Public Health Commons^™

Demographic Disparities In Contraceptive Use: Insights From Female Nsfg Respondents, 2015–2023, Adira Brenner

Rowan-Virtua Research Day

Disparities in contraceptive use persist in the United States despite expanded access to family planning services. Historical policies and ongoing social determinants of health (SDOH) are significant drivers of the continued inequality in reproductive healthcare access and utilization. This study examines demographic trends in contraceptive use using data from the National Survey of Family Growth (NSFG) between 2015 and 2023.

Data were obtained from the NSFG and the National Center for Health Statistics (NCHS) datasets. A cross-comparison was conducted, focusing on variables such as age, race/ethnicity, and educational attainment.

The consensus was that contraceptive use increased to approximately 65% in …

What Are The Correlations Between The Severity Of A Woman's Major Menopausal Symptoms And Their Eating Habits?, Kiely Hoyt, Philip Collins, Do

Rowan-Virtua Research Day

BACKGROUND

Menopause is a naturally occurring process during a woman’s life that is associated with a variety of symptoms that can significantly impact daily life.  Although hormone based therapies are available, they are not always effective or appropriate for all women.  As a result, there is growing interest in diet as a potential non-pharmacologic method to manage symptoms, though current evidence is limited.

HYPOTHESIS

Dietary habits are associated with menopause symptom severity, with certain dietary patterns potentially influencing symptom burden.

METHODS

A cross-sectional, survey study was conducted using an online questionnaire distributed through social media. A total of 129 menopausal …

Effects Of Vaccine Refusal On Adherence To Well-Child Visit Schedule In A Pediatric Population, Arshia Anand, Clare Stephens, Nicole Streeks-Wooden

Rowan-Virtua Research Day

Background: Hepatitis B (Hep B) vaccination at birth is a critical strategy for preventing both perinatal and horizontal transmission of the Hep B virus1 . Unfortunately, refusal of the birthdose vaccine has increased and is associated with subsequent vaccine refusal at 18 and 24 months2 . This trend raises significant concerns, that families who refuse the Hep B vaccine at birth may also engage less frequently in preventive pediatric care. However, the impact of this association on adherence to routine well-child (WC) visits remains unclear.

Hypothesis: Refusal, or incomplete uptake of the Hep B vaccine series is associated with decreased …

Determining The Impact Fitness Training Has On Cardiovascular Health Program For New Jersey Women With Socioeconomic Disadvantages, Aishwarya Muppoor, Amy Glasofer, Lisa Rosenberry, Emma Palma, Dawn Mcmath

Rowan-Virtua Research Day

WISEWOMAN is a 3-year federally funded program offered through Virtua Health to address lifestyle changes in women age 35-64 at risk for heart disease. The purpose of this project was to evaluate the additional of a fitness program to the standard nutrition program offered through Virtua Health’s WISEWOMAN program. Nutrition programming occurred during years 1 and 2 of the WISEWOMAN program, and fitness programming was offered to women in program year 3. Women who received nutrition + exercise (intervention) will have improved outcomes compared to those who receive nutrition programming only (control). We conducted a retrospective chart review to compare …

Comparing Community-Based And Social Media Interventions To Improve Vaccine Uptake In Low-Income U.S. Populations, Tanisha Shah, Nico Santorelli, Maureen Kennedy, Aastha Lele, Syed Ahmad Bilal, Megan Chien, Judith Anne Lightfoot

Rowan-Virtua Research Day

Background:

In recent years, vaccination has become a highly politicized topic, contributing to decreased trust in medical professionals. Exposure to medical misinformation, distrust in government and research, and concerns about vaccine safety have all led to increased vaccine hesitancy and decreased vaccine uptake. These trends are more widely seen in low socioeconomic status (SES) and certain racial populations, posing a significant public health concern despite the effectiveness of vaccines.

Objective: This literature review aims to compare the effectiveness of community-based interventions led by clinicians and community health leaders with social media campaigns in increasing vaccine uptake among low-income populations in …

Evaluating The 4mm Endometrial Thickness Threshold: Racial Disparities In Ultrasound Sensitivity And Diagnostic Delay, Ngozi Ikpeama, Sophia Vogiatzidakis, Xuezhi Jiang, Elizabeth Hertz, Vitoria Chaves, Peter Schnatz

Rowan-Virtua Research Day

Title: Evaluating the 4mm Endometrial Thickness Threshold: Racial Disparities in Ultrasound Sensitivity and Diagnostic Delay

Background: Current ACOG guidelines utilize a 4mm endometrial thickness (ET) threshold via transvaginal ultrasound (TVUS) to exclude malignancy in postmenopausal women. However, recent evidence suggests these standardized thresholds may not be equally effective across all racial cohorts. This systematic review evaluates the diagnostic performance of the 4mm threshold specifically in Black patients.

Methods: A systematic search of peer-reviewed literature was conducted to identify studies comparing TVUS sensitivity and clinical outcomes between racial groups. Data were extracted focusing on the diagnostic sensitivity of the 4mm threshold, …

Impact Of A Caregiver Wellness Workshop On Well-Being And Mental Health, Keertana Jonnalagadda, Morgan Yacoe

Rowan-Virtua Research Day

Family caregivers provide care for loved ones by addressing their activities of daily living (ADLs), instrumental activities of daily living (IADLs), and psychological needs. These demands impact a caregiver’s time and overall well-being. To address burnout and improve education regarding caregiver wellness, a workshop was created to build an effective support system for caregivers and teach them practical self-care strategies. Activities using visual art were designed to reduce caregiver anxiety and stress. Results from validated scales such as Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), WHO-5 Well-Being Index (WHO-5), and a unique caregiver wellness survey (CWS) in a small sample showed …

Assessing The Utilization Of Emergency Departments For Primary Care Services In Southern New Jersey, Joshua James Novello, Sheila Joazile, Mohammad Isa

Rowan-Virtua Research Day

Background: Primary care (PC) is essential to proactive, comprehensive, and preventative care that can improve patient outcomes. One-third of emergency department (ED) visits are for non-emergency care that can be appropriately treated by a PC provider. In New Jersey, more than $400 million is spent annually on avoidable ED visits. Decreasing the total PC treatable ED visits per year will improve the quality of care and decrease costs. New Jersey’s PC spending, based on total health spending, is one of the lowest in the country. Demographic and socioeconomic factors in the Social Vulnerability Index (SVI) examine potentially preventable ED …

A Quasi-Experimental Study To Examine The Food Bucks Rx Program For Food Insecure Patients With Chronic Conditions In A Hospital Outpatient Setting, Nicole A. Vaughn, Robert E. Post, Charlampos Papachristou, Maikel Mansour, April Schetler, Gwen Ockenlaender, Julia Koprak, Elise Mitchell, Benjamin Topiel, Melanie Ernest, Nadine Nugent, Carmen Byker Shanks

Rowan-Virtua Research Day

Objective: Primary purpose of this study was to determine the potential impact of FBRx versus standard of care (SoC) on dietary intake and health outcomes. Design: Quasi-experimental 2-group design, with pre- and post- data using the EHR to capture biometrics, food insecurity, and dietary behavior from participants over the intervention. Setting: Hospital-based food pantry program connected community resources Participants: 587 enrolled participants, 304 in intervention group and 283 in SoC group. Inclusion criteria: screened positive for food insecurity and at least 1 documented chronic condition.  Intervention: FBRx participants received $30 per month in produce vouchers for …

De-Epithelialization Versus Pedicle De-Skinning In Reduction Mammoplasty: Comparative Outcomes From The Literature, Samantha Fry, Karina Vizzoni

Rowan-Virtua Research Day

Background- Reduction mammoplasty treats symptomatic macromastia. A key step involves pedicle preparation before breast mound reconstruction. Two main techniques include: De-epithelialization: Removes epidermis, preserves dermis, De-skinning: Excises both epidermal and dermal layers. Evidence comparing surgical outcomes between these techniques is limited.

Hypothesis- De-epithelialization will result in fewer vascular complications but longer operative times than de-skinning; thus, superiority depends on case selection.

Methods- A literature review identified studies on skin removal techniques in breast reduction mammoplasty.

Results- De-skinning was faster than de-epithelialization, though energy-assisted modalities were fastest. Nipple–areola complex (NAC) ischemia and necrosis rates were low across all methods. Superficial de-epithelialization …

Hormonal Contraceptives And Menstrual Symptom Severity Among Women With Elevated Cardiovascular Disease Risk: Global And Daily Assessment, Maria Cox, Danielle Arigo, Gabrielle M. Salvatore

Rowan-Virtua Research Day

Hormonal contraceptive (HC) use is primarily for pregnancy prevention and may reduce menstrual symptoms in some individuals, though evidence is inconsistent. The aim of the study was to examine differences in symptom presence and severity among 64 menstruating women with ≥1 CVD risk factor (e.g., hypertension), including HC users (20.63%) and non-users (79.37%; sample M_age= 31.88 ± 9.89, M_bmi= 31.79 ± 7.6). Participants completed the global Premenstrual Screening Tool at baseline and then reported the presence and severity of 16 menstrual symptoms (1=Not Present to 4 = Severe) in end-of-day surveys over 45 days. In a …

Defining Success In Collegiate Recovery Programs: A Systematic Review, Brooke Trogdon, John B. Moore

The Corinthian

Background: The transition to higher education is a critical period for emerging adults. Often marked by increased substance use experimentation due to a variety of internal and external factors. This group faces a heightened risk of developing substance-related health issues, necessitating targeted intervention and prevention efforts. Purpose: To systematically review and define key indicators of success for collegiate recovery programs (CRPs) that support students in recovery from substance use disorders (SUDs). Methods: Following PRISMA guidelines, a comprehensive search was conducted using GALILEO and Google Scholar databases. Articles were appraised using the JBI critical appraisal tools. Results: CRPs provide a supportive …

Athletic Trainers And Access To Healthcare For Transgender Collegiate Athletes Of Color: The Role Of Intersectionality, Tarah Althea Holness

Walden Dissertations and Doctoral Studies

No abstract provided.

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

Barriers To Palliative Care Access In Rural South Dakota: A Policy And System-Level Analysis, Harshavardhan Kadarkaraisamy

Honors Thesis

Palliative care improves the quality of life for people living with serious illness. It helps by addressing symptoms, improving communication, and providing mental, physical, and spiritual support. However, in South Dakota access to palliative care is limited in rural areas. These challenges include geographic isolation, workforce shortages, healthcare infrastructure, reimbursement, and misunderstandings about palliative care. This thesis examines the key policy barriers that limit access to palliative care in rural South Dakota. This work involves engaging with South Dakota-specific literature, rural health research, policy sources, community education, telehealth expansion, and policy reform. By focusing on the rural context of South …

Falling Star Program: A Visual Cue Intervention To Reduce Falls In Long-Term Care, Maggie Shanahan

Evidence-Based Practice Project Reports

Falls among older adults in skilled nursing and long-term care settings remain a leading cause of injury, functional decline, and increased healthcare utilization, contributing significantly to morbidity and mortality in this population (Centers for Disease Control and Prevention [CDC], 2023; Agency for Healthcare Research and Quality [AHRQ], 2022). The primary purpose of this project aimed to implement and evaluate a structured visual cue–based fall prevention intervention to reduce fall rates among high-risk residents in a long-term care facility in Northwest Indiana. The project included 23 participants aged 65 years and older who were identified as high risk for falls. Using …

The Meaning Of Physical Activity In The Context Of Health Sciences: A Concept Analysis, Martín G. Farinola

International Journal of Physical Activity and Health

Physical activity has been defined in numerous ways. Thus, this study aimed to conduct a concept analysis of the existing physical activity definitions in the health sciences literature to evaluate its conceptual precision and assess the need for a revised or novel concept better suited for this domain. The concept analysis was accomplished using tools derived from philosophical semantics. The analysis identified six definitions that explicitly state what physical activity is with sufficient clarity to allow for conceptual examination. The findings indicated that these definitions frequently merge the concept of physical activity with its contextual attributes. To address these semantic …

Herbularyo (Folk Healer): An Herbal Medicine Card Game, Maryjane T. Magsino, Inah Marie Q. Rivera, Armando M. Guidote, Genejane M. Adarlo

Chemistry Faculty Publications

Herbularyo, a card game teaching about herbal plants (HPs), was created and evaluated as a viable educational card game based on Tuomisto and Aksela’s criteria. A quasi-experiment was performed on 81 Grade 8 students from a private high school and 50 Grade 11 from a public high school. Independent t-test revealed that the control group (CG) and experimental group (EG) (p=0.386), and EG1 (played ≤5) and EG2 (played >5) (p=0.681) are not comparable with each other. Paired t-test showed EG performed better (p=0.001) than CG (p=0.901) whereas ANCOVA showed that playing Herbularyo improved students’ information retention (p=0.006). EG1 and EG2 …

Descriptive Analysis: Effects Of Insufficient Sleep Among College Students Ages 18-22, Divine Ighalo

Honors Theses

Background: Not getting enough sleep is common among college students and is often linked to habits such as screen time, caffeine intake, stress, and irregular routines. This study examined how these lifestyle factors are associated with insufficient sleep among college students ages 18-22 and how poor sleep affects their overall wellbeing. Methods: This study used a cross-sectional survey design and collected data through an anonymous 25 question online Qualtrics questionnaire. This was completed by 150 participants. The survey was designed to be completed in about 5-7 minutes. It included a mix of multiplechoice questions, frequency-based responses and select all that …

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 …

Examining Biobehavioral Indicators Of Adhd In Children With Fxs, Hannah Pressler, Kayla Smith, Ramsey Coyle, Elizabeth Will, Jane E. Roberts

Caravel Undergraduate Research Journal

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention and hyperactivity/impulsivity behaviors that are inconsistent with developmental age. Children with fragile X syndrome (FXS), a genetic neurodevelopmental disorder, are often diagnosed with comorbid ADHD (53–59% of males with FXS). Despite the prevalence of ADHD in FXS, little is known about the early manifestation of ADHD. The current project aims to explore group differences in play behaviors between children with FXS and typically developing (TD) children as well as the relationship between infant play behavior and heart activity to future ADHD attention outcomes. Participants included male children with FXS and …

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 …

Evaluating The Role Of Stress, Self-Perceptions Of Health, And Self-Efficacy On Physical Activity Over Time: Results From Project Drive, Ashlynn Riley, Allison Sweeney, Dawn K. Wilson

Caravel Undergraduate Research Journal

Most Americans are not meeting the recommended levels of physical activity. In underserved communities, these inequities are even greater, with African American women being less likely to engage in physical activity and being at greater risk for chronic disease relative to non-minority women. This study seeks to further understand the factors that support or undermine engagement in physical activity among African American women. Specifically, the present study evaluates the impact of stress, self-perceptions of health, and self-efficacy on physical activity engagement in a 10-week physical activity intervention program for African American women. Participants (N = 33) completed measures of …

Isass Brave New Continuing Medical Education World: The Stifling Of Innovation In Spine Surgery Through Overrestriction Of Collaboration, Morgan P. Lorio, Kai-Uwe Lewandrowski, Óscar L. Alves, Avelino Parajón, Matthew Scott-Young, Hansen A. Yuan, Alex R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: in 2020, the accreditation Council for Continuing Medical education (aCCMe) released the Standards for Integrity and Independence in Accredited Continuing Medical Education, effective january 1, 2022, to ensure that accredited activities are accurate, balanced, evidence-based, and clearly separated from marketing and sales. although these aims are broadly supported, implementation may have unintended consequences in procedure-intensive specialties such as spine surgery, where surgeon–industry collaboration often drives device innovation, clinical trials, and dissemination of new techniques.

OBJECTIVE: To examine how current interpretations of ACCME eligibility and financial-relationship standards may affect continuing medical education in spine surgery and to propose practical adaptations …

A Cross-Cultural Investigation Of Consumer Hoarding Behavior During Covid-19: Differences Between Sweden And The United States, Christy M. Cook, Pia A. Albinsson, James E. Stoddard

Atlantic Marketing Journal

This study is a cross-cultural exploration of consumer hoarding behavior during Covid-19; specifically, a comparison between Sweden and the United States. This research analyzes whether Swedish and American consumer hoarding behavior factors of prosocial orientation, consumer resilience and consumer risk-taking propensity reflect identical relationships during less predictable environmental forces (i.e., Covid-19 or global pandemic). Results from Partial Least Squares-Structural Equation Modeling (PLS-SEM) show that consumer prosocial orientation is negatively related to consumer hoarding and prosocial orientation is positively related to consumer resilience. In turn, both prosocial orientation and consumer resilience exhibit a positive relationship towards consumer hoarding. Consumer resilience is …

The Effect Of Stress Hormones On Memory Formation And Academic Performance, Emma L. Hooks

Senior Honors Theses

With chronic stress becoming increasingly prevalent in academic settings, researchers have identified significant effects on learning and academic performance. Cortisol, a glucocorticoid hormone, is released following the activation of the hypothalamic-pituitary-adrenal (HPA) axis and plays a vital role in the stress response. Although acute increases in cortisol can improve attention and memory, sustained activation of the stress response can impair memory, executive functioning, and academic performance. This thesis draws on neuroscience, psychology, and education research to examine how chronic cortisol exposure affects the hippocampus and prefrontal cortex, and how the effects manifest in learning and academic performance, particularly in developmental …

Measuring Disability Prevalence In Healthcare: A Study Comparing Two Disability Measures, Kristen L. Milefchik, Rhonda K. Dailey, Sharon Milberger

Developmental Disabilities Network Journal

People with disabilities experience significant health disparities and interventions are needed to address them. Measuring disability prevalence is an essential aspect of designing effective, data-driven healthcare strategies. Accurately measuring disability prevalence is challenging given disability is a complex phenomenon, with biological, social, environmental, and cultural components. Previous studies have compared a variety of disability status measurements and found that measurements were incongruent with each other. This study examines the concordance between disability status using two different measures: the nationally recognized American Community Survey (ACS-6) functional difficulty questions and one disability identity question. We used data from 3,621 adult patients participating …

Delivering Food, Exercise, And Nutrition Education For The Prevention Of Chronic Disease, Ava Caron

Human Nutrition and Hospitality Management Undergraduate Honors Theses

Chronic diseases such as diabetes, heart and respiratory diseases, cancer, and stroke pose significant health challenges in the United States, with Arkansas experiencing some of the highest rates of related mortality. This project aimed to improve health literacy related to nutrition and physical activity among adults at risk for chronic disease in Arkansas, focusing on those living independently in Ozark, Ouachita, and Delta regions, as well as cooperative extension agents in Family & Consumer Sciences. Using a mixed-methods approach involving surveys and focus groups, the study explored participants’ nutrition knowledge, health awareness, physical activity engagement, and preferred methods of receiving …

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.

Prevention Of Dementia Using Mobile Phone Applications (Prodemos) – A Health-Economic Cost-Utility Analysis In People Aged 55–75 Years With Low Socio-Economic Status, Ron Handels, Marieke Hoevenaar-Blom, Manshu Song, Carol Brayne, Eric Moll Van Charante, Fiona E. Matthews, Junfang Xu, Linus Jönsson, Nicola Coley, Rachael Brooks, Xuening Jian, Tingting Qin, Youxin Wang, Wei Wang, Edo Richard, Anders Wimo

Research outputs 2022 to 2026

Introduction We aimed to explore the potential incremental cost-effectiveness of the PRODEMOS coach-supported mobile health intervention for primary prevention of dementia versus standard of care provided to people aged 55–75 years with low socio-economic status (SES) in the United Kingdom (UK), and any SES in China. Methods 12–18-month PRODEMOS trial (ISRCTN15986016) efficacy outcomes on hypertension, obesity, hypercholesterolemia, physical inactivity and smoking were extrapolated to lifetime impact on dementia onset, myocardial infarction, stroke and death using a health-economic open-source simulation model. Results Simulated outcomes showed dementia cases were avoided (UK = -206 (-658 to 281), China = -140 (-456 to 205) …