Behavioral Medicine Commons^™

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 …

Inpatient Utilization Among Medicaid Members With Substance Use And Serious Mental Illness In Oregon, Megan Holtorf

Articles, Abstracts, and Reports

No abstract provided.

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 …

Covid-19 Associated Worry And Emotional Distress In Youth And Young Adults With Chronic Kidney Disease., Joann Carlson, Erin M. Jones, Sharon Manne, Matthew B. Matheson, Lyndsay A. Harshman, Bradley A. Warady, Susan Furth, Stephen R. Hooper, Rebecca J. Johnson

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The COVID-19 (C19) pandemic impacted youth mental/behavioral health with a 25% increase in prevalence of anxiety and depression worldwide. Little is known about the emotional impact of C19 for children with Chronic Kidney Disease (CKD). The purpose of the current study is to describe C19-related distress and worry among youth with CKD.

METHODS: C19 questionnaire adapted from the SARS-CoV-19 worry scale was completed for participants. Covariate data were collected at or prior to C19 questionnaire administration.Analyses examined rates of C19 emotional distress and worry and included logistic regression to identify associations with socioeconomic and disease-related covariates.

RESULTS: The sample …

Ketamine Infusion Treatment For Depression, Isabella Schwing

Capstone Showcase

Depression remains a significant public health challenge in the U.S., affecting millions of adults and contributing to both psychological and financial burdens. Major depressive disorder impacts approximately 14.5 million U.S. adults, with about 30% of cases classified as treatment-resistant depression. Traditional antidepressant therapies, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, often have delayed onset and limited efficacy, leaving a substantial portion of patients without adequate relief. Given these limitations, there is an urgent need for alternative treatment options.

Recent research has highlighted ketamine as a promising intervention for Major Depressive Disorder and Treatment Resistant Depression. Initially identified as …

Efficiency Rx: Emr Training For Resident Wellness, Calder Dorn, Shelley Sanders

Abstracts, Posters, Presentations

*Winner of the top award in the wellness division

A Systematic Review And Narrative Synthesis Of Factors Affecting Pre-Exposure Prophylaxis Willingness Among Black Women For Hiv Prevention, Alexis Sims Haynes, Christine Markham, Vanessa Schick, Robert Suchting, Nivedhitha Parthasarathy, Sumaita Choudhury, Mandy J Hill

Faculty, Staff and Student Publications

Pre-exposure prophylaxis (PrEP) can significantly reduce human immunodeficiency virus (HIV) transmission among Black women in the United States (U.S.), a group disproportionately affected by HIV. However, PrEP uptake in this HIV-vulnerable population is low. This review analyzes the factors influencing Black women's PrEP willingness using the Behavioral Model for Vulnerable Populations (BMVP). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Population, Intervention, Comparison, Outcome, Study Design (PICOS) framework, we conducted a systematic literature search and selected 24 peer-reviewed studies on PrEP willingness. Narrative synthesis revealed a heterogeneous landscape of the determinants affecting PrEP willingness …

Association Between Trust In The Incumbent President And Covid-19 Preventive Behaviors During The Pandemic In Four Latin American Countries, Juliana Mejía-Grueso, Gloria Isabel Niño-Cruz, Javiera Alarcón-Aguilar, Pablo Roa-Urrutia, Sergio Mauricio Moreno-López, Adriano Akira Ferreira Hino, Alexandre Augusto De Paula Da Silva, Fernando López, Deborah Salvo, Rodrigo Siqueira Reis, Guillermo Rosas, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

The COVID-19 pandemic revealed disparities in policy responses in Latin America. We examined the association between trust in the president and COVID-19 preventive behaviors in Brazil, Chile, Colombia, and Mexico. We used data from the Collaborative COVID-19 Response Survey by the McDonnell Academy at Washington University in St. Louis (United States), from September 2020 to March 2021. Nonprobabilistic sampling included adult citizens from the four countries. Multivariate negative binomial regression models were applied. The study included 8,125 participants, with Brazil showing the lowest adherence to preventive behaviors (65.5%). Increased adoption of preventive behaviors was linked with ages 18-26 (aIRR = …

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 …

The Contributions Of Motor Skill Proficiency To Cognitive And Social Development In Early Childhood, Catherine M. Capio, Norman B. Mendoza, Rachel A. Jones, Rich S.W. Masters, Kerry Lee

Health Sciences Faculty Publications

With limited evidence from intervention studies, causal relationships between motor competence and cognitive and social development have yet to be clearly established. In this research, we investigated whether a targeted training programme to improve fundamental movement skills (i.e., object control, locomotor) in young children would also lead to improvements in the cognitive (i.e., executive function) and social (i.e., socioemotional competence) domains. Using a two-arm group randomised intervention design, 185 children aged 36 to 60 months (mean 47.51, SD 8.11 months) were allocated to a motor skill intervention group or an active control group. The intervention was implemented over one school …

Improving Healthcare Utilization Models And Uncovering Health Behavior Patterns In Asian Americans Through Data Disaggregation, Luke Cho

Undergraduate Research Symposium Podium Presentations

Although Asian Americans are made up of 20+ distinct ethnicities with unique health outcomes, previous healthcare research has treated them as a monolithic group, covering up many important disparities in health outcomes and healthcare utilization patterns. This study examines how disaggregating Asian American health data by ethnicity improves models analyzing healthcare utilization patterns, focusing on routine physicals, dental checkups, alternative medicine consultations, and preference for ethnic concordance.

Using data from the 2015 Asian American Quality of Life survey (2,609 adults in Austin, Texas), binomial generalized linear models (GLMs) analyzed the impact of income, age, gender, insurance status, and ethnicity on …

Millennial Nurses Experience High Burnout And Turnover Risk During A Pandemic, Dana N Rutledge, Elizabeth Winokur, Sarah Douville

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

S.T.O.P. Drop It At The Door: Reducing Caregiver Burnout In The Emergency Room, Alexandra Rowen

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Battling Compassion Fatigue, Burnout, And Nurse Retention, Nicole Raab

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

An Order Set For Maternity Patients With Potential Opioid Use Disorder, Katrina Munoz

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

The Effect Of Sleep Meditation Applications On Insomnia In Registered Nurses And Certified Nurse Assistants, Jaiden Tanaleon, Amy Hughes

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Use Of Agitation Scale Decision Scoring Grid To Improve Care Of Agitated/Anxious Patients In Dsu, Carmyle Seville, Angelica Taneca

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Personality Feedback With Tailored Self-Care Recommendations Improves Self-Efficacy For Cancer Management: A Randomized Controlled Trial, Laura M. Perry, Brenna Mossman, Sofia F. Garcia, Sheetal M. Kircher, Addison Dunn, Sarah Alonzi, Sanjana Easwar, Michael Hoerger

School of Medicine Faculty Publications

Objective: To test whether a personality feedback intervention improves three domains of cancer self-management: self-awareness, self-efficacy, and positive affect. Methods: From 11/2020-02/2021, 372 adults diagnosed with cancer participated in a randomized controlled trial (RCT) of an intervention that entailed reading a brief personality-related excerpt during an online survey. Eligibility included self-reported age ≥ 18 years, current or past cancer diagnosis, and ability to read English. The survey included a baseline assessment with a personality questionnaire, then randomized participants to one of two groups. The intervention group (n = 184) received a personality feedback report with tailored self-care tips, whereas the …

Life Course Stressors, Latent Coping Strategies, Alcohol Use, And Adherence Among People With Hiv, Amrita Gill, Gretchen Clum, Patricia Molina, David Welsh, Tekeda Ferguson, Katherine P. Theall

School of Medicine Faculty Publications

People with HIV (PWH) have often experienced chronic stressors across their lifespan, including adverse childhood experiences (ACES), lifetime economic hardship (LEH), and concurrent stressors associated with living in urban areas (urban stress). Prolonged exposure to stressors might result in differential coping patterns among PWH that can impact care trajectories. We utilized a life course-informed approach to examine chronic stressors as antecedents of latent coping strategies among PWH in care. High-risk alcohol use and non-adherence to anti-retroviral therapy (ART) were examined as consequences of latent coping strategies. Data were utilized from the baseline and interim follow-up visit of the New Orleans …

Driving Healthy Behaviors Through Social Support: The Role Of Co-Responsibility In Weight Loss And Maintenance, Melanie Knufinke-Meyfroyt, Carlo Lancia, Yentl Lodewijks, Simon Nienhuijs, Eva Deckers

Patient Experience Journal

Objective: The effectiveness of out of hospital lifestyle interventions in healthcare is likely co-dependent on social support from involved one's. We sought to investigate the interrelationships between patient-partner Co-responsibility, Spousal Support, and Self-efficacy and the mechanisms through which they contribute to health behaviors and outcomes relevant to weight loss and maintenance. Methods: Co-responsibility, Spousal Support, self-efficacy, health outcomes and health behaviors like total weight loss, physical activity, OBESI-Q, and health satisfaction were assessed through a questionnaire among 868 individuals attempting to lose weight. Full and semi-partial correlations were used to understand the association between Co-responsibility, Spousal Support, Self-efficacy …

Motivators And Barriers To Help-Seeking And Treatment Adherence In Major Depressive Disorder: A Patient Perspective, Rahn K. Bailey, Kristin M. Clemens, Bex Portela, Hannah Bowrey, Samantha N. Pfeiffer, Gabrielle Geonnotti, Anna Riley, Jay Sminchak, Susan Lakey Kevo, Ronaldo R. Naranjo

School of Medicine Faculty Publications

Understanding patients’ lived experiences can identify knowledge gaps, informing better care. The objective of the study was to gain a better understanding of the lived experiences of patients from diverse backgrounds diagnosed with major depressive disorder (MDD). US patients aged ≥18 years who self-reported having MDD diagnosed by healthcare professionals (HCPs) completed demographic surveys and one-on-one (1:1) semi-structured interviews. Participants were recruited from a Patient Engagement Research Council and the study was classified as market research. Transcripts were evaluated with thematic analyses using the Braun and Clarke approach, quantifying theme frequencies across demographic categories. Among 14 interview respondents, key motivators …

Using Geographic Momentary Assessment To Explore Spatial Environment Influences On Wellbeing In People With Hiv, Rayna E. Gasik, Ethan A. Smith, Simone J. Skeen, Stephanie Tokarz, Gretchen Clum, Erica Felker-Kantor, Katherine P. Theall

School of Public Health Faculty Publications

Place-based socio-economic and racial inequities contribute to health disparities among people with HIV (PWH). We used geographic ecological momentary assessment (GEMA) methodologies to explore the interplay between psychosocial outcomes in daily diaries and community spatial measures among PWH in New Orleans. PWH (N = 69) were recruited from a clinic-based cohort study. Micro-longitudinal data were collected via smartphone-based daily diaries and geospatial tracking over 14 days. First, correlations were run between diary derived outcomes (e.g., feeling safe in current location, stress), and spatial measures (e.g., violent crime, alcohol outlets, and vacant lots) within a half-mile buffer around each diary point …

Digital, Social Micro-Interventions To Promote Physical Activity Among Midlife Adults With Elevated Cardiovascular Risk: An Ambulatory Feasibility Study With Momentary Randomization., Danielle Arigo, Leah M Schumacher, Kiri Baga, Jacqueline A Mogle

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Although regular physical activity (PA) mitigates the risk for cardiovascular disease (CVD) during midlife, existing PA interventions are minimally effective. Harnessing social influences in daily life shows promise: digital micro-interventions could effectively engage these influences on PA and require testing.

PURPOSE: This feasibility study employed ecological momentary assessment with embedded micro-randomization to activate two types of social influences (i.e., comparison, support; NCT04711512).

METHODS: Midlife adults (N = 30, MAge = 51, MBMI = 31.5 kg/m2, 43% racial/ethnic minority) with ≥1 CVD risk conditions completed four mobile surveys per day for 7 days while wearing PA monitors. After 3 days …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

Rule Breakers Achieve Successful Shoulder Balance: Unraveling The Myth Of Upper Instrumented Vertebrae Selection Criteria, Luke C. Drake, Peter W. D’Amore, Bailli Fontenot, Tyler A. Tetreault, Manaf Younis, Claudia Leonardi, Jaquelyn Valenzuela-Moss, Lindsay M. Andras, Michael J. Heffernan

School of Medicine Faculty Publications

Purpose: This study compared shoulder balance outcomes in “rule breakers” (RB) vs. “rule followers” (RF) based on commonly utilized upper instrumented vertebrae (UIV) selection guidelines. Methods: Adolescent idiopathic scoliosis (AIS) patients (Lenke 1–4) who underwent posterior spine fusion (PSF) with minimum 2-year follow-up had radiographic measurement of shoulder balance including first rib angle (FRA), T1 tilt, coracoid process height difference (CPHD), and clavicle angle (CA) at preop, postop, 6-month, 1-year, and 2-year timepoints. Postoperative outcomes were compared between RB and RF groups defined based on the UIV selection guidelines of Rose and Lenke. Results: Among 88 patients (43 RF, 45 …

Correspondence To "A Preliminary Study Of Collaborative Group Intervention With Recovered Peer Supporters For Eating Disorders: Analyses Including Comparisons Between In-Person And Online Sessions", Nirjal Thapa, Don D Shamilov, David F Lo

Rowan-Virtua School of Osteopathic Medicine Departmental Research

We read with pleasure the article by Mochizuki et al., ¹ titled “A preliminary study of collaborative group intervention with recovered peer supporters for eating disorders: Analyses including comparisons between in‐person and online sessions.” We would like to offer additional commentary on the conclusions regarding group intervention and peer support and its heavy influence on combating eating disorders. We hope these perspectives may provide insight into areas that may require further research and improvement.