Public Health Commons^™

Self-Efficacy And Health Promotion: The Roles Of Family Health And Health Literacy, Müjdat Yeşildal, Yunus Emre Öztürk

Makara Journal of Health Research

Background: Chronic noncommunicable diseases are the leading causes of death globally and in Türkiye, emphasizing the need to explore how individual, familial, and informational factors shape health-promoting behaviors. This study examined whether family health and health literacy sequentially mediate the relationship between general self-efficacy and health-promoting behaviors among adults in Türkiye.

Methods: A cross-sectional correlational study was conducted with 1,240 adults in Konya Province, Türkiye, between November and December 2022. Participants completed the Turkish versions of the General Self-Efficacy, Family Health, Health Literacy, and Health-Promoting and Protective Behaviors Scales. Data were analyzed using descriptive statistics, Pearson correlation, and …

Exploring Systemic Challenges In The Western North Carolina Dental Safety Net: A Qualitative Analysis, Blaire Mirmow, Bill Milner, Nadia Laniado

Journal of Appalachian Health

Introduction: Despite statewide growth, rural communities in Western North Carolina (WNC) face persistent barriers to oral health care driven by chronic dental workforce shortages and systemic geographic disparities. Within this Appalachian region, the dental safety net serves as a vital yet strained support system, struggling with limited financial resources and a lack of provider participation that leaves many underserved populations without essential oral health services.

Purpose: This study aims to explore the experiences of individuals working within the WNC dental safety net to identify barriers and strategies required to strengthen the delivery of oral health care in high-need rural settings. …

Assessing The Aesthetic Responsiveness Among Patients In A Free Clinic Setting, Jack E. Pitts

Student Scholar Showcase

Art therapy has increasingly been recognized as a complementary intervention in healthcare settings, with demonstrated benefits for stress reduction and overall biopsychosocial well-being. However, limited research has explored aesthetic engagement within medically underserved and economically disadvantaged populations. This study examines aesthetic responsiveness among patients receiving care at the Free Clinic of Central Virginia using a standardized Aesthetic Responsiveness Assessment. The assessment consists of 14 Likert-scale questions assessing individuals’ cumulative aptitude across three domains: aesthetic appreciation, intense aesthetic experience, and creative behavior. Responses and data were collected voluntarily and anonymously, and they were analyzed to better understand how patients in an …

Perceived Stigmatization Of Mental Health Problems And Utilization Of Academic Accommodations Among College Students, Sabrina Williams, Robert E. Davis Ph.D., Kristin Bogda Ph.D.

2026 Honors Symposium

Background: Higher education is seeing an increase in students utilizing mental health services. Studies on students with disabilities suggest students often have reservations about accessing these accommodations due to anticipated social stigmatization. Purpose: This study aimed to assess relationships among stigmatization and indicators of psychological distress among a sample of students who qualify for accommodations. Methods: This was a cross-sectional survey of students at a large university in the central United States. Data collection measures included previously validated screening instruments for depression, anxiety, suicidal ideation, and adapted versions of the validated scales to assess specific aspects of stigma related to …

Haynes County Ems Outreach Quality Improvement, Anna Parker, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Bio-Cybersecurity: Securing The Healthcare Industry, Amanda D. Coleman

Cybersecurity Undergraduate Research Showcase

Bio-cybersecurity refers to the aspect of cybersecurity that applies to the biological sciences and the protection of digital biomedical information. Today’s healthcare industry has evolved with the enhancement of internet and biomedical technology. While hospitals and private medical providers remain compliant with the Health Information Portability and Accountability Act (HIPAA) through traditional means of securing documented patient information, the emergence of beneficial internet-based healthcare services like virtual appointments and digital patient records requires new policies and healthcare cybersecurity frameworks to protect sensitive information from unauthorized access. This paper examines the role of cybersecurity in healthcare, the vulnerabilities that exist and …

Effects Of A Major Disruption On Mental Health Of Pregnant Women In South Carolina, Lizmarie Maldonado

MUSC Theses and Dissertations

Mental health conditions are a leading cause of death among pregnant and postpartum women, and untreated mental health conditions are associated with adverse maternal and birth outcomes. Major disruptions, such as pandemics, hurricanes, or wildfires, create unprecedented challenges and may impose additional stressors during an already vulnerable time. Community or medical care disruptions during such events may lead to adverse health outcomes. This dissertation seeks to characterize the impact of a recent major disruption on mental health outcomes among pregnant women using administrative claims data for all births in South Carolina in 2019 and 2020. By leveraging unique data sources, …

Costs, Demographics, And Causative Agents In Patients Hospitalized For Drug Induced Liver Injury: Trends In A Large Academic Healthcare System, Megan Kozar, Yunisse Gonzalez, Dina Halegoua-De Marzio

Department of Medicine Faculty Papers

PURPOSE: Drug-induced liver injury (DILI) is an uncommon but potentially life-threatening condition. To date, the burden of DILI on a single, large healthcare system has not been investigated, preventing adequate resource allocation. This study aims to quantify DILI-related healthcare utilization within the Jefferson Health System (JHS) and identify case-related factors associated with high resource requirements; such information is crucial to focus efforts toward resource reduction.

PATIENTS AND METHODS: This study characterizes trends of 48 DILI cases within JHS, including demographics, payer status, causative agent, and DILI pattern. These variables were correlated with length of stay (LOS) and cost relating to …

A Mixed-Methods Research Study: Nc Health Department Directors’ Perspective On Local Impact Of Early Medicaid Expansion, Asma Warrich

MUSC Theses and Dissertations

North Carolina became the 41^st state to expand Medicaid under the Affordable Care Act. The bipartisan expansion addressed longstanding challenges; however, little is known about how Local Health Departments (LHDs) adapted to this policy change, especially in the 24 months following expansion. This study sought to fill that gap by documenting the perspectives of LHD Directors in North Carolina utilizing a ten-question REDCap survey with closed- and open-ended questions. Purposeful sampling targeted all 86 LHD Directors. Data was collected anonymously between November 2025 and January 2026. Descriptive and thematic analyses were conducted. Thirty LHD Directors completed the survey, which …

Validity And Reliability Of The Wut Hydration System When Assessed In The Afternoon, Peyton A. Hines, Rosie Perez, Rebecca Allen, Shawn Wierick, Xiujing Zhao, Corey Butts, Brendon Mcdermott

2026 Honors Symposium

The WUT (weight, urine color, and thirst) Venn diagram is recommended for individuals to self-assess their hydration status. However, current research is limited to comparisons between morning first-void markers and 24-hour markers. PURPOSE: To examine the validity and reliability of afternoon WUT scores in comparison to 24-hour hydration status. METHODS: Fifty participants (25 ± 8y, 72.2 ± 14.9kg) voluntarily participated in this study. Participants collected afternoon spot urine between 2:00 and 4:00 pm and 24-hour urine samples on three out of seven consecutive days. Body mass (BM), urine color (Ucol), urine osmolality (Uosm), urine specific gravity (USG), and thirst perception …

Navigating End-Of-Life Decisions: Cultural Considerations For Latine Patients, Michelle Carbajal Hernandez

Honors Capstones

Healthcare professionals face many challenges when communicating terminal illness prognoses for individuals. This responsibility to address a terminal prognosis is further complicated when communicating with Latine patients who may face multiple barriers within the healthcare system and whose cultural preferences influence end-of-life care planning (Carrion, 2010). For example, Latines are less likely to enroll in end-of-life (EOL) care services (e.g., hospice) (Barragan-Carrillo et al., 2022). As well as engage in end-of-life care planning than White Non-Latines (Shen et al., 2016). To understand this hesitancy towards EOL care options, this literature review aims to explore how terminally ill Latine and …

Lessons Learned From The Implementation Of A Pragmatic Trial Evaluating Non-Pharmacological Approaches To Dementia Care In Us Nursing Homes, Carin Wong, Catherine V. Piersol, Felicia Chew, Cara Lekovitch, Victoria Shier, Mike Morris, Jenny Martínez, Julie Britton, Natalie E. Leland

Department of Occupational Therapy Faculty Papers

RATIONALE: The consistent delivery of effective evidence into nursing home practice has been shown to enhance quality of care and residents' outcomes. Pragmatic trials enable the evaluation of efficacious interventions in a real-world context, including care of residents living with Alzheimer's Disease and Related Dementias (ADRD). Yet, there are limited pragmatic trials conducted in nursing homes and even less evidence on the strategies to successfully conduct such research in this setting.

OBJECTIVE: To identify the lessons learned from a pragmatic trial and provide recommendations for future successful studies in United States (US) nursing homes.

METHODS: Drawing on a case example …

Investigating Social Justice Implications Of Glyphosate Residues In Human Urine, Ananya Malhotra

Electronic Theses, Projects, and Dissertations

Background: Glyphosate, the nominal active ingredient in professional-grade Roundup weed and grass killer, is the most extensively used herbicide globally and in the United States (U.S. Environmental Protection Agency, 2020). An increasing level of concern has surfaced regarding its health consequences, particularly because of contamination of our food supplies. Recent research indicates distressing levels of detection of glyphosate in human blood and urine samples, revealing many instances of frequent human exposure (Conrad et al., 2017; Zhang et al., 2020).Most of the research about exposure is focused on agricultural workers or individuals living in close vicinity to agricultural lands.  Few …

Eating Disorder Prevention And Early Intervention In U.S. Higher Education – A Comparative Benchmarking Study, Jake R. Arcement

Senior Theses

Eating disorders (EDs), including anorexia nervosa, have the highest mortality rate of any psychiatric illness, yet remain underrecognized relative to their severity and treatment burden. Because the period of peak onset aligns with the college years, institutions of higher education are uniquely positioned to play an important role in prevention, early identification, and referral to specialized care. However, limited research has examined how colleges and universities structure ED prevention and treatment resources. This thesis applies a comparative benchmarking framework to assess current institutional practices across U.S. colleges and universities. A national survey of student health and counseling centers examined staffing, …

Using Ai-Based Predictive Scheduling To Improve Patient Flow And Reduce Wait Times In Healthcare Clinics, Oscar Martinez

Posters - 2026

• Healthcare systems face increasing challenges in patient access and wait times
• Average wait times for specialist care continue to rise, creating:
  • Delays in treatment
  • Reduced patient satisfaction
  • Increased system inefficiencies (Sanford, 2025)
• A major contributor is operational bottlenecks, defined as:
  • Points of congestion that slow or disrupt service flow
• Hospitals typically operate under process layouts, which:
  • Handle diverse patient needs
  • Reduce specialization efficiency
• Contributing factors to bottlenecks:
  • Physician shortages and burnout
  • Administrative burden
  • Inefficient scheduling systems (Moura & Pinho, 2025)
• AI offers potential solutions through:
  • Predictive scheduling
  • Automation of administrative processes
  • Data-driven optimization of patient flow

A Comparative Analysis Of Group Care: Trust, Professional Identity, And Health System Structure In The United Kingdom And The Netherlands, Samantha J. Kohlmann

Senior Theses

Group prenatal care (Group Care) has been associated with improved maternal experiences and select clinical outcomes, yet less is understood about how it functions within high-resource health systems and what mechanisms underlie its impact. This study examines how Group Care is implemented in the United Kingdom and the Netherlands, with particular attention to professional roles, relational dynamics, and health system context.

I employed a qualitative, comparative design and conducted four semi-structured interviews with midwife researchers involved in Group Care implementation in both countries. Data were analyzed thematically, with attention to cross-context similarities and differences.

Findings indicate that Group Care operates …

Analisis Disparitas Geospasial Dan Determinan Sosio-Demografis Masalah Kesehatan Jiwa Di Indonesia: Analisis Data Survei Kesehatan Indonesia (Ski) 2023, Alya Zahrah Zhafirah, Sutanto Priyo Priyo Hastono

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Kesehatan jiwa merupakan pilar utama pembangunan sumber daya manusia yang kini menjadi tantangan struktural di Indonesia. Masalah ini dipengaruhi secara signifikan oleh determinan sosio-demografi seperti tingkat pendidikan, status ekonomi dan lingkungan. Penelitian ini diinisiasi oleh urgensi untuk memetakan distribusi beban masalah kesehatan jiwa secara nasional sekaligus menginvestigasi ketidakonsistenan prevalensi antara data Riskesdas 2018 dan SKI 2023. Penelitian ini menggunakan desain potong lintang dengan menganalisis prevalensi masalah kesehatan jiwa pada penduduk Indonesia berusia ≥15 tahun, menggunakan data SKI 2023. Kondisi kesehatan jiwa dinilai menggunakan instrumen SRQ-20 untuk mengidentifikasi probabilitas masalah kesehatan jiwa. Hasil utama menunjukkan prevalensi masalah kesehatan jiwa Indonesia tahun …

Evaluating Sensory Sensitivities Among Children With Autism Spectrum Disorder In An Adaptive Gymnastics Program, Aicha Kaouss, Bradley Eppinger, Austin Ebbrecht, Kailash Ram, Kaitlin P. Hardy Md

Knowledge and Creativity Expo

Introduction: Children with autism spectrum disorder (ASD) participate in physical activity at lower rates than their neurotypical peers1. Sensory sensitivities, reported in approximately 75–95% of children with ASD, may contribute to this disparity2. Gymnastics environments involve bright lighting and loud noise, which can precipitate sensory overload. The impact of specific sensory features on participation in adaptive gymnastics remains underexplored.

Methods: A cross-sectional study recruited caregivers of children aged 3–12 years with an ASD diagnosis enrolled in the EVMS Adaptive Gymnastics Program. Caregivers completed the Sensory Experiences Questionnaire–Third Edition (SEQ-3)3 and supplemental survey items on Redcap which assessed environmental triggers and …

Sound, Speech, And Synapses: Rebuilding The Brain Through Neuroplasticity, Sireen Khader

The Cardinal Edge

No abstract provided.

Multi-Dimensional Research Appraisal: A Holistic Approach To Evidence-Informed Practice, John Damiao

Translational Science in Occupation

The field of occupational therapy (OT) and healthcare in general have made great strides in enhancing their scientific rigor through study methodologies that prioritize internal validity. However, concerns regarding reproducibility and replicability in research have cast doubt on traditional evidence-based models. This paper critically examines the limitations of an over-reliance on internal validity in evidence reviews and advocates for a multi-dimensional approach to evidence-based practice. By integrating methodological holism, contextual analysis, and a critical appraisal of external validity, this approach provides practitioners with a more nuanced and applicable framework for decision-making. The implications for research credibility and clinical confidence are …

Assessment Of Antimicrobial Transition Errors From Hospitals To Skilled Nursing Facilities, Amy Y. Kang, Guarina A. Garcia Delgado, Ashley Nguyen, Maddie Yeh, Tracy Ly, Richard C. Beuttler, Abisay Ortega, Donna Phan Tran, Evelyn Flores, Charis Tjeong, Andrew Bishop, Praneet Kalkat, Loren G. Miller

Pharmacy Faculty Articles and Research

Background More than 1 million Americans reside in skilled nursing facilities (SNFs). Antimicrobial transition errors among patients transferred from hospital to SNFs pose safety risks and may lead to poor outcomes, but data on such errors are limited.   Methods We conducted a retrospective cohort study of infectious diseases clinics from 1 June 2020 through 30 November 2023 at the Los Angeles County Department of Health Services, a large safety-net health system. We performed logistic regression analyses to identify factors associated with antimicrobial transition errors and poor infection outcomes.   Results We screened records of 6865 clinic patients, among whom 112 were …

Examining The Relationship Between Academic Excellence And Clinical Productivity In Orthopedic Surgery, Mohamad Y. Fares, Xiaoran Zhang, Harry H. Liu, Ana Paula Beck Da Silva Etges, Krishna Chopra, Brian Zhou, Ira Sivaram, Chrishaun Alexander, Peter Boufadel, Porter Jones, Derek A. Haas, Adam Z. Khan, Eric Wagner, Joseph A. Abboud

Rothman Institute Papers

Background/Objectives: The relationship between clinical volume and academic performance in orthopedic surgery remains understudied. The purpose of this study is to explore the characteristics of high-achieving academic orthopedic surgeons in an attempt to extrapolate patterns and trends that govern the relationship between clinical performance and academia in orthopedic surgery. Methods: The 2023 National Plan and Provider Enumeration System and Medicare claims data (2021–2022) databases were used to include all active orthopedic surgeons of different subspecialties. A publication score, based on publication volume, journal impact, and authorship position, was calculated for each included surgeon, and surgeons who scored in the top …

Exploring The Optimal Age For Total Knee Arthroplasty To Minimize Risk Of Adverse Outcomes: Machine Learning Analysis Of A Statewide Cohort, Chloe Heiting, Yiyuan Wu, Susan M. Goodman, Peter Sculco, Fei Wang, Said A. Ibrahim, Peter Cram, Rich Caruana, Bella Mehta

Department of Medicine Faculty Papers

BACKGROUND: Rates of total knee arthroplasty (TKA) in the United States have risen in patients of a wide age range. Although rates of postoperative TKA complications have decreased, they remain a significant concern. In this study, we aim to determine how the risk of adverse TKA outcomes changes dynamically with age and explore the optimal ages with the lowest risk for adverse outcomes.

METHODS: This retrospective cohort study included patients who underwent elective primary TKA from 2012 to 2018 in the Pennsylvania Health Care Cost Containment Council Database. We trained (70% train:30% test) an explainable boosting machine (EBM), a modern …

Short-Term Survival And Prognostic Factors In Cervical Cancer Patients Requiring Hemodialysis: A Retrospective Cohort Study, Muhammad Trihatmowijoyo Bundjali, Maruhum Bonar Hasiholan Marbun, Wulyo Rajabto, Ikhwan Rinaldi, Hamzah Shatri, Dwi Lestari Partiningrum, Dadang Makmun, Pringgodigdo Nugroho, Sukamto Koesnoe, Pradana Soewondo

Kesmas

Cervical cancer is a common gynecological malignancy, particularly in developing countries, where it coexists with renal impairment in over one-third of patients. This disease typically presents acutely and progresses rapidly. Consequently, kidney replacement therapy, including hemodialysis (HD), is commonly required. To assess survival rates and associated factors, this retrospective cohort study analyzed the medical records of 252 cervical cancer patients who began HD across a three-month follow-up period. Kaplan–Meier analysis indicated a median short-term survival duration of 71.5 days (range: 7–90), with 1-, 2-, and 3-month survival rates of 56%, 51%, and 49%, respectively. Multivariate Cox regression identified post-HD systolic …

Low-Dose Prophylaxis Versus On-Demand Treatment For Children With Severe Hemophilia A In Indonesia: A Conceptual Model, Levina Chandra Khoe, Nur Atika, Dhia Ticha Pertiwi, Septiara Putri

Kesmas

Hemophilia A is a rare bleeding disorder caused by a deficiency of clotting factor VIII, leading to recurrent bleeds, joint damage, and disability. Low-dose prophylaxis has been shown to achieve better clinical outcomes than on-demand treatment in reducing bleeding frequency. However, in Indonesia, access and affordability remain key challenges. This study aimed to develop a conceptual model for conducting a health economic evaluation of low-dose prophylaxis treatment for children with severe hemophilia A in Indonesia. This study followed the ISPOR-SMDM Modeling guidelines, outlining two-stage processes: conceptualization of the clinical problem and model development. A systematic literature review was conducted to …

The Role Of Gynecologic Oncologists In Improving Survival Outcomes Of Epithelial Ovarian Cancer: A Retrospective Cohort Study, Widyorini Lh Hanafy, Bambang Dwipoyono, Asri C. Adisasmita, Yosephine E. Regina, Airine S. Lians, Oktaviani P. Rahayu, Jane G. Auwelia

Kesmas

Epithelial ovarian cancer (EOC) is a leading cause of gynecological cancer mortality and is often diagnosed at an advanced stage, resulting in poor survival outcomes. Access to specialized gynecological oncology services has been associated with improved prognosis; however, data on its impact in Indonesia remain limited. This study aimed to evaluate the association between gynecologic oncologist (GO) services and disease-free survival (DFS) in patients with EOC. This retrospective cohort study included 76 patients with EOC who were treated at a national cancer hospital in Jakarta between 2015 and 2018. Patient data were obtained from medical records and followed for three …

From Waitlist To Activation: Exploring Patient Barriers And Team Interactions In Kidney Transplant Readiness, Judith I. Eguzoikpe

Harrisburg University Dissertations and Theses

Kidney transplant candidates frequently experience prolonged inactive waitlist status due to incomplete readiness requirements, yet limited understanding exists regarding how patient barriers and team interactions intersect to influence activation timelines. This transcendental-phenomenological study explored how patient barriers and team dynamics contribute to delays in kidney transplant readiness, guided by Team Theory. Semi-structured interviews were conducted with 16 participants (8 patients, 8 healthcare professionals) between December 2025 and February 2026. Data were analyzed using systematic phenomenological methods to identify patterns that address patient barriers, team interaction effects, and the teamwork improvements needed for earlier activation. Five interconnected themes emerged: Navigating a …

A Qualitative Analysis Of Progress, Successes, And Challenges Among Indiana Recipients As Part Of A National Initiative To Reduce Covid-19–Related Health Disparities, Marla Winters, Lily Darbishire

Purdue Journal of Service-Learning and International Engagement

In light of the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) provided funding to states as part of the CDC Disparities Grant initiative. The aim of the funding was to reduce chronic disease and COVID-19–related health disparities among vulnerable communities through four unique strategies. Funding was awarded to the Indiana Department of Health (IDOH) to begin an Indiana chapter of this initiative, called Indiana Healthy Opportunities for People Everywhere (I-HOPE). From 2021 to 2023, the IDOH provided I-HOPE funding to local communities (subgrantees) to support the design and implementation of programs to improve community health. For example, …

Global Public Health Feasibility: Digital Dentistry In Geriatric Population, Merna Amr Saleh

Theses and Dissertations

Oral health is a critical yet often overlooked determinant of well-being among older adults in Egypt, where mobility limitations, geographic barriers, and low awareness of preventive practices exacerbate dental disparities. DentalPal, a teledentistry-based mobile application, was developed to provide older adults with remote dental consultations, oral hygiene advice, and triage guidance. The platform enables users to submit oral photographs or radiographs for assessment, seek second opinions, and initiate follow-up chats directly with the healthcare provider. This flexible design allows users to access dental consultations on demand while ensuring continuity of care The question that guided this study was how older …

Safety Of Carotid Endarterectomy In The Elderly And Octogenarian Population: A Nationwide Study Including 80,000 Patients, Victor Gabriel El-Hajj, Joanna Roy, Basel Musmar, Wi Jin Kim, Michael Rizzuto, Nathaniel Ellens, Rabab Alshahrani, Victor Staartjes, Adrian Elmi-Terander, Ramachandra Tummala, Stavropoula Tjoumakaris, Michael Gooch, Robert Rosenwasswer, Ziad Khabbaz, Pascal Jabbour

Department of Neurosurgery Faculty Papers

INTRODUCTION: Carotid endarterectomy (CEA) is an established procedure for stroke prevention in patients with carotid artery stenosis. While CEA is considered safe in younger patients, perioperative risks in octogenarians remain debated, with current guidelines classifying the procedure as "high-risk" in this patient population. This study aimed to evaluate short-term outcomes of CEA across age groups and to assess whether comorbidity burden better predicts outcomes than chronological age.

METHODS: The ACS-NSQIP database (2013-2020), was used to identify patients eligible for inclusion. The cohort was stratified based on age <  60, 60-80, and > 80 years. Propensity score matching and multivariable logistic regression were used to compare …