Medicine and Health Sciences Commons^™

Puff, Puff, Pass? Examining Cannabis Use Among Black American Adults, Christopher B. Walker

Graduate Studies Theses and Dissertations 2026

In the United States, cannabis has become one of the most widely used controlled substances due to its increase in social acceptance, the growing number of states legalizing it for medical and non-medical purposes, and the expansion of consumption methods.  However, little is known about the modes of cannabis use chosen by Black American adults.  This population is of importance due to existing research suggesting their increased risk of developing cannabis use disorder compared to their White counterparts and their underrepresentation in existing literature.  The goal of this study is to examine cannabis use among Black adults in the U.S., …

Family Dementia Caregivers’ Disaster Preparedness In Chinese American Communities In New York City, Weiyu Mao, Bei Wu, Yaolin Pei, Zhen Cong

Health Sciences and Kinesiology Faculty Articles

Disaster preparedness is a significant public health concern. Disasters manifest in different forms and often lead to disruption of daily life. This is especially challenging for family dementia caregivers and their care recipients in the community. There remains much unknown regarding dementia caregiver disaster preparedness, especially in ethnic and racial communities. Guided by Protection Motivation Theory, with the backdrop of Hurricane Ida, this study explored the association between caregiving-related characteristics, cognitive appraisals, and disaster preparedness among caregivers in Chinese American communities. Data came from a pilot study on Chinese American family dementia caregivers in New York City between November 2021 …

Accelerated Molecular Aging In Neighborhood Poverty: A Racial/Ethnic Comparison, Jennifer Robinette, Jennifer Smith

Psychology Faculty Articles and Research

In the US, racial/ethnic health disparities are undeniable and partially stem from residing in low SES neighborhoods. Associations between neighborhood SES and health may have some underlying molecular mechanisms reflected in the epigenome. Yet, neighborhood characteristics are not always experienced the same way for all residents, and questions remain regarding whether those most exposed to low SES neighborhoods build greater resilience to, or embody greater harmful and cumulative outcomes from, such neighborhoods. The present study tested the hypothesis that greater neighborhood poverty would relate to accelerated epigenetic aging on the Horvath, Hannum, PhenoAge, and GrimAge clocks, and that these associations …

Hurricane Helene, One Year Later: Lived Experience, Geraldine A. Miller

Journal of Appalachian Health

Ashe County is located in the northwestern corner of North Carolina (NC), bordered by Virginia and Tennessee. The county is isolated, mountainous, and historically has lacked good highway access. Hurricane Helene, a category 4 hurricane at landfall, struck Western NC on September 27, 2024, resulting in flooding and wind damage that destroyed local communities in terms of land, homes, bridges, water, electricity, etc. with a damage of $59.6 billion.⁶ One year later, the recovery from the hurricane continues draining individuals and communities of their time, energy, and money. Geri Miller reflects on her hurricane impact experiences a year later. …

Impact Of West Virginia Abortion Ban On West Virginia Physician Trainee Practice Intentions, Rebecca Wald, Kristy Ward, Sarah Dotson

Journal of Appalachian Health

In June 2022, the Dobbs v Jackson Women’s Health Organization overturned the constitutional right to abortion established by Roe vs. Wade. Shortly after, West Virginia (WV) began enforcing a near total ban on abortion. Statewide restrictions on access to reproductive health care have important implications for the recruitment and retention of physicians. This project aimed to determine overall awareness of the 2022 changes in abortion laws among physician trainees, and whether the law influenced the intention of resident/fellow physicians to practice medicine in the state following completion of their medical training. A total of 178 resident and fellow physicians at …

Leveraging Community Health Worker’S Deep Community Knowledge To Address Food And Nutrition Security In Appalachia, Alexis Kimbro Scott, Melissa D. Olfert, Dawn Brewer, Makenzie Barr, Julie Plasencia

Journal of Appalachian Health

Introduction: Community health workers (CHWs) are trusted professionals in communities because of the deep understanding and cultural insights learned from their lived experiences. In Appalachia, CHWs are embedded in the community, giving them a unique understanding of how social determinants, like food and nutrition security, impact health outcomes.

Purpose: This study aimed to examine the professional characteristics and knowledge of CHWs while identifying culturally sensitive practices around food insecurity.

Methods: This cross-sectional, mixed-methods study used an online survey and in-depth phone interviews with CHWs in the Appalachian Region to examine their professional characteristics and knowledge on food security in their …

Stigmatization And Healthcare Inequity Perceived By Individuals Served By Homeless Shelters In An Appalachian City, Molly Powney, James M. Mears, Reagan Sharp, Lisa Calderwood

Journal of Appalachian Health

Introduction: People experiencing homelessness are medically vulnerable and suffer disproportionately from chronic physical and mental health conditions. Evidence-based standards to inform decisions surrounding care would be valuable for this population. Studies exploring how homeless individuals in Appalachia perceive their interactions with the healthcare system remain limited, however.

Purpose: The purpose of this study is to assess perceptions of the healthcare system among homeless individuals served by temporary housing shelters in an Appalachian city.

Methods: A voluntary anonymous survey was administered to residents at three shelters in Charleston, West Virginia (WV) from September 2023 – March 2024. Responses were collected utilizing …

Influence Of Family Health History And Parental Education On Body Mass Index, Blood Pressure, And Lipid Levels In 5th Grade Children: A Secondary Data Analysis Of The Cardiac Project, Madha Rani Das, Lee A. Plyes, Eloise Elliott, Christa L. Lilly

Journal of Appalachian Health

Introduction: Childhood obesity and related cardiovascular risks reflect the interplay of genetic predispositions and socioeconomic adversity. Appalachia’s poverty, limited health care, and educational gaps worsen family health risks, driving early cardio-metabolic problems in children, highlighting the need for effective interventions.

Purpose: The purpose of this study is to examine the association of family health history and parental education with BMI, BP, and lipid profiles among 5^th grade children in West Virginia (WV).

Methods: The study used WV CARDIAC data from 2006–2009. Outcomes were BMI, SBP/DBP, and fasting lipids (HDL, LDL, TG). Predictors were parental education and family health history …

Evaluating The Effect Of Ethnicity And Amyloid On Gait Speed In The Healthy Aging Brain Study-Health Disparities Study, Alexandra M. Reed, Andrew Hooyman, Edward Ofori, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

Background

Many novel Alzheimer's disease (AD) biomarkers have been studied in non-Hispanic White populations, despite Hispanic/Latino adults being 1.5 times more likely to develop AD and receiving a later diagnosis. Equitable, accessible assessments are needed to identify individuals at risk earlier. While cognitive screening monitors early AD signs, neuropsychological tests are often inequitable across ethnicity, race, and other social determinants of health. However, we have shown that performance-based motor assessments may be less susceptible to demographic factors than memory tests, and may be more equitable for screening older adults. Gait speed has been linked to elevated amyloid in non-Hispanic White …

The Cost Of Getting To “No”: Cultural Evolution Of Community Psychology In Two Indiana Communities, Catherine Cullen, Megan Peek

The Journal of Purdue Undergraduate Research

No abstract provided.

Systematic Review: Burnout In Health Care Professionals, Nicolas X. Tovar

The Journal of Purdue Undergraduate Research

No abstract provided.

The Equity Dead Zones: Legal Intersectionality Failure Points In Chapter 13 Bankruptcy, Tearria N. Simmons

The Guardianship Journal

Legal intersectionality failure points describe the systemic fractures that occur where overlapping legal, social, and economic inequalities converge, potentially producing compounded barriers to relief. Each failure point marks a site of marginalization. In what ways do individuals already recognized as vulnerable in Chapter 13 bankruptcy face a heightened risk when multiple forms of disadvantage intersect? When these intersections combine in mutually reinforcing ways—racial, economic, and relational disparities colliding with structural deficiencies in family, property, and bankruptcy law—does it result in pronounced negative outcomes, and, if so, what are those outcomes? Within this convergence, could there be a space where compounded …

Exploring The Impact Of Inpatient Mental Health Care On Adolescents, Alexandria M. Mckahan

2025 Fall Honors Capstones Projects - Archive

Adolescent psychiatric hospitalizations continue to rise, yet there is limited research on which daily practices inside inpatient units genuinely support engagement and recovery. This project examined how structure, staff tone, and therapeutic programming influence adolescents’ participation and emotional stability within a real inpatient setting. The study focused on three questions: how structured routines affect recovery, what challenges staff face when supporting adolescents with complex needs, and how adolescents’ engagement patterns reflect their perception of care. Using a mixed-methods case study at Mesa Springs Behavioral Health Hospital, I conducted approximately twenty field observations, semi-structured staff interviews, and descriptive engagement tracking across …

Best Integrated Writing Fall 2025 - Complete Edition, Wright State University School Of Humanities And Cultural Studies, Tracy Smith, Kristie Mckiernan

Best Integrated Writing

Best Integrated Writing includes excellent student writing from Integrated Writing courses taught at Wright State University.

Lycopene, Race And Periodontitis: Disparities In Older Adults, Katherine Kwong, You Lu, Zhuo Huan Li, Susu Luo, Zhaoyu Huang, Zhong Chen, Na Zhao, Tung Sung Tseng

School of Public Health Faculty Publications

Background Periodontitis is a severe gum disease that can be an indicator of other health conditions such as cardiovascular disease and diabetes. Lycopene has been suggested as an adjunct therapy for periodontitis. This study aims to investigate the association between insufficient lycopene intake and the risk of Periodontitis among non-Hispanic White (NHW) and non-Hispanic Black (NHB) older adults. Methods The study included 1,227 adults aged 65–79 years from the National Health and Nutritional Examination Survey (2009–2014). Total lycopene intake from daily diet was studied with age, race, marital status, smoking status, BMI, diabetes, sex, and education as independent variables in …

A World Between Worlds: The Hidden Disconnect Of Chinese Autistic Individuals, Joy Lu

Ought: The Journal of Autistic Culture

This paper examines the complex challenges faced by Chinese autistic individuals navigating both Western autism communities and broader Chinese cultural contexts. Drawing on personal experience, community observation, and cultural analysis, it explores how language barriers, cultural stigma, and differing values create a unique form of disconnection for the Chinese autistic community. This paper argues that current neurodiversity discourse is dominated by Western frameworks that often fail to account for this disconnect, resulting in the exclusion of entire groups. By centring Chinese perspectives, it calls for a more culturally responsive approach to autism advocacy: one that bridges linguistic, cultural, and historical …

Validation Of The Evaluating Nursing And Curriculum For Transformation Tool For Diversity, Equity, And Inclusion Curriculum Integration, Kendra M. Barrier, Mary Dioise Ramos

School of Nursing Faculty Publications

Background: The American Association of Colleges of Nursing (AACN) emphasizes Diversity, Equity, and Inclusion (DEI) as a foundational element for professional nursing education, crucial for preparing students to care for diverse patient populations. The purpose was to develop and validate an instrument to measure the extent to which DEI elements are integrated throughout the nursing curriculum. Methods: The ENACT (Evaluating Nursing and Curriculum for Transformation) was developed through a comprehensive process involving several phases: tool development based on DEI elements, framing each element within the Nursing Process (ADPIE), preliminary evaluation, obtaining content validity index (CVI) from experts, renaming the tool …

Asian College Students' Well-Being During A Period Of Rising Anti-Asian Sentiment, Kyuhan Choi, Ying Shi, Maria Zhu

Center for Policy Research

We use a large survey of students in U.S. colleges to study the distinct ways in which the COVID-19 pandemic and accompanying anti-Asian rhetoric shaped the experiences of Asian and Pacific Islanders (APIs). Using a difference-in-differences approach, we find that the pandemic led to Asian students experiencing more discrimination, feeling less safe during the day, and using fewer mental health services compared to White peers. The increase in discrimination and the perceived lower safety are concentrated among East and Southeast Asians, while South Asians were not affected. Despite these effects, we detect no relative deterioration in severe psychological distress or …

Improving Palliative Care Knowledge And Intentions Among Great Plains American Indians: Efficacy Results From A Randomized Clinical Trial Testing A Culture-Centric Palliative Care Message, Mary J. Isaacson, Kah Meng (Charlie) Soh, Christopher S. Wichman, Gina Johnson, Kelly Le Beaux, Semhar Michael, Lisa Sparks, Karla M. Hunter

Communication Faculty Articles and Research

Background

Methods

Results

Travel Time To Treating Facility And Mortality In Men With Prostate Cancer, Stephan M. Korn, Filippo Dagnino, Danesha Daniels, Zhiyu Qian, Hanna Zurl, Klara K. Pohl, Mei Chin Hsieh, Brenda Y. Hernandez, Andrea Piccolini, Alexander P. Cole, Amanda J. Reich, Joel S. Weissman, Quoc Dien Trinh, Hari S. Iyer

School of Public Health Faculty Publications

IMPORTANCE Geographic access to prostate cancer care may influence outcomes but is often measured using straight-line distance, which may not accurately capture the travel burden experienced by patients. OBJECTIVE To evaluate the association between estimated travel time from patients’ residence to treatment facilities and all-cause and prostate cancer–specific mortality. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used data from the Multilevel Epidemiologic Tumor Registry for Oncology, a nationally representative, investigatorinitiated, population-based cancer registry that integrates geomasked residential and treatment facility information from multiple US state cancer registries. The study included patients aged 40 to 99 years from Hawaii, Louisiana, …

Referral Strategies For Recruitment And Engagement Of Community Adults Into Online Extension Health Programs, Cheryl L. Eschbach, Dawn A. Contreras, Holly B. Tiret

Journal of Human Sciences and Extension

This article shares details behind building organizational capacity to establish program referrals for statewide recruitment of community adults into Cooperative Extension’s online health programs. This study explores the role of intentional recruitment strategies (active and passive) to increase participant program enrollment into health education and shares examples from one state that has created a trained workforce that offers ongoing research- and evidence-based programs. After many years of trying paper, phone, and electronic medical record methods to increase program reach, Michigan State University Extension tried an electronic referral process via a QR code and web link, accompanied by program marketing, to …

John Henryism And The African American Experience: An Exploration Of Risk And Protective Factors And Health Outcomes, Joseph L. Twitdy

All-Inclusive List of Electronic Theses and Dissertations

Racial discrimination has been tied to adverse mental and physical health outcomes among African Americans. In the face of this adversity, African Americans have developed strategies for coping with everyday experiences of discrimination. One such coping method is based on the concept of John Henryism. The folktale of John Henry tells the story of an African American steel-driver racing against a steam-powered drill to clear a path for trains through a mountain. Although John Henry wins the race, he later dies due to exhaustion, ultimately passing with his hammer in his hand. The psychological concept of John Henryism (JH) refers …

Assessing U.S. Fatal & Nonfatal Injury Trends By Worker Age, Alexander Mcdaniel

All-Inclusive List of Electronic Theses and Dissertations

Occupational injuries and fatalities in the United States have declined over time; however, meaningful differences by worker age remain a concern for employers and safety professionals. Younger workers often experience higher non-fatal injury rates due to limited experience and developing hazard-recognition skills, while older workers face increased risk of severe and fatal outcomes related to age-associated physical changes. The purpose of this study was to analyze long-term injury and fatality trends by age group and determine whether differences exist over time. National injury data from the Census of Fatal Occupational Injuries (1992–2023) and the Survey of Occupational Injuries and Illnesses …

Assessing Neurocognitive Functioning Among Adults Ageing With And Without Hiv At The Kenyan Coast: Measurement Issues And Correlates, Patrick Nzivo Mwangala, Carophine Nasambu, Ryan Wagner, Mihaela Duta, Gaia Scerif, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Cognitive impairment is one of the most prevalent complications of HIV infection, with significant medical and functional impacts. However, valid, and reliable assessment tools are lacking for the newly emergent ageing population of people living with HIV (PLWH) in many parts of sub-Saharan Africa (SSA), including Kenya. Without these tools, critical intervention opportunities, e.g., psychoeducation, treatment and additional support, are missed. To bridge this gap in Kenya, we adapted the Oxford Cognitive Screen Plus (OCSPlus), a tablet-based cognitive assessment tool designed for low-literacy settings, with adults ageing with HIV ≥ 50 years and their uninfected peers. This study examines …

A Quantitative Exploration Of Risk And Protective Factors Affecting The Mental Health Of Chitimacha Tribal Youth, Daphnie Vilcan-Tanner

LSU New Orleans Theses and Dissertations

This study examines the relationships between demographics, risk factors, and protective factors with mental distress among Chitimacha Tribal adolescents aged 12 to 18. Using a Positive Youth Development framework, the research aimed to identify the prevalence of mental distress, trauma, discrimination, and protective factors, as well as their collective and individual impacts on mental health. Data were collected through online surveys completed by 73 participants residing on or near the Chitimacha Tribal Reservation. Descriptive statistics and multiple linear regression analyses were conducted to analyze the data. Results revealed that while trauma and discrimination collectively predicted mental distress, family and community …

Living With Dementia In Kenya: Pathways To Care, Diagnosis And Management, Edna Bosire

Institute for Human Development, East Africa

Background: Sub-Saharan Africa (SSA) is experiencing a sharp rise in the size of theolder population; consequently, the incidence and prevalence of Alzheimer’s DiseaseRelated Dementias (AD/ADRD) is also expected to rise. There is limited research onAD/ADRD lived experiences have been conducted in SSA including Kenya. Our projectaimed to explore patient’s and caregivers lived experiences with Alzheimer’s disease inKenya.

Methods: This ethnographic study was conducted at the Aga Khan University hospital(AKUH), involving in-depth interviews with 21 health care providers, 26 patientswith mild cognitive impairment and 36 caregivers. We also conducted 10 homevisits and observations. Data were transcribed verbatim and thematically analysed.In what …

Drought, Worry, And Preparing For The Future: The Ethnopsychology Of Climate Distress In Kilifi County, Kenya, Edna Bosire, Syed Wahid, Linda Khakali, Benjamin Oestericher, Felix Agoi, Anthony Ngugi, Rosebella Iseme, Jasmit Shah, Zul Merali, Lukoye Atwoli

Brain and Mind Institute

The impacts of climate change in sub-Saharan Africa (SSA) presents a chronic and intensifying disaster, with drought, flooding, and extreme heat, presenting unique challenges and profound disruptions. Growing evidence links such events to ecological grief, ecological anxiety, and solastalgia – negative affective states that reflects responses to climate change related destruction of nature, species, culturally significant or sacred spaces, and other ways of life. While this literature is expanding in the Global North, little is known about how communities in SSA perceive and respond to deteriorating or depleting natural ecosystems. This article explores the ethnopsychology of distress precipitated by environmental …

Community Perspectives On Factors Contributing To Resilience For Healthy Aging In Kenya, Linda Khakali, Everline Onchari, Maureen Ondire, Catherine Onyancha, Chinedu Momoh, Edna Bosire

Brain and Mind Institute

Background: The global elderly population is increasing and expected to double in thenext decade. Aging increases the likelihood of adversities, with resilience becomingan important aspect of healthy aging. Understanding how individuals conceptualizeresilience offers an opportunity to create contextually relevant interventions forpromoting healthy aging. This study aimed to explore adults’ perspectives on factorsinfluencing resilience in Kenya.

Method: Using qualitative methods, 36 adults aged 35 years and above werepurposively recruited from various communities in Nairobi County to participate ininterviews. We asked questions about their understanding of aging, adversity andresiliency. We also provided them with case scenarios of two individuals respondingdifferently to the …

Reassessing Dementia Risk: Expanding The 2024 Lancet Commission Report For A More Accurate Global Understanding, Cyprian Mostert

Brain and Mind Institute

Background: The 2024 Lancet Commission Report analyzes 14 risk factors thataccount for 45 percent of global dementia cases. However, it overlooks four criticalrisk factors: poverty, wealth shocks, income inequality, and viral infections. This isparticularly concerning given that 57 percent of the identified risk factors in theLancet report are more prevalent in men, even though dementia predominantly affectswomen worldwide.

Method: In this policy paper, we used the recent global review studies and argue that itis essential to recalibrate and expand the 2024 Lancet Commission’s list of risk factorsto include poverty, wealth shocks, income inequality, and viral infections. Our analysissuggests that these …

Cultural Adaptation Of An Innovative Reproductive Health Assessment Tool For Dementia Research In Africa: Insights From The Fember-Africa Study, Alice Moraa Ondieki, Anne Njogu, Cynthia I Sabel Smith, Edna Bosire, Karen Blackmon, Harrison Kaleli, Jasmit Shah, Rachel Maina, Sheila Waa, Chinedu Momoh

Brain and Mind Institute

Background: Dementia research accounts for only 0.1% of all research in Africa,making it the lowest among all low- and middle-income country (LMIC) regions. Thedevelopment and adaptation of biological and psychosocial measures in ethnicallyand culturally diverse populations remain limited but are essential for culturallyinformed research. This is particularly critical for examining sex- and gender-basedvulnerabilities to Alzheimer’s disease and related dementias (ADRD), including factorssuch as reproductive health and fertility.

Method: We conducted a thorough review of our clinical and health questionnaires forcultural relevance and sensitivity through a series (n = 3) of focus groups discussions.These focus groups included a diverse range of …