Behavioral Medicine Commons^™

Psychological Adaptation In Colorectal Cancer Survivors: Pilot Study Findings, Anuja L. Sarode, Emily M. Su, Amber Kerstetter-Fogle, Steve Paciorek, Erica L. Laipply

HCA Healthcare Journal of Medicine

Background

In this pilot study, we examined psychological impacts of colorectal cancer (CRC), focusing on cancer-related posttraumatic stress disorder (CR-PTSD) symptoms, posttraumatic growth (PTG), and their relationship with coping strategies in surgically treated CRC patients.

Methods

This prospective pre- and postoperative pilot study assessed CRC patients at 2 time points, pre- and postoperative. Psychological symptoms were evaluated using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) and the PTG Inventory Short Form (PTGI-SF). Coping strategies were assessed using the Brief Coping Orientation to Problems Experienced (COPE) instrument. Changes in CR-PTSD, PTG, and coping …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Family Mental Health – A Case Report, Vikrant Arora, Medha Kosireddy, Mathumitha Ananth, Kishor M. Manohar Rao

Digital Journal of Clinical Medicine

Psychiatric illness in India is estimated to be 15% as per National Mental Health Survey 2015-16.  Mental health challenges within families, especially depression, anxiety disorders that are not common and when unaddressed exert cascading effects on all members, disrupting emotional cohesion, relational functioning, and socioeconomic stability. There are few case reports on entire family presenting to psychiatry department.

With informed consent a city-based middle-class family of non-consanguineous origin, where the 40-year-old female, presented with intractable limb pains and health anxiety, she had multiple consultation in last few months and her 48-year-old husband also had with episodic pains, irritability and her …

A Systematic Review Of Weight Loss Interventions Among Black Postpartum Women, Jhelma Velveder Perez

Honors Scholar Theses

Cardiovascular disease is a leading contributor to maternal mortality, which remains disproportionately high among Black women. Obesity and postpartum weight retention exacerbate cardiovascular disease risk and increase the likelihood of complications in future pregnancies. Weight loss during the postpartum period may reduce long-term chronic health risks and mortality for Black women. This systematic review aimed to understand the weight-related health needs of Black postpartum women by evaluating behavioral weight loss interventions within the first year after childbirth. A comprehensive search of the PubMed database identified 3 randomized controlled trials that met inclusion criteria. These studies evaluated home-based programs, mobile health …

Assessing The Impact Of The Covid-19 Pandemic On Mental Health In Patients Presenting To A Student-Run Free Clinic, Sabah Iqbal, Kirsten Carlberg, Emily Reilly, Jessica Ivanov, Victoria Youssef, Lily Roessler, Maikel Monsour, Nils Brolis

Rowan-Virtua Research Day

Background

Mental health is an important part of patient care, therefore it is imperative to understand how it’s recognized and treated. Socioeconomic status and the COVID19 pandemic contribute to disproportionate incidences of mental illness^{1, 2, 10, 11, 12}. This study uses data from a student-run clinic, the Rowan-Virtua Community Health Center (RVCHC), to examine disparities in mental health needs and screenings among the local population.

Hypothesis

It was hypothesized that underserved populations are at a disadvantage when it comes to both mental health screenings and treatment due to restricted access to healthcare and other unmet needs. Additionally, the …

Routine Overnight Assessments In Stable Pediatric Surgery Patients: A Critical Reconsideration, Morgan Brown, Rebecca Moreci, Hannah Megison, Elizabeth Long, Michael Maurer, Benjamin Bienvenue, Denise M. Danos, James H. Wood

School of Medicine Faculty Publications

Background: Hospitalized patients are subject to overnight vital sign (OVS) monitoring which leads to subsequent sleep disturbance and contributes to adverse outcomes and negative hospital experiences. Studies in pediatric populations have shown that routine OVS checks infrequently detect significant events. We hypothesized that OVS monitoring in pediatric surgery patients rarely detects abnormalities resulting in meaningful interventions. Materials and methods: We performed a retrospective chart review of patients ≥ 5 years old admitted to the pediatric surgery service at a stand-alone Children's Hospital from 2019 to 2021. ICU patients were excluded from analysis. Overnight vital signs were defined as those recorded …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Liv Selection In ‘Tweener’ Patients Treated With Magnetically Controlled Growing Rods Vs. Posterior Spinal Fusion, Brandon Yoshida, Claudia Leonardi, Jacquelyn Valenzuela-Moss, Lindsay M. Andras, Tyler A. Tetreault, John B. Emans, John T. Smith, Joshua M. Pahys, G. Ying Li, Michael J. Heffernan

School of Public Health Faculty Publications

Purpose: The purpose of this study was to compare the LIV selection in ‘tweener’ patients treated with MCGR or PSF. Methods: A multicenter pediatric spine database was queried for ambulatory patients ages 8–11 years treated by MCGR or PSF with at least 2-year follow-up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed. The relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), and the LIV were evaluated. Results: One hundred and fifty-nine patients met inclusion criteria. Preoperative curve magnitude was similar between groups (MCGR 68 …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

Understanding Provider Competency In Gender Affirming Care, Vanessa Castle, Lindsay Gietzen

Pacific Journal of Health

Lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual plus (LGBTQ+) individuals, especially transgender patients, face many healthcare disparities. It is extremely important for them to have access to high-quality healthcare, particularly Gender Affirming Care (GAC), to support their well-being and mental health. However, many healthcare providers, including clinical social workers, NPs, PAs, and MDs lack proper training to offer GAC. The current training opportunities available are often basic and lack comprehensive, detailed information. To reduce healthcare barriers for the transgender and gender-diverse community, we must have comprehensive training on GAC available for providers so they can treat their patients with …

Sexual Well-Being And High-Risk Behaviors : An Exploratory Mixed Methods Study For Questionnaire Development, Stephan R Smith

Covenant Nurses Week 2024

No abstract provided.

Back Pain In Adolescent Idiopathic Scoliosis: Frequency And Risk Factors, Stefan Sarkovich, Claudia Leonardi, Matthew Darlow, Davis Martin, Peter Issa, Tara Soria, Amy Bronstone, Carter Clement

School of Public Health Faculty Publications

Purpose: Although back pain is commonly reported in patients with adolescent idiopathic scoliosis (AIS), factors that influence the presence and severity of back pain in AIS, including curve-specific variables, have not been well studied. This study aims to describe the prevalence and severity of back pain in AIS patients and determine the extent to which patient characteristics, including curve-specific factors, are associated with a higher risk of back pain in AIS. Methods: The study was a retrospective medical records review of adolescents (aged 10–17 years) diagnosed with AIS between 01/01/2018 and 12/31/2021 at an academic tertiary children’s hospital. Patients with …

Understanding Organ Donation Messaging: A Qualitative Inquiry, Rebecca K. Britt, Amy A. Ritchart

The Qualitative Report

Promoting health communication about organ donation remains a crucial objective within Native American communities. The goals of the current study were to communicate with young adult Native Americans about the Organ Donation Willingness Model (ODWM; Horton & Horton, 1991) to gain their responses to materials from campaigns about donation strategies tailored to Native American communities. Six focus groups were conducted with a total of 31 participants. Data were analyzed using thematic analysis (Braun & Clarke, 2019, 2022) and following Smith’s guidelines (2008), which include showing deep respect for the group participants, conducting the study in a face-to-face setting, and being …

Optimal Duration Of Physical Therapy Following Total Knee Arthroplasty, Gregory Benes, Zachary Adams, Michael Dubic, Justin David, Claudia Leonardi, Amy Bronstone, Vinod Dasa

School of Medicine Faculty Publications

Aims & Objectives: The purpose of this study was to identify patient characteristics associated with engagement and completion of physical therapy (PT) following total knee arthroplasty (TKA) and examine the relationship between number of PT sessions attended and outcomes during the first 12 weeks after surgery. Methods: Patients underwent unilateral primary TKA by a single surgeon and were advised to complete 17 PT sessions over 6 weeks at a hospital-affiliated facility. Analyses examined predictors of PT engagement (attendance of ≥ 2 sessions) and completion (attendance of 17 ± 1 sessions) within 6 weeks and associations between number of PT sessions …

The Burden Of Burns: An Analysis Of Public Health Measures, Anastasiya Ivanko, Anna Garbuzov, Jonathan E. Schoen, Randy S. Kearns, Denise Danos, Erica Murata, Bart D. Phillips, Herb A. Phelan Iii, Jeffrey D. Carter

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Use Of The Burn Care Quality Platform (Bcqp) For Modern Burn Care Benchmarking, Madeline G. Lechtenberg, Jeffrey E. Carter, Denise Danos, Bart D. Phillips, Erica Murata, Jonathan E. Schoen, Herb A. Phelan Iii

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Behavioral Health Integration And Outcomes That Matter To Patients: A Longitudinal Mixed-Methods Observational Study, Reach Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

The study team hypothesized that patients would have a better experience over time in clinics that had greater degrees of behavioral health integration.

Lowest Instrumented Vertebrae In Early Onset Scoliosis: Is There A Role For A More Selective Approach?, Michael J. Heffernan, Claudia Leonardi, Lindsay M. Andras, Bailli Fontenot, Luke Drake, Joshua M. Pahys, John T. Smith, Peter F. Sturm, George H. Thompson, Michael P. Glotzbecker, Tyler A. Tetreault, Benjamin D. Roye, Ying Li

School of Public Health Faculty Publications

Purpose: This purpose of this study was to assess the impact of patient and implant characteristics on LIV selection in ambulatory children with EOS and to assess the relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), the sagittal stable vertebrae (SSV), and the LIV. Methods: A multicenter pediatric spine database was queried for patients ages 2–10 years treated by growth friendly instrumentation with at least 2-year follow up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed. The relationships between the TV, LSTV, SV, SSV, …

Addressing Healthcare Disparities Faced By Aging Down Syndrome Populations, Rhea Mistry

Pitzer Senior Theses

Down syndrome (DS) is a chromosomal genetic condition that impacts the development of the body and brain. The life expectancy of individuals with DS has drastically improved over the decades, increasing from 9 years in 1929 to 25 years in 1983 and further reaching 60 years by 2002. Individuals with DS face a variety of prominent co-occurring health conditions that are subject to change over time, including cognitive, visual, and hearing impairments, sleep apnea, cardiovascular defects, Down syndrome regression disorder, and dementia. Despite this increase in life span, DS is still most familiar to pediatric care providers, resulting in healthcare …

The Correlation Between Traumatic Brain Injury And Incarceration Among Adult Males In The United States, Shadi Shams

Rowan-Virtua Research Day

The United States has one of the largest growing prison populations in the world. A large amount of social and economic resources go towards the cost and maintenance of correctional facilities each year. Additionally, the current correctional programs are insufficient in assisting inmates with getting back to society; especially those with traumatic brain injury (TBI) who often remain undiagnosed and are usually treated unfairly in the prison system instead of receiving the appropriate help. Prior scholarly work has shown that patients in the post-TBI stage are more likely to enter the judicial system. In the recent population-based cohort study, the …

Addressing Breast Health Disparities Among Recent, Established African-Born Immigrant Women And Second-Generation Americans In Prince George County, Maryland, Omolola Okunromade

College of Graduate Studies: Theses & Dissertations

Background: Breast health disparities and underutilization of screening methods are major concerns in the United States (US), particularly affecting Black women who experience lower survival rates and advanced diagnoses. Despite the rapid growth of the African-born immigrant population, breast health among this group in the US is notably under-examined. This study aims to investigate the breast health knowledge and practices of first-generation African-born immigrants and second-generation immigrant women of African descent, aiming to understand the distinctive attributes of this group and the impact of acculturation on this public health issue.

Methods: Interviews were conducted among First Generation African immigrants and …

Behavioural Support And Nicotine Replacement Therapy For Smokeless Tobacco Cessation: Protocol For A Pilot Randomised-Controlled Multi-Country Trial, Faraz Siddiqui, Linda Bauld, Ray Croucher, Cath Jackson, Ian Kellar, Mona Kanaan, Subhash Pokhrel, Rumana Huque, Romaina Iqbal, Javaid Ahmed Khan

Community Health Sciences

Background: Smokeless tobacco (ST) is consumed globally by more than 350 million people, with approximately 85% of all users based in South and Southeast Asia. In this region, ST products are cheap and easily accessible. Evidence-based interventions to people quit ST use are lacking. This study aims to test the feasibility of conducting a future definitive trial of ST cessation, using a culturally adapted behavioural intervention, and/or nicotine replacement therapy (NRT) in three South Asian countries.
Methods: We will conduct a factorial design, randomised-controlled pilot trial in Bangladesh, India and Pakistan. Daily ST users will be recruited from primary health …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Starting Triple Oral Hypoglycemic Agent Therapy In Poorly Controlled Type 2 Diabetes Is A Suitable Therapeutic Strategy To Lower Hba1c When Insulin Therapy Is Not Desired, Mara A. Darian

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Søfteland E, Meier JJ, Vangen B, Toorawa R, Maldonado-Lutomirsky M, Broedl UC. Empagliflozin as Add-on Therapy in Patients With Type 2 Diabetes Inadequately Controlled With Linagliptin and Metformin: A 24-Week Randomized, Double-Blind, Parallel-Group Trial. Diabetes Care. 2016;40(2):201-209. https://doi.org/10.2337/dc16-1347

for a patient with uncontrolled type 2 diabetes on metformin and sitagliptin and hesitant to begin insulin therapy.

Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos

Electronic Theses, Projects, and Dissertations

In 2018, of 1.3 million Latinx adults in the United States facing concurrent issues with substance use disorders (SUD) and mental health disorders (MHD) 93% remained untreated for either diagnosis. This is concerning since Substance Abuse and Mental Health Services Administration (SAMHSA) data reveals that this population is at greater risk for suicidal thoughts, plans, and attempts. They also face structural barriers such as employment, housing, legal involvement, and insurability that further impede access to treatment.

This study’s purpose was to examine barriers to accessing treatment for Latinx populations confronting co-occurring SUDs and MHDs. This study used a qualitative design …

Historical Trauma Response Scores As A Function Of Unresolved Grief And Substance Use Disorder In American Indian Populations, Andrew R. Saunders

Undergraduate Research Symposium

Abstract

Researchers are interested in the outcomes of interventions, specifically, measuring historical trauma (HT) among American Indian/Alaska Native communities and the long-term distress and substance abuse as a result of historical trauma response (HTR). Previous literature has implicated limitations in the clinical conceptualization of the relationship between intergenerational transfer of HTR and substance abuse. The aim of the current study is to examine treatment efficacy of 50 homosexual, American Indian males randomized to a culturally-adapted juxtaposition of (1) Group Interpersonal Psychotherapy (IPT), (2) Cognitive Processing Therapy (CPT), and (3) Historical Trauma and Unresolved Grief Intervention (HTUG), or (4) waitlisted on …

Geriatrics In Clinical Practice And Beyond: Brain Health, The Sixth Vital Sign?, Nannette Hoffman

HCA Healthcare Journal of Medicine

Brain health in middle age and geriatric patients will take on greater importance for health care practitioners in our aging society. This article discusses various approaches clinicians can use for their patients to promote and improve brain health. These are generally the same lifestyle adoptions for cerebrovascular disease and cardiovascular disease prevention: weight management, exercise, and blood pressure and cholesterol lowering. Social stimulation and cognitive activities may also be important for the elderly.