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Ethnic And Gender Differences In Psychosocial Factors In Native Hawaiian, Other Pacific Islanders, And Asian American Adults With Type 2 Diabetes, Jillian Inouye, Dongmei Li, James Davis, Richard Arakaki

Journal of Health Disparities Research and Practice

This study examined the differences between 207 Asians and Native Hawaiian, other Pacific Islanders (NHOPI) with type 2 diabetes among various psychosocial measures. Responses to five multivariable regression models including the Diabetes Quality of Life Questionnaire (DQOL) and Short Form -36® Health Survey (SF-36) were analyzed. Differences were determined by linear contrasts in the multivariate linear regression models after adjusted for multiple demographic and socioeconomic variables. Compared to Asians, NHOPIs perceived a lower impact of diabetes on their quality of life; highlighting differences in perceptions of self-efficacy and self-care activities. Females did better on their diet while males perceived better …

Racial Disparities In Pain Management In Primary Care, Miriam Ezenwa

Journal of Health Disparities Research and Practice

This descriptive, cross-sectional, secondary data analysis was conducted to examine racial disparities in pain management of primary care patients with chronic nonmalignant pain using chronic opioid therapy. Data from 891 patients, including 201 African Americans and 691 Caucasians were used to test an explanatory model for these disparities. We predicted that: (1) African American patients would report worse pain management and poor quality of life (QOL) than Caucasians; (2) the association between race and pain management would be mediated by perceived discrimination relating to hopelessness; and (3) poor pain management would negatively affect QOL. Results revealed significant differences between African …

A Demographic Analysis Of Metro/Nonmetro Differences In Adult Normal Weight, Overweight, And Obesity, P. Johnelle Sparks, Susanne Schmidt

Journal of Rural Social Sciences

Overweight and obesity prevalence is increasing throughout the United States, and these two health conditions seem to disproportionately affect certain segments of the adult population. To date little research has examined adult differences in normal weight, overweight, and obesity by metropolitan or nonmetropolitan residential status while controlling for important demographic, socioeconomic, behavioral, and health status characteristics. This research helps to fill this gap. We used data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to empirically assess predictors of overweight and obesity risk for all adults and then by residential location. Multinomial logistic regression techniques were used to estimate …

A Portrait Of Rural Health In America, Jin Young Choi

Journal of Rural Social Sciences

introduction to special issue

Assessing Barriers To Health Care Services For Hispanic Residents In Rural Georgia, Michele Vitale, Conner Bailey

Journal of Rural Social Sciences

Since the 1990s, many Hispanics have been relocating to the rural South and their permanency (although beneficial to the economy) poses new challenges at the institutional level. One area of major concern is the adequate provision of health care. Our article evaluates the socioeconomic, cultural, and geographic/transportation barriers that Hispanic residents face when seeking primary health care services in Toombs County, Georgia. Data were acquired through personal interviews with Hispanic residents, local health professionals, and key community informants by using a combination of opportunity sampling and a snowball approach. Results indicate that the local health system and the county as …

Ruptured Identity Of Male Farmers: Subjective Crisis And The Risk Of Suicide, Anthony Hogan, Edward Scarr, Stewart Lockie, Brett Chant, Sylvia Alston

Journal of Rural Social Sciences

Suicide among male farmers is frequently discussed in the literature. While a wide range of factors are associated, a coherent theoretical framework that incorporates the various factors associated with male farmer suicide has not been developed. Moreover, the insights offered to date have not opened a more systemic approach to prevention. Drawing on substantive contributions from sociological theory, this paper proposes a framework for progressing understanding of the causes of this phenomenon and offers insights for prevention. The paper argues that ontological security is central to identity and social competence, and that loss of the coherency of identity and the …

Using Hermeneutics To Understand Burnout And Coping Strategies Utilized By Occupational Therapists, Sangeeta Gupta, Margo Paterson, Claudia Von Zweck, Rosemary Lysaght

The Qualitative Report

This research article explores the use of the hermeneutic approach in understanding practice challenges for occupational therapists in the contemporary health care arena. It provides insights into factors that lead to therapist burnout and the strategies they utilize to maintain competent practice. In this mixed methods study, hermeneutics was chosen as the qualitative approach to help understand the meanings occupational therapists ascribe to stressful situations at work and how they cope with those situations. Data was collected by conducting focus groups and semi-structured interviews with seven participants. Demands on time, conflict, lack of respect and autonomy emerged as the main …

Lived Experiences Of Diversity Visa Lottery Immigrants In The United States, Tekleab Elos Hailu, Bernadette M. Mendoza, Maria K.E. Lahman, Veronica M. Richard

The Qualitative Report

Every year approximately 50,000 people immigrate to the United States through the avenue referred to as the Diversity Visa (DV) Lottery. In this article, the authors present a literature review of immigration to the U.S. through the DV Lottery, reflect on their own immigration histories, and utilize phenomenology to investigate and describe participant feelings, expectations, and experiences as DV Lottery immigrants. Participants experienced mixed feelings, including high expectations prior to and difficulties after immigrating to the U.S. Findings presented include (a) life experienced in the U.S.; (b) access to learning and training opportunities; and (c) recommended support future DV Lottery …

Leadership Traits Of School Health Coordinators In Tennessee, Katherine Andrea Strickland

Electronic Theses and Dissertations

The purpose of this quantitative study was to explore the leadership traits of the school health coordinators (SHCs) for the state of Tennessee and to determine if self-perceptions of the SHC leadership traits coincide with supervisor and colleague perceptions of SHC leadership traits. The health challenges facing young Americans today are different from those of past decades and child health is a major federal and state policy platform. SHCs work at the nexus of 2 highly regulated and political entities: healthcare and education. Thus, it is critical for SHCs to possess strong leadership traits to navigate through the issues and …

Rural Appalachian Health Care Providers' Perceived Barriers To Intimate Partner Violence Screening In Primary Care, Jamie Tedder

Electronic Theses and Dissertations

Intimate Partner Violence (IPV) is a major problem in the United States. There are many health concerns associated with IPV (e.g. chronic pain, gynecological problems), leading researchers to examine the detection and management of IPV in primary care settings. However, a disproportionate amount of this research has focused on the detection and management of IPV in urban primary care clinics, with the detection and management of IPV in rural primary care being largely understudied. The current study addresses this gap in the literature by describing the screening practices and barriers to screening reported by rural providers as well as differences …

Experiences Of Success By Minority Students Attending A Predominantly Caucasian Nursing Program, Staci M. Boruff

Electronic Theses and Dissertations

Nursing educators have struggled for many years with the problem of student attrition in the minority population. Because there are so few minority students who choose nursing as a profession, educators strive to retain these students to graduation. Unfortunately, attrition rates of minority students continue to rise despite years of research into the problem. The majority of this research approaches the issue from the viewpoint of the failing student. What might happen if nursing research took a positive approach to the issue? The purpose of this study was to describe the influencing factors that led minority nursing students to be …

Cost-Effectiveness Of Outpatient Treatment For Anorexia Nervosa, Bulimia Nervosa, And Eating Disorder Not Otherwise Specified, Dwayne M. Horton

Theses and Dissertations

This study examined the cost effectiveness of treating Anorexia Nervosa, Bulimia Nervosa, and Eating Disorder Not Otherwise Specified (NOS), as well as the effects that modality of therapy (i.e. individual, family, and mixed therapy), license of therapist, and secondary diagnosis had on recidivism and total cost of treatment in the care of these patients. One-thousand and thirty-eight patients (56 males, 982 females) diagnosed with Anorexia Nervosa, 1,674 patients (56 males, 1,618 females) diagnosed with Bulimia Nervosa, and 1,997 patients (197 males, 1,800 females) diagnosed with Eating Disorder NOS were included in this study. Results revealed that family therapy was the …

Adolescent Dating Violence Prevention And Intervention In A Community Setting: Perspectives Of Young Adults And Professionals, Donna S. Martsolf, Crystal Colbert, Claire B. Drauker

The Qualitative Report

Adolescent dating violence (ADV) is a significant community problem. In this study, we examine the perspectives of two groups (young adults who experienced ADV as teens and professionals who work with teens) on ADV prevention/intervention in a community context. We interviewed 88 young adults and 20 professionals. Our research team used Thorne’s (2008) interpretive description methods to determine participants’ perspectives on community views on ADV, community ADV prevention/intervention programs, and ideal ADV prevention/intervention strategies. Participants perceived most communities as being blind to ADV. They perceived prevention programs as unavailable, inappropriate, or impersonal. Young adults indicated that professionals should use a …

Teachers’ Perceptions Of A Multiple High-Risk Behavior Prevention Program And Delivery Of Universal Programming, Crystal Collier, Richard C. Henriksen Jr.

The Qualitative Report

Much of the success of high-risk behavior prevention programs rests with teachers who deliver the curriculum however; few studies have investigated teachers' perceptions of program implementation. The objective of this phenomenological study was to answer the question, “What are the experiences of teachers who are asked to be involved in the implementation process when their school adopts a multiple high-risk behavior prevention program”? Participants included 10 teachers at a local, private high school in the Southern United States. Five themes emerged: (a) lack of consistent historical effort, (b) need for program, (c) positive but tentative perceptions, (d) challenges with implementation, …

Mom Blogs: Portrayals Of Contemporary Mothering Standards, Styles, And Secrets, Angela Nuttall Ward

Theses and Dissertations

Internet use is a routine element of daily life in the early 21st century for many middle-class Americans. Today, millions of middle-class American mothers read and write online web-logs detailing motherhood and domestic life and mom blogs, formerly known as "mommy blogs," facilitate substantial economic activity. Participants collectively invest millions of hours in these blogs, sharing information and experiences, and offering each other validation and support. The present qualitative study of American mom blogs uses traditional grounded theory methods as well as Netnography techniques to investigate the thematic content found in the publicly posted text of 25 different mom blogs …

Factors Affecting Relationship Quality In African-American/Caucasian Bi-Racial Couples, Joriann Lynn Mcgrath

Theses and Dissertations

This study examined the direct actor/partner effects of self-esteem, coming to terms, and relationship quality and the indirect effects of self-esteem on relationship quality when mediated by coming to terms. The sample included 160 interracial couples of which 69.4% were made up of an African-American male and a Caucasian female, while 30.6 were made up of an African-American female and a Caucasian male. These couples completed the RELATionship Evaluation (RELATE), a survey questionnaire. This study used three variables from the RELATE: self-esteem, coming to terms, and relationship quality. Results from Structural Equation Modeling indicated that self-esteem had a negative effect …

Enabling Outcomes For Students With Developmental Disabilities Through Collaborative Consultation, Michelle Villeneuve, Nancy L. Hutchinson

The Qualitative Report

Collaborative consultation has been widely adopted in school-based occupational therapy practice; however, limited research has examined how collaboration between educators and occupational therapists contributes to students’ outcomes. The purpose of this study was to describe the nature of collaborative working in two cases of school-based occupational therapy service delivery. This paper reports a cross-case analysis, comparing findings about the nature of a joint effort in each case study to identify workplace practices that facilitated educator-occupational therapist collaboration. Ethnographic case study methods (Stake, 1995; Wolcott, 2008) and socio-cultural activity theory (SCAT; Engeström, 2001) were used to examine multiple perspectives concerning school-based …

Transforming The Healthcare Response To Intimate Partner Violence And Taking Best Practices To Scale, Michele R. Decker, Shannon Frattaroli, Brigid Mccaw, Ann L. Coker, Elizabeth Miller, Phyllis Sharps, Wendy G. Lane, Mahua Mandal, Kelli Hirsch, Donna M. Strobino, Wendy L. Bennett, Jacquelyn Campbell, Andrea Gielen

CRVAW Faculty Journal Articles

BACKGROUND: Intimate partner violence (IPV) is prevalent among adolescent and adult women, with significant physical, sexual, and mental health consequences. In 2011, the Institute of Medicine's Clinical Preventive Services for Women consensus report recommended universal screening for violence as a component of women's preventive services; this policy has been adopted by the Health Resources and Services Administration (HRSA). These policy developments require that effective clinic-based interventions be identified, easily implemented, and taken to scale.

METHODS: To foster dialogue about implementing effective interventions, we convened a symposium entitled "Responding to Violence Against Women: Emerging Evidence, Implementation Science, and Innovative Interventions," on …

Individual And Social Network Sexual Behavior Norms Of Homeless Youth At High Risk For Hiv Infection, Kimberly A. Tyler, Lisa A. Melander

Department of Sociology: Faculty Publications

Although previous research shows that homeless youth engage in numerous risky sexual behaviors, little is known about whether or not specific rules govern this conduct within their social networks and how group norms influence subsequent sexual actions. The current study utilizes 19 in-depth interviews with homeless youth to investigate different elements of their sexual behavior. Findings reveal that their decision to have sex generally depends on chemistry and physical appearance whereas a potential partner’s risky sexual history and heavy substance use discourages youth from engaging in sex. Both males and females discuss condom usage as it relates to unknown sexual …

The National Elder Economic Security Standard Index, Gerontology Institute, University Of Massachusetts Boston

Gerontology Institute Publications

The Elder Economic Security Standard Index (Elder Index) is a new tool for use by policy makers, older adults, family caregivers, service providers, aging advocates, and the public at large. Developed by the Gerontology Institute at the University of Massachusetts Boston and Wider Opportunities for Women (WOW), the Elder Index is a measure of income that older adults require to maintain their independence in the community and meet their daily costs of living, including affordable and appropriate housing and health care. The development and use of the Elder Index promotes a measure of income that respects the autonomy goals of …

The Lived Experience Of The Parents Of High School Dropouts: A Phenomenological Study, Christine Ann Silano

Graduate Theses and Dissertations

The purpose of this study is to describe the experiences and perceptions of parents whose children did not receive a high school diploma. This subpopulation has been rarely studied. The central question is, "What are the perceptions and experiences of the parents of public high school dropouts as they pertain to schools, their children, and themselves?"

This phenomenological study examined the lived experience of the parents of high school dropouts. Five women and one man participated in the study by sitting for interviews. The collected interview data was transcribed and analyzed using qualitative methodology including open and axial coding as …

"Leadership Is Behaving And Acting Like A Leader": A Narrative Exploration Of The Life Stories Of Three Latino Leaders In Healthcare, Kevin L. Flores

Department of Agricultural Leadership, Education and Communication: Dissertations, Theses, and Student Scholarship

There is a dearth of Latino leaders holding executive positions in healthcare. The purpose of this study was to provide a privileged platform for the voice of Latino leaders in healthcare who, by definition, emanated from a marginalized population. This study began with the assumption that the stories of Latino leaders were different than leaders of the majority population due to their ethnicity. Latino critical theory asserts that concepts like leadership need to be viewed through an ethnic lens. The overarching question that guided this study was: What do the stories of three Latino leaders reveal about their development as …

Mental Health Treatment For Children And Adolescents: Cost Effectiveness, Dropout, And Recidivism By Presenting Diagnosis And Therapy Modality, David Fawcett

Theses and Dissertations

As many as one in five children and adolescents may suffer from a mental health disorder, yet there are barriers that often prevent children from receiving optimal treatment. The current study explores the influence of practitioner license type, therapy modality, diagnosis, age, and gender on mental health therapy for children and adolescents. Data was provided by Cigna, a leading health care insurance provider in the United States. Participants include 106,374 boys (53.2%) and 93,753 girls (46.8%) ages 3 to 18 (M = 12.1, SD = 3.9) who were treated in outpatient facilities throughout the United States of America. Results indicate …

Shared Journaling As Peer Support In Teaching Qualitative Research Methods, Aine M. Humble, Elizabeth Sharp

The Qualitative Report

Teaching qualitative research methods (QRM), particularly early on in one’s academic career, can be challenging. This paper describes shared peer journaling as one way in which to cope with challenges such as complex debates in the field and student resistance to interpretive paradigms. Literature on teaching QRM and the pedagogical value of journaling for metacognition are reviewed. The two authors describe key points about their teaching contexts and then demonstrate with journal excerpts how they developed (a) clarity, (b) confidence, and (c) connection through two years of co-creating their journal. The article concludes with recommendations for shared journal writing as …

Women In Transition: A Qualitative Analysis Of Definitions Of Poverty And Success, Crystale M. Marsh-Mcdonald, Sybil Schroeder

The Qualitative Report

A phenomenological approach examined the stories of ten women transitioning from childhood poverty to adult life. Women were chosen from a pool of participants in an Upward Bound program designed to assist low-income and/or first-generation college students in the Midwestern United States. Semi-structured interviews were conducted to retrospectively explore their lived experiences. Recurring themes included facilitators of change, specifically the people, including mental health professionals, family members, romantic partners, and friends who helped make change possible. Another frequent theme found in the research was the impact an education had on the participants. Finally, the participants shared their own insights related …

African American Women: The Face Of Hiv/Aids In Washington, Dc, Ndidiamaka N. Amutah

The Qualitative Report

In 2007, the estimated HIV and AIDS case rates among adult and adolescent African-American females in the United States was 60.6 per 100,000, as compared to 3.3 per 100,000 for adult and adolescent white American females. Women living with HIV or AIDS often face complex social problems that may inhibit them from accessing resources and healthcare services to assist them in coping with the disease. In-depth interviews and direct observations utilizing open-ended note taking were conducted at an HIV service provider’s office to determine the unique needs that develop because of these complex social issues, specifically among HIV positive women …

Selective Screening Of Type 2 Diabetes For Washoe County’S Hispanic Population, Linda M. Dunn

Nevada Journal of Public Health

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were …

How We Want To Be Treated! What Clark County African American Patients Want Their Health Providers To Know, Charlene A. Day, Joyce Woodson, Erica Archuleta

Nevada Journal of Public Health

Research continues to validate the fact that cultural values and beliefs play a major role in determining the extent to which an individual will engage in healthy behaviors, adhere to medical regimen, and seek care when necessary. A 2000 survey of 950 members of predominately African American churches in Clark County, Nevada (a county which comprises Las Vegas) conducted by the University of Nevada Cooperative Extension found members preferred healthcare providers as a source of information on health-related matters. Yet, research shows that for a variety of reasons, many African Americans do not regularly see a health care professional, and …

Screening For Mental Health Problems Among Incarcerated Youth In Nevada: Practice And Policy, Michelle Chino, Jennifer Personius-Zipoy, Denise Tanata

Nevada Journal of Public Health

Incarcerated youth in Nevada with serious mental health problems are not being effectively identified. The current study examined the utility of simple screening instruments as a mechanism for identifying incarcerated youth who may have a mental health disorder. Adjudicated youth, incarcerated at each of Nevada’s 12 juvenile detention facilities, participated in the study by completing a demographic questionnaire and a standardized mental health screening instrument: the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2). Findings indicate a high prevalence of mental health disorders among incarcerated juveniles in Nevada. Identifying youth with mental health problems is complicated by the lack of a systematic …

Exercise Determined Promise 2003 Logandale, Nevada Plague Prophylaxis Clinic: Exercising The Strategic National Stockpile, Kay Godby, Mary Ellen Harrell, Bonnie Sorenson, Maureen Fanning, Nancy Gerken, Jane Shunney

Nevada Journal of Public Health

The Department of Defense asked the Clark County Health District (CCHD) to participate in the disaster drill entitled Determined Promise ’03 (DP ‘03) from August 18 -23, 2003. The purpose of this exercise was to test the capacities of the U.S. Northern Command (U.S.Northcom) Homeland defense/homeland security mission and integration of the Joint Task Forces-Civil Support (JTF-CS) with state and local responders. Part of the JTF-CS mission was to coordinate military support to civilian state and local authorities when it was requested.