Medicine and Health Sciences Commons^™

Development Of An Age-Appropriate Household Dysfunction Measure And Its Concurrent Validity With Multiple Outcomes Among Middle School Adolescents In Southeast Texas, Sumaita Choudhury, Timothy J Walker, Emily T Hébert, Christine M Markham, Ross Shegog, Robert C Addy, Melissa F Peskin

Faculty, Staff and Student Publications

Existing adverse childhood experience (ACE) measures include a limited number of household dysfunction (HD) items and the use of adult-oriented language that is not always appropriate for middle schoolers. We developed an age-appropriate 10-item HD measure informed by previously validated ACE measures and tested its concurrent validity with dating violence (DV) perpetration, lifetime substance use, and mental health outcomes among middle schoolers in Southeast Texas. This cross-sectional study used the baseline data from a DV prevention intervention program for sixth graders (N = 126), Me & You Tech. Baseline data were collected from March 2023 to April 2023. To …

Optimizing Psychiatric Care Through Pharmacogenomics: An Evidence-Based Program To Increase Multi-Gene Pharmacogenomic Testing And Provider Competence In Mental Health Settings, Marc Boulanger

Doctor of Nursing Practice Final Manuscripts

Objective: This scholarly project aimed to enhance psychiatric providers' competency, confidence, and knowledge in the PHASER pharmacogenomic (PGx) testing program at the VA San Diego Healthcare System.

Background: PGx testing enhances psychiatric care by enabling precise medication management tailored to a patient’s genetic profile, improving treatment effectiveness and reducing adverse drug reactions. Despite demonstrated clinical utility, adoption of PGx remains limited due to provider knowledge gaps. This project addresses these gaps through targeted education.

Methods: Two educational modules, developed with input from the PHASER site-lead, aimed to enhance provider knowledge and confidence in PGx. Module one introduced the PHASER program …

Development And Pilot Testing Of An Addiction Clinic-Based Pre-Exposure Prophylaxis Uptake And Adherence Intervention For Women With Substance Use Disorders: Protocol For A Pilot Randomized Trial, Angela M Heads, Diane Santa Maria, Mandy J Hill, Robert Suchting, Kimberly N Evans, Zaneta Gaul, Luba Yammine, Constanza De Dios, Joy M Schmitz

Faculty, Staff and Student Publications

Background: Black and Hispanic women in the United States continue to bear disproportionate incidence of HIV related to sexual transmission and injection drug use. Specifically, women with substance use disorders (SUDs) are more likely to engage in vaginal or anal condomless sex associated with HIV transmission. Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention tool but is not widely used by racial or ethnic minority women. Effective interventions for engaging women with SUDs in HIV prevention interventions that are culturally appropriate and, therefore, more appealing to racial or ethnic minority women with SUDs are critically needed.

Objective: This 3-phased …

Cultivating Workplace Wellness: An Evaluation Of Gratitude Card Interventions Among University Faculty, Jeffrey Druck, Patrick Ockerse, Jamal Jones

Journal of Wellness

Introduction: There has been a growing interest in understanding the role of gratitude in promoting well-being. Gratitude, defined as a feeling of thankfulness and appreciation in response to receiving a benefit from someone else, has been shown to improve mood, increase social support, and decrease symptoms of depression and anxiety. This research paper explores an innovative intervention using gratitude cards for faculty members and measures the emotional impact of this intervention.

Methods: The study involved 32 clinical physicians from the Department of Emergency Medicine at the University of Utah. Participants were invited to write a gratitude card to …

Policy Proposal For Integrating Pediatric Mental Health Into Nursing Practice In Uganda, Giselle S. Perez

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Mental health disorders affect over 1 in 7 individuals aged 10 to 19 globally. In low- and middle-income countries like Uganda, limited access to mental health specialists and pervasive stigma exacerbate the gap in care. Nurses, often the first point of contact, typically lack adequate pediatric mental health training. The proposal aims to address this gap by equipping nurses with the knowledge and competencies to identify, intervene, and support children with mental health disorders. Purpose: This proposal advocates for implementing targeted, continuing education in pediatric mental health for Ugandan nurses. The goal is to enhance the quality of …

From Fee For Service To Outcome Based Care: A Policy Proposal To Reduce Provider Burnout In Assertive Community Treatment, Amanda M. Thompson

Doctor of Nursing Practice Final Manuscripts

Purpose: This project examines the impact of the fee-for-service (FFS) reimbursement models on provider burnout within Assertive Community Treatment (ACT) programs and proposes a hybrid reimbursement framework that integrates case-rate and outcome-based payment structures. The goal is to enhance care quality, improve provider retention and optimize patient outcomes by addressing financial and administrative inefficiencies inherent in the current model.

Background: Mental illness affects over 59 million U.S. adults with serious mental illness (SMI) presenting significant challenges in healthcare delivery. ACT is an evidence-based, multidisciplinary approach designed to provide intensive, community-based psychiatric care to individuals with serious mental illness (SMI). However, …

Systematic Review On The Treatment Of Emotional Abuse Victimization In Women By An Intimate Partner, Günnur Karakurt, Rhea D’Silva, Çerağ Oğuztüzün, Ankita Choudhary, Keming Gao, Shari Bolen

Faculty Scholarship

Purpose: Emotional partner abuse, often closely intertwined with physical assault, involves persistent emotional mistreatment by an intimate partner. Despite its significance, research specifically focusing on emotional IPV is limited. This study systematically reviews the effectiveness of treatments for women victimized by emotional abuse from an intimate partner. Methods: Following the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions, we identified four relevant studies published between 2010 and 2019 with interventions designed for survivors of IPV. Results: The total sample size of 857 was included in the current study (I² = 95%). Our systematic review revealed two …

Intersection Of Alcohol Use, Pain Symptoms, And Negative Affect In Total Knee Arthroplasty Patients And People With Hiv, Taylor Fitzpatrick-Schmidt, Vinod Dasa, Claudia Leonardi, Tekeda F. Ferguson, David A. Welsh, Patricia E. Molina, Martin J.J. Ronis, Scott Edwards

School of Medicine Faculty Publications

Alcohol is a well-known analgesic, although excessive alcohol use can lead to hyperalgesia and heightened negative affect. This cross-sectional study examined associations between alcohol use, self-reported pain, and negative affective symptoms in two distinct cohorts of patients vulnerable to chronic pain: individuals undergoing total knee arthroplasty (TKA) surgery and a cohort of people with HIV (PWH). Participants were enrolled in two clinical studies: a retrospective study of patients undergoing TKA and a longitudinal study of PWH, the New Orleans Alcohol Use in HIV (NOAH) cohort. Based on the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) score, participants in both …

Adhd Diagnosis And Treatment Within Ethnic Minority Groups, Dianthe Hoang

Undergraduate Honors Theses

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is commonly diagnosed in childhood, and the National Survey of Children’s Health reported that ADHD had a prevalence of around 6.1 million children aged 2-17 years old (NSCH, 2016). This review discusses the cultural and socioeconomic barriers that contribute to the underdiagnosis and treatment in members of ethnic minority communities. Black, Hispanic, Native American, and Asian adults received less mental health care compared to White Americans. Previous findings indicated that cultural factors, such as misinterpretation of symptoms from families and teachers and cultural perceptions of mental health, contributed to disparities …

Using Natural Materials In Art Therapy To Address Accessibility And Well-Being In Low-Income Older Adults, Ahlyana J. Richardson

Expressive Therapies Theses

This study investigated the implementation of natural materials during the artmaking processes in an older adult art therapy group (eco-art therapy), and its effects on their well-being and the role of accessibility in their lives. An open-studio approach was applied to emphasize the artmaking process being driven by the participants independently, while also sharing a collaborative space and creating community with each other. There was an exception to this condition in this study, being that the participants were encouraged to ask for assistance in using unconventional materials in their artwork if they felt they needed it. The participants were older …

Alive Old-Time Radio Play: Performance-Based Drama Therapy With Cognitively Healthy Older Adults, Aaron T. Dore

Expressive Therapies Theses

The live radio play format is uniquely positioned to offer social benefits for older adults when explored through a performance-based drama therapeutic lens. Though firsthand familiarity with old-time radio is not a prerequisite for meaningful participation in a group styled after this bygone era of storytelling, the format naturally supports accessibility needs common among the older adult population. The minimal blocking requirements, script-in-hand approach, and adaptable format make it especially accommodating to a wide range of skill levels and areas of interest. Research into therapeutic interventions for older adults tends to rely on reminiscence and life review approaches with an …

Icanfeel: A Digital Art Activity To Support Distress Detection In Adult Oncological Patients, Marie J. Deschamps

Expressive Therapies Dissertations

Considered the 6th vital sign, distress, a combination of hopelessness, anxiety, fear, and depression, can impact patients’ quality of life, treatment adherence, and mortality. While screening is required in oncological centers, distress remains under-detected. This study examined the use of Icanfeel, a novel digital art-based tool, to complement traditional psychometric assessments such as Edmonton Symptom Assessment System (ESAS), to support patients’ expressions of symptoms and distress detection. Hospitalized adult oncological patients (N = 22) engaged twice with Icanfeel and with an active control condition. At various time points during the protocol, patients self-reported symptom burden using ESAS, self-disclosure …

Dance/Movement Therapy Interventions That Can Address And Decrease Impacts Of Developmental Prosopagnosia: A Literature Review, Caitlin Rivenbark

Expressive Therapies Theses

This literature review explores dance/movement therapy (DMT) as a treatment modality for developmental prosopagnosia (DP) or face blindness. Research on DP causes and assessments are limited, as well as research on treatments and supportive management. In order to conceptualize how DMT might support people with DP, this paper focuses on mitigating the impacts of having the condition by exploring treatments for conditions with similar impacts including attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and social anxiety disorder (SAD). The interventions included were pharmacotherapy, behavioral contingencies, mainstream therapies, and alternative therapies including DMT and drama therapy (DT). The various …

The Authentic Self In Mental Health Practitioners Through The Use Of Internal Family Systems And Character Card Creation In Art-Based Therapy, Tracy J. Evans

Expressive Therapies Theses

Mental health practitioners, or therapists, are complex beings who carry not only the trauma from their life experiences but are also presented with the undertaking of trauma stewardship for clients. This study explores how participating with clients fosters self-expression and promotes emotional regulation, while enhancing social interactions within myself. Combining the terminology from the Internal Family Systems (IFS) Model and the concept of collaged card creation from SoulCollage to create character cards, made with clients, that represent the various parts of the personality. This qualitative study on the intervention found that it provided a safe space for both clients and …

How Can Tattoos Be Understood As Intermodal Expressive Arts Therapy?: Integrating Visual Art, Personal Narrative, And Embodied Experience: Development Of A Method, Rachel S. Hall

Expressive Therapies Theses

This paper explores the inherent intermodal nature of tattoos through the lens of expressive arts therapy, demonstrating how tattoos integrate visual art, personal narrative, and embodied experience. A group intervention was designed and implemented in an outpatient setting, drawing on existing literature and the Expressive Therapies Continuum (ETC) to examine how tattoos function as therapeutic tools that support identity formation, emotional healing, and self-expression. The intervention guided participants through an intermodal process that began with reflective writing on identity-forming experiences, followed by visual art-making and somatic engagement. This approach illuminated the transformative potential of tattoo conceptualization within a therapeutic context, …

A Proposal For The Theoretical Integration Of Cognitive Behavioral Therapy And Dance/Movement Therapy, Sarah Crain

Expressive Therapies Theses

A recognized integration of cognitive behavioral therapy (CBT) and dance/movement therapy (DMT) has not been developed because the concept currently lacks a strong philosophical and theoretical background. Observations from adjacent integrative expressive therapies and clinical practice provide encouragement that these models may provide a unique contribution to the field of psychotherapy. CBT would support the field of DMT toward better establishing an evidence-based theoretical background and framework. It is proposed that a well-supported approach to CBT and DMT should be built from a theoretical integration that upholds integrity of both models while identifying connective philosophical roots. This literature review initiates …

How Can Art Therapy Be Utilized To Support Emotional Communication For Autistic Individuals With An Alexithymic Profile?, Kathryn L. Cohen

Expressive Therapies Theses

The expressive nature of art therapy can aid those with communication and sensory processing differences. Art making allows for the individual to access and emote in a way that spoken language cannot. This literature review will investigate and explore the features of the processing differences related to autism, interoception and alexithymia. The findings from the research explore the effectiveness of utilizing art therapy as a method to expand emotional communication. There are many challenges pertaining to emotional regulation and communication for autistic individuals. Accessing mental health resources and service providers familiar with communication differences is another challenge for this population. …

"La Vida Es Un Carnaval": An Exploration Of Cuban Identity And Nostalgia Through Dance/Movement Therapy - A Community Engagement Project, Maria Fernanda Mendez Mendoza

Expressive Therapies Theses

“La Vida Es Un Carnaval” is a community engagement project and thesis that explores how identity and nostalgic resilience show up through dance/movement therapy with Cuban immigrants living in the United States, specifically Massachusetts. This project brought together six Cuban-born participants, ages 26 to 67, each with their own unique migration stories; from the Rafter Balsero Crisis of 1994, to the “Wet-Foot/Dry-Foot” policy, and family reunification. Through a mix of in-person and online sessions, participants explored their experiences using intermodal activities including dance/movement therapy techniques, conversation, journaling, artwork, and music. Themes of cultural pride, “Cubanía” – Cuban-ness, culture shock, and …

To Bear Witness: Analyzing Dmt As An Effective Trauma-Informed Approach For Treating Youth & Adolescents: A Critical Review Of The Literature, Jade Dennis

Expressive Therapies Theses

This literature review proposes dance/movement therapy (DMT) as a trauma-informed intervention for children and adolescents who have experienced psychological, emotional, or physical trauma. The project, inspired by internship experiences with young trauma survivors, explores the ways in which trauma manifests in the body, indicating that DMT may offer effective pathways toward healing. Many children exposed to potentially traumatic events exhibit emotional dysregulation, insecure attachment patterns, and behavioral or somatic symptoms that are not easily addressed through traditional talk therapy. As a body-based expressive arts modality, DMT engages the sensory, emotional, and relational aspects of trauma by supporting nonverbal expression, self-regulation, …

Therapeutic Qualities And Applications Of Clay In Expressive Arts Therapy: A Literature Review, Julia Caruso

Expressive Therapies Theses

This literature review investigates the therapeutic qualities and clinical applications of clay within the framework of expressive arts therapy (ExAT), with particular focus on sensorimotor, somatic, and developmental interventions. Drawing upon the expressive therapies continuum (ETC), this review synthesizes emerging research highlighting clay's kinesthetic and tactile properties as key mechanisms for facilitating emotional expression, accessing unconscious material, and promoting psychological resilience. Evidence is presented for specialized therapeutic modalities such as clay art therapy (CAT) and Clay Field Work, which engage the body-mind connection to support trauma integration and emotion regulation. Findings demonstrate that clay's inherent adaptability and sensory richness allow …

Spravato® Fda-Approved As Monotherapy For Adults With Treatment-Resistant Depression, Rileigh Rahrig, Kennedy Kosikowski, Haylee Whyde, Kiley Devoll, Allie Honigford, Macy Davis, Joshua Honaker, Samantha Mccord, Manoranjan D'Souza

Pharmacy and Wellness Review

Treatment-resistant depression (TRD) is a challenging and possibly life-threatening condition that affects millions of people worldwide. Patients with major depressive disorder (MDD) are diagnosed with TRD once they have tried and failed to respond to two antidepressant treatments at the maximum dose for a full trial of six to eight weeks. Most traditional antidepressant therapies work by increasing the levels of monoamine neurotransmitters such as dopamine, serotonin, and norepinephrine in the brain. These medications have a delayed onset of action, ranging from two to eight weeks, and often fail to relieve depressive symptoms in a patient with TRD. Therefore, targeting …

Fda Approval Of Cobenfy: A New Therapeutic Option For Schizophrenia, Brenna Hissong, Penlope Mazivanhanga, Alexander Defranco, Linda Azap, Haley Brown, Megan Rizo, Joshua Honaker, Samantha Mccord, Lindsey Ferraro

Pharmacy and Wellness Review

Schizophrenia is a complex illness characterized by behavioral, emotional, and cognitive dysfunctions. Common symptoms include hallucinations, delusions, cognitive decline, and social withdrawal. The disorder is related to structural brain abnormalities, neurotransmitter imbalances, and a combination of genetic and environmental elements, and affects about 24 million individuals globally. Currently, two medication classes are most commonly used to treat schizophrenia. These medications are first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs). Due to the side effect profiles that both medication classes carry, research is being conducted for new drug classes.

Cobenfy (xanomeline/trospium chloride), also known investigationally as KarXT, is a new class of …

Misused And Misunderstood: Examining The Inappropriate Use Of Stimulant Medications, Connor Dains, Madilyn Paphanchith, Makayla Eversole, Chaehyeon Jin, Minhwan Yang, Joshua Honaker, Samantha Mccord, Kayla Petkus

Pharmacy and Wellness Review

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity, and impulsivity. The American Academy of Pediatrics (AAP) endorses stimulant medications as the first-line treatment option. When combined with behavioral therapy, this pharmacologic class can improve focus, executive functioning, and the overall quality of life. While stimulant prescriptions can have a positive effect when used as directed, there is concern for the potential of provider overprescription and patient misuse related to these medications. Consequently, the Food and Drug Administration (FDA) revised the boxed warning and prescribing information for stimulant medications. Healthcare providers must educate …

Social Determinants Of Health Extraction From Clinical Notes Across Institutions Using Large Language Models, Vipina K Keloth, Salih Selek, Qingyu Chen, Christopher Gilman, Sunyang Fu, Yifang Dang, Xinghan Chen, Xinyue Hu, Yujia Zhou, Huan He, Jungwei W Fan, Karen Wang, Cynthia Brandt, Cui Tao, Hongfang Liu, Hua Xu

Faculty, Staff and Student Publications

Detailed social determinants of health (SDoH) is often buried within clinical text in EHRs. Most current NLP efforts for SDoH have limitations, investigating limited factors, deriving data from a single institution, using specific patient cohorts/note types, with reduced focus on generalizability. We aim to address these issues by creating cross-institutional corpora and developing and evaluating the generalizability of classification models, including large language models (LLMs), for detecting SDoH factors using data from four institutions. Clinical notes were annotated with 21 SDoH factors at two levels: level 1 (SDoH factors only) and level 2 (SDoH factors and associated values). Compared to …

Shifting To A Culture Of Inclusion By Design: Applying A Mixed-Methods Approach To Advance Accessibility Of Public Health Emergency Information & Communication Technology, Jessica L. Franks, Erin Vinoski Thomas

Developmental Disabilities Network Journal

Adults with intellectual and developmental disabilities (IDD) experience inequities in access to timely, accurate, and understandable information and communication technology (ICT), which increases risk for public health emergency (PHE)-related health disparities and impedes opportunities to achieve optimal health. This study assessed federal COVID-19 webpage accessibility levels and explored existing knowledge of and experience with filing accessibility complaints for federal ICT among adults with IDD. Through a mixed-methods approach, we evaluated compliance with accessibility standards for 18 federal agencies’ COVID-19 webpages (study 1) and interviewed 16 adults with IDD about experiences accessing federal webpages and filing accessibility complaints (study 2). We …

The Cost Of Accommodative Burdens: Prevalence & Impact On Deaf And Hard Of Hearing Individuals, Lorelei Becktel

Undergraduate University Honors Capstones

This exploratory qualitative study (n=8) investigated the mental health effects of lack of reciprocity in accommodation and the resulting accommodative burden on deaf and hard of hearing individuals. Lack of reciprocity occurs when the split of the burden for communication accommodations falls significantly more on the deaf or hard of hearing individual. The resulting accommodative burden occurs when deaf and hard of hearing individuals adapt to make communication easier for hearing people at a level that is uncomfortable, unwanted, and/or detrimental to their needs. Effects, determined by participant responses, were examined via semi-structured interviews and analyzed via thematic analysis. Relationships …

Assessing One-Year Health Impacts From Wildfires In Rural Communities: Roles For Extension In Promoting Wildfire Preparedness And Recovery, Marc T. Braverman, Sandi Cleveland Phibbs, Emily Jane Davis, Amanda Rau, Elijah Penner

Journal of Extension

Wildfires can produce health impacts that persist for years in affected communities. This article describes an Extension-led study of health impacts in rural Oregon communities one year after a destructive wildfire. Data collection included key informant interviews (n=36), an online survey (n=80), and three focus group interviews with survivors (n=23). Mental health, exposure to contaminants, physical stress, food insecurity, and other issues were frequently identified health concerns. Survivors’ difficulties in dealing with housing displacement significantly exacerbated health challenges. We describe potential roles for Extension in addressing wildfire risk and mitigating health impacts, including a description of the Oregon Fire Program.

Food Insecurity In Adolescent Athletes, Andrew Donaldson, Shannon Margherio, Jay Roberson, Kevin Latz

Research Days

Background: The prevalence of food insecurity among children in the United States is estimated at 21%. Food insecurity during childhood leads to worse school performance, more emotional and behavioral health concerns, and increased suicide attempts. Further, food insecurity has been noted to have multiple deleterious effects on the collegiate student athlete, including lower GPA, disordered eating, and substance use.

Hypothesis: Food insecurity is prevalent in the adolescent athlete population and exists across demographics.

Methods: Voluntary surveys were distributed to parents at all sports medicine clinics at our institution. Demographic data was collected including athlete age, race, school and school district, …

Evaluating Scheduling Tool To Improve Behavioral Health Counseling Scheduling Rates On Same Day Of Referral, Edward Delesky, Md, Oluwatoni Okuboyejo, Md, Elizabeth Franko, Md, Nwamaka Amobi, Md, Ronak Ahir, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Studies suggest 1 in 5 adults in the US suffer from mental illness, with up to 46% of Philadelphia residents reporting poor mental health.
• Care integration beginning with primary care physician evaluation and management is becoming more common.
• Behavioral health counseling (BHC), provided by a primary physician and trained psychologist, is vital in management of mental health conditions.
• Studies suggest same-day scheduling of follow up appointments improves treatment adherence.
• Goal: improve BHC scheduling rates on same-day of initial referral across two practice teams

Viral Hepatitis And Hiv Screening Amongst Inpatients With Substance Use Disorder: An Initial Pdsa Cycle Analysis, Christine Papastamelos, Md, Elizabeth Novick, Md, Carolyn Kramer, Md, John Zurlo, Md, Nikhil Seval, Md, Mollie Tucker, Md, Daniel Taupin, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• ~67,000 individuals in Philadelphia county are estimated to be living with substance use disorder (SUD).¹
• Persons who inject drugs (PWID) are at disproportionately higher risk of acquiring HIV and viral hepatitis compared to the general public.² 
• A 3-month retrospective chart review (11/6/23-1/22/24) of 160 inpatient SUD encounters with an Infectious Disease (ID) consult showed that 35%-42% of HIV and hepatitis C screening opportunities were missed.