Population Health Commons^™

Environmental Exposure Risk Education To Enhance Chronic Kidney Disease Prevention And Screening For Nurse Practitioners, Kelsea J. Carrier

Doctor of Nursing Practice Posters and Presentations

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Chronic kidney disease (CKD) affects approximately 36 million adults in the United States, with nearly 90% of individuals unaware of their diagnosis until advanced stages. While diabetes and hypertension remain the primary causes, increasing evidence highlights environmental exposures as significant and underrecognized contributors to CKD onset and progression. Exposures such as heavy metals, per- and polyfluoroalkyl substances (PFAS), air and water pollution, microplastics, and heat exposure have been linked to impaired renal function. Despite this growing body of evidence, environmental health content remains limited in nursing education, resulting in gaps in environmental health literacy (EHL) among nurse practitioners (NPs) and …

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Environmental Exposure Risk Education To Enhance Chronic Kidney Disease Prevention And Screening For Nurse Practitioners, Kelsea J. Carrier

Doctor of Nursing Practice Scholarly Projects

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Chronic kidney disease (CKD) affects approximately 36 million adults in the United States, with nearly 90% of individuals unaware of their diagnosis until advanced stages. While diabetes and hypertension remain the primary causes, increasing evidence highlights environmental exposures as significant and underrecognized contributors to CKD onset and progression. Exposures such as heavy metals, per- and polyfluoroalkyl substances (PFAS), air and water pollution, microplastics, and heat exposure have been linked to impaired renal function. Despite this growing body of evidence, environmental health content remains limited in nursing education, resulting in gaps in environmental health literacy (EHL) among nurse practitioners (NPs) and …

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Pengaruh Buerger Allen Exercise Terhadap Sirkulasi Ekstremitas Bawah Pada Pasien Luka Kaki Diabetik, Jannaim Jannaim, Ridha Dharmajaya, Asrizal Asrizal

Jurnal Keperawatan Indonesia

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The Influence of Buerger Allen Exercise on Lower Extremity Circulation in Patients with Diabetic Foot Ulcer. Diabetic footulcer (DFU) is a complication of diabetes caused by impaired venous and arterial blood circulation. Buerger allen exercise is a modality therapy with active postural movement. This study aims to assess the effect of buerge rallen exercise on the circulation of lower extremities in DFU patients. The study design was pre experimental pretest and posttest without control. The sampling technique was consecutive sampling and the large sample of 43DFU patients, analysis data was using Wilcoxon test. Increased circulation is measured using the Ankle …

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Fertility And Birth Rates In The Mountain West, 2024, Sydney Mitchell, Maisoon Faris, Caitlin J. Saladino, William E. Brown Jr.

Health

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This fact sheet reports 2024 data on the overall birth rate and birth-related health measures in the five Mountain West states of Arizona, Colorado, New Mexico, Nevada, and Utah using data from the Centers for Disease Control and Prevention (CDC) website. This fact sheet includes information from the National Center for Health Statistics, “Statistics by State” subsection related to birth. This subsection focuses on fertility rates, teen birth rates, infant mortality rates, births to unmarried mothers, cesarean deliveries, pre-term births, and infants with low birth weight.

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Leveraging Health Information Exchange (Hie) Data To Demonstrate The Impact On Health Outcomes Of Community Based Organization Interventions: Case Studies Of Housing Placement And Medically Tailored Meal Program, Kevin Kramer, Harm Scherpbier, William Marella

College of Population Health Faculty Papers

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Objective

To evaluate the use of longitudinal Health Information Exchange data to assess changes in healthcare utilization and selected clinical outcomes associated with community-based organization interventions addressing housing instability and food insecurity.

Methods

A retrospective pre-post study design was used to analyze two distinct community-based organization cohorts within a regional Health Information Exchange. The housing cohort included 228 individuals who received housing placement services, and the nutrition cohort included 786 individuals enrolled in a medically tailored meal program. Healthcare utilization and clinical outcomes were compared during the 365 days before and after program enrollment. Outcomes included inpatient admissions, emergency department …

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Sleep Disturbances Affect Sleep Quality Of Hospitalized Adults, Tonjia Hardesty

Dissertations

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Abstract

Background: Sleep disturbances affect the quality of sleep hospitalized adults experience, possibly extending patient recovery time. Treatment of insomnia frequently includes pharmacological interventions exposing patients to potential side effects, leading to negative patient outcomes.  The purpose of this project was to determine if a sleep hygiene toolkit including eye masks, earplugs, advocacy cards, and removal of nicotine patches at bedtime would improve patient sleep quality without use of pharmacological interventions.

Methods: A descriptive observational design was used in this quality improvement (QI) project. A convenience sample of 37 (N =37) participants over the age of 18 years and …

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Community-Based Tuberculosis Screening With Computer-Aided Detection Technology Alone And In Combination With Point-Of-Care C-Reactive Protein Testing: A Paired Screen-Positive Trial, Klaus Reither, Fiona Vanobberghen, Anna Verjans, Harsh Harkare, Bart Jacobs, Alastair Heerden, Shriya Misra, Fabrizio Tedios, Curdin Brugger, Alfred Keter

Population Health, East Africa

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Background Active tuberculosis case-finding in communities is crucial for early disease detection and disruption of transmission; however, it is complex and costly. A thorough analysis of tuberculosis screening strategies is essential, particularly because the health systems affected often have limited resources. We aimed to compare two community screening approaches in terms of tuberculosis case yield and cost.

Methods This pragmatic community trial, with a paired screen-positive design (ie, within-person comparison), was conducted in the Butha-Buthe District in Lesotho and the uMgungundlovu District in South Africa. All household members aged at least 18 years were eligible to participate, except those who …

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Advocacy For Inclusive Play In South Dallas: Expanding Access For Children In Underserved Areas, Aryanna Fellows, Mary Jan Greer

Summer 2026 OTD Capstone Symposium

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This capstone project aimed to advocate for more inclusive and accessible playgrounds for children of all abilities in underserved communities in South Dallas. Guided by the Person-Environment-Occupation-Performance (PEOP) Model, the project evaluated playground accessibility and identified environmental barriers that limit participation for children with disabilities. Methods included a community needs assessment, playground observations using a standardized accessibility assessment tool, surveys, and stakeholder collaboration. Participants included community members, caregivers, organizational stakeholders, and children who utilize local playgrounds. Findings were synthesized to develop evidence-based recommendations and educational resources to support future playground improvements. The expected outcomes included increased awareness of inclusive playground …

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Purposeful Rounds: A Structured Fall Prevention Plan: Final Report, Cincerlyn Lewis

All Doctor of Nursing Practice (DNP) Scholarly Projects

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Problem: Falls are the most frequently reported preventable events in hospitalized patients.  Falls in the project unit were increasing, and a gap analysis revealed variation in how nurses assessed fall risk and implemented interventions. Evidence indicated that inconsistent rounding undermined situational awareness and delayed identification of patient needs. This gap highlighted the need for a structured, evidence‑based rounding process to improve consistency and reliability.

Aim of the project: The Purposeful Rounds (PR) project aimed to implement a structured process to improve rounding consistency and staff responsiveness, while reducing fall rates over a 12‑week period.

Review of the Evidence: Evidence-based literature …

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Implementing The Walking Impairment Questionnaire For Peripheral Artery Disease Screening And Referral, Lisa Doyle

All Doctor of Nursing Practice (DNP) Scholarly Projects

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Problem: Peripheral artery disease (PAD) is a leading cause of cardiovascular morbidity, mortality, and lower extremity amputation. At a Level 1 veterans medical center, the absence of a standardized screening and referral process contributed to delayed identification of symptomatic PAD and underutilization of supervised exercise therapy (SET). Between August 2024 and July 2025, only four veterans completed SET despite a large high-risk population, demonstrating a significant gap in evidence-based recommendations and clinical practice.

Aim of the Project: The aim of this project was to improve patient outcomes by standardizing screening for symptomatic PAD using the Walking Impairment Questionnaire (WIQ) to …

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Persistent Gaps In Management And Risk Factor Control Among Patients With Atherosclerotic Cardiovascular Disease: All Of Us Research Program, Yakubu Bene-Alhasan, Soad Al Osta, Yussif Issaka, Isaac Acquah, Ahmad Alkhatib, Leen Othman, Samuel Mensah, Ato Howard, Christie Ballantyne, Salim S. Virani

Population Health, East Africa

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Background

Contemporary guidelines recommend aggressive low-density lipoprotein cholesterol (LDL-C) lowering in patients with atherosclerotic cardiovascular disease (ASCVD), yet significant treatment gaps persist in clinical practice. We evaluated lipid-lowering therapy (LLT) use, LDL-C control, and prevelance of cardiovascular risk factors among patients with coronary artery disease (CAD), peripheral artery disease (PAD), cerebral atherosclerosis (CAS) and those with all three (polyvascular disease) using real-world data from the NIH-run All of Us Research Program.

Methods

We analyzed electronic health records from 26,935 patients with ASCVD (CAD 21,573; PAD 4752; CAS 6864; and polyvascular 902) enrolled between 2018 and 2023. We assessed baseline LLT …

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U.S. Cardiovascular Mortality Before And During Covid-19: Cdc Wonder Vs Gbd Comparison, Mirza Ali Baig, Muhammad Umar, Carol Becker, Salim S. Virani, Dmitry Abramov, Xiaoming Jia, Abdul Minhas

Population Health, East Africa

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No abstract provided.

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New-Onset Cognitive Impairment After Delirium Among Hospitalised Older Ghanaians: A Pilot Study, John-Paul Omuojine, Richard Dei-Asamoa, Caleb Otu-Ansah, Gertrude Aboah, Belinda Opoku, George Amponsah, Stella Afeti, Leah Ratner, Ruth Owusu-Antwi, Cyprian Mostert

Population Health, East Africa

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Background Delirium is a potentially modifiable risk factor for dementia. However, post-delirium cognition has hardly been studied in Africa, where the burden of both disorders is rising disproportionately.

Objective We estimated the incidence of new-onset cognitive impairment (NCI) 6 months after hospitalisation with non-stroke delirium among older Ghanaians.

Methods This was a prospective observational pilot study conducted among 60 previously cognitively unimpaired (retrospective proxy assessment) adults aged ≥60 years, hospitalised with non-stroke prevalent delirium in a Tertiary Hospital. Delirium was confirmed and rated using the Confusion Assessment Method (CAM) and Severity Scale (CAM-S) within 24–72 hours of admission and reassessed …

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Urban-Rural Differences In The Association Between Physical Activity And Overweight/Obesity Among Indonesian Adolescents: A Cross-Sectional Study, Wahyu Wulandari, Mufti As Siddiq M. Irzal, Lady Farah Fatmawati

Jurnal Epidemiologi Kesehatan Indonesia

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Adolescent overweight/obesity is an increasing public health concern and contributes to the risk of non-communicable diseases later in life. Physical activity plays an important role in weight regulation. However, its association with overweight/obesity may vary according to residential setting. This study aimed to examine the association between physical activity and overweight/obesity among adolescents living in rural and urban areas of Indonesia. A cross-sectional study was conducted using data from the 2023 Indonesian Health Survey. The study included 115,372 adolescents aged 10–18 years. Physical activity was classified based on total Metabolic Equivalent of Task (MET)-minutes per week (≥600 MET-minutes/week), while nutritional …

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(Re)Claiming Homeplace: Dance As Embodied Resistance & Healing For Health & Spatial Justice, Preeya G. Kannan

University Honors Theses

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This thesis argues that dance functions as both an upstream public health intervention and a form of radical spatial resistance; creating healing, agency, and belonging among historically marginalized communities. Drawing on bell hooks' concept of homeplace, Jasbir Puar's assemblage theory, Nancy Krieger's eco-social theory, and Katherine McKittrick's Black geographies, I position the body as both an ecological and political landscape shaped by histories of colonialism, racial capitalism, displacement, and resilience.

Through this community-based participatory research study, Homeplace, I explore dance as a form of social prescription that centers liberation rather than pathology. Movement is often reduced in public health discourse …

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Healthcare Access Challenges Among Asian Americans, Phyo Theingi

University Honors Theses

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Asian Americans are the fastest growing racial ethnic group in the U.S. According to the 2023 U.S. Census Bureau population estimate, Asian Americans account for 25.2 million (or 7.4%) of the nation's population. Asian Americans are not a monolith and represent a diversity of rich histories, cultures, languages and ethnicities. According to research conducted by the Pew Research Center, most Asian Americans face discrimination of some kind, including being treated as a foreigner in the U.S and being stereotyped as a model minority. They also experience health care access barriers. Research found that Asian Americans face barriers related to language …

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Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

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Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

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Disability Rates Among South Asian Immigrants In The U.S. Vary By Country Of Origin, Sobia Mushtaq, Marc A. Garcia

Population Health Research Brief Series

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South Asian immigrants are often grouped together in U.S. health data, masking significant differences in health outcomes across subgroups. This brief uses data from the American Community Survey (ACS) 5-Year Public Use Microdata Sample (N = 6,643,738; 2020–2024) to describe disability rates among foreign-born adults from India, Pakistan, and Bangladesh residing in the U.S. The authors find that while South Asian immigrants as a group have lower disability rates than U.S.-born adults, this average is driven largely by Indian immigrants, who make up about 79% of South Asians in the U.S. Among adults aged 65 and older, Bangladeshi immigrants have …

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When School Culture Excludes: Deficit Discourse, Microaggressions, And The Mental Health Of Marginalized Students – A Conceptual Framework With Implications For School Psychology Practice And Equity Policy, Modupe Mercy Oyewunmi

Publications

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Deficit-laden language like ‘behavior problem,’ ‘not college material,’ ‘won’t fit in’, ‘not a cultural fit’, operates as a systemic form of implicit bias and microaggression in school settings. Despite decades of research on school belonging and well-being, school psychology has yet to integrate these exclusionary discursive practices into a coherent health-determinant model that also accounts for the current anti-diversity, equity, and inclusion (DEI) policy environment. This conceptual paper proposes a testable framework linking deficit discourse and school-based microaggressions to student identity suppression, academic impostor phenomenon, and educator moral injury, with downstream effects on school mental health outcomes. We situate these …

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Ambulatory Blood Pressure Monitoring Phenotypes And Circadian Blood Pressure Patterns Among Adults Referred For Diagnostic Evaluation At Aga Khan University Hospital, Nairobi, Kenya: A Retrospective Cross-Sectional Study, Nadeem Kassam, Mzee Ngunga, James Orwa, Alisa Bhojani, Mohamed Varwani, Swaffiya Salim, Yvonne Oketch, Salim Surani, Anthony Ochola, Barbara Karau, Jeilan Mohamed, Etienne Amendezo

Internal Medicine, East Africa

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Introduction: hypertension represents the primary modifiable risk factor for cardiovascular disease and poses a public health challenge in sub-Saharan regions, with Kenya experiencing particularly low detection and control rates. Traditional office-based blood pressure measurements often fail to detect key phenotypes, such as white-coat and masked hypertension. Ambulatory Blood Pressure Monitoring (ABPM) offers a comprehensive 24-hour profile that excludes white-coat hypertension and allows for the evaluation of circadian patterns, including nocturnal hypertension and non-dipping status, both of which are recognized as high-risk phenotypes strongly linked to adverse cardiovascular events. This study evaluated ABPM data from Aga Khan University Hospital, Nairobi …

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