Digital Commons Network^™

Rapid Response To Recovery: Expand Integrated, Technology-Enabled Crisis Care, Madison Chandler

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Behavioral health challenges in rural communities continue to place significant strain on healthcare systems, particularly through repeated reliance on emergency departments for crisis care. Nelson County, Kentucky, reflects this pattern, with higher reported rates of poor mental health and limited access to behavioral health providers. This paper proposes the Beacon Behavioral Health Response Program, a community-based, multidisciplinary crisis intervention model designed to improve access to timely care and strengthen continuity of support. The program combines mobile crisis response—delivered by a licensed clinical social worker and a peer support specialist—with a technology-enabled component using the Luma AI-supported mental health platform. Together, …

Promoting Maternal And Infant Health In Franklin County, Ky: A Community-Based Physical Activity And Education Intervention, Subin Kim

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Maternal and infant health outcomes are key indicators of population health, yet persistent disparities exist in rural communities across the United States. In Kentucky, Franklin County reflects this pattern, with concerning maternal and infant health indicators despite relatively favorable socioeconomic conditions. Identified challenges include elevated rates of poor physical and mental health days, high drug overdose mortality, provider shortages, and ongoing reproductive health concerns such as tobacco use during pregnancy and increased infant mortality associated with elevated maternal body mass index.

To address these gaps, a three-pronged, community-based prenatal and postpartum physical activity and education program is proposed. The program …

Fusion, 2026, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

J Am Coll Dent 2026 92 2b

Journal of the American College of Dentists

This special issue of the Journal of the American College of Dentists responds to a growing but long-underrecognized demand for humanities and ethics in dental education, practice, and scholarship. It emerges from the work of the National Collaborative on Humanities and Ethics in Dentistry (NCHED), a multi-institutional partnership formed in 2023 to address the persistent exclusion of dentistry from broader health humanities conversations. Through national webinars and scholarly collaboration, NCHED has demonstrated substantial interest in ethical reflection, historical analysis, narrative inquiry, and the arts as essential to understanding oral health and dental care.

The unexpectedly strong response to the call …

Measles Vaccine Hesitancy Improvement Bundle To Improve Vaccination Rates In A Rural Outpatient Clinic, Ramie Malone

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction

Despite the Centers for Disease Control and Prevention's recommendations to vaccinate children against measles, a decline in measles vaccination rates has been observed at a rural family medicine clinic. While numerous factors contribute to the decline in vaccination rates—including parental doubts about the necessity of vaccination, concerns about vaccine side effects, and insufficient education—the latter remains a fundamental underlying cause of suboptimal vaccination coverage.

Objectives

This project focused on surveying, educating, and boosting parents' confidence in measles vaccines for children under five to raise the measles vaccination rate.

Methods

This project used a pre- and post-intervention bundle over an …

Lumbosacral Orthosis Can Improve Postural Control In Older Adults With Chronic Low Back Pain, Régis M.-L. D'Assomption, Christian Lariviere, Hakim Mecheri, Suzy Ngomo, Rubens A. Da Silva

Études primaires

Background

Older adults with chronic low back pain may report poor postural control and increased fall risks. Possible key mechanisms are altered lumbar spine proprioception, stiffness and mobility, which could be enhanced through lumbar stabilization approaches. The purpose of this study was thus to evaluate the immediate effects of two lumbar stabilization approaches on postural control measures, namely a lumbosacral orthosis and the abdominal drawing-in maneuver.

Methods

57 older adults (> 65 yrs): 22 with chronic low back pain and 35 healthy controls performed two trials (30 s) of a semi-tandem balance task on a force platform, while three experimental …

Socio-Spatial Patterns Of Suicide Mortality In The United States, Kushagra Tiwari, M. Amin Rahimian, Marie-Laure Charpignon, Philippe J. Giabbanelli, Praveen Kumar

VMASC Publications

Suicides cause more than 49,000 deaths per year in the United States, including 55% associated with the use of a firearm. Across states and counties in the US, suicide mortality exhibits substantial geographical and sociodemographic heterogeneity. However, the role of large-scale social networks in shaping this variation remains underexplored. To assess how both the risk of suicide mortality and the effect of firearm restriction policies propagate through inter-county social ties, we integrate data on county-level suicide mortality (2010–2022) and the Facebook Social Connectedness Index (SCI), a continuous measure of the strength of social ties between counties used to derive weighted …

Reframing Sexual Assault And Intimate Partner Violence Through A Maternal And Child Health Lens: Implications For Integrated Prevention, Policy, And Practice, Daija C. Gibson

Theses and Dissertations

Sexual assault and intimate partner violence remain persistent public health concerns in the United States, with significant consequences for individual health, family stability, and population well-being. Although these forms of violence are frequently addressed through criminal justice and behavioral health frameworks, less attention has been given to their implications within maternal and child health, where relational dynamics, life course development, and intergenerational outcomes are central. This study reframed SA and IPV as core MCH issues to examine how integrated, systems-based approaches can strengthen prevention efforts. A structured literature review and systematic synthesis of peer-reviewed studies published between 2015 and 2026 …

Child Maltreatment Risk Identification In Complex Caregiving Environments: A Public Health Review Of Split-Custody And Multi-Household Family Contexts, Makenzie Lee

Theses and Dissertations

Child maltreatment remains a significant public health concern with lifelong consequences for children's health, development, and well-being. As children's caregiving environments become increasingly diverse through split-custody arrangements, blended families, kinship care, and other multi-household contexts, recognizing and assessing child safety concerns may become more complex. Although these family structures are not inherently associated with maltreatment, the distribution of caregiving responsibilities and information across multiple households may complicate child maltreatment risk identification.

This capstone presents a scoping review of peer-reviewed literature examining child maltreatment risk identification within complex caregiving environments. The review synthesized evidence related to caregiving environments, caregiver relationships, child …

Reducing School Absenteeism In Children With Avoidance Behaviors, Kimberly Carey

DNP Scholarly Projects

Background: Chronic absenteeism and school avoidance are a problem facing schools across the nation following the COVID-19 pandemic. Chronic absenteeism is financially, emotionally, and academically expensive for society. Purpose: This quality improvement project aimed to decrease absences by 50% over a 6-week timeframe when compared to the same timeframe from the previous year. Methods: Utilizing a Plan-Do-Study-Act framework, an intervention based on tracking multi-day consecutive absences and reaching out to families to provide education and support was implemented. At three days of absence, the school nurse would either call the family for absence with unknown etiology or email with an …

“Eres Mujer Y Te Tienes Que Aguantar”: Hispanic Maternal Wellbeing, Stephanie Reyes Bravo

CISLA Senior Integrative Projects

No abstract provided.

Understanding The Underutilization Of The Campus Recreation Facility: A Mixed-Methods Examination Of Basic Psychological Need Satisfaction, Social Physique Anxiety, Sense Of Community, And Physical Environment Barriers, Caden M. Pfingsten

Master's Theses or Doctor of Nursing Practice

Campus recreation facilities have been identified as important contributors to student well-being, academic persistence, and institutional belonging. Despite these documented benefits, a persistent gap exists between available services and actual student utilization at many institutions. This study examined the psychological, social, and environmental factors associated with students' underutilization of the Campus Recreation Facility (CRF) at a mid-sized Midwestern public university in favor of paid off-campus commercial gym memberships.

Using a cross-sectional survey design, 169 students completed a battery of validated and researcher-adapted instruments assessing basic psychological need satisfaction (autonomy, competence, and relatedness), Sense of Community, and social physique anxiety across …

Sexual Dysfunction In Women With Endometriosis In A Low-Middle-Income Country, Edna Chacha, Charles Muteshi, Felix Oindi, Elsie Wandera

Obstetrics and Gynaecology, East Africa

Background Endometriosis affects up to 10% of reproductive-age women and significantly impairs quality of life including sexual function, intimate relationships, fertility, and psychological wellbeing. While its impact has been extensively studied in Western populations, there is limited Sub-Saharan African data exploring how the disease affects female sexual health and distress. This study aimed to assess sexual function and sexual distress among women with endometriosis at a tertiary hospital in Kenya.

Methods A cross-sectional study was conducted involving 108 women aged 18 to 49 with confirmed endometriosis from January to June 2022. The study used validated self-administered questionnaires: Female Sexual Function …

The Divide Of Women’S Health: Systematic Thinking Of Women, Tasfia T. Howlader

Honors Theses

Women’s health has constantly been changing- from public health infrastructure to health policies, and even medical advancements. Yet, the struggles are persistent within the gaps present in women’s health. The Socio-Ecological Model (SEM) explains interactions between different levels of relationships, which result in health outcomes that vary from individual factors to environmental factors. Applying the SEM to describe health disparities can help explain how the relationships an individual has influenced their health. This project serves to exemplify these different levels while discussing the tailoring of services to the needs and the importance of populations based on their experiences. Specifically, adhering …

Developing An Educational Session And Epic-Based Tools To Help Nurses Provide Culturally Sensitive Care To Their Muslim Patients, Laila Albutmeh

Nursing | Senior Theses

Background: Islam is currently the fastest growing religion in the world and the chances of nurses having a Muslim patient is exceptionally high yet many nurses lack the knowledge and resources on how to accurately provide culturally sensitive care to Muslim patients. Hospitals lack educational sessions/training as well as Epic tools to help nurses provide culturally sensitive care to Muslim patients which leads to a knowledge deficit in cultural sensitivity of Islamic beliefs, values, and practices. Purpose: This thesis paper proposes a research design for a nurse education/training program on Islamic beliefs, values, and practices along with an implementation of …

Fitness To Work Evaluation In A Combined Physical And Office Working Activity With Piriformis Syndrome: A Case Report, Arif Prasetya, Nuri Purwito Adi

Occupational and Environmental Medicine Journal of Indonesia

Background Piriformis syndrome (PS) is a neuromuscular disorder with significant impact on workforce productivity. This case report presents a comprehensive evaluation of fitness for work and job modification strategies for a patient with PS in a combined physical and sedentary working environment. A 44-year-old male medical facility supervisor presented with left buttock pain, radiating to the left leg, diagnosed with left gluteal piriformis syndrome. Despite undergoing multiple conservative therapies by Physical Medicine and Rehabilitation Specialist, the patient showed minimal improvement.

Methods A seven-step fitness for work assessment approach was implemented following Indonesian Association of Occupational Medicine Specialists guidelines. The evaluation …

Factors Associated With The Atherogenic Index Of Plasma Among Workers At A National Respiratory Hospital In Jakarta, Muhammad Abror Rizani Fahmi, Herqutanto Herqutanto, Iqbal Mochtar, Dewi Yunia Fitriani, Marsen Isbayuputra, Resultanti Resultanti, Ariningsih Ariningsih

Occupational and Environmental Medicine Journal of Indonesia

Background Cardiovascular diseases (CVD) represent the primary cause of mortality globally. The atherogenic index of plasma (AIP) can predict the risk of CVD more accurately than other indices. Hospital workers are at risk of developing CVD. There are several factors that can influence the AIP. No studies have specifically investigated these associations in Indonesia, particularly regarding the AIP in hospital workers. This study aims to determine factors associated with the AIP among workers at a national respiratory hospital in Jakarta.

Methods This cross-sectional study collects data from the medical check-up records of workers at Persahabatan Hospital in 2024, who met …

Behavioral And Psychological Financial Hardship Among Caregivers Of Pediatric Cancer Patients, Josiane Kabayundo, Cheng Zheng, Edward S. Peters, Don W. Coulter, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Financial hardship encompasses material, behavioral, and psychological domains; however, most research among caregivers of pediatric cancer patients has focused on material hardship. This study examined factors associated with behavioral and psychological financial hardship among caregivers of pediatric cancer patients in Nebraska.

METHODS: We conducted a cross-sectional survey of caregivers of children diagnosed within the past 5 years and treated at two pediatric oncology specialty clinics. Behavioral hardship was defined as delaying medical or mental healthcare due to cost, while psychological hardship was measured by worry about ability to pay medical bills. Descriptive statistics and poisson regression with robust variance …

Three Essays On Disparities And Outcomes Among Patients With Diabetes, Aiemere O. Oikeh

Theses and Dissertations--Health Services Research (HSR)

The American Diabetes Association (ADA) recommends that patients with diabetes adopt 7 preventive care measures to improve their health outcomes. The recommendations are to check their blood glucose levels daily, undergo biennial hemoglobin A1c tests, undergo dilated eye exams once every 2 years, engage in regular physical activity, check their feet daily, have annual feet examinations performed by a clinician, and receive diabetes self-management education services (DSMES). Marital status has been found to be associated with positive health outcomes; thus, it is ideal to evaluate if there is an association between marital status and diabetes preventive care. The ADA also …

Return To Work After Percutaneous Coronary Intervention In Employee With Metabolic Comorbidities: An Evidence-Based Case Report, Bramantyo Eko Wahyudi Mr, Levina Khoe

Occupational and Environmental Medicine Journal of Indonesia

Background This evidence-based case report examines whether metabolic comorbidities independently predict return to work (RTW) after percutaneous coronary intervention (PCI) for myocardial infarction. A 52-year-old male senior manager with type 2 diabetes, hypertension, dyslipidaemia, and central obesity underwent PCI and required structured occupational assessment.

Methods A systematic literature search identified five eligible studies—one national registry cohort, three prospective cohort studies, and one narrative systematic review—critically appraised using Oxford Centre for Evidence-Based Medicine criteria.

Results Metabolic comorbidities showed consistent directional associations with reduced RTW probability in bivariate analyses and independently predicted longterm labour-market exit. However, in multivariate models across three of …

Étude Multidisciplinaire Du Confort Des Bouchons D'Oreilles : Vers Une Protection Auditive Efficace En Milieu De Travail, Olivier Doutres, Franck Sgard, Alessia Negrini, Alain Berry, Chantal Gauvin

Rapports de recherche scientifique

L'utilisation de protecteurs auditifs individuels (PICB), tels que les casques ou les bouchons d’oreilles souvent recommandés comme mesure temporaire, reste souvent le seul moyen d'assurer la protection des travailleuses et travailleurs exposés quotidiennement à des niveaux de bruit dangereux. Actuellement, le choix d'un PICB est principalement basé sur des considérations liées à l’atténuation acoustique qu’il offre (et mesurée en laboratoire par des organisations certifiées), et/ou à des caractéristiques de l'environnement de travail, telles que la chaleur, l'hygiène et la compatibilité avec d'autres équipements de protection individuelle (EPI). Le port de PICB est connu pour générer de nombreux inconforts qui peuvent …

Improving Patient Outcomes Through Structured Nursing Safety Huddles In Acute Care Settings: An Integrative Research Review (Irr), Brandon Everard Thomas

Covenant Nurses Week 2026

No abstract provided.

Wise Beyond Our Years: Menopause, Negative Body-Image, And Art As A Catalyst To Self-Acceptance, Nicole Lea

Art Therapy | Master's Theses

This mixed methods study examined the impact of menopause on women’s body image and self-acceptance through an arts-based group intervention. Quantitative data was collected using the Body Image Self-Compassion Scale, and qualitative data was gathered through art-making, group discussion, and individual interviews. Participants were (n=5) menopausal women aged 46-52 from the Bay Area who reported negative body image related to menopause. The intervention consisted of four one-hour open studio workshops with a fifth meeting added in which participants created altered books while engaging in peer support and discussion. Descriptive statistics indicated an increase in mean body image self-compassion scores from …

Community Resilience Drives Change, Andrew Thomas Solt

Graduate Theses, Dissertations, and Problem Reports (ETD)

The opioid crisis has impacted many Americans. From 1999 to 2023, approximately 800,000 people have died due to opioid overdose (CDC, 2025). What began as overprescriptions of painkillers has quickly evolved into a complex social health issue that is now further worsened by stronger synthetic drugs like fentanyl. Fentanyl and fentanyl analogs (synthetic opioids that are very similar chemically to fentanyl) are often found in illegal drug supplies and in counterfeit pills (CDC, 2025). Thus, individuals who might have been initially overprescribed painkillers might now be pushed towards illegally produced drugs that are significantly more potent than what they were …

Effectiveness Of Occupational Therapy-Inspired Educational Sessions For Mothers Accessing Women, Infants, And Children (Wic) Services, Samantha Annette Merew

Graduate Theses, Dissertations, and Problem Reports (ETD)

This doctoral capstone project examined the effectiveness of occupational therapy (OT)-inspired group and one-on-one educational sessions designed to support the emotional, mental, and social well-being of pregnant and postpartum mothers accessing Women, Infants, and Children (WIC) services in Onslow County, North Carolina. Grounded in the Model of Human Occupation and Cognitive Behavioral Frame of Reference, the program aimed to address gaps in holistic maternal health support, particularly among low-income and at-risk populations. Eight structured group sessions and five one-on-one sessions were developed, implemented, and evaluated, focusing on topics such as stress management, emotional regulation, self-care, role transition, and self-advocacy. A …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

Neighborhood Deprivation Associated With Impaired Sit-To-Stand Performance In Middle-Aged And Older Adults: A Cross-Sectional Analysis With Clinical Implications, Kenneth Harrison, Silvia Campos-Vargas, Brandon M. Peoples, Keven G. Santamaria-Guzman, David T. Redden, Michael A. Samaan, Jaimie A. Roper

Kinesiology and Health Promotion Faculty Publications

Background: Socioeconomic factors significantly influence health outcomes in older adults, yet their impact on specific aspects of mobility remains unclear. This study investigates the relationship between area-level socioeconomic disadvantage and mobility health in older adults.

Methods: We conducted a cross-sectional study of 110 community-dwelling older adults recruited and collected using voluntary response sampling at eight health fairs across rural Southeast Alabama in 2022–2024 (60 ± 16 years, 80% female). Area-level socioeconomic status was measured using the Area Deprivation Index (ADI), a validated composite measure of neighborhood disadvantage. Mobility was assessed using the Instrumented Timed Up and Go (iTUG) test and …

The Impact Of Gastric Sleeve And Roux-En-Y Gastric Bypass On Chief Cell Function And Protein Digestion In Obese Patients, Garikoitz Mikel Gainza

Honors Undergraduate Theses

Obesity has become one of the largest global health concerns of the 21^st century, correlating with numerous associated diseases. To help address the growing prevalence and burden of obesity, sleeve gastrectomy and Roux-en-Y gastric bypass have become two commonly performed surgical procedures done to promote weight loss by altering the anatomical structure of the stomach and surrounding organs of the gastrointestinal system. Although the benefits of improved metabolism linked to these surgical procedures are well studied, their impact on the physiology of gastric cells, and more specifically chief cells as they relate to protein digestion post-surgery, is yet to …

Iron Deficiency And Iron Deficiency Anemia: Inconsistent Screening Practices And Delayed Result Processing In Children 12-18 Months, Madonna J. Mahoney Marshall

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction:

Iron deficiency and iron deficiency anemia in children aged 12 to 18 months are prevalent conditions that, if not identified and treated early, are associated with adverse neurodevelopmental outcomes.

Purpose:

This quality improvement project evaluated the impact of a standardized screening and follow-up protocol on laboratory result retrieval, provider review, and caregiver follow-through in a military pediatric clinic.

Method:

A pre-post intervention design guided by the Plan-Do-Study-Act framework was implemented over 11 weeks and included staff education, standardized workflows, and caregiver outreach.

Results:

The intervention improved laboratory completion and caregiver follow-up rates; however, sustainability was limited by staffing constraints …

Hallucinogen Use Among Parents Of Children In The United States: Associations With Mental Health And Substance Use, Maggie K. Richardson

Theses and Dissertations--Educational, School, and Counseling Psychology

Hallucinogen use has reemerged in the United States amid expanding clinical research and shifting social and policy contexts. However, population-based evidence remains limited regarding hallucinogen use among adults living with children and its relationship with mental health impairment severity in caregiving environments. Therefore, this study’s objective was to examine associations between past-year hallucinogen use and past-year mental health impairment among U.S. adults, and to test whether associations differ by parental status and number of children in the household. A secondary aim examined correlates of co-occurring substance use among those reporting hallucinogen use.

Data were drawn from the 2023 National Survey …