Public Health Commons^™

The Impact Of Medicaid Policy Limitations On Access To Eating Disorder Treatment: Uncovering The Consequences Of A System Built To Fail, Meghan Frost

DSW Capstone Projects

Individuals who rely on Medicaid face major barriers when trying to access eating disorder (ED) treatment, reflecting broader patterns of structural disadvantage in publicly funded health care. Research shows delayed diagnosis, limited access to ED specialists, and frequent denials for recommended services. These gaps occur because Medicaid policies do not match the needs of evidence based ED care, resulting in delayed or incomplete care for many individuals with eating disorders.

This issue is highly relevant to social work practice because the policies shaping these barriers are complex and difficult for clients and ED providers to navigate. Social workers across clinics, …

Seeing Public Health In Color: Phenomenological Perspectives Of Bipoc Women In Leadership, Jasmyn Spicer

All Graduate Theses, Dissertations, and Other Capstone Projects

Public health is a complex, ever-changing industry that holds pivotal capacity to impact society on a larger scale. For the United States, disparities and inequity in public health have had significant consequences for Black, Indigenous, and People of Color (BIPOC) communities. Effective leadership in public health has the potential to impact roles, policy development, and the overall scope of oversight regarding the quality of care that communities are provided in the industry. While BIPOC women are underrepresented in public health leadership roles, they have the capacity to advance equity in the field and contribute to culturally responsive care in foundational …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

Examining Firefighter Perceptions Of Stress And Recovery Across A Shift And Engagement In Recovery Activities, Nathan T. Ebersole

College of Graduate Studies: Theses & Dissertations

The occupational demands of firefighting, such as fire suppression and rescue tasks, working in hazardous conditions, inconsistent sleep patterns, and exposure to traumatic events, can lead to work-related injuries, burnout, and feelings of isolation. To date, there is limited research on the impact of a single work-shift on firefighter perceptions of stress and recovery and the recovery activities that may influence these perceptions. Thus, the purpose of this study was to examine the effect of a single work-shift on firefighter perceptions of stress and recovery status as well as the recovery activities firefighters choose to engage in. Forty-three firefighters across …

A Scoping Review To Conceptualize Social Privilege For Studying Patients' Health Outcomes And Health Disparities, Elizabeth A. Brown, Priyanka Patel, Esther May B. Sarino, Vladimir Markovic, Carles Muntaner

Health Behavior, Policy & Management Faculty Publications

Background

The continued reliance on single-category self-reported demographic data (e.g., race/ethnicity) reflects conceptual limitations that hinder the study and understanding of health outcomes research. There is a pressing need for more precise measures of social privilege that conceptualize privilege and oppression while enabling the examination of their effects on health outcomes in the United States (US) healthcare system.

Objective

The purpose of this scoping review was to review the literature, determine how researchers have measured aspects of privilege and oppression, and develop a conceptual framework to study patients' social privilege in the US healthcare system and public health research.

Methods …

Parental Psychological Distress And Perceived Child Externalizing Behaviors: Examining Mediators And Bidirectional Effects, Abigail J. Anderson, Christina M. Rodriguez, James M. Henson

Psychology Faculty Publications

Parental psychological distress is a commonly examined risk factor for the emergence of child problem behaviors, but the factors that contribute to that relationship—such as limited parental resources like greater social support and coping skills—have not been adequately explored, particularly with attention to potential bidirectional relations that incorporate child evocative effects. The current longitudinal study examined maternal and paternal psychological distress in relation to perceived child externalizing behaviors, considering parental resources as mediators within a bidirectional model. The sample included a racially and socioeconomically diverse group of 201 primiparous mothers and 151 fathers. Mothers and fathers reported their current psychological …

Natural Resource Rents And Energy Poverty Nexus In Next Eleven Economies, Muhammad Salah Uddin, Ayub Ali, Zobayer Ahmed, Md Nasir Uddin Sikdar, Ahsan Habib, Abdullah Elah Al-Mahde

Finance Faculty Publications

Energy poverty (EP) remains a persistent global challenge with important implications for economic development, public health, and social welfare. While natural resources, particularly oil and gas, are often viewed as key sources of energy access, their effectiveness in mitigating EP remains underexplored in emerging economies. This study examines the relationship between natural resource rents (NRR), specifically oil rents (OR) and natural gas rents (NGR), and energy poverty (EP) in the Next Eleven (N-11) countries from 2000 to 2020. The primary objective is to assess how NRR influences EP at various levels of poverty using the Method of Moments Quantile Regression …

How Dentists Can Remain Advisors Of Merit To Their Patients, Daniel L. Orr Ii, Dds, Ms (Anesth), Phd, Jd, Md, Facd (Nevada Section Chair)

Journal of the American College of Dentists

This article examines how members of the dental profession can sustain their longstanding reputation as trusted advisors amid declining public confidence in major institutions. Grounded in ethical principles, informed consent, and professional self-regulation, dentistry has historically ranked among the most trusted professions. The discussion explores challenges to credibility, including media scrutiny, concerns about anesthesia safety, controversial treatment hesitancy, and debates over community water fluoridation. Emphasizing the concept of the “advisor of merit,” the author argues that continued trust depends on truthful communication, transparency about risks, respect for patient autonomy, and freedom from conflicts of interest in clinical and public health …

Comparison Of Mental Illness Comorbidity Pre-Pandemic Vs. Pandemic-Era And Associations With Clinical And Demographic Characteristics For Virginia Public Hospital Inpatient Discharges With A Substance Use Disorder, Marilyn Bartholmae, Tharidu Gunawardena

Department of Medicine Faculty Publications

The rise in mental illnesses after the COVID-19 pandemic is well documented. However, it is not known whether the rates of mental illness comorbidity increased. The objectives of this study were to compare mental illness comorbidity rates before and after the pandemic among inpatients with SUD and to test associations between mental illness comorbidity, physical illness, and demographics. We used a retrospective cross-sectional design in a sample of inpatient discharges (N = 233,017) at Virginia public hospitals from January 2018 to December 2022. We used Z tests to compare rates of mental illness comorbidity pre- and post-pandemic and Chi-square tests …

Visit Complexity Differs Between Scarring And Nonscarring Alopecia: A 5-Year Dataderm Analysis, Ian Noel Encarnacion, Noelle Desir, Nicholas Schell, Apoorva Mehta, Temitayo Ogunleye, Susan Taylor

Department of Medicine Faculty Publications

[Introduction] Accurate coding is a critical component of dermatologic practice, influencing reimbursement and documentation of clinical complexity. Although alopecia has significant psychosocial and financial burdens, Current Procedural Terminology (CPT) coding patterns in alopecia management remain largely understudied. Our population-level study using the American Academy of Dermatology's DataDerm clinical registry¹ evaluates alopecia CPT coding trends, pre-2021 and post-2021 evaluation and management (E/M) CPT coding updates,² aiming to inform coding practices and visit complexity, which have significant reimbursement implications.

Ensuring Rich Rigor Of Qualitative Methodologies In Behavior Analytic Research, Daria K. Lorio-Barsten, Selena J. Layden

Human Movement Studies & Special Education Faculty Publications

Quantitative methods remain the hallmark of research in applied behavior analysis. Yet, such methods frequently fail to capture the nuances of context where behavior analysis is practiced. Therefore, qualitative methods can provide complementary means to gain deeper insight into changes in socially significant behavior. We believe that researchers within the field of behavior analysis have much to gain from embracing qualitative methodologies. We propose that more researchers can and should consider conducting rigorous qualitative research to elevate the voices of the participants and relate the depth and complexities of their nuanced experiences. This article discusses Tracy’s “big tent” quality criteria …

Diagnosing The Discourse: How The Academy Of Breastfeeding Medicine Constructs And Constrains Treatment Of Tethered Oral Tissues, Mary E. Miller

Antioch University Dissertations & Theses

While breastfeeding is recognized as fundamental to global public health, oral restrictions that can affect infant latch, milk transfer, and feeding efficiency warrant further examination within policy frameworks. This dissertation proposes an expanded conceptualization of tethered oral tissues (TOTs) that encompasses not only anatomical frenal restrictions but also fascial tensions, neuromuscular limitations, and other conditions restricting orofacial function that may be congenital or acquired. The purpose of this study was to critically examine how this clinical guidance document shapes understandings and responses to TOTs. Using Carol Bacchi’s “What’s the Problem Represented to Be?” approach, a critical discourse analysis of the …

Puff, Puff, Pass? Examining Cannabis Use Among Black American Adults, Christopher B. Walker

Graduate Studies Theses and Dissertations 2026

In the United States, cannabis has become one of the most widely used controlled substances due to its increase in social acceptance, the growing number of states legalizing it for medical and non-medical purposes, and the expansion of consumption methods.  However, little is known about the modes of cannabis use chosen by Black American adults.  This population is of importance due to existing research suggesting their increased risk of developing cannabis use disorder compared to their White counterparts and their underrepresentation in existing literature.  The goal of this study is to examine cannabis use among Black adults in the U.S., …

Covid And The Great Retrenchment, Samuel R. Bagenstos

Articles

The past six years have seen two dramatic shifts in federal health and benefits policy. First, during the COVID pandemic, the government dramatically expanded public benefits. These expansions had incredibly positive effects, and recipients were largely satisfied with them. But after a relatively short time, Congress rolled back nearly all of the expansion. Worse, the immediate pullback set the stage for even more significant retrenchments in the second Trump Administration. Where in 2023 the United States came closest to universal health care in its history—with a record low uninsured rate of 7.7%—the Trump Administration’s Medicaid cuts and failure to extend …

Community Resilience Drives Change, Andrew Thomas Solt

Graduate Theses, Dissertations, and Problem Reports (ETD)

The opioid crisis has impacted many Americans. From 1999 to 2023, approximately 800,000 people have died due to opioid overdose (CDC, 2025). What began as overprescriptions of painkillers has quickly evolved into a complex social health issue that is now further worsened by stronger synthetic drugs like fentanyl. Fentanyl and fentanyl analogs (synthetic opioids that are very similar chemically to fentanyl) are often found in illegal drug supplies and in counterfeit pills (CDC, 2025). Thus, individuals who might have been initially overprescribed painkillers might now be pushed towards illegally produced drugs that are significantly more potent than what they were …

The Dual-Factor Model (Dfm) Of Mental Among Appalachian Youth, Mawyah Adel Bashatah

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background. Adolescent mental health is a critical public health concern, particularly in rural Appalachian communities where rates of depression, anxiety, and substance use exceed national averages and access to mental health resources remain severely limited. Traditional mental health frameworks rely predominantly on the identification and reduction of psychopathological symptoms, neglecting the independent contributions of positive well-being to adolescent risk and resilience. The Dual-Factor Model (DFM) of mental health offers a more comprehensive alternative by simultaneously assessing subjective well-being (SWB) and psychopathology, classifying individuals into four distinct groups: Complete mental health, Vulnerable, Symptomatic but content, and Troubled. Despite the DFM’s growing …

Overview Of Aboriginal And Torres Strait Islander Health Status 2025, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

This Overview provides a summary of the most recent indicators of the health and wellbeing of Aboriginal and Torres Strait Islander people (of all ages, where data are available). The topics included in the Overview cover chronic health conditions which are featured on the HealthInfoNet website. Over the years as additional funding has been obtained and in consultation with HealthInfoNet networks, more topics have been covered on the website and are now included in the Overview. The topics aim to reflect the status of Aboriginal and Torres Strait Islander health over this period and going forward.

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

Family Dementia Caregivers’ Disaster Preparedness In Chinese American Communities In New York City, Weiyu Mao, Bei Wu, Yaolin Pei, Zhen Cong

Health Sciences and Kinesiology Faculty Articles

Disaster preparedness is a significant public health concern. Disasters manifest in different forms and often lead to disruption of daily life. This is especially challenging for family dementia caregivers and their care recipients in the community. There remains much unknown regarding dementia caregiver disaster preparedness, especially in ethnic and racial communities. Guided by Protection Motivation Theory, with the backdrop of Hurricane Ida, this study explored the association between caregiving-related characteristics, cognitive appraisals, and disaster preparedness among caregivers in Chinese American communities. Data came from a pilot study on Chinese American family dementia caregivers in New York City between November 2021 …

Translating Evidence Into Action: Understanding How Community- Based Practitioners Make Intervention Implementation Decisions In Practice, Kristin C. Bennett

Dissertations and Theses (Open Access)

This study examined how community-based practitioners implement public health interventions in practice settings to identify gaps between existing implementation frameworks and real-world practice. Six farmers' markets in Southeast Texas served as cases to understand implementation decision-making by community-based practitioners addressing food access challenges. A qualitative case study approach was employed, using semi-structured interviews with program adopters and key stakeholders to examine how practitioners addressed food access problems, selected interventions, and navigated implementation decisions. This methodology captured the contextual nature of implementation decision-making in community settings. The findings revealed that program adopters recognized health problems through lived experience rather than formal …

Occupational Resilience (Part 2): Toward A Cross-Culturally Relevant Measure Of A Novel Construct, Bernard A. Muriithi, Milan Bimali

Occupational Therapy Faculty Scholarship

Occupational resilience (OR) refers to an individual’s ability to persist in performing an occupation, with the duration and intensity of engagement determining resilience for each occupation. It is a key determinant of both the manner and the extent to which occupations influence health; therefore, it is a promising construct with several potential applications. There are currently no validated OR measures; which problematizes its application. Three considerations were made in designing the Occupational Resilience Measure (ORM 1.0) and evaluating its potential as a cross-culturally relevant measure of OR: 1) the findings of a published study of lived experiences of refugees from …

A Study Of Perceptions, Readiness, Benefits, And Barriers Related To Exoskeleton Adoption In New Jersey’S Warehousing Sector, Terry Asante

Theses

The warehousing industry in New Jersey remains a vital component of the region's logistics network, employing more than 200,000 workers who routinely engage in lifting, bending, overhead reaching, and other physically demanding activities. These exposures contribute to musculoskeletal disorder (MSD) rates that exceed national averages, particularly affecting the low back and shoulders. Nationally, MSDs account for an estimated $420 billion in combined direct and indirect costs each year, underscoring the need for interventions that can effectively reduce biomechanical strain. Industrial exoskeletons have emerged as a potential solution, with prior research demonstrating reductions in muscle activation, perceived exertion, and fatigue during …

Food Apartheid And The Retail Food Environment In The Bronx, Aissatou Barry

CUNY Mexican Studies Institute

This project examines the structural mechanisms that contribute to unequal food access, both historical and ongoing, in the South Bronx, and applies the food apartheid framework created by Bronx food activist Karen Washington. This paper applies the framework to two food retail initiatives in NYC: the New York State Regional Hub and the New York City FRESH food program to assess whether their policies address the structural mechanisms that contribute to food inequality. I ask: How does the unequal distribution of healthy food access in the Bronx reflect broader patterns of racial and economic exclusion? To what extent do current …

Implementasi Pelaksanaan Program I-Help (Integrated Help Promoting School) Pada Sekolah Menengah Pertama Di Jakarta, Rachma Dhiyaa' Arroyyan, Sarah Handayani

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

Background. The I-HELP (Integrated Help Promoting School Programs) initiative is a school-based behavioural change intervention that integrates health values and belief-related variables into daily school activities. This program was developed as a follow-up to the collaboration between Universitas Muhammadiyah Prof. DR. Hamka (UHAMKA) and SEAMEO RECFON.

Aim. his study aims to describe implementation of the I-HELP (Integrated Help Promoting School Programs) at the junior high school level in Jakarta in 2022.

Method. This qualitative research employed a case study design conducted at SMP Muhammadiyah 4 and SMP Muhammadiyah 36 Jakarta. Data collection techniques included in-depth interviews, focus group discussions (FGDs), …

Documenting Death: Maternal Mortality And The Ethics Of Care In Tanzania (Adrienne E. Strong 2020), Luluk Oktavia, Megawati Sukarno

Paradigma: Jurnal Kajian Budaya

In recent decades, global efforts to reduce maternal mortality have become a primary focus in health development agendas. However, challenges in providing quality healthcare remain complex, especially in resource-limited countries. Adrienne E. Strong’s book, Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania, offers an ethnographic perspective on the relationship between bureaucratic structures, resource constraints, and healthcare practices in Tanzania. This review examines Strong’s key concepts, such as good enough care, documented care, and fierce care, which highlight the ethical dilemmas faced by healthcare workers in delivering care under administrative pressures and limited facilities. The critique of the …

Hurricane Helene, One Year Later: Lived Experience, Geraldine A. Miller

Journal of Appalachian Health

Ashe County is located in the northwestern corner of North Carolina (NC), bordered by Virginia and Tennessee. The county is isolated, mountainous, and historically has lacked good highway access. Hurricane Helene, a category 4 hurricane at landfall, struck Western NC on September 27, 2024, resulting in flooding and wind damage that destroyed local communities in terms of land, homes, bridges, water, electricity, etc. with a damage of $59.6 billion.⁶ One year later, the recovery from the hurricane continues draining individuals and communities of their time, energy, and money. Geri Miller reflects on her hurricane impact experiences a year later. …

Associations Between Social Media Usage, Physical Activity And Flourishing In Rural University Students, Anna Dysart, Minu Sara Thomas

Journal of Appalachian Health

Introduction: Most adolescents and young adults report significant use of social media.^1-3 However, there is limited research on the effect of social media use, specifically on physical activity and flourishing.

Purpose: This pilot research study examines the correlation between social media usage and the physical activity and flourishing levels of college students at a rural university in Appalachia.

Methods: The authors conducted a survey including the validated Secure Flourishing Index and Stanford Leisure-Time Activity Categorical Item, containing questions on social media use and demographics. Spearman’s rho was used for nonparametric correlations. Pearson’s correlation was used to determine the correlation …

Impact Of West Virginia Abortion Ban On West Virginia Physician Trainee Practice Intentions, Rebecca Wald, Kristy Ward, Sarah Dotson

Journal of Appalachian Health

In June 2022, the Dobbs v Jackson Women’s Health Organization overturned the constitutional right to abortion established by Roe vs. Wade. Shortly after, West Virginia (WV) began enforcing a near total ban on abortion. Statewide restrictions on access to reproductive health care have important implications for the recruitment and retention of physicians. This project aimed to determine overall awareness of the 2022 changes in abortion laws among physician trainees, and whether the law influenced the intention of resident/fellow physicians to practice medicine in the state following completion of their medical training. A total of 178 resident and fellow physicians at …

Leveraging Community Health Worker’S Deep Community Knowledge To Address Food And Nutrition Security In Appalachia, Alexis Kimbro Scott, Melissa D. Olfert, Dawn Brewer, Makenzie Barr, Julie Plasencia

Journal of Appalachian Health

Introduction: Community health workers (CHWs) are trusted professionals in communities because of the deep understanding and cultural insights learned from their lived experiences. In Appalachia, CHWs are embedded in the community, giving them a unique understanding of how social determinants, like food and nutrition security, impact health outcomes.

Purpose: This study aimed to examine the professional characteristics and knowledge of CHWs while identifying culturally sensitive practices around food insecurity.

Methods: This cross-sectional, mixed-methods study used an online survey and in-depth phone interviews with CHWs in the Appalachian Region to examine their professional characteristics and knowledge on food security in their …

Stigmatization And Healthcare Inequity Perceived By Individuals Served By Homeless Shelters In An Appalachian City, Molly Powney, James M. Mears, Reagan Sharp, Lisa Calderwood

Journal of Appalachian Health

Introduction: People experiencing homelessness are medically vulnerable and suffer disproportionately from chronic physical and mental health conditions. Evidence-based standards to inform decisions surrounding care would be valuable for this population. Studies exploring how homeless individuals in Appalachia perceive their interactions with the healthcare system remain limited, however.

Purpose: The purpose of this study is to assess perceptions of the healthcare system among homeless individuals served by temporary housing shelters in an Appalachian city.

Methods: A voluntary anonymous survey was administered to residents at three shelters in Charleston, West Virginia (WV) from September 2023 – March 2024. Responses were collected utilizing …