Digital Commons Network^™

Pediatric Streptococcal Pharyngitis Testing And Treatment Practices, Amanda Welch

Dissertations

Objective: The purpose of this pilot quality improvement study was to implement SmartPhrases and assess its impact on adherence to the Infectious Disease Society of America (IDSA) guideline for Group A Streptococcus (GAS) pharyngitis testing and treatment in pediatric patients ages 1-16 years old. The aim was to use SmartPhrases to improve adherence with the IDSA guideline by 30% for GAS pharyngitis swabbing and 10% for appropriate antibiotic prescribing in three months.

Methods: A retrospective data analysis approach was used, in reviewing SmartPhrases data from the electronic health records (EHR) in a metropolitan Urgent Care. This data were collected from …

Evaluating Sbirt In A Behavioral Health Urgent Care, Christina L. Williams

Dissertations

Background: Adolescent substance use (SU) is a major health concern. Most youth who engage in alcohol and other SU do not meet criteria for SU disorder (SUD). Nonetheless, evidence shows SU during adolescence impacts cognitive, social, and emotional development, increases risk of physical injury, and may progress to SUD in adulthood. Only half of clinicians properly screen adolescents for SU; those identified with SUD often receive no intervention. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based intervention to address this problem. The purpose of this project was to evaluate implementation of SBIRT using CRAFFT 2.1+N, a SU …

Intimate Partner Violence Education For Pregnant And Postpartum Adolescents And Young Adults, Tatiana Filajdic

Dissertations

Abstract

Problem The commencement of intimate partner violence (IPV) often begins with relationships during adolescence and young adulthood; hence, young age is a risk factor. Young adult females, pregnant and post-partum adolescents are at high risk of experiencing intimate partner violence (IPV).

Methods A prospective, descriptive design evaluating the impact of three IPV education sessions offered over a three-month period at a non-profit shelter specific for young adult, pregnant and post-partum adolescents.

Results Twelve participants attended the sessions (N=12), and seven (n=7, 61.5%) of shelter residents attended at least one IPV education session. A two-proportion z …

Impact Of Violence Exposure On Children's Mental Health And Family Functioning: An Ecological-Transactional Approach, Rice Mary Dusing

Dissertations

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A Vaccine Administration Training Program To Increase Adolescent Vaccination Rates, Claire Jensen

Dissertations

Abstract

Immunizations have been proven to control life-threatening diseases. Often Registered Nurses (RNs) administer vaccines but are unsure how to discuss vaccines with vaccine hesitant patients. Missouri’s adolescent vaccination rates are below its neighboring states. This initiative’s purpose was to increase adolescent vaccine administrations at a Missouri County Health Department (MCHD).

This quality improvement initiative had an observational, cross-sectional, descriptive design. RNs employed at three MCHD clinics attended an adolescent vaccine administration training program (VAT) and completed pre-/post-tests regarding the Advisory Council on Immunization Practices recommendations. Medical record reviews from March 1-April 30, 2018 and March 1-April 30, 2019 compared …

Effects Of Early Adolescent Exposure To D-Amphetamine In A Rodent Model Of Nicotine Reward, Eric Louis Harvey

Dissertations

Previous studies with rodents have found that adolescent exposure to psychoactive drugs can alter neurophysiology and produce behavioral effects that persist into adulthood. While several studies have examined the effects of adolescent exposure to nicotine on the subsequent rewarding value of various drugs of abuse in adulthood, to date, no known studies have examined the converse of this relationship. d-Amphetamine (i.e., dextroamphetamine, ProCentra®) is a potent psychostimulant that is commonly used in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in adolescents. The present study assessed the effects of adolescent exposure to d-amphetamine on the rewarding value of nicotine in …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

A Mixed-Methods Investigation On Contributing Factors To The Political Efficacy Of Eighth Grade Students In A Suburban School District In Missouri, Colette Edson

Dissertations

This study investigated the relationship between the political efficacy and expected civic engagement of eighth grade students in the Ferguson-Florissant School District, Missouri and demographic factors, reading ability, and parental attitudes. Data on students’ attitudes on topics such as citizenship, trust in institutions, opportunities, political efficacy, school efficacy, and political engagement were analyzed. The 180 students who completed the questionnaire demonstrated lower trust and assessment of access to opportunities and higher youth political engagement than the participants in the 1999 International Association for the Evaluation of Educational Achievement (IAE) Civic Education (CIVED) study. Tests to determine the impact of student …

Counselor Preparation And Adolescent Youth: A Study Of Clinical Mental Health Counselors, Brian R. Russ

Dissertations

Prevalence data have raised concerns that child and adolescent mental health issues are at an epidemic level. For example, Knopf, Park, and Mulye (2008) suggested that 20-25% of all youth experience symptoms of distress. Researchers have also estimated that one in five adolescents in the United States have a diagnosable mental health disorder, and one in ten with a disorder that would be considered severe (Kessler, Berglund, Demler, et al., 2005; Knopf, Park, & Mulye, 2008). Yet, the training of clinical mental health counselors who work with adolescent populations has received limited attention in the counselor education literature. Although the …

Character Education And Adolescents' Moral Identity Development (Actual And Ideal), Amani Faisal Qashmer

Dissertations

Moral identity is the individual’s degree of considering his or her moral character as a dominant part of his or her self-concept (Bock & Samuelson, 2015). Moral identity is a part of one’s character. Character education is a means of facilitating moral/character development. This research is an effort to examine the relationship between character education and moral identity (actual and ideal). The purpose of this study is to provide empirical evidence that moral identity is an outcome of character education. In order to better understand how character education impacts moral identity development, a clearer understanding of identity as a concept …

Acceptance And Commitment Therapy For Adolescent Difficulties With Emotion Regulation: An Open Trial, Julissa A. Duenas

Dissertations

Research suggests that youth rates of mental health problems are high and that evidence-based treatments for these populations exist; however, there is a significant problem in accessibility of mental health services. Recent movements in the mental health field have shifted focus to transdiagnostic dimensions of behavior in attempt to target a broader range of psychological difficulties across larger populations. One such construct, emotion regulation, has been defined as an ability to have awareness and acceptance of emotions and control urges and impulses in order to behave towards a goal. Emotion regulation has been linked to numerous internalizing and externalizing behavioral …

Emotion-Related Factors As Mediators In The Relation Between Family Stress And Adolescent Externalizing Problems, Kristy Marie Disabatino

Dissertations

Adaptive regulation of emotions, maternal depression, parenting stress, and environmental stress have all been related to adolescent psychosocial outcomes. Considering these established relations, the current study examined serial mediation models in which it was hypothesized that (1) maternal distress or community stress (examined in separate models) would positively relate to adolescent externalizing behaviors directly and (a) indirectly through maladaptive maternal emotion socialization (ES) practices (i.e., magnify, neglect, and punish), (b) indirectly through adolescent emotion regulation (ER) difficulties, and (c) indirectly through both maternal ES practices and adolescent ER difficulties; (2) maternal distress or community stress would positively relate to adolescent …

Assessing Change In Attachment Security Of Adolescents At Residential Therapeutic Programs, Laura Santa Thum

Dissertations

Adolescents with significant, persistent behavioral and mental health problems are increasingly being treated in private residential treatment programs (RTPs). Recent research at such programs shows that adolescents’ symptoms improve over the course of treatment and that such positive results persist up to a year post discharge. This study attempts to address what is occurring below the symptom level by exploring if attachment security increases as symptoms improve over the course of treatment in private RTPs. The level of attachment security was assessed along the dimensions of attachment avoidance and anxiety as a general construct and according to specific relationships (with …

Predictors And Profiles Of Antiretroviral Therapy Adherence Among African-American Adolescents And Young Adult Males Behaviorally-Infected With Hiv: A Classification Tree Analysis Approach, Israel Moses Gross

Dissertations

Adherence to antiretroviral therapy is crucial for thwarting disease progression and reducing secondary transmission, yet HIV+ youth struggle with adherence. The highest rates of new HIV infections occur in young African American men (YAAM), thus understanding reasons for non-adherence in this group is critical. Reasons for non-adherence can be complex and multifactorial, and innovative methods of exploration are needed for advancing prevention and treatment efforts. A sample of 387 HIV+ YAAM who reported currently taking HIV medications were selected from a cross-sectional assessment of 2,226 HIV+ youth from sites within the Adolescent Trials Network for HIV/AIDS Interventions (ATN) from 2009-2012 …

Understanding The Impact Of Adolescent Attachment On Academic Success, Cristina Cortesi

Dissertations

In recent years, studies are citing an increase in adolescent mental health diagnoses and symptomotology related to AD/HD, Bipolar Disorder, Depression, Anxiety, and Conduct Disorders. While the associated behaviors may be the result of several variables, recent neurobiological studies combined with Attachment Theory have pointed to a possible link to attachment issues. Because of the developmental stage of adolescents, these behaviors have been observed in both home and school environments. Schools, in general in the United States, have been experiencing significant struggles in terms of lack of adequate educational success which prompted the implementation of legislation commonly known as No …

Exploring Adolescent Experiences Of Race, Ethnicity, And Socioeconomic Status In Counseling Relationships: A Qualitative Approach, Christina Crans

Dissertations

The ACA Code of Ethics (2005) states the expectation that counselors must understand the diverse backgrounds of their clients. In addition, counselors are called to understand how their personal cultural identity informs and affects the counseling process. Yet there is paucity in the literature regarding the multicultural client experience within a counseling relationship. Of the few multicultural counseling studies that attempt to address multicultural client concerns, the approach has been quantitative or reliant on counselor self-report. In addition, the lived counseling experiences of adolescents and individuals from lower socioeconomic status (SES) is absent in present literature. This qualitative study examined …

Utility Of The Inventory Of Callous-Unemotional Traits In Adolescent Offenders And Non-Offenders: An Item Response Theory Analysis, Lisa Laurence Ansel

Dissertations

The current study utilized Item Response Theory (IRT) analyses to examine the item functioning of the Inventory of Callous-Unemotional Traits (ICU; Frick, 2003) in the assessment of psychopathy-linked traits in adolescents. Self-report psychopathy measures, such as the ICU, have become increasingly common for use with adolescents. However, questions remain regarding their reliability and utility for accurately assessing these traits (Poythress, Dembo, Wareham, & Greenbaum, 2006). IRT analyses offer unique methods of investigating test and item functioning in regards to the underlying trait an inventory purportedly assesses. The current study examined and compared the item functioning of the ICU for the …

Response To Violent Prone Female Adolescents: The Chicago Public School Approach, Marian E. Dozier

Dissertations

School violence has become increasingly more prevalent among adolescent females over the last ten years. As administrators, teachers, parents, and law enforcement officials try to control and decrease the number of violent incidents that occur in our schools, adolescent females continue to exhibit inappropriate and violent behavior at an alarming rate within our school communities. Adolescent females who behave badly have historically been overlooked or ignored, as girls have often been perceived as being incapable of demonstrating hostile conduct in an academic setting.

The purpose of this study was to investigate, describe, and analyze the frequency and nature of violent …

The Effect Of Urban Hassles On The Subjective Well-Being Of Low-Income Urban Adolescents, Kimberly Vacek

Dissertations

Low income urban youth have been identified as an understudied and important population to explore. The psychological effects of stress on the well-being of children and adolescents are of particular interest, and the stressors faced by low income urban adolescents are unique in that they are more chronic in nature and due to adverse environmental circumstances. While researchers have examined the effect of stress on the subjective well-being of low income urban adolescents, none have done so utilizing a measure of stress developed specifically to assess the unique stressors experienced by such populations. The Urban Hassles Index (UHI) is a …

The Relations Among Parental Monitoring And Warmth, And Adolescent Externalizing And Internalizing Distress: The Effects Of Parent And Adolescent Perception Of Neighborhood Danger, Jonathan Goldner

Dissertations

Parental monitoring and warmth have traditionally been studied in the context of white, middle-class families. This paper adds to recent research that has begun to explore what levels of these parenting behaviors are optimal for the prevention of adolescent psychopathology in impoverished, urban high crime areas. It also takes into account parent and child perceptions of neighborhood danger. This study employs a longitudinal design, with data collected at two times points one year apart, among a sample of 240 African American young adolescents and their parents in urban, high crime neighborhoods. It aims to study parental monitoring, parental warmth, parent …