Digital Commons Network^™

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

Facilitators And Barriers To Effective Scale-Up Of Evidence-Based Nonprofit-Level Hiv Prevention And Treatment Interventions Among Black Men Who Have Sex With Men (Msm), Ugochukwu C. Uzoeghelu

Master's Projects and Capstones

Since the scale-up of HIV/AIDS prevention evidence-based interventions (EBIs) has not been simple in nonprofit settings, it is crucial to examine processes that occur in the translation of the EBIs into practice that affect successful implementation through the lens of nonprofit principles and practices. This paper examines the facilitators and barriers to effective scale-up of evidence-based HIV prevention and treatment services for nonprofit health organizations that serve Black men who have sex with men (MSM). I interviewed nonprofit health organizations (n = 4) engaged in the global response to end the HIV epidemic, specifically those who provide HIV prevention and …

Explaining Adult Obesity, Severe Obesity, And Bmi: Five Decades Of Change, Ashley W. Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

Obesity rates have increased across all segments of society since the late 1970s, but the reason behind population-level increases in body weight remains unclear. We used the 1971–2020 NHANES data to examine whether the observed trend in obesity prevalence is attributable to changing public health behaviors (i.e., intracohort change) or changing publics (i.e., cohort replacement). We partitioned total change in mean BMI, and rates of obesity and severe obesity, into its IC and CR components using linear and algebraic decomposition methods. We found that the IC mechanism (i.e., broad sectors of individuals changing) plays a dominant role in the overall …

The Use Of Therapeutic Gardening In Addiction Recovery, Sophia Agne

Master's Projects and Capstones

Problem: Numerous recent studies have emerged detailing the benefits of horticultural therapy on mental health and wellness. Despite this, substance use disorder treatment facilities rarely include an outdoor component in their programming. The project seeks to examine the advantages of incorporating therapeutic gardening as a complementary part of addiction treatment.

Context: The microsystem where the study was conducted was at a 32-bed residential substance abuse treatment facility for adult men who have previously been involved in the criminal justice system. The treatment approach employed at the facility aligns with the Integrated Dual Disorder Treatment (IDDT) curriculum, which emphasizes mental health-informed …

The Child Healthcare At Mater Pediatric Study (Champs): A 2-Arm Cluster Randomized Control Trial Of Group Well Child Care For Mothers In Treatment For Opioid Use Disorder And Their Children, Vanessa L. Short, Diane J. Abatemarco, Erica Sood, Dennis J. Hand, Meghan Gannon, Jobayer Hossain, Neera K. Goyal

Department of Pediatrics Faculty Papers

BACKGROUND: Studies suggest that group-based well child care-a shared medical appointment where families come together as a group to receive pediatric primary care-increases patient-reported satisfaction and adherence to recommended care. Evidence supporting the use of group well child care for mothers with opioid use disorder, however, is lacking. The overall objective of the Child Healthcare at MATER Pediatric Study (CHAMPS) trial is to evaluate a group model of well child care for mothers with opioid use disorder and their children.

METHODS: CHAMPS is a single-site 2-arm cluster randomized controlled trial. A total of 108 mother-child dyads will be enrolled into …

Post-Resettlement Food Insecurity: Afghan Refugees And Challenges Of The New Environment, Zahra Goliaei, Mariaelena Gonzalez, Karina Diaz Rios, Mamata Pokhrel, Nancy J Burke

Faculty Publications & Research of the TUC Public Health Program

BACKGROUND: Lack of access to adequate, safe, and nutritious food is a major concern for the Afghan population due to ongoing war and humanitarian crises. Recently resettled Afghan refugees in the US continue to face challenges securing adequate, nutritious food resources in new environments. This study examined Afghan refugees' food access and insecurity in the San Joaquin Valley, California.

METHODS: Semi-structured, in-depth interviews were conducted to collect the perspectives and experiences of key informants and newly arrived Afghan refugees.

RESULTS: This study highlights environmental and structural factors (availability and accessibility of grocery stores; availability of religious-appropriate items in the stores; …

Review Of Gynaecological Cancer Among Aboriginal And/Or Torres Strait Islander People In Australia, Aime Powell, Ami Morseu-Diop, Maya Morton Ninomiya, Uday Narayan Yadav, Emily Phillips, Devendra Raj Singh, Tamara Butler, Emma Allanson, Lisa J. Whop

Journal of the Australian Indigenous HealthInfoNet

Gynaecological cancers bear a significant burden on the health of Australians. Whilst Australia has made great strides in reducing the overall gynaecological cancer burden nationally, Aboriginal and/or Torres Strait Islander women continue to experience disproportionately high rates of gynaecological cancers.

This review focuses on the social, cultural, and historical contexts that contribute to inequitable gynaecological cancer rates among Aboriginal and/or Torres Strait Islander women. An in-depth discussion on cervical cancer, ovarian cancer, and uterine cancer are described; including the incidence, mortality, survival, and management of these diseases for Aboriginal and/or Torres Strait Islander women.

It highlights both the persistent barriers …

Report: Evaluation Of Seal!Nd: School Year 2021-2022: North Dakota Department Of Health Oral Health Program’S School-Based Dental Sealant Program, Shawnda Schroeder, Tonya Connor

Indigenous Health Faculty Publications

The North Dakota Department of Health (DoH)a Oral Health Program (OHP)b has established a school-based dental sealant program, (SEAL!ND)c , which has been providing dental sealants, fluoride varnish applications, oral health education and dental screenings and referrals for students throughout North Dakota dating back to 2012. All services occur in the school during school hours. School-based sealant programs are a highly effective way to deliver preventive oral health services and dental sealants to children less likely to receive private dental care. The SEAL!ND program prioritizes providing preventive oral health care to low-income and underserved students by targeting schools with 45% …

Aligning Investments To Improve Population Health: A Statewide Strategy To Address The Social Determinants Of Health, Michael E. Swack, Sarah Boege, Kevin Barnett

Carsey Publications

In this report, authors Michael Swack, Sarah Boege, and Kevin Barnett discuss the initiative to develop a statewide strategy to address the social determinants of health in New Hampshire. Launched in 2020, this project is a collaboration between the Center for Impact Finance at the Carsey School of Public Policy at UNH, the Center to Advance Community Health and Equity (CACHE) at the Public Health Institute, the Institute for Health Policy and Practice at UNH, and the New Hampshire Hospital Association/Foundation for Healthy Communities. Michael Swack, director of the Center for Impact Finance at the Carsey School, serves as the …

Developing Tools For The Implementation And Evaluation Of Participatory Worker Health Promotion Interventions, Ryan J. Walsh

WUSM Theses and Dissertations – All Programs

The chronic disease burden among American workers leads to substantial expenditures on healthcare, lost productivity at work, and reduced quality of life. Workers from communities of lower socioeconomic status (SES) shoulder a disproportionate burden of chronic diseases and costs. A promising strategy for addressing this population health burden is to develop and implement participatory worker health promotion interventions in workplaces. Part of this effort to develop and implement these programs entails improving the quality of evaluation tools and approaches. Thus, we completed a series of secondary analyses of a large participatory worker health promotion program trial called Working For You. …

Health Disparities: Ranking Horry County's Most Disadvantaged Communities, Stephen Borders, Jacob Bradley, Mackenzie Cannon, William Hall

Public Health

Horry County is a rapidly growing region in South Carolina, with a diverse population of over 300,000 residents. Despite this growth, the county faces significant health challenges, including high rates of chronic diseases, such as diabetes and obesity, and a shortage of healthcare providers in certain areas. These challenges are exacerbated by the county's socio-economic disparities, with many low-income residents lacking access to basic health services. Our approach is to address these challenges by identifying the areas within the county with the greatest unmet needs, also known as disadvantaged communities. By identifying the needs of Horry County’s most disadvantaged communities, …

Mental Health Among D1 Female College Athletes: Prevalance And Links To Athletic And Academic Performance, Mary Goebel

Honors Theses

Background. NCAA Division I female student-athletes are underrepresented in mental health research; existing research among female athletes tends to focus only on disordered eating and body appearance. This study aims to 1) describe the prevalence of mental health issues (i.e., anxiety, depression, and stress) among female Division I college athletes, and 2) assess the association between mental health issues and the student-athlete experience (i.e., athletic and academic performance).

Methods. This was a quantitative, cross-sectional study that used a self-administered online survey. The participants were NCAA Division I female student-athletes, mainly from the University of Mississippi. Demographics and sample characteristics were …

Oral Health Literacy: A Tool To Reduce Oral Health Disparities Among Californians, Rubina Bukhari

Master's Projects and Capstones

Oral health is the health of the mouth, cheeks, teeth, and their supporting structure within the oral cavity. It helps in performing day-to-day routine functions such as swallowing, tasting, chewing, talking, and making a wide array of complex facial expressions. Apart from performing everyday functions, oral health is a crucial contributor to the overall state of well-being and good quality of life. It is measured by oral conditions such as tooth decay, gum disease (Periodontal), and oral cancers. Tooth decay and cavity formations are the most prevalent oral health conditions which affect people of all age groups. However, children are …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

Development And Validation Protocol For An Instrument To Measure Household Water Insecurity Across Cultures And Ecologies: The Household Water Insecurity Experiences (Hwise) Scale, Sera L. Young, Shalean M. Collins, Godfred O. Boateng, Torsten B. Neilands, Zeina Jamaluddine, Joshua D. Miller, Alexander A. Brewis, Edward A. Frongillo Jr., Wendy E. Jepson, Hugo Melgar-Quiñonez, Roseanna C. Schuster, Justin B. Stoler, Amber Wuitch, Hwise Research Coordination Network

Faculty Publications

Introduction A wide range of water-related problems contribute to the global burden of disease. Despite the many plausible consequences for health and well-being, there is no validated tool to measure individual- or household-level water insecurity equivalently across varying cultural and ecological settings. Accordingly, we are developing the Household Water Insecurity Experiences (HWISE) Scale to measure household-level water insecurity in multiple contexts.

Methods and analysis After domain specification and item development, items were assessed for both content and face validity. Retained items are being asked in surveys in 28 sites globally in which water-related problems have been reported (eg, shortages, excess …

An Examination Of Dyadic Diabetes Self-Management Education For Patients And Care Partners: A Scoping Review, Jessica L. Tucker

Honors Theses

Diabetes self-management education and support (DSMES) programs are crucial in equipping individuals with the necessary knowledge and skills. Involving care partners in diabetes management acknowledges that it is a collaborative effort within a social context, emphasizing the importance of integrating care partners into educational interventions. This approach offers benefits like emotional and practical support, shared responsibility in managing diabetes, enhanced treatment adherence, and improved communication.

To understand this concept better, this review's objectives are defining dyadic relationships, exploring implementation logistics, and assessing program outcomes and limitations to inform future research and program development.

This study revealed inconsistent terminology and definitions …

Human Trafficking And Nutrition: Assessing The Effects Of U.S. Public Policy On Food Security And The Malnourishment Of Refugees, Moxie R. Mccandless

Honors Projects

This research paper aims to assess the challenges associated with human trafficking within the lived experience of refugees, specifically focusing on food security, and the resulting system shaped by existing United States policies and programs. By examining this complex relationship, the study seeks to shed light on the influence of power dynamics on fulfilling basic human needs and to propose more effective strategies for improving food security among marginalized populations.

A comprehensive literature review is conducted, and a community nutrition needs assessment is performed in King County, Washington. Qualitative interviews are conducted with human trafficked organizations, government officials, and experts …

Telehealth And Its Impact On The Management Of Type 2 Diabetes Mellitus, Melissa N. Toulios

Evidence-Based Practice Project Reports

Diabetes mellitus type 2 (T2DM) is a growing epidemic that affects millions of people throughout the world. The recent COVID-19 pandemic has created many new challenges, including access to health care for treatment of chronic diseases, such as diabetes (Robson & Hosseinzadeh, 2021). Telehealth has offered a promising approach to improve the management of diabetes(Bellman, 2021). People with diabetes are less likely to manage their diabetes through the usual care because of risk of contracting COVID-19 (CDC, 2022). The purpose of this EBP project was to evaluate the effectiveness of T2DM management through a telehealth approach. This project has addressed …

'The Very Structure Of Opportunities Has Collapsed': How Taxation Policies Enhance, Decay, And Otherwise Affect The Distribution Of Health & Health Services In The United States, Valerie Pacino

Theses & Dissertations

Taxation is a function of government that patterns our lives socially, economically, and politically, but it remains understudied in public health. This dissertation examines three different elements of tax policy in the United States. First, a systematic review assesses the effects of in-work tax credits on child health outcomes and suggests they improve some infant and child health outcomes, particularly overall health, low birthweight, gestational age, and abuse and neglect. It concludes with suggestions to improve both the study of and structure of tax credits. Next, an interrupted time series analysis tracks ten years of community benefits spending by nonprofit …

Translating A Pediatric Weight Management Intervention Into Medically Underserved Areas, Caitlin Golden

Theses & Dissertations

Despite substantial prevention and treatment efforts, childhood obesity remains a pressing public health concern. Disparities persist in obesity prevalence among children of lower socioeconomic status, racial and ethnic minority groups, and those residing in rural areas. The vast majority of efficacious pediatric weight management interventions (PWMIs) have been based in larger cities and urban areas delivered through inter-disciplinary teams in a hospital or medical center, and the degree to which these or other efficacious PWMIs have been translated to, and are feasible in, typical rural or micropolitan areas is unclear. This dissertation describes a dissemination strategy and a systematic approach …

Neurodevelopment, Vision And Auditory Outcomes At Age 2 Years In Offspring Of Participants In The ‘Women First’ Maternal Preconception Nutrition Randomised Controlled Trial, Michelle Fernandes, Nancy F. Krebs, Jamie Westcott, Antoinette Tshefu, Adrien Lokangaka, Melissa Bauserman, Ana L. Garcés, Lester Figueroa, Sarah Saleem, Sumera A. Aziz, Robert L. Goldenberg, Shivaprasad S. Goudar, Sangappa M. Dhaded, Richard J. Derman, Jennifer F. Kemp, Marion Koso-Thomas, Amaanti Sridhar, Elizabeth M. Mcclure, K. Michael Hambidge

Global Health Articles

BACKGROUND: Maternal nutrition in preconception and early pregnancy influences fetal growth. Evidence for effects of prenatal maternal nutrition on early child development (ECD) in low-income and middle-income countries is limited.

OBJECTIVES: To examine impact of maternal nutrition supplementation initiated prior to or during pregnancy on ECD, and to examine potential association of postnatal growth with ECD domains.

DESIGN: Secondary analysis regarding the offspring of participants of a maternal multicountry, individually randomised trial.

SETTING: Rural Democratic Republic of the Congo, Guatemala, India and Pakistan.

PARTICIPANTS: 667 offspring of Women First trial participants, aged 24 months.

INTERVENTION: Maternal lipid-based nutrient supplement initiated …

Effects Of Income And Language On Health Literacy: A Study Between A Student-Run Free Clinic And A Family Medicine Office, Sahil Parikh, Emily Forester, Alisha Basak, Arpan Bhagat, Leah Cliatt, Usmaan Al-Shehab, Rebecca Moore

Rowan-Virtua Research Day

Background: Over one-third of the US population exhibit limited health literacy, leading to negative health outcomes and lifestyle choices. By employing the NVS assessment, RCHC sought to compare the health literacy levels of uninsured patients at their facility with those of insured patients at the Rowan Family Medicine office in Hammonton, NJ. This study aimed to assess specific factors that may influence health literacy levels.

Methods: This is an IRB-approved study which surveyed patients enrolled at the RCHC and Rowan Family Medicine Office between February 2021 and March 2023. Patients were given a nutrition label and verbally answered the NVS …

Prevalence Of Disordered Eating In Female Athletes Of The New Jersey Athletic Conference, Desiree Brower, Joanna Petrides

Rowan-Virtua Research Day

Background: In 2018, the American Academy of Child and Adolescent Psychiatry published that, 1 out of every 10 adolescent females suffer from an eating disorder in the United States. Although it is known that eating disorders have an impact on the entire population, there are currently no studies on the prevalence of disordered eating in female athletes of the New Jersey Athletic conference (NJAC). This study aims to determine how many athletes in this population are affected.

Methods: This IRB-approved project utilized a survey-based approach to assess the prevalence of disordered eating among female athletes within the NJAC. To participate, …

Language Barrier Contributions To Food Insecurity In Spanish-Speaking Populations, Amin Khan, Leeza Kumar, Edanur Kilic, Stephen Acheampong

Rowan-Virtua Research Day

Food insecurity refers to a household or individual’s inability to access adequate food to obtain a healthy lifestyle. This contributes to health concerns such as birth defects, low nutritional intake, anemia, cognitive problems, mental health disorders, diabetes, obesity, and heart disease. Low-income rural community members lack access to full grocery stores and often turn to convenience stores with unhealthy, expensive, and fewer food options. The aim of this study was to determine how language barriers affect Spanish-speaking populations with limited English proficiency. The research for this project was obtained from Google, Google Scholar, and PubMed. Keywords included “health disparities,” “Spanish-speaking,” …

What More Can Be Done? Childhood Obesity In Glassboro, Nj, N. Mirmanesh, Seth Spicer, Stephen Acheampong, Mary K. Duggan

Rowan-Virtua Research Day

Childhood obesity is a growing public health concern in the United States, with an estimated 20% of American children being obese. In New Jersey (NJ), 9% of high school students are obese, and there are disparities in obesity rates based on gender, sexual identity, and race/ethnicity. In Gloucester County, NJ, limited data is available on childhood obesity rates, but 36.4% of adults are obese, and lower SES is related to higher rates of obesity in youth. To address this issue, this research poster proposes a partnership with the Boys and Girls Club of Glassboro to provide nutritional resources and create …

Global Comparison Of Health Policies Focused On Gestational Diabetes: Recognizing Pertinent Gaps, Muskanjot Kaur, Isvita Marfatia, Samarth Gupta, Swetha Sundaram, Anudeep Deevi, Venkat Venkataraman

Rowan-Virtua Research Day

Introduction: Gestational diabetes mellitus (GDM) is a condition that affects 14.7% of women globally and occurs when a mother develops diabetes during the course of her pregnancy.1 Increased insulin resistance in pregnant mothers can lead to further complications, such as a larger baby, increased risk of the baby developing Type II diabetes, having low blood sugar, and even premature birth, which can lead to respiratory issues. The lack of policies in place to address GDM in various countries worldwide highlights the need for this literature. It is necessary to compile policies that are currently in place and to further discuss …

Food Insecurity And Dietary Restrictions, Courtney Williams, Savana Rodriguez, Tiffany Guerrero, Stephen Acheampong, Vanesa Pizutelli

Rowan-Virtua Research Day

According to the USDA Food Insecurity affects around 10.2 percent of the US population as of 2021. For families that have members with certain dietary restriction such as, but not limited to diabetes, hypertension, gluten intolerance, lactose intolerance, and food allergies, the challenge of securing food becomes an even greater burden with having to navigate food banks or discount stores that may not offer food items that meet their dietary requirements. Families with dietary restrictions often face greater food insecurity and less access to food. More research is needed to understand the challenges families with dietary restrictions face regarding food …

Immigration Status And Household Income As Predictors Of Childhood Obesity, Bhaumik Patel, Jeffery Powers

Rowan-Virtua Research Day

Childhood obesity rates have been on a remarkably steep rise in recent years. According to recent literature, the rate in the United States alone has more than doubled compared to other regions in the world such as Australia, Canada and Europe1,2 . Especially in the African immigrant community, there has been speculation of a higher prevalence of childhood obesity in the United States3 . This warranted further investigation into demographic factors impacting childhood obesity rates and their subsequent consequences with other clinical diseases such as diabetes and heart disease. The CDC reports that in 2011-2014, among individuals ages 2 to …

Clinical Practice Workflow Implementation For The Improvement Of Diabetic Metric Compliance, Sugosh Anur, Sohil Khanna, Alison Mancuso, Alexander Kowalski

Rowan-Virtua Research Day

Recent guidance suggests the management of screen-detected diabetes can be optimized using multifactorial interventions to improve overall disease burden, patient outcomes, and cost-savings. We explored preventive diabetic care and implemented interventions to increase recommended testing compliance among patients with Type II Diabetes Mellitus. This study employed a multi-faceted approach beginning with the distribution of surveys to patients in the Stratford Family Medicine Office in order to gauge their health literacy level pertaining to Diabetes management. Patient electronic medical records were evaluated to determine baseline levels for all laboratory values. Data analysis was completed using Statistical Package for the Social Sciences …

Association Of Maternal Biomarkers With Gestational Weight Gain And Pre-Eclampsia, Matthew Green, Xinhua Chen

Rowan-Virtua Research Day

Background: There is convincing evidence that excessive gestational weight gain (GWG), based on the Institute of Medicine’s (IOM) 2009 guidelines, increases the risk of both maternal and neonatal complications.1-6 Although the association between excessive GWG and pre-eclampsia is well-established, the reason why this association exists remains unclear.

Methods: Previously collected data from a cohort of pregnant women in Camden, NJ between the years of 1998-2007 was used to examine the association between maternal serum biomarkers (C-peptide, IGF-1, Insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)) collected at entry (week 16) and 3rd trimester (week 28) and longitudinally assessed gestational …