Digital Commons Network^™

Fall 2021

Scientia

A Decade of Progress and Success; Speech Language Pathology Program; COVID-19 Long-Hauler Study; Peer Mentors Initiative; Faculty Update; Expert Engagement: Three CSH initiatives further education and scholarship while supporting communities in need; Strategic Command: Business consultant and med tech expert Stephen Sichak helps others face pandemic challenges; Taking Care: A School of Nursing research team plumbs the pandemic experiences of nurses nationwide

Nourishing Births: A Program Evaluation Proposal For Community-Based Nutrition Education, Food Access, And Garden Engagement Among Black Birthing People, Naa Deedei-Vera Hammond

Master's Projects and Capstones

Black birthing people in the United States continue to experience unequal maternal health outcomes, shaped in part by racism and barriers to nutritious food, culturally relevant health education, and supportive community spaces. While prenatal nutrition education and food assistance programs can provide important resources, information alone cannot address the challenges many people face when trying to access healthy and affordable food during pregnancy. The Nourishing Births Initiative is a proposed community-based maternal health program designed to respond to these needs by bringing together prenatal nutrition education, help connecting to food resources, community gardening, and peer support for Black birthing people …

Adolescent And Young Adult Cancer Survivorship: Supportive Care Needs, Resources, And Barriers, Allison Bryn Koplos

Master's Projects and Capstones

Background: Adolescent and young adult (AYA) cancer survivors experience unique physical, psychosocial, developmental, and healthcare-related challenges that often persist beyond treatment completion. Although survivorship resources have expanded, gaps in supportive care needs persist. This scoping review examined the supportive care needs, survivorship resources, and barriers to accessing supportive care among AYA cancer survivors.

Methods: A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with the PRISMA-ScR guidelines. Peer-reviewed literature published between 2000 and 2026 was identified through searches in PubMed and Google Scholar. Studies examining supportive care needs, survivorship resources, or supportive care services …

Knowledge, Attitudes, And Practices (Kap) Of Parents Regarding The Prevention And Control Of Childhood Iron Deficiency Anemia In Egypt: A Cross-Sectional Study, Omnia Soliman

Theses and Dissertations

Childhood Iron Deficiency Anemia (IDA) remains a major public health challenge in Egypt, where its persistently high and rising prevalence carries substantial consequences for child growth, cognitive development, immunity, and long-term health outcomes. Globally, approximately 40% of children aged 6–59 months are affected by anemia (World Health Organization, 2025), and Egypt mirrors this burden, with national data showing a worsening trend in recent years. In Egypt, national strategies have traditionally focused on biomedical interventions such as iron supplementation and food fortification, while less attention has been directed toward behavioral and household-level determinants, particularly parental knowledge, attitudes, and practices (KAP) related …

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

Weathering The Divide: Social Determinants, Neighborhood Context, And Systemic Lupus Erythematosus Among African American Women, Vanessa Cl Morman

Electronic Theses and Dissertations

Background: Systemic lupus erythematosus (SLE) disproportionately affects African American women and contributes to racial health disparities in the United States. Although genetic susceptibility influences disease risk, growing evidence suggests that social determinants of health (SDOH), including neighborhood conditions, structural racism, and socioeconomic disadvantage, contribute to disease development and progression. Epigenetic mechanisms may provide a biological pathway linking adverse social conditions to chronic disease disparities. This dissertation examined the influence of SDOH on SLE disparities through evidence synthesis and empirical investigation to inform public health practice and policy.

Methods: This integrated learning experience consisted of three complementary manuscripts. Aim 1 was …

In Adults Older Than 18 Years With Obesity Living In Massachusetts, Can Engaging In A Weight Loss Program Help Them Lose Weight After Insurance Stops Covering Their Weight Loss Medications?, Angel Nagawa

Capstones

Executive summary

The Problem

Obesity rates continue to rise sharply across the United States. Weight loss medications have high compliance but face major insurance restrictions. Strict clinical criteria leave many patients without accessible treatment options.

The Proposed Solution

Launch structured, lifestyle-focused clinical weight loss programs. Provide an effective, accessible alternative to restricted pharmaceutical therapies.

Supporting Evidence

Evaluated data from three distinct randomized controlled trials. Findings confirm successful long-term weight management for program participants. Results prove effective control over serious obesity-related comorbidities.

Policy recommendation

Implement structured lifestyle programs as a primary, frontline intervention modality. Improve broad-scale patient health outcomes across clinical …

An Assessment Of Accessibility And Affordability Of Inpatient Psychiatric Care In Tennessee, Kailee Havrda

Electronic Theses and Dissertations

Introduction: Access to mental health has seen changes over the past decade, but little research and attention have been given to access to inpatient psychiatric facilities. Inpatient psychiatric care is crucial for patients experiencing mental health emergencies who need immediate access to care. Gaps in spatial accessibility, affordability, and the access and assessment process were identified due to a lack of available information in the field.

Methods: Secondary data from the Tennessee Department of Health were used to assess financial accessibility through payer source charges and patient encounters, as well as through mapping of inpatient psychiatric facilities and conducting drive …

Implementation And Effectiveness Of A Food Education Intervention To Promote Plant-Based Foods: A Partially Cluster-Randomized Controlled Trial, Henna Vepsäläinen, Satu Kinnunen, Sari Niinistö, Leena Forma, Suvi T. Itkonen, Tuuli E. Korhonen, Liisa Korkalo, Heli Kuusipalo, Jelena Meinilä, Kaija Nissinen, Susanna Raulio, Ros Sambell, Mari Åkerlund, Suvi M. Virtanen, Maijaliisa Erkkola

Research outputs 2022 to 2026

Background: Legumes can substitute for meat and are thus a particularly important food group for environmental sustainability. As the use of legumes among Finnish children is marginal, there is potential for a substantial increase in their consumption. However, food education delivered through early childhood education and care (ECEC) settings has rarely focused specifically on environmentally sustainable foods, such as legumes. This study describes the implementation and effectiveness of an ECEC-delivered food education intervention within the FoodStep study. Methods: The partially cluster-randomized FoodStep intervention aimed to increase the supply of vegetables, legumes, fruits, berries, and sustainable fish while reducing the provision …

Preventive Behaviors Associated With Fall Incidence Among Older Adults Living In Rural Communities Of Thailand: A Cross-Sectional Study, Rujira Nonsa-Ard, Sirapat Khodseewong, Kasama Wongprachum, Chaiwut Bourneow, Ploypailin Aneknan, Sumattana Glangkarn, Davina Porock

Research outputs 2022 to 2026

Background: The escalating population of older adults poses a significant challenge, particularly in lower-middle-income countries like Thailand. Falls represent a critical public health concern in this demographic. This study aimed to identify risk factors influencing fall occurrence in older adults within a specific rural community context, where the majority of participants remain engaged in farm work.

Methods: A cross-sectional study design was utilized, involving 1,256 participants recruited by the multistage random sampling approach. Data were collected via a questionnaire that included: demographic information, the Thai version of the Barthel Activities of Daily Living (ADL), the Thai Fall Risk Assessment Tool …

The Whole Patient: What Fascia Reveals About Pain, Adaptation, And The Case For Treating Together, Kelly Davis Pt, Dpt, Faaompt, Mt

New Orleans Dental Association News

The final piece in this series looks at fascia and the autonomic nervous system — the connective tissue and nerve pathways linking the jaw, neck, and airway into one continuous system — and why both matter to dentistry. Dr. Davis draws on current fascia and pain science research, including work from the 2025 International Fascia Research Congress in New Orleans, to explain how a misaligned bite can travel through this tissue and surface as headaches, how tongue posture and breathwork affect jaw stability, and why complex, chronic cases so often need more than one discipline to make headway. Told partly …

Kualitas Hidup Pasien Penyakit Gagal Ginjal Kronik Dan Kepuasan Pelayanan Di Unit Hemodialisis Rumah Sakit Alia Depok: Studi Mixed-Methods, Bimo Kusumo, Vetty Yulianty Permanasari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The prevalence of chronic kidney disease (CKD) in Indonesia remains a high-incidence condition and most of it underwent hemodialysis in Hospital. This study aims to analyze the quality of life of patients with chronic kidney disease and satisfaction with services in the hemodialysis unit. This study is a mixed-methods study with a quantitative study using the World Health Organization Quality of Life (WHOQOL-BREF) and Service Quality (SERVQUAL) questionnaires, and a qualitative study with in-depth interviews related to hospital services from both service providers (healthcare professionals) and service recipients (patients). The study found predominantly moderate scores on the WHOQOL-BREF and poor …

Health Horizons Journal, Volume 1, Issue 1

Health Horizons Journal

The Health Horizons Journal was founded in the fall semester of 2025 at Clemson University in order to establish a student-led journal that connects the Clemson community with global health content and empowers student researchers. The mission of this journal is to provide students with an opportunity to publish their research and promote access to scholarly work through open-access publication. This journal is dedicated to publishing at no cost to authors and providing submitting authors from any institution at the undergraduate or graduate levels with equal consideration.

Improving health outcomes on a global scale begins with interdisciplinary collaboration and the …

Analyzing Accessibility And Efficacy Of One Research Survey Website To Test Readability Of Physical Activity Promotion Material Disseminated Online: A Mixed Methods Pilot Study, Jafra D. Thomas, Anuraj Dhillon, Yi Sheng Wu, Jasmine C. Wong, Regina F. Hockert

Topics in Exercise Science and Kinesiology

Volume 7: Issue 1, Article 2, 2026.  Accessibility is the effort and ability required to access and navigate environments and participate in activities. Physical activity educational materials disseminated to the public and used within behavior change interventions may be hard to read and navigate, decreasing their accessibility and a study’s validity. This study documented, and addressed, issues that may hinder researchers’ ability to gauge accessibility of their online educational materials using the cloze procedure (a direct readability measure, requires guessing missing words from text passages). A multi-stage, mixed methods pilot study was utilized (August 2022 to May 2023). Phase 1: …

Implementation Of A Low-Cost Tobacco-Free Intervention In A Permanent Supportive Housing Program To Address Cancer Disparities Among People Who Have Experienced Homelessness, Ammar D. Siddiqi, Phoebe Wong, Cathy Crouch, Lorraine R. Reitzel

Advances in Cancer Education and Quality Improvement

Objectives: Permanent supportive housing residents who have experienced homelessness use tobacco products at elevated rates, contributing to higher cancer risk. Agencies that provide wraparound support services to this group are committed to rebuilding their stability by improving their health. Yet, their delivery of tobacco screening and cessation care is limited, as is information about their clients’ tobacco use behaviors. Here, we evaluated a low-cost intervention for an Albert Schweitzer Fellowship project conducted in a permanent supportive housing program with 650 adults who had experienced homelessness in Houston, Texas.

Materials and Methods: Between August 2024 and February 2025, client-facing staff members …

Murine Typhus In Georgia: Historical Context And A Probable Case Of Resurgence Where Previously-Thought Eradicated, Giovanni Mella-Velazquez, Christopher He, Bolanle Akinsola, Judson Miller

Journal of the Georgia Public Health Association

Background: Murine typhus, caused by Rickettsia typhi, is a flea-borne illness historically endemic to the southeastern United States, with initial cases reported in Atlanta, Georgia in 1913. Following vector control efforts, incidence declined significantly, and the disease was removed from the nationally notifiable disease list in 1987. While recent cases have been reported in select regions, murine typhus has not been documented in Georgia for decades. We present a pediatric case in Atlanta that may represent the first reported instance in nearly 40 years, suggesting possible reemergence in the Southeast.

Methods: We conducted a case report analysis of a pediatric …

Bridging Awareness And Action: A Multilevel Model Of Organizational Learning, Safety Climate, And Sickle Cell Trait Safety Compliance, Kimberly Snowden

Annual DBA Scholars Conference

Despite the existence of NCAA and National Athletic Trainers’ Association guidelines, preventable sickle cell trait (SCT)-related adverse events continue to occur in athletic settings. This study examines how organizational learning capacity, safety climate, leadership commitment, and individual risk perception influence compliance with SCT safety protocols and related safety outcomes. Drawing on Organizational Learning Theory, Safety Climate Theory, and the Health Belief Model, the study proposes a multilevel framework tested through an explanatory sequential mixed-methods design. Findings are expected to identify organizational predictors of compliance and provide practical recommendations to strengthen SCT safety implementation and reduce preventable athlete harm.

Effect Of Beverages With Varying Acidity On The Surface Microhardness Of Resin Composites: An In Vitro Study, Vishnu S, Shweta Purohit, Yashas Dm, Mangala G K, Chinnu Mary Jose, Athira Bs

International Arab Journal of Dentistry

Introductions: The increasing consumption of acidic beverages has raised concerns regarding their impact on the longevity of composite resin restorations. Surface microhardness is a critical parameter for evaluating the mechanical performance and durability of restorative materials.

Aim: To evaluate and compare the effect of beverages with varying acidity on the surface microhardness of different composite resin materials and to assess the relationship between beverage pH and microhardness reduction.

Materials and Methods: This in vitro experimental study included 140 disc-shaped specimens of four composite resins: Filtek Z350 XT, Tetric N-Ceram, Beautifil II, and Charisma Smart (n = 35 …

Diabetes Mortality In Georgia: Disparities, Social Determinants, And Rural-Urban Differences (2019-2021), Gwendolyn H. Cattledge, Temilola N. Luwoye, Gloria Elizabeth B. Ogionwo, Nyshanti B. Ross, Zachary M. Bremmer

Journal of the Georgia Public Health Association

Background: Diabetes mellitus remains a significant public health challenge globally and, in the U.S., notably impacts mortality. Georgia specifically faces a substantial burden, with disparities observed across populations and counties. Understanding the patterns and underlying drivers of diabetes-related deaths statewide is crucial for effective public health intervention.

Methods: This cross-sectional study analyzed age-adjusted diabetes mortality rates in Georgia from 2019-2021, using data from the Georgia Department of Public Health's OASIS and the CDC's Social Vulnerability Index (SVI) 2020. The study aimed to detail the distribution of mortality rates across counties, explore the role of social determinants of health, and analyze …

Prevalence And Correlates Of Digital Burnout Among Liberty University Students: A Cross-Sectional Study, Shaira Neupane

Masters Theses

Background: Digital burnout, characterized by chronic psychological and physiological fatigue from persistent digital engagement, is an emerging public health concern among university students. It is conceptually related to but distinct from academic burnout, and few U.S. studies have examined both constructs together using validated instruments.

Objective: To describe digital burnout among Liberty University students, identify its sociodemographic and behavioral correlates, assess its relationship with academic burnout, and evaluate student awareness of campus digital-wellness resources.

Methods: This cross-sectional study surveyed 336 Liberty University students during Summer 2026 using the Digital Burnout Scale (DBS) and the Academic Burnout Scale (ABS). Hierarchical linear …

Beyond Screening In Amyotrophic Lateral Sclerosis: A Domain-Standardized, Measure-Flexible Framework For Comprehensive Neuropsychological Assessment, Etiane Navarro

Archives of Assessment Psychology

Amyotrophic lateral sclerosis (ALS) is a multisystem neurodegenerative disorder in which cognitive, behavioral, language, and social-cognitive changes may occur across clinical phenotypes, including the ALS-frontotemporal spectrum. Neuropsychological assessment is important for characterizing nonmotor manifestations and identifying changes relevant to autonomy, everyday functioning, and clinical management. This systematic review examined literature identified through APA PsycINFO, PubMed, Google Scholar, and supplementary searching to characterize neuropsychological domains, measures, phenotype-related findings, and disease-specific limitations relevant to comprehensive assessment. Two hundred records underwent title and abstract screening, 150 reports were reviewed in full text, and 61 resources were retained for synthesis. ALS-specific screening instruments, including …

Community-Based Well Testing And Outreach To Mitigate Human Health Risk From Unsafe Drinking Water, W. Adam Sigler, Katharine Sutphen, Margaret J Eggers, Kaleena Miller, Michelle Grocke-Dewey

Journal of Extension

Twenty-two percent of groundwater wells tested nationwide have one or more contaminants above a health threshold, yet many private well owners are unaware of these risks because they have not tested their water. Researchers piloted a community well testing clinic for education/outreach and surveyed participants about outcomes. Two months later, 75% of participants with high or intermediate health risk water quality results had taken action or intended to, indicating that community private well testing clinics can be effective in mitigating human health risks from contaminated drinking water.

Rethinking Existing Extension Programming: A Foundation For Healthy Aging?, Nicholas J. Spokely, Sloane A. Montgomery, Kelsey J. Weitzel, Kristin A. Miller, Marta Novaes Oliveira, Stephen D. Ball, Breanne S. Baker

Journal of Extension

Muscle declines are becoming more prevalent in younger adults, driving the need for accessible exercise programs. The Stay Strong, Stay Healthy (SSSH) Extension program was developed for adults 60 years old or older, but for this study, we enrolled 135 participants aged less than 60 years old in rural and urban counties to assess if it could improve their muscle performance. We analyzed data with time and group comparisons using paired t-tests and 2 × 2 repeated measures ANOVAs. Younger adults significantly improved muscle performance after SSSH, and the results were similar between rural and urban counties. This study …

Have You Done Your Duty? Impact Of Direct Mailing Campaign On Septic System Owners' Maintenance Knowledge And Behaviors In Coastal Texas Watersheds, Audrey Mccrary, T. Allen Berthold

Journal of Extension

As part of a watershed protection plan, the Texas Water Resources Institute and AgriLife Extension Service developed and distributed an educational postcard (``mailer'') about septic system maintenance to mailing addresses outside of public sewer service areas. The mailer was distributed four times within 1 year. The impact of this mailer was evaluated with a retrospective pre/post-test within a mailed survey. Overall, the mailer was effective at increasing knowledge of septic system owners and prompting maintenance action. Mailers can be a cost-effective alternative for educational initiatives where the target audience is not able to or interested in in-person or online programs.

Environmental Predictors Of County-Level Drowning Rates In Georgia, Jeff Turner

Journal of the Georgia Public Health Association

Background: Recent increases in drowning rates, both nationally and within Georgia, have led to renewed interest in the individual, situational/behavioral, and environmental characteristics that impact drowning. This study examines the association between two environmental characteristics, natural surface water coverage and public pools, on drowning fatalities and drowning-related ER visits by county in Georgia

Methods: We gathered county-level data on drowning fatalities and drowning-related ER visits and the number of public pools from the Georgia DPH, surface water coverage from the US Census Bureau, and demographic measures from the CDC. We conducted a linear regression analysis to identify how …

Beyond Screening In Amyotrophic Lateral Sclerosis: A Domain-Standardized, Measure-Flexible Framework For Comprehensive Neuropsychological Assessment, Etiane Navarro

Archives of Assessment Psychology

Amyotrophic lateral sclerosis (ALS) is a multisystem neurodegenerative disorder in which cognitive, behavioral, language, and social-cognitive changes may occur across clinical phenotypes, including the ALS-frontotemporal spectrum. Neuropsychological assessment is important for characterizing nonmotor manifestations and identifying changes relevant to autonomy, everyday functioning, and clinical management. This systematic review examined literature identified through APA PsycINFO, PubMed, Google Scholar, and supplementary searching to characterize neuropsychological domains, measures, phenotype-related findings, and disease-specific limitations relevant to comprehensive assessment. Two hundred records underwent title and abstract screening, 150 reports were reviewed in full text, and 61 resources were retained for synthesis. ALS-specific screening instruments, including …

Virginia Team Nutrition Training Grant Workshop Participation Increased Intention To Change In Specific Topics, Rachel A Liebe, Kathleen J Porter, Valisa Hedrick, Elena Serrano, Kelly Shomo, Sandra Curwood, Sarah Misyak

Journal of Extension

Team Nutrition is implemented nationally to improve school food environments. Yet evidence on factors impacting implementation is limited. This study aimed to evaluate the execution of the Team Nutrition Training Grant (TNTG) in Virginia elementary schools using the RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) framework. The TNTG grant was implemented through two train-the-trainer workshops that were conducted with school nutrition directors (SNDs). Overall, SNDs from 84% of school divisions attended at least one workshop. Intention to change increased significantly from pre- to post- for both workshops in some target areas. This evaluation could help practitioners guide the development of evaluation …

Demographic And Socioeconomic Factors Influence Perceived Community Needs And Risk Factors For Firearm Violence In Mississippi, Masoumeh Karimi, Matthew Morris, Xiaoshan Gordy, Matthew Kutcher, Leila Seidfaraji, Michelle Brassfield, Erin Dehon, Alyscia Severance, Rukia Lumumba, Fredrick Womack, Lei Zhang

Journal of Public Health in the Deep South

Background: The burden of firearm-related injuries and deaths is not borne equally across sociodemographic groups. The present study investigated the perceived needs and risk factors of firearm related injuries and mortality across gender, education, and income levels through a quantitative needs assessment completed by community members and firearm injury survivors living in the greater Jackson, Mississippi, metropolitan area.

Methods: A total of 93 participants including gunshot wound patients, survivors and community members who have been recruited through community organizations completed the needs assessment survey collecting data on demographic information, firearm exposure, substance use, community exposure to crime and …

Pilot Evaluation Of A Cross-Disciplinary Training Addressing Substance Use Among Mississippi Mothers, Saijun Zhang, Catherine Poehling, Xiaoshan Gordy, Chinedu P. Chukwu, Jerome R. Kolbo, Masoumeh Karimi, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsenee Davis, Sonja Fuqua, Lei Zhang

Journal of Public Health in the Deep South

Background: Intimate partner violence (IPV) and substance use co-occurring is often managed in siloed systems. Training IPV and related service providers on substance use topics may strengthen screening, response, and referral.

Purpose: To assess whether a pilot training program on substance use disorders (SUDs) in Mississippi improved service providers’ knowledge, preparedness, and attitudes around substance use and satisfaction with the training.

Methods: Pre–post surveys were administered to healthcare and community service providers who completed the training, assessing substance use service-related knowledge, preparedness, and attitudes.  Descriptive statistics and t-tests were used to analyze the data.

Results: Fifty-nine providers completed a …

Prevalence Of Vitiligo In East Africa: Systematic Review And Meta-Analysis, Kedir Seid, Chala Getaneh Jaleta, Sintayehu Samuel Lorato, Mitiku Desalegn, Dawit Tesfaye Rundasa, Yohannes Godie Ashebir, Olyad Kuma Getahun, Gebeyehu Lakew, Mathewos Mekonnen Gemmechu, Mulualem Endeshaw Zeleke, Yibeltal Assefa Atalay, Amlaku Nigusie Yirsaw, Eyob Ketema Bogale, Abiy Hailu Tikuneh, Abas Ali Hassen, Eyasu Alem Lake, Tadesse Nigussie, Bushra Bibi, Fikiru Yigezu Y. Jaleta, Abebe Gedefaw Belete, Genanew Kassie Getahun

Research outputs 2022 to 2026

Background: Vitiligo is a chronic skin disorder characterized by the loss of melanocytes, resulting in depigmented macules and patches. No accurate estimate has been made of the prevalence of vitiligo in East Africa.

Objectives: To determine the prevalence of vitiligo in East Africa via a systematic review and meta-analysis of the literature.

Methods: A systematic review and meta-analysis were performed in accordance with the PRISMA guidelines. Eleven articles were retrieved from PubMed/MEDLINE, Embase, Scopus, Google Scholar, Science Direct, Web of Science and African Journals Online. Microsoft Excel was used to extract the data, which were then exported to STATA 17 …