Digital Commons Network^™

Mapping Youth Sexual And Reproductive Health Services In Orleans Parish, Louisiana: A Field-Tested Survey Methodology, Isabelle Jouve, Ryann Martinek, Zoey Ponder, Isabel Arce, Ryley White

Journal of the Louisiana Public Health Association

Background: Fragmented access to sexual and reproductive health (SRH) services is driving a sexual health crisis among the youth population in Orleans Parish, Louisiana. Rates of sexually transmitted infections, HIV, and teen pregnancy continue to rise while SRH education offerings decline. In response to these outcomes, a Sexual Health, Education, and Rights (SHER) Lab team presents a field-tested survey methodology to characterize the landscape of youth-accessible SRH service providers. Methods: In May 2025, the SHER Lab launched an SRH landscape assessment project to survey youth-serving organizations in Orleans Parish, Louisiana. The project team collected comprehensive feedback from community stakeholders to …

Using The Socio-Ecological Model To Explore Parents' Resilience And Perceptions Of Adverse Childhood Experiences: A Qualitative Study In The Southeastern United States, Maribel G Dominguez, Christine Markham, Andrew E Springer, Louis D Brown

Faculty, Staff and Student Publications

Background: The negative impact of adverse childhood experiences (ACEs) on child development is documented. The parent-child relationship protects against ACEs and improves healthy child development, playing a crucial role in preventing and mitigating ACEs by strengthening parental resilience. However, there is a gap in the literature on our understanding of parental resilience's impact on the parent-child relationship within the social-ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels). Objective: This study explores parents' perspectives on parental resilience as a protective factor for preventing and mitigating ACEs at every level of the SEM. Method: This study uses a thematic …

Determinants Of Pre-Exposure Prophylaxis Medication Use Among People Aged 18–29 Years Living In Florida, Jeremiah Magraubin Mchaka Wandabwa

Walden Dissertations and Doctoral Studies

No abstract provided.

Beyond Crisis: Patient Access And Sustainability, Miguel A. Mendoza

Doctoral Dissertations and Projects

Critical systems underwent drastic workflow adaptations during the COVID-19 pandemic. Many of these operational alterations persist today, while others have been reduced or eliminated. This is a qualitative study on the operational, technological, and human-centered challenges experienced by healthcare organizations providing primary care services in Southwest Ohio during and immediately after the pandemic. This flexible research design implements in-depth, semi-structured interviews with healthcare professionals leading primary care operations to capture a longitudinal perspective on pandemic-era service delivery, and the legacy systems still in place today. Thematic analysis revealed seven themes that determine the effectiveness of care delivery models. Social Determinants …

Inadequate Access To Healthcare In Low-Income Hispanic Communities In Brooklyn, Joanna Marie Garcia

Doctoral Dissertations and Projects

The purpose of this qualitative research was to understand healthcare disparities using the Solar and Irwin conceptual framework and to shed light on healthcare disparities as the reason low-income Hispanic patients, male and female, from the ages of 20-90 in Brooklyn, New York, received inadequate access to healthcare. Healthcare disparities represented a critical issue in providing adequate patient care for adult Hispanic patients within the United States healthcare system. Research into healthcare disparities has been conducted; however, detailed information about the causes of the disparities was lacking, especially concerning inadequate access to healthcare in low-income Hispanic communities. This qualitative research …

Exploring The Impact Of Cultural Beliefs On Death Anxiety: A Qualitative Study To Inform Healthcare Education And Practices, Sharon Sonnilal

Doctoral Dissertations and Projects

A hermeneutic phenomenological approach framed this qualitative study, examining how cultural beliefs, spiritual traditions, and relational contexts shape death anxiety and meaning-making among adults from diverse backgrounds. Terror Management Theory and Culturally Sensitive Grief Treatment guided the conceptualization of death anxiety as a culturally mediated and relational phenomenon rather than an isolated psychological response. A purposive sample of 13 adults aged 18 and older represented diverse cultural, racial, gender, and spiritual identities. Recruitment occurred via Instagram, and participants completed an open-ended demographic and narrative survey. Participants who provided rich survey narratives received invitations to complete semi-structured Zoom interviews to deepen …

Cognitive Behavioral Therapy-Based Psychosocial Interventions To Reduce Anxiety After Social Isolation In Adolescent Females, Bailey E. Noble

InnovateHER Meeting 2026

• COVID-19 social isolation linked with higher anxiety risk in adolescents, especially females
• Review examined whether CBT-based psychosocial interventions reduce anxiety after pandemic-related loneliness/social isolation
• Across 6 studies, remote and internet-delivered CBT linked with anxiety improvement 
• Strongest outcomes seen with therapist-assisted CBT
• Common barriers: privacy, motivation, scheduling, and digital access
• Nursing relevance: early screening, referral, and support for treatment participation

Health-Seeking Behaviors Of Ethiopian Women In The United States: A Pilot Qualitative Study, Hanna Belay, Felicia Leammuda, Ahmed Ugbad, Beamlak Kebede

InnovateHER Meeting 2026

This study explores how Ethiopian immigrant women understand health and navigate healthcare in the United States. Using qualitative interviews with two participants, findings show that health is viewed holistically, with strong reliance on traditional remedies. Participants engage with the U.S. healthcare system selectively, often seeking care only when symptoms become severe. Barriers such as system complexity, fear, and time delays influence healthcare decisions.

Advancing Exclusive Breastfeeding Through Prenatal Education, Emr Optimization, And Community Partnership: A Champs National Quality Improvement Initiative, Heather Klein, Hannah Koepp

InnovateHER Meeting 2026

CHAMPS National is a CDC-funded quality improvement initiative focused on improving exclusive breastfeeding rates, strengthening maternity care practices, and reducing racial disparities. This project implemented culturally responsive prenatal education, optimized EMR workflows, and strengthened community partnerships to support informed infant feeding decisions and improve breastfeeding equity.

Global Health Financing Of Diagonal Interventions: Building Resilient And Sustainable Health Systems In Sub-Saharan Africa, Lucy Kim

Master in Public Policy Theses

Background: Global health financing has historically prioritized disease-specific “vertical” programs over broader “horizontal” strengthening of general health systems. Vertical programs in HIV have led to unprecedented reductions in mortality worldwide, but HIV remains a significant public health threat in sub-Saharan Africa, where vertical strategies have long been criticized for creating fragmented health systems. In response, global health strategies have shifted towards combining vertical investments with broader horizontal activities, commonly referred to as “diagonal” programming. While evidence suggests that diagonal programming has the potential to create more resilient and sustainable health systems, evaluating its value for money is challenging due to …

Measuring Treatment Burden With The Treatment Burden Questionnaire (Tbq): A Narrative Literature Review And Implications For Geriatric Research And Clinical Practice, Jennifer Li-Wang, Sophia Hernandez, Sahana Ramasamy, Lawrence Qu, Jack Banks, Rafael Samper-Ternent, Holly Holmes, Aanand Naik, Dana Giza

Faculty, Staff and Student Publications

Background: Treatment burden refers to the demands that healthcare places on a patient's daily life, including managing appointments, medications, and lifestyle adjustments. It is a critical concern for older adults, particularly those with multiple chronic conditions. High treatment burden has been associated with poorer treatment adherence, increased disruptions in care, and diminished quality of care. The Treatment Burden Questionnaire (TBQ) is a validated tool that has been successfully used to measure treatment burden in a variety of geographic, clinical, and research settings.

Methods: We conducted a narrative literature review to identify studies that have applied the TBQ in older adult …

Tiktok And The Brain: Neuropsychological Correlates Of Short-Form Video Consumption, Caty Enders

Psychology ETDs

Short-form video platforms like TikTok have quickly become the fastest growing segment of social media, thanks to powerful algorithms serving up personalized content driven by large quantities of user data. This study investigates the neuropsychological correlates of digital media use, with a particular focus on TikTok and smartphone screen time among young adults. Combining correlational analyses and an experimental design (n = 49; n = 44 included in final sample), we examined the relationship between digital media use and cognitive and emotional functioning across multiple domains. Objective measures of digital media consumption (daily average screen time and time on TikTok) …

From Cranes To Clinics: Genomic Epidemiology At The Human-Animal Interface, Sarah Shrum

Biology ETDs

Emerging infectious diseases represent a significant, increasing threat to human life, economic stability, and global security. The One Health framework, which promotes human health and wellness through the understanding that animal, environmental, and human health are interwoven, is critical to understanding pathogen emergence and transmission. This is underscored by the fact that roughly 60% of all human pathogens and 75% of emerging infectious disease are zoonotic, meaning they are transmitted from animals to humans.

The work presented in this dissertation integrates genomic epidemiology, ecological analysis, and One Health Surveillance approaches to characterize cross-species circulation of opportunistic yeast pathogens (Candida …

“There Was Nothing Left To Give”: Experiences Of Compassion Fatigue Among Former In-Patient Psychiatric Clinicians, Katie Ladner

Counseling and Psychology Dissertations

Compassion Fatigue (CF) is a state of emotional and physical exhaustion resulting from prolonged exposure to stressful or traumatic experiences, specifically among healthcare workers, and it negatively impacts their ability to provide care to their patients and perform their jobs effectively (Singh et al., 2020). The purpose of this qualitative study is to explore the lived experiences of compassion fatigue in mental health clinicians who previously worked in in-patient psychiatric hospitals and their subsequent resignations. This phenomenological research explored participants' understanding and descriptions of their CF experiences in their roles within psychiatric hospitals and how CF contributed to their leaving …

Exploring Direct Support Professionals' (Dsps) Attitudes Regarding Trauma Informed Care And Its Impact On Turnover Intention, Lorraine D'Sylva-Lee

Seton Hall University Dissertations and Theses (ETDs)

The relationship between Direct Support Professionals’ (DSPs’) attitudes toward trauma-informed care (TIC) and their turnover intention has remained empirically untested, despite DSPs’ exposure to primary and secondary trauma. An estimated 8.38 million Americans with intellectual and developmental disabilities (IDD) depend on this workforce, yet 2024 turnover rates reach 53.7%. This convergent mixed methods study examined TIC attitudes, turnover intention, and their relationship among 109 DSPs in IDD provider agencies in New Jersey. Grounded in the Theory of Planned Behavior (TPB), the cross-sectional design used the ARTIC-10, TIS-6, and two open-ended items. DSPs with more favorable TIC attitudes were significantly less …

Unknowing Sacrifices: Public Health And Radiation Illness In New Mexico And Nevada, 1940s-1960s, Beatriz Avila-Marquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

The detonation of the first atomic bomb in the early morning of July 16, 1945, in New Mexico welcomed the atomic age that forever changed the world. After that day, thousands of lives were lost due to nuclear weapons, and hundreds of thousands more continued to suffer from the effects of atomic testing. The Atomic Energy Commission, fueled by the arms race of the Cold War, chose Nevada to continue the United States’ nuclear weapons testing. Knowledge of the dangers of radiation exposure, the effects of radiation, and techniques to prevent exposure are now available in part due to the …

Establishing A Comprehensive Framework For Sfrt Lattice Treatments: Optimization, Planning, And Clinical Evaluation, Gregory M. Gill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Spatially fractionated radiation therapy (SFRT) using lattice radiotherapy (LRT) has emerged as a promising treatment technique for bulky, nonresectable tumors by delivering spatially heterogeneous dose distributions consisting of high-dose vertices embedded within lower-dose regions. Although early clinical experiences have demonstrated potential therapeutic benefit, widespread clinical implementation of LRT remains limited due to the absence of standardized treatment planning workflows, consistent optimization strategies, and clearly defined evaluation metrics for heterogeneous dose distributions. The objective of this study is to develop and evaluate a structured framework to support efficient, reproducible, and safe clinical implementation of LRT.

To address these challenges, a comprehensive …

Proceedings Of The 18th Indonesian Occupational Medicine Update (Iomu) 2026 - Occupational Medicine Without Borders: Emerging Risks, Evolving Workforces, And Inclusive Collaboration, Indonesian Association Of Occupational Medicine Specialists (Perhimpunan Kedokteran Okupasi Indonesia / Perdoki)

Occupational and Environmental Medicine Journal of Indonesia

This Supplemental Issue of the Occupational and Environmental Medicine Journal of Indonesia (OEMJI) compiles the scientific abstracts presented at the 18th Indonesian Occupational Medicine Update (IOMU) 2026, convened in Surabaya, Indonesia, from 15 to 17 May 2026. The IOMU has matured into the most prominent annual scientific platform of the Indonesian occupational medicine community, hosted by the Indonesian Association of Occupational Medicine Specialists (Perhimpunan Kedokteran Okupasi Indonesia / PERDOKI). Since its inception, the conference has served as a meeting point where clinicians, academics, industrial hygienists, regulators, employers, and worker representatives gather to translate emerging scientific evidence into …

Developing A Health Education Program For Adults Reentering The Community After Incarceration, Tiffany Ayame Kinugawa-Larsen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Justice-impacted adults often experience challenges in confidently managing their health due to limited autonomy, disrupted health routines, and limited access to health education during incarceration. Studies have shown that incarcerated adults have a higher likelihood of developing chronic health issues, yet have limited access to resources that promote health and well-being after release from incarceration. Given that health management falls within the scope of occupational therapy (OT), the profession is positioned to promote health and well-being by applying OT principles that emphasize individualized, holistic care tailored to a justice-impacted population during community reintegration. A 5-week health education program grounded in …

Effect Of The Sava Syndemic On Hiv Viral Suppression Among People Living With Hiv In The United States: A Scoping Review And Meta-Analysis, Jacquelyn Rodriguez

UNLV Theses, Dissertations, Professional Papers, and Capstones

The SAVA syndemic highlights the interconnected and mutually reinforcing nature of substance use, violence victimization, and HIV/AIDS. The synergistic interaction of these conditions creates structural and behavioral barriers that disrupt the HIV care continuum and contribute to significant health inequities. Achieving a suppressed viral load is a critical clinical outcome for people living with HIV, while viral non-suppression can be an indicator of poor health, elevated transmission risk, and disease progression. Still, the association between SAVA factors and viral suppression/non-suppression outcomes within U.S. populations remains inconsistently characterized due to heterogeneous methodologies and variable inclusion of high-risk groups. This mixed-methods study …

Evaluating An Educational Intervention On Screen-Time And Behavior Change: A Pilot Study, Kayla L. Sweeney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Excessive screen time among adolescents has been associated with negative health outcomes, including sleep disturbances, anxiety, and depression. Despite growing awareness, many parents lack sufficient understanding of these risks and their impact on adolescent well-being. This project evaluated whether a brief educational intervention improved parents’ knowledge of the health effects of excessive screen time. Methods: A pre-and post-survey design was used to assess changes in parents’ understanding following an educational video intervention. The educational intervention consisted of evidence-based content highlighting the impact of screen time on mental health and sleep. The survey measured knowledge, beliefs, behavioral intentions, and strategies …

Healthcare Provider Trust As A Predictor Of Covid-19 Vaccine Hesitancy Among Nevada Residents, Joanna Joseph

UNLV Theses, Dissertations, Professional Papers, and Capstones

Trust in healthcare providers is one of the strongest predictors of vaccine hesitancy in the literature, yet it has not been examined as an independent predictor of COVID-19 vaccine hesitancy in Nevada. Nevada ranks last nationally in healthcare providers per capita and is among the lowest in immunization coverage for both adults and children. The COVID-19 pandemic exacerbated negative vaccine attitudes, and vaccine hesitancy continues to be a central public health issue. Prior Nevada analyses identified vaccine hesitancy across racial, political, educational, and economic groups but did not assess the role of provider trust in vaccine hesitancy. This cross-sectional study …

Evaluation Of Two Bioaerosol Sampling And Analysis Methods For The Collection Of Airborne Bacteria And Viruses, Elizabeth Detrick

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bioaerosols, defined as airborne particles of biological origin, include bacteria, fungi, viruses, and their byproducts. They are ubiquitous in both indoor and outdoor environments and can cause respiratory infections, allergic reactions, and toxin-mediated illnesses. Air sampling plays a vital role in bioaerosol monitoring by enabling the collection and analysis of airborne microorganisms to assess exposure risk and inform mitigation strategies. The objective of this study was to determine the relative collection efficiency of two air samplers, the MD8 Airscan, a filtration sampling method, and the SKC BioSampler, an impingement sampling method. Aerosolization tests were conducted in a controlled test chamber …

Exploring Lifestyle Habits Between Gamers And Non-Gamers: A Survey-Based Approach, Janavi Sathappan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Video gaming is a prevalent and meaningful occupation for a growing number of young adults, yet its relationship to health behaviors is inconsistent and unclear in literature. This cross-sectional survey-based study examined the differences in nutritional pattens, sleep hygiene, and physical activity between self-identified gamers and non-gamers in a sample of young adults aged 18-34. Recruitment occurred primarily through the University of Nevada, Las Vegas and associated networks. Participants were asked to complete the Mini Eating Assessment Tool, Sleep Hygiene Index, and the International Physical Activity- Short Form. Data was analyzed using Mann-Whitney U tests and Pearson’s chi-square tests, and …

Multiple Interest Holder Perspectives Of The True Grit Sci Residential Program: A Mixed Methods Program Evaluation, Keara Mcnair

Seton Hall University Dissertations and Theses (ETDs)

Young adults with spinal cord injury (SCI) face significant challenges during the transition to adulthood, including barriers to independence, community participation, and psychosocial adjustment (Ingimarsdóttir et al., 2023; Zebracki et al., 2010). Current rehabilitation models in the United States prioritize short-term physical recovery and offer limited support for the developmental and contextual needs that shape long-term outcomes after SCI, particularly during transitions from inpatient rehabilitation to the community (Anderson et al., 2024; Bryden & Gran, 2024). Community-based programs may help address these gaps, though few have been rigorously evaluated using implementation science frameworks that attend to health equity, contextual influences, …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Exploring Practicing Registered Eeg Technologies' Opinions And Preferences Regarding Electroencephalographic Scope Of Practice Standard Forms Of Occupational Regulations, Richard A. Steer

Seton Hall University Dissertations and Theses (ETDs)

Abstract Background: Neurodiagnostic (NDT) is the study and recording of electrical activity in the central and peripheral nervous systems, it is essential for providing critical information that can aid in the diagnosis and treatment of neurological disorders. EEGs are the most frequently performed NDT procedures. The proportion of hospitalizations involving EEG use increased by 122.7% from 2003 to 2014, an average increase of 11.2% annually and continues to grow. The rate of rEEG use increased by 49.4% over 11 years (4.5% annually), while cEEG use increased by 302.3% (27.5% annually) (Bernheimer et al., 2018). Under existing law, the EEG profession …

Impact Of Travel Time To Health Facilities On Perinatal Outcomes: A Systematic Review With Narrative Synthesis And Meta-Analysis, Sanam Roder-Dewan, Marwa Ramadan, Paul Ouma, Alexander Manu, Emelda A. Okiro, Natalie Strobel, Bibian N. Robert, Emily Odipo, Peter M. Macharia, Anthony Danso-Appiah, David C. Goodman, Queen Dube, Gagan Gupta, Hema Magge, Karen Edmond

Research outputs 2022 to 2026

Background: Evidence-based global guidance on safe travel time for small or sick newborns who require transfer to health facilities after birth is lacking. A two-hour threshold is frequently cited in low- and middle-income countries (LMICs), while 30 minutes is commonly used in high-income countries (HICs). Although these thresholds are widely referenced, their empirical basis and consistency across levels of newborn care and journey types have not been systematically examined. This study synthesises the evidence linking travel time and perinatal outcomes. Methods: We conducted a systematic review with narrative synthesis and meta-analysis to assess the impact of travel time or distance …

Vaccination-Related Applications And Health Care Professionals' Observed Changes In Human Papillomavirus Vaccine Hesitancy: Cross-Sectional Survey, Manali Desai, Shreela Sharma, Joel Fokom-Domgue, Robert Yu, Wenyaw Chan, Onyema G Chido-Amajuoyi, Charles Darkoh, Sanjay Shete

Faculty, Staff and Student Publications

Background: Digital tools are known to promote public health interventions such as vaccine delivery. The recommendation that health care professionals (HCPs) use vaccination-related mobile apps or web-based applications has contributed to improving vaccine awareness and acceptance in the United States. The state of Texas, which has one of the lowest human papillomavirus (HPV) vaccination rates, has seen a significant increase in HPV vaccine hesitancy, particularly during the COVID-19 pandemic.

Objective: This study aimed to examine the association between changes in HPV vaccine hesitancy observed by HCPs among patients in Texas and promotion of vaccination-related applications at the health care facilities …

Cigarette And E-Cigarette Use In Greater Philadelphia: Proportion Of Use Compared To National Data And Local Predictors Of Smoking Status, Munjireen Sifat, Joshua Banks, Lilianna Phan, Kuang-Yi Wen, Julie A. Barta, Rebecca J. Melillo, Hee-Soon Juon

College of Population Health Faculty Papers

UNLABELLED: Objective tobacco use, cigarette, e-cigarette, cancer-related beliefs, perceived risk, lifestyle attribution, cancer disparities, health equity. We assessed cigarette smoking and e-cigarette use in the Greater Philadelphia region alongside national data. The objectives were to descriptively explore differences in tobacco use by sociodemographic characteristics. We also examined cancer belief associations with smoking and e-cigarette use in the local context.

METHODS: We descriptively compared cross-sectional survey data from 2744 adults in the Sidney Kimmel Comprehensive Cancer Center (SKCCC) catchment area (Greater Philadelphia region; May-July 2022) with 6252 Health Information National Trends Survey (HINTS 6) nationally representative respondents (United States; March-November 2022). …