Public Health Commons^™

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 …

Patient Reported Experiences Of Anxiety And Depression Screenings In A Canadian Adult Cystic Fibrosis Clinic, Pat Macdiarmid, April Tanzler, Waqar Younas, Terra Stephenson, Nick Kanaan, Bradley S. Quon

Patient Experience Journal

The International Depression Epidemiological Study (TIDES) found rates of anxiety and depression 2–3 times higher in the cystic fibrosis (CF) population than in community samples. Following recommendations of the International Committee on Mental Health in CF we began conducting screenings at our Canadian Adult CF Clinic using the GAD-7 and PHQ-9, referring patients to mental health (MH) supports within and outside the clinic. Our aim was to provide a service patients themselves experienced as supportive of their MH. We found few studies on patient reported experiences of MH screening programs in CF clinics, and none in the Canadian context. Patients …

Patient Reported Experiences Of Mental Health And Substance Use In British Columbia Emergency Departments: A Patient-Oriented Exploration Of Survey Data, Ross Duncan, Ed Martin, Louise Yeoh, John Grogan, Riyad B. Abu-Laban

Patient Experience Journal

Project Title: Patient reported experiences of mental health and substance use in British Columbia Emergency Departments: A patient-oriented exploration of survey data. Background: Existing surveys of BC EDs have failed to engage patients to guide research. A provincial level survey of patient experiences in emergency departments was identified as a rich source of data for collaboration level patient-oriented research, with patient partners co-developing research questions and focus of data analysis. Methods: This Patient Oriented Research recruited three patient partners who, through a co-creation process, prioritized dimensions and questions on communication with providers, culturally safe and compassionate care, overall ED rating, …

Centering Torture Survivor Voices From Their Experiences, Linda Piwowarczyk, Nandini Agarwal, Kathryn Price, Dmitrii Krivorotko, Arslan Kasimov, Alexandra Brinker, Suzanne Wilson, Salma Amin, Tithi D. Baul

Patient Experience Journal

Background: Human rights violations persist globally, with torture routinely utilized as a mechanism to repress democratic expression and silence social movements. The Boston Center for Refugee Health and Human Rights (BCRHHR) is a hospital-based program providing services to refugees, survivors of torture (SOT), and asylum seekers. Emerging evidence suggests that circumstances encountered after resettlement may exert a greater traumatogenic effect than those experienced in the country of origin or along the migration journey. We performed a qualitative needs assessment interviewing 22 randomly selected patients who received BCRHHR services at least twice between January 1, 2021, and December 31, 2021. SOT …

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 …

Piloting The Strong Bodies Strength Training Program In Utah, Gabriela Murza, Jenna Dyckman, Cris Meier, Emma Parkhurst, Sadie Wilde, Christina Pay, Naomi Brower, Cindy Nelson

Outcomes and Impact Quarterly

Muscle and bone loss occurs as we age, impacting health and independence. We evaluated a pilot 12-week strength training program for older adults in Utah. Participants showed improved fitness metrics and increased confidence. Results demonstrate the program’s effectiveness and public value in expanding access to evidence-based exercise that supports healthy aging.

Hope Kit Program, Monica Reuber

Capstone Experience: Master of Public Health

Suicide is a leading cause of death in adolescents and young adults, with a disproportionate burden of those deaths in rural areas such as Kansas. High rates of depressive symptoms, suicidal thoughts, and suicidal attempts, combined with a shortage of mental health providers, emphasize the need for community-based intervention.

This capstone is designed to develop a plan for Hope Kits, a proposed suicide prevention program, among youth in grades 7-12 in Sheridan County, Kansas to improve coping skills, promote help-seeking behavior, and reduce suicide risks.

A logic model guides the program development, which aligns with available literature and Social Cognitive …

A Replication Study - Mental Health And Suicide Risk Among High School Students And Protective Factors — Youth Risk Behavior Survey, United States, 2023, Hannah Baiyor

Capstone Experience: Master of Public Health

The original study (Verlenden et al., 2024) aims to analyze how various protective factors may buffer poor mental health and suicide risk outcomes among US students in grades 9-12, an important public health topic as suicide is one of the leading causes of death among US teens (Centers for Disease Control and Prevention, 2024a). Through studying these associations, this study aims to uncover pathways to positive mental health outcomes and reduced suicide risk. The study utilizes the 2023 YRBS dataset, a nationally representative sample of US public and private school students in grades 9-12, to estimate prevalence of four mental …

"It's Probably Like A Web": Complex Relationships Between Pain And Mental Health Among Bisexual+ Women With Chronic Pain, Aster Harrison, Mansha Mirza

Department of Occupational Therapy Faculty Papers

INTRODUCTION: Bisexual+ women experience higher rates of both mental illness and chronic pain when compared to either straight or lesbian women. Their experiences of the relationship between their mental health and chronic pain remain underexplored. This article presents an intersectional Interpretive Phenomenological Analysis of the experiences of six bisexual+ women with chronic pain.

METHODS: Each woman completed two semi-structured interviews. Interviews were analyzed with Interpretive Phenomenological Analysis, beginning with in-depth case study analysis of each person's interviews before moving to comparison across cases.

RESULTS: Results indicated a complex web of multidirectional relationships between mental health and chronic pain. These relationships …

Eating Disorders: What Utahns Need To Know, Brie Sparks, Susan R. Madsen

Marketing and Strategy Faculty Publications

Eating disorders are serious mental health conditions characterized by persistent disturbances in eating behaviors and related thoughts and emotions. They affect individuals of all ages, backgrounds, body sizes, and life stages, often occurring alongside other mental health challenges. Eating disorders can have profound impacts on physical health, emotional wellbeing, relationships, educational attainment, and workforce participation. Understanding the prevalence, risk factors, and barriers to treatment in Utah is essential for developing effective prevention, intervention, and recovery efforts.

Evaluating The Impact Of A Community-Based Prenatal Education Program On Maternal Knowledge And Intentions In Utah, Aaron T. Hunt, Jenna Dyckman, Kaylee Cox

Journal of Human Sciences and Extension

Maternal and infant health in the U.S. has worsened, with rising rates of maternal mortality, gestational diabetes, postpartum depression, and infant mortality. Prenatal education is a proven strategy to improve outcomes, yet many expecting parents rely on unvetted information or lack access to reliable resources. To address this gap, a pilot prenatal education program was implemented through Utah State University Extension to improve knowledge, attitudes, and intentions related to breastfeeding, nutrition, mental health, and other key topics. The program consisted of 3 1-hour, evidence-based workshops incorporating lectures and interactive activities. A retrospective pre-post survey was completed by 28 pregnant participants …

Women & Mental Health: What Utahns Need To Know, Brie Sparks, Susan R. Madsen

Marketing and Strategy Faculty Publications

Mental health shapes how individuals think, feel, cope with stress, and engage in relationships and communities. Mental health concerns have increased nationally and in Utah, influenced by social isolation, economic stress, and lasting effects of the COVID‑19 pandemic. Utah now has one of the highest rates of mental illness in the country, with nearly 29.9% of adults reporting a condition, and women are disproportionately affected. Understanding these patterns and their drivers is essential to improving outcomes for women, families, and communities across the state.

When School Culture Excludes: Deficit Discourse, Microaggressions, And The Mental Health Of Marginalized Students – A Conceptual Framework With Implications For School Psychology Practice And Equity Policy, Modupe Mercy Oyewunmi

Publications

Deficit-laden language like ‘behavior problem,’ ‘not college material,’ ‘won’t fit in’, ‘not a cultural fit’, operates as a systemic form of implicit bias and microaggression in school settings. Despite decades of research on school belonging and well-being, school psychology has yet to integrate these exclusionary discursive practices into a coherent health-determinant model that also accounts for the current anti-diversity, equity, and inclusion (DEI) policy environment. This conceptual paper proposes a testable framework linking deficit discourse and school-based microaggressions to student identity suppression, academic impostor phenomenon, and educator moral injury, with downstream effects on school mental health outcomes. We situate these …

Predictive Models Of Student Mental Health: The Correlation Between Academic Burnout And Depression In The Higher Education Environment, Hyejoon Song

Masters Theses

Importance: Over 80% of U.S. college students report significant emotional difficulties, and 58% endorse academic burnout as a persistent concern, yet institution-specific data at faith-integrated universities such as Liberty University remain scarce, limiting evidence-based programmatic response.

Objective: To examine the correlation between academic burnout and depressive symptomatology at Liberty University, identify the most predictive individual burnout item via Random Forest machine learning, and characterize distinct student risk profiles via KMeans clustering. Design, Setting, Participants: Cross-sectional survey (IRB-FY24-25-1491, Exempt) of 236 Liberty University students (mean age 36.9 ± 14.3 years; 84.0% female; 61.0% graduate-level), 2025–2026 academic year.

Main Outcome and Measures: …

Perceptions Of The Effects Of Launch Control Center Environmental Exposures And Alert Schedules Among Missile Operations Officers: A Mixed Methods Phenomenological Study, Dawnie Rae Ramie

Doctoral Dissertations and Projects

This mixed methods hermeneutic phenomenological study focused on an investigation of the perceptions of missile operations alert duty and the effects on health and sleep hygiene among Air Force missile operations officers. Questionnaires, interviews, and surveys were all used to gather data on subjects’ experiences and perspectives, including methods to mitigate the effects of poor sleep. Driving questions of research included how missile alert schedules affect sleep habits, as well as how missileers perceived alert duties may impact their health. Data was collected through a web-based Qualtrics Likert questionnaire (N=139), open-ended interviews with purposively selected subjects (N=17), and web-based Qualtrics …

Evaluating An Educational Intervention On Screen-Time And Behavior Change: A Pilot Study, Kayla L. Sweeney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Excessive screen time among adolescents has been associated with negative health outcomes, including sleep disturbances, anxiety, and depression. Despite growing awareness, many parents lack sufficient understanding of these risks and their impact on adolescent well-being. This project evaluated whether a brief educational intervention improved parents’ knowledge of the health effects of excessive screen time. Methods: A pre-and post-survey design was used to assess changes in parents’ understanding following an educational video intervention. The educational intervention consisted of evidence-based content highlighting the impact of screen time on mental health and sleep. The survey measured knowledge, beliefs, behavioral intentions, and strategies …

The Role Of Paraprofessionals In The Mental Health Structure Of India, Amy Abraham, Kimberly D. Becker, Wendy Chu

Caravel Undergraduate Research Journal

The mental health treatment gap in India is part of a growing public health crisis, with over 95% of those in need of services never receiving them. Over 197 million Indians suffer from at least one diagnosable mental health disorder, and this number continues to grow given the treatment gap. The treatment gap is a result of four major factors: lack of government support, stigma, limited treatment facilities, and dearth of professionals able to provide treatment. The current study aimed to analyze several factors of paraprofessional-led mental health interventions including setting, treatments delivered, treatment models, and client outcomes. A narrative …

Predator Or Prey: The Analysis Of Gender And Race On The Perception Of Black Men As Sexual Assault Victims, Jordyn Livingston, Dr. Florencia Cornet

Caravel Undergraduate Research Journal

Men sexual assault victims have gained more attention in recent years. Despite the growing sociological literature on violence against men, previous research provides little acknowledgment of Black men sexual assault victims. In this manuscript, I analyze emerging literature in the socio-medical sciences to explore how gender and race affects the perceptions of Black men as sexual assault victims. Specifically, I utilize intersectionality as a theoretical framework to synthesize literature on blackness and masculinity in sexual assault victims to conclude that there is an intersectional point that disadvantages Black males, portraying them as sexual predators. In so doing, I provide research …

The Intersection Between Adolescent Pregnancy, Mental Health Concerns, Stigma, And Sex Education, Madelon Cox

Honors Program: Senior Projects (Public)

This thesis discusses research from the past two decades focused on factors contributing to an increased risk of adolescent pregnancy and the lasting impact of that pregnancy. The consequences of being a pregnant adolescent can be compounded by race, gender, socioeconomic class, and access to education. Adolescent pregnancy also carries significant physical and mental health risk for the adolescent and the child. Awareness and various interventions can help pregnant adolescents or those who may be at risk for adolescent pregnancy to support them, prevent isolation, and reduce further negative mental health conditions, such as depression and anxiety.

Development And Psychometric Assessment Of The Sub-Scales Of The Ontario Perception Of Care Tool For Mental Health And Addictions (Opoc-Mha), Brian Rush, Karen Urbanoski

Patient Experience Journal

Historically, the tools designed to measure of ``patient satisfaction'' or ``perception of care'' have been developed and evolved separately for the mental health and substance use health sectors. This presents challenges for implementation and usefulness of the results for quality improvement and evaluation given recent efforts aimed at more integrated services and systems. The objective of this study was to psychometrically evaluate eight domain-specific sub-scales of a perception-of-care tool developed specifically for mental health, substance use and/or concurrent disorder services - the OPOC-MHA. The development and process for widescale implementation of the OPOC-MHA has resulted in a large provincial dataset …

Questionnaire For Eudaimonic Well-Being: Psychometric Validation Among Malaysian Youth, Mohd Ahsani A. Malek, Nurulwahida Saad, Suzana Mohd. Hoesni, Muhamad Ariff Ibrahim, Nurul Shafira Adi, Mohd Nazir Mohd Nazori

Makara Journal of Health Research

Background: The rising prevalence of mental illness underscores the need to understand how individuals can live and flourish under such conditions. In Malaysia, research has largely emphasized diagnosis and treatment, with limited focus on positive psychology and few validated instruments. This study aimed to translate and validate the questionnaire for eudaimonic well-being (QEWB) among Malaysian youth.

Methods: The QEWB was translated into Malay using back-to-back translation and administered to undergraduates from four public universities through a cross-sectional survey design. Convenience quota sampling was used, resulting in 229 respondents completing the online form to measure sociodemographic characteristics, eudaimonic well-being, …

Occupational Therapy For Maternal Pelvic Floor And Mental Health: A Holistic Approach To Recovery, Diana S. Theodore

Student Capstone Papers

Maternal pelvic floor dysfunction (PFD) is highly prevalent yet often underrecognized in occupational therapy practice, despite its significant impact on mental health, daily function, and quality of life. Many postpartum women experience symptoms such as urinary incontinence, pain with intimacy, and pelvic organ prolapse, which are frequently normalized or left untreated. Occupational therapy practitioners often have limited training in addressing the complex relationship between pelvic floor function and maternal mental health, contributing to gaps in care. The purpose of this capstone project was to develop a comprehensive handbook for occupational therapy students and practitioners integrating pelvic floor function and maternal …

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

MUSC Theses and Dissertations

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

Can The Implementation Of The Pause Decrease Death Anxiety And Poor Mental Health In Practicing Nurses?, Lilli Meyer

Undergraduate Theses

Practicing nurses are frequently exposed to patient death, placing them at increased risk for death anxiety and compromised mental health. Despite this, there remains a lack of structured, in-the-moment interventions to support emotional processing within clinical settings. This study evaluates whether the implementation of “The Pause,” a brief moment of silence following a patient’s death, may reduce death anxiety and improve mental health outcomes among practicing nurses. A quantitative survey consisting of eight questions was distributed to nurses in the Louisville, Kentucky area over a three-month period, yielding 26 responses. Findings indicated that 80.8% of participants reported no improvement or …

Program Development For Maternal Mental Health During The Transition To Motherhood, Lindsey A. Lindsley, Cassandra Nelson

Spring 2026 OTD Capstone Symposium

The transition to motherhood can be both rewarding and challenging, with many women experiencing increased vulnerability to postpartum depression (PPD). This capstone project focused on developing and implementing a six-week maternal mental health program designed to support postpartum women through education, occupational engagement, and peer connection. Grounded in the Model of Human Occupation (MOHO), the program used a hybrid format combining in-person and virtual sessions to improve accessibility. Program outcomes were evaluated using surveys, the Occupational Self Assessment (OSA), and participant feedback. Participants demonstrated increased knowledge of postpartum mental health, greater confidence in their maternal roles, and improved ability to …

Occupational Therapy For People With Internet Gaming Disorder: A Concept Paper, Samuel R. Bender, Steven Gerardi

Spring 2026 OTD Capstone Symposium

Internet Gaming Disorder (IGD) is associated with occupational imbalance and disrupted routines, contributing to challenges in occupational participation and performance. Due to there being a gap in occupational therapy-based research and guidance for people with IGD, this capstone project focused on the development of a concept paper informed by The Model of Human Occupation (MOHO) that frames problematic video gaming as an occupational issue. The concept paper organizes assessment strategies, identifies problems, outlines intervention ideas, and discusses potential next steps for assisting people with IGD within occupational therapy. This capstone project is intended to help current occupational therapists more effectively …

Prevalence And Determinant Factors Of Depression Among Pregnant Women In Poned Health Center In Tangerang City Area, Dian Geumala Hayati, Sudijanto Kamso, Popy Yuniar, Yuli Puspita Devi

Jurnal Epidemiologi Kesehatan Indonesia

According to World Health Organization (WHO), approximately 10% of pregnant women experience mental disorders, with depression being particularly prevalent. In developing countries, this rate is was even higher, reaching 19.8% after childbirth and 15.6% during pregnancy. Various studies conducted in Indonesia show that the prevalence of depression among pregnant women ranges widely, from 21.4% to 26.2%.This study aimed to determine the prevalence and risk factors associated with depression during pregnancy in pregnant women at the PONED Community Health Center in Tangerang City Area. A facility-based cross-sectional study was conducted with 105 pregnant women attending antenatal check-ups at the 17 PONED …

How Does Striving Against Adversity Impact Emotional Well-Being And Cardiovascular Risk In Children?, Brooks B. Gump, Stefanie Pilkay, Xiafei Wang, Sara Vasilenko, Nader H. Attallah-Yunes, Sarah Woolf-King, Stephen Maisto, Edith Chen, Craig K. Ewart

Population Health Research Brief Series

Working hard and persisting through challenges (i.e., striving) are often encouraged for children who face adversity.  But for children facing severe adversity, striving can come with hidden costs. This brief summarizes findings from a study using data from the Environmental Exposures and Child Health Outcomes (EECHO) cohort (N=283, 2013-2017) of children ages 9-11 in Syracuse, NY. The authors find that children facing adversity who strived harder reported lower depression and hostility. However, high-striving high-adversity children also experienced significantly higher blood pressure and enlarged heart chambers than their lower striving peers, both risk factors for future heart disease.

School Climate As Primary Prevention: Mental Health And Violence Outcomes Among Lgbtq+ Youth In The U.S. South (2015–2024), Latarsha H. Michael, Brieah D. Hudson, Kenya T. Horne

Journal of Public Health in the Deep South

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adolescents in the U.S. South experience disproportionately high rates of bullying, discrimination, depression, and suicidality. Supportive and inclusive school climates are identified as key protective factors that can mitigate these risks and function as primary prevention against violence. This systematic narrative review synthesizes peer-reviewed research and high-quality survey reports published between 2015 and 2024 that assess school climate, mental health, and violence-related outcomes among LGBTQ+ youth with representation from Southern states, including Mississippi, Alabama, and Louisiana. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 1,167 records …

Challenges, Stressors, And Resilience Resources Experienced By Older Black Women In Rural South Carolina Throughout The Covid-19 Pandemic, Arielle N'Diaye, Camryn Garrett, Sarah Wilcox Phd, Bankole Olatosi Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D.

Faculty Publications

Background

Resilience has been established as a protective factor against mental health challenges (e.g., anxiety, depression). From an intersectional perspective, the stressors experienced by Black women living in rural communities are likely to have been exacerbated during the COVID-19 pandemic. This study aims to identify the challenges and stressors experienced and the resilience resources available to and relied upon by rural, Black women, during the pandemic.

Methods

Individual, in-depth, structured interviews (n = 24) were conducted among Black women living in rural South Carolina, recruited by local community health workers, from January to April of 2024. All interviews were recorded, …