Digital Commons Network^™

A Multilevel Analysis Of Hiv Care Outcomes Across Age, Race, And Housing Among United States Women Veterans, Giselle Day, Amber B Amspoker, Alan Z Sheinfil, Liang Chen, Emmanuel Guajardo, Maria E Fernandez, Cici Bauer, Irene Tamí-Maury, Jan Lindsay

Faculty, Staff and Students Publications

Background: Women veterans with HIV represent a growing, diverse population within the Veterans Health Administration (VHA). This study examined HIV care continuum outcomes among women veterans using a multilevel intersectional approach.

Methods: We conducted a retrospective analysis of 1154 women veterans with HIV in VHA care in fiscal year 2022, with outcomes assessed in fiscal year 2023. We applied Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to evaluate how combinations of social positions (age, race/ethnicity, housing status) were associated with HIV outcomes.

Results: MAIHDA models showed that younger age (< 45 years) and being unhoused were consistently associated with lower odds of care engagement and viral suppression than midlife (45-64) and older (65+) housed women veterans. Additionally, predicted probability analyses revealed distinct clustering patterns. Younger non-Hispanic White women consistently ranked among the lowest performing strata across all outcomes, while midlife and older Hispanic and non-Hispanic Black women veterans clustered among the highest. Variance Partition Coefficients from null models were modest (1.8-3.0%). Fully adjusted models showed no remaining between-stratum variance, suggesting that the included social positions explained the observed differences in our dataset.

Conclusions: These findings highlight disparities in HIV care …

Quality Improvement Project: Implementation Of The Patient Health Questionnaire-9 Modified For Teens, Hedy Gerber, Leah Buchko, Jennifer Van Winkle

All Faculty and Staff Scholarship

Background: Adolescent depression is a prevalent and significant public health concern, strongly linked to increased suicidality, poor health outcomes, impaired psychosocial functioning, and substantial societal costs. Although measurement‑based care using validated screening instruments is recommended by clinical practice guidelines, routine use of standardized depression screening tools remains limited in mental health settings.

Objective: The purpose of this quality improvement project was to assess the impact of implementing the Patient Health Questionnaire-9 modified for teens (PHQ-9M) in depression screening rates among adolescents aged 11-17 years at an outpatient mental health clinic in Southern Colorado.

Methods: A quantitative, quasi‑experimental pre- and post-intervention …

Decarbonizing Electrical Substations: An Integrative Review Of Green Technologies And Sustainable Practices Across The Infrastructure Life Cycle, Sulthan Syah Ali, Mohammed Ali Berawi, Mustika Sari

Smart City

Decarbonization of electrical infrastructure s becoming increasingly important in efforts to meet climate change mitigation targets, particularly in reducing emissions from substations. However, conventional substations continue to release significant quantities of GHG emissions throughout their life cycle As an example, a typical 500 kV substation emits around 150,000 tCO2e from construction to decommissioning. In addition, the development of green substation concepts remains limited, particularly in Indonesia where standardized approaches are not yet established. In response to the need for more sustainable power infrastructure, this study aims to identify, classify, and review all types of green technologies, practices, and innovations that …

Exploring Teachers' Perceptions Of The Influence Of Social Emotional Competencies On Virtual Students' Academic Success, Melanie Cheyanne Spence

Student Theses and Dissertations

The problem addressed in this study is that the effects of Social Emotional Learning (SEL) competencies on academic achievement for virtual learners in a Grades 5-8 classroom are not well known. The purpose of this qualitative narrative study was to explore teachers’ perceptions of how the practice of SEL competencies by students influence their academic success in a virtual Grades 5-8 classroom. This qualitative narrative inquiry was based around Social Emotional Learning (SEL), a conceptual framework identified by CASEL as including five competencies: self-awareness, self-management, social awareness, relationship skills, and responsible decision-making. The target audience was educational stakeholders who are …

Influences Of Transformational Leadership Mixed With Contemporary Practices Among High School Coaches: A Qualitative Exploratory Study, Kylene M. Brewton

Student Theses and Dissertations

This qualitative study examined factors influencing transformational leadership (TL) among high school coaches. Although previous research shows that TL improves athlete performance, emotional development, and team cohesion, little attention has been paid to how TL skills develop in secondary school sports, specifically to be used by coaching staff. Using Bass and Avolio’s four “I’s” framework—idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration—the study explored the impact of gender, coaching experience, sport coached, and mentorship on TL practices. Ten high school coaches from the mid-southern United States participated in three rounds of interviews using the Differentiated Transformational Leadership Inventory (DTLI). …

Understanding Educational Burnout: An Analysis Of The Perceptions Of K-5 Elementary Teachers, Melody Sebastian

Student Theses and Dissertations

Burnout in the educational environment is highly prevalent among teachers. Studies reveal that workplace burnout is characterized as chronic stress while on the job that persists over time. Although research has examined this issue, there remains a need for further studies focused specifically on elementary teachers’ perceptions and experiences with burnout. The purpose of this qualitative phenomenological study aimed to understand the perceptions of K-5 elementary classroom teachers’ experiences with burnout and how they informally built support systems to mitigate burnout. Maslach’s Multidimensional Theory of Burnout served as the theoretical framework for this study. The methodological approach utilized semi-structured, one-on-one …

Lived Experiences Of Competency-Based Grading: Implementation In The Secondary Public School Setting, Andrew Robbins Gillespie

Student Theses and Dissertations

The implementation of non-traditional grading systems is a current theme in American public school education. Competency-Based Grading (CBG) is a system that many school districts are considering. CBG is based on essential learning objectives and streamlines the grading of those objectives. CBG also removes high stakes assessment by allowing reassessment. However, studies have shown implementation efforts are often met with obstacles for either a lack of preparation or understanding. This dissertation seeks to understand the lived experiences of educational staff with the CBG implementation process through a phenomenological study. Data was gathered through interviews, observations, and document review. The themes …

The Influence Of Leadership Styles On Teacher Motivation And School Climate In Urban Schools From Three South-Central Region States, Jennifer L. Thomas

Student Theses and Dissertations

This phenomenological study explored how leadership styles influenced teacher motivation and school climate across three Southern South-Central region states. Through an analysis of 15 interviews, the research explored teachers' lived experiences and interactions with administrators that shaped their motivation, work efficacy, sense of value, and emotional well-being. Three states served as the data pool for the study: Arkansas, Texas, and Tennessee. Seven themes emerged related to motivation and school climate: Teacher Voice, Support, Empowerment, Relational Confidence, Feeling Valued, Emotional Safety, and Building Community. These themes illuminated how leadership behaviors can either strengthen or hinder teachers’ professional commitment, instructional effectiveness, and …

Impact Of Expanded Core Curriculum On College And Job Placement For The Blind And Visually Impaired, Susan Drake

Student Theses and Dissertations

Students who are blind or visually impaired face persistent barriers in postsecondary education and employment, despite access to academic instruction and legally mandated supports. Although academic accommodations are often provided, less is known about how instruction in nonacademic skill areas influences long-term outcomes. . This study addressed a critical gap by examining the perceived impact of Expanded Core Curriculum instruction on college readiness, employment attainment, and adult independence for blind or visually impaired high school graduates. The purpose of this qualitative study was to explore how former students described their access to, understanding of, and benefit from Expanded Core Curriculum …

Through Their Eyes: Understanding And Enhancing Retention Among Special Education Teachers Of Color, Barry L. Fargo

Student Theses and Dissertations

Retaining special education teachers of color within public schools remains an ongoing challenge. Although research on teacher retention has expanded in recent years, less attention has focused on how relational and organizational conditions shape the lived experiences of these teachers. Guided by the Four-Capital Theoretical Model of Teacher Retention, this qualitative phenomenological study explored how social and structural capital shaped the retention experiences of special education teachers of color. Participants included 15 special education teachers of color currently serving in K–12 roles in U.S. public schools with at least two years of special education teaching experience. Data were collected through …

Exploring The Barriers That Preclude Black Males From Pursuing Careers In Education, Marco Darnell French

Student Theses and Dissertations

The underrepresentation of African American males in the K–12 teaching workforce remains a critical issue with implications for educational equity, student outcomes, and workforce diversity. Despite ongoing efforts to diversify the profession, African American males continue to be disproportionately absent from classrooms, particularly in rural settings, limiting opportunities for culturally affirming instruction and mentorship. This study explored the barriers that preclude African American males from pursuing and persisting in careers in K–12 education within a rural Louisiana school district. Guided by Critical Race Theory, this qualitative revelatory single case study centered the lived experiences of African American males to examine …

Strategies And Practices For Improving Enrollment And Persistence By Native American Students In An Oklahoma Post-Secondary Education Institution, Mickey Jack

Student Theses and Dissertations

The historical oppression of Native Americans created a distrust in the educational system in American which was based on European models and designed for the advancement of white settlers. This historical oppression transcends generations and stills exists in our educational system. As a result, Native American students represent less than 1% of the student population in post-secondary education systems nation-wide. The purpose of this qualitative case study was to identify what strategies and practices were most effective for improving enrollment and persistence among Native American students in Oklahoma post-secondary education based on a transformative framework and TribalCrit. Three Native American …

Examining The Influence Of Job Demands And Resources On The Psychological Well-Being Of Arkansas Teachers, Amy C. Erstine

Student Theses and Dissertations

Teachers across the United States are experiencing declining psychological well-being due to increasing job demands and insufficient workplace resources. In Arkansas, this imbalance contributes to burnout, attrition, and persistent teacher shortages, affecting not only educators but also students, schools, and communities. Job resources are positively associated with well-being, whereas job demands are negatively associated with well-being. Understanding the job resources and demands influencing teacher well-being is critical to sustaining a stable and effective teaching workforce. The purpose of this non-experimental and predictive study was to examine the influence of job demands and resources on the psychological well-being of currently licensed …

Heritage As Performative Sovereignty: Situated Agency And Environmental (In)Equity In The Arkansas Delta, Faisal Mohammed

Student Theses and Dissertations

This dissertation focuses on the materiality of heritage as a proactive and strategic resource for ensuring survival and reshaping justice in rural places. Set in Phillips County, in the Arkansas Delta, a region where environmental neglect and economic marginalization are visibly apparent in the landscape, this research interrogates how a community responds to environmental crises in a contested landscape using locally driven, art-based initiatives. By centering the Water Story Project in Phillips County, funded by One Nation One Project, a national art-based initiative, I explore a ‘thin institutional ecology’ where the scarcity of regulatory oversight and intermediary civic support has …

The Impact Of Underrepresentation Of Male African American Teachers On African American Students’ (K-12) Classroom Learning, Carenzo George

Student Theses and Dissertations

The persistent underrepresentation of African American male educators in K–12 schools remains a significant concern in the field of education, particularly given the growing diversity of the student population. Despite increasing attention to teacher diversity, African American males continue to represent a small percentage of the teaching workforce. This disparity raises important questions about how representation influences the educational experiences of African American students. The purpose of this qualitative phenomenological study was to explore the perceptions of African American male teachers and administrators regarding the impact of the underrepresentation of African American male educators on African American students’ classroom experiences. …

Fear Of Negative Evaluation And Intrinsic Motivation In Resistance-Trained Individuals: A Comparison Of Novice And Experienced Lifters, Karter Bokker

Student Theses and Dissertations

This study examined the relationship between fear of negative evaluation (FNE) and intrinsic motivation in resistance-trained individuals and compared FNE levels between novice and experienced lifters. Twenty-two male participants (n = 8 novices, n = 14 experienced) completed questionnaires assessing FNE and intrinsic motivation. A Pearson correlation and independent-samples t-test were conducted. Results indicated no significant relationship between FNE and intrinsic motivation (r = -.144, p = .523). However, novice lifters reported significantly higher FNE scores than experienced lifters, (t20) = 2.71, p = .014, with a large effect size (d = 1.20). These findings suggest that while FNE may …

African American Genealogists And Family Historians: Perceptions, Motivations, And Learning Experiences, Vernita A. Morgan

Student Theses and Dissertations

In this qualitative phenomenological study, the motivations, learning experiences, challenges, and triumphs of African American genealogists and family historians will be revealed. The purpose of this study is to bridge the existing gap in the literature regarding the experiences of these individuals. The interconnectedness of self-directed learning and self-determination theory will demonstrate how these genealogists approach researching their ancestors, who were both enslaved and free people of color. Themes that arise from feedback from interviews will be used to offer answers to the research questions.

Perceptions Of Trauma-Informed Trained Campus Leadership, Shelly Hardin

Student Theses and Dissertations

The Centers for Disease Control and Prevention define adverse childhood experiences (ACEs) as potentially traumatic experiences that occur in a person’s life between birth and age 17. According to the Substance Abuse and Mental Health Services Administration (2024), more than two thirds of children experience at least one traumatic event by the age of 16, and this is likely an underestimate, as this percentage represents only those cases reported. The physical, emotional, and neurological impact of traumatic experiences can be detrimental to a child’s education, often contributing to learning deficits and behavioral issues. School leaders have the responsibility of creating …

The Efficacy Of Open Educational Resources On Achievement Outcomes In Higher Education Institutions, Charles Trevor Alder

Theses and Dissertations

Achievement gaps remain a concern in higher education, reflected in differences in academic performance, retention, and persistence. These gaps often affect students from lower socioeconomic backgrounds and underserved populations. Open educational resources (OER) have been suggested to reduce financial barriers and support student success. This study examined whether student-level and institutional-level factors predict academic performance in a business management course using OER. Average quiz scores were collected from students across 12 higher education institutions and analyzed using hierarchical linear modeling. Colleges were included in the analysis to determine whether outcomes differed based on the proportion of minority and Pell-eligible students. …

Leadership Strategies Healthcare Leaders Use To Improve Organizational Performance, Rushell Latoya Bryce

Walden Dissertations and Doctoral Studies

No abstract provided.

Teacher Retention: Do Job Satisfaction, Support From Administrators, Professional Development Opportunities, Student Behavior, And School Culture Directly Affect Whether A Teacher Decides To Stay At A School Or Leave?, Robert Dawson Parrott

Education Theses and Dissertations

Teacher retention has reached crisis levels nationwide, with nearly 50% of beginning teachers leaving within five years. Teacher attrition increased to 27.3% in 2022–2023 in a large suburban school district in North Texas. This translated to over $1.1 million dollars in teacher salary expenditures alone. This Dissertation in Practice utilized mixed-methods research grounded in Improvement Science and Plan-Do-Study-Act cycles to explore five campus-level contributors to teacher retention that fell under the control of building-level administrators: job satisfaction, administrative support, professional development, campus culture, and student behavior supports. In Phase 1 a teacher intent survey (n = 63) and focus group …

Across Borders, Across Cultures: A Quest For Health And Well-Being Portfolio, Carrington Connor

UN SDG Open Pedagogy Faculty Fellowship: Renewable Assignments

No abstract provided.

The Transitional Liver Clinic: Study Protocol For A Stepped-Wedge Cluster Randomized Trial, Lindsay Yoder, Elliot B. Tapper, Richard S. Kalman, Mary Rinella, Nicole Bendin, Manisha Verma, Francis Pike, Naga Chalasani, Neha Nalumasu, Eric S. Orman

Einstein Health Papers

BACKGROUND: Patients with complications of advanced liver disease experience high rates of hospital readmission after discharge. Transitional care models have improved outcomes in other chronic conditions, but their efficacy in liver disease care remains uncertain. This randomized trial evaluates the effectiveness of a tailored transitional care model-the Transitional Liver Clinic (TLC)-in reducing readmissions, improving quality of life, and enhancing patient satisfaction for patients with advanced liver disease.

METHODS: This is a 45-month, stepped-wedge cluster randomized trial enrolling up to 1000 patients with advanced liver disease across 4 academic medical centers. Each site transitions from usual care to the TLC intervention …

Research Networks As Social Infrastructure For Researcher Wellbeing And Inclusion In A Post-Merger Technological University, Shane Francis Conway Phd, James Britton Phd, Alan Naughton

Irish Journal of Academic Practice

As a recently established technological university, Atlantic Technological University continues to evolve its research structures across a distributed, multi-campus environment. As is common in post-merger contexts, there are opportunities to further strengthen cross-campus engagement, collegiality and inclusion. This paper presents a practice-based, research-informed analysis of Research Network formation at ATU, developed under the RISE@ATU programme. It demonstrates how such networks can serve as social infrastructure to support researcher wellbeing, connection and collaboration within a post-merger technological university, with particular relevance to other regionally distributed higher education institutions. The analysis is informed by institutional experience, including a university-wide researcher engagement campaign …

Assessing Rural Homelessness: A Mixed-Methods Case Study, Matthew J. Lyons

Faculty Articles

Rural homelessness represents a significant public health and human rights challenge, but research on homelessness in the United States has predominantly focused on urban settings. This case study describes a mixed-methods assessment of the prevalence, causes, and consequences of homelessness in a rural county. Through both surveys and interviews with stakeholders from multiple sectors (including both service providers and those experiencing homelessness), we built a rich picture of the scale and experiential dimensions of homelessness within the county. Here, we present our research methods, the main findings of each primary data collection arm, and the actionable conclusions drawn from the …

If It Doesn't Hurt You Aren't Working Hard Enough: An Examination Of Coach Experience In High School Debate, Rosie Valdez Block

Student Theses and Dissertations

High school debate coaching constitutes a uniquely demanding educational role, defined by emotional labor, extended work hours, institutional precarity, and systemic inequities. Despite their significant contributions to students’ intellectual and personal growth, the professional sustainability of debate coaches remains underexamined. This dissertation investigates the conditions contributing to burnout among high school debate coaches through the theoretical lenses of Maslach’s Burnout Theory, as contemporized by Edú-Valsania et al. (2022), and teacher self-efficacy theory, to understand how emotional exhaustion, depersonalization, and diminished professional confidence emerge in this context. The study is further guided by constructivist grounded theory (Charmaz, 2014), enabling a bottom-up, …

Quality Improvement Project: Impact Of Formalized Debriefing On Correctional Health Emergency Response, Angel Woody

Doctor of Nursing Practice Projects

Structured debriefing following medical emergencies has been identified as an evidence-based strategy to improve communication, reflective learning, and staff confidence within high-acuity healthcare settings. Inconsistent debriefing practices within correctional healthcare environments contributed to a gap in emergency response support and staff preparedness. The purpose of this quality improvement project was to evaluate whether implementation of a formalized debriefing protocol following medical emergencies impacted staff confidence during emergency response situations within a correctional healthcare setting. The project was guided by Bandura’s Self-Efficacy Theory and Lewin’s Change Theory. A quantitative one-group pretest-posttest quality improvement design was implemented in a county correctional healthcare …

A Portable Device To Elicit Sensory Trick And Monitor Forearm Muscle Activity In Pianists With Musician’S Dystonia, Josef Franczak

USF Tampa Graduate Theses and Dissertations

Musician’s Dystonia (MD) is a condition that can be acquired in professional musicians,causing involuntary contractions and the loss of fine motor control. The most common pharmaceutical treatment, botulinum toxin injections, has been shown to have side effects of muscle weakness and atrophy. The sensory trick, shown to temporarily relieve symptoms of dystonia, has potential to be used as an alternative or alongside current therapies, allowing patients with MD to return to playing music professionally. To systematically deploy the sensory trick and monitor forearm muscle activity, the first prototype of the Wearable Sensorimotor Integrator (wSMI) has been developed.

The wSMI is …

The Chemotherapy Use And Adverse Effects Of Patients With Lung Cancer At Regional General Hospital In Surabaya, Indonesia, Rika Yulia, Aguslina Kirtishanti, Heru Wijono, Eko Setiawan, Bobby Presley, Tjie Kok Go, Ni Putu Irma Mayani, Anna Febriani, Halim Priyahau Jaya, Fauna Herawati

Pharmaceutical Sciences and Research

In Indonesia, lung cancer is the leading cause of death related to cancer, according to Global Cancer Observatory. Chemotherapy is the most common treatment since it works systemically and can prevent cancer cells from spreading to other organs. Cytotoxicity of chemotherapy can also put patients at high risk of experiencing adverse effects. This study aimed to evaluate the congruity of chemotherapy use with treatment recommendations and the profile of adverse effects, not only acute but also delayed adverse drug reactions. This prospective observational study involved 41 adult patients with lung cancer who received chemotherapy. Data is collected through patients’ medical …

Exploring Hpv Vaccine Acceptance And Health Beliefs Among Arab American Parents In The United States: A Qualitative Study Using The Health Belief Model, Nada Alshahrani, Jesus Sanchez, Nancy Shehadeh

Posters

Abstract Background: Arab Americans are a rapidly growing ethnic minority in the United States, but their classification as ‚ÄúWhite‚Äù in federal health data renders them statistically invisible, creating a gap in understanding their preventive health beliefs. Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of cervical cancer and other cancers. Parental acceptance of the HPV vaccine is crucial for increasing vaccination among children and adolescents. The Health Belief Model (HBM) is commonly used to understand vaccine decision-making; however, its application to Arab American parents remains unexplored. Aim: This study aimed …