Digital Commons Network^™

Community-Based Well Testing And Outreach To Mitigate Human Health Risk From Unsafe Drinking Water, W. Adam Sigler, Katharine Sutphen, Margaret J Eggers, Kaleena Miller, Michelle Grocke-Dewey

Journal of Extension

Twenty-two percent of groundwater wells tested nationwide have one or more contaminants above a health threshold, yet many private well owners are unaware of these risks because they have not tested their water. Researchers piloted a community well testing clinic for education/outreach and surveyed participants about outcomes. Two months later, 75% of participants with high or intermediate health risk water quality results had taken action or intended to, indicating that community private well testing clinics can be effective in mitigating human health risks from contaminated drinking water.

Rethinking Existing Extension Programming: A Foundation For Healthy Aging?, Nicholas J. Spokely, Sloane A. Montgomery, Kelsey J. Weitzel, Kristin A. Miller, Marta Novaes Oliveira, Stephen D. Ball, Breanne S. Baker

Journal of Extension

Muscle declines are becoming more prevalent in younger adults, driving the need for accessible exercise programs. The Stay Strong, Stay Healthy (SSSH) Extension program was developed for adults 60 years old or older, but for this study, we enrolled 135 participants aged less than 60 years old in rural and urban counties to assess if it could improve their muscle performance. We analyzed data with time and group comparisons using paired t-tests and 2 × 2 repeated measures ANOVAs. Younger adults significantly improved muscle performance after SSSH, and the results were similar between rural and urban counties. This study …

Have You Done Your Duty? Impact Of Direct Mailing Campaign On Septic System Owners' Maintenance Knowledge And Behaviors In Coastal Texas Watersheds, Audrey Mccrary, T. Allen Berthold

Journal of Extension

As part of a watershed protection plan, the Texas Water Resources Institute and AgriLife Extension Service developed and distributed an educational postcard (``mailer'') about septic system maintenance to mailing addresses outside of public sewer service areas. The mailer was distributed four times within 1 year. The impact of this mailer was evaluated with a retrospective pre/post-test within a mailed survey. Overall, the mailer was effective at increasing knowledge of septic system owners and prompting maintenance action. Mailers can be a cost-effective alternative for educational initiatives where the target audience is not able to or interested in in-person or online programs.

Environmental Predictors Of County-Level Drowning Rates In Georgia, Jeff Turner

Journal of the Georgia Public Health Association

Background: Recent increases in drowning rates, both nationally and within Georgia, have led to renewed interest in the individual, situational/behavioral, and environmental characteristics that impact drowning. This study examines the association between two environmental characteristics, natural surface water coverage and public pools, on drowning fatalities and drowning-related ER visits by county in Georgia

Methods: We gathered county-level data on drowning fatalities and drowning-related ER visits and the number of public pools from the Georgia DPH, surface water coverage from the US Census Bureau, and demographic measures from the CDC. We conducted a linear regression analysis to identify how …

Beyond Screening In Amyotrophic Lateral Sclerosis: A Domain-Standardized, Measure-Flexible Framework For Comprehensive Neuropsychological Assessment, Etiane Navarro

Archives of Assessment Psychology

Amyotrophic lateral sclerosis (ALS) is a multisystem neurodegenerative disorder in which cognitive, behavioral, language, and social-cognitive changes may occur across clinical phenotypes, including the ALS-frontotemporal spectrum. Neuropsychological assessment is important for characterizing nonmotor manifestations and identifying changes relevant to autonomy, everyday functioning, and clinical management. This systematic review examined literature identified through APA PsycINFO, PubMed, Google Scholar, and supplementary searching to characterize neuropsychological domains, measures, phenotype-related findings, and disease-specific limitations relevant to comprehensive assessment. Two hundred records underwent title and abstract screening, 150 reports were reviewed in full text, and 61 resources were retained for synthesis. ALS-specific screening instruments, including …

Virginia Team Nutrition Training Grant Workshop Participation Increased Intention To Change In Specific Topics, Rachel A Liebe, Kathleen J Porter, Valisa Hedrick, Elena Serrano, Kelly Shomo, Sandra Curwood, Sarah Misyak

Journal of Extension

Team Nutrition is implemented nationally to improve school food environments. Yet evidence on factors impacting implementation is limited. This study aimed to evaluate the execution of the Team Nutrition Training Grant (TNTG) in Virginia elementary schools using the RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) framework. The TNTG grant was implemented through two train-the-trainer workshops that were conducted with school nutrition directors (SNDs). Overall, SNDs from 84% of school divisions attended at least one workshop. Intention to change increased significantly from pre- to post- for both workshops in some target areas. This evaluation could help practitioners guide the development of evaluation …

Demographic And Socioeconomic Factors Influence Perceived Community Needs And Risk Factors For Firearm Violence In Mississippi, Masoumeh Karimi, Matthew Morris, Xiaoshan Gordy, Matthew Kutcher, Leila Seidfaraji, Michelle Brassfield, Erin Dehon, Alyscia Severance, Rukia Lumumba, Fredrick Womack, Lei Zhang

Journal of Public Health in the Deep South

Background: The burden of firearm-related injuries and deaths is not borne equally across sociodemographic groups. The present study investigated the perceived needs and risk factors of firearm related injuries and mortality across gender, education, and income levels through a quantitative needs assessment completed by community members and firearm injury survivors living in the greater Jackson, Mississippi, metropolitan area.

Methods: A total of 93 participants including gunshot wound patients, survivors and community members who have been recruited through community organizations completed the needs assessment survey collecting data on demographic information, firearm exposure, substance use, community exposure to crime and …

Pilot Evaluation Of A Cross-Disciplinary Training Addressing Substance Use Among Mississippi Mothers, Saijun Zhang, Catherine Poehling, Xiaoshan Gordy, Chinedu P. Chukwu, Jerome R. Kolbo, Masoumeh Karimi, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsenee Davis, Sonja Fuqua, Lei Zhang

Journal of Public Health in the Deep South

Background: Intimate partner violence (IPV) and substance use co-occurring is often managed in siloed systems. Training IPV and related service providers on substance use topics may strengthen screening, response, and referral.

Purpose: To assess whether a pilot training program on substance use disorders (SUDs) in Mississippi improved service providers’ knowledge, preparedness, and attitudes around substance use and satisfaction with the training.

Methods: Pre–post surveys were administered to healthcare and community service providers who completed the training, assessing substance use service-related knowledge, preparedness, and attitudes.  Descriptive statistics and t-tests were used to analyze the data.

Results: Fifty-nine providers completed a …

Prevalence Of Vitiligo In East Africa: Systematic Review And Meta-Analysis, Kedir Seid, Chala Getaneh Jaleta, Sintayehu Samuel Lorato, Mitiku Desalegn, Dawit Tesfaye Rundasa, Yohannes Godie Ashebir, Olyad Kuma Getahun, Gebeyehu Lakew, Mathewos Mekonnen Gemmechu, Mulualem Endeshaw Zeleke, Yibeltal Assefa Atalay, Amlaku Nigusie Yirsaw, Eyob Ketema Bogale, Abiy Hailu Tikuneh, Abas Ali Hassen, Eyasu Alem Lake, Tadesse Nigussie, Bushra Bibi, Fikiru Yigezu Y. Jaleta, Abebe Gedefaw Belete, Genanew Kassie Getahun

Research outputs 2022 to 2026

Background: Vitiligo is a chronic skin disorder characterized by the loss of melanocytes, resulting in depigmented macules and patches. No accurate estimate has been made of the prevalence of vitiligo in East Africa.

Objectives: To determine the prevalence of vitiligo in East Africa via a systematic review and meta-analysis of the literature.

Methods: A systematic review and meta-analysis were performed in accordance with the PRISMA guidelines. Eleven articles were retrieved from PubMed/MEDLINE, Embase, Scopus, Google Scholar, Science Direct, Web of Science and African Journals Online. Microsoft Excel was used to extract the data, which were then exported to STATA 17 …

Women's Experiences Of Menstrual Pain And Perceptions Of Acupuncture: A Qualitative Study, Weiting Liu, Amanda Towell-Barnard, Khui Hung Lee

Research outputs 2022 to 2026

Introduction: Menstrual pain is a common reproductive health concern that can substantially disrupt physical, emotional, and social well-being, yet it is frequently normalised and insufficiently addressed within healthcare encounters. Acupuncture is increasingly used as a complementary approach for menstrual pain management; however, little qualitative research has explored how women understand, interpret, and navigate this option within their menstrual care.

Methods: A qualitative descriptive study was conducted using four online focus groups with 14 women aged 19–46 years residing in Australia who self-reported primary dysmenorrhea. Participants were purposively sampled from respondents to a previous cross-sectional survey study who had indicated willingness …

Flourishing Childhood Frameworks: A Scoping Review, Jacqueline A. Davis, Zenobia Talati, Lisa Y. Gibson, Jack Kennare, Christina Bethell, Christina Hinton, Hannah Block, Tara D'Silva, Desiree Silva, Susan L. Prescott

Research outputs 2022 to 2026

Objectives: Experiences in early life impact childhood, lifelong flourishing, and overall well-being. Yet a framework to guide promoting and measuring flourishing in early childhood has not emerged. The objective of this study was to identify frameworks and measures related to promoting and assessing early-childhood flourishing (0-5 years) to build on a preexisting, community-informed framework.

Methods: A systematic search was conducted across electronic databases and the gray literature for articles published between 2014-2026. Of 13 902 total references, 8592 were eligible for screening. A machine learning-assisted tool (Research Screener) was used to streamline screening of the abstracts against the inclusion criteria. …

Building Health Resilience Against The Threat Of “Jakarta Sinking”: A Scoping Review, Risky Kusuma Hartono, Dewi Shinta

Journal of Indonesian Health Policy and Administration

In Jakarta, land subsidence amplifies flood risks—often described as the city “sinking”—which increases exposure to waterborne and vector-borne diseases, disrupts essential health services, and undermines health system resilience. This review examines how subsidence-induced flood amplification impacts health and its implications for system resilience. This study employs a literature review approach that combines narrative synthesis with scoping-oriented evidence mapping. Peer-reviewed articles in English or Indonesian (2015–2025) were searched across PubMed, Scopus, ScienceDirect, Google Scholar, and Portal Garuda using the following terms: flooding, Jakarta land subsidence, health impacts, and health system resilience. Data on hazards, populations, health outcomes, and resilience functions were …

Situational Analysis Of Maternal And Child Health Problems In Dki Jakarta Province In 2024, Jennifer Irene Amorita Hadiono, Helda Helda, Tri Yunis Miko Wahyono, Inggariwati Inggariwati

Jurnal Epidemiologi Kesehatan Indonesia

Maternal and child health (MCH) is a critical indicator of national health development aligned with SDGs targets. DKI Jakarta, as a densely populated capital city, faces unique challenges in providing equitable MCH services. This study aims to analyze the situational status of MCH problems in DKI Jakarta Province in 2024 and to determine health priorities using the PAHO-adopted Hanlon method. A descriptive study using quantitative and qualitative approaches was conducted at the DKI Jakarta Provincial Health Office from October 2024 to January 2025. Primary data were collected through structured interviews, while secondary data were sourced from reports of the Nutrition …

Descriptive Epidemiology Of Tuberculosis Case With Diabetes Mellitus Identified Through Screening Activities In Indonesia, 2024, Chrisshanti Putri Pasaribu

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) remains a major public health problem, particularly among individuals with diabetes mellitus (DM), who are at an increased risk of developing TB disease. Screening activities conducted through health facility-based screening and active case finding (ACF) provide opportunities to identify TB cases with DM comorbidity. This study aimed to describe the epidemiological characteristics of TB-DM cases identified through screening activities in Indonesia in 2024. This descriptive study used routine secondary program data obtained from the Tuberculosis Information System (SITB). The source population consisted of 615,357 individuals screened for TB in 2024, among whom 14,727 TB cases were identified. Of …

Psychosocial And Demographic Determinants Of Work Stress Among Lecturers At University X, Natasha Putri Ayu Kayla, Fajaria Nurcandra, Dr. Dyah Utari, Nayla K. Fithri, Siti Norashikin Mohamad Shaifuddin

Jurnal Epidemiologi Kesehatan Indonesia

Occupational stress is a psychological pressure related to work conditions. Psychosocial and demographic determinants may be the influence. Lecturers are white collar workers who have the opportunity to experience occupational stress. The aim of this study is to determine the factors that influence occupational stress among lecturers in X University. This research is a quantitative study with a cross-sectional study design. The sampling technique used is Accidental Sampling. The number of samples used was 132 respondents. The study was conducted in April-June 2024. The Cox Regression Model was used to analyze. The instruments used were The Workplace Stress Scale, Multidimensional …

Evaluation Of Disaster Mitigation Policy Implementation And Public Health Integration Through The “Sipatokkong” Program In Strengthening Tourism Village Resilience, Nurul Azisah Sahrani, Andi Alif Raihan Analta

Journal of Indonesian Health Policy and Administration

Disaster risks in tourism villages are increasing, generating multidimensional impacts on environmental, economic, institutional, and public health. In late 2024, Mattabulu Tourism Village experienced an 83% decline in tourist visits following a series of disasters, disrupting tourism activities and weakening local governance capacity. This study uses a qualitative case study design to evaluate disaster mitigation policy implementation through the “Sipatokkong” Program. Evaluation applied four Organisation for Economic Co-operation and Development–Development Assistance Committee (OECD-DAC) criteria: relevance, effectiveness, impact, and sustainability, operationalized through policy implementation, street-level bureaucracy, and collaborative governance frameworks. Data were obtained from five documents and non-participatory field observations conducted …

Intimate Partner Violence And Child Wasting Across Countries: An Ecological Cross-Sectional Study, Wanri Lumbanraja, I Ketut Kasta Arya Wijaya, Ruben Cornelius Siagian

Journal of Indonesian Health Policy and Administration

Intimate partner violence (IPV) is a public health issue that can affect the well-being of women, their families, and the child-rearing environment. Meanwhile, wasting in under-five children reflects acute malnutrition linked to food insecurity, infectious diseases, poverty, and access to healthcare services. This study aimed to analyze the relationship between the prevalence of IPV among women in the past 12 months and the prevalence of wasting in children under the age of five at the national level. This study addresses the gap in cross-national research, which remains limited in linking IPV as an indicator of social vulnerability with wasting as …

Perceived Susceptibility And Automatic Compliance In Indonesia's Triple Elimination Screening: A Mixed-Methods Study, Ratna Dewi Puspita Sari, Josef Maria Seno Adjie

Journal of Indonesian Health Policy and Administration

Despite global commitments to eliminating mother-to-child transmission of human immunodeficiency virus, syphilis, and hepatitis B, gaps remain in understanding the behavioral and systemic drivers of screening coverage in decentralized health systems such as Indonesia. This study aimed to analyze individual behavioral determinants and structural health system barriers affecting triple elimination screening coverage among pregnant women, focusing on perceived susceptibility and automatic compliance. A mixed-methods sequential explanatory study was conducted in Central Jakarta, Surabaya, and Karawang. The quantitative phase involved a cross-sectional survey of 1,224 pregnant women, with Health Belief Model variables analyzed using logistic regression. The qualitative phase comprised three …

Effectiveness Of Pancreatic Cancer Screening In High-Risk Elderly Individuals In Florida, Adeleke A. Aromolaran

Walden Dissertations and Doctoral Studies

Routine preventive care supports early identification and management of health conditions among adults at high risk for pancreatic cancer. Evidence is limited regarding socioeconomic and health care access factors associated with engagement in routine preventive care among Florida adults aged 65 years and older at high risk for pancreatic cancer. The purpose of this quantitative cross-sectional correlational study was to examine these associations among this population. The health belief model served as the theoretical framework. Secondary data from the 2022 Florida Behavioral Risk Factor Surveillance System were analyzed for N = 4,032 participants using two multivariable binary logistic regression models …

A Retrospective Descriptive Profile Of Cancer Patients Seeking Homoeopathic Care In A Semi-Rural South African Setting, Radmila Razlog

Indian Journal of Research in Homoeopathy

Background: Patient profiling renders valuable information about the population's healthcare-seeking behaviours, critical for effective patient management. Khula Natural Health Centre (KNHC) in South Africa provides healthcare to rural communities, within the scope of Homoeopathy. Objective: The study aimed to create a preliminary cancer patient profile of KNHC from April 2017 to August 2024. Method: This retrospective study adopted a descriptive, exploratory design. Anonymised patient data was extracted from the KNHC database. Data that met the inclusion criteria were descriptively analysed to summarise and describe the dataset. Results: Forty-six participants' data, presenting a range of cancers, consulted at KNHC for homoeopathic …

Prenatal Cannabis Exposure Is Associated With Occipitotemporal Brain Surface Area In Neonates, Alexander J. Dufford, Sun Hyung Kim, Martin Styner, Xinyi Shen, Erika Iisa, Marilyn A. Huestis, Peter Fried, Christine Conageski, Jocelyn E. Phipers, Cristina Sempio, Jost Klawitter, Pilyoung Kim, Tessa L. Crume

Institute of Emerging Health Professions Faculty Papers

IMPORTANCE: Prenatal cannabis use has been associated with neurodevelopmental consequences for the offspring beginning in childhood; however, it is unclear if neonatal brain structural morphometry is impacted shortly after birth.

OBJECTIVE: We examined differences in regional surface morphometry among neonates exposed to chronic in utero cannabis compared to unexposed neonates.

DESIGN: The Moms Helping Moms study is a prospective pre-birth cohort selected based on chronic prenatal cannabis use and an unexposed control group. Exclusion criteria included alcohol, tobacco, or other substance use. Participants included in this analysis included 18 mother-neonate pairs with prenatal cannabis exposure and 21 unexposed pairs. Chronic …

Impact Of Sexual Orientation On Syphilis Diagnosis Among African American Men In Colorado, Emmanuel Bhatti

Walden Dissertations and Doctoral Studies

Syphilis remains an ongoing public health concern among African American men. Elevated rates during the COVID-19 pandemic further underscored the need for focused attention on this population. The risk factors driving syphilis diagnosis among African American men during a pandemic like COVID-19 remain poorly understood. The purpose of this quantitative cross-sectional study was to examine the association between sexual orientation and syphilis diagnosis among African American men in Colorado. Social cognitive theory was applied to understand the interaction among sexual orientation, HIV status, age, and syphilis diagnosis. Sexual orientation categories include men who have sex with men (MSM), men who …

Faktor-Faktor Yang Berhubungan Dengan Kejadian Prediabetes Pada Perawat Di Rumah Sakit X Tahun 2025, Putri Nurhaliza, Chandrayani Simanjorang, Agung Raharjo

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Prediabetes dapat berkembang menjadi diabetes melitus dan meningkatkan risiko penyakit kardiovaskular. Selain itu, beban ekonomi juga meningkat akibat tingginya biaya pelayanan kesehatan dan penurunan produktivitas kerja. Salah satu kelompok berisiko prediabetes adalah perawat karena karakteristik pekerjaannya, seperti penerapan sistem kerja sif serta tingginya beban dan tekanan kerja yang dapat memicu stres. Penelitian ini dilakukan untuk mengidentifikasi faktor-faktor yang berhubungan dengan kejadian prediabetes pada perawat di Rumah Sakit X pada tahun 2025. Desain studi yang digunakan adalah cross-sectional dengan sumber data primer yang dikumpulkan melalui pengisian kuesioner dan data sekunder yang diperoleh dari laporan hasil medical check-up tahun 2025. Populasi dalam …

Harmonies Of Healing: A Secondary Data Analysis On Music Engagement And Quality Of Life In Older Adults, Theophilus Eben Nartey

Doctoral Dissertations and Projects

The purpose of this quantitative, cross-sectional secondary data analysis was to examine the relationship between music engagement and self-reported quality of life among adults aged 60 years and older, using data from the Health and Retirement Study (HRS). Guided by the Biopsychosocial-Spiritual (BPSS) framework, the study explored whether music engagement significantly predicted perceived well-being in later adulthood while accounting for chronic health conditions. Secondary data from the HRS public-use dataset were analyzed using IBM SPSS Statistics Version 29. The final analytical sample consisted of 1,582 adults aged 60 years or older with complete data on all variables included in the …

Progress, Poetry, And Peace: Romantic Ideals And The Present Day, Kristen Dawn Morgan Hess

Masters Theses

In the busy, technologized, and mechanized life that most people live today, it can be difficult to find true rest, comfort, and peace because the very technology and machinery that is marketed as providing these 21st-century amenities often fall short in their delivery. Taking a look backward at the Romantic era ideals presented in the poetry of William Wordsworth can offer people today the chance to gradually improve their mental, physical, and emotional health by slowing down, minimalizing, and moderating their lifestyles. This thesis talks about the historical background of three of Wordsworth’s poems— “Lines Written in Early Spring,” “The …

Barriers And Facilitators To Health Literacy Among Black Americans With Overweight And Obesity In South Carolina: A Mini-Ethnographic Study, Shelly Campbell-Timmons

Doctoral Dissertations and Projects

The purpose of this qualitative mini ethnography adapted from traditional ethnography with limited time and scope, was to explore and understand perceptions of barriers and facilitators to health literacy among Black Americans with overweight and obesity in three South Carolina counties. Population data showed that approximately 40.3% of U.S. adults are obese. Moreover, Non-Hispanic Black communities are disproportionately affected by overweight and obesity despite efforts to combat the weight-related health risk. Still, limited health literacy should be the focus of public health strategies like teach-back and plain language communication, to address overweight and obesity prevalence and disparities. The study was …

Understanding The Lived Experiences Of Individuals With Post-Acute Sequelae Of Sars-Cov-2 Infection (Pasc) In Rwanda: A Phenomenological Qualitative Study, Iliza Grace Ndatinya, Simal Thind, Fernand Rwamwejo

Global Health Articles

OBJECTIVES: To qualitatively explore the lived experiences of individuals with post-acute sequelae of SARS-CoV-2 infection (PASC) in Rwanda, with the aim of informing context-appropriate interventions to improve patients' quality of life.

DESIGN: Qualitative, phenomenological study using in-depth interviews and thematic analysis.

SETTING: All provinces of Rwanda, including the City of Kigali.

PARTICIPANTS: Adults who tested positive for PASC during a nationwide prevalence study were purposively sampled across all study sites. A total of 30 people were interviewed before saturation was reached.

RESULTS: Participants' lived experiences with PASC were characterised by numerous themes. Despite describing significant life changes since their COVID-19 …

Degree Assortativity And Estimation Of Degree Distribution In A Contact Network Of People Who Inject Drugs, Peter Geissert

Dissertations and Theses

This dissertation analyzes data from a respondent driven sampling (RDS) study of people who inject drugs in Portland, OR.  The objective was to assess assumptions for the use of weighted estimators to estimate a population physical contact (syringe sharing) network degree distribution.

Visualization of degree distribution for social and physical networks, Kolmogorov-Smirnov tests of difference, and kernel tests of equivalence were used for comparison of distributions. Spearman's rho and GAM non-parametric regression models were used to test for association and assess non-monotonic relationship. The validity of Markov chain assumptions for RDS was assessed using a transition matrix, Markov chain graphs, …

Integrating Public Health Into Communication Sciences And Disorders Curriculum, Whitney D. Perkins, Yalanda M. Barner, Jennifer Wiles, Brandi Newkirk-Turner

Teaching and Learning in Communication Sciences & Disorders

The field of Communication Sciences and Disorders (CSD) is increasingly integrating public health into its practice and research. This is because less than 10% of speech-language pathology and audiology graduate programs are housed within Colleges or Schools of Public Health (PH), reducing the likelihood that students in CSD have the opportunity for coursework and co-curricular activities that integrate PH and CSD. In this paper, we discuss the holistic approach we used to integrate PH into a CSD program at a Historically Black University. The approach was guided by PH and CSD accreditation standards and involved a didactic course, CSD courses …

A Mixed Methods Study Of Inpatients’ Experiences, Priorities, And Health-Related Quality Of Life During High- Flow Nasal Cannula Therapy, Cintamani H. Ellsworth, Rebecca S. Bartlett

Journal of Patient-Centered Research and Reviews

Purpose: High-flow nasal cannula (HFNC) is an oxygen delivery method with numerous benefits for severely ill patients. There is a paucity of research focused on the perspectives of patients receiving HFNC oxygen therapy. This study aimed to engage with patients to gain a clearer understanding of their experiences, priorities, and health-related quality of life.

Methods: A cross-sectional, mixed methods study was completed with 10 adult inpatients who had received HFNC oxygen therapy during their hospital admission. Semi-structured interviews and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale were used to identify participant perceptions of their physical and …