Health Services Research Commons^™

Bio-Cybersecurity: Securing The Healthcare Industry, Amanda D. Coleman

Cybersecurity Undergraduate Research Showcase

Bio-cybersecurity refers to the aspect of cybersecurity that applies to the biological sciences and the protection of digital biomedical information. Today’s healthcare industry has evolved with the enhancement of internet and biomedical technology. While hospitals and private medical providers remain compliant with the Health Information Portability and Accountability Act (HIPAA) through traditional means of securing documented patient information, the emergence of beneficial internet-based healthcare services like virtual appointments and digital patient records requires new policies and healthcare cybersecurity frameworks to protect sensitive information from unauthorized access. This paper examines the role of cybersecurity in healthcare, the vulnerabilities that exist and …

Evaluating Sensory Sensitivities Among Children With Autism Spectrum Disorder In An Adaptive Gymnastics Program, Aicha Kaouss, Bradley Eppinger, Austin Ebbrecht, Kailash Ram, Kaitlin P. Hardy Md

Knowledge and Creativity Expo

Introduction: Children with autism spectrum disorder (ASD) participate in physical activity at lower rates than their neurotypical peers1. Sensory sensitivities, reported in approximately 75–95% of children with ASD, may contribute to this disparity2. Gymnastics environments involve bright lighting and loud noise, which can precipitate sensory overload. The impact of specific sensory features on participation in adaptive gymnastics remains underexplored.

Methods: A cross-sectional study recruited caregivers of children aged 3–12 years with an ASD diagnosis enrolled in the EVMS Adaptive Gymnastics Program. Caregivers completed the Sensory Experiences Questionnaire–Third Edition (SEQ-3)3 and supplemental survey items on Redcap which assessed environmental triggers and …

Ensuring Rich Rigor Of Qualitative Methodologies In Behavior Analytic Research, Daria K. Lorio-Barsten, Selena J. Layden

Human Movement Studies & Special Education Faculty Publications

Quantitative methods remain the hallmark of research in applied behavior analysis. Yet, such methods frequently fail to capture the nuances of context where behavior analysis is practiced. Therefore, qualitative methods can provide complementary means to gain deeper insight into changes in socially significant behavior. We believe that researchers within the field of behavior analysis have much to gain from embracing qualitative methodologies. We propose that more researchers can and should consider conducting rigorous qualitative research to elevate the voices of the participants and relate the depth and complexities of their nuanced experiences. This article discusses Tracy’s “big tent” quality criteria …

A Modern Analytical Method To Forecast Cerebrovascular Diseases (Cd), And Heart Diseases (Hd) Using Multivariate Time Series Model Utilizing The Cdc Provisional Mortality Data, Aditya Chakraborty, Mohan Pant

Cardiovascular Research Symposium

Background: In this study, a new analytical approach was introduced to answer specific questions related to mortalities due to cerebrovascular diseases, heart diseases, and the association of these mortalities with twelve other causes of death (COD).

Methods: A multivariate time series forecasting model was developed utilizing each of the CODs by taking the weekly and yearly seasonality into account, and the mortality counts were forecasted using the most recent CDC weekly mortality count data. A new COD data matrix was structured for all CODs as a function of weeks by combining the observed and predicted values of the mortality counts. …

Facilitated Group Care For Maternal And Child Health Model Fidelity: A Scoping Review, Ashley Gresh, Phoebe Parker, Anne Batchelder, Jalana Lazar, Christina X. Marea, Camilla Bjelland, Rohan D. Jeremiah, Giovanna Cristina Machado-Kayzuka, Hayden Geibel, Dhruvi R. Patel, Esnath Kapito, Kathleen F. Norr, Crystal L. Patil

Department of Pediatrics Faculty Publications

Group care is a transformative model of prenatal, postnatal, and well-child care. The Centering-based group care model has three core components: health care, interactive learning, and community building. It has been implemented in 33 countries with associated improved maternal and child health outcomes. Maintaining fidelity to the model is essential for its effectiveness. However, to date no standardised measure of fidelity to the group care model exists. This review aimed to explore how fidelity is measured in group care and identify common themes to understand what is essential to maintain fidelity. We used the scoping review framework by Arksey & …

Occupational Stress And Coping During A Public Health Emergency: A Mixed-Methods Approach To Understand The Experiences Of Lactation Professionals In Clinical Settings, Mya Michele Carter

Health Services Research Dissertations

Introduction: During public health emergencies, such as the coronavirus 2019 pandemic, breastfeeding is still the recommended feeding option, and mothers and babies may need additional support to reach breastfeeding goals. Pandemic-related, clinic-level restrictions posed new challenges for postpartum mothers and their healthcare teams, including lactation professionals (LPs). The pandemic and subsequent restrictions may have impacted lactation professionals’ work-related stress and limited their ability to provide lactation support. Coping strategies to mitigate occupational stress can be useful in preventing adverse outcomes for both the provider and the patient. The need for continuous support for this profession of healthcare workers is paramount. …

Pediatric Oral Health Literacy Among Caregivers Of Young Children, Melissa L. Sullivan

Health Services Research Dissertations

Early childhood caries (ECC) is a common dental condition that affects the primary teeth of infants and young children. ECC can have a significant negative impact on a child’s oral health and overall well-being. Caregivers have an important role in the prevention of early childhood caries through knowledge, understanding, and awareness of good oral hygiene practices. Caregivers who possess adequate oral health literacy (OHL) may be more likely to recognize the risks associated with ECC, implement proper oral hygiene practices, and make informed oral health choices for themselves and their child.

The overarching purpose of this dissertation is to explore …

Role Of Nativity In Mental Health Service Utilization Among Asian Americans: A Weighted Analysis Of Complex Survey Data, Anne Dumadag, Hadiza Galadima

College of Health Sciences Posters

Asian Americans represent both the fastest-growing population and the smallest group of consumers of mental health services (MHS) in the United States. The current study aimed to identify factors associated with MHS use and explore differences in MHS use by nativity among Asian Americans. Data from the 2015-2018 National Health and Nutrition Examination Survey (NHANES) were used to examine past-year MHS use among Asian Americans ages 18 and older. Weighted analyses were used to determine the distribution of the population by nativity and other covariates, and Rao-Scott Chi-Square tests were used to explore the association between past-year MHS use and …

A Global Perspective Of Advanced Practice Nursing Research: A Review Of Systematic Reviews Protocol, Kelley Kilpatrick, Isabelle Savard, Li-Anne Audet, Abby Kra-Friedman, Reneé Atallah, Mira Jabbour, Wentao Zhou, Kathy Wheeler, Elissa Ladd, Deborah C. Gray, Colette Henderson, Lori A. Spies, Heather Mcgrath, Melanie Rogers

Ellmer School of Nursing Faculty Publications

Introduction

In 2020, the World Health Organization called for the expansion and greater recognition of all nursing roles, including advanced practice nurses (APNs), to better meet patient care needs. As defined by the International Council of Nurses (ICN), the two most common APN roles include nurse practitioners (NPs) and clinical nurse specialists (CNSs). They help ensure care to communities as well as patients and families with acute, chronic or complex conditions. Moreover, APNs support providers to deliver high quality care and improve access to services. Currently, there is much variability in the use of advanced practice nursing roles globally. A …

Examining The Roles Of Acculturative Stressors And Cultural Factors In Major Health And Safety Issues Among Hispanic/Latino Farmworkers, Brenda Berumen-Flucker

Health Services Research Dissertations

Statement of the problem: Hispanic/Latino farmworkers are at increased risk of adverse health and safety outcomes. Heightened levels of acculturative stress and the unique cultural characteristics and beliefs reported by this group increase workers’ vulnerability for adverse outcomes.

Method: The first project consisted of a systematic review examining threats to the health and safety of Hispanic/Latino agricultural workers attributable to climate change, focusing specifically on their risk for heat-related illnesses (HRI) and cultural factors and beliefs increasing workers’ vulnerability for HRI. The second project was a secondary data analysis focused on identifying potential relationships between acculturative stressors, cultural factors, and …

Violence Against Healthcare Workers: An Epidemic Within A Pandemic, Michaela Ramandanes

College of Health Sciences Posters

Violence and harassment towards healthcare workers has been an underlying problem throughout history. However, with the rapid and evolving onset of the COVID-19 pandemic, the risks that healthcare workers face has been a focal topic of discussion among administration, staff and the public. What was once considered an occupational hazard is now being raised as a public health issue- an epidemic within a pandemic. This literature review seeks to identify the prevalence and causes of violence and harassment towards healthcare workers. Was healthcare violence as prevalent before COVID-19? Has violence increased because patient volume increased? Additionally, this review will determine …

The Assessment Of Clinical Reasoning In Preceptors Across The Athletic Training Profession, Gary Wayne Cohen Jr.

Health Services Research Dissertations

Clinical reasoning (CR) is defined as a complex multi-factorial metacognitive process for diagnosis formulation. Clinical reasoning begins as a student and develops over a career. Students are typically taught an analytical approach defined as hypothetico-deductive reasoning (HDR). Expert clinicians use a non-analytical approach defined as the Knowledge Based Model (KBM) of CR. It is accepted that clinicians use the KBM with cases that they have more experience to streamline the evaluation process. Unfortunately, because of the nuance of CR there have been limited investigations within athletic training to evaluate CR outside of the student population.

The overarching purpose of this …

Examining The Use Of Immersive Clinical Experiences In Athletic Training Education, Bailey Christine Jones

Health Services Research Dissertations

Clinical experiences are an essential aspect of athletic training education that offer students opportunities to practice their skills and engage in a variety of settings. The Commission on Accreditation of Athletic Training Education (CAATE) sets accreditation standards for athletic training programs to meet, including clinical education standards. In fall 2020, new standards took effect that include a few additions to the standards surrounding clinical education; these additions require programs to afford students opportunities to engage in immersive clinical experiences (ICEs), implement behaviors associated with core competencies, and identify strategies that account for patients’ social determinants of health. Educators believe ICEs …

Predictive Modeling And Estimation Of The Doubling Time Of Confirmed Cases Of Covid-19 In Niger, Ibrahim Sidi Zakari, Hadiza Galadima

Community & Environmental Health Faculty Publications

Modeling is increasingly used to assess scenarios and make projections on the future course of new coronavirus disease. This allows for better planning of care as well as a relaxation or tightening of the restrictive measures decreed by the government and the health authorities. The data analyzed in this study covers the period from March 19 to June 05, 2020 and allowed predictions of new cases of COVID-19 based on a growth model with a growth rate that changes linearly over time. In addition, we calculated and predicted the doubling time of the number of positive cases in each region …

A Global Perspective Of Advanced Practice Nursing Research: A Review Of Systematic Reviews, Colette Henderson, Abby Kra-Friedman, Li-Anne Audet, Isabelle Savard, Lori A. Spies, Heather Mcgrath, Wentao Zhou, Kathy Wheeler, Elissa Ladd, Deborah C. Gray, Mra Jabbour, Renée Atallah, Melanie Rogers, Kelley Kilpatrick

Ellmer School of Nursing Faculty Publications

No abstract provided.

Nursing Students’ Knowledge And Attitudes About Pain Management And Opioids, Hedieh Hatami Sirjani

Health Services Research Dissertations

Statement of the problem: healthcare professionals’ knowledge of using opioids for pain management safely is critical in preventing opioid abuse and overdose. Undergraduate curricula of health professional schools, including undergraduate nursing programs, need to improve and adopt a comprehensive education regarding this issue.

Method: the first project was a systematic analysis of the literature regarding the educational interventions’ impact on healthcare professional knowledge and practice behavior regarding prescription opioids. The second project was a qualitative study of nursing students to explore their experience, self-efficacy, and knowledge of prescription opioid use for pain management and whether they feel the need for …

A Three Article Study Examining Sexual And Gender Minority Competency Of Health Service Providers, Corrine N. Wilsey

Health Services Research Dissertations

Sexual and gender minority (SGM) individuals endure a number of health disparities, such as higher rates of violence, mental health conditions, and more medical conditions. These disparities are exacerbated by the fact that SGM individuals face issues such as accessing health insurance, social support programs, and health service providers who are knowledgeable about SGM health issues. Certain health service provider governing organizations (i.e., the American Psychological Association, the Association of American Medical Colleges, and the Gay and Lesbian Medical Association) have recognized the need for guidelines regarding SGM care in recent years and published guidelines for health service providers regarding …

The Determinants Of Physical Activity, Self-Monitoring Of Blood Glucose, And Poor Glycemic Control Among Individuals Diagnosed With Type 2 Diabetes In Saudi Arabia: A Cross-Sectional Study Based On The Saudi Health Interview Survey (Shis), Mohammed Abdulrahman S. Alsuliman

Health Services Research Dissertations

The prevalence of diabetes and poor glycemic control in Saudi Arabia has increased that contributed to the growing number of deaths in Saudi Arabia. It is known that type 2 diabetes (T2DM) can be prevented but there is a lack information about the magnitude of the of diabetes at national level as well as the risk factors for physical activity (PA), self-monitoring of blood glucose (SMBG), and poor glycemic. Thus, through utilizing Health promotion model (HPM), the aims are to examine the personal factors, cognitive-perceptual, and behavioral determinants of three outcomes; physical activity, SMBG, and poor glycemic control. A secondary …

Effects Of A Rehabilitation Program For Individuals With Chronic Spinal Cord Injury In Shanghai, China, Fengshui Chang, Qi Zhang, Haixia Xie, Yuhui Yang, Mei Sun, Airong Wu, Jinghua Wu, Gang Chen, Feng Shen, Chengyue Li, Jun Lu

Community & Environmental Health Faculty Publications

Background: Specialized Institution-Based Rehabilitation (SIBR) is the cornerstone of care and treatment for individuals with spinal cord injury, but most people with chronic spinal cord injury (CSCI) living in China have no SIBR experience after acute care hospital discharge. In 2009, an SIBR facility was set up in Shanghai (China) to fill this important gap in care. The purpose of the study was to evaluate the effectiveness of an integrated rehabilitation training program among individuals with CSCI living in Shanghai.

Methods: A within-subject pre-posttest design was used to evaluate the SIBR. The sample included 455 individuals ≥1 year post-SCI, who …

Association Between Participation In Annual Physical Examinations And Risk Factors For Noncommunicable Diseases In Adults With Disabilities: Evidence From Shanghai, China, Yugang Li, Qi Zhang, Xiaohong Li, Mei Sun, Jun Lu, Gang Chen

Community & Environmental Health Faculty Publications

The relationships between regular participation in annual physical examinations and the risk factors for noncommunicable diseases (NCDs) among adults with disabilities remains unclear. To address this gap, we used data from 130,899 individuals with disabilities in Shanghai (2014-2016) and evaluated four risk factors for NCDs: hypertension, hyperglycemia, hyperlipidemia, and being overweight. Overall, 4540 individuals participated in annual physical examinations across all three years and 11,388 missed examinations in 2015 (group without regular participation). Chi-squared tests and binary logistic regression were used to assess differences in patient characteristics and explore correlations between variables. Significant differences in age (χ² = 102.620, …

Contextualizing Performance Of Coordinated Care Network Of Veteran Services In Virginia, Marina Saitgalina, Donta Council

School of Public Service Faculty Publications

Coordinated care network is an approach to human service delivery that is recognized to improve client outcomes at a reduced cost. However, general mixed findings on the effectiveness of coordinated care networks warrant research contextualization. This article seeks to discover factors influencing the performance of a coordinated care network delivering social services to veterans and their families. The study provides a contextual analysis of a coordinated care network launched in 2016 in southeastern Virginia for two samples of 1,512 and 375 veterans and their families. Results of the regression analyses indicate that initial progress has been made both in efficiency …

Understanding Young Adult Survivors Of Childhood Cancers’ Participation In Late Effects Screening: A Mixed Methods Approach, Kristen Trost Mantlo

Health Services Research Dissertations

Significant advancements in the treatment of childhood cancers have helped to increase the 5-year survival rate from 56% in the early 1970s to approximately 80-85% in the early 2000s (Greenlee, Murray, Bolden, & Wingo, 2000; Hampton, 2005). Treatment modalities such as chemotherapy and radiation have led to many serious long-term side effects, known as late effects. Between 60% and 90% of survivors develop some form of long-term chronic condition due to their treatment and up to 40% of those conditions will be life-threatening (Howlader, N. et al., 2013). While the majority of young adult survivors of childhood cancer are at …

Depression Among Expectant And New Mothers: A Multi-Study Investigation Of Rates, Correlates, And Training For Healthcare Providers, Molly M. Long

Health Services Research Dissertations

Perinatal depression (PD) is a common concern among women. PD has been shown to have negative effects on the mother, child, and mother-child relationship. Screening for PD is inconsistent and low among healthcare providers. However, several governing organizations (e.g., The American College of Obstetricians and Gynecologists, The American Academy of Pediatrics) have provided guidelines for screening and treating PD, indicating the importance and utility of screening and treating PD by a variety of healthcare providers. Few studies, with low methodological rigor, have attempted to improve PD screening, treatment, and referral practices. Therefore, it is important to implement and assess additional …

Examining The Association Of Environmental Degradation And Poor Cardiovascular And/Or Respiratory Health Outcomes In A Disadvantaged Community, Khyati Niranjan Kantaria

Health Services Research Dissertations

Air pollution is associated with poor cardiovascular and/or respiratory health outcomes. The poor air quality in certain communities due to the emission of toxic air pollutants from industries and major roadways has been a growing concern. The main objective of this study was to examine whether residential proximity to environmental air pollution sources, individual-level risk factors (age, gender, and body mass index (BMI)) and number of years at same residence are associated with observed poor cardiovascular and/or respiratory health outcomes in the residents of Southeast community in Newport News, Virginia. Logistic regression was conducted to assess this association using the …

Sexual Violence Victimization, Mental Health, And University-Based Health Service Use Among College Females, Julie E. Stoner

Health Services Research Dissertations

Females between the ages of 18 and 24 consistently experience higher rates of sexual violence compared to females in any other age group (Sinozich & Langton, 2014). Approximately one in five college women experience sexual violence victimization (SVV; Krebs, Lindquist, Berzofsky, Shook-Sa & Peterson, 2016) during the academic year. Among undergraduate female students, 23.1% are victims of sexual violence due to physical force, violence or incapacitation (Cantor et al., 2015). Sexual victimization has been associated with several short- and long-term psychological health consequences, accounting for enhanced symptoms of depression, anxiety, PTSD, and suicide risk (Basile, Smith, Breiding, Black & Mahendra, …

Behavioral Determinants Of Exercise-Related Injury Prevention Program Participation, Emily M. Hartley

Health Services Research Dissertations

Lower extremity injuries are common among the physically active population. There are many negative consequences associated with these injuries which have led to a shift in clinical practice towards prevention. Exercise-related injury prevention programs (ERIPPs) were created to prevent musculoskeletal injuries that occur due to participation in physical activity. However, one of the major limitations to their effectiveness is the compliance of the users to complete the prescribed exercises. It is imperative to better understand the reasons why compliance is low to develop implementation strategies and improve compliance rates.

The overarching purpose of this dissertation was to gain a better …

Factors Associated With Prolonged Length Of Stay For Elective Hepatobiliary And Neurosurgery Patients: A Retrospective Medical Record Review, Siu Yin Lee, Soo-Hoon Lee, Jenny H.H. Tan, Howard S.L. Foo, Phillip H. Phan, Alfred W.C. Kow, Sein Lwin, Penelope M.Y. Seah, Siti Zubaidah Mordiffi

Management Faculty Publications

Background: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries. Thus, with potentially increased numbers of elective HPB and NS, this study seeks to explore perioperative factors associated with prolonged LOS for …

A Systematic Review On The Validity Of Teledentistry, Jafar H. Alabdullah, Susan J. Daniel

Dental Hygiene Faculty Publications

Objectives: The aim of this systematic review was to evaluate the validity of using teledentistry in oral care examination and diagnosis.

Methods: In June 2016, a systematic search of the literature was conducted without time restrictions in three electronic databases (Ebscohost, Pubmed, and Scopus). Two reviewers screened the retrieved articles first by title and then by abstract to determine relevant articles for full text review. Studies included were as follows: (1) related to teledentistry, (2) available in full text and English, (3) compared teledentistry application to a gold standard, and (4) provided clear statistical tests for validity. The methodological …

Demystifying Research: Accessing & Understanding Evidence For Clinical Practice, Kimberly A. Murphy, Meredith Poore Harold, Mary Huston

Communication Disorders & Special Education Faculty Publications

The demands on clinicians for evidence-based practice (EBP) are great. However, many speech-language pathologists have received little to no training in how to ‘do’ EBP. In this presentation, we aim to describe and provide practical suggestions for two of the steps in EBP—accessing, then reading and interpreting research to inform clinical decision-making. Our goal is to give clinicians the tools and confidence they need to grow into expert clinicians.

Learner Outcome 1: Describe the components of evidence-based practice (EBP)

Learner Outcome 2: Identify ways to access research

Learner Outcome 3: Identify steps in reading and evaluating the …

A Web-Based Interprofessional Education Program For School Nurses And Athletic Trainers: A Pilot Study, Lauren Ashley Welsch

Health Services Research Dissertations

Background: Interprofessional education (IPE) programs have been shown effective in improving interprofessional collaborative practice (ICP) through increased communication and teamwork amongst healthcare professionals with the ultimate goal of improving patient safety and outcomes. However, their use and subsequent outcomes have not been reported amongst athletic trainers (ATs) and school nurses (SNs) in secondary school healthcare. The purpose of this study is to develop, implement and evaluate an IPE program designed to meet the needs of this unique healthcare setting. In addition, qualitative analysis will further describe the communication between ATs and SNs. Methods: A mixed method exploratory design was employed. …