Digital Commons Network^™

Hapi Heroes Initiative: Innovating Patient Turn Strategies Utilizine The Braden Scale To Prevent Hospital Acquired Pressure Injuries (Hapi) In The Cardiac Telemetry Unit-A Reposition Disposition Quality Improvement Project, Kenn Everard Lachenal, Kimberlea Gale Hiett-Gonzales, Charmaine Capili, Jelly Jacob, Melissa Fallorina, Dillon Mckee

Covenant Nurses Week 2026

No abstract provided.

Enhancing Early Breastfeeding Initiation: An Integrative Review Of Barriers And Education, Staci Shaw

Covenant Nurses Week 2026

No abstract provided.

Wise Beyond Our Years: Menopause, Negative Body-Image, And Art As A Catalyst To Self-Acceptance, Nicole Lea

Art Therapy | Master's Theses

This mixed methods study examined the impact of menopause on women’s body image and self-acceptance through an arts-based group intervention. Quantitative data was collected using the Body Image Self-Compassion Scale, and qualitative data was gathered through art-making, group discussion, and individual interviews. Participants were (n=5) menopausal women aged 46-52 from the Bay Area who reported negative body image related to menopause. The intervention consisted of four one-hour open studio workshops with a fifth meeting added in which participants created altered books while engaging in peer support and discussion. Descriptive statistics indicated an increase in mean body image self-compassion scores from …

Unpacking And Re-Imagining Dental Ethics With Anti-Oppressive And Interdisciplinary Praxis, Eleanor Fleming Phd, Dds, Mph, Ficd, Facd

Journal of the American College of Dentists

Dental ethics are assumed to be neutral in their intent. With a social contract grounded in liberalism and assumptions centering whiteness, the resulting ethics reinforce hierarchy, otherness, and inequities. Because concepts and practices are rarely neutral, dental ethics is embedded with biases, which results in it falling short of the demands of the 21st century and exacerbating health inequities rather than supporting efforts for health justice. This manuscript invites the reader to reflect critically and re-imagine dental ethics using anti-oppressive and interdisciplinary praxis. For the improvement of public health, the narrowing of inequities, and a functioning oral health system, the …

Community Resilience Drives Change, Andrew Thomas Solt

Graduate Theses, Dissertations, and Problem Reports (ETD)

The opioid crisis has impacted many Americans. From 1999 to 2023, approximately 800,000 people have died due to opioid overdose (CDC, 2025). What began as overprescriptions of painkillers has quickly evolved into a complex social health issue that is now further worsened by stronger synthetic drugs like fentanyl. Fentanyl and fentanyl analogs (synthetic opioids that are very similar chemically to fentanyl) are often found in illegal drug supplies and in counterfeit pills (CDC, 2025). Thus, individuals who might have been initially overprescribed painkillers might now be pushed towards illegally produced drugs that are significantly more potent than what they were …

Stakeholder Perceptions Of West Virginia’S Artificial Food Dye Ban In K–12 School Meals: Initial Year Of 2025-2026, Leah Michelle Rogers

Graduate Theses, Dissertations, and Problem Reports (ETD)

OBJECTIVES: Artificial food dyes (AFD+) are an increasing policy concern in the U.S., particularly in children’s foods. West Virginia’s House Bill 2354, the first statewide AFD+ ban implemented in K-12 schools, restricts seven AFD+ in state-funded meals. Little is known about how AFD+ bans are perceived or implemented. This study examined how the ban functioned within school food systems and the barriers and facilitators experienced by school stakeholders within the initial year of implementation during the 2025-2026 school year.

METHODS: A cross-sectional, observational mixed-methods study was conducted among implementers, enforcers, and receivers of the policy. A survey tool …

Improving The Continuity Of Care For Opioid Use Disorder: Investigating Fentanyl Overdose Outcomes And Pharmacy-Level Buprenorphine Access, Lyn Yuen Choo

Graduate Theses, Dissertations, and Problem Reports (ETD)

Opioid overdose (OD) deaths remain a leading cause of injury-related death in the United States (US) and approximately 76,516 drug OD deaths were predicted in the past year prior to April 2025. While previous research has focused on fatal opioid ODs, less is known about outcomes following non-fatal opioid ODs (NFOO) involving fentanyl. Patients who experienced a fentanyl OD may develop significant morbidity and inpatient mortality due to fentanyl’s high potency, rapid onset of action, and decreased response to naloxone. Research efforts to improve continuity of care for opioid use disorder (OUD) are highly needed to ensure appropriate follow-up care …

Effectiveness Of Occupational Therapy-Inspired Educational Sessions For Mothers Accessing Women, Infants, And Children (Wic) Services, Samantha Annette Merew

Graduate Theses, Dissertations, and Problem Reports (ETD)

This doctoral capstone project examined the effectiveness of occupational therapy (OT)-inspired group and one-on-one educational sessions designed to support the emotional, mental, and social well-being of pregnant and postpartum mothers accessing Women, Infants, and Children (WIC) services in Onslow County, North Carolina. Grounded in the Model of Human Occupation and Cognitive Behavioral Frame of Reference, the program aimed to address gaps in holistic maternal health support, particularly among low-income and at-risk populations. Eight structured group sessions and five one-on-one sessions were developed, implemented, and evaluated, focusing on topics such as stress management, emotional regulation, self-care, role transition, and self-advocacy. A …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

Neighborhood Deprivation Associated With Impaired Sit-To-Stand Performance In Middle-Aged And Older Adults: A Cross-Sectional Analysis With Clinical Implications, Kenneth Harrison, Silvia Campos-Vargas, Brandon M. Peoples, Keven G. Santamaria-Guzman, David T. Redden, Michael A. Samaan, Jaimie A. Roper

Kinesiology and Health Promotion Faculty Publications

Background: Socioeconomic factors significantly influence health outcomes in older adults, yet their impact on specific aspects of mobility remains unclear. This study investigates the relationship between area-level socioeconomic disadvantage and mobility health in older adults.

Methods: We conducted a cross-sectional study of 110 community-dwelling older adults recruited and collected using voluntary response sampling at eight health fairs across rural Southeast Alabama in 2022–2024 (60 ± 16 years, 80% female). Area-level socioeconomic status was measured using the Area Deprivation Index (ADI), a validated composite measure of neighborhood disadvantage. Mobility was assessed using the Instrumented Timed Up and Go (iTUG) test and …

The Impact Of Gastric Sleeve And Roux-En-Y Gastric Bypass On Chief Cell Function And Protein Digestion In Obese Patients, Garikoitz Mikel Gainza

Honors Undergraduate Theses

Obesity has become one of the largest global health concerns of the 21^st century, correlating with numerous associated diseases. To help address the growing prevalence and burden of obesity, sleeve gastrectomy and Roux-en-Y gastric bypass have become two commonly performed surgical procedures done to promote weight loss by altering the anatomical structure of the stomach and surrounding organs of the gastrointestinal system. Although the benefits of improved metabolism linked to these surgical procedures are well studied, their impact on the physiology of gastric cells, and more specifically chief cells as they relate to protein digestion post-surgery, is yet to …

Iron Deficiency And Iron Deficiency Anemia: Inconsistent Screening Practices And Delayed Result Processing In Children 12-18 Months, Madonna J. Mahoney Marshall

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction:

Iron deficiency and iron deficiency anemia in children aged 12 to 18 months are prevalent conditions that, if not identified and treated early, are associated with adverse neurodevelopmental outcomes.

Purpose:

This quality improvement project evaluated the impact of a standardized screening and follow-up protocol on laboratory result retrieval, provider review, and caregiver follow-through in a military pediatric clinic.

Method:

A pre-post intervention design guided by the Plan-Do-Study-Act framework was implemented over 11 weeks and included staff education, standardized workflows, and caregiver outreach.

Results:

The intervention improved laboratory completion and caregiver follow-up rates; however, sustainability was limited by staffing constraints …

Barriers To Immunity: Understanding Covid-19 Vaccine Uptake In Africa, Emilia Blechschmidt

Honors Theses

This thesis examines the factors influencing COVID-19 vaccine uptake across African countries, with a focus on structural, informational, and behavioral barriers to immunization. Drawing on cross-country data, the study analyzes how access to transportation, reliable information, and healthcare resources shape vaccination rates, alongside the effect of demographics and institutional factors in shaping individual perceptions of risk and vaccine safety.

The findings emphasize that the broader strength and preparedness of national health systems strongly influence vaccine uptake. Countries that demonstrated higher coverage of routine childhood immunizations, such as polio and hepatitis B, also tended to perform better in COVID-19 uptake efficiency …

Caregiver Training: Improving Social Determinants Of Health, Patient Safety, Empowerment Through Improving Elder Care Education And Skills, Kathleen Thimsen

Nursing Faculty Research

Caregiver training (CaGi TRaining) is a time-tested intervention aimed at improving safety in elders living and aging in place in the community. While elder abuse and maltreatment was the intial purpose of the project, with over 3500 Caregivers graduated from this program since 2009, the course has addresses social determinants of health, and improved workforce pipelines by providing stable employment, improved self-efficacy, and confidence demonstrated by self-reports at graduation and in follow up surveys. Previously learners without a high school diploma retruned to school to obtain a GED (40%), with an additional return to school for bacalaureate and degrees (27%) …

Hallucinogen Use Among Parents Of Children In The United States: Associations With Mental Health And Substance Use, Maggie K. Richardson

Theses and Dissertations--Educational, School, and Counseling Psychology

Hallucinogen use has reemerged in the United States amid expanding clinical research and shifting social and policy contexts. However, population-based evidence remains limited regarding hallucinogen use among adults living with children and its relationship with mental health impairment severity in caregiving environments. Therefore, this study’s objective was to examine associations between past-year hallucinogen use and past-year mental health impairment among U.S. adults, and to test whether associations differ by parental status and number of children in the household. A secondary aim examined correlates of co-occurring substance use among those reporting hallucinogen use.

Data were drawn from the 2023 National Survey …

One-Stop-Shop (Oss): Community Health Nursing: (For Undergraduate Nurses), Sarmad Muhammad Soomar

Books

No abstract provided.

Facilitating Shared Reading Exposure To Promote Health Outcomes In A Rural Pediatric Primary Care Clinic, Meredith L. Longino

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this scholarly project was to address a gap in early literacy promotion for rural children by incorporating the Reach Out and Read program. This program bolsters foundational literacy by providing a book and anticipatory guidance at every well-child visit from birth through age 5. This project was expected to decrease no-show well-child attendance rates and improve provider morale.

Background

The project was implemented in an established rural pediatric primary care clinic in Northeast Texas. 

Methodology

Process implementation was measured through books distributed and EHR documentation of the intervention. Process objectives were measured by no-show rates for …

Improving Parental Self-Efficacy And Stress Management Among Parenting Youth Experiencing Homelessness: Development And Implementation Of A Standardized Group Parenting Curriculum At An Urban Homeless Shelter, Liam Jerez

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project developed and implemented an evidence-informed group parenting curriculum, The Parenting Hub: Mindful Moments (TPHMM), at an urban youth shelter, aiming to increase parental self-efficacy by 20% and decrease parental stress by 20% among homeless parenting youth.

Background

Nearly half (49%) of 18–24-year-olds in families experiencing homelessness are parents, often facing low parenting confidence, limited support, and high stress. The project site, serving up to 150 youths, with a fluctuating number of young parents, lacked a standardized parenting curriculum.

Methodology

This pre-/post-test QI pilot used the Model for Improvement; Plan-Do-Study-Act cycles refined delivery in the …

Adolescent Girls’ Experiences Of Digital Dating Abuse Through Social Media: A Scoping Review, Kiara E. Rodriguez

Social Work Theses

Teen dating violence (TDV) is a prevalent adverse childhood experience with lasting psychological and behavioral consequences. As adolescents increasingly engage with social media, with 95% of teens aged 13-17 reporting using it, digital spaces have become a significant context in which dating abuse can occur. Digital dating abuse (DDA) refers to patterns of abusive behaviors that are directed toward a dating partner through digital technologies, including social media and mobile phones. Despite the growing role of social media in adolescent relationships, research on how adolescent girls experience DDA in these contexts remains limited. The central question for this scoping review …

Établissement De L'Équivalence De La Méthode Irsst 381 Pour La Mesure De L'Exposition Professionnelle Aux Fumées D'Asphalte En Conformité Avec La Nouvelle Valeur D'Exposition Admissible, Simon Aubin, Ousmane Bangoura, Corina Tue

États de la question, rapports d’expertise et revues de littérature

Depuis quelques décennies, la valeur d’exposition admissible consiste en une valeur d’exposition moyenne pondérée (VEMP) des fumées d’asphalte est de 5 mg/m³, prélevée en fraction « particules totales », pour laquelle une mesure gravimétrique non spécifique est préconisée. (Règlement sur la santé et la sécurité du travail) Une nouvelle VEMP entre en vigueur en mars 2026 avec la valeur et l’expression suivante : 1,5 mg/m³ [particules et vapeur exprimée en fraction soluble dans le benzène ou son équivalent] prélevé en fraction « particules totales » (Pt). La méthode préconisée pour soutenir cette VEMP est la …

Les Répercussions Des Changements Climatiques Sur La Sst : État Des Lieux Et Pistes D'Action, Sophie De Serres, Alain Marchand

États de la question, rapports d’expertise et revues de littérature

Cet état des lieux expose les répercussions multidimensionnelles des changements climatiques (CC) sur la santé et la sécurité du travail (SST), en se concentrant sur les contextes nord-américain et européen. L'augmentation de la température moyenne mondiale, qui atteint désormais +1,2 °C par rapport à l'ère préindustrielle, transforme les conditions de travail et exacerbe les dangers professionnels existants. Le stress thermique induit par la chaleur excessive provoque des pathologies allant de l'épuisement au coup de chaleur mortel, tout en dégradant la vigilance et en augmentant le risque de blessures traumatiques. Au-delà des atteintes physiques, les CC aggravent les risques psychosociaux, engendrant …

Socioeconomic Influences On Doula Access And Perceived Care Quality Among Black Women Experiencing Severe Maternal Morbidity, Deborah Esene

2026 Spring Honors Capstones Projects

Black women experience disproportionately high rates of maternal morbidity and mortality, making it essential to examine access to and the perceived impact of doula support. This study examines whether socioeconomic status influences access to and the perceived benefits of doula support among Black women who experienced severe maternal morbidity (SMM). Researchers surveyed Black women ages 18-49 who had a live birth within the past two years and experienced SMM. Participants were recruited and completed an online survey in late 2020. Key variables included income, education, doula use, and perceived quality of prenatal, intrapartum, and postpartum care. Among 188 participants, 12.2% …

Clinical Subtypes Of Co-Morbid Insomnia And Obstructive Sleep Apnea (Comisa): Results Of A Cluster Analysis, Yuan Shi, Xujun Feng, Fengyi Hao, Yuru Nie, Yihui Zhang, Zhaohua Chen, Siqi Guan, Larry D. Sanford, Michael V. Vitiello, Xiangdong Tang

Department of Pathology & Anatomy Faculty Publications

Background

Variations in the bidirectional relationship between obstructive sleep apnea (OSA) and insomnia in co-morbid insomnia and OSA (COMISA) may form distinct subtypes of COMISA, which have not been previously characterized. This study aims to identify and characterize subtypes of COMISA.

Methods

From a community-recruited COMISA cohort 256 individuals who met diagnosis for COMISA were used to identify subtypes using a two-step clustering methodology. Demographics and multidimension clinical characteristics were collected and compared among obtained subtypes. Logistic models were used to evaluate whether these subtypes were associated with cardiometabolic and mental disorders. A clinical cohort of 1816 COMISA patients was …

Identifying And Prioritizing Essential Healthcare Services For A Private Start-Up Healthcare Hub In Laxmipasha, Bangladesh, Ferdous Ara Mostofa

Dissertations

This quantitative study identifies and prioritizes essential healthcare services for developing a private start-up healthcare hub in Laxmipasha, Bangladesh, a rural community with significant gaps in healthcare access. Using secondary data from national and international sources, the research analyzed disease burden, population characteristics, and service availability to determine the most urgent health priorities. A structured, evidence-based framework was used to evaluate services based on mortality and morbidity, service gaps, and potential health impact. The findings indicate that Maternal and Child Health (MCH), Non-Communicable Disease (NCD) management, and infectious disease control represent the most critical priorities for initial implementation. The study …

Impact Of An Educational Video Intervention On Word Recognition And Vocabulary Knowledge Of Paediatric Dental Terms Among Low-Income Caregivers Of Youth Children, Melissa L. Sullivan, Denise C. Mckinney, Abdullah Al-Taiar, Deanne Shuman

Dental Hygiene Faculty Publications

Objective

To evaluate the impact of an educational intervention on paediatric dental term recognition and vocabulary knowledge among low-income caregivers of young children.

Methods

A randomized two-group pretest-posttest trial was used to analyze the impact of an educational intervention on caregivers' word recognition and vocabulary knowledge of paediatric dental terms. The study included 60 pregnant women and caregivers with children enrolled in a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the Southeastern United States. Both groups received an educational pamphlet on children's oral health. The experimental group also received an educational video with common paediatric dental …

Leading The Way In Pediatric Oral Health Promotion, Denise C. Mckinney

Dental Hygiene Faculty Publications

[Introduction] Dental hygienists promote oral health and provide preventive services to patients throughout their lifespan. The Commission on Dental Accreditation, Dental Hygiene Standards emphasize that graduates must be competent in providing dental hygiene care for all patient populations, including children.¹ In fact, promoting pediatric oral health begins prior to birth with the expectant mother and/or caregiver. Oral health care to include education is essential during pregnancy; specifically, around the prevention and treatment of dental caries for the mother and the unborn child.² In the U.S., from 2013-2016, roughly 30% of women aged 20-44 years had untreated dental caries.³ Expectant mothers …

Racial Disparities In Maternal Mortality: The Role Of Explicit And Implicit Bias In U.S. Healthcare, Lailah Allen

Capstone Showcase

Maternal mortality in the United States remains a critical public health crisis, with disproportionately high rates among Black and other minority women. Despite advances in obstetric medicine, racial disparities in pregnancy-related deaths persist due to structural inequities, implicit bias in healthcare delivery, unequal access to prenatal and postpartum care, and broader social determinants of health. Nationally, Black women are significantly more likely to experience severe maternal morbidity and mortality compared to White women, reflecting longstanding inequities embedded within the healthcare system. This paper examines the relationship between race, healthcare access, and maternal outcomes through a focused case study of and …

Improving Maternal Health: Investigating The Early Impacts Of Medicaid Coverage Of Doulas In Oregon, Miriam Akhmetshin

Scripps Senior Theses

While the U.S. spends more per-capita than any country on healthcare, we experience the worst maternal health outcomes of high-income nations. In addition to hefty healthcare bills, an overwhelming majority of mothers experience pregnancy-related health issues that decrease productivity and utility. Thus, it is critical to research cost-effective solutions that can improve maternal health and promote equitable outcomes. Doulas are trained non-medical professionals who support mothers and families before, during and after birth. As a growing body of medical literature points to the role of doulas in decreasing costly medical interventions, insurance companies have begun covering their services. In 2014, …

Food Stamp Participation And Health Outcomes In Ca Immigrants, Esther Kang

Scripps Senior Theses

The U.S. social welfare system includes programs aiming to increase access to nutritious food to reduce nutrition insecurity. However, studies suggest that immigrants continue to face disproportionate risks of nutrition insecurity and may face barriers to enrollment due to legal status. This study, using secondary data from the 2023 California Health Interview Survey, examines the associations between food stamp participation, food insecurity, and clinical diagnosis of diabetes among adult U.S.-born, naturalized, and non-citizen adults in California. The findings suggest that those enrolled in food stamps are more likely to report food insecurity than those who are not enrolled, and that …

A Zinc Chelate Of Lysine/Glutamic Acid Reduces Alcohol-Induced Ciliary Dysfunction, Emily Do, Daren L. Knoell, Christopher Bauer, Deanna Mosley, Deandra R. Smith, Derrick R. Samuelson, Todd A. Wyatt

Journal Articles: Environmental, Agricultural & Occupational Health

Alcohol misuse is a known risk factor for pneumonia, and up to 50% of individuals who misuse alcohol are zinc deficient. Chronic alcohol misuse can lead to alcohol-induced ciliary dysfunction (AICD), preventing effective mucociliary clearance and protection against lung infection. Because zinc salts fail to alter AICD, we hypothesized a form of zinc (Zinpro Zinc LG) with enhanced cell uptake would protect against AICD. Human and mouse airway epithelial cells were treated with 50 mM ethanol for 1-24 h followed by the ciliostimulatory agents. Cilia beat frequency (CBF) and cAMP-dependent protein kinase (PKA) activity were assayed. Cyclic AMP or beta …