Medicine and Health Sciences Commons^™

Client-Centered Practice When Professional And Social Power Are Uncoupled: The Experiences Of Therapists From Marginalized Groups, Brenda L. Beagan, Kaitlin R. Sibbald, Tara M. Pride, Stephanie R. Bizzeth

The Open Journal of Occupational Therapy

Background: Client-centeredness is foundational to occupational therapy, yet virtually no research has examined this aspect of practice as experienced by therapists from marginalized groups. The discourse of client-centeredness implicitly assumes a “dominant-group” therapist. Professional power is assumed to be accompanied by social power and privilege. Here, we explore what happens when professional and social power are uncoupled.

Method: In-depth interviews grounded in critical phenomenology were conducted with Canadian therapists (n = 20) who self-identified as disabled, minority sexual/gender identity (LGBTQ+), racialized, ethnic minority, and/or from working-class backgrounds. Iterative thematic analysis employed constant comparison using ATLAS.ti for team coding. …

The Influence Of Integrated Behavioral Health Primary Care Setting On The Utilization Of Mental Health Services And Depression Treatment Response Among Men, Tendai Masiriri

Dissertations

The 2010-2013 National Health Interview Survey showed that nearly 9% of men had daily feelings of anxiety or depression, yet less than 41% sought help for their symptoms (Blumberg et al., 2016). Men are more reluctant than women to seek help (Angst et al., 2002; Brownhill et al., 2005). The failure to seek help among men is associated with multiple factors related to stigma and gender, yet male suicide rates are approximately 3-5 times higher than their female counterparts. However, they have a higher likelihood of seeking help from a medical provider rather than a mental health provider. If men …

Disability And Health In African Americans: Population Research And Implications For Occupational Therapy Community-Based Practice, Emily Schulz, Debarchana Ghosh, Eddie M. Clark, Beverly R. Williams, Randi Williams, Lijing Ma, Crystal L. Park, Cheryl L. Knott

The Open Journal of Occupational Therapy

Background: Population-based research and community-based interventions are integral to occupational therapy’s scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African American population, guided by the Person-Environment-Occupation-Performance Model.

Method: Using data from an observational cross-sectional nationwide telephone survey of African American adults, we examined differences between African Americans who are receiving disability payments (RDP) and those who are employed full time (FTE) on several physical health behaviors and psychosocial health indicators. We further compared the differences between African Americans RDP versus those FTE on those physical health …

Ethnic Comparisons In Perceptions Of Health, Happiness, Hope, And Related Social Determinants Of Health In A Majority-Minority Midwestern Town, Virginia Chaidez, Yumou Qiu, Angela L. Palmer-Wackerly, Julie A. Tippens, Gilbert R. Parra, Patrick Habecker, Kimberly Gocchi Carrasco, Jordan Soliz, Lisa M. Pytlikzillig, Kirk Dombrowski

The Journal of Sociology & Social Welfare

In a rural Midwestern community sample (n=273), large proportions of Somalis and Whites ranked overall health as "Very good" (57% and 50%, respectively), while Hispanics (42%) considered it "Good". Across all groups, most are either "Happy" or "Very happy" with their jobs—64%, 91%, 83%—or their families—85%, 93%, 91.6%— with reference to Hispanics, Somalis, and Whites, respectively. When asked “In the past 30 days, how often did you feel hopeless?”, 83% of Somalis and two-thirds (67%) of Whites responded, "None of the time", while half (50%) of Hispanics indicated the same. Overall, Hispanics appeared to be less …

Addressing The Needs Of African American Grandparents: An Intersectionality Perspective, Dorothy Smith-Ruiz, Kendra Jason

The Journal of Sociology & Social Welfare

This study seeks to demonstrate the intersecting structural and compounding challenges African American custodial grandparents experience collectively, rather than as separate non-competing factors, which has been modeled in prior studies. Using a mixed-method research design, the study explored the challenges faced by African American and white custodial grandparents. These challenges included difficulties attaining different types of support, respite care, and programs for teens and special needs grandchildren. Results showed that caregiving challenges among African Americans were more pervasive than their White counterparts. These findings have significant implications for the development of intervention programs for custodial African American grandmothers and their …

Cancer Health Disparities Among African Americans: A Socioecological Approach, Seth M. Spitzley

The Hilltop Review

Research shows that health outcomes are influenced by race or ethnicity, socioeconomic status, education and literacy levels, and the physical environment (U.S. Department of Health and Human Services, 2014). The health statuses of minority groups, such as African Americans, are adversely impacted by inequality (Randall, 2009). In Kalamazoo, Michigan, the leading cause of death for all residents in Kalamazoo County was cancer, where black individuals have the highest death rate among any other racial or ethnic group. That African Americans comprise less than 11% of the population in Kalamazoo County thus suggests that African Americans are disproportionately impacted by cancer …

Multiplicative Advantages Of Hispanic Men Living In Hispanic Enclaves: Intersectionality In Colon Cancer Care, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey

The Journal of Sociology & Social Welfare

We examined Hispanic enclave paradoxical effects on cancer care among socioeconomically vulnerable people in pre-Obamacare California. We conducted a secondary analysis of a historical cohort of 511 Hispanic and 1,753 non-Hispanic white people with colon cancer. Hispanic enclaves were neighborhoods where 40% or more of the residents were Hispanic, mostly first-generation Mexican American immigrants. An interaction of ethnicity, gender and Hispanic enclave status was observed such that the protective effects of living in a Hispanic enclave were larger for Hispanic men, particularly married Hispanic men, than women. Risks were also exposed among other study groups: the poor, the inadequately insured, …

Sexual Harassment Of Biology And Biomedical Sciences Undergraduates: A Study On The Effects Of Larry Nassar And William Strampel, Kathleen Ryan

Honors Theses

Sexual harassment amongst undergraduate women of science is a prominent issue, gaining much media attention. The goal of this study is to determine if, and how, major sexual harassment cases impact women pursuing science-related careers, and what the sexual harassment climate is like for these individuals. The study will examine prevalence of harassment, common types of sexual misconduct, perpetrators, and severity through an anonymous survey. Additionally, this study will look into the effects of the Nassar and Strampel cases regarding desire to report harassment, and students’ fear of experiencing harassment in their future educations and careers. It is hypothesized that …

Kinship Diversion In The District Of Columbia: A Review Of Local Practice To Inform National Policy, Marla P. Spindel, Beth A. Stekler, Stephanie Ridgway Mcclellan

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This article addresses a practice commonly known in the child welfare community as “kinship diversion,” where a child welfare agency informally places children with relatives as an alternative to foster care. While evidence predominantly shows that abused and neglected children have better outcomes when they are placed with relatives when they cannot remain safely at home, serious concerns about these children’s safety and well-being arise when the placement with relatives is informal. Indeed, it is often not understood that these same relatives can be approved as foster parents and can receive essential financial assistance and supportive services to help safely …

Assessment For Mild Cognitive Impairment: Striving For Best Practice, Julie Leigh Dalmasso

Dissertations

This dissertation is a series of three studies aimed at determining the best assessment practices for mild cognitive impairment (MCI) that can employed by speech-language pathologists (SLPs). The first study was non-experimental and descriptive examining whether three commonly used assessment instruments yielded similar categorical results. The data were analyzed to determine whether the Eight-Item Interview to Differentiate Aging and Dementia (AD8), the Mini-Mental State Examination (MMSE), and the Cognitive-Linguistic Quick Test (CLQT) identified the same participants from a neurotypical sample as having cognitive deficits. Very little agreement was found amongst the three tools.

Study two was modified to include two …

Grandparenting In Selected West African Countries: Implications For Health And Hygiene Behaviours In The Household, Joshua Oyeniyi Aransiola Dr, Akanni Ibukun Akinyemi Dr, Ambrose Akinlo Dr, Funmi Togonu-Bickesteeth Prof.

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This is a descriptive study of the health and hygiene behaviors of grandparents who are the primary caregivers of their grandchildren in four West African countries, Ghana, Liberia, Nigeria, and Sierra Leone. The article utilizes data from each country’s most recent Demographic and Health Survey (DHS). The study identified 20,841 households where grandparents were primary caregivers. As expected, most of these households are in Nigeria given their population exceeds the collective population of the other three West African countries. However, the number of grandfamilies in Ghana, Sierra Leone and Liberia is still worrisome for their population size. In each country, …

The Association Between Neighborhood Factors And Mexican Americans’ Mental Health Outcomes: A Systematic Review, Kai Wei, Jaime Booth

The Journal of Sociology & Social Welfare

This systematic review seeks to elucidate the association between neighborhood factors and Mexican American mental health outcomes. We searched PsycINFO and Academic Search Premier for studies related to neighborhood factors and mental health. Google Scholar was used to identify additional studies, followed by a manual inspection of the related work. Eleven studies were identified. Nine studies found that neighborhood factors had a significant impact on mental health among this group. Neighborhood compositional factors influenced mental health directly, among which minority concentration was found to be protective for Mexican American mental health. Neighborhood contextual factors influenced mental health directly and indirectly …

When ‘Places’ Include Pets: Broadening The Scope Of Relational Approaches To Promoting Aging-In-Place, Ann M. Toohey, Jennifer A. Hewson, Cindy L. Adams, Melanie J. Rock

The Journal of Sociology & Social Welfare

Aging-in-place is a well-established concept, but discussions rarely consider that many older adults live with pets. In a ‘pet-friendly’ city, we conducted semi-structured interviews to explore perspectives of community-based social support agencies that promote aging-in-place, and those of animal welfare agencies. Applying a relational ecology theoretical framework, we found that pets may contribute to feeling socially- situated, yet may also exacerbate constraints on autonomy experienced by some older adults. Pet-related considerations at times led to discretionary acts of more-than-human solidarity, but also created paradoxical situations for service-providers, impacting their efforts to assist older adults. A shortage of pet-friendly affordable housing …

Digital Storytelling As Poetic Reflection In Occupational Therapy Education: An Empirical Study, Lisebet S. Skarpaas, Grete Jamissen, Cecilie Krüger, Vigdis Holmberg, Pip Hardy

The Open Journal of Occupational Therapy

Stories are powerful aids to reflection. Thus, the use of stories may be a pathway to enhanced reflective practice and clinical reasoning skills. The aim of this study was to evaluate whether and how digital storytelling can contribute to occupational therapy (OT) students’ learning through reflections on experiences from placement education. A cohort of OT students (n = 57) participated in a 2-day workshop to create digital stories. Data were generated through a questionnaire with a response rate of 100% of students who completed the workshop (n = 34). Quantitative analysis methods were used to reveal a level of agreement …

Facing Our Demons: Psychiatric Perspectives On Exorcism Rituals, Joel R. Sanford

The Hilltop Review

Belief in possession by malevolent spirits exists in many cultures and religions throughout the world, and such beliefs often serve as explanations for a variety of psychological and emotional afflictions. Traditional remedies in these cases often involve exorcism rituals, which are believed to expel spirits from a person's mind and/or body. Some of the cases commonly attributed to involuntary spirit possession are diagnosed within the psychiatric community as schizophrenia or some sort of dissociative disorder and treated with psychotherapy and/or medicine. For some in the psychiatric community, exorcisms and their use by patients are viewed as problematic due to their …

Demographic Profile, Geographic Distribution, Disability Prevalence, And Likelihood Of Being In-Poverty Amongst Grandparents Responsible For Grandchildren, Carlos Siordia, Mary E. Rauktis

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

Evidence-based research on Grandparents Responsible for Grandchildren (GRfG) continues to grow in recent decades. This brief report expands global knowledge on custodial grandparents by making use of a large data resource in the United States (US). The specific aim was to delineate the demographic profile, geographic distribution, and prevalence of specific-disabilities for the GRFG population in the US mainland. We also explore how demographic factors are associated with likelihood of being in-poverty. The analysis used data from the 2009-2013 American Community Survey (ACS) 5-year Public Use Microdata Sample (PUMS) file. The ACS is a nationally representative, yearly, statistical survey administered …

Executive Functions And Social Interactions: Developing Social Scenarios, Mackenzie Waite

Masters Theses

The aim of this study was to develop a series of vignettes to form the basis for an assessment of executive functions (EFs) for 9 – 12 year old children. Although EFs are necessary for effective social communication and positive social interactions, currently, most EF assessments focus on impersonal activities. Little research exists that incorporates real-time processing using ecologically valid social scenarios. The current study aims to develop realistic scenarios that children could encounter in daily life. Ethnographic interviews were conducted with six participants, who worked in a school with 9-12 year old children, to gain their perspective on social …

Perceived Neighborhood Safety And Psychological Distress: Exploring Protective Factors, Jaime Booth, Stephanie L. Ayers, Flavio F. Marsiglia

The Journal of Sociology & Social Welfare

While a growing body of literature has established a relationship between "disordered" neighborhoods and psychological distress, less is known about the specific mechanisms at work. Using data collected in the 2008 Arizona Health Survey (N = 4,196), hierarchal linear regression was conducted to assess both the independent effect of perception of neighborhood safety on psychological distress, as well as the mediating effects of powerlessness, social isolation and mistrust. The findings suggest that the more safe individuals feel in their neighborhood, the less psychological distress they experience (b = 1.07, SE = .17, p < .001). This relationship appears to be partially mediated by feelings of powerlessness, social isolation and mistrust, indicating potential risk and protective factors.

In Their Own Words: The Lived Experiences Of Unemployed African American Men, Kenlana R. Ferguson

Dissertations

Due to staggering unemployment rates, African American men's experience with work in the U.S. has historically received widespread attention in the media and social science literature. Terms such as black male unemployment crisis, puzzle, epidemic and catastrophe have been used to describe the unemployment woes of black. Attempts at explaining why African American men are experiencing such difficulty in the world of work has been undertaken across the disciplines, however much of this work has amounted to nothing more than acknowledgement that isolating independent factors as causes does not suffice and that a more interdisciplinary framework is needed if we …

Emergency Room Use By Undocumented Mexican Immigrants, Ayse Akincigil, Raymond Sanchez Mayers, Fontaine H. Fulghum

The Journal of Sociology & Social Welfare

This study examined emergency room use by undocumented Mexican immigrants and their sources of health care information. Thirty-eight percent of the respondents reported that they would use a hospital emergency room (ER) for primary medical care. ER use rates declined with time spent in the United States. Emergency room use rates varied significantly by region. Respondents receiving information from a church reported less ER use, compared to all others; respondents receiving information from U.S. newspapers reported higher ER use rates. Lack of health care access for undocumented immigrants remains a public health issue as well as a social justice concern.

Health Service Access For Rural People Living With Hiv/Aids In China: A Critical Evaluation, Xiying Wang, Xiulan Zhang, Yuebin Xu, Yurong Zhang

The Journal of Sociology & Social Welfare

The increasingly serious HIV/AIDS epidemic creates a significant burden for the public health system; however, little attention has been paid to the issue of health service access in rural China. Based on a qualitative study of 34 Chinese rural People Living with HIVIAIDS (PLWHA) and 13 health providers, this study fills a gap by examining health service access from both the demand and supply-side. Utilizing access theory, this study explores the availability, affordability and acceptability of health services in rural China. Moreover, this study focuses on access barriers and institutional obstacles that PLWHA meet during their illness and considers the …

Evaluation Of Verbal Behavior In Older Adults, Amy Gross

Dissertations

Older adults make up a large and increasing portion of the population (U.S. apply those assessments to the evaluation of verbal behavior in older adults with and without dementia. The research addressed two questions. First, in what way do verbal behavior problems differ between older adults with and without dementia? Second, does language deteriorate in a pattern compatible with Skinner's analysis of functionally independent verbal operants? Thirty-one participants were categorized into Control (n=15) and Dementia (n=16) Groups based on their score on the Dementia Rating Scale-2. Verbal behavior assessments were administered to participants on two occasions, separated by one week. …

Exploring The Well-Being Of Foster Children Of Parents With Substance Abuse Problems In Family Dependency Treatment Courts, Barbara M. Howes

Dissertations

The aim of this three-paper format dissertation is to explore how the well-being of foster children of parents with substance abuse problems is defined and promoted through Family Dependency Treatment Courts (FDTC) within the context of the Adoption and Safe Families Act (ASFA). The benefit to the author of the three-paper method is the task of submitting the findings of the study for publication is eased as the dissertation contains three stand-alone articles. A drawback for the reader of the three paper method is that there is redundancy in reading the same sections in each paper. The reader is encouraged …

Latina Women’S Reasons For And Experience Of Sexual Assault Disclosure: A Qualitative Investigation, Melissa Villarreal

Dissertations

This study describes Latina women’s experiences of sexual assault disclosure. The research questions are: (1) What reasons do Latinas give for choosing to disclose, not to disclose, or to delay disclosure of their experiences of sexual assault? (2) Can patterns be detected regarding to whom Latinas disclose and under what circumstances? (3) What feelings and consequences do Latinas remember experiencing during their initial disclosure? (4) In retrospect, how do Latinas interpret their self-disclosure decisions? Participants for this study agreed to be interviewed about their sexual assault experiences. Seven interviews were gathered in 2005 and six in 2011. A constant comparison …

Life History And Narrative Analysis: Feminist Methodologies Contextualizing Black Women's Experiences With Severe Mental Illness, Marya R. Sosulski, Nicole T. Buchanan, Chandra M. Donnell

The Journal of Sociology & Social Welfare

This paper discusses a methodological approach to research that enhances critical analysis by contextualizing qualitative research findings within participants' individual experiences. We demonstrate the combined use of life history methods and feminist narrative analysis to explore Black women's everyday experiences with mental illness, from their perspectives. These interpretive methods reach beyond pathologized conceptions of identity and adjustment that often narrowly characterize mental illness among Black women. Instead, these methods holistically describe a participant's experiences and strategies she uses to pursue goals and enhance her life. The use of the methods is illustrated with examples from the life narrative of "Maria," …

Lgb-Affirmative Therapists' Use Of Developmental Models Of Lgb-Identity In Therapy. A Phenomenological Investigation, Victoria E. Cane

Dissertations

Socially sanctioned hostility toward sexual minority persons continues to be a reality in the United States and worldwide. Therapists working with sexual minorities have responsibility to provide non-pathologizing, affirmative therapy to these clients. A central aspect of affirmative therapy is therapists' recognition and understanding of sexual orientation (SO) identity and developmental models of sexual minority identity have a played a vital role in promoting this understanding. Although such models have been central to the practice and training of affirmative therapy, therapists' applied use of the models has not been empirically investigated. For this phenomenological study, nine affirmative therapists were interviewed …

Ethnicity Matters: The Socioeconomic Gradient In Health Among Asian Americans, Emily S. Ihara

The Journal of Sociology & Social Welfare

This study examines the relationship between socioeconomic indicators and health status among Asian Americans using data from the 2001 California Health Interview Survey (CHIS), a population-based random-digit-dial survey with race-ethnic supplemental samples. Multivariate logistic regression analyses show that the inverse relationship between socioeconomic position and health status is similar for Asian Americans when measured as an aggregate group compared to Whites. However, when specific Asian American ethnic groups are examined, the relationship varies greatly. For example, among Chinese Americans and Vietnamese Americans, education is a significant predictor of poor health status, but household income is more significant among Korean Americans. …

Visual Impairment And Eye Care Among Older Americans: Secondary Analysis Of The Behavioral Risk Factor Surveillance System (Brfss), Amy L. Freeland

Dissertations

The aim of this three-paper format dissertation is to explore three topics relevant to public health and vision loss. The three papers are independent studies, yet build upon each other by first describing the population of people aged 40 years and older in the United States in terms of visual impairment, diagnosed eye disease/injury, and their use of eye care, and then next exploring the factors that influence eye care use for both the general population and the subpopulation of people with diagnosed diabetes. The first paper provides a state-level examination of the characteristics of people aged 40 years and …

Using Social Construction Theory As A Foundation For Macro-Level Interventions In Communities Impacted By Hiv And Addictions, David Allen Patterson, Robert H. Keefe

The Journal of Sociology & Social Welfare

Many professionals working with people living with HIV and alcohol and other drug addictions rely heavily on micro and mezzo-level interventions. The authors argue that although these approaches are effective for helping people living with some social problems they are too narrow for working effectively with HIV-positive and alcohol and other drug-addicted individuals. The authors use social construction theory to analyze the social problems of HIV/AIDS and addictions and make recommendations for macro-level interventions that may help curtail the dual problems of HIV and addictions.

The Use Of Critical Ethnography In Managed Mental Health Care Settings, Cassandra L. Bransford

The Journal of Sociology & Social Welfare

How social workers in managed mental health care settings exercise their professional authority may have profound consequences for the provision of ethical and value-based services to vulnerable populations. Building upon Gidden's theory of structuration, this article describes the use of critical ethnography as a specific research methodology that may support social workers in the exercise of their authority. This article examines the historical roots of critical ethnography and provides a detailed examination of its underlying assumptions and research procedures. The article concludes with a case example of a critical ethnography conducted within a managed mental health care setting.