Public Health Education and Promotion Commons^™

Rural Access To Certified Community Behavioral Health Clinics (Ccbhcs), Aaron P. Smith, Jeffrey Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

▪ The number of Certified Community Behavioral Health Clinics (CCBHCs) expanded from 2022 to 2023, increasing from 371 to 480. Most of the growth was driven by rural counties (57.9% increase, 126 to 199) while urban counties increased by 14.7% (245 to 281).

▪ The number of services offered at CCBHCs is similar in both rural and urban localities, but urban CCBHCs were more likely to offer services that cater to a diverse client base, such as speaking different languages, and nicotine cessation programs. Rural CCBHCs were more likely to have programs for minors, veterans, and …

Assessing The Accessibility Of Wound Care Education For Unhoused Individuals Of South Jersey, Marilyn A. Chen, Selma S. Benkhoukha, Allysone Martinez

Rowan-Virtua Research Day

Unhoused individuals face disproportionately high rates of wound-related complications due to environmental exposure, limited access to hygiene facilities, and delayed care. This study assessed the accessibility of wound care for the unhoused population in South Jersey, where approximately 2,607 individuals experience homelessness on any given night. Our research identified significant barriers to wound care access, including transportation limitations, lack of identification documents, absence of a physical mailing address, and language barriers. Data analysis revealed concerning trends: a 24% increase in New Jersey's homeless population in 2024, with Black/African American individuals representing 49% of the homeless population despite comprising only 12% …

Analyzing Preventative Skin Care Practices Among Diabetic, Pre-Diabetic And Non-Diabetic Patients, Hetasvi A. Saraiya, Nils Brolis

Rowan-Virtua Research Day

Background and Hypothesis: Diabetes Mellitus refers to a chronic metabolic syndrome where patients have high blood glucose due to the body’s inability to produce adequate amounts of insulin. This hyperglycemia and other factors make diabetic patients more prone to a number of skin conditions such as dry skin, skin rashes, itchiness and bacterial or fungal infections. There are specific skin practices recommended to reduce the risk of these skin ailments including moisturizing regularly, avoiding hot showers, examining feet regularly for any changes, seeing a physician for major cuts/burns/infections amongst several others. However, there is no available literature that analyzes the …

Vaccine Booster Hesitancy And Factors Associated Amongst Minority Students In South Jersey, Charles Ezenwanne, Resty Mercado, Priya Patel

Rowan-Virtua Research Day

In October 2022, COVID-19 vaccine coverage for two doses in NJ was 77.4%. This exceeded the US national average of 67.8%. However, initial booster uptake remained low at only 50% statewide, and bivalent booster uptake was just 16.8% by March 2023. South Jersey, including Gloucester County and Glassboro, contains large marginalized populations that have experienced barriers to vaccination access, misinformation, and skepticism regarding government and pharmaceutical intentions. This health equity service project was to provide clear, factual, and relatable information to increase vaccine confidence and uptake among minority students at Rowan University and the broader South Jersey community. By addressing …

Maternal Health And Nutrition: Combating Maternal Mortality Through Proper Nutrition, Archna Mahendru, Yeisanai Cardona Torres, Maya Blayne Partee, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality is an increasing concern in the United States. According to the WHO, from 2018-2022 the Maternal Mortality Rate (MMR) was 23.3 deaths per every 100,000 live births. New Jersey's MMR exceeded this average at 26 per 100,000 during the same period, with 91% of cases deemed preventable. While medical care plays a crucial role, research shows that non-medical determinants such as food insecurity, lack of nutritional education, limited access to transportation, and systemic barriers to health care contribute significantly to maternal health outcomes. Among these factors, proper nutrition plays a critical role before and during pregnancy, particularly in …

Assessing The Impact Of The Covid-19 Pandemic On Health Literacy In Patients Presenting To A Student-Run Free Clinic, Sabah Iqbal, Kirsten Carlberg, Krisha S. Patel, Ashlyn Mcclelland, Sarah Marotta, Rebecca Moore

Rowan-Virtua Research Day

Background

Health literacy as defined by the Center for Disease Control and Prevention (CDC), refers to an individual’s ability to find, understand, and use health information and services1. This definition has evolved with the onset of the COVID-19 pandemic and increasing emphasis on preventative healthcare. We aimed to observe the impact of the pandemic on the health literacy of patients in a free community clinic run by medical students.

Hypothesis

This study aims to assess the effect of various demographic and socioeconomic factors and the COVID-19 pandemic on health literacy levels estimated by the NVS assessment in the patient population …

Impact Of Language Barriers On Out-Of-Hospital Cardiac Arrest Recognition And Response, Kinjal Mody, Sophie Cherfane, Curt Cackovic

Rowan-Virtua Research Day

Out-of-hospital cardiac arrest (OHCA) causes nearly 350,000 deaths annually in the U.S., with survival largely depending on the timely recognition of cardiac arrest and the initiation of bystander CPR by emergency dispatchers. However, English-centric dispatch systems create barriers for individuals with limited English proficiency, potentially delaying critical responses. This study aims to synthesize research on how language differences impact OHCA recognition and CPR initiation in emergency dispatch settings. We hypothesize that language barriers cause significant delays.

PubMed, Scopus, and Web of Science databases were used to identify relevant studies, using search terms like "language barriers," "cardiac arrest," and "CPR." Inclusion …

Optimizing Preventive Care: The Impact Of A Student-Led Initiative To Improve Cancer Screenings In Primary Care, Katherine Klein, Priya Srivastava, John Sauer, Sahiba Gill, Nirali Trivedi, Fadia Barakzai, Yeonwoo Sim, Matthew Green, Anne Jones, Philip Collins

Rowan-Virtua Research Day

Context:

Preventative health measures, including routine cancer screenings, are essential for early detection, timely treatment, and reduction of cancer mortality rates.

Colorectal, breast, and cervical cancer are among the most routinely screened cancers due to advancements in screening technologies1. However, despite the well-established importance of early detection, patient adherence and compliance with national guidelines remain suboptimal, limiting the effectiveness of these screening efforts and delaying possible treatment.2

Objective:

To address this issue, we initiated a medical student-led project focused on improving adherence to national cancer screening guidelines across Rowan-Virtua Family Medicine (FM) practices. This poster outlines the overall efficacy of …

Bridging The Nature Gap: Understanding Barriers And Promoting Outdoor Engagement Among African Americans In Chattanooga, Kennie Almonor

Honors Theses

This paper outlines my process of writing a physical guidebook for outdoor engagement in Chattanooga. It explores the historical context of Black exclusion from outdoor spaces and examines the health disparities that disproportionately affect Black communities. The physical connection between outdoor activity and overall well-being will also be explained. Additionally, this paper details my methodology for conducting focus groups to better understand barriers to outdoor engagement and how participant insights could inform the guidebook’s development. This paper also outlines my research on best practices for structuring an effective guide, writing process, challenges faced, and considerations for extending this project in …

Quality Of Affected Upper Extremity Use During A Ride-On Toy-Based Training Program In Children With Unilateral Cerebral Palsy: A Pilot Study, Megan Carlmark

Honors Scholar Theses

Unilateral cerebral palsy (UCP) is a subtype of cerebral palsy that impacts movement and coordination on one side of the body. This condition often leads to reduced use of the affected upper extremity in daily tasks. This pilot study explored the feasibility and potential of a joystick-operated ride-on-toy training program as an engaging home-based and play-based intervention to promote affected upper extremity use in children with UCP. Five children from a larger sample of 15 children with a diagnosis of UCP between the ages of 3 and 8 years old were used as data for this thesis. This study included …

Analysis Of Blood Pressure, Blood Glucose, And Cholesterol Screening Results Collected During Street Outreach Events In Atlantic County, New Jersey, As Part Of A Mobile Community Health Worker Program To Identify Residents At High Risk For Severe Covid-19, Kenneth W. Stagliano, Richard T. Jermyn, Alexander E. Abbott, Donato F. Tassoni, Amy Palen, Frank Carozza, Nicole M. Miller

Rowan-Virtua Research Day

Background: This study seeks to evaluate the status of random blood pressure, cholesterol, and blood glucose screening results in Atlantic County, NJ. This study also aims to identify the rates of hyperlipidemia, hyperglycemia, and hypertension within the target population, and potential differences between surveyed age demographics.

Methods: Medical students participating in the COVID-19 CHW Service Corps collected blood pressure, cholesterol, and blood glucose screenings at multiple screening events in Atlantic County, NJ during a two-year period. This data was analyzed retrospectively using ANOVA, non-parametric Kruskal Walis Test, and Tukey's pairwise comparisons.

Results: Senior adults had significantly higher SBP than …

Examining The Relationship Between Nutritional Access And Childhood Obesity In Low-Resource South Jersey Communities, Anastasiya Matveyenko, Saul Madrid-Flores, Arleen Fortuna, Kirsten Marie Carlberg

Rowan-Virtua Research Day

BACKGROUND: Childhood obesity is defined as a child considered to have obesity when their body mass index falls in the top 5% compared to other children of the same age and gender. Unhealthy eating habits formed during childhood have been associated with diseases such as obesity and diabetes. We aim to examine the relationship between childhood obesity and barriers to optimal nutrition in our local South Jersey community.

METHODS: We conducted a literature review through Google, Google Scholar, and PubMed utilizing the key terms, “low socioeconomic status (SES),” “Childhood obesity in NJ,” “Nutritional Intervention,” and “Health Risks.”

RESULTS: Our study …

Patient Education And Health Literacy Effects On Statin Use And Adherence, Ian M. Smith, Richard G. Olarsch, Alison M. Mancuso

Rowan-Virtua Research Day

Background: While the use of statins (HMG-CoA reductase inhibitors) plays a significant role in the prevention of cardiovascular disease, it is estimated approximately 60% of patients who would benefit from a statin are receiving these medications. Current research suggests that a preference for life-style intervention over medical management, concern over medical adverse reactions, and a lower perceived risk of cardiovascular events is associated with statin non-adherence.

Methods: An IRB-approved paper survey was administered to patients aged 18 to 89 at an ambulatory primary care clinic for non-acute visits. Qualtrics was utilized to collect, store, and process data. Information elicited from …

Promoting Safe Firearm Storage Through Media-Based Interventions, Abigail Bordelon

Health, Human Performance and Recreation Undergraduate Honors Theses

Given the ongoing phenomenon of unintentional pediatric firearm deaths, this project seeks to examine how the mainstream media reports on these events and how media frames could be altered to better promote public health prevention efforts.

Analysis Of Marshallese Perceptions Of Health And Weight In Adolescents, Sterling Thomas

Health, Human Performance and Recreation Undergraduate Honors Theses

Purpose: The purpose of the research is to understand the perceptions of Marshallese adolescents on the topic of health and weight, in order to provide guidance for interventions and public health efforts. The United States has the largest Marshallese population outside the Marshall Islands. Perceptions of weight and health is under researched for minority communities and from the insight of adolescents. Pacific Islanders such as the Marshallese are often categorized as part of the larger Asian American ethnic population, which is not always accurate in certain aspects where public health could provide support areas of concern.

Design: Focus groups …

Community Voices, Climate Action Choices: Working Towards A Resilient Monterey County, Lesley A. Solano Alonso

Capstone Projects and Master's Theses

Vulnerable communities in Monterey County face disproportionate environmental and health impacts due to climate change, yet many residents remain unaware of the tools and resources available to support local action. This capstone project was implemented in partnership with Ecology Action (EA) and the Resilient Central Coast (RCC) campaign to increase awareness and engagement with the RCC platform. Serving diverse communities across Monterey County, the project included bilingual outreach efforts, community tabling, educational presentations, and a climate action survey. Over 650 residents were engaged directly, resulting in 99 new household sign-ups on the RCC website, a major milestone for the agency. …

On Death And Disease: How Physicians’ Perspectives Compare Across Specialties Through Written Work, Stephanie Anne C. Alkonga

Honors Capstones

Narrative medicine is a tool that the medical field is increasingly utilizing to cultivate patient-centered and culturally competent doctors and to reflect on lived experiences through texts that focus on psychosocial best practices. This study aims to examine the language used in physician-written works that address how physicians in different medical specialties treat the aging and the terminally ill, and how they view the deceased. Qualitative data guided by thematic questions will primarily be used in the analysis and comparison of these texts’ tone, rhetoric, diction, and similar literary devices to uncover if certain patterns arise across such specialties. Findings …

A Review Of Praziquantel Resistance In Schistosomes And The Future Of Schistosomiasis Control, Gabriela G. Eastham

Senior Honors Theses

Schistosomiasis is a group of both acute and chronic parasitic trematode infections of the genus Schistosoma. Praziquantel (PZQ) has been the drug of choice to treat schistosomiasis for decades. Though it is effective against all three clinically relevant species, heavy reliance on PZQ has led to concerns of schistosome resistance, especially in areas that have implemented this drug in mass drug administration (MDA) programs. Although there is currently insufficient evidence to conclude that schistosomes are becoming resistant to PZQ on a large scale, other control methods are a necessity to best treat and eliminate schistosomiasis. This article summarizes the …

Kansas City Health Department – Childhood Lead Poisoning Prevention Program – Quality Improvement, Hanh Pham

Capstone Experience: Master of Public Health

This capstone manuscript evaluates the Kansas City Health Department's Childhood Lead Poisoning Prevention Program’s effectiveness. Through comprehensive data analysis of grant utilization, return-on-interest (ROI) and participant satisfaction evaluation, the project will provide actionable recommendations for improving sustainable long-term outcomes in lead poisoning prevention.

Exercise As An Intervention For Postpartum Depression (Ppd), Kylie P. Mistretta

Honors Scholar Theses

Objective: To illustrate the applications of exercise for preventing the development of postpartum depression (PPD) and addressing associated risk factors identified in the literature. Data Sources: PubMed and EBSCO: Academic Search Premier were accessed using the search terms exercise OR physical activity OR yoga AND postpartum depression OR postnatal depression. A secondary search of PubMed was conducted using the search terms exercise AND pregnancy AND depression OR gestational diabetes OR weight gain OR sleep quality.

Study Selection: Studies selected for inclusion were peer-reviewed, published after January 2012, written in English, and relevant to the PPD risk factors examined. Only clinical …

Awareness And Attitudes Toward Diabetes Among Students In The California State University System, Cesar Fajardo

Electronic Theses, Projects, and Dissertations

Background and Aims: The prevalence of type 2 diabetes has been increasing globally. Studies examining patient awareness and attitudes toward diabetes have been conducted and found that diabetes education does increase patient knowledge but has no effect on attitudes. Additionally, many of these studies did not assess university students’ views on type 2 diabetes. Given that type 2 diabetes incidence is increasing among young adults, more attention must be given to this population. Therefore, the aim of this study was to investigate CSUSB students' understanding and attitudes toward type 2 diabetes.

Methods: A cross-sectional study using electronic surveys with …

Evaluating The Impact Of Community Gardens On Social Equity And Public Health: A Case Study Of Caramel Connections Foundation's (Ccf) Seeds Of Joy Community Garden, Elizabeth Pinder

Electronic Theses, Projects, and Dissertations

Community gardens have been increasingly recognized as effective public health interventions that address food insecurity, foster social cohesion, and promote environmental sustainability. This evaluation examines the impact of the Caramel Connections Foundation (CCF) Seeds of Joy Community Garden in Ontario, California, by assessing its effectiveness in advancing social equity, improving public health outcomes, and fostering community engagement. Using an evaluation framework, this study measures key program outcomes, including improvements in community well-being, inclusivity, and access to green spaces.

A mixed-methods evaluation design was applied, incorporating process and impact evaluation methodologies. Secondary data collected from CCF’s existing program records, survey responses, …

Investigating The Suitability Of Dichotomous Responses For The Water Insecurity Experiences (Wise) Scales Using Nationally Representative Data From 39 Countries, Indira Bose, Joshua D. Miller, Hilary J. Bethancourt, Olga P. García, Hugo R. Melgar-Quiñonez, Rosana Salles-Costa, Mauro E. Delgrossi, Scott M. Miller, Tessa L. Durham, Teresa Shamah-Levy, Pablo Gaitán-Rossi, Sera L. Young, Edward A. Frongillo Jr. Ph.D.

Faculty Publications

The Water Insecurity Experiences (WISE) Scales have been validated to comparably measure water insecurity globally. The scales consist of 12 items that can be administered in approximately 3 minutes. There is interest in developing more rapid versions of the tools for when time is limited. One alternative is to use a subset of 4 items, which has been validated, but has some drawbacks. Here we investigate another alternative: dichotomous (yes/no) response options instead of the original four levels of frequency-based (polytomous) responses. We used nationally representative data from 39 countries to simulate dichotomized responses by collapsing the four levels of …

Produce Prescription Policy Project For The Securement Of A Grant To Address Food Insecurity For Low-Income Type Ii Diabetic Patients, Isabel D. Garcia-Gallegos

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This policy-focused Doctor of Nursing Practice (DNP) quality improvement (QI) project aims to secure grant funding through the Gus Schumacher Nutrition Incentive Program (GusNIP) to implement a produce prescription program at a community clinic in Texas. The program targets low-income adults (18-65 years) with type II diabetes who experience food insecurity and are affected by Medicaid non-expansion.

BACKGROUND

Texas’ decision not to expand Medicaid has exacerbated food insecurity among low-income residents, particularly those managing type II diabetes. This decision creates a healthcare policy gap that this project aims to address with a food-as-medicine program.

METHODOLOGY

Using the Plan-Do-Study-Act (PDSA) …

Navigating Travel Therapy: Balancing Benefits And Risks For Optimal Wellness, Fangli Hu, Jun Wen, Wei Wang

Research outputs 2022 to 2026

This research note examines travel therapy as a novel healthcare approach in which positive travel experiences serve to promote well-being. It emphasizes the need for a balanced assessment of the benefits and risks associated with travel therapy, offering insights into this practice's evolving roles in the health and wellness domains.

Gender And Ethnic Differences In Mental Health Outcomes In Sexual And Gender Minority (Sgm) Youth And Young Adults In Texas And California, 2022-2024, Michelle Gil

Open Access Theses & Dissertations

Background: Depression and anxiety affect populations differently, particularly LGBTQ+, ethnic minorities, and youth with limited access to competent care. Risk factors include harassment, victimization, and discrimination. Purpose: To examine gender identity and ethnic differences in depression and anxiety among SGM youth in Texas and California. It is hypothesized that both Latinx and gender minority youth will report higher rates of depression and anxiety compared to non-Latinx and cisgender youth. Methods: Secondary analysis used data from the Family, Housing, and Me (FHAM) Project, following 83 LGBTQ+ youth from South Texas and California's Inland Empire over 25 months. Data includes sociodemographic characteristics, …

Finding Strength In The Struggle: The Impact Of Resilience On Life Satisfaction Among Veterans With Mental Illness, Marissa Gonzalez

Open Access Theses & Dissertations

Background: Veterans living with mental illness often face challenges that impact their overall life satisfaction and adjustment to civilian life. While resilience is widely considered a protective factor, limited research has examined its role in conjunction with personality traits, psychosocial factors, and demographic characteristics. Purpose: This cross-sectional study examined the associations between resilience and life satisfaction among U.S. veterans with mental illnesses, while accounting for personality dimensions, demographic variables, and psychosocial factors. Methods: Secondary data from 156 veterans diagnosed with mental illness were analyzed. Hierarchical linear regression was used to assess the relationship between resilience and life satisfaction, controlling for …

Exploring Willingness To Seek Help And Well-Being In Rural Veterans With Health Conditions: A National Rural Health Study, Jimena Isabel Ortiz

Open Access Theses & Dissertations

The population of Veterans in the United States has increased significantly, with a substantial number residing in rural areas. This study aims to highlight and understand the correlation between military service members' physical and mental well-being and the quality/access to care they receive. This study also aims to explore mental health-seeking behaviors, health, and well-being in rural Veterans with health conditions. The study included 400 rural-dwelling Veterans with documented physical and mental health conditions. Data was collected through surveys distributed via various media channels, including social media platforms, and the results demonstrated that willingness to seek psychological help was positively …

Pilot Study To Compare A Therapeutic Exercise Protocol And Neuromuscular Taping On Improving Plantar Foot Pressure Among Type 2 Diabetes Patients, Sandra Rivera

Open Access Theses & Dissertations

Background: Diabetes has become one of the most prevalent non-communicable diseases worldwide. Diabetic foot ulcers (DFU) are a common complication of diabetes as it causes peripheral neuropathy. It is estimated that up to 50% of peripheral neuropathy in patients with diabetes may be asymptomatic. Justification: The purpose of this study was to determine if the therapeutic exercise protocol and/or Neuromuscular taping can delay changes in the plantar pressure of the foot in patients with Diabetes. Methods: A two-group quasi-experimental design was used in this study; data was collected at two different points in time; pre- and post-intervention. Baropodometric was used …

Testing A Benign Multi-Modal Bilingual Intervention To Increase Self-Efficacy, Intentions, And Willingness To Administer A Covid-19 Antigen Rapid Test In A Predominately Hispanic Sample, Uchenna Gbugu

Open Access Theses & Dissertations

Introduction. Testing is one of the most effective methods for reducing the spread of COVID-19. COVID-19 antigen tests can detect proteins from the COVID-19 virus called antigens and produce results within minutes, making them suitable for at-home use. Several factors have been identified as barriers to self-administering a COVID-19 antigen test, including the language of the testing instructions, the cost of testing, and access to tests. Interventions to reduce barriers to self-administering COVID-19 rapid tests are warranted to reduce the spread of COVID-19. The purpose of the present study is to test the impact of a benign multi-modal bilingual intervention …