Wellness in Action: Implementation of an Experiential Wellness Elective for Occupational Therapy Students

Wellness In Action: Implementation of an Experiential Wellness Elective for Occupational Therapy Students Graduate student mental health is a growing concern in higher education, highlighted by the student experience of high levels of stress, burnout, and declining well-being that impair academic and daily functioning (SenthilKumar et al.,2023; Bullock et al.,2017). Research highlights the need for proactive, holistic interventions that provide education and support skill development (Henrico, 2021; Van Oss et al., 2025). To address this need, this capstone project aimed to design, implement, and evaluate an experiential wellness elective for occupational therapy (OT) doctoral students within a graduate health professions academic department. Key project aims included development of a tailored, evidence-informed course, expansion of student access to wellness resources, and gathering of data to inform future implementations of wellness interventions. Course design was guided by SAMHSA’s eight dimensions of wellness and the Model of Human Occupation and was implemented using a group-based, experiential format over a 12-week period. Six OT students participated in the course comprised of (n=4) 2nd year and (n=2) 3rd year students. Course content was organized into four modules focusing on four domains of wellness; physical, emotional, social, and occupational wellness. The content of each module included lectures, reflective practices, skill-building activities and tools, and community-based experiential sessions. The aims of the course focused on fostering student resiliency, self-efficacy, exploration of wellness topics and resources, and the practical application of wellness strategies for personal and professional use. Project impacts were evaluated using a mixed-methods approach, including pre- and post-course quantitative surveys and post-course qualitative interviews. Following the course, all participants (n=6) reported improved overall well-being and increased engagement in wellness behaviors. Participants also demonstrated enhanced self-efficacy, knowledge of wellness strategies, and confidence in applying these skills in both personal and professional contexts. Qualitative data supported these outcomes and highlighted the role of structured reflection, development of skills (e.g. self-compassion), and application of wellness strategies in personal routines and in promoting wellness in others. References Bullock, G., Kraft, L., Amsden, K., Gore, W., Prengle, B., Wimsatt, J., Ledbetter, L., Covington, K., & Goode, A. (2017). The prevalence and effect of burnout on graduate healthcare students. Canadian Medical Education Journal, 8(3), e90–e108. Henrico, K. (2022). Sustaining student wellness in higher educational institutions: Possible design principles and implementations strategies. The Journal for Transdisciplinary Research in Southern Africa, 18(1). https://doi.org/10.4102/td.v18i1.1114 SenthilKumar, G., Mathieu, N. M., Freed, J. K., Sigmund, C. D., & Gutterman, D. D. (2023). Addressing the decline in graduate students’ mental well-being. American Journal of Physiology-Heart and Circulatory Physiology, 325(4), H882–H887. https://doi.org/10.1152/ajpheart.00466.2023 Van Oss, T., Miller, M., D’Amicantonio, S., Wood, M., Sawyer, M.D. (2025). Incorporating Self Care into First Year Student Curriculum to Promote Healthy Lifestyles. Am J Occup Ther, Vol. 79(Supplement_2), 7911500423p1. https://doi.org/10.5014/ajot.2025.79S2-PO40

Developing a Video Case-Based Learning Module to Enhance Clinical Skill Confidence and Competence in Occupational Therapy Students

Introduction: Video case-based learning is a teaching tool that offers students access to authentic clinical cases through real patient-therapist treatment videos. This style of instruction has demonstrated improvements in occupational therapy (OT) student clinical skill acquisition (Murphy & Stav, 2018). This capstone project was completed in collaboration with an international subscription-based resource database that offers authentic treatment videos as well as other educational resources and a documentation learning system. Purpose: The purpose of this capstone project was to build OT educational resources to enhance student clinical skill acquisition and foster a more inclusive, accessible, and effective classroom. Methods: A video case-based learning lesson plan was developed, including clinical reasoning questions with suggested answers, an evaluation SOAP note, and a sample treatment SOAP note. Materials were refined through iterative feedback and submitted for publication on the capstone site. Lesson plan materials as well as an anonymous, optional, mixed-methods REDCap survey were distributed to third-year OT doctoral students (n=8) who had completed similar lesson plans in the past, passed OT clinical fieldwork, and assisted during a clinical skills course for second-year students. Quantitative and qualitative data were analyzed using descriptive statistics and thematic analysis, respectively. Results: All participants agreed that the learning activity increased their confidence (100%) and preparedness (100%) for clinical fieldwork. Qualitative analysis revealed that documentation practice with sample notes for comparison and guided clinical reasoning questions that promoted deep thinking were perceived as most helpful. Students suggested including prospective clinical reasoning questions to further enhance learning. Overall, the lesson plan was described as organized, clear, and effective. Impact: The project provides a scalable video case-based learning activity for use across OT programs, supporting increased student confidence and preparedness for clinical fieldwork. References Murphy, L. F., & Stav, W. B. (2018). The impact of online video cases on clinical reasoning in occupational therapy education: A quantitative analysis. The Open Journal of Occupational Therapy, 6(3). https://doi.org/10.15453/2168-6408.149

Enhancing Pediatric Outpatient Occupational TherapyThrough Self-Regulation Interventions

Enhancing Pediatric Outpatient Occupational Therapy  Through Self-Regulation Interventions Self-regulation is defined as the understanding, acceptance, and regulation of emotional responses necessary for successful adaptation to one’s psychosocial environment, goal achievement, and overall mental health (Alarcón-Espinoza et al., 2022). This project was conducted in collaboration with two Charleston based mentors who developed a self-regulation education program with the mission to empower children and their caregivers through research-informed, trauma-sensitive strategies. The program emphasizes interoception, mindful awareness, and compassionate connection to support children in understanding their sensory needs and fostering emotional regulation. The purpose of this project was to expand pediatric self-regulation resources available to clinicians and increase their confidence by developing an evidence-based activity resource for use in therapeutic settings. This project involved the creation of a collection of over 20 self-regulation activities aligned with key concepts, including interoceptive awareness, self-compassion, connection, and mindfulness. These activities were implemented and trialed over a 14-week period in both outpatient and school-based pediatric settings. Ongoing feedback was obtained from mentors and stakeholders throughout the implementation process. Resources were revised based on this feedback to improve clinical effectiveness, usability, and sustainability. The final product was adapted to support a wide range of pediatric ages, settings, and group formats, providing clinicians with a comprehensive and flexible toolkit of evidence-based interventions to support the development of self-regulation skills in children. References Alarcón-Espinoza, M., Sanduvete-Chaves, S., Anguera, M. T., Samper García, P., & Chacón-Moscoso, S. (2022). Emotional self-regulation in everyday life: A systematic review. Frontiers Media SA. 10.3389/fpsyg.2022.88475

Recruitment as Care: Building Trust with Hard-to-Reach Populations in Sensitive Health Research

Recruiting participants for sensitive health research on social media presents unique ethical and methodological challenges. This session shares lessons learned from a qualitative study examining how young adults in South Carolina use TikTok to seek sexual health information. The presentation highlights creative and trauma-informed recruitment strategies that successfully engaged a hard-to-reach population while maintaining participant trust and privacy. Attendees will learn how recruitment language, social media algorithms, and transparency practices shape engagement, and why building trust matters more than technology alone. The session also considers how these lessons can inform future research in health sciences librarianship, especially for librarians supporting or conducting studies with marginalized or stigmatized communities. By reframing recruitment as a relational process rather than a procedural one, this session offers practical insights for designing inclusive, ethical, and participant-centered approaches to digital research. From a broader perspective, this study underscores the value of librarian-researcher collaboration in supporting equitable and ethical recruitment. Health and medical librarians are particularly well-positioned to advise on privacy-preserving data practices, inclusive communication strategies, and digital literacy principles that ensure participants’ rights and safety are prioritized. Objectives: Describe common methodological and ethical challenges in recruiting hard-to-reach or stigmatized populations for health research conducted in digital environments. Identify trust-centered and trauma-informed recruitment practices that balance participant care with methodological rigor. Evaluate how language choice, transparency, and platform affordances shape participant engagement and data quality. Apply lessons from this case study to support or conduct equitable, participant-centered recruitment in their own research or when advising faculty and community partners. Methods: This study employed a dual-method qualitative design combining semi-structured interviews and digital walkthroughs to explore how young adults in South Carolina seek and interpret sexual health information on social media. The research was conducted remotely, enabling participants to demonstrate their information-seeking behaviors directly within the digital environments they regularly use, including TikTok, Instagram, and Reddit. Twenty participants aged 18–25, representing diverse gender, sexual orientation, and cultural backgrounds, were recruited using trust-centered, trauma-informed strategies developed through iterative testing of recruitment materials across multiple platforms. Recruitment emphasized participant care and ethical transparency. Materials were customized to each platform’s moderation policies to avoid suppression of sexual health–related language. Participants were invited through organic social media posts, university and community partnerships, and peer referrals. Screening and consent processes prioritized privacy, autonomy, and emotional wellbeing, allowing participants to skip sensitive questions or pause walkthroughs as needed. Interviews and walkthroughs were recorded with participant consent, transcribed, and coded thematically using reflexive thematic analysis. The focus of this paper centers on the recruitment phase, highlighting how iterative adjustments built trust with participants Results: Preliminary findings indicate that recruitment effectiveness hinged on trust, transparency, and language choice rather than the platform. Neutral, curiosity-based framing increased engagement, while clinical or risk-oriented language reduced it. Algorithmic moderation required adaptive phrasing and timing, and snowball sampling through peer networks proved most successful. These results highlight recruitment as an act of care, grounded in empathy, privacy, and participant agency. For health sciences librarians, this study demonstrates how trauma-informed, trust-centered recruitment practices can strengthen ethically responsible research design and support faculty and community partners working with hard-to-reach or stigmatized populations. Conclusions: This study concludes that recruitment for sensitive, digitally mediated health research must be reframed as an ethical, relational process rather than a procedural one. Across platforms, transparency, neutral framing, and participant agency were critical to building trust with young adults discussing stigmatized topics such as sexual health. Emerging trends in the field, particularly the rise of algorithmic moderation and growing attention to trauma-informed research, underscore the need for adaptable, care-centered methodologies. For health sciences librarians, these findings highlight expanding roles as research partners who can guide ethical recruitment design, privacy-conscious data practices, and inclusive communication strategies that ensure marginalized voices are represented responsibly

The Role of Intravascular Ultrasound Imaging in 30-Day Readmissions Among Acute ST-Elevation Myocardial Infarction Patients

Cardiovascular disease (CVD) remains one of the leading causes of death in the United States. Coronary artery disease (CAD) is the largest contributor to deaths that result from cardiovascular disease. When CAD is left untreated, it can result in an acute ST elevation myocardial infarction (STEMI). To treat coronary blockages caused by CAD, a percutaneous coronary intervention (PCI) is performed. A PCI is a non-invasive procedure that uses coronary balloons and stents to open a narrowed or blocked coronary artery and restore blood flow. An acute ST elevation myocardial infarction (STEMI) is a major cause of early hospital readmissions. Technological advancements have improved clinical outcomes in PCI procedures. In recent years, advancements such as intravascular ultrasound (IVUS) have improved stent optimization, arterial imaging, and stent deployment. Despite these innovations, readmissions within 30 days remain a challenge for healthcare organizations. Existing studies have shown that IVUS significantly affects long-term outcomes; there is limited evidence of its impact on short-term outcomes, such as 30-day admissions. The purpose of this study is to examine the role of IVUS in 30-day readmissions among Medicare patients diagnosed with an acute ST-elevation myocardial infarction. This study used a quantitative, retrospective observational approach to examine the impact of IVUS-guided PCI on 30-day readmissions in Medicare patients versus angiography-guided PCI. The study population was derived from the Medicare 5% LDS. Using ICD-10 and CPT codes, patients were identified with an acute ST elevation myocardial infarction diagnosis. A multivariable logistic regression analysis was used to compare IVUS-guided PCI with angiography-guided PCI and to assess the association with 30-day readmission, controlling for demographics. The findings of the study suggest that procedural innovations and advancements, such as IVUS, affect procedural outcomes but are not statistically significantly associated with 30-day readmissions. The findings suggest that other variables, such as comorbidities and socioeconomic barriers, are statistically significantly associated with 30-day readmissions. These results highlight the importance of addressing health disparities among high-risk populations, tailoring healthcare to the individual patient, and implementing practices that prioritize post-discharge care

Cerebrovascular and Inflammatory Effects of High-Fat Diet Induced Midlife Obesity in Alzheimer’s Disease

Alzheimer’s disease (AD) is a complex and progressive neurodegenerative disorder affecting approximately 7.2 million Americans aged 65 and older. While advancing age remains the primary risk factor, lifestyle factors also play a significant role in disease progression. AD is no longer viewed exclusively as a condition defined by amyloid plaque deposition and neurofibrillary tangles; it is now recognized as a multifaceted pathology involving significant disruption of the brain’s vascular system, leading to impaired cerebral blood flow and neuroinflammation. Obesity, which affects nearly half of the adult population in the United States, has been strongly linked to cognitive impairment and an increased risk of age-related dementia. Based on an extensive review of the literature (Chapter 2), the central hypothesis of this dissertation proposes that high-fat diet (HFD)-induced mid-life obesity drives metabolic stress and early cerebrovascular dysfunction. These changes result in impaired cerebral blood flow, which in turn prime neuroinflammatory signaling pathways and accelerate AD-related pathology and cognitive decline (Chapter 1). To test this hypothesis, multiple aspects of disease pathology were examined as described in the methodology section (Chapter 3). These included measurement of cortical cerebral blood flow, circulating serum biomarkers, amyloid pathology, differential gene expression, exploratory behavior, and cognitive function in APP/PS1 mice, a preclinical mouse model of AD following diet-induced obesity. Our findings show (Chapter 4) that the metabolic dysfunction induced by the HFD leads to region-specific impairments in cerebral blood flow, alterations in circulating biomarkers, changes in exploratory behavior, and shifts in gene expression associated with hypoperfusion, metabolic stress, and early immune priming. Notably, these changes occur prior to clear cognitive deficits or significant amyloid plaque accumulation. As discussed in Chapter 5, we conclude that diet-induced obesity exacerbates early signs of AD via cerebrovascular axis

Examining Hospital Admissions Among Patients (0-21 years) with Autism Spectrum Disorder: A Quantitative Analysis

Nationwide, one in 31 children are diagnosed with Autism Spectrum Disorder (ASD), a neurodevelopmental condition associated with substantial healthcare utilization, family burden, and rising system-level costs. Evidence-based interventions such as Applied Behavior Analysis (ABA) have demonstrated improved developmental and behavioral outcomes; however, their relationship to hospitalizations outcomes remain underexamined nationwide. This study employs a retrospective secondary analysis of the 2023 Merative MarketScan Commercial database to examine hospitalization patterns among privately insured children and youth aged 0–21 years diagnosed with ASD. The study aims to 1) describe ASD-related hospitalizations and length of stay, 2) evaluate whether ABA therapy exposure is associated with hospitalizations, and 3) assess geographic differences in hospitalization outcomes. Descriptive statistics were used to examine the sample population, and multivariable regression models were used to examine associations between ABA therapy exposure and hospitalization outcomes while adjusting for demographic characteristics and comorbidities identified using the Pediatric Complex Chronic Conditions algorithm. This research addresses critical gaps in understanding how evidence-based interventions and system-level factors are associated with hospital utilization among children and youth with ASD. Findings are expected to inform health policy, payer strategies, and care coordination models aimed at reducing avoidable hospitalizations, improving equity in access to autism care, and advancing value-based approaches for ASD service delivery

Out-of-Pocket Cost Burden in Outpatient Orthopedic Surgery: Economic Drivers and Opportunities for Alignment

Introduction: Out-of-pocket costs represent a growing financial burden for patients; however, the magnitude of out-of-pocket costs across surgical care settings remains underexamined and under-documented, as many expenses (economic, opportunistic, and otherwise) are not captured within claims data, and impact patients and their families when accessing care. This study examines the impact of the outpatient surgical care setting on out-of-pocket costs when undergoing high-volume outpatient orthopedic surgery in the US. Methods: We conducted a retrospective, quasi-experimental study analyzing the top 10 outpatient orthopedic surgeries in the 2023 Merative MarketScan Commercial and Medicare research databases, with a quantitative analysis focusing on the impact of site of service (ASC vs. HOPD) on out-of-pocket costs. To control for selection bias, we propensity-matched patients (1:1) to model the propensity for site of service using patient demographic, financial, and clinical variables. We then modeled out-of-pocket costs using a doubly-robust regression to estimate cost differences. Results: While the total cost of care was 23% higher in the HOPD than in the ASC, the opposite was true for out-of-pocket costs, which were 5% lower in the HOPD than in the ASC. Conclusions: Financial cost savings associated with the transition from HOPD to ASC have not yet translated into out-of-pocket costs, leading to a lack of awareness and incentives for patients to consider the cost of care. Addressing these gaps will require targeted policy responses to increase systemic awareness and alignment of incentives to reduce costs in orthopedic surgery

Geographic Patterns of Pediatric Health and Opportunity: An Analysis of Social Vulnerability, Community Context, and Health Outcomes in South Carolina

Pediatric health outcomes are influenced not only by clinical factors but also by the social and environmental conditions in which children live, yet this relationship remains underexplored at the community level. This retrospective, ecological study integrated all-payer claims data (2022) for South Carolina (SC) children and adolescents (≤19 years) with county-level Social Vulnerability Index (SVI) and Child Opportunity Index (COI) data to identify geographic hotspots of pediatric health conditions and assess associations with community-level factors. This hotspot analysis examined clustering of asthma, vaccine-preventable illnesses, mental health disorders, and avoidable hospitalizations, with a multivariable regression model controlling for rurality. Among the 134,185 healthcare encounters across 46 counties, significant geographic clustering was identified, with hotspots concentrated in high-SVI counties along the southern interior corridor of SC. Counties in the highest vulnerability quartile demonstrated elevated rates of asthma, preventable hospitalizations, and injury/trauma. A spatial analysis identified 13 hotspot counties, which were predominantly rural with small pediatric populations. Counties with large pediatric populations and moderate prevalence rates contributed disproportionately to the overall prevalence despite not meeting hotspot criteria. Pediatric health outcomes in South Carolina are not randomly distributed across the state. They follow clear geographic patterns and are linked to social vulnerability and opportunity, underscoring the need for targeted, place-based interventions to advance health equity

The Impact of the Different VDAC Isoforms on HBV Replication and HBx Localization

Chronic hepatitis B virus (HBV) infection is the leading cause of hepatocellular carcinoma worldwide. Despite the availability of a preventative vaccine, there are approximately 254 million people living with a chronic HBV infection. There are 9 known HBV genotypes, each with their own clinical impacts and manifestation in infected patients. HBx is the only regulatory protein encoded by the HBV genome and is required for efficient viral replication. HBx has many effects in infected hepatocytes besides known effects on HBV replication, such as localization to the mitochondria. HBx is also known to have impacts on mitochondrial membrane potential, mitochondrial permeability transition pore activity, and mitochondrial calcium homeostasis. Specifically, HBx is known to localize to the outer mitochondrial membrane (OMM) and interact with voltage dependent anion channel 3 (VDAC3). There are three isoforms of VDAC expressed by human cells: VDAC1, VDAC2, and VDAC3. There are various pathogens that utilize VDAC and mitochondrial biology to benefit their own life cycle or survival. In our studies, we aimed to understand the impact that VDAC isoform expression had on HBV replication and HBx localization. We utilized HepG2 cell lines that only expressed one isoform of VDAC and measured HBV replication and HBx localization to mitochondria. We found that HBV genotypes had differential replication depending on the VDAC isoform present. Cells with only VDAC1 expression showed drastically increased replication, while cells with only VDAC2 or VDAC3 showed lower viral replication across most genotypes tested. Additionally, HBx was found to localize to both VDAC1 and VDAC3, but not VDAC2. These studies uncover more about the importance of not only knowing which proteins HBx may interact with in cells, but also the impact on the virus because of the interaction. The new interaction of HBx-VDAC1 and the increased replication with only VDAC1 expression opens new avenues to therapies for HBV infected individuals and deepens the understanding of HBV biology