Medicine and Health Sciences Commons^™

Perceptions Of Whole Plant-Based Diets And Weight Among Hispanics In Miami, Florida, Zoraida Powell

Walden Dissertations and Doctoral Studies

Being overweight or obese poses major public health concerns and contributes to the development of chronic illnesses. While researchers have explored how a total plant-based diet impacts excess body weight or obesity, there is still a lack of clarity about how Hispanics living in Miami, FL, perceive or understand this diet concerning overweight and obesity. Using a generic qualitative approach, this study was conducted on how Hispanics in Miami, FL, understand and view a whole plant-based diet (WPBD) for preventing and reducing overweight and obesity. Through interviews with 14 diverse Hispanic participants, the study revealed that they see WPBD as …

Rurality’S Impact On Alaska Native Elders’ Levels Of Physical Activity And Obesity, Jessie Doherty

Walden Dissertations and Doctoral Studies

While there have been studies on obesity levels and physical activity levels across many populations and age groups, few studies have focused on Alaska Native Elders. The purpose of this study was to examine rurality (urban vs. rural counties), physical activity, and obesity level while controlling for sex, self-reported loneliness, and self-reported stress. The theoretical foundation for this study was based on the socio-ecological model (SEM), and the research questions in this study explored how rurality impacted obesity levels and how rurality impacted physical activity levels in Alaska Native Elders. The methodology of this study was a quantitative cross-sectional design …

Benefits Of Intergenerational Programming In Occupational Therapy, Rachel Mitchell

Honors Theses

Occupational therapy helps clients work toward their meaningful occupational goals. Within this career, a person’s roles and habits are also addressed and taken into account when creating intervention plans. Many individuals live in a multi-generational home, living with others of different generations, or even interacting with them in their daily lives. Intergenerational programming is designed to bring people of different generations together. Whether the client lives with someone from a different generation, or sees them in their life, it is vital to have an understanding of each other. Areas that can be addressed include mental health, cultural identity, social isolation …

Lived Experiences Of Obese Women In Mississippi Concerning The Role Of Psychosocial Factors In The Development Of Obesity, Temitope Olabode

Walden Dissertations and Doctoral Studies

One of the highest rates of obesity in the United States is in Mississippi, where middle- aged obese women deal with a variety of social, cultural, and personal issues, including shame, discrimination, and stigma based on weight, mental anguish, cultural norms, financial limitations, and restricted access to healthcare. This study investigated the psychosocial factors that contribute to obesity in women aged 40- 60 years, and the effects of obesity on body image, self-esteem, health behaviors, and quality of life. A qualitative phenomenological study using the social ecological model (SEM) framework looked at the individual, interpersonal, and policy levels of the …

Comparing Fall Champions Versus Standard Protocol To Enhance Fall Prevention In An Adult Medical-Surgical Unit, Lily Denney

Walden Dissertations and Doctoral Studies

I conducted this quality improvement (QI) initiative with the aim of reducing inpatient falls within an adult medical-surgical unit through the implementation of a Fall Champions model supported by structured education and decentralized nursing leadership. Inpatient falls pose a persistent threat to patient safety, often leading to injury, prolonged hospitalization, and increased healthcare costs. Internal audits conducted through VigiLanz reporting revealed inconsistent protocol compliance and minimal accountability, signaling the need for targeted practice reform. Framed by the guiding question of whether Fall Champions could reduce inpatient falls compared to standard protocols, I evaluated the role of frontline leadership in reinforcing …

Alternative And Traditional Schooling On Sexual Risk Behaviors Among Alaska Native Youth In The Lower Kuskokwim, Nathaniel Hebert

Walden Dissertations and Doctoral Studies

Alaska Native youth experience disproportionately high rates of sexual risk, yet disaggregated data and school-contextual analyses remain limited. Understanding how school type (alternative vs. traditional) and individual factors influence sexual risk among Alaska Native youth is essential for informing targeted, culturally responsive health interventions and addressing ongoing health disparities. This quantitative study aimed to examine the association between three behaviors (condom use, multiple sexual partners, and substance use) by school type, controlling for gender, grade level, body mass index, and afterschool activity. Guided by the social-ecological model, this cross-sectional study provided new insights into the relationship between school type and …

Does Staff Education About Diabetic Self-Management Improve Knowledge And Intent To Educate Their Patients?, Bambi Lee Lane

Walden Dissertations and Doctoral Studies

This doctoral project was an education program for staff aimed at increasing their knowledge about diabetic self-management compliance. With improved knowledge, they will be better prepared to educate their patients. Diabetes is a highly complex disease that requires self-management care, including monitoring of blood glucose levels, control of diet, and medication adherence. Despite extensive pharmacology and diet counseling, irregularities between staff training and education program implementation have led to variable results in patients' compliance and control of glycemia at the project site. The significance of such an issue lies in its direct impact on patient morbidity, avoidable complications, and increased …

Addressing The Impact Of Workplace Violence On Staff Injury And Turnover Rates, Kia Denae Walker

Walden Dissertations and Doctoral Studies

This is an evaluation of a quality initiative (QI) project to determine the effectiveness of the 2023 workplace violence prevention training program in reducing workplace violence-related injures increasing the staff’s self-reported confidence in managing violence-related injuries and increasing the staff’s self-reported confidence in managing violent incidents during the six-month evaluation period. The objective of this QI evaluation project was to analyze the effectiveness of staff education intervention in reducing workplace violence and its costs. The level of increase in staff’s knowledge, level of compliance with safety measures, and number of violence-related cases and claims was the focus of the post-implementation …

Staff Education Program To Increase Staff Knowledge On Evidence-Based Practices To Reduce Falls, Ariella Carrenan

Walden Dissertations and Doctoral Studies

Falls among older adults in long-term care facilities constitute a pressing concern, affecting 30% to 40% of residents each year due to physiological changes associated with aging. Such incidents precipitated injuries, extended hospitalizations, elevated healthcare costs, and increased the potential for legal liabilities. This project investigated the effect of a structured educational intervention on nursing staff knowledge of fall prevention strategies in a long-term care facility where the fall rate of 3.4% exceeded the state average of 2.5% and the national average of 3.3%. The project explored the question: In a long-term care facility, does staff education increase staff knowledge …

Identifying And Addressing Barriers To Long Term Follow Up Care Of Patients With Hepatitis C In A Rural Southern Appalachian Clinic, Sarah M. Brown

Doctoral Projects

This project addressed the issue of loss to follow-up (LTFU) among patients infected with hepatitis C virus (HCV), a significant barrier to achieving sustained virologic response (SVR) and improving outcomes. LTFU is particularly critical among marginalized and rural populations who face socioeconomic barriers, stigma, and other social determinants of health (SDOH) that affect treatment adherence. Grounded in the Social Ecological Model (SEM), this project examined systemic, community, interpersonal, and individual factors influencing LTFU (Ahmed et al., 2022; Al-Khazraji et al., 2019; Kilanowski, 2017).

This Doctor of Nursing Practice (DNP) quality improvement initiative sought to improve patient retention in HCV care …

Followership Theory In The Age Of Artificial Intelligence: A Phenomenological Study Of How The Integration Of Ai Into An Ai-Human Hybrid Cancer Research Team Affects Followership Characteristics, John F. Carrera

PhD in Organizational Leadership

Artificial intelligence (AI) is rapidly becoming part of cancer research teams, helping with data analysis, pattern recognition, and decision support. Although AI changes how work is completed, little is known about how AI changes how followers adapt when AI becomes part of the team. This study examined how AI influences followership characteristics within AIhuman hybrid cancer research teams. A qualitative phenomenological research design was used to explore the lived experiences of nine cancer research professionals who interacted with AI as part of their routine work. Semi-structured interviews were conducted, transcribed, and analyzed through multiple rounds of qualitative coding to find …

Smarter Disease Detection From Electronic Health Record Data: An End-To-End Ai-Augmented Pipeline For Computable Phenotyping, Dylan Owens

Statistical Science Theses and Dissertations

Electronic Health Records (EHR) contain a wealth of structured and unstructured patient data that can be leveraged for computable phenotyping, the process of algorithmically identifying patient cohorts with specific diseases or conditions. Traditional rule-based phenotyping approaches, while interpretable, often struggle with scalability, portability across institutions, and effective use of unstructured clinical narratives. Recent advances in large language models (LLMs) present new opportunities for synthesizing complex free-text information into concise, clinically meaningful representations. However, integrating LLMs into phenotyping workflows requires careful design to maintain transparency, interpretability, and measurable uncertainty—features essential for clinical adoption and downstream applications such as decision support.

We …

The Impacts Of Sports Specialization On Youth Development, Madison M. Allen

Honors Thesis

To this date, there has been a rise in the professionalism of youth sports, which has increased the competitiveness and likelihood of early specialization in young athletes. While this allows youth athletes to have recognition at a young age, many athletes experience negative effects that inhibit their ability to make it to the elite level at a later age. Sports specialization can be defined as the participation and/or training of one sport year-round, typically excluding participation in all other sports. Current research suggests that sports specialization can contribute to injury and musculoskeletal disorders, impact motor skills and coordination, and cause …

Spatiotemporal Modeling Of Maternal Mortality In South Carolina 2018-2023, Leah Wood, Ray Bai, Emily Mann

Senior Theses

Maternal death serves as a public health indicator due to fact that it is considered preventable with the availability of modern biomedicine, however, it persists broadly throughout the United States. Current literature outlines national trends in maternal mortality with complicating, preexisting conditions, and structural upstream factors often cited as being the largest contributors to increased risk. This study utilizes publicly available, county-level data for maternal death in addition to demographic and descriptive data in order to estimate maternal mortality rates in each of South Carolina’s 46 counties from 2018 to 2023. In order to address sparsity in the outcome variable …

Fit For Success: Exploring Physical Activity Promotion And Effects On Students At The University Of South Carolina Through A Podcast Series, Maia Schwarzmueller

Senior Theses

College students face unique challenges when trying to maintain physical activity levels, such as time constraints, stress, and lack of proper facilities. The Fit for Success podcast will explore how physical activity is a powerful tool towards enhancing self-perception, academic success, and stress management as well as delve into the specific barriers that University of South Carolina students face to physical activity. The podcast will also explore different aspects of physical activity promotion including group fitness, competition, and built environment. The goal of the podcast is to help students to see physical activity as an important component of many facets …

Determinants Of Uptake Of Breast Cancer Screening Among Women Of Reproductive Age In Makueni County, Lola Ndirangu

MSc in Advanced Practice Nursing

Background: Breast cancer is the most diagnosed cancer in all women worldwide, with women in low and middle-income countries dying of the disease in disproportionate numbers because of late diagnosis and access to screening services. Sub-Saharan Africa is an under-researched area, and the level of screening uptake in Kenya, especially in rural and semi-arid areas, including Makueni County, is low. This research assessed the factors that determine the reproductive age women's screening uptake of breast cancer in Makueni County.

Methodology: The cross-sectional design was analytical and was conducted in Makueni County Referral Hospital, where 301 randomly chosen women …

Positive Depression Screen Among Pregnant Women Attending Antenatal Clinic At Aga Khan University Hospital, Michael Maina Muriithi

Master of Medicine in Obstetrics and Gynecology

Introduction: One in seven women experience peripartum depression, a common disorder that can occur during pregnancy or in the postpartum phase. Women are particularly vulnerable to depressive symptoms during pregnancy and the immediate postpartum period due to physiological changes during pregnancy as well as other sociocultural stressors. Peripartum depression is associated with significant maternal and perinatal adverse outcomes, including self-neglect, substance use, preterm birth, low birth weight and poor neurocognitive development, in offspring. There is a need to understand the prevalence and factors associated with depressive symptoms during pregnancy to improve maternal and neonatal outcomes. To our knowledge, this …

Combating Obesity: Creating A Comprehensive Wellness Plan For Uninsured & Low-Income Populations, Kayla C. Berrios

Doctor of Nursing Practice Scholarly Projects

Aim: The aim of this project was to research the specific barriers encountered by obese patients that are low-income and uninsured. The goal of this data collection was to inform the stakeholders involved in creating a comprehensive wellness plan for obese patients.

Background: The staff at Good Neighbor Clinic have struggled to support their support their obese patients with weight reduction. Many of the ailments that patients seek care for correlate to their obesity. Health promotion in this community clinic needs a more comprehensive program to support patients during their weight loss experience, providing support and resources to allow for …

Exploring Barriers To Patient Care In A South Carolina Free Clinic, Jonathan G. Green

Doctor of Nursing Practice Scholarly Projects

Access to healthcare remains a persistent challenge for medically underserved populations who rely on free medical clinics for primary care services, particularly in non-Medicaid expansion states such as South Carolina. Free clinics serve as critical safety-net providers, yet patients frequently encounter barriers that limit access, continuity, and quality of care. The purpose of this Doctor of Nursing Practice (DNP) project was to explore and identify the structural, social, and interprofessional barriers to patient care within a South Carolina free medical clinic to inform targeted, evidence-based interventions. A mixed-methods needs assessment design was used, combining a retrospective chart review of forty …

Empowering Mothers: A Digital Intervention For Perinatal Mental Wellness, Morgan Edmunds

Doctor of Nursing Practice Scholarly Projects

Aim: The aim of this project was to develop a smartphone application prototype for peripartum mental health. The goal of this application was to enhance access to education and quality mental health care.

Background: Currently, in the United States, peripartum mental health conditions are the leading cause of maternal morbidity and mortality (The Joint Commission, 2023). There is a gap in education, screening, and treatment for peripartum mental health due to distrust and a lack of resources, including a lack of mental health providers (Dossette et al., 2024; Feldman & Perret, 2023). Therefore, there is a significant number of women …

Advancing University Student Health And Wellbeing Through Peer-Led Health Promotion: A Quality Improvement Project​ ​, Rojeda Merani, Elizabeth Page, Elizabeth Roth

DNP Projects

Background: Peer-led health promotion is widely recognized as an effective strategy for increasing engagement, trust, and health literacy among university students. However, few frameworks guide development and implementation of these programs.

Objective: To evaluate the feasibility, implementation process, and perceived effectiveness of a peer-led health promotion model supported by Doctor of Nursing Practice (DNP) mentorship at a mid-sized private university.

Participants: Thirteen undergraduate students from a diverse set of academic programs were recruited as Peer Health Ambassadors (PHAs) and paired with DNP student mentors.

Methods: Guided by the Implementation Research Logic Model, the project used a four-phase QI process: targeted …

Food Insecurity And Social Connection Of Nicaraguan Refugees And Asylum Seekers In Costa Rica: A Qualitative Study, Keren Herran

Theses and Dissertations

Background

Given the physical and mental health consequences of food insecurity, solutions should be evidence-based and seek to prioritize vulnerable populations. This qualitative study adds to limited literature on how refugees and asylum seekers use their social connections to mitigate food insecurity by investigating how Nicaraguan refugees and asylum seekers in Costa Rica foster social connections and use these connections to acquire and manage food.

Methods

In fall 2024, 35 in-depth semi-structured interviews were conducted in San José, Costa Rica. Participants were recruited through six migrant-serving nonprofit organizations. For study inclusion, participants had to: 1) be 18 or older; 2) …

Development Of A Strategy To Neutralize Ccl8 Activity And Ablate Ccl8 Cellular Targets, Bernardo Chavez

Theses and Dissertations

The chemokine CCL8 (monocyte chemoattractant protein-2) is a versatile signaling molecule involved in tumor progression, immune cell recruitment, and therapeutic resistance. Through activation of receptors including CCR1, CCR2B, and CCR5, CCL8 promotes leukocyte trafficking, epithelial–mesenchymal transition, and the establishment of immunosuppressive tumor microenvironments. In breast cancer and inflammatory diseases, elevated CCL8 levels correlate with poor clinical outcomes, making it a promising therapeutic target.

A strategy was developed to block CCL8 activity and selectively ablate CCL8 receptor expressing cells. A neutralizing monoclonal antibody, 1G3E5, was identified from a panel of murine candidates based on high affinity CCL8 binding. Sequencing revealed two …

Hungry Minds: Analyzing The Impact Of Food Insecurity And Food Assistance Programs On Neurocognitive Development And Childhood Mental Health, Kayla A. Davenport

Senior Theses

Introduction: Food insecurity affects millions of children in the United States and is increasingly recognized as a significant risk factor for poor nutritional intake and adverse health outcomes. However, less is known about how the experience of food insecurity disrupts healthy development and well-being, particularly among American youth. This thesis had two aims: (1) to examine the relationship between household food insecurity and children’s neurocognitive and mental health outcomes and (2) to evaluate how major food assistance programs address, or fail to address, these developmental risks.

Methods: This thesis uses a mixed-methods approach, integrating a narrative literature review, a cross-sectional …

The Role Of Fibroblast Activation Protein On Left Ventricular Growth And Extracellular Matrix Remodeling As A Function Of Age And Pressure Overload, Amelia Marie Churillo

Theses and Dissertations

Fibroblast activation protein (FAP) is abundantly expressed in cancer associated fibroblasts and contributes to extracellular matrix (ECM) remodeling. Recent studies using imaging techniques have identified increased levels of FAP in the left ventricle (LV) of patients identified as at risk for developing heart failure. However, the role of FAP in regulated LV myocardial structure and function remains unclear. This project tested two hypotheses: First, genetic ablation of FAP would modify LV structure and function and be more pronounced with aging. Second, genetic ablation of FAP would modify LV structure and function with LV pressure overload (LVPO) accompanied by ECM remodeling.

Reducing Aspiration Pneumonia By Implementing An Enhanced Oral Care Toolkit, Jennifer London

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Oral care is essential for reducing bacteria and preventing aspiration pneumonia. The risk of aspiration pneumonia increases when protocols are not followed. In 2024, a regional hospital in the Midwest United States spent approximately one million dollars on the preventable healthcare-associated infection known as aspiration pneumonia. A pre-project chart audit of 100 random patient charts on a medical/surgical step-down unit revealed that only 1 of the 100 charts had oral care documented as completed.

Aim of the Project: The primary aims of this project were to increase nursing documentation of oral care by 50% and to decrease …

Improving Pain Assessment After Bedside Percutaneous Endoscopic Gastrostomy (Peg) Placement, Sherman Cotton

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Baseline audits at a 44-bed critical-illness recovery hospital showed low reliability in two post-PEG practices: (1) pain reassessment within 90 minutes of an intervention and (2) complete PEG-site documentation (skin, drainage, tube position/measurement). Baseline performance averaged 55% and 62%, both of which were below the organization’s 90% benchmark.

Aim of the Project: From May to July 2025 (12 weeks), improve on-time pain reassessment and ensure PEG-site documentation reaches at least 90%, maintaining this level for three or more consecutive weeks; monitor workload to prevent increases in perceived charting time and ensure safety by avoiding a rise in PEG-related …

Implementing A Standardized Ssri Tapering Protocol In The Outpatient Setting, Chelsea Sopo-Ngwa

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Selective serotonin reuptake inhibitors (SSRIs) are one of the most prescribed antidepressant medications in the outpatient psychiatric setting. Abrupt discontinuation or improper tapering of these medications may result in SSRI withdrawal symptoms. Adverse effects may lead to poor patient outcomes and increase healthcare utilization. A baseline chart review and provider readiness survey within the outpatient psychiatric practice revealed inconsistency in provider documentation related to SSRI tapering plans, patient education, and follow-up planning. The gap in practice highlighted the lack of a standardized SSRI tapering protocol to guide evidence-based medication tapering practices and promote patient safety.

Aim: The …

Reducing Hospital-Acquired Pressure Injuries In Critical Care Using A Preventing Pressure Ulcers Data Tool, Elizabeth Appiah-Caslin

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) are preventable yet remain a significant source of patient harm, especially in high-acuity settings like the Neurocritical Care (NCC) unit. HAPIs increase morbidity, length of stay, and healthcare costs. Despite having a prevention bundle, the NCC unit exceeded national benchmarks due to inconsistent adherence, delayed consultations, and variable documentation. Addressing this issue supports the organization's goals for safety and quality, aligning with CMS and Joint Commission standards.

Aim of the Project: This 12-week quality improvement project aimed to reduce HAPI incidence in the NCC unit by implementing the AHRQ Preventing Pressure Ulcers Data Tool. The …

Enhancing Nursing Documentation Accuracy For Female External Urinary Collection Devices Through Structured Documentation Huddles, Tiffany Ealy

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Accurate documentation of female external urinary collection devices (EUCDs), such as the PureWick, is crucial for maintaining continuity of care and ensuring efficient resource utilization. However, inconsistent nursing documentation practices have led to gaps in regulatory compliance and communication among healthcare teams. Baseline data revealed frequent omissions and inaccuracies in female EUCD charting, indicating a significant practice gap that requires targeted improvement.

Aim of the Project: The purpose of the evidence-based practice (EBP) project was to improve nursing documentation accuracy for female EUCDs by implementing structured documentation huddles, thereby enhancing organizational compliance.

Review of the Evidence: A …