Medicine and Health Sciences Commons^™

Reducing Opioid Related Deaths And Improving Rehabilitation Access Through The Elk Grove Village Cares Program: A Program Evaluation, Rebecca Barron

Doctor of Nursing Practice (DNP) Manuscripts

Abstract The goal of the Elk Grove Village Cares program is to decrease the deaths and overdoses of those who abuse opioids through harm reduction strategies and provide access to treatment. The article is a program evaluation of the Elk Grove Village Cares program. Surveys, interviews and the synthesis of program data is used to evaluate the efficacy of program activities. Results: The rate of death from opioid use has decreased an average of 1.7 deaths since program implementation in 2018. Law enforcement officers (LEO) and the community responded similarly to many survey questions regarding attitudes surrounding addiction. Within the …

The Potential Of Mental Health Policy Implementation: Methods And Applications, Meagan Renee Pilar

Arts & Sciences Electronic Theses and Dissertations

Mental illness affects roughly 20% of the world in some capacity and can be debilitating. Though a large emphasis has historically been placed on individual-level interventions (e.g., therapy or medication), mental health policies present an opportunity to intervene on a large scale, with the potential to enhance impact and equity. This dissertation contributes to the mental health policy research literature in three main ways—(1) exploring factors affecting policymakers’ overall support of mental health policies; (2) assessing the use and quality of quantitative and qualitative methods within this field; and (3) exploring implementation determinants and outcomes, as well as strategies used …

Healthcare Access Barriers And Proposed Solutions For Limited English-Proficient (Lep) Latinx Patients In Southwest Michigan, Carmen Vinkemulder

Honors Theses

This research study explores the circumstances and experiences of LatinX patients with limited English proficiency (LEP) when seeking treatment in the healthcare system of Southwest Michigan, in addition to proposing solutions to better facilitate this population’s access. The terminology used in this research, LatinX, is an American English neologism used as a genderinclusive term used interchangeably with Latino/a and/or Hispanic. This research provides an overview of the current socio-political legislature and climate of the American healthcare system as it pertains to the LatinX population to spread awareness and identify the barriers existing in our current healthcare model. This study will …

The Impact Of Corporal Punishment For Timorese High School Graduates, Veronica Godinho Pereira

Graduate Theses and Dissertations

This research examines the impacts of corporal punishment for Timorese high school graduates. Physical punishment is a pervasive method of disciplining students and children used in Timor-Leste because it has been such a tradition (UNICEF 2017). Few researchers have attempted to analyze the negative impacts of corporal punishment and possible gender differences; there is no known research on the impacts of corporal punishment in Timor-Leste. This study uses an in-depth interview method, where data were collected from 26 Timorese high school graduates composed of both men and women from both private and public schools in Timor-Leste. The ages of the …

When It Hits The Fan, Does Network Management Matter? : A Study On Policy Shocks And The Production And Delivery Of Public Goods And Services By Service Delivery Networks, Jennie Rhodes Law

Legacy Theses & Dissertations (2009 - 2024)

EXECUTIVE SUMMARYFor decades public administration and management scholars have conceptualized organizational networks as solutions to failures of markets and hierarchies (see, for example, Goldsmith and Eggers 2005; Osborne and Gaebler 1992). Relationships among organizations or actors within a network are framed positively as channels through which human, financial, and knowledge resources flow to address complex or “wicked” social problems (see, for example, Rittel and Weber, 1973). However, recent scholarship has sought to pull the curtain back and identify the pitfalls of networked arrangements for public service delivery (see, for example, O’Toole & Meier, 2006; O’Toole & Meier, 2004). Such studies …

Sleeping With The Enemy: Examining The Relationship Between Sleep And Pain In Post-9/11 Veterans, John L. Schwartz Jr.

Psychology Theses & Dissertations

United States veterans are a diverse group of individuals, yet as a result of their service, they share a unique set of customs, traditions, and values. Post-9/11 veterans are more likely to experience elevated levels of pain and poor sleep quality compared to their civilian counterparts; however, little is known about how beliefs related to veterans’ pain impact their sleep and how levels of pain acceptance influence the sleep-pain association. This study examined relationships between sleep and pain in a sample of 102 post-9/11 veterans. Results support associations between pain and sleep identified in other populations. Positive correlations were found …

Responding To Domestic Violence With Transformative Justice And Community Accountability, Anaiis Nysether

Capstone Projects and Master's Theses

Walnut Avenue Family & Women’s Center (WAFWC) wanted to create a survivor-driven transformative justice program for survivors of domestic violence and the people who caused them harm. The program needed to be customizable enough to suit the specific needs and individual safety considerations of the participants, but also needed enough structure that it could be reproducible from case to case. In order to design a program that was based on these ideas and able to be used in the context of a non-profit organization, WAFWC researched ways other communities had been using transformative justice and community accountability to address issues …

The Debate On Physician-Assisted Death In The United States: A Narrative Analysis Of Formula Stories, Rebecca Blackwell

USF Tampa Graduate Theses and Dissertations

Public policy discussions can be viewed as empirical windows into broadly shared culturalvalues and emotions of the social contexts in which the policy discussions take place. This project is a narrative analysis of the public debate on physician-assisted death (PAD), drawing from three data sources: newspaper articles, the websites of social movement organizations, and testimonies from a state legislative hearing. This analysis explores ways in which social actors deploy personal stories that contribute to shape the policy-making process by appealing to cultural beliefs and broadly shared emotions. The findings of this project constitute a contribution to the study of emotions …

Impact Of Covid-19 On Port Terminal Performance In The United States Of America, Ian Michael Sulzer

World Maritime University Dissertations

No abstract provided.

An Epidemic Amidst A Pandemic: A Critical Policy Analysis Of Supervised Consumption Sites, Vanisa Ezukuse

Electronic Thesis and Dissertation Repository

This study's primary purpose is to critically appraise current federal and provincial policies regarding supervised consumption sites (SCS), noting intended and unintended consequences; and how these policies could impact SCS users. This study's secondary goal is to compare current policies related to SCS in Alberta, British Columbia, Ontario, and Quebec to provide critical insight and suggestions for ongoing policy development. Carol Bacchi’s (2009) “What is the Problem Represented to Be?” framework was applied to the Canadian policy document with a focus on SCS. Four themes are proposed: Public Health versus Criminality, Presumptions versus Assumptions, Policy Unaccountability, and Policy Duality. It …

Patient Reported Outcomes In Sickle Cell Disease Examined Within A Conceptual Model, Swapandeep Mushiana, Marsha Treadwell Phd, Sherif M. Badawy Md, Ms, Liliana Preiss Phd, Allison King Md Mph Phd, Barbara Kroner Phd, Yumie Chen Bs, Jeffrey Glassberg, Victor Gordeuk Md, Nirmish Shah Md, Angie Snyder Phd Mph, Theodore Wun Md

Doctoral Dissertations

Objective: To examine the relations between patient reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 – 45 years enrolled in the Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD related factors and barriers to care would independently contribute to functioning as measured using the PRO domains. Additionally, pain and other SCD related complications are expected to impact the relation between the variables. Methods: Participants completed a 48-item survey that included socio-demographics and PRO measures, such as social functioning, pain impact emotional distress, and cognitive functioning. …

Disease, Development, And Disorder: Examining The Effect Of Health On Subnational Development And Conflict In Sub-Saharan Africa, Dlorah C. Jenkins

Doctor of International Conflict Management Dissertations

Progress towards achieving the Sustainable Development Goals (SDGs) has been uneven across and within countries - particularly in Africa, least developed countries, and low-income countries. The COVID-19 pandemic has threatened to reverse much of the progress made towards achieving the SDGs, especially SDG 3, which aims to “ensure healthy lives and promote well-being for all at all ages”.

The tendency for disease, underdevelopment, and conflict to occur concomitantly suggests potential causal mechanisms linking them. This study attempts to address two pieces of the puzzle: the causal effect of disease on underdevelopment and the impact of development on conflict risk. Focusing …

Multiple Baseline Interrupted Time Series: Describing Changes In New Mexico Medicaid Behavioral Health Home Patients’ Care, Jessica Reno

Mathematics & Statistics ETDs

In 2016, the CareLink New Mexico behavioral health homes program began enrolling Medicaid recipients with the goal of increasing care coordination, improving access to services, and decreasing long-term costs of care for adults with serious mental illness (SMI) and children with severe emotional disturbance (SED). To evaluate these aims, a retrospective interrupted time series study using Medicaid claims data was designed. First, a comparable subset of non-enrolled individuals was selected from the pool of Medicaid recipients with SMI or SED using propensity score matching. Then, segmented regression was applied to three outcomes: total Medicaid charges, number of outpatient behavioral health …

Incarceration And Suicide: Do The Risk Factors Differ For Civilians And Veterans?, Rheannon Gail Ramsey

Dissertations and Theses

Suicide is one of the leading causes of death in United States jails and prisons. Many researchers have looked at suicides in prisons and what can potentially cause suicidal ideation but there are conflicting findings among civilian incarcerated populations and United States military veteran incarcerated populations.

The intent of this study is to examine which risk factors are most prevalent among adults in custody, with a focus on mental health and substance use or abuse and how these risk factors differ between incarcerated civilians and incarcerated veterans. Using survey data from the 2002 Survey of Inmates in Local Jails conducted …

Informing Indigent Health Care Service Programs Within A Local Government Context: Strategies For Population-Based Service Planning, Assessment, And Policy Development, Joshua Troy Barnett

USF Tampa Graduate Theses and Dissertations

The number of medically indigent adults continues to grow in the United States, despite recent expansions in health care coverage to individuals who are non-disabled, low income, and uninsured. Indigent health care programs (IHCPs) are safety net services that are often funded and operated by local governments. These IHCPs provide access to health services at low to no-cost which protect the health and financial welfare of the individuals these programs serve and support the sustainability of the health systems that treat them. Although localities continue to expand their presence in safety net health care delivery, little is known about locally …

Evaluating Public Masking Mandates On Covid-19 Growth Rates In U.S. States, Angus K. Wong

Masters Theses

U.S. state governments have implemented numerous policies to help mitigate the spread of COVID-19. While there is strong biological evidence supporting the wearing of face masks or coverings in public spaces, the impact of public masking policies remains unclear. We aimed to evaluate how early versus delayed implementation of state-level public masking orders impacted subsequent COVID-19 growth rates. We defined “early” implementation as having a state-level mandate in place before September 1, 2020, the approximate start of the school-year. We defined COVID-19 growth rates as the relative increase in confirmed cases 7, 14, 21, 30, 45, 60-days after September 1. …

Impact Of Covid-19 On The Severe Acute Malnutrition Admissions Among Children Under 5 Years Of Age Seeking Nutrition Services In Afghanistan, Sahar Sayedy

Graduate Theses and Dissertations

The purpose of the study was to assess the impact of COVID-19 on the number of admissions of severe acute malnutrition among children under 5 years of age seeking nutrition services in Afghanistan especially in the provinces where the prevalence of COVID-19 was high, for the period of February – September 2020. The study used comparison and analysis of secondary datasets of the Integrated Management of Acute Malnutrition – a national program for detection and management of moderate and severe acute malnutrition in the country.

This study analyzed the association between COVID-19 cases and severe acute malnutrition (SAM) admissions of …

The Relationship Between Regulation And Care Access In The Doula Industry, Charissa Billings

University Honors Theses

Birth doulas are unregulated service providers in the United States, who provide informational, emotional, and physical support before, during, and after birth. Currently, the United States has the highest maternal mortality rate amongst the most developed nations, as well as a serious racial gap, with Black women being twice as likely to die due to pregnancy-related complications when compared to White women. Birth doulas can help close the gaps with trained support and advocacy. Since over 40% of the births in the US are covered by Medicaid, providing birth doula services to Medicaid recipients could result in improved birth outcomes. …

Attitudes Toward Mindfulness And Adherence In Chronic Pain Management, Sarah Johnson

Global Honors Theses

Chronic pain is a global public health problem, affecting 10-25% of the population. Mindfulness is an effective treatment but requires consistency. Because of its benefit, it is important to examine obstacles to mindfulness practice. In order to determine if negative attitudes toward mindfulness are related to non-adherence, 748 adults with chronic pain were recruited to fill out a series of questionnaires assessing treatment adherence and attitudes toward mindfulness. We found that positive attitudes toward mindfulness predicted reduced adherence. However, those who had more positive feelings toward mindfulness made more attempts at the therapy. Upper and middle-class participants had more positive …

Female Infertility In The United States And India: An Analysis Of Treatment Barriers And Coping Strategies, Devneet Singh

Honors Theses

This research studies barriers to accessing fertility treatment in the United States (U.S.) and India, as well as the coping strategies infertile women use. Barriers include reproductive health knowledge, cost, and politics, while coping is affected by cultural stigma, family, and religion. These two countries were chosen for their different cultural contexts, healthcare systems, and political infrastructure. Ten fertility specialists across both countries were interviewed as expert informants. Reproductive health knowledge was the most important barrier to accessing care in both countries, with similar gaps in understanding when and what type of care to utilize, though social media can educate …

Influenza Vaccine Uptake In Caregivers And Non-Caregivers: Implications For Policy And Practice, Nicholas Mercado

NYMC Student Theses and Dissertations

Background: Caregivers are a critical and highly utilized healthcare resource. Previous research suggests that caregivers experience adverse physical and mental health outcomes and practice less self-care while serving their role. Influenza, or the flu, is a common and infectious disease caused by a virus that is responsible for millions of doctor visits, hospitalizations, and approximately 43,000 deaths annually. The most effective measure for addressing the flu is primary prevention, which includes a seasonal flu vaccine. Methods: Behavioral Risk Factor Surveillance System (BRFSS) data from 2016-2018 were analyzed. The study population included 154,170 respondents from 27 states and the District of …

The Relationships Between Stress, Psychosocial Resources, And Mental Health And Adherence Outcomes Among Perinatally Hiv-Infected Adolescents In South Africa, Thabani Nyoni

Brown School Theses and Dissertations

Adolescents living with perinatally acquired HIV (APHs) in sub-Saharan Africa (SSA) constitute a significant population group that is experiencing poor HIV treatment outcomes (CIPHER Global Cohort Collaboration, 2018). Compared to younger children and older adults within the SSA sub-region, APHs experience poorer health outcomes, including retention in care, virologic treatment failure, and mortality rates (Anderson et al., 2019). Among countries in the SSA sub-region, South Africa has 360,000 adolescents living with HIV (ages 10-19), a disproportionate burden, accounting for 20% of the global adolescents living with HIV (UNAIDS, 2019a). The public health costs of suboptimal antiretroviral treatment (ART) adherence in …

Group Living Environment Responses To Pandemic: A Case Study Of Advocates, And The Covid-19 Crises, Nicole K. Atchue

School of Professional Studies

The literature will take a deeper look in the personal lives of developmentally disabled members and their staff who experienced COVID-19 pandemic in a group living environments. The holistic approach of understanding will navigate the history of care and the level care needed as well as external factors that played a larger role in explanation for the support provided.

Bail Discrimination: Racial Disparities In The United States Bail Determination Process, Collin Porter

School of Professional Studies

Nationwide, there is a systemic problem with bail determination: the process that a citizen goes through after they are arrested and before they go to trial to determine guilt or innocence for the crime they have been accused of committing. The United States leads all other countries with approximately half a million individuals detained before trial each year, a number nearly double the next highest country (China) (Nejdl, 2017). The high rate of pre-trial detention in the United States is due to both widespread use of monetary bail and the limited financial resources of most defendants; specifically, African American men. …

Pernet Family Health Service, Inc.: Organizational Restructuring & Change Management Best Practices, Carly Massino

School of Professional Studies

Research exhibits that between 70-75% of change initiatives fail and a major contributor to this trend is employee resistance. Although change can bring exciting growth and innovation, it can cause employees heightened stress and worsened physical and mental health outcomes. These effects are often amplified when organizations enact multiple change initiatives at once. These worsened outcomes are often a result of feelings of distress, anxiety, powerlessness, and apprehension and unknowns such as how one’s position will be affected, how operations will change, or how one fits into the change. This topic is incredibly relevant for Pernet Family Health Service, Inc., …

The Global Impact Of The Covid-19 Pandemic On Women’S Careers, Allison Bach

School of Professional Studies

This paper explores the impact that the COVID-19 pandemic has had on women’s careers on a global scale in the past year. It begins by focusing on the many pre-existing barriers that existed in realizing gender equality in the workplace prior to the pandemic, such as inadequate access to proper childcare, uneven participation in household labor between the genders, and pay inequality. The paper then continues to examine the impact that the pandemic has had on women’s careers across a variety of industries, countries, and specific groups. It was hypothesized that the COVID-19 crisis had created worse effects for women’s …

Moving From Shelter To A Housing First Reponse, Robyn Kennedy

School of Professional Studies

Massachusetts is a right to shelter state for families who experience homelessness. Based on decisions made several decades ago, the state assigned the response to families who experience homelessness to the Department of Welfare (now the Department of Transitional Assistance) and a shelter, rather than a housing response was adopted. Following national best practice, the state has decided to transition the system to a Housing First response. Through this research, I will be evaluating the trends in the industry and assessing what Massachusetts needs to do to achieve a Housing First approach to serving families who are experiencing homelessness. Unless …

Happening In Plain Sight: An Evaluation Of Sexual Harassment In Municipal Government Through A Case Study Of Newark, New Jersey, Hoween R. A. Flexer, Caitlin R. Louie

School of Professional Studies

In the city of Newark, New Jersey, Sebrevious Scott, a participant in the New Jersey Reentry program was hired as part-time office assistant in the city's re-entry office. After being transferred to the city’s Parks and Grounds Departments, she started being sexually harassed, inappropriately touched and propositioned by her supervisor, Richard Kirkland. Scott made repeated attempts to report these actions through the appropriate channels. She was met with dismissal, resistance, and later retaliation. While working in this hostile environment she was also pursuing a full-time employment opportunity with the city upon the completion of the reentry program. Unfortunately, this never …

The Human Services Workforce Crisis: Moving Forward With Intention In Massachusetts, Suzanne Gray Henderson

School of Professional Studies

The human services field is growing rapidly in Massachusetts as it is across the country, and the Commonwealth does not have enough qualified staff to fill vacancies. The workforce shortage has risen to crisis levels due to high turnover, insufficient training, low wages, and a lack of recognition and appreciation for direct support professionals. The individuals receiving services in Massachusetts deserve quality and stability. The state budget – strained by inefficient service models and reactive fixes – also demands systemic change. The human services workforce crisis impacts a variety of stakeholders. Individuals served are directly affected, as are the direct …

A Comprehensive Analysis Of Food Insecurity And Solutions In Worcester, Massachusetts, David Sullivan

School of Professional Studies

Worcester, Massachusetts is a postindustrial city with high levels of potential that faces the persistent obstacle of food insecurity for its low-income and ethnic minority communities. This research thesis examines food insecurity in general and explores data and trends in Worcester, then combines this with conceptual frameworks which explain how socioeconomic factors play into food security. It also explains the systemic inequalities present as a result of food insecurity and critiques academic assumptions surrounding food insecurity. One of these assumptions is that food deserts on their own can explain food insecurity in Worcester and elsewhere, though it has been found …