Digital Commons Network^™

Observation And Reflection Of Neighborhood And Community 2026: Social Determinants Of Health Related To Air And Food Quality, Ryan Christian, Shridula Kotakondla, Yousef Emara, Adel Zeibo, Hwajeong Yi, Ava Boutrous, Jordan Hicks, Nicolas Basaka

Patient Education Projects

No abstract provided.

Beyond The Cycle: How Menstruation Influences Gender Identity And Well-Being In Binary And Non-Binary Adults, Rin Nguyen

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Approximately 1.8 billion people worldwide menstruate, including transgender and gender-diverse (TGD) people, yet their experiences remain underrepresented in research. Given that menstruation can affect gender alignment and psychological well-being, understanding its impact on TGD people is critical. Gender congruence, or alignment between one’s gender identity and expression, is a key factor influencing well-being, with research linking it to reduced depression and anxiety. Furthermore, emerging research on gender euphoria, the joy experienced when gender congruence is experienced, suggests it may serve as a protective factor for mental health and well-being. Gender euphoria has been associated with reduced psychological distress and increased …

Factors Affecting Pedestrian-Vehicle Conflicts: An Empirical Analysis, Christo D. Jamo

Honors Scholar Theses

The number of pedestrian deaths increased by 78% between 2009 and 2023, while other motor vehicle crash deaths increased by 13% in the same period [1]. To identify potential pedestrian safety measures, this study analyzed the effects of location-based demographics, pedestrian phasing type, and other physical infrastructure and behavior variables on the probability of pedestrian-vehicle conflicts at signalized intersections, which is a surrogate measure of crash risk. Data were collected from 55 intersections in Connecticut, and the pedestrian-vehicle interactions were classified by severity based on the Swedish Traffic Conflict Technique: undisturbed passage, potential conflict, minor conflict, or serious conflict. Because …

From Prescription To Plate: Redefining The Pharmacist’S Role In Food Is Medicine Initiatives, Aleena R. Thomas

Honors Scholar Theses

Produce prescription (PRx) programs are an emerging Food is Medicine intervention designed to address diet-related chronic diseases and food insecurity by integrating healthcare delivery with access to fruits and vegetables. Diet-related conditions such as type 2 diabetes, hypertension, and cardiovascular disease represent a major public health burden in the United States, particularly among populations with limited access to nutritious food. Despite growing evidence supporting PRx programs, pharmacists -- who routinely manage these conditions and monitor outcomes -- are underutilized in program implementation. The objective of this project is to translate the public health aspects of PRx programs into an accessible, …

Addressing Substance Use Disorder In Rural Appalachia: Improving Access And Treatment Outcomes For Justice-Involved Individuals, Jessica Muldowney

Electronic Theses and Dissertations

Background: Opioid use disorder (OUD) represents a critical public health crisis disproportionately affecting justice-involved (JI) populations, with approximately 65% of incarcerated individuals having substance use disorders (James & Beatty, 2006). Rural Appalachian communities face compounded challenges due to limited healthcare access, provider shortages, and cultural stigma surrounding addiction treatment. Despite evidence demonstrating that medication-assisted treatment (MAT) reduces recidivism and overdose deaths, only 20% of correctional facilities offer these services (Klein & Seppala, 2019).

Objective: This mixed-methods study evaluated organizational readiness and infrastructure capacity for implementing evidence-based OUD interventions, specifically MAT programs across three rural counties in northwestern North Carolina.

Methods: …

Tips For Health Care Practitioners: A Guide For Adolescent Obesity, Regina Santana

Electronic Theses, Projects, and Dissertations

Adolescent obesity continues to be a significant public health concern that is associated with long term physical consequences. The purpose of this project was to develop an evidence based, user friendly guidebook that supports healthcare professionals in the education of adolescents with obesity and their families. A structured literature review development process was used to inform the current development of the guidebook. The guidebook includes components of obesity management such as nutrition and physical activity recommendations. The validity of the content was established through the evaluation of five healthcare professionals that include registered dietitians and licensed therapists. The guidebook was …

Glucagon-Like Peptide-1ra As A Public Health Interventions, Briana Sepeda

Electronic Theses, Projects, and Dissertations

Glucagon-like peptide receptor agonist (GLP-1RA) medications have become a prominent topic of interest both in clinical medicine and broader societal discussions. Although the medication are relatively new and expensive, ongoing research continues to explore pharmacologic modifications aimed at improving therapeutic effectiveness and prolonged drug half-life. GLP-1RAs have gained significant traction due to their ability to lower glycosylated hemoglobin (A1c) and blood glucose levels in individuals who have been diagnosed with type 2 diabetes (T2D). In addition to glycemic control, evidence suggests its associations with appetite suppression, weight loss, reducing cardiovascular disease, improved renal dysfunction, neuroprotective effects related to neurodegenerative disease …

Feasibility Of Assessing Dietary Patterns And Anxiety In College Students: A Pilot Study Using Nutrition Questionnaires, Gad-7, And Asq, Kylie Ford

Electronic Theses and Dissertations

Anxiety is highly prevalent among college students representing a significant public health concern. Research indicates that dietary patterns may influence mental health outcomes; however, the practicality of collecting comprehensive dietary and psychological data in college populations remains unclear. This pilot study assessed the feasibility of evaluating dietary patterns and anxiety using self-report instruments. Participants completed the Nutrition and Eating Habit questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), and the Anxiety Sensitivity Questionnaire (ASQ). Although twenty-one students were recruited, survey completion rates were low, with only seven participants completing the nutrition questionnaire necessary to calculate the Dietary Inflammatory Index (DII). Descriptive analyses …

Ethical Engagement In Global Missions: A Qualitative Inquiry Into Planner Motivations And Host Experiences, Harrison J. Ihrig

Electronic Theses and Dissertations

Short-term mission (STM) trips are limited duration service experiences, commonly organized by faith-based organizations (FBO), in which volunteers travel domestically or international to provide ministry, community outreach, and/or health-related services. In recent decades, the number of these trips organized by organizations in the United States has increased exponentially, but the phenomenon is difficult to accurately measure due to its decentralized nature and the lack of standardized terminology. Despite their prominence, limited research has been conducted to examine planning, implementation, and evaluation processes of international STMs organized by FBO, particularly through a public health lens. The purpose of this study was …

Evaluating The Impact Of Myplate-Based Expanded Food And Nutrition Education Program (Efnep) On Healthy Dietary Choices Among Low-Income Families, Theresa N. Agbonome

Electronic Theses, Projects, and Dissertations

Dietary behaviors towards healthy food choices remain a major public health issue in the United States, with prevalence among low-income families. The University of California Agriculture and Natural Resources (UCANR) with Expanded Food and Nutrition Education Program (EFNEP) trains both health educators and volunteers to provide community-based nutrition education, which prioritizes low-income families. The initiative employs the MyPlate guidelines that are composed of 5 different food groups which include fruits, vegetables, protein, grains, and dairy products. This project focuses on evaluating nutritional habits of disadvantaged families within San Bernardino County (SBC) by using an evidence-based evaluation tool known as the …

Development Of An Employee Leave Guide Handbook At The California University Of Science And Medicine, Leyal Nidal Fakhreddine

Electronic Theses, Projects, and Dissertations

Employee leave policies play an important role in supporting workforce well-being, organizational compliance, and retention of skilled labor, especially in medical and educational health institutions. However, employees still experience confusion when trying to make sense of complicated leave options such as the Family and Medical Leave Act (FMLA), maternity and paternity leave, and military leave. The lack of clear, centralized guidance can result in delays, miscommunication, and increased workplace stress.

This project was carried out as a part of the Master of Public Health (MPH) program integrative learning experience requirements at California State University, San Bernardino, and was conducted during …

Associations Between Water Intake, Dietary Quality, And Beverage Consumption Among University Students, Mohammad A. Qazi

Electronic Theses, Projects, and Dissertations

Title: Associations Between Water Intake, Dietary Quality, and Beverage Consumption Among University Students

Background and Aims: Sugar-sweetened beverage (SSB) and ultra-processed food (UPF) consumption significantly contribute to chronic disease risk and is often more common in underserved and racially/ethnically diverse communities. Drinking water is a low-cost, calorie-free behavior that may support healthier beverage and dietary patterns. Previous studies show that increased daily water consumption positively correlates with better diet quality and is inversely correlated with SSB and UPF consumption. This study aims to examine whether (1) increased daily water intake is associated with self-reported diet quality and (2) self-reported hydration …

Promoting Influenza Vaccination Among College Students, Wajeeha Khan Valley

Electronic Theses, Projects, and Dissertations

Influenza remains a significant public health concern on college campuses, where high population density, shared living environments, and frequent social interaction increase the risk of viral transmission. Despite the availability of safe and effective influenza vaccines, vaccination rates among college-aged students remain consistently low. Many students underestimate their personal risk for influenza and hold persistent misconceptions regarding vaccine safety, effectiveness, and side effects. The widespread use of social media further influences these attitudes, as misinformation can rapidly spread while credible health messaging often struggles to gain visibility. It is important to eliminate vaccine hesitancy among college students through innovative, behavior-focused …

An Integrated Framework For Early Detection And Transmissibility Assessment Of Emerging Variants In Wastewater, Xingwen Chen, Tin Phan, Wei Lin Lee, Katie Clark, Steven F Rhode, Samantha Brozak, Bruce Pell, Tsultrim Palden, Mats Leifels, Anna Gitter, Yang Kuang, Stefan Wuertz, Janelle Thompson, Kristina D Mena, Eric J Alm, Fuqing Wu

Faculty, Staff and Student Publications

Tracking the emergence of new viral variants is critical for epidemic preparedness, but remains challenging because variants typically circulate at low prevalence during the early phase of outbreaks. Here, we present an integrated framework that combines sensitive variant detection in wastewater with quantitative assessment of transmissibility through dynamic epidemic modeling. Using the SARS-CoV-2 Omicron variant as a proof of concept, we developed a novel nested allele-specific RT-qPCR assay (NAS-PCR) that achieved a thousand-fold increase in sensitivity compared with allele-specific RT-qPCR (limit of detection: 0.5 copies/μl). NAS-PCR detected Omicron in wastewater samples from the Greater Boston area starting in September 2021, …

Associations Of Blood Biomarkers Of Glial Cell Dysfunction And Neuronal Injury With Future Cognitive Decline And Incident Dementia, Srishti Shrestha, Xiaoqian Zhu, B Gwen Windham, Kevin J Sullivan, Priya Palta, Rebecca F Gottesman, Russell P Tracy, Clifford R Jack, Petrice M Cogswell, Prashanthi Vemuri, Sudha Seshadri, Thomas H Mosley, Michael E Griswold, Myriam Fornage

Faculty, Staff and Student Publications

Introduction: Prospective studies of blood-based biomarkers reflecting pathogenic processes, other than Alzheimer-specific pathologies, that contribute to dementia in diverse cohorts are lacking.

Methods: We jointly fitted linear mixed-effect models and proportional hazards models to examine associations of midlife glial fibrillary acidic protein (GFAP), chitinase-3-like protein 1 (YKL-40), soluble cluster of differentiation-14 (sCD14), neurofilament light chain (NfL), total tau (t-tau), and ubiquitin C-terminal hydrolase L1 (UCHL1) levels in serum (collected in 1993 to 1995) with cognitive decline and incident dementia (ascertained over 29 years through 2022) in the community-based Atherosclerosis Risk in Communities Study. sCD14 and YKL-40 were measured in 3082 …

Perceived Neighborhood Environment And Objectively Assessed, Habitual Physical Activity Among Us Adults: An All Of Us Research Program Study, Natalia I Heredia, Michael C Robertson, Christopher D Pfledderer, Ethan T Hunt, Timothy J Walker, Deborah Salvo

Faculty, Staff and Student Publications

Introduction: The purpose of this study was to assess the associations between perceived socioenvironmental neighborhood attributes and objectively assessed habitual physical activity among US adults as well as whether associations vary by sociodemographic characteristics.

Methods: We used data from the All of Us research program, a longitudinal cohort study of a diverse sample of Americans. Perceived neighborhood social cohesion, physical and social disorder, walkability, and sociodemographic characteristics were self-reported. Habitual physical activity was ascertained using Fitbit-derived step counts over ≥24 weeks. Generalized additive mixed-effects models were used to test the associations between perceived socioenvironmental neighborhood attributes and daily step counts. …

A Bilingual Ai-Based Chatbot For Nutrition Education In A Food Is Medicine Intervention For High-Risk Pregnant Women: Design And Development Study, Lorena Macias-Navarro, Nalini Ranjit, Gregory W Bounds, Brendon A Providence, Yesmeena Shmaitelly, Naomi M Tice, Shreela V Sharma

Faculty, Staff and Student Publications

Background: Conversational agents (artificial intelligence [AI]-based chatbots) offer a novel approach to health interventions by providing personalized, adaptive interactions that improve over time based on user engagement. In nutrition education, given the wide variation in knowledge, skills, and abilities across participants, AI-based chatbots have the potential to enhance accessibility, engagement, and behavior change. Food is Medicine (FIM) interventions, which aim to improve food security and diet quality among multicultural, at-risk populations, often face challenges related to sustained engagement and use.

Objective: This paper describes the design, development, and iterative refinement of a bilingual AI-driven nutrition chatbot integrated into an FIM …

Detecting Early Physiological Signs Of Work-Related Muscle Strain And Fatigue Using Quantitative Sensory Testing, Omar Alberto Cano

Open Access Theses & Dissertations

Background: Work-related musculoskeletal disorders (WRMSDs) are a major source of occupational disability and economic burden worldwide. Early detection of physiological strain remains challenging since traditional methods often rely on self-reported pain or diagnosis after symptom development. Quantitative Sensory Testing (QST) may provide an objective, non-invasive method for identifying early sensory changes associated with repetitive upper-extremity loading. Purpose: This pilot study examined the responsiveness of Pressure Pain Threshold (PPT) and Thermal Threshold Testing (TTT) for detecting Acute muscular strain and fatigue following repetitive manual task performance. Methods: A within-subject counterbalanced design was conducted with sixteen healthy participants. Each participant completed both …

Social Correlates Of Trauma And Posttraumatic Stress Disorder: The Importance Of Context, Lukoye Atwoli, Linnet Ongeri

Internal Medicine, East Africa

Understanding trauma and posttraumatic stress disorder (PTSD) requires a contextual perspective that considers historical legacies, social environments, and cultural realities. This paper draws on empirical evidence from Kenya and Uganda to demonstrate the limitations of applying trauma frameworks developed in high-income countries to African contexts. Findings from the Orphaned and Separated Children’s Assessment Related to Their Health and Well-Being (OSCAR) study challenge assumptions about care environments. The study reveals higher PTSD rates among orphans in family-based settings compared to institutional care, and highlights the protective roles of religion and social support. The Neuropsychiatric Genetics of African Populations-Psychosis (NeuroGAP-Psychosis) study provides …

Observation And Reflection Of Neighborhood And Community 2026: Food Access, Housing, Religious Community, And Health Care Access Reflection, Celene Philip, Michaela Kizy, Haley Montgomery, Akash Dantuluri, Josh Hailo, Abdel Kareem Hilo, Shadi Charara, Sarah Schenck

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Social Determinants Of Health: Food, Transportation, Healthcare Facilities And More, Eboni Sawyer, Jesse Hawkins, Sephora Dafinescu, Andrew Robinson, Dev Patel, Sara Mccurry, Lauren Collins, Brandon Rogers

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Employment, Education, Fitness, Healthy Food, Pharmacies, And Reflection, Annika Tekumulla, Vamsi Gollapalli, Sebastian Reczek, Alston Prabhu, Matthew Haerens, Ashna Mehra, Susan Dong, Madison Martin

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Observation And Reflection Of Food Availability, Housing, Public Spaces, Recreation, And Healthcare In The Community, Celestino Mangulabnan, Melanie Kajy, Gabriel Hay, George Naguib, Arya Mohanty, Schednah Laraque, Charles Dickson

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Education, Access To Healthy Foods, Neighborhood & Physical Environment, Economic Stability, Taylor Brown, Tanya Bhardwaj, Sara Komaiha, Duncan Mcleod, Jonah Harman, Jai Kukreja, Dominic Marsalese, Elizabeth O'Brien

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Neighborhood & Built Environment, Social & Community Context, Health Care Access & Quality, Courtney Alexander, Sarah Okeke, Bashar Jawich, Joshua Weiss, Shoshana Leflein, Mitchell Finesilver, Liz Ana Palacios

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Sdoh Needs: Food And Community Spaces Reflection, Mohamed Attie, Katie Gahn, Maggie Lomasney, Emerson Woodbury, Muhammad Hatim, Justinas Sapiega, Isaac Agranoff, Braysila Ford

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: A Reflection On The Limited Resources Available For A Healthy Lifestyle, Jana Hatahet, Steven Jones, Laila Shatela, Pegi Laci, Anushka Dalvi, Michael Becker, Albert Oh, Anthony Marquez

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Social Determinants In Action: A Field Reflection On Community Health, Jamaica Jordan, Razanne Zaghloul, Raj Khuperkar, Lissette Valdez, Nathan Morren, Cole Duvall, Alexis King

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Education, Environmental Conditions, And Food Insecurities Reflection, Skylar Hall, Badruddin Mahamed, Jenna Andersen, Evan Robyns, Andrew Singh, Julia Correll, Yousef El-Magharbel, Tiffany Adam

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Neighborhood And Built Environment: Facilitating Safety, Community, And Preventative Health, Zachary Hart, Batoul Dabajeh, Maaz Munawar, Josie Mclearen, Theodore Belecciu, Laura Zvinys, Tarek Harhash, Emily Critchfield

Patient Education Projects

No abstract provided.