Community Health Commons^™

Investigating Suicide Risk Factors Among Appalachian West Virginian Adults, Erin D. Caswell, Angela M. Dyer, Summer D. Hartley, Caroline P. Groth, Mary Christensen, Sahiti K. Tulabandu, Bryce K. Weaver, Ruchi Bhandari

Journal of Appalachian Health

Introduction: Suicide rates in the United States have increased over the past two decades, with rural areas, particularly the Appalachian Region, facing unique challenges that elevate suicide risk. These include economic hardships, social isolation, and limited access to mental health services.

Purpose: This study addresses critical gaps in understanding lifetime suicide risk in West Virginia (WV), a predominantly rural state entirely within the Appalachian Region. By identifying the factors driving urban-rural differences in suicide risk, this research seeks to inform interventions tailored to the state's distinct needs and provide insights applicable to the broader Appalachian Region

Methods: Using 2021 Mountain …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Smart Goal-Setting On Behaviors To Enhance Intrinsic Motivation For Exercise: A Pilot Study With Orangetheory Fitness Participants, Adam Relitz

Williams Honors College, Honors Research Projects

Abstract

PURPOSE: Sustaining long-term motivation for exercise remains a challenge within health and fitness, particularly when extrinsic factors like weight loss dominate motivational strategies. This study investigates the role of behavioral SMART (Specific, Measurable, Achievable, Relevant, Time-bound) goal-setting in fostering intrinsic motivation, a self-driven form of engagement, among participants in a structured fitness program. The primary aim was to evaluate the effectiveness of a SMART goal-setting curriculum in promoting intrinsic motivation and behavior-based goals over external outcomes like losing weight. METHODS: Participants (N = 24) were recruited from a fitness challenge program and selected one behavioral SMART goal from a …

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

Improving Food Security To Decrease Hypertension At An Urban Community Clinic, Christine S. Villalta

Master's Projects and Capstones

Diet and lifestyle changes have been proven to reduce blood pressure in patients with hypertension, and a key dietary approach aligned with this recommendation is the DASH diet, which includes consuming fruits and vegetables. Food insecurity, defined as lacking enough safe, nutritious food to maintain an active and healthy life, is a growing crisis in the United States, affecting 13.5% of U.S. households in 2023. This is especially significant for those whose chronic disease management depends on the accessibility of healthy food. An urban community clinic implemented a Food Security Program to decrease food insecurity and reduce hypertension among their …

Improving Health Equity: Integrating Mental Health Services Into Mobile Health Clinics For Unhoused And Low-Income Populations In The United States, Tiffany Lynn Wong

Master's Projects and Capstones

Mental health disparities among homeless and low-income populations in the United States highlight significant challenges in access and quality of care. This literature review explores the integration of mental health services into Mobile Health Clinics (MHCs) as a promising recommendation to address these disparities. I used various search engines, extracting 10 articles published from 2013 to 2023 focused on the U.S. MHCs show its effectiveness in improving healthcare access and quality of care, covering different services like mammography, reproductive health, COVID-19 testing, and diabetes care. Building on these successful models, this paper proposes extending MHCs to include mental health screenings, …

Understanding And Intervening In Children's Tick Risk Perceptions And Protective Behaviors: A Grounded Theory, Ariel Dawdy

Department of Entomology: Dissertations, Theses, and Student Research

Children, ages 8 years and younger, are at a particularly high risk of contracting a tick-borne disease. This is partially due to the misconceptions spread about tick protective behavior and a poor understanding of how antibiotic treatment can help. Because most communities and families believe that tick control is the individual’s responsibility, looking at the interaction between ticks and human children is essential to understanding the individual’s motivations to protect themselves. To help alleviate the number of individuals contracting tick-borne diseases, misconceptions must be addressed, intervention programs implemented, and a behavioral change must occur. This study used a qualitative research …

Obesity: Influencing Behavioral Consumption Through Meal Kit Distribution, Alejandro Hernandez

Capstone Projects and Master's Theses

Founded in 2002, Everyone’s Harvest is a grassroots nonprofit dedicated to providing access to healthy, affordable fruits and vegetables through certified farmers markets and community food programs. Its key initiatives—Fresh Rx, Market Match, Edible Education and Farms Together —focus on alleviating nutrition insecurity and combating diet-related health conditions by providing vulnerable populations the resources to purchase, or receive, fresh produce and gain nutritional knowledge. This study explores a new intervention: the distribution of farmers' market meal kits as a complementary strategy to the current Edible Education program. These meal kits, which feature seasonally available produce and pre-measured ingredients, aim to …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

A Pilot Randomized Clinical Trial Of A Smartphone-Based Application To Support At-Home Psa Screening And Culturally Tailored Prostate Cancer Education For African American Men: A Study Protocol, Jordan Neil, Bingjing Mao, Ruosi Shao, E. Ogunsanya Motolani, Summer Frank-Pearce, Michael Businelle, Michael Cookson, Kelly Stratton, Mark Doescher, Stephanie Pharr, Valerie Moise, Brianna Fleshman, Jack Fronheiser, Kimberly Estrada, Iván Flores, David Bradley, Ashley Kendrick, Adam C. Alexander

School of Public Health Faculty Publications

Background: Prostate cancer is the most diagnosed cancer in Black/African American men (AA) and the second‑leading cause of cancer-related deaths. A prostate-specific antigen (PSA) blood test is an early detection screening tool for prostate cancer, but uptake of PSA screening remains low among AA men. Greater PSA screening rates among AA men, coupled with earlier treatment, may reduce disparities in prostate cancer outcomes, including mortality. The current pilot study will test the first-of-its-kind mobile health (mHealth) app to improve prostate cancer knowledge and increase PSA screening uptake among AA men using home-based screening methods. Methods: AA men aged 55 to …

Successful Application Of Craniosacral Therapy In A Case Of Colic In An 8-Week-Old Baby, Caro O’Neill, Angie Butterfield

Journal of Transformative Touch

This case study reports on the effectiveness of CranioSacral Therapy (CST) for an eight-week-old baby boy experiencing colic. A CST pediatric protocol was utilized during two sessions, a week apart, in May 2023. An improvement in symptoms was recorded after the first treatment. After the second treatment the baby was no longer presenting with symptoms related to infant colic. This case suggests that CST can be an effective support for babies experiencing infant colic.

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Expanding Healthcare Access For The Undocumented Immigrant Community: The Heal For Immigrant Families Act Of 2023, Perla Torres Estrada

The Gettysburg Journal for Public Policy

When it comes to the topic of universal healthcare, most of us will readily agree that healthcare is a human right. Where this agreement usually ends, however, is on the question of who should be granted this right, and if it should be left to the free market to determine access and affordability. Specifically, the political debate on expanding healthcare access to undocumented immigrants in the United States revolve around concerns over costs, legality, and equity. Proponents maintain that it is a human right whereas opponents question the potential burden on taxpayers and the implication for immigration policy. The HEAL …

Framing The Path To Fitness: Age Differences In Response To Framed Exercise Messages, Iliya Sherif, David B. Taullahu, Alyssa R. Minton, Joseph A. Mikels

DePaul Discoveries

Physical activity is one of the most protective health behaviors one can engage in, yet 75% of active adults in the US, meaning those who exercise regularly, fall short of the recommended levels of physical activity, with an even greater percentage of older adults living inactive lives, meaning they exercise minimally and engage in prolonged sedentary behavior (CDC, 2019). The goal of the current study was to explore different types of message framing targeted at encouraging older and younger adults to exercise. We recruited older adults (n = 184; Mage = 69.45 years, age range: 65- 80 years) and younger …

Understanding Organ Donation Messaging: A Qualitative Inquiry, Rebecca K. Britt, Amy A. Ritchart

The Qualitative Report

Promoting health communication about organ donation remains a crucial objective within Native American communities. The goals of the current study were to communicate with young adult Native Americans about the Organ Donation Willingness Model (ODWM; Horton & Horton, 1991) to gain their responses to materials from campaigns about donation strategies tailored to Native American communities. Six focus groups were conducted with a total of 31 participants. Data were analyzed using thematic analysis (Braun & Clarke, 2019, 2022) and following Smith’s guidelines (2008), which include showing deep respect for the group participants, conducting the study in a face-to-face setting, and being …

Indo-Caribbean Youth And Suicidal Behavior: A Systematic Review, Raul Ruiz Camacho, Shiryn D. Sukhram

Publications and Research

The suicide rates in Guyana, Suriname and Trinidad and Tobago are among the highest in the Americas, containing significant Indo-Caribbean populations that are suggested to be most vulnerable to suicide. This systematic review analyzes the existing literature and identifies knowledge gaps in risk and protective factors against suicide in these countries. The literature search conducted followed PRISMA guidelines using the PubMed and APA PsycInfo databases. The PRISMA flow diagram illustrated that eight scholarly papers were eligible for inclusion. Included literature examined stratified data focused on the aforementioned countries, as well as their Indo-Caribbean adolescent populations. Excluded literature did not mention …

Successful Application Of Craniosacral Therapy In A Case Of Acute Ptosis Following A Covid-19 Infection., Efterpi Rompoti

Journal of Transformative Touch

This case study offers a unique insight on the effectiveness of CranioSacral therapy (CST) in a 49 year old woman experiencing an acute stage of a viral infection (Covid-19) causing a partial left Oculomotor nerve palsy. A CST glial/Cerebrospinal Fluid (CSF) specific protocol was utilised over 2 consecutive days. The patient recovered fully after 5 days. The results of this particular case can open up the possibility of utilising CST more widely in treating cranial nerve palsies following a viral infection to support the healing process and the functional restoration.

Cardiovascular Disease Risk Reduction Program For Hispanics In The Us Midwest: A Culturally Adapted Intervention, Armando De Alba

Theses & Dissertations

Cardiovascular disease (CVD) represents the second leading cause of death in Nebraska (NE), accounting for approximately one in every five deaths. In the state, there are marked ethnic and rural-urban disparities in the prevalence of chronic diseases and resultant deaths. For instance, while the rates in NE of coronary heart disease and myocardial infarction between 2001 and 2010 decreased among non-Hispanic Whites, the rates for Hispanics almost tripled. There is little evidence of CVD risk factor reduction strategies being implemented in Midwestern areas and Hispanic populations.

One promising approach for reducing CVD risk involves health education and lifestyle modification programs …

Unveiling The Impact: Structural Racism And Childhood Lead Exposure's Health Consequences In Philadelphia, Mahhum Naqvi, Mahrukh Naqvi, Justin Stout, Colton Spencer

Rowan-Virtua Research Day

Childhood lead exposure poses a significant risk to health and well-being, adversely affecting brain function, nervous system development, and behavioral patterns. This study examines the health disparities and inequities associated with childhood lead exposure in Philadelphia, focusing on structural racism and residential segregation as crucial lenses for analysis. By delving into the sociocultural context of lead exposure, this study underscores the imperative of collaborative efforts among stakeholders to safeguard Philadelphia's most vulnerable populations. Healthcare professionals and policymakers play pivotal roles in enhancing funding and prevention strategies. Addressing this issue through the prism of structural racism allows for the identification and …

Reimaging Safety After Sexual Violence: A Qualitative Exploration Of Survivors' Experiences With Formal And Informal Crisis Response Networks., Hallie Ruth Decker

Electronic Theses and Dissertations

Sexual violence (SV) is a highly prevalent public health and human rights concern impacting communities across the United States. SV is associated with a myriad of adverse physical, reproductive, sexual, mental, behavioral, financial, and social health outcomes which may be acute or chronic. Health challenges associated with post-traumatic stress and post-traumatic stress disorder are particularly common among victims and survivors of SV. Engagement in early psychological/psychosocial intervention strategies may prevent or reduce PTSD-related symptomatology after experiencing an SV encounter. Despite the availability of crisis response and support options to support individuals who have experienced SV, significant barriers exist across social …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Family Medicine’S Role In Addressing The Intersections Of Redlining And Climate Change, Daryl O. Traylor, Eboni E. Anderson, Brianna Clark, Alex M. Smith, Cooper K. Allenbrand

Journal of Sustainable Social Impact

Redlining, the practice of discriminating against specific neighborhoods based on race and socioeconomic status, leads to persistent environmental hazards and socioeconomic inequalities that have lasting adverse health effects on their populations. Health disparities are further exacerbated through the concentration of environmental hazards, as well as the escalating impact of climate change, which poses an increased risk of respiratory illness, cardiovascular disease, mental health issues, heat-related illness, infectious diseases, food insecurity, and socioeconomic difficulties in redline neighborhoods.

This paper examines the interplay of redlining, climate change, and health disparities, with an emphasis on the enduring consequences for these marginalized communities. Through …

An Ot Needs Assessment For Children And Families Residing In Shelters, Jessie Siono, Susan Macdermott

Spring 2024 Virtual OTD Capstone Symposium

This study created a needs assessment is to determine the unique occupational deficits of children and their families in California experiencing homelessness within a shelter setting via recording their lived experiences. A local family shelter was analyzed via observation and interviews with staff and residents of the shelter. The results were compiled into a facility assessment to identify supports and barriers to occupation. Results were also utilized to complete an occupational needs assessment for families and children living in homeless shelters. The study determined the occupational needs and occurrences of occupational deficits that were experienced by residents of the family …

Knowledge And Implementation Of Tobacco Control Practices In Rural Louisiana Community Health Centers, Michael D. Celestin Jr, Ty-Runet Bryant, Tung Sung Tseng, Krysten Jones-Winn, Qingzhao Yu

School of Public Health Faculty Publications

Association for Clinical and Translational Science 2024; April 3 - April 5, 2024; Las Vegas, NV

Clinical Pathway Using Arabic Written Medical Information To Improve Incontinence Healthcare Utilization, John F. Knapp, Codrut Radoiu, Emma Ross, Jack Vercnocke Md, Aron Liaw Md, Nivedita Dhar

Medical Student Research Symposium

Introduction and Objective: Metro Detroit holds ~13% of all Arabic speakers in the U.S.A. and 91% of those in Michigan. Evidence supports that patients who do not speak the local language have poor access to healthcare. This study describes our preliminary experience of managing Arabic only speaking women with bothersome stress urinary incontinence (SUI) from May 2022 to October 2023. These women routinely request same-sex interpreters, which is not always possible, leading to a lack of detailed translation. A potential solution is to use Arabic written medical information (AWMI). The purpose of the study was to retrospectively look at the …

It Takes A Village To Raise A Grandchild: Developing Communities Of Support For Grand-Families On Pei, Canada, Christina Murray, Laura Bain, Nora Spinks, Donald Avery

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

In this practice brief, we outline our research focused on grandparents raising grandchildren in Prince Edward Island (PEI), Canada. Specifically, we highlight a series of collaborative community workshops implemented as part of our research project. Using a participatory action research approach, we worked with grandparents raising grandchildren to co-design and implement the workshops, which we titled It Takes a Village to Raise a Grandchild. These workshops brought together grandparents raising grandchildren and key community members, including clergy, educators, healthcare providers, politicians, social services, child services, and researchers. The goal of these workshops was to build awareness and increase understanding …

A Case Study To Investigate Factors Influencing The Santa Clara County Getting To Zero Initiative’S Collective Impact Model, Harit Agroia, Rebecca Reno, Jenette Spezeski, Leyla Mousli, Richard Sarabia, Erin Starzyk

Journal of Social, Behavioral, and Health Sciences

Our objective was to explore how factors, such as backbone organization changes and COVID-19, affected a collective impact (CI) initiative’s progression through the five CI phases and its components of success. We conducted a case study using semistructured interviews with 17 representatives from the action committee, community-based organization, and health department between January and February 2023 in Santa Clara County, California. Participants were asked how internal and external factors affected their engagement and experiences with the CI initiative. We analyzed the data using structural and holistic coding. Results showed that the initiative’s progression was impacted by intersecting factors; overall findings …

The Education Prescription: Exploring The Potential Of Patient Education To Reduce Mental Health Issues In Hormonal Contraceptive Users, Maria Abraham

Nursing | Senior Theses

The many birth control options available impact a woman’s life, as hormonal contraceptives are commonly used but often misunderstood. These contraceptives, which contain progestin only, or estrogen and progestin combined, can come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches. They offer benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they may lead to adverse side effects which can include increased blood pressure, nausea, headaches, breakthrough bleeding, and a higher risk of blood clots, with research indicating a potential link between oral contraceptive use and a decline in the user’s …

Role Of Social Determinants Of Health And The Renin- Angiotensin Aldosterone System In Risk For Hypertensive Disorders Of Pregnancy And Related Adverse Outcomes., Esther Letushila Ndashaala

Theses and Dissertations--Nutrition and Food Systems

Background: Hypertensive disorders of pregnancy (HDP) represent a significant public health issue, contributing to maternal and fetal morbidity and mortality. Women from lower socioeconomic backgrounds or marginalized racial and ethnic groups face higher risks of HDP, which have been incompletely described. In addition, risk for HDP may be linked to a reduction in the normal activity of the renin-angiotensin-aldosterone system (RAAS). This study investigates the role of socioeconomic factors and RAAS components in the risk for HDP and adverse maternal and neonatal outcomes. Methods: This study is a secondary analysis of data from 180 pregnant individuals from a high-risk maternal-fetal …