Lessons Learned From The Implementation Of A Pragmatic Trial Evaluating Non-Pharmacological Approaches To Dementia Care In Us Nursing Homes, Carin Wong, Catherine V. Piersol, Felicia Chew, Cara Lekovitch, Victoria Shier, Mike Morris, Jenny Martínez, Julie Britton, Natalie E. Leland

Department of Occupational Therapy Faculty Papers

RATIONALE: The consistent delivery of effective evidence into nursing home practice has been shown to enhance quality of care and residents' outcomes. Pragmatic trials enable the evaluation of efficacious interventions in a real-world context, including care of residents living with Alzheimer's Disease and Related Dementias (ADRD). Yet, there are limited pragmatic trials conducted in nursing homes and even less evidence on the strategies to successfully conduct such research in this setting.

OBJECTIVE: To identify the lessons learned from a pragmatic trial and provide recommendations for future successful studies in United States (US) nursing homes.

METHODS: Drawing on a case example …

Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong

Centre of Excellence in Women and Child Health

No abstract provided.

Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong

Centre of Excellence in Women and Child Health

No abstract provided.

Visits Related To Alcohol, Substance Use, And Mental Health In New Mexico’S Emergency Departments: Social Determinants Of Health And Discharge Disposition, 2021-2024, Samuel L. Swift, Maya Stefanovic, Dylan Pell

Population Health Research and Scholarship

No abstract provided.

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

Undergraduate Theses and Capstone Projects

Art therapy has been increasingly recognized as a complementary intervention in healthcare settings, with demonstrated benefits for stress reduction and overall biopsychosocial well-being (Liu 2022; Magsamen, 2014). However, limited research has explored aesthetic engagement within medically underserved and economically disadvantaged populations. This study uses the Aesthetic Responsiveness Assessment to examine the relationship between art and patients receiving care at the Central Virginia Free Clinic in Lynchburg. The survey consists of 14 Likert-scale questions assessing individuals’ cumulative aptitude across three domains: aesthetic appreciation, intense aesthetic experience, and creative behavior. There was an additional 15th qualitative question that assessed the desire for …

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 …

Rural Health In Pike County: A Richard & Magnolia Community Health Needs Assessment, Victoria Bracey

Honors Theses

Rural communities across the United States suffer from poor health outcomes due to lack of resources and other compounding factors that make access to quality healthcare difficult. Mississippi is a predominantly rural state, and in the southwestern region of Mississippi lies the community of Magnolia and the community of Richard within Pike County. To better understand the health needs of Pike County, a community health needs assessment was conducted. This study aimed to assess the needs of Pike County in southwest Mississippi through the use of a community health needs assessment using focus groups. Two focus groups, with a total …

Application Of The Multi-Theory Model To Determine Predictors Of Initiating And Sustaining Stress Management Behaviors In Undergraduate College Students, Bishoy T. Samuel, Joshua Mann, Michael Welsch, Manoj Sharma, Vinayak K. Nahar

Journal of Public Health in the Deep South

Background: Undergraduate college students face stress and concomitant mental health issues that can be mitigated by proper stress management behavior.

Purpose: This article examines the multi-theory model (MTM) of health behavior as a predictor of change in the primary outcomes of initiation and sustenance of relaxation-seeking behavior in undergraduate college students for the purposes of stress mitigation. The two main research hypotheses tested were that (a) participatory dialogue, behavioral confidence, and change in physical environment have statistically significant effects on initiation of behavioral change, and (b) emotional transformation, practice for change, and change in social environment have statistically significant effects …

Farmers Markets And Produce Purchasing Behaviors Among University Faculty And Staff, Kritika Gupta, Laurel Lambert, Jangwoo Jo, Selby Rebecca Entrekin, Georgianna Mann

Journal of Public Health in the Deep South

Background: This study explores produce purchasing criteria (PPC) and produce purchasing frequency (PPF) among university faculty and staff, a population often underrepresented in dietary behavior research.

Purpose: To identify distinct PPC profiles among university faculty and staff and examine how these profiles are associated with PPF and farmers market usage, while also assessing the role of demographic and behavioral factors in shaping these relationships.

Methods: Using a 29-item online survey administered to faculty and staff at a southern United States university (N = 175), three distinct PPC clusters were identified: health/label conscious, utilitarian, and no-specified-criteria consumers. Statistical analyses — including …

Telemedicine Kiosks: Can Technology Solve Rural Mississippi's Healthcare Crisis?, Babu George, Martha Ravola

Journal of Public Health in the Deep South

Background: Mississippi’s rural counties face hospital gaps, clinician shortages, and limited broadband/device access that collectively delay care and constrain telehealth uptake.

Purpose: This paper assesses whether telemedicine kiosks can improve rural healthcare access in Mississippi while also supporting viable local entrepreneurship and community development.

Methods: A conceptual, policy-and-market analysis integrated narrative literature synthesis, secondary data and policy review, and 5-year financial modeling under two cost-allocation scenarios: an Operator Model (subscription fees covered by partners/grants) and a Network Model (subscription fees borne by the kiosk operator).

Results: Kiosks with embedded connectivity and diagnostic peripherals can deliver device-independent virtual care and directly …

Promoting A Culture Of Academic Integrity In The Context Of Artificial Intelligence: Lessons From One School Of Public Health In The Southeast, Gregory Pavela, Lindsay C. Aycock, Mercy Aula, Angela Sullivan, Matthew Fifolt

Journal of Public Health in the Deep South

No abstract provided.

Aircraft Wastewater Surveillance As A Tool For Monitoring Disease In The Pacific, Carla J. Eaton, Joanne R. Chapman, Brent J. Gilpin

Pacific Journal of Health

Wastewater surveillance is a powerful tool for monitoring infectious diseases within a population. However, as most wastewater surveillance relies on interconnected wastewater networks to provide samples representative of the population, many Pacific Islands have been excluded from benefiting from this tool due to their lack of reticulated sewerage systems. Many diseases of concern for the Pacific are detectable in wastewater even though individuals may be asymptomatic. We investigated whether analysis of wastewater from aircraft arriving in New Zealand from Pacific Island nations could be used as a proxy for in-country surveillance. Flights from the Pacific arrive in Auckland daily, with …

Risk Factors Of Leptospirosis Among Agricultural Workers In Southeast Asia: Literature Review, Ronggo Adi Wibowo, Wawa Najwa Nurzakia, Meirany Sasitha Kirana, Yulia Arthemisia Wijaya, Jasmine Ayumaharani Sekaryudha, Dwi Sarwani Sri Rejeki, Rosita Dwi Jayanti

Jurnal Epidemiologi Kesehatan Indonesia

The agricultural sector is the primary source of livelihood for communities in Southeast Asia; however, these activities increase the risk of exposure to zoonotic diseases, particularly leptospirosis. Southeast Asia is one of the regions with the highest incidence of leptospirosis in the world. This literature review aims to identify risk factors for leptospirosis among agricultural workers in Southeast Asia. The search for research articles utilized three databases (Google Scholar, PubMed, and ScienceDirect) using a descriptive approach based on literature review and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 9,800 articles were screened for …

Factors Associated With Stunting Among Children Aged 6 – 59 Months Attending Integrated Health Post (Posyandu) In Selapajang And Kedaung Wetan Villages, Neglasari Sub-District, Tangerang City: A Matched Case-Control Study, Michael Alexander Solang, Joue Abraham Trixie, Gloria Semula, Tiona Simamora, Conny Tanjung

Jurnal Epidemiologi Kesehatan Indonesia

Stunting is a problem in Indonesia. In 2022, Kedaung Wetan and Selapajang Villages in Neglasari sub-district, Tangerang City, were identified as a priority. This study aimed to identify factors associated with stunting among children (6 – 59 months) in these villages. A matched case-control study consisting of 214 children (107 cases and 107 controls) was conducted, with individual matching based on age, sex, and prematurity at birth. Cases were children with height-for-age (H/A) measurement less than -2SD (according to WHO standard), while controls were children with H/A equal to or greater than -2SD. Conditional logistic regression was used for the …

Incidence Of Carpal Tunnel Syndrome After The Diagnosis Of Ulnar Neuropathy, Harrison S. Fellheimer, Eric Didomenico, Mahaa Ayub, Magnolia Livingston, William L. Justice, Gabriel I. Onor, Eric Tecce, Pedro K. Beredjiklian

Department of Orthopaedic Surgery Faculty Papers

PURPOSE: The purpose of this study is to determine whether patients diagnosed with ulnar nerve lesions (UNLs) have an increased risk of developing carpal tunnel syndrome (CTS).

METHODS: A retrospective cohort study was conducted using the TriNetX database, which contains data of >100 million patients. We identified 360,021 patients with UNLs and matched them 1:1 with controls. The incidence of CTS was assessed at 1, 2, 3, 4, and 5 years following the diagnosis of UNL. Statistical analyses were used to evaluate the development of CTS in the UNL cohort compared with controls.

RESULTS:  Patients with UNL demonstrated a significantly …

Impact Of Tropical Cyclones On Food And Nutrition Security: A Global Scoping Review And Thematic Analysis, Patience M. Chiotha, Budi Haryanto

Jurnal Epidemiologi Kesehatan Indonesia

The increasing frequency and intensity of tropical cyclones driven by climate change pose growing threats to food and nutrition security. Globally, an estimated 80–90 tropical cyclones occur annually, affecting approximately 119 million people. Evidence regarding their impact on food systems, dietary patterns, and nutritional status remains fragmented. This scoping review aimed to map global evidence on the impacts of tropical cyclones on food and nutrition security, identify key pathways of impact, and examine affected indicators at household and individual levels. The review followed Joanna Briggs Institute guidelines and PRISMA-ScR. Searches were conducted in PubMed/MEDLINE, Web of Science, Scopus, and Google …

Analisis Disparitas Geospasial Dan Determinan Sosio-Demografis Masalah Kesehatan Jiwa Di Indonesia: Analisis Data Survei Kesehatan Indonesia (Ski) 2023, Alya Zahrah Zhafirah, Sutanto Priyo Priyo Hastono

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Kesehatan jiwa merupakan pilar utama pembangunan sumber daya manusia yang kini menjadi tantangan struktural di Indonesia. Masalah ini dipengaruhi secara signifikan oleh determinan sosio-demografi seperti tingkat pendidikan, status ekonomi dan lingkungan. Penelitian ini diinisiasi oleh urgensi untuk memetakan distribusi beban masalah kesehatan jiwa secara nasional sekaligus menginvestigasi ketidakonsistenan prevalensi antara data Riskesdas 2018 dan SKI 2023. Penelitian ini menggunakan desain potong lintang dengan menganalisis prevalensi masalah kesehatan jiwa pada penduduk Indonesia berusia ≥15 tahun, menggunakan data SKI 2023. Kondisi kesehatan jiwa dinilai menggunakan instrumen SRQ-20 untuk mengidentifikasi probabilitas masalah kesehatan jiwa. Hasil utama menunjukkan prevalensi masalah kesehatan jiwa Indonesia tahun …

Determinants Of Stunting Among Under-Five Children (0–59 Months) In Central Sulawesi Province, Marchell Bamba, Mondastri Korib Sudaryo, Ratna Djuwita, Helwiah Umniyati

Jurnal Epidemiologi Kesehatan Indonesia

Stunting is caused by chronic malnutrition which can be caused by various factors including poverty, poor nutritional intake and maternal health, and inappropriate infant feeding. This study was conducted to determine what factors cause stunting in Central Sulawesi Province. This study was conducted using a cross-sectional observational analysis method using secondary data from the Survei Kesehatan Indonesia (SKI) 2023. The analysis was carried out using logistic regression. The sample used was 2179 respondents. The dependent variable is stunting while the independent variables are age, gender, area of residence, gestational age, provision of PMT, exclusive breastfeeding, maternal occupation, maternal education, and …

The Effects Of Ultra-Processed Food Consumption On Cancer Development, Bailey G. Ottmann

Emerging Writers

The dramatic rise in ultra-processed food (UPF) consumption worldwide has sparked growing concerns about its impact on cancer development and human health. UPFs contain high levels of added sugars, unhealthy fats, chemical additives, dyes, and toxic compounds formed during cooking and processing. This study investigates the relationship between UPF consumption and cancer through a review of primary and secondary sources, alongside an observational survey conducted among 15 healthcare professionals, including physicians, nurses, and nursing educators. Survey findings indicate that 53% of participants observed higher cancer prevalence in patients consuming large amounts of UPFs, with colorectal cancer most frequently reported. The …

Patterns Of Multimorbidity Among Low-Income Adults Who Smoke With Implications For Tailored Interventions: A Cluster Analysis Using A Mixture Of Bernoulli Model, Monique T. Cano, Michael R. Lindstrom, Oscar F. Rojas Perez, Ricardo F. Muñoz

School of Mathematical & Statistical Sciences Faculty Publications

Introduction: Smoking cigarettes remains a leading modifiable risk factor for preventable health conditions. In the United States, the health burden of smoking disproportionately impacts low-income individuals. Multimorbidity is common in this group, complicating treatment and worsening outcomes. Identifying multimorbidity clusters can support targeted, individualized interventions. This study aimed to identify multimorbidity clusters among individuals who smoke and experience economic hardship and provide clinical recommendations to enhance health outcomes.

Method: Individuals who smoke and experience economic hardship (N = 60) were recruited from the San Francisco Health Network (SFHN) and were assessed for physical and mental conditions. Cluster analysis was …

U.S. Pharmacists’ Perceptions Of Getting The Covid-19 Vaccine And How That Affects Their Interactions With The Public, Megan Boals

Walden Dissertations and Doctoral Studies

Pharmacists play a pivotal role in public health, particularly in promoting vaccination. However, vaccine hesitancy among pharmacists significantly undermines their willingness to provide effective patient counseling and to advocate for vaccination, potentially eroding public trust in vaccines. This descriptive-phenomenological study sought to understand the factors contributing to pharmacists’ COVID-19 vaccine hesitancy and how this hesitancy affected their willingness to recommend vaccines to patients. Twenty practicing pharmacists were interviewed via Zoom between September 23 and October 14, 2025. The health belief model helped interpret the study findings. Thematic analysis, as described by Braun and Clarke, was conducted to identify and interpret …

Associations Between Caregiver-Provider Communication Quality And Unmet Care Needs Among Older Adults, Jiaming Liang, Rafael Samper-Ternent, Brian Downer, Zhigang Xie

Faculty, Staff and Student Publications

BACKGROUND: Unmet care needs (lack of assistance with daily activities) among older adults are common and linked to adverse health outcomes, greater healthcare utilization, and caregiver burden. While effective patient-provider communication is known to improve care quality, less is understood about the role of caregiver-provider communication, particularly across sociodemographic, health, and caregiving contexts. METHODS: We conducted a cross-sectional secondary analysis of pooled 2021–2023 National Health and Aging Trends Study (NHATS) and National Study of Caregiving (NSOC) data, restricted to community-dwelling older adults (65 + years) who received assistance from caregivers due to difficulty with daily activities, and had at least …

A Livelihood Intervention Improved Nutritional, Mental Health And Sexual Health Outcomes Among Hiv-Affected Adolescents In Western Kenya: Results From The Shamba Maisha Randomised Controlled Trial, Sheri D. Weiser, Lila Aziz Sheira, Pauline Wekesa, Jennifer Monroe Zakaras, Edward A. Frongillo Jr. Ph.D., Elly Weke, Jason M. Nagata, Amy A. Conroy, Marguerita Lightfoot, Torsten B. Neilands, Lisa M. Butler, Elizabeth A. Bukusi, Craig R. Cohen, Maricianah Atieno Onono

Faculty Publications

Introduction Interventions that address household-level factors, including food insecurity (FI) and poverty, may reduce HIV risk and improve sexual and reproductive health (SRH) among adolescent girls and young women (AGYW).

Methods This cluster randomised controlled trial in Kenya assessed AGYW living in households of adults enrolled in Shamba Maisha (SM). SM was a multisectoral agricultural livelihood intervention designed to improve HIV health. At the trial end, we used linear and logistic regressions to compare differences between the intervention and control arms in FI, and mental health among AGYW-caregiver pairs and SRH outcomes among the AGYW, accounting for clusters with robust …

Evaluating U.S. Health Policy Levers Using Difference-In-Differences: Hospital Acquisitions, Global Budgets, And Income Policies, Kola Adegoke

NYMC Student Theses and Dissertations

Abstract

Background: U.S. health policy relies on multiple levers to influence system performance, financial stability, and population health. This dissertation uses a three-paper portfolio to evaluate organizational change (hospital acquisitions), payment reform (Maryland all-payer global budgets), and income-related state policies, applying difference-in-differences (DiD) designs with prespecified diagnostics to support causal interpretation.

Methods: Study 1 examined hospital change-of-ownership (CHOW) acquisitions using a national hospital-year panel from RAND HCRIS (2014–2023), linked to CHOW timing data from 2016–2023. Effects on revenue outcomes were estimated using a staggered difference-in-differences design implemented with the Callaway and Sant’Anna estimator, using doubly robust inverse probability weighting, hospital-level …

Socioeconomic Disparities In Readmission Outcomes And Cardiac Procedures Among Atrial Fibrillation Hospitalizations, Muhammad U. Almani, Muhammad Yousuf, Noor Fatima, Muhammad Q. Ullah, Muhammed Arshad

Einstein Health Papers

Introduction: Atrial fibrillation (AF) remains one of the leading dysrhythmias incurring hospitalization. We set out to determine the impact of socioeconomic status (SES) on in-hospital cardiac procedures and the readmission outcomes in patients with AF. Methods: The National Readmission Database (NRD) was searched for adults with a primary diagnosis of AF between 2010 and 2019. We determined unplanned AF-specific readmission within 30 days. Median neighborhood household income was assessed by patient zip code as quartiles: low income (Q1), middle income (Q2), upper-middle income (Q3), and high income (Q4). Differences in in-hospital cardiac procedures during the index hospitalization and probability of …

What Factors Influence Health Professions Trainees’ Preferences For Employment In Rural Appalachia? A Qualitative Study To Inform The Design Of A Discrete Choice Experiment, Chris Gillette, Jan Ostermann Ph.D., Aylin A. Aguillar, Sarah O'Neal, Chris Everett, Dawn Caviness, Esita Patel, Laiton Steele, Dawn Goel, Quazi Minhaz Tabassum

Faculty Publications

Optimizing the geographic allocation of health care providers has the potential to improve health care access and health outcomes for rural populations. To inform the design of a discrete choice experiment (DCE) survey to elicit health professions trainees' preferences for rural practice, this formative research aimed to: (1) elicit factors that influence job selection among health profession trainees, including medical residents physician assistant (PA) and nurse practitioner (NP) students, (2) identify how these trainees evaluate trade-offs for rural job placement and (3) inform attribute selection for inclusion into a future DCE to identify health professions trainees’ preferences for rural practice. …

Transformational Leadership In Higher Education, Dr. Jewel Hale, Jr., Kristi Apostel

Tapestry: Journal of Research in Education

A crisis can highlight the critical need for resilient leadership within higher educational settings. Educational leaders encounter extraordinary difficulties, ranging from different learning options to prioritizing the well-being of both staff and students, necessitating flexible and innovative methods. By exploring how school leaders apply transformational techniques in actual educational environments, this article addresses the impact of the four I’s of transformational leadership, idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration, on building educator resiliency, sustaining school effectiveness, and promoting student achievement in higher education.

Fierce Leadership-Perspectives Of Black Women Educational Leaders: A Transcendental Phenomenological Study, Janice Taylor, Dianne Reed

Tapestry: Journal of Research in Education

The authors of this transcendental phenomenological study aimed to describe the lived experiences of Black women based on their perceptions, values, and beliefs about the complexities of leadership and the kind of leadership required to succeed in their respective roles, as educational leaders. This study was framed by the adaptive leadership theory. Adaptive leadership recognizes the need for leaders to stay flexible and resilient in fast-paced environments (Nelson & Squires, 2017). The three Black women leaders in this study were fierce adaptive leaders. The information acquired from this study is significant and highlights how Black women educational leaders developed the …

Research Literacy And Research Production Skills As Core Competencies In Leaders, Kk O'Byrne

Tapestry: Journal of Research in Education

No abstract provided.

Predictors Of Employment Attrition In Lebanon During Multifaceted Crises: The Role Of Chronic Diseases – A National Cross-Sectional Study, Myriam Dagher, Ali Abboud, Ghada E. Saad, Rita Itani, Rindala Fayyad, Hala Ghattas Ph.D., Stephen J. Mccall, Jocelyn Dejong, Malak Ghezzawi, Nisreen Salti, Sasha Fahme, Serena Canaan

Faculty Publications

The COVID-19 pandemic and Lebanon’s ongoing economic crisis exacerbated existing workforce and health disparities. This study explored the predictors of employment attrition during Lebanon’s concurrent crises and examined the association between chronic conditions and employment attrition. This cross-sectional study recruited adults aged 19–64 years residing in Lebanon through random digit dialing (January – July 2024). Data collected included socio-demographics, household characteristics, employment history and characteristics, and self-reported chronic conditions. The outcome was loss of paid employment (employment attrition) during the crises. Predictors were identified through a Least Absolute Shrinkage and Selection Operator (LASSO) regression, and model discrimination and calibration were …