Preparation Of Physician Assistant Students To Manage Patients Living With Hiv/Aids In A Primary Care Setting, Austin Parrish

SIU Journal of Medical Science Scholarly Works

This study examined Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS), Pre-Exposure Prophylaxis (PrEP), and Post-Exposure Prophylaxis (PEP) educational exposure among clinical-phase physician assistant (PA) students and evaluated how well current curricula prepare future providers for HIV prevention and care. A cross-sectional survey of 109 PA students assessed HIV-related knowledge, clinical exposure, and awareness of key public health concepts, while lecture materials from 30 PA programs were analyzed for curricular content. Students demonstrated moderate but incomplete baseline knowledge, and fewer than one-quarter reported observing PrEP prescribing during primary care rotations. Awareness of Undetectable = Untransmittable (U=U) was limited, with only …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 Preventive Dental Guidelines In The Primary Healthcare Setting In Egypt: A Delphi Method, Basant Mehriz

Theses and Dissertations

This study addresses the critical need for standardized preventive dental care guidelines within Egypt's primary healthcare system amid the rising burden of oral diseases. Through a systematic two-phase methodology combining a comprehensive literature review and a Delphi consensus-building process engaging 35 dental professionals, the research established priorities for contextually appropriate preventive measures. The consensus framework revealed strong support for clinical interventions (mean of 83% agreement), particularly fluoride-based prevention; community initiatives (mean of 83%), especially school-based programs; policy measures (mean of 77%) such as workforce and educational development, though with variable support for taxation and social determinants approaches. Statistical analysis demonstrated …

Implementing The Fib-4 Tool For Liver Fibrosis Screening In Diabetic Patients In Primary Care, Robert I. Montillano

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly non-non-alcoholic fatty liver disease (NAFLD), affects over 1 in 3 adults with type 2 diabetes mellitus (T2DM) and is a leading cause of advanced liver fibrosis. Despite guideline support from the American Diabetes Association (ADA) and American Association for the Study of Liver Diseases (AASLD), screening practices remain inconsistent in primary care. The Fibrosis-4 (FIB-4) index is a validated, low-cost, noninvasive tool for fibrosis risk stratification, yet it remains underutilized despite its availability in many electronic health record (EHR) systems.

Purpose: This Doctor of Nursing Practice (DNP) evidence-based practice (EBP) project …

Heart To Heart: Exploring Why Cardiovascular Risk Is Higher In South Asians, Jasjeet Kaur Dhaliwal

Rowan-Virtua Research Day

Cardiovascular disease (CVD) is a leading global cause of mortality, but South Asians experience a disproportionately high burden of disease, often developing CVD at younger ages and with lower body mass indices compared to other populations. This project explores the underlying genetic and lifestyle factors contributing to elevated cardiovascular risk in South Asians, aiming to highlight the need for targeted prevention strategies and policy reforms.

A literature review was conducted using peer-reviewed studies, meta-analyses, and reviews published between 2007 and 2024. After screening 47 initial articles, 18 were selected for analysis based on their relevance to genetic and lifestyle risk …

The Impact Of An Iron-Rich Diet On Fatigue In Menstruating Women With Non-Anemic Iron Deficiency, Meagan Seraydar, Lauren Latimer, Sam Miragliatto

Department of Nutrition Student Projects

Fatigue without diagnosed anemia is prevalent in menstruating women, with iron deficiency being a potential contributor. While iron supplementation is a standard intervention, dietary sources of iron may offer a sustainable alternative. This study aims to assess the impact of an iron-rich diet on fatigue levels in menstruating women. A 12-week randomized controlled trial (RCT) will be conducted, assigning participants to either an iron-rich diet group or a control group following their usual diet without specific iron recommendations. Fatigue will be measured using the Fatigue Severity Scale (FSS) at baseline, six weeks, and twelve weeks, alongside iron status biomarkers, including …

Off-Label Long-Term Use Of Phentermine For Weight Management, Monique Morin, Yamini Pandey, Sarah Bdeir, Rumyah Rafique, Taim-Allah Al-Jarrah, Ali Farhat

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Hendricks EJ, Greenway FL, Westman EC, Gupta AK. Blood pressure and heart rate effects, weight loss and maintenance during long-term phentermine pharmacotherapy for obesity. Obesity. 2011;19(12):2351-2360 https://doi.org/10.1038/oby.2011.94

for a patient struggling at the intersection of weight loss and financial instability.

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

Health Literacy: Impact And Interventions, Elizabeth Simpson

Lynchburg Journal of Medical Science

The objectives of this paper are to examine the connection between health literacy level and patient outcome, identify contributing factors of low health literacy, and identify ways in which providers and health literacy programs can promote health literacy on an individual and community level. I conducted a literature search using PubMed and Google Scholar in order to lend evidence to these objectives.

The results demonstrated a clear correlation between low health literacy levels and poor patient outcomes. Low health literacy is also correlated with reduced medication adherence, improper use of medication, more emergency department visits, and unhealthy habits during pregnancy …

Testosterone Replacement Therapy In The Middle-Aged Male, Gina N. Demilt

Lynchburg Journal of Medical Science

The purpose of this review was to investigate the use of testosterone supplementation in the middle-aged male with a focus on the pathophysiology of testosterone throughout the lifespan, current supplementation options and their adverse effects, and the overall benefit of supplementing to enhance quality of life. A comprehensive search of electronic databases was conducted identifying studies that assessed clinical outcomes, pathophysiology, supplementation options, adverse effects and benefits of treatments. The findings suggested that testosterone levels naturally decline with age with most men developing symptoms of hypogonadism around age 60. Testosterone supplementation outside of current guidelines is not recommended, however men …

Updating A Rural Clinic In Tiburón, Haiti, Akankcha Alok, Mohamed Bakhit, Djenie Helne, Philipe Milord, Marcellas Socrate, Camil Clermont, Marie A. Kima

HCA Healthcare Journal of Medicine

Background

Tiburón is a small fishing village in Haiti with a clinic overseen by the Oblate missionaries and the Ministry of Public Health and Population (MSPP). This village was hugely impacted by Hurricane Matthew in 2016, leading to increased health care demands. The clinic was inaccessible from the furthest parts of the village and lacked basic medication supplies and adequate manpower. We aimed to reinforce the infrastructure and update the clinic using a multifaceted approach.

Methods

We developed a quality improvement project to strengthen the clinic's infrastructure and modernize its facilities with a comprehensive approach focused on enhancing health care …

Characteristics And Outcomes Of Adults Hospitalized With Respiratory Syncytial Virus, Brian S. Shaw, Cara Slaton, Ian P. Murphy, Michael Mcalister, Daniel Egan, Kwabena Ayesu

The University of Louisville Journal of Respiratory Infections

Background: Respiratory syncytial virus (RSV) is a negative sense single-stranded RNA virus (ssRNA) that primarily causes respiratory infections in both children and older adults. We examined clinical characteristics and outcomes of hospitalized adult patients who tested positive for RSV.

Methods: This was a multicenter, retrospective, descriptive study that examined adult patients admitted with a positive RSV test over two years across eight hospitals in Orlando, Florida.

Results: A total of 120 patients were included, of which 88 (73%) were 60 years old and older. Overall, patients with RSV infection were caucasian (62%) with a median age of 70 years and …

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …

Improving Food Security To Decrease Hypertension At An Urban Community Clinic, Christine S. Villalta

Master's Projects and Capstones

Diet and lifestyle changes have been proven to reduce blood pressure in patients with hypertension, and a key dietary approach aligned with this recommendation is the DASH diet, which includes consuming fruits and vegetables. Food insecurity, defined as lacking enough safe, nutritious food to maintain an active and healthy life, is a growing crisis in the United States, affecting 13.5% of U.S. households in 2023. This is especially significant for those whose chronic disease management depends on the accessibility of healthy food. An urban community clinic implemented a Food Security Program to decrease food insecurity and reduce hypertension among their …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Laboratory Literacy: Surveying Lab Result Interpretations Of A Local Patient Population, Jordan Franco, Mark K. Fung

Patient Experience Journal

A patient's independent interpretation of their medical laboratory data has become an unspoken prerequisite in the current age of medicine. In the outpatient setting, it is anecdotally commonplace for patients to receive their lab results before their physicians, resulting in patients often relying on self-interpretations of their results. This study analyzed the degree to which patients are comfortable interpreting lab results and sought to shed light on the question: How are patients interpreting their laboratory reports? A survey was constructed to include the items from a validated health literacy screening tool, followed by items inquiring about the respondent's experience and …

Socio-Economic Disparities In Prenatal Prognosis And Intervention Accessibility, Simona Raluca Iacoban, Madalina Piron Dumitrascu, Camil Laurentiu Bohiltea, Ioan Dumitru Suciu, Silviu Cristian Voinea, Nicolae Suciu

Journal of Mind and Medical Sciences

Objectives. This study aimed to assess the impact of socio-economic factors on prenatal care accessibility and outcomes and to evaluate the effectiveness of specialized integrative prenatal care in mitigating these disparities. Materials and Methods. A prospective cohort study was conducted between 2020 and 2023 in Bucharest, Romania, involving 100 pregnant women. Participants were equally divided into two groups that received standard and specialized prenatal care. Data were collected through structured interviews, medical record reviews, and standardized questionnaires at multiple time points during pregnancy and postpartum. Results. Women receiving integrative care had longer gestation periods (37.8 vs. 37.6 weeks), higher average …

Asynchronous Online Training Increased Knowledge, Confidence, And Intent To Screen And Treat Substance Use Disorders Among Primary Care Clinicians Practicing In Texas, Roger Zoorob, Sung In Kim-Vences, Jacqueline M Hirth, Kylie Schaper, Larissa Grigoryan, Sandra Gonzalez, Alicia Kowalchuk

Faculty, Staff and Students Publications

Introduction: Despite increasing prevalence of substance use disorders (SUD), few patients are diagnosed and treated in primary care settings. This study evaluated changes in knowledge, confidence, and intention to implement screening and brief intervention (SBI) and SUD treatment after clinicians participated in an asynchronous online education course.

Methods: A self-selected sample of primary care clinicians in Texas participated in online SBI and SUD education March 2021-July 2023. Baseline and post-training surveys evaluated changes in knowledge, confidence, and intent to implement SBI and SUD treatment. Changes were compared using paired t-tests. Multivariable linear regression examined factors potentially associated with confidence and …

A Multi-Modal Intervention To Decrease Hpv Vaccine Hesitancy And Increase Uptake In Young Adult Women, Rylee Cartales

Evidence-Based Practice Project Reports

Human Papillomavirus (HPV) is the leading cause of cervical cancer worldwide and the most common sexually transmitted disease, yet hesitancy towards the HPV vaccine remains high and uptake of the HPV vaccine remains remarkably low (CDC, 2021b). The purpose of this evidence-based practice (EBP) project was to determine if the implementation of a multimodal intervention including a motivational interview, strong provider recommendation, and educational materials will decrease HPV vaccine hesitancy and consequentially increase uptake of the vaccine. Eleven young adult women ages 18-26 from a rural outpatient Obstetrics and Gynecology (OBGYN) clinic in Indiana participated in this project. After agreeing …

Investigating Patient Barriers In Receiving Mammography Screenings Following The Covid-19 Pandemic, Nicole Clarke, Tara Pellegrino

Rowan-Virtua Research Day

Current literature shows reduced breast cancer mortality is associated with compliance of mammographic screenings (Duffy, 2020), specifically increasing the survival rate an estimated 1-2% every year for the past thirty years (Giordano, 2004). However, during the Covid-19 pandemic, rates of basic cancer screenings, including breast cancer, all declined (Chen, 2021). Unfortunately, even in a “post-pandemic” world, years after the height of the pandemic, the Rowan-Virtua School of Osteopathic Medicine Family Medicine Office has noticed many female patients still have not kept up with their routine basic healthcare screenings. While there are many barriers in access to healthcare, this survey-based study …