Mental and Social Health Commons^™

Effect Of The Covid-19 Pandemic On Hpv Vaccination Rates, Jennifer Sepede, Kathy Chen

Rowan-Virtua Research Day

Human papillomavirus (HPV) is a common sexually transmitted infection that potentiates cancer in both males and females. There are over 200 different types of HPV and while some strains, specifically HPV 6 and 11, may result in genital and skin warts, others remain clinically silent. High risk strains, HPV 16 and 18, are most associated with cervical cancer in women. During the COVID-19 pandemic, there was widespread hesitancy and rejection towards vaccination. Similarly, the Human Papilloma Virus (HPV) vaccine has also been met with distrust since it’s release. Studies have shown that there is a low vaccination rate due to …

Assessing The Need For Mental Health Screenings In A Student-Run Free Clinic And A Family Medicine Office, Sahil Parikh, Emily Forester, Alisha Basak, Jennifer Walpow, Rebecca Chae, Sahiba Gill, Tara Pellegrino

Rowan-Virtua Research Day

Background: The US Preventive Services Task Force provides strong evidence that early screening helps identify depression in primary care settings, promotes intervention, and facilitates treatment. The Rowan Community Health Clinic (RCHC) in Lindenwold, NJ is a student-run free clinic who serves patients regardless of patient gender, race, income or insurance status. This study aims to determine if there is a need to build internal infrastructure at RCHC for depression and anxiety management.

Methods: This is an IRB-approved study that began in June 2021. Data was collected from Rowan Community Health Center and Rowan Family Medicine patients. Patients were administered mental …

Examining The Marketing Strategies Of Campus Mental Health On A Minority Student Population, Rochelle Bernarte

Electronic Theses, Projects, and Dissertations

Background: Public health, particularly mental health services aimed at making a positive impact can be difficult to market to populations. Promoting mental health services to a target demographic of predominantly minority students at a university comes with its own set of unique variables making the task especially tough. This can be concerning as studies have shown that minority students experience greater amounts of stress than their White counterparts but are less likely to seek mental health services (DeFreitas et al., 2018; Duffy, 2019; Lipson, et al., 2022). The purpose of this study was to gauge the Attitudes and Practices …

Covid19-Associated New-Onset Movement Disorders: A Follow-Up Study, Susanne A Schneider, Soaham Desai, Onanong Phokaewvarangkul, Elena Cecilia Rosca, Jirada Sringean, Pria Anand, Gary Álvarez Bravo, Francisco Cardoso, Anna M Cervantes-Arslanian, Harshad Chovatiya, David Crosiers, Femke Dijkstra, Conor Fearon, Francisco Grandas, Eric Guedj, Antonio Méndez-Guerrero, Muhammad Hassan, Joseph Jankovic, Anthony E Lang, Karim Makhoul, Lorenzo Muccioli, Sarah A O'Shea, Vahid Reza Ostovan, Javier Ricardo Perez-Sanchez, Ritesh Ramdhani, Victoria Ros-Castelló, Christina Schulte, Priyank Shah, Lars Wojtecki, Pramod Kumar Pal

Faculty, Staff and Students Publications

BACKGROUND: Neurological symptoms are common manifestation in acute COVID-19. This includes hyper- and hypokinetic movement disorders. Data on their outcome, however, is limited.

METHODS: Cases with new-onset COVID-19-associated movement disorders were identified by searching the literature. Authors were contacted for outcome data which were reviewed and analyzed.

RESULTS: Movement disorders began 12.6 days on average after the initial onset of COVID-19. 92% of patients required hospital admission (mean duration 23 days). In a fraction of patients (6 of 27; 22%; 4 males/2 females, mean age 66.8 years) the movement disorder (ataxia, myoclonus, tremor, parkinsonism) was still present after a follow-up …

The Effects Of Multiple Micronutrient Fortified Beverage And Responsive Caregiving Interventions On Early Childhood Development, Hemoglobin, And Ferritin Among Infants In Rural Guatemala, Alysse J. Kowalski, Victor Alfonso Mayen, Silvia De Ponce, Kaley B. Lambden, Nick Tilton, Lisa M. Villanueva, Ana M. Palacios, Greg A. Reinhart, Kristen M. Hurley, Maureen M. Black

Health Policy & Community Health: Faculty Publications

Undernutrition and a lack of learning opportunities can jeopardize long-term growth and development among infants in low- and middle-income countries. We conducted a 6-month 2 × 2 cluster-randomized trial to assess the effects of multiple micronutrient-fortified beverages and responsive caregiving interventions among infants 6–18 months in 72 community sectors in southwest Guatemala. We administered baseline and endline assessments of childhood development (Bayley Scales of Infant and Toddler Development) and socioemotional development (Brief Infant Toddler Socio-Emotional Assessment) and measured ferritin and hemoglobin on a subsample. The trial was analyzed using linear mixed models. At the baseline, the mean age (SD) was …

Piloting An Oral History Approach To Investigate Cancer Perspectives Among Residents Of Appalachian Kentucky, Courtney Martin, Lauren Hudson, Nathan L. Vanderford

Journal of Appalachian Health

Introduction: Kentucky ranks first in the U.S. in overall cancer incidence and mortality rates. Areas of the state that fall within the Appalachian Region, along Kentucky’s eastern border, experience disproportionately high rates of cancer compared to non-Appalachian counties.

Purpose: This pilot study investigates whether oral history interviews can be used to understand perspectives on cancer among residents of Appalachian Kentucky.

Methods: In 2020, participants (n = 5) who identified as being from and/or having strong connections to Appalachian Kentucky were recruited to participate in this pilot study. Participants included individuals working in cancer-related fields, oncology professionals, and those with personal …

Attitudes Toward Personal Health Data Sharing Among People Living With Sickle Cell Disorder, Exemplar For Study Of Rare Disease Populations, Rebecca Baines, Sebastian Stevens, Zainab Garba-Sani, Arunangsu Chatterjee, Daniela Austin, Simon Leigh

Journal of Patient-Centered Research and Reviews

Purpose: Rare conditions are often poorly understood, creating barriers in determining the value treatments can provide. This study explored barriers and facilitators to personal health data sharing among those with one particular group of rare hematologic disorders, ie, sickle cell disorder (SCD) and its variants.

Methods: A single online focus group among those > 18 years of age and living with SCD was conducted. Participants (N = 25) were recruited through a United Kingdom-based SCD charity. Discussions were transcribed verbatim, with data therein analyzed using inductive thematic analysis.

Results: Five primary motivators for sharing health data were identified: improving awareness; knowing …

Oral Health Considerations For Aging Patients Living With Hiv/Aids, Madeleine Daily Dds, Susan Liu Dds, Yuna Park Dds, Mph, Ms, Emily Byington Msw, Ivette Estrada Ma, Mphil, Sunil Wadhwa Dds, Carol Kunzel Phd

The New York State Dental Journal

People living with HIV/AIDS (PLWH) have an increased life expectancy due to advances in antiretroviral therapy. In 1996, the life expectancy for a 20-year old living with HIV was 39-years old; today, it is >70-years old. As life expectancy increases, PLWH are burdened with age-associated comorbidities. This paper reviews the interaction between aging and HIV and how it affects social, physical, and oral health issues. The shift in demographics presents new challenges for clinicians in how to identify, address, and manage these complex manifestations. This review summarizes how to approach HIV-related changes when providing care as a dental clinician.

Exploring Modern Trends And Prevention Strategies For Childhood Obesity: A Comprehensive Literature Review, Anya E. Bogen

Honors Program: Senior Projects (Public)

This literature review seeks to provide an overview of the current research on childhood obesity. The study examines the prevalence and causes of childhood obesity, including genetic, environmental, and behavioral factors. The review also discusses the health consequences associated with childhood obesity, such as the increased risk for chronic diseases and psychological and social problems. Additionally, the review explores the effectiveness of interventions designed to prevent childhood obesity, including individual lifestyle modifications, education from health practitioners and school programs, and global, national, and state programs to promote wellness. The literature review concludes that childhood obesity is a complex and multifactorial …

Well-Being Content Inclusion In Pharmacy Education Across The United States And Canada, Elizabeth Buckley, Simi Gunaseelan, Benjamin D Aronson, Heidi N Anksorus, Victoria Belousova, Tram B Cat, Kristine M Cline, Stacey D Curtis, Christina E Deremer, David Fuentes, Mckenzie S Grinalds, Seena L Haines, Hannah E Johnson, Karen Kopacek, Jessica M Louie, Nkem P Nonyel, Natasha Petry, Shawn Riser Taylor, Suzanne C Harris, Cheryl A Sadowski, Anandi V Law

Faculty, Staff and Student Publications

Objective. To describe the landscape of well-being content inclusion across schools and colleges of pharmacy in the United States and Canada through identification of content implementation, incorporation, and assessment.

Methods. A cross-sectional survey was distributed to all accredited schools and colleges of pharmacy in the United States (n=143) and Canada (n=10). Survey questions included curricular and cocurricular timing, frequency, assessment strategies, and support for well-being initiatives, using a framework of eight dimensions (pillars) of wellness to categorize content.

Results. Descriptive data analyses were applied to 99 completed surveys (65%), 89 (62%) in the United States and 10 (100%) in Canada. …

Worse Postoperative Outcomes And Higher Reoperation In Smokers Compared To Nonsmokers For Arthroscopic Rotator Cuff Repair, Susan G. Wager, Spencer Brown, Michael Gaudiani, Joshua P. Castle, Eric Jiang, Vasilios Moutzouros, Eric Makhni, Stephanie J. Muh

Medical Student Research Symposium

Introduction: Smoking impairs healing potential and is a significant risk factor for complications following orthopaedic surgeries. The purpose of this study was to determine if a cohort of former or current smokers at time of surgery met the minimally clinical important difference (MCID) for Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS-UE), Depression (PROMIS-D), and Pain Interference (PROMIS-PI) scores in comparison to nonsmokers.

Methods: A retrospective review of patients who underwent rotator cuff repair was performed. Patients who completed preoperative and 6-month postoperative PROMIS scores were included. The MCID was calculated using a distribution technique with a threshold of 0.5 …

“Community Members Have More Impact On Their Neighbors Than Celebrities”: Leveraging Community Partnerships To Build Covid-19 Vaccine Confidence, Maria Tjilos Mph, Autumn L. Tamlyn, Elizabeth J. Ragan Mph, Sabrina A. Assoumou Md, Mph, Katherine Gergen Barnett Md, Petrina Martin Mba, Rebecca Perkins Md, Msc, Benjamin P. Linas Md, Mph, Mari-Lynn Drainoni Phd, Med

Medical Student Research Symposium

Vaccines are a strong public health tool to protect against severe disease, hospitalization, and death from COVID-19. Still, inequities in COVID-19 vaccination rates and health outcomes continue to exist among Black and Latino populations. Boston Medical Center (BMC) has played a significant role in vaccinating medically underserved populations, and organized a series of community-engaged conversations to better understand community concerns regarding the COVID-19 vaccine. We accessed and analyzed nine publicly available recordings of the community-engaged conversations which were held between Mar 2021-Sep 2021 (n=8-122 attendees). We employed a Consolidated Framework for Implementation Research-driven codebook to code our data and utilized …

Editorial: Assessing And Addressing Health Inequities And Disparities: The Role Of Health Informatics, Gulzar H. Shah, Anjum Khurshid, Joanne Chopak-Foss

Health Policy & Community Health: Faculty Publications

No abstract provided.

Supporting Caregivers Of The Aging Adult: A Program Evaluation, Tanya O'Brien

Student Scholarly Projects

There is an ever-increasing burden on caregivers of individuals with cognitive illness as a result of the increasing number of older adults with dementia and Alzheimer's disease. Currently, St. John's County Florida offers three programs designed to provide support for caregivers of individuals with cognitive illness. This project evaluated the three programs as part of a program evaluation to determine the efficacy of program selection for sustainability. Utilizing the Center for Disease Control's (CDC) Program Evaluation Framework (PEF), a detailed and thorough evaluation review of the Power Tools for Caregivers, Savvy Caregiver, and an original three-model program developed by the …

Syndemics And Social Factors: Infectious Disease Patterns Within The Population Of People Experiencing Homelessness In The United States, Kathleen Berzonsky

Honors Program: Senior Projects (Public)

Individuals experiencing homelessness are at increased risk of suffering from infectious diseases. This is due to a number of social factors and healthcare disparities, as well as the idea of syndemics, by which diseases cluster together to worsen disease burden. Current intervention strategies approach treatment from a post-infection perspective, but reducing transmission rates of infectious diseases within the population of people experiencing homelessness will require a shift in the healthcare framework. The issue of people experiencing homelessness must be viewed through a biosocial lens, focusing on preventative care and treatment. I provide an overview of the social factors governing infectious …

A Nationwide Study Of The “July Effect” Concerning Postpartum Hemorrhage And Its Risk Factors At Teaching Hospitals Across The United States, Zahra Shahin, Gulzar H. Shah, Bettye Apenteng, Kristie Cason Waterfield, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

Objective To assess the “July effect” and the risk of postpartum hemorrhage (PPH) and its risk factors across the U.S. teaching hospitals. Method This study used the 2018 Nationwide Inpatient Sample (NIS) and included 2,056,359 of 2,879,924 single live-birth hospitalizations with low-risk pregnancies across the U.S. teaching hospitals. The International Classification of Diseases, Tenth Revision (ICD-10) from the American Academy of Professional Coders (AAPC) medical coding was used to identify PPH and other study variables. Multivariable logistic regression models were used to compare the adjusted odds of PPH risk in the first and second quarters of the academic year vs. …

Determinants Of Child Stunting, Wasting, And Underweight: Evidence From 2017 To 2018 Pakistan Demographic And Health Survey, Maryam Siddiqa, Gulzar H. Shah, Tilicia Mayo-Gamble, Amber Zubair

Health Policy & Community Health: Faculty Publications

Child malnutrition persists in low-resource countries such as Pakistan, indicating an urgent need for interventions and policies aimed to address this critical population health issue. The World Health Organization Global Target 2025 includes the reduction of malnourishment in the form of stunting, wasting, and low weight. This study aims to examine the prevalence of factors associated with three measures of child malnutrition, i.e., stunting, wasting, and low weight in Pakistan. This study uses a secondary data analysis design based on data from Pakistan Demographic and Health Survey (2017-18) that used a two-stage cluster sampling approach. National level data covering urban …

Pediatric Consultation-Liaison Psychology: Insights And Lessons Learned During The Covid-19 Pandemic, Nicole M Schneider, Dara M Steinberg, Andrea M Garcia, Jessy Guler, Emily Mudd, A Monica Agoston, Katherine N Schwartzkopf, Kristin A Kullgren, Laura Judd-Glossy

Faculty, Staff and Students Publications

COVID-19 has presented a variety of challenges to the provision of psychology services. In the first month of the pandemic, pediatric consultation-liaison (CL) psychologists reported significant changes in methodology of service delivery (Steinberg et al. in Clin Pract Pediatr Psychol 9:1, 2020). To better understand how and if these changes persisted, as well as other emerging trends, a follow-up study examined changes and challenges six months into the pandemic. An anonymous questionnaire assessed topics related to pediatric CL psychology including practice changes, perception of changes, and institutional support. The questionnaire was sent to the APA Society of Pediatric Society's special …

Covid-19 Induced Environments, Health-Related Quality Of Life Outcomes And Problematic Behaviors: Evidence From Children With Syndromic Autism Spectrum Disorders, Corneliu Bolbocean, Kayla B Rhidenour, Maria Mccormack, Bernhard Suter, J Lloyd Holder

Faculty, Staff and Students Publications

Between July 2020 and January 2021, 230 principal caregivers completed a questionnaire to measure proxy-assessed health-related quality of life outcomes (HRQoL), behavioral outcomes in children with syndromic autism spectrum disorders and COVID-19 induced changes to lifestyle and environments. HRQoL and behavioral outcomes reported earlier during the pandemic were generally worse compared to those reported later. COVID-19 induced reduction to a caregiver's mental health appointments, and hours spent watching TV were associated with decreases in HRQoL and increased the likelihood of problematic behaviors. Increasing time outdoors and time away from digital devices were positively associated with HRQoL and behaviors and might …

Implementation Of A Novel Social-Emotional Learning Program To Advance Integration Of Wellness In Education Practice, Kit Knier, Gauri Sood, Will Ruffin Ii, Jennifer Arroyo, Ankit Sabharwal, Michael Bostwick, Chris Pierret

The Journal of Advancing Education Practice

Social-emotional learning (SEL) programs aim to enhance emotional intelligence by teaching problem solving, self-awareness, self-management, social awareness, and relationship building skills. SEL interventions have been shown to improve quality of life and wellbeing, increasingly important outcomes in the wake of the staggering effects of the COVID-19 crisis on mental health. HappiGenius is a novel SEL program with the addition of mindful attention and self-compassion. We hypothesized HappiGenius would improve positive emotions, self-compassion, attention, mindful self-awareness, and social skills in a group of students. This observational cohort study took place at a diverse elementary school in a midsize midwestern city and …

Physicians' Knowledge And Attitudes Towards Psychedelics, Arazoo Shwany, Arren Hill, Mary Seamons

Annual Research Symposium

No abstract provided.

The Silent Suffering Of Survivors: The Covid-19 Pandemic's Impact On Domestic Violence Resources, Osoniya I. Wodi

XULAneXUS

Increased reports of domestic violence has coincided with the eruptions and growth of the COVID-19 pandemic. Previous research has shown a positive correlation between domestic violence and the occurrence of humanitarian crises. Recently published research about domestic violence police reports in the COVID-19 pandemic has also supported this correlation. We used data from the National Network To End Domestic Violence (NNEDV) to analyze the number of survivors served by domestic violence programs in the United States, type of resources available, and unmet request from 2019-2021, one year pre-pandemic and the first two years of the pandemic. Findings from this study …

Evaluation Of Bnt162b2 Covid-19 Vaccine In Children Younger Than 5 Years Of Age, Flor M Muñoz, Lawrence D Sher, Charu Sabharwal, Alejandra Gurtman, Xia Xu, Nicholas Kitchin, Stephen Lockhart, Robert Riesenberg, Joanna M Sexter, Hanna Czajka, Grant C Paulsen, Yvonne Maldonado, Emmanuel B Walter, Kawsar R Talaat, Janet A Englund, Uzma N Sarwar, Caitlin Hansen, Martha Iwamoto, Chris Webber, Luke Cunliffe, Benita Ukkonen, Silvina N Martínez, Barbara A Pahud, Iona Munjal, Joseph B Domachowske, Kena A Swanson, Hua Ma, Kenneth Koury, Susan Mather, Claire Lu, Jing Zou, Xuping Xie, Pei-Yong Shi, David Cooper, Özlem Türeci, Uğur Şahin, Kathrin U Jansen, William C Gruber

Faculty, Staff and Students Publications

BACKGROUND: Safe and effective vaccines against coronavirus disease 2019 (Covid-19) are urgently needed in young children.

METHODS: We conducted a phase 1 dose-finding study and are conducting an ongoing phase 2-3 safety, immunogenicity, and efficacy trial of the BNT162b2 vaccine in healthy children 6 months to 11 years of age. We present results for children 6 months to less than 2 years of age and those 2 to 4 years of age through the data-cutoff dates (April 29, 2022, for safety and immunogenicity and June 17, 2022, for efficacy). In the phase 2-3 trial, participants were randomly assigned (in a …

A Focused Review Of Multidimensional Well-Being Assessments, Samantha Schonhardt, Stephanie Sullivan, Rebecca Shisler Marshall

Journal of Wellness

Introduction: Interest in the topic of well-being continues to grow and has resulted in the creation of a variety of well-being assessments. However, each assessment often brings its own terminology, theories, definitions, and dimensions. This creates a muddled research base that produces inconsistencies in the field of well-being. Therefore, the aim of this review was to identify assessments that measure multiple dimensions of well-being, catalogue and group the dimensions into categories, and develop definitions for the categories based on the conceptualizations in the literature. In doing so, the dimensionality of well-being portrayed in the literature can be better understood. …

Association Between E-Cigarette Use Behaviors And Perceived Harmfulness Of E-Cigarettes And Anxiety/Depression Symptoms Among Black/African American Adults, David Adzrago, Kayo Fujimoto, Melissa B Harrell, Antwan Jones, J Michael Wilkerson

Faculty, Staff and Student Publications

Black/African American adults are at greater risk of experiencing negative health outcomes stemming from tobacco use, yet little research has examined e-cigarette use behavior in the Black/African American adult-only population. We examined the association between e-cigarette use behaviors (never, former, and current use) and perceived harmfulness of e-cigarette use and anxiety/depression symptoms among Black/African American adults. This cross-sectional study was a secondary analysis of nationally representative data from the 2011-2020 Health Information National Trends Survey (n = 6,268). Multinomial logit models were used to examine differences in e-cigarette use behaviors (reference group = never used e-cigarettes), given the risk factors …

Effectiveness Of Telemedicine In Diabetes Management: A Retrospective Study In An Urban Medically Underserved Population Area (Umupa), Lisa Ariellah Ward, Gulzar H. Shah, Jeffery A. Jones, Linda Kimsey, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

This paper examines the efficacy of telemedicine (TM) technology compared to traditional face-to-face (F2F) visits as an alternative healthcare delivery service for managing diabetes in populations residing in urban medically underserved areas (UMUPAs). Retrospective electronic patient health records (ePHR) with type 2 diabetes mellitus (T2DM) were examined from 1 January 2019 to 30 June 2021. Multiple linear regression models indicated that T2DM patients with uncontrolled diabetes utilizing TM were similar to traditional visits in lowering hemoglobin (HbA1c) levels. The healthcare service type significantly predicted HbA1c % values, as the regression coefficient for TM (vs. F2F) showed a significant negative association …

Urban Land-Based Healing: A Northern Intervention Strategy, Nicole Redvers, Melanie Nadeau, Donald Prince

Indigenous Health Faculty Publications

Urban Indigenous populations face significant health and social disparities across Canada. With high rates of homelessness and substance abuse, there are often few options for urban Indigenous Peoples to access land-based healing programs despite the increasingly known and appreciated benefits. In May 2018, the first urban land-based healing camp opened in Yellowknife, Northwest Territories, Canada, one of the first to our knowledge in Canada or the United States. This camp may serve as a potential model for an Indigenous-led and Indigenous-based healing camp in an urban setting. We seek to present preliminary outcome data from the healing camp in a …

Centering Culture In The Treatment Of Opioid Use Disorder With American Indian And Alaska Native Communities: Contributions From A National Collaborative Board, Katherine A. Hirchack, Melanie Nadeau, Angel Vasquez, Alexandra Hernandez-Vallant, Kyle Smith, Cuong Pham, Karen Anderson Oliver, Paulette Baukol, Karen Lizzy, Raquel Shaffer, Jalene Herron, Aimee M. C. Campbell, Kamilla L. Venner

Indigenous Health Faculty Publications

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation …

Brain Nuclear Receptors And Cardiovascular Function, Mengjie Wang, Yongjie Yang, Yong Xu

Faculty, Staff and Students Publications

Brain-heart interaction has raised up increasing attentions. Nuclear receptors (NRs) are abundantly expressed in the brain, and emerging evidence indicates that a number of these brain NRs regulate multiple aspects of cardiovascular diseases (CVDs), including hypertension, heart failure, atherosclerosis, etc. In this review, we will elaborate recent findings that have established the physiological relevance of brain NRs in the context of cardiovascular function. In addition, we will discuss the currently available evidence regarding the distinct neuronal populations that respond to brain NRs in the cardiovascular control. These findings suggest connections between cardiac control and brain dynamics through NR signaling, which …

Review Of Alcohol And Drug Treatment For Aboriginal And Torres Strait Islander Peoples, Marguerite Tracy, Bradley Freeburn, Kylie Lee, Julie Woods, Kate Conigrave

Journal of the Australian Indigenous HealthInfoNet

This review provides an overview of treatments for problem alcohol and other drug (AOD) use for Aboriginal and Torres Strait Islander people. It includes information on the available research and discusses core principles for providing treatment. The review outlines how effective mainstream treatment approaches can be adapted to be more suitable for Aboriginal and Torres Strait Islander ways of being or worldview. It also highlights that services, such as those offered by Aboriginal community controlled health organisations are in a unique position to offer culturally secure treatment approaches. The barriers to accessing treatment are discussed as well as recommendations for …