Public Health Commons^™

Vaccine Booster Hesitancy And Factors Associated Amongst Minority Students In South Jersey, Charles Ezenwanne, Resty Mercado, Priya Patel

Rowan-Virtua Research Day

In October 2022, COVID-19 vaccine coverage for two doses in NJ was 77.4%. This exceeded the US national average of 67.8%. However, initial booster uptake remained low at only 50% statewide, and bivalent booster uptake was just 16.8% by March 2023. South Jersey, including Gloucester County and Glassboro, contains large marginalized populations that have experienced barriers to vaccination access, misinformation, and skepticism regarding government and pharmaceutical intentions. This health equity service project was to provide clear, factual, and relatable information to increase vaccine confidence and uptake among minority students at Rowan University and the broader South Jersey community. By addressing …

The Impact Of Obesity On The Risk Of Venous Thromboembolism In Users Of Combined Oral Contraceptives: A Comprehensive Literature Review, Adeena Javed

Rowan-Virtua Research Day

Background: Combined oral contraceptives (COCs) are a widely used method of birth control in the U.S., particularly among women aged 15–44. COCs are known to increase the risk of venous thromboembolism (VTE). Obesity, which affects over 40% of adult women in the U.S., is also a recognized independent risk factor for VTE. However, the compounded risk posed by the simultaneous presence of obesity and COC use has not been thoroughly explored.

Hypothesis: Obesity significantly elevates the risk of VTE in women using COCs, demonstrating a synergistic interaction between these two factors.

Methods: A systematic literature review was conducted using PubMed, …

Exploring Anticoagulant Prescription Disparities: A Focus On Hispanic Patient Care, Michael Acevedo, Vanessa Veltre

Rowan-Virtua Research Day

Anticoagulants play a critical role in preventing thromboembolic events, yet disparities persist in their prescription among minority populations. This presentation explores inequities in anticoagulant prescribing patterns, with a specific focus on Hispanic patient care. Using retrospective electronic health record data, we analyzed the prescription rates of warfarin versus direct oral anticoagulants (DOACs) among adults with clinical indications for anticoagulation. Our findings reveal that Hispanic patients are significantly less likely to receive DOACs compared to non-Hispanic White patients, even after adjusting for demographics, comorbidities, and insurance status. Contributing factors include language barriers, lack of insurance, and potential implicit bias in provider …

Literature Review: Prazosin Used For Ptsd In Pregnancy, Afshan Khan, Natali Sharma, Rebekah M. Dietrich, Martin Forsberg

Rowan-Virtua Research Day

Posttraumatic Stress Disorder (PTSD) affects 3–4% of pregnant and postpartum individuals and is associated with complications such as preterm birth, low birth weight, and postpartum depression. Pharmacologic treatment options during pregnancy are limited by concerns about fetal safety.

Methods: A literature review was conducted focusing on studies reporting maternal or neonatal outcomes following prazosin exposure in pregnancy.

Results: One observational study of 11 pregnancies found 54.5% had uneventful outcomes, with rates of preterm birth, miscarriage, and preeclampsia similar to the general population. Hypotension and limited lactation data remain concerns.

Conclusion: Early evidence suggests prazosin may be a relatively safe and …

Pain Management In Pregnant Women With Opioid Use Disorder: A Systematic Review, Adeena Javed

Rowan-Virtua Research Day

Background: The prevalence of opioid use disorder (OUD) among pregnant individuals has risen significantly, posing challenges in managing labor and postpartum pain. Factors such as opioid tolerance, opioid-induced hyperalgesia, and concerns about relapse complicate analgesic strategies. Despite these complexities, evidence-based guidelines for pain management in this population remain limited.

Hypothesis: Pregnant women with OUD experience disparities in pain management during labor and postpartum periods, leading to suboptimal outcomes.

Methods: A systematic review was conducted, analyzing peer-reviewed studies from databases including PubMed and Embase. Inclusion criteria encompassed studies focusing on pain management in pregnant women with OUD. Data extraction focused on …

Carbon Footprint Of Inhaled Anesthetics – Do The Risks Outweigh The Benefits?, Liam Kerrick, Joseph Moschella

Rowan-Virtua Research Day

Global warming presents many challenges to the healthcare system. Not only does the increasing global temperature have detrimental health effects itself, but the healthcare sector is also a huge contributor to global warming. One big contributor to global warming is the use of inhaled anesthetics, which possess global warming potentials up to 2,000 times greater than carbon dioxide. Recent proposals, such as a prospective ban of desflurane in 2026 by the European Commission, demonstrate the need to reevaluate many of the common practices within anesthesiology. This review looks to investigate the environmental impact, cost, and clinical efficacy of various anesthetic …

Maternal Health And Nutrition: Combating Maternal Mortality Through Proper Nutrition, Archna Mahendru, Yeisanai Cardona Torres, Maya Blayne Partee, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality is an increasing concern in the United States. According to the WHO, from 2018-2022 the Maternal Mortality Rate (MMR) was 23.3 deaths per every 100,000 live births. New Jersey's MMR exceeded this average at 26 per 100,000 during the same period, with 91% of cases deemed preventable. While medical care plays a crucial role, research shows that non-medical determinants such as food insecurity, lack of nutritional education, limited access to transportation, and systemic barriers to health care contribute significantly to maternal health outcomes. Among these factors, proper nutrition plays a critical role before and during pregnancy, particularly in …

Children Born To Mothers With Inflammatory Bowel Disease: A Review Of Pediatric Outcomes, Simran Gandhi, Kush Patel, Harmann Singh

Rowan-Virtua Research Day

Background: Inflammatory Bowel Disease (IBD), comprising Crohn’s disease and ulcerative colitis, frequently affects women during their reproductive years. While the impact of IBD on pregnancy has been widely studied, less is known about the long-term health outcomes in children born to affected mothers, particularly in the context of in utero exposure to immunosuppressive therapies.

Hypothesis: We hypothesize that children born to mothers with well-managed IBD experience normal growth and development, with minimal risk for immune-related complications, despite potential exposure to biologics and other IBD medications during gestation.

Methods: A literature review was conducted using PubMed and Google Scholar. Search terms …

The Physical And Mental Health Implications On Patients Of Childbearing Age Following The Dobbs Deicison, Jaclyn M. Schultz, Mariana A. Sales, Amy C. Nguyen, Chloe M. Triolo, Melissa K. Crisci

Rowan-Virtua Research Day

Background: In June 2022, the Supreme Court ruled to overturn Roe v. Wade in the Dobbs v. Jackson case which allowed for individual states to determine the legality of abortion. Thirteen states had “trigger” laws in place that immediately restricted abortion access. Since then, many states have enacted laws restricting access to abortion, increasing the total number of states where abortion is outlawed or heavily restricted.

Hypothesis: The goal of this review was to examine the potential implications of restricted access to abortion care on the physical and mental health of patients of childbearing age, which was hypothesized to be …

Is Increased Screen Time Associated With A Higher Prevalence Of Myopia In Elementary-Aged Children Globally?​, Katerina Kasatkin, Sree Gowri Sudharshan, Lakumi Dias, Adira Brenner, Emily Reilly, Maikel Mansour

Rowan-Virtua Research Day

Background: The onset of myopia in children has emerged as a significant public health concern, especially with increased screen time and reduced outdoor activity following the COVID-19 pandemic. The global prevalence of myopia is expected to rise significantly, with children being particularly vulnerable. Various studies have explored how screen time, near-work activities, and outdoor exposure influence the increasing prevalence of myopia in pediatric populations worldwide.

Hypothesis: This paper aims to evaluate whether increased screen time, especially following the COVID-19 pandemic, is associated with a higher prevalence of myopia in young children, providing a more robust understanding of this relationship across …

Effectiveness Of Exercise After Meals In Reducing Blood Sugar In People Who Are Overweight, Obese, Or Have Type 2 Diabetes: A Systematic Review And Meta-Analysis, Brian Fardman, Jie Kang, Nicholas Ratamess, Avery Faigenbaum, Jill Bush

Rowan-Virtua Research Day

Studies investigating the acute effect of postprandial exercise (PPE) on glucose responses exhibit significant heterogeneity in terms of participant demographic, exercise protocol, and exercise timing post-meal. As such, this study aimed to further analyze the existing literature on the impact of PPE on glycemic control in overweight individuals and individuals with obesity and type 2 diabetes (T2DM). A literature search was conducted through databases such as PubMed, CINAHL, and Google Scholar. Thirty-one original research studies that met the inclusion criteria were selected. A random-effect meta-analysis was performed to compare postprandial glucose area under the curve (AUC) and 24 h mean …

The Repercussions Of Race-Based Egfr On The Morbidity & Mortality Of Black Children With Renal Disease, Angelina Siino

Rowan-Virtua Research Day

This study investigates the implications of race-based adjustments in estimated glomerular filtration rate (eGFR) calculations on the health outcomes of Black children with renal disease. Historically, a race coefficient has been added to eGFR calculations for patients identified as Black, resulting in an artificial inflation of kidney function by approximately 16%. This inflation can delay the classification of chronic kidney disease (CKD), postpone eligibility for essential interventions like preemptive kidney transplantation, and prolong reliance on maintenance dialysis. Through a comprehensive literature review of peer-reviewed U.S. medical journal articles published between 2000 and 2023, this work explores how these clinical delays …

Clinical Outcomes For Patients With Ventilator-Associated Pneumonia In Octogenarians, Nonagenarians, And Centenarians: A Population-Based Study, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

We sought to examine the national inpatient sample data-base to describe in-hospital outcomes among patients over seventy who acquire ventilator-associated pneumonia after being on the ventilator for over 48 hours.

Addressing Gaps In Clinical Trial Access For African Americans, Vanessa Veltre, Michael Acevedo, Alexandra Stone, Lydell Lettsome, Brian Stone

Rowan-Virtua Research Day

Background: Clinical trials are essential for generating evidence on the safety and efficacy of new treatments. However, Black Americans remain underrepresented in clinical research, particularly for conditions that disproportionately affect them. This underrepresentation compromises the generalizability of findings and perpetuates health disparities. This study aimed to identify barriers and facilitators to African American participation in clinical trials and to inform culturally sensitive strategies to improve enrollment of diverse populations.

Methods: We developed a 38-question web-based survey, divided into three domains: (1) cultural affinity, (2) trust, and (3) background information. The survey was administered using Jotform, a HIPAA-compliant platform. Participants—Black adults …

Assessing The Impact Of The Covid-19 Pandemic On Health Literacy In Patients Presenting To A Student-Run Free Clinic, Sabah Iqbal, Kirsten Carlberg, Krisha S. Patel, Ashlyn Mcclelland, Sarah Marotta, Rebecca Moore

Rowan-Virtua Research Day

Background

Health literacy as defined by the Center for Disease Control and Prevention (CDC), refers to an individual’s ability to find, understand, and use health information and services1. This definition has evolved with the onset of the COVID-19 pandemic and increasing emphasis on preventative healthcare. We aimed to observe the impact of the pandemic on the health literacy of patients in a free community clinic run by medical students.

Hypothesis

This study aims to assess the effect of various demographic and socioeconomic factors and the COVID-19 pandemic on health literacy levels estimated by the NVS assessment in the patient population …

Beyond The Label: Understanding And Addressing Occupational Stigma In Psychiatry, Mahesh Vasudevan, Madeeha Sheriff

Rowan-Virtua Research Day

Introduction:Stigma is a social classification that devalues individuals or groups, and occupational stigma targets entire professions. Psychiatry is particularly affected, often viewed by the public and medical community as lacking scientific rigor and prestige. This negative perception has far-reaching consequences.

Methods:A narrative literature review was conducted to explore the scope, sources, and impact of occupational stigma toward psychiatrists. Peer-reviewed articles and professional resources published between 2002 and 2023 were selected based on relevance to psychiatric stigma, education, and public perception. Databases searched included PubMed, Google Scholar, and professional association websites using keywords such as “psychiatry stigma” and “psychiatrist …

Relationship Between Maternal Mortality And Zip Code In New Jersey, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality remains a pressing public health concern in the United States, with significant disparities influenced by geography and social determinants of health. This study investigates the relationship between zip code-level factors and maternal mortality rates (MMR) in New Jersey (NJ), a state with demographic and socioeconomic diversity. Using data from the NJ Department of Health, CDC, and recent literature, I identified patterns correlating higher MMR with areas experiencing poverty, limited access to healthcare, and predominantly minority populations. Counties such as Essex, Union, and Cumberland—classified as Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs)—exhibited particularly high vulnerability. These …

Exploring The Effects Of Target Race, Gender, And Weight On Pain Perception, Catherine Awad, Theresa Miller, Azer Tuerxuntuoheti, Peter Mende-Siedlecki

Rowan-Virtua Research Day

Healthcare equity is an essential right, and while the quality of care is assumed to be uniform, notable disparities in care are associated with factors of race, gender, and weight-particularly in the domain of pain evaluation and care. In experimental work, target race and gender have varying, and interacting effects on visual thresholds for perceiving painful expressions. Racial bias in pain perception is well established as participants see pain on black faces less readily than pain on white faces; gender also impacts pain treatment, where women are susceptible to having their pain discredited. Across two experiments, the influence of weight …

Disparities In Demographics Of Patients Presenting To A Student-Run Free Clinic In South Jersey, Kirsten Carlberg, Sabah Iqbal, Christian Moya Gamboa, Daliza Diaz, Cerena Moreno, Rebecca Moore

Rowan-Virtua Research Day

Medical schools around the country have established free clinics to better serve the underserved patient populations. In this study, we aimed to evaluate demographic characteristics in the patient population at our free clinic, Rowan-Virtua Community Health Clinic (RVCHC), compared to the general population of Camden County. We found a disproportionately higher percentage of black patients at our clinic when compared to the county overall. Addressing these disparities would require targeted outreach to specific patient populations and improved transit access. Future studies should aim to identify RVCHC health outcomes through the management of chronic disease and understanding emergency room utilization.

The Impact Of Food Deserts And Food Insecurity On Cardiovascular Outcomes In New Jersey, Amina Baig, Cheyenne Myklebust, Jack Hennen, Leah Perez, Rhoda Ukenna-Izuwa, Tayyiaba Farooq

Rowan-Virtua Research Day

Food deserts - areas with limited access to affordable, healthful food - are increasingly being recognized as risk factors for adverse cardiovascular outcomes. This review discusses the link between food desert density and cardiovascular disease risk with a special emphasis on New Jersey. A systematic PubMed, Cochrane, and Embase literature review of studies from 2014 through 2024 was conducted, with some relevant older research dating back to 2001. Some of the keywords used in the search included "food desert," "food insecurity," "cardiovascular disease," and "New Jersey." The search was restricted to English-language research conducted within the United States. The literature …

Screening And Prevention Of The Female Athlete Triad, Lia Summer Goldberg, Kate Whelihan

Rowan-Virtua Research Day

Background The Female Athlete Triad—a syndrome of low energy availability, menstrual dysfunction, and decreased bone mineral density—poses a significant risk to female athletes, particularly those in sports emphasizing leanness or endurance. Despite its potential to impair both performance and long-term health, the Triad remains frequently underdiagnosed due to stigma, nonspecific symptoms, and limited screening practices. This review investigates current strategies for screening and preventing the Triad, aiming to identify best practices and areas needing improvement.

Methods A literature review was conducted using PubMed, focusing on studies published after 2005. Keyword searches included “female athlete triad screening,” “prevention,” “education,” and “awareness.” …

Chemical Exposures In Utero: Phthalates And Congenital Heart Defects, Demi Poulathas

Rowan-Virtua Research Day

Background: Congenital heart defects (CHDs) are the most common type of birth defect. Approximately 80% of CHDs have unknown causes, and phthalates may play a contributing role. Phthalates are ubiquitous environmental chemicals used as plasticizers in a wide range of products, including cosmetics and electronic devices. After entering the body, phthalates bind to the progesterone receptor, which is necessary for fetal development. While multiple studies have explored environmental factors in CHD development, few have examined the effects of phthalates on CHDs in humans. Methods: A literature review was conducted to investigate the relationship between parental occupational phthalate exposure and the …

Impact Of Language Barriers On Out-Of-Hospital Cardiac Arrest Recognition And Response, Kinjal Mody, Sophie Cherfane, Curt Cackovic

Rowan-Virtua Research Day

Out-of-hospital cardiac arrest (OHCA) causes nearly 350,000 deaths annually in the U.S., with survival largely depending on the timely recognition of cardiac arrest and the initiation of bystander CPR by emergency dispatchers. However, English-centric dispatch systems create barriers for individuals with limited English proficiency, potentially delaying critical responses. This study aims to synthesize research on how language differences impact OHCA recognition and CPR initiation in emergency dispatch settings. We hypothesize that language barriers cause significant delays.

PubMed, Scopus, and Web of Science databases were used to identify relevant studies, using search terms like "language barriers," "cardiac arrest," and "CPR." Inclusion …

Assessing The Efficacy Of Prolonged Doxycycline Pep Use In High-Risk Populations For Sti Prevention, Lam Doan, Pearl Joslyn, Lizann Sung, Timothy Breiner, Sarah Marotta, Shikhar Rastogi

Rowan-Virtua Research Day

First recommended in October 2022, doxycycline post-exposure prophylaxis (DoxyPEP) has been increasingly used as a treatment for multiple sexually transmitted infections (STIs). To evaluate the efficacy of prolonged DoxyPEP use in high risk populations - men who have sex with men (MSM) and transgender women - for STIs, different sources addressing various aspects of DoxyPEP, its efficacy in STI prevention, and the potential consequences of its widespread use in terms of antimicrobial resistance were examined. Across 9 studies, DoxyPEP was found to decrease the incidence of bacterial STIs, specifically, syphilis, chlamydia, and gonorrhea with varying efficacy, especially for gonorrhea. Furthermore, …

Optimizing Preventive Care: The Impact Of A Student-Led Initiative To Improve Cancer Screenings In Primary Care, Katherine Klein, Priya Srivastava, John Sauer, Sahiba Gill, Nirali Trivedi, Fadia Barakzai, Yeonwoo Sim, Matthew Green, Anne Jones, Philip Collins

Rowan-Virtua Research Day

Context:

Preventative health measures, including routine cancer screenings, are essential for early detection, timely treatment, and reduction of cancer mortality rates.

Colorectal, breast, and cervical cancer are among the most routinely screened cancers due to advancements in screening technologies1. However, despite the well-established importance of early detection, patient adherence and compliance with national guidelines remain suboptimal, limiting the effectiveness of these screening efforts and delaying possible treatment.2

Objective:

To address this issue, we initiated a medical student-led project focused on improving adherence to national cancer screening guidelines across Rowan-Virtua Family Medicine (FM) practices. This poster outlines the overall efficacy of …

Bridging The Nature Gap: Understanding Barriers And Promoting Outdoor Engagement Among African Americans In Chattanooga, Kennie Almonor

Honors Theses

This paper outlines my process of writing a physical guidebook for outdoor engagement in Chattanooga. It explores the historical context of Black exclusion from outdoor spaces and examines the health disparities that disproportionately affect Black communities. The physical connection between outdoor activity and overall well-being will also be explained. Additionally, this paper details my methodology for conducting focus groups to better understand barriers to outdoor engagement and how participant insights could inform the guidebook’s development. This paper also outlines my research on best practices for structuring an effective guide, writing process, challenges faced, and considerations for extending this project in …

Addressing Pediatric Vaccine Hesitancy Through Medical Education: A Critical Review, Brooke M. Fasano, Chelsey Ameda, Juan G. Ruiz

Cooper Rowan Medical Journal

ABSTRACT

Background: Immunization rates among pediatric patients are declining, largely due to growing vaccine hesitancy among parents and guardians. Addressing public health concerns related to vaccines is critical to preventing a significant reduction in vaccination coverage.

Objective: This critical review examines the effectiveness of training physicians in communication strategies, such as motivational interviewing, on improving vaccine acceptance.

Methods: A systematic search was conducted in PubMed using MeSH terms “Training AND (Motivational Interviewing OR Online Systems) AND Vaccination Hesitancy NOT COVID-19.” The search yielded 26 results, from which 7 studies met the inclusion criteria for full-text review, focusing on training interventions …

Detection Of Covid-19 Variants, Christina Aglieco

Honors Scholar Theses

The outbreak of Covid-19 in December 2019 was devastating to many but led to major advancements in vaccine research and development. The development of a vaccine against SARS-CoV-2 infection offers protection for the public but cannot eliminate the risk of contracting Covid-19 due to the many viral mutations since the initial wild-type strain isolation in 2019. Analysis of these viral mutations will allow for the development of vaccines with greater protection against the new variants of the coronavirus. Secondary to Covid-19 infection seen in the pediatric population is Multisystem Inflammatory Syndrome in Children or MIS-C. Through qPCR analysis of pediatric …

A Systematic Review Of Weight Loss Interventions Among Black Postpartum Women, Jhelma Velveder Perez

Honors Scholar Theses

Cardiovascular disease is a leading contributor to maternal mortality, which remains disproportionately high among Black women. Obesity and postpartum weight retention exacerbate cardiovascular disease risk and increase the likelihood of complications in future pregnancies. Weight loss during the postpartum period may reduce long-term chronic health risks and mortality for Black women. This systematic review aimed to understand the weight-related health needs of Black postpartum women by evaluating behavioral weight loss interventions within the first year after childbirth. A comprehensive search of the PubMed database identified 3 randomized controlled trials that met inclusion criteria. These studies evaluated home-based programs, mobile health …

Quality Of Affected Upper Extremity Use During A Ride-On Toy-Based Training Program In Children With Unilateral Cerebral Palsy: A Pilot Study, Megan Carlmark

Honors Scholar Theses

Unilateral cerebral palsy (UCP) is a subtype of cerebral palsy that impacts movement and coordination on one side of the body. This condition often leads to reduced use of the affected upper extremity in daily tasks. This pilot study explored the feasibility and potential of a joystick-operated ride-on-toy training program as an engaging home-based and play-based intervention to promote affected upper extremity use in children with UCP. Five children from a larger sample of 15 children with a diagnosis of UCP between the ages of 3 and 8 years old were used as data for this thesis. This study included …