Social and Behavioral Sciences Commons^™

Developing A Taskforce To Improve Digital Health Equity, Samuel Wilson, Natalia Queenan, Julianna Lenoir, Alexzandra Gentsch, Jay Trivedi, Rohith Tudi, Nikita Nair, Akshay Krishnan, Andrew Vanichkachorn,, Tien Vu, Alexandra Cohen, Eleanor Jenkins, Marissa Witmer, David Rigas, Jeffrey Ndubisi, Isabella Muti, Kristin Rising, Md

Health Equity and Quality Improvement (HEQI) Summit

Our Population

• Thomas Jefferson University Hospital (TJUH) is a tertiary care center and L1 trauma center, and we serve patients from all areas in Philadelphia for acute health crises
• In Philadelphia, major disparities exist regarding health factors and health outcomes
• When stratifying by neighborhood or zip code, these disparities become even more apparent
• Several studies have also shown that these geographic demarcations coincide with racial disparities for access to health resources, like primary care physicians, COVID-19 vaccinations, and public health interventions
• Accessibility of health resources for our inpatients is thus highly variable.

Identifying Inappropriate Dual Anti-Platelet Therapy (Dapt) Utilization In The Outpatient Setting, Youssef Elfatatry, Julia Palecki, Nevin Varghese, Amry Majeed, Alexis Wickersham

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement:

• Dual anti-platelet therapy (DAPT) is a cornerstone in management of many cardiovascular and cerebrovascular conditions; however, inappropriate and prolonged use can lead to increased bleeding risk. Despite guidelines on optimal DAPT duration for various clinical scenarios, a proportion of patients receive inappropriately extended courses of therapy, exposing them to unnecessary risk.

Project AIM:

• We aim to (1) identify inappropriate DAPT use using established clinical guidelines at two academic primary care clinics and (2) develop and implement a targeted best practice advisory (BPA) in EPIC to address gaps in adherence to DAPT guidelines to enhance patient safety and …

Socioeconomic Status And Comorbidity Burden Influence On Mortality Index In Spinal Neurological Surgery Operations, Carey Preston, Bs, Pious Patel, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Pre-existing comorbidities are generally thought to increase risk of undergoing surgical procedures
• Low socioeconomic status (SES) has been correlated with increased comorbidity burden previously
• Patients with low SES undergoing spinal neurological surgery operations may have existing comorbidities that impact expected surgical outcomes
• Vizient Inpatient Mortality uses pre-existing comorbidities during an inpatient stay to estimate post-operative expected mortality
• With increased comorbidity burden, expected mortality in low SES patients may not be accurately represented by

Timely Ambulatory Follow Up After Emergency Department Discharge, Kevin Endersby, Jackson Weber, Marisyl De La Cruz

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement:

Patients over the age of 65 lack timely ambulatory follow up after discharge from the ED, leading to increased return to the ED, resource utilization, and mortality.

Project AIM:

Within 6 months of intervention, 70% of patients over the age of 65 who were recently discharged from the ED will follow up with their PCP within 7 days of the timeline recommended by the ED provider.

Social Needs Screenings Programs: Factors For Success, Varun Jayanti, Akshay Krishnan, Zachary Goldberg, Md, David Nash, Md, Mba

Health Equity and Quality Improvement (HEQI) Summit

Abstract

Introduction: In January 2024, the Centers for Medicare and Medicaid Services (CMS) implemented Health Quality Measure (HQM) 487, which required participating hospitals to annually screen admitted patients for the 5 domains of the Social Determinants of Health (SDOH). These requirements allowed hospitals to develop individualized, but compliant, screening programs. Previous SDOH screening research has focused on measurement tools, but not the mechanisms of screening present in various hospitals.

Research Objectives: This study will investigate the mechanism(s) for a social needs screening program (which is reflective of underlying SDOH disparity) in a large, multi-hospital academic health system in the Northeastern …

Key Stakeholder Perceptions Of Doula Support For Persons With Perinatal Opioid Use Disorder, Meghan Gannon, Phd, Msph, Dennis Hand, Phd, Vanessa Short, Phd, Taylor Carrubba, Grace Thiele, Samantha Pancoe, Sarah Lawson, Nadia H-Yazdi, Phd, Scott Keith, Phd, Diane Abatemarco, Phd

Health Equity and Quality Improvement (HEQI) Summit

Background

• Maternal child health disparities are prevalent among pregnant and parenting women in treatment for opioid use disorder (OUD).
• Doulas have been utilized as a perinatal support in other vulnerable populations to increase healthcare utilization and improve birth outcomes.
• While research demonstrated that doula services can be feasibly implemented for populations experiencing poverty and trauma, there are limited studies to support that this could be true for patients with OUD as well.

Los Intérpretes Médicos Son Un Derecho, No Un Privilegio, Morgan Uesseler

World Languages and Cultures Senior Capstones

This essay explores medical interpretation as a right, not a privilege. It argues that medical interpretation is a vital service that should be required in all healthcare settings, not just in those that are funded by the government. Themes addressed include the difference between interpretation and translation, face-to-face interpretation versus telecommunication, liabilities and risks associated with untrained and uncertified medical interpreters, and the federal law Title VI of the Civil Rights Act of 1964. Challenges experienced during any medical session are underscored, while giving special focus to limited English proficient Hispanic patients whose healthcare literacy is in Spanish, not English.

Identifying Phytoremediation Performing Plant Species That Can Be Utilized In The Improvement Of Heavy Metal Contaminated Soils, Ashley Clark*, Samuel Mutiti

Graduate Research Showcase

Heavy metal pollution is a problem associated with industrialization and development. Two major metals that are commonly mined and can enter the environment, which can jeopardize communities’ health, are copper (Cu) and lead (Pb). There are different options for reducing heavy metal pollution in the environment via remediation efforts, including physical, chemical, and biological methods. However, physical and chemical remediation can be costly and labor-intensive, making them unsuitable for regions that do not have the funds to utilize these practices. Biological remediation is a more cost-conservative practice that has been shown in many studies to be effective in the gradual …

Building Trust To Extinguish Burnout: A Qualitative Study Of Hospital, State, And Federal Policies That Impact Pediatric Nurse Burnout In Connecticut, Cecelia Angelica Morello

Senior Theses and Projects

This thesis explores how federal and state governments, as well as individual hospitals, respond or fail to respond to pediatric nurse burnout. The problem of nurse burnout is not new, and can cause nurses to make mistakes on shift, experience increased anxiety and depression, and increase risk of patient death or injury. Solutions to burnout in healthcare workers have been organized at the hospital, state, and federal government level. However, this thesis examines a lack of research on pediatric nurse burnout more specifically. After reviewing the national landscape of hospital-based solutions, short-term policy solutions, and long-term policy solutions, I examine …

The Role Of Acculturation In The Professional Identity Of Art Therapy And Counseling International Students, Ana Marcela Tobar Chavez

Art Therapy Counseling Final Research Projects

In a country of immigrants, the concept of acculturation needs to be familiar to almost any professional in the mental health field and it is a reality for immigrants and international students. As international and immigrant students continue to join the Art Therapy Counseling profession, it is important to understand how acculturation plays a role in the development of their counseling professional identity. Unlike most master’s students in the art therapy counseling profession, international and immigrant students go through unique experiences such as being born and raised in a different country with difference in cultures, languages, and immigration statuses that …

Incorporating Ai Tools To Enhance Information Literacy And Critical Thinking In First Year Medical Students, James Martin, Mercedes Byrd

Rowan-Virtua Research Day

This study aims to evaluate the impact of an educational intervention incorporating medical databases, search engines, and generative artificial intelligence (GAI) tools on the critical thinking skills and confidence of first-year medical students at Rowan-Virtua School of Osteopathic Medicine (SOM). Approximately 125 students participating in a three-week pre-matriculation program will be subjects of the study. The intervention will consist of a curriculum focused on developing research questions, using search tools and GAI, evaluating sources, and writing a research paper. Pre- and post-tests, including a CARS assessment and a perceived knowledge and abilities questionnaire, will be administered to measure changes in …

Lep Prevalence In Southern New Jersey And The Use Of Interpreting Services In Healthcare Settings, Katherine Chavarria, Ariana Blake, Marlyn Valentin

Rowan-Virtua Research Day

Language barriers pose a great challenge to populations of Limited English Proficiency (LEP) in understanding their health, diagnosis, and treatments in healthcare settings. Our research aimed to gain a better understanding of the language access needs in Southern New Jersey. We analyzed census data in order to determine the prevalence of LEP populations in Southern New Jersey, as well as the languages most spoken by LEP populations. Additionally, our research looked at the use of interpreting services in healthcare settings. In Camden county, specifically we found that the top 3 languages spoken by LEP populations were Spanish, Vietnamese, and Chinese. …

Evaluation Of Unexplained Bone Fractures In A 3-Month-Old Infant – A Case Report, Hannah Ngo, Rachel Silliman Cohen

Rowan-Virtua Research Day

Child physical abuse is a significant cause of injury in infants and young children and can present in a variety of ways. Failure to recognize abuse in infants and young children can be life-threatening and is often recurrent until safety interventions occur. Consequently, it is of paramount importance that providers strongly consider child physical abuse on the differential, along with metabolic bone disease and accidental traumatic injury, when evaluating fractures in young children and infants. This case report will focus on the evaluation of a 3-month-old male infant who was admitted to the hospital with irritability and decreased right arm …

Unveiling The Impact: Structural Racism And Childhood Lead Exposure's Health Consequences In Philadelphia, Mahhum Naqvi, Mahrukh Naqvi, Justin Stout, Colton Spencer

Rowan-Virtua Research Day

Childhood lead exposure poses a significant risk to health and well-being, adversely affecting brain function, nervous system development, and behavioral patterns. This study examines the health disparities and inequities associated with childhood lead exposure in Philadelphia, focusing on structural racism and residential segregation as crucial lenses for analysis. By delving into the sociocultural context of lead exposure, this study underscores the imperative of collaborative efforts among stakeholders to safeguard Philadelphia's most vulnerable populations. Healthcare professionals and policymakers play pivotal roles in enhancing funding and prevention strategies. Addressing this issue through the prism of structural racism allows for the identification and …

Is There An Association Between Living In A Rural Area And The Incidence Of Postoperative Complications Or Hospital Readmissions Following Left Ventricular Assist Device (Lvad) Implantation, Compared To Urban Lvad Recipients?, Samrat Gollapudi, Abhiram Gollapudi, Srinidhi Banala, Sheraj Singh, Bhaumik Patel

Rowan-Virtua Research Day

Background: Left ventricular assist devices (LVADs) are utilized as a therapeutic option for patients with end-stage heart failure. While LVAD implantation can significantly improve survival rates and quality of life, the procedure is not without risks, and postoperative complications are common. This review aims to investigate whether there is an association between living in a rural area and the incidence of postoperative complications or hospital readmissions following LVAD implantation, compared to urban LVAD recipients.

Methods: A comprehensive review of the literature was conducted, examining studies that compared postoperative outcomes between rural and urban LVAD recipients. Data were extracted on adverse …

Improving Primary And Gynecological Care In Transmasculine Patients, Alison N. Mautner, Joanna Petrides

Rowan-Virtua Research Day

Introduction: This study aimed to assess the healthcare experiences of transmasculine individuals in primary and gynecological care settings. An online, anonymous survey was conducted to gather insights into positive and adverse encounters, factors influencing care-seeking behaviors, and strategies for improving care delivery in this population.

Methods: A survey was administered between June 1st and July 23rd, 2023, recruiting participants from three LGBTQ+ affirming healthcare offices in South Jersey and via Reddit. Data analysis involved SPSS to gain information from 499 valid responses.

Results: The majority of participants (55%) were aged 18-24, with 51% identifying as transgender men. Over two-thirds (68.5%) …

Evaluating The Effectiveness Of A School-Based Cognitive Behavioral Youth Depression Prevention Program In Improving Life Satisfaction, Roshani Patel, Steven M. Brunwasser, Alissa Hochman

Rowan-Virtua Research Day

Depression is the leading cause of disability worldwide, known as the global burden of disease. Incident cases from 1990 to 2017 have increased by 49.86%. Additionally, rates have been seen to dramatically rise in adolescents aged 18-25 (17%) compared to rates in individuals aged 10-14 (1.1%). This makes it beneficial to have prevention programs for middle school aged children. The Penn Resiliency Program (PRP) is a youth depression prevention program focused on cultivating healthy thinking styles and behavioral coping skills. In our study, we used archival data from a randomized control trial of PRP to evaluate whether the program led …

The Impact Of The Covid-19 Mask Mandate On Effective Communication Between Healthcare Providers And Deaf/Hoh Patients, Antonia J. Conti, Alexa Gingerich

Rowan-Virtua Research Day

During the peak of the COVID-19 pandemic, many countries mandated the use of facial masks in public environments, especially in healthcare settings.[3] While this was beneficial in reducing the spread of the coronavirus disease, it created many challenges for the deaf/HoH community.[4] In particular, it limited effective communication between healthcare providers and deaf/HoH patients. It was found that masks limit word recognition for both deaf/HoH and non-deaf/HoH individuals. Additionally, both surgical and N95 masks hinder word recognition for deaf/HoH individuals and significantly impact communication during medical appointments.

Investigating Risk Factors Contributing To The High Incidence Of Covid-19 Among The Diné People Of The Navajo Nation, Elizabeth Lila Reynolds

Rowan-Virtua Research Day

Background: COVID-19 became international news in December 2019 and subsequently impacted global health. The research shows that the Diné people of the Navajo Nation were one of the most severely impacted populations¹. The Navajo Nation is a region spanning Arizona, New Mexico, and Utah that is composed of North American indigenous people known as the Diné. Purpose: To explore the risk factors contributing to the increased rates of COVID-19 infection and severity of infection among the Diné people. Methods: This literature review research process utilized PubMed and JAMA to find scholarly articles on this topic. Search terms …

Zine-Making As An Expressive Arts Therapy Method In An Adult Psychiatric Inpatient Hospital, Lauren Classe

Expressive Therapies Capstone Theses

Zines are handmade versions of magazines with themes embracing art, music, politics, and social issues, offering individuals a platform to reclaim their narratives and connect with others. This paper explores zine-making as an expressive arts therapy method and its potential to foster individual and community expression within the inpatient psychiatric setting. The psychiatric care system is an often chaotic and even oppressive environment for the patients it serves, with a history of stigmatization that drives underfunding, understaffing, and an over-reliance on the biomedical model. By engaging in therapeutic zine-making, individuals in psychiatric care have the opportunity to explore their emotions, …

Association Between Cultural Factors And Postpartum Depression, Usha Modukuru

Rowan-Virtua Research Day

Postpartum depression (PPD) is present in 17.22% of the world population. The negative physical and psychological impacts of PPD impact not only the mother, but also those around her. This raises the importance of identifying factors contributing to its onset. Studies have shown that PPD prevalence rates vary between non-Western and Western regions of the world. Cultural postpartum practices differed significantly region to region. Search terms including postpartum depression and cultures were used to find peer-reviewed articles, primary surveys, and patient interviews between 2013-2023. Qualitative analyses were performed on the results. Ethnokinship cultures, commonly present in non-Western countries, prioritized social …

Barriers To Healthcare Access Between English And Spanish Speakers In An Underserved Population, Adeena Javed, Dale Johnson, Gerardo J. Rivera-Colón, Nathaniel J. Byrnes, Kristin Bertsch, Anne C. Jones

Rowan-Virtua Research Day

• According to the NJ State Department of Health, Atlantic County has higher rates of smoking, respiratory disease, hypercholesterolemia, as well as death rates due to coronary heart disease, HIV, and all cancers compared to the NJ state average1,2.

• With over 20% of Atlantic County's population identifying as Hispanic, Spanish speakers encounter greater obstacles compared to their English-speaking counterparts in accessing healthcare services and improving health outcomes1,2 .

• Existing research indicates that various factors, including health insurance coverage, proximity to healthcare facilities, transportation options, health literacy levels, and trust in the medical profession, significantly influence access to healthcare …

A Brief Overview Of Food Insecurity In Southern New Jersey, Lisa Ting Huang, Krisha Darji, Jariatou Diallo, Amin Abdul Khan

Rowan-Virtua Research Day

Atlantic County, located off the Jersey Shore, faces the highest level of food insecurity in New Jersey, with a rate of 11.2% as of 2021, surpassing the state's overall rate of 8.8%. This situation contributes to health issues such as hypertension, diabetes, and heart disease.

The objective of this research is to understand and address the persistence of food insecurity in Atlantic County. Community stakeholders and local physicians were interviewed to identify barriers and disparities contributing to food insecurity.

Methods included a literature review using keywords like "food insecurity" and "southern New Jersey". Proposed interventions suggest collaboration with health centers …

Cut The Pressure: Blood Pressure Screening In A Community Based Setting, Harold Kareem Knight Jr., Katharine Milani

Rowan-Virtua Research Day

This study addresses the pressing issue of cardiovascular health disparities in African American males through community-based interventions, specifically blood pressure screenings and surveys conducted in a local barbershop setting. Despite a preference among participants for clinical settings, an overwhelming 97.7% expressed high comfort levels in the community-based environment, highlighting the importance of culturally sensitive approaches in healthcare delivery. With 92.5% indicating willingness to return for future screenings, the study underscores the efficacy of non-traditional settings in fostering healthcare engagement. Findings suggest the potential for broader impact through scalable, community-centric initiatives, offering promising avenues for improving health outcomes in underserved populations.

Exploring Hypertension Prevalence Among Ill-Housed Individuals In Urban Environments, Lia Goldberg, Sameer Shah, Nikhila Archakam, Murod Khikmatov, Kesha Choksi, Anddee White

Rowan-Virtua Research Day

This study explores the interrelations of hypertension, homelessness, and access to healthcare in urban ill-housed populations. It was found that conditions such as heart disease and diabetes significantly exacerbate hypertension, which remains highly prevalent due to the population's limited access to consistent medical care. Homelessness further complicates the management of hypertension due to unstable living conditions, making adherence to treatment and follow-up with healthcare providers challenging. Additionally, factors like higher rates of substance abuse and malnutrition among homeless populations contribute to worsening hypertension, which, if untreated, can lead to severe health crises including heart attacks and strokes.

The research underscores …

Review Of Missing Data Elements For Client Enrollment In The Minority Aids Initiative For High-Risk Men Of Nj, Vrushank Shah

Rowan-Virtua Research Day

The Minority AIDS Initiative study funded in NMI seeks to enhance healthcare outcomes for underserved individuals. Implementing outreach programs, the initiative provides healthcare and post-treatment follow-up to this demographic. The proposed project, a component of this study, concentrates on individuals with substance abuse disorder, specifically targeting those who have been onboarded but subsequently lost to follow-up. In the United States, approximately 20 million people are diagnosed with substance abuse disorder, yet in 2016, only 3.8 million received treatment. Within this cohort, between 20% and 70% of individuals undergoing residential substance abuse treatment disengage before completion. Various factors hinder the sustained …

Pros, Cons, And The Barriers To Implementing A Universal Healthcare System In The United States, Arpun Shah

Rowan-Virtua Research Day

Background: The United States has the most expensive healthcare system in the world. Despite that, it also has worse health outcomes than that of several other countries. The United States is also the only wealthy/developed country without universal healthcare. Universal healthcare, also known as a single-payer healthcare system, refers to the concept that the government finances and governs healthcare for most, if not all residents of the country. The United States currently has a multi-payer system, which means that healthcare is financed through various sources such as the public and private sectors. Purpose: The purpose of this is …

Colorblind Racial Attitudes And Emotion Dysregulation: Impact On White People’S Ethnocultural Empathy And Feelings Towards People Of Color, Vanessa L. Veltre, Alissa Hochman

Rowan-Virtua Research Day

Colorblind racial attitudes, which minimize the importance of race, have been identified as a barrier to understanding systemic racism and fostering empathy towards people of color (POC). This study aimed to examine the relationship between emotion dysregulation and White people's ethnocultural empathy and warmth towards people of color, and to explore the potential moderating role of colorblind racial attitudes.

The study utilized data from 511 White participants (ages 19-50) who completed the Difficulties in Emotion Regulation Scale (DERS), Colorblind Racial Attitudes Scale (CoBRAS), Scale of Ethnocultural Empathy (SEE), and a feeling thermometer scale measuring warmth towards POC. Participants were categorized …

Cost-Effectiveness And Outcomes Of Utilizing Tisagenlecleucel Therapy (Car T-Cell) In Pediatric Acute Lymphoblastic Leukemia In Comparison To Standard Of Care (Soc) Therapies: A Scoping Review, Andrew Atschinow, Evangeline Attota, Warren Chan, Pooja Kasarapu, Priyal Shah, Karina Vizzoni

Rowan-Virtua Research Day

Aims

This review aims to assess the correlations between outcomes and cost of treatment methods for pediatric acute lymphoblastic leukemia patients, specifically comparing CAR T-cell therapy and Standard-of-Care (SoC) therapy. The socioeconomic background of patients will also be taken into consideration to see if there are differences in their outcomes.

Methods

Peer-reviewed publications were collected from PubMed and Web of Science. The keyword strings used were “acute lymphoblastic leukemia,” “pediatric acute lymphoblastic leukemia,” “pediatric,” “CAR T-cell therapy,” and “cost-effectiveness.” 27 citations were obtained. Titles were screened by 6 authors. Articles met the inclusion criteria including potential Quality-Adjusted Life Year (QALY) …

Addressing The Black Maternal Mortality Rate, Kennedy Sanders, Venkateswar Venkataraman, Kate Whelihan

Rowan-Virtua Research Day

Introduction: As of 2021, the Black maternal mortality rate in the United States was 69.9 deaths per 100,000 live births as compared to the national average of 32.9 and the White American average of 26.61. It has been demonstrated that this discrepancy is not fully explained by socioeconomic status. Doulas are professionals who provide support and guidance throughout pregnancy, birth, and early parenthood. Encouraging the use of doulas may be an effective approach to improve the birth experience for Black mothers. Methods: A literature review was performed using PubMed and the following search strings: maternal mortality rate (+race, +race +ethnicity, …