Digital Commons Network^™

Aligning Clinical Documentation With Payer Requirements To Improve Wheelchair Access, Alexandria Morales

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

The wheelchair acquisition process is complicated and requires an interdisciplinary team of Assistive Technology Professionals (ATP) and either Occupational Therapists (OT) or Physical Therapists (PT). Without a proper mobility device, many wheelchair users report frustration due to decreased participation in work, school, medical appointments, and social events. Improper documentation of specific wheelchair needs contributes to payment authorization denials, causing long delays in the approval process and the timeliness of patients receiving their devices. (Nancy R. Mudrick, April, 2025). According to the 2024 reporting period for Centers for Medicaid and Medicare Services (CMS), “insufficient documentation accounted for 79.7% of improper payments …

Wellness In Action: Implementation Of An Experiential Wellness Elective For Occupational Therapy Students, Heather Short

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Wellness In Action: Implementation of an Experiential Wellness Elective for Occupational Therapy Students

Graduate student mental health is a growing concern in higher education, highlighted by the student experience of high levels of stress, burnout, and declining well-being that impair academic and daily functioning (SenthilKumar et al.,2023; Bullock et al.,2017). Research highlights the need for proactive, holistic interventions that provide education and support skill development (Henrico, 2021; Van Oss et al., 2025). To address this need, this capstone project aimed to design, implement, and evaluate an experiential wellness elective for occupational therapy (OT) doctoral students within a graduate health professions …

Fostering Engagement In Healthy Lifestyle Choices: A Health Management Curriculum For Community-Dwelling Older Adults, Gabriela Kay

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

The older adult population continues to grow, necessitating intentional efforts to support health maintenance and independence within this group. Current literature emphasizes that healthy aging requires a multifaceted approach, including consistent engagement in a range of health-promoting behaviors. The purpose of this capstone project was to develop an educational and interactive program for community-dwelling older adults aimed at increasing knowledge of healthy lifestyle choices and promoting active participation in these behaviors. The overarching goal was to empower older adults to better manage their health and reduce the risk of functional decline and loss of independence.

A needs assessment was conducted …

Advancing Health Equity In Women With Sci Through Ob/Gyn Provider Education, Nethra S. Ankam, Md, Amanda Parezo, Otd, Otr/L, Beth I. Schwartz, Md, Trisha Hicks, Lsw, Med

Department of Rehabilitation Medicine Training Videos and Materials

Background

Individuals with spinal cord injury (SCI) experience persistent disparities in reproductive healthcare access. OB-GYN providers often report limited training and discomfort in addressing these needs. These gaps contribute to inequitable care, reduced patient satisfaction, and missed opportunities for patient-centered care.

Purpose

To develop, implement, and disseminate an evidence-informed educational module aimed at improving OB-GYN provider knowledge, confidence, and clinical competence in delivering accessible, inclusive, and patient-centered reproductive healthcare for individuals with SCI.

Methods

• Community Advisory Board (CAB) engagement 
• Needs assessment survey (SCI population)
• Iterative module development
• Articulate Rise module creation
• Implementation across interdisciplinary providers

Results/Outcomes

Reach & Implementation

• 18 …

Optimizing Makeup Application Techniques For Women With Tenodesis: Adaptations And Ergonomic Solutions, Ashley J. Medina, Wendy Tremaine, Lee Ann Hoffman

Spring 2026 OTD Capstone Symposium

To enhance independence in makeup application for women utilizing a tenodesis grasp, Ashley Medina, OTS, in collaboration with Able Faith, Inc., developed and presented a capstone poster outlining a targeted program of adaptive strategies and ergonomic solutions. This program was designed to address the unique functional challenges experienced by women with spinal cord injuries (SCIs) while promoting autonomy and confidence in daily self-care routines.

The experience objectives included: (1) identifying existing adaptive equipment that supports individuals with SCIs in completing makeup application tasks; (2) examining and understanding the roles of interdisciplinary team members working with individuals with SCI in comparison …

Start With What They Know: Using Motivational Interviewing To Create A Cooking Class, A Culinary Intervention For Teens (Autistic And Non-Autistic), Gwendolyn S. Tedder

LEND Trainee Presentations

Autistic teens are at greater risk for having heart disease and diabetes as adults. Food particularity, sensory issues, fixed mindset, and anxiety over trying new things can slow down their interest in preparing food for themselves. Nurturing basic cooking skills and gently encouraging trying new foods would provide more nutritional options to teens as they move into adulthood. A cooking class preceded by Motivational Interviewing (MI) developed further interest in preparing food afterward in teens, both autistic and non-autistic, and in trying new foods for autistic teens with food concerns.

Occupational Therapy’S Role In Supporting Caregivers Of Children And Adolescents With Type 1 Diabetes, Ania G. Millan

Student Capstone Papers

Caregivers of children and adolescents with Type 1 Diabetes (T1D) often experience increased stress, occupational imbalance, and challenges related to maintaining their own health and wellness while managing their child’s complex daily care needs. Despite the significant impact caregiving responsibilities may have on daily routines, self-care, and overall quality of life, occupational therapy’s (OT) role in supporting caregivers within endocrinology settings remains underrecognized. The purpose of this capstone project was to explore caregivers’ perceptions of their health and wellness and examine the differences and similarities between caregivers’ and occupational therapy practitioners’ (OTPs) perspectives regarding OT’s role in supporting caregivers of …

Empowering Mothers: Occupational Therapy Video Series For Postpartum Depression, Brenda J. Ramos

Student Capstone Papers

The purpose of this research is to highlight the importance of maternal mental health and the use of self-regulation techniques to improve PPD. OTs can use self-regulation techniques as an intervention to assist mothers feel regulated and get through day-to-day tasks.

Building Caregiver Capacity: Sensory Processing Education And Practical Strategies For Supporting Children In Residential Care, Karissa J. Varner

OTD Capstone Projects

This doctoral capstone project was completed through partnership with the Tennessee Baptist Children’s Homes Brentwood. Tennessee Baptist Children’s Homes is an organization with 3 campuses across Tennessee with the purpose of providing Christ-centered homes for children in hard places through compassionate on-campus homes. The goal of this project was to create informative and practical resources for staff to increase knowledge and confidence in supporting the children in their care. Two live staff trainings were conducted, introducing trauma-informed sensory processing and advocacy. Additionally, a 25-page evidence-based resource guide was developed, detailing sensory processing supports and occupational therapy strategies to assist house …

Promoting Mental Health And Wellness For Adults With Developmental And Intellectual Disabilities, Tristen Six Caceres

OTD Capstone Projects

This doctoral capstone project was completed in partnership with the Metro Parks disABILITIES Program. This community-based program provides recreational, social, and wellness opportunities for adults with intellectual and developmental disabilities (IDD) in the Nashville area. The purpose of this capstone project was to address a need for increased mental health support, education, and accessible resources for adults with IDD participating in the day programs, as well as for the staff who support these participants. Adults with IDD often experience barriers to receiving mental health care, including limited access to providers with appropriate training and confidence in working with this population. …

Interventions For Geriatric Patients With Dementia In Inpatient Psychiatric Settings, Kenya Raybon

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Geriatric patients with dementia in inpatient psychiatric units are admitted with cognitive and behavioral challenges that often lead to increased agitation and greater reliance on 1:1 support, limiting participation in group therapy. While evidence supports structured, activity-based and sensory-informed interventions to promote regulation and engagement, implementation is often inconsistent due to workflow barriers, staffing limitations, and lack of structured guidance for staff, especially if cognitive impairment is not immediately recognizable.

This quality improvement capstone project aimed to develop and implement an evidence-informed staff training program, along with a structured activity binder system with adaptable, unit-specific interventions to support consistent activity-based …

Effects Of Ndbi With Just-In-Time Programming Of Vsds On Communication Of Children With Asd, Jenna M. Rogers

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

Autism Spectrum Disorder (ASD) is a prominent neurological and developmental disability that often requires communication support, such as Augmentative and Alternative Communication (AAC). Visual Scene Displays (VSDs) are an AAC support that directly immerses in the user’s life, using images from real environments the user has or may experience. Naturalistic Developmental Behavioral Intervention (NDBI) is an evidence-based approach to early intervention that targets social communication during naturalistic routines, including those who rely on AAC support to communicate. Despite recent research indicating that combining NDBI and AAC is a promising approach (Pope et al., 2024), no studies to date have examined …

Self-Management Challenges And Psychosocial Support Needs In Clean Intermittent Catheterization: A Qualitative Study Of Individuals With Neurogenic Bladder And Caregivers, Lianyu Zou, Xiaomei Wu, Shun Chen, Shuluan Feng, Xiaohua Huang, Weiting Liu

Research outputs 2022 to 2026

Background – Clean intermittent catheterization (CIC) is widely regarded as the preferred approach to bladder management for individuals with neurogenic bladder (NB). Nevertheless, a considerable gap persists between evidence and clinical practice: patients and caregivers frequently encounter self-management barriers that compromise clinical outcomes during CIC. This qualitative study explores these barriers to provide an empirical foundation for developing tailored strategies that improve quality of care. Design – A descriptive qualitative study. Methods – From August to October 2025, a convenience sampling method was employed to recruit 16 participants individuals with NB or their long-term caregivers from the Department of Rehabilitation …

Bridging Cultures: Developing A Culturally Responsive Educational Website For Pediatric Service Providers, Aimun Aziz, Wendy Tremaine

Spring 2026 OTD Capstone Symposium

The increasing cultural diversity of the pediatric population in the United States highlights the need for culturally responsive, family-centered care. However, many providers report limited training and practical resources to support the integration of cultural humility into clinical practice. This capstone project aimed to develop and evaluate an evidence-based educational website to support pediatric service providers in delivering culturally responsive care.

A program development framework was used, incorporating family needs assessments, pre- and post-intervention surveys of pediatric therapy staff, and thematic analysis of key factors related to communication, trust, and provider preparedness. Community field visits with diverse populations informed the …

Ready, Set, Play! Empowering Caregivers Through Adaptive Playground Resources, Makenna Thigpen, Angela Blackwell, Brianne Harryman

Spring 2026 OTD Capstone Symposium

This doctoral capstone project addressed the need for accessible, caregiver-friendly education to support inclusive play opportunities for children of diverse abilities. Guided by occupational therapy frameworks emphasizing participation, environmental supports, and family-centered care, this project involved collaboration with the local Parks and Recreation Department to better understand community needs and existing inclusive playground resources. Through this partnership, the project supported efforts to promote awareness and accessibility of inclusive play spaces within the community.

As part of the project, educational video resources were developed to increase caregiver knowledge of inclusive playground equipment, play strategies, and environmental modifications. Content focused on promoting …

Enhancing Student Engagement In Leadership And Advocacy, Rosanoemi A. Mejia, Jazminne Orozco Arteaga

Spring 2026 OTD Capstone Symposium

Occupational therapy has a unique capacity to foster social change and occupational justice. Leadership and advocacy are essential components of the daily academic practice for occupational therapists. However, leadership development within the field is largely socially driven, and students often lack access to structured, mentored pathways that would empower them to speak up and engage in advocacy. This capstone project aimed to fill this gap by addressing the shortage of coordinated mentorship and leadership development opportunities, which hinder advocacy efforts and professional growth. The study employed a mixed-methods approach, involving occupational therapy students in quantitative Likert-scale surveys and qualitative semi-structured …

Menstrual Cycle Hormonal Fluctuations And Non-Contact Acl Rupture Risk In Female Athletes: A Literature Review, Alexa K. Larson

Honors Thesis

Anterior cruciate ligament (ACL) injuries are among the most common and debilitating injuries in athletic populations, with female athletes experiencing significantly higher rates of non-contact ACL rupture compared to males, often while participating in the same sports. Hormonal fluctuations associated with the menstrual cycle have been proposed as a potential intrinsic risk factor influencing injury susceptibility. The purpose of this literature review was to examine current research investigating how menstrual cycle-related hormonal fluctuations may influence the risk of non-contact ACL rupture in female athletes. A comprehensive search of PubMed, SPORTDiscus, and CINAHL databases identified fourteen peer-reviewed studies that met the …

Evaluation Of Prosthetic And Orthotic Technologies Using Ai Technology, Iris Reyna, Samerial Brown, Gary Guerra, Ed Khu

Posters - 2026

Individuals with lower limb prosthetics have amputations and abnormal limb motions, which poses a high risk of injury when doing everyday activities. In this field, evaluation of individuals' prosthetics are done through biomechanical analysis and gait analysis. This analysis is used to study human movement and evaluate the mobility and quality of life of amputee patients as well as determining the modifications, positioning, and alignment needed to ensure stability with prosthetic and orthotic technologies (Kumar & Bhowmik, 2024). Trunk flexion has importance to the study because of its impact on lower limb kinetics, kinematics, the increase of ground reaction forces, …

Language Barriers In The Healthcare System, Gulten Altunbulak

Student Capstone Papers

Language barriers in healthcare can negatively affect quality of care, patient satisfaction, and health equity, particularly among individuals with limited English proficiency (LEP). This capstone project aimed to develop and implement an occupational therapy communication protocol in a skilled nursing facility to address these barriers. A mixed-methods approach was used, including a pre-survey of 25 staff members, post-implementation interviews, and observational feedback to evaluate communication practices, interpreter use, and staff confidence. Interventions included staff education on interpreter services and culturally responsive care, as well as bilingual communication tools, personalized resident posters, and a Language Line training video. Guided by the …

Lessons Learned From The Implementation Of A Pragmatic Trial Evaluating Non-Pharmacological Approaches To Dementia Care In Us Nursing Homes, Carin Wong, Catherine V. Piersol, Felicia Chew, Cara Lekovitch, Victoria Shier, Mike Morris, Jenny Martínez, Julie Britton, Natalie E. Leland

Department of Occupational Therapy Faculty Papers

RATIONALE: The consistent delivery of effective evidence into nursing home practice has been shown to enhance quality of care and residents' outcomes. Pragmatic trials enable the evaluation of efficacious interventions in a real-world context, including care of residents living with Alzheimer's Disease and Related Dementias (ADRD). Yet, there are limited pragmatic trials conducted in nursing homes and even less evidence on the strategies to successfully conduct such research in this setting.

OBJECTIVE: To identify the lessons learned from a pragmatic trial and provide recommendations for future successful studies in United States (US) nursing homes.

METHODS: Drawing on a case example …

Evaluation Of An Affordable Prosthetic Liner In Resource Limited Settings, Samerial Brown

Posters - 2026

The lower limb prosthesis is an important assistive technology for persons with limb amputations and differences. The interface (prosthetic liner) between the rigid prosthetic socket and the residual limb is often made of silicone, urethane or thermoplastic elastomer gel. This material provides cushioning and support as well as suspension for the transtibial (below knee) prosthetic leg. Unfortunately the cost of liners range from $3-$600. This cost precludes its use in resource limited settings such as Sri Lanka. As a result patients are fit with a foam liner which has less cushioning and suspension capabilities than a gel type liner. This …

Identifying Factors Influencing Occupational Therapy Decision-Making Regarding Telehealth, In-Person, And Hybrid Care Within A Veterans Affairs Healthcare Setting In South Carolina, Christina R. Smith

Senior Theses

Telehealth has become an increasing part of healthcare service delivery, expanding client access to services across disciplines, including occupational therapy. Existing research suggests that telehealth occupational therapy can produce similar outcomes to in-person care in certain populations; however, variability in patient characteristics, technological readiness, intervention demands, and environmental contexts influences its suitability, and limited research examines how practitioners determine the appropriate service delivery model. The purpose of this qualitative study is to explore the factors that influence occupational therapy practitioners within a Veterans Affairs healthcare setting in South Carolina when determining the appropriateness of telehealth, in-person, or hybrid service delivery …

Learning In Motion: How Small Groups Can Promote Self-Regulated Learning In Physical Therapy Students, Sara Mclaren

STEMPS Theses & Dissertations

Self-regulated learning (SRL) is a critical skill for success in rigorous graduate health professions programs, where students must independently manage complex academic demands. Despite its importance, limited research has examined SRL processes among Doctor of Physical Therapy (DPT) students in the didactic phase of training. Guided by Zimmerman’s cyclical model of self-regulated learning, this study examined SRL behaviors among second-year DPT students and explored how small group learning contexts may influence engagement in SRL processes and academic performance.

This mixed-methods study included 39 DPT students enrolled in a physical therapy program at a public university in the southeastern United States. …

From Theory To Practice: Splint Fabrication Through Occupational Therapy Video Library, Caitlyn Mccaughey

Capstone Projects

This doctoral capstone experience (DCE) highlights the need for educational resources on occupational therapy splint fabrication by producing a comprehensive video library to aid skill acquisition among students and new graduates. This project involved developing 21 tutorial videos featuring detailed, step-by-step demonstrations designed to accommodate visual, auditory, and kinesthetic learning styles amongst individuals. A literature review emphasized the growing popularity of video-based education and the lack of accessible, high-quality splinting resources, with a needs assessment revealing low confidence levels among occupational therapy students due to limited educational support. Through collaboration and integration of evidence-based practices, this project successfully produced an …

Bridging The Gap: A Trauma-Informed Approach To Real-Time Counselor Support Training At Kesem, Elizabeth Fallon

Capstone Projects

This capstone project involved the development and implementation of a trauma-informed care training program for college-aged counselors within Kesem, a nonprofit organization supporting children affected by a parent or caregiver’s cancer. The project addressed gaps in existing counselor training related to recognizing and responding to trauma in real time. The literature identified increased risk for psychosocial challenges in this population, including anxiety, depression, as well as the importance of peer support, safe environments, and developmentally appropriate communication.

The training program included different modules on trauma, grief, and child development, as well as interactive role-play scenarios tailored to different age groups …

Creation And Implementation Of Nature And Sensory Based Therapy Programming To Support The Health And Well-Being Of Catholic Dominican Sisters, Sydney Payne

Capstone Projects

As the older generation ages, diseases such as dementia can cause sensory processing systems to be less efficient. When they become less efficient, it can create confusion and undermine one’s sense of safety (Champagne, 2018 pg 29-30). Engaging in sensory experiences provides support for these deficits while fostering participation in everyday life activities (Champagne, 2018 pg 30). This capstone project included a sensory garden (nature-based therapy) and associated multi-sensory activities. This was done through creation of nature and sensory-based programming, implementation of this programming one-on-one with sisters, two group sensory, dementia-friendly activities, and formation of a sustainability binder. Occupational therapy …

Implementation Of A Cardio Drumming Program To Promote Health And Wellbeing In Community-Dwelling Older Adults, Amanda Moyer

Capstone Projects

This doctoral capstone experience focused on implementation of a cardio drumming program at the Ecumenical Senior Center (ESC), a day center for older adults, in Kalamazoo Michigan. Cardio drumming is a unique way of exercise that combines drumming to upbeat music with an exercise ball, laundry basket, and drumsticks. Cardio drumming is low impact and can be adapted to many different abilities. This form of exercise can be done in a seated or standing position. The program began once a week for 30 minutes but soon increased to two times a week for 35 minutes and lasted 9 weeks due …

The Bronco Well: An Educational Podcast For Pediatric Caregivers’ Wellbeing & Quality Of Life, Molly Veldheer

Capstone Projects

Pediatric caregivers of children with increased and complex physical, cognitive, and emotional needs are an often-overlooked population. Though their children may be involved in many essential services including occupational therapy, the needs of these caregivers largely go unmet. Occupational therapists are equipped to provide valuable care and education to the entire family and not just their pediatric clients. In efforts to fill the unmet needs, this occupational therapy-based podcast was created as resource for pediatric caregivers about pediatric caregivers. The development of this capstone considered the time, energy, and financial strains that are often placed on pediatric caregivers and determined …

Creative Art-Based Program To Address Body Image In Cancer Survivors And Caregivers, Tisa Lightfoot

Capstone Projects

This doctoral capstone experience (DCE) explored the role of occupational therapy in promoting the use of creative art-based interventions to address body image in cancer survivors and caregivers. Within the oncology population, body image concerns are a prevalent psychosocial factor that affects survivors’ self-perception, emotional well-being, and occupational engagement in their daily lives. To address this gap, a six-week program was developed to promote art as a meaningful occupation to support the psychosocial well-being related to body image in cancer survivors and caregivers. Additional initiatives of the program included resource development and integration of education on current literature on the …

Social Skill Program Development: Social Thinking Curriculum, Anna Holman

Capstone Projects

This capstone project examined the implementation of the Social Thinking It: Tweens and Teens curriculum to support adolescent social participation within a group-based setting. Social participation is a core domain of occupational therapy; however, many adolescents experience challenges with communication, emotional regulation, and peer relationships. This project addressed a gap in structured, evidence-based social skills programming at the capstone site. Primary objectives included implementing the Social Thinking curriculum, facilitating weekly group sessions, evaluating participant engagement, and skill development. Intervention strategies included role-playing, guided discussion, modeling, and reflective activities embedded within the curriculum framework. Outcomes demonstrated increased participant engagement and improved …