Medicine and Health Sciences Commons^™

Identifying Social Determinants Of Health Subgroups And Their Associations With Health Outcomes In A Prospective Us Adult Covid-19 Cohort: An Analysis Of The Inspire Registry, Yohali Burrola-Mendez, Eugene Lin, Canada Parrish, Chialing Hsu, Mandy J. Hill, Michael Gottlieb, Kristin L. Rising, Lauren E. Wisk, Nicole L. Gentile, Rachel E. Geyer, Robert A. Weinstein, Michelle Santangelo, Kristyn Gatling, Jonathan W. Dyal, Joann G. Elmore, Robert M. Rodriguez, Phillip Watts, Ji Chen, Zihan Diao, Erica S. Spatz, Kwun Cg Chan, K A. Stephens, Kelli N. O'Laughlin, Inspire Group

Department of Emergency Medicine Faculty Papers

OBJECTIVE: To identify subgroups with similar social determinants of health (SDOH) characteristics using latent class analysis (LCA) and examine their associations with physical and mental health, cognitive function and missed workdays at 3 and 6 months post-SARS-CoV-2 infection. We hypothesised that intersecting SDOH factors would differentially influence COVID-19-related health outcomes across subgroups.

DESIGN: Prospective cohort study from the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), with longitudinal data collection and cross-sectional analyses at baseline, 3-month and 6-month follow-ups.

SETTING: Multicentre registry across eight US academic medical centres (Chicago, Dallas, Houston, Los Angeles, New Haven, Philadelphia, San Francisco and …

When School Culture Excludes: Deficit Discourse, Microaggressions, And The Mental Health Of Marginalized Students – A Conceptual Framework With Implications For School Psychology Practice And Equity Policy, Modupe Mercy Oyewunmi

Publications

Deficit-laden language like ‘behavior problem,’ ‘not college material,’ ‘won’t fit in’, ‘not a cultural fit’, operates as a systemic form of implicit bias and microaggression in school settings. Despite decades of research on school belonging and well-being, school psychology has yet to integrate these exclusionary discursive practices into a coherent health-determinant model that also accounts for the current anti-diversity, equity, and inclusion (DEI) policy environment. This conceptual paper proposes a testable framework linking deficit discourse and school-based microaggressions to student identity suppression, academic impostor phenomenon, and educator moral injury, with downstream effects on school mental health outcomes. We situate these …

Psychogastroenterology: An Introduction For Behavioral Health And Healthcare Professionals, Jerrod Brown Ph.D., M.A., M.S., M.S., M.S., M.S., M.S., Jeremiah B. Schimp Phd, Ma, Lpcc, Leanne Skehan Dcn, Msacn, Mph, Mba, Cns, Ches, Shelley Mydra Dmft, Lmft, Jonathan Ward Dc, Phd(C), Ms, Dibcn, Tiffany Flaten Cns, Ldn

Nutritional Neurocriminology Today

Although often difficult to discuss with clients, gastrointestinal (GI) issues affect an estimated 60 to 70 million Americans (American Gastroenterological Association, 2022). Yet only about 25% of those experiencing these conditions receive treatment. This is troubling because GI issues frequently co-occur with clinically significant consequences for physical health, psychological well-being, daily functioning, and overall quality of life. Designed for behavioral health and healthcare professionals, this brief article introduces the field of psychogastroenterology, with emphasis on symptoms, stigma, diagnosis, and treatment. Key topics include the gut-brain axis, common digestive health conditions, and the mental health implications associated with gastrointestinal disorders.

Adverse Childhood Experiences Among Kenyan Adolescents: Psychometric Properties, Prevalence Rates And Correlates, Tom Osborn, Rosine Baseke, Faith Kamau, Winnan Munyasa, Christine Wasanga, Maureen Ngesa, Victoria Mutiso, Moses Nyongesa, Jasmit Shah, Zul Merali

Brain and Mind Institute

Background: Adverse Childhood Experiences (ACEs) have been consistently linked to poor mental health outcomes, yet research on their impact in low- and middle-income countries (LMICs) settings of Africa, remains relatively unexplored. In Kenya, where childhood adversity is widespread, there is a critical need to examine the validity of ACE measures and their associations with mental ill health. This study aimed to validate the Adverse Childhood Experiences questionnaire (ACE-10) in a Kenyan adolescent sample and assess its associations with symptoms of depression and anxiety, bullying, and sociodemographic factors.

Methods: Data was collected from N = 2,842 adolescents and young …

Feasibility And Acceptability Of A Mobile App And Wearable Device For Collecting Mental Health Survey And Passively Sensed Data Among Health Care Workers In Kenya: Mixed Methods Pilot Study, Linda Khakali, Andrew Aballa, Dorcas G. Mwigereri, Willie Njoroge, Rachel Maina, Amos Bunde, Peris Musitia, Moses Nyongesa, James Orwa, Jasmit Shah, Anthony Ngugi, Lukoye Atwoli, Amina Abubakar, Zul Merali

Brain and Mind Institute

Background: Mobile apps and wearable devices may help to facilitate early detection of mental health conditions by providing objective, real-time data to supplement other forms of feedback and diagnoses. Few studies have investigated the acceptability and feasibility of using a mobile app to track survey- and wearable-based data in mental health research in Sub-Saharan Africa.

Objective: This pilot study evaluated the feasibility and acceptability of using a mobile app and wearables to capture mental health–based survey data and passively sensed data among Kenyan health care workers.

Methods: A mixed methods study was conducted among health care workers …

Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

Narrative Roots - What We Inherit, What We Tell, What We Become: Intergenerational Storytelling, Meaning-Making, And Mental Health, Adam Sholder

Critical and Creative Thinking Capstones Collection

This capstone synthesis explores how the family stories we inherit and the stories we tell across generations shape who we become, with particular attention to their impact on identity and mental health. Drawing on narrative identity theory, reflective practice, and relational understandings of family life, it introduces the Recursive Narrative Integration Model, which positions intergenerational storytelling as both a method of inquiry and a mechanism of meaning-making. Informed by a recursive process of creative and reflective writing, this synthesis approaches storytelling not only as an object of study, but as a lived and generative practice through which experience and narrative …

Perinatal Mental Health Screening And Care Among Those With Pregnancy Complications, Alison N Goulding, Terri L Fletcher, Emily S Miller

Faculty, Staff and Students Publications

Perinatal mental health conditions are common and, without effective treatment, can contribute to adverse maternal and child outcomes. In the United States, mental health conditions are a leading cause of maternal morbidity and mortality, contributing to over 20% of pregnancy-related deaths. This expert review aims to assess current literature and provide recommendations regarding mental health care in high-risk patients who experience pregnancy complications. Individuals experiencing pregnancy complications are at increased risk for perinatal mental health conditions, including depression, anxiety, and post-traumatic stress disorder, as compared to those with uncomplicated pregnancies. Despite this increased disease burden, there is limited research on …

Predictive Models Of Student Mental Health: The Correlation Between Academic Burnout And Depression In The Higher Education Environment, Hyejoon Song

Masters Theses

Importance: Over 80% of U.S. college students report significant emotional difficulties, and 58% endorse academic burnout as a persistent concern, yet institution-specific data at faith-integrated universities such as Liberty University remain scarce, limiting evidence-based programmatic response.

Objective: To examine the correlation between academic burnout and depressive symptomatology at Liberty University, identify the most predictive individual burnout item via Random Forest machine learning, and characterize distinct student risk profiles via KMeans clustering. Design, Setting, Participants: Cross-sectional survey (IRB-FY24-25-1491, Exempt) of 236 Liberty University students (mean age 36.9 ± 14.3 years; 84.0% female; 61.0% graduate-level), 2025–2026 academic year.

Main Outcome and Measures: …

Perceptions Of The Effects Of Launch Control Center Environmental Exposures And Alert Schedules Among Missile Operations Officers: A Mixed Methods Phenomenological Study, Dawnie Rae Ramie

Doctoral Dissertations and Projects

This mixed methods hermeneutic phenomenological study focused on an investigation of the perceptions of missile operations alert duty and the effects on health and sleep hygiene among Air Force missile operations officers. Questionnaires, interviews, and surveys were all used to gather data on subjects’ experiences and perspectives, including methods to mitigate the effects of poor sleep. Driving questions of research included how missile alert schedules affect sleep habits, as well as how missileers perceived alert duties may impact their health. Data was collected through a web-based Qualtrics Likert questionnaire (N=139), open-ended interviews with purposively selected subjects (N=17), and web-based Qualtrics …

Using Weekly Guided Meditation To Develop Community, Connection And Improved Overall Experience And Wellbeing At Work, Mary Patterson Friedmeyer

InnovateHER Meeting 2026

The majority (99%) of respondents rated the Weekly Guided Meditation (via zoom) as being both impactful and valuable in their lives. The majority (82%) of respondents reported finding more balance in the workday and improvement in overall well-being. The majority (63%) of respondents were neutral on building community, with just over one third (36%) of respondents responding positively to community building.

Evaluating An Educational Intervention On Screen-Time And Behavior Change: A Pilot Study, Kayla L. Sweeney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Excessive screen time among adolescents has been associated with negative health outcomes, including sleep disturbances, anxiety, and depression. Despite growing awareness, many parents lack sufficient understanding of these risks and their impact on adolescent well-being. This project evaluated whether a brief educational intervention improved parents’ knowledge of the health effects of excessive screen time. Methods: A pre-and post-survey design was used to assess changes in parents’ understanding following an educational video intervention. The educational intervention consisted of evidence-based content highlighting the impact of screen time on mental health and sleep. The survey measured knowledge, beliefs, behavioral intentions, and strategies …

Barriers And Bridges: Exploring Factors That Shape Mental Health Service Utilization In Rural America, Margaret Wiwuga

Educational Specialist, 2020-current

Despite disproportionately higher suicide mortality rates and comparable prevalence of mental illness across urban and rural communities in the United States, rural populations across the nation experience significantly lower access to and utilization of mental health services, naturally leading to worse comprehensive outcomes. This literature review examines multifaceted factors shaping mental health service use in rural America, taking note of both barrier and enabling factors that impede or enable these unique populations’ willingness and ability to access and use mental health services. Ten articles published prior to September 9, 2025, were selected from the James Madison University Libraries’ Psychology and …

From Exploitation To Healing: Mental Health And Resilience Among Native American Survivors Of Sex Trafficking, Katelin A. Stoebner

Honors Thesis

The mental health impacts of sex trafficking on Native American survivors and pathways to resilience are important to understanding healing. Native Americans are disproportionately affected by sex trafficking due to systemic inequities, historical trauma, and socioeconomic vulnerability. Using interviews with 47 Native survivors conducted as part of a larger Office on Violence Against Women project, this study analyzes the mental health challenges and recovery strategies identified by participants. Findings reveal that survivors commonly experience significant psychological effects, including post-traumatic stress disorder (PTSD), depression, and anxiety. Among participants, PTSD emerged as the most frequently reported condition, followed by depression and anxiety, …

Mental Health Screening For The Military Spouse: Prevention In Practice, Lura Allison Mcgrath

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

In recent years, a focus on mental health has moved to the forefront of healthcare. This is especially true when caring for United States military service members. The military spouses of these service members also struggle and suffer from mental health disorders. However, the mental health needs of military spouses often receive insufficient attention. Research shows military spouses are at an increased risk of developing mental health disorders and/or suffering from mental illness. A large contributor is the impact of the military lifestyle and its challenges for these spouses. However, research also reveals there has been minimal effort put …

Left Out And At Risk: Post-Pandemic Continuation Of Organizational Service Reduction In Metropolitan New York City Coincides With Rise In Opiate Use And Mental Health Problems For Latinos, Ruth Lin Campbell, Smita Ekka Dewan

Publications and Research

Increasing opiate use and mental health problems among younger and older Latinos in urban US contexts prompted this investigation into the organizational resources that facilitate help-seeking efforts of Latinos in New York State (NYS). Guided by a Vulnerability Model and a framework of organizational enabling resources, this study used complementary longitudinal and cross-sectional designs. The longitudinal component examined changes in levels of organizational facilitators for Latino substance use disorder (SUD) help-seeking in Downstate NYS across three time periods, while the cross-sectional component compared post-pandemic facilitator levels across service types and regions. A convenience sample of 241 SUD clinicians participated in …

What Are The Effects Of Exposure To Green Spaces On Attention, Adhd Symptoms, Depression, And Overall Mental Health?, Emily Marie Hackett

Rowan-Virtua Research Day

This poster is a literature review examining the relationship between green space exposure and mental health outcomes. Examples of green spaces include nature, hiking trails, city parks, tree cover, and gardens. This literature review finds that green space exposure has positive effects on the symptoms of ADHD, depression, and anxiety. Nature exposure may serve as a complementary intervention to improve patient well-being.

Effect Of Pcos Treatment On Mental Health Outcomes, Audriti Mazumder, Aubrey Olson

Rowan-Virtua Research Day

Abstract (250 words)

Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with a range of physical symptoms, including hirsutism, acne, weight gain, insulin resistance, and infertility. While its metabolic and reproductive manifestations are well characterized, the impact of PCOS on mental health remains underexplored. This study aims to evaluate the relationship between PCOS and mental health outcomes, with a particular focus on changes in symptoms following treatment and the influence of demographic factors.

A survey-based study was conducted using a Qualtrics questionnaire distributed via QR code and social media platforms. Questions were modeled after validated screening tools, including …

The Role Of Paraprofessionals In The Mental Health Structure Of India, Amy Abraham, Kimberly D. Becker, Wendy Chu

Caravel Undergraduate Research Journal

The mental health treatment gap in India is part of a growing public health crisis, with over 95% of those in need of services never receiving them. Over 197 million Indians suffer from at least one diagnosable mental health disorder, and this number continues to grow given the treatment gap. The treatment gap is a result of four major factors: lack of government support, stigma, limited treatment facilities, and dearth of professionals able to provide treatment. The current study aimed to analyze several factors of paraprofessional-led mental health interventions including setting, treatments delivered, treatment models, and client outcomes. A narrative …

Predator Or Prey: The Analysis Of Gender And Race On The Perception Of Black Men As Sexual Assault Victims, Jordyn Livingston, Dr. Florencia Cornet

Caravel Undergraduate Research Journal

Men sexual assault victims have gained more attention in recent years. Despite the growing sociological literature on violence against men, previous research provides little acknowledgment of Black men sexual assault victims. In this manuscript, I analyze emerging literature in the socio-medical sciences to explore how gender and race affects the perceptions of Black men as sexual assault victims. Specifically, I utilize intersectionality as a theoretical framework to synthesize literature on blackness and masculinity in sexual assault victims to conclude that there is an intersectional point that disadvantages Black males, portraying them as sexual predators. In so doing, I provide research …

How Nutrition And Physical Activity Shape Your Well-Being, Stacy Phillips

EFNEP

This publication will explore the link among nutrition, physical activity, physical health, and mental health and how it impacts whole-body well-being. Understanding how multiple aspects of a person's lifestyle can affect an individual's overall well-being is essential to providing better education on how to make better choices to improve their well-being.

The Intersection Between Adolescent Pregnancy, Mental Health Concerns, Stigma, And Sex Education, Madelon Cox

Honors Program: Senior Projects (Public)

This thesis discusses research from the past two decades focused on factors contributing to an increased risk of adolescent pregnancy and the lasting impact of that pregnancy. The consequences of being a pregnant adolescent can be compounded by race, gender, socioeconomic class, and access to education. Adolescent pregnancy also carries significant physical and mental health risk for the adolescent and the child. Awareness and various interventions can help pregnant adolescents or those who may be at risk for adolescent pregnancy to support them, prevent isolation, and reduce further negative mental health conditions, such as depression and anxiety.

Exploring Exercise Motivation And Mental Well-Being In College Students, Elaine M. Lindesmith, Anqi Deng Dr

Health, Human Performance and Recreation Undergraduate Honors Theses

This study examined the relationship between physical activity, exercise motivation, and mental well-being among 48 undergraduate students at the University of Arkansas. Guided by Self-Determination Theory, the study used survey data to measure depression, anxiety, physical activity, and open-ended exercise motivation responses. Motivation responses were coded as autonomous or controlled.

Results showed that physical activity was weakly and negatively related to depression and anxiety, but these relationships were not statistically significant. There were also no significant differences in mental health between autonomous and controlled motivation groups, and motivation did not significantly predict mental health outcomes in regression analyses. Overall, the …

Chit-Chat With Hats: Addressing Mental Health Decline Through Art Therapy And Community Engagement, Zoe G. Mendez-Sosa

Capstone Projects and Master's Theses

This capstone addresses the prominent social issue of mental health decline in Central Pacific California driven by lack of support systems for individuals. In partnership with Health Advocacy Team Support (HATS), “Chit-Chat with HATS was developed as a peer to peer group with art therapy techniques to promote emotional resilience and community connection. The primary objective of the program was to provide individuals struggling with mental health with tools to help them manage their feelings and thoughts.

The program was structured with check-ins, mindfulness techniques, and opportunities of creative expression through art therapy techniques to help participants with processing complex …

Easy Travel-Friendly Snack Recipes For College Students To Support Mental Well-Being, Lidia Vides

Electronic Theses, Projects, and Dissertations

College is a pivotal period in life of a young adult, marked by newfound independence, increased responsibilities, heightened academic pressure, and significant changes in daily routine. While this transition can often be exciting for a young adult, it also presents many different challenges. As a result, many students experience increased levels of stress, anxiety, and depression. Nutrition plays a powerful yet often overlooked role in supporting mental and physical health. Current research studies show that a balanced diet rich in whole food ingredients can help regulate mood and promote emotional well-being through multiple biological pathways. However, despite this knowledge, convenient, …

Factors Associated With Postpartum Depression Symptoms Following Antepartum Hospitalization, Alison N Goulding, Daniel Palacios, Sukru Aras, Hu Chen, Sasidhar Pasupuleti, Marika Toscano, Nicole Cirino, Israel C Christie, Zhandong Liu, Emily S Miller, Terri L Fletcher

Duncan NRI Faculty and Staff Publications

Background: Hospitalized antepartum patients are at increased risk for postpartum depression (PPD). Developing approaches to identify those at highest risk for PPD would enable timely and targeted intervention.

Objective: We aimed to identify factors associated with the development of PPD symptoms in hospitalized antepartum patients and to assess their predictive utility.

Study design: This retrospective cohort study included pregnant individuals hospitalized in a regional referral center due to medical or obstetric complications between 2012 and 2025. Data were extracted from the electronic health record, including demographics, medical and obstetric history, hospitalization characteristics, and postpartum Edinburgh Postnatal Depression Scale (EPDS) scores …

Development And Psychometric Assessment Of The Sub-Scales Of The Ontario Perception Of Care Tool For Mental Health And Addictions (Opoc-Mha), Brian Rush, Karen Urbanoski

Patient Experience Journal

Historically, the tools designed to measure of ``patient satisfaction'' or ``perception of care'' have been developed and evolved separately for the mental health and substance use health sectors. This presents challenges for implementation and usefulness of the results for quality improvement and evaluation given recent efforts aimed at more integrated services and systems. The objective of this study was to psychometrically evaluate eight domain-specific sub-scales of a perception-of-care tool developed specifically for mental health, substance use and/or concurrent disorder services - the OPOC-MHA. The development and process for widescale implementation of the OPOC-MHA has resulted in a large provincial dataset …

Heart Rate Variability In The Context Of Mental Health And Substance Use, Sage M. Lopez

Bridges: An Undergraduate Journal of Contemporary Connections

Heart Rate Variability (HRV) has been linked to various areas of cardiovascular disease and mortality in previous research. Within this area, certain mental illnesses and use of psychoactive substances have been associated with low HRV and its health implications. Little research exists that examines the combined effects of mental illness and psychoactive substance use. The current research aims to understand if there is a compounding negative effect of these two factors when studied in tandem. Using a three-phase study design, HRV was analysed at baseline and at physiological relaxation, with participants being included under certain mental health, substance use, or …

Mental Health In Relation To Parental Absence: A Systematic Review, Mohammed Barry, Abdulaziz Alyahyawi, Heba Jafar Sabbagh

Saudi Medical Journal

Objective: To evaluate the literature based on the relationship between orphaned children and mental health, compared to non-orphaned children. Mental well-being of orphaned children is a profound intricate topic that connects with broader concerns of childcare. This systematic review aims to evaluate the literature regarding the relationship between mental health and parental absence. Methods: We conducted a systematic search of PubMed, MEDLINE, and Science Direct in October 2025, with 1017 screened studies. Six studies met the inclusion criteria. Independent reviewers performed quality assessments using the Newcastle-Ottawa scale (NOS). Subsequently, a meta-analysis was performed when possible. Results: Findings indicate that orphaned …

Quality Improvement Project: Enhancing Staff Delivery Of Non-Pharmacological Interventions In Serious Mental Illness Care, Kimberly Vann

Doctor of Nursing Practice Projects

Serious mental illness places a significant burden on global healthcare systems, increasing hospital utilization and critically impairing patients' functional status. Often crippling, these illnesses are mostly treated with medication therapy despite proven research to show effective outcomes with holistic and non-pharmacological therapies. Non-pharmacological interventions (NPIs) are often underutilized in outpatient mental health settings. The purpose of this quality improvement project was to determine whether structured training impacted staff confidence in delivering NPIs and impacted documentation frequency in the electronic health record (EHR). The project was guided by the Iowa Model of Evidence-Based Practice and implemented using the Plan-Do-Study-Act (PDSA) cycle, …