Digital Commons Network^™

Association Between Homelessness And Maternal Health Outcomes Among Non-Hispanic Black Women In Georgia, Miranda Weaver

Walden Dissertations and Doctoral Studies

Maternal health disparities among homeless non-Hispanic Black women in Georgia represent a critical public health concern, driven by inequitable access to care and elevated risks of adverse pregnancy outcomes. This study examined how homelessness influences perinatal care utilization (timing and frequency of prenatal visits and postpartum checkups) and pregnancy complications (gestational diabetes, hypertension, and depression), and whether these associations differ by geographic context (urban versus rural). Grounded in the Social Determinants of Health framework, the study used a quantitative cross-sectional design, analyzing secondary data (n = 1,540; weighted ≈ 203,571) from Phase 8 (2017–2021) of the Pregnancy Risk Assessment Monitoring …

The Covid-19 Lockdown And Diabetes Self-Management In Esan Northeast Area Of Edo State, Esther Ehivbaun Rapu

Walden Dissertations and Doctoral Studies

The COVID-19 lockdown impacted chronic diseases care globally, but there is limited research on how individuals in rural Nigerian communities managed diabetes during this period. This qualitative phenomenological study explored the lived experiences of self-management with diabetes during the COVID-19 lockdown among adults in Esan Northeast. The socioecological model (SEM) served as the guiding conceptual framework, allowing for the exploration of the impact of individual, interpersonal, community, and institutional factors on self-care behaviors. The research explored how cultural, social and economic factors impacted how adults with diabetes in Esan Northeast managed their condition during the COVID-19 lockdown. Semi-structured interviews via …

Predicting Dietary Behavior In Obese Adult Diabetics Using Social Cognitive Theory, Precious Mueller

Walden Dissertations and Doctoral Studies

Predicting Dietary Behavior in Obese Adult Diabetics Using Social Cognitive Theory by Precious Mueller MA, University of Phoenix, 2009 BS, University of Iowa, 2006 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University November 2024 “ Diabetes mellitus Type II is a prevalent and serious condition affecting millions globally, particularly among obese adults. The association between dietary behaviors and diabetes management is critical, as it directly impacts health outcomes and quality of life for affected individuals. This study aims to identify the determinants of dietary behaviors that influence Type II …

“The Technology We’Ve Been Forced To Use”: Impact Of Online Service Delivery For Kinship Families During The Covid-19 Pandemic, Angela Tobin, Amanda Klein-Cox, Ramona Denby

Social Work Faculty Research

Purpose: The COVID-19 pandemic rapidly changed the service landscape for both professionals and families. Kinship families, who often navigate multiple systems concurrently with higher service needs, were among the most vulnerable. This study explores kinship caregivers’ and child welfare professionals’ perceptions of changes in service delivery during the pandemic, specifically the sudden shift to virtual platforms.

Materials and Methods: To understand participants’ experiences, focus groups with protocols shaped by initial Delphi Rounds were implemented with 25 kinship caregivers and 34 child welfare professionals from a national sample.

Results: Caregiver and professionals shared themes related to how COVID-19 precautions impacted service …

Unintentional Drowning In Florida: An Analysis Of Demographic And Water Type Associations Among Youth And Young Adults, Michelle Sterling

Walden Dissertations and Doctoral Studies

Unintentional drowning is a leading cause of preventable injury fatalities among youth and young adults in the United States. Despite the preventability, drowning continues to affect specific populations disproportionately. Limited research has examined demographic and environmental factors that contribute to drowning fatalities among individuals aged 5 to 25 years old in Florida. Understanding these patterns is key to informing targeted prevention strategies. This quantitative, retrospective study explored the relationship between demographic characteristics (i.e., gender, race, and ethnicity), environmental context (i.e., water type), and drowning fatalities of 5- to 25-year-olds in Florida from 2018 to 2022. Data for this study, which …

Enhancing Hypertension Management In Correctional Facilities: Educating Advanced Practice Providers On Effective Strategies, Kimbreya E. Otey

Doctoral Dissertations and Projects

Hypertension is a leading risk factor for cardiovascular disease and remains a significant public health concern, particularly within correctional facilities where access to consistent guideline-based care is often limited. Incarcerated individuals experience higher rates of chronic conditions, including hypertension, yet standardized approaches to management are frequently lacking. To address this gap, an evidence-based educational program was developed for nurse practitioners (NPs) and physician assistants (PAs) working in the correctional setting. Grounded in the International Society of Hypertension (ISH) guidelines, the program was developed to enhance awareness and knowledge among NPs and PAs regarding evidence-based hypertension management practices using the International …

The Protective Factors Of Trauma-Informed Care For Parents With Autistic Children, Carolynn J. Redd-Recksiek

Doctoral Dissertations and Projects

The purpose of this current phenomenological study is to understand the experience of parents with autistic children and their lack of trauma-informed care from direct care providers in Northern Utah. This study is guided by trauma-informed theory, which is a model of care delivery created by Maxine Harris and Roger D. Fallot (2001). Trauma-informed care recognizes how adverse experiences can impact a person and have a negative impact on the health and well-being of that person and how those negative experiences have a direct impact on the health and well-being of the family, which directly impacts the health and well-being …

Type Of Intimate Partner Violence And Association With Perpetrator Demographics, Katrisha Williams

Walden Dissertations and Doctoral Studies

Intimate partner violence (IPV) is a public health concern because of its long-term impact on health and well-being with 1 in 4 American women experiencing some form of IPV. To help understand how age, gender, and race of both, the perpetrator and victim, impact the type of IPV, multiple regression analysis was performed with secondary data from the National Intimate Partner and Sexual Violence survey (N=541). This study used Raewyn Connell’s Theory of Masculinity as a conceptual framework. This theory states that males have a need to show dominance, strength, and suppress emotion, which can inform patterns of violence in …

Black Men And Health Literacy: Strategies For Improvement In A Digital Age Through The Adaptation Of A Chronic Disease Self-Management Program, Evelina Weidman Sterling, Laura Stevens, Vanessa Robinson-Dooley, Tyler Collette

Faculty Articles

Health literacy is a critical determinant of health outcomes, yet it is often overlooked, particularly among marginalized groups. This paper explores the significance of health literacy, with a particular focus on low-income African American and Black (AA/B) men, a population that faces unique challenges due to intersecting factors such as race, gender, socioeconomic status, and educational disparities. We examine how these factors contribute to health literacy gaps, highlighting adverse effects on health outcomes for AA/B men compared to the general population. Additionally, we stress the growing importance of digital literacy in an increasingly technology-driven world. Not actively addressing digital health …

Academic Stress Among Jss High School Students In Mysuru And Chamarajanagar Districts: A Cross-Sectional Study, Lathika R, Dr Sunil Kumar D, Krishnamurthy K V, Dr Rakshitha J

Digital Journal of Clinical Medicine

Background

In today's world, students face academic stress which leading to anxiety, poor performance in academics and many other issues like nervousness, panic attacks and depression mainly derived from grades, parental pressure, and competition between the students. With the above background study aims to estimate the prevalence and assess the associated factors of academic stress among high school adolescents.

Method

A cross-sectional study was conducted to explore the academic stress among JSS high school students of Mysuru and Chamarajanagar districts. A total of 379 were selected through Probability proportional to size (PPS) sampling. Structured questionnaire was used to assess the …

Stratifying The Population Based On Health Risk: Identification Of Patient Key Health Risk Factors Through Consensus Techniques, Carolina Castagna, Andrew Huff, Aaron Douglas, Phd, Matteo Garofano, Massimo Fabi, Richard W. Hass, Vittorio Maio

College of Population Health Faculty Papers

BACKGROUND: Risk stratification is a population health management approach that classifies patients according to their health risks and projected care needs. This strategy is especially valuable in primary care, where timely interventions for high-risk individuals can lead to better health outcomes, reduced healthcare expenditures, and a more sustainable healthcare system. The goal of this study was to establish expert consensus on the clinical and sociodemographic patient factors that should be incorporated into a primary care risk stratification tool.

METHODS: A multidisciplinary expert panel of 24 healthcare professionals, including primary care providers (PCPs), specialists, and allied health professionals, was convened in …

A Cancer Education Needs Assessment: Informing Middle-Aged Female Patients About The Relationships Between Obesity And Women’S Health Concerns In The Reproductive System, Breast, And Endometrial Health, Batul Mirza

MUSC Theses and Dissertations

Obesity significantly impacts women’s health, particularly among middle-aged women, by increasing the risk of hormone-sensitive cancers such as breast, endometrial, and reproductive system cancers. This study examines the educational needs of this demographic group regarding obesity-related cancer risks and explores effective intervention strategies. Obesity-induced mechanisms – hormonal imbalances, chronic inflammation, and insulin resistance – drive cancer susceptibility, emphasizing the need for targeted health education. The study employs a qualitative design, which includes interviews with subject matter experts (SMEs) and surveys of middle-aged women. The goal is to assess awareness, perceived barriers, and preferred learning methods. Findings suggest that with many …

State-Level Immigrant Policies And Diabetes Prevalence In Latino And Asian American Groups: A Weighted Multilevel Analysis, Md Towfiqul Alam, Jennifer Toller Erausquin, Erica Payton, Elizabeth Vásquez, Sandra Echeverria

Faculty Scholarship

Introduction: Growing literature has shown that immigrant-related policies influence population health by limiting or enhancing immigrants’ rights. However, less is known about the role of state-level immigrant policies shaping chronic health conditions such as type 2 diabetes (T2DM). This cross-sectional study examined the association between state-level immigrant policies (both criminalising and inclusive) and prevalence of T2DM among individuals of Latin American and Asian American origin.

Method: We included adults aged 18+years sampled in the 2014–2018 behavioral risk factor surveillance system (BRFSS) (n=201 824), a survey design that allows the calculation of state-level estimates. Using existing policy measures, states …

Prenatal Maternal Mood Instability And Child Externalizing Problems: An Ecological Momentary Assessment Study, Sophie G. Srivastava, Curt A. Sandman, Elysia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

This study examines whether exposure to affect fluctuations during fetal development have implications for child psychopathology. To evaluate maternal mood instability, participants (N = 154) completed Ecological Momentary Assessment (EMA) eight times per day across three days at 15-, 25-, and 35-weeks' gestation, and then at two months postpartum. The EMA measured depressive symptoms (Center for Epidemiologic Studies Depression Scale), anxiety (Profile of Mood States), and stress (Perceived Stress Scale). Mood instability was quantified by calculating root mean square of successive differences (RMSSD), which captures both variability and temporal dependency of mood states. When the children were 3 years …

Prenatal Psychosocial Distress Screening For Individuals Experiencing Pregnancies Complicated By Fetal Anomalies., Kara Hansen, Lisa Mische Lawson, Abigail Wilpers

Manuscripts, Articles, Book Chapters and Other Papers

Pregnant individuals who receive a fetal anomaly diagnosis experience significantly elevated rates of depression, anxiety, and traumatic stress-up to four to six times higher than those for individuals with low-risk pregnancies. In low-risk pregnancies, perinatal mental health conditions are the leading cause of maternal mortality and are associated with adverse birth outcomes, including preterm birth and low birth weight. These risks are likely compounded in pregnancies involving fetal anomalies due to the intersecting psychological and social burdens that complicate maternal well-being and access to care. However, there is a critical gap in understanding how these mental health symptoms translate into …

Analyzing Environmental Health: Air Pollution And Human Health Using Geospatial Data Science, Yanhong Huang

Geography ETDs

Air pollution from industrial emissions and wildfire smoke poses growing threats to public health. This dissertation employs geospatial data science to examine these challenges through three interrelated studies. The first study investigates the relationship between maternal residential exposure to industrial pollutants and low birth weight, identifying five chemicals as significant risk factors. The second study assesses the impact of industrial air pollution on lung and bronchus cancer survival, finding that exposure to 1,1,1-trichloroethane and cobalt is associated with reduced survival. The third study explores disparities in wildfire smoke PM_2.5 exposure and its association with asthma exacerbations. Results show disparities …

Mechanisms And Intermediate Outcomes Of A Community Translation To Adapt A Whole Family-Inclusive Lifestyle Intervention: A Pilot Evaluation, Megan J. Moran, Kimberly Padilla, Abby Neiser, Nicole Clark, Virginia Jimenez, Natalia Sanchez, Talia Thompson, Ana M. Gutierrez-Colina, Jesse Owen, Chesleigh Keene, Matthew A. Haemer, Lauren B. Shomaker

Journal of Patient-Centered Research and Reviews

Purpose: Involving community members in the process of translating scientific evidence into health messaging and interventions can lead to improved health outcomes and more patient-centered healthcare. Community Translation (CT) is one methodology for fostering collaboration between researchers and community members, and it has been shown to result in locally relevant, acceptable solutions to health challenges. There has been very little research on the direct effects that participation may have on community members who become involved in CT. Understanding the mechanisms of CT and its outcomes on participating community members is essential to maximizing the potential of CT. To address this …

Emergency Managers Perceived Effectiveness Of Disaster Mitigation Plans And Training Focused On The Special Needs Population, Jessica Windsor

Walden Dissertations and Doctoral Studies

The special needs population faces increased vulnerability during disasters, yet disaster planning often overlooks their unique requirements. This study focuses on the experiences and perceptions of emergency managers in the Southeastern United States. The purpose of the study was to examine the extent to which emergency management plans recognize and address the needs of special populations and identify training gaps. The research questions aimed to uncover the factors that influence inclusive planning, training effectiveness, and resource allocation. Grounded in the Disaster Health Framework, the study utilized a qualitative research design involving surveys with 14 emergency managers, followed by thematic analysis …

Akses Jaminan Kesehatan Terhadap Pekerja Perempuan Rentang Umur 25-29 Tahun Pada Setiap Provinsi Di Indonesia Tahun 2017: Studi Cross-Sectional, Rahma Rosita Dewi, Sabrina Putri Fatonah, Zahra Amalia, Intan Silmi Alya Mahmud, Rayhan Ramadhan

National Journal of Occupational Health and Safety

Health insurance is a fundamental right guaranteed by the Indonesian government. However, coverage among female workers aged 25–29 remains low with significant disparities across regions. This cross-sectional study aims to analyze access to health insurance among female workers aged 25–29 in Indonesia and identify factors contributing to these gaps. The study used secondary data from the 2017 Indonesian Demographic and Health Survey (SDKI), involving 8,394 women who met the inclusion criteria, focusing on health insurance ownership status. Descriptive analysis was conducted to assess the distribution of coverage proportions across regions, with bias control performed through data selection and multi-layered validation …

Faktor Yang Berhubungan Dengan Keluhan Heat Strain Pada Pekerja Overhaul Tangki Di Pt. X Kota Balikpapan, Bratarini Hassya Chilwindwi, Iwan Muhamad Ramdan, Dewi Novita Hardianti, Muhammad Sultan, Ida Ayu Indira Dwika Lestari

National Journal of Occupational Health and Safety

Heat strain is a physiological reaction of the body that functions to release excess heat through sweat output, increased body temperature, heart rate, blood pressure, and weight loss. PT X is a company that operates in the oil and gas sector. The results of the study found that the workload was not appropriate and the incidence of work accidents that occurred due to fatigue. This study was conducted to see the heat strain complaints experienced by tank overhaul workers in the Oil Refinery Area of PT. X Balikpapan City and the associated factors. This research applied quantitative method with analytical …

Pengaruh Penerapan Teknik Relaksasi Otot Progresif Berbasis Musik Instrumental Terhadap Gejala Stres Kerja Pada Pegawai Di Dinas Kesehatan Kabupaten Probolinggo, Salwa Isna Barlian, Anita Sulistyorini, Marji Marji, Agung Kurniawan

National Journal of Occupational Health and Safety

Work stress symptoms are a condition where there is a mismatch between a person's condition and work demands, resulting in mental (psychological), physical, and behavioral disorders. Government employees are among those who are vulnerable to experiencing work stress symptoms. Based on preliminary study results, the Probolinggo Regency Health Office is one of the type A offices with a high workload, and several employees have been found to experience symptoms of work stress. The purpose of this study was to determine the effect of applying instrumental music-based progressive muscle relaxation techniques on work stress symptoms in employees at the Probolinggo Regency …

Hubungan Repetitive Motion, Beban Kerja, Shift Kerja, Dan Kualitas Tidur Dengan Kelelahan Kerja Pada Petugas Aviation Security, Cindy Puspita Sari, Anita Sulistyorini, Marji Marji, Erianto Fanani, Tika Dwi Tama

National Journal of Occupational Health and Safety

The aviation sector is one of the work areas that requires the implementation of Occupational Health and Safety (OHS). Work in the aviation sector also presents various risks, one of which can occur in work accidents caused by fatigue. Based on preliminary studies conducted on Aviation Security Officers (AVSEC), there are symptoms of work fatigue. The study aims to determine the relationship of repetitive motion, workload, work shifts, and sleep quality with job fatigue in AVSEC officers. The research used a quantitative observational study with an analytic design through a cross-sectional approach with a total of 76 AVSEC officers. The …

Faktor-Faktor Yang Berhubungan Dengan Kecelakaan Kerja Pada Operator Dump Truck Di Pt. X Kabupaten Kutai Timur, Anindya Sashi Kirana, Muhammad Sultan, Ida Lestari, Iwan Muhamad Ramdan, Dewi Novita Hardianti

National Journal of Occupational Health and Safety

Coal mining is one of the industries that has a high level of danger and risk of work accidents. In 2023, in PT X department Z there were 36 work accidents with the most units occurring in the dump truck unit. The purpose of this study was to determine the factors associated with work accidents in dump truck operators at PT X East Kutai Regency in 2025. This study used a cross sectional study design with 78 respondents who were dump truck operators taken by stratified random sampling. Data collection using questionnaires and CMR (Compliance Monitoring Report) observation sheets that …

Impact Of Primary Care Healthcare Providers Patient Electronic Medical Records Completion Rates Using Speech Recognition Dictation, Pepper Losely

Student Scholarly Projects

Practice Problem: Completion of electronic medical records (EMRs) is an ongoing problem for providers, facilities, and insurance reimbursement. Current completion of EMRs lack standardized processes to make EMRs completion easier for providers with their busy workday and allow optimal time for patient care.

PICOT: For healthcare providers at primary clinics (P) will implementing speech recognition dictation (SRD) for data entry into the electronic medical records (EMRs) (I) compared to the current practice of manually typing all data causing long medical record turnaround times (c) improve medical record completion within 30 days (O) over 10-weeks (T).

Evidence: Evidence that was …

Incidence And Clinical Profile Of Cardiovascular Abnormalities In Infants Of Diabetic Mother, Kailas Randad, Praveen Das, Akash Dnyandeo Sarkate, Qudsiya Ansari

Digital Journal of Clinical Medicine

Background: Maternal diabetes is associated with adverse pregnancy outcomes, notably congenital heart disease (CHD) in infants of diabetic mothers (IDMs). This study evaluated the prevalence and spectrum of CHDs in IDMs and the effect of maternal glycemic control.

Materials and Methods: A prospective observational study was conducted over 18 months at a tertiary care centre in Mumbai. A total of 112 IDMs were enrolled. Maternal glycemic status was assessed using HbA1c and random blood sugar. All infants underwent clinical examination, oxygen saturation measurement, and echocardiography.

Results: CHDs were identified in 26.7% of infants. The most frequent lesions …

Parents’ Experience Of The Effects Of Racism On The Psychological And Physical Health Of Teenagers With Intellectual And Developmental Disabilities, Akane Nakamura

Walden Dissertations and Doctoral Studies

Many children and adults in the United States experience developmental disabilities and mental health challenges, leading to bias, marginalization, and economic hardship. Racism exacerbates these issues for individuals with intellectual and developmental disabilities (IDD), increasing depression, isolation, and health disparities. The purpose of this study was to explore parents' perspectives on the impact of racism on the psychological and physical health of teenagers aged 13–18 years with moderate IDD in the Northwestern United States. Disability critical race theory provided a lens for examining how race and disability intersect to create barriers for these teenagers. The research method was qualitative. Phenomenology …

Qualitative Insights Into Drug Use Safety Strategies And Social Support Among Sexual Minority Women Who Inject Drugs In Baltimore, Maryland, Jennifer L. Glick, Leanne Zhang, Aimee Huang, Megan Nguyen, Danielle German

School of Public Health Faculty Publications

Background: Sexual minority women (SMW) experience higher rates of substance use relative to heterosexual women in the U.S. but remain an under-studied population. SMW who inject drugs (SMWWID) navigate an unpredictable drug market and may experience complex relationships within their social spheres. We explore cisgender SMWWID’s strategies to maintain safety while injecting drugs, and the influence of their social support systems on those strategies. Methods: We conducted N = 16 phone-based, semi-structured, in-depth interviews with SMWWID in Baltimore, Maryland between June-October 2021. The interviews explored participants’ sexual orientation and gender identities, social networks and support systems, drug use behaviors and …

The Role Of Self-Reported Health Ratings In Identifying Hospitalization Risk Among Older Adults: An Integrated Review And Secondary Analyses Of Medicare Claims Data, Mary B. Prybylo

MUSC Theses and Dissertations

Purpose: This study examined how Self-Reported Health (ratings), a person’s own evaluation of their overall health, relates to hospital admissions and emergency department utilization. It further assessed the extent to which demographic characteristics, Risk Adjustment Factor (RAF) scores (used to estimate healthcare expenditures based on clinical complexity), and the number of chronic conditions influence SRH rating and the likelihood of hospitalization.

Problem and Aim: The growing population of older adults places greater demands on healthcare services, leading to increased financial strain and a need for improved care strategies. Primary care teams, particularly those managing older adults, require effective assessment …

Co-Design Of A Program For Medical Students’ Experiential Learning In Community-Engaged Research, Daenique H. A. Jengelley, Tess D. Weathers, Dustin O. Lynch, Morgan E. Ness, Luis Garcia, Gina E. Claxton, J. Dennis Fortenberry, Tamara S. Hannon

Journal of Community Engagement and Higher Education

Medical education may lack experiential training on authentic community engagement (CE). Employing a human-centered design approach with medical faculty and students to identify goals, opportunities, needs, and barriers to implementing CE research, we developed an Experiential Community Engagement Learning Series (EXCELS) pilot program. EXCELS supported both our community partners and medical students as a platform from which to learn from each other. EXCELS can be accomplished virtually, incorporated in medical training, and disseminated broadly.

Sex-Specific Effects Of Early-Life Unpredictability On Hippocampal And Amygdala Responses To Novelty In Adolescents, Elysia Poggi Davis, Bianca T. Leonard, Robert J. Jirsaraie, David B. Keator, Steven L. Small, Curt A. Sandman, Victoria B. Risbrough, Hal S. Stern, Laura M. Glynn, Michael A. Yassa, Tallie Z. Baram, Jerod M. Rasmussen

Psychology Faculty Articles and Research

Background

Unpredictable childhood experiences are an understudied form of early-life adversity that impact neurodevelopment. The neurobiological processes by which exposure to early-life unpredictability impact development and vulnerability to psychopathology remain poorly understood. In the current study, we investigated the sex-specific consequences of early-life unpredictability on the limbic network, focusing on the hippocampus and the amygdala.

Methods

Participants included 150 youths (54% female). Early-life unpredictability was assessed using the Questionnaire of Unpredictability in Childhood (QUIC). Participants engaged in 1 or more task–functional magnetic resonance imaging scans between the ages of 8 and 17 (223 total observations) measuring blood oxygen level–dependent (BOLD) …