Medicine and Health Sciences Commons^™

Bringing Awareness And Education To Rural Areas About The Role Occupational Therapy (Ot) Has In Infant Care, Makenzi Richwald

Occupational Therapy Doctorate Capstone Posters

This capstone project focused on education and advocacy. The aim of my capstone project was to provide education to parents of eastern Kentucky (KY) about what Occupational Therapy (OT) can address with infants aged 0-18 months. I saw a gap in knowledge in the eastern KY community about what OT could do for infants and wanted to address this. Through my research, consultation with my mentors, and collaboration with the occupational therapists at my site (BPT) I discerned 14 areas of development and/or common reasons of needed referral for OT services by this age group. These educational materials aimed to …

The Restorative Effects Of Virtual Reality Nature Simulations: An Empirical Investigation, Isabel T. Folger, Yichen Zhang, Kenneth B. Abrams

Psychology Faculty Work

Although extensive research demonstrates that nature films can facilitate recovery from stress and cognitive overload, it remains unclear whether more immersive media, such as virtual reality (VR), are more effective than similar two-dimensional films. The present study examined the effects of immersiveness on affective, cognitive, and physiological restoration. Three levels of immersiveness for film viewing were employed: 2D (computer monitor), standard VR (visual and auditory input), and enhanced VR (standard VR plus olfactory and haptic input). All participants were exposed to parallel versions of a six-minute nature film. We hypothesized that greater immersiveness would produce stronger restorative effects. All versions …

Cocaine Upregulates Microglial Lipid Droplet Formation Through Increasing Lipid Synthesis Activity In Vitro And In Vivo, Yan Cheng, Brooke Russell, Liam Liyang Guo, Aryan Patel, Yan Y. Sanders, Ming-Lei Guo

Department of Biomedical and Translational Sciences Faculty Publications

A novel subtype of microglia, lipid droplet accumulation microglia (LDAMs), has been identified in the aged brain, which is characterized by sustained inflammation and senescent-like phenotypes. LDAMs are deeply involved in promoting brain aging as well as the pathogenesis of multiple neurodegenerative diseases. Cocaine can alter brain lipidomic profiles, induce microglial activation, and accelerate brain aging. This suggests that cocaine might affect microglial lipid metabolism, which ultimately aggravates aging-related neurological disorders in people with addictions. In this study, we explored the effects of cocaine on microglial lipid metabolism. Our results showed that chronic cocaine administration altered brain lipid profiles and …

Hepatitis C Virus Transmission Among People Who Inject Drugs In Rural United States: Mathematical Modeling Study Using Stochastic Agent-Based Network Simulation, Lin Zhu, Jennifer R. Havens, Abby E. Rudolph, April M. Young, Golnaz Eftekhari Yazdi, William W. Thompson, Liesl M. Hagan, Liisa M. Randall, Jianing Wang, Rebecca Earnest, Shayla Nolen, Benjamin P. Linas, Joshua A. Salomon

Center on Drug and Alcohol Research Faculty Publications

People who inject drugs (PWID) account for the majority of hepatitis C virus (HCV) infections in the United States. The injection-equipment-sharing network likely plays an important role in shaping the dynamics of HCV transmission. Recognizing the emerging HCV epidemic in rural communities, we developed an agent-based network simulation model of HCV transmission via injection equipment sharing and used data on rural PWID networks to inform model parameterization and calibration. We then simulated an array of networks that varied key network properties to understand their impact on the magnitude and distribution of HCV incidence. The results show substantial heterogeneity in HCV …

Alcohol Awareness, Prevention, And Education In Greek Life, Vivian J. Mcmechen, Kara Ann Lasater, Page Dobbs

2026 Honors Symposium

Background: Alcohol consumption is normalized in Greek Life culture, and this social standard can lead to risky health behaviors and overconsumption. At the University of Arkansas, approximately one-third of students are members of Greek Life; there is a need for prevention methods that understand students’ lived experiences. Purpose: The purpose of this study is to examine students’ experiences with alcohol prevention, awareness, and education as current members of Greek Life at the University of Arkansas. Through student interviews and surveys, this project aims to inform and provide recommendations for relatable and student-centered alcohol prevention and education efforts. Methodology: This study …

From Mandate To Meaning: Designing Implementation Supports For Organizational Readiness In Behavioral Health Service Planning, Lauren K. Mergen

Theses and Dissertations--Education Sciences

Behavioral health agencies often struggle to translate the Transformational Collaborative Outcomes Management (TCOM) framework into practice when implementation is externally mandated. This study examined how educational leaders can support meaningful use of TCOM tools under a Midwestern state’s October 2024 requirement that behavioral health providers use the state Child and Adolescent Needs and Strengths assessment in service planning.

Using a Mixed Methods Action Research design, the study progressed through six phases: Diagnosis, Reconnaissance, Planning, Acting, Evaluation, and Monitoring. The Diagnosis Phase identified a knowledge-to-practice gap and weaknesses in implementation support infrastructure. Practitioner surveys administered immediately after training and six months …

The Caregiving Experience: Comparing Stress And Quality Of Life Among Caregivers Of Children With And Without Autism Spectrum Disorder, Mona Khayal

Antioch University Dissertations & Theses

This comparative cross-sectional study investigated caregiving burden, quality of life, and anxiety among primary caregivers of children with autism spectrum disorder compared to caregivers of typically developing children. Using Bronfenbrenner’s Ecological Systems Theory, 66 caregivers (31 autism, 35 comparison) of children aged 6-18 completed the Zarit Burden Interview-12, WHO Quality of Life-BREF, and GAD-7. According to the results, autism caregivers reported substantially higher burden (M = 31.26 vs. 13.23, d = 2.42) and anxiety (M = 9.13 vs. 4.63, d = 1.04), with 90% exceeding clinical burden thresholds compared to 26% of comparison caregivers. Quality of life was lower across …

Understanding The Underutilization Of The Campus Recreation Facility: A Mixed-Methods Examination Of Basic Psychological Need Satisfaction, Social Physique Anxiety, Sense Of Community, And Physical Environment Barriers, Caden M. Pfingsten

Master's Theses or Doctor of Nursing Practice

Campus recreation facilities have been identified as important contributors to student well-being, academic persistence, and institutional belonging. Despite these documented benefits, a persistent gap exists between available services and actual student utilization at many institutions. This study examined the psychological, social, and environmental factors associated with students' underutilization of the Campus Recreation Facility (CRF) at a mid-sized Midwestern public university in favor of paid off-campus commercial gym memberships.

Using a cross-sectional survey design, 169 students completed a battery of validated and researcher-adapted instruments assessing basic psychological need satisfaction (autonomy, competence, and relatedness), Sense of Community, and social physique anxiety across …

“Medical Cannabis”: Advising Patients While Navigating Medical Ethics And Limited Evidence, Anna-Maria South, Shanna L. Babalonis, Laura C. Fanucchi, Michelle R. Lofwall

Internal Medicine Faculty Publications

Cannabis is increasingly legalized in more areas of the USA and marketed under the misnomer “medical cannabis.” Yet, there are no official dosing guidelines or approved medical uses for plant cannabis by the Food and Drug Administration. Due to significant federal barriers, research on efficacy, safety, and adverse effects of cannabis is limited. Patients are interested in cannabis as potential treatment of medical issues and/or symptoms and clinicians should include a discussion of the risks of cannabis consumption. However, many risks are not yet known, and clinicians might be unaware of the emerging literature. This perspective summarizes the potential harms …

Discrimination Distress And Current Combustible And Non-Combustible Tobacco Product Use Among Us Youth, 2023, Meman Diaby, Osayande Agbonlahor, Maggie K. Richardson, Joy L. Hart, Shyanika W. Rose, Delvon T. Mattingly

Markey Cancer Center Faculty Publications

Introduction: Discrimination is the unfair treatment of people based on their identity. Youth who experience discrimination may cope with associated distress by using tobacco products, with amplified health consequences depending on the type of product.

Methods: We used data from the 2023 National Youth Tobacco Survey (n = 22 069) and derived an overall continuous measure from the 15-item Adolescent Discrimination Distress Index, as well as three continuous discrimination distress sub-indices: educational, institutional, and peer (range for each: 0–5). We defined current tobacco use as two outcomes: any past 30-day use of combustible (cigarettes, cigars, hookah, roll- your-own, pipe, bidis) …

Psilocybin-Assisted Therapy And Alcohol Use Disorder, Zoe R. Evans

Theses, Dissertations and Capstones

This current paper has studied whether the psilocybin-assisted treatment has been linked with meaningful shifts in three clinical outcomes among adults 18 years old and above diagnosed with alcohol use disorder (AUD): percentage of heavy drinking days, abstinence rates, and neural responsiveness to alcohol-related cues. A literature review following a systematic approach was performed using guidelines from PRISMA 2020 based on four databases, namely PubMed and PsycINFO, and Scopus and CINAHL, where peer-reviewed articles published between 2015 and 2026 were included. A semi-structured professional interview with a clinical researcher in the Division of Addiction Sciences of Marshall University was also …

Effectiveness Of Post-Discharge Interventions Following Psychiatric Hospitalization On Readmissions And Suicide Prevention Among Adolescents, Maria Paz Eladia Posadas

Nursing | Senior Theses

Background: Suicide is a pervasive and far-reaching issue. Psychiatric hospitalization is often used as an intervention for individuals, including adolescents, experiencing suicidal ideation and/or behavior. However, post-discharge care may lack structure or clearly defined follow-up services, which can result in rehospitalizations and increased suicidality. Objective: The goal of the proposed research study is to investigate how implementation of peer support groups for adolescents following psychiatric hospitalization can assist in reducing readmissions and mitigating suicide risk. This can also help shape strategies for managing care after discharge. Method: The proposed research study utilizes a quantitative quasi-experimental design to determine the efficacy …

Precision In Practice: Subject Matter Expert Integration To Support Excellence In Population-Specific Documentation, Sara Pump, Mary Hawes, Lauren Spain, Virginia Kasenic, Meagan Talent, Alivia Stewart, Carrin Shaw, Chad Gautreaux, Dori Cousin, Ponesea Allen, Jonathan Rowe

2026

This poster describes a quality improvement initiative that integrated psychiatric resource nurses as subject matter experts (SMEs) into clinical documentation workflows to improve documentation compliance for high-risk behavioral health patients. The intervention resulted in substantial improvements in charting accuracy and compliance, including an increase in emergency department documentation compliance from 28% to 95% over seven months, while enhancing staff education, collaboration, and patient safety.

Chatbot Therapy - Help Or Hindrance, Kadi Rae Smith

Anthós

Introduction

Generative artificial intelligence (Gen-AI) chatbots are complex computer programs designed to mimic human conversations using programming that incorporates large language models (LLM) and natural language models (NLM) to simulate human interactions that are being rapidly integrated into everyday life across an increasing amount of online platforms. This article explores the applications and efficacy of chatbots for mental healthcare, from self-directed chatbot interactions to clinician-supervised implementation of chatbot-based therapeutic tools, weighing the benefits and limitations of this ever-expanding technology.

Methodology/Taxonomy

A literature review was conducted primarily using Web of Science, accessed through Portland State University, and Google Scholar, with specifications …

Art As Medicine: Exploring The Intersection Of African Cultural Practices And Art Therapy To Examine Its Efficacy In Pain Management And Healing Among Black Women With Lupus, Kandace I. Simmons

Art Therapy | Master's Theses

This thesis examined the intersection of chronic illness and systemic inequities faced by Black women living with lupus. These women often encountered unique challenges in managing their health and well-being, exacerbated by both the physical and sociocultural implications of the disease. Through a Black Feminist/Womanist theoretical lens, this research investigated the potential of art therapy to serve as a transformative instrument for pain management and healing when infused with culturally relevant practices. Employing a narrative approach and qualitative methodology, this study explored the lived experiences of African American women with lupus, incorporating their art and personal stories to inform the …

The Use Of Visual Autobiographies In First, Second, And Third-Generation Children Of Immigrants In Navigating Belonging And Identity, Sorprisela Martinez

Art Therapy | Master's Theses

This study explored how autobiographical artmaking supports adolescents of immigrant-origin in understanding identity and sense of belonging through visual and narrative reflection on personal stories. The qualitative research approach was guided by three research questions examining: (1) the ways autobiographical work expresses complexities of immigrant heritage and multiple identities; (2) how narrative lens supports a deeper interpretation of autobiographical expressions; and (3) how adolescents’ understanding of their parents’ migration stories contributes to their own identity formation and self-presentation. Seven adolescents participated in a two-session, arts-based process that included creating autobiographical books, discussion of their images, and reflection on their cultural …

Wise Beyond Our Years: Menopause, Negative Body-Image, And Art As A Catalyst To Self-Acceptance, Nicole Lea

Art Therapy | Master's Theses

This mixed methods study examined the impact of menopause on women’s body image and self-acceptance through an arts-based group intervention. Quantitative data was collected using the Body Image Self-Compassion Scale, and qualitative data was gathered through art-making, group discussion, and individual interviews. Participants were (n=5) menopausal women aged 46-52 from the Bay Area who reported negative body image related to menopause. The intervention consisted of four one-hour open studio workshops with a fifth meeting added in which participants created altered books while engaging in peer support and discussion. Descriptive statistics indicated an increase in mean body image self-compassion scores from …

The Impact Of Gastric Sleeve And Roux-En-Y Gastric Bypass On Chief Cell Function And Protein Digestion In Obese Patients, Garikoitz Mikel Gainza

Honors Undergraduate Theses

Obesity has become one of the largest global health concerns of the 21^st century, correlating with numerous associated diseases. To help address the growing prevalence and burden of obesity, sleeve gastrectomy and Roux-en-Y gastric bypass have become two commonly performed surgical procedures done to promote weight loss by altering the anatomical structure of the stomach and surrounding organs of the gastrointestinal system. Although the benefits of improved metabolism linked to these surgical procedures are well studied, their impact on the physiology of gastric cells, and more specifically chief cells as they relate to protein digestion post-surgery, is yet to …

Caregiver Training: Improving Social Determinants Of Health, Patient Safety, Empowerment Through Improving Elder Care Education And Skills, Kathleen Thimsen

Nursing Faculty Research

Caregiver training (CaGi TRaining) is a time-tested intervention aimed at improving safety in elders living and aging in place in the community. While elder abuse and maltreatment was the intial purpose of the project, with over 3500 Caregivers graduated from this program since 2009, the course has addresses social determinants of health, and improved workforce pipelines by providing stable employment, improved self-efficacy, and confidence demonstrated by self-reports at graduation and in follow up surveys. Previously learners without a high school diploma retruned to school to obtain a GED (40%), with an additional return to school for bacalaureate and degrees (27%) …

Hallucinogen Use Among Parents Of Children In The United States: Associations With Mental Health And Substance Use, Maggie K. Richardson

Theses and Dissertations--Educational, School, and Counseling Psychology

Hallucinogen use has reemerged in the United States amid expanding clinical research and shifting social and policy contexts. However, population-based evidence remains limited regarding hallucinogen use among adults living with children and its relationship with mental health impairment severity in caregiving environments. Therefore, this study’s objective was to examine associations between past-year hallucinogen use and past-year mental health impairment among U.S. adults, and to test whether associations differ by parental status and number of children in the household. A secondary aim examined correlates of co-occurring substance use among those reporting hallucinogen use.

Data were drawn from the 2023 National Survey …

Counselors' Lived Experiences Of Moral Injury: A Social Ecological Perspective, Lisa M. Belknap

Antioch University Dissertations & Theses

This study explores the lived experiences of counselors who encountered moral injury when sociopolitical, institutional, and organizational conditions constrained their ability to practice in alignment with their personal morals, professional values, and the counseling profession’s code of ethics. Participants (N = 15) included licensed counselors who self-identified as having experienced moral injury in response to directives from legitimate authorities that conflicted with professional ethics, social justice commitments, or client welfare. Grounded in social ecological systems theory, this phenomenological study employed a confidential, cross-sectional online survey. Reflexive thematic analysis identified seven themes: (a) Profit Over People, (b) Structural Forces Contributing to …

Bridging Worlds Of Care: A Qualitative Exploration Of Integrating Non-Western Healing Modalities With Mental Health Counseling, Douglas Valdez

Antioch University Dissertations & Theses

The aim of the study is to explore the experiences of practitioners who treat individuals presenting with depression and anxiety using culturally integrative non-Western healing modalities. Participants included 15 experienced practitioners (minimum five years of practice) who identified as Traditional Chinese Medicine providers (e.g., acupuncturists, herbalists) and/or Curandero/x/as. The approach was qualitative, utilizing open-ended survey responses collected electronically and analyzed with thematic analysis. Results indicated six primary themes: (a) Philosophies in Healing, highlighting culturally grounded conceptualizations of depression and anxiety; (b) Traditional Chinese Medicine Interventions, including acupuncture, botanical, nutritional, manual, and movement-based practices; (c) Curanderismo Pláticas and Integrative Western Healing …

"Why Don't I Talk To A Therapist?": Motivations And Reflections Of Female-Identifying Chinese Immigrants Seeking Psychotherapy For Depression, Qiuyi Wei

Antioch University Dissertations & Theses

This phenomenological study explored the lived experiences of Chinese immigrants and temporary residents struggling with depressive symptoms and their process of seeking and accepting psychotherapy support. The study aimed to describe the factors that motivated participants to enter therapy for depression while also addressing their internal concerns about treatment. Nine female-identified Chinese immigrant adults with such experiences were recruited. Participants’ perceptions of their depressive symptoms and the factors contributing to their decision to seek professional therapy were explored through in-depth, semi-structured qualitative interviews conducted in Mandarin. The interview transcripts were analyzed in Mandarin using interpretative phenomenological analysis, through which four …

Bi+ Cismale Experiences With Straight Cismale Friends, Taylor M. Hardock

Antioch University Dissertations & Theses

Minority Stress Theory (2006) posits that individuals with a marginalized sexual identity have unique challenges and stressors. Bisexual+, or bi+, individuals have particular stressors related to not holding a monosexual identity, including specific mental health challenges. Research has shown that friendship can have many positive benefits on individuals, though the literature looking at friendship among bi+ identifying people is very limited. This qualitative study investigates the experiences of friendship between bi+ and straight cis men, especially as they may relate to minority stress and experiences of resilience and community belongingness. A thematic analysis was utilized to understand the personal experiences …

Improving The Continuity Of Care For Opioid Use Disorder: Investigating Fentanyl Overdose Outcomes And Pharmacy-Level Buprenorphine Access, Lyn Yuen Choo

Graduate Theses, Dissertations, and Problem Reports (ETD)

Opioid overdose (OD) deaths remain a leading cause of injury-related death in the United States (US) and approximately 76,516 drug OD deaths were predicted in the past year prior to April 2025. While previous research has focused on fatal opioid ODs, less is known about outcomes following non-fatal opioid ODs (NFOO) involving fentanyl. Patients who experienced a fentanyl OD may develop significant morbidity and inpatient mortality due to fentanyl’s high potency, rapid onset of action, and decreased response to naloxone. Research efforts to improve continuity of care for opioid use disorder (OUD) are highly needed to ensure appropriate follow-up care …

Navigating Family, Culture, And Well-Being: A Qualitative Study Of First-Generation Adult Children Of Middle Eastern Immigrants In The United States, Ramona Amely

Antioch University Dissertations & Theses

The purpose of this study is to explore the lived experiences of first-generation adult children of Middle Eastern immigrant parents/caregivers living in the United States. This was a phenomenological study with reflexive thematic analysis. Participants (N=10) were interviewed via Zoom, and transcripts were analyzed using Reflexive Thematic Analysis (RTA). The results included four themes: (1) Migration Contact and Cultural Formation, (2) Bicultural Identity Development, (3) Family System Adaptation, and (4) Emotional Socialization and Psychological Impact. This study highlights how first-generation adult children of Middle Eastern immigrants navigate complex, interwoven processes of bicultural identity development, family adaptation, and emotional socialization shaped …

A Qualitative Exploration Of Counselor Traits And Wellness Practices, Emily Velidow

Antioch University Dissertations & Theses

This study is a qualitative thematic analysis of counselor wellness practices as well as how selfidentified personal traits are part of how a counselor practices and prioritizes wellness. Theoretical underpinnings of the study integrate trait activation theory (Tett & Burnett, 2003), Martin Seligman’s wellbeing theory (Seligman, 2011), and Urie Bronfenbrenner’s ecological systems theory (Bronfenbrenner, 1977). Participants included nineteen licensed counselors (N=19). Analyzed responses lead to four main themes, each with two to four subthemes. Resulting themes included (1) intentional caseload and workday structure, (2) deliberately emphasizing physical wellness, (3) setting boundaries attending to mental and emotional energy, and (4) the …

Emergency Department-Initiated Standard Versus High-Dose Buprenorphine Induction (Envision): A Randomised Clinical Trial Protocol, Kathryn Hawk, Andrew Herring, Marek Chawarski, Erik S. Anderson, Michael Baumann, Alyrene Dorey, August F. Holtyn, Christopher Jones, Shara Martel, Patricia Owens, Kaitlin Kmiecik, Tania D. Strout, Peter Taillac, Michelle R. Lofwall, Sharon L. Walsh, Gail D’Onofrio

Center on Drug and Alcohol Research Faculty Publications

Introduction: The initiation of buprenorphine for patients with opioid use disorder (OUD) in the emergency department (ED) has been associated with improved outcomes including reduced ED visits and increased treatment engagement. Though both standard-dose (8 mg buprenorphine equivalent) and high-dose (24 mg buprenorphine equivalent) strategies to initiate buprenorphine have been used in the ED, no prospective trials comparing outcomes among patients receiving these treatments have been reported.

Methods and analysis: This multisite randomised clinical trial is a multisite double-blind, double-dummy, randomised clinical trial enrolling 360 emergency department patients with moderate-to-severe OUD. Enrolled patients will be randomised to one of two …

Facebook As A Strategy To Deliver A Peer Navigation Intervention For Recently Incarcerated Women With Opioid Use Disorder: A Mixed Methods Descriptive Profile, Martha Tillson, Jaxin Annett, Marguerite A. Webster, Amanda Fallin-Bennett, Mandi Webster, Amber Clemons, Cynthia Robinson, Kevin Crabtree, Casey Baker-Romans, Michele Staton

Center on Drug and Alcohol Research Faculty Publications

Recovery support and treatment linkages are critical during transitions from incarceration to community but can be challenging to deliver to hard-to-reach populations. This paper will examine Facebook contacts between peer navigators (PNs) and women with opioid use disorder (OUD) following jail release to explore women’s use of PN services, including purpose and content of Facebook messages. As part of a larger clinical trial under the Justice Community Opioid Innovation Network (JCOIN), PNs provided OUD treatment navigation and recovery support for 12 weeks following women’s release from jail, using remote options such as Facebook. Facebook Messenger transcripts between PNs and participants …

Aging With Mercy, Thriving In Place, Emma Layne Katzman, Karen Weis, Jennifer Rugletic Washko

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

Occupational engagement, spirituality, and quality of life are recognized as important dimensions of aging, however, these factors remain underexplored among older adults residing within faith-based communal living environments. This doctoral capstone experience, Aging with Mercy, Thriving in Place, consisted of two distinct but complementary components: an Institutional Review Board (IRB)-approved mixed methods research study and a quality improvement initiative. The purpose of the research study was to explore occupational engagement, occupational role transitions, spirituality, identity, and perceived quality of life among older adults residing within a faith-based communal living environment. Quantitative data were collected using the World Health Organization Quality …