Digital Commons Network^™

An Evaluation Of Virtual Supervision Effectiveness Within Department Of Veterans Affairs (Va) Health Professionals Training Programs, Linda M. Kawentel, John P. Donnelly, Kaylee W. Burgan, Gezan M. Yahya, Joanna S. Doredla, Jessica L. Johnson, Kimberly Falco, Marjorie A. Bowman, John Byrne, Nicholas W. Bowersox

Population and Public Health Sciences Faculty Publications

Background Limited information exists on whether virtual training is equivalent to traditional in-person training in supporting the development of clinical providers. Methods A multi-site evaluation using survey methods was conducted with a multidisciplinary group of health professions trainees and supervisors within the Veterans Health Administration to assess the equivalence of two supervision modalities – exclusively in-person supervision and supervision incorporating at least some virtual supervision – on trainee clinical competency development, trainee preparedness to respond to patient emergencies, and effective trainee/supervisor working relationships. Results Trainees who experienced some virtual supervision rated their clinical competency levels as higher than trainees with …

Factors Associated With Emergency Hospitalization Of Kidney Disease Patients In A National Hospital Kenya., Dorcus Miyombe

MSc in Advanced Practice Nursing

Introduction: Emergency hospitalizations among End Stage Kidney Disease (ESKD) is a major global health burden, with low- and middle-income countries in sub-Saharan Africa (SSA), experiencing the highest rates of morbidity and mortality. Limited resource, economic burden, and insufficient health infrastructure were the main challenges. Emergency hospitalizations at Kenyatta National Hospital remains high due to systemic gaps and poor continuity of care. Prerenal, intrarenal, post-renal injuries, as well as any combination of these, are the primary causes of ESKD. There are stipulated guidelines for ESKD patients’ management however, realization of these goals has not been achieved leading to hospitalization KDIGO …

Community Health Promoters’ Experiences In Mitigation Of Cardiovascular Diseases In Lari Sub-County - Kiambu County, Kenya, Emily Njeri Muchina

MSc in Advanced Practice Nursing

Background: Cardiovascular diseases (CVDs) are a rising public health issue in low- and middle-income countries, including Kenya, where there is an escalation of their deaths and preventable risk factors. Community health promoters (CHPs) have a crucial role in the prevention of CVDs. Yet, low knowledge of CVD prevention and low detection of CVD risk factors characterise most underserved communities in Kenya. Little has been documented about CHPs' experiences in mitigating CVDs despite the presence of multilevel barriers and facilitators that can shape their experiences.

Aim: To gain an in-depth insight into the experiences of CHPs in mitigating CVD …

Predictors Of Complications Among Adult Patients Diagnosed With Type 2 Diabetis Mellitus At Thika Level Five Hospital, Kenya, Bernard Wambua Mbithi

MSc in Advanced Practice Nursing

Introduction: Despite advances in the management of Type 2 diabetes mellitus (T2DM), anecdotal reports from Thika Level Five Hospital indicate that patients still present with diabetes mellitus-associated complications. Therefore, this research aimed to determine the predictors of complications among adult patients diagnosed with T2DM in the hospital.

Methodology: Analytical cross-sectional design was utilized in this research. To select the respondents, purposive sampling was used to recruit six nurse managers and their deputies (making a total of 12 nurses), while 294 patients in the clinic were recruited using systematic sampling. Purposive sampling was also used to recruit 15 patients …

Public Views Towards Lifespan, Healthspan, And Healthy Longevity Medicine In Singapore: A Qualitative Study From The Healthy Longevity (Helo) Initiatives, Belinda Wang, Anna Szucs, Elena Sandalova, Zhi Meng Lim, E. J. Horberg, Paul A. O’Keefe, Louis Island, Sonny Rosenthal, Andrea B. Maier

Research Collection College of Integrative Studies

Introduction: Healthy Longevity Medicine (HLM) offers a strategy to reduce the healthspan-lifespan gap, yet public perspectives remain unclear. This study refines the Healthy Longevity (HELO) framework through a qualitative exploration of public views towards lifespan, healthspan, and HLM.Methods: Individuals living in Singapore participated in semi-structured group or individual discussions to explore (a) their understanding of lifespan and healthspan, (b) motivational factors for health behaviours, and (c) their awareness of HLM. Sampling maximised variation across age, sex, and ethnicity. Data obtained through 13 discussions were analysed with a mixed, inductive-deductive approach employing the HELO framework.Results: Thirty-six participants (mean age = 49.4 …

Referral Strategies For Recruitment And Engagement Of Community Adults Into Online Extension Health Programs, Cheryl L. Eschbach, Dawn A. Contreras, Holly B. Tiret

Journal of Human Sciences and Extension

This article shares details behind building organizational capacity to establish program referrals for statewide recruitment of community adults into Cooperative Extension’s online health programs. This study explores the role of intentional recruitment strategies (active and passive) to increase participant program enrollment into health education and shares examples from one state that has created a trained workforce that offers ongoing research- and evidence-based programs. After many years of trying paper, phone, and electronic medical record methods to increase program reach, Michigan State University Extension tried an electronic referral process via a QR code and web link, accompanied by program marketing, to …

The Role Of Fast-Food Consumption, Residential Fast-Food Exposures, And Urinary Essential Trace Heavy Metals In Colorectal Cancer (Crc) Outcomes., Jeevan Adhikari

Electronic Theses and Dissertations

Background: Colorectal cancer (CRC) is a public health concern. Within the United States (US), fast-food consumption and environmental exposure to heavy metals have increased. The impact of fast-food consumption frequency from fast-food restaurants, residential fast-food exposures, and urinary essential trace heavy metals in relation to CRC outcomes have not yet been rigorously evaluated in the US. Methods: Within the LEAPS-CRC study, we used geographic information systems (GIS) and logistic regression to study the association of fast-food consumption, residential proximity to a fast-food outlet, and urinary essential trace metals with CRC incidence. Additionally, within Kentucky Cancer Registry (KCR) CRC cases, the …

Power, Interests, And Maternal Health Care: A Political Economy Analysis Of Service Delivery Redesign In Kenya, Jacinta Nzinga, Easter Olwanda, Kennedy Opondo, Hillary Kimutai, Jan Cooper, Brian Arwah, Benjamin Tsofa, Edwine Barasa, Kevin Croke

Institute for Human Development, East Africa

The maternal and newborn health (MNH) service delivery redesign (SDR) in Kakamega County, Kenya, represents the country's first system-level reorganization of MNH services. The reform aimed to improve care quality and reduce mortality by centralizing delivery services at designated hubs. Using a political economy lens, we examined how ideology, political dynamics, and institutional structures shaped the agenda-setting, adoption, implementation, and sustainability of SDR. We drew on data from document reviews, stakeholder analysis, semi-structured interviews, and non-participant observation to assess the structural, contextual, and institutional factors influencing the reform. Ambiguity around SDR's purpose contributed to the community's uncertain engagement characterized by …

Bridging The Language Gap: The Impact Of In-Person Versus Remote Interpreter Services On Medication Adherence And Patient Safety In Adult Spanish-Speaking Patients, Ashley E. Alarcon Martinez, Jocelyn N. Lopez Maradiaga

Nursing | Student Research Posters

Background: Significant health inequities are caused by language barriers between patients and health care staff, resulting in miscommunication among adult Hispanic patients with low English proficiency, reducing medication adherence, impairing patient safety, and raising the possibility of medical errors. To address this issue, interpreter services, both in-person and remote translation, have been introduced in healthcare settings to enhance communication. Objective: The purpose of this study is to investigate the differences in patient safety and medication adherence between in-person and remote translation services for adult Hispanic individuals with limited English proficiency in healthcare settings. Methods: The proposed research involves five local …

Environmental Sanitation In Long-Term Care Facilities: A Focus On Regulations And Implementations, Ruwan Dissanayake Dissanayake Mudiyanselage

All Theses

Environmental sanitation is a fundamental component of infection prevention in long-term care facilities (LTCFs), where residents are at increased risk due to advanced age, underlying health conditions, and communal living arrangements. Despite its critical role, significant gaps remain in implementing environmental sanitation procedures and the regulatory frameworks that guide them.

This study combines two components: (1) an across-state regulatory review of environmental sanitation in LTCF regulations and (2) a cross-sectional survey assessing environmental sanitation characteristics of nursing homes (NHs) and assisted living facilities (ALFs) and Rural and Urban LTCF observation study in South Carolina (SC) . For the regulatory review …

Enhancing End-Of-Life Quality In Hospice Care, Gerson Orellana Prudencio

Capstone Projects and Master's Theses

The‍‌‍‍‌ increasing demand for hospice care in Monterey County is a clear indicator of the rapid growth in the need for end-of-life services driven by the aging population. The project was developed at the Department of Hospice of the Central Coast, which is under the Montage Health Foundation, a non-profit organization. The community served consists of elderly people receiving hospice and end-of-life care, as well as volunteers who provide administrative and indirect support. The Volunteer Handbook aims to create a comprehensive procedural manual for hospice volunteers to improve administrative efficiency and ensure the quality of care. Interviews were conducted with …

Evaluation And Identification Of Risk Factors For Stress Among Maquiladora Workers Based On The Mexican Official Standard 035 Survey Tool, Andrea Baca Melendez

Open Access Theses & Dissertations

Background and significance: Occupational psychosocial risk factors are workplace conditions that can trigger physiological, emotional, cognitive, and behavioral changes. They are strongly associated with mental health issues such as anxiety and depression, as well as non-mental health conditions like myocardial infarction, stroke, and occupational injuries. Analyzing these risks from a sociodemographic perspective provides valuable insights for improving work environments and workers’ well-being. Purpose: This study aimed to identify and determine the levels of occupational psychosocial risk factors among workers in a manufacturing company in Cd. Juárez, Chihuahua, and to examine their relationship with sociodemographic variables to inform future interventions in …

Relationships Between Social Determinants Of Health And Pain Outcome Changes After Exercise In Adults With Knee Osteoarthritis, Klarissa Siebert

Open Access Theses & Dissertations

Background: Knee osteoarthritis (KOA) is a common musculoskeletal disease with pain as the primary symptom. KOA pain is a major contributor to disability and reduced quality of life and has been associated with social determinants of health (SDOH) variables. As for treatments of KOA pain, exercise such as stationary cycling is a first-line and recommended treatment. However, limited research has examined how SDOH influence pain outcomes following such interventions. Objective: This study investigated whether income level, education level, employment status, acculturative stress, and perceived ethnic discrimination are associated with changes in pain following a standardized cycling ergometer exercise in adults …

Understanding Hepatitis C Risk And Harm Reduction Needs Among People Who Smoke Drugs: A Client-Centered Qualitative Inquiry, Maxwell Gustin

Anthropology

The spread of Hepatitis C virus (HCV) via non-injectable equipment is plausible, making people who smoke drugs (PWSD) at-risk for possible infection and transmission. While much research has been conducted into injection drug use (IDU), likely due to the rising opioid epidemic, limited studies focus on the risks PWSD face. Currently, state-funded syringe service programs (SSPs) provide harm reduction education and materials to combat these risks. Safer smoking initiatives have been created and are widely used by PWSD, and have access to SSPs. To gain better insight into the HCV and non-HCV-related risks and burdens PWSD face, a qualitative study …

Identifying Barriers For Community Pharmacies As Vaccines For Children (Vfc) Providers In Rural Alabama: Opportunities For Solutions, Myra Bajwa

Honors Theses

Significant Human papillomavirus (HPV) vaccination disparities exist between rural and urban areas in the US. A primary contributor is low access to preventive care in rural areas. Among the most promising strategies to overcome this is increasing access through offering HPV vaccination in non-traditional, convenient health settings such as pharmacies. In rural areas, community pharmacies are trusted, convenient pillars of the community. In Alabama, community pharmacies are eligible for enrollment in the Vaccines for Children (VFC) Program, a federally-funded program that provides free vaccines to children and adolescents under 18 years old who are uninsured, underinsured, American Indian, or Alaska …

Enhancing Crna's Knowledge Of Radiation Safety Through Online Education, Angela Iledan, Madeline Pousson

Doctoral Projects

Although ionizing radiation is frequently used in anesthesia-related procedures, many CRNAs receive minimal training in radiation safety principles and protective measures. This knowledge gap increases the risk of cumulative radiation exposure for providers and patients. To address the issue, this doctoral project developed and implemented an online educational intervention designed to enhance CRNAs’ understanding of radiation safety, ultimately promoting safer practices in radiation-prone environments.

The doctoral project follows a QI and EBP approach that incorporated diverse adult learning styles to enhance engagement and knowledge retention of CRNAs. The online educational module was designed and delivered to CRNAs that currently practice …

Drought, Worry, And Preparing For The Future: The Ethnopsychology Of Climate Distress In Kilifi County, Kenya, Edna Bosire, Syed Wahid, Linda Khakali, Benjamin Oestericher, Felix Agoi, Anthony Ngugi, Rosebella Iseme, Jasmit Shah, Zul Merali, Lukoye Atwoli

Brain and Mind Institute

The impacts of climate change in sub-Saharan Africa (SSA) presents a chronic and intensifying disaster, with drought, flooding, and extreme heat, presenting unique challenges and profound disruptions. Growing evidence links such events to ecological grief, ecological anxiety, and solastalgia – negative affective states that reflects responses to climate change related destruction of nature, species, culturally significant or sacred spaces, and other ways of life. While this literature is expanding in the Global North, little is known about how communities in SSA perceive and respond to deteriorating or depleting natural ecosystems. This article explores the ethnopsychology of distress precipitated by environmental …

A Quantitative Exploration Of Risk And Protective Factors Affecting The Mental Health Of Chitimacha Tribal Youth, Daphnie Vilcan-Tanner

LSU New Orleans Theses and Dissertations

This study examines the relationships between demographics, risk factors, and protective factors with mental distress among Chitimacha Tribal adolescents aged 12 to 18. Using a Positive Youth Development framework, the research aimed to identify the prevalence of mental distress, trauma, discrimination, and protective factors, as well as their collective and individual impacts on mental health. Data were collected through online surveys completed by 73 participants residing on or near the Chitimacha Tribal Reservation. Descriptive statistics and multiple linear regression analyses were conducted to analyze the data. Results revealed that while trauma and discrimination collectively predicted mental distress, family and community …

Tricounty Vaccine Improvement Program (Tc-Vip): Enhancing Vaccine Confidence And Uptake In Rural Utah, Aaron Hunt, Yvette Rea, Annalyz Castro

Outcomes and Impact Quarterly

The Utah State University Extension TriCounty Vaccine Improvement Program addressed low rural vaccination rates across a three-county area through bilingual social media campaigns, health fairs, training in motivational interviewing, and neuromarketing. Evaluation results showed improved skills, broad community reach, and positive participant feedback, demonstrating a replicable model to reduce vaccine hesitancy and strengthen rural health systems.

Determinants Of Utilization Of Skilled Birth Attendant Among Women Of Reproductive Age In Habeswein Ward, Wajir County, Kenya, Suada Hassan

MSc in Advanced Practice Midwifery

Background: Maternal care provided by a skilled birth attendant (SBA) during pregnancy, at delivery, childbirth, and the postpartum period is vital for reducing maternal and neonatal mortality. In sub-Saharan Africa, the overall prevalence of usage of SBA in a 2021 study was 63%. Tanzania recorded the lowest rate at 13.8%, while Kenya registered 89.3% in 2023. However, disparities exist within Kenyan counties, for instance, in Wajir County only 57% of births were assisted by skilled health providers, a disparity that could be due to socio-cultural differences.

Aim: This study aimed to determine the factors influencing the utilization of skilled …

Wildfire Smoke And Public Health: Comparing 2023 Canadian Wildfire Events With Hospital Admissions In Douglas County, Nebraska, Jeremy Poell

Capstone Experience: Master of Public Health

Wildfires are becoming increasingly common in Canada and the United States. Smoke produced from these fires creates a multitude of air pollution constituents that can cause breathing and other health issues for humans, particularly those with asthma and other respiratory conditions. Of these pollutants, PM2.5 (particulate matter that is 2.5 microns or smaller) is particularly problematic as these particles are inhaled deep into lung tissue, where they create inflammation and oxidative stress. Poor air quality can also trigger asthma and respiratory issues, leading to an increase in emergency department admissions for breathing treatments. The goal of this study is to …

Evaluating Knowledge Of Emergency Procedures For Top Hazards Among Hospital Staff, Aisha Zahid

Capstone Experience: Master of Public Health

Hospitals serve as frontline responders during public health emergencies, but the effectiveness of their response relies heavily on staff awareness and engagement with emergency preparedness training. This capstone project assesses hospital staff’s baseline knowledge of procedures for responding to the top emergency hazards. These hazards were selected based on Nebraska Medicine’s biannual Hazard Vulnerability Analysis (HVA), which identifies fire, severe weather events, and winter storms as high-priority risks requiring consistent staff readiness. Despite the existence of emergency procedures and training materials, literature reveals limited data on staff knowledge of these procedures across different hazards. This study, conducted at a large …

The Road To Regulation: A Literature Review Of The Influences On The Updated Silica Standards, Skye M. Medcraft

Capstone Experience: Master of Public Health

Silica is a hazardous compound that poses a risk to human health resulting from dust creating activities across various industries. Several agencies, including OSHA (Occupational Health and Safety Administration) and MSHA (Mine Safety and Health Administration) have adopted regulatory oversight of silica exposure in the workplace. As more research has been conducted on silica exposure, the health effects are becoming better described, which has led to the creation and updating of exposure regulations to protect worker health. The objective of this literature study is to review the data presented to the Department of Labor and discuss how the factors that …

A Literature Review: Back Injuries Affecting Certified Nursing Assistants In Nursing Facilities, Nesta Nsembene-Ntoutoume

Capstone Experience: Master of Public Health

Certified nursing assistants (CNAs) are at a higher risk of back injuries in healthcare, particularly in long-term care settings. This literature review assessed the primary causes of these injuries and the efficacy of current interventions, particularly Safe Patient Handling and Mobility (SPHM) programs. A total of 26 peer-reviewed articles were published between 2014 and 2025, including experimental simulations, cross-sectional and longitudinal studies, quasi-experimental training interventions, and evaluations of SPHM programs. Across the literature, the primary contributors to back injuries included high physical workload, inadequate ergonomic design, limited access to assistive devices, and staff shortage.

Experimental and biomechanical studies have demonstrated …

Infectious Disease Crisis Communication After The Covid-19 Pandemic, Macy Lloyd

Capstone Experience: Master of Public Health

Since the COVID-19 pandemic, the United States has experienced a proliferation of mis- and disinformation, an increasing politicization of health and science, and growing distrust in government, science, and institutions. While these trends present challenges for normal public health communications, during a public health emergency, such as an infectious disease outbreak, these challenges are even more acute. To address challenges at the local level, health departments need plans, products, and tools that adapt health crisis communications to the current media environment and meet community members where they are across the trust continuum. To develop an infectious disease incident communication plan, …

Barriers To Mental Health Access Among Immigrant Populations In The U.S., Cecilia Menzinger

Capstones

No abstract provided.

Deficiencies In Non-Emergency Medical Transportation For Aging Rural Residents Of Iosco County, Michigan, Richard L. Douglass, Donald Stansloski, James Mortimer, Sam Purdy, Dale Evilsizer, Scott Rice

Michigan Journal of Public Health

Introduction: The rural aging population in Michigan struggles to access medical care often available only at significant distances due to limited health system resources and provider shortages. Access to routine care is challenged by lack of non-emergency medical transportation (NEMT). The Iosco County Commission on Aging provides home-delivered meals to eligible county residents. The Rural Health Group investigated the needs of home-delivered meal recipients (aged ≥60 years) for healthcare transportation access. Utilizing data from this investigation, we examined if medical care needs were hindered by problems with transportation in rural Iosco County, Michigan.

Methods: We conducted a cross-sectional survey with …

Fostering Dialogue, Learning, And Reflection: The Role Of Book Discussions For Public Health Professionals, Naomi E. Ervin, Belinda Aberle, Katherine Balint, Lynn Mcdaniels, Paula Tomczak

Michigan Journal of Public Health

Background: The Public Health Nursing (PHN) Section of the Michigan Public Health Association (MPHA) works to improve public health and public health nursing practice in Michigan. In 2021, the PHN Section initiated virtual book discussions to engage public health professionals in meaningful discussion about topics of critical importance to public health and public health nursing; provide continuing education contact hours; and recruit new section members. Methods: The discussions are conducted virtually four times per year. A moderator introduces each book and leads the one-hour discussion. As an added incentive to read the books, the PHN Section sends a limited number …

Associations Between Food Insecurity And Gpa Among Full-Time California State University Undergraduates During Covid-19: The Impact Of Mental Health, Lindsey Jones

Master's Theses

Food insecurity is a persistent public health concern among college students that has been associated with student’s academic and mental health outcomes. This thesis examined the associations between food insecurity, academic performance (measured by GPA) and mental health (using Kessler 6 psychological distress and self-perceived mental health impacts on academic performance), among full-time undergraduate students within the California State University (CSU) system. Cross-sectional analyses were conducted using data from the Spring 2021 CSU National College Health Assessment, administered across all 23 campuses. Of the 20,167 respondents, 12,899 students were included in the analytical sample. Bivariate analyses were conducted to analyze …

Healthcare Professionals’ Awareness Of And Barriers To Shared-Clinical-Decision-Making For Hpv Vaccination Among Adults 27–45 Years, Manali Desai, Shreela V Sharma, Joel Fokom Domgue, Onyema Chido-Amajuoyi, Robert Yu, Wenyaw Chan, Charles Darkoh, Sanjay Shete

Faculty, Staff and Student Publications

The Advisory Committee on Immunization Practices recommends human papillomavirus (HPV) vaccination for inadequately vaccinated adults aged 27–45 based on shared clinical decision-making (SCDM). However, little is known about awareness and barriers to SCDM among US healthcare providers (HCPs), especially in Texas, where HPV vaccination rates are below the national average. Between January and April 2021, we conducted a population-based cross-sectional survey (12% response rate) of HCPs licensed in Texas to assess the prevalence and factors associated with awareness of the SCDM recommendation. HCPs were asked if they were aware and if they foresaw any barriers in implementing SCDM for HPV …