Digital Commons Network^™

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). …

Behavioral Science Applications In Collegiate Athlete Nutrition And Sleep: A Scoping Review, Maryam Yuhas, Katherine M. Kidwell, Olivia Moskuna, Rajib Mandal, Jessica L. Garay

Nutrition - All Scholarship

Nutrition and sleep are key health behaviors supporting athletic performance. Collegiate athletes in the United States (U.S.) are at high risk of insufficient dietary intake and nightly sleep given the competing demands of elite sports and academics. Researchers have developed interventions to improve collegiate athletes’ sleep and nutrition, either individually or collectively. However, progress in understanding how best to create sustained behavior change in this population has been slow. This may be due to the lack of application of behavioral science principles such as lack of a guiding theory, effective strategies, and consideration of implementation contexts. This scoping review takes …

Assessment And Mitigation Of Covid-19 Occupational Hazards Among Small Businesses In A High-Risk Community, Sadie H Conway, Denise Vasquez, Soyoung Kwon, Kristina D Mena, Louis D Brown, Janelle Rios

Faculty, Staff and Student Publications

Purpose –: This project explored COVID-19 workplace hazards and factors influencing the implementation of risk mitigation approaches among small businesses in a high-risk community.

Design/methodology/approach –: Using a novel framework, data were collected from 90 workplaces through site visits and consultations with at least one owner, manager or supervisor ("employer") and at least one non-managerial staff member ("employee"). A risk assessment and mitigation plan were prepared based on site-specific hazards; later, a follow-up visit assessed whether recommendations had been implemented and factors influencing these decisions.

Findings –: A total of 84 businesses (93.3%) implemented at least one recommendation, citing ease …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

Smart Pediatric Oncology Tracker Of Symptoms (Spots), A Web-Based Interface For The Pediatric Pro-Ctcae: Development And Usability Study, Stacey Crane, Deevakar Rogith, Melody Hellsten, Andrew D Miller, Jacqueline Castillo, Brandy Boeger, Susan Vidaurre, Stefanie Pieper, Cecile Nguyen, Duc Anh Thanh Huynh, Jessica Wooden, Amy Franklin, Karen Moody, Wenyaw Chan, Pamela S Hinds, Constance Johnson

Faculty, Staff and Student Publications

Background: Children undergoing cancer treatment experience a range of treatment-related toxicities that significantly affect quality of life and adherence to therapy. Current methods for symptom reporting rely heavily on clinician interpretation of caregiver or child verbal reports, which can result in incomplete or inaccurate records. The Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Pediatric PRO-CTCAE; National Cancer Institute) provides a validated mechanism for direct symptom reporting by children and caregivers, yet its traditional administration and preselection of questions limit the breadth of symptom capture.

Objective: This research aimed to co-design and conduct formative usability testing …

Vaccines And Guns Data File, Alice Ann Crandall

ScholarsArchive Data

Three generation study of family health. The data sets associated with this submission examine attitudes about vaccines and guns across generations.

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

The Influence Of Prosthetic Obturators On Quality Of Life In Individuals With Maxillectomy Defects, Minseok Kim

Oral Health

Abstract

Introduction: In recent years, there has been a growing focus on understanding the impact of oral cancer on patients' quality of life. Prosthetic rehabilitation techniques, such as maxillary obturators, often in conjunction with reconstructive surgery, have emerged as interventions to address the challenges posed by post-maxillectomy abnormalities.

Objective: This study aims to systematically review and evaluate the effectiveness of maxillofacial prosthetic rehabilitation using obturators in enhancing the quality of life of patients following maxillectomy.

Methodology: Systematic review of identified literature spanning the timeframe from 2000 to 2020 was used. The comprehensive search encompassed widely recognized databases including PubMed, …

Care Without Barriers: Dei And Cultural Competency In Athletic Training Education Programs, Sydney Hotz

Graduate Theses, Dissertations, and Capstones

In the field of athletic training, cultural competency is a topic that is highly under-researched. Athletic trainers (ATs) are healthcare professionals who provide care in a variety of settings, including secondary schools, where their patient population often includes student-athletes experiencing adverse social determinants of health and barriers to healthcare access. Only since 2022 has the governing body of athletic training education mandated that programs include cultural competency and DEI education in their programs, and to this day does not require programs to report adherence and methods of implementation. A quantitative, cross-sectional analysis was conducted to assess the relationship between cultural …

Bio 340 Final Project: Rural Population Structure And Food Production Interact To Shape Global Undernourishment, Ava Ripanti

Biology Student Scholarship

Ava Ripanti - Environmental Biology '27

Undernourishment remains a major global public health challenge, reflecting the proportion of a population lacking sufficient dietary energy intake. While food availability is central to food security, undernourishment is also shaped by structural and socioeconomic factors such as population distribution and access to resources. Although rural populations are closely tied to agriculture, they often experience higher food insecurity due to limited infrastructure, market access, and healthcare. Prior research emphasizes that broader determinants, particularly inequality and development, are stronger predictors of undernourishment than agricultural output alone, that food insecurity exists in both rural and urban …

Serological Evidence Of Onchocerca Volvulus Exposure And Entomological Indicators Of Parasite Transmission, Didier Kapuku Bakajika

Walden Dissertations and Doctoral Studies

No abstract provided.

The Ethical Imperative Of Public Health Institutions To Protect The Reproductive Autonomy Of Vulnerable Populations, Kennethea Wilson

Electronic Theses and Dissertations

This dissertation establishes the ethical responsibility of public health institutions to safeguard reproductive autonomy, especially among vulnerable populations. While reproductive decision-making is traditionally framed within individual clinical encounters, this work contends that reproductive autonomy is fundamentally a matter of public health ethics. Socioecological determinants, including social, legal, environmental, and structural factors, often constrain individuals’ ability to make meaningful reproductive choices, leading to preventable harm.

Reproductive autonomy is defined as the capacity to make informed decisions about whether and when to conceive, as well as how to parent. The dissertation critiques the sufficiency of clinical ethics frameworks, such as informed consent …

How Do Adverse Social Determinants Of Health Influence 30-Day Hospital Readmission Rates Among Patients With Heart Failure?, Noor Baig

Rowan-Virtua Research Day

Heart failure is one of the leading causes of hospitalization in the United States, with nearly 1 in 4 patients readmitted within 30 days of discharge. Clinical severity largely accounts for this risk, but social determinants of health (SDOH), including income, housing stability, transportation access, and health literacy, also play a role in post-discharge outcomes. This review synthesized seven cohort, observational, and qualitative studies from PubMed (2018–2025) examining the relationship between SDOH and 30-day readmission in heart failure patients.

Several patterns emerged across the literature. Neighborhood socioeconomic disadvantage, measured through ADI and SDI, was independently associated with higher readmission and …

Health Outcomes In Heat-Intense Areas In Response To Socioeconomic Status, Victoria Zheng, Chandni Patel, Emily Fried, Jayanth Ambat, Lincoln Opara, Rohan Gupta

Rowan-Virtua Research Day

Background: As ambient temperature rises, regions experiencing extreme heat face serious health concerns. This disproportionately affects lower socioeconomic status (SES) individuals in urban areas. This review examines how these “heat islands” affect the health outcomes for those in different socioeconomic statuses.

Methods: The databases used were PubMed, Embase, and Medline, and were searched with keywords such as “heat islands”, “social inequality”, “SES”, and “health outcomes”. After compiling, articles were screened using the inclusion criteria of ages, gender, peer-reviewed and English-written publications, from any location, social determinants as a primary outcome, and directly compared heat with social determinants of health. Articles …

Developing A Comprehensive Resource Guide For Caregivers Within The Area Agency On Aging, Aiden R. Murphy

Public Health Capstone Projects

This project developed a new universal caregiver resource guide for caregivers within the Area Agency on Aging, in order to improve resource navigation and workflow efficiency. Resources were collected, verified, and organized into a new, streamlined guide via the ARIA chatbot, covering multiple needs. Caregiver resources were collected and verified by the capstone student and mentor, Michael Kroeker, and organized into a centralized knowledge base within the ARIA chatbot. A mixed methods evaluation was conducted utilizing a 5-point Likert scale with three quantitative questions and one open-ended qualitative question. The data was given to the SeniorLine staff, who wanted to …

Impact Of Spanish-Speaking Medical Interpreters On Healthcare Access, Outcomes, And Equity In Patients With Limited English Proficiency, Emily Fried, Catherine Awad, Rebecca Moore

Rowan-Virtua Research Day

Impact of Spanish-Speaking Medical Interpreters on Healthcare Access, Outcomes, and Equity in Patients with Limited English Proficiency

Background

Limited English proficiency (LEP) is a significant barrier to equitable healthcare in the United States and is associated with reduced access to care, poorer clinical outcomes, and increased healthcare disparities. The Spanish-speaking population represents the largest proportion of LEP patients, making language access a crucial component of high-quality care. Language discordance between patients and providers contributes to impaired communication, increased medical errors, and decreased utilization of preventative services1-4.

Objectives

The objective of this study was to evaluate the impact of Spanish-speaking professional …

The Obstacles Of Performing A Retrospective Chart Review, Emily Reilly, Robert Hudrick D.O.

Rowan-Virtua Research Day

Introduction: This research project "Comparing timing of care for skin cancer patients with limited English proficiency who require interpretation during medical visits to patients with English proficiency" was accepted under the CREATE Grant. The hypothesis was that patients who require medical interpretation during their visits would show a longer period of time between noticing a skin lesion to definitive diagnosis. Previous research has shown improved health care outcomes, but has mixed results on patient satisfaction and health care experience. This poster aims to detail the limitations faced during the execution of a retrospective chart review from the perspective of a …

Health Disparities In Pediatric Epilepsy: A Narrative Review Of Barriers To Equitable Care, Nikhila Archakam, Akhila Archakam, Wesley Kim, Harshal Parmar

Rowan-Virtua Research Day

Epilepsy affects approximately 1% of children in the United States, representing over 456,000 pediatric patients with active seizure disorders. Despite advances in antiseizure medications and surgical interventions, the benefits of these developments are not distributed equally across racial, socioeconomic, and geographic groups. A narrative review of the literature was conducted using PubMed, Scopus, Embase, and Medline using search terms including "pediatric epilepsy," "health disparities," "health equity," "social determinants of health," "race," "socioeconomic status," and "access to care." Articles were included if they focused on pediatric populations aged 0 to 17, addressed at least one disparity domain, and were published between …

Addressing Diabetes Risk Through Preventative Education In Multicultural And Economically Underserved South Jersey Communities, Bavly Nagy Halaka, Janet Jimenez-Merino, Izayah Diaz

Rowan-Virtua Research Day

BACKGROUND: Diabetes and prediabetes affect a substantial and growing portion of the U.S. population, with adolescent prediabetes rates more than doubling from 11% in 1999 to 28% in 2018. In multicultural and economically underserved South Jersey communities, structural barriers including food insecurity, limited access to preventive healthcare, and language gaps make early detection and prevention particularly difficult. We aimed to assess diabetes risk, management behaviors, and preferred education formats among a Camden-area bilingual community, and to identify culturally responsive intervention strategies.

METHODS: We conducted a literature review utilizing data from the CDC, NJ Department of Health, NJSHAD, and the U.S. …

Improving Blood Pressure Through A Multimodal Intervention, Kalynn Solomey

Evidence-Based Practice Project Reports

Hypertension is a major modifiable risk factor for cardiovascular disease and remains a significant public health concern in the United States (Centers for Disease Control and Prevention [CDC], 2023a). Despite the availability of effective pharmacological therapies, many patients struggle to achieve adequate blood pressure control, highlighting the need for accessible, evidence-based lifestyle interventions. An extensive literature search of five databases provided 11 articles for utilization. The purpose of this project was to evaluate the effectiveness of a multimodal intervention that included hypertension education, individualized lifestyle counseling, self-measured blood pressure training, and a progressive walking program in reducing systolic blood pressure …

Comparing Community-Based And Social Media Interventions To Improve Vaccine Uptake In Low-Income U.S. Populations, Tanisha Shah, Nico Santorelli, Maureen Kennedy, Aastha Lele, Syed Ahmad Bilal, Megan Chien, Judith Anne Lightfoot

Rowan-Virtua Research Day

Background:

In recent years, vaccination has become a highly politicized topic, contributing to decreased trust in medical professionals. Exposure to medical misinformation, distrust in government and research, and concerns about vaccine safety have all led to increased vaccine hesitancy and decreased vaccine uptake. These trends are more widely seen in low socioeconomic status (SES) and certain racial populations, posing a significant public health concern despite the effectiveness of vaccines.

Objective: This literature review aims to compare the effectiveness of community-based interventions led by clinicians and community health leaders with social media campaigns in increasing vaccine uptake among low-income populations in …

Falling Star Program: A Visual Cue Intervention To Reduce Falls In Long-Term Care, Maggie Shanahan

Evidence-Based Practice Project Reports

Falls among older adults in skilled nursing and long-term care settings remain a leading cause of injury, functional decline, and increased healthcare utilization, contributing significantly to morbidity and mortality in this population (Centers for Disease Control and Prevention [CDC], 2023; Agency for Healthcare Research and Quality [AHRQ], 2022). The primary purpose of this project aimed to implement and evaluate a structured visual cue–based fall prevention intervention to reduce fall rates among high-risk residents in a long-term care facility in Northwest Indiana. The project included 23 participants aged 65 years and older who were identified as high risk for falls. Using …

The Meaning Of Physical Activity In The Context Of Health Sciences: A Concept Analysis, Martín G. Farinola

International Journal of Physical Activity and Health

Physical activity has been defined in numerous ways. Thus, this study aimed to conduct a concept analysis of the existing physical activity definitions in the health sciences literature to evaluate its conceptual precision and assess the need for a revised or novel concept better suited for this domain. The concept analysis was accomplished using tools derived from philosophical semantics. The analysis identified six definitions that explicitly state what physical activity is with sufficient clarity to allow for conceptual examination. The findings indicated that these definitions frequently merge the concept of physical activity with its contextual attributes. To address these semantic …

Athletic Trainers And Access To Healthcare For Transgender Collegiate Athletes Of Color: The Role Of Intersectionality, Tarah Althea Holness

Walden Dissertations and Doctoral Studies

No abstract provided.

Isass Brave New Continuing Medical Education World: The Stifling Of Innovation In Spine Surgery Through Overrestriction Of Collaboration, Morgan P. Lorio, Kai-Uwe Lewandrowski, Óscar L. Alves, Avelino Parajón, Matthew Scott-Young, Hansen A. Yuan, Alex R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: in 2020, the accreditation Council for Continuing Medical education (aCCMe) released the Standards for Integrity and Independence in Accredited Continuing Medical Education, effective january 1, 2022, to ensure that accredited activities are accurate, balanced, evidence-based, and clearly separated from marketing and sales. although these aims are broadly supported, implementation may have unintended consequences in procedure-intensive specialties such as spine surgery, where surgeon–industry collaboration often drives device innovation, clinical trials, and dissemination of new techniques.

OBJECTIVE: To examine how current interpretations of ACCME eligibility and financial-relationship standards may affect continuing medical education in spine surgery and to propose practical adaptations …

Addressing Socioeconomic Factors Related To Health Disparities In Predominantly Hispanic Texas Communities, Gabriela M. Gomez

Theses & Dissertations

This qualitative study examined the socioeconomic factors that influenced health outcomes in predominantly Hispanic Texas communities in San Antonio, Texas. Few studies have been conducted that address how socioeconomic conditions have shaped the lives of the Hispanic population in Texas, indicating a significant gap in the research. The research question guiding this study asked: How do Hispanic individuals between the ages of 26 and 64 who live in predominantly Hispanic communities describe health disparities in San Antonio, Texas? To address the research question, a qualitative inquiry was conducted using semi-structured in-person interviews with participants who met the inclusion criteria. A …

Group B Streptococcus In Pregnant Women: Universal Guidelines And Protocols, Dania Presteguin

Undergraduate Honors Thesis Collection

Background: Group B Streptococcus (GBS) is a leading cause of maternal sepsis and neonatal mortality globally. Variability in screening and treatment guidelines influences global disease burden.

Objective: This study uses a cross-national analysis to compare screening and treatment guidelines and their impact on prevalence, screening, intrapartum antibiotic prophylaxis (IAP), and maternal-neonatal clinical manifestations Methodology: A systematic review of secondary literature was conducted using PubMed, Scopus, and CINAHL (2010-2025). Inclusion criteria include maternal GBS colonization and one or more measures of interventions and neonatal infection rates. No geographic or demographic restrictions were applied. A total of 67 studies were screened, and …

Nourish: Simple Meals For The Whole Family, Children's Health, Sophie Le

Publications

This English-language cookbook provides simple, affordable, and culturally diverse recipes designed to help families prepare nutritious meals at home while building healthy eating habits. It also includes practical nutrition guidance, such as balanced meal planning, smart pantry choices, and food safety tips to support overall family wellness.

Promoting Influenza Vaccination Among College Students, Wajeeha Khan Valley

Electronic Theses, Projects, and Dissertations

Influenza remains a significant public health concern on college campuses, where high population density, shared living environments, and frequent social interaction increase the risk of viral transmission. Despite the availability of safe and effective influenza vaccines, vaccination rates among college-aged students remain consistently low. Many students underestimate their personal risk for influenza and hold persistent misconceptions regarding vaccine safety, effectiveness, and side effects. The widespread use of social media further influences these attitudes, as misinformation can rapidly spread while credible health messaging often struggles to gain visibility. It is important to eliminate vaccine hesitancy among college students through innovative, behavior-focused …

Caregiver Self-Reflection: Does It Matter? A Study Of The Relationship Between Caregiver Self-Reflection And Participation In Home Programs In Outpatient Pediatric Physical Therapy Settings, Andrea Myane

Graduate Theses and Dissertations

Despite evidence that caregiver coaching can improve patient outcomes and caregiver participation, little information exists on the effects of its individual components. Additionally, previous research has highlighted the importance of home programs in improving pediatric physical therapy outcomes. The aim of this study is to explore the role that caregiver self-reflection, a component of caregiver coaching, plays in facilitating outcomes in the pediatric physical therapy outpatient setting. Caregivers will be asked to complete a series of self-reflection questions based on Gibbs’ Reflective Cycle, while also recording the number of minutes they spend facilitating a prescribed home program. All study participants …