Mental and Social Health Commons^™

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 …

Gen Z Perspectives On Mental Health Service Interaction: A Qualitative Content Analysis Of Reddit Discourse, Victor A. Aguiar

Honors Undergraduate Theses

Compared to prior generations, Generation Z engages with mental health and mental health service interaction in distinct ways, frequently using social media platforms to share experiences, concerns, and opinions. Previous research has examined mental health discourse on Reddit; however, much of this work relies on inductive thematic approaches and offers limited focus on mental health service interaction and the factors influencing utilization. Guided by the Theory of Planned Behavior (TPB), this study examines how Generation Z discusses mental health service use through online discourse. Public Reddit posts authored by users identifiable as Generation Z, based on self-reported age, school enrollment, …

Social Determinants Of Health Affecting Cardiovascular Health Among South Asian Americans, Ann Mary Thomas

Honors Undergraduate Theses

Background: South Asian Americans experience disproportionately high rates of cardiovascular disease, yet the social determinants contributing to these disparities remain understudied.

Objective: This systematic review examines the role of social determinants of health (SDOH) in shaping cardiovascular outcomes among South Asian Americans.

Methods: A systematic literature search was conducted across PubMed, MEDLINE, and Web of Science using predefined search terms related to South Asian populations, cardiovascular health, and SDOH. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 reporting guidelines, and study screening and management were performed using Covidence. A total …

Socioeconomic Stressors And Their Association With Anxiety And Depression In Undergraduate And Graduate Students, Shreyaashri Selvakumar

Honors Undergraduate Theses

Socioeconomic status (SES) is a social determinant of mental health that may influence the prevalence of anxiety and depression in undergraduate and graduate students. Students from lower socioeconomic backgrounds often encounter financial, academic, and social stressors, which may contribute to poorer mental health outcomes. This study investigates the association between SES-related factors and symptoms of anxiety and depression in undergraduate and graduate students. Data were collected from a large national survey of students in various degree programs and included measures of financial circumstances, food and housing insecurity, access to mental health services, and other demographic variables. Symptoms of depression and …

Perceptions Of Illicit Drug Use And Perceived Drug Misuse Risks Among Individuals With Military Experience, Emilia Havlicek

Honors Undergraduate Theses

This study investigates perceptions of illicit drug use and perceived drug misuse risks among individuals with military experience in the United States, highlighting how military service shapes attitudes toward substance misuse. Using data from the National Survey on Drug Use and Health (NSDUH), this research examines the influence of military status, combat exposure, PTSD, gender, and sociodemographic factors on perceptions of drug-related risk. Findings indicate that while most individuals perceive illicit drug use as highly risky, important differences exist among subpopulations, particularly female veterans, who are more likely to perceive lower levels of risk. The study explores how military culture, …

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

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 …

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 …

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 …

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 …

Accessing Campus Mental Health Services In A Nigerian Southwestern University: Barriers To Academic Success, Caroline Dada

Electronic Theses and Dissertations

Mental health disorders are a significant health concern among higher education institutions in sub-Saharan Africa, including Nigeria. A substantial treatment gap exists in the Nigerian healthcare system, and this gap is further worsened by cultural and religious barriers, which reinforce stigma that discourages students from seeking professional help. This qualitative narrative inquiry explored the barriers students encountered when accessing mental health services at a university in Southwestern Nigeria, to increase service access. Qualitative semistructured interviews were conducted with seven professional mental health providers at a university counseling center between March and April 2025. Inductive thematic analysis was used to identify …

Enhancing Occupational Engagement And Wellness In Middle-Aged And Retired Adults Through Movement And Mindfulness Program Development, Erin J. Harvey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Occupational imbalance and a diminished sense of purpose are common challenges faced during middle age and the transition into retirement. These issues can contribute to increased burnout, decreased participation in meaningful activities, and an overall decline in health and well-being. Occupational therapy is well-equipped to address these concerns through comprehensive and holistic, occupation-based wellness programs that promote healthy routines and engagement in meaningful roles. This doctoral capstone project involved developing and implementing two community-based wellness programs tailored to different populations. The first program included self-paced wellness modules for middle-aged adults, aiming to encourage healthy lifestyle habits, enhance coping skills, and …

Exploring Relational Leadership And Psychological Safety During Ai Integration In The Workplace, Solmaz Kaynama

Antioch University Dissertations & Theses

This study explores employee psychological safety, or its lack, during artificial intelligence (AI) integration in the workplace through a relational leadership lens. The population included employees of for-profit business corporations currently integrating or adopting AI technologies (N = 14). Participants completed in-depth, semi-structured interviews. Results showed eight themes: relational leadership creates a psychologically safe workplace climate; unsupportive and dysfunctional leadership erodes trust and psychological safety; psychological safety determines whether employees speak up openly or hold back; employees’ experience daily work through workplace culture, pace, and remote or hybrid conditions; AI may delivers immediate productivity benefits while introducing new psychological and …

Beyond The Diagnosis: A Qualitative Exploration Of Men Living With Hiv, David R. Romanelli

Antioch University Dissertations & Theses

This qualitative study explored the lived experiences of men (18+ years old) living with HIV to better understand how they navigate identity, mental health, relationships, and healthcare systems after diagnosis. The method included a qualitative thematic analysis with 10 participants. Eight themes emerged from the data: (1) reactions, reflections, and meaning-making after diagnosis; (2) managing medication, treatment, and co-occurring conditions; (3) stigma, disclosure, and negotiation of identity; (4) substance use, housing instability, and socioeconomic stressors; (5) navigating the changing HIV landscape; (6) experiences with family and intimate relationships; (7) implications for mental health counseling; and (8) the role of community …

How To Reduce Inpatient Violence: A Theory Synthesis From Four Models, Arthur Walker

Antioch University Dissertations & Theses

Working in an inpatient setting inherently involves an increased risk of violence. This violence can affect both staff and patients alike and can lead to psychological trauma, serious bodily injury, and even death. To mitigate this risk, many models for preventing inpatient violence have been proposed for hospitals to implement. However, the evidence for the efficacy of these methods is inconsistent, and the theoretical underpinnings are varied and slim. This dissertation seeks to improve these models by re-examining the theoretical structures for common themes of four models for inpatient violence reduction and proposing additional recommendations informed by this synthesis. First, …

Survivors Of Historical Intergenerational And Familial Trauma Scale For Black American Descendants Of Enslaved People: A Development And Initial Validation Study, Loryn Chás Kimbrough

Graduate Research Theses & Dissertations

Despite extensive research documenting cultural and racialized trauma, no validated assessment tool had previously captured the intrafamilial mechanisms of trauma transmission specific to the BADEP population, whose trauma lineage is rooted in slavery. The present study addresses this gap through the development and initial validation of the Survivors of Historical Intergenerational and Familial Trauma Scale (SHIFTS), a culturally grounded instrument designed to measure the transmission of historical trauma (HT) and ongoing intergenerational trauma (IGT) among Black American Descendants of Enslaved People (BADEPs). The SHIFTS examines how HT gives rise to the continued transmission of two interrelated legacies: survival-based and trauma-rooted …