Medicine and Health Sciences Commons^™

Social Determinants Of Health, Telehealth, And Hiv/Aids: Implications For Public Health Research And Practice In The State Of Virginia, Sonal S. Sathe, Adati Tarfa

Virginia Journal of Public Health

Purpose: The purpose of this commentary is to assert the importance of addressing the social determinants of health to support HIV/AIDS control efforts, to describe the importance of telehealth in HIV/AIDS control, and to recommend courses of action to support HIV/AIDS control efforts within the state of Virginia.

Discussion: We provide an overview of the social determinants of health and their role in HIV/AIDS control, telehealth and its uptake within the HIV/AIDS community, and issues in Virginia facing HIV/AIDS control.

Conclusion and Recommendations: We conclude that addressing social determinants of health, especially stigma, is an important measure of HIV/AIDS control …

Integrating Stakeholder Feedback Into The Design Of A Peer-Delivered Primary Care Wellness Program: A Rapid Qualitative Study, Emily M. Johnson, Kyle Possemato, Matthew Chinman, Gala True, Jacob Hedges, Brittany N. Hampton, E. Jennifer Edelman, Stephen A. Maisto

School of Medicine Faculty Publications

Background: Individuals seen in Primary Care with behavioral health concerns who decline behavioral health treatment may benefit from the support of peers (consumers in recovery from behavioral health concerns employed to support other consumers). Whole Health STEPS is a new intervention for Veterans in Primary Care with behavioral health concerns which combines essential elements of peers’ role and the Whole Health model using a stepped-care design. We incorporated stakeholder feedback in the Whole Health STEPS design to improve fit with Veterans, peers, and primary care settings. Methods: We conducted semi-structured qualitative interviews with VA staff using questions derived from the …

Assessment Revision Of ‘Perceptions Of Disabled Veterans In The Civilian Workforce’, Rebecca L. Reed

Pacific Journal of Health

As there continues to be limited research related to perceptions of disability status in the workforce, specific to the veteran population, the importance of employer understanding as well as willingness to provide accommodations is necessary to help promote change. This study carefully reviewed the assessment tool used by Reed (2016) to measure perceptions towards hiring disabled veterans as they enter the civilian workforce. To help support validity and/or reliability of the tool previously used, two professional experts were interviewed to provide feedback on the data tool in support of revisions. The vignettes, job attainment questionnaire, and demographics questionnaire were revised …

Moral Injury, Identity Dissonance, And Reintegration: A Compendium Of Reintegration And Survey Of United States Military Veterans, Thomas Hodges

Doctor of International Conflict Management Dissertations

How do military moral injuries affect reintegration? All service members leave the military eventually, but reintegration can be challenging, bringing changes in career, family life, and friendships, potentially prompting a loss of purpose, drive, and connection. Service members may also struggle with a crisis of identity upon separating from the military, feeling their military identity is incompatible with civilian life. While these difficulties are common for service members in reintegration, they may be worsened by moral injury, the adverse biological, social, psychological, and spiritual effects of experiencing an event that deeply offends a person’s sense of right and wrong. People …

Group Art Therapy With Resilience-Based Cognitive Behavior Therapy For Female North Korean Defectors In The United States, Yuri Kim

Expressive Therapies Dissertations

This study engages in phenomenological qualitative research, focusing on three North Korean defectors residing in the United States. The research comprised six sessions, each lasting ninety minutes. These sessions involved the active participation of the subjects in six face-to-face group art therapy (AT) sessions, adhering to the six guidelines outlined in the Amita Treatment Framework (ATF). These sessions encompassed the following components: 1) analyzing self-image; 2) finding positive qualities; 3) identifying challenges; 4) behaviors driven by emotions in challenging situations; 5) reframing challenges; and 6) reconstructing self-image and goal setting.

Results from the study revealed phenomenological insights into the participants' …

Associations Between Internalization Of The Model Minority Myth And Burnout Among Asian College Students, Tu Truong

Honors Theses

Background. Burnout has become increasingly prevalent among college students in recent years. A potential risk factor for burnout among Asian and Asian American college students is internalization of the Model Minority Myth, for it may cause psychological distress within Asians. This study has two aims: 1) to examine the association between internalization of the Model Minority Myth (i.e., achievement orientation, unrestricted mobility) and burnout (i.e., exhaustion, cynicism, and efficacy) among Asian college students; and 2) to assess whether the association between internalization of the Model Minority Myth and burnout among Asian college students differs by international student status.

Methods. A …

The Effects Of Cigarette Price Incentive And Regulatory Policies In Taiwan, Che-Ning Yang, Yi-Fan Lin

Journal of Health Research

Background: Price affects the demand for cigarettes, but its direct impact on smoking behaviors remains unclear. This study evaluated the effects of cigarette price increases and non-pricing tobacco control policies on adult smoking behaviors in Taiwan, using data from national annual survey during 2004~2015 with 166,325 valid respondents.

Methods: We established mixed-effects models of logistic regression for each of the three dependent variables, “smoking,” “quit attempts,” and “cessation maintenance,” to characterize smoking behaviors. Socioeconomic and sociodemographic factors were also included in the models.

Results: Non-pricing tobacco control policies had no significant effects on smoking behaviors. Conversely, cigarette price …

Anxiety And Depression In Palliative Care Cancer Patients In Vietnam: Baseline Data From A Randomized Controlled Trial Of Multidisciplinary Palliative Care Versus Standard Care, Quynh Xuan Nguyen Truong, The Ngoc Ha Than, Duong Le Dai, Khoa Duy Duong Duong, Bumi Herman, Surasak Taneepanichskul

Journal of Health Research

Background: Understanding anxiety and depression is important to managing cancer patients’ distress in palliative care and improving their quality of life. We aim to describe depression and anxiety rates among cancer patients referred to palliative care and identity factors associated with these symptoms.

Method: We analyzed the baseline data from an experimental study of comprehensive palliative care in Vietnam. This study included patients with stage 3 or 4 cancer diseases, during their first hospitalization for an inpatient palliative care service. A cut-off of above 8 points for each subscale on the Hospital Anxiety and Depression Scale was used …

Overcoming Foreign Language Speaking Anxiety: Practical Approaches In The Classroom, Sarah Day

Honors Projects

Foreign language speaking anxiety is a prevalent issue impacting language learners' confidence, participation, and overall language acquisition. With personal experiences as a language learner, a Spanish teacher in the United States, and an English teacher in Spain, I have observed how foreign language speaking anxiety affects learners from various demographics. Using a combined approach of personal observations, experiences as a language learner and teacher, and secondary research this project aims to address the primary sources of foreign language speaking anxiety among high school students and how both students and teachers can work to lessen the negative effects of foreign language …

Trends In Ductus Arteriosus Stent Versus Blalock-Taussig-Thomas Shunt Use And Comparison Of Cost, Length Of Stay, And Short-Term Outcomes In Neonates With Ductal-Dependent Pulmonary Blood Flow: An Observational Study Using The Pediatric Health Information Systems Database, Bethan A Lemley, Lezhou Wu, Amy L Roberts, Russell T Shinohara, William O Quarshie, Athar M Qureshi, Christopher L Smith, Yoav Dori, Matthew J Gillespie, Jonathan J Rome, Andrew C Glatz, Sandra Amaral, Michael L O'Byrne

Faculty, Staff and Students Publications

Background: The modified Blalock-Taussig-Thomas shunt is the gold standard palliation for securing pulmonary blood flow in infants with ductal-dependent pulmonary blood flow. Recently, the ductus arteriosus stent (DAS) has become a viable alternative.

Methods and results: This was a retrospective multicenter study of neonates ≤30 days undergoing DAS or Blalock-Taussig-Thomas shunt placement between January 1, 2017 and December 31, 2020 at hospitals reporting to the Pediatric Health Information Systems database. We performed generalized linear mixed-effects modeling to evaluate trends in intervention and intercenter variation, propensity score adjustment and inverse probability weighting with linear mixed-effects modeling to analyze length of stay …

Skills To Support Mental Health In Uncertain Times, Part 2: Cultivating Awareness, Heather H. Kelley, Rachel Byers, Ty Aller, Timothy Keady

All Current Publications

Uncertainty and worry can be a common struggle for many people, whether they are uncertain about their jobs, health, or relationships. Events such as COVID-19 and the recent wars in Israel and Ukraine increase the stress and uncertainty many people face. This fact sheet discusses awareness, a fundamental part of psychological flexibility, which can help individuals maintain a high quality of life—even when experiencing uncertainty and mental health concerns.

What We Know About School-Based Health Centers: Literature On Outcomes, Cost Impact, Implementation, And Sustainability, Michelle R. Coble, Valerie F. Mcdaniel

Pacific Journal of Health

Many children lack access to adequate healthcare in the United States. School Based Health Centers (SBHC) are a useful resource for accessing those needed services. The purpose of this study is to evaluate the available research for the strengths of SBHCs with improving health outcomes and health equity, cost impact of SBHCs, and best practices for implementing and sustaining an SBHC. The focus of this study was on reviewing the current literature on the impact of SBHCs on improving health equity, health outcomes, cost impact, and to establish best practices for implementing and sustaining an SBHC. Although the current literature …

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …

From Life To Life: Transitioning To Freedom After 45 Years Of Incarceration- A Single Subject Case Study, James O. Mackey, Lindsay Gietzen

Pacific Journal of Health

This case study delves into the complex process of reintegrating an elderly parolee who recently emerged from a 45-year-long incarceration within California's state prisons. The research explores this unique individual's reentry experiences and compares them with those of parolees of average age and sentence length. Factors such as family support, educational background, criminal history, health, social support, employment, access to age-appropriate resources, and recidivism rates are meticulously examined to provide valuable insights into the successful reintegration of elderly individuals back into society.

Perceptions Of Stress In Community Clinic Nurses During The Covid-19 Pandemic, Jomeka Smith

Dissertations

The COVID-19 pandemic is one of the largest healthcare crises that has affected the entire healthcare industry. Community health nurses in the front-line roles are greatly threatened by the COVID-19 pandemic that has decimated healthcare systems. The well-being of nurses is vital to perform their full potential of adequate patient care. Increased demands and pandemic related stressors can increase the risk of mental health problems. Nurses work in a variety of healthcare settings, however, the expectations, the fear of the unknown, and changes in demands have largely contributed to the unprecedented stressors that accompany nurses in clinical settings. Stress among …

Social Media & Mental Health: An Examination Of Tiktok & Mental Health Outcomes, Jessica Maddox

Masters Theses & Specialist Projects

The goal of this research study was to examine the relationship between amount of Tiktok use and the results of various mental health scales. The hypothesis was that increased Tiktok use would be correlated with a decrease in self-esteem, and an increase in depressive symptoms, anxiety symptoms, and overall loneliness. Participants were recruited on Amazon Mechanical Turk (MTurk) and paid a small monetary benefit in exchange for completion of the study. There were a total of 285 participants. Correlations and linear regression analysis were used to determine statistical significance; results showed no statistical significance and none of the hypotheses were …

Western Maine Addiction And Recovery Initiative's Substance Misuse Prevention And Wellness Day: Year 2 Feedback Survey For Mvhs, Tyler Egeland Ba, Evelyn Ali Bs, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

As part of the evaluation of the Western Maine Addiction Recovery Initiative’s (WMARI) HRSA Rural Communities Opioid Response Program grant, staff from the Catherine Cutler Institute’s Substance Use Research and Evaluation team developed a survey to gather feedback from individuals who participate in substance misuse prevention and wellness events. Two separate PRE/POST surveys were deployed at Mountain Valley High School to assess knowledge gain, beliefs, and satisfaction. For more information, please contact Lindsey Smith at [email protected]

Encouraging Medication Compliance By Implementing A Medication Adherence Tool, Regina Taylor

Doctoral Projects

Medication non-adherence has been a common and challenging problem in health care, especially among mental health patients. Studies show medication compliance among psychiatric patients has been at a lower rate than patients with physical conditions. Non-compliance with medications has been one of the considerable contributions to rapid psychiatric hospital readmission. Rapid readmissions have been costing health care billions of dollars annually. The stigma behind mental health has a large contribution to why mental health patients are non-compliant with their psychotropics. Utilization of the Medication Adherence Rating Scale (MARS) on a patient to evaluate the patient's willingness and ability to take …

Planners Vs. Non-Planners: Do Preterm Births Impact Future Contraceptive Use?, Jessie Moore

NYMC Student Theses and Dissertations

Background: In the United States, 45% of all pregnancies are unintended and occur when contraception is not used or is used inconsistently. Among those pregnancies, 1 in 10 women will experience a preterm birth, which is defined as a birth occurring before 37 weeks gestation. Women who have delivered preterm are at an increased risk for preterm birth in future pregnancies and are encouraged to wait at least 18 months between giving birth and getting pregnant again. Among women who have experienced a preterm birth, the desire to delay future pregnancy or avoiding it all together often becomes a necessity …

Western Maine Recovery Rally Feedback Survey, Evelyn Ali Bs, Tyler Egeland Ba, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The 7th Annual Western Maine Recovery Rally was hosted on September 17th, 2023 from 11am to 3pm in downtown Norway, Maine; several hundred people attended the event. The local evaluation team developed a survey with the goal of understanding how participants felt about the rally and how future events could be improved. The survey was deployed via QR code on paper materials distributed at the rally, and through social media after the event. For more information, please contact Lindsey Smith at [email protected]

Implementing A Systematic Depression Screening In The Primary Care Setting, Cassandra Moore

Doctoral Projects

The Advanced Practice Nurse is responsible for providing quality care and treatment for the whole person. 3 John 1:2 KJV states, “I wish above all things that you may prosper and be in health, even as your soul prospers” (King James Bible, 2023, para. 2). To prosper and be in health refers to a holistic approach in which the mind, body, and spirit of an individual is considered. Mental health care is an integral part of the holistic health approach.

Mental illness affects approximately one in five adults (52.9 million) in the United States alone (National Institute of Mental Health …

Anxiety Screening At A Psychiatric Inpatient Facility: A Quality Improvement Project, Irene Akwitti

Doctor of Nursing Practice

Background. Generalized anxiety disorder is characterized by persistent anxiety and uncontrollable worry occurring more days than not for a minimum of 6 months (Patriquin & Mathew, 2017). Presently, anxiety screening and evidence-based practice treatment for adults are suboptimal. It is impossible to overemphasize the importance of early diagnosis and prompt treatment of generalized anxiety disorder in patients. Purpose. The purpose of this quality improvement project was to implement the Generalized Anxiety Disorder-7 (GAD-7) screening tool, a validated, evidence-based instrument, in a psychiatric inpatient facility to improve early detection and treatment of anxiety disorders in patients. Methods. Staff members were educated …

Prevalence Of Substance Use Among Lesbian, Gay, And Bisexual High School Students In 2019 Vs. 2021, Jordyn Lee, Elisabeth Hayes, Adam Wyatt

Nursing & Health Sciences Research Journal

Background: Studies suggest that LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, plus) youth are at increased risk of engaging in alcohol and substance use. The COVID-19 pandemic forced many students to isolate in 2020 and 2021, and the impacts of this have been purported to be detrimental. This study examines the prevalence of alcohol and substance use among lesbian, gay, and bisexual (LGB) U.S. high school students before the pandemic in 2019 versus 2021. Methods: This cross-sectional descriptive study used results from the 2019 Youth Risk Behavior Survey (YRBS) and the 2021 Adolescent Behavior and Experiences Survey (ABES). The 2019 YRBS …

Early Emergency Department Experience With 7-Day Extended-Release Injectable Buprenorphine For Opioid Use Disorder., Gail D'Onofrio, Jeanmarie Perrone, Kathryn F. Hawk, Ethan Cowan, Ryan Mccormack, Edouard Coupet, Patricia H. Owens, Shara H. Martel, Kristen Huntley, Sharon L. Walsh, Michelle R. Lofwall, Andrew Herring, The Ed-Innovation Investigators

Center on Drug and Alcohol Research Faculty Publications

As the opioid overdose epidemic escalates, there is an urgent need for treatment innovations to address both patient and clinician barriers when initiating buprenorphine in the emergency department (ED). These include insurance status, logistical challenges such as the ability to fill a prescription and transportation, concerns regarding diversion, and availability of urgent referral sites. Extended-release buprenorphine (XR-BUP) preparations such as a new 7-day injectable could potentially solve some of these issues. We describe the pharmacokinetics of a new 7-day XR-BUP formulation and the feasibility of its use in the ED setting. We report our early experiences with this medication (investigational …

What Role Do Parents And Acculturation Play In Chinese Female International High School Students’ Mental Health?, You Wu

Doctoral Dissertations

This study examines the challenges and mental health issues faced by Chinese female international students in private Catholic female high schools in the U.S. It explores three main areas: the types of acculturation challenges students face, the impact of these challenges on their mental health, and the role of parental communication in shaping students' and parents' perceptions of acculturation and mental health. Using qualitative methods, the research involved interviews with nine students and five parents from a girls' Catholic high school in California. Data were collected via narrative-inspired Zoom interviews, and analyzed using phenomenological principles, focusing on understanding the lived …

Protocol For Intervention Development To Improve Adolescent Perinatal Mental Health In Kenya And Mozambique: The Inspire Project, Kethakie Lamahewa, Sally Griffin, Nadine Seward, Marleen Temmerman, Jonathan West, Málica De Melo, Elizabeth Raby, Aline Alonso, Bethan Burnside, Fernando Chissale

Obstetrics and Gynaecology, East Africa

Introduction: Mental health interventions have traditionally been developed by clinicians and researchers without the meaningful engagement and partnership with those who would receive, deliver, and fund them. Recent progress has highlighted the importance of the co-design of interventions, through stakeholder participation, as a means of increasing the integration of mental health interventions into existing health, education, and social care systems. This protocol describes the pre-implementation phase of the INSPIRE (Innovative approaches to adolescent perinatal wellbeing) project which aims to identify challenges, and design and test interventions to promote mental wellbeing and good mental health of adolescent girls during pregnancy and …

An Analogue Study Of Expected Working Alliance And Hope With Victims Of Military Sexual Trauma Among Civilian And Military-Oriented Therapists, Alishia D. Salyer

Dissertations

Victims of military sexual trauma (MST) face unique challenges as they pursue mental health treatment and supportive care. Understanding what factors impact potential treatment outcomes is critical in aiding in their recovery (Castro et al., 2015; Kroviak, 2020). Although a substantial amount of research has been conducted to evaluate prevalence and client factors associated with treating victims of MST (Teit et al., 2015; Turchik & Wilson, 2010), little is known about therapists’ factors including therapists’ expectations working with such clients. The purpose of this study was to examine the relationships between therapist type (military-affiliated versus civilian), therapist gender, client gender, …

Unmasking And Addressing Burnout In The Mental Health Profession, Sara Edwards

University Honors Theses

Burnout poses a significant challenge among mental health workers, impacting both the well-being of practitioners and the outcomes for their patients. The key inquiries guiding this literature review are: what factors contribute to burnout, and what interventions are essential for treating and preventing burnout in mental health professionals? The findings reveal that factors such as level of experience, lack of quality supervision, vicarious trauma, working conditions, and personal beliefs significantly contribute to burnout. Effective prevention and treatment measures for mental health workers vulnerable to burnout encompass self-monitoring, participation in support groups, additional training, and organizational interventions. These insights could serve …

Design Guidelines For Homeless Shelter And Resource Center Site Plans, Samuel Johnson

All Graduate Reports and Creative Projects, Fall 2023 to Present

Homelessness is one of the most pressing humanitarian issues facing the country today. Lack of affordable housing, among many other complicating factors, have led to many cities scrambling to find both short-, middle-, and long-term solutions to the issue. The Covid-19 pandemic added a disruption in services, critical record-keeping, and data-gathering, which has further confounded experts looking for an effective path forward. As it stands, there is a significant gap in academic research addressing best practices for shelter site design, particularly as it relates to landscape. The role of landscape and greenspace within and around a shelter is not well …

Barriers In Immigrant Mental Healthcare: Women, Children And Fathers, Alisa Pickett

Honors Theses

The American Psychological Association has identified immigrant families as a vulnerable population, whose access to mental healthcare is impacted by numerous barriers (DeAngelis, 2023). Within these communities there is a need for mental health resources, but due to the many barriers these communities face they are often left without care. In this literature review, I will identify the mental health needs, and the barriers that each member of the family (e.g., mothers, children, and fathers) uniquely faces. The discussion will review how these barriers are currently being addressed, specifically looking at changes within practices, use of logotherapy, and changing the …