Impact Of Traditional (Non-Affirming) Black Church Affiliation On Exploration Of Sexual Identity For Black Assigned Female At Birth Lgbq+ Individuals And The Associated Mental Health Risk, Aurielle J. Sutton

Doctoral Dissertations

This dissertation explored the impact of Black traditional church upbringing on the sexual and religious identity development, including the subsequent mental health risk, for Black assigned female at birth (AFAB) LGBQ+ individuals. Studies conducted on Black AFAB LGBQ+ individuals are limited, especially in terms of  assessing their experiences in sexual identity development based on religious upbringings. Studies have overlooked the experience of LGBQ+ Black AFAB individuals navigating sexual orientation development and religious and racial identities. Studies have greatly favored Black gay men and supported health risks such as HIV. In the present study, twelve Black AFAB Queer individuals participated in …

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 …

A Qualitative Exploration Of How Spanish-Speaking Latino Parents Communicate With Their Adolescent Children About Substance Use, Diana Karina Diaz

Doctoral Dissertations

Substance use during adolescence remains a significant public health concern, particularly within Latino communities where cultural values, family dynamics, and communication patterns play a central role in youth development. This qualitative study explored how Latino parents communicate with their adolescent children about substance use, the strategies they use for prevention, and the cultural and contextual factors that shape these conversations. Using a focus group design, data was collected from four focus groups consisting of two groups of Latino mothers (n = 10) and two groups of Latino fathers (n = 9). A thematic analysis revealed six primary themes: (1) parent–child …

Mental Health And Substance Use Interventions Within Muslim Community Spaces: A Community Based-Participatory Research Proposal, Halah Mansour Alayleh

Master's Projects and Capstones

Background. Muslim Americans face significant mental health and substance use challenges compounded by Islamophobic discrimination, cultural stigma, and barriers to accessing culturally competent services. They also significantly underuse professional mental health services. Purpose. This study aims to collaborate with Muslim communities within the San Francisco Bay Area to develop a replicable intervention framework for addressing mental health and substance use stigma within mosques and other Muslim community spaces. Methods. The proposal uses a community-based participatory research (CBPR) methodology while integrating the theory of planned behavior (TPB) and stigma theory in the framework. This proposal outlines the four phases of intervention …

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 …

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, …

Supporting South Korea’S Aging Population: How Ai And Iot Acceptance Connects The Young And Old, Bobby Im

Master's Projects and Capstones

In 2024, South Korea surpassed every other nation by becoming the country with the lowest fertility rate (below 0.7%). Population decline will hinder future ability to care for their aging population and although the government and private corporations are investing millions of dollars on developing Artificial Intelligence-Internet of Things (AI-IoT) devices to support the aging, the acceptance levels and the amount of family support required is undervalued. By examining AI-IoT’s current use and role in South Korea’s public health system this paper shows how intergenerational support helps optimize existing procedures and equipment, increases the level of acceptance and use, and …

The Impact Of High Temperatures On Child Anthropometric Outcomes Worldwide, Natalia A. Cancino Garcia

Master's Theses

High temperatures caused by climate change significantly impact society, including child nutrition. Our research focuses on the impact of high temperatures on the anthropometric outcomes of children aged 1 to 5 in 54 countries worldwide. We analyze the historical climate and anthropometric data to evaluate the effect of high temperature on weight-for-age (WAZ) and weight-for-height (WHZ) in children. Results indicate that high temperatures negatively affect child nutrition, particularly in areas above 20°C, and children in rural areas are more vulnerable. The impact of monthly temperature on child anthropometric outcomes varies across countries, regions, and cultural practices. Economic status alone is …

Community Health Worker Program: Chronic Non-Communicable Diseases In Children, Julia L. Newell

DNP Qualifying Manuscripts

Abstract

Background: Childhood obesity, asthma, and untreated mental health conditions, are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Community health workers (CHWs) are in a unique position to address these negative health externalities by leveraging linguistic, cultural, and socioemotional connectedness within their communities.

Local Problem: Minority children in the Central Valley of California, face additional risk factors for the development of CNDs. CHWs working in this area require enhanced training on CNDs to improve their practice.

Methods: In partnership with Save the Children (STC), the University of San Francisco (USF) …

Meet Me In The Middle: A Scoping Review On Understanding Adolescent Needs In Climate Communication, Gwendolyn Monica Hoff Anderson

Master's Projects and Capstones

The greatest effects of climate change are likely to be felt by youth. Young people are disproportionately affected by climate change due to their critical developmental stage and lack of power, and they experience both higher severity and prevalence of mental health issues related to climate change. Strong emotions have long been recognized as potential catalysts for action, or they may lead to paralyzing feelings of being overwhelmed. Climate communication is a critical tool to spark climate concern and encourage action. Activism, in turn, may help youth manage their anxiety about climate change. This scoping review examines emerging evidence on …

Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb

Master's Projects and Capstones

In a world that demands the constant requirement of adaptability and technology, the need for ‘hands on the ground’ continues to persist, and perhaps even grow. This research project explores burnout in the healthcare and nonprofit settings, as a pre-existing and ongoing issue, that was brought to centre-stage during the Covid-19 pandemic. The researcher explores the intersections of burnout with workplace culture, person-centered care (PCC), sweat equity and duty-of-care, through expert interviews and literature reviews. Data collected provides an immediate understanding of current workplace cultures and environments for human service providers, in both healthcare and nonprofit sectors. While the data …

Therapeutic Gardening For Mental Health In Substance Use Recovery, Stephanie E. Schafer

Master's Projects and Capstones

Abstract

As the clinical nurse leader (CNL) in this project, I used the “[CNL]

Essential 1: Background for Practice from Sciences and Humanities” (Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice, 2013) and its competencies to focus on designing nursing care for a clinical or community-focused population based on biopsychosocial, public health, nursing, and organizational sciences and to synthesize evidence for practice to determine appropriate application of interventions across diverse populations. With the help of the CNL competencies and collaboration with the healthcare team, we created and implemented a therapeutic garden for residents in a substance use …

Mental Health Navigators Bridging The Gap Of Care, Valentina Loreto-Ashley

DNP Qualifying Manuscripts

Individuals with schizophrenia are most vulnerable at time of discharge due to risk factors that lead to relapse, re-admission, suicide and/or danger to others. A successful discharge process can decrease overall care costs, promotes team collaboration, supports the therapeutic relationship between client and care provider, and helps the client to reach autonomy and self-efficacy. This DNP is a quality improvement project that aims at educating Mental Health Navigators about symptoms of schizophrenia, medications management, and community resources. Effectiveness of the educational intervention will be assessed as the differences between the pre- and post-test assessment score on insight or lack of …

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 …

Implementation Of Community Health Workers To Improve Birth Outcomes, Emiko Maruri, Trinette Radasa, Jo Loomis

DNP Qualifying Manuscripts

Those who have ever been affected by an adverse childhood experience (ACE) have a greater likelihood of having poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss. Black and Latina women have been identified by the Center’s for Disease Control (CDC) as those most affected by ACEs. The direct relationship is that Black and Latinas therefore have poor birth outcomes. With the implementation of nurse trained Community Health Workers (CHWs), the impacts within the community includes decreasing health care costs, adopting healthier choices for mother and child, and providing support and …

Weathering The Storm: Is California’S Anti-Harassment Education Training The Life Preserver Lgbtq Youth Have Been Hoping For?, Natalie Purcell O'Dwyer

University of San Francisco Law Review

No abstract provided.

Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …

California's Master Plan For Aging, Health Reimagined: A Case For Seniors To Age-In-Place, Remonia A. Bowie

Master's Projects and Capstones

Abstract

In 2021 Worldwide, communities face a singular yet common challenge; and this is the significant aging of their senior adult populations. Current evidence from the literature suggests that older adults prefer to stay in their homes as they age. However, the facilitators and challenges older people encounter in realizing their aging goals have been inadequately addressed by the current body of literature given the projected increase in the number of older people in the United States preferring to age from their homes. Aging adults are vulnerable to daily frustration, which could negatively impact their aging process. However, knowledge of …

The Importance Of Nutrition Education As A Recovery Component For Individuals With Severe Mental Illnesses, Emily Martinez

Master's Projects and Capstones

In efforts to challenge the Western medicine’s determination of nutrition as a holistic approach, this paper represents the intent for mental health facilities in California to improve or implement nutrition education curriculum by enhancing interprofessional teams with dietitians as an important component of recovery for severe mental illness patients. There is concrete evidence proving that individuals who are in facilities recovering from mental illnesses have benefited from optimal nutrition consumption. Nutrition education has become a component among the toolbox of recovery options, but unfortunately it is not encouraged enough. Pharmaceutical companies advertise drug therapy as the most effective way to …

Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek

DNP Qualifying Manuscripts

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.

Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …

Offering Medical Providers Capacity And Competence In Caring For Transgender And Non-Binary Patients: Evaluation Of A Pilot Digital Training Program, Lexis Manzara

Master's Projects and Capstones

Purpose: Stigma and discrimination in health care settings contribute to health disparities for transgender and non-binary (TGNB) people. Evidence suggests that a lack of training on the care for transgender and non-binary TGNB patients in medical school curricula has contributed to providers feeling unprepared to provide quality care for this population. Health care providers have the opportunity to play a key role in the reduction of health disparities for TGNB patients.

Methods: Twenty-five health care providers completed the eight-module digital training program. Pre- and post-tests assessed provider knowledge, self-efficacy, preparedness, and behavior. Paired samples t-tests were conducted to compare pre-and …

Evaluating The Effectiveness Of Peer Engagement And Knowledge (Peak): A Community-Based Group Intervention For Youth In Hawai‘I, Jennifer T. T. Ho

Doctoral Dissertations

This study is a program evaluation with a mixed methods design that evaluated the effectiveness of Peer Engagement and Knowledge (PEAK), a six-week community-based group intervention that incorporates mindfulness-based interventions (MBIs) to address multiple health behaviors for multiracial youth in Hilo, Hawai‘i. A total of 51 youth, ages 12-23 years old, participated in this study which included pre-/posttest analyses of health risk factors such as substance use and depression and health promoting factors such as resilience, self-esteem, and mindfulness. Responses from two subsets of participants, who engaged in a focus group (n = 11) and composed gratitude letters ( …

Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott

Doctoral Dissertations

Historically, patients with dual diagnosis have been subjected to ineffective treatment and negative attitudes from healthcare providers. Further, these patients are plagued with myriad afflictions that exist beyond substance abuse and mental illness. The treatments and collateral damage associated with the diagnosis impose excessive healthcare costs and can be of significant detriment to society. Largely, patients suffering from dual diagnosis do not receive adequate treatment. As such, psychiatric emergency services are frequently utilized as an alternate treatment, wherein the main focus of care is on the substance abuse alone. This study argues that solely treating the substance abuse is not …

Finding The Narrative In Incident Reports, La'eeqa Aslam

Master's Projects and Capstones

The Progress Foundation, as licensed by the state of California and the Community Care Licensing, is required to use incident reports for internal audits and remain in compliance as a health facility. Incident reports are used to record events or accidents that have occurred within an organization. Often times, reports are made, handed off, and given from the residence home to the Community Care Licensing with little to no information of how an incident was managed. The Progress Foundation is working towards tracking information from the incident reports to improve internal management and understand the trends in the reports.

In …

In Home Support For All: A Community Outreach Project, Lily Moll

Master's Projects and Capstones

Abstract

In Home Supportive Services Public Authority (IHSSPA) is a Medi-Cal funded organization that helps the elderly and disabled living in San Francisco find care and support at home. The Public Authority component of IHSS specializes in providing support to their clients or “consumers” when attempting to hire home care workers or “providers.” However, IHSSPA services remain relatively unknown throughout many communities in San Francisco county and there is a need for increased community outreach. To address this problem, communities that are currently underserved by IHSSPA were defined by their zip code. These communities were compared with data indicating which …

Grounding Frequent Flyers: Understanding High Er Utilization And Developing Primary Care Solutions, Jillian Millares

Master's Projects and Capstones

Background: Regular access to primary care can positively impact long-term, chronic conditions. However, medically underserved individuals, particularly individuals with Severe Mental Illnesses(SMI), typically underutilize primary care. Root causes include client level factors such as socioeconomic barriers, provider level issues such as lack of training or general knowledge of SMI issues, and system level factors such as a lack of coordinated services. Methods: The present study conducted a needs assessment to identify the most influential of these factors on clients at an Acute Residential Treatment Center in San Francisco, California. The needs assessment consisted of semi-structured client and staff interviews. Results: …

A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez

Doctoral Dissertations

The current study is a program evaluation at John Muir Behavioral Health, Center for Recovery. The research determined the effectiveness of the program at Center for Recovery that is offered to patients that struggle with substance use disorder and their families. The purpose of this study is to assess patients’ behavioral, cognitive and social/environmental factors as it relates to their commitment to sobriety and examine how the involvement of family members influences the patient’s recovery process. I utilized a mixed methodology of quantitative and qualitative interviews of patients and family members. The findings suggest depressive symptoms were negatively correlated with …

On-The-Spot Mindfulness Based Practices For Addressing Behavior Challenges Among 3rd Graders, Christina Francis

Master's Projects and Capstones

Purpose: The purpose of this project was to introduce and implement a mindfulness based tool that will empower students to manage their stress which contributes to their classroom behavior and allow teachers to minimize the amount of classroom time spent addressing behavior challenges.

Methods: Observations of third grade classrooms, key informant interviews with third grade teachers and community observations were conducted at the Achieve Academy School while throughout the school day.

Results: Findings showed that students would benefit from the implementation of On-The-Spot Mindfulness Based Techniques and Practices by minimizing stress, increasing academic success and improving the overall behavior, …