Community Health and Preventive Medicine Commons^™

Post-Pandemic Telebehavioral Health: Sustaining And Regulating Remote Mental Health Care As A Core Modality, Weiqiao Dong

Dartmouth College Master’s Theses

The United States continues to face a persistent mental health crisis after the COVID-19 pandemic, raising a policy question about the long-term role and regulation of telebehavioral health as a core modality of care. This thesis examines that question through a case study of New York State, an early center of the pandemic and a leader in telehealth policy reform.

Guided by the Health Policy Triangle framework, this thesis integrates longitudinal data from all 62 New York counties for 2010-2025 with a 2025 cross-sectional dataset covering 61 counties. Seventeen standardized indicators are organized into four dimensions: geographic, economic, demographic, and …

The Efficacy Of Transversus Abdominis Plane Block As An Adjunct To Spinal Anesthesia For Cesarean Delivery: An Evidence Synthesis And Implementation Toolkit, Alyssa Hebert, Alex Potts, Gabriela Robertson

Graduate Theses, Dissertations, and Capstones

Postoperative pain hinders cesarean delivery recovery and overall patient experience. Although spinal anesthesia with intrathecal opioids remains the standard of practice, associated side effects and concerns regarding opioid exposure highlight the need for effective opioid-sparing strategies. Anesthesia providers play a critical role in advancing postoperative pain management through evidence-based protocol development, provider education, and interdisciplinary collaboration to optimize maternal outcomes. The transversus abdominis plane (TAP) block provides somatic analgesia to the anterior abdominal wall by targeting the thoracolumbar nerves (T6–L1) and has increasingly been incorporated into multimodal postoperative pain management strategies for abdominal surgery. Nevertheless, a gap remains in obstetric …

Motherwise In Nicaragua: The Implementation Of Culturally Adapted Relationship Education For Women During Pregnancy And Postpartum, Amanda Key Correa Love

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Intimate partner violence (IPV) is a concerning public health issue of global proportions, particularly within rural and under-resourced settings. Communities in these settings face elevated risk for relationship abuse, further compounded by barriers to access culturally responsive preventive intervention programming. This qualitative study investigated participant experiences, cultural adaptation, and implementation of the MotherWise program, a healthy relationship education intervention in rural Leon, Nicaragua. Semi-structured interviews were conducted with former and current program participants as well as the program facilitator following the initial program implementation. Data were analyzed using thematic analysis to identify patterns related to participant experiences, the types of …

Lessons Learned In Providing Infant And Early Childhood Mental Health Consultation During The Covid-19 Pandemic, Rashele Wade

Journal of Global Awareness

Access to quality childcare is a protective factor from lifelong issues such as school failure, school drop-out, and incarceration. Conversely, preschool suspension and expulsion are significant risk factors. Evidence-based interventions, such as Infant and Early Childhood Mental Health Consultation, aim to reduce and eliminate the incidence of preschool suspensions and expulsions. The COVID-19 pandemic disrupted access to quality childcare for many children across the country and globally. This study utilized a qualitative action research approach and generic qualitative inquiry to examine the research question, “How can we improve Infant and Early Childhood Mental Health Consultation through lessons learned during the …

Alcohol Awareness, Prevention, And Education In Greek Life, Vivian J. Mcmechen, Kara Ann Lasater, Page Dobbs

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Alcohol consumption is normalized in Greek Life culture, and this social standard can lead to risky health behaviors and overconsumption. At the University of Arkansas, approximately one-third of students are members of Greek Life; there is a need for prevention methods that understand students’ lived experiences. Purpose: The purpose of this study is to examine students’ experiences with alcohol prevention, awareness, and education as current members of Greek Life at the University of Arkansas. Through student interviews and surveys, this project aims to inform and provide recommendations for relatable and student-centered alcohol prevention and education efforts. Methodology: This study …

Feasibility Of Assessing Dietary Patterns And Anxiety In College Students: A Pilot Study Using Nutrition Questionnaires, Gad-7, And Asq, Kylie Ford

Electronic Theses and Dissertations

Anxiety is highly prevalent among college students representing a significant public health concern. Research indicates that dietary patterns may influence mental health outcomes; however, the practicality of collecting comprehensive dietary and psychological data in college populations remains unclear. This pilot study assessed the feasibility of evaluating dietary patterns and anxiety using self-report instruments. Participants completed the Nutrition and Eating Habit questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), and the Anxiety Sensitivity Questionnaire (ASQ). Although twenty-one students were recruited, survey completion rates were low, with only seven participants completing the nutrition questionnaire necessary to calculate the Dietary Inflammatory Index (DII). Descriptive analyses …

Governing Addiction: An Anthropological Comparison Of Care In The United States And The Netherlands, Kiren K. Bagga

Bates College Journal of Political Studies

This article examines addiction care as a form of moral governance through a comparative anthropological analysis of the United States and the Netherlands. Drawing on a Foucauldian theory of biopolitics alongside this study argues that approaches to addiction treatment reveal how states differentially value life, citizenship, and vulnerability. Joan Tronto's relational definition of ethical care is used to move beyond a solely moral context, towards an ethical understanding of both caretakers and those who require care. In the United States, addiction policy has historically functioned as a punitive and moralizing project, shaped by racialized drug criminalization, neoliberal ideals of individual …

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, …

Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.

Journal of Appalachian Health

Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …

Health Data And Policy Related To Methamphetamine-Use Suicide In Mississippi, Mary C. Drane

Honors Theses

The purpose of this research is to investigate how methamphetamine use in Mississippi, especially in its rural areas, intersects with public health, policy, and suicide outcomes in the state. Mississippi's methamphetamine crisis has evolved significantly, shifting from locally produced drugs to cartel-supplied crystal methamphetamine, while state and federal policies have struggled to keep pace with the scale and complexity of the problem. Using a convergent parallel mixed-methods design, this research analyzed CDC Wonder multiple causes of death data and SAMHSA Treatment Episode Data Set Admissions (TEDS-A) data from 2018 to 2024 alongside four qualitative key informant interviews with stakeholders across …

A Qualitative Analysis Of Progress, Successes, And Challenges Among Indiana Recipients As Part Of A National Initiative To Reduce Covid-19–Related Health Disparities, Marla Winters, Lily Darbishire

Purdue Journal of Service-Learning and International Engagement

In light of the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) provided funding to states as part of the CDC Disparities Grant initiative. The aim of the funding was to reduce chronic disease and COVID-19–related health disparities among vulnerable communities through four unique strategies. Funding was awarded to the Indiana Department of Health (IDOH) to begin an Indiana chapter of this initiative, called Indiana Healthy Opportunities for People Everywhere (I-HOPE). From 2021 to 2023, the IDOH provided I-HOPE funding to local communities (subgrantees) to support the design and implementation of programs to improve community health. For example, …

Facebook Interaction As A Potential Marker Of Cognitive Decline: Pilot Study, Esraa M. Qansuwa

Theses and Dissertations

One of the critical challenges in brain disorder research is the early identification of individuals with mild cognitive impairment (MCI) who may later develop Alzheimer’s disease (AD) or other dementias. MCI in older adults is frequently associated with diminished social engagement and observable behavioral changes. With the rapid expansion of social media platforms and advances in Machine Learning (ML), digital traces from online activity present a novel and scalable avenue for mental health screening. In particular, predictive ML approaches have demonstrated strong potential in building reliable classifiers for early detection of neurocognitive decline. This study introduces an innovative framework that …

An Exploratory Study Of Social Determinants And Pediatric Lead Exposure In Chemung County, Ny, Jenna Mccracken, Anika Stundtner, Megan Kerbag, Madison Desantis, Jennifer Coseo, Richard Terry

Advances in Clinical Medical Research and Healthcare Delivery

Background: Lead exposure in children is a persistent public health concern due to its irreversible neurological and developmental effects. Children under 6 years old are particularly vulnerable due to frequent hand-to-mouth activity and increased environmental exposure. Existing literature suggests a relationship between adverse social determinants of health (SDOH), such as low parental education and residence in high-poverty areas, and elevated pediatric blood lead levels (BLLs). This study, subsidized through a community service grant from Excellus Blue Cross Blue Shield, aimed to examine the association between BLLs and SDOH among children screened at the ACCEL Community Health Clinic in Chemung County, …

Fact Sheet: Kratom, Cadence Johnnie, Ashley Yaugher, Aaron Hunt, Cara Murray, Timothy Keady

All Current Publications

There are many common myths and misunderstandings associated with kratom. Kratom (Mitragyna speciosa) is a tropical tree native to Southeast Asia. In recent years, kratom use has grown in the United States. It is sold in various forms, including capsules, powders, and most commonly as liquid extracts or “shots." These kratom products are promoted as health supplements, advertised for benefits such as boosting energy, enhancing mood, or producing opioid-like effects. However, most users may not fully understand what they are consuming or the potential risks it carries. Commercial kratom products vary widely in their chemical composition. Synthetic (human-made) or …

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

College of Graduate Studies: Theses & Dissertations

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

Caregiver Training: Improving Social Determinants Of Health, Patient Safety, Empowerment Through Improving Elder Care Education And Skills, Kathleen Thimsen

Nursing Faculty Research

Caregiver training (CaGi TRaining) is a time-tested intervention aimed at improving safety in elders living and aging in place in the community. While elder abuse and maltreatment was the intial purpose of the project, with over 3500 Caregivers graduated from this program since 2009, the course has addresses social determinants of health, and improved workforce pipelines by providing stable employment, improved self-efficacy, and confidence demonstrated by self-reports at graduation and in follow up surveys. Previously learners without a high school diploma retruned to school to obtain a GED (40%), with an additional return to school for bacalaureate and degrees (27%) …

The Connection Between Medicaid And Obesity In Northeast Ohio, Sophie Kheder, Emmie Kelley

Williams Honors College, Honors Research Projects

Obesity is a major public health concern in the United States that is projected to increase exponentially over the next few years. Obesity is commonly associated with a lower socioeconomic status. Lower-income individuals tend to be supported by Medicaid, a federal insurance program for low-income Americans. Prior studies have shown a positive correlation between income status and obesity prevalence. Our goal was to find if there was a correlation between Medicaid patients and obesity in Northeast Ohio, to provide physicians with a set of characteristics to better combat obesity, since preventative and treatment guidelines are tailored to national trends. We …

The Role Of Resistance Training In Managing Menopause-Related Changes, Alyson K. Strauss

Honors Undergraduate Theses

Resistance training serves as a critical non-pharmacological strategy for mitigating the physiological and psychological declines associated with the menopausal transition. This natural biological phase, marked by declining estrogen levels, typically leads to accelerated bone mineral density loss, sarcopenia, metabolic regulation disturbance, and heightened mood disturbances. To evaluate the efficacy of targeted exercise interventions, a systematic review was conducted following PRISMA guidelines. From an initial pool of 60 relevant articles, 13 studies met the specific inclusion criteria, focusing on structured resistance training protocols for perimenopausal, menopausal, and postmenopausal cohorts.

The synthesis of these studies indicates that resistance training is a highly …

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

The Impact Of Substance Abuse Problems And Serious Mental Illness/Serious Emotional Distress On Post-Discharge Residential Status Among Clients With Behavioral And Cognitive Disorders: Evidence From Samhsa Mh-Cld Data, Eden Moges, Norma Rochez, William Peycha, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

BACKGROUND: Behavioral and cognitive disorders can undermine housing stability, a key determinant of mental health recovery, with persistent disparities across demographic and socioeconomic groups. This study examined the associations of substance abuse problems (SAP) and serious mental illness/serious emotional distress (SMISED) with residential status at discharge from mental health facilities.

METHODS: This cross-sectional study used the utilized data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to summarize demographic characteristics, whereas univariate and multivariable logistic regression models were employed to assess associations between the covariates and the residential outcome, adjusting for a variety of …

The Implementation Of Indoor Urban Gardening: A Microgreens Pilot Study In A University Setting, Kathryn Chang, Samantha Brink, Annette Gadegbeku

Transformative Medicine

Introduction: “Food deserts” are geographical areas that lack affordable full-service grocery stores and have higher densities of unhealthy or “fast food” options. These deserts not only exist in communities such as Philadelphia, but also on college campuses. One solution to creating access to fresh vegetables is urban farming, which refers to green areas (i.e. community gardens) that provide places for food to be grown by local residents. Microgreens Health Outreach Project (HOP), aimed to build and implement a small, indoor community garden cart within the Health Sciences Building (HSB) at Drexel University; the organization hoped that this cart would be …

Prevalence And Factors Associated With Alcohol And Illicit Drug Use Among Brazilian Youth: A Multicenter Cross-Sectional Study, Emerson Brito, Marina Bessel, Natalia Luiza Kops, Lucas Albrechet-Souza, Flavia Moreno, Alexis Koskan, Thayane Martins Dornelles, Ben Hur Graboski Pinheiro, Suelen Basgalupp, Eliana Wendland

School of Medicine Faculty Publications

This study examined alcohol and illicit drug use among Brazilian youth aged 16 to 25 during the transition to adulthood. A multicenter, cross-sectional survey was conducted between Sep-2016 and Dec-2017 across all 26 Brazilian state capitals and the Federal District. A total of 8,581 participants completed structured interviews on substance use and sociodemographic characteristics. Lifetime prevalence was 71.6% for alcohol and 30% for illicit drugs. Frequent alcohol use was more common among males, while the most used illicit substances were cannabis (27.4%) and cocaine (9.9%). Participants without a partner had higher rates of alcohol and hallucinogen use, while those with …

A Quantitative Exploration Of Risk And Protective Factors Affecting The Mental Health Of Chitimacha Tribal Youth, Daphnie Vilcan-Tanner

University of New Orleans Theses and Dissertations

This study examines the relationships between demographics, risk factors, and protective factors with mental distress among Chitimacha Tribal adolescents aged 12 to 18. Using a Positive Youth Development framework, the research aimed to identify the prevalence of mental distress, trauma, discrimination, and protective factors, as well as their collective and individual impacts on mental health. Data were collected through online surveys completed by 73 participants residing on or near the Chitimacha Tribal Reservation. Descriptive statistics and multiple linear regression analyses were conducted to analyze the data. Results revealed that while trauma and discrimination collectively predicted mental distress, family and community …

Orthostatic Hypotension In Older Adults And Its Economic Impact On The Healthcare System: A Systematic Literature Review, Olushola E. Ilogho, Jennifer Broyles, Viet Le, Denise Rizzolo

Lynchburg Journal of Medical Science

ABSTRACT

Orthostatic Hypotension (OH) has been shown to lead to poor quality of life, falls, and death. Literature suggests that falls from OH may be preventable, therefore opportunities to reduce its associated cost to the healthcare system exist. This literature review aims to evaluate the importance of diagnosing and treating OH in older adult patients. OH is the drop in blood pressure upon changing to an upright position. This acute hemodynamic drop in blood pressure causes hypoperfusion in the brain, leading to dizziness, syncope, and falls. An extensive literature search for publications in PubMed and Cumulative Index in Nursing and …

The Association Between Pain Catastrophizing, Somatization, Psychological Distress And Low Back Pain Severity Among Academics In Malaysia, Noordiyana Izyanti Mohamad Saufi, Eva Nabiha Zamri

Makara Journal of Health Research

Background: Psychological factors may influence the severity of low back pain (LBP), especially in high-stress professions such as academia. This study aimed to identify the relationship between psychological factors and LBP severity among Malaysian public university academics.

Methods: This cross-sectional study aimed to assess the relationship between psychological factors and LBP among academics at four public universities located in the northern region of West Malaysia. A self-administered questionnaire was used to collect information on sociodemographic characteristics, work information, lifestyle factors, LBP presence and intensity, and psychological factors. Data were analyzed using ordinal logistic regression and reported in terms …

Socioeconomic, Behavioral, And Health Profiles Of Women With Eclampsia: Findings From The 2020–2022 National Pregnancy Risk Assessment Monitoring System Data, Jessi Bates, Gurgen Grigoryants, Hongyun Fu

Cardiovascular Research Symposium

Background: Eclampsia is a severe obstetric complication with significant maternal health implications, disproportionately affects women with certain sociodemographic and health risk factors. This study investigates the characteristics and outcomes of women who experienced eclampsia using data from the national Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods: This analysis included a sample of 729 women with eclampsia from the 2020–2022 PRAMS (N = 238,575). Descriptive statistics, chi-square tests, and multivariate logistic regression were conducted to examine patterns and factors associated with preterm-birth, low birth weight (LBW), and cesarean delivery.

Results: Over half of the women were aged ≥35 years (50.6%), unmarried …

Mechanisms And Intermediate Outcomes Of A Community Translation To Adapt A Whole Family-Inclusive Lifestyle Intervention: A Pilot Evaluation, Megan J. Moran, Kimberly Padilla, Abby Neiser, Nicole Clark, Virginia Jimenez, Natalia Sanchez, Talia Thompson, Ana M. Gutierrez-Colina, Jesse Owen, Chesleigh Keene, Matthew A. Haemer, Lauren B. Shomaker

Journal of Patient-Centered Research and Reviews

Purpose: Involving community members in the process of translating scientific evidence into health messaging and interventions can lead to improved health outcomes and more patient-centered healthcare. Community Translation (CT) is one methodology for fostering collaboration between researchers and community members, and it has been shown to result in locally relevant, acceptable solutions to health challenges. There has been very little research on the direct effects that participation may have on community members who become involved in CT. Understanding the mechanisms of CT and its outcomes on participating community members is essential to maximizing the potential of CT. To address this …

Improving Hiv Nonoccupational Postexposure Prophylaxis Completion In Survivors Of Sexual Assault, Rebecca Aden

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This project aimed to increase adherence to HIV nonoccupational postexposure prophylaxis (nPEP) among adult survivors of sexual assault using a 24-hour nurse-led callback intervention to reinforce patient education and support treatment completion.

BACKGROUND

This project was implemented within a public healthcare system’s forensic nursing program. Sexual assault survivors face an elevated risk of HIV transmission, yet completion of the 28-day nPEP regimen often remains below 40%. Barriers to completion include limited understanding, gaps in follow-up, as well as psychosocial and socioeconomic challenges.

METHODOLOGY

The FADE QI framework was utilized for this project. The population included adult, non-incarcerated patients who …

Transforming Primary Care: Innovative Post Graduate Pa Training For Real-World Solutions, Kenneth Botelho, James Ali

Lynchburg Journal of Medical Science

The ongoing crisis in primary care demands innovative and scalable strategies to prepare and retain advanced practice providers. This article introduces the Primary Care Practitioner (PCP) Program, a conceptual postgraduate training model designed for certified physician associates/assistants (PAs) who aim to serve in underserved and rural communities. The program integrates advanced clinical training, leadership development, telehealth competencies, VR-enhanced simulation, and evidence-based strategies to promote provider resilience. Rooted in systems-based thinking and real-world applicability, the PCP Program culminates in capstone projects that encourage innovation in care delivery and population health.

Aligned with national frameworks such as the HRSA Primary Care Training …

The Social Standing Versus The Mind Standing Of Older Adults In Egypt: Cross-Sectional Analysis Of The Relationship Between Social Capital And Cognitive Functions, Shaza H. Shinaishen Dr

Theses and Dissertations

Introduction: Egypt's population, much like that of other countries, is expected to age considerably over the course of the coming decades. Although biological and socioeconomic predictors of cognitive function have been studied widely, personal level social capital remains unexplored, especially in LMICs.

Purpose: This study primarily investigates the relationship between individual social capital and cognitive functioning among older adults aged 65 years and older in Egypt using the structural and cognitive components of social capital, including group membership, civic engagements, and caregiving roles.

Methods: A cross-sectional survey on 363 older individuals in different geographical and demographic segments of Egypt using …