Public Health Commons^™

Impact Of Water Quality On The Nutritional And Phytochemical Properties Of Culinary Herbs, Genesis Arroyo

Electronic Theses, Projects, and Dissertations

Water quality significantly affected food safety, especially since contaminated water impacted crop growth and the nutrient composition of foods. Nitrates occur naturally in vegetables. However, when introduced into the food supply through water contamination, excessive levels disrupted the natural physiological processes of vegetables and other agricultural plants. These excessive levels eventually led to nutrient imbalances, decreased phytochemical concentrations, and potential health risks such as the formation of carcinogenic N-nitroso compounds in humans. This study evaluated the effects of nitrates on the nutritional outcomes of food crops, focusing on commonly used culinary herbs. While synthesizing findings from relevant peer-reviewed articles, I …

What Makes A Hospital Gown Functional? A Comparative Case Study Of Effective Patient-Centered Design Practices In Four (N = 4) Hospital Gowns, Robmarie Lopez

Patient Experience Journal

A hospital gown is essentially a patient uniform. Yet, the typical ``tie in the back'' hospital gown, standard garb for routine medical procedure, can have great influence over key intervention factors like receptiveness to treatment and patient self-esteem. Thus, the goals of this study are two-fold: 1) To understand patient perceptions of the standard hospital gown, and 2) To understand which principles and elements of design underpin effectively functional hospital gown redesign. Aim 1 was assessed via a comprehensive literature review of n = 5 qualitative or mixed-methods studies which surveyed or interviewed patients on their experience with the standard …

Adolescents With Cystic Fibrosis Expressing Their Possible Selves Through Photovoice: A Longitudinal Interpretative Phenomenological Analysis To Prepare A Peer Support Intervention For Healthcare Transition, Maxime Morsa, Adélaïde Vincent-Lardy, Julie Haesebaert, Catherine Llerena, Lucie Pelz, Philippe Reix, Rémi Gagnayre, Quitterie Reynaud

Patient Experience Journal

While the transition from pediatric to adult care has become a field of study and practice focused on preparing the adolescent to ``become an adult with a chronic condition'', we are conducting participatory research to develop, implement, and evaluate a peer-support intervention aimed at supporting transition from pediatric to adult care for adolescents living with cystic fibrosis within two hospital centers in France. In preparation for this intervention, we would like to better understand how peer support could support identity self-determination of the adolescents. We conducted a longitudinal qualitative research using photovoice technique. For one year, 8 French adolescents (15–18 …

Understanding The Care Experiences And Support Needs Of Uk Adults Treated In Hospital For Meningitis, Harriet Hay, Amy Tallett Dr, Bec Aeddi, Beverley Corbett, Claire Donovan, Jane Blewitt, Juan Abad Madroñero

Patient Experience Journal

Background: Meningitis often results in ongoing and multifaceted after-effects, which can impact many aspects of people's lives, yet relatively little support and follow-up is offered. This study explored post-treatment care experiences of UK adults aged 16 and over following a recent stay in hospital for meningitis. Methods: A survey was designed to ask about hospital discharge, recovery, information provision and aftercare support. The research involved 5 semi-structured, in-depth interviews and a 15-participant online asynchronous focus group. The themes arising from this qualitative stage informed the development of a quantitative 32-item questionnaire which was hosted and promoted online between September 2022 …

Unveiling Patient Satisfaction: Exploring Demographics, Interactions, And Health-Seeking Behavior, Vanessa B. Crowther, Cassandra Shaw-Johnson, Robbya R. Green-Weir, Pia S. Woodley, Marilyn A. Weatherspoon, Errick D. Farmer, Arlesia L. Mathis

Patient Experience Journal

Objective: This study examined the social context of the patient visit (demographics, waiting room experience, patient-provider interaction) and their relationship to satisfaction with the quality of care when seeking medical treatment. It also examined satisfaction as a predictor variable for its effect on three patient behavioral outcomes. Methods: The study was implemented using a cross-sectional quantitative design among adults aged 18 and older. One hundred fifty-eight participants responded to the survey, and the final sample size was n = 147. We employed advanced data analysis, hierarchical regression, three-way ANOVA, linear regression, and logistic regression to examine four outcome variables. Results: …

Effectiveness Of Incident Reporting Tools In Ensuring Patient Safety: A Systematic-Narrative Hybrid Review, Valentina Cerrone, Vincenzo Andretta, Angela Prendin, Bernadette Ilardi, Carloluigi Bonetti, Mario Capunzo, Marco Cascella

Patient Experience Journal

Background: Ensuring Patient Safety in healthcare is essential and requires efficient methods to reduce risks and improve the quality of care. Although incident reporting tools are commonly used to identify possible and actual care failures, their efficacy differs among various environments. The aim is to evaluate the effectiveness of incident reporting tools in enhancing patient safety. Methods: This review employed a combined methodology that integrates systematic and narrative approaches to gain a thorough understanding of incident reporting practices. In accordance with PRISMA guidelines, databases including PubMed, Embase, and Cochrane Library were systematically searched for studies published from January 2013 to …

Patient Perspectives On Implementing A Person-Centered Care System: Experiences From The U.S. Veterans Health Administration's Whole Health System Of Care, Ekaterina Anderson, Renda S. Wiener, Brianne Molloy-Paolillo, Megan Mccullough, Bo Kim, J. Irene Harris, Seppo T. Rinne, Barbara G. Bokhour

Patient Experience Journal

Objectives. Replacing the disease-centered, paternalistic approach in healthcare with a person-centered model has become a widely recognized imperative. However, patients' perspectives on and experiences with real-life efforts to implement this approach to care are rarely studied. We examined this issue at a health system with a prominent record of commitment to implementing person-centered care on the system level – the U.S. Veterans Health Administration (VHA). For over a decade, VHA has been transforming itself into a Whole Health (WH) system of care that is person-centered, holistic, and empowering. Methods. We conducted semi-structured qualitative interviews with 19 patients recruited from a …

My Life, My Story And Life Recovery Among Veterans With Substance Use Problems, Grace Chang Md, Mph, Martha J. Duffy Md, Susan Nathan Md

Patient Experience Journal

Objective: The United States Veterans Health Administration My Life, My Story (MLMS) program is a patient-centered care intervention where veterans are interviewed about their life story and may grant permission to include it in their electronic health record (EHR). Our purpose was to focus on a sample of MLMS narratives from veterans with self-disclosed substance use (SU) from our institution, and to evaluate the potential relationship between their content and a life change for the better, and to compare their content with the EHR. Methods: The narratives were reviewed on 4 domains (past challenge, substance use, experience of a turning …

The Impact Of Learners On Patient Satisfaction In The Orthopedic Setting, Sydney Boike, Kevin Hodge, Lynsey Malin, Timothy Nyangacha, Rebekah Kleinsmith, Megan Reams, Julia Stumpf, Bradley Nelson

Patient Experience Journal

This investigation evaluates the impact of learners and their post-graduate year (PGY) levels on patient satisfaction in the orthopedic outpatient clinic, an area with limited prior research. A retrospective cohort study was conducted using data from July 2020 to December 2022, involving 2,484 patients, with a 39% response rate. Satisfaction was measured via NRC Health surveys, focusing on the likelihood of recommending the provider or clinic based on the presence of learners, categorized as none, present in the clinic, or involved in patient care. Non-parametric statistical analysis revealed significant reductions in satisfaction when learners were involved in care, with top-box …

A Qualitative Study: Patients' Expectation Of Private Hospitals, Sarah Jada, Jessy Jacob, Ahmad Nasrallah

Patient Experience Journal

Objectives: This study was conducted to explore patients' expectations and perceptions of private healthcare facilities, understand the key factors influencing their choice of such facilities, also identify elements that enhance patient satisfaction and loyalty, enabling the development of actionable recommendations to improve patient-centered care in private healthcare settings. Method: A qualitative study using thematic analysis was conducted with 29 patients from various nationalities and backgrounds who received services in private hospitals in Kuwait, including Dar Al Shifa Hospital. Insights were gathered through semi-structured interviews. Results: The study delved into the significant correlation between patients' experience of their healthcare encounters and …

Patient Perspectives On Health Care Utilization At Two Free Clinics – A Qualitative Study, Patrick Fagan, Danny Guillen Perez, Roberta D. Baer, John Petrilli

Patient Experience Journal

Millions of uninsured Americans access health care through free clinics, but their experience with the medical system is understudied. This study sought to understand patterns in free clinic patients' experience with healthcare utilization through qualitative and descriptive analyses. Data were collected through face-to-face, open-ended interviews at two free clinics in an urban Florida community. The clinics included one student-run free clinic and one community-based free clinic. Survey questions were developed based on prior literature and validated through expert consensus and pilot interviews. The interviewers conducted 74 interviews between May 7 and June 10, 2022. Responses were coded by the authors, …

The Patient Ombudsperson's Experience Of Patient Partnership And Mutual Understanding Of Rights, Sanna Ryynänen

Patient Experience Journal

Mutual understanding between the patient and the healthcare professional can be considered a key factor of a positive patient experience in the care relationship. Mutual understanding can be promoted through patient partnership, which, in this personal and professional narrative, the author (a patient ombudsperson, known as patient ombudsman, and researcher of patient experience) describes as participation through patient rights during care. In the relationship between the patient and the healthcare professional (i.e., who acts as a care provider in the patient's care), medical treatment decisions and related patient rights go hand in hand. Even in difficult care situations of mutual …

Beyond The White Coat: Mental Health In The Life Of A Junior Doctor, Araya Gautam

Patient Experience Journal

This article underscores the profound need for a culture that prioritises mental health, especially among doctors navigating their early careers. This personal narrative also highlights the importance of overcoming this and the challenges one can face while trying to do so. A journey of a 30-year-old doctor, as she hurdled along life with the passing of her grandparents and studying for the exam, it looked like a task that was achievable at first, but as time went by anxiety and self-doubts were not easy to navigate. This piece outlines why it is of utmost importance that we as doctor realise …

Escuchame: A Story Of Patient Resilience, Daniel Murillo Armenta, John Paul Braun

Patient Experience Journal

This article is a narrative following a patient's experience through the American Healthcare system. This article is written by a second-year medical student. During this time the individual repeatedly engaged in different specialties of medicine such as neurology, neurosurgery, oncology, emergency medicine, gynecology, and primary care. This narrative demonstrates how certain issues such as healthcare access, patient demographics, defective communication, and general mistrust of the healthcare system negatively impact patient outcomes. As an uninsured immigrant, the patient was in a disadvantaged position when her health problems first began. Due to her lack of insurance, she did not have an established …

Re-Recruitment: An Essential Aspect Of Human Experience, Thom Mayer, David Fessell, Amy Young

Patient Experience Journal

Healthcare staffing is a major issue facing leaders at all levels and is affected by turnover rates in ``The Great Resignation,'' as well as the issue of burnout, moral injury, and turnover. In seeking to deal with defining and making human experience as reality, these factors affect every level, from patient experience to workforce experience to community experience, all of which are related to not just adequate staffing and preventing turnover but doing so with our highest performing ``A Team'' members. Using the tool of re-recruitment of these high-level professionals and team members can be critical to retaining talent, while …

Leading In Turbulent Times: Why Experience Is Essential To Healthcare's Future, Jason A. Wolf

Patient Experience Journal

Healthcare systems around the world and throughout our community are being buffeted from all sides, with higher acuity patients, a vulnerable and stressed workforce, unsure finances and support structures, and even challenges to long-held medical truths. For as much as we traversed a once in a lifetime moment through the pandemic years, the residual effects and social and political sways that followed have woven their ways into healthcare overall. There is great uncertainty. There are rapidly emerging innovations. There are greater tensions in our society which show up in behaviors that impact how we provide care. These issues and more …

The Impact Of The Utilization Of Shared Decision-Making Tools In Contraceptive Counseling On Patient Satisfaction In Adolescents: A Scoping Review, Akaninyene Ruffin Msn,Fnp-C, Judith Tunney Bsn, Rn, Mary Katherine Fouquier Phd, Aprn, Cnm, Facnm, Margaret Harvey Phd, Aprn, Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Robust adolescent contraceptive counseling requires deep understanding of the specific context in which adolescents are receiving reproductive health care. As teen pregnancy rates rise, particularly in places across the Deep South, providers must find ways to engage their adolescent patients about their sexual and reproductive health. Professional organizations like the American College of Obstetricians and Gyencologists and the American Academy of Pediatrics both offirm the need for robust contraceptive counseling for adolescents. The purpose of this is to ascertain the impact of utilizing shared-decision making aids during contraceptive counseling on patient satisfaction in adolescent populations.

Methods

A systematic literature …

The Self-Sustainability Of Federally Qualified Health Centers, Javier Vallejo

MUSC Theses and Dissertations

This exploratory data analysis examines the self-sustainability of Federally Qualified Health Centers (FQHCs) using the 2023 Uniform Data Systems (UDS) dataset, focusing on health centers' reliance on government grants as a revenue source. FQHCs provide high-quality healthcare services to medically underserved populations; today, nearly 1 out of every 11 Americans receives some form of care at an FQHC. There is widespread variability in the delivery of care amongst FQHCs. Additionally, funding and reimbursement methodologies vary across states and geographic regions. FQHCs face challenges maintaining operational efficiency amid federal funding shortfalls, shifting reimbursement methodologies, and the lingering impact of the COVID-19 …

Sbirt Workflow, Dory Hart Emery, Tory Gamage, Sara Watts, Carol Mcclure, Anne Barker, Liz Berry, Liz Anderson

Operations Transformation

SBIRT stands for Screening – Identify patients with unhealthy substance use. Brief Intervention – A collaborative conversation that raises a person’s awareness of substance use and its consequences and encourages behavioral changes. Referral to Treatment – Actively link patients to resources when needed. It is a substance use screening tool that we ask patients 18 yrs. old and older to fill out once a year when having their CPE or AWV. SBRIT has been recognized as an integral part of primary care. It is an approach that delivers prevention, detection, and early intervention for individuals at risk of substance use …

Exploring The Lived Experiences Of Menstrual Hygiene Management Among In-School Visually Impaired Adolescent Girls In Rwanda: A Phenomenological Study, Marie Laetitia Ishimwe Bazakare, Gerard Kaberuka Kaberuka, Aimable Nkurunziza, Justine Bagirisano, Godfrey Katende

School of Nursing & Midwifery, East Africa

Background In low-income countries, many menstruating persons continue to face numerous challenges regarding menstrual hygiene management. Visual impairment further compounds the difficulties faced by in-school adolescent girls, but little is known about its consequences in Rwanda. Objective To explore the lived experiences of menstrual hygiene management among in-school visually impaired adolescent girls in Rwanda. Design descriptive phenomenology. Methods This study was conducted in four specialized educational institutions for visually impaired students in Rwanda. We conducted four focus group discussions with 25 visually impaired adolescent girls selected purposively. The seven steps of Colaizzi’s method were used to analyze the data. Results …

Challenging Race-Based Health Care Discrimination: A New Private Right Of Action, Aaron Pinkett

Northwestern University Law Review

The Hippocratic Oath calls on doctors to “do no harm.” Yet we know from extensive public health research that clinicians repeatedly cause harm to Black patients by dismissing their medical concerns, misdiagnosing them, and undertreating their pain. These practices of differential treatment for Black patients have led to steadily increasing racial disparities in health care outcomes throughout the United States. Title VI of the Civil Rights Act of 1964 prohibits this type of disparate impact, but modern Supreme Court jurisprudence forecloses opportunities for affected parties to seek legal relief—despite the clearly established legislative intent of Title VI. However, another legal …

The Importance Of Well-Being For College Students, Benjamin Williamson, Dr. Mary Jan Greer, Phd, Otr

Spring 2025 OTD Capstone Symposium

Provided education on well-being, enabled independence, and improved quality of life, specifically for college students in this setting.

Advocate for Sustainable Programs:

Advocated for more programs to address the needs of college students and integrated all 8 dimensions of wellness into their current lifestyle

Support Academic Advancement:

Addressed college students' needs for overcoming occupational adversities which affects the longevity and academic success of college students

Motivate College Students:

Provided accessible and occupation-based resources that supported participating college students in independently improving their occupational roles

Advance Holistic Based Strategies:

Incorporated holistic based strategies that apply to each occupational role affecting participating …

Indeterminate Benefit Of Long-Term Beta-Blocker Use After Acute Myocardial Infarction For Some Patients, Logan S. Thayer, Khush Hussain, Nicholas Apostolakis, Gretchen Swift, Arifbillah Sarowar, Mohammad Al-Hadidi, Scott Yaekle

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Yndigegn T, Lindahl B, Mars K, et. al., Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. April 7 2024;390:1372-1381. https://doi.org/10.1056/NEJMoa2401479

for a patient showing 55% left ventricular ejection fraction after myocardial infarction.

Impact Of Cde Referral On A1c Control In Adult Type 2 Dm Patients., Alivia Watts Bsn, Rn, Yesica Sanchez Bsn, Rn, Morgan Hilliard Bsn, Rn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Type II Diabetes Mellitus is a chronic health condition impacting many adults in Tennessee. Certified Diabetic Educators (CDEs) are specifically trained in educating and addressing the health care needs of patients with diagnoses of Type I or Type II Diabetes. Research has shown that education conducted by CDEs leads to improved outcomes and self- care in those with diabetes (Bowen, et al., 2016, King et al., 2019). Not only are CDEs cost effective services leading to a decrease in healthcare costs, but they also aid in the improvement of hemoglobin A1C (Hgb A1C) levels and decrease complications associated with Type …

Expanded Patient Reach At New Student Run Free Medical Clinic Location, Olivia Krol, Hana Warmflash, Alex Foster

OHSU-PSU School of Public Health Annual Conference

Background: Critical to modern medical education, student run free medical clinics (SRFCs) are present at more than 75% of AAMC member institutions. SRFCs educate students while providing low-barrier, free healthcare to underserved populations. SRFCs provide unique leadership and health systems management opportunities not traditionally emphasized in training, including leading logistical and operational changes.

In this project, we highlight the impact of a student-led operational initiative that transitioned our clinic from the River District Navigation Center (RDNC) to the Resource Center (RC), improving accessibility.

Methods:

Deidentified patient data from medical clinics from January 2024 to February 2025 were analyzed using RStudio …

Improving The Rates Of Sexually Transmitted Infection Diagnosis By Increasing Provider Knowledge About Testing, Lauren Cunningham

Student Scholarship & Creative Works

There has been a significant increase in sexually transmitted infection (STI) rates since 2021. Though this issue is nationwide, rural providers require education regarding testing, screening, and transmission of disease processes. The infections with the most significant increase are gonorrhea, chlamydia, and syphilis. The purpose of this project was to provide education to providers regarding local STI statistics, in addition to when to and not to test for sexually transmitted STI infections. Education was provided to three Advance Practice Nurse Practitioners about disease signs and symptoms, transmission, and local STI statistic rates. STI testing rates were observed three months prior …

Reevaluating Informed Consent: Integrating Shared Decision-Making Into Spinal Surgery For Better Patient Outcomes., Jeffrey N Wang, Mohamed A Elhakeem, Matthew J Mesimer, Paul G Mastrokostas, Salman Ahmad, Tim Reed, Brandon Klein, Lucas E Bartlett, Adam D Bitterman, Andrew Megas

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Study Design: Narrative review.

Objectives: The objectives of this study were to answer the following questions: (1) What is the quality of informed consent in spine surgery, including both neurosurgery and orthopaedic spine surgery? (2) What limitations impede the ability of surgeons to engage in effective shared decision-making (SDM) and obtain adequate informed consent? (3) What strategies and solutions may improve the quality of informed consent and SDM? (4) What factors decrease the incidence of litigation in spine surgery?

Methods: N/A.

Results: SDM is a collaborative process where patients are involved in their treatment choices through open communication about risks, …

Exploring The Web And Language Accessibility Of Medical Tourism Providers’ Websites: Implications For Online Marketing And Patient Recruitment Practices, Alicia Mason, Elizabeth Spencer, Kristen Livingston, Treyton Meyers

Faculty Submissions

Background: Web accessibility as an attribute of the digital presence of organizations has been studied across domains and contexts. Our study aims to add to existing lines of research inquiry by examining the web and language accessibility of medical tourism provider (MTP) websites commonly used to market and promote international medical tourism treatments and services globally.

Objective: This study aims to (1) systematically analyze the web and language accessibility of MTP online health messages and (2) discuss challenges and implications for medical tourists’ user experiences when seeking health information online.

Method: We conducted an exploratory quantitative content analysis of web …

Advancing Pandemic Response: Integrated Strategies For Testing, Prediction, And Bias Mitigation, Tianshu Gu

Theses and Dissertations (ETD)

The COVID-19 pandemic, along with prior outbreaks such as SARS and Ebola, has revealed critical gaps in global pandemic preparedness, emphasizing the need for integrated approaches to infectious disease management. This dissertation addresses three key areas of pandemic response: developing scalable screening strategies, constructing reliable predictive models, and mitigating demographic biases in artificial intelligence (AI) models used for healthcare decision-making.

The first study introduces a global screening strategy designed to optimize resource use and increase testing capacity, particularly in low- and middle-income countries (LMICs) where resources are limited. This study leverages pooled testing methods, where multiple samples are combined into …

The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher

Theses and Dissertations (ETD)

Stroke is a major contributor to disability in the United States, with ischemic stroke accounting for approximately 87% of all cases. The use of approved reperfusion therapies, including intravenous thrombolysis with tissue plasminogen activator (tPA) and mechanical thrombectomy, has significantly improved functional outcomes for ischemic stroke patients. However, hyperglycemia at the time of hospital arrival is associated with worse outcomes, including increased infarct growth, higher rates of disability, and elevated mortality. Despite this, current stroke guidelines neither exclude hyperglycemic patients from receiving reperfusion therapy nor recommend glucose management during the hyperacute phase of care. While recent studies suggest that mild …