Community Health and Preventive Medicine Commons^™

A Literature Review Of Nature-Based Expressive Arts Therapy For Bereaved Children, Wendy Dalton

Expressive Therapies Capstone Theses

There is a need for increased visibility of child bereavement to expand research in and accessibility of developmentally appropriate supports, which views the child holistically and within their biopsychosocial context. Worden’s (1996) formative work with child bereavement resulting in the "tasks" of child bereavement was the first and most recent study of its scale and kind. This marked an affirming of grief as normative response to death and occurring throughout the developmental lifespan. This work also highlights the need for additional inquiry to expand and deepen understanding of child bereavement. A growing body of research suggests that ecotherapy and expressive …

“Do I Need Exercise?” A Qualitative Study On Factors Affecting Leisure-Time Physical Activity In India, Shalini Garg, V Raman Kutty

The Qualitative Report

Physical activity can reduce the risk of premature mortality from various chronic diseases. Previous research in Kerala, India indicates several barriers which can impact physical activity levels. Perceptions about the importance of health-promoting physical activity were examined among adults in Kerala and various facilitators, motivators and barriers to physical activity were identified using focus group discussions and interviews with key informants. At present, the attitude of people and health professionals is that physical activity has to be taken up when diagnosed with a disease (obesity, diabetes) and advised by a health professional. Men were more likely to start exercising after …

Using Mobile Phones To Improve Young People's Sexual And Reproductive Health In Low- And Middle-Income Countries: A Systematic Review Protocol To Identify Barriers, Facilitators And Reported Interventions, Anam Shahil Feroz, Farina Abrejo, Sumera Aziz Ali, Rozina Nuruddin, Sarah Saleem

Community Health Sciences

Background: Due to a growing reliance on mobile phone technology and decreasing mobile phone costs, the use of mobile phones is on the rise, especially among the youth population. Young people are responsive and enthusiastic to use novel approaches such as mHealth to access sexual and reproductive health information and services. Globally, reproductive health programs have used mHealth to provide sexual and reproductive health education and services to young people, through diverse communication channels. However, few attempts have been made to systematically review the mHealth programs for young people sexual and reproductive health (SRH) in low- and middle-income countries (LMICs). …

Adolescent Sexual Reproductive Health Course: A Mixed Media Intervention And Quality Improvement Project In A School-Based Setting, Stephanie Calabrese

Doctor of Nursing Practice (DNP) Projects

Section I: Abstract

Problem: California’s adolescents carry a significant burden of newly acquired sexually transmitted infections (STIs) and gaps in adolescent sexual and reproductive health (SRH) knowledge have led to poor adolescent health outcomes. (CDE, 2019). Context: The California Healthy Youth Act (AB 329) was enacted on January 1, 2016, calling all school districts to ensure that all pupils receive comprehensive sexual health education, and HIV prevention education (CDE, 2019). In a proactive motion, parents from a northern California middle school approached a university to provide a Doctor of Nursing Practice (DNP) student to instruct its sixth grade’s …

Enhancing Nutrition Education For School Aged Children; A Preventive Health Measure And Quality Improvement Project, Fanny M. Powell

Doctor of Nursing Practice (DNP) Projects

Objective: The purpose of the DNP project was to improve nutritional knowledge of the adolescents at Kings Canyon Unified School District while also improving their perceived ability to choose healthy food. This project was enveloped in a larger community outreach mission utilizing a free school-based clinic for the purposes of providing sports physicals to students and health screening and physicals to the community. Additionally, nurse practitioner students engaged in a cultural immersion experience through clinical rotations in Central Valley.

Methods: Adolescent students who registered for the clinic watched a nine-minute nutrition video, created by the DNP student, while waiting …

The Effects Of A Mobile Fitness Application On Weight Management And Physical Acticity Amongst University Students, Erica Deenihan

Evidence-Based Practice Project Reports

The prevalence of obesity, and obesity related diseases throughout America, specifically in regard to the college student population has steadily climbed over the course of the last forty years, due largely in part to the increase in sedentary lifestyle behaviors, amongst other factors (Swanson, 2016). Physical activity has been widely recognized as a valid means of combatting obesity and weight gain while promoting health related quality of life (Swanson, 2016). Therefore, implementing strategies aimed at increasing physical fitness in attempt to control weight management is imperative to promoting improved health outcomes. The purpose of this evidence-based project was to examine …

The Effect Of Home Blood Pressure Monitoring And Self-Titration On Achieving Blood Pressure Targets, Katina A. Varner

Evidence-Based Practice Project Reports

One-third of U.S. adults over the age of 20 are hypertensive, with an estimated cost of $47.5 billion in direct medical expenses and increased individual CVD risk (CDC, 2018). Routine office visits afford primary care providers a means of managing hypertension; however, time constraints limit the ability to accurately assess and track BP in most patients (Jung, 2015). The purpose of this project was to determine if implementation of HBPM and an algorithm for selftitration of antihypertensive medications increased the number of participants at guideline recommended BP goal over a 90-day period. The Health Promotion Model provided the theoretical framework …

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

Typical Diet Quality In New Zealand Compared To Other Westernized Countries With An Emphasis On Chronic Disease, Emily Kollar

Honors Projects

The diet quality was analyzed for people living in New Zealand and people living in other Westernized Countries (United States, Canada, Western Europe) based on the dietary guidelines. Diet quality was analyzed by looking at consumption of food groups such as fruits, vegetables, meat, and seafood as well as nutrients such as saturated/trans/unsaturated fat, sodium, and added sugars. These nutrients have been linked to certain health outcomes and chronic disease; therefore, the prevalence of chronic disease was researched to determine if there was a correlation between New Zealand's diet and their chronic disease rates in comparison to other Westernized countries.

Health Care In The Caribbean: A Comparative Analysis Between Cuba And Puerto Rico, Matheus Moreira Sanches Peraci

Honors Projects

The paper at hand focuses on comparing the differences of the Cuban and Puerto Rican health care (HC) system and conditions. As this is a comparative research analysis, this was done by reviewing many different reliable sources and compiling the relevant information from Cuba and Puerto Rico. The factors that were taken into account are: (a) Political and Health Care Systems, (b) Natural and Artificial Disaster and (c) Country’s Demographics and Health Statistics.

Analysis Of Tobacco Use Vital Sign Assessment, Latonya King

Electronic Theses and Dissertations

There is a massive problem of tobacco-related cancer outcomes in patients that are affected by race and ethnicity. Although this is a known disparity, there continues to be a gap in care for asking patients if they use tobacco and in advising and assisting them in making a quit attempt. Health information technology requirements and meaningful use regulations require the utilization of systematic electronic documentation. In order to improve and support tobacco use screening, systematic tobacco use assessment and documentation are essential. There is a widespread belief that adding screening for tobacco use to the vital sign assessment will lead …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

Perceptions Of Parents And Religious Leaders Regarding Minimal Invasive Tissue Sampling To Identify The Cause Of Death In Stillbirths And Neonates: Results From A Qualitative Study, Anam Shahil Feroz, Mohsina Noor Ibrahim, Elizabeth M. Mcclure, Anum Shiraz Ali, Shiyam Sunder Tikmani, Sayyeda Reza, Zahid Abbasi, Jamal Raza, Haleema Yasmin, Khadija Bano, Afia Zafar, Sameen Siddiqi, Robert L. Goldenberg, Sarah Saleem

Community Health Sciences

Background: Recently, the minimal invasive tissue sampling (MITS) procedure has been developed to support determination of the cause of death as an alternate to conventional autopsy, especially in countries where complete diagnostic autopsy is not routine. To assess the feasibility of implementation of the MITS procedure for a study to determine cause of death in premature births and stillbirths in south Asia, we explored the views and perceptions of parents and religious leaders on the acceptability of MITS.
Methods: A qualitative study was conducted at the National Institute of Child Health (NICH) hospital of Karachi, Pakistan. Focus group discussions (FGDs) …

Potentially Reduced Exposure Products, Occupational Variations In Smoking, And Hardcore Smokers: Examining Important Elements In The Tobacco Use Spectrum, Raees A. Shaikh

Theses & Dissertations

The purpose of this research was to examine three important aspects of the smoking phenomenon that are, and will remain, important for the future of tobacco control research and policy. First and currently one of the most debated and researched topics in the tobacco research field relates to the group of products regarded by some as the potentially reduced exposure products (PREPs). We studied determinants of use of these products. Second aspect was to examine the socioeconomic subgroup of smokers based on their occupations who might potentially benefit from the use of PREPs and the third stage involved studying the …

Increasing Food Security: Developing And Testing A Nutrition Education Curriculum For A Mobile Food Pantry, Alexandra Lepecha, Kathleen M. Kraft

Senior Honors Projects, 2010-2019

Background: The Neighborhood Produce Market (NPM) is a food distribution model similar to a mobile food pantry. NPM stakeholders observed a lack of community engagement and familiarity with produce offered.

Project Description: The objective was to develop a nutrition education curriculum for NPM volunteers to better engage families and community members by providing food samples, recipes, and nutrition education. A stakeholder steering committee guided the needs assessment, curriculum development, volunteer training, and pilot test. The curriculum consisted of food safety, cultural considerations, and nutritional information for nine produce items and food tasting procedures and recipes. Seven student volunteers were trained …

An Examination Of Factors Associated With Body Appreciation, Sociocultural Attitudes Of Appearance, And Ratings Of Diverse Performing Artists, Stephanie Rathjen

Senior Honors Projects, 2010-2019

Introduction: Multiple studies have found that performing artists have low body image which may be associated with the media’s portrayal of performers. Low body image can cause negative health effects including depression and eating disorders. This study explores body attitudes among performing and non-performing arts students and the possible media influences on those attitudes.

Methods: Undergraduate students (n=522) were asked to participate in an anonymous online survey regarding their perceptions of their individual body perception. During the survey, they were randomized to watch a video depicting either slim mostly Caucasian performers (video A) or performers of different ethnicities …

Community-Based Healthcare | Interlace Of Biophilic Design In Outpatient Facilities, Joshua Robinson

Bachelor of Architecture Theses - 5th Year

This thesis questions how architects can redesign typical healthcare typology in response to the medical and sociological needs of the community while integrating the measures of wellness and biophilic design. By redefining architectural programs within a wellness clinic, this can allow the facility to prioritize the communities needs through non-medical determinants. The research will look at both the social and medical needs of a community, along with the Seven Standards of Wellness as defined by the Well Building Standard and The Fourteen Patterns of Biophilic Design as defined by the Terrapin Bright Green, to develop a connection between the facility …

Referral Patterns, Procedures, And Outcomes Of A Large Community- Based Urology Group: A Retrospective Chart Review, Hassan A. Al Saleh, Gregory C. Mcmahon, Michael Douglas, Michael Console, Mihir Thaker, Gordon A. Brown

Rowan-Virtua Research Day

In 2012 The United States Preventive Services Task Force (USPSTF) recommended against prostate cancer (Pca) screening. The purpose of our study is to assess the effects of the USPSTF grade D recommendation for PSA based screening on new PCa diagnoses within a large-community based private practice setting. We completed a retrospective chart review of men with an elevated PSA seen in our clinic between May 2009–May 2015 who had undergone a prostate biopsy and were diagnosed with PCa. We observed that following the 2012 USPSTF recommendations, there was a significant increase in patients with clinically significant prostate cancer GG ≥ …

The Modifiability Of Risk Factors Associated With Adolescent Suicide And Its Preventions, Nastaeen Tajin

Honors College Theses

Adolescent suicide has been of major concern in the past few decades, with the rates steadily increasing every year. Suicide can be defined as the act of intentionally taking one’s life. Adolescent refers to children between the age of 13 and 19, although the term will be used interchangeably with ‘teen’ throughout this paper. The purpose of this study had been to identify the risk factors of suicide associated with children of this age range, and propose preventative measures based on the modifiability of these risk factors. In order to achieve this, the two search catalogs utilized were the Wayne …

The Relationship Of Creatinine, Sodium, Hematocrit And Hemoglobin A1c To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes, Shmilah Choudhary, Meet Shah, Sanath Shetty, Terri Ginsberg, Matthew H. Mclaughlin

Rowan-Virtua Research Day

Introduction:Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes would help identify patients at risk of rehospitalization.

Objective:The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM. Factors to be investigated are: patient demographics and three admission laboratory values.

Methods:Participants were older adult s>65 years old with T2DM, admitted to a community hospital …

The Relationship Of Cardiovascular Disease To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes Mellitus, Meet Shah, Shmilah Choudhary, Sanath Shetty, Terrie Ginsberg, Matthew H. Mclaughlin

Rowan-Virtua Research Day

Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes (T2DM) would help identify patients at risk of rehospitalization. The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM.Factors to be investigated are: patient demographics and whether the patient was hospitalized for cardiovascular disease. Participants were older adults>65 years old with T2DM, admitted to …

Assessment Of The Perceived Access To Health Care By Migrant And Seasonal Farm Workers In Southern New Jersey, Karen Custodio, Xitlalichomiha O'Dell, Lori Talbot

Rowan-Virtua Research Day

Migrant and seasonal farm workers (MSFW) are one of the most economically disadvantaged populations in the United States. MSFW confront numerous health challenges as a result of occupational hazards, poor living conditions, and inadequate nutrition, in addition to common health concerns like diabetes and hypertension. The objective of this study was to identify major barriers to health care for individuals working in the agriculture industry in southern New Jersey. Though there are numerous factors which impact health for migrant farmers, we hypothesized that language, financial burden, and fear from immigration status will be the most significant. Research was conducted using …

Effects Of Social Media On Patient Perceptions And Compliance, Annmarie Butare, Adarsh Gupta

Rowan-Virtua Research Day

It is the physician’s responsibility to ensure that their patients are collecting credible and accurate information. Considering the significant proportion of patients using social media to assist with medical decision making, physicians should incorporate this into their patient education in order to ensure patient understanding of the information gathered both outside and inside the medical office, thereby improving compliance and outcomes.

The goals of this study were to examine the influence of social media on patient perceptions of healthcare and use this infomration to improve physician understanding of patient health information-seeking behaviors to improve patient compliance. The three-part survey included …

Retrospective Analysis On The Susceptibility Of Opiate Addiction Based On Prescribed Medications And Chronic Pain Diagnoses, Momna Ayub, Richard Jermyn

Rowan-Virtua Research Day

Introduction: Opioid medications have been increasingly prescribed in recent years, particularly to treat individuals with chronic pain. In the U.S., opioid abuse has been declared an epidemic by the Department of Health and Human Services as the number of opioid-related overdoses in 2010 exceeded 16000 and alarmingly continued to rise 15% from 2015 to 2016. Due to opioid dependence and abuse, opioids are a gateway to subsequent drug addiction.

Objective: The goal of this project was to identify a link between certain prescribed opiates and a susceptibility for abuse or misuse in patients with chronic pain through a retrospective analysis. …

The Relationship Of Risk Of Falls And Activities Of Daily Living To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes, Sanath Shetty, Shmilah Choudhary, Meet Shah, Terrie Ginsberg, Matthew H. Mclaughlin

Rowan-Virtua Research Day

Introduction: Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes (T2DM) would help identify patients at risk of rehospitalization.

Objective: The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM. Factors to be investigated are: patient demographics, whether patients were at risk for falling, and patients’ activities of daily living (ADL) at discharge.

Methods: …

Pre-Operative Clinical Variation By Health Insurance Carrier In 12,285 Male Surgical Patients With Moderate Morbid Obesity, Matthew E. Moore, Gus J. Slotman

Rowan-Virtua Research Day

In the ongoing obesity epidemic, every surgeon now treats patients with weight-related medical problems. In managing these medically fragile surgical patients, every clinical insight helps. While variation according to health insurance has been reported in mixed sex bariatric surgery populations, whether or not clinical characteristics in the subset of moderately obese male surgical patients vary by insurance carrier is unknown. The objective of this study was to identify clinical variation by insurance type in moderately obese men.

Results showed that pre-operative clinical characteristics of moderately obese male surgical patients vary by the health insurance coverage type to which they subscribe. …

Validity And Reliability Of The Exercise Vital Sign Questionnaire In An Ethnically Diverse Group: A Pilot Study, Noberto N. Quiles, Aston K. Mccullough, Lin Piao

Publications and Research

The purpose of this study was to determine the validity and reliability of the Exercise Vital Sign (EVS) questionnaire in an ethnically diverse sample. Participants (N = 39) were asked to wear an accelerometer at the hip for at least 7 days and to complete the EVS at the beginning (T1) and end (T2) of the wear period. The EVS questionnaire validity was determined against accelerometry, and bias was calculated as the mean difference between measures. The sensitivity and specificity of the EVS questionnaire were also evaluated. The reliability of the questionnaire was calculated using intraclass correlation coefficient (ICC) between …

The Modeling Assessment Of World Vision’S Water, Sanitation, And Hygiene Program In Southern Africa Countries, Malawi, Mozambique, And Zambia: Analyses Using Lives Saved Tool, Chulwoo Park, Armen Martirosyan, Seble Frehywot, Erin Jones, Ashley Labat, Yvonne Tam, Emmanuel Opong

Faculty Publications

Background: Since 2010, the humanitarian aid organization World Vision has implemented a community-based water, sanitation, and hygiene (WASH) program in 76 area development programs (ADPs) for a total target population of 2,831,535 in three Southern Africa countries: Malawi, Mozambique, and Zambia.

Methods: This study was conducted using the Lives Saved Tool (LiST) to analyze the isolated impact of World Vision WASH interventions on child morbidity and mortality during the four-year implementation period from 2010 to 2014. The combined effects of WASH interventions – improved water source, home water connection, improved sanitation, handwashing with soap, hygienic disposal of children’s stools – …

Selling Childhood: How The Middle Class Used Children In The Anti-Tuberculosis Movement (1930s-1940s), Hannah Fisher

Senior Theses

During the anti-tuberculosis movement of the 1930s and 1940s, children were chosen as focal points, with their roles shaped by society’s changing view of childhood, the emergence of the middle class, and the socioeconomic and political climate. Children were used by middle-class reformers as conduits through which to disseminate information and enact controls on the working class. Health education in schools had two main goals: (1) for educated children to become educated adults, and (2) for educated children to transform the behaviors of adults around them. Although researchers have studied middle-class interventions into children’s health, few have analyzed the role …

It's Not Easy - Impacts Of Suicide Prevention Research On Study Staff, Jason I. Chen, Ginnifer L. Mastarone, Lauren M. Denneson

Communication Faculty Publications and Presentations

Suicide prevention researchers who work with individuals at high risk of suicide or are exposed to details of suicide attempts and deaths may experience negative impacts on their own well-being. This is not unlike the experiences of mental health providers, where repeated exposure to clients' difficult experiences gas long been identified as an occupational risk (Molnar et al., 2017). however, there have been few studies evaluating how exposure to details of suicide-related behavior impacts researcher well-being. This gap in the literature is worrisome, as researcher' mental health and well-being might be negatively impacted by repeated exposure to graphic details of …