Medicine and Health Sciences Commons^™

Barriers And Bridges: Exploring Factors That Shape Mental Health Service Utilization In Rural America, Margaret Wiwuga

Educational Specialist, 2020-current

Despite disproportionately higher suicide mortality rates and comparable prevalence of mental illness across urban and rural communities in the United States, rural populations across the nation experience significantly lower access to and utilization of mental health services, naturally leading to worse comprehensive outcomes. This literature review examines multifaceted factors shaping mental health service use in rural America, taking note of both barrier and enabling factors that impede or enable these unique populations’ willingness and ability to access and use mental health services. Ten articles published prior to September 9, 2025, were selected from the James Madison University Libraries’ Psychology and …

Black Maternal Mental Health: Counseling Considerations For Prenatal Depression And Anxiety, Morgan Renee Williams

Educational Specialist, 2020-current

The maternal mortality rate of Black women in the United States is four times higher than white women (Centers for Disease Control and Prevention, 2020). The CDC defines a maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy… but not from accidental or incidental causes” (Centers for Disease Control and Prevention, 2024, para. 1). This statistic is a consequence of the inequality within and outside of the American healthcare system (National Academies of Sciences, Engineering, and Medicine, 2020). For the purposes of this research, Black women are defined as any women …

What’S Behind The Mask: The Diagnostic Divide In The Female Autism Phenotype, Shelley Gies Alston

Educational Specialist, 2020-current

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by differences in social communication and restrictive, repetitive behaviors; however, women are diagnosed at significantly lower rates than men. This study examined whether DSM-5-TR diagnostic practices may contribute to the underdiagnosis and delayed identification of ASD in individuals assigned female at birth (AFAB), with attention to masking behaviors, gendered social expectations, and clinician interpretation of symptoms. Grounded in the Female Autism Phenotype (FAP), a retrospective mixed-methods study surveyed 12 AFAB individuals aged 18–24 who self-identified or were formally diagnosed with ASD. Participants completed a 44-item online survey including Likert-scale and open-ended …

Enhancing Access Through Integrated Behavioral Healthcare: Expanding Counselor Identity And Social Determinants Of Health Competency, Tiffany N. Snow

Dissertations, 2020-current

Abstract

The counseling profession has historically differentiated its identity by emphasizing a wellness-oriented approach. However, this has often led to the exclusion of counselors from integrated behavioral healthcare (IBH). With the 2024 enactment of the Mental Health Access Improvement Act, counselors now have unprecedented opportunities to serve as behavioral health providers in federal medical settings. This three-manuscript dissertation explores the intersection of counselor professional identity, social determinants of health (SDoH) competency, and interprofessional collaboration within IBH.

Manuscript 1 presents a conceptual framework for reconciling traditional counselor identity with the "medical model" of Primary Care Behavioral Health (PCBH), arguing that this …

Behavioral Science Applications In Collegiate Athlete Nutrition And Sleep: A Scoping Review, Maryam Yuhas, Katherine M. Kidwell, Olivia Moskuna, Rajib Mandal, Jessica L. Garay

Nutrition - All Scholarship

Nutrition and sleep are key health behaviors supporting athletic performance. Collegiate athletes in the United States (U.S.) are at high risk of insufficient dietary intake and nightly sleep given the competing demands of elite sports and academics. Researchers have developed interventions to improve collegiate athletes’ sleep and nutrition, either individually or collectively. However, progress in understanding how best to create sustained behavior change in this population has been slow. This may be due to the lack of application of behavioral science principles such as lack of a guiding theory, effective strategies, and consideration of implementation contexts. This scoping review takes …

Early Detection Of Alzheimer's Disease And Related Dementias From Spontaneous Speech Using Foundation Speech And Language Models: Comparative Evaluation, Jingyu Li, Lingchao Mao, Xi Mao, Hairong Wang, Zhendong Wang, Xuelei Sherry Ni

Economics and Finance Faculty Publications

Background: Alzheimer's disease and related dementias (ADRD) are progressive neurodegenerative conditions where early detection is critical for timely intervention and care planning. However, current diagnostic methods are often inaccessible, costly, and delayed, especially for underserved populations. There is a growing need for scalable, noninvasive tools that can support timely diagnosis. Spontaneous speech contains rich acoustic and linguistic markers that can serve as noninvasive behavioral markers for cognitive decline. Foundation models, pretrained on large-scale audio or text data, generate high-dimensional embeddings that encode rich contextual and acoustic information.

Objective: This study benchmarks open-source foundation language and speech models to evaluate their …

A Survey Of Health Professions Learners’ Attitudes Towards Social Media In Medical Education: A Substance Use Disorders Education Case Study, Gregory A. Jaffe, Sarah Lawson, William Leach, Mallika Kodavatiganti, Erin Avanzato, Katherine Fesperman, Heather Klusaritz

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Social media is a ubiquitous part of the modern world and plays a key role in the dissemination of information. While utilizing social media for educational purposes has been repeatedly demonstrated as feasible, it has been underutilized in medical education and remains a critical opportunity to integrate microlearning and stigma reduction curricula.

METHODS: A cross-sectional survey on social media usage, attitudes, and beliefs was sent to medical and nursing students at two large academic institutions within Philadelphia. Descriptive statistics are reported, and non-parametric tests were utilized for exploratory analyses.

RESULTS: Health learners were low consumers of social media, reporting …

Incorporating The Use Of Puppets And Puppetry-Based Approaches In Nutrition: A Scoping Review Of Interventions, Basil H. Aboul-Enein, Nada Benajiba, Majd Jan, Sarah Ali Alasmari, Patricia J. Kelly, Stephen F. Gambescia, Elizabeth Dodge

College of Nursing Faculty Papers & Presentations

Puppetry-based activities could serve as a low cost and manageable intervention in improving health-related outcomes. This review aims to identify the research to date and gaps in practice of the role and application of puppetry interventions in nutrition education. A scoping review was conducted using the PICOS framework and PRISMA-ScR guidelines, identifying studies across eight databases between January, 1980 and July, 2025.Twenty-five studies were identified, with the majority (n = 19) aimed at pre-school and school-aged children. Fifteen studies used quasi-experimental, pre-post designs. The use of hand and finger puppets was common, as well as videos and puppet theatre. …

Leveraging Mobile Health To Prevent Coronary Artery Disease Through Physical Activity Promotion Among Underserved Youth, Alina Yang, Jessh M. Mavoungou, Matthew C. Miller, Zarmina Amin, Zan Gao

International Journal of Physical Activity and Health

Coronary artery disease (CAD) develops earlier than often recognized, with underserved youth facing disproportionate cardiometabolic risk. Low participation in moderate-to-vigorous physical activity (PA) is a key driver. This viewpoint explores how mobile health (mHealth) technologies can serve as tools to increase PA engagement among underserved youth, guided by a combined Self-Determination Theory and RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. It highlights current barriers to mHealth adoption, limited cultural relevance, engagement challenges, and accessibility gaps, and presents key considerations for designing culturally informed, age-tailored, and youth-centered mHealth interventions. Overall, the paper calls for a more inclusive and targeted approach …

The Mediating Effect Of Physical Activity On Mental Health Among Sexual Minority Adolescents During Covid-19, You Fu, Ryan D. Burns, Hayley Almes, Xiangren Yi, Nora Constantino

International Journal of Physical Activity and Health

Purpose: Adolescents identifying as a sexual minority frequently experience mental health issues exacerbated by the COVID-19 pandemic. Physical activity (PA) has numerous benefits for mental health and emotional development. The purpose of this study was to examine the mediating effect of PA on the association between sexual minority status and mental health among adolescents during COVID-19. Methods: A sample of adolescents (grades 9-12) completed the online Adolescent Behaviors and Experiences Survey (ABES; N = 7677; 49.6% male) in 2021. The independent variable in this study was a recorded binary response item asking about sexual orientation. The dependent variable was a …

The Impact Of Trump Administration Immigration Policies On Connecticut Educators And Families, Elena C. Bielesz

Honors Scholar Theses

Anti-immigrant rhetoric, policies, and practices, which have grown increasingly prevalent due to the current national political climate, have adverse effects on the mental health of immigrant families and the teachers that support them in Connecticut. This study seeks to represent the opinions of Connecticut K-12 MLL (Multilingual Learners) Education Teachers and Administrators whose daily lives are impacted by the anti-immigrant and anti-refugee policies and procedures. The study employed a human subjects-based approach supported by a review of related literature. MLL Educators from around the state of Connecticut were interviewed. These interviews found that while immigration-based trauma and stressors are common …

Boosting Psychological Well-Being In One Session: A Rapid Counseling Approach To Digital Detox And Music Therapy, Aryobimo Oentarto

Buletin Konseling Inovatif

The rapid acceleration of technology has trapped modern youth in a digital connectivity paradox, where constant social media exposure triggers cognitive distortions and maladaptive behaviors that erode psychological well-being. This study evaluates the effectiveness of a Rapid Counseling approach integrated with Single-Session Music Therapy (RC-SSMT) in enhancing the psychological well-being of youth by breaking the cycle of digital addiction. Using a pre-test and post-test experimental design, the study focused on six youths (aged 15–17) at Church "X" in Jakarta who were identified as having low psychological well-being. The intervention combined a mandatory digital detox as a behavioral task with music …

Preparing A Qualified Workforce To Support The Disability Community Through The Lend Interprofessional Learning Experience, Megan K. Roberts, Beth W. Degrace, Mark J. Fisher, Sandra H. Arnold

Developmental Disabilities Network Journal

Leadership and workforce preparation are vital roles of the nation’s academic institutions to advance health care services for the members of our communities. Leadership Education in Neurodevelopmental and other Related Disabilities (LEND) programs aim to prepare leaders in health care services and advocacy to improve systems and the quality of care and supports for the disability community, specifically children with developmental disabilities. LEND programs enhance standard health care pre-service training by providing interdisciplinary learning experiences for student trainees from a minimum of ten disciplines in 300 hours of learning activities over one academic year. An innovative feature of LEND programs …

Disability: An Autopathography, Isabell A. Collins

The International Journal of Ecopsychology (IJE)

No abstract provided.

Against The Whistle: How Congress Can Stop Sports Piracy, Julianna Kapovic

The University of Cincinnati Intellectual Property and Computer Law Journal

No abstract provided.

The Influence Of Prosthetic Obturators On Quality Of Life In Individuals With Maxillectomy Defects, Minseok Kim

Oral Health

Abstract

Introduction: In recent years, there has been a growing focus on understanding the impact of oral cancer on patients' quality of life. Prosthetic rehabilitation techniques, such as maxillary obturators, often in conjunction with reconstructive surgery, have emerged as interventions to address the challenges posed by post-maxillectomy abnormalities.

Objective: This study aims to systematically review and evaluate the effectiveness of maxillofacial prosthetic rehabilitation using obturators in enhancing the quality of life of patients following maxillectomy.

Methodology: Systematic review of identified literature spanning the timeframe from 2000 to 2020 was used. The comprehensive search encompassed widely recognized databases including PubMed, …

Education, Evaluation, And Impact Of A Delegation Learning Session In The Care Pair Model, Tiffany M. Whitney

Doctor of Nursing Practice Projects: College of Nursing

The persistent nurse shortage is forcing the health sector to think about the way care is provided, and teams collaborate. One model, the Care Pair Model (CPM), pairs registered nurses (RNs) with nursing assistants (NAs) to distribute responsibility and provide patient care in a timely manner and with the best quality. Even though the model encourages working together effectively, many nurses still find it difficult to delegate to uncertainty, lack of confidence, or communication barriers. Improving these abilities is essential for fostering trust, ensuring a smooth workflow, and providing for patient and provider needs.

This Doctor of Nursing Practice (DNP) …

Menstruation Behind Bars: A Mixed-Methods Study On Menstrual Product Access And Distribution Practices In Mississippi County Jails, Eron Hendrix

Honors Theses

This study examines menstrual product access and distribution practices in Mississippi county jails. It highlights the impact of period poverty as a critical yet underexplored public health and human rights issue within the corrections system. While existing research documents widespread inequities in access to menstrual products women’s healthcare in the correctional system, limited attention has been given to menstrual health at the local jail level. Using a mixed-methods approach, this study combines qualitative interviews with jail correctional staff and quantitative survey data from formerly incarcerated women to better understand institutional practices and lived experiences.

Interviews were conducted with sheriffs, jail …

More Than A Rod: Reconceptualizing Medical Student Development Through The Lens Of Social Determinants Of Learning, Dejour Young

Electronic Theses and Dissertations

Medical education traditionally follows a biomedical paradigm that emphasizes academic rigor but often overlooks non-academic factors that fundamentally influence student success. The aim of this study was to reconceptualize medical student development by shifting focus from traditional academic metrics to the systemic, non-academic factors that affect learning and well-being.

This study employs a systemic analysis of structural barriers, defined as institutional policies, practices, and environments that create and perpetuate inequity in medical education. This investigation was grounded in the Integrated Social-Ecological Framework for Learning (ISEF-L), a three-tiered conceptual framework developed for this study. The ISEF-L includes Social Determinants of Learning …

Quantifying Black Carbon Concentrations In Georgia And Analyzing Associated Public Health Risks, Khloe R. Osborne

Honors Theses

Quantifying Black Carbon Concentrations in Georgia and Analyzing Associated Public Health Risks

One of the most daunting challenges of the industrial world is air pollution. Within this broad spectrum, there is an inhalable particle group named PM2.5, which contains black carbon. Black carbon has evidence that supports the generation and worsening of adverse health impacts, which may include birth complications, cognitive deficits in children, pulmonary aggravation, asthma, cardiovascular issues, neurological degenerative patterns, and cancer risk. This is especially seen in vulnerable populations, like children, elderly, and those who already suffer from weakened health, many of which reside in the southern …

It’S Up To The States: The Role Of State-Based Safety Net Programs In Maternal Health Outcomes, Brooklyn Hall

Honors Theses

This thesis explores the relationship between state-based safety net programs and maternal health outcomes in the United States. Using the case studies of five states, namely Mississippi, Alabama, Wisconsin, Minnesota, and California, this research examines how variations in programs such as Medicaid, the Earned Income Tax Credit (EITC), Temporary Assistance for Needy Families (TANF), and Paid Family Leave (PFL) influence maternal mortality rates and overall maternal health outcomes. The analysis shows that states with more generous and comprehensive safety net programs, like California and Minnesota, tend to report lower maternal mortality rates. In contrast, states with less robust programs, such …

Making Sense Of Hospitalization: An Interpretative Phenomenological Analysis Of Covid-19 Patients’ Psychological Experiences In Indonesia, Mira Wahyu Kusumawati, Heni Dwi Windarwati, Setyawati Soeharto

The Qualitative Report

While previous research has probed into the experiences of COVID-19 patients during isolation in hospitals, little is known about their psychological experiences and the meaning of such experiences. To address the gap,this study was designed to explore the psychological experiences of patients who were confirmed positive for COVID-19 while undergoing isolation in hospitals. Using a phenomenological approach, we recruited 19 COVID-19 survivors who were confirmed positive for COVID-19 in the first six months of the pandemic entering Indonesia, located in Madiun Regency, East Java Province, Indonesia. We conducted face-to-face semi-structured interviews with health protocols and analysed the data using the …

What Is Screen Apnea And How Does It Affect You?, Kristi M. Soileau

New Orleans Dental Association News

Screen apnea is a modern epidemic of significant proportions. Research suggests that nearly 80% of people unconsciously alter their breathing, often holding their breath or breathing shallowly, while working on digital devices. This subtle shift in respiration, sometimes called “email apnea,” can place the body into a low-grade stress response without being noticed by the individual at the screen. When breathing becomes restricted from poor posting or content anxiety, the nervous system enters into a sympathetic response, much as it interprets signs of threats to that person. The resultant physiological response may be exhibited by muscle tension, mental fog, increased …

The Legacy Of Lead: Lead Exposure's Harmful Effects And Its Concentration In Poc Communities, Layla Sophronia Barber

Student Theses 2015-Present

This thesis examines the disproportionate burden of lead exposure carried by low income, POC communities. The systemic nature of this problem is a symptom of a longstanding legacy of environmental injustice in the United States. Decades of federal neglect are reflected in the higher statistics of lead exposure and poisoning in predominantly black communities. While it is understood that lead exposure poses a serious threat to physical health and early cognitive development, there is a discouraging lack of urgency to remove the toxin from non-wealthy communities. The material covered by this thesis aims to identify and correct the discriminatory social …

Values-Based Clinical Ethics: A New Model Of Health And Ethics Consultation For Patients Suffering In Extremis, Adam Trainer

Electronic Theses and Dissertations

This dissertation argues that contemporary clinical ethics is inadequately equipped to support patients suffering in extremis because it relies on an insufficiently discriminating account of health and a constrained model of moral reasoning. Drawing on Bernard Lonergan, it reconceives health as an emergent, multi-layered, heuristic notion shaped by biological, psychological, social, and existential goods. On that basis, it critiques principlism’s global applicability thesis and the undergirding claim that its principles form part of the common morality, arguing that this justificatory structure is philosophically insufficient and practically limited for clinical ethics in cases marked by profound suffering, moral plurality, and normative …

Challenges And Innovations In Tennis Coach Development: International Insights From Practitioners Across Continents, Miguel Crespo, Rafael Martinez-Gallego, Christine Nash

Journal of Coach Development

Tennis is a global sport with effective coaches being essential to the continued appeal, therefore the work of the coach developers within the International Tennis Federation (ITF) is crucial. This research examined the work and aspirations of coach developers in tennis using in-depth interviews with 10 ITF coach developers. Subsequently, we developed detailed pen portraits of two ITF coach developers at different levels of experience and engagement in order to highlight any differences in work, objectives or ambition. Findings from coach developers revealed three themes: support from ITF; barriers to learning; making learning less traditional. The pen portraits added further …

Using Geospatial Analysis To Compare Metropolitan Greenspace And Adolescent Obesity, Rachel Schild, Denyelle Kenyon, Zachary Schild

Scholarship Pathways Program

Using Geospatial Analysis and Machine Learning to Compare Metropolitan Greenspace and Rates of Adolescents with Obesity

 Rachel Schild MD | DenYelle Kenyon PhD

 Introduction: Insufficient outdoor activity, influenced by limited access to exercise-friendly greenspaces, may contribute to increasing childhood obesity rates. However, rigorous evaluation of greenspace quality on a citywide scale is lacking. This study aims to characterize greenspace vegetation types and correlate them with adolescent obesity outcomes, identifying optimal characteristics for promoting health. This data could aid city planners in optimizing greenspace allocation and improving vegetation choices.

Methods: Satellite imagery and municipal data were used to map ten cities, …

Lifestyle And Activity Patterns Of The Classic Period Maya From Chac Balam And San Juan, Ambergris Caye, Belize, Abigail L. Hornbeck

Honors Theses

Bioarchaeological research often uses skeletal remains to reconstruct patterns of activity and labor in past populations. This study examines potential sex-based differences in long bone morphology among individuals from the Classic Maya sites of Chac Balam and San Juan on Ambergris Caye, Belize. These coastal communities participated in maritime trade networks, and daily activities such as cargo transport, canoe travel, and fishing may have placed distinctive mechanical stresses on the skeleton. The goal of this study was to evaluate whether measurable differences in bone structure between males and females reflect differences in habitual activity patterns.

Two complementary methods were used …

Expertise First: Reflections On Informal Artificial Intelligence Mentoring In An Asynchronous Nursing Faculty Community, Anna Liza D. Villena Phd, Rn, Fnp-Bc

Journal of Online Mentoring

The integration of generative artificial intelligence (AI) into higher education has arrived faster than the support structures designed to help faculty navigate it. This article reflects on one faculty member’s experience providing informal AI integration mentoring to nursing colleagues at Walden University, a fully asynchronous online graduate nursing program, where clinician-educators with deep disciplinary expertise often struggled to recognize that expertise as an asset in their interactions with AI tools.

Drawing on Rogers’ (2003) diffusion of innovations theory, the article describes the mentoring approach that emerged from practice, the central insight that faculty are not failing to integrate AI because …

The Ethical Imperative Of Public Health Institutions To Protect The Reproductive Autonomy Of Vulnerable Populations, Kennethea Wilson

Electronic Theses and Dissertations

This dissertation establishes the ethical responsibility of public health institutions to safeguard reproductive autonomy, especially among vulnerable populations. While reproductive decision-making is traditionally framed within individual clinical encounters, this work contends that reproductive autonomy is fundamentally a matter of public health ethics. Socioecological determinants, including social, legal, environmental, and structural factors, often constrain individuals’ ability to make meaningful reproductive choices, leading to preventable harm.

Reproductive autonomy is defined as the capacity to make informed decisions about whether and when to conceive, as well as how to parent. The dissertation critiques the sufficiency of clinical ethics frameworks, such as informed consent …