Digital Commons Network^™

Assessing One-Year Health Impacts From Wildfires In Rural Communities: Roles For Extension In Promoting Wildfire Preparedness And Recovery, Marc T. Braverman, Sandi Cleveland Phibbs, Emily Jane Davis, Amanda Rau, Elijah Penner

Journal of Extension

Wildfires can produce health impacts that persist for years in affected communities. This article describes an Extension-led study of health impacts in rural Oregon communities one year after a destructive wildfire. Data collection included key informant interviews (n=36), an online survey (n=80), and three focus group interviews with survivors (n=23). Mental health, exposure to contaminants, physical stress, food insecurity, and other issues were frequently identified health concerns. Survivors’ difficulties in dealing with housing displacement significantly exacerbated health challenges. We describe potential roles for Extension in addressing wildfire risk and mitigating health impacts, including a description of the Oregon Fire Program.

Reaching Tomorrow’S Extension Customer: A Food And Health Needs Assessment, Morgan Szczepaniak, Sarah L. Francis, Ruth Litchfield, Ulrike Genschel, Shannon Coleman, Anirudh Naig

Journal of Extension

The food and health needs and preferences of Iowans (n=452) were examined. The leading food and health information sources were online platforms, social media, and print media. Program topics with high participation likelihood were cooking, food preservation, food safety, and gardening. Short, low-cost, online programs were preferred. Extension use was more likely among those who identified as persons of color, Hispanic/Latino, or were food insecure (p < 0.030). Those with less education and chronic disease were less likely to be interested in Extension programming (p < 0.040). These results provide valuable information regarding future directions for Extension programming.

Science Tikkun: A Bioscience Pandemic Framework In A Hebrew Tradition Of Global Repair, Peter Hotez

Center for Medical Ethics and Health Policy Staff Publications

Over the past decade we have seen a steady increase in dangerous pandemic threats. They include two major Ebola epidemics and cholera in Africa; dengue, Zika, yellow fever in the Americas; a COVID-19 pandemic; and H5N1 in Texas. This is happening because of a confluence of modern forces including urbanization, deforestation, and climate change. Yet as pandemics emerge on a crowded and warming planet, anti-science disinformation and antisemitism impede our response. Science tikkun is an overarching framework for repair and redress. It honors the legacy of Maimonides, Teilhard de Chardin, and others who have sought reconciliation between science and religion.

Climate Change Impacts On Drinking Water Security: A Comparative Study In Australia’S Remote Central Australia And Torres Strait Islands, Nina Lansbury, Julia Bradford, Sandra J. Creamer, Geoffrey Evans

Journal of the Australian Indigenous HealthInfoNet

Aboriginal and Torres Strait Islander communities are well adapted to the many different environments in which they have lived for thousands of years. However, their environments and communities are highly vulnerable to impacts of anthropogenic climate change, including increasing threats to the security of drinking water supplies. Climate change is intensifying the significant social and economic disadvantage Australia’s Aboriginal and Torres Strait Islander communities face from poverty, poor housing, and poor health including high exposure to infectious and other diseases. Lack of sufficient safe, clean, drinking water could force Aboriginal and Torres Strait Islander people to leave their homelands, adding …

Centralising Local Aboriginal Language And Culture In Healthy Skin Books On The See Treat Prevent (Stop) Trial In The Kimberley Region Of Western Australia: A Process And Impact Inquiry, Tracy Mcrae, Kelli Mcintosh, Hannah Mm Thomas, Stephanie Enkel, Abbey Ford, John Jacky, Slade Sibosado, Marianne Mullane, Alexandra Whelan, Rebecca Dalton, Juli Coffin, Jonathan R. Carapetis, Roz Walker, Asha C Bowen

Journal of the Australian Indigenous HealthInfoNet

Language is significant for communicating knowledge across cultures and generations and has the power to attribute meanings and alter our worldviews. More than 250 Aboriginal and Torres Strait Islanders languages were spoken in 1788. This number has diminished to approximately 110 languages spoken in 2016, of which 90% were considered endangered in 2019. Language custodians and speakers across Australia are working to preserve and ensure languages are strongly spoken into the future. Language revitalisation initiatives can facilitate (re)connection to Country, cultures and communities and be recognised as acts of reconciliation for Aboriginal and Torres Strait Islander peoples. In a health …

Observed And Reported Outcomes Following Experiential Cultural Capability And Clinical Yarning Training For Clinicians Treating Aboriginal And Torres Strait Islander People With Persistent Pain, Stuart Ekberg, Renata F. I Meuter, Ivan Lin, Roslyn Rowen, Angela Kinnell, Eva Malacova, Tania Waring, Kushla Houkamau, Marayah Taylor, Matthew Bryant, Jermaine Isua, Andrew Claus, Paul Gray, Joseph Kluver, Christina M. Bernardes, Greg Pratt

Journal of the Australian Indigenous HealthInfoNet

Communication is recognised as crucial to culturally safe healthcare, and poor communication remains a major reason that Aboriginal and Torres Strait Islander people do not access healthcare. This pragmatic, pre-post comparison study employed mixed methods to evaluate cultural capability and clinical yarning training delivered to 57 clinicians supporting Aboriginal and Torres Strait Islander people at three persistent pain management services in Queensland, Australia. Observable outcomes of the training were evaluated by video recording clinicians’ training experiences and seven consultations with patients that occurred either pre- or post-training. Reported outcomes were evaluated by using a modified Cultural Safety Survey (CSS), which …

Investigating How Social Support Impacts The Use Of Primary Healthcare Services For Women Undergoing Treatment For Opioid Use Disorder, Sydney Macon, Vanessa Short, Phd, Mph

Health Equity and Quality Improvement (HEQI) Summit

Background

Individuals with substance use disorders often face challenges in accessing and utilizing primary care, exacerbated by a lack of social support. Understanding the intricate dynamics between social support and primary care utilization is crucial for enhancing healthcare delivery, especially among vulnerable populations such as women undergoing substance use disorder treatment. There is a lack of research regarding this connection and our research aims to change that. We want to explore how social support influences the use of regular healthcare, particularly for women facing substance use challenges. By doing this research, we hope it will lead to future discoveries of …

Improving Guideline-Based Prep Management In A Philadelphia-Based Academic Family Medicine Office, Brittany Macdonald, Md, Marshall Miller, Md, Nwando Ekezie, Md, Maia Mandel, Md, Christina Boras, Md, Eunice Choe, Md, Meghan Swyryn, Md, Meg Broderick, Md, Pascaline Karanja, Md, Julia Beatini, Md, Julie Jones

Health Equity and Quality Improvement (HEQI) Summit

Background

Pre-Exposure Prophylaxis (PrEP) significantly reduces the risk of contracting HIV:

• Reduces risk from sexual contact by 99%
• Reduces risk from injection drug use by at least 74%

Despite its effectiveness, PrEP is underutilized in the USA.

• In 2019, an estimated 224,000 Americans received a prescription for PrEP despite 1.1 million people having indications for PrEP.
• Lack of provider knowledge surrounding PrEP clinical guidelines is a common reason for underutilization.

Utility Of Community Partnership And Sustainable Street Outreach, Daniel Lee, Hannah Klinghoffer, Mallika Kodavatiganti, Luke Benedict, Kelsey Van Housen, Ashley Wetzel, Lele Yang, Alisha Agarwal, Shane Nieves, Charlotte Harris, Jessica Lely, Vinh Dang, Ivel Morales, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• 14,088 individuals experience homelessness (IEH) across the state of Pennsylvania, with over 50% concentrated in Pittsburgh and Philadelphia¹
• In late 2021, only 4 medical school programs existed that conducted street outreach to support individuals experiencing homelessness in Pennsylvania before the pandemic.² None existed at the undergraduate level.
• Street outreach has been linked to increased motivation of IEH to seek services by removing stigma via positive, nonjudgmental relationships.^3,4

Enhancing Patient Education Of Antimicrobial Side Effects At Discharge, Isaac Daudelin, Md, Phd, Bojan Lazarevic, Jordan Feingold-Link, Md, Nehar Damle, Md, Pharmd, Caroline Brugger, Crnp, Rachel Carr, Pa-C, Devin Weber, Md, Daniel Taupin, Md, Mhqs

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem: Patients discharged from the hospital on antimicrobial agents often receive insufficient education about potential side effects that warrant medical attention(1). We identified a critical gap in patient communication and safety that occurred during discharge at a large urban academic center.

Stakeholders

• Patients
• Physicians
• Nurses
• Pharmacists
• Outpatient providers
• Nurse practitioners
• Physician assistants

Objective: This project aimed to utilize a multidisciplinary team to:

1. Quantify a gap in patient education
2. Create an interactive navigator- which would not rely on provider memory and automatically include relevant information in patient discharge paperwork
3. Implement within 3 months into the EPIC system
4. Measure the effect …

Future Of Transplant Centers: Leveraging Integration Of Transplant Institutes To Mitigate The Impact Of Transplant Professional Shortages And Enhance Patient Outcomes, Kiran Goli, Prashamsa Shenoy, Paula Martinez-Cantarin, Maitreyee Gupta, Rakesh Gulati, Pooja Singh

Health Equity and Quality Improvement (HEQI) Summit

Background

The Increasing Organ Transplant Access (IOTA) Model introduced by the Centers for Medicare & Medicaid Services (CMS) emphasizes increasing transplant volumes, reducing disparities, and enhancing care efficiency. Transplant centers face unique challenges, including workforce shortages, growing demand for organ transplants, care delivery inefficiencies, and the need to align with the achievement, efficiency, and quality domains of the IOTA model while fostering health equity. Integration, whether through mergers, acquisitions, or strategic alliances, offers transplant centers a competitive advantage in optimizing resources, expanding access, and meeting CMS metrics.

Quantiferon Tb Gold Test Utilization During Inpatient And Emergency Department Encounters At A Multi-Site, Single Academic Institution, Laxman Singanamala, Bs, Laura Walters, Do, Devin M. Weber, Md, Courtney E. Comar, Phd

Health Equity and Quality Improvement (HEQI) Summit

Background

• The QuantiFERON-TB Gold Plus test (QG) is an in vitro Interferon Gamma Release Assay that can be used to assess for prior exposure to Mycobacterium tuberculosis (MTB). The optimal use is in screening for latent disease.
• The United States is a low endemic country for MTB infection with 2.5 cases/100,000-persons in 2022 (CDC). Yet, we noted high utilization of the QG in our institution.
• Our goal was to understand our patient population and the clinical rationale for testing to create an electronic medical record (EMR) order set to optimize appropriate test use, decreasing unnecessary testing for patients and healthcare …

Enhancing Community Health Center Safety Through Participatory Co-Design, Arman Afifi, Kelsey Smith, Megan Reed, Phd, Mph, Lara Weinstein, Md, Mph

Health Equity and Quality Improvement (HEQI) Summit

Introduction and Objective

Pathways to Housing PA (PtHPA) is a permanent supportive housing program with a mission to end homelessness for people with serious mental illness and substance use disorders. This urban based program serves approximately 500 people and has an on-site integrated healthcare clinic. The PtHPA offices temporarily closed in October of 2020 after a serious onsite safety event. In preparation for reopening, the PtHPA community sought to cultivate a safer space through utilizing co-design as a vehicle to solicit feedback from program participants and staff. Co-design research is a collaborative approach where researchers and stakeholders—such as community members, …

Improving Viral Hepatitis Testing With A Clinical Scenario Based Order Set: The Viral Hepatitis Hub, Jordan Feingold-Link, Md, Elizabeth A. Braden, Md, Courtney E. Comar, Phd, Jonathan M. Fenkel, Md, Kory S. London, Md, Sean P. Moss, Md, Elizabeth Novick, Md, Matthew Pettengill, Phd, Christine Papastamelos, Md, Jeffrey M. Riggio, Md, Daniel Taupin, Md

Health Equity and Quality Improvement (HEQI) Summit

Background and Problem

Viral hepatitis disproportionately affects historically marginalized populations, with less than one-third of high-risk patients receiving appropriate screening. Racial and ethnic minoritized groups, rural residents, and PWID face significant disparities in both testing and treatment.

Paradoxically, while underserved populations remain undertested, providers frequently order inappropriate hepatitis tests, particularly acute- phase markers like HAV IgM and HBV core IgM, in clinical situations where guidelines do not indicate their use. This pattern of inappropriate testing is partly driven by provider uncertainty regarding the selection of appropriate serologic tests from a complex array of options. Clinical decision support (CDS) within computerized …

Curricular Impact: Training Dpt Students To Look Upstream, Rebecca Operacz, Pt, Dpt, Edd

Health Equity and Quality Improvement (HEQI) Summit

Background and Problem

• Healthcare literature highlights extensive health inequities and continued mistrust of the healthcare system among historically marginalized communities.
• Accrediting bodies advocate for inclusion of SSDH in training to prepare practitioners to address health inequities.
• Limited guidance exists regarding implementation of SSDH content or expectations for student clinicians.
• Effectiveness of education is typically measured by metrics with little connection to patients and populations (GPA, graduation rates, licensing exams).

Improving The Quality Of Internal Medicine Discharge Summaries Via Accurate Admission Medication Reconciliation, Natasa Kostic, Md, Tammy Tran, Md, Kenneth Meserole, Md, Jon Zaid, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Transitions of care are a time of vulnerability for patients.
• Nearly 20% of patients experience an adverse event within 3 weeks of hospital discharge, with adverse drug events being the most common.
• Discharge (DC) summaries serve to provide safe transition of care by describing hospital course and medication changes for review by outpatient providers.
• At TJUH, DC summaries are completed by internal medicine (IM) senior residents, but there is variability in quality of hospital course and thoroughness of medication reconciliation.
• Inaccurate admission medication reconciliation may lead to inaccurate reporting of discharge medication lists, causing confusion for both patients and …

Project Proposal: The Impact Of The Septa Zero Fare Program On Healthcare Access Among Philadelphia's Refugee And Migrant Population, Emily Hashem, Bs, Paranshu Shah, Mitchell Kaminski, Md, Mba

Health Equity and Quality Improvement (HEQI) Summit

Background

Since the 1960s, private, state sponsored, and charitable programs have attempted to increase transportation programs to improve healthcare access. Among these are the Centers for Medicare and Medicaid Services' Non-Emergency Medical Transportation (NEMT) program, Pennsylvania’s Medical Assistance Transportation Program (MATP) benefiting Medicaid recipients, Southeastern Pennsylvania Transit Association’s (SEPTA) SEPTA Access (formerly known as CCT connect) for disabled and elderly people, and ModivCare, a social services corporation that offers non-emergency medical transportation for qualifying people with low incomes. The importance of these programs is emphasized by the body of evidence surrounding healthcare metrics and transportation access. A Robert Wood Johnson …

Framing The Future: A Community Health Analysis Of The Pee Dee Region, Stephen Borders, Jean Anton, Rian Fontaine, Donielle Phillips, Treyton Ringer, Jessica Robinson, Caitlin Thompkins

Public Health

This report presents a comprehensive, data-driven analysis of community health across South Carolina’s Pee Dee region, encompassing Florence, Darlington, Chesterfield, Marlboro, Marion, and Dillon Counties. Using tract-level data from CDC PLACES, the U.S. Census, and the National Provider Identifier registry, it assesses chronic health conditions, health behaviors, and social determinants of health. The analysis incorporates the South Carolina Healthy Communities Index (SCHCI) and a Suitability Analysis to identify the region’s most disadvantaged communities. The findings highlight persistent disparities, particularly in rural counties, where high rates of poverty, chronic disease, and unmet basic needs intersect with limited access to care. Despite …

A Retrospective Study Of Pulmonary Function Tests In Bronchiectasis: An Infectious Disease Of The Respiratory System, Vinod Mutkule, Mahesh Shinde, Vidya Bapmare, Sangramsingh Dixit, Atharva Sharma, Kshitij Sarwey, Yogeshwari Patil, Sanket Jethlia, Aayushi Dwivedi, Disha Pardeshi, Anmol Rai, Kunal Shah, Vidhi Kalwar

The University of Louisville Journal of Respiratory Infections

Introduction: Bronchiectasis, currently being recognized worldwide, is an abnormal dilatation of the bronchi and bronchioles brought on by recurrent cycles of inflammation and airway infection. Impaired pulmonary function has a predictive significance in bronchiectasis. When treating patients with suspected or confirmed respiratory diseases, pulmonary function tests (PFT) are useful examinations. Very few studies have been done on PFTs in bronchiectasis. The main aim of this study is to study PFTs in bronchiectasis.

Method: This is a retrospective observational study done on 50 patients over two years at the tertiary care center. The previous records of patients were collected from the …

Impact Of Safety Practices On Laboratory-Acquired Infections In Clinical Laboratories From 2018 To 2023, Lori Bane

Walden Dissertations and Doctoral Studies

Laboratorians identifying unknown pandemic pathogens face elevated risks of laboratory-acquired infections yet limited research examines how regulated safety practices influence these risks. This quantitative, correlational study used the Centers for Disease Control and Prevention’s secondary data (2018–2023) to examine two research questions. The first one questioned whether there were differences in safety incidents between registered and exempt clinical laboratories. The second research question investigated whether there was an association of laboratory incidents between BSL-2 and BSL-3 laboratories. The research was limited to incident reports from registered and exempted clinical laboratories working in BSL-2 and BSL-3 conditions. Guided by the Health …

Community Health Workers’ Lived Experience Of Using Videoconferencing With Community Members, Valdora Lejune Avery

Walden Dissertations and Doctoral Studies

Community health workers in the United States faced significant challenges in conducting in-person community practice during the COVID-19 pandemic, which adversely affected their communication, training, and service delivery outcomes. Videoconferencing enabled workers to connect with underserved populations for individual and community crisis response. The purpose of this study was to describe the lived experiences of community health workers in the Rural Community Health Worker Network (RCHWN) regarding the use of videoconferencing among community members in practice and how members in RCHWN perceive the availability of videoconferencing devices to communicate in the community. Transcendental phenomenology provided the conceptual framework and research …

Detection And Quantification Of Total Airborne Fungi And Coccidioides Species In Environmental Samples, Theresa T. Roehr

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fungal exposure can cause acute and chronic illnesses or exacerbate existing illnesses. Some fungi are opportunistic pathogens and can lead to serious systemic fungal infections. In 2020, more than 150 million cases of severe fungal infections were reported globally resulting in an estimated 1.7 million deaths. Coccidioidomycosis, or Valley fever, is classified as a serious fungal infection caused by the fungi Coccidioides immitis and C. posadasii. These particular fungi are prevalent in the soil of the Southwestern United States, including Las Vegas, Nevada. In 2024, there were a total of 269 cases of Valley fever reported in Nevada, and …

Qualitative Analysis Of Clinical And Community Perinatal Providers’ Perceived Barriers To Equitable Care For Food Insecurity In Underserved Communities In Southern Nevada, Kaelia Lynn KeapomekuʻUaloha Saniatan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is prevalent among underserved communities and contributes to increasing maternal-child health disparities. The perinatal period from pregnancy through one year postpartum provides a critical window of opportunity to identify and address food insecurity (FI). However, barriers such as inadequate staffing, lack of institutional and community resources have prevented perinatal providers from offering equitable care for FI, defined as providing screening, referrals, and follow-up services. The Social Ecological Model (SEM) is a framework that observes concepts at multiple levels, including (i) individual, (ii) interpersonal, (iii) institutional, (iv) community, and (v) policy. The objective of this study is to understand …

Empowering Nurses, Enhancing Mobility: A Qi Initiative Using Plof And Clof To Promote Patient Ambulation, Kaela Nguyen

Master's Projects and Capstones

The quality improvement project involves the intervention of implemented mobility educational flyers about the mobility tools, Clinician Reported Level of Function (CLOF) and Patient Reported Level of Function (PLOF) and aims to increase patient mobility post surgery. The quality improvement project was conducted in two medical surgical units in a San Francisco hospital. To address unmet mobility goals, during change of shift, in-services on the educational flyers about the mobility tools (CLOF and PLOF), were utilized to provide education about the importance of mobility, how to utilize the mobility tools, and correctly document ambulation. More than twenty flyers were posted …

Improving Healthcare Access Among Hunter College Students – Suggestions For A Hunter College Student Health Center, Jacob Villorente

Publications and Research

This study investigates disparities in healthcare access among students at CUNY Hunter College, an urban public university in Manhattan serving over 22,000 students. 89% of Hunter students receive financial aid, with 67% of students receiving Pell grants. Hunter College only offers limited health services, primarily short-term mental health counseling and wellness workshops. A cross-sectional survey (n = 33) assessed insurance status, coverage (dental, vision, psychiatric), access barriers (e.g., transportation), mental health symptoms, and impacts to academia. While 69.7% of respondents reported comprehensive insurance, students with public insurance (Medicaid, Medicare) experienced substantially higher access barriers than those with employer-sponsored plans and …

The Silent Killer In Women's Prisons, Samantha Boman

Themis: Research Journal of Justice Studies and Forensic Science

If present in the body for an extended period, the human papillomavirus (HPV) can cause aberrant cells to develop in the cervix. Left undetected, these abnormalities can manifest into cancer. Incarcerated women are among the highest demographic to be diagnosed with cervical cancer - diagnoses that could be averted through HPV vaccinations, regular cervical cancer screenings, Pap smears, and comprehensive sexual education. The lack of these preventative measures points to an insufficiency of reproductive healthcare within women’s prisons. In its early stages, cervical cancer is asymptomatic. Once symptoms appear, damage to the body is irreparable. The absence of symptoms before …

Piloting The Inclusion Of Dollar Stores In The Modified Retail Food Environment Index (Mrfei) In Urban Clark County, Nevada, Tiana T. Tu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is the condition of having limited or uncertain access to adequate food. It contributes to poor diet-related health outcomes which are in turn influenced by the food environment. The Centers for Disease Control and Prevention (CDC) developed the Modified Retail Food Environment Index (mRFEI) to characterize food environments by measuring the proportion of healthy and non-healthy retailers. The CDC mRFEI considers a variety of establishments but fails to include dollar stores, which contribute to the food environment by offering food and, in some cases, fresh produce. This study proposed an “expanded mRFEI” that modified the CDC mRFEI methodology …

“Do You Even Lift, Bro?”: Correlates Of Muscle Dysmorphia Symptomatology In Filipino Male University Students, Pamela Paula C. Pioquinto

UNLV Theses, Dissertations, Professional Papers, and Capstones

Muscle Dysmorphia (MD) is a subtype of Body Dysmorphic Disorder (BDD) and is marked by the desire to increase muscularity and reduce body fat. MD is typically more prevalent among younger male populations, and it often drives comorbid disorders, including substance abuse, eating disorders, and social anxiety. Despite the growing literature on MD, it remains understudied in certain racial/ethnic populations, such as Filipinos. Acculturation, defined as the process in which an individual adopts, acquires, and adapts to a new cultural environment as a result of immigration, influences body image by reshaping an individual’s perceptions of beauty and muscularity standards. Guided …

More Than A Diagnosis: Elevating Person-Centered Care In The Surgical Intensive Care Unit Through Personalized Communication Boards, Sierra B. Poe

Master's Projects and Capstones

Objective: Intensive care units are associated with complex care and high acuity interventions, however, there is a potential for dehumanization of patients. With the focus being placed on life-saving interventions, many patients and their family members feel that they are not being treated beyond their medical diagnosis. Aim: This quality improvement project aims to address these barriers in care by designing and implementing communication whiteboards in the surgical intensive care unit (SICU) at Hospital A to enhance patient and family-centered care, improve patient satisfaction, and enhance interdisciplinary communication. Post-implementation, the goal was to increase utilization of the standardized whiteboards from …

Enhancing Intimate Partner Violence Screening: Implementing Standardized Ehr Protocols And Staff Education In A Community Health Center Serving The Latinx Community, Gabriela Alejandra Davila Barajas

Master's Projects and Capstones

Intimate Partner Violence (IPV) is a public health issue that disproportionately impacts Latinx populations, who often face barriers such as cultural stigma, language barriers, fear of legal consequences, and limited access to culturally competent care. Community Health Centers (CHCs) are well-positioned to identify and address IPV. This project aims to increase IPV screening rates in a CHC serving a predominantly Latinx population by implementing standardized EHR protocols and culturally responsive staff education. The project’s goal is to raise IPV screening rates to 25% by April 15, 2025. The intervention includes two key components: integrating the Hurt, Insulted, Threatened, and Screamed …