Association Between Use Of Services To Address Adverse Social Determinants Of Health And Documented Suicide Attempt Among Patients In The Veterans Health Administration, John R. Blosnich, Aerin Derussy, Joshua S. Richman, Melissa E. Dichter, Gala True, Ann Elizabeth Montgomery

School of Medicine Faculty Publications

Suicide prevention is a top priority for the US Department of Veterans Affairs (VA), and suicide is often associated with adverse social factors (e.g., financial, legal, and housing problems). The VA provides social services integrated with healthcare services, which may increase the opportunities to detect and document suicide attempt in EHR records. Using VA administrative data, we examined three cohorts of all patients from 2014 to 2018 who had housing instability (n = 659,987), justice involvement (n = 200,487), and unemployment (n = 346,556). Administrative records were used to determine ordinal indicators of receipt of VA social services (no services, …

Preferences And Willingness For Starting Daily, On-Demand, And Long-Acting Injectable Hiv Pre-Exposure Prophylaxis Among Transfeminine Persons In The Us, 2022-2023, Duygu Islek, Travis Sanchez, Stefan Baral, Carolyn Brown, Joanna A. Caldwell, Jennifer L. Glick, Danielle Friedman Nestadt, Jeb Jones, Iaah L. Lucas, Supriya Sarkar, Annemiek De Ruiter, Patrick S. Sullivan, Mariah Valentine-Graves, Savannah Winter, Vani Vannappagari

School of Public Health Faculty Publications

Background There remains limited information concerning US transfeminine persons preferences across varying PrEP options. We examined PrEP option willingness, preferences, and associated factors among a US nationwide sample of transfeminine persons. Methods Sexually active transfeminine persons age 15 + were recruited online between June 2022-October 2023 through social media advertisements. Transfeminine persons not diagnosed with HIV were asked about willingness to initiate, and ranked preference, of three PrEP options- daily oral (DO), on-demand, and long-acting injectable (LA-PrEP). Log-binomial models were used to examine PrEP modality willingness and associated sociodemographic and behavioral characteristics. Results Among 2657 transfeminine persons not currently using …

"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 …

Cultural And Religious Perspectives On Suicide And Healing, Arielle Friedman

be Still

This essay is built off of a paper I wrote in a college global health course on culture and mental illness. I have always been fascinated by cultural interpretations of illness & believe that as a future physician, it is my responsibility to educate myself and others on the complex interplay between religious ideologies & recognition/management of biological disease in order to provide appropriate patient-centered care.

A Wellness And Social Engagement Program For Post-Lower Limb Amputees, Graciela Gonzalez, Cassandra Nelson

Spring 2025 OTD Capstone Symposium

A wellness and social engagement program was developed and implemented to provide education relating to the mental health impacts, decrease in health management, and lack of social participation after a lower-limb amputation amongst adults, 18 years or older. The program provided a manual with educational information, external resources, and visual aids to enhance independence in activities of daily living (ADLs).

Hubungan Dukungan Sosial Rekan Kerja Dengan Stres Kerja (Studi Pada Pekerja Di Pt X), Aisyah Permatasari

Jurnal Ilmu Kesejahteraan Sosial

Workers are vulnerable to work-related stress due to job demands, time constraints, and limited leisure time, leading to psychological issues such as anxiety related to their work. In the context of social welfare studies, job stress affects overall workers’ well-being and disrupts their social functioning in the workplace. Social support from coworkers is potentially reduce stress in workplace, which is crucial for creating organizational well-being. It also helps workers improve job engagement, cope with fatigue, and manage stress. This study examined the relationship between social support from coworkers and job stress among 90 employees …

Caring Across Borders: Demographic Shifts And Migrant Care In Asean-Korea Dynamics, Saqib Fardan Ahmada, Wahid Nur Kartiko

Jurnal Ilmu Kesejahteraan Sosial

This article aims to examine the migration policies and migrant care in the context of relations between ASEAN Member States (AMS) and Korea. As Korea is dealing with an aging population, an increase in female labour force participation, and an ultra low fertility rate, caregiving, especially for the elderly, has become a pivotal issue. Besides, the traditional nuclear family structure, which has historically served as the primary caregiver for the elderly, is also losing its prominence. In such demographic shift, migrant care workers from AMS are filling the demand for caregiving in Korea, leading to a cross-border international migration from …

Understanding And Addressing Mental Health In Honors Programs, Gavin D. Hood, Katherine H. Tennis

Journal of the National Collegiate Honors Council Online Archive

Evidence of psychological experiences unique to high-achieving students is examined, revealing prominent themes relating to student mental health including academic identity, perfectionism, imposter syndrome, burnout, and overcommitment. These themes are explored in the context of program feedback from honors students gathered through focus group meetings as part of the program review process. Strategies for reframing failure, normalizing self-care, fostering supportive community, and engaging in nonacademic self-exploration are included. The article closes with suggestions for programmatic interventions that directly address these concerns among high-achieving students. While most honors programs are not positioned to engage in clinical interventions, they can take small …

Supervisees’ Responsiveness In Supervision With Doctoral Student Supervisors, Zübeyde Akpakır

Counseling & Human Services Theses & Dissertations

This study explores the factors that influence the responsiveness of master’s-level counselors-in-training (CITs) to university-based supervision with doctoral student supervisors. Supervision is an important element and the requirement of CITs' professional development (Bernard & Goodyear, 2019; CACREP, 2024), and many counselor education programs educate their doctoral student to supervise master’s-level CITs (Luke, 2019). Despite its significance, there is no empirical data on how CITs engage with feedback and guidance, particularly in supervision led by novice doctoral supervisors. The study employed an exploratory sequential mixed methods design, Q methodology (McKeown & Thomas, 2013), to analyze CITs' subjective perspectives and identify factors …

Navigating Recovery: Community College Student Journeys Through Collegiate Recovery Programs, Eric Scott Klein

Educational Leadership & Workforce Development Theses & Dissertations

There is an inherent regional need to support students in recovery, and often their demographics and lived experiences coincide with the student body of a community college. This is particularly salient to the segments of this population which concurrently suffer maltreatment due to other intersectional biases implicit in many health care and education-based systems inside the United States (Cole, 2009; Mance et al., 2010; Rosenthal, 2016). Community colleges are not doing enough to equitably support students in recovery from substance use disorder (SUD) and help buoy their recovery capital (Appiah, 2021; Ashford, Curtis, et al., 2018; Association of Recovery in …

Impacts On College-Aged Asian American Mental Health, Zahra Soherwardy

Senior Theses

This study explores the relationship between different forms of racial harassment and mental health issues in Asian American college students. Asian American mental health is a growing concern in the field of public health. Asian Americans have the lowest treatment rates and some of the highest stigma levels of any demographic. They are also impacted by the model minority myth and discrimination, further alienating them from getting help. The topics of subtle racism, blatant racism, and current racial discrimination were compared to depressive symptoms, anxiety, self-esteem, and four domains of aggression using survey data. Subtle racism was found to be …

Supporting College Students’ Mental Health Through Occupational Therapy, Mallory R. Watts

Selected Honors Theses

The mental health of college students has emerged as a significant concern, particularly because of the pressures of academic, social, and personal demands intensify. This study investigates the role of Occupational Therapy (OT) in supporting the mental health of college students, exploring the potential need for integrating OT services into campus programs. By assessing the current mental health resources available to students and evaluating their effectiveness, this research aims to identify gaps in support and determine whether OT could serve as a valuable addition to existing services. Through a combination of surveys, interviews, and literature reviews, the study examines students' …

The Impact Of Success Coaching On Psychological Well-Being And Sense Of Belonging In First-Year College Students, Lashay Y. Mcqueen

Educational Leadership & Workforce Development Theses & Dissertations

As higher education institutions seek to assist students with the first-year transition, coaching is one intervention shown to increase academic performance and retention rates (Capstick et al., 2019). Along with academics, fostering student success from a holistic perspective is imperative (Bentrim & Henning, 2022). The purpose of this study was to determine the impact of participation in success coaching on the psychological well-being and sense of belonging for first-year college students. The study also investigated the impact of success coaching on first-generation students. Existing data were used to compare participation in success coaching to overall psychological well-being and sense of …

Inked Insight: A Consensual Qualitative Research Study Exploring The Perspectives Of Visibly Tattooed Counselors, Megan Ashley Lalonde-Pittman

Counseling & Human Services Theses & Dissertations

This study explored the experiences of visibly tattooed mental health counselors (VTMHC) through consensual qualitative research (CQR), examining how visible tattoos were perceived to have impacted the participants (N=14) professional experiences, development, and relationships within the counseling field. Seven domains arose from the data: Prejudices experienced by VTMHC, VTMHC Interactions with others, Culture experienced by VTMHC, Appearances of the VTMHC, Professional therapeutic work of the VTMHC, Workplace environment of the VTMHC, Processing the experience of being a VTMHC The implications for multicultural education and future research are explored.

Exploring University Student Mental Health And Wellbeing Through A Low-Barrier Peer-Led Service: Emerging Insights From The Living Room, Amanda L. Cole, Fiona Navin, Dawn Reid

Research outputs 2022 to 2026

Universities are increasingly recognising the importance of addressing the social and emotional wellbeing of their students. Mental health challenges experienced while at university can hinder academic achievement and exacerbate existing mental ill-health. In response to this identified need, many institutions have implemented mental health services, such as psychological and counselling support. However, barriers such as stigma, accessibility, and effectiveness often limit their reach and impact. Many students do not avail themselves to services, or access the supports available, due to these barriers. This study gathered initial data from 110 participants who visited Edith Cowan University’s “The Living Room” (TLR) within …

Fostering Cognitive Complexity In Behavioral Health Providers: Perspectives From Supervisors In Integrated Primary Care, Katherina Nako

Counseling & Human Services Theses & Dissertations

The integration of behavioral health into primary care settings, known as Integrated Primary Care (IPC), offers a holistic approach to addressing both physical and mental health needs (Ramanuj et al., 2019). Efforts to expand access to mental healthcare have contributed to the growing presence of IPC settings (Martin 2017), with mental health providers, such as mental health counselors, joining these teams as Behavioral Health Providers (BHPs; Blount, 2017). However, the unique complexities of IPC often leave BHPs feeling underprepared, largely due to the traditional training frameworks emphasized in many graduate counseling programs. The need for BHPs to adapt to the …

Designerly Skills: An Educational Design Research Study On K-5 Teacher-Designers N Trauma-Informed Technology-Enhanced Learning Environments, Kristin Marie Herman

STEMPS Theses & Dissertations

This study explored how K-5 teachers exhibit designerly skills when creating trauma-informed, technology-enhanced learning environments. While teachers have long been recognized as designers, asset-based research on their specific designerly skills, particularly in trauma-informed digital spaces, remains limited. Using an educational design research (EDR) approach focused on research-for-interventions, this study examined which skills teachers consider essential and how these skills manifest in course designs supporting student belonging.

The study employed a multi-method qualitative approach over 12 months, following 23 K-5 teachers and administrators engaged in designing Canvas courses. Data collection included reflective discussion boards, design studio sessions, individual think-aloud protocols, and …

Acculturation Experiences Of International Students In The U.S. Cacrep-Accredited Counselor Education Programs: Challenges, Support Systems, And Systemic Barriers, Nargiza Amirova

Counseling & Human Services Theses & Dissertations

International students significantly enrich U.S. counselor education and supervision programs by contributing diverse cultural perspectives that inspire teaching, research, and professional growth. Yet, these students often face complex challenges including cultural adjustment, language barriers, social isolation, and the academic demands of counseling academic programs that impact their educational outcome s and psychological well-being. Systemic barriers, such as visa restrictions and institutional unawareness, further complicate their experiences. This study explored acculturation experiences of international students enrolled in CACREP-accredited counselor education programs in the United States.

Using Interpretative Phenomenological Analysis (IPA), in-depth interviews were conducted with seven international students on J1/F1 visas, …

Selected Social And Lifestyle Correlates Of Brain Health Markers: The Cross-Cohort Collaboration Consortium, Jeannette Simino, Jan Bressler, Robin Bülow, Charles S Decarli, Alison E Fohner, Laura B Harrington, Catherine Helmer, M Arfan Ikram, Rozenn N Lemaitre, Oscar L Lopez, W T Longstreth, Julia Neitzel, Michelle C Odden, Priya Palta, Carsten O Schmidt, Rajesh Talluri, Meike W Vernooij, Henry Völzke, Trudy Voortman, Quest Whalen, Katharina Wittfeld, Hans J Grabe, Thomas H Mosley, Bruce M Psaty, Frank J Wolters, Sudha Seshadri, Carole Dufouil

Faculty, Staff and Student Publications

Introduction: To investigate the associations of education level, marital status, and physical activity with dementia risk and brain MRI markers.

Methods: Data from six community-based samples from the Cross-Cohort Collaboration Consortium were analyzed. Self-reported education level, marital status, and physical activity at age 60 to 75 years were harmonized. Subsamples of participants with brain MRI markers at time of exposure were selected. Associations with dementia risk and cross-sectional MRI markers were meta-analyzed.

Results: Higher education level was associated with lower dementia risk (hazard ratio [HR] = 0.65, 95% confidence interval [CI] = 0.59; 0.72 vs low level) but not significantly …

Otolith And Genomic Data Reveal Temporal Insights Into Stocking Across A Large River Basin In A Mobile, Long-Lived Australian Freshwater Fish Species, Katherine A Harrisson, Luciano B Beheregaray, Christopher M Bice, Emily J Booth, Chris J Brauer, Gavin L Butler, David Dawson, Olga Dudchenko, Benjamin G Fanson, Graeme Hackett, Annique Harris, Matthew J Jones, Parwinder Kaur, Wayne M Koster, Kyne Krusic-Golub, Erez Lieberman Aiden, Jason A Lieschke, Jarod Lyon, John R Morrongiello, Nicholas P Murphy, James O'Dwyer, Scott M C Raymond, Meaghan L Rourke, Arron Strawbridge, Jason D Thiem, Zeb Tonkin, Jian D L Yen, Brenton P Zampatti

Staff and Researcher Publications

Freshwater ecosystems and their biota are under increasing pressure from anthropogenic stressors. In response to declining fish stocks, hatchery and stocking programmes are widely implemented as core components of restoration and management strategies, with positive outcomes for some wild populations. Despite this, stocking remains contentious due to potential genetic and ecological risks to wild populations. Monitoring and evaluation of stocking outcomes are critical to ensuring the long-term sustainability of wild populations, but identification of stocked individuals post-release remains a key challenge, particularly for mobile species. In this study, we combined otolith (natal origin and age) and genomic data to identify …

Personality Factors Associated With Manner Of Death: A Psychological Autopsy Study, Christopher I Gurguis, Scott D Lane, Edison Leung, Joy M Schmitz, Consuelo Walss-Bass, Thomas D Meyer

Staff and Researcher Publications

Psychological autopsies are a well-established tool for understanding contributing factors in suicide completion. These tools have been used less often to understand personality characteristics of people with other manners of death (e.g. overdose). This study examined personality characteristics related to the manner of death in 83 autopsy cases using the UTHealth Psychological Autopsy Interview Schedule (UTH-PAIS), a psychological autopsy which assesses the presence of mental illness or substance use disorder but also includes items to capture transdiagnostic personality factors. Exploratory factor analysis of the items assessing personality factors was used to examine patterns in personality, and these factors were confirmed …

Understanding How Family Dynamics Affect Mental Health Communication In Inside Out: A Content Analysis, Kataryna Morton

Honors Program: Senior Projects (Public)

This study examines the impact of open communication between family members on mental health and a child’s sense of belonging in the film Inside Out. Previous research has shown the impact of media on children’s socialization, which can influence stigma and make it less likely for vulnerable communication to occur. It is crucial for children to learn to communicate their emotions, and the media can play a key role in shaping these beliefs. Inside Out provides a positive example of mental health communication, which is specifically explored through Riley’s communication with her parents throughout the film. Using a content analysis, …

Liver Tet1 Promotes Metabolic Dysfunction-Associated Steatotic Liver Disease, Hongze Chen, Muhammad Azhar Nisar, Joud Mulla, Xinjian Li, Kevin Cao, Shaolei Lu, Katsuya Nagaoka, Shang Wu, Peng Sheng Ting, Tung Sung Tseng, Hui Yi Lin, Xiao Ming Yin, Wenke Feng, Zhijin Wu, Zhixiang Cheng, William Mueller, Amalia Bay, Layla Schechner, Xuewei Bai, Chiung Kuei Huang

School of Public Health Faculty Publications

Global hepatic DNA methylation change has been linked to human patients with metabolic dysfunction-associated steatotic liver disease (MASLD). DNA demethylation is regulated by the TET family proteins, whose enzymatic activities require 2-oxoglutarate (2-OG) and iron that both are elevated in human MASLD patients. We aimed to investigate liver TET1 in MASLD progression. Depleting TET1 using two different strategies substantially alleviated MASLD progression. Knockout (KO) of TET1 slightly improved diet induced obesity and glucose homeostasis. Intriguingly, hepatic cholesterols, triglycerides, and CD36 were significantly decreased upon TET1 depletion. Consistently, liver specific TET1 KO led to improvement of MASLD progression. Mechanistically, TET1 promoted …

Combating Compassion Fatigue Using Mindfulness Techniques, Christie Baker, Summer Cross

Student Scholarship & Creative Works

Demands placed on health care professionals have steadily increased and as a result, compassion fatigue has become an issue by adversely affecting the well-being of nurses and health care organizations. Compassion fatigue is a widely accepted phenomenon in nursing, creating an array of physical and emotional manifestations, impairing a health care provider’s ability to provide optimum quality care. The goal of this quality improvement project aimed to educate and provide emergency room nurses with a resource for self-care enhancement to subsequently decrease their risk of developing compassion fatigue. Nurses of a small, rural emergency department located in the southeastern region …

Implementation Of A Mental Health Wellness Toolkit For Student Registered Nurse Anesthetists, Mckenzie Lawson

Scholars Week

There is significant evidence that proves that Student Registered Nurse Anesthetists score exceptionally high on stress and anxiety scales. Research has demonstrated that high levels of anxiety and stress can lead to burnout and mental health concerns, including depression, fatigue, substance abuse, and suicidal ideation. A PICOT question was developed for this problem and is as follows: For first-year student registered nurse anesthetists starting clinicals in the operating room, how does participating in a wellness program where students are taught stress-reduction techniques affect their stress and resiliency scores one month and three months following the implementation of the program? This …

Dyke-Davidoff-Masson Syndrome: A Rare Cause Of Drug Refractory Epilepsy In An Adult, Paresh Zanzmera, Vaidehi Chauhan, Tvisha Patel, Jaineel Patel, Ankit Dumaswala, Kinjal Shah

Tower Health Research Day

No abstract provided.

Unveiling The Stigma: Doctor Mental Health And Intervention Strategies, Joseph Heirigs

Honors Program: Senior Projects (Public)

Background

The mental health of physicians is a pressing issue that has received increasing attention in recent years. The alarmingly high suicide rates for physicians underscores the critical need to address the mental health challenges that doctors face. Physicians are exposed to stressors that are unique to their profession, including high-stakes decision making, long work hours, traumatic patient situations, and the emotional toll of patient care. These challenges contribute to high rates of anxiety, depression, burnout, and other mental health issues. However, despite these factors, physicians are often reluctant to seek mental health treatment due to fears of professional repercussions, …

Optimizing Interventions For Major Depressive Disorder And Provider Burnout: Self-Speak Exercise Dosing (Sed), Laureen Maloney-Gepfert

Lynchburg Journal of Medical Science

ABSTRACT

Major Depressive Disorder (MDD) is ranked highest among mental illnesses in the United States (US) and significantly contributes to the mental health care crisis. Patients experience resistance to pharmacologic interventions, side effects, co-morbidities, and mental health provider shortages. Subsequently, 33 % of Serious Mental Illnesses (SMIs) are being redirected to Primary Care Providers (PCPs). Concurrently, prescriber mental health is in crisis. Growing workloads for physicians and Advanced Practice Providers (APPs) have increased provider burnout syndrome (BOS). Major Depressive Disorder and BOS are positively affected by exercise, Cognitive Restructuring (CR), and Behavioral Activation (BA). Sports medicine and psychology research shows …

Spirituality And Ptsd Outcomes Among Service Members And Military Veterans, Jennifer Urbina Dmsc, Pa-C

Lynchburg Journal of Medical Science

Post-traumatic stress disorder (PTSD) is a prevalent and debilitating condition among military service members and veterans, often co-occurring with moral injury (MI) and spiritual distress (SD). While conventional PTSD treatments include cognitive behavioral therapy (CBT), exposure-based therapies, and pharmacological interventions, growing evidence suggests that spirituality may play a vital role in improving PTSD outcomes. This paper explores the integration of spirituality in PTSD treatment, examining its potential to mitigate symptoms, enhance resilience, and facilitate post-traumatic growth. Military chaplaincy, spiritually integrated therapies, and Department of Defense (DoD) holistic health models provide frameworks for addressing the spiritual dimensions of PTSD. Studies indicate …

Efficacy And Safety Of Behavioural Activation On Depression In People With Co-Occurring Non-Communicable Diseases: Systematic Review And Meta-Analysis, Engida Yisma, Kuda Muyambi, Sandra Walsh, Shwikar Othman, Richard Gray, Kuan Liung Tan, Mary Steen, Martin Jones

Research outputs 2022 to 2026

Background People with non-communicable diseases (NCDs) have a higher prevalence of comorbid depression than the general population. While previous research has shown that behavioural activation is effective for general depression, its efficacy and safety in treating depression associated with NCDs remains unclear. Aims To compare the efficacy and safety of behavioural activation against comparators in reducing depression symptoms in people with NCDs. Method We searched six databases from inception until 30 March 2023 (updated 23 September 2024) for randomised controlled trials (RCTs) comparing behavioural activation with comparators for depression in people with NCDs. Risk of bias was assessed using the …