Population Health Commons^™

Evaluating The 4mm Endometrial Thickness Threshold: Racial Disparities In Ultrasound Sensitivity And Diagnostic Delay, Ngozi Ikpeama, Sophia Vogiatzidakis, Xuezhi Jiang, Elizabeth Hertz, Vitoria Chaves, Peter Schnatz

Rowan-Virtua Research Day

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Title: Evaluating the 4mm Endometrial Thickness Threshold: Racial Disparities in Ultrasound Sensitivity and Diagnostic Delay

Background: Current ACOG guidelines utilize a 4mm endometrial thickness (ET) threshold via transvaginal ultrasound (TVUS) to exclude malignancy in postmenopausal women. However, recent evidence suggests these standardized thresholds may not be equally effective across all racial cohorts. This systematic review evaluates the diagnostic performance of the 4mm threshold specifically in Black patients.

Methods: A systematic search of peer-reviewed literature was conducted to identify studies comparing TVUS sensitivity and clinical outcomes between racial groups. Data were extracted focusing on the diagnostic sensitivity of the 4mm threshold, …

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Barriers To Accessing Mental Healthcare Among Refugee Populations In Southern New Jersey, Paul Cardillo, Hijab Zaidi, Jacob Trainer, Alison Mancuso Do, Facofp

Rowan-Virtua Research Day

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This project examines barriers to accessing mental healthcare among refugee populations in Southern New Jersey, with a focus on individuals with limited English proficiency (LEP). Using a narrative review of peer reviewed studies and government reports, key challenges were identified, including language barriers, cultural stigma, and limited familiarity with the U.S. healthcare system. Findings show that refugee populations experience significantly higher rates of mental health disorders, including PTSD and depression, driven by trauma, structural inequities, and social disadvantage. Effective interventions emphasize culturally competent care, integration of bicultural staff, and community based approaches. Addressing these barriers is essential to improving equitable …

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Assessing The Utilization Of Emergency Departments For Primary Care Services In Southern New Jersey, Joshua James Novello, Sheila Joazile, Mohammad Isa

Rowan-Virtua Research Day

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Background: Primary care (PC) is essential to proactive, comprehensive, and preventative care that can improve patient outcomes. One-third of emergency department (ED) visits are for non-emergency care that can be appropriately treated by a PC provider. In New Jersey, more than $400 million is spent annually on avoidable ED visits. Decreasing the total PC treatable ED visits per year will improve the quality of care and decrease costs. New Jersey’s PC spending, based on total health spending, is one of the lowest in the country. Demographic and socioeconomic factors in the Social Vulnerability Index (SVI) examine potentially preventable ED …

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Barriers To Palliative Care Access In Rural South Dakota: A Policy And System-Level Analysis, Harshavardhan Kadarkaraisamy

Honors Thesis

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Palliative care improves the quality of life for people living with serious illness. It helps by addressing symptoms, improving communication, and providing mental, physical, and spiritual support. However, in South Dakota access to palliative care is limited in rural areas. These challenges include geographic isolation, workforce shortages, healthcare infrastructure, reimbursement, and misunderstandings about palliative care. This thesis examines the key policy barriers that limit access to palliative care in rural South Dakota. This work involves engaging with South Dakota-specific literature, rural health research, policy sources, community education, telehealth expansion, and policy reform. By focusing on the rural context of South …

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Dfend: A Nutrition Education Intervention To Improve Food Budgeting, Shopping, And Meal Preparation Skills Among Adults In Arkansas, Samantha K. Edwards

Human Nutrition and Hospitality Management Undergraduate Honors Theses

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Preventive strategies targeting modifiable lifestyle factors related to food, nutrition, and health are needed as chronic health conditions continue to rise. Nutrition literacy refers to having the knowledge and skills needed to obtain, understand, and apply nutrition information to make informed dietary decisions. Without adequate nutrition education and food security, vulnerable populations are at risk of malnutrition and poor dietary behaviors. Educational interventions that increase food literacy can help improve dietary choices and food selection skills.

The purpose of this creative project was to develop a nutrition education toolkit for Extension agents to implement among rural populations with low health …

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Determinants Of Hypertension Awareness And Control In Kenya: A Secondary Analysis Of National Survey Data, Alexander K. Davis

Poster Presentations

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No abstract provided.

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Nutrir: Recetas Sencillas Para Toda La Familia, Children's Health, Sophie Le

Publications

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This Spanish-language cookbook provides simple, affordable, and culturally diverse recipes designed to help families prepare nutritious meals at home while building healthy eating habits. It also includes practical nutrition guidance, such as balanced meal planning, smart pantry choices, and food safety tips to support overall family wellness.

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Nourish: Simple Meals For The Whole Family, Children's Health, Sophie Le

Publications

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This English-language cookbook provides simple, affordable, and culturally diverse recipes designed to help families prepare nutritious meals at home while building healthy eating habits. It also includes practical nutrition guidance, such as balanced meal planning, smart pantry choices, and food safety tips to support overall family wellness.

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Determinants Of Hypertension Awareness And Control In Kenya: A Secondary Analysis Of National Survey Data, Alexander K. Davis

Honors Theses

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In low- and middle-income countries (LMICs), cardiovascular diseases (CVDs) are prevalent and pose a major concern as the current healthcare systems are oriented primarily towards communicable diseases. The largest contributor to CVDs, hypertension, is a significant issue in Kenya, a model LMIC. Based on previous studies in this lab, high rates of hypertension are present in the region of Kasigau, Kenya. Kasigau is a small region within Taita-Taveta County, Kenya. Traditional risk factors are not necessarily predictive of hypertension in all regions of Kenya. This study aims to address the lack of tested risk factors for hypertension in Kenya and …

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Exploring Exercise Motivation And Mental Well-Being In College Students, Elaine M. Lindesmith, Anqi Deng Dr

Health, Human Performance and Recreation Undergraduate Honors Theses

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This study examined the relationship between physical activity, exercise motivation, and mental well-being among 48 undergraduate students at the University of Arkansas. Guided by Self-Determination Theory, the study used survey data to measure depression, anxiety, physical activity, and open-ended exercise motivation responses. Motivation responses were coded as autonomous or controlled.

Results showed that physical activity was weakly and negatively related to depression and anxiety, but these relationships were not statistically significant. There were also no significant differences in mental health between autonomous and controlled motivation groups, and motivation did not significantly predict mental health outcomes in regression analyses. Overall, the …

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Associations Between Water Intake, Dietary Quality, And Beverage Consumption Among University Students, Mohammad A. Qazi

Electronic Theses, Projects, and Dissertations

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Title: Associations Between Water Intake, Dietary Quality, and Beverage Consumption Among University Students

Background and Aims: Sugar-sweetened beverage (SSB) and ultra-processed food (UPF) consumption significantly contribute to chronic disease risk and is often more common in underserved and racially/ethnically diverse communities. Drinking water is a low-cost, calorie-free behavior that may support healthier beverage and dietary patterns. Previous studies show that increased daily water consumption positively correlates with better diet quality and is inversely correlated with SSB and UPF consumption. This study aims to examine whether (1) increased daily water intake is associated with self-reported diet quality and (2) self-reported hydration …

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Stochastic Universal Differential Equations For Epidemiological Modeling: Uncertainty Quantification In Disease Transmission Dynamics, Alice Menaya Armah-Bonney

Electronic Theses and Dissertations

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Epidemic forecasting requires not only predictions of expected case counts, but also quantification of uncertainty, although existing surrogate modeling frameworks for agent-based models remain fundamentally deterministic. In this thesis a Stochastic Universal Differential Equation framework is presented that extends the deterministic Universal Differential Equation approach by incorporating a learnable stochastic diffusion term, enabling calibrated probabilistic forecasts while preserving the mechanistic interpretability and computational efficiency of the deterministic baseline. In doing so, a two-phase training algorithm is introduced to ensure stable convergence and the framework is validated against the ensemble output from ExaEpi, an exascale agent-based model of a COVID-19 outbreak …

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Addressing Substance Use Disorder In Rural Appalachia: Improving Access And Treatment Outcomes For Justice-Involved Individuals, Jessica Muldowney

Electronic Theses and Dissertations

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Background: Opioid use disorder (OUD) represents a critical public health crisis disproportionately affecting justice-involved (JI) populations, with approximately 65% of incarcerated individuals having substance use disorders (James & Beatty, 2006). Rural Appalachian communities face compounded challenges due to limited healthcare access, provider shortages, and cultural stigma surrounding addiction treatment. Despite evidence demonstrating that medication-assisted treatment (MAT) reduces recidivism and overdose deaths, only 20% of correctional facilities offer these services (Klein & Seppala, 2019).

Objective: This mixed-methods study evaluated organizational readiness and infrastructure capacity for implementing evidence-based OUD interventions, specifically MAT programs across three rural counties in northwestern North Carolina.

Methods: …

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Participant Recruitment, Baseline Characteristics And Burden Of Cardiometabolic Risk Markers Among Adults With Prediabetes In Kenya: Insights From The Fermented Foods And Prediabetes Study, Rosebella Iseme, Alex Muia, Jacob Shabani, Samuel Mucheru, Catherine Gathu, Eliphas Gitonga, Redempta Mutisya, Peter Kioko, Jalal Safipour, Cornelia Witthöft

Population Health, East Africa

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Aims

Cardiometabolic abnormalities such as obesity, hypertension, and dyslipidemia are rising globally and straining health systems. This study assessed the burden of cardiometabolic risk factors among prediabetic adults in Kenya.

Methods

We analyzed baseline data from the Fermented Foods and Prediabetes Randomized Controlled Trial, which recruited adults with prediabetes (HbA1c 39–46 mmol/mol; 5.7%–6.4%) from Aga Khan University Hospital outreach clinics in five Kenyan counties. Standardized questionnaires and clinical assessments were conducted, with HbA1c measured via turbidimetric inhibition immunoassay. Data were managed in REDCap and analyzed in Stata v13. Poisson regression identified factors associated with co-occurrence of cardiometabolic risk factors.

Results …

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Charity Pharmacies: An Integrative Overview Of Operations: A Continuing Education Program For Pharmacists, Stella Bertram

Honors Theses

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PROGRAM DESCRIPTION

The goal of this activity is to educate pharmacists about Charity Pharmacies by creating an integrative overview of their purpose, laws and regulations, processes and procedures, eligibility, and opportunities for involvement. This course will ensure pharmacists are competent in the operations involved in volunteering or working within a charitable pharmacy.

Additionally, the information provided supports pharmacists in understanding their roles as well as roles of volunteers. They will understand the importance of their role in the community and the depth of their service within Charity Pharmacies.

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Improving Glp-1 Ra Initiation In Primary Care Through A Paper-Based Clinical Decision Support Tool, Carissa R. Bowery, Karen Carver

Epsilon Sigma at-Large Research Conference

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Title: Improving GLP-1 RA Initiation in Primary Care Through a Paper-Based Clinical Decision Support Tool

Authors: Carissa R. Bowery, MSN, FNP-C; East Tennessee State University College of Nursing. Karen M. Carver, PhD, APRN, FNP-C; East Tennessee State University College of Nursing

This quality improvement project focuses on improving evidence-based pharmacologic management of adults with type 2 diabetes mellitus (T2DM) and obesity through implementation of a paper-based clinical decision support (CDS) tool in primary care. The aim is to increase initiation of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among eligible patients and improve provider adherence to current clinical guidelines.

Processes: This …

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Rhode Island Right To Life: Veritas Grant Funded Internship Summer 2025, Ekaterina Rau

Biology Student Scholarship

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No abstract provided.

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Empowerment Of Patients Through Sexual Wellness Programming, Carly M. Busby

OTD Capstone Projects

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Abstract:

This doctoral capstone project was completed in collaboration with Dr. Jenny Archer with Archer Physical Pelvic Floor Therapy. This project highlights empowerment of Dr. Archer and her team through administrative tasks and empowerment of clientele through education materials. The primary deliverable of my project is a six week ‘course,’ addressing pelvic pain through evidence-based therapy practices. Other deliverables include education materials that cover an expanse of pelvic floor and pregnancy related topics. The prominent goal of this capstone project was empowerment through education.

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Examining Outcomes Of Client Education Interventions To Reduce Caffeine Intake In The College-Age Population, Mackenzie Leonard, Mikayla Evans

James Madison Undergraduate Research Journal (JMURJ)

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This scoping review aimed to explore health interventions that address excessive caffeine consumption in college students aged 18–23 years. Excess caffeine intake is associated with a range of health concerns, including neurological, cardiovascular, and behavioral issues, highlighting the need for effective interventions to mitigate its impact on overall wellness. The literature exploring interventions aimed at modifying health behaviors among the college student population is notably limited. Furthermore, there has been a lack of studies replicating interventions aimed at reducing caffeine intake. These gaps suggested the need for further investigation and exploration of reports pertaining to health promotion. The results of …

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Effects Of A Major Disruption On Mental Health Of Pregnant Women In South Carolina, Lizmarie Maldonado

MUSC Theses and Dissertations

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Mental health conditions are a leading cause of death among pregnant and postpartum women, and untreated mental health conditions are associated with adverse maternal and birth outcomes. Major disruptions, such as pandemics, hurricanes, or wildfires, create unprecedented challenges and may impose additional stressors during an already vulnerable time. Community or medical care disruptions during such events may lead to adverse health outcomes. This dissertation seeks to characterize the impact of a recent major disruption on mental health outcomes among pregnant women using administrative claims data for all births in South Carolina in 2019 and 2020. By leveraging unique data sources, …

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