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Maternal-Child Cortisol Attunement Differs In Preschoolers With Autism, Fragile X Syndrome, And Neurotypical Development, Rachel Hantman Aug 2024

Maternal-Child Cortisol Attunement Differs In Preschoolers With Autism, Fragile X Syndrome, And Neurotypical Development, Rachel Hantman

Theses and Dissertations

Early maternal-child attunement sets a critical foundation for later social development. While maternal and child cortisol attunement in neurotypical (NT) development has been clearly established, little research has examined these relations in neurodevelopmental populations, such as those with autism spectrum disorder (ASD) and Fragile X Syndrome (FXS). Given their elevated-risk for disrupted maternal-child attunement and given elevated stress and dysregulated cortisol patterns in both children with ASD and FXS and their parents independently, this is a critical gap. This study addressed this gap in the literature by examining early maternal-child cortisol attunement in 97 mother-child dyads (nNT = …


Associations Between Infant Vagal Regulation, Early Social Communication, And Socidemographic Risk, Tessa Djiko Aug 2024

Associations Between Infant Vagal Regulation, Early Social Communication, And Socidemographic Risk, Tessa Djiko

Theses and Dissertations

Respiratory sinus arrythmia (RSA), a measure of parasympathetic nervous system activation, has been linked to socioemotional and language development (Porges, 2007; Thayer & Lane, 2000). Children diagnosed with autism spectrum disorder (ASD) show lower RSA (Patriquin et al., 2011) while both children with ASD and children from lower SES backgrounds show differences in early social-communication development (Jones-Mason et al., 2018). However, little is known about interactions between sociodemographic risk and physiological regulation within the context of ASD and social-communication development. The present study addresses this gap by examining the relationship between RSA (as indexed by RSA suppression and resting-state RSA), …


The Importance Of Sense Of Community In Recovery For Individuals Living With Serious Mental Illness, Natalia Gomez Aug 2024

The Importance Of Sense Of Community In Recovery For Individuals Living With Serious Mental Illness, Natalia Gomez

Theses and Dissertations

People with serious mental illness face a variety of barriers to participating in community life. Some of these barriers include limits in social functioning which can then affect social relationships and life satisfaction (Sanchez et al, 2016). Devaluation based on mental health status is an important barrier to address due to its connection to stigma and relationships. The more an individual fears that they will be undervalued and discriminated against, the more they may fear interacting with others. They may hide that they are in mental health treatment or avoid social encounters that they consider as possibly rejecting. These behaviors …


Understanding The Impact Of Adverse Childhood Experiences On Borderline Features And Deliberate Self-Harm Behaviors Among College Students: The Mediating Roles Of Emotion Regulation And Interpersonal Functioning, Sydney Mari Levine Oct 2023

Understanding The Impact Of Adverse Childhood Experiences On Borderline Features And Deliberate Self-Harm Behaviors Among College Students: The Mediating Roles Of Emotion Regulation And Interpersonal Functioning, Sydney Mari Levine

Theses and Dissertations

Research has established ACEs as significant predictors of deliberate self-harm (DSH) in both clinical and community populations. Further, adults meeting criteria for borderline personality disorder (BPD) are nearly 14 times more likely to report childhood adversity. No previous studies have examined the critical roles of emotion regulation and interpersonal functioning as mediating mechanisms in these relations. Thus, the current study explored the mechanism by which ACEs affect borderline personality features (BPF) or deliberate self-harm through emotion regulation and interpersonal functioning in a sample of emerging adult college students. Participants (N = 2,255, M age = 19.25) included college students from …


Supporting Our Heroes: The Need For A Community Of A Community Of Practice Dedicated To The Support Of Military-Connected Families Living In The Southeastern United States, Ashley Gwyneth Monier Oct 2023

Supporting Our Heroes: The Need For A Community Of A Community Of Practice Dedicated To The Support Of Military-Connected Families Living In The Southeastern United States, Ashley Gwyneth Monier

Theses and Dissertations

Military families face unique challenges that many civilian families may not be familiar with, to include frequent geographical relocations and extended periods of separation due to military deployments. This study aims to identify the resources available to military families and identify gaps in services and programming to highlight the need for a Community of Practice dedicated to addressing issues that impact our all-volunteer force in the southeastern United States. Furthermore, this study aims to give a voice to the military community regarding the unique difficulties that are commonplace within the military life, to include regular mandated geographical relocations and extended …


Piloting Brief, Just-In-Time Training Videos For Mentors: Expanding And Strengthening Motivational Interviewing For Youth, Mackenzie J. Hart Oct 2023

Piloting Brief, Just-In-Time Training Videos For Mentors: Expanding And Strengthening Motivational Interviewing For Youth, Mackenzie J. Hart

Theses and Dissertations

Having paraprofessional providers, such as youth mentors, deliver evidence-based services, has been posited to increase the reach of youth services given the affordability and ubiquity of mentors in school settings. Further, examinations of mentor-delivered Motivational Interviewing (MI) have shown promise in increasing youth mentees’ academic performance and wellbeing. Yet, traditional methods used for training mentors to use MI effectively and sustainably can be costly and time-consuming processes. Previous work has suggested the value of asynchronous, brief, just-in-time trainings (JITTs) to help offset these challenges; however, MI JITTs for mentors have not yet been formally evaluated. As such, the present study …


The Effect Of Model Size On The Root Mean Square Error Of Approximation (Rmsea): The Nonnormal Case, Yunhang Yin Oct 2023

The Effect Of Model Size On The Root Mean Square Error Of Approximation (Rmsea): The Nonnormal Case, Yunhang Yin

Theses and Dissertations

This study aimed to understand the effect of model size on the Root Mean Square Error of Approximation (RMSEA) under nonnormal data. We considered three methods for computing the sample RMSEA and the associated confidence intervals (i.e., the normal theory method [Browne & Cudeck, 1993], the BSL method [Brosseau-Liard, Savalei & Li, 2012], and the Lai method [Lai, 2020]). The performance of the three methods was compared across various model sizes, sample sizes, levels of misspecification, and levels of nonnormality. Results indicated that the normal theory RMSEA should not be used under nonnormal data unless the model size is very …


The Association Between Symptoms Of Adhd And Alcohol Use And Related Consequences In College Students: Social And Environmental Protective And Risk Factors As Moderators Of This Relation, Cameron Shepard Massey Oct 2023

The Association Between Symptoms Of Adhd And Alcohol Use And Related Consequences In College Students: Social And Environmental Protective And Risk Factors As Moderators Of This Relation, Cameron Shepard Massey

Theses and Dissertations

Alcohol use, while common in college student populations, can bring about significant mental health and educational problems that have negative consequences (Harris et al., 2017; White & Hingson, 2013). Attention-deficit/hyperactivity disorder (ADHD) can also result in significant impairment in academic settings (Kuriyan et al., 2012; Blase et al., 2009, Barbaresi et al., 2007), and those with ADHD often show increased rates of alcohol consumption and related problems, which can greatly increase the risk for students to struggle in college (Barbaresi et al., 2013; Baker et al., 2012). Examining the impact that specific risk and protective factors play in this relation …


Neural Correlates Of Audiovisual Integration, Jonathan Conrady Oct 2023

Neural Correlates Of Audiovisual Integration, Jonathan Conrady

Theses and Dissertations

Successfully integrating multiple streams of information is paired with a variety of behavioral enhancements. Multisensory research over the past few decades has demonstrated the criticality of spatial proximity and stimulus effectiveness. Here, we focused on the temporal aspects and underlying neural activity of frequency-varying, audiovisual stimuli using scalp recorded electroencephalography (EEG). Our set of stimuli was particularly chosen because humans are most sensitive to the auditory sound and visual spatial frequencies that make up speech. Recent work has shown that audiovisual integration effects of low-level, simple stimuli are largest when both modalities fall within, compared to outside of, their respective …


The Effects Of Poly-Strengths On Psychological Wellbeing Amongst Young Adults With Childhood Poly-Victimization, Nakisa Asefnia Jul 2023

The Effects Of Poly-Strengths On Psychological Wellbeing Amongst Young Adults With Childhood Poly-Victimization, Nakisa Asefnia

Theses and Dissertations

The field of trauma and victimization has undergone many evolutions in its efforts to conceptualize the impacts of victimization and more recently poly-victimization. Poly-victimization refers to the experiencing of multiple types of victimization over the lifespan. This has led to an ever-growing base of literature highlighting the many deleterious effects of these experiences on individuals’ wellbeing, and the factors which may make a person more vulnerable to victimization. However, a growing movement in the field aims to take a more strengths-based perspective that highlights the resilience of individuals, rather than risk factors, in the hopes of better understanding the factors …


Comorbid Adhd And Pediatric Sickle Cell Disease: Prevalence And Risk Factors, Sarah Bills Jul 2023

Comorbid Adhd And Pediatric Sickle Cell Disease: Prevalence And Risk Factors, Sarah Bills

Theses and Dissertations

Objective: Sickle cell disease (SCD) is a genetic blood condition that places youth at increased risk for deficits in attention and executive functioning suggestive of increased rates of Attention Deficit/Hyperactivity Disorder (ADHD). There is pronounced inconsistency in reported prevalence rates for attention deficits and ADHD diagnoses among youth with SCD, which is due in part to variability in methodology of previous studies. The primary aim of the present study is to use systematic screening to identify the prevalence of inattentive ADHD symptoms and ADHD diagnoses in a pediatric SCD population seen at a large hematology clinic. A secondary aim is …


An Examination Of Sustained Attention During Complex Multitasking Scenarios, Jonathan Cheshire Rann Jul 2023

An Examination Of Sustained Attention During Complex Multitasking Scenarios, Jonathan Cheshire Rann

Theses and Dissertations

This dissertation project examined the time-course of vigilance decrements that occur when operators perform demanding multitasking activities. For this aim, we conducted three experiments which implemented a novel paradigm we developed that measured performance during two sessions: a Single-Task session in which participants performed a go-no-go target detection task in the absence of any other task for approximately 12 minutes; and a Multi-Task session in which participants performed the detection task simultaneously with a driving-based tracking task for the same duration. A total of 183 participants from the University of South Carolina Department of Psychology took part in this study. …


Neural Mechanisms Of Lexical Semantics: Investigating The Roles Of Hubs And Distributed Action-Perception Systems, Nicholas Andrew Riccardi Jul 2023

Neural Mechanisms Of Lexical Semantics: Investigating The Roles Of Hubs And Distributed Action-Perception Systems, Nicholas Andrew Riccardi

Theses and Dissertations

Understanding the meaning of words and concepts is vital for communication, forming relationships, and navigating everyday life. Loss of this knowledge through brain damage can have drastic consequences for one’s health and well-being. It is therefore important to learn how this information is organized anatomically in the brain. In this dissertation, I report a series of structural and functional neuroimaging studies in healthy adults and survivors of stroke seeking to understand how lexical semantics are represented. Specifically, I used a variety of tasks to examine the contributions of putative ‘hubs’ and distributed action-perception systems. Results indicated that damage or disruption …


An Exploration Of Racial Trauma And Protective Factors In Black Youth, Daria Chantal Thompson Jul 2023

An Exploration Of Racial Trauma And Protective Factors In Black Youth, Daria Chantal Thompson

Theses and Dissertations

Black students’ experiences in school can vary due to racism and discrimination within and outside of the classroom, which can impact their academic progress and overall well-being. In this three-part study, the impact of discrimination is observed to determine if there is a long-term effect of these situations and, if so, determine if there is utility to implement school-based resources to decrease these negative effects. The first study examined whether ethnic-racial socialization in childhood could moderate against symptoms of trauma in young adulthood that were potentially caused by discrimination from peers and teachers in childhood through hierarchical regressions. The second …


Parent Facilitation Of Child Emotion Regulation In Autism Spectrum Disorder, Aimee K. Rovane Jul 2023

Parent Facilitation Of Child Emotion Regulation In Autism Spectrum Disorder, Aimee K. Rovane

Theses and Dissertations

Parents play a substantial role in their children's emotional regulation (ER) abilities, promoting both adaptive and maladaptive development. Children with autism spectrum disorder (ASD) often have difficulties regulating their emotions, manifesting in externalizing behavioral issues (Mazefsky & White 2014). Though there are many similarities to parents of typically developing (TD) children, parents of children with ASD facilitate their children's ER development (i.e., emotion socialization) in response to unique challenges, often developing resiliency but other times contributing to their children’s dysregulation and behavioral challenges. Using Morris et al.'s (2007) Tripartite Model of Family Impact of Children's Emotion Regulation and Adjustment as …


Effects Of Parenting And Self-Efficacy On Diet, Family Mealtime And Weight-Related Outcomes In African American Adolescents, Haylee Michele Loncar Jul 2023

Effects Of Parenting And Self-Efficacy On Diet, Family Mealtime And Weight-Related Outcomes In African American Adolescents, Haylee Michele Loncar

Theses and Dissertations

Despite substantial research and concern, adolescent overweight and obesity continues to be a significant public health problem. Theory based on developmental literature emphasizes the role of adolescent self-regulatory factors, like self-efficacy, in health behavior engagement and weight-related outcomes. There is also extensive literature that highlights parents’ role in promoting self-regulatory development through warm and responsive behaviors and practices. However, few studies have considered longitudinal associations and changes in weight-related outcomes over time, as well as moderated effects by parenting. This study assessed longitudinal associations between adolescent self-efficacy parenting factors and adolescent BMI, diet, and family mealtime to fill gaps in …


Feasibility Of A Parent-Focused, Stress Management Intervention To Decrease Adolescent Bmi, Reduce Stress, And Increase Well-Being Among African American Families, Colby J. Kipp Jul 2023

Feasibility Of A Parent-Focused, Stress Management Intervention To Decrease Adolescent Bmi, Reduce Stress, And Increase Well-Being Among African American Families, Colby J. Kipp

Theses and Dissertations

African American adolescents in the United States experience a higher prevalence of obesity as compared to their White counterparts. This health inequity presents a public health concern as consequences of weight-related chronic diseases often persist into adulthood and are increasingly problematic. As chronic stress has been found to be higher among African American youth compared to White adolescents, it presents as a potential barrier to participation for African American families in health promotion interventions. Additionally, it may be beneficial to target stress in health promotion programs as a modifiable factor in conjunction with health behaviors that may improve outcomes related …


Using Factor Mixture Modeling To Counter Faking, Raul Corrêa Ferraz Apr 2023

Using Factor Mixture Modeling To Counter Faking, Raul Corrêa Ferraz

Theses and Dissertations

Self-reports (SRs) of typical behavior are often the only existing feasible method to gather data on important drivers of human performance. In applications such as personnel selection, SRs are vulnerable to intentional distortions, often referred to as faking. A review of the literature suggests that so far, the methods proposed to address faking are unsatisfactory. In a recent breakthrough, Pavlov et al. (2019) showed that high-stakes scale scores are best modeled as a function of a) propensity to fake, b) honest scores, and c) the interaction of these two terms. Pavlov et al. did not, however, propose any method to …


Understanding Intergenerational Transmission And Frequency Of Ethnic-Racial Socialization Practices Among Racial Ethnic Minority Groups, Ryan Chantz Houston-Dial Apr 2023

Understanding Intergenerational Transmission And Frequency Of Ethnic-Racial Socialization Practices Among Racial Ethnic Minority Groups, Ryan Chantz Houston-Dial

Theses and Dissertations

Ethnic-racial socialization (ERS) is a multidimensional concept that can be defined as the transmission of attitudes, beliefs and messages about ethnic-racial group membership (Hughes et al., 2006). To counteract the negative effects of discriminatory experiences, ethnic minority parents proactively impart race-salient messages to their youth. Sociodemographic variables such as regional location has been shown to affect the frequency of ERS messages as well (Thornton et al., 1990). The current study examines ERS practices in 436 African American, Hispanic/Latinx and Asian American parents. This study also explores the concept of intergenerational transmission, in which parents pass on to their own children …


The Relation Between Adhd Symptoms And Life Satisfaction/Self-Esteem Among Youth: Family Structure And Parenting Practices As Moderators, Yvette Rother Apr 2023

The Relation Between Adhd Symptoms And Life Satisfaction/Self-Esteem Among Youth: Family Structure And Parenting Practices As Moderators, Yvette Rother

Theses and Dissertations

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) may be particularly vulnerable to lower life satisfaction and self-esteem, given negative perceptions about their abilities and self, as well as related impairments in academic, social, and interpersonal functioning. Family factors, such as family structure and parenting behaviors, can impact youth development and behaviors. However, it is unclear what role family factors play in the relation between ADHD symptoms and life satisfaction and self-esteem among youth. This study therefore examined whether ADHD symptoms have an impact on the life satisfaction and self-esteem of children and adolescents in grades 4-12. Moreover, it explored whether …


An Examination Of The Prevalence And Predictors Of Drugging Victimization And Drugging Perpetration In A National Sample, Amber Nicole Wallace Apr 2023

An Examination Of The Prevalence And Predictors Of Drugging Victimization And Drugging Perpetration In A National Sample, Amber Nicole Wallace

Theses and Dissertations

Objective: The current study sought to expand the understanding of the nascent phenomenon of drugging, the administering of a drug or alcohol substance to an individual without their knowledge or consent (Swan et al., 2017). Specifically, in this paper, the lifestyle-routine activities theory (L-RAT) is used as a framework to examine what factors may contribute to the occurrence of drugging. Prevalence rates of drugging victimization and drugging perpetration are examined by participant characteristics including gender, sexual orientation, and race/ethnicity, and by risk behaviors including illicit drug use, marijuana use, and binge drinking. Trait sensation seeking, which has been shown to …


Gratitude Buffers The Effects Of Stressful Life Events On Early Adolescents’ Life Satisfaction And Externalizing Behaviors But Not Internalizing Behaviors, Mimi Scott Webb Oct 2022

Gratitude Buffers The Effects Of Stressful Life Events On Early Adolescents’ Life Satisfaction And Externalizing Behaviors But Not Internalizing Behaviors, Mimi Scott Webb

Theses and Dissertations

Identifying psychological strengths that foster healthy development in youth has become a topic of exploration in the field of positive psychology (e.g., Suldo & Huebner, 2004; Valle et al., 2006). Gratitude is a promising trait-like characteristic with qualities indicative of a potential psychological strength that may serve as a protective factor for early adolescents in the face of stressful life events. This study utilized data from a sample of 1,880 middle school students from the Southeastern United States. Hierarchical regression analyses investigated gratitude’s role as a moderator in the relationship between stressful life events and adolescent well-being. Specifically, gratitude’s ability …


An Intersectional Lens To Covid-19: Promoting Youth Well-Being In The Midst Of Social-Political Stressors, Magdalena S. Moskal Oct 2022

An Intersectional Lens To Covid-19: Promoting Youth Well-Being In The Midst Of Social-Political Stressors, Magdalena S. Moskal

Theses and Dissertations

Guided by interpretative phenomenological methodology and intersectionality theory, this thesis aims to uncover the mental health experiences of youth surrounding the COVID-19 pandemic. This study also seeks to situate these experiences with the subsequent stressors that young people face in the current social-political context (e.g., witnessing trauma in the media, uprisings to address racism and the resulting backlash, rhetoric of the 2020 presidential election). Furthermore, this thesis aims to give insight and voice how intersectionality shapes the COVID-19-related experiences of youth in South Carolina. Data was collected through semi-structured interviews with 23 participants aged 16-21 years old in South Carolina. …


Predicting Therapists’ Intentions To Use An Innovation: The Role Of Innovation-Specific, Individual, And Organizational Factors, Jonathan KuʻUhoaepilipono Ahuna Oct 2022

Predicting Therapists’ Intentions To Use An Innovation: The Role Of Innovation-Specific, Individual, And Organizational Factors, Jonathan KuʻUhoaepilipono Ahuna

Theses and Dissertations

Understanding factors that contribute to an individual’s decision to use an innovation can increase the public health impact of innovations in children’s mental health services. Objective. This study examined whether and to what extent therapists’ innovation-specific judgements (e.g., innovation is easy to use, socially desirable) were associated with intentions to use an innovation using constructs from one of the most robust theories of innovation use–the Unified Theory of Acceptance and Use of Technology (UTAUT). Method. Two aims were addressed using data collected from 95 therapists and 28 supervisors who participated in a multi-site cluster randomized trial. Therapists used either a …


Belonging In Context: An Exploration Of Sense Of Belonging Among College Students, Ladonna L. Gleason Oct 2022

Belonging In Context: An Exploration Of Sense Of Belonging Among College Students, Ladonna L. Gleason

Theses and Dissertations

Feeling a sense of belonging is essential to human health and functioning and has been well documented in the literature. However, questions of context remain. Research in belonging has focused on social aspects of belonging, leaving broader contextual frames unexplored. There has been little work in identifying and differentiating the contexts in which belonging is experienced or in developing an understanding of how the experience of belonging differs across contexts. Current belonging theory lacks this important contextual perspective that could inform the ways in which belonging is constructed and reconstructed through disruption. With the advent of the COVID-19 pandemic, new …


Experiences Of Stigma, Social Support, And Anxiety In People Living With Hiv In South Carolina, Sarah J. Miller Oct 2022

Experiences Of Stigma, Social Support, And Anxiety In People Living With Hiv In South Carolina, Sarah J. Miller

Theses and Dissertations

People living with HIV (PLHIV) experience numerous psychosocial stressors, including HIV-related stigma and heightened prevalence of mental health disorders such as depression, substance use disorders, and anxiety. However, limited research has investigated predictors of anxiety within this population. This study aimed to explore the relationship between HIV-related stigma and anxiety symptoms among PLHIV in South Carolina (SC) and to examine the role of social support as a mediator for this relationship. A total of 402 PLHIV receiving HIV care at large immunology center in SC completed a paper and pencil survey, reporting sociodemographic variables, as well as experiences of HIV-related …


Sleep Challenges And Temperament Among Infants At Elevated Likelihood Of Autism Spectrum Disorder, Miranda Hope Foster Oct 2022

Sleep Challenges And Temperament Among Infants At Elevated Likelihood Of Autism Spectrum Disorder, Miranda Hope Foster

Theses and Dissertations

The current study used parent report in a prospective longitudinal design to examine the relationship between early sleep difficulties and temperament among infants with an older sibling diagnosed with ASD (EL-ASIB, n = 32), those born pre-term (EL-PT, n = 24) and those with no familial history of ASD (LL, n = 28) across the first year of life. At 3, 4, 6 and 12 months, caregivers completed the Short Form of the Infant Behavior Questionnaire-Revised (IBQ-R) (Putnam et al., 2014). To understand how sleep difficulties are related to temperament, a new scale of Sleep Challenges was created with items …


The Moderating Impact Of Gender And Friendship Quality On The Effects Of Interparental Conflict On Adolescent Internalizing Problems, Jessica Dandan Jul 2022

The Moderating Impact Of Gender And Friendship Quality On The Effects Of Interparental Conflict On Adolescent Internalizing Problems, Jessica Dandan

Theses and Dissertations

In response to escalating concerns about the increasing incidence of adolescent internalizing disorders, several mechanisms have been investigated to understand their etiology. Though genetic predisposition contributes to the risk for psychopathology, its interaction with environmental stressors such as interparental conflict appears to further increase this risk. Girls are more susceptible to stressors and twice as likely as boys to develop internalizing problems. However, friendship quality may buffer some of the adverse effects incurred from exposure to interparental conflict. A recent review of proposed mechanisms through which conflict is associated with youth psychopathology pinpointed the need for further adolescent-focused research including …


Cognitive Consequences Of Covid-19 Infection And Quarantine-Induced Social Isolation: Hope For The Young And Mildly Infected, Kristin Nickole Kirchner Jul 2022

Cognitive Consequences Of Covid-19 Infection And Quarantine-Induced Social Isolation: Hope For The Young And Mildly Infected, Kristin Nickole Kirchner

Theses and Dissertations

Coronavirus disease 2019 (COVID-19) has infected over 539 million individuals worldwide, and initial research supports the possibility that COVID-19 may damage the central nervous system either directly or indirectly. Neurological signs and noted cognitive deficits observed in even mildly infected patients are a cause for concern for those infected by COVID-19; the effect of social isolation on the central nervous system is also of interest. The present study sought to determine the extent of these potential cognitive deficits in a young and mildly infected sample of college students. Participants completed an extensive survey assessing their experience with COVID-19 and any …


Integrated Behavioral Health And Primary Care: Refining A Determinant Framework, Ariel Michelle Domlyn Jul 2022

Integrated Behavioral Health And Primary Care: Refining A Determinant Framework, Ariel Michelle Domlyn

Theses and Dissertations

The integration of behavioral health and primary care is a best practice to improve patient outcomes and achieve health equity. However, the process of integrating is opaque, requiring organizational change and sometimes a complete system overhaul. Implementation science offers useful ideas for helping healthcare organizations to implement care. This field has identified potential environmental conditions and determinants of successful implementation; however, much is still unknown about how these factors may be relevant for organizations seeking to integrate care. To address the limited existing knowledge in this area, this dissertation gathers practice-based evidence using exploratory methods. Results are translated into an …