Medicine and Health Sciences Commons^™

The Benefits And Barriers To Expanding Crna Programs In Michigan, Grace Van Zweden

Honors Theses

The demand for Certified Registered Nurse Anesthetists (CRNAs) and their delivery of safe, high-quality anesthesia care has increased significantly due to nationwide anesthesia provider shortages and the growing reliance on CRNAs to meet healthcare system needs. This demand underscores the importance of expanding nurse anesthesia programs in Michigan and across the United States to support nurses pursuing advanced education and to improve patient access to essential care within their communities. The CRNA profession has evolved over time to meet the changing needs of the healthcare system, and current CRNA programs require applicants to satisfy rigorous and highly specific admission criteria. …

Bridging The Gap: Critical Resources For Grandparent Caregivers And Their Grandchildren, Kathy Dial, Cara Tonn, Omotomilola Jegede, Cindy Kekeh, Loriena Yancura, Michele Kekeh

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

US population estimates indicate that approximately 2.5 million children live apart from both parents. Family relatives, often called kinship caregivers, care for 70% to 90% of these children, with grandparents making up the largest category (Radel et al., 2016). This study aimed to identify the most helpful resources and sources for grandparent caregivers to support the overall well-being of their families. Phone or Zoom interviews were conducted among a purposive sample of 24 grandparent caregivers from February to March 2022 to examine their initial experiences as caregivers, the current support services and resources they received, and other resources and services …

Montana Kinship Navigator Program: A Statewide Frontier Initiative Promoting Kinship Family Health And Wellness, Daniel J. Koltz Dr., Peyton Vining, Yu Jiang

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This practice brief report describes the development, implementation, and new updates of the Montana Kinship Navigator Program (MTKNP), a statewide initiative designed to support kinship caregivers in a large, rural frontier context. Montana’s geographic isolation, limited infrastructure, and sparse population create significant barriers for kinship families, including restricted access to healthcare, transportation, childcare, and social services. These challenges are compounded when caregivers unexpectedly assume responsibility for children, often with limited resources and support. MTKNP addresses these gaps through a comprehensive, evidence-informed model that integrates information and referral services with individualized case management. The program serves both formal and informal kinship …

The Health And Well-Being Of Grandparents Who Report Major Responsibilities For Grandchildren: Perceived Physical Health, Depressive Affect, And Life Satisfaction, Tze-Li Hsu Phd, Patricia Drentea Phd

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This study examines how grandparents who report major responsibilities for their grandchildren experience perceived physical health, depressive affect, and life satisfaction compared to grandparents who do not report these responsibilities. Using data from the third wave of MIDUS (2013–2014), a nationally representative dataset focused on mid to later life (n = 1,819), we analyzed a sample of grandparents. Ordered logistic regression was used for perceived physical health, and ordinary least squares (OLS) regression was used for depressive symptoms and life satisfaction. Results indicate that grandparents with caregiving responsibilities are more likely to be women, non-White, and have lower incomes and …

The Effects Of Anti-Gdnf On The Sensory And Autonomic Nervous System In The Heart, Tryphosa Konadu

Honors Theses

Heart disease is the number one leading cause of death; about 1 in every five deaths is due to heart disease. “Heart disease” is a catch-all phrase that encompasses a variety of conditions that affect the heart’s structure and function. Many of these symptoms can be attributed to dysfunction within the parasympathetic, sympathetic, and sensory nervous systems. Neurotrophic factors like GDNF (Glial cell line-derived neurotrophic factor), BDNF (Brain-derived neurotrophic factor), and NGF (Nerve growth factor) promotes neuronal survival, and regeneration of the nerve fibers of the heart, especially sensory and autonomic nerve fibers. Studies have suggested that increased expression of …

Setting The Stage For Surviving Cancer, Kelly Allen

The Open Journal of Occupational Therapy

Margaret Petersen, theater artist and assistant stage manager of the Grand Rapids Ballet, is featured in the cover art for the Summer 2026 issue of the Open Journal of Occupational Therapy (OJOT). The self-portrait photograph depicts Petersen standing cheerfully on a terrace, dressed as an orange “safety cone” holding onto an IV pole. She takes in some fresh air as she receives her chemotherapy medication at the Lemmen-Holton Cancer Pavillion. Donned in orange coveralls and a modified hat topped with a small traffic cone and the word SAFETY emblazoned across the front, it is the costume she created to wear …

Occupational Therapy's Role In Optimizing Health Using 4ms Framework: Primary Care And Beyond, Nicole Karabas, Lydia Royeen, Bridget Hahn

The Open Journal of Occupational Therapy

As the older adult population in the United States continues to grow rapidly, the health care system faces increasing challenges in meeting their complex needs. A proactive, rather than reactive, approach to health care is necessary to support older adults in maintaining function and well-being. The Age-Friendly Health Systems 4Ms Framework; What Matters, Medication, Mentation, and Mobility, provides an evidence-based model for optimizing care across settings. Occupational therapists are uniquely positioned to implement the 4Ms framework because of their holistic and client-centered approach to evaluation and intervention.

By addressing "What Matters," occupational therapists  align care with individual goals and daily …

Occupational Therapists’ Emerging Role In Running Bereavement Support Groups, Diana Daus, Rondalyn V. Whitney, Susan Taddonio

The Open Journal of Occupational Therapy

Grief is well recognized as a stress response and, as such, significantly impacts engagement in meaningful occupational performance and engagement in meaningful occupations. Prolonged grief disorder (PGD), a newly recognized diagnosis, reflects the public health risk for the bereaved. Multiple client factors and performance patterns of those experiencing grief disrupt multiple areas of occupation. This opinion paper evaluates occupational therapy’s role in bereavement groups in the occupational therapy scope of practice.

Incivility And Toxicity In Occupational Therapy Academic Environments, Sharon Gutman, Sandra Rogers, Rondalyn V. Whitney

The Open Journal of Occupational Therapy

Toxicity in the academic environment is defined as an insidious form of behavior that is characterized by overt negativity with the intent to cause harm and includes bullying, manipulation, gas lighting, discrimination, preferential treatment, and ostracization. Reasons accounting for the existence of toxicity in academia include long-standing cultural norms of competition for scarce resources, devaluing of collaboration, unrealistic workload expectations and benchmarks for success, a milieu of excessive and negative critique, low salaries and professional rewards, and a hierarchical ranking system that encourages abuse of power without consequences. The impact of toxicity in academia on occupational therapy faculty include high …

Primary Care Reimbursement: Current Processes And Future Advocacy, Brenda Koverman, Monika I. Robinson, Lydia Royeen

The Open Journal of Occupational Therapy

Occupational therapy’s (OT) role in primary care is emerging as a viable practice area. Yet, operational efforts that include reimbursement continue to lag and have been identified as a barrier to entry. Current literature reveals confusing and overlapping reimbursement descriptions. Payment for services is critical for the sustainability of this practice area. This paper proposes a taxonomy to assist frontline clinicians, leaders, and provider practice managers to determine the best reimbursement strategy for their specific clinic. Differentiating and defining payment models, reimbursement determinants, and reimbursements methods allows OT leaders a shared language. Implementing the best reimbursement tactic will ensure the …

Practical Insights For Implementing An Intensive Therapeutic Day-Camp For Children With Hemiplegia: Guidelines For Practice, Rachel M. Vaughn, Holly Holland, Kerry Blazek, Jessica Margaret Cassidy

The Open Journal of Occupational Therapy

This guideline for practice provides practical recommendations for successfully executing a therapeutic day-camp for children with hemiplegia. By drawing from the literature and providing an in-depth explanation of our camp model, we address the challenges clinicians encounter when initiating therapeutic camp programming. A panel of physical and occupational therapists provides a comprehensive program description entailing a detailed explanation of camp programming, the combined therapeutic approach of intensive uni and bimanual training, and sample documents and activities. The program description, including camp attributes in relation to the ICF framework, provides an overview of our day-camp model, which has served children and …

Integrating Occupational Therapy In Homeless Street Outreach, Andrea Leflore, Cassandra Pagliaruli, Ryan Thomure

The Open Journal of Occupational Therapy

People experiencing unsheltered homelessness (PEUH) face multifaceted barriers to daily activity performance, characterized by barriers to performing basic needs, maintaining immediate safety, and accessing resources to manage health and transition into housing. Systemic barriers further impact access to care with discrimination in health care and homeless settings. With homelessness steadily increasing in the U.S., federally-funded initiatives have prioritized street outreach as an effective approach to meeting people where they are living with contextually adapted services. Street outreach interventions bring resources directly to communities, prioritizing relationship building to facilitate transitions to more stable living situations. This article presents a case analysis …

Occupational Therapy Students’ Demonstration Of Interprofessional Competencies During Simulation: An Observational Analysis, Elizabeth Crampsey, Shelley Cohen Konrad, Debra J. Ford

The Open Journal of Occupational Therapy

Quality care and patient safety are primary goals in health care, with interprofessional collaboration as a crucial strategy to achieve them. This study reports the behavioral outcomes of Occupational Therapy (OT) students applying core competencies, like Communication and Teamwork, during a longitudinal case-based team simulation activity designed to enhance interprofessional education (IPE). The activity was designed to improve implementation of IPE competencies during a collaborative teamwork exercise with standardized patients. A content analysis using the Interprofessional Collaborator Assessment Rubric (ICAR) assessed 21 graduate OT students’ deployment of IPE core competencies while participating in a semester-long interprofessional simulation (Sim-IPE) activity. Findings …

Exploring Student And Faculty Perspectives On Professionalism In Occupational Therapy Education, Mary Roduta Roberts, Jilaine Barton, Amy Janzen, Carolina Johnson, Lauren Painchaud

The Open Journal of Occupational Therapy

The development of professionalism is critical for occupational therapy (OT) students to become competent occupational therapists. This paper reports on the first phase of a multi-phase project to develop and pilot a situational judgement test to support teaching, learning, and development of professionalism in an OT program. The purpose of this study was to explore faculty and students’ perspectives on professionalism and OT. Twenty-two semi-structured interviews were completed with students (n = 18) and faculty (n = 4). The main insights shared included challenges in defining professionalism in OT, the importance of context, and differing perspectives on the effectiveness of …

Perceptions Of Capstone Mentors: Differentiating Capstone And Fieldwork Students In Occupational Therapy Doctoral Capstones, Sara Stephenson, Rochelle S. Reiss

The Open Journal of Occupational Therapy

This qualitative descriptive study explored occupational therapy doctoral capstone (OTD) mentors’ perceptions of differences between capstone and fieldwork students to inform mentor training development. Retrospective data from 157 mentors (145 occupational therapists, 12 non-OT professionals) mentoring 178 OTD students from 2020 to 2023 were analyzed using rapid analysis integrated with Kielhofner’s Qualitative Data Analysis Procedure. Mentors were selected by students through a structured process involving interviews and alignment of professional interests, contrasting with assigned FW placements. Six themes emerged: independence/student autonomy, mentoring relationship, professional skill refinement, unique experience, project development, and negative or neutral challenges. These themes highlight capstone students’ …

Evaluating Students' Experience In Applying Model Of Human Occupation In Acute-Care Settings Through Actor-Based Case Simulations, Tiffany T. Lin, Homa Zahedi

The Open Journal of Occupational Therapy

Occupational therapists in hospital settings play a critical role in facilitating rehabilitation and promoting safe discharge, thereby reducing hospital readmissions and preventing hospital-acquired injuries, such as deep vein thrombosis and falls. Despite the benefits of occupation-based interventions, novice therapists often revert to an impairment-focused approach because of difficulties in applying occupation-centered models. The Model of Human Occupation (MOHO) offers a framework to support occupation-based practice, yet students and early-career therapists frequently encounter challenges in translating theoretical models into clinical application.

This study aims to examine occupational therapy students’ experiences with actor-based case simulation sessions designed to enhance confidence and application …

Occupational Therapy Holistic Admissions At A Public, Urban Research University: Process, Outcomes, And Transitions, Ashley Stoffel, Dalmina Arias, Toni Van Denend, Caitlin Smith, Jenica Lee, Maria Larson, Gail Fisher

The Open Journal of Occupational Therapy

Implementing a holistic admissions process reflecting the mission of the university provides the means to expand enrollment of students from diverse backgrounds who have life experiences and values that are well matched to the communities they serve. This article explores the historical significance, outcomes, and transitions of a holistic admissions process in a public, urban research university.

The holistic admission process outlined in this article offers a balanced and equitable approach to student selection by considering a broad array of backgrounds, experiences, and attributes beyond traditional metrics, such as grades. With a commitment to inclusivity, access, and belonging, the department …

Feasibility Of Therapeutic Drumming Intervention For Autistic Youth: An Exploratory Study, Zahava L. Friedman, Dina Prisco, Jorge Ochoa, Talia Nuesi, Carmen Guarino, Patricia Higgins, Danielle Centi

The Open Journal of Occupational Therapy

Background: There is a need to identify a wider variety of neurodiversity-affirming interventions within the scope of occupational therapy. Therapeutic drumming, percussive music-making as a therapeutic intervention, holds potential for occupational therapy practice, though few studies have explored its efficacy with this population. The purpose of this study was to explore the design and effectiveness of therapeutic drumming for autistic youth from perspectives of drumming facilitators to identify relevant outcome variables and usefulness in the study and practice of therapeutic drumming.

Methodology: This exploratory feasibility study recruited twelve facilitators and 10 autistic youth. An occupational therapy graduate student …

Service Disruptions In Early Intervention Amid Covid-19: Understanding Challenges Faced By Families And Providers, Tiana T. Nguyen, Samantha Mong, Juliana Lainez, Domenique Embrey

The Open Journal of Occupational Therapy

Background: Infants at risk for developmental delays require early intervention (EI) services to support their development. However, many families face barriers to receiving services, which were exacerbated by the COVID-19 pandemic.

Objective: This qualitative study examined how COVID-19 impacted access to EI therapy services from the perspectives of families and EI providers in the San Francisco Bay Area. The study aimed to identify existing barriers and new pandemic-specific challenges to inform strategies for improving continuity and quality of EI care during future service disruptions.

Methods: Semi-structured virtual interviews were conducted with caregivers of eligible infants and EI providers. …

Theme Park Experiences Of Families With A Disabled Child Regarding Accessibility And Participation: Mixed Methods Study, Kylie Allan, Karen Park

The Open Journal of Occupational Therapy

Background: Despite the large number of children with disabilities, there is little research focused on the experiences families with a child who has a disability have while at theme parks. Both play and leisure participation offer meaningful opportunities for self-expression and can support skill acquisition and building social connections, particularly in family-oriented environments, like amusement parks.

Methods: Using environmental assessments, surveys, and semi-structured interviews, this mixed-methods study explored the experiences of these families, specifically looking at accessibility and participation in the theme park environment. Thirty-seven parents and guardians completed the online survey, while 10 individuals also elected to …

The Impact Of Computer Training On Confidence And Occupational Participation In Community-Dwelling Older Adults, Alicia Jones, Joseph A. Scazzero, Rosanne Dizazzo-Miller

The Open Journal of Occupational Therapy

Background: It is fundamental to understand why older adults choose and use technology to fully understand how to meet the needs of an aging population in a technologically advanced society. This research aimed to design and implement a holistic technology training program for older adults that explores using a laptop beyond basic internet use.

Method: A pre-post mixed-method survey study took place at a local senior center. A classroom-style program was designed to deliver information and instruction using a digital device. An 11-item survey on attitudes toward technology using a 7-point Likert scale with qualitative responses was used to collect …

A Retrospective Study Correlating Omsq-12 And Quickdash Scores Of Post-Operative Upper Extremity Patients, Sabrina Nassir, Mariem Metry, Yuju R. Huang

The Open Journal of Occupational Therapy

Background: This retrospective study aimed to identify a correlation between the Örebro Musculoskeletal Screening Questionnaire (ÖMSQ-12) and Quick Disabilities of the Arm, Shoulder, and Hand (DASH) of postoperative male patients with elbow and or wrist/hand conditions. The study aimed to discover how an individual’s comorbidities affect overall functionality over 6 weeks of treatment at Select Physical Therapy Hand Therapy in Orange, CA.

Methods: Data collected from male workers' compensation patients (N = 43) aged 20-50 years with elbow and/or wrist/hand conditions from January 1, 2021, to January 1, 2025, were included. Throughout a patient's therapy experience, they are …

The Content Validity Of The Functional Cognition Index In Instrumental Activities Of Daily Living (Fci-Iadl) As A Screening Tool For Mild Cognitive Impairment (Mci) In Older Adults In Singapore, Namrata P. Sadarangani, Phyllis Simon

The Open Journal of Occupational Therapy

Background: Mild Cognitive Impairment (MCI) is a syndrome that is considered a transition phase between healthy cognitive aging and dementia. The person may have subjective memory complaints, substantiated by family or caregiver and/or impaired executive function, that lead to difficulties performing complex Instrumental Activities of Daily Living (IADLs). Our objective was to develop a tool to assess functional cognition in IADLs as a screen for MCI in older adults.

Method: A Qualtrics survey questionnaire was rated by 15 content experts on the relevance of the 22 test item questions to the cognitive domains being measured using a 4-point …

Reframing Occupational Therapy In A Reactive Health System Through Prevention And Caregiver Training, Rosanne Dizazzo-Miller

The Open Journal of Occupational Therapy

This article explores the expanding role of occupational therapy in chronic disease management, prevention, and caregiver supported care. Occupational therapy is uniquely positioned to support health promotion and caregiver training but remains underused in prevention-focused health care models. Current literature from the Open Journal of Occupational Therapy highlights the importance of caregiver training, the systemic barriers limiting occupational therapy's role in chronic disease management, and the need for the profession to embrace a broader role within this area of practice.

An Attachment Perspective For Help-Seeking Intentions Among Emerging Adult Women Child Sexual Abuse Survivors, Dominique Giroux

Dissertations

Child sexual abuse (CSA) is an adverse childhood experience and a global health issue. Approximately one in four girls encounter CSA per year. Research evidence suggests approximately 50% of CSA survivors encounter sexual revictimization during adulthood (Walker & Wamser-Nanney, 2023), but formal help and intervention can mitigate further psychosocial harm experienced by CSA survivors (Widom et al., 2008). Attachment theory has provided a theoretical framework for identifying individuals at risk for revictimization and help-seeking patterns, such that individuals who have insecure attachment styles report more revictimization frequency, but the literature is mixed about attachment styles and help-seeking (Brenner et al., …

Exploring How Therapist Trainees’ Mentalization, Attachment Styles, And The Working Alliance Impact Treatment Outcomes In Psychotherapy, Hanali Gilbert

Dissertations

A burgeoning area of research within the past 30 years has sought to identify which specific therapist factors contribute to differential treatment outcomes (Barkham et al., 2017). The purpose of the current naturalistic study was to explore how two personal characteristics of therapist trainees, mentalization capacity and attachment styles, impact early treatment outcomes at two Midwestern psychology training clinics. This study also examined whether therapist mentalization and the working alliance interacted to influence client outcomes. Therapists completed the Mentalization Scale (MentS; Dimitrijević et al., 2018) and the Experiences in Close Relationships scale (ECR; Brennan et al., 1998), while the Working …

Predicting Clinical Outcomes Of Non-Specific Low Back Pain By Studying The Interaction Of Clinical And Demographic Factors Of A Retrospective Data Set, Erica Michelle Fernandes

Dissertations

The purpose of this research is to investigate demographic factors, including age, gender, body mass index (BMI), race, marital status, insurance type, severity of disease (initial pain level), and clinical factors such as number of visits (no. of visits) at physical therapy (PT), length of time at PT and the type of clinician either physical therapist versus physical therapy assistant (PTA), that most predict PT clinical outcomes in patients with nonspecific low back pain (NSLBP) and see if there is an interaction between demographic and clinical variables.

Methods

The current study is a retrospective, cross-sectional, observational study using secondary electronic …

Personal And High-Intensity Gait Factors Associated With Balance And Walking Improvement With Outpatient Stroke Rehabilitation: A Retrospective Study, Heather Staal

Dissertations

Objective: The purpose of this study is to examine the relationships between personal factors and High-Intensity Gait variables and balance and walking improvement in an outpatient stroke population.

Background: Stroke is a leading cause of long-term disability, with persistent gait and balance impairments commonly limiting independence and participation. High-intensity gait training (HIGT) is an evidence-based rehabilitation approach that improves walking outcomes following stroke; however, guidance on how specific training variables are applied in outpatient physical therapy settings remains broad.

Methods: This retrospective observational study analyzes clinical data from outpatient physical therapy episodes in which HIGT is a …

Attachment Style, The Working Alliance, And Client Self-Disclosure In Individual Psychotherapy, Jennifer S. Baar

Dissertations

Client self-disclosure is a core component of the psychotherapy process and increased levels of client self-disclosure have been shown to predict more positive therapeutic outcomes (Pattee & Farber, 2008; Sloan & Kahn, 2005). Similarly, the working alliance and attachment are constructs that have been studied in psychotherapy research and are consistently associated with therapeutic outcomes. Specifically, stronger working alliance ratings and higher levels of secure attachment have been found to predict more positive therapy outcomes (e.g., Flückiger et al., 2018; Mallinckrodt et al., 2005; Sauer et al., 2010). As these three constructs have been found to influence psychotherapy outcomes, the …

Metabolic And Replicative Constraints On Pathogen Virulence: Isoleucine Catabolism In Shigella And Comparative Tanapoxvirus Replication In Cell Cultures, Benecia Angelica

Masters Theses

Pathogens survive by balancing metabolic demands with environmental challenges that shape their virulence and adaptability. Shigella flexneri, a highly infectious human pathogen responsible for severe diarrheal disease worldwide, utilizes branched-chain amino acid (BCAA) metabolism to withstand stress conditions encountered within the host environment. In this study, we explored the Shigella isoleucine catabolism pathway by knocking out four genes in the S. flexneri isoleucine catabolic pathway (ilvE, fadA, fadD, and acnB) and examining their metabolism and virulence. We found that the ilvE and acnB mutants displayed reduced metabolic activity and smaller plaque size, while the fadD mutant showed decreased invasion. In …