Community Health Commons^™

“When I’M Not Heard, I Feel Like I Don’T Matter”: Advancing Equity In Disability Policy Through Critical Participatory Action Research With People With Intellectual Disability, Cris Marchionne

Student Theses

People with intellectual disability deserve a system that offers flexible, timely, and person-centered support — one that is innovative, sustainable, and holistic in enabling them to live fulfilling lives. This qualitative study, grounded in Critical Participatory Action Research (CPAR), examines how people with intellectual disability experience participation in decision-making within New York State's disability service system. By centering lived experience, the study identifies factors that facilitate or hinder participation in decision-making and examines structural, social, and policy-related barriers that limit agency. Through six focus groups and a Photovoice project with self-advocates receiving OPWDD services, participants described systemic barriers that limited …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Diverse Families Navigating Mental Health At The Pediatrician’S Office: A Mixed Methods Exploration Of The Interplay Of Stress, Culture, And Child Mental Health In The Primary Care Setting, Sara B. Budowsky

Dissertations

Low-income and ethnic minority youth experience high psychiatric need but persistently low participation in traditional mental health care. General pediatricians are often the first and only healthcare providers with whom many families engage around their child’s emotional and behavioral development. Using both quantitative analysis of retrospective secondary data and Interpretative Phenomenological Analysis (IPA) of in-depth interviews with diverse caregivers, this project explored influencers of child mental health and family utilization of pediatric primary-care-based mental health services in the context of a uniquely multicultural clinic serving a predominantly Medicaid population. Three key findings include: 1) Caregiver Stress was a highly significant, …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Barriers And Bridges: Exploring Factors That Shape Mental Health Service Utilization In Rural America, Margaret Wiwuga

Educational Specialist, 2020-current

Despite disproportionately higher suicide mortality rates and comparable prevalence of mental illness across urban and rural communities in the United States, rural populations across the nation experience significantly lower access to and utilization of mental health services, naturally leading to worse comprehensive outcomes. This literature review examines multifaceted factors shaping mental health service use in rural America, taking note of both barrier and enabling factors that impede or enable these unique populations’ willingness and ability to access and use mental health services. Ten articles published prior to September 9, 2025, were selected from the James Madison University Libraries’ Psychology and …

Aging With Mercy, Thriving In Place, Emma Layne Katzman, Karen Weis, Jennifer Rugletic Washko

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

Occupational engagement, spirituality, and quality of life are recognized as important dimensions of aging, however, these factors remain underexplored among older adults residing within faith-based communal living environments. This doctoral capstone experience, Aging with Mercy, Thriving in Place, consisted of two distinct but complementary components: an Institutional Review Board (IRB)-approved mixed methods research study and a quality improvement initiative. The purpose of the research study was to explore occupational engagement, occupational role transitions, spirituality, identity, and perceived quality of life among older adults residing within a faith-based communal living environment. Quantitative data were collected using the World Health Organization Quality …

Introducing Neuro Sscial Work: A Brief Reflection On Neuroscience And The Profession, Priscila Llamosa

Social Work Faculty Publications

This reflection introduces and contextualizes the term Neuro Social Work, which I coin to name a specialized practice area at the intersection of social work, neuroscience, and neurodiversity. Drawing on my experience as a social work educator and practitioner, I discuss social work’s uneasy relationship with neuroscience, marked both by the opportunity to deepen our understanding of trauma, development, and healing, and by the risks of using brain‑based evidence to individualize structural harms or justify surveillance of marginalized communities. I outline, in broad strokes, what distinguishes Neuro Social Work from general neuroscience‑informed practice. The note is intended as a concept …

Addressing Psychosocial Barriers To Participation In People Experiencing Homelessness: An Occupational Therapy Workshop, Preston Bender, Steven M. Gerardi, Lacey Spark

Summer 2025 OTD Capstone Symposium

Despite the occupational therapy (OT) profession's emphasis on holistic, person-centered care, many OT practitioners and students report feeling a lack of self-efficacy and preparedness to navigate the complex psychological, social, and systemic barriers that hinder occupational participation in people experiencing homelessness (PEH). This capstone project aimed to address the perceived unpreparedness among clinicians through the creation of an 8-hour interactive educational workshop aligned with Experiential Learning Theory. The content is grounded in the Model of Human Occupation (MOHO) and informed by the Bridging the Transition from Homelessness: A Social Justice Framework (BTTF), trauma-informed care (TIC), harm reduction, and diversity, equity, …

Enhancing Client Intake Efficiency In The Removal Defense Program: A Nursing-Led Quality Improvement Initiative, Johnny Linares, Julia Tran Ngo, Daniel Orea, Atheana Yadira Lopez

Master's Projects and Capstones

This quality improvement project focuses on optimizing the intake process for the Removal Defense Program at a nonprofit immigration legal office serving asylum-seeking clients. The existing intake relied on unstructured, phone-call-based intake interviews that gathered incomplete information, leading to inconsistent documentation, reduced efficiency, and significant client processing delays. A structured, multilingual, and multiplatform new-client admission protocol coupled with the implementation of a client-facing resource guide for waitlist clients were co-developed and implemented using the Lippitt Change Theory framework. Utilizing a mixed methods approach, the study involved staff interviews and observational assessments with staff members from the program. Baseline intake process …

Resonant Disruptions: Understanding Canadian Nurses’ Practice With Youth Survivors Of Sexual Exploitation, Danielle E. Giebelhaus, Andrew Estefan Phd, Rpn

Dignity: A Journal of Analysis of Exploitation and Violence

The sexual exploitation of youth is a global concern. Youth survivors of sexual exploitation present to and require healthcare services, but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this article, we report on a qualitative, hermeneutic study undertaken to explore nursing practice with youth survivors of sexual exploitation. Hermeneutics is concerned with understanding, and is a helpful way to conduct research when little is known about a topic. In this study, we asked the research question, “How might we …

Living Heritage, Resilience And Ethically Informed Infrastructures In Malawi, Martha B. Lerski, Frank Puluputu Mwale

Publications and Research

Rooted in a rural community’s needs, this paper explores how historically, and ethically informed infrastructures can support community engagement towards identification, documentation, and dissemination of local, traditional, and indigenous knowledge relating to climate change. The paper examines climate adaptation and sustainability issues through the lenses of community organizing and Library & Information Science best practices. It draws on a growing body of literature identifying a role for expanded epistemological and subject discipline perspectives. While the impacts of climate on material culture are increasingly recognized, intangible, and biocultural heritage have not received as much attention. Living heritage traditions and knowledge systems …

Arts-Based Sustainability: From New York To Malawi, Martha B. Lerski

Publications and Research

Recognizing that libraries serve multiple constituencies and subject areas, this chapter documents and advocates for development of transdisciplinary arts-based research (ABR) and culture-related projects linked to environmental challenges. Libraries contribute collections and spaces, as well as the research of library and information scientists. Libraries are currently among invisible contributors to sustainability planning and services. The chapter will link this invisibility to the value of what visual arts refer to as negative space elements in subjects ranging from traditional ecological knowledge to environmental science. Library collections, projects, and research contribute to education for sustainable development (ESD) as required to achieve the …

Intersecting Inequities: Latinx Access To Mental Health Services, Melissa Thorson

Dissertations

This study examined barriers to mental health service utilization among Latinx populations using data from the 2022 National Survey on Drug Use and Health (NSDUH). Through the theoretical frameworks of Minority Stress Theory and Toxic Stress Theory, the study investigated the relationships between age, language proficiency, socioeconomic status, and mental health service access among different Latinx subgroups. Statistical analyses included chi-square tests, multiple regression, and mediation analyses on a sample of Latinx adults (N = 9,852). Results indicated associations between age and English proficiency (χ² = 145.23, p < .001, Cramer's V = 0.38), with 45% of adults aged 50 and older reporting limited English proficiency. Socioeconomic analysis revealed that 32% of older Latinx adults reported family incomes below $20,000, with insurance status partially mediating the relationship between income and service utilization (indirect effect = 0.15, 95% CI [0.08, 0.23]). differences in utilization rates emerged among Latinx subgroups (F(6, 1243) = 8.76, p < .001, η² = 0.12), with Mexican-origin individuals showing higher utilization (10%) compared to Puerto Rican individuals (2-3%). Age and socioeconomic status demonstrated interaction effects (β = 0.18, p < .01), while language proficiency moderated the relationship between age and service utilization (β = 0.24, p < .001). These findings suggest that barriers to mental health service utilization among Latinx populations are complex and interconnected, requiring multilevel interventions that address linguistic, cultural, and socioeconomic factors simultaneously. Implications for healthcare policy and service delivery are discussed, emphasizing the need for culturally responsive and linguistically appropriate mental health services.

From Industrial Building To Affordable Senior Housing: An Idea Book Beyond Code, Weiyi Ma

Masters Theses

This thesis envisions a proposal to adaptively re-purpose Rhode Island’s extant industrial building stock into affordable housing tailored to the needs of its older and more vulnerable citizens. Architectural dignity, in terms of older citizens amidst this housing crisis, is the creation of living environments that honor their autonomy, comfort, and identity through design interventions that provide accessible, luminous, breathable, and socially enriching spaces, reaffirming their rightful place within the community. With humanistic care and logical rigor, it establishes a mathematical framework for assessment and execution, anchored in five criteria: light, air, space, accessibility, and livability, and presents itself in …

Health Care In Women’S Carceral Spaces, Kate Gouveia Pereira

Culture, Society, and Praxis

Canada has had a long history of mistreating incarcerated women in their jails. The carceral system was built to fit around the needs of men, neglecting to consider the various health issues that only women face. For many years. federally imprisoned women were held in one deteriorated prison, the Prison for Women (P4W), and were held in abhorrent conditions and experienced many acts of violence. Despite the opening of five more prisons and funding for various programs for women, incarcerated women continue to experience violence and health crises, leaving imprisoned women extremely vulnerable to mental and physical distress. In particular, …

Shifting To A Culture Of Inclusion By Design: Applying A Mixed-Methods Approach To Advance Accessibility Of Public Health Emergency Information & Communication Technology, Jessica L. Franks, Erin Vinoski Thomas

Developmental Disabilities Network Journal

Adults with intellectual and developmental disabilities (IDD) experience inequities in access to timely, accurate, and understandable information and communication technology (ICT), which increases risk for public health emergency (PHE)-related health disparities and impedes opportunities to achieve optimal health. This study assessed federal COVID-19 webpage accessibility levels and explored existing knowledge of and experience with filing accessibility complaints for federal ICT among adults with IDD. Through a mixed-methods approach, we evaluated compliance with accessibility standards for 18 federal agencies’ COVID-19 webpages (study 1) and interviewed 16 adults with IDD about experiences accessing federal webpages and filing accessibility complaints (study 2). We …

Food Insecurity In Adolescent Athletes, Andrew Donaldson, Shannon Margherio, Jay Roberson, Kevin Latz

Research Days

Background: The prevalence of food insecurity among children in the United States is estimated at 21%. Food insecurity during childhood leads to worse school performance, more emotional and behavioral health concerns, and increased suicide attempts. Further, food insecurity has been noted to have multiple deleterious effects on the collegiate student athlete, including lower GPA, disordered eating, and substance use.

Hypothesis: Food insecurity is prevalent in the adolescent athlete population and exists across demographics.

Methods: Voluntary surveys were distributed to parents at all sports medicine clinics at our institution. Demographic data was collected including athlete age, race, school and school district, …

Using Expressive Arts Therapy With Autistic Children To Help Regulate And Build Coping Skills: A Literature Review, Swara Swaminathan

Expressive Therapies Theses

This literature review is about whether we can use Expressive Arts Therapy with autistic children to regulate and build coping skills. The author could not find articles that covers the entire topic, but she split the topic in terms of autism in India and various application of Expressive Arts Therapy globally. She was able to find Expressive Arts Therapy or Creative Arts Therapy was helpful to autistic children, or children with trauma. She could also notice the stigma of autism in India in some of the articles.

Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano

Psychology Division Scholarship

Repeated eras of mass incarceration, criminalization of marginalized communities, and substance use policies have created a revolving door of justice involved populations. The ever-increasing prison population has repeatedly become the largest contingency of mental health clientele for an overburdened mental health system. Those who work with formerly incarcerated individuals in the community often don’t know the unique set of challenges faced by practitioners within the system. Increased understanding and coordination of care can offer opportunities for sustained recovery and reduced levels of recidivism. In this presentation participants will learn about the unique insights on mental health treatment that can be …

Hubungan Dukungan Sosial Rekan Kerja Dengan Stres Kerja (Studi Pada Pekerja Di Pt X), Aisyah Permatasari

Jurnal Ilmu Kesejahteraan Sosial

Workers are vulnerable to work-related stress due to job demands, time constraints, and limited leisure time, leading to psychological issues such as anxiety related to their work. In the context of social welfare studies, job stress affects overall workers’ well-being and disrupts their social functioning in the workplace. Social support from coworkers is potentially reduce stress in workplace, which is crucial for creating organizational well-being. It also helps workers improve job engagement, cope with fatigue, and manage stress. This study examined the relationship between social support from coworkers and job stress among 90 employees …

Caring Across Borders: Demographic Shifts And Migrant Care In Asean-Korea Dynamics, Saqib Fardan Ahmada, Wahid Nur Kartiko

Jurnal Ilmu Kesejahteraan Sosial

This article aims to examine the migration policies and migrant care in the context of relations between ASEAN Member States (AMS) and Korea. As Korea is dealing with an aging population, an increase in female labour force participation, and an ultra low fertility rate, caregiving, especially for the elderly, has become a pivotal issue. Besides, the traditional nuclear family structure, which has historically served as the primary caregiver for the elderly, is also losing its prominence. In such demographic shift, migrant care workers from AMS are filling the demand for caregiving in Korea, leading to a cross-border international migration from …

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 …

Adaptation For Whom? Understanding The Impacts Of Dyke Policies On Small-Scale Farmers In Ca Mau Province Of Vietnam, Nguyen Minh Quang, Nguyen Van Minh, Nguyen Vo Chau Ngan, Martha B. Lerski

Publications and Research

Low-lying deltas worldwide are extremely vulnerable to sea-level rise. As the risks of climate-induced flooding become increasingly clear, the thirst for infrastructure-driven adaptation increases. This highlights a patent need to understand the impacts of engineering adaptation solutions, especially those targeting built structures such as dykes and sluices, on farmers from a bottom-up, farmer-centred perspective. The study addresses this call by examining cases where dyke policies, while successful in some dimensions, have undermined small-scale farmer livelihoods in Ca Mau ― Vietnam’s southernmost rural province. It identifies areas in need of attention and adds empirical data related to this group of farmers. …

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 …

Bridging The Gap: Fostering Open Dialogue On Resource Access And Service Needs, Cameron Castillo

Capstone Projects and Master's Theses

This project investigates whether there are additional resources desired by clients or are needed to better support said clients in their recovery at the Interim, Inc. organization. This agency is a nonprofit organization whose sole purpose is to build community connections through providing services to individuals facing mental health and substance use challenges. While there is a wide range of programs available, there may still be clients with unmet needs. The purpose of this project was to identify any service gaps by conducting separate surveys of clients and staff members. Through the use of open-ended questions, the expectation of receiving …

Impacting Community Well-Being Through Effective Engagement Using The Seed Method, Carlin Rafie, Emily B. Zimmerman, Angelina Hargrove, Theodora Biney Amissah, Samantha Lee

Journal of Extension

Cooperative Extension can make a significant impact on health in the United States through effective community engagement that focuses on the complex socio-ecological factors that impact health. The Stakeholder Engagement in Question Development Method (SEED Method) employs community based participatory research principles to engage communities in research, problem-solving, and action planning. Projects employing the SEED Method engage community members from diverse backgrounds, create community capacity, result in tangible outcomes, and foment inter-organizational trust and networking. A SEED Toolkit is available on the Extension Foundation Campus site and provides implementation instructions, tools and timelines, and potential applications within Extension.

Post-Pandemic Needs Of Unpaid Family And Friend Caregivers To Effectively Continue Caregiving Duties In One Northern Ontario Health Authority, Jodi Webber, Erin Mulroney, Mark Tatasciore, Brianna Smith, Patti-Jo Duggan, Louis Ferron, Hannah Albani, Bianca Feitelberg, Laura Tenhagen, Sophia Myles

Patient Experience Journal

The Covid-19 pandemic had a significant impact on the support networks for older adults and caregivers as health and social care systems were forced to dramatically change the ways patients and clients interacted with providers, services, and programs. In Northern Ontario, caregivers are older, caring in more intense situations, more likely to be caring for multiple care recipients simultaneously and less likely to be in contact with health professionals. This research sought to explore the post-pandemic needs of caregivers in a Northern Ontario health catchment to better understand the needed supports. Using a collaborative and co-design approach with caregiver advisors …

Negara Hukum Kesejahteraan Di Batas Pantai: Paradoks Perlindungan Negara Terhadap Masyarakat Pesisir Di Tengah Perubahan Iklim, Aji Baskoro

Jurnal Ilmu Kesejahteraan Sosial

Climate change poses significant challenges to vulnerable coastal communities in Indonesia. As a welfare state, the Indonesian government is expected to safeguard these vulnerable groups through policies that promote their welfare and sustainable livelihoods. However, current policies create a paradox. This article explores this paradox: on the one hand, Indonesia adheres to the welfare state principle, which demands that all government actions be grounded in law, ensuring public safety and welfare. On the other hand, the policies focus on exploiting natural resources, exacerbating the vulnerabilities of coastal communities, particularly in the face of climate change. The article employs a normative …

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 …

Reclaiming Healing Spaces: A Phenomenological Study On The Transformative Power Of Outdoor Therapy From The Lived Experiences Of Black Clinicians Working With Black Clients, Lynn Murphy

Dissertations

This phenomenological study involved assessing the experiences of Black therapists who engaged Black clients in outdoor therapeutic contexts. The study was founded on the existing literature that shows the quality of the therapeutic relationship is pivotal for client retention and the Western standards that have historically favored treatment within indoor environments. To contextualize this research, a comprehensive literature review was commenced, covering topics such as the decolonization of therapy, the historical and present-day relationship between Blacks and the outdoors in the United States, sedentary lifestyles, the psychological benefits of time spent in nature, various types of outdoor therapy, and the …