Mental and Social Health Commons^™

Co-Design Of An Online Mindfulness Program For Informal Carers Of People Living With Dementia: A Qualitative Study Of Co-Designers’ Experience, Charunya A.K.R. Abeysinghe Mudiyanselage, Seng Giap Marcus Ang, Aisling Smyth, Joanne M. Dickson, Beverley Ewens

Research outputs 2022 to 2026

Introduction: Informal carers face significant challenges related to care provision for people living with dementia. Participating in a mindfulness-based stress reduction program could improve the wellbeing of informal carers. However, engaging in these programs can be difficult for informal carers due to the needs of their care recipients. Purpose: This study aimed to co-design an online mindfulness program in collaboration with a range of stakeholders and those with lived experience as carers. Methods: This co-design study adopted an interpretive descriptive qualitative approach to the development of the program. The stakeholders (co-designers) included people with lived experience as informal carers and …

Anchoring Roots And Spreading Branches: The Growth And Regulation Of Art Therapy In Singapore, Christine Phang

Art Therapy | Doctoral Dissertations

The development of art therapy in Singapore has advanced rapidly over the last two decades. Yet, to date, there has not been a comprehensive overview of art therapy in Singapore. Additionally, more research is needed to understand how the complex component of regulation can benefit the profession of art therapy. This study therefore set out to paint a picture of art therapy in Singapore, capture the art therapy community’s thoughts and opinions concerning regulation, and identify actionable ways to advance the profession. A mixed method design was employed which utilized a survey and interviews to gather quantitative, qualitative, and arts-informed …

Creativity In A Flash: Exploring The Perceived Therapeutic Effects Of Combining Creative Arts Therapies And Flash Technique, Celia J. Gagnon

Art Therapy | Doctoral Dissertations

Since the onset of the COVID-19 pandemic, research has revealed a significant strain on mental healthcare systems and healthcare professionals. Concurrently, there has been a rapid escalation in the prevalence of anxiety, depression, loneliness, and adolescent suicide rates, all of which have reached critical levels (World Health Organization, 2025; World Health Organization, 2022; Institute for Health Metrics and Evaluation, 2025; American Psychiatric Association, 2024). Post-pandemic, these statistics continue to rise across all nations and socioeconomic groups (WHO, 2025). Consequently, there is an urgent need to intensify research that supports the enhancement of mental health services globally (Institute for Health Metrics …

Enhancing Self-Acceptance And Reducing Anxiety Through Tree Ring Self-Portraits In Art Therapy: A Mixed-Methods Study, Stacey Kamp

Art Therapy | Doctoral Dissertations

This mixed-methods dissertation examined the therapeutic potential of the Tree Ring Self-Portrait, a novel art therapy intervention designed to enhance self-acceptance and reduce anxiety through symbol-based, life-phase self-portraiture grounded in narrative meaning-making and image-based processing (White & Epston, 1990; Moon, 2010; Hinz, 2020). Adults who self-identified with anxiety-related concerns were recruited through community and clinical referral sources and completed a standardized three-session intervention involving reflective mapping of life phases, a watercolor-based concentric-ring self-portrait process, and a guided review of the completed artwork with semi-structured interviews. The final sample (n = 20; ages 22–74) included participants with varied engagement in psychotherapy …

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 …

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 …

“Kuchoka”: Investigation Of Research Fatigue In Mosoriot, Kenya, Felishana Cherop, Violet Naanyu, Juddy Wachira, Lukoye Atwoli

Internal Medicine, East Africa

Background: Health research is key to the promotion of population and community health, however, conducting many research studies in a community can cause research fatigue.

Purpose: We determined the prevalence of research fatigue and associated factors in Mosoriot, Kenya.

Methods: We conducted a cross-sectional study in the Mosoriot community from Wednesday 28, May 2014, to Thursday 30, April 2015, involving (n = 327) community members who were randomly sampled to respond to self-administered and/or guided questionnaires. We analyzed descriptive statistics to summarise the data and used the Pearson Chi-Square test to assess the bivariate associations between the …

“Why Can’T I Do My Homework Without Crying?” Neurodivergence And The Gendered Expectations Of Functioning, Alia Wang

Pitzer Senior Theses

The purpose of this qualitative interview study was to examine the experiences of neurodivergent women and gender-diverse individuals regarding productivity. Neurodivergence is often understood in biological and medical terms; far less attention has been given to how neurodivergent individuals experience and navigate everyday life. Meanwhile, productivity is often framed as a neutral measure of efficiency, but in practice, it is shaped by social norms that shape particular ways of thinking, working, and behaving.

Particularly for women and gender diverse people, these expectations are compounded not only by cognitive differences but also by gendered norms around behavior. This creates a mismatch …

Feeding Missoula: Food Insecurity In Rural Children And Youth, Chani Brammer, Braelee Cheeks, Jordin Holland, Rayne Mccollough, Laurel Palmer, Therese Solomon

Undergraduate Theses, Professional Papers, and Capstone Artifacts

In Montana, approximately one in seven children live in a food-insecure household, with rural Montanans in particular facing significant barriers. Existing needs-based food assistance programs, such as SNAP and WIC, have structural weaknesses: SNAP benefits are often not sufficient to last through the month, and those eligible for these programs face a confusing application process, shame and stigma, and logistical hurdles, such as limited transportation.

“Feeding Missoula” began with an evaluation of how current food assistance programs met or failed to meet the needs of rural youth. Our methodology integrated a comprehensive review of existing literature and structured interviews with …

A Group Motivational Intervention To Support Motivation For Physical Activity Among Adults In Residential Treatment For Substance Use Disorders: A Series Of N-Of-1 Studies, Sascha Thal, Nikos Ntoumanis, Stephen Bright, Bronwyn Myers, Dominika Kwasnicka, Peter Verboon, James Clarke, Eleanor Quested

Research outputs 2022 to 2026

Objective: Physical activity (PA) may offer health benefits for individuals undergoing substance use disorder (SUD) treatment, yet relapse, comorbidities, and motivational challenges often hinder PA maintenance. This study assessed the impact of a motivational intervention aimed at increasing PA motivation and maintenance in a residential SUD treatment setting. Methods and Measures: This non-concurrent multiple-baseline N-of-1 study consisted of a six-week baseline and a ten-week intervention period. The study was conducted with 17 participants from a male-only residential SUD treatment facility in Perth, Australia. Seven participants provided sufficient data for statistical analysis. Participants received ten weekly sessions of a motivational face-to-face …

Fall Prevention Strategies And Fall-Related Outcome Measures Used For Inpatients In Mental Health Settings: A Scoping Review, Min Zhang, Gideon Di Ji, Irene Ngune, Khairul Dzakirin Bin Rusli, Maggie Zgambo, Rosemary Saunders, Seng Giap Marcus Ang

Research outputs 2022 to 2026

Introduction Patients in mental health settings are at risk of falling and sustaining injury due to the unique risk factors related to their mental illness and its accompanied treatment. Objective To examine the literature on the fall prevention strategies used, and fall-related outcome measures reported for inpatients in mental health settings. Methods A literature search was conducted using Medline, CINAHL, PsycINFO, Web of Science, Scopus and sources from the Grey Literatures. Peer-reviewed research studies that examined fall prevention strategies for inpatients in mental health settings were included. The fall prevention strategies and fall-related outcome measures were extracted and grouped using …

Early-Life Pathways To Inequalities In Child Mental Health: Evidence From Eight Birth Cohorts, Demetris Avraam, Gabriella Melis, Tim Cadman, Jennie Carson, Marie Aline Charles, Yu Wei Chua, Ahmed Elhakeem, Joaquín Escribano, Veit Grote, Dariusz Gruszfeld, Kathrin Guerlich, Rae-Chi Huang, Jennifer R. Harris, Jesus Ibarluzea, Jordi Julvez, Berthold Koletzko, Ashleigh Lin, Unai Martin, Rosemary Mceachan, Maria Melchior, Phillip Melton, Johanna Thorbjornsrud Nader, Angela Pinot De Moira, Maja Popovic, Simona Porru, Lorenzo Richiardi, Blanca Sarzo, Daniela Schlüter, Jordi Sunyer, Morris Swertz, Elvira Verduci, John Wright, Annick Xhonneux, Tiffany Yang, Daniela Zugna, Anne-Marie Nybo Andersen, Katrine Strandberg-Larsen, David Taylor-Robinson

Research outputs 2022 to 2026

Background: Socioeconomic inequalities in children's emotional and behavioural problems are already present at school entry. We examined associations between early-life socioeconomic conditions and children's externalising and internalising problems and assessed whether early-life risk factors mediated these associations.

Methods: We analysed harmonised individual participant data from eight birth cohorts within the EU Child Cohort Network. Maternal educational level during pregnancy was used as an indicator of early-life socioeconomic conditions (SECs). Scores of children's externalising and internalising problems around school entry age were used as the outcome variables. Inequalities were quantified using the Slope Index of Inequality which captures the difference in …

Cohort Profile: The Resilient Minds National Study Of Mental Health And Cognitive Resilience In Community Dwelling Adults Aged 18 To 93, Kaarin J. Anstey, Brooke Brady, Lidan Zheng, Jana Koch, Md Hamidul Huque, Michelle K. Lupton, Ralph Martins, Daniel Ashworth, Erin Goddard, Nikki Anne Wilson, Claudia M. Hillenbrand, Ralf B. Loeffler, Maria Markoulli, Arun V. Krishnan, Tanya Layton, Ranmalee Eramudugolla

Research outputs 2022 to 2026

Purpose: The Resilient Minds (ReMind) cohort was established to investigate cognitive and mental health resilience across the life course, addressing a gap in longitudinal evidence about resilience. The study collected data on traditional medical and lifestyle risk factors for chronic disease, genetics, and a range of mental health and cognitive outcomes. It also aimed to explore contemporary contextual influences on resilience, including internet use, social engagement, environmental exposures, and life course adversities such as perceived discrimination. Participants: The cohort included 1,640 adults aged 18–93 years, recruited through social media and community groups, to participate in a fully remote, two-year health …

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 …

Nicotine Self-Administration And The Impacts On Medial Habenula And Interpeduncular Nucleus Neurophysiology, Nathan Alexander Olszewski

Theses, Dissertations and Capstones

Nicotine use is a tremendous public health issue in the United States, with over 23 million people being dependent on the substance. Low cessation rates associated with nicotine use are largely attributed to the withdrawal and craving symptoms that occur after abstinence of use from nicotine. The medial habenula (MHb) and interpeduncular nucleus (IPN) are two brain regions heavily associated and linked with nicotine withdrawal. Here, I sought to understand how these brain regions are altered in their physiology during nicotine intake. Utilizing E-Vape self-administration, mice were first taught to selfadminister nicotine of various, clinically relevant, dosages which correlate to …

Collaboration In Acute Care: Enhancing Occupational Therapy Outcomes Through Canine Therapy Integration​, Deanna Hamke

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

The utilization of animal-assisted therapy has the potential to increase patient participation, motivation, and help simulate real-life experiences to promote a successful discharge from therapy services. The purpose of this doctoral capstone project was to: 1) expand collaboration between occupational therapists & canine therapy handlers through use of a communication platform and 2) to create a resource outlining in-session responsibilities to facilitate partnership between occupational therapists and canine therapy handlers. Occupational therapy treatment sessions were completed using canine therapy interventions targeting mobility, engagement, and emotional regulation. The final deliverables included multiple educational resources and a platform for communication. These deliverables …

Investigating The Relationship Between Drug Overdose Deaths, Excessive Alcohol Drinking, And Adult Smoking In Urban And Rural Ohio Counties In 2025, Sumin Byoun, Anne Griffin

Scholarship in Medicine - All Papers

Deaths from drug overdoses have been increasing each year. Ohio ranks among states with the highest number of drug overdose deaths per year. There is a gap in the literature regarding discussions of how excessive alcohol drinking and cigarette smoking rates may predict drug overdose death rates in a community. First, this study investigates differences in excessive drinking, adult smoking, and drug overdose deaths between urban and rural counties in Ohio. Second, this study explores whether excessive drinking and smoking behaviors can predict drug overdose death rates in urban and rural Ohio counties. Data exclusive to Ohio counties was obtained …

Minority Stress And Drug Use Among 2slgbtq+ Canadians, Robert Chin-See, Todd Coleman

Theses and Dissertations (Comprehensive)

Background: Several social and environmental factors influence drug use behaviors and contribute to frequent drug use among Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer, and other (2SLGBTQ+) individuals. The purpose of the current study was to examine the relationship between the minority stress, drug use, and other socio-ecological factors.

Methods: This study employed structural equation modelling on data (2021—2022) from a nationally representative pan-Canadian survey (N = 1542) on 2SLGBTQ+ health to examine the association between minority stress, drug use, and relevant socio-ecological predictors. A separate mediation analysis was conducted and controlled for socio-demographic characteristics.

Results: SEM results showed parsimonious fit …

Factors Associated With Opioid-Involved Overdose: Descriptive Data From A Randomized Controlled Trial Evaluating Extended-Release Buprenorphine For Perinatal Opioid Use Disorder, Sara M. Witcraft, Leah Holcomb, Yingjia Wei, Gerald Cochran, John T. Winhusen, Michelle R. Lofwall, Peter R. Martin, Jessica L. Young, Jessica Spinali, Constance Guille

Center on Drug and Alcohol Research Faculty Publications

Background: Opioid use disorder (OUD) during pregnancy is a leading contributor to peripartum morbidity and mortality, with overdose deaths rising significantly in recent years. Despite the identification of various factors associated with overdose events, including social, demographic, psychiatric, and neonatal outcomes, the relative contributions of these factors to peripartum overdose history (or lack thereof) remain unclear. Thus, this study aims to characterize factors associated with lifetime opioid-involved overdose events among currently pregnant individuals receiving buprenorphine (BUP) treatment for OUD.   Methods: Treatment-seeking pregnant individuals with an estimated gestational age of 6 to 30 weeks were enrolled in a large multisite randomized …

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 …

Culturally Responsive Dialectical Behavior Therapy With Chinese Sexual And Gender Minority Individuals: A Qualitative Study, Weiyi Liao M.S.

Selected Full Text Dissertations, 2011-

Professional guidelines emphasize the importance of adapting evidence-based treatments to the cultural and contextual needs of minoritized populations. Although substantial research has examined lesbian, gay, bisexual, transgender, and queer (LGBTQ+) mental health, comparatively little is known about the psychotherapy experiences of Chinese sexual and gender minority individuals or how dialectical behavior therapy (DBT) may be delivered responsively with this population. DBT is an evidence-based treatment for emotion dysregulation, self-harm, and suicidal behavior that explicitly addresses the effects of invalidating environments. Because Chinese cultural contexts and LGBTQ-related minority stress may both shape emotional expression, help-seeking, and treatment experiences, this qualitative study …

Bringing Awareness And Education To Rural Areas About The Role Occupational Therapy (Ot) Has In Infant Care, Makenzi Richwald

Occupational Therapy Doctorate Capstone Posters

This capstone project focused on education and advocacy. The aim of my capstone project was to provide education to parents of eastern Kentucky (KY) about what Occupational Therapy (OT) can address with infants aged 0-18 months. I saw a gap in knowledge in the eastern KY community about what OT could do for infants and wanted to address this. Through my research, consultation with my mentors, and collaboration with the occupational therapists at my site (BPT) I discerned 14 areas of development and/or common reasons of needed referral for OT services by this age group. These educational materials aimed to …

The Restorative Effects Of Virtual Reality Nature Simulations: An Empirical Investigation, Isabel T. Folger, Yichen Zhang, Kenneth B. Abrams

Psychology Faculty Work

Although extensive research demonstrates that nature films can facilitate recovery from stress and cognitive overload, it remains unclear whether more immersive media, such as virtual reality (VR), are more effective than similar two-dimensional films. The present study examined the effects of immersiveness on affective, cognitive, and physiological restoration. Three levels of immersiveness for film viewing were employed: 2D (computer monitor), standard VR (visual and auditory input), and enhanced VR (standard VR plus olfactory and haptic input). All participants were exposed to parallel versions of a six-minute nature film. We hypothesized that greater immersiveness would produce stronger restorative effects. All versions …

Hepatitis C Virus Transmission Among People Who Inject Drugs In Rural United States: Mathematical Modeling Study Using Stochastic Agent-Based Network Simulation, Lin Zhu, Jennifer R. Havens, Abby E. Rudolph, April M. Young, Golnaz Eftekhari Yazdi, William W. Thompson, Liesl M. Hagan, Liisa M. Randall, Jianing Wang, Rebecca Earnest, Shayla Nolen, Benjamin P. Linas, Joshua A. Salomon

Center on Drug and Alcohol Research Faculty Publications

People who inject drugs (PWID) account for the majority of hepatitis C virus (HCV) infections in the United States. The injection-equipment-sharing network likely plays an important role in shaping the dynamics of HCV transmission. Recognizing the emerging HCV epidemic in rural communities, we developed an agent-based network simulation model of HCV transmission via injection equipment sharing and used data on rural PWID networks to inform model parameterization and calibration. We then simulated an array of networks that varied key network properties to understand their impact on the magnitude and distribution of HCV incidence. The results show substantial heterogeneity in HCV …

Legislative Debate-Attributed Suicidality Among Lgbtq+ Adults: The Buffering Effect Of Community Belongingness, Keith J. Watts, Shawndaya S. Thrasher, Laneshia R. Conner, Nicole Campbell, Louis G. Baser, Dekeitra Griffin, Sydney P. Howard, Missy Spears, Justin X. Moore

Counseling & Human Services Faculty Publications

Background: In recent years, the sociopolitical landscape in the United States has shifted due to an increase in state-level legislation regarding LGBTQ+ rights, a trend that has been particularly pronounced in the Commonwealth of Kentucky. While the mental health impacts of enacted laws are increasingly documented, a critical gap remains in understanding the psychological toll of the legislative debates themselves—the prolonged periods of public discourse surrounding the restriction of rights. Methods: Utilizing data from the 2025 Queer Kentucky Survey (N = 817), this exploratory study examined the association between LGBTQ+ community belongingness and acute suicidality attributed specifically to anti-LGBTQ+ legislative …

Editorial For Issue 20(2), Jeff Moe, Peighton Corley, Aaron Albright

Counseling & Human Services Faculty Publications

[Introduction] Hello to the readers of the Journal of LGBTQ Issues in Counseling. Like many counselors, counselors-in-training, scholars, and other individuals you may be coming to the journal looking for insights into your counseling work. Along with publishing original research that creates space for exploring LGBTQ+ lifeways from an open and affirmative perspective, the manuscripts published in the journal have always been grounded in application.

Reflections From A Community Capacity Building Forum To Support People Bereaved By Suicide, Colleen Carlon, Jacquie Tarrant, Marie Eckersley, Priscilla Vindin

Research outputs 2022 to 2026

An estimated half the population may be impacted by suicide loss. The combination of grief and trauma makes the experience particularly complex. Recognised as the most stigmatised of all sudden losses people bereaved by suicide are in sociocultural contexts that disrupt constructive grief processes and create barriers for help seeking and supportive responses. Effecting change in this context poses a significant health promotion challenge. Social workers in the South West Region of Western Australia sought to develop and deliver a unique postvention approach aimed at strengthening the self-support capacity of people bereaved by suicide while building broader community capacity for …

Ensuring That Marginalized Young People Feel Welcome, Understood, And Empowered In Health Services: A Qualitative Examination Of The Service Needs Of Aboriginal Lgbtqa+ Young People, Shakara Liddelow-Hunt, Ashleigh Lin, Yael Perry, Braden Hill, Bep Uink

Research outputs 2022 to 2026

A lack of appropriate care and discrimination in healthcare settings likely compounds the existing risks to mental health and well-being for Aboriginal and Torres Strait Islander lesbian, gay, bisexual, trans, queer/questioning, and asexual (LGBTQA+) young people. The current study contributes findings from Aboriginal LGBTQA+ young people’s perspectives on their health service needs and preferences. Data consists of qualitative interviews and focus groups with N = 14 Aboriginal LGBTQA+ young people aged 14–25 years in Boorloo (Perth), Western Australia. The data was analyzed using reflexive thematic analysis. Analysis identified three major themes: (1) Unmet need for “whole self” care, (2) Communicating …

Towards A Person-Centred Holistic Consultation Framework For Paramedics Attending Non-Acute Presentations: A Multidisciplinary Commentary, Robbie King, Angela Martin, Alan M. Batt, Sonia Louise Martin, Nigel Barr, Caroline Hwang, Bill Lord, Peter O’Meara, Louise Reynolds, Staffan Hammarbäck, Shaun Hosein, Julie Kempton, Brendan Shannon

Research outputs 2022 to 2026

Introduction: Traditional rapid-assessment models may not be fully suited for the complex non-acute presentations that paramedics commonly encounter. As paramedicine evolves to meet non-acute patient needs, extended practice community paramedic roles are emerging to deliver holistic and collaborative community-based healthcare. Purpose: This commentary outlines the need for a person-centred holistic clinical consultation framework for paramedics attending complex non-acute presentations. A framework that provides a structured and systematic process for paramedics, particularly those who are transitioning into extended practice community paramedic roles, to guide them in conducting holistic person-centred assessments. This commentary highlights the importance of understanding the biopsychosocial factors influencing …

Understanding The Underutilization Of The Campus Recreation Facility: A Mixed-Methods Examination Of Basic Psychological Need Satisfaction, Social Physique Anxiety, Sense Of Community, And Physical Environment Barriers, Caden M. Pfingsten

Master's Theses or Doctor of Nursing Practice

Campus recreation facilities have been identified as important contributors to student well-being, academic persistence, and institutional belonging. Despite these documented benefits, a persistent gap exists between available services and actual student utilization at many institutions. This study examined the psychological, social, and environmental factors associated with students' underutilization of the Campus Recreation Facility (CRF) at a mid-sized Midwestern public university in favor of paid off-campus commercial gym memberships.

Using a cross-sectional survey design, 169 students completed a battery of validated and researcher-adapted instruments assessing basic psychological need satisfaction (autonomy, competence, and relatedness), Sense of Community, and social physique anxiety across …