Community Health and Preventive Medicine Commons^™

Rural–Urban Disparities In Monkeypox-Related Behaviors And Attitudes Among Men Who Have Sex With Men, Patcharaporn Krainara, Benjamas Klahan, Rungrot Jaiyong, Jitti Hanprasertpong

Journal of Health Research

Background: Monkeypox (Mpox) is a global health threat, particularly among men who have sex with men (MSM). Despite the predominance of urban cases in Thailand, rural–urban disparities in Mpox-related attitudes and behaviors remain underinvestigated. This study aimed to compare Mpox-related attitudes and preventive behaviors among urban (Chonburi) and rural (Nakhon Nayok) MSM and identify their influencing factors.

Method: This cross-sectional study was conducted between March and April 2025. A total of  842 MSM (421 urban; 421 rural) were recruited via convenience sampling. Data were collected using paper-based, self-administered Health Belief Model (HBM) questionnaires and analyzed using descriptive statistics and multivariable …

School Policy, Health Equity, And Lgbtq+ Youth: Implications Of Mahmoud V. Taylor, Anna Folta

Online/Hybrid MPH Integrative Learning Experience (capstone projects)

School-based policy functions as a critical lever for reducing health disparities among LGBTQ+ youth, who face elevated risks of suicidality, bullying, unsafe school environments, and housing instability. An extensive body of research identifies inclusive school practices—such as affirming curricula, supportive staff, and student organizations—as key protective factors that foster belonging and improve mental health outcomes. However, recent political and legal developments threaten the implementation and consistency of these protections.

Using a structured literature review and comparative policy analysis of federal, state, and district responses, this project integrates public health evidence with legal interpretation to assess how emerging parental opt-out frameworks …

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 …

Moving Beyond Traditional Cost Containment For Glp-1 Coverage Within Oregon's Proposed Universal Health Plan, Manoj Rajesh

University Honors Theses

In 2022, Oregon voters passed Measure 111, constitutionally mandating access to affordable health care. As the Universal Health Plan Governance Board (UHPGB) designs the state's proposed single-payer system, it faces an unprecedented financial vulnerability: the clinical demand for GLP-1 receptor agonists. These high-cost, indefinite-use medications for obesity and metabolic syndrome threaten to overwhelm fixed public budgets. Historically, both the Oregon Health Plan's Medicaid framework and commercial private insurers have relied on static cost-containment models—categorical exclusions, step therapy, and aggressive utilization management—that achieve short-term fiscal solvency at the expense of comprehensive preventative care. This thesis argues that to fulfill the mandate …

Extending The Global Impact Of Dnp Education: Integrating Scholarly Dissemination And International Practice Projects, Cynthia Plonien, Pricilla Muisyo, Deborah Behan, Kristine Cope, Cathy Brown

Nursing Faculty Publications & Presentations

The Doctor of Nursing Practice (DNP) Program at the University of Texas at Arlington initiated a global outreach effort in 2024 through two complementary strategies: expansion of a digital repository to support dissemination of DNP scholarly work and implementation of pilot DNP projects in Kenya. Together, these initiatives represent an integrated model for global engagement that combines knowledge dissemination with application of practice-based scholarship. The repository has facilitated international access to DNP projects, demonstrating significant global reach across multiple countries. Concurrently, a pilot project in Kenya was established through a strategic in-country professional partnership, enabling culturally relevant and sustainable implementation …

Do Rural-Urban Disparities Translate Into Nursing Complexity At Hospital Admission? Evidence From A Single Tertiary-Care Pediatric Hospital In Italy, Manuele Cesare, Gianfranco Damiani, Gloria Anderson, Jessica Preziosi, Rosemary Frasso, Leonardo Villani, Nursing And Public Health Group, Vittorio Maio, Antonello Cocchieri

College of Population Health Faculty Papers

BACKGROUND/OBJECTIVES: Rural-urban disparities are well documented in pediatric healthcare, influencing access, service organization, and outcomes. However, whether these differences extend to the domain of nursing care remains unclear. This study examined the association between degree of urbanization and nursing complexity among children admitted to a single tertiary-care pediatric hospital, comparing clinical, organizational, and nursing characteristics across geographic groups.

METHODS: Routinely collected electronic nursing documentation and hospital administrative records were retrospectively examined in a tertiary-care pediatric hospital in Rome, Italy. Children aged 2 to < 18 years were consecutively included. Degree of urbanization was defined using the ISTAT-derived DEGURBA classification. The study outcome for nursing complexity corresponded to the number of nursing diagnoses documented at hospital admission. Descriptive analyses and a multivariable negative binomial regression model assessed the association between urbanization and nursing complexity, adjusting for age, sex, DRG weight, number of medical diagnoses, and chronic conditions.

RESULTS: Among 1652 pediatric hospitalizations, those from rural areas showed a higher clinical burden, with significantly higher …

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 …

Five Corridors: A Community Health Needs Assessment Of Horry County, Stephen Borders, Hayley Bilko, Molly Craig, Olivia Guthrie, Ashley Mcconnell, Emily Mcgowan, Anna Quick, Abigail Rike, Makayla Wilson

Public Health

This report presents a Community Health Needs Assessment (CHNA) of Horry County, South Carolina. Its central analytical contribution is a five-corridor framework derived from k-means cluster analysis of the county's 76 residential census tracts, drawing on social and economic indicators from the American Community Survey and health estimates from the CDC PLACES program. The analysis organizes the county into five distinct community types — Affluent Coastal Retirement, Moderate Coastal Retirement, Inland Rural/Suburban Transitional, Concentrated Disadvantage, and Hispanic Hospitality Worker — each with a characteristic profile of social and health conditions.

Within this framework, the assessment examines a range of social …

Slouching Towards Inefficiency? The Cardiometabolic And Cognitive Costs Of Poor Posture, Ava Mae Fitzenrider

Honors Projects

Posture affects all of our lives. It is both static and dynamic, adapting continuously to environmental demands. One postural alteration frequently observed in occupational settings is hyperkyphosis, which can be induced by sitting position. During computer use, individuals commonly adopt a slouched posture, which can exacerbate hyperkyphosis, and contribute to dis-ease within the body. Previous research has demonstrated that such postural deviations can negatively affect pulmonary function, as well as other bodily functions. Despite these findings, the effects of acute hyperkyphosis (“slouching”) on cardiometabolic function and cognition remain largely unexplored. Therefore, the purpose of this study was to examine the …

Health Practices And Use Of Traditional Medicine Among Asian Indian Immigrants In The United States: A Pilot Study, Parita Patel, Anil N.F. Aranha

Medical Student Research Symposium

Title: Health Practices and Use of Traditional Medicine Among Asian Indian Immigrants in the United States: A Pilot Study

Authors

Parita Patel, MPH¹; Anil N.F. Aranha, PhD^1,2

Medical Education¹, Internal Medicine², Wayne State University School of Medicine, Detroit, Michigan

Abstract

Background and Purpose: Traditional and alternative medicine (TAM), including Ayurveda, Homeopathy, Naturopathy, and home remedies, remains widely used among Asian Indian (AI) immigrants in the United States alongside Western medicine. Cultural familiarity, family influence, and perceived safety shape these practices. This pilot study examined TAM prevalence, patterns, and perceptions among AI immigrants and …

Titanium Dioxide: An Inquiry Into The Mechanisms And Implications Of Exposure In Gut Dysbiosis And Metabolic Disorders, Meghan Gardiner

Senior Honors Theses

Titanium dioxide (TiO₂) is one of the most prevalent food additives utilized in commercial products in the United States. While TiO₂ was originally hailed as a nontoxic and cost-effective additive, studies are beginning to reveal that TiO₂ is not as safe as it once seemed. TiO₂ may contribute to the development of insulin resistance and metabolic disorders through direct and indirect mechanisms. The compound induces gut dysbiosis, leading to alterations in bacterial metabolites and pro-inflammatory cytokines, which results in the selective resistance of glucocorticoid receptors. Additionally, TiO₂ itself can translocate from the gut to …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Proceedings Of The 18th Indonesian Occupational Medicine Update (Iomu) 2026 - Occupational Medicine Without Borders: Emerging Risks, Evolving Workforces, And Inclusive Collaboration, Indonesian Association Of Occupational Medicine Specialists (Perhimpunan Kedokteran Okupasi Indonesia / Perdoki)

Occupational and Environmental Medicine Journal of Indonesia

This Supplemental Issue of the Occupational and Environmental Medicine Journal of Indonesia (OEMJI) compiles the scientific abstracts presented at the 18th Indonesian Occupational Medicine Update (IOMU) 2026, convened in Surabaya, Indonesia, from 15 to 17 May 2026. The IOMU has matured into the most prominent annual scientific platform of the Indonesian occupational medicine community, hosted by the Indonesian Association of Occupational Medicine Specialists (Perhimpunan Kedokteran Okupasi Indonesia / PERDOKI). Since its inception, the conference has served as a meeting point where clinicians, academics, industrial hygienists, regulators, employers, and worker representatives gather to translate emerging scientific evidence into …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Colorectal Cancer Screening: Implementation And Evaluation Of A Screening Algorithm In A Rural Family Practice Clinic, Mollie M. Tate, Whitney Dubas

Doctor of Nursing Practice Projects: College of Nursing

Background: Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States and disproportionately affects rural populations. Although more than 90% of cases occur in adults older than 50 years, increasing incidence among younger adults prompted an update to national guidelines recommending screening beginning at age 45. Rural residents face multiple barriers to colorectal cancer screening (CRCS), including limited access to care, transportation challenges, lack of insurance, and absence of standardized screening processes in primary care. These barriers contribute to lower screening rates, delayed diagnosis, and poorer outcomes. Evidence demonstrates that CRCS reduces CRC morbidity and …

How Do Adverse Social Determinants Of Health Influence 30-Day Hospital Readmission Rates Among Patients With Heart Failure?, Noor Baig

Rowan-Virtua Research Day

Heart failure is one of the leading causes of hospitalization in the United States, with nearly 1 in 4 patients readmitted within 30 days of discharge. Clinical severity largely accounts for this risk, but social determinants of health (SDOH), including income, housing stability, transportation access, and health literacy, also play a role in post-discharge outcomes. This review synthesized seven cohort, observational, and qualitative studies from PubMed (2018–2025) examining the relationship between SDOH and 30-day readmission in heart failure patients.

Several patterns emerged across the literature. Neighborhood socioeconomic disadvantage, measured through ADI and SDI, was independently associated with higher readmission and …

Challenges For Older Veterans In Disaster-Prone Rural Areas, Umayma Saifuddin, Joshua Ehrenberg, Elizabeth Tran Phung

Rowan-Virtua Research Day

Purpose: To describe a case in which an elderly veteran was unable to receive necessary health services due to environmental factors and routine natural disaster in his rural coastal town. Methods: A case report is presented. Results: A 95 year-old WWII veteran with a complex medical history and numerous disabilities including hearing impairment, visual impairment, and chronic pain struggles to receive proper care as he lives in a small coastal town. The patient’s son lives an hour away and this area is prone to flooding, making accessing health services extremely challenging. In order to respect the patient’s wishes to remain …

Assessment Of Health Disparities Among Community Clinic Patients In Southern New Jersey, Hetasvi Saraiya, Priyal Gajera, Mahhum Naqvi, Nils Brolis

Rowan-Virtua Research Day

Introduction:

The Rowan Community Health Center (RCHC) is a student-run free clinic that provides primary care services to uninsured and underserved populations in southern New Jersey. Access to quality healthcare remains a persistent challenge for these communities due to social and economic barriers1 . This study aims to identify and analyze the most common health disparities and barriers to care. The primary outcome of this study was to assess health disparities and barriers to care, secondary outcomes included characterizing chief complaints and identifying alternative care options patients would pursue if not seen at the clinic

Methods:

This survey-based study was …

Using Group Activities To Improve Engagement And Help Alleviate Loneliness Among Older Adults At Macedonia Face, Taylor Corcoran

Public Health Capstone Projects

Introduction: Social isolation and loneliness are increasing public health concerns due to their association with heightened risk for chronic disease and their disproportionate impact on Black older adults (BOA). This project was designed to develop, implement, and evaluate the effectiveness of culturally relevant, low-cost activities on engagement rates among older adults during unscheduled program periods at the Macedonia Family Community Enrichment Center (FACE).

Methods: This project used a mixed methods approach over a 4-week implementation period. Three activities were introduced by the student facilitator, including UNO!, Name That Tune (NTT), and coloring pages. Engagement was measured by comparing the …

Improving Pediatric Vaccination Rates In The United States, Maanasi Dudi

Rowan-Virtua Research Day

Pediatric vaccination has been one of the most effective public health strategies for preventing infectious diseases and reducing childhood morbidity and mortality. However, vaccination rates have dropped in recent years, due to increasing vaccine hesitancy, as well as interruptions in regular healthcare during the COVID-19 pandemic. This has been reflected in primary care settings, where pediatricians are seeing more parents refuse vaccinations.

This literature review examines current trends in pediatric vaccination rates, factors contributing to vaccine hesitancy, and interventions that have been used to improve vaccination uptake. A systematic search of peer-reviewed literature was conducted on PubMed to identify studies …

Impact Of Spanish-Speaking Medical Interpreters On Healthcare Access, Outcomes, And Equity In Patients With Limited English Proficiency, Emily Fried, Catherine Awad, Rebecca Moore

Rowan-Virtua Research Day

Impact of Spanish-Speaking Medical Interpreters on Healthcare Access, Outcomes, and Equity in Patients with Limited English Proficiency

Background

Limited English proficiency (LEP) is a significant barrier to equitable healthcare in the United States and is associated with reduced access to care, poorer clinical outcomes, and increased healthcare disparities. The Spanish-speaking population represents the largest proportion of LEP patients, making language access a crucial component of high-quality care. Language discordance between patients and providers contributes to impaired communication, increased medical errors, and decreased utilization of preventative services1-4.

Objectives

The objective of this study was to evaluate the impact of Spanish-speaking professional …

The Obstacles Of Performing A Retrospective Chart Review, Emily Reilly, Robert Hudrick D.O.

Rowan-Virtua Research Day

Introduction: This research project "Comparing timing of care for skin cancer patients with limited English proficiency who require interpretation during medical visits to patients with English proficiency" was accepted under the CREATE Grant. The hypothesis was that patients who require medical interpretation during their visits would show a longer period of time between noticing a skin lesion to definitive diagnosis. Previous research has shown improved health care outcomes, but has mixed results on patient satisfaction and health care experience. This poster aims to detail the limitations faced during the execution of a retrospective chart review from the perspective of a …

Racial Inequities In Maternal Health And Birth Outcomes In South Jersey, Yariza Orellana, Amenata Dukuray, Christine Ortiz

Rowan-Virtua Research Day

Racial disparities in maternal morbidity and mortality remain a persistent public health issue in the United States, with Black non-hispanic women experiencing a 2.4 to 3.3 greater risk of pregnancy-related complications compared to their white counterparts. In New Jersey, these disparities are similarly pronounced, with severe maternal morbidity occurring at more than twice the rate among non-Hispanic Black mothers. These inequities extend beyond maternal outcomes and contribute to adverse infant health outcomes, including stillbirth, preterm birth, and low birth weight. This study was conducted using databases such as PubMed and Google Scholar, as well as public health sources including the …

Addressing Diabetes Risk Through Preventative Education In Multicultural And Economically Underserved South Jersey Communities, Bavly Nagy Halaka, Janet Jimenez-Merino, Izayah Diaz

Rowan-Virtua Research Day

BACKGROUND: Diabetes and prediabetes affect a substantial and growing portion of the U.S. population, with adolescent prediabetes rates more than doubling from 11% in 1999 to 28% in 2018. In multicultural and economically underserved South Jersey communities, structural barriers including food insecurity, limited access to preventive healthcare, and language gaps make early detection and prevention particularly difficult. We aimed to assess diabetes risk, management behaviors, and preferred education formats among a Camden-area bilingual community, and to identify culturally responsive intervention strategies.

METHODS: We conducted a literature review utilizing data from the CDC, NJ Department of Health, NJSHAD, and the U.S. …

Invisible Shipwrecks And Neurological Endangerment: The Trade-Off In Seeking Asylum - Reframing The Neurobiological Cost Of Forced Migration, Eisha Giran

CISLA Senior Integrative Projects

Forced migration along the Spain–Morocco route represents one of the most visible humanitarian crises of the twenty-first century, yet its neurological dimensions remain insufficiently examined. This paper investigates how prolonged displacement and trauma reshape neural systems involved in stress regulation, memory, and emotional processing. It introduces the concept of neurological endangerment, defined as a condition of prolonged and inescapable threat exposure during forced migration in which stress-response systems remain chronically activated, opportunities for recovery are structurally constrained, and cumulative neurobiological risk persists beyond the period of immediate danger.

To address the gap between biological measurement and lived experience, this paper …

Barriers To Asthma Management And Specialty Care Among Low-Income Families In South Jersey, Sally Park, Courtney Ray-Fofana, Christal Onwuegbule

Rowan-Virtua Research Day

Asthma is a chronic respiratory condition that remains a significant public health concern, particularly among low-income and underserved populations. This poster presents a focused review of existing literature and publicly available data to examine barriers to asthma management and access to specialty care in South Jersey, with emphasis on counties such as Camden, Atlantic, and Cumberland.

Data were synthesized from sources including PubMed, the New Jersey Department of Health, and the National Institutes of Health to evaluate asthma prevalence, disease burden, and the impact of social determinants of health. Current estimates suggest that approximately 8.8%–9.0% of adults in New Jersey …

The Rowan University Wellness Village: An Innovative Community Advancing Health And Well-Being, Thomas Cavalieri Do, Brandi Dockett Ma, Matt Mclaughlin Bs

Rowan-Virtua Research Day

No abstract provided.

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

Rowan-Virtua Research Day

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

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

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

Rowan-Virtua Research Day

Background:

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

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

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

Rowan-Virtua Research Day

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