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A Comparative Analysis Of Women’S Health In Latin America And The United States: Geographical Context And Preventative Actions, Holly J. Robinson

Honors Program: Senior Projects (Public)

Cervical cancer, breast cancer, sexually transmitted infections (STIs), pregnancy complications, and gender-based violence are dangers faced by women everywhere. However, the severity of these risks can increase significantly due to a country’s geography, government control, and level of development. This thesis expands upon information gained directly from on-site experiences with medical professionals and locals (including doctors, nurses, nutritionists, and patients) in Peru, Ecuador, and Costa Rica, and further research to look at Latin America as a whole, in relation to the United States. Both the US and Latin America exhibit problems with their healthcare systems. The United States is more …

Scoping Literature Review: The Role Of Leptin In Autism Spectrum Disorder (Asd) And Associated Obesity, Diana B. Riestra, Andrea Iannuzzelli

Rowan-Virtua Research Day

Overweight and obesity (OW/OB) are significant concerns among individuals with Autism Spectrum Disorder (ASD), yet the underlying causes remain unclear. Emerging evidence points to metabolic and hormonal factors—particularly leptin, a hormone involved in appetite regulation—as potential contributors. This scoping review examined five key studies from 2003 to 2024 that investigated the relationship between leptin and ASD in overweight populations. Across studies, individuals with ASD consistently exhibited elevated leptin levels compared to controls. While some findings also noted changes in other adipokines, such as lower resistin or progranulin, leptin was the most consistently dysregulated. These patterns suggest systemic alterations in energy …

Promoting Safe Firearm Storage Through Media-Based Interventions, Abigail Bordelon

Health, Human Performance and Recreation Undergraduate Honors Theses

Given the ongoing phenomenon of unintentional pediatric firearm deaths, this project seeks to examine how the mainstream media reports on these events and how media frames could be altered to better promote public health prevention efforts.

The Relationship Of Peer Recovery Support Specialists And Recovery Of Perinatal Women With A Substance Use Disorder, Mary C. Talbot

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: Substance use in pregnant and postpartum women is a growing issue in the United States. Drug use while pregnant can lead to birth defects, stillbirths, and problems providing positive parenting to their children. Many women with substance use disorders (SUD) feel extreme shame and stigma related to their substance use and have trouble accessing recovery-related treatment and other services. Peer recovery support treatment uses the lived experiences of individuals in current recovery from SUD to facilitate and support recovery in others. Purpose: The purpose of this review was to evaluate the impact of peer recovery support specialists on the …

Analysis Of Marshallese Perceptions Of Health And Weight In Adolescents, Sterling Thomas

Health, Human Performance and Recreation Undergraduate Honors Theses

Purpose: The purpose of the research is to understand the perceptions of Marshallese adolescents on the topic of health and weight, in order to provide guidance for interventions and public health efforts. The United States has the largest Marshallese population outside the Marshall Islands. Perceptions of weight and health is under researched for minority communities and from the insight of adolescents. Pacific Islanders such as the Marshallese are often categorized as part of the larger Asian American ethnic population, which is not always accurate in certain aspects where public health could provide support areas of concern.

Design: Focus groups …

The Effect Of Maternal Anxiety On Breastfeeding Exclusivity And Duration, Zoe E. Treat

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: The postpartum period, especially during the first year, presents a heightened risk for maternal anxiety. Research suggests a potential negative relationship between maternal anxiety and breastfeeding duration, though there is currently a gap in the existing literature regarding how maternal mental health impacts breastfeeding outcomes.

Purpose: This study seeks to investigate the influence of postpartum anxiety on both the duration and exclusivity of breastfeeding, crucial knowledge required to support and implement targeted interventions. We expected that maternal anxiety would predict shorter exclusive and total breastfeeding durations.

Methodology: To explore the relationship between postpartum anxiety and breastfeeding behaviors, we distributed …

Risk Communication And Public Health Emergency Responses During Covid-19 Pandemic In Rural Communities In Kenya: A Cross-Sectional Study, Wilberforce Cholo, Fletcher J. Njororai, Walter Ogutu Amulla, Caleb Kogutu Nyaranga

Population Health Leadership and Analytics Faculty Publications and Presentations

Background: The COVID-19 pandemic highlighted the crucial role of community preventive behaviors in controlling the virus’ spread. Studies show that people’s risk perceptions and awareness significantly contribute to the containment and prevention of infections by motivating adoption of desired actions and behaviors. This study aimed at assessing the role of risk communication and factors that influenced responses during the COVID-19 pandemic in rural communities in Western Kenya. Methods: A descriptive cross-sectional study was conducted using a quantitative research approach, collecting data from 806 individuals across Kisumu, Vihiga, and Kakamega counties. Descriptive statistics were used to detail the demographic characteristics of …

Euroqol Data For Assessment Of Population Health Needs And Instrument Evaluation (Eq-Daphnie): A Study For Enhancing Population Health Assessment, Jeffrey A. Johnson, Mathieu F. Janssen, Fatima Al Sayah, Henry Bailey, Mihir Gandhi, Dominik Golicki, Nils Gutacker, Erica I. Lubetkin, Brendan Mulhern, Fredrick Dermawan Purba, Juan M. Ramos‑Goñi, Desiree Scott, Hilary Short, Trudy Sullivan, Rosalie Viney, Zhihao Yang, Victor Zárate

Publications and Research

Background

Methods for collecting self-reported health status measures in population health surveys vary significantly across countries, presenting challenges to comparability. The EuroQol Data for Assessment of Population Health Needs and Instrument Evaluation (EQ-DAPHNIE) project aims to address this issue by developing infrastructure to generate representative datasets across multiple countries. This initiative aims to standardize data collection methodologies and to evaluate the performance of various health status measures, providing a foundation for reliable population health assessments. This paper describes the rationale, design and data collection methods for the EQ-DAPHNIE project.

Methods/design

EQ-DAPHNIE employs a cross-sectional online survey design targeting the general …

Community Voices, Climate Action Choices: Working Towards A Resilient Monterey County, Lesley A. Solano Alonso

Capstone Projects and Master's Theses

Vulnerable communities in Monterey County face disproportionate environmental and health impacts due to climate change, yet many residents remain unaware of the tools and resources available to support local action. This capstone project was implemented in partnership with Ecology Action (EA) and the Resilient Central Coast (RCC) campaign to increase awareness and engagement with the RCC platform. Serving diverse communities across Monterey County, the project included bilingual outreach efforts, community tabling, educational presentations, and a climate action survey. Over 650 residents were engaged directly, resulting in 99 new household sign-ups on the RCC website, a major milestone for the agency. …

Assessing And Addressing The Needs Of Socially Vulnerable Populations To Enhance Community Emergency Preparedness And Resilience: A Mixed Methods Study, Jennifer E. Harris

Dissertations: Doctor of Public Health

Background: A robust understanding of the needs of individuals and communities can help reduce the impact of a disaster, especially on those communities that already have associated health disparities. By strategically including these populations into mitigation, preparedness, response, and recovery planning, emergency management plans can be enhanced to be more inclusive and effective by identifying targeted resources during a crisis. Additionally, understanding and improving upon individual resiliency can potentially bolster a community’s resiliency level and reduce overall susceptibility to a disaster event, and expedite the recovery phase. Purpose: The purpose of this study is to assess the emergency …

On Death And Disease: How Physicians’ Perspectives Compare Across Specialties Through Written Work, Stephanie Anne C. Alkonga

Honors Capstones

Narrative medicine is a tool that the medical field is increasingly utilizing to cultivate patient-centered and culturally competent doctors and to reflect on lived experiences through texts that focus on psychosocial best practices. This study aims to examine the language used in physician-written works that address how physicians in different medical specialties treat the aging and the terminally ill, and how they view the deceased. Qualitative data guided by thematic questions will primarily be used in the analysis and comparison of these texts’ tone, rhetoric, diction, and similar literary devices to uncover if certain patterns arise across such specialties. Findings …

Local Systems Change: Applied Research Methods For Sustainable Communities, Taylor Barrett Hill

Graduate Student Portfolios, Professional Papers, and Capstone Projects

No abstract provided.

To Heal A Mind: A Comparison Of Functional And Conventional Treatments In Major Depressive Disorder, Gillian Chambers

Senior Honors Theses

Incidence of major depressive disorder is increasing year over year, with little able to be done to halt the spread of the condition. However, there are many treatment possibilities considered unconventional by the healthcare system. This thesis examines the respective benefits and risks, in comparison to one another, between conventional pharmacological treatment and functional, holistic treatment of depression. This was done via integrative review of available clinical literature, synthesizing evidence on both conventional and functional treatments for depression, as dictated by Whittemore and Knafl (2005). Exploratory search methods revealed 758 records fulfilling inclusion criteria, which were screened and narrowed down …

Highly Pathogenic Avian Influenza Outbreak Preparedness In The United States: A Scoping Review, Emma J. Gurley

Honors Theses

In order to gauge preparedness for an outbreak of highly pathogenic avian influenza (H5N1) in the United States, a scoping review of the current literature was conducted. This process involved (1) identifying the research question, (2) identifying studies relevant to the topic, (3) selecting studies for inclusion (4) charting the data, and (5) analyzing and reporting the final data. Ultimately, seventeen studies were deemed appropriate for examination within this scoping review and several key themes were identified. The results emphasize the importance of adopting a One Health approach, the key role that vaccination may well play in preventing the spread …

“Re-Storying” Anne Shirley And The Adhd Child: A Crip Genealogy Of Anne Of Green Gables, Darian Aleyna Wilson

Department of English: Dissertations, Theses, and Student Research

This thesis explores the contested nature of Attention Deficit Hyperactivity Disorder (ADHD), focusing on its cultural and historical constructions. While ADHD has been included in the Diagnostic and Statistical Manual of Mental Disorders since 1980, its legitimacy remains a subject of debate across medical, disability studies, and historical scholarship. Using Eli Clare’s critique of diagnosis as a tool rather than a fact, this project examines how ADHD is both pathologized and re-storied within societal and medical discourses. It highlights the tension between medical classifications and lived experiences of those diagnosed with ADHD, particularly in the context of girlhood.

The central …

The Impact Of Stigma On Individuals Affected By Leprosy: A Pilot Study, Mardo Tarr

Capstone Experience: Master of Public Health

Background: Leprosy, while a treatable condition, continues to be associated with significant stigma, which adversely influences the physical, psychological, social, and economic well-being of affected individuals throughout their lives. The stigma linked to leprosy leads to social exclusion, mental health difficulties, and obstacles to accessing healthcare and employment opportunities (Brakel et al., 2019; Sermrittirong & Van Brakel, 2014). This research employs Life Course Theory to describe the long-term experiences of stigma, coping strategies, and social support individuals living with leprosy. By synthesizing findings from existing literature and conducting a qualitative interview, the study offers an in-depth understanding of how various …

Severe Acute Malnutrtion Among Children Under Five In South Sudan, Rhoda Elia Iburu Kenyi

Capstone Experience: Master of Public Health

Severe acute malnutrition (SAM) is a life-threatening condition characterized by severe wasting. The World Health Organization defines SAM as a low weight-for-height Z-score (WHZ) less than -3 standard deviation (SD) from the median growth standard or the presence of edema of both feet and/or mid-upper arm circumference (MUAC) less than 115mm. SAM is a significant public health concern affecting children under five in developing countries, with South Sudan being one of the most severely affected regions. Persistent food insecurity, weak healthcare systems, and ongoing conflict contribute to the high SAM prevalence in the region, where political, religious, and social divisions, …

An Exploration Of Substance Abuse By Healthcare Workers During The Covid-19 Pandemic: A Scoping Review, Andrew Hills

Capstone Experience: Master of Public Health

Objective

This scoping review aims to identify available literature and research on substance abuse by healthcare workers (HCWs) during the COVID-19 pandemic to examine whether the stress of their duties during the pandemic exacerbated existing issues of substance abuse.

Methods

A literature search using PubMed and Google Scholar using Harzing Publish or Perish identified 100 relevant professionally-authored, peer-reviewed, English-language academic articles published between 2015 and 2025 on substance abuse by HCWs. Exclusions were done via a review of the abstract and then from the full text, reducing the number of articles to three from those three articles which generated an …

The Association Between Economic Outcomes And Abortion: A Scoping Review, Larisa Nicole Stephenson

Capstone Experience: Master of Public Health

Background: Abortion access is not just an issue of autonomy, but an economic issue as well. Evidence of the intersectionality of abortion health care and economics has endured due to the financial cascading effects a denial of an abortion, or the inability to access an abortion, has on one’s personal, professional, and economic upward mobility. A change in recent policies impacting access to abortion warrants an updated synthesis examining the relationships between economic outcomes and abortion access for people of reproductive age in the United States (U.S.).

Aim: This scoping review summarizes evidence pertaining to the association …

Focus Group Study Of Racial Disparities And The Effects Of Parental Marijuana Use On Youth Marijuana Use, Avina K. Mahroke

Capstone Experience: Master of Public Health

Marijuana has become one of the most used drugs in the United States. There has been an increase in use among both adults and youth during the past several years. Public health interventions are needed to address marijuana use because of its detrimental effects on youth well-being. Research shows that marijuana can lead to problems with memory, learning, attention, and even depression among youth. Furthermore, marijuana exposure in-utero can lead to developmental issues and problems with other organs such as the lungs. Youth are influenced to start using drugs, like marijuana, for numerous reasons, and parents are one of those …

Exercise As An Intervention For Postpartum Depression (Ppd), Kylie P. Mistretta

Honors Scholar Theses

Objective: To illustrate the applications of exercise for preventing the development of postpartum depression (PPD) and addressing associated risk factors identified in the literature. Data Sources: PubMed and EBSCO: Academic Search Premier were accessed using the search terms exercise OR physical activity OR yoga AND postpartum depression OR postnatal depression. A secondary search of PubMed was conducted using the search terms exercise AND pregnancy AND depression OR gestational diabetes OR weight gain OR sleep quality.

Study Selection: Studies selected for inclusion were peer-reviewed, published after January 2012, written in English, and relevant to the PPD risk factors examined. Only clinical …

Health And Community Resource Book, Gabriela Gonzalez

Electronic Theses, Projects, and Dissertations

ABSTRACT

The High Desert Health and Resource Guide offers an in-dept exploration of the challenges and resources available to support the high desert communities, particularly to include cities of Apple Valley, Phelan and Victorville. These communities are composed of low-income households, and they face significant health disparities and food insecurity. Factors such as limited access to healthcare, mental health services, homeless shelters, and limited availability of health food choices. Additionally, many cities in the region are affected by food deserts, which further hinder resident’s ability to access nutritious, wholesome food. The resource guidebook highlights both the challenges and issues that …

Assessing The Relationship Between The Incidence Of Campylobacteriosis And Ecological Risk Factors In Tennessee, Emmanuel Angmorteh Mensah

Electronic Theses and Dissertations

Background: Campylobacteriosis although is the leading causes of bacterial diarrheal illnesses, have not gained prominent awareness and there are gaps in the understanding of transmission routes for sporadic, non-outbreak cases and their risk factors at the communal level to humans. This study, therefore, aimed to identify the campylobacteriosis risk factors and risk perception from the existing literature in the United States, determine the incidence and ecological risk factors for campylobacteriosis zip code level in Tennessee, and to perform spatiotemporal analysis of campylobacteriosis incidence cases in Tennessee.

Method: To achieve the first aim, a scoping review was conducted to synthesize …

The Impact Of Emdr Therapy On Past Suicidal Ideation: Lived Experiences Of Young Adults, Lindsey Faehnrich

Undergraduate Honors Theses

This study explores the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy in reducing suicidal ideation and improving mental health outcomes among college-attending young adults (ages 18–24) with a history of trauma. EMDR is a body-based psychotherapy designed to alleviate distressing thoughts and trauma. It gained attention for its positive impact on PTSD and has more recently been applied to other mental health disorders. The literature review highlights risk factors including trauma, mental health disorders, suicidal ideation, and EMDR. The methods detail a phenomenological approach, interviewing four young adults who underwent EMDR and experienced past suicidal ideation. This provided …

Evaluating The Impact Of Community Gardens On Social Equity And Public Health: A Case Study Of Caramel Connections Foundation's (Ccf) Seeds Of Joy Community Garden, Elizabeth Pinder

Electronic Theses, Projects, and Dissertations

Community gardens have been increasingly recognized as effective public health interventions that address food insecurity, foster social cohesion, and promote environmental sustainability. This evaluation examines the impact of the Caramel Connections Foundation (CCF) Seeds of Joy Community Garden in Ontario, California, by assessing its effectiveness in advancing social equity, improving public health outcomes, and fostering community engagement. Using an evaluation framework, this study measures key program outcomes, including improvements in community well-being, inclusivity, and access to green spaces.

A mixed-methods evaluation design was applied, incorporating process and impact evaluation methodologies. Secondary data collected from CCF’s existing program records, survey responses, …

Investigating The Suitability Of Dichotomous Responses For The Water Insecurity Experiences (Wise) Scales Using Nationally Representative Data From 39 Countries, Indira Bose, Joshua D. Miller, Hilary J. Bethancourt, Olga P. García, Hugo R. Melgar-Quiñonez, Rosana Salles-Costa, Mauro E. Delgrossi, Scott M. Miller, Tessa L. Durham, Teresa Shamah-Levy, Pablo Gaitán-Rossi, Sera L. Young, Edward A. Frongillo Jr. Ph.D.

Faculty Publications

The Water Insecurity Experiences (WISE) Scales have been validated to comparably measure water insecurity globally. The scales consist of 12 items that can be administered in approximately 3 minutes. There is interest in developing more rapid versions of the tools for when time is limited. One alternative is to use a subset of 4 items, which has been validated, but has some drawbacks. Here we investigate another alternative: dichotomous (yes/no) response options instead of the original four levels of frequency-based (polytomous) responses. We used nationally representative data from 39 countries to simulate dichotomized responses by collapsing the four levels of …

The Influence Of Scientific, Genetic, And Health Literacy On Carrier Screening Decision-Making, Brenna D. Albracht

Dissertations and Theses (Open Access)

For those wishing to assess their reproductive risks and make informed decisions in their reproductive planning, carrier screening for autosomal recessive and X-linked conditions, as well as cell-free DNA (cfDNA) screening for aneuploidy, are recommended during pregnancy. Despite similarities in purpose, sample requirements, insurance coverage, and safety, a lower percentage of individuals elect carrier screening than cfDNA screening, suggesting there may be a disconnect in what patients perceive as valuable information for their pregnancy. Previous studies have attempted to explain the factors associated with carrier screening uptake or decline; however, no models have yet accounted for a patient’s literacy level …

Survival In Patients With Rheumatoid Arthritis And Recently Diagnosed Early-Stage Colorectal, Lung, Or Prostate Cancer Receiving Tumour Necrosis Factor Inhibitors: A Retrospective Cohort Study, Juan I Ruiz, Xiudong Lei, Sharon H Giordano, Hui Zhao, Suja S Rajan, Heather Lin, Maria E Suarez-Almazor

Faculty, Staff and Student Publications

Background: Tumor necrosis factor (TNF) inhibitors could impair tumoural immunity in patients with rheumatoid arthritis and cancer. We aimed to investigate the association between survival and TNF inhibitor treatment during the first 3 years after a diagnosis of colorectal, lung, or prostate cancer in patients with rheumatoid arthritis.

Methods: In this cohort study, we conducted a secondary data analysis of the Surveillance, Epidemiology, and End Results Medicare-linked dataset. We included patients aged 66 years and older with rheumatoid arthritis diagnosed with colorectal, lung, or prostate cancer between Jan 1, 2008, and Dec 31, 2019, using ICD-O-3 site and histology codes. …

An Updated Systematic Review And Consensus Definitions For Standardised Endpoints In Perioperative Medicine: Patient Comfort And Pain Relief, Paul S Myles, Sophie Wallace, Oliver Boney, Mari Botti, Frances Chung, Allan M Cyna, Tong J Gan, Michael P W Grocott, Mark P Jensen, Henrik Kehlet, Andrea Kurz, Maxime Leger, Ulrica Nilsson, Phillip Peyton, Daniel I Sessler, Martin R Tramèr, Christopher L Wu, Alfred Health Patient Experience And Consumer Engagement Group

Faculty, Staff and Student Publications

Background: Improving comfort during and after surgery is a key concern for anaesthetists and other clinicians. With the inclusion of patient and public involvement, we undertook a Delphi consensus process to update previously recommended endpoints to be used in clinical trials evaluating treatments aiming to improve patient comfort after surgery.

Methods: We undertook a systematic review to identify domains and outcome measures of patient comfort used in perioperative studies. Focus groups, workshops, and a multi-round Delphi consensus process that included clinician-researchers and a patient experience and consumer group updated a recommended list of standardised endpoints focused on patient comfort. Consensus …

Associations Between The Timing Of 24 H Physical Activity And Diabetes Mellitus: Results From A Nationally Representative Sample Of The Us Population, Qian Xiao, Qiuyu Feng, Martin K Rutter, Gali Albalak, Heming Wang, Raymond Noordam

Faculty, Staff and Student Publications

Aims/hypothesis: Growing evidence suggests that timing may be an important aspect of physical activity that influences cardiometabolic health. However, the current literature is inconclusive regarding the time of day that physical activity offers the greatest metabolic advantages. We investigated associations between hourly physical activity levels and diabetes mellitus and glycaemic biomarkers in a cross-sectional and nationally representative sample of US adults.

Methods: We studied 7074 adults (mean age 48 years; 52% women) from the National Health and Nutrition Examination Survey (2011-2014). Physical activity was measured by actigraphy. A monitor-independent movement summary (MIMS) unit was used to derive the total activity …