Community Health and Preventive Medicine Commons^™

How To Create A Self-Sustaining Meditation Garden, Heather Salazar, Lydia Barrett-Miller, Kaitlyn Parisan

Honors in Practice Online Archive

This essay presents the creation and maintenance of a campus meditation garden as an outgrowth of four successive philosophy classes in honors. The authors describe the garden’s inception, execution, curricular advantages, and administration, with specific examples of the impact on student health and well-being. The authors observe the ways in which honors students attained skills in transformational leadership by collaborating to develop projects and lead events, suggesting that a meditation garden may be appropriate for any learning environment emphasizing cooperation, creativity, mindfulness, and well-being.

Enhancing Wellbeing Through Caregiver Support: Improving Quality Of Life For Individuals With Special Needs And Complex Medical Diagnoses In Nicaragua, Jenna K. Devchand

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Individuals with disabilities living all over the world are constantly faced with additional barriers. In low-income countries, such as Nicaragua, there is often a gap in access to resources and education, for both individuals living with disabilities and their caregivers. Access is essential to provide high quality care to meet unique needs. This occupational therapy doctoral capstone project was created to support individuals providing care to children with special needs and complex medical diagnoses in Nicaragua by providing community-based education and sustainable resources to caregivers to enhance wellbeing in daily life. The deliverable was presented in country in Nicaragua to …

Researching Dementia Indicators Among Rural Populations, Justin S. Yount

Theses and Dissertations--Community & Leadership Development

The study explored potential dementia indicators and risk factors among older adults residing in rural areas who are actively engaged in farming operations. Data was collected in three components a questionnaire, an audiogram test, and a memory impairment screening. 104 people responded to the questionnaire, 133 participants took the audiogram test, and 94 participated in the memory impairment screening. The findings revealed that 80.9% of participants showed no sign of cognitive impairment while 19.1% showed signs of possible impairment. Participants reported moderate levels of physical and social activity, but common risk factors such as elevated BMI, diabetes, hearing loss, and …

Supports For Mental Well-Being Valued By Healthcare Workers: Qualitative Analysis Of Data From A Canadian Cohort Of Healthcare Workers During The Covid-19 Pandemic, Shannon Marie Ruzycki, Anil Adisesh, Quentin Durand-Moreau, France Labrèche, Tanis Zadunayski, Erica Stroud, Nicola Cherry

Études primaires

A prospective cohort of 4964 HCWs from four Canadian provinces was established early in the COVID-19 pandemic. Participants were invited to comment about workplace mental health supports at three time points. We performed a thematic content analysis of responses from 1738 participants using the Social Support Behaviour Code framework to categorize barriers to support as informational, tangible, emotional, social, or expressing esteem. Themes were synthesized into suggestions for healthcare organizations to prepare for future crises. Formal and informal peer support, workplace mental health supports, and one-on-one counseling were most often mentioned as valued. Analysis suggested that workplace social networks as …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

The Role Of Social Isolation In Shaping Health Outcomes In Older Adults: A Regional Analysis, Vince Falco, Lynn Wiles, Jonathan Romero, Leorey Saligan

Ellmer School of Nursing Faculty Publications

Social isolation is a critical public health concern in older adults and is linked to a range of adverse health outcomes across diverse sociodemographic groups. This study investigated the associations between social isolation with physical and mental health of older adults residing in Hampton Roads, a racially diverse region in Southeastern Virginia, home to a large population of senior military veterans. Secondarily, the study explored how social determinants of health (SDoH) and comorbid medical conditions influenced the relationship of social isolation with physical and mental health of these seniors. Physical and mental health were measured using the Patient-Reported Outcomes Measurement …

Sparkled: Social Programming In Kids Affects Risk Of Latent Endothelial Disease, Rebecca Drakowski

Theses & Dissertations

Background: Social Health Programming (SHP) is a holistic intervention that can empower communities to address modifiable risk factors for poor cardiovascular health, including suboptimal nutrition or psychosocial stressors. SHP participation has been shown to increase dietary intake of fruits and vegetables, decrease perceived stress, and improve cardiovascular endurance. However, it is unknown how SHP participation during adolescence affects carotenoid serum levels, hair cortisol concentrations (biological marker of chronic stress), or vascular reactivity index (VRI; measure of subclinical cardiovascular health).

Methods: Adolescent girls and young adult women (12–29-year-old) were enrolled in this observational cohort study. Serum, hair, and saliva samples were …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

Improving Food Security To Decrease Hypertension At An Urban Community Clinic, Christine S. Villalta

Master's Projects and Capstones

Diet and lifestyle changes have been proven to reduce blood pressure in patients with hypertension, and a key dietary approach aligned with this recommendation is the DASH diet, which includes consuming fruits and vegetables. Food insecurity, defined as lacking enough safe, nutritious food to maintain an active and healthy life, is a growing crisis in the United States, affecting 13.5% of U.S. households in 2023. This is especially significant for those whose chronic disease management depends on the accessibility of healthy food. An urban community clinic implemented a Food Security Program to decrease food insecurity and reduce hypertension among their …

Obesity: Influencing Behavioral Consumption Through Meal Kit Distribution, Alejandro Hernandez

Capstone Projects and Master's Theses

Founded in 2002, Everyone’s Harvest is a grassroots nonprofit dedicated to providing access to healthy, affordable fruits and vegetables through certified farmers markets and community food programs. Its key initiatives—Fresh Rx, Market Match, Edible Education and Farms Together —focus on alleviating nutrition insecurity and combating diet-related health conditions by providing vulnerable populations the resources to purchase, or receive, fresh produce and gain nutritional knowledge. This study explores a new intervention: the distribution of farmers' market meal kits as a complementary strategy to the current Edible Education program. These meal kits, which feature seasonally available produce and pre-measured ingredients, aim to …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Opioid Knowledge And Experiences In Nebraska College Students, Natalie Holding

Theses/Capstones/Creative Projects

This study investigated opioid-related knowledge and experiences among 83 Nebraska college students, with an emphasis on awareness, perceived risks, and educational needs regarding opioids and the overdose-reversing drug, naloxone. For participants who have used opioids outside of a doctor’s orders, questions were asked regarding motivations, comorbidities, coping mechanisms, and treatment experiences. Data were collected via an anonymous survey featuring closed- and open-ended questions. Results showed that 41% of participants reported feeling moderately knowledgeable about opioid risks, while 34% felt only slightly knowledgeable. Although 80.7% of participants were aware of naloxone, most were uncertain either about (22.9%) or did not know …

Volunteering For Medically Underserved Children: Clinic With A Heart–Back-To-School Clinics, Isabella Marie Kerby Kessinger

Honors Program: Senior Projects (Public)

Medically underserved children, often from low-income families or areas with limited healthcare resources, face significant barriers in accessing essential medical services and represent a fundamental challenge to equity and social justice. School physicals and back-to-school clinics play a crucial role in addressing these healthcare needs, serving as a gateway to educational and extracurricular opportunities.

Clinic With a Heart (CWH), a non-profit medical and dental clinic in Lincoln, Nebraska, serves as a model for addressing healthcare disparities. In 2023, CWH provided 3,109 visits to 1,846 unique patients, with 83% lacking health insurance and 63% having household incomes below $16,000 annually. The …

Understanding And Intervening In Children's Tick Risk Perceptions And Protective Behaviors: A Grounded Theory, Ariel Dawdy

Department of Entomology: Dissertations, Theses, and Student Research

Children, ages 8 years and younger, are at a particularly high risk of contracting a tick-borne disease. This is partially due to the misconceptions spread about tick protective behavior and a poor understanding of how antibiotic treatment can help. Because most communities and families believe that tick control is the individual’s responsibility, looking at the interaction between ticks and human children is essential to understanding the individual’s motivations to protect themselves. To help alleviate the number of individuals contracting tick-borne diseases, misconceptions must be addressed, intervention programs implemented, and a behavioral change must occur. This study used a qualitative research …

Impacting Community Well-Being Through Effective Engagement Using The Seed Method, Carlin Rafie, Emily B. Zimmerman, Angelina Hargrove, Theodora Biney Amissah, Samantha Lee

Journal of Extension

Cooperative Extension can make a significant impact on health in the United States through effective community engagement that focuses on the complex socio-ecological factors that impact health. The Stakeholder Engagement in Question Development Method (SEED Method) employs community based participatory research principles to engage communities in research, problem-solving, and action planning. Projects employing the SEED Method engage community members from diverse backgrounds, create community capacity, result in tangible outcomes, and foment inter-organizational trust and networking. A SEED Toolkit is available on the Extension Foundation Campus site and provides implementation instructions, tools and timelines, and potential applications within Extension.

Examining Ptsd Prevalence Among Underserved Populations In The Integrated Community Mental Health Setting 2019 To 2022, Siran Koroukian, Stephen Zyzanski, Kurt C. Stange

Faculty Scholarship

Background: The prevalence of Post Traumatic Stress Disorder (PTSD) has been rising since the start of the COVID-19 pandemic, and affects females, sexual and gender minorities, and individuals with social risks at higher rates. Objective: This study examines if the prevalence of PTSD increased from 2019 to 2022 among patients who received care in a national network of safety-net, community-based health centers with integrated behavioral health programs that serve patients at high risk for PTSD. Methods: We analyzed electronic health record data from patients with 1 or more behavioral health visits during 2019 to 2022 using repeated cross-sectional data to …

Barriers To Help-Seeking Behavior For Maternal Mental Health Disorders: Application Of The Health Belief Model, Tobi F. Oloyede, Joanne Chopak-Foss

Journal of the Georgia Public Health Association

Perinatal mood and anxiety disorders (PMADs) have become a leading cause of maternal mortality due to suicide among women in the first year following pregnancy. Although the profile for new mothers who die by suicide is predominantly white, disparities exist between Black and White women in their seeking help for perinatal and/or post-natal mood disorders. For Black, Indigenous, and People of Color (BIPOC), there are differences in the perceptions of the benefits of seeking help for PMADs. The COVID-19 pandemic exacerbated maternal mental health disorders in the United States particularly for women who live in communities with limited access to …

Increasing Referrals To Local Resources For The Treatment Of Aud By Increasing Audit-C Usage By Increasing Awareness Of Aud Through Use Of Educational Materials ​, David Ortiz, Gerardo Munoz Monaco

Research Colloquium

Background: One in nine people will suffer from alcohol use disorder, if of legal drinking age. One in nine of our patients might suffer from AUD. Among those suffering from AUD, only 1.6% were found to be treated with evidence-based medications for treatment of AUD. Underdiagnosing may be a reality.

Methods: Evaluate physicians-in-training knowledge regarding AUD at time zero and after 3 months after an educational presentation is giving containing information on AUD diagnosis, treatment, and available local resources. This repeated cross-sectional data analysis aims to increase screening using the AUDIT-C tool, as well as referral/utilization to local resources. Patients …

Proactive Psychiatry: Innovating The Delivery Of Consultation-Liaison Services In A Pediatric Hospital, Elizabeth Schindler, Katherine Winner, Ramzi W. Nahhas, Gianni Maione, Aisha Jamison, Kelly Blankenship

Population and Public Health Sciences Faculty Publications

Background: The benefits of a proactive consultation-liaison psychiatry service have been well documented in the adult population, including decreased length of stay (LOS), increased satisfaction among physicians, and enhanced collaborative care. However, there is no available research on the effectiveness of this model in pediatric hospitals. Objective: This study compared patients aged 5–18 years on a general medical floor receiving a proactive psychiatry consult to concurrent controls receiving no consult and to historical controls receiving traditional reactive consults. Methods: New admissions to two pediatric general medical hospital teams were reviewed on weekday mornings to identify those with active psychiatric concerns. …

Past-Year Hiv Testing, Current Antiretroviral Therapy Use, And Participation In Services For People Who Inject Drugs, Itunu Sokale, Johnny Wilkerson, Paige Wermuth, Folefac Atem, Janet Burnett, Cyprian Wejnert, Salma Khuwaja, Catherine Troisi

Faculty, Staff and Student Publications

Evaluating routine HIV testing and treatment and use of services for people who inject drugs (PWID) is critical to curb the ongoing HIV epidemic. We analyzed data from the 2018 National HIV Behavioral Surveillance of PWID aged 18 years or older, recruited using respondent-driven sampling and offered anonymous HIV testing after survey. We performed bivariate and multivariable analyses with log-linked Poisson regression of the generalized linear models to examine the associations between demographics and PWID service use, past-year HIV testing, and current antiretroviral therapy (ART) use. Among 10,311 HIV-negative PWID, 56% reported past-year HIV testing, and of the 553 HIV-positive …

Neuroscience-Based Harm Reduction Education For College Students In Portland, Or, Catriona Swallow

University Honors Theses

Harm reduction (HR) is a movement focused on reducing the harms of the opioid overdose crisis through education, advocacy, and community engagement. A key component of HR is naloxone, a medication which reverses opioid overdoses when administered. Due to increased fentanyl contamination, opioid overdose deaths have been on the rise among adolescents in the U.S and HR practices are crucially important at this point in time. In recent years, alternative curricula of HR education have included a neuroscience-based approach to the topic of substance use. While both traditional and alternative programs have had success increasing substance use literacy among adolescents, …

What Do Extension And Public Health Educators Need To Address Substance Misuse?, Lisa Washburn, Karen Franck

Journal of Extension

Limited organizational capacity has hindered Extension’s ability to address substance misuse in communities. To inform capacity-building efforts, we obtained Extension educator and health educator feedback on opportunities, challenges and resource needs using the Delphi technique. Opportunities included collaboration and partnerships with local entities. Stigma, inadequate resources, and limited knowledge and skills of educators were challenges. Top resource needs were updated youth curricula, funding, and clear guidance on what educators can do and what should be referred externally. Findings provide insights to educator perceptions and suggest additional training and resources needed to implement evidence-based approaches to address substance misuse.

Biofeedback Gaming For Substance Use Disorder, Rebecca L. Chevrel

University Honors Theses

Substance Use Disorder (SUD) and stress are often predictive of one another, bidirectionally causal, and mutually intensifying. This thesis describes the bi-directional connection between physiological stress-modulating systems and Substance Use Disorder, and explores some emerging biofeedback stress-reduction gaming technology as a potential adjunct to recovery treatments. Improving autonomic balance, often described by Heart Rate Variability, has been shown to be beneficial for physical and psychological recovery, as well as improving self-control. For this reason, regular biofeedback for stress relief could be helpful in augmenting SUD treatment and preventing relapse. This exploration found that presenting it through a gaming lens may …

Strengthening U.S. Jail Systems’ Response To Infectious Diseases: An Evaluation Of The Covid-19 Pandemic, Erinn Bacchus

Dissertations and Theses

Jails across the United States were struck with increased infections and deaths during the COVID-19 pandemic. Studies have shown the structural make up of jails, lack of preparedness plans, and overcrowding contributed to health risks and poor health outcomes both inside jails and local communities. Yet little research has been dedicated to strengthening jail responses to infectious disease outbreaks spanning prevention measures, data collection, and reentry planning. Gaps include information on the (1) myriad infectious disease mitigation strategies used in jails and adherence to CDC prevention guidelines, (2) development of a standardized epidemiologic surveillance system, and (3) experiences working at …

A Microcosting Approach For Planning And Implementing Community-Based Mental Health Prevention Program: What Does It Cost?, Sharmily Roy, Henry Shelton Brown, Lisa Sanger Blinn, Sarah Carter Narendorf, Jane E Hamilton

Faculty, Staff and Student Publications

BACKGROUND: Estimating program costs when planning community-based mental health programs can be burdensome. Our aim was to retrospectively document the cost for the first year of planning and implementing Healthy Minds Healthy Communities (HMHC), a mental health promotion and prevention multi-level intervention initiative. This Program is among the first to use the Community Initiated Care (CIC) model in the US and is aimed at building community resilience and the capacity for communities to provide mental health support, particularly among those disproportionately impacted by COVID-19. Our objective is to share our methods for costing a program targeting 10 zip codes that …

Cardiovascular Disease Risk Reduction Program For Hispanics In The Us Midwest: A Culturally Adapted Intervention, Armando De Alba

Theses & Dissertations

Cardiovascular disease (CVD) represents the second leading cause of death in Nebraska (NE), accounting for approximately one in every five deaths. In the state, there are marked ethnic and rural-urban disparities in the prevalence of chronic diseases and resultant deaths. For instance, while the rates in NE of coronary heart disease and myocardial infarction between 2001 and 2010 decreased among non-Hispanic Whites, the rates for Hispanics almost tripled. There is little evidence of CVD risk factor reduction strategies being implemented in Midwestern areas and Hispanic populations.

One promising approach for reducing CVD risk involves health education and lifestyle modification programs …

Pricks And Pills, Anna A. Charles

Theses and Dissertations

"Pricks and Pills" is a collection of audio pieces designed for an online platform where individuals with diabetes can listen to and find emotional support from others who share their experiences. This audio project provides an intimate look into the lives of people navigating the challenges of diabetes. Through heartfelt interviews with individuals and their families, the podcast highlights their journeys, showcasing both their struggles and triumphs.

The Impact Of Stress During Adolescence And The Prevalence Of Pediatric Obesity, Olatunbosun Olakunri, Venkat Venkataraman

Rowan-Virtua Research Day

Obesity is a chronic condition that can be attributed to myriad factors including socioeconomic status, biological risk factors, and various environmental factors. These factors can be considered stress factors, and exposure to various levels of stress can impact the development of stress within the pediatric patients. The purpose of this study is to assess the association between the environmental, mental, social, physical, and psychological stress adolescents are exposed to and how they contribute to the prevalence of pediatric obesity throughout the United States. Understanding these risk factors can help us as a community and most importantly as clinicians develop better …

Unveiling The Impact: Structural Racism And Childhood Lead Exposure's Health Consequences In Philadelphia, Mahhum Naqvi, Mahrukh Naqvi, Justin Stout, Colton Spencer

Rowan-Virtua Research Day

Childhood lead exposure poses a significant risk to health and well-being, adversely affecting brain function, nervous system development, and behavioral patterns. This study examines the health disparities and inequities associated with childhood lead exposure in Philadelphia, focusing on structural racism and residential segregation as crucial lenses for analysis. By delving into the sociocultural context of lead exposure, this study underscores the imperative of collaborative efforts among stakeholders to safeguard Philadelphia's most vulnerable populations. Healthcare professionals and policymakers play pivotal roles in enhancing funding and prevention strategies. Addressing this issue through the prism of structural racism allows for the identification and …

Barriers To Healthcare Access Between English And Spanish Speakers In An Underserved Population, Adeena Javed, Dale Johnson, Gerardo J. Rivera-Colón, Nathaniel J. Byrnes, Kristin Bertsch, Anne C. Jones

Rowan-Virtua Research Day

• According to the NJ State Department of Health, Atlantic County has higher rates of smoking, respiratory disease, hypercholesterolemia, as well as death rates due to coronary heart disease, HIV, and all cancers compared to the NJ state average1,2.

• With over 20% of Atlantic County's population identifying as Hispanic, Spanish speakers encounter greater obstacles compared to their English-speaking counterparts in accessing healthcare services and improving health outcomes1,2 .

• Existing research indicates that various factors, including health insurance coverage, proximity to healthcare facilities, transportation options, health literacy levels, and trust in the medical profession, significantly influence access to healthcare …