Medicine and Health Sciences Commons^™

Evaluating Healthcare Professionals’ Perceptions Of The Ist Algorithm In Maternal-Fetal Health Clinic: Usability And Satisfaction, Terri Taylor

Doctor of Nursing Practice Projects

Background: Standardizing substance-use screening in perinatal care is essential for optimizing clinical decision-making and promoting equitable patient outcomes. To address gaps, the Integrated Screening Tool (IST) algorithm was introduced in a Maternal–Fetal Medicine (MFM) clinic. However, 2023 data revealed inconsistent utilization. Evaluation Question: This Doctor of Nursing Practice (DNP) project evaluated: (1) How do nurse practitioners, medical doctors, and registered nurses perceive the usability of the IST algorithm for standardized drug screening in pregnancy? (2) How do these providers rate their satisfaction with the IST algorithm in managing patients with positive drug screens? Methodology: A cross-sectional survey was conducted with …

School-Based Mental Health Services For Students With Disabilities: Exploring Benefits, Barriers, And The Role Of A Multi-Tiered System Of Supports, Veronica R. S. Meiners Perez

Electronic Theses, Projects, and Dissertations

Schools play a significant role in the academic, behavioral, and social-emotional development of children. Students with disabilities have legal rights to all necessary support for their educational success, including mental health supports. School-based mental health and its implementation are a work in progress, facing many barriers, but the benefits speak for themselves. Research suggests that the use of a multi-tiered system of supports ensures equal and equitable interventions for all students, especially students with disabilities. This literature review analyzes 16 studies regarding school-based mental health, special education, students with disabilities, and the MTSS framework. Support students' mental health, regardless of …

Potential Adverse Effects On Lifestyle And Food Intake Pattern In Night Shift Workers, Stacie L. Coleman

Electronic Theses, Projects, and Dissertations

Abstract

Night shift work is prevalent in healthcare and other industries, yet its effects on lifestyle factors such as food intake, sleep quality, and mental health remain underexplored. This study investigates the impact of night shift schedules on nurses’ wellness, focusing on eating patterns, sleep, physical activity, and mood. A sample of 13 nurses were divided into two shift groups: day (n=5) and night (n=8); and they completed a questionnaire to assess the variables related to their behavior, food choices, eating habits, sleep patterns.

The results of previous research studies indicate that night shift nurses are more likely to adopt …

The Impact Of Social Media Use On Postpartum Depression, Jaila Randle

Capstone Experience: Master of Public Health

Postpartum depression (PPD) is a serious form of depression that affects one in eight women. Symptoms include feeling sad all the time, being anxious, and having trouble bonding with their child. As social media sites like Facebook and Twitter become more important for moms to find support and health information, it has become a public health concern to learn how they affect mental health after giving birth. This literature review explores the positive and negative impacts of social media use on postpartum depression among mothers. A systematic search identified peer-reviewed studies published between 2014 and 2025. Studies were selected using …

Acceptability Of Corticosteroid Use In The Treatment Of Infant Bronchiolitis: Utilizing The Theoretical Framework Of Acceptability To Design Research Instruments, Caroline R. Smetanka

Capstone Experience: Master of Public Health

Bronchiolitis is the leading cause of hospitalization among infants under six months, yet treatment remains largely supportive due to clinical guidelines that discourage pharmacologic intervention. Recent research suggests that bronchiolitis is not a uniform condition, and a subgroup of infants (those classified within “Profile A”) may benefit from targeted corticosteroid therapy. However, these treatments remain outside current clinical guidelines, and their successful adoption depends on stakeholder acceptability. This Capstone project developed and refined four data collection instruments- two questionnaires and two interview guides- designed to assess how healthcare providers and caregivers perceive the acceptability of corticosteroid treatment for Profile A …

Utilization Of Tricare’S Childbirth And Breastfeeding Support Demonstration: Access To Lactation Services Among Military Families, Holly Johnson

Capstone Experience: Master of Public Health

In January 2022, the Department of Defense launched a five-year pilot program called the TRICARE Childbirth and Breastfeeding Support Demonstration. This demonstration aimed to cover lactation services for Tricare beneficiaries. This project included an electronic survey and was created and completed by 577 participants. Eligible participants needed to have given birth in the last 24 months and have TRICARE as their primary insurance. Participants completed this survey to help understand if they were aware of lactation benefits, if they utilized the service, and if it improved their breastfeeding experience.

Out of the 577 participants, 485 were eligible for the project. …

Creating Actionable, Culturally Appropriate Interventions From Survey Data: A Community-Driven Capstone Pilot Project, Nicole Placke

Capstone Experience: Master of Public Health

The Community-Driven Capstone Track is a pilot program designed as an alternative to the traditional capstone track. With this track, students are able to engage with community partners through an integrative learning experience. The goal is to address real organizational needs in a way that demonstrates the mastery of foundational and concentration competencies.

Unlike the traditional capstone track, the CDC offers flexibility in both project type and deliverables. Rather than one formal written report, students might produce a series of products or tools. Deliverables are decided collaboratively between the student, community partners, and the faculty committee to ensure they are …

The Effectiveness Of Interventions In Reducing Sexually Transmitted Infections Among African American Adolescents: A Comprehensive Literature Review, Brandy M. Leaver

Capstone Experience: Master of Public Health

In the United States, an estimated 20 million new sexually transmitted infections occur annually, with half of the cases occurring in adolescents. The infection rate among African American adolescents is four times higher than that among white adolescents. Although many types of interventions exist, few are specifically designed for African American adolescents. In conducting this comprehensive literature review and synthesis, I examined the effectiveness of existing interventions in creating behavioral change among African American adolescents by applying the health belief model to interpret and organize the findings. The databases PubMed, Embase, and Google Scholar were searched on October 1, 2025. …

Reducing Sleep-Related Infant Deaths In Douglas County, Lauren J. Maskin

Capstone Experience: Master of Public Health

Douglas County, including the city of Omaha, covers 339.6 square miles along the border of the Missouri River in Nebraska with a population of 517,110 (https://www.douglascounty-ne.gov/) and is one of seven large urban counties in the state. There are approximately 8,000 infants born in Douglas County annually (Nebraska Vital Statistics Birth Dashboard). The Douglas County Health Department (DCHD), established in 1854, is one of the oldest county health departments in the state and manages multiple public health projects annually. In 2024-2025, a renewed focus for DCHD has been its infant mortality rate (IMR). In 2024, 44 infant mortalities occurred in …

Breaking The Silence With Routine Genitourinary Syndrome Of Menopause Screening: A Quality Improvement Project, Ashley R. Noel

Electronic Theses and Dissertations

Affecting upwards of 87% of women in post menopause, genitourinary syndrome of menopause is greatly under-diagnosed, and consequently, under-treated. Genitourinary syndrome of menopause refers to health conditions impacted by hypoestrogenic state experienced in menopause. Common symptoms of GSM include vaginal dryness, irritation, clitoral or labial atrophy, dyspareunia, decreased libido, anorgasmia, dysuria, recurrent UTI, urinary incontinence (Kaufman et al., 2025). Despite the burdensome consequences of GSM, women are unlikely to vocalize their symptoms and seek treatment. Additionally, societal beliefs of shame surrounding sexual health impede patients and clinicians from addressing GSM specifically (Mili et al., 2021). As a result, the North …

Safety In Stability: A Cdc-Guided Evaluation Of Hospital Fall Prevention Practices, Matthew C. Dougherty

Electronic Theses and Dissertations

Hospital falls remain a persistent and preventable cause of patient harm, emphasizing the need for continuous evaluation of fall prevention practices. This project assessed the effectiveness of AdventHealth Orlando’s fall prevention policy using the Centers for Disease Control and Prevention (CDC) Program Evaluation Framework. A mixed-methods design incorporated quantitative analysis of 12 months of fall data and qualitative feedback from frontline staff surveys and discussions. Results demonstrated a decrease in total falls from 549 in the previous year to 528 in the current year, indicating early progress despite the incomplete reporting period. Unit-level analysis showed a mean improvement of 16.9% …

Enhancing Provider Knowledge And Implementation Of Medication For Opioid Use Disorder (Moud) To Improve Treatment Outcomes: A Quality Improvement Project., Motunrayo Abigael Ibraheem

Electronic Theses and Dissertations

This quality improvement project sought to enhance healthcare providers' knowledge and attitudes toward Medication for Opioid Use Disorder (MOUD) at Galt Ocean Rehab Center to improve treatment outcomes for patients with opioid use disorder. Despite evidence supporting the efficacy of MOUD, significant knowledge gaps and stigmatizing attitudes among providers create barriers to optimal care. Sixteen healthcare providers participated in a comprehensive educational intervention grounded in Jean Watson's Theory of Transpersonal Caring and the Institute for Healthcare Improvement's Model for Improvement. The intervention consisted of a 4-hour workshop, six weekly reinforcement sessions, and the implementation of standardized buprenorphine management protocols. Pre- …

A Human Factors Analysis And Classification System (Hfacs) Approach To Compare Cardiovascular, Orthopedics, Trauma Care, And Neurosurgery, Asfandyar Khan

Doctoral Dissertations and Master's Theses

Background: Despite significant progress in patient safety, human error continues to occur at high rates in procedural settings. Traditional safety models tend to focus on retrospective incident analysis, often overlooking the systemic conditions that allow errors to occur. The Human Factors Analysis and Classification System (HFACS) offers a proactive lens to understand how and where errors emerge and is useful for identifying active and latent failures.

Objective: To evaluate the utility and reliability of the Human Factors Analysis and Classification System (HFACS) in categorizing and comparing the pattern of frequencies (events) in cardiovascular, orthopedic, trauma care, and neurosurgical procedure.

Design, …

Decomposition Processes And Insect Indicators In Forensic Investigations, Eli Taylor

University Honors Theses

Insects play an essential biological and ecological role in human life, and their predictable relationship with decomposing remains has positioned them as a cornerstone of modern forensic science. Since the early 20th century, forensic entomology has provided critical evidence for estimating the postmortem interval (PMI), relying on patterns of colonization, species succession, and insect developmental timelines. Accurate PMI estimations are vital to medicolegal investigations, influencing the interpretation of biological evidence, guiding resource allocation, and informing determinations of cause and manner of death. However, insect activity is profoundly shaped by environmental and ecological variables, including temperature, humidity, seasonal shifts, and geographic …

Comparative Assessment Of Lower Limb Neuromusculoskeletal Activation And Joint Kinematics In Normal And Impaired Gait, Jack Ryan Schule

Theses and Dissertations

This thesis evaluates whether accessible and affordable technologies can provide clinically significant, quantifiable gait analysis comparable to traditional marker-based motion capture systems. Modern high-end systems offer excellent accuracy but remain financially and logistically inaccessible to many clinicians and researchers. To address this gap, a framework was developed using markerless pose estimation using the model, MediaPipe, inertial measurement units (IMUs) processed through an Extended Kalman Filter (EKF), and surface electromyography (sEMG) to measure joint kinematics and neuromuscular activity during gait. An experiment was performed where data was collected from participants with both normal gait and pathologies including: Osgood–Schlatter disease, Plica Band …

Wildfire Smoke And Public Health: Comparing 2023 Canadian Wildfire Events With Hospital Admissions In Douglas County, Nebraska, Jeremy Poell

Capstone Experience: Master of Public Health

Wildfires are becoming increasingly common in Canada and the United States. Smoke produced from these fires creates a multitude of air pollution constituents that can cause breathing and other health issues for humans, particularly those with asthma and other respiratory conditions. Of these pollutants, PM2.5 (particulate matter that is 2.5 microns or smaller) is particularly problematic as these particles are inhaled deep into lung tissue, where they create inflammation and oxidative stress. Poor air quality can also trigger asthma and respiratory issues, leading to an increase in emergency department admissions for breathing treatments. The goal of this study is to …

A Replication Study- Frequent Social Media Use And Experiences With Bullying Victimization, Persistent Feelings Of Sadness Or Hopelessness, And Suicide Risk Among High School Students- Youth Risk Behavior Survey, United States (2023), Diana C. Andrade

Capstone Experience: Master of Public Health

This replication study examines the association between frequent social media (SM) use and bullying victimization, persistent feelings of sadness or hopelessness, and suicide risk among U.S. young adults using data from the 2023 Youth Risk Behavior Survey. The study replicates the findings of Young et al. (2024), the first CDC report to incorporate SM into national adolescent behavioral surveillance. Using a weighted, cross-sectional sample of 15,203 students, the replication analysis estimated unadjusted and adjusted odds ratios for outcomes, controlling for age, sex, race/ethnicity, and sexual identity. 77% of students reported frequent SM use. It was significantly associated with higher odds …

Analysis Of The Hospital Medical Surge Preparedness Index In Relation To Hospital Characteristics And Social Determinants Of Health, Philipp Lirk

Capstone Experience: Master of Public Health

Objective

Substantial investments have been made in hospital emergency preparedness. The Hospital Medical Surge Preparedness Index (HMSPI) has been proposed as a metric to assess health system readiness. This index summarizes hospital system characteristics, space and facilities, staff availability, and supply planning.

Methods

The primary objective was to evaluate the relationship between the HMSPI and characteristics of the respective hospitals, including size, type, location, performance on the Hospital Resilience Index (HRI), and Social Determinants of Health (SDoH).

Results

Higher HMSPI scores were found in suburban compared to rural hospitals, a higher HMSPI in larger hospitals with greater patient volumes and …

Evaluating Knowledge Of Emergency Procedures For Top Hazards Among Hospital Staff, Aisha Zahid

Capstone Experience: Master of Public Health

Hospitals serve as frontline responders during public health emergencies, but the effectiveness of their response relies heavily on staff awareness and engagement with emergency preparedness training. This capstone project assesses hospital staff’s baseline knowledge of procedures for responding to the top emergency hazards. These hazards were selected based on Nebraska Medicine’s biannual Hazard Vulnerability Analysis (HVA), which identifies fire, severe weather events, and winter storms as high-priority risks requiring consistent staff readiness. Despite the existence of emergency procedures and training materials, literature reveals limited data on staff knowledge of these procedures across different hazards. This study, conducted at a large …

The Road To Regulation: A Literature Review Of The Influences On The Updated Silica Standards, Skye M. Medcraft

Capstone Experience: Master of Public Health

Silica is a hazardous compound that poses a risk to human health resulting from dust creating activities across various industries. Several agencies, including OSHA (Occupational Health and Safety Administration) and MSHA (Mine Safety and Health Administration) have adopted regulatory oversight of silica exposure in the workplace. As more research has been conducted on silica exposure, the health effects are becoming better described, which has led to the creation and updating of exposure regulations to protect worker health. The objective of this literature study is to review the data presented to the Department of Labor and discuss how the factors that …

High Test-Retest Reliability Of Nucleus Accumbens Activity During Reward Anticipation, Nathaniel Bouton

Graduate Theses and Dissertations

Recent research has questioned the reliability of Functional Magnetic Resonance Imaging (FMRI). The findings suggest poor test-retest reliability of FMRI measures across brain areas and tasks, and specifically in subcortical brain areas during reward-related tasks. Further, data from the Adolescent Brain Cognitive Development (ABCD) study showed low reliability and low stability of the fitted coefficients from whole-brain regression analyses of the Monetary Incentive Delay (MID) task. However, optimizing methods might improve reliability, for example: (1) acquiring single-band rather than multi-band FMRI sequences, (2) extracting raw activity rather than fitted coefficients, and (3) honing analyses to target brain areas during specific …

Influence Of Food Insecurity On Adolescent Mental Health: A Comprehensive Literature Review, Sarah Foss

Capstone Experience: Master of Public Health

Food insecurity is a growing public health concern with significant implications for adolescent mental health. This literature review provides an overview of current research on the relationship between food insecurity and adolescents’ mental health in the United States. A literature review was completed to identify studies examining the association between food insecurity and anxiety, depression, or attention deficit disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD). Evidence shows that the experience of food insecurity in adolescence is associated with a higher risk of developing or experiencing an exacerbation of anxiety, depression, or ADD/ ADHD. This review utilizes the socioecological model to explain …

A Literature Review: Back Injuries Affecting Certified Nursing Assistants In Nursing Facilities, Nesta Nsembene-Ntoutoume

Capstone Experience: Master of Public Health

Certified nursing assistants (CNAs) are at a higher risk of back injuries in healthcare, particularly in long-term care settings. This literature review assessed the primary causes of these injuries and the efficacy of current interventions, particularly Safe Patient Handling and Mobility (SPHM) programs. A total of 26 peer-reviewed articles were published between 2014 and 2025, including experimental simulations, cross-sectional and longitudinal studies, quasi-experimental training interventions, and evaluations of SPHM programs. Across the literature, the primary contributors to back injuries included high physical workload, inadequate ergonomic design, limited access to assistive devices, and staff shortage.

Experimental and biomechanical studies have demonstrated …

Linking Training To Confidence: A Literature Review On Advancing Nutrition Environments In Child Care Programs, Jeanne M. Vanorsdal

Capstone Experience: Master of Public Health

This comprehensive literature review examined child care nutrition training interventions using the Health Belief Model (HBM) to understand how to increase providers’ ability to serve nutritious food. By analyzing HBM constructs such as perceived severity, benefits, and barriers, the review assessed how training influences provider abilities and identified barriers and facilitators to consistently offering healthy meals and snacks. Studies were 1) published in English; 2) research conducted in the United States; 3) population involved home-based or center-based child care providers caring for children from birth to age 5; 4) articles published from January 1, 2015, to October 5, 2025; 5) …

Infectious Disease Crisis Communication After The Covid-19 Pandemic, Macy Lloyd

Capstone Experience: Master of Public Health

Since the COVID-19 pandemic, the United States has experienced a proliferation of mis- and disinformation, an increasing politicization of health and science, and growing distrust in government, science, and institutions. While these trends present challenges for normal public health communications, during a public health emergency, such as an infectious disease outbreak, these challenges are even more acute. To address challenges at the local level, health departments need plans, products, and tools that adapt health crisis communications to the current media environment and meet community members where they are across the trust continuum. To develop an infectious disease incident communication plan, …

Implementing A Nurse Navigator Role In An Outpatient Procedural Setting To Improve Patient Satisfaction Scores: A Quality Improvement Project, Lashanti King

Doctor of Nursing Practice Projects

Much focus has been placed on patient experience since the Affordable Care Act was signed into law in 2010 due to its regulatory, financial, and business growth implications. Patient satisfaction is crucial to maintaining and growing a customer base and fulfilling the target growth established in institutional strategic plans. This project aimed to determine whether implementing a nurse navigator role to perform rounds in the preoperative and waiting areas for two months would increase patient-reported satisfaction scores regarding being informed about delays and the likelihood of recommending the facility. Due to its subjective nature, it is challenging to consistently maintain …

Improving Post-Resuscitation Debriefing Completion Rates In An Acute Care Community Hospital: A Quality Improvement Project, Tiffany Tolden

Doctor of Nursing Practice Projects

Background: Post-resuscitation debriefing improves team dynamics and CPR quality and can identify systemic barriers to quality care delivery. However, completion rates remain low in acute care settings. Purpose: This quality improvement project evaluated whether a one-hour training session for rapid response nurses and charge nurses, combined with weekly reminder emails, would increase completion rates of post-resuscitation debriefings and influence nurses’ perceptions of their usefulness in an acute care community hospital. PICOT Questions: Will a one-hour training session (I) with rapid response nurses and unit charge nurses (P), along with a weekly reminder system (I), increase the completion rate (O) of …

Assessing The Impact Of Maternal Oral Health On The Risk Of Adverse Birth Outcomes, May Amr Salama

Health Services Research Dissertations

Preterm birth (PTB) and low birth weight (LBW) are leading causes of neonatal morbidity and mortality. Maternal periodontal disease (PD) has been increasingly linked to these adverse birth outcomes (ABOs), yet questions about causality and treatment effectiveness persist due to study design heterogeneity and potential unmeasured confounding. These gaps hinder the development of clear clinical and public health guidelines. This dissertation addresses these gaps through three interconnected studies assessing the relationship between maternal oral health and ABOs.

The first study employed a meta-epidemiological analysis of 62 original studies from nine systematic reviews to evaluate the impact of unmeasured confounding on …

Mitochondria-Mediated Epigenetic Transfer Between Chondrosarcoma And Wild-Type Cells, Caleb C. J. Wyckoff

Biomedical Sciences Theses & Dissertations

Glioblastoma (GB), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), cholangiocarcinoma, and chondrosarcoma (CS) cancers all contain mutations in the gene isocitrate dehydrogenase 2 (IDH2). The mutant IDH2 enzyme exhibits transformation of alpha-ketoglutarate (αKG) into the oncometabolite D-2-hydroxyglutarate (D2HG) in the mitochondria of these cancers. Mitochondrial-mediated transfer between cancer cells and recipient cells is a significant event that impacts the physiology of the receiving cell, specifically the epigenetic landscape. Previous experiments indicating increased DNA methylation in mesenchymal stem cells exposed to IDH1 or IDH2 conditioned medium underscore the potential role of D2HG to alter methylation states. Additionally, the presence of …

Schema, Stigma, And The “We-Them” Divide: Perspectives On Ageism From Everyday Life To Healthcare, Temple D. West

English Theses & Dissertations

Ageism remains a pervasive and often underexamined form of discrimination, affecting older adults across both everyday and clinical contexts. This paper explores how cognitive schemas—mental frameworks that shape perception and experience—and stigma interact to reinforce a “we–them” divide between and older patients and healthcare providers, as well as between older and younger individuals in broader society. Through focus groups and listening to the voices of older patients, this study examines how assumptions of age-based decline are embedded in society and inform schemas of ageism. It considers how those schemas shape the spoiled identity of older people as a stigmatized group, …