Digital Commons Network^™

Precision Approaches Improve Community Health, Roger A. Rennekamp, David Buys

Journal of Extension

Recent advances in data science provide Extension practitioners with access to data sorted by zip code, census tract, or neighborhood. Such hyper-local data now allows Extension personnel to assess community needs and assets at a more granular level and focus their work on the people and communities of greatest need. In this article, we introduce an approach we refer to as precision public health. Using such a precision approach to community assessment and, ultimately, programming can save money, increase the likelihood of producing measurable results, and create more manageable workloads for county-based Extension personnel.

The Long-Term Effects Of Covid-19 On Pulmonary Function, Emily Russell, Chris Russian, Kevin Collins

Internet Journal of Allied Health Sciences and Practice

Background: The COVID-19 pandemic has resulted in millions of hospitalizations and significant long-term health consequences. While acute COVID-19 symptoms are well-documented, the long-term pulmonary effects remain incompletely understood, particularly in patients with mild or asymptomatic infections. This review examines the long-term effects of COVID-19 on pulmonary function, including spirometry, lung volumes, diffusion capacity, and related outcomes such as exercise capacity and quality of life. Methods: A comprehensive literature search was conducted using CINAHL Ultimate, Google Scholar, and PubMed databases, yielding 10 articles for review (6 cohort studies, 3 review articles, and 1 systematic review and meta-analysis). Studies were assessed for …

Systematic Review Of Sports Safety Best Practice Implementation In Non-Scholastic Youth Sport Organizations, Katie Sniffen, Hayley J. Root, Richelle M. Williams

Internet Journal of Allied Health Sciences and Practice

Purpose: Non-scholastic youth sports organizations offer competitive and recreational activities to millions of children each year but lack centralized oversight for health and safety policy. Despite the benefits of sport participation, there are inherent risks, including cardiac-, concussion-, heat-, and musculoskeletal-related conditions. Therefore, it is important to understand how youth sports safety policies are implemented in non-scholastic youth sport organizations. This systematic review aimed to synthesize the current literature on the implementation of youth sports safety policies in non-scholastic youth sport organizations in the United States. Methods: A computerized search of Cochrane, CINHAL, Ovid Medline, Web of Science, and Scopus …

State-Level Implementation Of Health And Safety Policies In Mississippi Secondary Schools, Heather L. Shirley, Valerie J. Moody

Internet Journal of Allied Health Sciences and Practice

Background: State-level investigations of health and safety policy implementation in secondary school athletics highlight ongoing challenges in ensuring student-athlete safety that aligns with evidence-based best practices. Purpose: The purpose of this study was to examine current state-level implementation of health and safety policies in Mississippi secondary schools from the perspective of athletics/activities directors, athletic trainers, and other school administrators. Methods: In May 2025, a 26-item web-based questionnaire was distributed to 226 athletic directors and 114 athletic trainers across Mississippi secondary schools. The survey assessed participant demographics, access to healthcare resources, emergency action planning (EAP), required coaches’ health and safety training, …

Piloting The Strong Bodies Strength Training Program In Utah, Gabriela Murza, Jenna Dyckman, Cris Meier, Emma Parkhurst, Sadie Wilde, Christina Pay, Naomi Brower, Cindy Nelson

Outcomes and Impact Quarterly

Muscle and bone loss occurs as we age, impacting health and independence. We evaluated a pilot 12-week strength training program for older adults in Utah. Participants showed improved fitness metrics and increased confidence. Results demonstrate the program’s effectiveness and public value in expanding access to evidence-based exercise that supports healthy aging.

Preliminary Data: Old Trails Fire--Field Reconnaissance (Rpd1195), Rapid, University Of Washington

Spokane Wildfire Academic Consortium Repository

The .ZIP file contains preliminary field reconnaissance findings from the Old Trails Fire in Spokane, Washington, including geospatial datasets and the source code used to support the project's interactive web map. The data and observations reflect work completed through September 4 and should be considered preliminary. As additional analysis and information become available, updates will be published as new records in the Wildfire Consortium Repository.

Access the interactive map: https://designsafe-ci.github.io/rapid-fire-field-reconnaissance/

Access the DesignSafe-CI rapid-fire-field-reconnaissance GitHub repository: https://github.com/DesignSafe-CI/rapid-fire-field-reconnaissance/

The Ramifications Of Covid-19 On Young Adults With Ocd, Clare E. Mcintosh

Dissertations

The coronavirus disease of 2019 (COVID-19) pandemic was a profound event in modern history, contributing to significant disruptions on a societal and individual level. This period of time was marked by elevated uncertainty and fear among individuals. COVID-19 contributed to deterioration in not only physical health but also psychological well-being. One mental health condition frequently under-examined and saturated with misconceptions is obsessive-compulsive disorder. Obsessive-compulsive disorder is a condition characterized by the presence of obsessions and/or compulsions. Intolerance of uncertainty is a core component of the condition, and the pandemic was riddled with unpredictability. The purpose of this study was to …

Lidocaine Combined With Low-Dose Esketamine For Movement-Evoked Pain After Hepatectomy: A Double-Blind Randomised Controlled Trial, Yan Xu, Li Zhou, Qianqian Tang, Feng Yu, Jingwen Wu, Siyu Yan, Min Cai, Jialu Wan, Yi Kang, Lajing Luowu, Mengmeng Zhou, Lulong Bo, Daniel I Sessler, Chunling Jiang

Faculty, Staff and Student Publications

Introduction: Pain following hepatectomy may delay recovery and increase opioid use. We tested the primary hypothesis that combining lidocaine and low-dose esketamine would reduce movement-evoked pain 24 h after hepatic resection. We also evaluated whether this approach reduced opioid consumption and improved quality of recovery.

Methods: Patients having elective hepatic resections were allocated randomly to receive lidocaine-esketamine or placebo from induction of anaesthesia until the end of surgery. After surgery, patients allocated to lidocaine-esketamine were given a continuous infusion of lidocaine with esketamine for 72 h. All patients received transversus abdominis plane blocks with ropivacaine 2 mg.kg-1 after induction of …

Underfunded And Undervalued: Community-Based Health Promotion Practitioners’ Experiences Of Western Australia’S Prevention Sector, Ruth M. Wallace, Leesa N. Costello, Elizabeth J. Cook

Research outputs 2022 to 2026

Prevention is a central policy focus of contemporary health promotion, offering cost-effective strategies to reduce disease burden and improve population well-being. Despite this, Australia allocates a small proportion of its health budget to prevention, with funding models characterized by short-term cycles and competitive tendering. While the consequences for public health are well documented, the impact on the health promotion workforce remains underexplored. Workforce health and stability are critical for program delivery, ethical practice, continuity of relationships with communities, and the capacity to sustain long-term prevention efforts. This qualitative study examined the experience of 19 community-based health promotion practitioners in Western …

Cardiovascular Disease Incidence And Cancer Risk In Two Large European Prospective Cohorts, Emma Fontvieille, Vivian Viallon, Laia Peruchet-Noray, Quan Gan, N. Charlotte Onland-Moret, Yvonne Koop, Anne Tjønneland, Nicola Bondonno, Verena Katzke, Rudolf Kaaks, Matthias B. Schulze, Catarina Schiborn, Calogero Saieva, Vittorio Simeon, Claudia Agnoli, Rosario Tumino, Fulvio Ricceri, Leila Luján-Barroso, Maria José Sánchez, Conchi Moreno-Iribas, Konstantinos K. Tsilidis, Marc J. Gunter, Adam Butterworth, Elio Riboli, Heinz Freisling, Pietro Ferrari

Research outputs 2022 to 2026

Our study investigated the association between incident cardiovascular disease (CVD) and subsequent cancer risk in two large European prospective cohorts. We included 568,926 adults from the European Prospective Investigation into Cancer and Nutrition and United Kingdom Biobank, all of whom were free of CVD, cancer and type 2 diabetes at baseline. Multivariable Cox proportional hazards regression models were used to estimate cancer hazard ratios (HRs) and 95% confidence intervals (CIs) in relation to incident CVD events. CVD was treated as a time-varying exposure, and models accounted for time since CVD diagnosis and other lifestyle factors. Study-specific estimates were pooled using …

New York City Women’S Experiences With Perinatal Depression Inquiries, Diagnosis, And Treatment Initiation, Caterina Pisciotta

Dissertations, Theses, and Capstone Projects

Perinatal depression represents a significant public health concern, yet many women who experience depression symptoms during the perinatal period (either during pregnancy and/or after birth) do not receive treatment. Initiatives, such as ThriveNYC, were designed to address these gaps by screening and treating perinatal women for maternal depression, integrating screening into routine perinatal care and strengthening pathways to treatment. Using representative survey data collected between 2016 and 2021 via the Center for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System (PRAMS), this study examined trends in perinatal depression inquiries (a proxy for “screening”) and postpartum diagnosis, as well as …

Gene-Environment Interactions In Cardiovascular Aging: Volunteering, Polygenic Risk, And Biomarker Change In European And African Ancestry Populations, Seoyoun Kim, Byeongju Ryu, Erin Ware, Koichiro Shiba, Cal J. Halvorsen

Brown School Faculty Publications

Volunteering has been associated with better cardiovascular health, but whether this association varies by genetic susceptibility to cardiovascular disease remains unclear. This study examined associations between volunteering and cardiovascular biomarkers, assessed associations between biomarker-specific polygenic scores (PGSs) and these outcomes, and tested whether polygenic risk moderated volunteering–biomarker associations among U.S. adults aged 51 years and older.

Understanding Barriers To Systems Change Among Regional Western Australian Food Security Initiative Leaders, Isabelle Chiera, Melissa Stoneham, Jess Doe, Amanda Devine, Stephanie L. Godrich

Research outputs 2022 to 2026

Food security (FS) is a complex, 'wicked' issue involving regular and reliable physical, social, and economic access to food. People living in geographically isolated areas are disproportionately affected by FS challenges and addressing these issues demands a systems-based approach. The Food Community project has implemented an adapted Systemic Innovation Lab (SIL) approach to support FS initiatives operating across rural, regional, and remote Western Australia to enhance their effectiveness. This paper aimed to identify what FS initiative leaders perceive as barriers to delivering their services, in relation to undertaking activities that align with the 36 systems change characteristics embedded within the …

Towards Equivalence Of Care: Integrating Custodial Settings Into Alcohol And Other Drug Strategies In Australia, Thileepan Naren, Jocelyn Chan, Sarah Pellicano, Michael Curtis, Shelley Walker, Jocelyn Jones, Jarrah Duckett, Alexander Campbell, Stuart A. Kinner

Research outputs 2022 to 2026

No abstract provided.

Beyond The Binary: Strengthening Nursing Students’ Proficiency Of Equitable Health Promotion, Martha K. Findley

Theses

Background: Sexual and gender diverse (SGD) populations continue to experience significant health inequities, yet prelicensure nursing curricula often lack structured, evidence‑based training to prepare students for equitable care.

Purpose: This study evaluated whether a targeted, transgender‑focused simulation could improve nursing students’ clinical knowledge and preparedness for providing equitable health promotion to SGD populations.

Methods: A pre‑/post‑intervention design was used with senior‑level nursing students who completed a transgender patient simulation emphasizing communication, assessment, and equitable health promotion. Students completed a validated survey measuring knowledge and preparedness in caring for SGD patients.

Results: Significant improvements across most survey items demonstrated that the …

Spatial Association Of Acute Respiratory Infection, Diarrhea, And Low Birth Weight With Stunting Prevalence In Indonesia, 2024, Dian Rosadi, Husaini Husaini, Triawanti Triawanti, Musafaah Musafaah

Kesmas

Stunting remains unevenly distributed across Indonesia, but national evidence integrating spatial analysis and spatial regression is limited. This study examined the spatial distribution of stunting and its associations with acute respiratory infection (ARI), diarrhea, and low birth weight (LBW) across Indonesian provinces. An ecological cross-sectional study used data from the 2024 Indonesian Nutritional Status Survey. Stunting-only analyses included all 38 provinces, whereas analyses involving ARI, diarrhea, and LBW included 37 provinces with complete data. Spatial analyses used a row-standardized symmetric four-nearest-neighbor spatial weights matrix and included Global Moran’s I, bivariate spatial analysis, Local Indicators of Spatial Association, ordinary least squares, …

Understanding Factors Influencing Multiple Tobacco Product Use Among Adolescents In Thailand: A Structural Equation Modeling Approach, Chaowalit Srisoem

Graduate Doctoral Dissertations

Tobacco use among Thai adolescents is shaped by personal, environmental, and product-related factors. However, the pathways linking these influences to actual behavior remain unclear. This study examined how personal, environmental, and product-related factors, along with intentions to use, relate to tobacco use among Thai adolescents. A cross-sectional secondary analysis was conducted using data from the 2022 Thailand Global Youth Tobacco Survey of 6,235 students aged 13–15 years. Survey weights methods were applied to produce nationally representative estimates. Confirmatory factor analysis and structural equation modeling assessed latent constructs, and multinomial logistic regression examined predictors of single, dual, and multiple product use. …

Cost Analysis Of Rheumatoid Arthritis In Insured Patients And Its Determinant Factors: Data From A National Referral Hospital In Indonesia, Rudy Hidayat, Fara Fauzia, Mochammad Alfansyah Dhifanra, Aries Maulana

Kesmas

Rheumatoid arthritis (RA) leads to progressive functional impairment and considerable economic burden. This study estimated the annual (12-month) cost per patient among patients with RA and its determinant factors. A descriptive cross-sectional economic study of RA patients who had been treated for at least one year at the outpatient clinic of a national referral hospital in Jakarta, Indonesia, and met the 2010 ACR–EULAR criteria. Data collected from January 2023 to December 2024 were obtained from medical and billing records for demographic characteristics, direct medical costs, and DAS28-based disease activity, whereas non-medical and indirect costs were collected through structured patient interviews. …

Validation Of A Home-Based Tool For Preschool Children Fall Prevention: A Rasch Analysis, Devie Fitri Octaviani, Fatma Lestari, Indang Trihandini, Dadan Erwandi

Kesmas

Unintentional falls are a leading cause of injury among preschool children, primarily occurring in home environments, yet validated tools to assess household fall prevention capacity in low- and middle-income countries remain limited. This study aimed to develop and psychometrically validate the Home-Based Preschool Fall Prevention Instrument using the Rasch Measurement Model. A cross-sectional validation study was conducted in Depok City, Indonesia, involving 167 primary caregivers of preschool children enrolled in kindergartens selected through multistage cluster random sampling. The instrument was developed based on an etiological injury model, socio-ecological perspectives, and risk management principles, and comprised four main factors: child, home, …

Understanding Oral Habits And Malocclusion In School-Aged Children: Insights From Parental And Child Knowledge, Attitudes, And Practices, Maria Laurentia Sanjaya, Evan Raditya Pratomo, Markus Santoso, Agrippine Putricia Asaeli, Eveline Yulia Darmadi, Joy Janny Thenarianto, Jennifer Regina Putri Purwono, Eunike Jacquelyn Widarto

Kesmas

Malocclusion is a prevalent oral health problem in children associated with oral bad habits, yet the extent to which parental and child knowledge, attitudes, and practices (KAP) influence orthodontic status remains insufficiently understood. This cross-sectional study investigated relationships between parental and child KAP, oral habits, and malocclusion in school-aged children, involving 67 child–parent pairs from an elementary school in Surabaya, Indonesia. Parental and child KAP as well as child-reported oral habits were assessed using a validated questionnaire. Children subsequently underwent standardized clinical orthodontic examinations, including alginate jaw impressions to produce dental study models, which were evaluated using the Index of …

Determinants Of Multimorbidity Among Stroke Patients For Epidemiological Management In Indonesia's Agro-Coastal Communities, Krish Naufal Anugrah Robby, Isa Ma'rufi, Farida Wahyu Ningtyias, Latifatul Izzah, Nurjazuli Nurjazuli, Suhartono Suhartono, Muchlis Achsan Udji Sofro, Ida Srisurani Wiji Astuti, Olivia Listiowati Prawoto, Dedek Sutinbuk, Taufik Kurrohman, Elhoussin Ouassou

Kesmas

Multimorbidity remains a major public health challenge among stroke patients, particularly in agro-coastal communities characterized by socioeconomic vulnerability, limited healthcare access, and lifestyle changes. This study aimed to analyze the determinants of multimorbidity among stroke patients in agro-coastal communities. A quantitative observational analytical design was employed, involving 45 stroke patients selected through total sampling in Jember District, Indonesia. Data were collected through structured interviews, anthropometric measurements, and secondary health records. The model included biological, socioeconomic, healthcare access, and lifestyle as exogenous variables, with multimorbidity as the endogenous variable. Data were analyzed using PLS-SEM, including evaluation of measurement and structural models …

Provincial Disparities In Adolescent Fertility In Indonesia: An Ecological Analysis Of Child Marriage, Median Age At First Marriage, And Family Development Index, Andi Nisa Fathimiyah Afidah, Milla Herdayati

Kesmas

Adolescent fertility remains a public health concern in Indonesia, with substantial variations across provinces. However, the evidence explaining provincial disparities using population-level indicators remains limited. This study aimed to examine provincial disparities in adolescent fertility and assess the association of child marriage, median age at first marriage among women, and the Family Development Index called iBangga with adolescent fertility across Indonesia. This ecological, cross-sectional study used aggregated data from 34 Indonesian provinces. Descriptive statistics, spatial visualization, Pearson’s correlation, and multiple linear regression analyses were performed. The mean adolescent fertility rate was 25.0 births per 1,000 female adolescents aged 15–19 years, …

The Association Between Rapid Growth In Children Under The Age Of Five And Adolescent Obesity, Ratu Ayu Dewi Sartika, Fadila Wirawan, Iche Andriyani Liberty, Nurul Husna Mohd Shukri, Siti Arifah Pujonarti, Edy Purwanto, Munaya Fauziah

Kesmas

Early-life nutrition is a critical predictor of long-term health, yet the association between rapid early-childhood growth and adolescent obesity, particularly in relation to the “double burden of malnutrition,” remains under-researched in Indonesia. This study aimed to analyze the association between rapid growth and adolescent obesity. Data were obtained from the 1997, 2000, and 2014 waves of the Indonesian Family Life Survey (IFLS). This study included 641 children (aged 0–23 months at baseline) with complete anthropometric measurements across all three waves. Rapid growth was defined as an increase in z-scores of >0.67 in weight-for-age (WAZ), height-for-age (HAZ), or weight-for-height (WHZ) between …

Self-Management Interventions For Adults With Type 2 Diabetes Mellitus In Thai Primary Care And Community Settings: A Scoping Review, Sansanee Seetangkham, Supaluk Seetunya, Subhawan Yodprong

Kesmas

Diabetes mellitus is a leading cause of mortality and economic burden, with significant impacts on health outcomes and quality of life. Effective self-management is crucial for controlling Type 2 Diabetes Mellitus (T2DM). Thailand has implemented diverse self-management interventions for adults with T2DM in primary care and community settings, but the components, delivery, duration, and outcomes of these interventions have not been synthesized. Following the Arksey and O’Malley framework, Joanna Briggs Institute guidance, and PRISMA-ScR, five databases were searched from inception to June 2025. Eligible English-language intervention studies involved Thai adults with T2DM in primary care or community settings. Study characteristics …

Environmental Perspective For System Dynamics Modeling Of Stunting Mitigation To Achieve The Sustainable Development Goals In West Sumatra, Indonesia, Elsa Yuniarti, Nabila Azzahra, Yulhendri Yulhendri, Heldi Heldi, Mery Delvina, Saskia Putri Azeli

Kesmas

This study developed a system dynamics model to simulate stunting reduction in West Sumatra Province, Indonesia, by integrating infant and toddler health, maternal health, and environmental determinants. Secondary data from 2020–2024 on low birth weight, immunization, malnutrition, exclusive breastfeeding, maternal chronic energy deficiency, iron and folic acid supplement distribution, sanitation, and safe drinking water access were compiled from West Sumatra Provincial Health Office and Statistics Indonesia, and validated through consultation with five stakeholder institutions. Causal Loop Diagrams mapped feedback relationships among determinants and were translated into Stock Flow Diagrams using Powersim Studio 10. The model was validated through structural verification, …

Breaking The Cycle: From Victimization To Offending Through The Lens Of Human Services, Colette R. Penalosa

Master of Arts in Human Services

The victim-offender overlap challenges the common view that victims and offenders are separately labeled by recognizing that both groups have experienced significant childhood trauma, physical, emotional, and psychological abuse, neglect, and other adverse childhood experiences (ACEs). Current research implies these experiences can increase the risk of offending as they all influence cognitive and behavioral development while leaving criminal behavior undetermined. The purpose of this capstone is to analyze the relationship between childhood victimization and offending from a human service perspective; analyzing the pathways a victim takes on the road to offending. Research conducted will focus on exploring the victim-offender overlap, …

Early Immune Dysregulation In Mtb/Siv Co-Infection Resists Cart Treatment At The Single-Cell Level, Riti Sharan, Yi Zou, Zhao Lai, Korri Weldon, Todd Bradley, Xi Luo, Hulin Wu, Shabaana A Khader, Deepak Kaushal

Faculty, Staff and Student Publications

Using single-cell transcriptomics of bronchoalveolar lavage cells from Mtb/SIV co-infected rhesus macaques on cART, we reveal profound immune dysregulation during early SIV co-infection of latent tuberculosis. SIV induces a sharp decline in CD4+ T cells, NK, and NKT cells, with incomplete recovery of Mtb-specific TH1 effector responses despite viral suppression. Instead, a persistent TH17-skewed environment emerges, alongside sustained myeloid inflammation driven by Type I interferon signaling and pro-inflammatory regulators such as KLF6 and NFKB1. Ligand-receptor network analyses demonstrate expanded CD4+ T cell-macrophage crosstalk and loss of immune homeostasis that cART fails to fully restore. These findings expose …

From “Fixer” To “Facilitator”: A Clinical Review Of Shared Medical Appointments As A Strategy For Workforce Sustainability, Barbara A. Slusher

Lynchburg Journal of Medical Science

Clinician burnout remains a significant threat to workforce sustainability, particularly in resource-constrained settings managing complex chronic diseases. While shared medical appointments (SMAs) have demonstrated clear benefits in patient satisfaction and access, their impact on clinician well-being and professional fulfillment is less clearly defined. This review evaluates whether participation in SMAs improves clinician satisfaction and mitigates burnout by facilitating a conceptual transition from isolated “Fixer” to collaborative “Facilitator.”

A targeted literature search of PubMed, the Cochrane Library, and Google Scholar identified peer-reviewed publications examining shared medical appointments and clinician-centered outcomes, including burnout, clinician satisfaction, and workforce sustainability. …

Defining Quality Of Life: The Lived Experience Of Adults With Pulmonary Hypertension And The Impact Of Activity-Induced Respiratory Distress, Bethany Jean Adams

Walden Dissertations and Doctoral Studies

Pulmonary hypertension (PH) is a progressive, life-limiting disease that significantly affects quality-of-life (QoL). Limited research has explored lived experiences of individuals with PH. Guided by Parse’s human becoming theory, this qualitative descriptive phenomenological study explored the lived experiences of individuals affected by PH and examined how activity-induced respiratory distress affected QoL. The research Question was: How do individuals with PH describe the impact of activity-induced respiratory distress on their QoL. I conducted interviews with nine participants, including eight adults diagnosed with PH and one caregiver of an individual with PH. Data were analyzed using Saldaña's comparative coding framework to identify …

Predictors Of Academic Performance In First-Year Bsn Students: The Role Of Emotional Exhaustion, Alcohol Use, And Resilience, Jennifer Nerius

Doctoral Dissertations and Projects

The first year of nursing school can be academically demanding and emotionally challenging as students adjust to rigorous coursework, clinical expectations, and professional responsibilities. Understanding factors that influence student well-being and academic success is important for supporting students during this transition. The purpose of this quantitative longitudinal correlational study was to examine the relationships among emotional exhaustion, alcohol use, resilience, and academic performance in first-year Bachelor of Science in Nursing (BSN) students. Guided by Resilience Theory, the study explored whether resilience was associated with emotional exhaustion and alcohol use and whether emotional exhaustion, resilience, and alcohol use predicted academic performance. …