Digital Commons Network^™

Promoting Increased Consumption Of Fruits And Vegetables In Older Adults Through Self-Efficacy And Social Cohesion, Ashley Lynn Nelson

Doctor of Nursing Practice Scholarly Project

The purpose of this scholarly project was to design and offer a nutrition education program on fruit and vegetable consumption to a group of rural adults aged 65 and older. It was hypothesized that the nutrition program would directly motivate older adults to increase dietary consumption of fruits and vegetables. The project utilized the Health Promotion Model as the theoretical framework. To incorporate this project into a quantitative design, the methodological design that was applied is a non-experimental or observational design. This project included a four-week educational program in the Spring of 2023 that provided information on the importance of …

Stress And Burnout Among Icu Nurses, Jaspreet Kaur

2025 Spring Honors Capstone Projects - Archive

Burnout is a significant occupational hazard for Intensive Care Unit (ICU) nurses. High patient acuity, staffing shortages, and long shift hours increase stress and diminish well-being among nurses, affecting patient care outcomes. This study examined the prevalence of stress and burnout among ICU nurses to identify contributing factors and potential interventions. An anonymous online survey was conducted among 110 ICU nurses, utilizing the Maslach Burnout Inventory (MBI) and the Perceived Stress Scale(PSS). Findings revealed that 42.5% of nurses reported high emotional exhaustion, while 37.5% felt they had little to no control at work. The most frequently cited workplace stressors were …

Understanding The Impact Of Language Barriers And Visit Duration On Caregiver Satisfaction In Pediatric Primary Care, Gavin Miller

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Children from households that speak languages other than English (LOE) face barriers in accessing healthcare, leading to poorer health outcomes. Language barriers contribute to these disparities, often resulting in diminished communication between providers and families. Visit duration may play a key role in facilitating effective communication and improving patient satisfaction.

Purpose: This study examines how language barriers affect caregiver satisfaction in pediatric primary care, and whether visit duration mediates this relationship. We hypothesized that caregivers from LOE households would have comparable visit durations to English-preferring caregivers but report lower satisfaction due to receiving less information within that time. …

A Review Of Studies Assessing Modifiable Risk Factors For Dementia Among Family Caregivers In The United States Based On Behavioral Risk Factorsurveillance System (Brfss), Shruthi Ranjithkumar

2025 Spring Honors Capstone Projects - Archive

Caregivers of individuals with Alzheimer's Disease and Related Dementia (ADRD) face an increased risk of developing dementia due to advanced age and modifiable risk factors. The 2024 Lancet Commission Report identified 14 such risk factors, whose mitigation could reduce dementia cases by 45%. Despite this, research on modifiable dementia risk factors among ADRD caregivers remains limited. This study investigates whether peer-reviewed studies utilizing Behavioral Risk Factor Surveillance System (BRFSS) data assess modifiable dementia risk factors among ADRD caregivers. A PubMed search retrieved 27 relevant articles, which were analyzed for risk factors identified by the Lancet Commission, including traumatic brain injury, …

Investigating Mental Health Outcomes Of National Collegiate Athletic Association (Ncaa) Division I Student-Athletes At The University Of Louisville, 2019-2023., Paul Harvey

Electronic Theses and Dissertations

Mental health outcomes among collegiate student-athletes, has become a broader concern in the 21^st century. This study examines prevalence and incidence of anxiety and depression amongst student-athletes at the University of Louisville from 2019-2023 across different Sports Groups. The prevalence of anxiety was found to be 20.22% and risk of anxiety was 15.65%. The prevalence of depression was found to be 13.11% and risk of depression was 18.75%. Logistic regression was used to estimate the association between sports groups and anxiety/depression. There was a borderline association between sports groups and prevalence of anxiety after confounder adjustment (OR=1.86, 95% CI: …

Modeling Buprenorphine Treatment Discontinuation In Opioid Use Disorder – Predictors And Disparities Using Statistical And Machine Learning Approaches, Wanru Guo

Dissertations and Theses (Open Access)

Background: Opioid Use Disorder (OUD) remains a major public health crisis in the U.S., and while buprenorphine is an effective treatment, early discontinuation undermines its impact. Existing statistical and machine learning (ML) models often overlook key social and healthcare-related predictors and fail to capture subgroup disparities, limiting their utility for equitable intervention design. This study addresses these gaps using a nationwide, longitudinal dataset and a two-stage modeling approach focused on disparity identification. Methods: We analyzed buprenorphine treatment episodes for OUD from the IQVIA Pharmetrics Plus database (2006–2023), defining discontinuation as episodes lasting under 180 days. A Cox proportional hazards model …

Enhancing The Eden Alternative Model With Well Standards: A Case Study Analysis, Mariah Stoner

Architecture Masters of Science Program: Theses

This thesis investigates the potential for improving the Eden Alternative Model, a person-centered approach to elder care that emphasizes creating a homelike environment and meaningful relationships, using WELL Standards, a building certification system focused on enhancing human health and well-being through improvements in environmental quality. Through a mixed-methods approach involving quantitative data analysis and qualitative case studies, this research examines how WELL Standards, which cover aspects such as air quality, water quality, lighting, and thermal comfort, can improve environmental quality and resident satisfaction within the Eden Alternative Model. This research introduces a tailored approach to elder care by combining these …

Implementing Early Detection Of Cognitive Impairment In Primary Care To Improve Care For Older Adults, Nicole R. Fowler, Katherine A. Partrick, James Taylor, Michael Hornbecker, Malaz Boustani, Jeffrey L. Cummings, Tim Macleod, Michelle M. Mielke, Jared R. Brosch, Chinedu Momoh

Brain and Mind Institute

Primary care is the ideal setting for early detection of mild cognitive impairment (MCI) and Alzheimer's disease and related dementias (ADRD), as it serves as the primary point of care for most older adults. With the growing aging population, reliance on specialists for detection and diagnosis is unsustainable, highlighting the need for primary care-led assessment. Recent research findings on successful brain health prevention strategies, AD diagnostic tools, and anti-amyloid treatments empower primary care to play a central role in early detection and intervention. Primary care-focused resources are being developed, including tools for cognitive assessments and materials designed to educate patients …

Analyzing Preventative Skin Care Practices Among Diabetic, Pre-Diabetic And Non-Diabetic Patients, Hetasvi A. Saraiya, Nils Brolis

Rowan-Virtua Research Day

Background and Hypothesis: Diabetes Mellitus refers to a chronic metabolic syndrome where patients have high blood glucose due to the body’s inability to produce adequate amounts of insulin. This hyperglycemia and other factors make diabetic patients more prone to a number of skin conditions such as dry skin, skin rashes, itchiness and bacterial or fungal infections. There are specific skin practices recommended to reduce the risk of these skin ailments including moisturizing regularly, avoiding hot showers, examining feet regularly for any changes, seeing a physician for major cuts/burns/infections amongst several others. However, there is no available literature that analyzes the …

Mental Health Crisis Of Medical Staffs During The Pandemic – How Has The Covid-19 Impacted Health Care Workers’ Mental Status, Yue Chen

Rowan-Virtua Research Day

The COVID-19 pandemic has waged a relentless battle against humanity, but amidst the physical toll lies a hidden front: the war on the mental health of our healthcare workers (HCWs).

Previous reviews have demonstrated a potential prevalence of mental health problems among HCWs, but these reviews necessitate updating and inclusion of more studies, along with a comparative analysis of pre- and post-pandemic backgrounds. Therefore, the aim of my study is to deliver updated prevalence estimates for mental health concerns among HCWs in the aftermath of the COVID-19 pandemic.

The results show not only a drastic increase in the percentage of …

The Use Of Glp-1 Agonists In Alcohol Use Disorder And Reducing Alcohol Consumption: A Scoping Review, Alec Birnbaum, Yashas Sattur, Akash Patel

Rowan-Virtua Research Day

Alcohol use disorder (AUD) reigns as one of the most pressing issues in the United States with high rates of complications, morbidity, and mortality. Recent studies have exhibited the potential for Glucagon-Like Peptide-1 (GLP-1) agonists to decrease alcohol cravings or alcohol-related adverse events through human and animal studies via reward and satiety signaling pathways. To investigate the ability of GLP-1 agonists to decrease alcohol use, alcohol cravings, and alcohol-related adverse events, this study conducted a scoping review of the current literature to uncover the potential benefit of GLP-1 agonists in patients with AUD. A systematic search across 6 databases was …

Vaccine Booster Hesitancy And Factors Associated Amongst Minority Students In South Jersey, Charles Ezenwanne, Resty Mercado, Priya Patel

Rowan-Virtua Research Day

In October 2022, COVID-19 vaccine coverage for two doses in NJ was 77.4%. This exceeded the US national average of 67.8%. However, initial booster uptake remained low at only 50% statewide, and bivalent booster uptake was just 16.8% by March 2023. South Jersey, including Gloucester County and Glassboro, contains large marginalized populations that have experienced barriers to vaccination access, misinformation, and skepticism regarding government and pharmaceutical intentions. This health equity service project was to provide clear, factual, and relatable information to increase vaccine confidence and uptake among minority students at Rowan University and the broader South Jersey community. By addressing …

Literature Review: Prazosin Used For Ptsd In Pregnancy, Afshan Khan, Natali Sharma, Rebekah M. Dietrich, Martin Forsberg

Rowan-Virtua Research Day

Posttraumatic Stress Disorder (PTSD) affects 3–4% of pregnant and postpartum individuals and is associated with complications such as preterm birth, low birth weight, and postpartum depression. Pharmacologic treatment options during pregnancy are limited by concerns about fetal safety.

Methods: A literature review was conducted focusing on studies reporting maternal or neonatal outcomes following prazosin exposure in pregnancy.

Results: One observational study of 11 pregnancies found 54.5% had uneventful outcomes, with rates of preterm birth, miscarriage, and preeclampsia similar to the general population. Hypotension and limited lactation data remain concerns.

Conclusion: Early evidence suggests prazosin may be a relatively safe and …

Is Increased Screen Time Associated With A Higher Prevalence Of Myopia In Elementary-Aged Children Globally?​, Katerina Kasatkin, Sree Gowri Sudharshan, Lakumi Dias, Adira Brenner, Emily Reilly, Maikel Mansour

Rowan-Virtua Research Day

Background: The onset of myopia in children has emerged as a significant public health concern, especially with increased screen time and reduced outdoor activity following the COVID-19 pandemic. The global prevalence of myopia is expected to rise significantly, with children being particularly vulnerable. Various studies have explored how screen time, near-work activities, and outdoor exposure influence the increasing prevalence of myopia in pediatric populations worldwide.

Hypothesis: This paper aims to evaluate whether increased screen time, especially following the COVID-19 pandemic, is associated with a higher prevalence of myopia in young children, providing a more robust understanding of this relationship across …

Exploring The Effects Of Target Race, Gender, And Weight On Pain Perception, Catherine Awad, Theresa Miller, Azer Tuerxuntuoheti, Peter Mende-Siedlecki

Rowan-Virtua Research Day

Healthcare equity is an essential right, and while the quality of care is assumed to be uniform, notable disparities in care are associated with factors of race, gender, and weight-particularly in the domain of pain evaluation and care. In experimental work, target race and gender have varying, and interacting effects on visual thresholds for perceiving painful expressions. Racial bias in pain perception is well established as participants see pain on black faces less readily than pain on white faces; gender also impacts pain treatment, where women are susceptible to having their pain discredited. Across two experiments, the influence of weight …

Screening And Prevention Of The Female Athlete Triad, Lia Summer Goldberg, Kate Whelihan

Rowan-Virtua Research Day

Background The Female Athlete Triad—a syndrome of low energy availability, menstrual dysfunction, and decreased bone mineral density—poses a significant risk to female athletes, particularly those in sports emphasizing leanness or endurance. Despite its potential to impair both performance and long-term health, the Triad remains frequently underdiagnosed due to stigma, nonspecific symptoms, and limited screening practices. This review investigates current strategies for screening and preventing the Triad, aiming to identify best practices and areas needing improvement.

Methods A literature review was conducted using PubMed, focusing on studies published after 2005. Keyword searches included “female athlete triad screening,” “prevention,” “education,” and “awareness.” …

Bridging The Nature Gap: Understanding Barriers And Promoting Outdoor Engagement Among African Americans In Chattanooga, Kennie Almonor

Honors Theses

This paper outlines my process of writing a physical guidebook for outdoor engagement in Chattanooga. It explores the historical context of Black exclusion from outdoor spaces and examines the health disparities that disproportionately affect Black communities. The physical connection between outdoor activity and overall well-being will also be explained. Additionally, this paper details my methodology for conducting focus groups to better understand barriers to outdoor engagement and how participant insights could inform the guidebook’s development. This paper also outlines my research on best practices for structuring an effective guide, writing process, challenges faced, and considerations for extending this project in …

Healthy Dietary Patterns’ Impact On Depressive Symptoms: A Meta-Analysis Of Randomized Controlled Trials, Angela Encardone

All Theses

As the search for innovative mental health treatments expands, dietary interventions have emerged as a promising approach for alleviating depressive symptoms. This thesis presents a meta-analysis of randomized controlled trials (RCTs) examining the efficacy of whole-of-diet nutritional interventions in reducing depression symptoms among adults. Grounded in Bronfenbrenner’s Bioecological Model and Engel’s Biopsychosocial Model, this study explores the intersection of biological, psychological, and social factors that influence mental health outcomes. A systematic review identified six eligible RCTs assessing the impact of healthy dietary patterns, including the Mediterranean diet and other plant-based interventions, on depression symptoms. A random-effects meta-analysis revealed a significant …

A Systematic Review Of Weight Loss Interventions Among Black Postpartum Women, Jhelma Velveder Perez

Honors Scholar Theses

Cardiovascular disease is a leading contributor to maternal mortality, which remains disproportionately high among Black women. Obesity and postpartum weight retention exacerbate cardiovascular disease risk and increase the likelihood of complications in future pregnancies. Weight loss during the postpartum period may reduce long-term chronic health risks and mortality for Black women. This systematic review aimed to understand the weight-related health needs of Black postpartum women by evaluating behavioral weight loss interventions within the first year after childbirth. A comprehensive search of the PubMed database identified 3 randomized controlled trials that met inclusion criteria. These studies evaluated home-based programs, mobile health …

Assessing The Impact Of The Covid-19 Pandemic On Mental Health In Patients Presenting To A Student-Run Free Clinic, Sabah Iqbal, Kirsten Carlberg, Emily Reilly, Jessica Ivanov, Victoria Youssef, Lily Roessler, Maikel Monsour, Nils Brolis

Rowan-Virtua Research Day

Background

Mental health is an important part of patient care, therefore it is imperative to understand how it’s recognized and treated. Socioeconomic status and the COVID19 pandemic contribute to disproportionate incidences of mental illness^{1, 2, 10, 11, 12}. This study uses data from a student-run clinic, the Rowan-Virtua Community Health Center (RVCHC), to examine disparities in mental health needs and screenings among the local population.

Hypothesis

It was hypothesized that underserved populations are at a disadvantage when it comes to both mental health screenings and treatment due to restricted access to healthcare and other unmet needs. Additionally, the …

The Overturning Of Roe V. Wade And People Capable Of Pregnancy: An Interpretative Phenomenological Analysis, Carrie Bohmer

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

On June 24, 2022, the Supreme Court of the United States (SCOTUS) overturned Roe v. Wade in their decision within Dobbs v. Jackson Women’s Health Organization, removing the constitutional right to abortion within the United States (US). Leading up to this anticipated and highly politicized case, 13 states passed preemptive legislation (i.e. “trigger bans”) that immediately made abortion illegal following the Dobbs decision. Limited research has explicitly explored the intersection of sexual health and reproductive health from a psychological perspective. Grounded in a reproductive justice framework, this interpretative phenomenological analysis sought to understand how people capable of pregnancy living …

Support, School Climate And Teacher Wellbeing In The Wake Of Covid-19: A National Study Using Ntsp Data, Annastashia M. Teepe

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Research indicates a significant number of teachers planned to leave the profession following the COVID-19 pandemic, with national surveys in 2021 revealing about 25% considering departure. Stress, low pay, remote teaching demands, and lack of support contributed to attrition, impacting school climate, which influences productivity, collaboration, and job satisfaction, and is inversely related to turnover. The shift to remote learning also demanded new skills and exposed technological disparities. This quantitative study examined the pandemic's impact on teachers' perceptions of school climate, support, resources, job satisfaction, burnout, and intent to leave using the 2020–2021 National Teacher and Principal Survey. Factor analyses …

Patient Education And Health Literacy Effects On Statin Use And Adherence, Ian M. Smith, Richard G. Olarsch, Alison M. Mancuso

Rowan-Virtua Research Day

Background: While the use of statins (HMG-CoA reductase inhibitors) plays a significant role in the prevention of cardiovascular disease, it is estimated approximately 60% of patients who would benefit from a statin are receiving these medications. Current research suggests that a preference for life-style intervention over medical management, concern over medical adverse reactions, and a lower perceived risk of cardiovascular events is associated with statin non-adherence.

Methods: An IRB-approved paper survey was administered to patients aged 18 to 89 at an ambulatory primary care clinic for non-acute visits. Qualtrics was utilized to collect, store, and process data. Information elicited from …

Barriers To Care For Neonatal Abstinence Syndrome In Southern New Jersey, Gabriela Taslitsky, Hijab Zaidi, Nafisa Zalil

Rowan-Virtua Research Day

Neonatal Abstinence Syndrome (NAS) is a spectrum of clinical manifestations seen in newborns due to withdrawal secondary to intrauterine illicit and/or prescription drug exposure. Newborns with NAS present with common signs of withdrawal such as poor feeding, irritability, seizures, hypertonicity, low birth weight, loose stool, and premature birth. Maternal opioid use is the most common cause of NAS and with the increase in opioid use in the past decade the cases of NAS have also increased. This study examines the prevalence and challenges associated with NAS in Southern New Jersey. Our analysis reveals that Atlantic and Gloucester counties reported the …

I Am (Me)Dicine: An Analysis On The Influence Of Humanities Courses Within The Construction Of Internal And External Identities Within Pre-Med Students At Uno, Alix Barnes

Theses/Capstones/Creative Projects

The purpose of this project is to investigate how arts and humanities coursework may enhance the development of internal and external identities for premedical students beyond their traditional scientific coursework. A literature review shows positive findings on identity development and the influence of arts and humanities coursework on medical education. This investigation will take place through a mixed-method survey distributed to UNO premedical students and will explore themes of self-reflection, personal and professional growth, and understanding of external perspectives. An optional question prompts respondents to reflect further on their work within arts and humanities courses and their impact on these …

Analysis Of Marshallese Perceptions Of Health And Weight In Adolescents, Sterling Thomas

Health, Human Performance and Recreation Undergraduate Honors Theses

Purpose: The purpose of the research is to understand the perceptions of Marshallese adolescents on the topic of health and weight, in order to provide guidance for interventions and public health efforts. The United States has the largest Marshallese population outside the Marshall Islands. Perceptions of weight and health is under researched for minority communities and from the insight of adolescents. Pacific Islanders such as the Marshallese are often categorized as part of the larger Asian American ethnic population, which is not always accurate in certain aspects where public health could provide support areas of concern.

Design: Focus groups …

The Effect Of Maternal Anxiety On Breastfeeding Exclusivity And Duration, Zoe E. Treat

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: The postpartum period, especially during the first year, presents a heightened risk for maternal anxiety. Research suggests a potential negative relationship between maternal anxiety and breastfeeding duration, though there is currently a gap in the existing literature regarding how maternal mental health impacts breastfeeding outcomes.

Purpose: This study seeks to investigate the influence of postpartum anxiety on both the duration and exclusivity of breastfeeding, crucial knowledge required to support and implement targeted interventions. We expected that maternal anxiety would predict shorter exclusive and total breastfeeding durations.

Methodology: To explore the relationship between postpartum anxiety and breastfeeding behaviors, we distributed …

Risk Communication And Public Health Emergency Responses During Covid-19 Pandemic In Rural Communities In Kenya: A Cross-Sectional Study, Wilberforce Cholo, Fletcher J. Njororai, Walter Ogutu Amulla, Caleb Kogutu Nyaranga

Population Health Leadership and Analytics Faculty Publications and Presentations

Background: The COVID-19 pandemic highlighted the crucial role of community preventive behaviors in controlling the virus’ spread. Studies show that people’s risk perceptions and awareness significantly contribute to the containment and prevention of infections by motivating adoption of desired actions and behaviors. This study aimed at assessing the role of risk communication and factors that influenced responses during the COVID-19 pandemic in rural communities in Western Kenya. Methods: A descriptive cross-sectional study was conducted using a quantitative research approach, collecting data from 806 individuals across Kisumu, Vihiga, and Kakamega counties. Descriptive statistics were used to detail the demographic characteristics of …

Euroqol Data For Assessment Of Population Health Needs And Instrument Evaluation (Eq-Daphnie): A Study For Enhancing Population Health Assessment, Jeffrey A. Johnson, Mathieu F. Janssen, Fatima Al Sayah, Henry Bailey, Mihir Gandhi, Dominik Golicki, Nils Gutacker, Erica I. Lubetkin, Brendan Mulhern, Fredrick Dermawan Purba, Juan M. Ramos‑Goñi, Desiree Scott, Hilary Short, Trudy Sullivan, Rosalie Viney, Zhihao Yang, Victor Zárate

Publications and Research

Background

Methods for collecting self-reported health status measures in population health surveys vary significantly across countries, presenting challenges to comparability. The EuroQol Data for Assessment of Population Health Needs and Instrument Evaluation (EQ-DAPHNIE) project aims to address this issue by developing infrastructure to generate representative datasets across multiple countries. This initiative aims to standardize data collection methodologies and to evaluate the performance of various health status measures, providing a foundation for reliable population health assessments. This paper describes the rationale, design and data collection methods for the EQ-DAPHNIE project.

Methods/design

EQ-DAPHNIE employs a cross-sectional online survey design targeting the general …

The Sun Shines Beyond The Mountains: The Creation Of A Suicidality Needs Assessment For Lesotho, Layhla Currier

Theses/Capstones/Creative Projects

The country of Lesotho has the highest suicide mortality rate in the world. Although this is true, there has seldom been research into the cause of this astronomical rate, and even less evaluating how to address the issue. This study focused on the analysis of available data to better understand the possible causes of the high suicide rate in Lesotho. Additionally, a suicidality needs assessment was created to collect data regarding mental health, social support, risk factors, and previous suicidality from Basotho (moniker for residents of Lesotho) in a non-stigmatizing way. Two varying suicidality assessments were used to create this …