Public Health and Community Nursing Commons^™

Socioeconomic Influences On Doula Access And Perceived Care Quality Among Black Women Experiencing Severe Maternal Morbidity, Deborah Esene

2026 Spring Honors Capstones Projects

Black women experience disproportionately high rates of maternal morbidity and mortality, making it essential to examine access to and the perceived impact of doula support. This study examines whether socioeconomic status influences access to and the perceived benefits of doula support among Black women who experienced severe maternal morbidity (SMM). Researchers surveyed Black women ages 18-49 who had a live birth within the past two years and experienced SMM. Participants were recruited and completed an online survey in late 2020. Key variables included income, education, doula use, and perceived quality of prenatal, intrapartum, and postpartum care. Among 188 participants, 12.2% …

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

Examining The Barriers To Healthcare Among Native Hawaiian And Pacific Islander Populations Living In Hawaii, Gracie L. Kaye

Honors Undergraduate Theses

The state of Hawaii was annexed by the United States in 1898, and served as a starting point from which the U.S. influenced Hawaii's socioeconomic conditions and healthcare access. The literature review examines healthcare views and outcomes among Native Hawaiian and Pacific Islander residents, utilizing various tools and resources to investigate how these factors have impacted overall health statistics and the reasons behind these trends. Results found that the western colonization of the island and the disease outbreaks led to an initial mistrust of “western ideas.” Additionally, due to long-standing cultural beliefs, there is a natural preference for traditional cultural …

Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

What Is The Evolving Role Of Nurses In Telehealth As Future Healthcare Professionals?, Emma G. Lowry

Honors College Theses

Telehealth has evolved into an essential component of healthcare delivery in today's world, something that occurred alongside the COVID-19 pandemic. As healthcare professionals, nurses must be adequately prepared and equipped to use the tools for telehealth. This paper examines the evolving role of nurses in telehealth by assessing undergraduate nursing students’ and practicing nurses’ knowledge, attitudes, and perceived competencies. Data will be collected through a Qualtrics survey utilizing the Awareness, Knowledge, Attitude, and Skills (AKAS) Scale for Telemedicine, supplemented by interviews with telehealth practitioners to provide qualitative context. It is expected that variations in proficiency and attitudes, from previous biased …

Efikasi Diri Dalam Melakukan Diet Sehat Pada Masyarakat Desa Cipacing, Sumedang, Hilmi Khairun Nisa, Neti Juniarti, Adelse Prima Mulya

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. Noncommunicable diseases (NCDs) account for 57 million deaths (71%) worldwide and 73% of all deaths in Indonesia. Eating habits are one of the factors contributing to the incidence of NCDs. In the process of improving a healthy lifestyle, including a healthy diet, self-confidence or self-efficacy in maintaining a healthy diet is necessary.

Objective. This study aims to identify the level of self-efficacy in maintaining a healthy diet among the community in Cipacing Village, Sumedang.

Methods. This study was conducted using a quantitative descriptive research design among the community of Cipacing Village, Sumedang Regency, West Java. The sample was …

Dementia In Downs Syndrome – A Case Report, Clarita Shynal Martis Ms, Elsa Sanatombi Devi Dr, Panambur Venkataraya Bhandary Dr

Manipal Journal of Nursing and Health Sciences

Down syndrome, is a chromosome 21-related genetic condition, frequently manifests as intellectual difficulty, growth retardation, and distinctive facial traits. People with Down’s Syndrome usually develop Dementia, a major cause of cognitive impairment, impaired judgment memory loss in their midlife. The present report describes a case study of a female diagnosed with dementia in Down’s Syndrome. The report explores the challenges her parents faced in securing appropriate care when diagnosed with dementia and Down's syndrome. It aims to inform caregivers about the best practices for home care in such cases. It follows the woman's history from birth until her dementia was …

Interventions To Promote Menstrual Health Among Adolescents In Lmic’S: Protocol For A Systematic Review, Precilla Dsilva, Sudhir Prabhu Dr, Prajna Kumari Dr, Baby S. Nayak Dr, Judith Noronha Dr

Manipal Journal of Nursing and Health Sciences

Background: Menarche brings out significant change in each girl’s life. Coping with the discomforts and adopting the body changes becomes a biggest challenge for every teen. Cost effective non pharmacological interventions will help to bring about improvement in the general wellbeing and quality of life in each adolescents life.

Objective: This review aims to determine the different menstrual interventions adopted by adolescent girls residing in Low and Middle Income Countries (LMIC’s). The Review question will be :What interventions are currently available, and how do they contribute in promoting menstrual health among adolescents from LMICs

Methods: This review will include …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …

Emergency Preparedness Education And Simulation Training For Nursing Students In Southern India, Kevin C. Cameron, Taryn Mccoy, Laura Gray, David Phillippi

DNP Projects

Introduction

To address the identified gap in emergency preparedness education and training among nursing students at a teaching hospital in southern India, a private university in the southeastern United States partnered with the site to develop a quality improvement initiative aimed at strengthening these skills. Nursing students at the partner hospital have limited access to simulation-based training opportunities due to constraints in both curriculum and availability of simulation resources. This lack of exposure may hinder the development of critical emergency preparedness competencies

Methods

Educational content focused on triage and basic life support (BLS). One hundred twenty-four students participated in the …

Improving Staff Satisfaction And Flu Vaccine Uptake Through Standardized Workflow Tools, Salma Adriana Blanco

Master's Projects and Capstones

Objective: Insufficient workflows can cause documentation to be confusing, which ultimately

limits staff engagement. This has led to staff dissatisfaction and a low vaccination uptake in

outpatient clinics. The implementation of a standardized workflow tool and proper staff

education and training can improve staff satisfaction and vaccination adherence, as indicated by

a review of literature. Aim: The purpose of this quality improvement project is to implement a

change in workflow in the electronic health record and staff training in an urban community

health clinic primarily serving low income and Latino patients. This intervention seeks to

increase medical assistant user satisfaction …

Evaluating Fall Prevention Outcomes: Fall Rates, Staff Fall Knowledge, And Perceptions On Safety Culture, Priscilla Greco

Student Scholarly Projects

Practice Problem: The practice problem addressed in this project was the elevated fall rates on a 46-bed medical–surgical unit with a reported sentinel fall event, prompting the need to evaluate the current fall prevention program.

PICOT: The PICOT question that guided this project was: In nursing staff on a medical–surgical unit (P), how does the implementation of an evidence-based fall prevention program evaluation using AHRQ tools (I), compared with no formal program evaluation (C), influence staff knowledge, perceptions of safety culture, and fall rates (O) over 8-weeks (T)?

Evidence: Evidence supporting this project emphasized that structured staff education, strong communication, …

Understanding Lyme Iaci: Implications For Camp Nurses, Mary Tobin

CompassPoint

Lyme Infection-Associated Chronic Illness (Lyme IACI) is a term adopted by the U.S. National Academies of Sciences, Engineering, and Medicine (NASEM) to describe persistent, often debilitating symptoms that follow Lyme disease infection. Affecting an estimated 10–20% of individuals treated for Lyme disease, Lyme IACI includes fatigue, musculoskeletal pain, cognitive dysfunction, and sleep disturbances that can last months or even years despite standard antibiotic therapy (NASEM, 2025). Unlike acute Lyme disease, Lyme IACI is not well understood and lacks validated diagnostic tools or biomarkers, making it a challenge to diagnose or treat for clinicians and caregivers—especially those working with children in …

Predictors Of Complications Among Adult Patients Diagnosed With Type 2 Diabetis Mellitus At Thika Level Five Hospital, Kenya, Bernard Wambua Mbithi

MSc in Advanced Practice Nursing

Introduction: Despite advances in the management of Type 2 diabetes mellitus (T2DM), anecdotal reports from Thika Level Five Hospital indicate that patients still present with diabetes mellitus-associated complications. Therefore, this research aimed to determine the predictors of complications among adult patients diagnosed with T2DM in the hospital.

Methodology: Analytical cross-sectional design was utilized in this research. To select the respondents, purposive sampling was used to recruit six nurse managers and their deputies (making a total of 12 nurses), while 294 patients in the clinic were recruited using systematic sampling. Purposive sampling was also used to recruit 15 patients …

Fostering Dialogue, Learning, And Reflection: The Role Of Book Discussions For Public Health Professionals, Naomi E. Ervin, Belinda Aberle, Katherine Balint, Lynn Mcdaniels, Paula Tomczak

Michigan Journal of Public Health

Background: The Public Health Nursing (PHN) Section of the Michigan Public Health Association (MPHA) works to improve public health and public health nursing practice in Michigan. In 2021, the PHN Section initiated virtual book discussions to engage public health professionals in meaningful discussion about topics of critical importance to public health and public health nursing; provide continuing education contact hours; and recruit new section members. Methods: The discussions are conducted virtually four times per year. A moderator introduces each book and leads the one-hour discussion. As an added incentive to read the books, the PHN Section sends a limited number …

Bridging The Language Gap: The Impact Of In-Person Versus Remote Interpreter Services On Medication Adherence And Patient Safety In Adult Spanish-Speaking Patients, Ashley E. Alarcon Martinez, Jocelyn N. Lopez Maradiaga

Nursing | Student Research Posters

Background: Significant health inequities are caused by language barriers between patients and health care staff, resulting in miscommunication among adult Hispanic patients with low English proficiency, reducing medication adherence, impairing patient safety, and raising the possibility of medical errors. To address this issue, interpreter services, both in-person and remote translation, have been introduced in healthcare settings to enhance communication. Objective: The purpose of this study is to investigate the differences in patient safety and medication adherence between in-person and remote translation services for adult Hispanic individuals with limited English proficiency in healthcare settings. Methods: The proposed research involves five local …

Assessing The Role Of Social Media As A Complementary Source In Pharmacovigilance: Insights From Faers, X (Formerly Twitter), And Askapatient Data Across Multiple Drug Classes, Nwanneka Okere

Dissertations

Background: Adverse drug reactions (ADRs) pose significant public health challenges yet remain substantially underreported in traditional pharmacovigilance systems. Social media platforms and patient-reported outcome forums have emerged as potential complementary sources for capturing real-time patient experiences with medications, but their integration with established surveillance systems remains underexplored.

Purpose: This study examined ADR reporting patterns across FDA Adverse Event Reporting System (FAERS), X (formerly Twitter), and Askapatient to evaluate whether patient-generated digital data can complement traditional pharmacovigilance systems for enhanced drug safety monitoring.

Methods: An explanatory sequential mixed-methods design analyzed 107,753 reports representing 289,740 individual ADR occurrences for …

Implementing Diabetes Education And Prevention Protocol, Lilyanna B. Conkle, Alyssa M. Woodall

Scholars Week

This Evidence-Based Practice project proposes the implementation of a diabetes education and prevention protocol in school systems to address the rising prevalence of diabetes among students. The initiative includes mandatory pre-academic year training for school staff to improve recognition and response to diabetes related emergencies. To support school nurses, often the sole healthcare provider on campus; a mobile app will be introduced to alert personnel during emergencies and provide evidence-based intervention steps. This approach aims to enhance student safety, improve health outcomes, and ensure timely, coordinated care.

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

Orthostatic Hypotension In Older Adults And Its Economic Impact On The Healthcare System: A Systematic Literature Review, Olushola E. Ilogho, Jennifer Broyles, Viet Le, Denise Rizzolo

Lynchburg Journal of Medical Science

ABSTRACT

Orthostatic Hypotension (OH) has been shown to lead to poor quality of life, falls, and death. Literature suggests that falls from OH may be preventable, therefore opportunities to reduce its associated cost to the healthcare system exist. This literature review aims to evaluate the importance of diagnosing and treating OH in older adult patients. OH is the drop in blood pressure upon changing to an upright position. This acute hemodynamic drop in blood pressure causes hypoperfusion in the brain, leading to dizziness, syncope, and falls. An extensive literature search for publications in PubMed and Cumulative Index in Nursing and …

Ready Or Not? An Autoethnography Of A Midwife’S Preparedness And Readiness Journey, Kristen Graham

The Qualitative Report

This emotive autoethnography explores my experiences working as an Australian midwife in low- and middle-income countries, which led to a Doctor of Philosophy journey exploring primary care midwives' preparedness and readiness in rural and remote communities in this context. I use the midwifery tradition of storytelling to explore personal experiences of preparedness and readiness as a way towards researcher reflexivity, understanding and meaning. Emerging themes of preparation for practice, resource limitations, heartache, and emotional resilience offer insights to inform midwifery education, research, and practice.

Association Of Covid-19 Status With Maternal And Neonatal Outcomes Among Pregnant Women At Mombasa County Referral Hospital, Kenya, Salome Mghoi Rajab

MSc in Advanced Practice Midwifery

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A …

Student Nurse-Led Hypertension Management In A Rural Free Clinic, Leslie Okhirkhian

Cardiovascular Research Symposium

This pilot project seeks to evaluate the effect of nurse-led assessments and education on blood pressure control among adult patients with prehypertension and hypertension who attend a free health clinic located inside of a rural community in Southeastern Virginia. A leading, modifiable risk factor for cardiovascular disease is hypertension, yet disparities in consistent healthcare access and education disproportionately affect rural populations. Nurse-led interventions are a promising strategy for improving hypertension control through personalized education, blood pressure monitoring, and follow-up.

Methods: Participants with a diagnosis of prehypertension or hypertension were recruited from a free rural health clinic (n=20). Over a 7-week …

Promising Practices To Address Healthcare Needs Voiced By Local Native Americans, Noelle Taylor, Mykin R. Higbee, Raiden Gaul

Transforming Communities

Purpose

To examine barriers and facilitators to nursing education among Native Americans and identify evidence-based strategies to increase the number of Native American nurses working in their local communities to address health disparities.

Background

Native Americans experience significantly higher rates of chronic illnesses such as diabetes and heart disease, and lower life expectancies. Only 4% of registered nurses identify as Native American, with no growth despite increased funding for diversity in nursing education. This underrepresentation contributes to culturally insensitive care and persistent healthcare inequities stemming from historical marginalization and trauma.

Methods

A comprehensive literature review was conducted using CINAHL, PubMed, …

Bridging Evidence With Community: Five Routes To Diabetes Prevention In Latino Adults, Ann M. Maliackal

Doctor of Nursing Practice Final Project Abstract

Bridging Evidence with Community: Five Routes to Diabetes Prevention in Latino Adults

Background: This project used the Eightfold Path policy analysis approach to identify and recommend an evidence-based diabetes prevention program (DPP) for Latino adults in the Rio Grande Valley (RGV). The aim was to reduce diabetes prevalence by selecting an intervention that is culturally appropriate and effective for this population.

Methodology: The Eightfold Path policy analysis approach guided this project. A comprehensive literature review identified diabetes prevention programs (DPPs) tailored for Latino adults, and the Critical Appraisal Skills Programme (CASP) was used to assess study quality. Five DPPs were …

The Impact Of Mindfulness Therapy To Reduce Disruptive Behavior In High School, Wendy Nell Peters

Electronic Theses and Dissertations

The aim of this project was to determine the impact and effectiveness of Gina Biegel’s mindfulness techniques for stressed teens method on adolescent anxiety and the disruptive symptoms that lead to high school adolescents being assigned to detention. This project described a quantitative correlational design research project that investigated a small adolescent sample size, with a goal of decreasing the number of local high school adolescent students who are repeat detention offenders, by implementing Gina Biegel’s mindfulness techniques for stressed teens method on those high school adolescents who were assigned to detention. This was achieved by collecting demographic data from …

Living In Fear: Be Empathetic (Life)-Tool Kit, Desiree A. Díaz, Heather Peralta, Samantha Stephenson, Danny Hernandez, Geraldine Luzincourt, Syretta Spears, Ann Marie Parker, Trysten Altamirano

Nursing Handouts, Tools, and Other Documents

Open source materials to immerse learners in rural and public health experiences are needed to ensure the new work force is equipped to care for a variety of people in differing circumstances. Public health remains a vital yet underemphasized component within healthcare education, specifically nursing education. This often limits opportunities for students to develop the skills necessary to become strong advocates for equity and systemic change. A

This project emerged from a commitment to provide experiential opportunities replicating the communities we serve. A Empathy Walk and LIFE Clinic (Díaz et al., 2025) was created as a strategy designed to engage …

Improving Hiv Nonoccupational Postexposure Prophylaxis Completion In Survivors Of Sexual Assault, Rebecca Aden

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This project aimed to increase adherence to HIV nonoccupational postexposure prophylaxis (nPEP) among adult survivors of sexual assault using a 24-hour nurse-led callback intervention to reinforce patient education and support treatment completion.

BACKGROUND

This project was implemented within a public healthcare system’s forensic nursing program. Sexual assault survivors face an elevated risk of HIV transmission, yet completion of the 28-day nPEP regimen often remains below 40%. Barriers to completion include limited understanding, gaps in follow-up, as well as psychosocial and socioeconomic challenges.

METHODOLOGY

The FADE QI framework was utilized for this project. The population included adult, non-incarcerated patients who …

Unsuitable Underlying Cause-Of-Death Statements: Implementation And Evaluation Of A Structured Process For Healthcare Providers Certifying Natural Causes Of Death In An Outpatient Setting, Naida Rutherford

Doctor of Nursing Practice Projects

Background: Accuracy in death certification is crucial for effective public health initiatives. Inaccuracies in unsuitable Underlying Cause-of-Death (UCOD) statements can distort mortality statistics, influence health policy, and impact resource allocation. In South Carolina, changes in the death registration process and the introduction of an unsuitable cause-of-death list highlighted an urgent need for structured training among certifiers to enhance accuracy in death documentation.

Purpose: The purpose of this project was to implement a standardized training program for healthcare providers certifying natural causes of death and assessing the impact of reducing the unsuitable underlying cause-of-death inaccuracies in an outpatient hospice setting.

Project …