Digital Commons Network^™

Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau

Theses and Dissertations

Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …

Department Chairs’ Impact On The Diversity, Equity, And Inclusion Of Their Departments, Nicholas R. Garcia Ii

Theses and Dissertations

Department chairs serve not only as the leaders of their departments but also as middle managers in their schools, colleges, and universities. While many department chairs see their role as having little authority, they still play an integral role in day-to-day campus operations (Hunt & Jones, 2015). As leaders of their departments, chairs can directly influence the department’s organizational culture (Schein, 2010), including the culture of diversity and inclusiveness. Departments nationwide are being held responsible for increasing the diversity of the faculty and responding to students' calls for diversity. Departmental organizational culture and the role of the chairperson are essential …

Children With Special Healthcare Needs: The Cost Of Medical Care, Kasey Dye

Theses and Dissertations

The purpose of this study was to explore factors that impact children with special healthcare needs’ (CSHCN) health insurance coverage and out-of-pocket medical expenses. The Ecological Model for Health Promotion developed by McLeroy et al. (1988) was the guiding theoretical framework for this study. Using data from the 2020 National Survey of Children’s Health, I conducted descriptive statistics, logistic regressions, and multilevel modeling analyses to determine if health insurance coverage and out-of-pocket expenses for CSHCN differed by individual, family, and community, organization, and policy factors. Results indicated that race, gender, disorder category, insurance type, and family’s federal poverty level were …

Assessing The Relationships Between Direct And Vicarious Exposure To Healthcare Discrimination And Erasure, Mistrust In Healthcare, And The Healthcare Utilization Behaviors Among Transgender And Gender Independent Individuals, Kyle L. Mason

Theses and Dissertations

Healthcare inaccessibility through direct exposure (i.e., personal) to myriad forms of gender identity-related discrimination and erasure among the Transgender and Gender Independent (TGI) population has been documented by prior studies. The myriad barriers that individuals who embody TGI identities encounter to accessing healthcare are associated with the underutilization of healthcare, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of the harm that direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, their exposure to such harm vicariously (i.e., through observation …

Underrepresentation Of Black Participants In Drug Court: Reasons Reported For Non-Admission In Six Jurisdictions, Kathryn J. Genthon

Theses and Dissertations

Despite the beneficial impacts of drug court participation, access to these programs may not be equitable across racial groups. The reasons behind racial disparities in access to these programs are not well-documented in the current literature. This study investigates disparities in access to drug court and the possible reasons they occur. Chi-square tests are used to assess for disparities in admissions between Black and White individuals referred to drug court. Additional statistical analyses addressed the association of sex and age with admission to provide a broader picture of the impact of a variety of demographic characteristics on admission to drug …

Academic Health Science Centers And Health Disparities: A Qualitative Review Of The Intervening Role Of The Electronic Health Record And Social Determinants Of Health, Wies Rafi

Theses and Dissertations

Literature on the magnitude of negative health outcomes from health disparities is voluminous. Defined as the health effects of racism, environmental injustice, forms of discrimination, biases in science, and sociological or socioeconomic predictors across populations, health disparities are part of an ongoing and complicated national problem that health equity programs are specifically designed to address. Academic Health Science Centers (AHC) institutions are a complex and unique educational-healthcare ecosystem that often serves as a safety net for patients in vulnerable and lower-income communities. These institutions are often viewed as one of the most uniquely positioned entities in the U.S. with an …

The Civil Right To Belong: A Case Study On Immigrant Integration Of Muslim Students In Educational Institutions, Mamoona H. Siddiqui

Theses and Dissertations

Constitutional equal protection values serve as social integration policies for new Americans and generations that follow. They promise equal opportunity, fair treatment, protection from unlawful discrimination, and freedom to preserve cultural identities in their new communities. However, in times of national security crises and political polarization, the disjuncture in the way equal protection doctrines have been historically implemented often reflect deep-rooted inequities that impact underrepresented communities. American Muslims are one such community in which members have experienced anti-Muslim and anti-immigrant sentiment particularly after 9/11 and political polarization on immigration and civil rights policies. The study explores the equal protection doctrine …

Preventing Obesity: A Social Ecological Exploration Of Centers For Disease Control Prevention Strategies And Guidance Toward Healthy Eating, Physical Activity, And Communities, Ryan Kelly

Theses and Dissertations

Abstract

Obesity has reached nearly 40% of the adult public in the United States, costing the citizen taxpayer over $200 billion annually in healthcare costs. Those suffering from obesity deal with multiple physical and mental repercussions. Through a content analysis of four Centers for Disease Control (CDC) documents and guided by the conceptual framework of the social ecological model, this research explores the federal approach to preventing obesity. The analysis finds that CDC solutions to obesity involve connecting people to each other and healthier choices, an orientation toward local public administration, and an emphasis on environmental and infrastructure improvements. The …

Cost-Effectiveness Of Interventions Targeting Hard-To-Reach Populations Living With Hiv In Eastern And Southern Africa, Deo Mujwara

Theses and Dissertations

In Eastern and Southern Africa, hard-to-reach populations (e.g., long distance truck drivers and female sex workers), defined as populations that are difficult to interact or engage with due to their unique behaviors and characteristics, are disproportionately affected by the HIV epidemic and are at high-risk of acquiring and transmitting HIV. Further, these populations have substantially low uptake of HIV testing services, and those that have been diagnosed with HIV and on antiretroviral therapy experience high loss-to-follow-up from treatment programs.

Hard-to-reach populations face unique barriers in accessing and utilizing routine HIV care such as provider stigmatization towards sex workers and highly …

Perceived Organizational Support For Women’S Advancement And Turnover Intentions And Career Advancement Aspirations. The Mediating Role Of Job And Employer Satisfaction., Marta Squadrito

Theses and Dissertations

The purpose of this research is to examine whether the lack of organizational support for women’s advancement decreases female supervisors and managers’ aspiration to advance their careers and increases their turnover intentions and, the mediating effect of job satisfaction and employer satisfaction on the relationship between support and advancement aspirations and turnover intentions.

The antecedents of turnover intentions have been widely studied in the literature, while the antecedents of career aspirations, especially women’s, have not been a focus of much scholarly attention. Based on a review of the literature and drawing upon social exchange theory, and social cognitive theory, it …

Gender Equity Implications Of Nonprofit Youth Programs: Education Outcomes Of Three African American-Led Nonprofits, Yali Pang

Theses and Dissertations

Significant racial and gender differences in school performance have been a great concern in the past decades, and especially the significant differences in education performance between both Black youth and other racial groups and between Black males and Black females. Nonprofit youth programs are increasingly considered a promising intervention that can effectively improve Black youth development and education outcomes. While there is a growing body of literature evaluating the outcomes of nonprofit youth programs, little is known about gender differences in the outcomes, and specifically whether these nonprofit programs are equally effective for both Black males and females. This study …

Associations Between Social Determinants Of Health And Chlamydia Infections Among Georgia Counties, Bre'auna K. Beasley

Theses and Dissertations

Chlamydia is a growing public health concern that disproportionately impacts southern states. While social determinants of health are not direct causes of chlamydia infections, studies have found that these determinants do influence infections by creating environments that promote or hinder health seeking behaviors, as well as exposure to risk factors. Guided by the Social Ecological Model of Public Health and the Healthy People 2030 Social Determinants of Health Conceptual Framework, this dissertation study aimed to examine the associations between social determinants of health and chlamydia infections among Georgia counties. This study employed a correlational research design. Aggregate-level secondary data for …

First-Year Retention At Virginia Commonwealth University: Understanding Student Departure And The Potential Impact Of Academic Advising, Ben Plache

Theses and Dissertations

This dissertation examines first-year enrollment at Virginia Commonwealth University to determine what factors are associated with an increased likelihood of a student not being retained, and for which of these factors there is evidence that academic advising is an effective intervention. A survey of common retention models identified six factors associated with retention likelihood: student background prior to enrollment (“pre-enrollment factors”), financial support, institutional support, institutional performance, institutional engagement, and student intention. Prior research has shown that academic advising is an effective intervention for two of these factors: institutional performance and institutional support.

The significance of these factors was tested …

The Impact Of Registered Apprenticeships On The Middle-Skills Gap In Virginia, Yolanda Macklin Crewe

Theses and Dissertations

The skills gap debate has raged among scholars and policymakers for the last few decades. The key questions are whether the gap exists, the extent of the gap and how to minimize the gap. Of particular concern is a skills gap for middle-skills occupations. Since 2014, the federal government has invested over $500 million in registered apprenticeships as a strategy to address the skills gap. Likewise, Virginia has invested over $7.5 million and implemented policies such as VA Executive Order 49 (EO49), to expand registered apprenticeships as a workforce strategy to diminish the skills gap.

The goal of this research …

A Comparative Study Of The Influence Of Credential Attainment On Employment Outcomes In Rural And Urban Localities, Carrie S. Douglas

Theses and Dissertations

The significance of credentials has heightened considerably in recent decades with numerous federal and state policy initiatives aimed at increasing credential attainment. Various public workforce programs support these efforts, including the federal Workforce Investment Act (WIA), which provided training to job-seekers from 1998 through 2015. Scholars point to human capital theory to explain how education investments yield economic gains. Screening, signaling, and credentialist theories provide a framework for examining the ways that credentials are used in labor markets. The literature on rural labor markets suggests that conditions are very different from their urban counterparts, with significant challenges existing in terms …

Why We Use A New Currency: The Role Of Trust And Control In Explaining The Perception And Usage Of Bitcoin, Joseph B. Walton

Theses and Dissertations

Social media, e-commerce, global peer-to-peer technologies, and the near ubiquity of computers and smartphones allow people to interact, trust, and exchange value across traditional socio-economic control boundaries and over significant distances. Since the creation in 2008 of a new cryptographic currency system called Bitcoin, a financial technology market sector of about 250 billion USD has rapidly emerged, raising questions about the nature of currency in society and whether new types of non-national money are warranted and viable. This debate has pitted heterodox economic interests against orthodox economic interests while it has rekindled interest in theories that view money as a …

The Nail That Sticks Up Isn't Always Hammered Down: Women, Employment Discrimination, And Litigiousness In Japan, Kristen Luck

Theses and Dissertations

Much recent scholarship is devoted to projecting Japan’s future and analyzing its prospects as a global power. After two decades of economic stagnation, alarming demographic trends, and the 3/11 triple disaster, some scholars argue that Japan is grappling with an era of precarity, marked with instability and anxiety. Prime Minister Shinzo Abe returned to office in 2012, promoting his economic reform policy, “Abenomics” and within the third “arrow" of this approach targeting structural reforms, he promoted “womenomics”, a term coined by Kathy Matsui of Goldman-Sachs. Prime Minister Abe’s objective is to create a society where "women can shine” and women …

Students’ Awareness, Knowledge, And Perceptions Of Mandatory Reporting Of Sexual Victimization On College Campuses, Dhara Minesh Amin

Theses and Dissertations

The purpose of this study is to identify students’ awareness, knowledge, and perceptions of the mandatory reporting policy related to Title IX of the Education Amendments of 1972 (Title IX). Mandatory reporting requirements are being implemented in higher educational institutions; however, existing literature does not examine students’ perceptions or their knowledge of the specific requirements that apply exclusively to them. This exploratory study examines the perceptions of college students at Virginia Commonwealth University (VCU) in Richmond, Virginia. Drawing on survey data (N = 501) from a large, public research university, the study explores two outcome variables: students’ awareness of the …

Understanding Effectiveness Of A Diverse Board In The Nonprofit Sector: The Role Of Board Inclusion & Critical Mass Of The Diverse Board Members, Suparna Dutta

Theses and Dissertations

Using rated responses from nonprofit CEOs who participated in the 2016 BoardSource national survey, this study investigates whether nonprofit board inclusive behavior or board inclusive practices are positively correlated with nonprofit board effectiveness. It further examines whether a critical mass of racial and ethnic minority or women board members may moderate the relationship stated above. To answer these questions, the study tested six hypotheses using principal component analysis, followed by hierarchical regression analysis, and found no evidence of statistical significance in main or moderator effects. The study recommends that policymakers should frame policies that ensure mandatory quotas for women and …

Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker

Theses and Dissertations

Provider incentives are a commonly used policy tool to mold provider behaviors.¹ However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.

Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic …

The Racialization Of Space: How Housing Segregation Caused The Racial Wealth Gap In The United States, Tia Goode

Theses and Dissertations

This project addresses how residential segregation have stymied home ownership and wealth in the black community; inhibiting true housing equity. This thesis project will attempt to use design as a means to help address past and continuing discrimination. Accessibility, affordability and accountability are central to this goal, which will be addressed in the project.

The site chosen for this project is the St. Luke’s Building located in Richmond, VA. This building was home to the Independent Order of St. Luke, a fraternal and cooperative insurance society for blacks. It also housed the St. Luke Penny Savings Bank which was founded …

Feedback And Innovative Work Behavior Among Local Government Employees In Korea: The Roles Of Trust In Supervisor, Affective Commitment, And Risk-Taking Climate, Hyeonuk Bak

Theses and Dissertations

The purpose of this study is to explore the mechanisms of how feedback from supervisor affects innovative work behavior among local government employees in Korea. Another purpose of this study is to explore the mediating roles of trust in supervisor and affective commitment, and the moderating role of risk-taking climate, using various theories, such as organizational support theory, social exchange theory, intrinsic motivation theory, and psychological climate theory.

The results from a cross-sectional study based on a sample of 1,699 local government employees from 65 local governments find that feedback from supervisor has a significant direct effect on innovative work …

Spillover Theory: Unintended Consequences Of Provisions In The Affordable Care Act, Robert T. Braun

Theses and Dissertations

Objective: To examine spillovers from a federal policy, managed care market, and community perspective.

Data Sources/Study Setting: We studied spillovers from a federal policy and managed care market perspective using the Health Care Utilization Project’s (HCUP) State Inpatient Database (SID). American Hospital Association (AHA) data, Interstudy Commercial Managed Care, and Area Health Resource File (AHRF). Medicare Advantage county-level payment schedules originate from CMS. We examined community uninsurance spillovers using 2011-2015 Medical Expenditure Panel Survey (MEPS), the Area Health Resource File (AHRF), and the Small Area Health Insurance Estimator (SAHIE).

Study Design: Ordinary Least Squares (OLS) and difference-in-difference regression analyses were …

Prosecution As The "Soul Crushing Job:" Complexities Of Campus Sexual Assault Cases, Tammi L. Slovinsky

Theses and Dissertations

On April 4, 2011, the U.S. Department of Education issued a Dear Colleague Letter on campus sexual assault reaffirming the intent of Title IX, the 1972 law that prohibits discrimination sex-based under any education program or activity receiving federal financial assistance. In response to growing concern over due process rights for defendants, in September 2017 the guidance was rescinded. Public policy continues to evolve, leading to potentially lasting institutional changes on many college campuses. These developments include the formalization of campus investigations and adjudications, the development of campus coordinating committees and expanded support mechanisms for victims. In Virginia, laws passed …

Why Local Governments Collaborate: Perspectives From Elected Officials And Local Government Managers On Regional Collaboration, Stephanie D. Davis

Theses and Dissertations

This study examined the factors that influence a local government’s decision to engage in regional collaborations. Analysis of 7 local government managers and eleven elected officials revealed that the decision to engage in regional collaboration was influenced by external factors, organizational factors, and internal motivations. Elected officials and local government managers identified a disaster occurrence, fiscal stress, outside agencies, jurisdictional benefit, and communication as key factors. Further, this research highlights the importance of the role of the elected official in intergovernmental arrangements, the role of the local government manager as the policy entrepreneur, and the influence of shared norms and …

Reliability And Stability Of The Six Question Disability Measure In The Current Population Survey: What The Data Can And Cannot Tell Us About Disability And Labor Force Participation, Jeffrey Joy Dr.

Theses and Dissertations

The Current Population Survey (CPS) has been a major source of disability data for public policy and research. The aim of this study was two-fold. First, the study examined the six disability measures added to the CPS in 2008 to determine if they are both a reliable and stable method of describing disability over a period of two survey administrations in a 12-month period. Second, this study then assessed the impact of disability upon labor force participation. This research used a subset of the respondents to the longitudinal CPS Annual Social and Economic Supplement; it included (N=11,721) respondents …

Affordability, Utilization And Satisfaction With Care: A Policy Context For Improving Health Care Experiences, Anushree M. Vichare

Theses and Dissertations

Disparate healthcare experiences continue to pose a challenge; vulnerable populations such as low-income and racial and ethnic minorities may not be able to afford or utilize care when needed or receive quality care. The sources of disparities are complex and multi-factorial, which include health care system-level factors such as insurance and health care workforce. It is relatively less known to what extent these contribute to disparities related to a patient’s overall health care experience across three important domains – affordability, utilization and satisfaction with care.

This dissertation has three objectives. First, to assess how insurance benefit design affects health care …

Recognizing Her Characteristics As A Leader: An Examination Of The Self-Assessment Of Women Leaders As Shaped By Social Identity Theory And The Concept Of Double Consciousness, John C. Gregory

Theses and Dissertations

Women leaders are grossly underrepresented in police and Army organizations and relevant research suggests that women face the most significant challenges in reaching leadership positions in male dominant organizations. Although there have been recent policy changes to increase opportunities for women in police and Army organizations, women are still barely represented in senior command and primary staff positions in police and Army organizations. When women are underrepresented, particularly at the most senior ranks, there are implications regarding cultural, structural, and attitudinal challenges that simply should not still exist in these organizations. Using qualitative methods, this study examined the experiences of …

Perceptions Of The Homeless Toward Nonprofit Human Service Provider, Lequan M. Hylton

Theses and Dissertations

As the debate intensifies regarding developing remedies to meet the needs of America’s homeless, one solution is for governmental agencies to collaborate with and employ organizations from the nonprofit sector to assist with the needs of the homeless population. Included in the nonprofit sector, faith-based organizations (FBOs) have historically been a source of debate and contention in terms of collaborations with the government. However, Presidents Reagan, George H. Bush, Clinton, George W. Bush, and Obama have embraced the idea of including FBOs in the pool of service providers offering human services. In the Richmond, Virginia region, FBOs and nonreligious nonprofit …

Influence Of Public Insurance On Healthcare Access And Cancer Care, Wafa W. Tarazi

Theses and Dissertations

Medicaid expansion under the Affordable Care Act (ACA) facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Tennessee’s Medicaid program experienced a dramatic Medicaid contraction when the program disenrolled approximately 170,000 nonelderly adults in 2005. Pre-ACA expansions were associated with better access to and utilization of healthcare services. However, little is known about the effect of these policy changes on improvement in health outcomes for women diagnosed with breast cancer, access to care for cancer survivors, and the effect of generosity and duration of expansion on access to care.

This dissertation has three …