Community Health and Preventive Medicine Commons^™

The School Nurse's Experience Of Secondary Exposure To Trauma, Catherine A. Grano

Seton Hall University Dissertations and Theses (ETDs)

The school nurse (SN) is often the sole health care expert in the school setting, providing for the physical and socio-emotional needs of others. SN may be exposed to reports of trauma, a widespread and costly public health issue. This study sought to explore the experience of the SN when exposed to reports of trauma from those in their care. Seven N.J. certified school nurses participated in two online interviews via Microsoft Teams, spaced one to two weeks apart between June 2021 and September 2021. Interviews were recorded & transcribed verbatim and thematic analysis applied. This study found that SN …

Factors Associated With Covid-19 Death In The United States: Cohort Study, Uan-I Chen, Hua Xu, Trudy Millard Krause, Raymond Greenberg, Xiao Dong, Xiaoqian Jiang

Faculty, Staff and Student Publications

BACKGROUND: Since the initial COVID-19 cases were identified in the United States in February 2020, the United States has experienced a high incidence of the disease. Understanding the risk factors for severe outcomes identifies the most vulnerable populations and helps in decision-making.

OBJECTIVE: This study aims to assess the factors associated with COVID-19-related deaths from a large, national, individual-level data set.

METHODS: A cohort study was conducted using data from the Optum de-identified COVID-19 electronic health record (EHR) data set; 1,271,033 adult participants were observed from February 1, 2020, to August 31, 2020, until their deaths due to COVID-19, deaths …

National Early Warning Score (News) For Covid-19 Infected Patients: A Clinical Guidance Tool, Robert Villegas

Doctor of Nursing Practice Final Manuscripts

Background: Coronavirus 2019 (COVID-19) presents with variable clinical manifestations from asymptomatic to life-threatening organ dysfunction. The National Early Warning Score, also known as NEWS, was initially developed to detect adult inpatient deterioration using existing physiological data and adverse clinical outcomes from 35,585 medical admissions. The NEWS guideline consists of six parameters: respiratory rate, pulse, oxygen saturation, temperature, systolic blood pressure, and level of consciousness.

Purpose: This project implemented NEWS guidelines to identify patients at high risk for deterioration with COVID-19.

Evidence-Based Interventions: The project included retrospective-prospective chart reviews for 100 patients diagnosed with COVID-19 from October 2020 to December 2020. …

Health Equity & Obesity Management: An Improvement Project In A Federally Qualified Healthcare Center In Central Harlem, Brianna Bouchez

Doctor of Nursing Practice Scholarly Projects

Description of the problem: Obesity is a growing healthcare problem worldwide with extraordinary costs to the individual's health and the healthcare system. Individuals most affected by obesity include socioeconomically disadvantaged individuals, often with limited resources to seek specialized care.

Available knowledge: Various weight-loss interventions exist but access and success rates vary. Weight loss is often modest and additional factors such as social determinants of health, health literacy, and patient motivation are all factors important to the success of an intervention.

Specific Aims: The purpose of this quality improvement project was to improve self-regulatory weight loss behaviors and increase weight loss …

Covid-19 Booster Vaccination Hesitancy In The United States: A Multi-Theory-Model (Mtm) Based National Assessment, Kavita Batra, Manoj Sharma, Chia-Liang Dai, Jagdish Khubchandani

School of Medicine Faculty Research

Background: Despite the availability of COVID-19 vaccines and the proven benefits of vaccinations outweighing the potential risks, hesitancy to accept vaccines and additional doses remains a persistent problem. Therefore, the purpose of the study was to investigate hesitancy, confidence, literacy, and the role of the multi-theory model (MTM) constructs in COVID-19 booster uptake. Methods: This cross-sectional study utilized a 52-item psychometric valid web-based survey conducted during the month of October 2021 to recruit a nationally representative sample of U.S. adults. Univariate, bivariate, and multivariate statistical tests were used to analyze the data. Results: Among the booster hesitant group (n = …

An Exploratory Look Into The Effects Of Mississippi's Population Decline On Rural Dental Care, Allen Bailey Saffold

Honors Theses

Literature reviews and interviews with dentists working in rural Mississippi counties examined the effects of population decline on rural dental care in Mississippi. With the state’s continual population decline, loss of industry follows a loss of people. Through a cascade of effects, this can further reduce underserved areas’ access to dental care. In order to address the issue of rural Mississippi continuing to be underserved, policies need to be implemented that will make rural practice at least enticing if not desirable.

Comorbidity Burden And Covid-19 Vaccination Intention: Application Of The Health Belief Model, Michael Raymond

Honors Theses

The COVID-19 pandemic impacted many aspects of American’s lives causing over 79 million cases and over 950,000 deaths. Existing research shows severity of COVID-19 infection may be linked to number of underlying health conditions, known as comorbidities. The objective of this study was to determine if comorbidity burden was associated with intention to vaccinate against COVID-19. This relationship was looked at through the Health Belief Model (HBM) and its mediating variables of perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Our sample was compromised of 350 individuals recruited from an online platform who were not already vaccinated against COVID-19. …

Rates And Perceptions Of Covid-19 Vaccination From University Of Mississippi Students, Josie Parham

Honors Theses

The trials, tribulations and triumphs of the global COVID-19 pandemic are impacted by and are a product of behaviors that occur at the level of nations, states, cities and, ultimately, communities. In the wake of the development of safe and effective vaccines against SARS-CoV2, the virus responsible for the pandemic, the significance of the vaccine is closely linked to the number of individuals that receive the vaccine. To date, surveys have measured sizable variations in vaccination rates between nations, states, cities, and communities. Focusing on events that have transpired in one such local community, the present study (i) measured the …

Evaluation Of Awareness, Knowledge, And Preventive Intervention Of Nonalcoholic Fatty Liver Disease Among Chinese Young Adults, Yi Du

Theses & Dissertations

The prevalence of nonalcoholic fatty liver disease (NAFLD) among Chinese young adults (CYA) aged 18-25 years ranges from 4.7% to 15.1% and has kept increasing in recent years. Previous studies reported limited awareness and knowledge of NALFD among middle-aged and older Chinese populations, however, they have not investigated awareness in CYA, for which there is no well-validated questionnaire. There is currently no efficacious educational intervention on NAFLD for CYA.

The objectives were 1) to develop and validate a questionnaire which can be used to assess the awareness and knowledge of NAFLD among CYA; 2) to assess the awareness and knowledge …

Contextual Factors And Sti/Hiv Sexual Risk Behaviors Among Hispanic Youths Aged 13 To 24 Years, Mariam Taiwo

Theses & Dissertations

Despite the growing population of Hispanics and several efforts to combat the high STI/HIV rates among Hispanic youths aged 13 to 24 years in the United States, this population continues to experience stark disparities in STI/HIV and is underrepresented in STI/HIV research relative to their White peers. This dissertation consists of three distinct studies designed to identify and understand the contextual factors of STI/HIV sexual risk behaviors across the social-ecological model that are pertinent to Hispanic youths.

Results from the first study showed that STI/HIV sexual risk behavior varied by Hispanic youths’ acculturation types and moderated by gender. We found …

Effects Of The Covid-19 Pandemic On Health Behaviors And Mental Health During Pregnancy: A Systematic Review, Kara C. Middleton

Honors College Theses

The Coronavirus pandemic had many negative impacts on healthcare. During the COVID-19 pandemic, specialist care providers closed their offices to reduce transmission. Maternal healthcare was severely impacted. Mothers were unable to receive the prenatal and perinatal care they needed. Other specialist care, such as mental healthcare was severely impacted as well. There was also a lack of prenatal care occurring due to offices being closed. There is an established link between anxiety, depression, emotional eating, and Gestational weight gain. Gestational Weight Gain is associated with a higher prevalence of behavioral health conditions that were exacerbated by the COVID-19 pandemic.

Creating A Guideline For Sti Testing In The Pediatric Population, Alexandria Molaro, Alexandra Evans, Alex Niebrugge

Doctor of Nursing Practice Projects

Sexually transmitted infection (STI) prevention, education, screening, and management in pediatric primary care settings are of importance due to the increasing number of cases yearly. Almost half of the 26 million new STIs that occurred in 2018 were among young people 15-24. An opportunity existed in a rural pediatric primary clinic, for improved adherence to Centers for Disease Control and Prevention (CDC) or American Academy of Pediatrics (AAP) recommendations to screen/test patients. An evidence-based project (EBP) was developed to address this concern. Project objectives included: developing STI screening guidelines for pre-teen to young adults, developing a screening algorithm, providing alternative …

Increasing Obesity Education In An Underserved Latino Population, Morgan Lippert, Kelsey Beard

Doctor of Nursing Practice Projects

Obesity is a rapidly growing health problem in the United States. Certain populations are at high risk for developing obesity including the Latino population and underserved communities. This Quality Improvement project aimed to develop a more patient centered approach for primary care providers use to deliver obesity education to an at-risk Latino population. The project was completed at a clinic in southern Illinois where the majority of the population is underserved and Spanish speaking. Obesity education tools in both Spanish and English were given to the patients in order to decrease the language barrier and improve patient education and understanding …

Covid-19, Vaccination, And Heart Transplantation, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Evaluating The Relationship And Outcomes Of Ischemic Stroke In Patients With Covid-19 While Also Reviewing Overall Incidence And Mortality Of Stroke In Vulnerable Populations In The Us, Jaime Dougherty

Rowan-Virtua Research Day

COVID-19 has affected the worldwide population since early 2020 and has remained a health issue. Among the various symptoms and outcomes people are encountering when infected with COVID-19, this virus has also been connected to severe vascular insults involving large vessel occlusions.

Current stroke statistics indicate a nearly twice as high risk of stroke in African Americans when compared to whites. This brings into question how social determinants of health are affecting COVID-19 and stroke incidence.

The purpose of this review is to investigate the relationship between COVID-19 and ischemic stroke while advocating for a more robust primary prevention approach …

Identifying Motivators For Getting Vaccinated Against Sars-Cov-2 In Those Who Have Been Vaccinated. A Single Center Cross-Sectional Study, Nicole Lacap, Suzanna Hosein

Rowan-Virtua Research Day

The purpose of this study is to explore the primary motivations of patients getting vaccinated against SARS-Cov-2 as well as to determine any correlations between demographic information and specific motivators. We hypothesized that generally internal motivators (being in the best interest of oneself) will predominate as the reason for vaccination. The sample consisted of 227 patients vaccinated against SARS-CoV-2 at the Rowan Medicine Vaccine Clinic during the month of June 2021. Patients were given an online questionnaire collecting demographic information as well as primary reason for getting vaccinated. Preliminary analysis shows that 63% of participants were motivated by reasons that …

Implementing A Case Management Program At A Free Student-Run Clinic, Shelly Sharma, Mark Conforti, Wali Kamran, Fatou Drame, Mary Kate Heard, Samuel Irungu

Rowan-Virtua Research Day

• The Rowan Community Health Center (RCHC) located in Lindenwold, New Jersey, reopened in September of 2019
• Patients come to RCHC for physicals/wellness checks or medical ailments
• Many patients are from underserved communities and may not have a primary care physician or insurance
• Trend in lack of follow up among patients
  • o Leads to discontinuity of care
  • o Unaware if patients are obtaining their prescribed medications, following up with recommended specialists, or if chief complaints/primary diagnosis are improving
• RCHC’s Special Projects Department decided to implement a Case Management program to improve patient follow-up and adherence to care

The Need For Depression And Anxiety Screenings At A Student-Run Clinic, Shayna Peterzell, Sahil Parikh, Alicia Podwojniak, Vibha Chauhan, Riya Tandra, Emily Forester, Saumil Parikh, Jessica-Sophie Horoschak, Patrick Pearce, Roma Padalkar, Sobiah Khan, Tara Pellegrino

Rowan-Virtua Research Day

General anxiety and major depressive disorder are common and treatable mental health disorders. The US Preventive Services Task Force provides strong evidence that early screening helps identify depression in primary care settings, promotes intervention and facilitates treatment. Many medical offices use validated screening tools, GAD-7 and PHQ-9, to measure symptom severities and further help guide treatment modalities for patients with anxiety and depression, respectively. The Rowan Community Health Clinic (RCHC) in Lindenwold, NJ is a student-run free clinic that serves patients regardless of patient gender, race, income, or insurance status. This study aims to determine if there is a need …

Evaluating Reasons For Moderna Covid-19 Vaccine Hesitancy At A Vaccine Distribution Center In South Jersey, Arghyadeep Sarkar, Suzanna Hosein

Rowan-Virtua Research Day

RowanSOM held a student-run vaccine clinic in 2020 during the Covid-19 pandemic.

Despite published research stating the safety and efficacy of the vaccine, there were still vaccine-hesitant individuals.

While the CDC reported that hesitancy to receive vaccination against SARS-CoV-2 had decreased, 32.1% of American adults did not intend to get vaccinated as of December 2020.

Understanding reasons for this hesitancy could help create informational ads directed towards people’s concerns.

Examining The Relationship Between Adolescent Obesity Rates And School Health Programs In Grades 9-12 In The United States, Joseph Melillo, Alison Mancuso

Rowan-Virtua Research Day

- In the United States, it was found that the prevalence of obese adolescents ages 12-19 was 21.2%.1

- According to a study by Ward et. al published in the New England Journal of Health (NEJH), the researchers estimated 88.2% of obese 19-year-olds would still be obese by the age of 35.2

- The purpose of this study was to evaluate school provided health programs and their impact on BMI values of students within these schools.

- This study aimed to compare health outcomes between different schools across the United States and identify aspects of school programming that can be …

The Effectiveness Of Culturally Relevant Obesity Programs On Decreasing Bmi Of Hispanic Children, Cindy Nativi

Rowan-Virtua Research Day

Obesity epidemic a public health concern in the United States

• significantly increases health burden in affected individuals
• linked to increased risk of diabetes, cardiovascular disease and cancer
• childhood obesity linked to earlier onset or presence in adulthood of the same diseases
• crucial to address this disease at the preventative level

Centers for Disease Control and Prevention reports obesity affects 19.3% of children and adolescents in the United States

• affects all ethnicities, but increased burden on minority populations of low socioeconomic status
• 1 in 5 Hispanic children considered obese

Latinos one of the fastest growing minority populations

• comprise approximately 17% of …

The Opioid Epidemic & Narcan® Education: Current State Of Narcan® Use, Alicia Podwojniak, Fatimah Seyed-Ali, Akhil Abraham, Archana Salek

Rowan-Virtua Research Day

Objectives:

• Investigate the need for increased naloxone awareness and availability in communities across the state [New Jersey]
• Assess the current advantages and disadvantages of Narcan® use
• Identify the barriers preventing naloxone from becoming a socially accepted treatment
• Develop an education plan to effectively teach target communities about Narcan® training and related resources/centers in that area.

The Impact Of The Covid-19 Pandemic On Pediatric Obesity In School-Aged Children, Amaani Faizal, Maryanna Schweininger, Suzanna Hosein

Rowan-Virtua Research Day

The prevalence of childhood obesity in those aged 2-19 in the United States was 19.3% in 2017-2018. Childhood obesity is a major health concern with growing rates of incidence. Being overweight or obese put children at risk for developing several chronic conditions such as coronary artery disease, type 2 diabetes mellitus, hypertension and asthma at a younger age. Studies have shown that higher BMI numbers in childhood added an increased risk of being obese as an adult.

The pathophysiology of developing obesity includes several complex factors ranging from nutrition, physical activity, genetic background and lifestyle preferences. Among children, nutrition and …

Understanding Changes In Mortality With Implementation Of Safe Injection Sites, Shubh Bhambri

Rowan-Virtua Research Day

The purpose of this study is to analyze mortality due to overdose in areas that have implemented supervised injection sites and understand what factors these facilities affect that can lead to a change in outcomes.

Trends In Pediatric Obesity Of School-Aged Children During The Covid-19 Pandemic, Maryanna Schweininger, Amaani Faizal, Suzanna Hosein

Rowan-Virtua Research Day

Since the start of the COVID-19 pandemic, children have been more sedentary due to nationwide school closures resulting in classes being held virtually. Due to restrictions, children could no longer participate in physical education classes and after school activities at the same frequency. The pandemic also placed a disproportionate burden on low-income families thus, potentially amplifying food insecurity. The aim of this study was to identify the impact of the COVID-19 pandemic on childhood obesity.

Income And Its Effects On Health Literacy: A Study Between A Student-Run Free Clinic And A Family Medicine Office, Shayna Peterzell, Sahil Parikh, Thomas Ruta, Rabiye Ayaz, Srujan Dadi, Emily Forester, Olivia Choi, Rachel Fletcher-Slater, Melodi Harfouche, John Cruz, Roma Padalkar, Sobiah Khan, Rebecca Moore

Rowan-Virtua Research Day

More than 1/3 of people nationwide (80+ million) have limited health literacy, which contributes to poor health outcomes and lifestyle choices. Health literacy is defined as the understanding and application of words, numbers & documents (i.e., medication labels, medical forms). The Rowan Community Health Center (RCHC), located in Lindenwold NJ, is a student-run clinic that wanted to assess the health literacy of our patients in order to further provide better care. RCHC provides cost-free primary care services regardless of income, insurance, or legal status. To assess health literacy, RCHC used the New Vital Signs (NVS) literacy assessment tool to investigate …

Assessing The Impact Of The Covid-19 Pandemic On Adolescent Mental Health, Vanessa Pizutelli, Yanil Morales, Christina Copeland, Archana Salek

Rowan-Virtua Research Day

Adolescence is a crucial period in which adverse childhood experiences, social relationships, and habits can influence mental wellbeing. According to the CDC, the onset of mental illness is 14.5 years old, which is why it is imperative that individuals with mental health conditions receive early intervention. Since the start of the Covid-19 pandemic, research has shown a dramatic decline in adolescent mental health. Specifically in New Jersey, it has been reported that individuals ages 18-23 have the highest levels of stress and depressive symptoms since the start of the pandemic. In light of these findings, it is vital that more …

Assessing The Effectiveness Of Phone Call Proactive Naloxone Co-Prescribing Enrollment, Tyler Klecha, David Aloisio, Eshani Choksi, Manasa Gowda, Christina Kanagawa, Charles M. Defendorf

Rowan-Virtua Research Day

Opioid use is increasing at never-before-seen rates. As a result, it is imperative that medical facilities educate and provide resources for those who may be at risk of an opioid overdose. With our study, we aimed to see the demographics of our population here at Rowan Medicine and identify associations of those participating in our naloxone co-prescription program. Majority of enrollees in our program were aged 50 or older and identified as Caucasian. A large proportion also reported being unable to work. Given this information, improvements in our naloxone coprescription program may include spreading more awareness of the benefits of …

Case Report: Unintentional Edible Thc Ingestion (Gummi Worms) In A Child, James Espinosa, Kelly Hamilton, Alan Lucerna, David Ho, Henry Schuitema

Rowan-Virtua Research Day

We report the case of a 4 year male who presented to the ED with what his mother described as unusual fatigue and sleepiness. The mother related that family and friends had some to her house for a holiday gathering and that one of the guests had an accessible and open handbag that contained gummi worm THC. The guest observed the child eating the gummi worms and immediately notified the patient’s mother. Poison control was contacted. The child was observed for 6 hours and left the ED in good condition without any specific treatment needed. Awareness of the potential of …

Editorial: The Interplay Between Social Determinants Of Health And Cancer Related Health Disparities, Tung-Sung Tseng, Chien Ching Li, Alicia K. Matthews

School of Public Health Faculty Publications

No abstract provided.