Medicine and Health Sciences Commons^™

Caregiving And Mental Health Among Mothers During The Covid-19 Pandemic, Makayla Elise Techentine

Walden Dissertations and Doctoral Studies

The 2019 coronavirus (COVID-19) pandemic led to reliance on family members or friends to care for the sick, resulting in a burden of informal caregiving stressors and relationship to mental health. Guided by the stress process model, this quantitative, cross-sectional study aimed to assess the relationship between caregiving stressors and the mental health of mothers of children aged 18 years or younger who were serving as informal caregivers. Secondary data from the 2020-2021 Behavioral Risk Factor Surveillance System (N = 1,772) considered the independent variables related to caregiving stressors, including hours spent caregiving, time since becoming a caregiver, personal care …

Behavioral Intentions And Use Of Telehealth Among Afro-Caribbean Immigrants In Florida, Patsy Patricia Lindo-Wood

Walden Dissertations and Doctoral Studies

Many researchers have documented the benefits of telehealth in managing cardiovascular disease and its risk factors. However, acceptance and use of telehealth among immigrants in the United States were low compared to other users, and little is known about Afro-Caribbean immigrants and their telehealth acceptance and use. Guided by the unified theory of acceptance and use of technology, this study explored how performance expectancy, effort expectancy, social influence, and facilitating conditions shape behavioral intentions and telehealth use among Afro-Caribbean immigrants in Port St. Lucie, Florida. A generic qualitative design with a purposive sampling strategy was used to interview 17 Afro-Caribbean …

Leadership-Mediated Retention Strategies To Sustain Workforce Capacity And Performance In Public Health, Meredith Winslow Wilkins

Walden Dissertations and Doctoral Studies

Workforce retention challenges continue to affect public health leaders by contributing to staffing shortages, reduced organizational capacity, and disruptions in service delivery. Public health leaders are concerned with employee turnover because it affects workforce stability, organizational performance, and the ability to meet community health needs. Grounded in Herzberg’s motivation-hygiene theory, the purpose of this qualitative pragmatic inquiry was to explore effective workforce retention strategies used by public health leaders to retain skilled staff and strengthen organizational capacity and revenue. The participants were eight public health leaders in the Northeast region of the United States with responsibility for workforce management and …

Extracellular Vesicle-Mediated Transfer Of Gsdme-Nt Pores As A Mechanism Of Inflammation Propagation, Bifeng Xiao

Master's Theses

Inflammasomes are multiprotein complexes that initiate inflammatory signaling through activation of caspase-1, cytokine maturation, and cleavage of Gasdermin D (GSDMD). Cleaved GSDMD forms membrane pores that contribute to cytokine release and pyroptotic cell death. Recent evidence suggests that extracellular vesicles (EVs) may facilitate the intercellular transfer of inflammatory mediators. This study investigated whether GSDMD N-terminal fragment (GSDMD-NT) associates with EV-enriched fractions and contributes to inflammation propagation. Doxycycline-inducible HeLa cells expressing FLAG-tagged GSDMD-NT were used to generate EV-enriched fractions. Western blot analysis detected GSDMD-NT-associated material within EV fractions, while EV marker analysis supported successful enrichment of EV-associated material. Exposure of recipient …

Covid-19 Case Study, Armando Olmeda

Distinguished Student Scholarship Collection

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, continues to affect healthcare systems and public health worldwide. This case study examines COVID-19 from an epidemiological perspective by looking at how the disease spreads, the populations most affected, the major risk factors, and the impact on healthcare systems. It also analyzes key epidemiological measures, including incidence, prevalence, hospitalization, and mortality trends, to better understand how the pandemic has changed over time. The findings show that older adults, individuals with chronic medical conditions, and socially disadvantaged populations continue to experience the greatest burden of disease, with social determinants of health playing an important …

Inactive Nurses In New Mexico: Insights Into License Lapse And Inactive Reserve Status, Kiyoko Dell Davis

Doctor of Nursing Practice Scholarly Projects

Nursing shortages have varied over the decades, yet persist at local, national, and global levels. Nurses report leaving the workforce for many reasons, including professional environment factors resulting from these shortages, further exacerbating a shrinking workforce and population growth. Recent efforts include recruitment and education incentives and implementation of the New Mexico Board of Nursing (NMBON) Inactive Reserve Licensure option, which allows retiring nurses to maintain a reduced-scope nursing license with fewer barriers. Despite these efforts, questions remain: why are nurses in New Mexico leaving the profession and would this licensure category have impacted retention? The purpose of this project …

Improving Continuity Of Care: Evaluating Universal Nursing Handoff Sheets, Elizabeth Ifeloluwa Sanya

Doctor of Nursing Practice Scholarly Projects

Effective communication during nursing handoffs is essential for safe, patient-centered care, as breakdowns in communication are a leading cause of adverse patient outcomes. At a large academic level I trauma center, inconsistent nursing handoff practices were identified across progressive care units following the COVID-19 pandemic. This variability contributed to incomplete transfer of patient information and was associated with increased patient safety incidents, including delayed wound care, central line dressing lapses, and medication errors involving high-alert therapies. The purpose of this DNP project was to plan, implement, and evaluate the use of  standardized nursing handoff sheet and its impact on continuity …

Assessing Hpv And Hpv Vaccine Awareness And Perception Amongst Undergraduate Students, Maura Hawkins

Honors Theses

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections in the United States. Vaccination rates remain low among college-aged students despite an effective vaccine being available. This study investigates HPV and HPV vaccination-related knowledge, beliefs, and perceptions among undergraduate students to inform targeted intervention strategies. Participants included undergraduate students (n = 19) who attended one of three focus groups conducted in April 2025 at the University of South Alabama. Structured interview guides explored HPV knowledge, perceived risk and severity, attitudes towards vaccination, autonomy in health decision-making, trust in health information sources, and preferred educational strategies. Discussions were …

Fractured Focus: Understanding Stress In Second-Year Radiologic Science Students Across Alabama, Kelsi Clotfelter

Honors Theses

Higher education is a period of rapid transition and growing responsibility, where stress often becomes a routine part of students’ lives. In health professional programs, the combined demands of intensive coursework and clinical training can intensify emotional strain and negatively affect overall well-being. Radiography students experience uniquely high levels of academic, clinical, and emotional stress due to the simultaneous demands of didactic coursework, competency-based clinical training, and high-stakes professional expectations. A cross-sectional mixed-methods study was employed to evaluate the prevalence, sources, and perceived impact of stress among second-year radiography students across multiple Alabama institutions with the goal of identifying strategies …

Reducing Missed Opportunities For Crc Screening Via Provider Reminder System In A Primary Care Setting, Komfort Cofield

Doctor of Nursing Practice Projects

Background: Although highly preventable with screening, colorectal cancer (CRC) continues to be a major source of illness and mortality in the United States. Healthcare providers at the Doctor of Nursing Practice (DNP) project site inconsistently ordered CRC screening for eligible patients due to deficiencies in the point-of-care reminder system. These system failures created missed opportunities for CRC prevention and reduced compliance with established practice guidelines.

Purpose: This DNP project aimed to implement and evaluate a CRC screening checklist given to patients at appointment check-in, serving as a reminder for providers to order appropriate screening tests.

Project Design: Using the National …

Addressing Hypertension Medication Non-Adherence Through The Use Of Reminders And Morisky Medication Adherence Scale In Adults Diagnosed Within The Past Year In A Rural Primary Care Clinic, Amanda M. Weaver

Doctor of Nursing Practice Projects

Background: Adherence to antihypertensive medications is essential for decreasing long-term consequences of uncontrolled hypertension, including stroke, kidney failure, and cardiovascular diseases. However, nonadherence is a widespread problem among patients diagnosed with hypertension. In patients who have been diagnosed with hypertension in the past year, more than half stop taking their medications. Mobile health interventions, such as text message or telephone reminders, are a low-cost way to improve medication adherence.

Purpose: The purpose of this Doctor of Nursing Practice project is to examine how a weekly text message or telephone reminder impacts medication adherence among patients taking antihypertensives in a rural …

A Multifaceted Approach To Human Papillomavirus (Hpv) Vaccine Uptake Among Adolescents Ages 10-14 In A Public Health Clinic, Amy T. Norris

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of several preventable cancers. Although the HPV vaccine is safe, highly effective, and routinely recommended for adolescents, vaccination rates remain below national targets, particularly in rural and public health settings. Multiple internal and external factors contribute to low HPV vaccination rates in public health settings.

Purpose: The Doctor of Nursing Practice quality improvement project aimed to increase HPV vaccine uptake through the implementation of a multifaceted, evidence-based intervention.

Project Design: Guided by Pender’s Health Promotion Model and the Reach, Effectiveness, Adoption, …

Reducing Asthma-Associated Absenteeism At A School-Based Health Center Using Asthma Control Test (Act) Scoring, Concetta Terry

Doctor of Nursing Practice Projects

Background: Asthma is a common chronic condition that can lead to increased school absences and lower academic performance. A needs assessment at a rural school-based health clinic identified gaps in care for students with asthma and high absenteeism rates.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce asthma-related absences by personalizing care using Asthma Control Test (ACT) scoring.

Project Design: Using a pre- and post-intervention design, this DNP quality improvement project followed the Plan-Do-Study-Act (PDSA) framework to evaluate the impact of implementing the ACT on asthma-related absenteeism in a rural school-based health center. The project …

Reducing Missed Appointments In An Ambulatory Infusion Center, Jacqueline G. Jones

Doctor of Nursing Practice Projects

Background: Missed appointments at ambulatory infusion centers (AIC) continue to be a problem, even with improved scheduling systems and care coordination efforts. Nationally, missed appointment rates average 10%–12%, and in Central Alabama, the rate is 11.7%. However, one local AIC has a much higher missed-appointment rate of 17.8%. Missed appointments lead to wasted facility resources, increased healthcare costs, and interruptions in infusion therapies.

Purpose: This Doctor of Nursing Practice project used live reminder calls to help lower missed appointments in an AIC. The goal was to improve attendance, reduce missed appointments, and maintain consistent care.

Project Design: Over ten weeks, …

Improving The Accuracy Of Medication Reconciliations For Medicare Advantage Patients At A Primary Care Clinic Using An Interdisciplinary Team, Sallie Mann

Doctor of Nursing Practice Projects

Background: Medication-related problems (MRPs) are a significant and often preventable cause of patient harm, particularly among older adults with complex medication regimens. In primary care settings, inaccurate or incomplete medication reconciliations contribute to adverse drug events, avoidable hospitalizations, increased healthcare costs, and reduced patient satisfaction.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate whether implementing an interdisciplinary medication reconciliation process using the Medications at Transitions and Clinical Handoffs (MATCH) Toolkit would improve reconciliation accuracy in Medicare Advantage patients aged 65 and older in a primary care clinic.

Project Design: This DNP project used the …

Optimizing Workflow In Advanced Gastroenterology: An Initiative To Improve Turnaround Times, Aundrea Prewitt

Doctor of Nursing Practice Projects

Background: Procedure room turnaround time in advanced gastroenterology is defined as the interval between one patient exiting the procedure room and the subsequent patient entering. Prolonged turnaround times contribute to decreased operational efficiency, delays in care delivery, and suboptimal resource utilization. Current facility turnaround time is 39 minutes, and there is no standardized policy to guide the turnaround process.

Purpose: The purpose of this quality improvement project was to develop a standardized operating procedure that guides policy change in advanced gastroenterology through implementing a sustainable turnaround process that reduces procedure room turnaround time.

Project Design: The quality improvement initiative used …

Pragmatic Measures In Aided Language Measurement: Aac Clinical Expert Perspectives, Makayla Hydiea Smith

Speech and Hearing Sciences ETDs

Purpose: The augmentative and alternative communication (AAC) discipline currently lacks psychometrically sound aided language measures. This thesis is designed to address one step in developing such measures: to begin to establish the clinical feasibility of three pragmatic measures – communicative intent, independence/co-construction, and imitation/non-imitation. Therefore, the objective of this thesis is to identify the useability of these pragmatic measures.

Method: A qualitative approach in the form of a focus group was used to examine the perceptions of SLP practitioners who are experts in AAC. Rapid qualitative analysis (RQA) was used to identify relevant themes and subthemes.

Results: Overall, the themes …

Exploring Primary Care Providers’ Compassionate Care And Their Evidence-Based Practice With Death, Grief, And Loss: Patient Experience And Perspective, Kathryn Krzykala

Dissertations

Research on primary care providers’ (PCPs) education regarding Death, Grief, and Loss (DGL) remains limited. Specifically, data is lacking regarding patients' perceptions and opinions on what they need and expect from their PCPs regarding grief and loss. This exploratory mixed-method study comprised 146 participants who had experienced death and non-death loss. It examined participants' perceptions of 1) PCP compassion, 2) PCP utilization of evidence-based grief and loss practices, 3) their own level of comfort discussing DGL with their PCPs during medical visits, and 4) their personal grief and loss experiences. The findings revealed that PCPs' grief-informed evidence-based treatment, as reflected …

Improving Iv Access Outcomes In Obstetric Care Through A-Diva Scale Utilization And Point-Of-Care Ultrasound, Parth S. Patel, Matthew T. Komorowski

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric (OB) patients frequently present physiological changes, including edema, obesity, and peripheral vasoconstriction, that increase the risk of difficult intravenous access (DIVA). Multiple IV attempts can delay time-sensitive therapies in obstetric emergencies and increase patient discomfort and provider workload. Research studies have supported the use of the Modified Adult Difficult Intravenous Access (A-DIVA) scale to assess patients for DIVA, and the use of point-of-care ultrasound (POCUS) guided peripheral intravenous access (PIVA). In 2025, a preceding Doctor of Nurse Anesthesia Practice (DNAP) project implemented A-DIVA in the Labor & Delivery (L&D) unit of an OB department and found that 35% of …

Empowering Domestic Violence Survivors Through Community-Based Self-Regulation Suppor, Xen Gabrielle O. Advincula

Occupational Therapy Student Capstones

Purpose: Program development of trauma-informed, occupation-based resources and program and incorporating OT-related principles to support occupational balance and engagement of survivors of DV and IPV

Goal: Enhance and support the staff’s capacity and understanding of OT-scope in community settings and incorporation of OT-focused self-regulation strategies

Outcome: Increase the staff’s confidence levels of knowledge on the scope of OT within community-based settings and OT-related strategies to support self-regulation levels

An Epilepsy Community Collective Towards Occupational Justice And Empowerment, Tyler Debuty

Occupational Therapy Student Capstones

Underutilization of epilepsy-specific resource programs, lack of public awareness about epilepsy, limitations in community belonging, and implications for self-management programs aimed towards improving quality of life and reducing the burden of care during the transition into adulthood and throughout the lifespan for people with epilepsy.

Improving Quality Of Life For Informal Caregivers Of Post-Stroke Survivors: Implementing Preventative, Advocacy And Educational Strategies, Joann Bennett

Occupational Therapy Student Capstones

Stroke recovery extends beyond hospital discharge, yet community-dwelling stroke survivors and their informal caregivers often have limited access to continued education, wellness resources, and community-based support.

This gap contributes to caregiver burden, reduced occupational participation, and decreased quality of life.

Amplifying Parental Well-Being: Ot-Informed Support For Families Of Children With Hearing Loss, Joelle Barth

Occupational Therapy Student Capstones

Despite the many demands placed on parents of children diagnosed DHH, limited support exists to specifically address their mental health needs

Bridging Gaps In Spanish-Speaking Individuals In Rural Areas About Parkinson’S Disease, Fabiola Barajas Velasco

Occupational Therapy Student Capstones

Provide education and bring awareness of Parkinson’s disease in rural areas through educational trainings and community outreach, specifically those close in contact with farmworkers or farmworkers themselves.

Occupational Therapy Approaches To Mitigating Cancer-Related Fatigue (Crf): A Scoping Review And Practice Framework, Brooke Carson

Occupational Therapy Student Capstones

Goal: Improve knowledge and competence in CRF management through evidence-based education to improve CRF interventions in oncology rehabilitation

Outcome: Increased confident and application of evidence based CRF intervention strategies, leading to improved functional performance and occupational engagement for individuals experiencing CRF

Promoting Mental Health Awareness, Advocacy, And Occupational Justice For First-Generation College Students, Gilberto Duran Garcia

Occupational Therapy Student Capstones

First Generation College Students (FGCS) face a high prevalence of mental health concerns

Stress, anxiety, depression, financial burden, cultural expectations, imposter syndrome, pressure to meet expectations, fear of the unknown, lack of guidance, and lack of preparedness

Enhancing New Mother's Mental Health And Confidence After Discharge, Breana De La Cruz

Occupational Therapy Student Capstones

New mothers lack guidance, education and resources for common postpartum complications resulting in a decreased overall wellbeing in the postpartum period.

Exploring The Role Of Functional Cognition In Early Psychosis Care: An Occupational Therapy Perspective, Angelica Detata

Occupational Therapy Student Capstones

Cognitive impairment is a core feature of psychosis significantly impacting functional outcomes. Functional cognition as a target in early psychosis treatment is insufficiently addressed.

Fostering Wellness: Developing Strategies To Improve Mental Health And Decrease Burnout For Professionals Serving Foster Youth, Amaya Dorado Ledesma

Occupational Therapy Student Capstones

High burnout rates, turnover, and decreased mental health are limiting not only foster youth professionals, but also the families and children they serve.

Going With The Flow: Psychological Flow & The Mental Health Of Occupational Therapy Students, Sydney Buchanan

Occupational Therapy Student Capstones

Despite a growing interest in psychological flow as a factor associated with positive mental health outcomes, its relationship to OTD student well-being has remained underexplored.