Public Health Commons^™

Knowledge And Attitudes Toward Over-The-Counter Medications Among Undergraduate Students At The University Of Mississippi, Anna S. Dawson

Honors Theses

This study examines and compares knowledge and attitudes towards over-the-counter (OTC) medications among undergraduate college students at the University of Mississippi. OTCs are purchased and administered without a prescription, making them an efficient, safe, and affordable method of healthcare. It is important to determine the attitudes college students have towards these drugs and if they are able to safely and correctly use them. Information gathered from this study can be used to guide future education on medication literacy and to gain insight into how college students use OTCs to medicate themselves. A Qualtrics survey was sent out to a random …

From State To Nation: A Federal Framework For Breast Cancer Primary Prevention Informed By California's Paths To Prevention, Serena Padda

Master's Projects and Capstones

The United States’ federal government should adopt a primary prevention framework for breast cancer modeled after Breast Cancer Prevention Partners’ (BCPP) Paths to Prevention: the California Breast Cancer Primary Prevention Plan. The plan focuses on systemic actions to reduce breast cancer risk through a social and racial justice lens. Breast cancer is the leading diagnosed cancer among women in the United States, with incidence rates increasing annually by 1% since 2012. Disparities persist in communities disproportionately burdened by chemical and environmental exposures, contributing to unequal and preventable risk. Current federal policy focuses primarily on secondary prevention through screenings, which does …

Nourishing Births: A Program Evaluation Proposal For Community-Based Nutrition Education, Food Access, And Garden Engagement Among Black Birthing People, Naa Deedei-Vera Hammond

Master's Projects and Capstones

Black birthing people in the United States continue to experience unequal maternal health outcomes, shaped in part by racism and barriers to nutritious food, culturally relevant health education, and supportive community spaces. While prenatal nutrition education and food assistance programs can provide important resources, information alone cannot address the challenges many people face when trying to access healthy and affordable food during pregnancy. The Nourishing Births Initiative is a proposed community-based maternal health program designed to respond to these needs by bringing together prenatal nutrition education, help connecting to food resources, community gardening, and peer support for Black birthing people …

Adolescent And Young Adult Cancer Survivorship: Supportive Care Needs, Resources, And Barriers, Allison Bryn Koplos

Master's Projects and Capstones

Background: Adolescent and young adult (AYA) cancer survivors experience unique physical, psychosocial, developmental, and healthcare-related challenges that often persist beyond treatment completion. Although survivorship resources have expanded, gaps in supportive care needs persist. This scoping review examined the supportive care needs, survivorship resources, and barriers to accessing supportive care among AYA cancer survivors.

Methods: A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with the PRISMA-ScR guidelines. Peer-reviewed literature published between 2000 and 2026 was identified through searches in PubMed and Google Scholar. Studies examining supportive care needs, survivorship resources, or supportive care services …

Surveillance And Comparative Genomics Of Bacteria From Hospital And Human Reservoirs, Emily E. Benedict

WUSM Theses and Dissertations – All Programs

Bacteria are diverse and adaptable and, consequently, present in a wide variety of environments. They are capable of growing under intense pressures, including those brought on by the human immune system and disinfection strategies. To survive these pressures, bacteria develop resistances. Antimicrobial resistance, which occurs when a microbe is no longer responsive to the antibiotic intended to control it, is one such adaptation that presents an especially serious threat, as it limits treatment options for infections caused by antimicrobial resistant microbes. Similarly, the ability of bacteria to survive in environments subjected to heavy disinfection efforts, such as intensive care units …

Knowledge, Attitudes, And Practices (Kap) Of Parents Regarding The Prevention And Control Of Childhood Iron Deficiency Anemia In Egypt: A Cross-Sectional Study, Omnia Soliman

Theses and Dissertations

Childhood Iron Deficiency Anemia (IDA) remains a major public health challenge in Egypt, where its persistently high and rising prevalence carries substantial consequences for child growth, cognitive development, immunity, and long-term health outcomes. Globally, approximately 40% of children aged 6–59 months are affected by anemia (World Health Organization, 2025), and Egypt mirrors this burden, with national data showing a worsening trend in recent years. In Egypt, national strategies have traditionally focused on biomedical interventions such as iron supplementation and food fortification, while less attention has been directed toward behavioral and household-level determinants, particularly parental knowledge, attitudes, and practices (KAP) related …

In Adults Older Than 18 Years With Obesity Living In Massachusetts, Can Engaging In A Weight Loss Program Help Them Lose Weight After Insurance Stops Covering Their Weight Loss Medications?, Angel Nagawa

Capstones

Executive summary

The Problem

Obesity rates continue to rise sharply across the United States. Weight loss medications have high compliance but face major insurance restrictions. Strict clinical criteria leave many patients without accessible treatment options.

The Proposed Solution

Launch structured, lifestyle-focused clinical weight loss programs. Provide an effective, accessible alternative to restricted pharmaceutical therapies.

Supporting Evidence

Evaluated data from three distinct randomized controlled trials. Findings confirm successful long-term weight management for program participants. Results prove effective control over serious obesity-related comorbidities.

Policy recommendation

Implement structured lifestyle programs as a primary, frontline intervention modality. Improve broad-scale patient health outcomes across clinical …

Weathering The Divide: Social Determinants, Neighborhood Context, And Systemic Lupus Erythematosus Among African American Women, Vanessa Cl Morman

Electronic Theses and Dissertations

Background: Systemic lupus erythematosus (SLE) disproportionately affects African American women and contributes to racial health disparities in the United States. Although genetic susceptibility influences disease risk, growing evidence suggests that social determinants of health (SDOH), including neighborhood conditions, structural racism, and socioeconomic disadvantage, contribute to disease development and progression. Epigenetic mechanisms may provide a biological pathway linking adverse social conditions to chronic disease disparities. This dissertation examined the influence of SDOH on SLE disparities through evidence synthesis and empirical investigation to inform public health practice and policy.

Methods: This integrated learning experience consisted of three complementary manuscripts. Aim 1 was …

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

An Assessment Of Accessibility And Affordability Of Inpatient Psychiatric Care In Tennessee, Kailee Havrda

Electronic Theses and Dissertations

Introduction: Access to mental health has seen changes over the past decade, but little research and attention have been given to access to inpatient psychiatric facilities. Inpatient psychiatric care is crucial for patients experiencing mental health emergencies who need immediate access to care. Gaps in spatial accessibility, affordability, and the access and assessment process were identified due to a lack of available information in the field.

Methods: Secondary data from the Tennessee Department of Health were used to assess financial accessibility through payer source charges and patient encounters, as well as through mapping of inpatient psychiatric facilities and conducting drive …

Foundation Models In Healthcare: Pre-Training, Alignment, And Clinical Applications, Arvind Pillai

Dartmouth College Ph.D Dissertations

Foundation models offer an impactful paradigm for healthcare by learning generalizable representations from vast amounts of unlabeled data that can efficiently adapt to a wide range of clinical tasks. This thesis presents five studies organized around three pillars crucial to advance foundation models in healthcare. Pillar I: Pre-training: Chapter I introduces PaPaGei, an open foundation model designed for photoplethysmography (PPG) signals. PaPaGei is pre-trained on large-scale continuous optical data using a morphology-aware self-supervised objective, outperforming general time-series models across diverse clinical tasks while remaining parameter-efficient and robust across skin tones. Pillar II: Alignment: To bridge continuous sensor data and language …

Analysis Of The Deborah Sampson Act Of 2020: Improving Women Veterans’ Care, Jessica N. Shipp

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Women Veterans are one of the fastest-growing populations served by the Veterans Health Administration (VHA), yet gaps persist in access to gender-responsive, trauma-informed care. Despite requirements established by the Deborah Sampson Act (DSA) of 2020, implementation remains inconsistent in Women's Health Primary Care Provider (WH-PCP) access, women's mental health (MH) services, military sexual trauma (MST) care, workforce capacity, care coordination, and accountability.

Aim of the Project: The aim was to evaluate the effectiveness, feasibility, equity, and implementation fidelity of the DSA using the Centers for Disease Control and Prevention (CDC) Policy Analytical Framework (POLARIS) and identify evidence-based recommendations to …

Program Evaluation: Effectiveness Of Case Management Carehub For Skilled Nursing Facility Transitions, Rachel Choudhury

All Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Ineffective communication during transitions from acute care hospitals to skilled nursing facilities (SNFs) contributes to avoidable bed days (ABDs), prolonged length of stay (LOS), and discharge delays. Although evidence-based tools such as InterQual and Milliman Care Guidelines supported clinical decision-making, a standardized communication process among case managers, social workers, payers, and SNF partners was lacking. This program evaluation examined the effectiveness of a standardized CareHub communication workflow designed to improve discharge coordination and transitions to SNFs.

Methods: Guided by the Centers for Disease Control and Prevention Program Evaluation Framework, a 90-day program evaluation (February-April 2026) was conducted in a …

Improving Screening And Referral Of Adolescent Depression In Pediatric Primary Care, Eleanor Shaw

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: A practice gap existed in a rural primary care clinic where adolescents aged 12–18 years were not routinely screened for depression during annual well-child visits. A retrospective review of 22 adolescent charts identified no routine PHQ-9 screenings during well-child visits, establishing a baseline routine screening rate of 0%.

Aim of the Project: The aim was to implement a standardized Patient Health Questionnaire-9 (PHQ-9) screening process and increase routine depression screening to at least 90% of eligible adolescents while achieving documented follow-up within 14 days for at least 85% of adolescents with positive screens.

Review of the Evidence: Evidence supports …

A Spatiotemporal Study Of Environmentally Associated Pulmonary Diseases In Georgia, Jason Raymond Baum

Walden Dissertations and Doctoral Studies

Exposures to particulate dust matter (PM10 and smaller) from aggregate comminution facilities (ACF) can lead to the onset of environmentally associated pulmonary diseases (EAPDs); acute and chronic asthma (Type I allergic hypersensitivity reaction), chronic pulmonary disease, interstitial lung disease (ILD), and lung cancer. In this environmental epidemiological research study, three primary spatial and spatiotemporal research questions related to nonoccupational exposures from 118 facilities across Georgia were evaluated. Secondary data analysis was conducted from the Centers for Disease Control and Prevention’s (CDC) 2018–2023 Behavioral Risk Factor Surveillance System (BRFSS) and the Metropolitan Statistical Areas, Micropolitan Statistical Areas, and Metropolitan Divisions to …

Effectiveness Of Pancreatic Cancer Screening In High-Risk Elderly Individuals In Florida, Adeleke A. Aromolaran

Walden Dissertations and Doctoral Studies

Routine preventive care supports early identification and management of health conditions among adults at high risk for pancreatic cancer. Evidence is limited regarding socioeconomic and health care access factors associated with engagement in routine preventive care among Florida adults aged 65 years and older at high risk for pancreatic cancer. The purpose of this quantitative cross-sectional correlational study was to examine these associations among this population. The health belief model served as the theoretical framework. Secondary data from the 2022 Florida Behavioral Risk Factor Surveillance System were analyzed for N = 4,032 participants using two multivariable binary logistic regression models …

Relationship Between High-Risk Cytogenetic Abnormalities And Tent5 Mutations And Disease Outcomes Of Multiple Myeloma Patients, Erica Lea Richardson

Walden Dissertations and Doctoral Studies

Multiple myeloma (MM) patients have the lowest 5-year cancer survival rates due, in part, to the time it takes for symptoms to develop and the presence of one to four high-risk cytogenetic abnormalities (HRCA). The Terminal Nucleotidyltransferases 5 (TENT5) subfamily, which regulates myeloma cell migration and tumorigenesis, may also increase the risk for developing MM and impact survival rates. The purpose of this study was to investigate the association between the number of HRCA and TENT5 mutation hits with disease outcomes in MM patients while controlling for the stage of the disease (i.e., I, II, or III) at diagnosis. The …

Sociodemographic And Geographic Factors Underlying Breast Cancer Survival Disparities Among Women In The United States, Colletta Brabham-Orr

Walden Dissertations and Doctoral Studies

Breast cancer-specific mortality in the United States remains higher among women in rural and socioeconomically disadvantaged areas, yet few population-based studies have been conducted to jointly scrutinize demographic and structural determinants of this disparity. Informed by the social determinants of health framework, this secondary data analysis, using records from the SEER Research Plus database, examined the association between age at diagnosis, race and ethnicity, rural/urban residence, county-level median household income, and breast cancer-specific mortality among U.S. women aged 18 and older diagnosed with malignant invasive breast cancer between 2010 and 2020 (N = 285,865). Bivariate chi-square tests and binary logistic …

Impact Of Sexual Orientation On Syphilis Diagnosis Among African American Men In Colorado, Emmanuel Bhatti

Walden Dissertations and Doctoral Studies

Syphilis remains an ongoing public health concern among African American men. Elevated rates during the COVID-19 pandemic further underscored the need for focused attention on this population. The risk factors driving syphilis diagnosis among African American men during a pandemic like COVID-19 remain poorly understood. The purpose of this quantitative cross-sectional study was to examine the association between sexual orientation and syphilis diagnosis among African American men in Colorado. Social cognitive theory was applied to understand the interaction among sexual orientation, HIV status, age, and syphilis diagnosis. Sexual orientation categories include men who have sex with men (MSM), men who …

Degree Assortativity And Estimation Of Degree Distribution In A Contact Network Of People Who Inject Drugs, Peter Geissert

Dissertations and Theses

This dissertation analyzes data from a respondent driven sampling (RDS) study of people who inject drugs in Portland, OR.  The objective was to assess assumptions for the use of weighted estimators to estimate a population physical contact (syringe sharing) network degree distribution.

Visualization of degree distribution for social and physical networks, Kolmogorov-Smirnov tests of difference, and kernel tests of equivalence were used for comparison of distributions. Spearman's rho and GAM non-parametric regression models were used to test for association and assess non-monotonic relationship. The validity of Markov chain assumptions for RDS was assessed using a transition matrix, Markov chain graphs, …

Prostate Cancer Survival Among Young Males Within The United States, Maxine M. Findlay

Walden Dissertations and Doctoral Studies

Prostate cancer incidence has increased among younger men in the United States, and treatment affects both patient survival and family well-being. This quantitative retrospective study examined survival among young men diagnosed with prostate cancer who received chemotherapy, radiation therapy, and/or prostatectomy, while accounting for socioeconomic factors of residence and ethnicity. Social cognitive theory was the framework. Ordinal logistic regression was used to determine whether treatment method, socioeconomic factors of residence and ethnicity predicted survival among young men diagnosed with prostate cancer. Data was sourced from the National Cancer Database Participant User File 2004-2021 specific to prostate cancer. The study cohort …

Socioecological Factors Associated With Advanced Primary Tumor Category At Diagnosis Among Adults With Head And Neck Cancer Residing In Pennsylvania And New Jersey, Diane Elizabeth Crawford

Walden Dissertations and Doctoral Studies

Disparities in head and neck cancer (HNC) diagnosis may contribute to poorer outcomes among socially and economically disadvantaged populations. This quantitative secondary data analysis examined associations between socioecological factors and advanced primary tumor category among adults with HNC residing in Pennsylvania and New Jersey. Guided by the socioecological model, deidentified data (N = 350) from two Fox Chase Cancer Center research protocols were analyzed using three domain-specific multivariable logistic regression models. Primary tumor category was classified as lower (Tis–T2) or advanced (T3–T4) based on tumor size and/or local extent. Black participants had greater adjusted odds of advanced primary tumor category …

Evaluation Of The Association Between School Prevention Programs And Adolescents’ Opioid Abuse In The United States, Lida Moazezi

Walden Dissertations and Doctoral Studies

This study examined adolescent opioid misuse in the United States and the role of school-based prevention. Guided by the health belief model, the purpose was to test whether participation in school-based drug prevention lessons was associated with past-year opioid misuse among adolescents ages 14–17 and whether race and gender moderated that association. This quantitative, cross-sectional, nonexperimental secondary analysis used the 2019 National Survey on Drug Use and Health (N = 8,965). Analyses included weighted descriptives, chi-square tests, and complex-samples logistic regression controlling for age and socioeconomic status. The sample included adolescents ages 14–17 with complete data on school-based prevention participation, …

Surviving The Divide: Exploring Endometrial Cancer Survival In Idaho’S Urban And Rural Landscapes, Elena G. Estrada

Walden Dissertations and Doctoral Studies

Endometrial cancer is the fourth most common gynecologic malignancy in the United States, with a rising incidence among postmenopausal women. Although geographic disparities in cancer outcomes have been documented nationally, survival differences by urban versus rural residence and receipt of surgery remain understudied in Idaho. The purpose of this quantitative, retrospective cohort study was to examine the associations of urban versus rural residence, and receipt of surgery with 5-year survival among women in Idaho, a largely rural and underserved state. Guided by the social-ecological model and social determinants of health, this study used secondary data from the National Cancer Institute, …

The Ramifications Of Covid-19 On Young Adults With Ocd, Clare E. Mcintosh

Dissertations

The coronavirus disease of 2019 (COVID-19) pandemic was a profound event in modern history, contributing to significant disruptions on a societal and individual level. This period of time was marked by elevated uncertainty and fear among individuals. COVID-19 contributed to deterioration in not only physical health but also psychological well-being. One mental health condition frequently under-examined and saturated with misconceptions is obsessive-compulsive disorder. Obsessive-compulsive disorder is a condition characterized by the presence of obsessions and/or compulsions. Intolerance of uncertainty is a core component of the condition, and the pandemic was riddled with unpredictability. The purpose of this study was to …

New York City Women’S Experiences With Perinatal Depression Inquiries, Diagnosis, And Treatment Initiation, Caterina Pisciotta

Dissertations, Theses, and Capstone Projects

Perinatal depression represents a significant public health concern, yet many women who experience depression symptoms during the perinatal period (either during pregnancy and/or after birth) do not receive treatment. Initiatives, such as ThriveNYC, were designed to address these gaps by screening and treating perinatal women for maternal depression, integrating screening into routine perinatal care and strengthening pathways to treatment. Using representative survey data collected between 2016 and 2021 via the Center for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System (PRAMS), this study examined trends in perinatal depression inquiries (a proxy for “screening”) and postpartum diagnosis, as well as …

Beyond The Binary: Strengthening Nursing Students’ Proficiency Of Equitable Health Promotion, Martha K. Findley

Theses

Background: Sexual and gender diverse (SGD) populations continue to experience significant health inequities, yet prelicensure nursing curricula often lack structured, evidence‑based training to prepare students for equitable care.

Purpose: This study evaluated whether a targeted, transgender‑focused simulation could improve nursing students’ clinical knowledge and preparedness for providing equitable health promotion to SGD populations.

Methods: A pre‑/post‑intervention design was used with senior‑level nursing students who completed a transgender patient simulation emphasizing communication, assessment, and equitable health promotion. Students completed a validated survey measuring knowledge and preparedness in caring for SGD patients.

Results: Significant improvements across most survey items demonstrated that the …

Understanding Factors Influencing Multiple Tobacco Product Use Among Adolescents In Thailand: A Structural Equation Modeling Approach, Chaowalit Srisoem

Graduate Doctoral Dissertations

Tobacco use among Thai adolescents is shaped by personal, environmental, and product-related factors. However, the pathways linking these influences to actual behavior remain unclear. This study examined how personal, environmental, and product-related factors, along with intentions to use, relate to tobacco use among Thai adolescents. A cross-sectional secondary analysis was conducted using data from the 2022 Thailand Global Youth Tobacco Survey of 6,235 students aged 13–15 years. Survey weights methods were applied to produce nationally representative estimates. Confirmatory factor analysis and structural equation modeling assessed latent constructs, and multinomial logistic regression examined predictors of single, dual, and multiple product use. …

Breaking The Cycle: From Victimization To Offending Through The Lens Of Human Services, Colette R. Penalosa

Master of Arts in Human Services

The victim-offender overlap challenges the common view that victims and offenders are separately labeled by recognizing that both groups have experienced significant childhood trauma, physical, emotional, and psychological abuse, neglect, and other adverse childhood experiences (ACEs). Current research implies these experiences can increase the risk of offending as they all influence cognitive and behavioral development while leaving criminal behavior undetermined. The purpose of this capstone is to analyze the relationship between childhood victimization and offending from a human service perspective; analyzing the pathways a victim takes on the road to offending. Research conducted will focus on exploring the victim-offender overlap, …

The Association Of Age, Race, And Gender And Novel Interventions In The Prevention Of Catheter-Associated Urinary Tract Infection, In Washington State, Lamin Darboe

Walden Dissertations and Doctoral Studies

Delayed removal of indwelling urinary catheters (IUCs) contributes to catheter-associated urinary tract infections, a leading healthcare-associated infection. A dot/smart-phrase communication tool, guided by the Health Belief Model construct of cues to action, to promote timely IUC removal interventions was evaluated in this quantitative, cross-sectional study. Secondary data from N = 372 adult patients with acute urinary retention in acute and critical care settings in Washington State were analyzed using SPSS Version 30. Binary logistic regression examined relationships among demographic variables, intervention-related factors (adherence within 48 hours, cosignature within 24 hours, and secure chat communication), and clinical outcomes (IUC removal and/or …