Community Health Commons^™

Examining The Utility Of The Canadian Occupational Performance Measure (Copm) Vs. Cognitive Mapping And Motivational Interviewing (Cm/Mi) To Provide Person-Centered Care (Pcc) For People With Parkinson’S Disease (Pwpd), Mary Lagasca, Karen Aranha

Spring 2023 Virtual OTD Capstone Symposium

Background: Parkinson’s disease (PD) limits occupational engagement and quality of life. Clinicians need tools to help understand the lived experiences of people with PD to provide more person-centered care (PCC). The Canadian Occupational Performance Model (COPM) is one tool used with this population, but its predetermined categories may be limiting. In contrast, Cognitive Mapping and Motivational Interviewing (CM/MI) is a non-standardized method that may provide more insight. Objective: To identify the benefits of the COPM to CM/MI in delivering more person-centered care (PCC). Methodology: A qualitative phenomenological self-study was used. Data collection compared the assessments and reflected on determining if …

Pathways To Care Of Maine Youth With Psychosis, Elizabeth M. Mutina, Rebecca Jaynes, Dave Weiss, Elizabeth Bernier, Kristen A. Woodberry

Costas T. Lambrew Research Retreat 2023

Study clinicians conducted semi-structured interviews to identify the timing and steps of each person’s Pathway to Care (PtC).

The Past, Present, And Future Of Distress Screening: Launching A Robust Distress Screening Program At A Large Outpatient Medical Oncology Practice Serving Rural/Underserved Communities, Kevin Stein, Trisha Warren-Vanhorn, Meredith Curtis, Amy Litterini, Amit Sanyal

Costas T. Lambrew Research Retreat 2023

After redesign, administration of the DT at initial chemotherapy teaching sessions and robust searchable databases integrated with EHR systems, allowing providers/researchers to create reports filtered by date ranges, encounter type, clinical site/facility, scores of ≥4, domain (physical, emotional, practical), and outcome (referral to specialist)

The Relationship Between Quality Of Life And Functionality In Patients With Schizophrenia – A Preliminary Report, Vlad Dionisie, Mihnea Costin Manea, Manea Mirela, Lavinia Steluta Bonciu, Sorin Riga, Maria Gabriela Puiu

Journal of Mind and Medical Sciences

This research aimed to investigate the relationship between quality of life and level of functioning in a group of Romanian patients with schizophrenia. A cross-sectional, observational, prospective study on 47 patients with schizophrenia was conducted. Socio-demographic and clinical data were documented and WHOQOL-BREF and Life Skills Profile-16 instruments were further administered. To examine the correlation between variables, Person correlation test was employed. The mean age of the sample was 38.32±12.32 years and 66% of the patients were males. Significant correlations were found between all aspects of the quality of life (physical health, psychological, social relationships and environmental health) and total …

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

Journal of Appalachian Health

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

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

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

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

Journal of Patient-Centered Research and Reviews

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

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

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

Clinical Decision Support System For Standardization Of Disease-Specific Education, Paul Nava

Student Scholarly Projects

The evidence-based, contextually relevant, disease-specific health education materials aim to provide strategies for improvement in health literacy, disease management comprehension, and medication adherence. The health education materials address difficulties many adults experience in understanding health information. The health education system must remain a contextually relevant, patient-specific reference for standardizing disease-specific education according to the patient's mental capability (Fereidouni et al., 2019). Nurse-driven education material system addresses equity, diversity, and inclusion, tailored for all literacy degrees.

Clinical decision-making is a complicated process influenced by a highly variable process that exponentially increases error rates, selection, or exclusion, unintended or not, by presenting …

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

Honors Program: Senior Projects (Public)

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

Comparative Medicaid Policy Analysis Related To Maternal And Infant Birth Outcomes In South Carolina, Cassidy L. Lena

Senior Theses

The United States despite being one of the most industrialized and wealthiest nations in the world, has the worst maternal and child health outcomes of any industrialized nation. The rates of maternal morbidity, mortality, and infant mortality have been increasing within the past decade, when many causes of death for this population are preventable. This study conducted a literature review on Medicaid policies and associated programs between three states (South Carolina, North Carolina, and California) in order to gain background information. Secondly, a comparative Medicaid policy analysis was completed using the Centers for Disease Control and Prevention [CDC] framework, which …

Demographic And Psychosocial Factors Associated With Suicide Mortality Among Childbearing-Aged Individuals: A Case-Control Study, Katerina A. Furman, Amy Loree Phd, Lyuba Gavrilova Bs, Leah Hecht Phd, Hsueh-Han Yeh, Frances Lynch, Brian Ahmedani, Rebecca Rossom, Anne Beck Phd, Yihe Daida Phd, Gregory Simon Md, Christine Lu Phd, Joslyn Westphal Mph, Ashii Owen-Smith Phd, Stephen Waring, Cathrine Frank Md

Medical Student Research Symposium

Objective: Examine pregnancy-related, demographic, psychosocial and healthcare utilization factors associated with suicide mortality among childbearing-aged women. Methods: Data from nine health care systems in the Mental Health Research Network were included. A case-control study design was used in which 290 childbearing-age women who died by suicide (cases) from 2000-2015 were matched with 2,900 childbearing-age women from the same healthcare system and enrolled during the same time period who did not die by suicide. Conditional logistic regression was used to analyze associations between patient characteristics and suicide. Results: Women who died by suicide were more likely to have mental health or …

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

Medical Student Research Symposium

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

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

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

Faculty, Staff and Students Publications

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

Poster Presentation: Acupressure Modality Effectiveness: Research Results For Pain And Anxiety Poster, Deanna Waggy Otr, Carroll Noel Mozer Otr/L, Marilyn Zurwaski Otr/L

Journal of Transformative Touch

According to recent studies, including Monson et all, JACM, 2019, there is growing evidence for the effective and safe use of acupressure as a non-pharmacological approach to reducing pain and anxiety. Acupressure can quiet the mind, promoting a sense of well-being by decreasing anxiety.

A collaborative retrospective analysis of self-rated pain and anxiety scores before and immediately after administration of a stress release protocol indicate that acupressure is a highly satisfactory complementary therapy. Results were clinically significant for a decrease in self-rated pain and anxiety scores.

Occupational therapy practitioners as well as those who use the Kawa model of reference …

Acupressure Modality Effectiveness: Research Results For Pain And Anxiety, Deanna Waggy Otr, Carroll Noel Mozer Otr/L, Marilyn Zurwaski Otr/L

Journal of Transformative Touch

According to recent studies, including Monson et all, JACM, 2019, there is growing evidence for the effective and safe use of acupressure as a non-pharmacological approach to reducing pain and anxiety. Acupressure can quiet the mind, promoting a sense of well-being by decreasing anxiety.

A collaborative retrospective analysis of self-rated pain and anxiety scores before and immediately after administration of a stress release protocol indicate that acupressure is a highly satisfactory complementary therapy. Results were clinically significant for a decrease in self-rated pain and anxiety scores.

Occupational therapy practitioners as well as those who use the Kawa model of reference …

Home-Based Primary Care In Patients With Dementia: Impact On Cost, Medication Use, And Patient Satisfaction, Megan O'Leary

Theses and Graduate Projects

Background: Individuals living with dementia deserve affordable, accessible, and effective healthcare. These patients often face barriers that make it difficult to consistently access traditional in office primary care. Home-based primary care (HBPC) holds the opportunity to bridge the gap between individuals with dementia and preventative healthcare resources.

Purpose: Dementia rates are increasing as the population ages, and additional research is needed to determine the optimal treatment model for individuals with dementia. This literature review evaluates if patients with dementia receive improved care with HBPC vs in office primary care through examining cost, medication use and compliance, and patient satisfaction.

Methods: …

Sex And Race Disparities In Mortality And Years Of Potential Life Lost Among People With Hiv: A 21-Year Observational Cohort Study, Rachael A Pellegrino, Peter F Rebeiro, Megan Turner, Amber Davidson, Noelle Best, Chandler Shaffernocker, Asghar Kheshti, Sean Kelly, Stephen Raffanti, Timothy R Sterling, Jessica L Castilho

Faculty, Staff and Student Publications

BACKGROUND: Since the availability of antiretroviral therapy, mortality rates among people with HIV (PWH) have decreased; however, this does not quantify premature deaths among PWH, and disparities persist.

METHODS: We examined all-cause and premature mortality among PWH receiving care at the Vanderbilt Comprehensive Care Clinic from January 1998 to December 2018. Mortality rates were compared by demographic and clinical factors, and adjusted incidence rate ratios (aIRRs) were calculated using multivariable Poisson regression. For individuals who died, age-adjusted years of potential life lost (aYPLL) per total person-years living with HIV were calculated from US sex-specific life tables, and sex and race …

Addressing Breast Health Disparities Among Recent, Established African-Born Immigrant Women And Second-Generation Americans In Prince George County, Maryland, Omolola Okunromade

College of Graduate Studies: Theses & Dissertations

Background: Breast health disparities and underutilization of screening methods are major concerns in the United States (US), particularly affecting Black women who experience lower survival rates and advanced diagnoses. Despite the rapid growth of the African-born immigrant population, breast health among this group in the US is notably under-examined. This study aims to investigate the breast health knowledge and practices of first-generation African-born immigrants and second-generation immigrant women of African descent, aiming to understand the distinctive attributes of this group and the impact of acculturation on this public health issue.

Methods: Interviews were conducted among First Generation African immigrants and …

Lessons Learned From Interdisciplinary Efforts To Combat Covid-19 Misinformation: Development Of Agile Integrative Methods From Behavioral Science, Data Science, And Implementation Science, Sahiti Myneni, Paula Cuccaro, Sarah Montgomery, Vivek Pakanati, Jinni Tang, Tavleen Singh, Olivia Dominguez, Trevor Cohen, Belinda Reininger, Lara S Savas, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Despite increasing awareness about and advances in addressing social media misinformation, the free flow of false COVID-19 information has continued, affecting individuals' preventive behaviors, including masking, testing, and vaccine uptake.

OBJECTIVE: In this paper, we describe our multidisciplinary efforts with a specific focus on methods to (1) gather community needs, (2) develop interventions, and (3) conduct large-scale agile and rapid community assessments to examine and combat COVID-19 misinformation.

METHODS: We used the Intervention Mapping framework to perform community needs assessment and develop theory-informed interventions. To supplement these rapid and responsive efforts through large-scale online social listening, we developed a …

Risk Of Depression In A Suburban Primary Care Setting Before And During The Covid-19 Pandemic, Carman H Whiting, Pouran Yousefi, Jude K A Des Bordes, Nahid J Rianon

Faculty, Staff and Student Publications

INTRODUCTION: Major depression is a common disorder affecting millions of adults each year. Many population-based surveys showed an increase in the number people with symptoms of depression at the onset of the COVID-19 pandemic. Our aim was to determine and compare the prevalence of depression risk in a primary care setting before and during the COVID-19 pandemic.

METHODS: We conducted a cross-sectional study based on retrospective review of medical records from a large suburban primary care clinic. Records of adults 18 years and older, seen between January 1, 2019 and December 31, 2020 and who had also been screened for …

History Of Falls, Mild Cognitive Impairment, And The Presence Of Home Environmental Hazards Among Community-Dwelling Older Persons In District V, Manila, Marilou J. Raval, Donald S. Lipardo

Philippine Journal of Physical Therapy

Introduction: It is important to investigate factors that may increase the fall risk in the geriatric population. This study aimed to determine the relationship between: 1) mild cognitive impairments (MCI) and history of falls; 2) home environmental hazards (HEH) and history of falls; and 3) MCI and HEHs among older adults.

Methods: Community-dwelling older persons of District V, Manila were random sampled to participate in this cross-sectional correlational study. The Home Falls and Accidents Screening Tool for Health Professionals (HOMEFAST-HP) and Fall History Questionnaire were used to collect information on the presence of HEH and history of falls, respectively. Chi-Square …

Avpcancerfree: Impact Of A Digital Behavior Change Intervention On Parental Hpv Vaccine –Related Perceptions And Behaviors, Ross Shegog, Lara S Savas, C Mary Healy, Erica L Frost, Sharon P Coan, Efrat K Gabay, Sharice M Preston, Stanley W Spinner, Mathew Wilbur, Elisabeth Becker, Travis Teague, Sally W Vernon

Faculty, Staff and Student Publications

Parent hesitancy contributes to reduced HPV vaccination rates. The HPVcancerfree app (HPVCF) was designed to assist parents in making evidence-based decisions regarding HPV vaccination. This study examined if parents of vaccine-eligible youth (11-12 yrs.) who use HPVCF in addition to usual care demonstrate significantly more positive intentions and attitudes toward HPV vaccination and greater HPV vaccination rates compared to those not using HPVCF. Clinics (n = 51) within a large urban pediatric network were randomly assigned to treatment (HPVCF + usual care) or comparison (usual care only) conditions in a RCT conducted between September 2017 and February 2019. Parents completed …

Creatively Capturing Structure And Energy: Zero Balancing's Essential Elements (Article & Video), Lisa Bardarson

Journal of Transformative Touch

Through the creative use of coloring, I am devising a way to document Zero Balancing’s two foundational elements, structure and energy and the changes that occur following a ZB session. I believe this experiential activity will be a creative fulcrum, helping the client connect more effectively with the deepest part of themselves thereby experiencing greater ease and freedom from their issues. As the activity of coloring is a “right brain”/ creative endeavor, I believe it can serve to enhance a client’s expanded state of consciousness, one of the hallmarks of a Zero Balancing session, as well as improve their overall …

Prevalent Multimorbidity Combinations Among Middle-Aged And Older Adults Seen In Community Health Centers, Ana R Quiñones, Steele H Valenzuela, Nathalie Huguet, Maria Ukhanova, Miguel Marino, Jennifer A Lucas, Jean O'Malley, Teresa D Schmidt, Robert Voss, Katherine Peak, Nathaniel T Warren, John Heintzman

Faculty, Staff and Student Publications

BACKGROUND: Multimorbidity (≥ 2 chronic diseases) is associated with greater disability and higher treatment burden, as well as difficulty coordinating self-management tasks for adults with complex multimorbidity patterns. Comparatively little work has focused on assessing multimorbidity patterns among patients seeking care in community health centers (CHCs).

OBJECTIVE: To identify and characterize prevalent multimorbidity patterns in a multi-state network of CHCs over a 5-year period.

DESIGN: A cohort study of the 2014-2019 ADVANCE multi-state CHC clinical data network. We identified the most prevalent multimorbidity combination patterns and assessed the frequency of patterns throughout a 5-year period as well as the demographic …

Demographic And Socioeconomic Factors Predict Maternal Postpartum Rehospitalization: A Retrospective Numom2b Dataset Study, Colin Wakefield

Tower Health Research Day

No abstract provided.

How To Survive College As An Acoa: The Effectiveness Of University Resources On Helping Acoas Socially And Psychologically Succeed During Their Academic Career, Kelly Buchan

Senior Theses

In 2019, 14.5 million people ages 12 and older had Alcohol Use Disorder (AUD), but only 10% received treatment (National Institute on Alcohol Abuse and Alcoholism [NIAAA], 2022). Parental drinking problems can directly affect children, or “Adult Children of Alcoholics.” Of the few studies targeting ACoAs, results show that ACoAs not only have higher risks of mental illness, but they also have lower GPAs and social health (Schroeder & Kelley, 2008). Thus, this study assessed the extent to which perceptions of the college drinking environment are related to higher depression rates in ACoAs, certain drinking motivations, and reluctance to use …

Effect Of Yoga And Mindfulness Intervention On Symptoms Of Anxiety And Depression In Young Adolescents Attending Middle School: A Pragmatic Community-Based Cluster Randomized Controlled Trial In A Racially Diverse Urban Setting, Alessandra N. Bazzano, Yaoyao Sun, Vaughne Chavez-Gray, Temitope Akintimehin, Jeanette Gustat, Denise Barrera, Cody Roi

School of Medicine Faculty Publications

Mental health conditions in childhood and adolescence are increasing in the U.S. population and require early intervention, as highlighted by a recent Surgeon General’s Advisory on Protecting Youth Mental Health. These health issues, which have been exacerbated by the COVID-19 pandemic, impair functioning, and may lead to longer term reductions in quality of life. Young adolescents are likely to experience stressors including academic pressure, feelings of loneliness and isolation, and excessive exposure to social media, all of which have been made worse by the pandemic and associated disruptions. Universal preventive programs at school serve as an important strategy for equipping …

Inspire Yourself: Volunteer!, Judith Sullivan

Journal of Transformative Touch

Doing volunteer short Zero Balancing sessions once a month for 13 years for staff, volunteers and sometimes "guests" at The Haven, a a multi-resource day shelter in downtown Charlottesville, Virginia supports the community in many ways.

Behavioural Support And Nicotine Replacement Therapy For Smokeless Tobacco Cessation: Protocol For A Pilot Randomised-Controlled Multi-Country Trial, Faraz Siddiqui, Linda Bauld, Ray Croucher, Cath Jackson, Ian Kellar, Mona Kanaan, Subhash Pokhrel, Rumana Huque, Romaina Iqbal, Javaid Ahmed Khan

Community Health Sciences

Background: Smokeless tobacco (ST) is consumed globally by more than 350 million people, with approximately 85% of all users based in South and Southeast Asia. In this region, ST products are cheap and easily accessible. Evidence-based interventions to people quit ST use are lacking. This study aims to test the feasibility of conducting a future definitive trial of ST cessation, using a culturally adapted behavioural intervention, and/or nicotine replacement therapy (NRT) in three South Asian countries.
Methods: We will conduct a factorial design, randomised-controlled pilot trial in Bangladesh, India and Pakistan. Daily ST users will be recruited from primary health …

Identifying Critical Aging Care Challenges And Opportunities In High-Income Countries: A Cross-Country Comparison Of Denmark, Germany, And The United States, Cassandra Martin

Capstone Collection

Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …