Digital Commons Network^™

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

Electronic Theses, Projects, and Dissertations

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

Understanding The Impact Of Childhood Trauma On Recidivism Among Justice-Involved Youth, Jasmine Valencia, Karina V. Garcia, Genaro Fabela

Electronic Theses, Projects, and Dissertations

Adverse Childhood Experiences (ACEs) are especially common among youth involved in the juvenile justice system, and research has consistently linked these early traumatic experiences to a variety of negative behavioral and developmental outcomes. Still, we do not fully understand how strongly cumulative ACE exposure predicts whether detained youth will reoffend, or whether trauma-informed rehabilitation programs can help reduce that risk. This proposed quantitative study explores the relationship between ACE scores and recidivism among youth ages 11–18 detained at the San Bernardino County Juvenile Detention Center. Grounded in trauma theory and ecological systems theory, the study focuses on two primary questions: …

Encounters Of Third Space: A Case Study On Salvadoran Political Art And Identity Interplay, Breanna Delgado

Electronic Theses, Projects, and Dissertations

Third space is an in-between thought space designated for marginalized collectives, allowing multiple recontextualizations of identity interplay. However, Third Space is colonized due to western ideological influences such as criminalization of political art, stunting collective growth. This project serves to question and challenge Salvadoran political art and collective identities through questions such as why political art? Can political art be considered “safe spaces”? and dissecting the process of political art, third space meaning making, and identity interplay. Preserving the collective’s political art serves as a grassroots method of justice, accountability, and collective reparation.

I applying three conceptual frameworks: Bhabha’s (1994) …

Easy Travel-Friendly Snack Recipes For College Students To Support Mental Well-Being, Lidia Vides

Electronic Theses, Projects, and Dissertations

College is a pivotal period in life of a young adult, marked by newfound independence, increased responsibilities, heightened academic pressure, and significant changes in daily routine. While this transition can often be exciting for a young adult, it also presents many different challenges. As a result, many students experience increased levels of stress, anxiety, and depression. Nutrition plays a powerful yet often overlooked role in supporting mental and physical health. Current research studies show that a balanced diet rich in whole food ingredients can help regulate mood and promote emotional well-being through multiple biological pathways. However, despite this knowledge, convenient, …

Lgtbq+ Foster Youth Aging Out Of The Child Welfare System, Anna M. Gutierrez Chavez

Electronic Theses, Projects, and Dissertations

ABSTRACT

On the average time frame, former foster youth were reported homeless between 2012 and 2017. Equally important, is that nearly 39% of homeless youth identify as LGTBQ+.  This research will discuss disproportionality and disparities among youth who struggle with homelessness in the LGTBQ+ population. Research suggests that youth aging out of foster care are more likely to become homeless. Studies found that LGBTQ+ youth being discharged from care did not receive adequate support and guidance from the child welfare system to help them transition into adulthood, which may have led to homelessness.  This study will examine what services and …

Utilizing Self-Determination Theory In Therapy For Veterans With Substance Use And Mental Health Disorders, Carlos A. Tinoc

Electronic Theses, Projects, and Dissertations

Substance use disorder (SUD) has increasingly affected U.S. veterans, with rising misuse of alcohol and opioids. Many veterans also confront mental health issues, including Post-Traumatic Stress Disorder (PTSD). To explore this issue further, the researcher will investigate the effectiveness of Self-Determination Theory (SDT) in addressing substance use and mental health disorders (dual diagnosis) among veterans. Previous research on the implementation of SDT for dual-diagnosis patients has not sufficiently addressed the veteran population. The researcher will review existing systematic literature reviews on the topic of SDT implementation in the treatment of SUDs and mental health disorders among both civilian and veteran …

Healing Beyond Bars: Integrated And Sustainable Recovery Models For Post-Incarcerated Women, Patricia A. Nunez, Jonathan Solomon

Electronic Theses, Projects, and Dissertations

Substance Use Disorders (SUDs) significantly impact the re-entry process for formerly incarcerated individuals, particularly Latina/x women, who face unique cultural, social, and economic challenges in accessing effective treatment. The purpose of this study is to explore the effectiveness of substance use disorder treatment programs in support of successful reentry outcomes for Latina/x women post-incarceration. Previous research on SUD treatment for this population remains limited despite growing awareness of the need for gender-responsive and culturally informed interventions. Qualitative research with an exploratory design within an interpretive research paradigm will be utilized to investigate the lived experiences of Latina/x women who have …

The Effects Of Excessive Smartphone Use On Interpersonal Relationships, Lisa M. Whitesell

Electronic Theses, Projects, and Dissertations

Smartphones are integral to daily life, generating a propensity for overuse that raises concerns about the potentially adverse effects on social connections and communication. Previous research is primarily quantitative, focused on male subjects outside the United States, and has not explored the impact of smartphone use on relationships from the perspective of close friends and family. This study addresses the gap by applying qualitative methodologies using a more balanced gender sample in the United States. Semi-structured interviews will capture participants’ experiences and perceptions of how excessive smartphone use affects their interpersonal relationships. Open-ended questions will explore smartphone use patterns, the …

Examining Distrust Marginalized Populations Experience Within Healthcare In The Us, Mikela Jennings, Marco Ramos, Estrella Garcia

Electronic Theses, Projects, and Dissertations

Background: In the United States (US), Black and Brown individuals experience a significant amount of distrust towards medical professionals in the healthcare field. This distrust often results in an ongoing underutilization of medical care due to fears surrounding the quality of treatment Black and Brown individuals receive within the healthcare system. Previous research on this issue has identified many factors that contribute to the severity of medical distrust. Objective: This proposed quantitative study seeks to describe and examine the commonalities Black and Brown individuals have in association with medical distrust towards the healthcare system in the US. Methods: …

Examining Physical Activity Behaviors And Associated Health Indicators In College Students, Elizabeth A. Reyes

Electronic Theses, Projects, and Dissertations

Background: Physical activity (PA) is a critical determinant of both physical and mental health, yet many individuals fail to meet recommended guidelines. College students face increasing challenges related to physical inactivity, elevated stress levels, and poor sleep quality, all of which negatively impact their overall health and academic success. College students who fail to meet recommended PA guidelines are at an increased risk of chronic diseases. This study aimed to examine patterns of PA among college students and explore associations with sleep quality and perceived stress.

Methods: A cross-sectional design was employed using a self-administered questionnaire that included items on …

Racial Disparities In Sentencing Across The United States: A Regression Analysis, Katlyn Moreno

Electronic Theses, Projects, and Dissertations

Background: Mass incarceration has been a serious social problem in the United States with millions of people under the supervision of the criminal justice system. This problem is even more challenging for minority populations with African-Americans, Hispanics, and other minority racial groups experiencing harsher punishment than their non-minority counterparts. Previous research on this topic is limited in scope and methodology. Purpose: This study will fill a gap in the literature by comparing sentencing lengths among racial groups in the United States. It was hypothesized that racial minorities (African-American and Hispanic offenders will receive lengthier sentencing as compared to their counterparts …

Structural Erasure And Suicide Risk: The Impact Of Gender Misrecognition And Institutional Nonsupport On Incarcerated Transgender Adults In California, Julliana Lex Alcala, Allyza Rae Roxas

Electronic Theses, Projects, and Dissertations

Incarcerated transgender and gender-diverse (TGD) individuals experience disproportionately high rates of suicide risk, and correctional environments may intensify minority stress through institutional misrecognition, discrimination, victimization, and restricted access to gender-affirming care. Despite protective policy reforms such as Senate Bill 132, limited research have examined how structural practices shape suicidal ideation among incarcerated TGD populations. This study will investigate how denial of gender-affirming recognition and staff support contributes to suicidal ideation among incarcerated TGD adults in California state prisons. From the perspective of the Gender Minority Stress framework, this study will use a convergent mixed-methods design to examine both statistical relationships …

Impact Of Social Worker Bias On African American Fathers With Open Children Family Services Cases, Jenna Espinosa, Cecil Perry, Jasmine Alvarado, Jennifer Garcia, Lacrietia Grate-Dixson

Electronic Theses, Projects, and Dissertations

Systemic barriers and biases within institutions and policies affect how African American fathers engage with Children and Family Services (CFS). According to research, social worker bias, whether overt or covert, can influence case decision-making, affecting fathers' access to resources and overall involvement in their children’s lives. This study aims to quantitatively assess the impact of social worker bias on African American fathers' engagement by evaluating service completion rates at the .21e hearing. A quantitative research design will be utilized by implementing a validated survey to measure social worker bias and case file reviews to assess service completion. Statistical analyses, including …

Eating Patterns Among College Athletes, Sarah Sanchez

Electronic Theses, Projects, and Dissertations

The purpose of this cross-sectional study was to examine eating patterns among college athletes attending a minority-serving, urban institution where commuting is highly prevalent to assess potential risks of disordered eating, nutrient deficiencies, and food insecurity. A total of 189 students [M age (SD) = 20.29 + 1.46 years] from a mid-sized university in the U.S. responded to an anonymous online survey. The survey consisted of questions regarding food security, hydration/beverage status, demographics, disordered eating attitudes and behaviors, and food consumption patterns. Findings indicated a low prevalence of severe disordered eating behaviors within this sample. However, attitudes about disordered eating …

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

Electronic Theses, Projects, and Dissertations

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

The Development And Evaluation Of A Group Therapy Program For Perinatal Loss In Rural Appalachia, Hope O'Neill

Electronic Theses and Dissertations

Perinatal loss can have vast adverse psychological consequences and has limited psychotherapeutic options to assist with those outcomes. Currently, there is no gold standard psychotherapy for the treatment of perinatal grief. Group therapy has proven to be an effective modality for various populations and has been shown to be beneficial for perinatal loss and the subsequent psychological outcomes. This study utilized a previously conducted systematic review to develop and evaluate a group psychotherapy for perinatal loss. The ten sessions of the group were completed by two participants and several constructs were explored pre- and post-intervention: grief, depression, anxiety, post-traumatic stress, …

“Better Late Than Never” – Exploring The Challenges And Triumphs From Late-Diagnosed Autistic Women, Angela C. Altomare

Electronic Theses and Dissertations

The diagnostic process for adult autistic women is a transformative experience that reshapes identity, their histories, and self-understandings. This study examines the impact of a late-in-life autism diagnoses on women through the examination of narratives from the Reddit community r/AutismInWomen, and autoethnography.

Drawing on personal experience as a late-diagnosed autistic researcher, and the shared stories within r/AutismInWomen, the research demonstrates the challenges experienced, such as navigating stigma, negotiating identity, and seeking support.

The research reveals that online platforms serve as critical spaces for stigma negotiation, identity validation, self-advocacy, and community building among autistic women. Furthermore, these narratives underscore …

On The Paleontology Of Belize, Alson Ovando

Electronic Theses and Dissertations

Paleontology can be considered an underrepresented and emerging area of science in Belize. A primary aim of this thesis is to provide a background of paleontology in Belize and present the first comprehensive study of Quaternary vertebrate fossils known from the country. Quaternary fossil sites across Belize include caves, rivers, and sinkholes. In addition to reviewing and assessing material from known sites, this thesis presents new information and discoveries that were made while investigating Belize’s Quaternary fossil record. This thesis also includes a geospatial model depicting ecoregions in Belize during the last glacial maximum. Overall, the results presented here demonstrate …

Academic Self-Efficacy Of Black, White, And Hispanic Students Pursuing Professional Education Degrees And Licensure At An Hbcu In Midwest Ohio, Nathan Boles

Electronic Theses and Dissertations

The purpose of this comparative quantitative study was to determine, using three self-efficacy scales, General Self-Efficacy (GSE), Academic Self-Efficacy (ASE), and Educational Self-Efficacy (ESE), the differences in academic and educational self-efficacy among Black, White, and Hispanic students seeking a Professional Education degree and licensure at a Historically Black College and University in Midwest Ohio. Pre-service students’ self-efficacy and goal commitment can affect their likelihood of graduating with a license and may directly affect the number of novice teachers of color in the classroom. The literature examines factors that disrupt students’ self-efficacy, academic confidence, and persistence through the theoretical frameworks of …

Stochastic Universal Differential Equations For Epidemiological Modeling: Uncertainty Quantification In Disease Transmission Dynamics, Alice Menaya Armah-Bonney

Electronic Theses and Dissertations

Epidemic forecasting requires not only predictions of expected case counts, but also quantification of uncertainty, although existing surrogate modeling frameworks for agent-based models remain fundamentally deterministic. In this thesis a Stochastic Universal Differential Equation framework is presented that extends the deterministic Universal Differential Equation approach by incorporating a learnable stochastic diffusion term, enabling calibrated probabilistic forecasts while preserving the mechanistic interpretability and computational efficiency of the deterministic baseline. In doing so, a two-phase training algorithm is introduced to ensure stable convergence and the framework is validated against the ensemble output from ExaEpi, an exascale agent-based model of a COVID-19 outbreak …

Leaving College In Rural Central Appalachia: A Hermeneutic Phenomenological Study Of Lived Experience And Meaning-Making, Amanda Sawyers

Electronic Theses and Dissertations

This hermeneutic phenomenological study explored how individuals raised primarily in rural Central Appalachian communities interpret and make meaning of their decision to engage in college departure prior to degree completion. The study examined college departure as a lived experience shaped by family obligations, cultural identity, and rural structural conditions. Ten semi-structured interviews were conducted with participants from West Virginia, Eastern Kentucky, Southwest Virginia, East Tennessee, and Western North Carolina who had enrolled in higher education but did not complete a degree. The main research question was: How do rural Central Appalachian residents interpret their college departure? Hermeneutic phenomenological thematic analysis …

On The Algebraicity Of The Tic-Tac-Toe Matroid And Homogeneous Mixed Bowtie Systems, Benjamin R. Allen

Electronic Theses and Dissertations

This thesis is presented in two parts. First, we explore whether the class of algebraic matroids is closed under duality, a decades-old open question. We consider the Tic-Tac-Toe matroid as a potential candidate to answer the open question. The Tic-Tac-Toe matroid is known to satisfy many of the necessary conditions for a matroid to be algebraic and has a non-algebraic dual.  Second, we focus on decompositions of the complete mixed graph into mixed bowties. A complete mixed graph has between every pair of vertices an undirected edge and antiparallel arcs. A mixed bowtie is a graph consisting of two 3-cycles …

Malnutrition And Frailty Risk Among Community Dwelling Older Adults In Northeast Tennessee, Shreeyesha Pradhan

Electronic Theses and Dissertations

Frailty and malnutrition are prevalent conditions among community-dwelling older adults, affecting approximately 10% and 25% of this population, respectively. Despite overlapping symptoms such as functional decline, their relationship remains underexplored in community dwelling older adults. This cross-sectional feasibility study examined the association between frailty and nutritional status among 47 older adults in the East Tennessee Tri-Cities area using the Fried’s Frailty Phenotype (FFP) and the Mini Nutritional Assessment-Long Form (MNA-LF®). Results indicated 13% were pre-frail, 24% were frail, 21% were at risk for malnutrition, and 2% were malnourished. Regression analyses revealed that self-perceived nutritional status (37.6%), daily meal frequency (29.0%), …

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

Electronic Theses and Dissertations

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

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

Methods: …

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

Electronic Theses and Dissertations

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

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

Electronic Theses and Dissertations

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

Extreme Precipitation Events And Population Exposure: Site Recommendations For The Future Tennessee Mesonet, Victoria G. Redlund

Electronic Theses and Dissertations

This study examines frequency of and population exposure to extreme rainfall events in Tennessee to guide the placement of future mesonet weather stations. Using 1991-2021 daily nClimGrid precipitation records, extreme events were defined as events of rainfall ≥50 mm. These events were collated on an annual scale and normalized alongside square-root-scaled population densities derived from Landscan to develop extreme rainfall vulnerability maps. Results highlight where extreme rainfall is most frequent relative to population densities in each county. The findings were compared with models of mesonet suitability and feasibility to determine how meteorological needs correlate with siting needs such as land …

Ontogeny And The Effects Of Perinatal Stress In The First Immature Skeleton Of Teleoceras Aepysoma (Perissodactyla, Rhinocerotidae), Joe Gajewski

Electronic Theses and Dissertations

Recovery of an immature fossil rhinoceros (Teleoceras aepysoma) skeleton (ETMNH 32999) from the Gray Fossil Site in Tennessee offers the first insights into the ontogeny of the species. ETMNH 32999 is interpreted to be a subadult male in an age class equivalent to ~17-20% of potential lifespan. Comparative analyses support the hypothesis that subadults of related taxa are typically ~91% of average adult size in most dimensions. However, certain cranial dimensions are substantially lower than expected in ETMNH 32999, averaging only ~74% of the average conspecific adult. Such departure from typical growth rates is suggested to be attributable …

Utilizing Physics Informed Neural Networks For Disrupted Signal Dynamics, Nicholas J. Joyner

Electronic Theses and Dissertations

Physics-informed neural networks (PINNs) have been used in many applications including engineering and physical sciences. PINNs allow the incorporation of a priori understanding of a process’ structure into the modeling. We attempt to leverage the PINN structure toward the evaluation of disruptions to classical dynamical models by combining elements of ordinary differential equations into our loss function with sigmoidal gating to balance the penalties for deviations from the data with those for structural deviations. This enables the identification of the signal structure and the limits of disruption influence. As a use case, we consider stock value from 2019-2021, which expresses …

The Influence Of Intervention Strategies On Students With Disabilities Who Exhibit Challenging Behaviors In Rural Public Schools: Teacher Perceptions, Ben B. Robertson

Electronic Theses and Dissertations

This phenomenological qualitative study addressed rural teachers' perceptions of the influence of intervention strategies on students with disabilities who exhibit challenging behaviors. The purpose of this study was to examine teachers’ perceptions of the effect of intervention strategies on academic achievement, student behavior outcomes, and teacher self-efficacy through the lens of Bandura’s Social Cognitive Theory. This theory is a complex, dynamic interaction among people, their behaviors, and their environments. Data collection included 14 individual interviews, conducted on Zoom with educators from one school district in Southern Virginia, including seven general education teachers and seven special education teachers. Data analysis strategies …