Post-Pandemic Telebehavioral Health: Sustaining And Regulating Remote Mental Health Care As A Core Modality, Weiqiao Dong

Dartmouth College Master’s Theses

The United States continues to face a persistent mental health crisis after the COVID-19 pandemic, raising a policy question about the long-term role and regulation of telebehavioral health as a core modality of care. This thesis examines that question through a case study of New York State, an early center of the pandemic and a leader in telehealth policy reform.

Guided by the Health Policy Triangle framework, this thesis integrates longitudinal data from all 62 New York counties for 2010-2025 with a 2025 cross-sectional dataset covering 61 counties. Seventeen standardized indicators are organized into four dimensions: geographic, economic, demographic, and …

Cultural Tailoring Of Digital Nutrition Interventions: A Scoping Review Of Adaptation Strategies, Evaluation Methods, And Evidence Gaps, Wendy Liang

Master's Projects and Capstones

Background: Nutrition-related chronic diseases disproportionately affect culturally diverse populations, highlighting the need for effective and equitable interventions. Digital nutrition interventions have expanded rapidly due to their accessibility; however, the extent to which they incorporate and evaluate cultural tailoring remains unclear.

Research aim: This scoping review maps the existing evidence on culturally tailored digital nutrition interventions, describes cultural adaptation strategies used, examines methods used to evaluate cultural appropriateness, and identifies gaps for future research and public health practice.

Methods: A scoping review was conducted following the PRISMA-ScR guidelines.

Findings: Culturally tailored digital nutrition interventions generally improved participant engagement, acceptability, and dietary …

Reducing Potentially Preventable Emergency Department Visits (Ppvs) Through A Telehealth Intervention In Children With Asthma Within A Managed Care Organization (Mco), Renee A. Roker

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose:  The purpose of this quality improvement project was to reduce unnecessary ED utilizations among children with asthma enrolled in a Medicaid managed care health plan. The project aimed to improve access to care and enhance asthma self-management.

Background:  Asthma is one of the leading causes of Emergency Department (ED) utilization, among vulnerable populations. Members experience barriers to timely primary and specialist care, contributing to Potentially Preventable ED Visits (PPV) rates. This places managed care organizations (MCOs) at risk for financial penalties if not meeting the Texas PPV benchmark.

Methodology:  Guided by the Chronic Care Model, Lean Six Sigma …

Refining Of An Online Rotator Cuff Related Pain Screening Tool (Orcs): A Mixed Methods Refinement Study, Andrew J. Smythe, Rhiannon Whale, Melanie Farlie, Peter Malliaras

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study is to refine an online rotator cuff related shoulder pain screening tool. Method: A mixed methods item-refinement study was used. The original tool was designed through expert opinion and informal literature review. In this study the original tool was refined over three rounds of cognitive interviews totalling 39 participants. The screening tool consisted of two sections, red flag screening followed by rotator cuff related shoulder pain differential diagnostic items. Results from each round of interviews were summarised and informed a nominal group research panel review process to modify items and develop a finalised version …

Utilizing Remote Patient Monitoring With Dnp Students To Provide Pre-Natal Care, Sara Mccumber

InnovateHER Meeting 2026

This educational project introduced Nurse Practitioners to the use of RPM during pre-natal care for a patient with pre-natal hypertension. Hypertension is a risk factor in 16% of pregnancies and 5-8% of US births are impacted by hypertensive disorders and preeclampsia (CDC, 2023).

Identification and effective management of hypertension in pregnancy recently was an initiative of the Minnesota Perinatal Quality Collaborative (MPQC, 2022).

Cognitive Behavioral Therapy-Based Psychosocial Interventions To Reduce Anxiety After Social Isolation In Adolescent Females, Bailey E. Noble

InnovateHER Meeting 2026

• COVID-19 social isolation linked with higher anxiety risk in adolescents, especially females
• Review examined whether CBT-based psychosocial interventions reduce anxiety after pandemic-related loneliness/social isolation
• Across 6 studies, remote and internet-delivered CBT linked with anxiety improvement 
• Strongest outcomes seen with therapist-assisted CBT
• Common barriers: privacy, motivation, scheduling, and digital access
• Nursing relevance: early screening, referral, and support for treatment participation

Assessing Current Telehealth Mobile Applications In The United States: Accessibility, Privacy, And Care Delivery, Rosemary K. Frugé

Honors Theses

Telehealth has improved patient access by reducing barriers to convenient, cost-effective, and quality health care. Telehealth mobile applications allow individuals to remotely access services through smartphone-based platforms. The purpose of this study was to evaluate leading telehealth applications available in the United States, analyzing key factors that influence platform selection, including cost, prescribing and diagnostic capabilities, user feedback, and data privacy practices. Applications were identified through keyword-based searches of major app stores using the term “telehealth,” and each app was systematically evaluated using predefined criteria. Findings highlight variability across platforms in pricing transparency, service offerings, and privacy disclosures, despite generally …

Telemedicine Kiosks: Can Technology Solve Rural Mississippi's Healthcare Crisis?, Babu George, Martha Ravola

Journal of Public Health in the Deep South

Background: Mississippi’s rural counties face hospital gaps, clinician shortages, and limited broadband/device access that collectively delay care and constrain telehealth uptake.

Purpose: This paper assesses whether telemedicine kiosks can improve rural healthcare access in Mississippi while also supporting viable local entrepreneurship and community development.

Methods: A conceptual, policy-and-market analysis integrated narrative literature synthesis, secondary data and policy review, and 5-year financial modeling under two cost-allocation scenarios: an Operator Model (subscription fees covered by partners/grants) and a Network Model (subscription fees borne by the kiosk operator).

Results: Kiosks with embedded connectivity and diagnostic peripherals can deliver device-independent virtual care and directly …

Abortions In The Mountain West, 2022-2025, Olivia K. Cheche, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data on the number of abortions provided annually in the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah between July 2022 and June 2025. The data are retrieved from the Society of Family Planning’s #WeCount report,  which includes data on abortion volume across all 50 U.S. states and Washington, D.C. This fact sheet focuses on the administration of both in-person and telehealth abortions in the Mountain West.

Implementation And Outcomes Of A Digital Onboarding Taskforce In The Acute Care Setting, Julianna Lenoir, Alexzandra Gentsch, Akshay Krishnan, Jeffrey Ndubisi, Marissa Witmer, Kristin L. Rising, Brooke Worster, Angela M. Gerolamo

Jefferson Center for Connected Care Faculty Papers

INTRODUCTION: Use of digital health technology can improve patient health outcomes; however, not all patients have the knowledge and skills to download a health app and access a patient portal. Providing digital onboarding support to hospitalized patients has potential to overcome some barriers to accessing needed education in the community, including both having the time and a location to receive education. To address this, our team developed the Jefferson Digital Onboarding Taskforce (JeffDOT), a group of staff and students who approach hospitalized patients and provide one-on-one teaching on how to sign up for and use a patient portal.

METHODS AND …

Referral Strategies For Recruitment And Engagement Of Community Adults Into Online Extension Health Programs, Cheryl L. Eschbach, Dawn A. Contreras, Holly B. Tiret

Journal of Human Sciences and Extension

This article shares details behind building organizational capacity to establish program referrals for statewide recruitment of community adults into Cooperative Extension’s online health programs. This study explores the role of intentional recruitment strategies (active and passive) to increase participant program enrollment into health education and shares examples from one state that has created a trained workforce that offers ongoing research- and evidence-based programs. After many years of trying paper, phone, and electronic medical record methods to increase program reach, Michigan State University Extension tried an electronic referral process via a QR code and web link, accompanied by program marketing, to …

Geographic And Socioeconomic Predictors Of Early Follow-Up Loss In Patients Undergoing Pituitary Neuroendocrine Tumors (Pitnets) Resection: A Retrospective Review Of 1143 Cases, Daniel Quintana, Rithvik Ramesh, Robert C. Osorio, Wesley Shoap, Paul Mcmillan Villalobos, Philip V. Theodosopoulos, Sandeep Kunwar, Jose Gurrola, Ivan H. El Sayed, Manish K. Aghi, Ezequiel Goldschmidt

School of Medicine Faculty Publications

OBJECTIVE: Postoperative follow-up after PitNET resection is essential for monitoring tumor recurrence and endocrinological deficits. Despite advances in telehealth, loss to follow-up remains a persistent challenge across neurosurgical patients. This study aims to identify factors to identify patients are at higher risk of being lost to follow-up after surgery. METHODS: A retrospective analysis was conducted on 1,143 adult patients who underwent PitNET resection between 2012 and 2019 at a single institution. Clinical and radiological data were analyzed to assess loss to follow-up in the cohort. Multivariable logistic and negative binomial regression models were used to identify factors independently associated with …

Minimizing Travel Burden Of Gynecologic Cancer Surveillance Through A Unique Multidisciplinary Telehealth Program, Avni Shridhar, Suzanne Viator, Tara Castellano, Holly Provost, Navya Nair, Elizabeth Neupert, Amma Agyemang, Amelia Jernigan

School of Medicine Faculty Publications

OBJECTIVE: STEEL MAGNOLIAS (shared telehealth for multidisciplinary gynecologic cancer survivorship) is a novel gynecologic cancer surveillance care-delivery program in which rural patients see a close-by gynecologist in person with simultaneous virtual gynecologic oncology consultation. This study assesses feasibility of STEEL MAGNOLIAS by examining travel burden reduction, cancer outcomes, visit activities, guideline adherence, and patient satisfaction. METHODS: We retrospectively reviewed charts of patients with gynecologic cancer in remission under the STEEL MAGNOLIAS program in rural south Louisiana (March 2020-September 2023). Travel metrics, patient satisfaction, cancer outcomes, survival status, reasons for visit, and adherence to follow-up as per National Comprehensive Cancer Network …

Focus Group Interview: Perspectives Of Virtual Dietary Counseling Method’S Post Covid-19 Pandemic, Maria Mendoza

Journal of the Symposium of University Research and Creative Expression

Project Mentor(s): Nicole Stendell-Hollis, PhD; Tafere Belay, PhD; Katy Williams; Jessica Tyrrell

The purpose of this study is to examine the perceptions related to different delivery methods of dietary counseling. This qualitative research study will examine the perceptions related to different methods of dietary counseling (telephone calls, video calls, or face-to-face visits). Focus group one contained provider participants (N = 7), which were all RDNs and focus group two hosted patient participants (N = 6). Semi structured interviews were performed asking subjects about any personal experiences related to receiving or providing nutrition education, positive or negative, as they participated in …

Sociodemographic Determinants Of Telehealth Visits: A Comparison Of Mental Health And Substance Use Disorders With Other Services, Stanley Nkemjika, Orman Trent Hall, Jeanette Tetrault, Ayana Jordan

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND/OBJECTIVES: Discrimination has wide-ranging implications, affecting patients' trust in healthcare professionals and their intentions to seek care. It can cause barriers that can affect access to care, especially among racial and ethnic minority groups in mental healthcare settings. Hence, we aim to examine the relationship between racial discrimination and reasons for using telehealth services.

METHOD: Using the 2022 Health Information National Trends Survey (HINTS-6), we isolated 6017 participants who reported on discrimination inquiry. The primary dependent variable in this study is self-reported discrimination in healthcare, while the main independent variable is the reason for the most recent telehealth visit, and …

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

Transforming Primary Care: Innovative Post Graduate Pa Training For Real-World Solutions, Kenneth Botelho, James Ali

Lynchburg Journal of Medical Science

The ongoing crisis in primary care demands innovative and scalable strategies to prepare and retain advanced practice providers. This article introduces the Primary Care Practitioner (PCP) Program, a conceptual postgraduate training model designed for certified physician associates/assistants (PAs) who aim to serve in underserved and rural communities. The program integrates advanced clinical training, leadership development, telehealth competencies, VR-enhanced simulation, and evidence-based strategies to promote provider resilience. Rooted in systems-based thinking and real-world applicability, the PCP Program culminates in capstone projects that encourage innovation in care delivery and population health.

Aligned with national frameworks such as the HRSA Primary Care Training …

Development Of Recommendations For The Future Of Telehealth Use Among Sexual And Gender Minorities (Sgm), Jeffrey A. Wilhite

Dissertations and Theses

It is now well-documented that sexual and gender minoritized individuals (SGMs) face consistent stigmatization from not just the health care system, but also from overarching community, federal, and societal entities. Subsections of the SGM community, like gay men for example, face higher rates of eating disorders, certain cancers, alcoholism, mental illness and even obesity, when compared to heterosexual counterparts. Many of these challenges could be exacerbated by current political administration efforts to silence the community. Ensuring access to clinical care is one way of preserving the health and livelihood of the community. Telehealth, or synchronous, remote based clinical care, can …

Utilizing A Clinical Resource Hub To Improve Access And Workflow For Retinopathy Screenings In The Veteran Population, Erin Kelly Pope

Doctor of Nursing Practice Final Manuscripts

Abstract

Utilizing a Clinical Resource Hub to Improve Access and Workflow for Retinal Screenings in the Veteran Population

Erin K. Pope, MSN, RN, AGCNS-BC, AMB-BC

Scot Nolan, DNP, RN, CNS, PHN, CCRN, CNRN, SCRN, FCNS

Background: Diabetic retinopathy (DR), a progressive complication of diabetes mellitus (DM), is the leading cause of blindness among working-age adults. As DR can remain asymptomatic until advanced stages, annual screenings are critical for early detection and management. Teleretinal imaging is an evidence-based method for DR screening, offering cost efficiency and reduced demand on ophthalmology clinics. At the Veterans Administration’s (VA) Loma Linda Healthcare System …

Evaluating Surge Capacity In The Emergency Department: A Comprehensive Literature Review On Preparedness And Response Frameworks, Tanner J. Riscoe

Capstone Experience: Master of Public Health

Medical surge capacity in emergency departments is influenced by four critical factors: staff, stuff, space, and systems. Understanding these factors and the interplay between them is critical. Emergency departments are increasingly encountering issues with overcrowding, patient boarding, and medical surge events causing interruptions in care and depleting critical resources. Coordination of medical surge is challenging during normal operations but is intensified during times of crisis. This comprehensive literature review seeks to better understand the current state of the literature surrounding surge preparedness and response in emergency departments across the United States, identify gaps in the current literature, and ultimately recommend …

Barriers To Telehealth Uptake And Use: A Scoping Review, Mackenzie Kemp, Kristin L. Rising, Gregory Laynor, Jessica Miao, Brooke Worster, Anna Marie Chang, Andrew J. Monick, Amanda Guth, Tracy Esteves Camacho, Kiana Mcintosh, Grace Amadio, Lindsey Shughart, Tingann Hsiao, Amy E. Leader

Jefferson Center for Connected Care Faculty Papers

OBJECTIVES: We conducted a scoping review to identify barriers to telehealth use and uptake from the perspective of patient, provider, and system that were documented in the literature. In addition to identifying and categorizing the barriers, we aimed to assess how barriers differed for studies conducted during the COVID-19 pandemic, as well as how barriers differed between the United States vs internationally based studies.

MATERIALS AND METHODS: Comprehensive searches of the PubMed/MEDLINE, CINAHL, and Scopus databases conducted on December 29, 2021 yielded 17 887 results, with 11 221 potentially eligible documents after duplicates were removed. The team conducted an initial …

Addressing Diabetic Retinopathy Prevalence In Low-Income Communities: Barriers To Quality Healthcare And Strategies For Equitable Treatment Access, Morkeia A. Mutchelknaus

Honors Thesis

Studies have shown a strong correlation between diabetes and individuals in low-income communities, which often lack access to equitable healthcare for a variety of reasons. This honors thesis will focus on diabetic retinopathy, its prevalence, prevention, and treatment strategies in both low- and high-income communities. A comprehensive literature review was conducted to define diabetic retinopathy, assess its prevalence, and review past and present approaches to its treatment and prevention. This paper aims to identify strategies to improve healthcare accessibility in low-income communities by analyzing current strategies in place to prevent and treat diabetic retinopathy and proposing potential solutions that will …

Anesthesia And Pain Management In Conflict-Affected Regions: Addressing Global Health Barriers To Access And Quality Of Care​, Naeel Uddin, Sierra Brown, Maria Easler, Ayanda Mkhize, Marwa Hamdam, Chandu Goli, Lauren Draper

Annual Research Symposium

This poster examines how to deliver safe, effective anesthesia and pain control in areas with limited resources and ongoing security threats. Focusing on portable technology, ketamine-based protocols, and telemedicine, we highlight ethical considerations, training needs, and global collaborations. Our findings outline a pathway to reduce suffering and improve surgical outcomes in vulnerable populations by addressing challenges unique to conflict settings.

The Opportunities And Barriers Surrounding The Use Of Digital Health And Telemedicine In Sub-Saharan Africa, Aveline Langmead, Afua Osei-Wusu, Erica Tutuwan, Sara Mcmahon, Porter Biggs

Annual Research Symposium

No abstract provided.

Addressing Barriers To Equitable Telehealth For Older Adults, Bruce Leff, Christine S. Ritchie, Kristin L. Rising, Kendell Cannon, Liane Wardlow

Jefferson Center for Connected Care Faculty Papers

No abstract provided.

Federally Qualified Health Center Patients’ Experiences With Remote Patient Monitoring As Part Of Telehealth Services For Self-Measured Blood Pressure Monitoring, Natalia I Heredia, Maria E Fernandez, Ella R Garza, Jabria Pittman, Fernanda Velasco-Huerta, Tracy L Judd, Jocelyn Hunyadi, Elvis Longanga Diese, Deevakar Rogith, William B Perkison, Susan H Fenton

Faculty, Staff and Student Publications

BACKGROUND: Remote patient monitoring (RPM) for hypertension management has become increasingly popular, demonstrating benefits for both clinics and patients. However, patient engagement in self-measured blood pressure (SMBP) monitoring remains low despite healthcare providers' efforts. This study aimed to assess adherence and acceptance of RPM for SMBP among Texas Federally Qualified Health Center patients.

METHODS: Participants enrolled in the SMBP monitoring program were recruited at three health centers. Data was collected from patient health records, and a questionnaire assessed hypertension self-management, technology acceptance, intentions, and attitudes toward SMBP. Thematic analysis was conducted for open-ended responses that followed each item, and multivariate …

A Proposed Mhealth Intervention To Address Patient Barriers To Colposcopy Attendance: Qualitative Interview Study Of Clinic Staff And Patient Perspectives, Jennifer Hemler, Rachel Wagner, Brittany Sullivan, Myneka Macenat, Erin Tagai, Jazmarie Vega, Enrique Hernandez, Suzanne Miller, Kuang-Yi Wen, Charletta Ayers, Mark Einstein, Shawna Hudson, Racquel Kohler

Department of Medical Oncology Faculty Papers

BACKGROUND: Cervical cancer disparities persist among minoritized women due to infrequent screening and poor follow-up. Structural and psychosocial barriers to following up with colposcopy are problematic for minoritized women. Evidence-based interventions using patient navigation and tailored telephone counseling, including the Tailored Communication for Cervical Cancer Risk (TC3), have modestly improved colposcopy attendance. However, the efficacious TC3 intervention is human resource-intense and could have greater reach if adapted for mobile health, which increases convenience and access to health information.

OBJECTIVE: This study aimed to describe feedback from clinic staff members involved in colposcopy processes and patients referred for colposcopy regarding adaptions …

Evaluating The Effectiveness Of Teledermatology For Undeserved Populations During And Post-Covid-19, Jakob Gibbs, Sean Hanshaw

Theses, Dissertations and Capstones

Introduction: Teledermatology, a subset of telemedicine, has gained prominence as a means to increase access to dermatologic care while reducing costs and improving patient satisfaction. The swift expansion of teledermatology during the COVID-19 pandemic was driven by the necessity to limit physical contact and adapt to public health restrictions. This technological shift aimed to address longstanding disparities in dermatology access, especially in rural and underserved populations, and to respond to the rising demand for dermatologic services amid provider shortages.

Purpose of the Study: The purpose of this study was to analyze the effects that teledermatology following the COVID-19 pandemic had …

Focus Group Interview: Perspectives Of Virtual Dietary Counseling Methods Post Covid-19 Pandemic, Maria R. Mendoza

All Master's Theses

In response to the prevalence of morbidity and mortality, studies to avert these conditions in a cost-effective and accessible manner are also increasing. Developing new methods to provide nutrition education that are more accessible is critical to reaching individuals who may experience socioeconomic barriers impacting their ability to access healthcare. The purpose of this study is to examine the perceptions related to different delivery methods of dietary counseling. This qualitative research study will examine the perceptions related to different methods of dietary counseling (telephone calls, video calls, or face-to-face visits). Focus group one contained provider participants (N = 7), which …

Shifting Patterns In Primary Care Telehealth Utilization Among Medicare Beneficiaries And Providers, Yunxi Zhang, Lincy S Lal, Saurabh Chandra, John Michael Swint

Faculty, Staff and Student Publications

Introduction: The COVID-19 pandemic accelerated telehealth adoption, but disparities in its utilization persist. This study examines primary care patient sociodemographic characteristics, telehealth utilization patterns, and provider adoptions before and during the pandemic.

Methods: A retrospective cohort study analyzed data from Mississippi Medicare beneficiaries continuously enrolled in Parts A, B, and D who accessed primary care services from 2019 to 2021.

Results: Among 201 677 Medicare beneficiaries accessing primary care, 1364 used telehealth before the pandemic, compared to 73 994 during the pandemic. Telehealth utilization shifted during the pandemic to younger, female, White beneficiaries, and those enrolled in Medicare due to …