding their health, diagnosis, and treatments in healthcare settings. Our research aimed to gain a better understanding of the language access needs in Southern New Jersey. We analyzed census data in order to determine the prevalence of LEP populations in Southern New Jersey, as well as the languages most spoken by LEP populations. Additionally, our research looked at the use of interpreting services in healthcare settings. In Camden county, specifically we found that the top 3 languages spoken by LEP populations were Spanish, Vietnamese, and Chinese. …

Review Of Missing Data Elements For Client Enrollment In The Minority Aids Initiative For High-Risk Men Of Nj, Vrushank Shah

Rowan-Virtua Research Day

The Minority AIDS Initiative study funded in NMI seeks to enhance healthcare outcomes for underserved individuals. Implementing outreach programs, the initiative provides healthcare and post-treatment follow-up to this demographic. The proposed project, a component of this study, concentrates on individuals with substance abuse disorder, specifically targeting those who have been onboarded but subsequently lost to follow-up. In the United States, approximately 20 million people are diagnosed with substance abuse disorder, yet in 2016, only 3.8 million received treatment. Within this cohort, between 20% and 70% of individuals undergoing residential substance abuse treatment disengage before completion. Various factors hinder the sustained …

The Efficacy Of Telemental Health Interventions For Mood Disorders Pre-Covid-19: A Narrative Review, Alyssa M. Edwards, Jordan C. Petitt, Martha Sajatovic, Sanjana Kumar, Jennifer B. Levin

Faculty Scholarship

The onset of the COVID-19 pandemic saw a significant surge in the utilization of telemental health (TMH) services. This narrative review aimed to investigate the efficacy of TMH for serious mood disorders prior to the COVID-19 pandemic. A search across databases was conducted for randomized controlled trials focusing on TMH interventions for mood disorders, encompassing major depressive disorder (MDD) and bipolar disorder (BD). Study and patient characteristics, interventions, and outcomes were extracted. From a pool of 2611 papers initially identified, 17 met the inclusion criteria: 14 focused on MDD, while 4 addressed BD. Among these, 6 papers directly compared TMH …

Barriers To Healthcare Access Between English And Spanish Speakers In An Underserved Population, Adeena Javed, Dale Johnson, Gerardo J. Rivera-Colón, Nathaniel J. Byrnes, Kristin Bertsch, Anne C. Jones

Rowan-Virtua Research Day

• According to the NJ State Department of Health, Atlantic County has higher rates of smoking, respiratory disease, hypercholesterolemia, as well as death rates due to coronary heart disease, HIV, and all cancers compared to the NJ state average1,2.

• With over 20% of Atlantic County's population identifying as Hispanic, Spanish speakers encounter greater obstacles compared to their English-speaking counterparts in accessing healthcare services and improving health outcomes1,2 .

• Existing research indicates that various factors, including health insurance coverage, proximity to healthcare facilities, transportation options, health literacy levels, and trust in the medical profession, significantly influence access to healthcare …

Reducing Non-Communicable Diseases Among Palestinian Populations In Gaza: A Participatory Comparative And Cost-Effectiveness Modeling Assessment, Sanjay Basu, John S. Yudkin, Mohammed Jawad, Hala Ghattas Ph.D., Bassam Abu Hamad, Zeina Jamaluddine, Gloria Safadi, Marie Elizabeth Ragi, Raeda El Sayed Ahmad, Eszter P. Vamos, Christopher Millett

Faculty Publications

We sought to assess the effectiveness and cost-effectiveness of potential new public health and healthcare NCD risk reduction efforts among Palestinians in Gaza. We created a microsimulation model using: (i) a cross-sectional household survey of NCD risk factors among 4,576 Palestinian adults aged ≥40 years old in Gaza; (ii) a modified Delphi process among local public health experts to identify potentially feasible new interventions; and (iii) reviews of intervention cost and effectiveness, modified to the Gazan and refugee contexts. The survey revealed 28.6% tobacco smoking, a 40.4% prevalence of hypertension diagnosis (with a 95.6% medication treatment rate), a 25.6% prevalence …

Effects Of An Educational Evidence-Based Website To Improve Breast Health Knowledge And Self-Efficacy Of Breast Self-Examination: Interim Analysis, Mackenzie Koch, Jennifer Cera, Brooke Hancock, Elizabeth Graham

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Breast disease, whether benign or malignant, encompasses a wide array of diagnoses. Breast self- examination (BSE) is a simple screening assessment that improves early recognition and diagnosis. With changes in the 2021 ACOG practice guidelines from mandatory to optional provider-performed clinical breast examinations (CBE), it is imperative for patients to possess basic breast health knowledge and accurate BSE techniques. Current standard patient education is provided via brochures or pamphlets. An educational multimedia website was created using ACOG guidelines to impart knowledge and demonstrate proper BSE techniques. Aims were to evaluate changes in participant’s (1) breast health knowledge …

Implementation Of A Doula-Supported Postpartum Wellness Toolkit In A Black Community-Based Maternal Wellness Program, Janice Luethje, Leslie Torres

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to expand the areas of focus within a maternal wellness program at a Black community center and to evaluate the satisfaction levels of the doulas who utilized the material during postpartum home visits. The toolkit covers a range of postpartum topics in the areas of nutrition, exercise, sexual health, mindfulness, and social support as well as a postpartum mental health screening tool.

Design: This quality improvement project included three distinct phases: The pre-implementation phase, the implementation phase, and the post-implementation phase.

Setting: The project location was a Black community center in Lincoln, Nebraska. …

A Problem-Based Approach To Racial And Ethnic Inequities In The German Health System, Thomas C. Lane

German Studies Undergraduate Senior Theses

This work is the first comprehensive book-length survey of racial and ethnic inequities in Germany’s health system. It takes a novel approach to understanding health inequities by focusing on the overarching structures which shape them in the German context, using examples from various areas of the health system to clarify their nuances. The Introduction grounds the need for understanding and combating health inequities in Germany’s unique postwar constitutional commitment to human dignity. Next, Chapter 1 outlines the current methods by which inequities are measured in Germany and why they are problematic. Chapter 2 covers current inequities in the provision of …

Evaluation Of Community Healthcare Workers Of Faith-Based Workers In Northern Omaha, Ashley Piwkiewicz

Capstone Experience: Master of Public Health

The University of Nebraska Medical Center (UNMC) developed a training and certificate program for Community Health Workers (CHWs) in faith-based organizations in Northern Omaha. Each recruited trainee developed an experimental program they implemented in their faith-based community. This research study aims to explore and analyze the implementation of these programs in the community, the effects that these programs have on the community, and the extent to which the goals of the CHWs' implemented programs were met.

To achieve this, data was collected through a 41-question survey administered via REDCap to 12 CHW trainees. Descriptive statistics of this data were analyzed …

Identifying Barriers To Healthcare Access And Utilization Experienced By Lgbtq+ Adults With Chronic Diseases Through The Lens Of The Social Ecological Model, Devin Mottier

Capstone Experience: Master of Public Health

The purpose of this literature review is to comprehensively examine and synthesize existing research on present barriers to health access and utilization that contribute to the disparities in chronic disease prevalence within the adult LGBTQ+ population. In the context of this review, the social-ecological model (SEM) was used to describe the nuanced and multifaceted nature of healthcare access and utilization. This literature review was based upon the following question: ‘Using the social-ecological model, what are the barriers to health access and utilization that contribute to high rates of chronic disease in LGBTQ+ adults?’ Outcome measures of interest included the following …

Examining The Impact Of Racial And Ethnic Disparities In Colorectal Cancer Screening Compliance In The United States And The Potential Of Targeted Interventions., Jessica Ware

Capstone Experience: Master of Public Health

Objectives:

Examine Colorectal cancer (CRC) screening compliance among racial and ethnic groups in the United States (US) based on the US Preventive Services Task Force (USPSTF) recommendations.

Identify targeted interventions to promote screening compliance, early diagnosis, and CRC survivorship.

Methods: This cross-sectional study utilized 165,878 selected participant responses from the 2022 Behavioral Risk Factor Surveillance System. We modeled and investigated CRC screening compliance based on the USPSTF recommendations as inclusion criteria between racial/ethnic groups in the US while adjusting for covariates using a weighted stepwise logistic regression.

Results: With covariates adjustment, Hispanics (POR 1.16 95%CI 1.04-1.29), Asian …

Assessing The Association Between Income And Breast Cancer Screening Practices, Hannah M. Zantow

Capstone Experience: Master of Public Health

Objectives

To determine how breast cancer screening practices differ between high- and low-income women aged 40-74. To determine the effects of sociodemographic factors on the relationship between income and breast cancer screening practices.

Methods

This was a cross sectional study. Survey data was obtained from women aged 40-74 who completed the Behavioral Risk Factor Surveillance Survey (BRFSS). The exposure was income. The outcome was if a woman ever received a mammogram. The final sample size was 171,111 participants. Regression models were used to assess the association between income and screening practices.

Results

There was a significant association between income and …

Association Between Depression And Coronary Heart Disease: A Cross-Sectional Study Using Behavioral Risk Factor Surveillance System (Brfss), 2022, Juliana Monono

Capstone Experience: Master of Public Health

Objectives: To examine the association of depression and coronary heart disease in U.S. adults.

Methods: This cross-sectional study uses the Behavioral Risk Factor Surveillance System (BRFSS), 2022 data for non-institutionalized U.S adults aged 18 and older. The exposure variable is depression, the outcome is coronary heart disease (CHD), and covariates are age, race, education, and physical activity. Performed univariate, bivariate, and multivariate analyses to assess the association between depression and CHD.

Results: The analytical sample size consisted of 427,217 individuals. A total of 88,841(20.7%) of the population reported having coronary heart disease, while 338,376(70.3%) reported having no …

Association Between Long Covid-19 And Insurance Status Using The Behavioral Risk Factor Surveillance System (2022), Elizabeth E. Osbourn

Capstone Experience: Master of Public Health

Objective. To determine if insurance status can directly predict self-diagnosed Long COVID and what sociodemographic factors are significantly associated with a self-diagnosis of Long COVID among those who tested positive for COVID-19.

Methods. This cross-sectional study uses data from the 2022 Behavioral Risk Factor Surveillance System to conduct a multivariate logistic regression model analysis. Out of 445,132 participants, 110,402 participants were identified to be used in this study.

Results. After testing positive for COVID-19, 21.7% of individuals were self-diagnosed with Long COVID. After controlling for confounders, insurance status wasn't significant (p-value: 0.8458). However, in crude analysis, individuals with Medicaid (cPOR:1.44; …

Examining The Relationship Between Deafness And Mental Health Status: An Analysis Of The Behavioral Risk Factor Surveillance System (Brfss) 2022, Brianna Stroud-Williams

Capstone Experience: Master of Public Health

Objective: The objective of the research is to examine the association between mental health status as measured by number of mentally healthy days in the past month and deafness and binge drinking.

Methods: The Behavioral Risk Factor Surveillance System (BRFSS) study was conducted via telephone survey in 50 states, including the District of Columbia and US territories. The sample size is 402,156 participants. Univariate, bivariate, and multivariate regressions, odds ratio, and 95% confidence interval were used to measure the data.

Results: Deaf respondents have 1.56 times the odds of having poor mental health than those who are not deaf. (95% …

Exploring The Nexus: The Influence Of Acculturation And Stress On Infant Outcomes Among Hispanic And Black/African American Adolescents, Mia I. Moreno

2024 Spring Honors Capstone Projects - Archive

Numerous studies on acculturation and acculturative stress exist; however, findings are inconsistent and overlook an exploration of differences between Hispanic and Black/African American (B/AA) adolescents’ acculturation, stress, and birth outcomes. Despite societal and cultural challenges for both minorities, Hispanic women typically have positive birth outcomes comparable to White women, but B/AA women show an increased risk for negative birth outcomes. Further, minority and adolescent childbearing women frequently receive fewer prenatal care (PNC) visits than recommended which may impact birth outcomes. Therefore, my study sought to compare Hispanic and B/AA women’s birth outcomes assessing acculturation and stress and examine the relationship …

Global Burden Of 288 Causes Of Death And Life Expectancy Decomposition In 204 Countries And Territories And 811 Subnational Locations, 1990–2021: A Systematic Analysis For The Global Burden Of Disease Study 2021, Gbd 2021 Causes Of Death Collaborators, Veincent Christian F. Pepito

Ateneo School of Medicine and Public Health Publications

Background

Methods

Young People's Alcohol Use In And Around Water: A Scoping Review Of The Literature, Renee N. Carey, Gemma Crawford, Jonine Jancey, Tina Lam, Lauren Nimmo, Gina Trapp, Christina Pollard, Paula Hooper, Justine E. Leavy

Research outputs 2022 to 2026

Issues: The surrounding social and commercial context, including alcohol advertising, heavily influences alcohol consumption. Alcohol use is a major risk factor for both fatal and non-fatal drowning, particularly for young people. Approach: We conducted a scoping review to explore the peer-reviewed literature on the use of alcohol by young people (aged 15–34 years) in the context of aquatic environments. Five electronic academic databases were searched for English-language studies conducted in high-income countries and published in the last 15 years (since 2008). The MetaQAT framework was used to assess methodological quality of included studies. Key Findings: The review included a total …

Long-Term Healthcare Utilisation, Costs And Quality Of Life After Invasive Group B Streptococcus Disease: A Cohort Study In Five Low-Income And Middle-Income Countries, Farah Seedat, Simon Procter, Ziyaad Dangor, Shannon Leahy, Sridhar Santhanam, Hima John, Quique Bassat, Celine Aerts, Amina Abubakar, Carophine Nasambu

Institute for Human Development, East Africa

Introduction There are no published data on the long-term impact of invasive group B Streptococcus disease (iGBS) on economic costs or health-related quality of life (HRQoL) in low-income and middle-income countries. We assessed the impact of iGBS on healthcare utilisation, costs and HRQoL in Argentina, India, Kenya, Mozambique and South Africa.

Methods Inpatient and outpatient visits, out-of-pocket (OOP) healthcare payments in the 12 months before study enrolment, and health-state utility of children and caregivers (using the EuroQol 5-Dimensions-3-Level) were collected from iGBS survivors and an unexposed cohort matched on site, age at recruitment and sex. We used logistic or Poisson …

Species Distribution And Logistic Regression Analysis Of Nosocomial Legionella Detection And Infection In New York State, 2017 – 2023, Roxann Brna

Legacy Theses & Dissertations (2009 - 2024)

Healthcare facilities are high-risk areas for legionellosis infections, as they have large, complex potable water systems ideal for Legionella proliferation, and they host susceptible populations. New York State regulation 10 NYCRR § 4-2: Protection Against Legionella in Healthcare Facilities was implemented in July 2016 to reduce healthcare-acquired legionellosis. This regulation mandated environmental surveillance of healthcare facilities’ potable water systems via culture. Data from these environmental reports were paired with data for cases of healthcare-acquired legionellosis infections for the years 2017-2023. Using these data, geographic Legionella species and serogroup distributions were described, and logistic regressions evaluated facility attributes associated with potable …

A Content Analysis Of Tiktok Challenges In The News, Michael Jakakas

ALL - Honors Theses

Social media is a phenomenon that has drastically altered how people receive information about current events, communicate with each other, and consume entertainment. Apps such as TikTok have become widely used by many but have also faced increased scrutiny for the nature of its content including viral challenges where users will post a challenge video doing an activity that often has the potential to lead to injury. This content analysis study looks to analyze how these TikTok challenges are covered by news media by assessing how frequent news coverage of TikTok challenges is and the characteristics of such coverage. The …

Extreme Temperature And Other Environmental Factors On Diabetes Admissions, Donghong Gao

Legacy Theses & Dissertations (2009 - 2024)

Background: Although total environmental factors have been linked with adverse health outcomes, the impacts of temperature and other total environmental factors on diabetes-related hospitalizations and emergency department (ED) visits remain inconclusive.Objective: This dissertation aims to Aim 1) test the associations between extreme heat and diabetes hospitalizations in the summer and its transitional months, identify populations vulnerable to extreme heat’s effects, and examine the modification effects of greenness on the heat-diabetes associations in warm months (Chapters 3 and 4); Aim 2) investigate the associations between extreme cold and diabetes hospitalizations in the winter and its transitional months, identify populations vulnerable to …

Protocols For Enhancing The Role And Value Of Spiritual Care Resources In The Metropolitan Nashville Police Department, Garrett Harper

Doctor of Ministry Theses and Dissertations

This thesis addresses the assessment of innovative practices in police chaplaincy. The purpose of the project intervention is to develop protocols that can guide police chaplains through an assessment process. The intervention relies on practical theology as exemplified through the ministry of chaplaincy. This ministry comprises police chaplains offering spiritual comfort to persons encountering critical incidents involving violence, accident, or other trauma-intensive events and situations. Adoption of innovations can allow police chaplains to be more effective in fulfilling many outward-focused tasks such as delivery of death notifications. I conclude that: (1) police chaplaincy is amenable to use of protocols to …

Well-Being Behaviors And Outcomes In Arkansas Teachers: A Qualitative Analysis Of Teachers In Arkansas During The Covid-19 Pandemic, Ashton Elizabeth Human

Graduate Theses and Dissertations

Introduction: The COVID-19 pandemic introduced new challenges to teachers and emphasized those already existing in the education system. The increased reliance upon technology and lack of administrative support perceived during distance learning led to lower levels of commitment to teaching and increased levels of teacher burnout. Burnout risk is associated with an increased workload, exhaustion from job demands, cynicism toward the professional community and has been shown to have a negative relationship with well-being. Teachers experiencing burnout are unable to establish positive relationships with students, understand students’ needs, stay in contact with trends in the education field, or provide pedagogically …

Immigration Exams At Community Healthworx In Alexandria, Louisiana From 2014 To 2023, David J. Holcombe, Joshua Mjolsness

Journal of the Louisiana Public Health Association

No abstract provided.