Mental and Social Health Commons^™

Cross-Cue Reactivity Of Nicotine And Cannabis Vaping Products, Madeline Smith

Graduate Theses, Dissertations, and Problem Reports (ETD)

SIGNIFICANCE. The rewarding properties of nicotine increase when administration is paired with external stimuli, or “cues”, including those related to vaping products. Given the visual similarity between nicotine vaping products (NVPs) and THC vaping products (TVPs), exposure to one product may elicit reactivity (e.g., craving, urge to use) to the other. The present study aimed to develop a set of cues capable of differentiating NVPs from TVPs to inform investigations of cross-cue reactivity. METHODS. Images (n=61 NVPs; n=64 TVPs; 7=unspecified) were obtained via an online search using both generic (“vape”, “vape pen”) and product-specific (e.g., “nicotine vape”, “dab pen”) keywords …

Simulating Social Attitudes With Llms: Accuracy, Demographic Effects, And Refusal Behavior In The Sensitive Domain Of Suicide Prevention, Cristina J. Perez, Michael P. Vasquez Jr., Philippe J. Giabbanelli, Patrick Y. Wu

VMASC Publications

Large language models (LLMs) are increasingly used to simulate public opinion, yet their validity in sensitive policy domains remains underexplored. We evaluate whether LLMs can reproduce attitudes toward suicide prevention policies using 32 questions drawn from seven nationally representative U.S. surveys (2023-2025). We systematically vary demographic conditioning (race/ethnicity, gender, age, education, income, party), prompt framing (direct elicitation, respondent embodiment, specialist embodiment), and model architecture (GPT-5 Nano, DeepSeek V3.2, Meta Llama 3.1 8B, Mistral Small 24B). Across 811,560 prompts, the mean absolute error—the average gap between predicted and human response distributions—is 23 percentage points. We also find that LLM responses to …

Prenatal Exposure To Nicotine And Postpartum Depression: A Systematic Review And Meta-Analysis, Reem Sharaf-Alddin, May Salama, Denise Mckinney, George Saade, Qi Zhang

Health Behavior, Policy & Management Faculty Publications

Purpose: Postpartum Depression (PPD) is the most common mental health complication of childbirth, and has short-term and long-term consequences for mother, child, and the entire family. PPD is a function of several factors. Prenatal exposure to nicotine (PEN) by Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), or Electronic Nicotine Products (ENPs) is a major potential risk factor. This systematic review and meta-analysis aim to summarize and evaluate all evidence regarding the association between PEN and PPD.

Methods: We searched the following databases, PubMed, Medline, Cochrane, EMBASE, and CINHAL, for studies published between Jan.1st ,2000&Sep.19th ,2024, with the outcome PPD. Studies …

Student And Faculty Perspectives On Perceived Stress, Coping, And Educational Practice In A Community College Occupational Therapy Assistant Program, Kristen Morgus, Tiffany Karalis Noel, Christopher Stavisky

Journal of Occupational Therapy Education

This mixed methods study examined occupational therapy assistant (OTA) students' and faculty members' perceptions of supports and challenges influencing perceived stress, with the aim of generating actionable recommendations for OTA education. While existing literature offered information regarding stressors and coping mechanisms for occupational therapy and non-traditional students, the confluence of these two identities in this OTA student population, as well as faculty perspectives, presented an underexplored area of inquiry. Specifically, this study examined how the intersection of OTA student identity and non-traditional student status influenced perceived stress, an underrepresented focus in the existing occupational therapy education literature. Data were collected …

Magnifying Mental Health In The Perinatal Population: A Systematic Review, Kasey E. Arnold, Alyssa M. Maki

Williams Honors College, Honors Research Projects

Pregnant individuals often experience significant anxiety, which can negatively affect both pregnancy and fetal outcomes. This systematic review evaluates the effectiveness of pharmacologic versus non-pharmacologic anxiety-relieving interventions, primarily focusing on the labor period. The PICOT question is: In perinatal patients, do non-pharmacologic anxiety-relieving measures, compared to pharmacologic anxiety-relieving measures, have a greater impact on ease of delivery and overall mental health during pregnancy and the perinatal period? PRISMA (2020) guidelines were used with inclusion criteria of human subjects, English language, and published within the last six years. Databases included PubMed, CINAHL, and Cochrane Library. Twenty-three studies were analyzed to examine …

The Influence Of Familial Substance Use Disorder On Perceptions And Attitudes Towards Substance Use Disorders And Participant Substance Use Behavior Among Emerging Adults, Elijah M. Lefeld, Jennifer Stanley

Williams Honors College, Honors Research Projects

This research project explores how the lived experience of having an immediate family member with a substance use disorder (SUD) influences a person’s perceptions, attitudes, and behaviors related to substance use. Rather than focusing on the individual diagnosed with SUD, the study examines the reciprocal impact on family members within the social subsystem. Using a quasi-experimental design, the project will compare participant responses using with and without a familial connection to SUD. Data will be collected through Qualtrics surveys distributed via SONA. These measures will record demographic information, personal substance use habits, attitudes toward addiction, perception of substance use disorders, …

The Connection Between Medicaid And Obesity In Northeast Ohio, Sophie Kheder, Emmie Kelley

Williams Honors College, Honors Research Projects

Obesity is a major public health concern in the United States that is projected to increase exponentially over the next few years. Obesity is commonly associated with a lower socioeconomic status. Lower-income individuals tend to be supported by Medicaid, a federal insurance program for low-income Americans. Prior studies have shown a positive correlation between income status and obesity prevalence. Our goal was to find if there was a correlation between Medicaid patients and obesity in Northeast Ohio, to provide physicians with a set of characteristics to better combat obesity, since preventative and treatment guidelines are tailored to national trends. We …

Increasing Occupational Therapy’S Visibility In College Sports Medicine In Student-Athletes With Season-Ending Injuries, Mickaela H. Buzzy, Bonnie Fischer-Camara

Post Professional Occupational Therapy Doctoral (PPOTD) Student Capstone Projects

Sport is an essential part of a student-athlete’s life. Many student-athletes gain a strong “athletic identity” in their sport. When a student-athlete is faced with an injury, specifically a season-ending injury, they are at risk of facing a significant sense of loss of identity and adverse psychological effects on their mental health. In the collegiate athletic setting, athletic trainers are often the first to notice signs of psychological distress of student-athletes; however, they frequently report limited education, training, and confidence in providing necessary psychosocial interventions. The purpose of this capstone project was to increase occupational therapy’s visibility in the collegiate …

Association Between Caregiver Status And Physical And Mental Health Among National Senior Games Athletes, Chibuzo Uchechukwu Victor Obasi

Graduate Research Theses & Dissertations

As the population ages, more people rely on informal caregivers, which puts many older adults at risk for health problems. Caregiving can be meaningful and strengthen family bonds, but it often leads to more psychological stress, especially for older adults who also have their own health concerns. Research shows that regular physical activity can help older adults build resilience and improve their mental well-being. Still, we know little about the health of older caregivers who stay very active. This study examines the health effects of caregiving among members of the National Senior Games Association (NSGA), a group of highly active …

Exploring African Students’ Experiences With Culturally Responsive Mental Health Apps In The U.S., Emelia Essumanba-Josiah

Graduate Research Theses & Dissertations

Digital mental health applications have proven to be effective, yet adoption remains very low among African international students in the United States. This study investigated how 17 university students perceive the usefulness of mental health apps, evaluate existing tools through their cultural lens, and recommend what a culturally responsive app would look like – all through a semi-structured interview with an app exploration exercise at a Midwestern public university. Guided by the Technology Acceptance Model and the African-Centered Wellness Model, there were six (6) key themes that emerged revealing participants carried skewed pre-migration mental health frameworks, dealt with their stressors …

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

Enhancing Nursing Education To Improve Care For Women Experiencing A Substance Use Disorder During Pregnancy, Sadie Caddell

UNH URC Open (2026 and after)

Enhancing Nursing Education to Improve Care for Women Experiencing a Substance Use Disorder During Pregnancy

[Review Of The Book The Prescription-To-Prison Pipeline: The Medicalization And Criminalization Of Pain, By M. Smirnova], Hayley Jackey

Sociology & Criminal Justice Faculty Publications

[Introduction] Smirnova’s The Prescription-to-Prison Pipeline offers a critical examination of the impacts of prescription drugs as well as the over-policing and policies created to push individuals into the carceral system rather than providing other options for assistance. Smirnova further captures the social inequalities of race and class of those encased in this pipeline. Within this understanding of the detriment that the system, medical providers, and society place on those who use substances, Smirnova’s use of interviews allows for a clear understanding of how these systems work in conjunction to uphold the pipeline.

Family- And Cultural-Level Influences For Latine Adolescent Nicotine Use: A Qualitative Study Informing Prevention, Cindy M. Hernandez Castro

Theses and Dissertations

Early tobacco use among Latine adolescents represents a critical public health concern, with 23.8% reporting current use and exceeding rates among other racial/ethnic groups (Birdsey et al., 2023; Gaddy et al., 2022). This early initiation elevates risks for nicotine dependence and related morbidity in adulthood (Tsao et al., 2023). Guided by Structural Ecosystems Theory (Szapocznik & Coatsworth, 1999) and contemporary grounded theory analysis (Braun & Clarke, 2006; Charmaz, 2006; Noble & Mitchell, 2016), this study examined multilevel influences on nicotine-related attitudes among Latine youth, including: (1) familial factors (i.e., parental monitoring, caregiver-youth communication), (2) cultural dynamics (i.e., cultural values and …

Examining The Physiological Stress-Reducing Effects Of Virtual Nature Exposure And Slow Breathing, Jesse Benefiel

Cal Poly Humboldt theses and projects

In a time of excess stress, it is essential to examine accessible stress-reduction methods. Research has demonstrated that virtual nature exposure and slow breathing can independently reduce stress, but the literature is lacking with regard to their combined effects. The present study aimed to replicate independent effects of breathing and nature on stress and to test for potential effects, including whether their combination would produce an interaction effect. Using a 2 Environment (Natural v. Control) by 2 Breathing (Slow v. Normal) between-subjects design, 63 participants completed a modified color-word Stroop task to induce stress and were then exposed to either …

Reframing Trauma-Informed Care For Refugee And (Im)Migrant Health Systems: From Interpersonal Practice To Structurally Embedded Care, Hyojin Im, Sophia Banu, Aisha Koroma, Sarmaya Mustafayeva

Faculty, Staff and Students Publications

No abstract provided.

Prevalence Of Substance Use In Northwest Syria: A Cross-Sectional Study, Isabel Draper, Dania Albaba, Heba Mesbah, Huda Taktak, Nidhal Saadoun, Mohammad Alhusein, Elharit Alissa, Anas Barbour, Zaher Sahloul, Nidal Moukaddam

Faculty, Staff and Students Publications

Objectives: Syria has undergone significant socio-political turmoil since 2011 as internal conflict displaced portions of the population, destroyed infrastructure, and destabilized the economy. In the context of multilevel healthcare system disruptions, there have been increasing reports of substance use. This study seeks to evaluate patterns of substance use in Northwestern Syria.

Methods: Trained staff administered questionnaires to community members in Azaz, Syria. Questions focused on the substance use prevalence, societal and public health impacts, and perspectives on treatment availability.

Results: 480 individuals were surveyed (80·88% male, 19·12 % female; 43·39% were 18-25 yrs, 11·5% reported personal substance use). H-booz (amphetamines), …

Variability In Documentation Of Neurological And Psychiatric Examinations Among Emergency Department Patients With Behavioral Health-Related Presentations: A Retrospective Study, Heba Mesbah, Payton Kim, Jide Oluwadare, Abdulelah Almanie, Inaara Malick, Nidal Moukaddam

Faculty, Staff and Students Publications

Background: Emergency departments (EDs) serve as a critical safety net for individuals experiencing acute behavioral health crises, a population that faces substantial medical morbidity and well-documented disparities in healthcare delivery. Thorough physical and neuropsychiatric assessment is essential in this setting to identify medical conditions that may mimic or exacerbate psychiatric symptoms. Incomplete documentation of these assessments may reflect gaps in care processes and represent a potential marker of inequity.

Objective: To characterize the completeness of documented neurological and psychiatric examinations among adult ED patients presenting with primary behavioral health-related chief complaints and to assess whether documentation patterns suggest persistent gaps …

Psychometric Properties Of A Novel Affective Bias Task And Its Application In Clinical And Nonclinical Populations, Prathik Kalva, Kourtney Kanja, Brian A Metzger, Xiaoxu Fan, Brian Cui, Bailey Pascuzzi, John Magnotti, Madaline Mocchi, Raissa Mathura, Kelly R Bijanki

Faculty, Staff and Students Publications

To mitigate limitations in self-reported mood assessments, we introduce a novel affective bias task (ABT). The task quantifies instantaneous emotional state by leveraging the phenomenon of affective bias, in which people interpret external emotional stimuli in a manner consistent with their current emotional state. This study establishes task stability in measuring and tracking depressive symptoms in clinical and non-clinical populations. Initial assessment in a large non-clinical sample established normative ratings. Depressive symptoms were tracked relative to task performance in a non-clinical sample, as well as in a clinical cohort undergoing surgical evaluation for severe epilepsy. In both cohorts, a stronger …

Prevalence Of Clinically Relevant Nightmares And Their Differences By Sex And Diagnosis In Psychiatric Inpatients, Katrina A Rufino, Michelle A Patriquin, Courtney B Worley, Michael R Nadorff

Faculty, Staff and Students Publications

Nightmares have been shown to be associated with numerous forms of psychopathology, but the vast majority of this research has taken place in the general population and very little is known about their relation with psychopathology in those requiring inpatient hospitalization. In a sample of 1170 voluntarily admitted psychiatric inpatients, this study explores the frequency of reported nightmares in psychiatric inpatients with the aim of examining the prevalence of psychiatric diagnosis in those with and without clinically relevant nightmares. Participants completed the Disturbing Dream and Nightmare Severity Index (DDNSI) and the Structured Clinical Interview for DSM Disorders (SCID-5) at admission. …

First Responders' Best Friends: A Mental Health And Trauma-Informed Care Program For First Responders, Jordan Postiglione

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

First responders experience consistent exposure to traumatic events in their day-to-day profession, placing them at increased risk for mental health challenges, including stress, burnout, anxiety, depression, and post-traumatic stress disorder.  The First Responder’s Best Friends doctoral capstone quality improvement project aimed to increase mental health and well-being in first responders as well as to bring awareness to the importance of mental health and the impact of trauma.  The capstone project consisted of three different areas of focus: program development and implementation, advocacy, and clinical practice skills.  Program development and implementation was a 12-week mental health program at the Kingston Fire …

The Impact Of Substance Abuse Problems And Serious Mental Illness/Serious Emotional Distress On Post-Discharge Residential Status Among Clients With Behavioral And Cognitive Disorders: Evidence From Samhsa Mh-Cld Data, Eden Moges, Norma Rochez, William Peycha, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

BACKGROUND: Behavioral and cognitive disorders can undermine housing stability, a key determinant of mental health recovery, with persistent disparities across demographic and socioeconomic groups. This study examined the associations of substance abuse problems (SAP) and serious mental illness/serious emotional distress (SMISED) with residential status at discharge from mental health facilities.

METHODS: This cross-sectional study used the utilized data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to summarize demographic characteristics, whereas univariate and multivariable logistic regression models were employed to assess associations between the covariates and the residential outcome, adjusting for a variety of …

The Moderating Role Of Social And Emotional Support In The Association Between Adverse Childhood Experiences And Adult Mental Health Across Racial Groups: The Need For Investing In Social Capital, Syeda S. Jesmin, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

The sustained impact of Adverse Childhood Experiences (ACE) on mental health outcomes in adulthood is well documented in the literature. ACE survivors may be especially vulnerable to poor mental health outcomes if they have limited or no social support. This study examined the moderating role of social support on the association of ACEs and mental health across different racial groups.

Methods

Data were obtained from the 2022 Behavioral Risk Factor Surveillance System (n = 14,327). The nine ACE questions about traumatic events in childhood were used to create ACE scores. Chi-square tests were used for bivariate comparisons. Both stratified …

Gender Differences In The Association Between Adverse Childhood Experiences And Drug Use: Findings From A Community-Based Survey In China, Hongyun Fu, Elizabeth Monk-Turner, Xiushi Yang

Department of Pediatrics Faculty Publications

Background

While adverse childhood experiences (ACEs) are widely recognized risk factors for behavioral health problems, including drug use, prior research has largely been conducted in Western countries, focused primarily on males, and relied on convenience samples without comparison groups of nonusers. Limited work has examined the impact of ACEs on drug use in non-Western contexts. This study examines gender differences in the relationship between ACEs and drug use in China, using data from a population-based probability sample survey.

Methods:

Cross-sectional data were collected in 2019 from one city in Yunnan Province in Southwest China and one city in Guangdong Province …

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …

Comparison Of Mental Illness Comorbidity Pre-Pandemic Vs. Pandemic-Era And Associations With Clinical And Demographic Characteristics For Virginia Public Hospital Inpatient Discharges With A Substance Use Disorder, Marilyn Bartholmae, Tharidu Gunawardena

Department of Medicine Faculty Publications

The rise in mental illnesses after the COVID-19 pandemic is well documented. However, it is not known whether the rates of mental illness comorbidity increased. The objectives of this study were to compare mental illness comorbidity rates before and after the pandemic among inpatients with SUD and to test associations between mental illness comorbidity, physical illness, and demographics. We used a retrospective cross-sectional design in a sample of inpatient discharges (N = 233,017) at Virginia public hospitals from January 2018 to December 2022. We used Z tests to compare rates of mental illness comorbidity pre- and post-pandemic and Chi-square tests …

The Interplay Between Loneliness, Cortisol, And Nk Cell Function: The Role Of Cortisol In Nk Cell Dysfunction, Abhinav Saurabh, Yvonne Baumer, Laurel G. Mendelsohn, Elizabeth M. Aquino Peterson, Dana Sadler, Shirley J. Lopez De Leon, Ayushi Dave, Andrew S. Baez, Lola R. Ortiz-Whittingham, Mario A. Pita, Manuel A. Cintron, Hannatu A. Tarfa, Sandy T. Reynolds, Shelby R. Hicks, Sonal Sharda, J. Eleanor Seo, Maria Lopez-Ocasio, Pradeep K. Dagur, Skyler A. Kuhn, Neelam R. Redekar, James F. Troendle, Ayanna L. Wells, Marie Marah, Katherine J. Tolentino, Michael J. Corley, Alika K. Maunakea, Lynnette K. Nieman, Marcus R. Andrews, Tiffany M. Powell-Wiley

Department of Biomedical and Translational Sciences Faculty Publications

Chronic psychosocial stressors contribute to cardiovascular disease (CVD) and related risk factors, particularly in under-resourced communities. Psychosocial stressors activate the hypothalamic-pituitary-adrenal (HPA) axis, leading to sustained cortisol action on immune cells. Natural killer (NK) cells are altered in distribution and function in cardio-metabolic diseases; however, pathways linking cortisol as a marker of chronic stress to NK cell dysfunction remain understudied. We recruited 186 African American women from the Step It Up Community-Engaged, Digital Health Physical Activity Intervention study and collected cortisol, NK cell measures, and psychosocial stress measures using validated questionnaires, including chronic stress and loneliness. Plasma cortisol levels were …

Mental Health And Art Adherence In A Multisite International Study: The Mediating Roles Of Social Support And Substance Use In People With Hiv, Joseph Awad, Wenxiu Sun, Diane Santa Maria, Rebecca Schnall, Panta Apiruknapanond, Tongyao Wang, Claudia Patricia Valencia, Christine Horvat Davey, Solymar Solis Baez, Sheila Shaibu

School of Nursing & Midwifery, East Africa

ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from N = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental …

Prevalence Of Dengue Infection In Bangladesh: A Systematic Review And Meta-Analysis, Md. Estiar Rahman, Abdullah Al-Taiar, May Salama, Michele A. Kekeh, Ahmed N. Albatineh

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective: 

To estimate the pooled prevalence of dengue infection in Bangladesh.

Methods:

Literature search was conducted across PubMed, Web of Science, and Hinari between December 2024 and April 2025, supplemented by references searching. The Joanna Briggs Institute checklist was used for evaluating study quality. A random effects meta-analysis of proportion, including subgroup analyses, was performed with R software (version 4.5.1).

Results:

Out of 2 087 records, 28 studies were included. The pooled prevalence of confirmed dengue infection among clinically suspected patients was 49.3% (95% Cl 36.1-62.6), with a significant high heterogeneity (I²=99.2%, τ²=1.81, P< 0.001). Stratified analysis showed a pooled prevalence of 47.9% (95% Cl 34.0-62.2, I2=99.1%, …

The Current State Of Behavioral Health Curriculum Within Professional Athletic Training Programs, Bethany R. Rohl

Graduate Research Theses & Dissertations

Behavioral health concerns among adolescents and young adults have increased in recent years, placing greater expectations on athletic trainers (ATs) to recognize and respond to these conditions in clinical practice. Although accreditation standards require behavioral health competencies within professional athletic training education, variability may exist in how faculty are prepared to teach this content. This study examined athletic training faculty preparation for teaching behavioral health, how programs implement and assess behavioral health content, and faculty perceptions of student satisfaction with behavioral health education.

Consensual qualitative research method was used. Eleven athletic training faculty (9 females, 2 males; age = 37.91 …