Digital Commons Network^™

Social Correlates Of Trauma And Posttraumatic Stress Disorder: The Importance Of Context, Lukoye Atwoli, Linnet Ongeri

Internal Medicine, East Africa

Understanding trauma and posttraumatic stress disorder (PTSD) requires a contextual perspective that considers historical legacies, social environments, and cultural realities. This paper draws on empirical evidence from Kenya and Uganda to demonstrate the limitations of applying trauma frameworks developed in high-income countries to African contexts. Findings from the Orphaned and Separated Children’s Assessment Related to Their Health and Well-Being (OSCAR) study challenge assumptions about care environments. The study reveals higher PTSD rates among orphans in family-based settings compared to institutional care, and highlights the protective roles of religion and social support. The Neuropsychiatric Genetics of African Populations-Psychosis (NeuroGAP-Psychosis) study provides …

Miserly Thinking: Understanding The Factors Shaping Public Support Towards Project Wolbachia In Singapore, Shirley S. Ho, Agnes S. F. Chuah, Fiona J. W. Goh, Nova Mengxia Huang, Mengxue Qu, Hye Kyung Kim, Sonny Rosenthal

Research Collection College of Integrative Studies

Project Wolbachia is a vector control method that releases male Wolbachia-infected Aedes mosquitoes to curb dengue transmission in Singapore. While research has primarily focused on its efficacy, few studies have examined public opinion. This study draws upon the cognitive miser model and scientific literacy model to examine the factors shaping public support for Project Wolbachia. A nationally representative door-to-door survey was conducted in Singapore (N = 1,000) using multi-stage stratified random sampling. Our findings revealed that while knowledge about Project Wolbachia explains public support, laypeople may often rely on cognitive shortcuts, such as value predispositions, media attention, and pre-existing perceptions, …

The Flourishing Child: Study Protocol For An Acceptability And Feasibility Trial Of A Digital Early Childhood Flourishing Intervention, Zenobia Talati, Jack Kennare, Natasha L. Bear, Lisa Y. Gibson, Robyn Power, Van Zyl Kruger, Desiree Silva, Susan L. Prescott, Jacqueline A. Davis

Research outputs 2022 to 2026

Background: Globally, rates of children with physical and mental health problems are increasing. Health issues in early childhood often persist into adulthood, highlighting the need to ensure children are supported to flourish from the start of life. Objectives: This protocol describes methods used to test the acceptability and feasibility of a novel digital Flourishing Intervention (designed to empower parents and promote child wellbeing), comprising a Flourishing Check (a newly developed online questionnaire) and a Pathway Tool (an online directory of high-quality, evidence-based programmes and resources). Methods: Using a randomised feasibility trial, participants (N = 600 parents of children aged 0–5 …

Show And Tell: Integrating The Arts Into Transdisciplinary Public Health And Community Organizing Education, Bree L. Hemingway, Margaret Hawkins

The Transdisciplinary STEAM+ Journal

This field note examines the integration of arts-based pedagogy into a transdisciplinary graduate course that brings together students from public health, medicine, the social sciences, humanities, education, technology, and the arts. Central to the course is the Show and Tell assignment, in which students select and present a work of art connected to a social movement. Over three years and 42 student submissions, this assignment has served as an accessible entry point for exploring how artistic expression shapes activism, fosters community, and deepens understanding of justice-oriented work. Through an inductive content analysis of student-selected artworks and presentations, five major thematic …

Occupational Stressors And Health Impacts Among First Responders, Mason N. Roach

Honors College Theses

The United States 911 emergency response system is an interconnected web of public services that seeks to provide its community with care, resources, and safety in times of need. However, the impact of this support on the employees providing the service often goes unnoticed. This review identifies and analyzes the unique strains on first responders' physical and mental health using the Job Demand-Control Model and the Allostatic Load Model. A review of available research literature supports the conclusion that occupational-related stress, including trauma exposure, shift work, poor leadership, and inadequate communication, can have long-lasting negative impacts on provider health.

The Relationship Between Consumption Frequency And Energy Intake Of Ultra-Processed Food And Obesity Based On Body Fat Percentage Among Fph Ui Students In 2025, Sarah Keisya Budiargo, Triyanti Triyanti, Asih Setiarini, Dieta Nurrika

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is the accumulation of excessive body fat and increases the risk of various non-communicable diseases. Obesity prevalence among FPH UI students based on health examination data in 2022-2024 has reached 13.6%, exceeding the public health concern threshold and requiring more accurate measurement than Body Mass Index. This study aimed to determine the relationship between ultra-processed food (UPF) consumption frequency and energy intake with obesity incidence based on body fat percentage among 147 FPH UI students in 2025. This cross-sectional study utilized the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) based on NOVA classification to assess UPF intake. Body fat percentage was …

The Relationship Between Parenting Styles And Breakfast Habits With Adolescent Eating Behavior, Nailul Nufarohah, Siti Soraya, Hilda Carmitha Panjaitan

Indonesian Journal of Public Health Nutrition (IJPHN)

Adolescence is a critical transitional period requiring adequate and balanced nutrition to support optimal physical growth and psychosocial development. However, unhealthy Eating Behaviors such as skipping breakfast, consuming unbalanced diets, and frequent intake of foods high in sugar, salt, and fat are still commonly observed. Parenting styles and breakfast habits are considered important factors influencing adolescents’ Eating Behavior. This study aimed to analyze the relationship between parenting styles and breakfast habits with Eating Behavior among adolescents. This study employed a quantitative approach with a cross-sectional design conducted at SMK Negeri 62 Jakarta, South Jakarta. The population consisted of 578 active …

The Relationship Between Obesity Among Children And Adolescents With Dietary Intake And Physical Activity: A Scoping Review, Devi Dwi Yolani, Tania Okta Wardhani, Rani Aqilah Ni’Matul Maula, Almira Sitasari, Tri Siswati

Indonesian Journal of Public Health Nutrition (IJPHN)

Childhood and adolescent obesity remain a significant public health issue worldwide. This review summarizes research on the relationship among obesity, physical activity, and diet. This study aims to investigate the relationship between children's and adolescents' obesity, their physical activity levels, and diet. A scoping review was conducted by assessing 81 research journal articles from 2014 to 2023 from electronic databases such as Google Scholar and PubMed. The search strategy used Boolean operators as follows: (“child*” OR “adolescent”) AND (“obesity”) AND (“diet” OR “food intake”) AND (“physical activity”), selected based on the inclusion criteria of children and adolescents aged 1-18 years …

Enhancing Provider Engagement Through Peer-To-Peer Coaching: The Provider Ambassador Program, Jason Vallee, Jodi Stewart, Sam Verkhovsky, Steve Del Giudice, Janet Aug, Amanda Higgins, James Perry, Alice Kennedy, Brant Oliver

Patient Experience Journal

Provider burnout and disengagement are associated with diminished patient satisfaction, reduced clinical quality, and adverse organizational outcomes. Peer-to-peer coaching has emerged as a promising, scalable intervention to support provider engagement and improve the patient care experience. This study evaluates the effectiveness of the Provider Ambassador Program, a structured peer-to-peer coaching initiative designed to improve patient satisfaction by enhancing provider communication, professional behavior, and patient engagement skills. A pre-post quasi-experimental design was used to assess changes in provider CG-CAHPS ``Provider Overall'' top-box scores following coaching. Eligible providers (n = 83) across five BLANK Health locations were identified based on top-box scores …

From Talking The Talk To Walking The Walk: Reflection On Dartmouth Health's Care Experience Week, Rosie Bartel, Corey Kimpson, Tanya Lord, Victoria Lyons, Tony Serge, Brant Oliver

Patient Experience Journal

This article explores the participation of expert members from the Beryl Institute's Global Patient and Family Advisory Board (GPFAB) during Dartmouth Health's Care Experience Week, under the theme ``From Talking the Talk to Walking the Walk.'' This week aligns with the national Patient Experience Week. The Patient Family Advisor (PFA) presenters and authors of this article have shared their lived experience locally, nationally, and internationally through conferences, webinars, podcasts, videos, blogs, white papers, journal articles, books, and in many other ways for and as PFA members of a multitude of healthcare organizations co-create change that improves outcomes for all human …

Improving Human Experience In Health Care: Leveraging ``Humanistic Learning Health Systems'' To Accelerate Change At Scale, Brant J. Oliver, Jason A. Wolf

Patient Experience Journal

Included in a special segment in this issue of the Patient Experience Journal, are a series of reports on improving HX in healthcare supported by a humanistic LHS– the Dartmouth Promise Partnership Coproduction Learning Health System in New Hampshire, USA. Promise is a strategic partnership between a medical school and a multi-center rural academic health system. It integrates translational science education and research, data informatics, and scaled and networked humanistic applied change initiatives. One of these initiatives is the Care Experience Collaborative, a multi-center improvement initiative across the health system focused on improving HX. This special segment includes five reports …

Utilization Of Visual Metaphors For Improving Health Literacy, Kadir Alp Özler, Morgan Dressel, Madeline Weiner, Robert D Lucito, Alice Fornari

Patient Experience Journal

Health education is practiced in patient encounters via verbal communication and educational pamphlets. However, these techniques are faulty and do not provide true patient comprehension of their conditions and treatments reform is necessary to prevent the mortality and hospitalization rates that are linked to poor health literacy. Visual aids and metaphors are individually known to be powerful educational tools. A student organization at Stony Brook University, Artists in Medicine, has sought to synergize these tools to create visual metaphors artwork that links everyday concepts to patient illnesses to facilitate comprehension of this information. For example, one project “Aortic Dissections” depicts …

Patient Experience (Px) In Low- And Middle-Income Countries (Lmics): A Scoping Review, Yara Abou Harb, Geoffrey A. Silvera

Patient Experience Journal

Patient Experience (PX) is a growing subject in the healthcare industry due to its association with improved clinical outcomes, patient safety, and business motives. While PX is well studied in high income countries, little is known about the state of PX in Low and Middle-income countries (LMICs). Objective: The study aims to examine literature on PX and related concepts in LMICs. Methods: This study executes a PRISMA literature review of academic databases (Ovid Medline, CINAHL, EMBASE and Google Scholar) as well as hand searching of PX related websites from 2005 to 2024. Results: 67 references met search criteria. Four themes …

Virtual Caregiving And The Evolving Role Of Carers And Patients: Virtual Hospital Interview Analysis, Kanesha Ward, Tim Jackson, Jenna Bartyn, Shannon Saad, Sue Amanatidis, Owen Hutchings, Annie Y.S. Lau

Patient Experience Journal

Virtual hospitals are transforming healthcare by enabling remote monitoring and management of patients, improving accessibility and care continuity. As part of the transformation, there are changes to the roles and responsibilities of patients and their carers as they engage in virtual hospital care. The impact on family caregiving remains underexplored. Guided by Family Systems Theory, this qualitative study investigated how family caregiving roles adapt within a virtual hospital and identified opportunities to further support families. Semi-structured interviews were conducted with patients, carers, and healthcare workers from one model of care, at a metropolitan virtual hospital in New South Wales, Australia. …

Supporting Families Of Children With Craniosynostosis: A Qualitative Exploration Of Parental Usage Of Online Forums, Elisha L. Rea, Rachel M. Roberts, Amanda J. Osborn

Patient Experience Journal

Objective: Craniosynostosis is characterised by the early fusion of cranial sutures, resulting in an abnormal head shape. This study examines the psychosocial impact of a child's craniosynostosis diagnosis on families, by analysing online forum discussions. While surgery is often needed to address appearance-related and neuropsychological concerns, parents face challenges navigating their child's diagnosis. Many seek support through online forums, yet research on their experiences remains limited. This study aims to understand parental needs and experiences by analysing forum discussions. Method: Online forums were analysed using reflexive thematic analysis. Significant features of the data were systematically coded and themes reflecting …

Validation Of A Copd Patient-Reported Experience Measure (Prem-C9) In Ontario, Canada, Elaine Zibrowski, Floriana Islami, Alyson Kellar, Christopher Licskai, Madonna Ferrone, Shannon L. Sibbald

Patient Experience Journal

Objective: Patient-reported experience measures (PREM) are important tools for evaluating healthcare quality, yet their implementation in chronic obstructive pulmonary disease (COPD) care within Canada remains limited. Our objective was to examine the construct validity of the PREM-C9 instrument in a Canadian context and explore its potential clinical applications beyond measuring patient experience. Methods: A two-phase, prospective, cross-sectional, mixed-methods study was conducted across 41 Best Care COPD sites in Ontario, Canada. In the quantitative phase, confirmatory factor analysis assessed the construct validity of the PREM-C9. In the qualitative phase, focus group interviews with COPD case managers explored implementation experiences and perceived …

A Study To Assess Prom And Prem Of Cld Patients In A Tertiary Care Hospital, Anagha Nandakumar, Rubasree M, Priya Nair, Dr. Dinesh Nair, Krishnapriya S

Patient Experience Journal

Chronic liver disease (CLD) leads to progressive liver dysfunction, significantly affecting patients quality of life (QOL). Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are critical in evaluating the health status and care experiences of CLD patients. This study aimed to assess the impact of PROMs and PREMs in CLD patients undergoing endoscopic procedures. A prospective study was conducted in the Gastroenterology and Hepatology Department over three months, involving 245 CLD patients (160 inpatients and 85 outpatients). PROMs were assessed using the Liver-specific PROM (LC PROM), which focused on daily living, symptom management, psychological well-being, and treatment effectiveness. PREMs …

Patient-Centered Care To Improve Recruitment And Retention In Clinical Trials: Insights From A Real-Time Interview-Based Satisfaction Study, Christina Zhuang, Aishwarya Prasad, Anshu Arora, Arun Arora, Jeena Vaid, Wisam Aljumaili, Arif Khan

Patient Experience Journal

Patient-centered care is increasingly recognized as essential for understanding participant expectations and generating more accurate and reliable clinical trial results. This study aimed to evaluate an interview-based feedback tool designed to provide a comprehensive assessment of patient experience at a free standing high-enrolling clinical site in the Pacific Northwest. The primary objectives were to identify strengths and weaknesses in current procedures, enhance recruitment and retention, and develop a model adaptable to other sites. A structured interview tool was independently developed based on literature supporting the integration of qualitative and quantitative feedback to capture a multidimensional view of patient experience. The …

Cartoon-Printed Uniforms: A Strategy To Ease Pediatric Hospital Anxiety, Karnellya R. Ohol, Janaki P. Shinde

Patient Experience Journal

This quasi-experimental study evaluated the effectiveness of cartoon-printed nurse uniforms in reducing anxiety among hospitalized children aged 3–12 years. Conducted at a tertiary care hospital in Maharashtra, India, the study included 100 participants (50 intervention, 50 control) who received care from nurses wearing either cartoon-printed uniforms or traditional clinical attire. Anxiety was assessed at baseline and on hospital days 2, 3, and 4 using validated age-appropriate scales: the modified Faces Anxiety Scale (ages 3–6) and the STAI-C short form (ages 7–12). Mixed-effects repeated-measures ANOVA demonstrated a significant group × time interaction (F(3,294) = 42.67, p < .001, partial η² = .304). Children cared for by nurses in cartoon uniforms showed a 48.8% reduction in anxiety compared to 14.7% in controls. Between-group effect sizes increased progressively across days (d = 0.87 to 2.13), indicating cumulative benefit rather than transient novelty. Clinically meaningful improvement (≥30% reduction) was achieved by 76% of intervention participants versus 24% of controls (NNT = 1.92). Staff acceptability was high (95%). Findings indicate that cartoon-printed uniforms are a simple, low-cost, high-impact environmental intervention that significantly enhances pediatric patient experience. Their strong clinical utility, ease of implementation, and alignment with child-centered care principles support adoption across pediatric healthcare settings.

Veteran Emergency Waiting Areas And Turned-Off Televisions: An Overlooked Variable, Randall Vanadisson

Patient Experience Journal

The significance of environmental design in emergency department (ED) waiting areas is increasingly acknowledged as a vital element affecting patient experience and stress levels, especially among veterans who may already encounter heightened psychological susceptibility. Aim: To investigate the impact of a non-operational television (TV) at a veteran's medical center emergency department waiting area on patient behavior, perceived stress, and environmental involvement. Methods: This naturalistic observation study employed non-participatory observation of 19 patients in the waiting area of a Veterans Affairs hospital. Field notes captured behavioral responses, seating patterns, and nonverbal stress cues. Observable engagement with the physical environment, …

The Patient's Lived Experience: A Phenomenological Study On Factors Influencing Tuberculosis Treatment Outcomes In Medan, Indonesia, Erida Novriani, Urip Harahap, Khairunnisa Khairunnisa, Wiryanto Wiryanto

Patient Experience Journal

This qualitative phenomenological study was conducted to analyze the factors influencing tuberculosis (TB) treatment outcomes from the patient's perspective in Medan, North Sumatra, Indonesia. The objective was to uncover the nuanced human factors shaping the patient's treatment journey, moving beyond a sole reliance on statistics and quantitative methods. The research was conducted across all 41 Primary Health Centers (PHCs) in Medan. Through a purposive sampling strategy, data was collected from 22 TB patients via in-depth interviews until data saturation was achieved. The collected data was analyzed using thematic, narrative, and phenomenological approaches to interpret the detailed lived experiences of the …

Applying A Patient Journey Mapping Approach To Understand Maternal Care Patient Journeys: A Pilot Study, Nicole Hicks, Kristin Tully, Christopher Goodier, Sreenath Chalil Madathil, Ayaba Logan, Myrtede Alfred

Patient Experience Journal

Introduction: In the United States, giving birth is the most common cause of hospitalization. Maternal care frequently represents birthing people's first experiences of prolonged interactions with the healthcare system. However, the structure of services is often fragmented and misaligned with individuals' needs, particularly for Black birthing people. Documenting birthing people's experiences during pregnancy and postpartum allows for identification of practices working well and opportunities to improve patient-centered maternal care. Methods: The mixed-methods study was conducted in the southeastern United States and used patient journey mapping(PJM) to document experiences of patients receiving maternal care at a large academic hospital …

No One-Size-Fits-All: Patient Perspectives Of Key Factors Influencing Their Inpatient Rehabilitation Experience, Mirline Milien, Megan Bewernitz, Katherine Stallings, Mary Ellen Young

Patient Experience Journal

Although patient experience in healthcare settings has historically been an ambiguous concept, it has received increasing recognition as a measure of healthcare quality. Despite this growing recognition and efforts to define patient experience, few studies have explored patient perspectives on the key factors driving this quality indicator. This study aimed to explore the core elements patients view as influencing their experiences in the inpatient rehabilitation setting. This was a single-visit, cross-sectional qualitative interview study. Thirteen patients with diverse diagnoses who received at least one week of rehabilitation services were recruited from a single inpatient rehabilitation facility. Purposive sampling was employed …

The Implementation Of Family-Centered Care And Family Satisfaction In Caring For Children With Cancer, Lenny Gannika, Mulyadi Mulyadi, Jeanette Irene Christie Manoppo

Patient Experience Journal

Background: Family-Centered Care (FCC) is an approach that involves families actively in their children's care by emphasizing respect, collaboration, and support. The goal is to increase family satisfaction with the care of children with cancer. FCC covers six subscales: general satisfaction, information, family inclusion, communication, technical skills, and emotional needs. Objective: This study aims to analyze the relationship between implementing FCC and family satisfaction when caring for children with cancer. Methods: A cross-sectional quantitative study was conducted at the Estella Children's Cancer Center in Manado, Indonesia, from June to October 2024. Parents of hospitalized children with cancer were selected for …

Improving Patients' Experience Through Nurturing Care For Patients Undergoing Kidney Biopsies: A Feedback Survey, Molefe Rapalai, Mahmoud Elshehawy, Johann Nicholas, Patrick Anthony Ball, Hana Morrissey

Patient Experience Journal

Background: Renal biopsies are a key tool in diagnosing kidney diseases, providing histopathological insights for personalised treatment plans. Despite their clinical value, little is explored about how patients experience this invasive procedure. Understanding these experiences is important for improving care quality, safety, and ensuring the process is as patient friendly as possible. There is also a lack of research capturing patient experience feedback on renal biopsies, making studies like this essential for guiding service improvement initiatives. Method: Observational study, May 2022 to June 2024. Eighty-six percutaneous renal biopsies performed. Fifty eligible patients invited to complete the Kidney Biopsy Patient Experience …

Capturing Patient-Centered Quality Of Life: Usability And Initial Validation Of The Pediatric Patient-Generated Index Following Esophageal Atresia Repair, Zanib Nafees, Julia Ferreira, Elena Guadagno, Nikki Ow, Nancy Mayo, Jean-Martin Laberge, Dan Poenaru

Patient Experience Journal

The Patient-Generated Index (PGI) is an individualized measure that allows patients to define the domains most important to their quality of life (QoL). This study evaluates the usability and preliminary validity of the pediatric Patient-Generated Index (pPGI) in children who previously underwent esophageal atresia (EA) repair. We conducted a mixed-methods study including the pPGI, EuroQol-5D-Youth (EQ-5D-Y), and PROMIS Life Satisfaction Short Form-8a. Children aged 7–17 years completed self-reports, while parents served as proxies for younger children. Cognitive interviews explored how children understood and completed the pPGI, and clinician interviews assessed clinical usability. Among 25 participants, the pPGI generated 104 text …

Mindful Tea Drinking As A Low-Cost Sensory Intervention For Reducing Stress In College Students, David Gabel

Honors Projects

The proposed study would investigate the effects of a tea-based sensory mindfulness exercise on stress in college aged participants. Participants would listen to a mindful tea exercise and a non-mindful tea exercise after a mild stress-inducing Stroop test. For both conditions, the participants would report their current state of distress on the Subjective Units of Distress Scale (SUDS) before and after each tea exercise and their heart rate variability (HRV) would be measured during each segment of the experiment.

Descriptive statistics and a paired samples t-test would be used to compare the mindful tea condition with the non-mindful condition following …

Staff Educational Impact On School-Based Mental Health Services: A Scoping Review, Daniel J. Kim, Di'yana Fisher, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

            Trends are consistently increasing among adolescents in regard to mental health diagnoses and suicide risks, which emphasizes the necessity for early identification via school-based psychiatric screenings. The Patient Health Questionnaire-9 (PHQ-9) has proven effective in uncovering symptoms of depression; variable application and limited staff knowledge continue to be substantial hurdles. This scoping review examined the influence of staff education and training on the efficacy of school-based psychiatric screening.

Methods

            PubMed, CINAHL, Medline, Elsevier, Google Scholar, and JAMA were utilized to conduct this scoping review. Peer-reviewed studies published between 2020 and 2025 were included if they involved adolescents aged 13-18, …

Prenatal Care Access And Pregnancy Outcomes Among Black Women Ages 15–44 In Cook County, Illinois, Deandrea Heggins

Walden Dissertations and Doctoral Studies

Maternal health disparities affecting Black women in the United States remain a persistent public health concern due to inequities in prenatal care access and adverse birth outcomes. Prior research has shown that socioeconomic conditions, insurance coverage, and systemic barriers influence prenatal care utilization and maternal outcomes; however, limited research has examined how Medicaid coverage, household income, preterm birth, and birth weight are collectively associated with prenatal care access among Black women in Cook County, Illinois. The purpose of this quantitative correlational study was to examine the relationships among these factors and access to prenatal care among Black women ages 15–44 …

Barriers Asian Adoptees Face In Screening For Inheritable Conditions Due To A Lack Of Family Medical History, Anna Shea

Honors Projects

Adoption has been increasingly common in the United States, with more than 7.8 million people in the United States adopted (Wexler et al., 2025) and over 280,000 children in the United States adopted internationally (Orr et al., 2024). Despite this, those who are adopted, especially internationally, often face medical disadvantages compared to those biologically related to their family. The differences in treatment between adoptees and those who are biologically related are largely due to the knowledge, or lack of knowledge, of the individual’s family medical history and genetic information. Genetic or inherited disease screening is often only completed or covered …