Digital Commons Network^™

The Impact Of Economic Stability On Diagnostic Timing Of Autism Spectrum Disorder In Children, Leslie Box Simms

ETDs from 2020-2029

Diagnosis of neurodevelopmental delays in children, including autism spectrum disorder, is an often lengthy and burdensome process, potentially placing children with economic instability at risk for diagnostic delay. The first aim of this dissertation was to explore the impact of economic stability on diagnostic timing of autism spectrum disorder via a scoping review of the literature. Papers were summarized by study design, data sourcing, handling of variables, statistical methodology, and the effect of economic stability factors on diagnostic timing of autism. Income and healthcare insurance were the most frequently employed measures of economic stability, with transportation, housing, and food security …

Trends Of Pediatric Psychotropic Polypharmacy In Massachusetts Before And During The Covid-19 Pandemic, Gianna D'Ambrozio

Graduate Doctoral Dissertations

Youth in the U.S. and internationally are increasingly being diagnosed with depression and related psychiatric conditions (Murthy, 2021) many of whom are being subjected to non-evidence-based, or what has been termed irrational, psychotropic polypharmacy (Barnett & Concepcion Zayas, 2019). Psychotropic polypharmacy can be defined as “the use of 2 or more psychiatric medications in the same patient,” (Zito et al., 2021) though definitions can vary. Using data from the Center for Health Information Analysis’ Massachusetts All-Payer Claims Database, this study examined the sociodemographic factors associated with high rates of polypharmacy, a hypothesized increase in pediatric psychotropic polypharmacy rates in Massachusetts …

Lessons Learned In Providing Infant And Early Childhood Mental Health Consultation During The Covid-19 Pandemic, Rashele Wade

Journal of Global Awareness

Access to quality childcare is a protective factor from lifelong issues such as school failure, school drop-out, and incarceration. Conversely, preschool suspension and expulsion are significant risk factors. Evidence-based interventions, such as Infant and Early Childhood Mental Health Consultation, aim to reduce and eliminate the incidence of preschool suspensions and expulsions. The COVID-19 pandemic disrupted access to quality childcare for many children across the country and globally. This study utilized a qualitative action research approach and generic qualitative inquiry to examine the research question, “How can we improve Infant and Early Childhood Mental Health Consultation through lessons learned during the …

Geauxhealth.Org: A Technological Approach To Community Resources In New Orleans, Madelin Mlynczak

Journal of the Louisiana Public Health Association

Background: Connecting patients to appropriate community resources remains a significant challenge for healthcare providers in New Orleans. Existing resource guides have limitations in clinical workflows, highlighting the need for a tool tailored to healthcare professionals. The primary objective of this study was to evaluate the effectiveness of the GeauxHealth.org website in improving medical residents’ and fellows’ knowledge of community resources and decreasing perceived struggle in referring patients to community resources. Methods: We conducted a pre- and post-intervention survey among residents and fellows at two academic institutions in New Orleans. Participants were introduced to GeauxHealth.org, a locally developed and searchable online …

Vol 6. May '26 Full Issue, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

“There Was Nothing Left To Give”: Experiences Of Compassion Fatigue Among Former In-Patient Psychiatric Clinicians, Katie Ladner

Counseling and Psychology Dissertations

Compassion Fatigue (CF) is a state of emotional and physical exhaustion resulting from prolonged exposure to stressful or traumatic experiences, specifically among healthcare workers, and it negatively impacts their ability to provide care to their patients and perform their jobs effectively (Singh et al., 2020). The purpose of this qualitative study is to explore the lived experiences of compassion fatigue in mental health clinicians who previously worked in in-patient psychiatric hospitals and their subsequent resignations. This phenomenological research explored participants' understanding and descriptions of their CF experiences in their roles within psychiatric hospitals and how CF contributed to their leaving …

Exploring Direct Support Professionals' (Dsps) Attitudes Regarding Trauma Informed Care And Its Impact On Turnover Intention, Lorraine D'Sylva-Lee

Seton Hall University Dissertations and Theses (ETDs)

The relationship between Direct Support Professionals’ (DSPs’) attitudes toward trauma-informed care (TIC) and their turnover intention has remained empirically untested, despite DSPs’ exposure to primary and secondary trauma. An estimated 8.38 million Americans with intellectual and developmental disabilities (IDD) depend on this workforce, yet 2024 turnover rates reach 53.7%. This convergent mixed methods study examined TIC attitudes, turnover intention, and their relationship among 109 DSPs in IDD provider agencies in New Jersey. Grounded in the Theory of Planned Behavior (TPB), the cross-sectional design used the ARTIC-10, TIS-6, and two open-ended items. DSPs with more favorable TIC attitudes were significantly less …

Keeping Families Together: Companion Animals As A Public Health Imperative, Lori R. Kogan, Rebecca Niemiec

Journal of One Health Systems

Contemporary US public health frameworks emphasize social, economic, and environmental determinants of health, yet largely overlook the reality that most households include companion animals regarded as family members. This omission has tangible consequences during crises such as housing instability, illness, domestic violence, or disasters, when families are often forced to choose between their own safety and the safety of their animals. We argue that this represents a significant public health failure. Drawing on interdisciplinary evidence, we propose that companion animals function as a social determinant of health, that forced separation constitutes a public health harm, and that Human-Animal Support Services …

How Do Adverse Social Determinants Of Health Influence 30-Day Hospital Readmission Rates Among Patients With Heart Failure?, Noor Baig

Rowan-Virtua Research Day

Heart failure is one of the leading causes of hospitalization in the United States, with nearly 1 in 4 patients readmitted within 30 days of discharge. Clinical severity largely accounts for this risk, but social determinants of health (SDOH), including income, housing stability, transportation access, and health literacy, also play a role in post-discharge outcomes. This review synthesized seven cohort, observational, and qualitative studies from PubMed (2018–2025) examining the relationship between SDOH and 30-day readmission in heart failure patients.

Several patterns emerged across the literature. Neighborhood socioeconomic disadvantage, measured through ADI and SDI, was independently associated with higher readmission and …

Barriers To Palliative Care Access In Rural South Dakota: A Policy And System-Level Analysis, Harshavardhan Kadarkaraisamy

Honors Thesis

Palliative care improves the quality of life for people living with serious illness. It helps by addressing symptoms, improving communication, and providing mental, physical, and spiritual support. However, in South Dakota access to palliative care is limited in rural areas. These challenges include geographic isolation, workforce shortages, healthcare infrastructure, reimbursement, and misunderstandings about palliative care. This thesis examines the key policy barriers that limit access to palliative care in rural South Dakota. This work involves engaging with South Dakota-specific literature, rural health research, policy sources, community education, telehealth expansion, and policy reform. By focusing on the rural context of South …

The Undergraduate Education And Scientific Literacy: Exploring How College Influences Student Perception Of Covid-19 Events, Peyton Brooking

Theses/Capstones/Creative Projects

Current undergraduate students received much of their education following the events of the COVID-19 pandemic. Many of these students experienced pandemic events before receiving any or most of their science-based higher education. Exploring their progress through higher education, and how it retroactively influenced their perception of pandemic events, serves as an informative research area. This study explores how undergraduate education in the sciences influences student engagement with complex recent events in science. In addition, this study asked how higher education builds confidence in interpreting this information. Additionally, students were surveyed to understand their scientific literacy baseline at the beginning of …

The 2026 Mda Award Winners: Recognizing Outstanding Service, David Foe

The Journal of the Michigan Dental Association

This article lists the recipients of the 2026 MDA awards, highlighting their contributions to the dental profession and public health. Notable winners include Dr. Christopher Smiley, recipient of the Meritorious Award for a lifetime of achievement in dental journalism and leadership, and Dr. Charles Burling, honored as Dentist Citizen of the Year for his community service. The feature also recognizes educators, legislative advocates, and volunteers in the Donated Dental Services (DDS) program who provide care to vulnerable populations.

Investigating The Effectiveness Of Different Modalities In Interprofessional Training, Rose Ann Mathai, Sean Lopez, Maureen Emlund, Jim Scherrer, Elisa Buzinski, Julia Sonnichsen, Myra Carew

Patient Experience Journal

Background: Interprofessional education (IPE) highlights the importance of values and ethics, teamwork, communication, and roles and responsibilities for healthcare professionals. Different modalities have been used to teach these skills. The most effective teaching modality must be determined to enhance the collaborative learning experience. Purpose: This study evaluated the changes in student perceptions on each interprofessional competency with respect to the teaching modality. Two groups were evaluated for this study. One was taught using a hybrid curriculum and the other in-person. Methods: This study utilized the Students' Perceptions of Interprofessional Clinical Education (SPICE-R2) survey to determine the changes in student …

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 …

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, …

Evaluating An Lgbtq+ Adolescent Sexual Health Toolkit: Boosting Confidence And Provider Knowledge, Joslyn Lypka

Doctoral Dissertations & Projects

When leveraged correctly, sexual health education empowers youth to build resilience, deepen self-understanding, and confidently navigate gender and sexual identities. However, many school-based programs emphasize cisgender and heterosexual norms, leaving LGBTQ+ adolescents with limited access to inclusive and affirming sexual health information. This project aimed to develop and evaluate an online sexual health education toolkit designed to increase knowledge and support self-advocacy among LGBTQ+ adolescents, parents/caregivers, and healthcare providers. In collaboration with a Midwest nonprofit organization serving sexual and gender-diverse individuals, an online toolkit was developed and evaluated using two sequential Plan–Do–Study–Act (PDSA) cycles. During the first cycle, subject matter …

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. …

Can The Implementation Of The Pause Decrease Death Anxiety And Poor Mental Health In Practicing Nurses?, Lilli Meyer

Undergraduate Theses

Practicing nurses are frequently exposed to patient death, placing them at increased risk for death anxiety and compromised mental health. Despite this, there remains a lack of structured, in-the-moment interventions to support emotional processing within clinical settings. This study evaluates whether the implementation of “The Pause,” a brief moment of silence following a patient’s death, may reduce death anxiety and improve mental health outcomes among practicing nurses. A quantitative survey consisting of eight questions was distributed to nurses in the Louisville, Kentucky area over a three-month period, yielding 26 responses. Findings indicated that 80.8% of participants reported no improvement or …

Using Somatic Experiencing To Mitigate Symptoms Of Secondary Traumatic Stress In Female Helping Professionals, Jillian Christie Guinta

Doctoral Dissertations and Projects

This phenomenological and quantitative study explored the lived experiences of a dozen women within the veterinary, social work, and nursing communities and how secondary traumatic stress impacts their lives. Faced with unanticipated patient illnesses, facilitating compassionate end-of-life procedures, and rapidly moving from one emotional state to the next between patients, professionals are carrying tremendous unprocessed emotional burdens that can affect them physiologically and psychologically. Somatic Experiencing (SE) indicates tremendous promise in rehabilitating practitioners’ trauma-impacted nervous systems by offering techniques to release emotional stress and re-regulate the nervous system (Kuhfuß et al., 2023). This mixed-methods study explored the world of these …

The Role Of Community Health Workers In Rural South Carolina, Sarah W. Haselden

Senior Theses

This paper aims to explore the role of Community Health Workers (CHWs) in rural South Carolina through a literature review as well as the data supplied from the Community Health Alignment Initiative (CHAI) and Community Health Workers Changing Outcomes in SC (CCOSC). Through reviewing the collection of materials and data, the effectiveness of CHWs can be studied. Community Health Workers (CHWs) provide a unique aspect to primary care within communities through their aid in prevention of health conditions. CCOSC and CHAI collected data throughout South Carolina to determine the needs of communities and how CHWs can work to address those …

Navigating End-Of-Life Decisions: Cultural Considerations For Latine Patients, Michelle Carbajal Hernandez

Honors Capstones

Healthcare professionals face many challenges when communicating terminal illness prognoses for individuals. This responsibility to address a terminal prognosis is further complicated when communicating with Latine patients who may face multiple barriers within the healthcare system and whose cultural preferences influence end-of-life care planning (Carrion, 2010). For example, Latines are less likely to enroll in end-of-life (EOL) care services (e.g., hospice) (Barragan-Carrillo et al., 2022). As well as engage in end-of-life care planning than White Non-Latines (Shen et al., 2016). To understand this hesitancy towards EOL care options, this literature review aims to explore how terminally ill Latine and …

Dental Insurance Status Among Formerly Incarcerated Older Adults, Alexander Testa, Rafael Samper-Ternent, Dylan B Jackson, Kyle T Ganson, Vahed Maroufy, Jason M Nagata, Ana C Neumann

Faculty, Staff and Student Publications

Formerly incarcerated individuals have poorer oral health and less frequent dental care utilization than the general population. However, prior work has overlooked the relationship between prior incarceration and disparities in dental insurance coverage. Using data from the Health and Retirement Study (n = 11,638), findings from multiple logistic regression analyses demonstrate that formerly incarcerated older adults are significantly less likely to have dental insurance coverage (odds ratio [OR] = 0.745, 95% confidence interval [CI] = 0.608, 0.912). After accounting for the income-to-poverty ratio, this association was no longer statistically significant. Analyses using the Karlson-Holm-Breen method demonstrated that approximately 45% of …

Caregiver Challenges And Health Access For Individuals With Developmental Disabilities In Mississippi, Kirsten Cunningham

Honors Theses

Current literature has highlighted the health disparities faced by individuals within the disability community and how it affects the care they receive. However, for many individuals with developmental disabilities, they require caregivers to make medical decisions for them. The purpose of this study is to focus on the caregiver’s perspective of caregiver stress, physical access to care, and health literacy to combat the challenges faced when getting access to healthcare resources for individuals with developmental disabilities in Mississippi. The researcher hypothesized, based on the literature review, that caregivers with higher levels of educational attainment would have less caregiver stress, more …

Gynecological Effects Of Sex Trafficking, Tracey Sylvester

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Food Insecurity’S Influence On Obesity, Hypertension, And Diabetes In Rural Vermont And Adirondack New York, Lindsay Morse

Walden Dissertations and Doctoral Studies

Food insecurity (FI) is a persistent public health challenge in the United States and disproportionately affects rural communities. Guided by syndemic theory, this quantitative cross-sectional study examined associations between FI and chronic disease outcomes among rural residents of Vermont and the Adirondack region of New York. Social determinants of health screenings and electronic medical records from 35 rural primary care sites were analyzed. Secondary data from n = 72,505 adults were used to evaluate these relationships. Binary logistic regression models assessed obesity, hypertension (HTN), and diabetes (DM), and a multinomial logistic regression model evaluated the combined presence of obesity and …

Navigating Homelessness And Housing Accessibility: An Ethnography Of Guests At Operation Nightwatch, Chase Kawika Patton

Dissertations and Theses

In 2025, over 7,000 individuals in Portland, Oregon experiencing unsheltered homelessness are without access to shelter or transitional housing. In this resource gap Operation Nightwatch (ON) provides material support for people experiencing homelessness (PEH) in the University District neighborhood of downtown Portland. This study focused on the experiences of chronically homeless guests of Nightwatch as they navigated homelessness and housing access. The study relied on semi-structured interviews with staff and guests and on-site participant observation to determine the availability of support to access housing in a system governed by Coordinated Access and the Housing First model. Primary research took place …

Substance Use Stigma: Examining The Role Of Social Work Education., Eboni Burton

Doctor of Social Work Capstone Projects

This study explored the extent of substance use related stigma among social work students and professionals (i.e., BSW, MSW, PHD and DSW) and its relationship to specialized education/training in substance use and professional practice with people who use drugs (PWUD)/live with a substance use disorder (PWSUD). Stigma was measured using the Opening Minds Provider Attitudes Toward Opioid Use Scale and the Medical Condition Regard Scale. The final sample size was 263. Results indicate that current enrollment in a social work program, post degree or non-curriculum related substance use related training, and personal and professional experience with substance use specifically, mitigate …

Preferences For Game-Based Elements To Increase Preexposure Prophylaxis And Hiv Prevention Engagement Among Latino Men Who Have Sex With Men: South Florida, 2022, Lacey Despres, Edda Rodriguez, Ross Shegog, Stephanie Diez, Susanne Doblecki-Lewis, Kayo Fujimoto, Suzanne Randolph Cunningham, Mariano Kanamori

Faculty, Staff and Student Publications

We explored gaming elements as a tool to promote engagement in HIV prevention services among Latino men who have sex with men. We conducted thematic content analysis of semistructured interview data that we collected from 12 Latino men who have sex with men (April-August 2022) in South Florida. Themes emerged related to intervention delivery, components, and perceptions. Our findings will guide the development of a game-based intervention to improve preexposure prophylaxis and HIV prevention engagement among Latino men who have sex with men.

Diagnostic Trends And Service Enhancements In Deaf Mental Health: A Longitudinal Analysis, Kent Schafer, Steve Hamerdinger, Frank Wu, Rie Sakai Bizmark, Charlene Crump

JADARA

A longitudinal study investigated mental health diagnostic trends and patterns among Deaf and Hearing individuals using a comprehensive dataset from Alabama Department of Mental Health spanning 2004-2024 (Deaf=4,547; Hearing=2,056,188). Chi-square analysis revealed significant proportional differences in diagnoses between the groups. Deaf individuals showed significantly higher proportions of psychotic (12.93% vs. 8.33% Hearing), mood (20.76% vs. 18.84% Hearing), and personality (0.58% vs. 0.43% Hearing) disorders. These findings suggest that increased access to specialized and competent mental health services for individuals who are Deaf, particularly following the increase of staffing patterns for the Office of Deaf Services in 2015,contributed to more accurate …