Digital Commons Network^™

Handgrip Strength, Handgrip Endurance And Bmi: A Comprehensive Approach To Health Assessment Among The General Population Of Madikeri, Dr Asha S. Das, Dr Ravikiran Kisan, Dr Suhas Y. Shirur, Dr Narasimha Rai K, Dr Sanjay Bhagoji

Digital Journal of Clinical Medicine

Introduction: Being physically fit is essential for lowering the risk of illness and enhancing longevity. While Body Mass Index (BMI) is frequently used to evaluate body composition, Hand Grip Strength (HGS) and Hand Grip Endurance (HGE) are important indicators of general well-being. Goal: To assess BMI, HGS, and HGE and ascertain how they correlate in a selected group of subjects. Methods: Fifty participants between the ages of 20 and 40 years participated in a comparative cross-sectional study at the Department of Physiology, Kodagu Institute of Medical Sciences, Madikeri. Participants were divided into three BMI groups after anthropometric measurements were taken. …

Association Between Maternal Factors And Stunting Based On The Indonesia Family Life Survey 5 (Ifls-5), Charissa Otniel Sukamto, Siti Nur Fatimah, Noormarina Indraswari

Makara Journal of Health Research

Background: Stunting remains a major issue in Indonesia. Maternal factors during pregnancy are one of the key determinants in preventing stunting. This study aimed to analyze the association between maternal history during pregnancy (age, height, parity, and inter-pregnancy interval) and stunting, with a comparison between urban and rural areas.

Methods: This analytical cross-sectional study used data from 3,639 children aged 1-5 years old from the household survey of Indonesia Family Life Survey 5, conducted between late October 2014 and August 2015 within 13 provinces in Indonesia. Data was analyzed using chi-square and binary logistic regression methods.

Results: …

Self-Efficacy And Health Promotion: The Roles Of Family Health And Health Literacy, Müjdat Yeşildal, Yunus Emre Öztürk

Makara Journal of Health Research

Background: Chronic noncommunicable diseases are the leading causes of death globally and in Türkiye, emphasizing the need to explore how individual, familial, and informational factors shape health-promoting behaviors. This study examined whether family health and health literacy sequentially mediate the relationship between general self-efficacy and health-promoting behaviors among adults in Türkiye.

Methods: A cross-sectional correlational study was conducted with 1,240 adults in Konya Province, Türkiye, between November and December 2022. Participants completed the Turkish versions of the General Self-Efficacy, Family Health, Health Literacy, and Health-Promoting and Protective Behaviors Scales. Data were analyzed using descriptive statistics, Pearson correlation, and …

Examining The Psychometric Properties Of The Big Three Perfectionism Scale–Short Form (Btps-Sf) Among Malaysian Chinese Students At A Private University, Kam-Fong Lee, Ashraf Sadat Ahadzadeh, Shin Ling Wu

Makara Journal of Health Research

Background: Perfectionism is increasingly prevalent among young adults and is a significant predictor of pathological and behavioral outcomes. Despite its relevance, validated and reliable measures of perfectionism tailored to university students, particularly within the Malaysian cultural and academic context, are lacking. This study addresses this gap by examining the psychometric properties of the BTPS-SF among Chinese students at a private university in Malaysia.

Methods: Data were collected using a cross-sectional design with convenience and snowball sampling from 380 students aged 18–25 years, predominantly from a Chinese student population.

Results: The results of the exploratory factor analysis, conducted …

Questionnaire For Eudaimonic Well-Being: Psychometric Validation Among Malaysian Youth, Mohd Ahsani A. Malek, Nurulwahida Saad, Suzana Mohd. Hoesni, Muhamad Ariff Ibrahim, Nurul Shafira Adi, Mohd Nazir Mohd Nazori

Makara Journal of Health Research

Background: The rising prevalence of mental illness underscores the need to understand how individuals can live and flourish under such conditions. In Malaysia, research has largely emphasized diagnosis and treatment, with limited focus on positive psychology and few validated instruments. This study aimed to translate and validate the questionnaire for eudaimonic well-being (QEWB) among Malaysian youth.

Methods: The QEWB was translated into Malay using back-to-back translation and administered to undergraduates from four public universities through a cross-sectional survey design. Convenience quota sampling was used, resulting in 229 respondents completing the online form to measure sociodemographic characteristics, eudaimonic well-being, …

An Ot Educational Program For Individuals With Upper And Lower Limb Amputations, Laurie R. Spinks Mrs, Cassandra Nelson

Spring 2026 OTD Capstone Symposium

An OT approach to reducing prosthetic abandonment with an accessible guide to promote self sufficiency and community connections for individuals with amputations.

Occupational Therapy For Maternal Pelvic Floor And Mental Health: A Holistic Approach To Recovery, Diana S. Theodore

Student Capstone Papers

Maternal pelvic floor dysfunction (PFD) is highly prevalent yet often underrecognized in occupational therapy practice, despite its significant impact on mental health, daily function, and quality of life. Many postpartum women experience symptoms such as urinary incontinence, pain with intimacy, and pelvic organ prolapse, which are frequently normalized or left untreated. Occupational therapy practitioners often have limited training in addressing the complex relationship between pelvic floor function and maternal mental health, contributing to gaps in care. The purpose of this capstone project was to develop a comprehensive handbook for occupational therapy students and practitioners integrating pelvic floor function and maternal …

Using Geospatial Environmental And Income Variables As Predictors Of Diabetes In Appalachia, John Kunicki Huth

Walden Dissertations and Doctoral Studies

Diabetes remains disproportionately prevalent in Appalachia, and macroenvironmental contributors remain poorly understood. Guided by spatial epidemiology, this quantitative, cross-sectional ecological study examined whether county-level environmental factors including distance to mine, distance to landfill, distance to water, mean annual precipitation, mean annual temperature, forest classification, distance to impervious surface, and median income were independently and collectively associated with diabetes cases per capita in West Virginia, used as a surrogate for Appalachia. Research questions addressed environmental predictors of diabetes cases per capita with and without controlling for median income. Publicly available county-level data from 53 West Virginia counties representing adults aged 20 …

Perceived Inadequate Neighborhood Food Shopping And Cardiovascular Disease Risk: The Multi-Ethnic Study Of Atherosclerosis, Amier Haidar, Ghadi Ghanem, Rishi Rikhi, Karol E Watson, Shreela V Sharma, Michael D Shapiro

Faculty, Staff and Student Publications

Background: Individuals with access to healthy food have healthier diets, improved cardiometabolic risk profiles, and decreased cardiovascular disease (CVD). However, previous studies have focused on the neighborhood food environment as distance to and density of food retailers. Our study examines the association between an individual's perceived adequacy of neighborhood food shopping and incident CVD.

Methods: We analyzed data from 6814 participants in the MESA (Multi-Ethnic Study of Atherosclerosis), a prospective cohort study of individuals aged 45 to 84 who were enrolled in the study between 2000 and 2002 and followed longitudinally. Cox proportional hazards models estimated hazard ratios (HRs) for …

Cervical Cancer Screening Among Women Across The United States, Srivathsan Vijaya Raghavan

Walden Dissertations and Doctoral Studies

While cervical cancer is not among the most frequently diagnosed cancers in the United States, it remains a significant concern due to its preventability through regular Pap smears and Human Papillomavirus (HPV) vaccination. However, incidence rates are rising as screening participation among U.S. women declines. This quantitative study (N = 15714) explored cervical cancer screening behaviors by analyzing levels of community involvement and social functioning, guided by the socioecological model (SEM). The dependent variable was cervical cancer screening, while the independent variables were community involvement and social functioning. The study controlled for health insurance status, age, race, ethnicity, employment, education, …

Long Work Hours, Suboptimal Diabetes Management, And Differences By Sex And Race/Ethnicity, Nhanes (2011-2018), Tailisha Gonzalez, Margrethe Horlyck-Romanovsky, Terry T.-K. Huang, Sandra E. Echeverria

Publications and Research

In the United States (US), occupational segregation by sex and race/ethnicity can contribute to health disparities. Although work schedule characteristics have been previously linked to elevated cardiovascular risk, little is known about the effects on chronic disease management in women and minoritized workers. We examined the association between work hours and diabetes management among US workers, testing for differences by sex and race/ethnicity. We utilized 2011–2018 National Health and Nutrition Examination Survey (NHANES) data on working adults (age ≥20 years) with diagnosed diabetes (n = 1041). Suboptimal diabetes management was defined as HbA1c ≥7%. Work hours were categorized per WHO …

From Tradition To Transition: Evaluating Culinary Medicine As A Tool For Metabolic Health Among Nigerian Immigrants In The United States And The United Kingdom, Simi Oduwole M.S.

Department of Nutrition Student Projects

This scoping review examines existing publications to evaluate whether Culinary Medicine can be used as a tool for metabolic health among Nigerian immigrants in the United States and the United Kingdom. Nigeria is one of the fastest-growing populations globally, with increasing migration to high-income countries such as the United States and the United Kingdom. Evidence suggests that Nigerian immigrants experience a rise in diet-related chronic diseases, including obesity, diabetes, and cardiovascular disease, as duration of residence increases. This phenomenon is often attributed to dietary acculturation and shifts toward Westernized eating patterns. This scoping review evaluates whether culinary medicine can mitigate …

Evaluating The Feasibility And Preliminary Effectiveness Of A Tailored Diabetes Education Program For Rural Residents, Brittany L. Smalls, Oluwatosin Leshi, Suraksha Khanal, Grejika E. Abram-Erby

Journal of Appalachian Health

Introduction: Diabetes is a top ten Rural Healthy People 2030 priority for health improvement among rural Americans. Socioeconomic, environmental, geographic and political barriers contribute to the type 2 diabetes (T2D) prevalence and its disparate impact in rural communities. However, promoting proper self-care behaviors via self-management education can help people with diabetes better manage their condition.

Purpose: To account for the social environmental factors that affect rural residents, a tailored diabetes education program was developed, and the program’s effectiveness in improving diabetes knowledge and T2D-related health outcomes was assessed.

Methods: Using data collected from Appalachian Kentucky residents enrolled in a six-week, …

Rural Community Perspectives On Hurricane Helene In Western North Carolina, Jennifer A. Horney, Lilly Moreau, Search Wnc

Journal of Appalachian Health

Introduction: After making landfall on the Florida Gulf Coast in September 2024, Hurricane Helene impacted Western North Carolina (WNC) with historic flooding, landslides, and hurricane-force winds. More than 100 deaths in the region were attributed to the storm’s direct impacts.

Purpose: The purpose of this study was to assess community perspectives of long-term recovery in Mitchell and Yancey Counties, two rural WNC counties severely impacted by Hurricane Helene.

Methods: A 14-question interview guide was developed based on prior disaster research and the community engagement work of Sustaining Essential and Rural Community Healthcare (SEARCH). Questions covered post-Helene experiences related to access …

Exploring Systemic Challenges In The Western North Carolina Dental Safety Net: A Qualitative Analysis, Blaire Mirmow, Bill Milner, Nadia Laniado

Journal of Appalachian Health

Introduction: Despite statewide growth, rural communities in Western North Carolina (WNC) face persistent barriers to oral health care driven by chronic dental workforce shortages and systemic geographic disparities. Within this Appalachian region, the dental safety net serves as a vital yet strained support system, struggling with limited financial resources and a lack of provider participation that leaves many underserved populations without essential oral health services.

Purpose: This study aims to explore the experiences of individuals working within the WNC dental safety net to identify barriers and strategies required to strengthen the delivery of oral health care in high-need rural settings. …

The Effects Of Hurricane Helene On Mental Health And Physical Activity, Hunter Smathers, Robyn York, Jarrett Walbolt

Journal of Appalachian Health

Introduction: Hurricane Helene brought widespread damage to Southern Appalachia, disrupting utilities, health care, and recreation. While natural disasters are linked to declines in mental and physical health, few studies have examined their effects on distinct types of physical activity (PA).

Purpose: This study evaluated the effects of Hurricane Helene on perceived stress, depressive symptoms, post-traumatic stress disorder (PTSD) symptomology, and intentional (exercise for health benefits) and incidental (physical labor or transportation) PA. Evacuation status influence was also explored.

Methods: Twenty participants completed assessments four weeks before (BASE), immediately after (0POST), and four weeks after landfall (4POST). Measures included the Perceived …

Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.

Journal of Appalachian Health

Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …

Assessing The Aesthetic Responsiveness Among Patients In A Free Clinic Setting, Jack E. Pitts

Student Scholar Showcase

Art therapy has increasingly been recognized as a complementary intervention in healthcare settings, with demonstrated benefits for stress reduction and overall biopsychosocial well-being. However, limited research has explored aesthetic engagement within medically underserved and economically disadvantaged populations. This study examines aesthetic responsiveness among patients receiving care at the Free Clinic of Central Virginia using a standardized Aesthetic Responsiveness Assessment. The assessment consists of 14 Likert-scale questions assessing individuals’ cumulative aptitude across three domains: aesthetic appreciation, intense aesthetic experience, and creative behavior. Responses and data were collected voluntarily and anonymously, and they were analyzed to better understand how patients in an …

Perceived Stigmatization Of Mental Health Problems And Utilization Of Academic Accommodations Among College Students, Sabrina Williams, Robert E. Davis Ph.D., Kristin Bogda Ph.D.

2026 Honors Symposium

Background: Higher education is seeing an increase in students utilizing mental health services. Studies on students with disabilities suggest students often have reservations about accessing these accommodations due to anticipated social stigmatization. Purpose: This study aimed to assess relationships among stigmatization and indicators of psychological distress among a sample of students who qualify for accommodations. Methods: This was a cross-sectional survey of students at a large university in the central United States. Data collection measures included previously validated screening instruments for depression, anxiety, suicidal ideation, and adapted versions of the validated scales to assess specific aspects of stigma related to …

Experiences Of Maternal Care In The Gypsy, Roma, And Traveller Population In The United Kingdom: A Cultural Care Model, Sarah Englebert Crowson

Walden Dissertations and Doctoral Studies

Gypsy, Roma, and Traveller women (GRT) in the United Kingdom face persistent maternal health disparities and show poor engagement with healthcare services. Exclusion, discrimination, and a lack of cultural competence from healthcare professionals contribute to poor health outcomes including preterm births; and GRT women have more babies born with congenital anomalies than non-GRT women in the United Kingdom. The purpose of this focused ethnographic qualitative study was to explore how self-identified GRT women living in the United Kingdom experienced maternal care and how cultural identity and social structures influenced their interactions with healthcare providers based on Madeleine Leininger’s cultural care …

A Multilevel Analysis Of Prescriber-Reported Buprenorphine Induction Challenges In Fentanyl-Endemic Settings, Alyssa Vawn Long

Walden Dissertations and Doctoral Studies

The emergence of illicitly manufactured fentanyl has increased clinical uncertainty during buprenorphine induction in medication-assisted treatment for opioid use disorder. The purpose of this quantitative, retrospective cohort study, guided by the Transtheoretical Model (TTM), was to examine whether prescriber-level buprenorphine induction practices and experiences with precipitated withdrawal were associated with reported buprenorphine induction challenges, and whether county-level fentanyl prevalence contributed to these challenges after accounting for geographic clustering. Secondary, de-identified archival data were obtained from the National Institute on Drug Abuse Clinical Trials Network study CTN-0134 and included 64 prescribers practicing in fentanyl-endemic settings. Buprenorphine induction challenges were operationalized as …

Health Data And Policy Related To Methamphetamine-Use Suicide In Mississippi, Mary C. Drane

Honors Theses

The purpose of this research is to investigate how methamphetamine use in Mississippi, especially in its rural areas, intersects with public health, policy, and suicide outcomes in the state. Mississippi's methamphetamine crisis has evolved significantly, shifting from locally produced drugs to cartel-supplied crystal methamphetamine, while state and federal policies have struggled to keep pace with the scale and complexity of the problem. Using a convergent parallel mixed-methods design, this research analyzed CDC Wonder multiple causes of death data and SAMHSA Treatment Episode Data Set Admissions (TEDS-A) data from 2018 to 2024 alongside four qualitative key informant interviews with stakeholders across …

Risk Factors Affecting Functional Outcomes Of Traumatic Brain Injury Patients During Long-Term Acute Care Hospital Rehabilitation, Arturo Olazabal

Walden Dissertations and Doctoral Studies

Traumatic brain injury (TBI) is a major public health concern associated with long-term disability and high healthcare utilization. Evidence guiding post-acute rehabilitation for medically complex TBI populations remains limited, particularly in long-term acute care hospital (LTACH) settings serving medically unstable patients. This study examined clinical and system-level factors associated with functional rehabilitation outcomes among adults with moderate-to-severe TBI in LTACHs. Guided by the Socioecological Model, recovery was conceptualized as interactions across individual, clinical, and organizational levels. This dissertation included three manuscripts using cross-sectional logistic regression and CMS Section GG measures. In Manuscript 1, longer time from injury to LTACH admission …

Examining Outcomes Of Client Education Interventions To Reduce Caffeine Intake In The College-Age Population, Mackenzie Leonard, Mikayla Evans

James Madison Undergraduate Research Journal (JMURJ)

This scoping review aimed to explore health interventions that address excessive caffeine consumption in college students aged 18–23 years. Excess caffeine intake is associated with a range of health concerns, including neurological, cardiovascular, and behavioral issues, highlighting the need for effective interventions to mitigate its impact on overall wellness. The literature exploring interventions aimed at modifying health behaviors among the college student population is notably limited. Furthermore, there has been a lack of studies replicating interventions aimed at reducing caffeine intake. These gaps suggested the need for further investigation and exploration of reports pertaining to health promotion. The results of …

Maladaptive Influences Of Direct-To-Consumer Pharmaceutical Advertising: The Moderating Influence Of Age And Consumer Loneliness, Sanjay Puligadda

Atlantic Marketing Association Proceedings

No abstract provided.

Caring For Caregivers: A Health Care Marketing Opportunity, Yvette Lynne Bonaparte Dr.

Atlantic Marketing Association Proceedings

No abstract provided.

Association Between Childhood Exposure To Family Substance Abuse, Mental Health Issues, And Cervical Screening Among Women Ages 18-65 In South Carolina, Ashley Laine Hamm

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs) have been associated with adverse health outcomes in adulthood; however, less is known about their relationship with preventive health behaviors such as cervical cancer screening. The purpose of this quantitative, correlational study was to examine associations between selected ACEs and cervical cancer screening among women aged 18–65 in South Carolina. Data were drawn from the 2020 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) and included 1,323 women. Binary logistic regression analyses were used to examine unadjusted and adjusted associations between ACE exposures and being up to date with Pap testing, controlling for age, race/ethnicity, income, …

Sociodemographic Factors And Dating Violence Among Adolescents Living In Rural Southern U.S. Communities, Kiara Patricia Sims-Thrasher

Walden Dissertations and Doctoral Studies

Adolescent dating violence (ADV) is a significant public health issue that disproportionately affects youths in southern rural communities, yet these populations remain underrepresented in research. The purpose of this quantitative cross-sectional study was to examine the association between ADV and sociodemographic factors (gender, race, age, and education level), alcohol consumption, and bullying among adolescents in Alabama, Arkansas, and Mississippi using data from the 2021 Youth Risk Behavior Surveillance System. Guided by the social-ecological model, binary logistic regression analyses were conducted to assess relationships between ADV victimization and the selected predictors. Results indicated that females had significantly higher odds of reporting …

The Association Between Advanced Technology Use And Quality Of Life Among Those With A Disability, Sarah Antus

Walden Dissertations and Doctoral Studies

Advanced medical technology use among individuals with physical disabilities remains understudied, creating a significant gap in understanding its impact on quality-of-life (QoL) outcomes across demographic and age groups. Guided by the social ecological model, the purpose of this quantitative study was to examine associations between advanced medical technology use, disability status, demographic factors (age, gender, and race/ethnicity), and QoL outcomes using 2017–2018 National Health and Nutrition Examination Survey data. The sample included 9,254 individuals age 6 years and older with physical functional limitations and complete technology-use and QoL data. Advanced medical technology use was significantly associated with improved QoL (p < .001). Disability status demonstrated a statistically significant but modest association with technology use, OR = 0.84, 95% CI [0.83, 0.85], p < .001. Age-stratified analyses indicated that advanced technology use significantly predicted improved QoL among adults aged 20 years and older, OR = 6.90, 95% CI [6.89, 6.91], p < .001, but not among youths aged 6–19 years (p = .929). Gender was a significant predictor of technology use, with females having higher odds than males, OR = 1.07, 95% CI [1.06, 1.08], p < .001. Race/ethnicity was also significantly associated with technology use; compared with non-Hispanic White adults, Mexican American (OR = 0.43, 95% CI [0.42, 0.44], p < .001), other Hispanic (OR = 0.58, 95% CI [0.57, 0.59], p < .001), and non-Hispanic Black adults (OR = 0.79, 95% CI [0.78, 0.80], p < .001) had lower odds of advanced medical technology use. The study may inform health care stakeholders about strategies to promote equitable access to advanced medical assistive technologies for social change

Noise-Induced Gains: Are You Damaging Your Hearing While You Train?, Taylor Hitschmann, Lillian Beauvais, Blake Roth, Andrew Gannon

SACAD: Scholarly Activities

This study investigated the potential risk of noise-induced hearing loss (NIHL) among individuals who listen to music during exercise. Survey data were collected alongside sound intensity measurements to better understand listening behaviors in fitness settings. Results indicated that although most participants reported listening at recommended safe levels, a notable proportion exceeded these thresholds, potentially increasing their risk of NIHL. These findings highlight the importance of monitoring listening habits during workouts. Hearing health professionals are encouraged to enhance public awareness and promote safe listening practices to help reduce the likelihood of long-term auditory damage.