Digital Commons Network^™

The Impact Of Awareness Of Campus Health Services On Utilization Of Medical Care Among Residential Students At Liberty University, Catherine Pandagade

Masters Theses

College students represent the most prominent group of individuals when considering their lifestyles throughout aging. Therefore, this age group serves as a good opportunity for health education that could build positive health behaviors for life. Existing literature have said that the 18-25 year olds tend to have fewer resources and be often uninsured and have the highest rates of preventable diseases.2 Objective: The aim of this research is to investigate the impact of awareness and its subsequent effect on utilization of available health resources on campus among the student population of Liberty University. Additionally, the purpose of the research through …

Self-Efficacy Change Among Diverse Family Caregivers In Dementia Care, Deborah M Oyeyemi, Erich J Greene, Yunshan Xu, David R Lee, Rafael Samper-Ternent, Maya L Lichtenstein, Alan Stevens, Jeff D Williamson, Arun S Karlamangla, Debra Saliba, David B Reuben

Faculty, Staff and Student Publications

Objectives: To determine whether changes in caregiver self-efficacy (beliefs about one's ability to manage dementia-related problems and access help) differed by caregiver race and ethnicity across all participants enrolled in a large pragmatic trial of comprehensive dementia care.

Methods: In the Dementia Care Study (D-CARE), community-dwelling older adults with dementia and their unpaid family caregivers were randomized to receive usual care, community-based, or health system-based comprehensive dementia care. Caregiver self-efficacy was assessed at baseline, 6 months, and 18 months using a 4-item scale (range 4-20, higher scores indicate greater self-efficacy). Among all caregivers, we compared least squares means for overall …

Broad Laboratory Testing Does Not Show Utility For Telogen Effluvium: A Retrospective Analysis Of 22-Million Laboratory Results Using Trinetx, Zachary J.K. Neubauer, Shari R. Lipner

Student Papers, Posters & Projects

No abstract provided.

Cancer Literacy And Social Determinants Of Health: An Epidemiological Analysis Of Trust, Digital Engagement, And Healthcare Utilization In Cancer Information Seeking, Kimberly Leeann Hazel

Walden Dissertations and Doctoral Studies

The rise of online health information has increased access to cancer resources but also amplified misinformation, creating trust gaps that threaten prevention, treatment, and health equity. This study examined how trust in cancer information sources, online information-seeking, and healthcare perceptions relate among U.S. adults. Guided by the health information seeking behavior, the socioecological model, and the structural influence model of health communication, data from the 2022 Health Information National Trends Survey (N = 6,197) were analyzed with logistic regression, mediation, and moderation modeling, controlling for demographics. Trust in government agencies predicted greater cancer information seeking (odds ratio [OR] = 1.94, …

Factors Affecting The Level Of Grief Experienced By Men Whose Female Partner Died In The United States, Keona C. Lee

Walden Dissertations and Doctoral Studies

Grief is an emotional reaction to the loss of a loved one through death. Although grief is a universal human experience, its perspective is unique, and research has often ignored the varied experiences of racial/ethnic and cultural groups, particularly men of color in the United States. The purpose of this quantitative study was to measure the level of grief experienced by men whose female partner died and to determine whether ethnicity, having a prior mental health diagnosis, social support, and traumatic or anticipated loss significantly impacted their level of grief. The study was guided by the social-ecological model to explain …

Music Therapy Versus Cognitive Behavioral Therapy Via Telehealth For Anxiety In Survivors Of Cancer: A Randomized Clinical Trial, Kevin T. Liou, Joke Bradt, M. Beatriz Currier, Raymond Baser, Katherine Panageas, Jodi Macleod, Desiree Walker, Susan Q. Li, Ana Maria Lopez, Kelly Mcconnell, Jun J. Mao

Department of Medical Oncology Faculty Papers

PURPOSE: Anxiety is prevalent, disruptive, and undertreated among survivors of cancer. Cognitive behavioral therapy (CBT) is the first-line treatment, but not all individuals have access, respond to treatment, or prefer this option because of stigma. Music therapy is effective for short-term anxiety reduction, but it is unknown whether it is noninferior to first-line CBT for long-term anxiety reduction.

METHODS: This comparative effectiveness trial randomly assigned English- or Spanish-speaking survivors of cancer to seven weekly telehealth sessions of music therapy or CBT. The coprimary end points were changes in the Hospital Anxiety and Depression Scale (HADS) anxiety score at weeks 8 …

Intimate Partner Violence Experience, Support Seeking And Coping Strategies Among Pregnant Women In Southwestern Uganda, Eve Katushabe, John Baptist Asiimwe, John Bosco Ndinawe, Editor Abeneitwe, Agnes Katusiime, Gladys Nakidde, Vincent Batwala

School of Nursing & Midwifery, East Africa

Intimate partner violence (IPV) during pregnancy remains a global health challenge. This study aimed to explore pregnant women’s experiences of IPV, support seeking, and coping strategies in Southwestern Uganda. Pregnant women who had experienced IPV during pregnancy were purposively selected and completed in-depth interviews, with data saturation reached after 25 participants. Guided by the feminist theory, data were analyzed deductively and inductively using thematic analysis. Participating pregnant women were exposed to physical violence (e.g., the gravid abdomen being stepped on), psychological violence (e.g., verbal abuse), sexual violence (e.g., being forced into uncomfortable sexual positions), and financial control and manipulation (e.g., …

Trends In The Implementation Of The Cyberchondria Severity Scale: Bibliometric Analysis, Adam C Powell, Cayetana Calderon-Smith

College of Population Health Faculty Papers

BACKGROUND: Cyberchondria, a combination of the words "cyber" and "hypochondriasis," is a condition that is receiving increasing attention from clinicians and researchers globally. Researchers are currently using multiple instruments to quantify it. Furthermore, the instruments have been translated into multiple languages.

OBJECTIVE: This study aimed to examine the extent to which researchers are measuring cyberchondria using the 33-item Cyberchondria Severity Scale (CSS) and its 12-item abbreviated version, the CSS-12. It also examined the relative use of cyberchondria instruments in different languages.

METHODS: PubMed and PsycInfo were searched for articles published between May 1, 2019, and December 31, 2024, featuring the …

M-O-M-S On The Bayou: Implementation Of An Intervention To Improve Mental Health After Disaster, E. W. Harville, Gloria Giarratano, M. Patterson, M. Schultheis, K. S. Dorans, S. Turner, S. Harris, S. Longo, K. Weis

School of Nursing Faculty Publications

Pregnant women are a vulnerable population after disaster. Their health may be improved through community-based support programs in addition to their standard prenatal care. We conducted a prenatal peer support program, Mentors Offering Maternal Support (M-O-M-S), focused on improving mental health in hurricane-affected areas in southern Louisiana. M-O-M-S consists of six biweekly sessions covering pregnancy acceptance, maternal role identification, family and partner relationships, preparation for labor/fears around labor, well-being/safety of self and baby, and post-delivery health and maternal-infant bonding. The program is led by a “mentor”, an experienced mother but not necessarily a clinician or social worker, who guides the …

Circumciser Type And The Type Of Female Genital Mutilation/Cutting Prevalence For Girls Ages 0-14 Years In Ethiopia, Jean-Pierre Ramazani Abedi

Walden Dissertations and Doctoral Studies

Despite ongoing eradication efforts, female genital mutilation and cutting (FGM/C) remains a major public health and human rights concern in Ethiopia. This quantitative study was conducted to examine how circumciser type (traditional cutter, birth attendant, or health professional) influences FGM/C prevalence and severity among girls ages 0–14, considering the moderating effects of residence and mothers’ FGM status, while controlling for age and income. Guided by the social ecological model and using 2016 E Ethiopian Demographic Health Surveys data, analysis indicates a significant association between circumciser type and FGM/C type (χ² (2, N = 1,553) = 6.86, p = .032), which …

Nurse-Led Interventions To Reduce Occupational Hand Injuries In Manufacturing, Patti Harter

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Occupational hand injuries cause preventable morbidity, lost productivity, and workers’ compensation costs in manufacturing. Although safety policies and personal protective equipment (PPE) are in place, inconsistent glove use, slow hazard identification, and delayed response still cause injuries. This quality improvement (QI) project evaluated an eight-week, nurse-led injury-prevention bundle at a Texas heavy-vehicle manufacturing facility. The intervention required daily glove inspections, Safety Champion participation, real-time electronic hazard reporting, and corrective action within the shift. Injury outcomes were measured using Occupational Safety and Administration (OSHA) rates per 200,000 work hours and percentage change from baseline. After implementation, hand injury rates fell from …

Improving Colorectal Cancer Screening Adherence, Albin Abraham

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

As the second leading cause of cancer-related deaths in the United States, colorectal cancer (CRC) is a prevalent but highly preventable form of cancer (American Cancer Society National Colorectal Cancer Roundtable [ACSNCCR], 2026; Maratt et al., 2024). Screening for CRC is fundamental to prevention and early detection. Despite advances in screening measures, CRC screenings remain suboptimal (Tonini & Zanni, 2024). In the US, more than one in three adults 45 years or older are not screened as recommended (ACSNCCR, 2026).

Purpose

As a safety-net county health network primarily serving the under-resourced population, the organization is uniquely positioned to impact …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

How Instructor Engagement Shapes Nursing Students’ Perceptions And Specialty Preference, Marissa M. Sigel

Nursing | Senior Theses

Background: As nursing students approach graduation, choosing a specialty becomes a key decision. Although clinical rotations offer exposure to different practice areas, the role of the clinical instructor is equally influential. Instructor engagement extends beyond teaching skills and may shape how students perceive clinical environments. Objective: This study examines how clinical instructor engagement influences senior nursing students’ specialty preferences. Method: A longitudinal cohort design will be used with pre-licensure BSN students at a small private university in Northern California. Students will complete the same survey twice during their program, and paired t-tests will be used to assess changes in specialty …

The Association Between Personal Particulate Matter Exposures And Cognitive Function Among Stroke Patients, Kentucky, Usa, Nana Afua Ankomah Dei

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Stroke, a major cause of long-term disability and cognitive problems in the U.S., significantly affects people’s quality of life. Exposure to particulate matter (PM_2.5) may result in systemic inflammation and oxidative stress, which can worsen the cognitive function of post-thrombectomy stroke patients. This project thus assessed the relationship between PM_2.5 exposure and its effect on the cognitive function of post-thrombectomy stroke patients. Fifteen stroke patients (9 non-Appalachian and 6 Appalachian) undergone thrombectomy were recruited. Personal PM_2.5 exposure was measured using wearable sensors for a week during the study period. Montreal Cognitive Assessment (MoCA) scores and covariates …

Guidelines For Community Engaged Health Research, Carrie Leach, Hayley Thompson, Alex Sass, Patricia Wren, Rodlescia Sneed, Rhonda Dailey, Elizabeth Towner, Maha Albdour, Carla Caringi, Alyssa W. Beavers, Theresa A. Hastert, Vanessa Rorai, Peter A. Lichtenberg, Angulique Outlaw, Ijeoma Nnodim Opara

Institute of Gerontology

Executive Summary:

Wayne State University’s Guidelines for Community Engaged Health Research provide a practical framework for designing, conducting, and evaluating ethical, equitable, and impactful health research that engages community experts in projects that advance health equity in Detroit.

Purpose 

Developed for WSU faculty, staff, and research teams, the guidelines support the meaningful involvement of community experts across all phases of research. They respond to common challenges in community-engaged work, including limited experience with engagement approaches, the need for reflexive and equitable practices, and the time and coordination required for authentic collaboration.

The document defines Community-Engaged Research (CEnR) as collaborative work …

Reverse Koebner Phenomenon In Linear Scalp Morphea Following Punch Biopsy: A Rare Therapeutic Response, Suhas C. Gowda, Akshay Samagani, Shreyas C. Gowda

Digital Journal of Clinical Medicine

Morphea is a chronic immune-mediated fibrosing disorder characterized by excessive collagen deposition in the skin. Linear morphea of the scalp (en coup de sabre) commonly demonstrates the Koebner phenomenon, wherein lesions develop at sites of trauma; however, the reverse Koebner phenomenon—trauma-induced regression—is exceptionally rare. We report an unusual case of linear scalp morphea showing early regression following a diagnostic punch biopsy. A 71-year-old male presented with an asymptomatic, indurated linear plaque on the scalp of two months’ duration. Histopathology from a 3.5-mm punch biopsy confirmed morphea, demonstrating dense collagen bundles with lymphoplasmacytic infiltrate. At follow-up eight days after …

From Silos To Systems: A Conceptual Framework For Workforce Aligned Oral Health Education, Meghan Bastin

2026 Scholarly Teaching Conference: Poster Session Papers

In the current U.S. educational system, becoming a dentist follows a few prescriptive pathways.  Learners typically complete an undergraduate degree before entering time-intensive doctoral training.  This results in only 3-4 years of direct professional education embedded within an eight -year process, while learners accumulate significant financial investment in their education.  With the average cost of graduate-level dental education alone exceeding $300,000 and new federal borrowing limits likely to further constrain access, there is an opportunity to explore alternative ways of structuring oral health education.

This poster presents a conceptual, system-level framework that explores a perspective in which oral health education …

Associations Between Accelerometer-Measured Physical Activity And Sleep Duration And Health Indicators In Children And Adolescents With Attention-Deficit Hyperactivity Disorder: A Systematic Review And Meta-Analysis, Xiao Liang, Hui Qiu, Justin A. Haegele, Xiao Li, Minghui Li, Jiayue Li, Shirley Xin Li

Human Movement Studies & Special Education Faculty Publications

Objective

This systematic review and meta-analysis synthesized available studies to explore relationships between accelerometer-measured physical activity (PA) levels or sleep duration and health-related outcomes in children and adolescents with attention-deficit hyperactivity disorder (ADHD).

Methods

Following the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, the six databases APA PsychInfo, CINAHL Ultimate, Embase, MEDLINE, SPORTDiscus with Full Text and Web of Science were searched from inception through July 2024. The correlation coefficient (r) was employed to determine the effect size in the meta-analysis. A random-effects model was utilised to estimate the potentially heterogeneously distributed effect sizes with a 95 % …

Felt Ambivalence Weakens The Attitude-Intention Pathway For Regular Leisure-Time Physical Activity In Chinese Adolescents: A Three-Wavee Prospective Study, Yaogang Han, Yubing Wang, Pan Li, Guohua Zheng

Human Movement Studies & Special Education Faculty Publications

Background: Favorable attitudes toward regular leisure-time physical activity may not always translate into intention if adolescents feel ambivalent about the behavior. This study tested whether felt ambivalence weakens the prospective attitude–intention association and the indirect effect of attitude on later behavior through intention. Methods: Chinese adolescents (N = 1714; Grades 7–12; mean age = 15.0 years) completed a three-wave survey at approximately two-week intervals. Wave 1 assessed attitudes toward regular leisure-time moderate-to-vigorous physical activity, felt ambivalence, and physical activity habit; Wave 2 assessed intention; and Wave 3 assessed leisure-time physical activity. Moderated mediation was tested in a structural equation model …

Sexual Dysfunction In Women With Endometriosis In A Low-Middle-Income Country, Edna Chacha, Charles Muteshi, Felix Oindi, Elsie Wandera

Obstetrics and Gynaecology, East Africa

Background Endometriosis affects up to 10% of reproductive-age women and significantly impairs quality of life including sexual function, intimate relationships, fertility, and psychological wellbeing. While its impact has been extensively studied in Western populations, there is limited Sub-Saharan African data exploring how the disease affects female sexual health and distress. This study aimed to assess sexual function and sexual distress among women with endometriosis at a tertiary hospital in Kenya.

Methods A cross-sectional study was conducted involving 108 women aged 18 to 49 with confirmed endometriosis from January to June 2022. The study used validated self-administered questionnaires: Female Sexual Function …

Surgical Interventions For Treating Vesicovaginal Fistula In Women, Yoshiyuki Okada, Tomomi Matsushita, Takeshi Hasegawa, Hisashi Noma, Erika Ota, Bob Achila, Yasukuni Yoshimura

Obstetrics and Gynaecology, East Africa

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows:

To assess the benefits and harms of surgical interventions for treating vesicovaginal fistula in women.

Co-Designing Impact: Student-Led Prevention Messaging For The Primary Prevention Of Violence Against Women, Narelle Lemon, Lisa Holmes, Christina C. Gray, Jason Goopy

Research outputs 2022 to 2026

Executive Summary:

Violence against women remains one of Western Australia's most serious and persistent social problems, and young adults aged 18–24 represent a pivotal demographic for primary prevention — the work of stopping violence before it starts. The Co-Designing Impact project, funded by the Department of Communities' Family and Domestic Violence Primary Prevention Grants Program 2024/2026 and delivered in partnership between Yourtoolkit.com and Edith Cowan University (ECU), engaged university students aged 18–24 in a six-session co-design program. Participants learned about the drivers of violence against women and the principles of primary prevention, then co-designed social media messaging intended to shift …

Overview Of Aboriginal And Torres Strait Islander Health Status 2025, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

This Overview provides a summary of the most recent indicators of the health and wellbeing of Aboriginal and Torres Strait Islander people (of all ages, where data are available). The topics included in the Overview cover chronic health conditions which are featured on the HealthInfoNet website. Over the years as additional funding has been obtained and in consultation with HealthInfoNet networks, more topics have been covered on the website and are now included in the Overview. The topics aim to reflect the status of Aboriginal and Torres Strait Islander health over this period and going forward.

Meconium Metal Concentrations And Infant Temperament And Development, Fiona Fogarty

Dissertations and Theses

BACKGROUND: Prenatal exposure to metals poses significant health consequences for early childhood development. Understanding the factors influencing metal concentrations that infants are exposed to in-utero is crucial for developing targeted interventions, particularly when maternal characteristics and environmental factors, may contribute to varying levels. Meconium offers insight into in-utero exposures for the developing infant, and the effect of each individual metal may be mediated or exacerbated by another and therefore should be studied in the context of a mixture. The effect of metal mixture exposure, as measured in meconium, on milestone and temperament outcomes has yet to be determined.

DESIGN: …

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

Photovoice Exploration Of Afghan Refugee Background Women's Food-Related Well-Being, Eileen C. Lindemann

Graduate Research Theses & Dissertations

More than 117,000 Afghans have been relocated to the United States following the U.S. military withdrawal in August 2021. Research indicates that Afghan refugees resettled in the U.S. are at increased risk of psychological distress, with Afghan women particularly susceptible compared with Afghan men, and diet-related chronic disease. However, research also shows that traditional food and eating customs foster cultural identity, social support, integration, and well-being. The purpose of this study was to collaboratively explore the food-related well-being and daily life contexts of resettled refugee participants through the photovoice method, a participatory research strategy in which participants photograph aspects of …

Feeding Missoula: Food Insecurity In Rural Children And Youth, Chani Brammer, Braelee Cheeks, Jordin Holland, Rayne Mccollough, Laurel Palmer, Therese Solomon

Undergraduate Theses, Professional Papers, and Capstone Artifacts

In Montana, approximately one in seven children live in a food-insecure household, with rural Montanans in particular facing significant barriers. Existing needs-based food assistance programs, such as SNAP and WIC, have structural weaknesses: SNAP benefits are often not sufficient to last through the month, and those eligible for these programs face a confusing application process, shame and stigma, and logistical hurdles, such as limited transportation.

“Feeding Missoula” began with an evaluation of how current food assistance programs met or failed to meet the needs of rural youth. Our methodology integrated a comprehensive review of existing literature and structured interviews with …

Health Disparities In Cardiovascular Care: The Impact Of Diabetes Education And Post-Discharge Interventions For African American Adults At Risk For And After Myocardial Infarction, Trinity L. Billingsley

Nursing | Senior Theses

Background: Cardiovascular disease is the leading cause of death in the United States, affecting African American adults at higher rates compared to other racial and ethnic groups. Diabetes as a comorbidity is one of the risk factors of experiencing a myocardial infarction, remaining one of the leading causes of death among individuals with diabetes. Objective: To examine the effectiveness of structured diabetes education tailored to African American adults who are at risk for and after a myocardial infarction. Additionally assessing the complications of a myocardial infarction, the outcomes associated with structured education will be compared to the outcomes of …

The Role Of Participant–Clinician Relationality And Intervention Source In A Violence Reduction Trial: A Qualitative Study, Paul Leslie Simpson, Freya Stephenson, Patricia Morgan, Emaediong I. Akpanekpo, Jocelyn Jones, Peter William Schofield, Lee Knight, Tony Butler

Research outputs 2022 to 2026

Violence and domestic violence are global public health problems with prevention programs showing limited effectiveness. The form of delivery of such programs can influence their utility yet delivery characteristics are often poorly described. We analysed interviews with clinicians (n = 5) and participants (n = 12) involved in ReINVEST, a violence reduction clinical trial, to identify key elements of delivery. Three themes were identified: (1) clinician accessibility; (2) clinicians as participant advocates; and (3) humane care, reflecting participant–clinician ‘relationality’ as a central component of program delivery. We propose that this relationality is more likely to emerge in interventions delivered independently …