Preventive Medicine Commons^™

Countering Hpv Vaccine Misinformation On Social Media: Practical Strategies For Healthcare Providers, David Baldwin

Lynchburg Journal of Medical Science

Human papillomavirus (HPV) vaccination is a highly effective strategy for preventing cervical and other HPV-related cancers; however, vaccine hesitancy remains a significant barrier to optimal vaccination rates. Social media has become a major source of health information while simultaneously amplifying misinformation that influences parental attitudes toward HPV vaccination. This narrative literature review examined the relationship between social media misinformation and HPV vaccine hesitancy and identified evidence-based strategies healthcare providers can use to improve vaccine confidence.

A literature search of PubMed and Google Scholar identified 31 articles published between 2016 and 2025, of which 19 met inclusion criteria. The literature demonstrates …

Small Cell Lung Cancer In A Never-Smoking Patient: A Case Highlighting Diagnostic And Screening Gaps In Primary Care, Edward Hamilton, Alexandra She, Francis Jenney

The Journal of Integrated Primary Care

Small cell lung cancer (SCLC) is best known in relation to tobacco exposure and tends to be seen in advanced disease. Contemporary guidelines in lung cancer screening demonstrate a strong emphasis on smoking exposure, which may serve as a barrier to recognition in never-smokers who lack conventional risk factors. As a result, SCLC in never-smokers remains an important but underrecognized consideration in general and primary care settings. The current case involves a 65-year-old African American man who has never been a smoker but who presented with progressive thoracic pain, shortness of breath, and unintended weight loss, leading to the discovery …

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

Honors Theses

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

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Exercise Prescription For Adults With Prediabetes In The Primary Care Clinic, Katherine W. Hall

Doctor of Nursing Practice Final Manuscripts

Prediabetes affects approximately one in three adults in the United States, with an estimated 10% progressing to Type 2 Diabetes Mellitus (T2DM) annually. Despite strong evidence supporting exercise as a first-line intervention to prevent disease progression, most patients in primary care settings do not receive structured physical activity counseling. This evidence-based project (EBP) aims to address this gap by implementing a standardized protocol to assess baseline physical activity levels and deliver individualized exercise prescriptions to adults with prediabetes in the primary care clinic.

Eligible participants, defined by HbA1c values between 5.70% and 6.49%, were identified during routine primary care visits …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Cigarette And E-Cigarette Use In Greater Philadelphia: Proportion Of Use Compared To National Data And Local Predictors Of Smoking Status, Munjireen Sifat, Joshua Banks, Lilianna Phan, Kuang-Yi Wen, Julie A. Barta, Rebecca J. Melillo, Hee-Soon Juon

College of Population Health Faculty Papers

UNLABELLED: Objective tobacco use, cigarette, e-cigarette, cancer-related beliefs, perceived risk, lifestyle attribution, cancer disparities, health equity. We assessed cigarette smoking and e-cigarette use in the Greater Philadelphia region alongside national data. The objectives were to descriptively explore differences in tobacco use by sociodemographic characteristics. We also examined cancer belief associations with smoking and e-cigarette use in the local context.

METHODS: We descriptively compared cross-sectional survey data from 2744 adults in the Sidney Kimmel Comprehensive Cancer Center (SKCCC) catchment area (Greater Philadelphia region; May-July 2022) with 6252 Health Information National Trends Survey (HINTS 6) nationally representative respondents (United States; March-November 2022). …

Increasing Medication Adherence In Those With Hypertension, Holly Kimiecik

Evidence-Based Practice Project Reports

Hypertension is a chronic condition characterized by persistently elevated blood pressure and remains a significant contributor to morbidity and mortality in the United States. According to the Centers for Disease Control and Prevention (2024), approximately 47.7% of U.S. adults have hypertension, yet only about one in five achieve blood pressure control below 130/80 mm Hg. Medication adherence plays a critical role in managing hypertension and preventing complications. Adults aged 18 years and older prescribed antihypertensive medications from a primary care clinic in Valparaiso, Indiana, participated in this six-week quality improvement intervention. Evidence from a comprehensive literature review supports combining patient …

Adhesion Of Antibiotic-Resistant Bacteria To Thermoplastic Materials Used In Fabricating Medical Devices: Patient Consequences, Dev V. Mehta

Poster Presentations

Burn injury patients wear supportive orthoses made by heat-forming sheets of thermoplastic material (Figs. 1 & 2). Bacteria cause severe soft tissue infections in patients wearing contaminated orthoses. Thermoplastic medical devices can develop biofilms that include antibiotic-resistant (AR) bacteria, which significantly reduces the number of available treatment options. A biofilm is a community of microorganisms that share resources allowing them to exist in a nutrient-limited environment. Biofilm microbes secrete extracellular polymeric substance (EPS) that attaches them firmly to a substrate surface while protecting them from harmful substances, including antibiotics. Bacteria living within biofilms on inanimate surfaces can survive for extended …

Evaluation Of The Effectiveness Of Antihypertensive Therapy Chosen Through Maternal Hemodynamic Profile Analysis, Margaret Weimer

Honors Theses

Medication choice is tightly regulated in most situations, but in the field of obstetric medicine, the American College of Obstetricians and Gynecologists (ACOG) recommends both labetalol and nifedipine as oral treatments for emergent hypertension, with no preference shown between the two. Studies have suggested that consideration of hemodynamic profile may be an effective way to determine medication, but have not considered the Rule of 55, a simple calculation to predict hemodynamic profile. The goals of this study were to determine whether tailoring the oral hypertensive medication to a patient’s hemodynamic profile is associated with better blood pressure control within 72 …

Spectral Characterization Of Colorectal Cancer Using Excitation-Scanning Hyperspectral Imaging, Natalie Hadad

Honors Theses

Colorectal cancer is one of the most common and deadly cancers worldwide, with a lifetime risk of approximately one in twenty-three for men and one in twenty-five for women. Although early detection significantly improves survival, current diagnostic approaches such as tissue biopsy are invasive, reliant on subjective interpretation, have extended turnaround times, and risk missing flat or depressed lesions that are more difficult to detect than raised polyps. These limitations highlight the need for objective, minimally invasive technologies capable of detecting early tissue changes. This study investigates excitation-scanning hyperspectral imaging (Ex-HSI) as a label-free optical approach for identifying colorectal cancer–associated …

Patient-Provider Communication Among Deaf English Users: Disparities And Implications For Cancer Screening, Ciara Luttrell

Undergraduate University Honors Capstones

Early detection is one of medicine's powerful tools; routine cancer screenings can help diagnose cancer early and enable immediate treatment. Cancer screening and prevention efforts have accounted for 4.75 million (80%) cancer deaths averted between 1975 and 2020 for five major cancer types (NIH, 2025). Nevertheless, this powerful tool is not shared equally. Many deaf adults who use English still experience barriers and disparities. Accordingly, the purpose of this study is to investigate how deaf English-using individuals in the United States interact with their healthcare providers and whether these interactions are associated with cancer screening interest among these populations. The …

Superior Mediastinal Cut-Off Measurements In Chest Radiographs For Screening Of Silent Thoracic Aortic Diseases, Kantheera Leesmidt, Boonyarit Sintuvikaiwong, Apichaya Sripariwuth

Chulalongkorn Medical Journal

Objective: To determine cut-off values for superior mediastinal width and the mediastinal width-to-thoracic cage ratio from chest radiographs for the early detection of unrecognized thoracic aortic diseases. Additionally, this study aims to enhance diagnostic strategies for identifying aortic abnormalities.

Materials and Methods: This retrospective analysis included 152 subjects who underwent both computed tomography angiography (CTA) of the thoracic aorta and chest radiograph between April 2007 and January 2021. Superior mediastinal width was measured at 3 levels on chest radiographs. Thoracic CTA findings were categorized into normal and abnormal groups, the latter comprising aortic dissection, intramural hematoma, penetrating atherosclerotic …

Improving Awareness Of Physician Ergonomics In Gynecologic Surgery, Priyanka Raju Md, Annika Eveland Md, Tamara Lalovic Do, Dominic Cammarano Do

Transformative Medicine

Introduction:
Surgeons experience disproportionately high rates of work-related musculoskeletal (MSK) disorders due to prolonged static postures, repetitive motions, and suboptimal instrument design. Gynecologic surgery, in particular, involves sustained non-neutral positioning and physical strain, yet formal ergonomic education is lacking. This study aimed to evaluate gynecologic surgeons’ awareness of ergonomic principles and determine whether targeted education improves knowledge and recognition of ergonomic risk factors during surgery.

Methods: A quality improvement intervention was implemented at a large teaching hospital. Eighty-three recorded gynecologic surgeries (open, laparoscopic, and vaginal) were analyzed for common postural deviations based on ergonomic guidelines. The most frequent errors were …

Educational Intervention To Improve Awareness Of The Female Athlete Triad Among Division I Athletes, Carly J. Haring, Jonathan Olson Md

Aesculapius Journal (Health Sciences & Medicine)

Introduction: The Female Athlete Triad poses short- and long-term health risks for female athletes through the interrelated components of low energy availability, menstrual dysfunction, and impaired bone health. Despite its prevalence, awareness and education surrounding the Triad remain limited, contributing to delayed recognition and care. The objective of this project was to assess baseline knowledge and comfort discussing Female Athlete Triad–related topics among Division I female athletes and to evaluate the impact of a brief educational intervention on knowledge, attitudes, and help-seeking intentions.

Methods: A community-based educational initiative was conducted in November 2025 among Division I female athletes …

Rates And Predictors Of Intention To Get Preventive Screenings Among Individuals In Recovery From Substance Use Disorders, Afsha Hossain, Ban A. Majeed, Lia Pierson Bruner

Journal of the Georgia Public Health Association

Background: Individuals with substance use disorders (SUDs) are at greater risk for chronic disease but often face barriers to access and uptake of preventive screenings, so the aim of this study was to identify rates and predictors for intention to get preventive screenings among residents at two recovery centers.

Methods: We used a cross-sectional survey (N=95, response rate 51%) to determine previous screening rates and the intention to get recommended preventive screenings among residents of two long-term recovery programs in Athens, GA, using bivariate analysis with chi-square to look for associations with intention.

Results: Prior use of preventive health services …

Role Of Continuous Positive Airway Pressure In The Prevention Of Cardiovascular Events In Patients With Obstructive Sleep Apnea: A Systematic Review And Meta-Analysis Of Randomized Clinical Trials, Saif Almuzainy, Mohamed Lemine, Rayan Aljubeh, Ahmad Alilo, Maryam Altaher, Mohamed Almuzainy, Sami Alsalem, Mohamed Dawdi

Journal of the Saudi Heart Association

Background: Obstructive sleep apnea (OSA) is prevalent among patients with cardiovascular disease and is associated with increased risk of major adverse cardiovascular events (MACE). Continuous positive airway pressure (CPAP) is the standard treatment for OSA, but its impact on cardiovascular outcomes remains uncertain, particularly in randomized controlled trials (RCTs).

Objectives: To evaluate the effect of CPAP therapy on cardiovascular outcomes in patients with OSA, and to explore the influence of adherence on treatment efficacy.

Methods: We conducted a systematic review and meta-analysis of RCTs comparing CPAP with placebo or usual care in adults with OSA. Databases including PubMed, Scopus, Ovid, …

Undergraduate Health And Wellbeing Course And Study Away Program To Alaska, Lorraine S. Wallace, Steven J. Mousetes, Jennifer Bickley

Journal of Global Education and Research

High-impact practices, such as diversity/global education, have been shown to positively contribute to student development, engagement, and success. As the US is both culturally and linguistically diverse, domestic study away programs can offer students impactful multicultural educational experiences without leaving the country. The purpose of this study was to describe the design of a health and well-being academic course and accompanying study away program to Alaska for undergraduates at The Ohio State University (OSU). The authors (1) describe the application of the backward design process in guiding ELOs development, (2) provide a sample of course assignments and student responses, and …

Utilization Of Evidence-Based Secondary Preventive Therapies Post-Acute Coronary Syndrome: A Heart Registry Cohort Study In Kenya, Anthony Ochola, Jasmit Shah, Jeilan Mohamed, Harun Otieno, Anders Barasa, Felix Barasa, Constantine Akwanalo, Benard Gitura, Mzee Ngunga

Internal Medicine, East Africa

Introduction: cardiovascular disease is a growing concern in Africa, with coronary artery disease emerging as a leading cause of mortality. Despite strong evidence and international guidelines recommending secondary prevention therapy post-acute coronary syndrome (ACS)-including antiplatelet agents, statins, beta blockers, and angiotensin-converting enzyme (ACE) inhibitors-suboptimal use remains a concern, especially in low- and middle-income countries. This study aimed to quantify the use of guideline-recommended secondary prevention medications after ACS in Kenya using the data from the Kenya Heart Registry study.

Methods: a cohort study was conducted using data from the Kenya Heart Registry across three hospitals in Kenya from …

Improving Colorectal Cancer Screening Adherence, Albin Abraham

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

As the second leading cause of cancer-related deaths in the United States, colorectal cancer (CRC) is a prevalent but highly preventable form of cancer (American Cancer Society National Colorectal Cancer Roundtable [ACSNCCR], 2026; Maratt et al., 2024). Screening for CRC is fundamental to prevention and early detection. Despite advances in screening measures, CRC screenings remain suboptimal (Tonini & Zanni, 2024). In the US, more than one in three adults 45 years or older are not screened as recommended (ACSNCCR, 2026).

Purpose

As a safety-net county health network primarily serving the under-resourced population, the organization is uniquely positioned to impact …

Human Milk Feeding And Its Impact On The Incidence Of Necrotizing Enterocolitis, Maya C. Kern

Nursing | Senior Theses

One of the leading causes of morbidity and death for preterm and very low birth weight (VLBW) newborns is still necrotizing enterocolitis (NEC). Existing literature consistently shows that the bioactive, anti-inflammatory, and microbiome-supporting components of human breast milk, including donor human milk, significantly lower the incidence of NEC. However, a lot of infants are forced to rely on formula and nutrient fortifiers because they cannot obtain maternal or donor milk. A critical gap persists regarding whether human milk derived fortifiers offer greater NEC protection than bovine derived fortifiers in infants who must receive formula. This thesis examines three interconnected themes; …

Implementation Of A Pressure Injury Prevention Bundle To Reduce Hospital-Acquired Pressure Injuries In The Intensive Care Unit, Xibo Lan

Doctor of Nursing Practice Final Project Abstract

Purpose

The goal of this quality improvement project was to utilize the SKINSAFE pressure injury prevention bundle during 12 weeks of implementation to increase evidence-based pressure injury prevention practices adherence and decrease risk of hospital-acquired pressure injury (HAPI) in the intensive care units (ICU).

Background

ICU patients experience high risk for hospital acquired pressure injuries (HAPIs) secondary to immobility and device related pressure. Initial adherence to SKINSAFE bundle was 55-56%. There was inconsistent use of heel offloading devices, wound photography and documentation. Prevention bundles were affected by staffing fluctuations and leadership turnovers.

Methodology

The Plan-Do-Study-Act cycle for this project included …

Enhancing Sepsis Prevention In Long-Term Care Facilities: Development Of An Infection Prevention Sepsis Toolkit, Emmalyn A. Tuhin

Student Scholarly Projects

Objectives: The purpose of this Doctor of Nursing Practice (DNP) project was to create, validate, and refine an Evidence-Based Sepsis Prevention Toolkit to enhanced early sepsis recognition and interprofessional coordination of care within long-term care facilities (LTCFs).

Background: Sepsis remains a leading cause of mortality and preventable transfer to the hospital for the elderly residents within the LTCFs. A significant practice gap persists because sepsis in this population often presents atypically, resulting in delayed or inaccurate diagnosis and treatment.

Methods: This project was guided by the following PICOT question: For healthcare professionals caring for patients aged 65 years and older …

Comparing Lower Extremity Kinematics Using Trazer And Inertial Motion Capture Systems, Gabriella Juoza-Clark Spt, Joellen Carter Spt, Nikki Stam Spt, Kevin Robinson Pt, Dsc, Ocs

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: This study assessed the validity of a non-immersive body motion tracking system (TRAZER) as an alternative to using Inertial Measurement Units (IMU)-based motion capture (MyoMotion) for lower extremity kinematic analysis. Methods: Twenty healthy participants (10 females, 10 males) with a mean age of 24.03 years (range: 20-33 years) and a mean BMI of 25.15 kg/m² (range: 18.45-32.23 kg/m²) performed double and single-leg squats. Data Analysis: Kinematic data from TRAZER and MyoMotion IMUs were compared using a mixed two-way ANOVA. Results: No significant differences were observed in knee flexion data across all movements (p > 0.05) and knee abduction during the …

Role Of Addiction Medicine Consultation Service In A Community Hospital: Evaluation Of The Novel Service, Srikrishna Varun Malayala, Wesley Cervantes Perez, Rukshar Thapa, Archie Madan, Kushagar Singla, Pragyat Singh, Pelash Kumar, Akshay Thaper

Journal of Community Hospital Internal Medicine Perspectives

Objectives: Fewer than 2,500 physicians nationwide are certified in addiction medicine. Inpatient addiction hospitalist services have been shown to improve patient outcomes, but their capabilities and impact are underexplored in community hospitals. This study evaluates the role of an addiction medicine hospitalist service in enhancing patient outcomes in two community-based hospitals.

Methods: A retrospective chart review was conducted on patients who received care from addiction medicine service in two hospitals. The data were collected within the first 120 days of the establishment of service. The reason for consultation, substances used, types of management, impact on transition of care, readmissions and …

Surgeon Ergonomics While Performing Total Knee Arthroplasty, Cameron Dahman

Electronic Theses and Dissertations

One of the most prevalent hazards to orthopedic surgeons are musculoskeletal disorders with 97% of arthroplasty surgeons reporting procedural-related musculoskeletal pain and 66% of orthopedic surgeons reporting procedural-related musculoskeletal injury [1], [2], [3]. With the annual number of total knee arthroplasties (TKA) on the rise, orthopedic surgeons are taking on larger annual caseloads and retiring later in life [4], [5]. The goal of this study was to quantify postural demand for 11 discrete surgical steps of TKA to identify ergonomically unfavorable positions surgeons experience while operating. Four orthopedic surgeons performed TKA while their motions were recorded using marker-based motion capture. …

Increasing The Feasibility, Impact, And Equity Of The Medicare Annual Wellness Visit (Awv) With A Practice Tailored Awv Intervention: A Stepped Wedge Clinical Trial Protocol, Chi-Hong Tseng, Neil S. Wenger

Faculty Scholarship

Background Older adults vastly underutilize evidence-based preventive health services and screenings that reduce illness, morbidity and mortality. The free-to-patient Medicare Annual Wellness Visit (AWV) is an opportunity to enhance preventive healthcare use, but also is underused. Objectives To evaluate the effect of a practice-tailored intervention on the sustained use of Medicare AWVs and on guideline-recommended preventive services and racial/ethnic disparities in 3 types of practice settings. Methods This is a stepped wedge cluster randomized controlled trial. The intervention will be implemented at the practice level in 24 primary care practices across the country (8 community-based, 8 academic, and 8 serving …

Intention To Take Pre-Exposure Prophylaxis (Prep) As An Hiv Preventive Medication: An Application Of The Health Belief Model And Theory Planned Behavior, Besuthu Nakekelwa Nkambule

Graduate Theses and Dissertations

South Africa (SA) has 7.7 million citizens (12.6% of its 2023 population) living with human immunodeficiency virus (HIV). The use of pre-exposure prophylaxis (PrEP) as an antiretroviral medication for HIV-negative individuals is a promising HIV prevention strategy in SA that can help the attainment of an HIV free generation. PrEP offers greater than 90% protection against HIV acquisition. Despite SA’s efforts in increasing PrEP coverage for its citizens, primarily to those at substantial risk, its adoption remains relatively low. Structural barriers related to access, costs, lack of awareness, and, more recently, US funding cuts exacerbate the challenges of PrEP’s potential …

Food Literacy Program Among Adults In A Primary Care Setting, Marie K. Williams

Student Scholarly Projects

Practice problem: The increase in preventable chronic diseases is associated with food illiteracy, which arises from a lack of understanding of nutritional value and dietary guidelines (Silva et al., 2023).

PICOT: (P) In adult primary care patients aged 30-75 years, (I) does the implementation of evidence-based food literacy program (C) compared to standard practice (O) improve food literacy (T) in eight weeks?

Evidence: Using a validated food literacy questionnaire effectively measures improvements in food literacy. Customized programs that fill knowledge gaps are essential for enhancing overall food literacy. Intervention: Customized educational tools were provided to participants based on their knowledge …

Care Coordination In Pediatric Primary Care, Alyssa K. Durzo

Dissertations

No central documentation of care plans exists for children with special healthcare needs (CSHCN) in the electronic health record (EHR). Providers of a large pediatric primary care office in St. Louis Missouri were asked to identify CSHCN in the practice. Clinic nurses completed a comprehensive chart review of the patients identified and constructed care coordination documents using a pre-established smart-text phrase. Subsequently, these were documented centrally in the EHR under the Problem List.

Likert score data was obtained from providers on the acceptability, appropriateness, and feasibility of the intervention through the verified tools: Acceptability of Intervention Measure (AIM), Intervention Appropriateness …