Medicine and Health Sciences Commons^™

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …

From Vapor To Vice: Unraveling The Links Between Vaping And Traditional Substance Abuse Among Youth, Ayana Powell

Capstone Experience

ABSTRACT:

Objective: To evaluate whether vaping or using e-cigarettes is associated with the use of traditional substances, such as cigarettes, alcohol, and marijuana.

Methods: Using data from the Monitoring the Future surveys, a multivariable logistic regression model was performed, and prevalent odds ratio were calculated to evaluate the association between vaping and traditional substances.

Results: Vaping use among U.S. adolescents and teenagers was found to be an associated with use of traditional substances (cigarette use [OR]= 6.36 [CI]= 4.84, 8.38; alcohol use [OR]=5.80 [CI]= 5.28, 6.38; and marijuana use [OR]= 7.77 [CI]= 6.95, 8.70).

Conclusion: This study will assist …

Spotlight On Mental Health On A Healthcare Campus: An Assessment Of Psychological Trauma Awareness, Training, And Treatment In The University Of Nebraska Medical Center College Of Public Health Community, Jenny E. Mueller

Capstone Experience

Background: Psychological trauma has been recognized as a public health concern of epidemic proportions globally. Public health community awareness of and education in trauma is likely to be integral to preparing future public health professionals to work effectively and safely in the field. Currently, the extent of trauma awareness, training, and treatment on the University of Nebraska Medical Center College of Public Health (UNMC COPH) campus is not known.

Aims: The aims of this project are to investigate and assess the level of psychological trauma awareness, training, and treatment on the UNMC COPH campus; and to provide recommendations for actions …

Housing Is Safety: An Evaluation Of A Transitional Housing (Th), Rapid-Rehousing (Rrh), And Joint Th/Rrh Program For Survivors Of Interpersonal Violence, Bridget L. Claborn

Capstone Experience

In this capstone project, I created a program evaluation plan and conducted preliminary analysis for the Mar􏰀 Parrish Center􏰁s (MPC) transitional housing (TH), rapid-rehousing (RRH), and joint TH/RRH programs for survivors of interpersonal violence and their families. The intent of the project is: (1) to better understand the impact of MPC housing programs; (2) to inform strategies for continuous improvement in client outcomes, access, and satisfaction; (3) to further evaluation capacity for the organization; and (4) to generate practice-based evidence to inform the field at large. As a practitioner in the field of interpersonal violence and former MPC staff member, …

The Role Of Psychological Safety On Employee Satisfaction And Retention In Healthcare Delivery Settings: A Systematic Literature Review, Jamey Paul

Capstone Experience

The healthcare industry typically has a high rate of employee turnover due to higher job stresses and burnout, lower job satisfaction, and insufficient organizational support and work culture. This turnover has worsened since the onset of the COVID-19 pandemic. Psychological safety, a shared belief by organizational members that the team/unit is safe for interpersonal risk-taking, can be one of the many ingredients that contribute to employee satisfaction and reduce turnover. This systematic literature review explored the role of psychological safety on job satisfaction and retention of healthcare workers in delivery settings by synthesizing the known antecedents and outcomes of psychological …

Program Evaluation: Utilizing Health Department’S Community Health Needs Assessment Data To Improve Emergency Preparedness Plans, Kathleen Gottschalk

Capstone Experience

Public health officials conducting emergency response plans must know how to easily identify the vulnerable populations in their community or jurisdiction. It is beneficial for access and functional needs appendices to include information and resources directed at the identified vulnerable groups before an emergency event to improve health outcomes. Community Health Needs Assessments (CHNA) can provide population-level statistics and information needed to easily identify vulnerable or at-risk groups. This report aims to evaluate the use of the CHNA data to guide the development of inclusive emergency response plans that account for vulnerable populations in local health department jurisdictions. The 2021 …

Comprehensive Literature Review: Assessing The Impact Of Covid-19 Policies, School Closures And Social Distancing, On The Mental Health Of School Age Children, Fatuma A. Hassan

Capstone Experience

Mental health is vital to the well-being of all individuals, especially children. COVID-19 unveiled a significant public health issue with poor mental health during the pandemic. There is limited literature about the mental health implications of COVID-19 policies for children and adolescents and preventive strategies for future pandemics. This comprehensive literature review seeks to further investigate the mental health impacts of school shutdowns and social distancing, which were nonpharmaceutical strategies, on school-aged children, 5-18 years old, and propose recommendations for public health officials to mitigate the mental health impacts for future pandemics. Additionally, the review aims to highlight the potential …

The Merit Of Inclusion: A Policy Review Examining The Convergence Of Special Education And Inclusions Policies With Compensatory Medicaid Policies In The Wake Of The Covid-19 Pandemic, Corbyn Baggett

Capstone Experience

On March 11, 2020, the World Health Organization (WHO) formally recognized the novel coronavirus (COVID-19) outbreak as a global pandemic. This global issue compelled governments to announce careful virus containing policies in order to prevent further spread and control of the disease. Although it has been proven that measures like social isolation could aid in scaling the spread of illness, the resulting extended school closures that occurred in response to an increased number of COVID-19 outbreaks posed significant challenges for all students, but especially those students with special needs. The unpredictable nature of COVID-19 at the outset of the pandemic …

Hispanic/Latino Mothers Of Children With Developmental Disabilities: Identifying Factors Associated With Practicing Self-Care And Mental Health Outcomes, Jessica Gutierrez

Capstone Experience

Caring for a child with developmental disabilities can be challenging, exhausting, and overwhelming for many parents. The level of care that a child with disabilities requires can be intense, resulting in stress and negatively impacting caregivers' mental health. Many Hispanic/Latino mothers of children with developmental disabilities are not practicing self-care or using support services; thus, the mothers may experience high stress, depression, and anxiety. Previous research studies have found adverse psychological effects such as high levels of stress, depression, and anxiety. This quantitative study sought to identify the gaps and barriers Hispanic/Latino mothers of children with developmental disabilities encounter when …

The Differences In Mental Well-Being For Individuals With And Without Service Dogs, Katelyn Morales

Capstone Experience

Trained service dogs can be used for many tasks, but the growing literature focuses on the benefits of the psychosocial health and well-being of individuals experiencing depression or anxiety. This study analyzes the effects of service dogs on the mental well-being of individuals with a diagnosed disability who have depression or anxiety. This quasi-experimental design assesses the mental well-being of individuals who have a service dog compared to those who do not have a service dog. Mental well-being was measured using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) and focused on individuals with a service dog and diagnosed depression or anxiety …

Analysis Of The Utilization Of Nebraska Medicine's Price Transparency Tool, Ingrid A. Olson

Capstone Experience

Healthcare costs have become a significant concern for patients, healthcare facilities, economists, and politicians within the United States. In an effort to understand and reduce health-related costs, price transparency laws were enacted at the beginning of 2021. Because of these new laws, hospitals must provide a price transparency tool for their patients. “Price transparency in healthcare makes pricing information more readily available, defines the value of services, and enables patients and other care purchasers to identify, compare, and choose providers that offer the desired level of value” (AAMC, 2022). However, research results on price transparency tools use and efficacy is …

Helping Our Heroes: An Evaluation Of Mental Health And Organizational Policies Surrounding Suicide Prevention And Postvention Strategies For Nebraska First Responders, Maria S. Mickles

Capstone Experience

Suicide is ranked as one of the leading causes of death in the United States. Over 40,000 individuals die by suicide each year (Stanley, Hom, & Joiner, 2016; Vigil et al, 2021), and, in 2020, it was ranked in the top 9 causes of death for all ages (10-64), and second for those 10-14 and 25-34 years of age (Centers for Disease Control and Prevention, 2022). These statistics disproportionately reflect first responders (i.e., firefighters, dispatchers, law enforcement, EMS, paramedics, etc.), as they die by suicide more than the general public (National EMS Management Association, 2016). Within their line of work …

Evaluating Nebraska Ems Providers' Ability And Willingness To Respond To Bioterrorism Emergencies, Ryan Houser

Capstone Experience

Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack, and identify factors that predict preparedness and willingness among Nebraska Emergency Medical Service providers, who are key to resilience in the face of an attack. The survey was available for one month in 2021 during which 190 EMS providers responded to the survey. The subjects included Registered Nurses, doctors, EMTs, and paramedics. Only 10% of the respondents are both …

Evaluating A Community-Based Breastfeeding Support Organization In Nebraska, Katelyn Elaine Goodroe

Capstone Experience

Specific Aims: The aims of this evaluation plan are to investigate the role of the Nebraska nonprofit organization, MilkWorks, in promoting breastfeeding and family support programming and to identify future internal and external growth opportunities through an assessment of the organizational practices using stakeholder perspectives and marketing structure to better promote infant and parental health.

Significance: As a best practice, evaluation of MilkWorks is critical to providing proper services for promoting infant development and parental health in urban and rural Nebraska communities.

Background: MilkWorks was founded in Lincoln, Nebraska, by mothers with the intention of promoting breastfeeding by offering support …

Nebraska Public Guardianship Of Unbefriended Patients: A Preliminary Review Of Health Outcomes And Cost Savings, Emily N. Berzonsky

Capstone Experience

Unbefriended patients often experience an extended length of stay in the hospital while their medical providers await legal appointment of a public guardian to make their medical decisions. The medically unnecessary days the unbefriended patient spends in the hospital equates to high costs for the hospital, but more importantly, negative health outcomes for the patient. The purpose of this study is to provide literature and data to support recommendations for possible changes in Nebraska’s public guardianship appointment process. A literature review seeks to answer: (1) What is the median hospital length of stay for an unbefriended patient without a guardian …

Structural Magnetic Resonance Imaging As A Diagnostic Biomarker Of Hiv-Associated Neurocognitive Disorders (Hand), Mikki Schantell

Capstone Experience

Objective: The goal of this study was to do an exploratory analysis to determine if gray matter brain volumes and cortical thickness measures obtained from structural magnetic resonance imaging (sMRI) can discriminate people with HIV-associated neurocognitive disorders (HAND), neurocognitively unimpaired people with HIV (NU PWH), and HIV-negative controls (HIV- controls) using linear discriminant analyses.

Methods: A total of 231 participants, including 110 PWH and 121 HIV- controls, completed a neuropsychological (NP) battery and an sMRI protocol. The bilateral gray matter volumes and cortical thickness brain regions were analyzed using 18 linear discriminant models to assess the discriminability of gray matter …

A Review Of The Characteristics Of Super-Utilizers And Evidence-Based Approaches To Reduce Healthcare Utilization, Suswara Mandala Rayabandla

Capstone Experience

A significant fraction of health care resources in the United States of America is utilized by a comparatively small number of people. An examination of the attributes and patterns and associated evidence-based interventions for such high-utilizing patients might aid clinicians to improve interventions to address the distinctive needs of these patients, decrease their risks for numerous hospitalizations, and contribute to reducing the costs. This study aims at exploring the existing literature on the characteristics of super-utilizers and interventions to reduce avoidable use of health care among this population. The method used for this research is a comprehensive literature review. Search …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

An Evaluation Of Implementing Trauma-Informed Care Training In Healthcare Settings, Amanda Kis

Capstone Experience

Background: Trauma-informed care (TIC) has recently become a popular topic in medical science. Many patients’ health conditions have been diagnosed and treated purely as medical issues, yet emerging research indicates that trauma is sometimes the source of many physical and mental conditions. Implementing TIC education in healthcare systems may lead to preventing the onset of symptomology related to undiagnosed, chronic trauma experience.

Objectives: The primary goal of this Capstone project was to implement TIC training developed by Trauma Matters Omaha Coalition and assess preliminary evidence for changes in participants’ confidence, clinical knowledge, professional knowledge, self-awareness, and assumptions and biases regarding …

Collaboration Between University Centers For Excellence In Developmental Disabilities (Ucedds) And Independent Living Networks, Sarah Swanson

Capstone Experience

In every state and U.S. Territory, there is a University Center for Developmental Disabilities (UCEDD), which is part of the state Developmental Disabilities network and an Independent Living (IL) Network, composed of Centers for Independent Living and Statewide Independent Living Councils. Each of these receive federal funding (and frequently state funding) to support people with disabilities and their families. However, each has different federal funding sources, different origins within federal legislation and different requirements. Through discussions with IL and UCEDD leadership it is clear that there are collaborations between the two, yet this is not widely recognized. This research proposal …

Assessment Of Caffeine And Sugar Sweetened Beverage Consumption Among Adult Pregnant Women In An Urban Medical Center In Nebraska, Shilpa Karanjit

Capstone Experience

Abstract

Background: Unhealthy non-alcoholic drinks for pregnant women include beverages with high caffeine and added sugar. High caffeine intake during pregnancy has been reported to be linked with adverse pregnancy outcomes such as miscarriages and stillbirth. In addition, high sugar-sweetened-beverages (SSBs) intake increases the risk of maternal obesity that is associated with many serious health problems in both mother and the fetus such as gestational diabetes, hypertension, congenital anomalies, macrosomia, childhood obesity and cardiac diseases. Maternal obesity also increases the cost of prenatal and postnatal healthcare by increasing the need of surgical and anesthetic care for mother and intensive care …

Identifying The Newly Insurable Medicaid Coverage Gap Population Under The Affordable Care Act: Who They Are And Where They Live, Samuel L. Woodruff

Capstone Experience

The goal of this Capstone Project is to better define and geographically locate the potential distribution of individuals who fall within the current Medicaid Coverage Gap and those populations who would be eligible for Medicaid under the expansion of Medicaid within the state of Nebraska. Using data from multiple United States Census Bureau sources, along with available data from the Health Resources and Services Administration (HRSA), this project looks to also locate populations of these individuals that may live within established Medically Underserved Areas (MUA's) or Health Professional Shortage Areas (HPSA's) within the state. American Community Survey 5-year Public Use …