Community Health Commons^™

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

Youtube, Cyberbullying And Covid-19, Ani Shavliashvili

Dissertations and Theses

The purpose of this research is to uncover how people discuss bullying or cyberbullying experiences via YouTube videos before and after the start of the COVID-19 pandemic. Since people were indoors during the pandemic, individuals took to social media and left comments on YouTube about bullying. Since people could not discuss bullying in-person, it was interesting to see how people shared their views on bullying and cyberbullying via YouTube, as well as how that might have changed after the start of COVID-19. The purpose of this study is to demonstrate how social media platforms like YouTube provide a safe space …

Antipsychotic Medication Administration In Oregon Assisted Living/Residential Care Settings: Analyzing An Action Situation, Sarah Dys

Dissertations and Theses

Antipsychotic medication use (APU) in assisted living and residential care (AL/RC) settings is an under-studied and controversial health policy issue. APU in older adults with dementia is associated with an increased risk of falls, hospitalizations, and early mortality. I operationalize the Institutional Analysis and Development Framework using a situational analysis approach, an extension of grounded theory methods, to explore the APU in Oregon AL/RC settings. Regulatory deficiency citations, Oregon AL/RC population data, and semi-structured interviews suggest that staff role clarity, organizational characteristics, and perceived agency influence decision-making around APU. AL/RC providers and caregivers are forced to simultaneously balance and prioritize …

An Examination Of Hiv Risk, Testing And Prevention Intervention Participation Among Vulnerable Youth, Bianca V. Lopez

Dissertations and Theses

Background: Young gay, bisexual and other men who have sex with men (YGBM) of color are disproportionately affected by HIV and bear the burden of the disease in the United States. Gay and bisexual men – referred to in surveillance systems as men who have sex with men (MSM) – continue to be the risk group most severely affected by HIV in the United States. The dissertation study explored factors related on HIV prevention intervention participation, HIV testing and sexual risk behaviors among YGBM ages 13-29 in the Bronx. Additionally, this dissertation endeavored to study the concept of “intervention fatigue”, …

Impactful Care: Addressing Social Determinants Of Health Across Health Systems, Nicole Lisa Friedman

Dissertations and Theses

There is emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs. Unmet health-related social needs, such as food insecurity, inadequate or unstable housing, and lack of access to transportation may increase the risk of developing chronic conditions, reduce an individual's ability to manage these conditions, increase health care costs, and lead to avoidable health care utilization. In response, work on social needs is happening across large health systems in the United States, but the pace of progress is slow and accountability is diffuse.

The goal of this applied research project is …

Framing Physical Activity: Weight Control Frames And Physical Activity Motivation, Kristin Spurkland

Dissertations and Theses

Public health institutions and popular media frequently frame weight loss and weight control as primary benefits of physical activity. This exploratory, descriptive study examined how respondents rated statements exemplifying three physical activity frames: a weight control frame, a medical frame, and an active embodiment frame. An anonymous, online survey was conducted in March 2018; respondents rated frame statements in terms of inspiring motivation to engage in physical activity, and in terms of perceived credibility. They also provided anthropometric data and physical activity data. Data were analyzed for the entire sample as well as stratified by multiple variables, including body mass …

Dietary And Physical Activity Acculturation And Weight Status In Chinese College Students, Yanni Zhang

Dissertations and Theses

This cross-sectional study examined the relationships between length of residence in the United States (U.S.) and dietary and physical activity acculturation, and the relationships between dietary and physical activity acculturation and weight status in 55 Chinese college students. Length of residence in the U.S. was positively associated with larger portion size, greater amount of physical activity, and change in BMI in male participants. Adoption of a Western diet was associated with weight gain. Portion size change was positively associated with BMI change. Lunch size change was positively correlated with BMI change in males while negatively correlated with BMI change in …

A Cross-Sectional Study Of Student-Athlete Needs Satisfaction And Well-Being, Abigail M. Gunnink

Dissertations and Theses

Grounded in self-determination theory (Deci & Ryan, 2000), the purpose of this study was to examine (a) the effects of the social environment, as defined by the divisions of the Department of Athletics, on student-athletes' perceptions of basic needs satisfaction, (b) the effects of basic needs satisfaction on well-being, and (c) the effects of time demands, during in-season and off-season, on well-being, among student-athletes at Portland State University (PSU). Participants were student-athletes at PSU (n = 118). The participants completed a multi-section survey assessing basic needs satisfaction and well-being. Cumulative mean scores highlighted the satisfaction of the basic psychological needs …

The Historical, Political, Social, And Individual Factors That Have Influenced The Development Of Aging And Disability Resource Centers And Options Counseling, Sheryl Dejoy Elliott

Dissertations and Theses

This thesis reports on the perspectives and experiences of policymakers, advocates, agency supervisors, and experts in the field of gerontology, about the development of Aging and Disability Resource Centers (ADRC) programs and Options Counseling (OC). By examining the foundations upon which ADRCs and OC are built, this study sought to inform future research about the effectiveness of existing practice, increase understanding of best practices, and clarify whether these emerging services are accomplishing original goals.

ADRCs and OC intend to address long-term care issues and healthcare needs by providing a single entry point to the social service system. ADRCs offer information, …

Empowerment In Community-Based Participatory Research With Persons With Developmental Disabilities: Perspectives Of Community Researchers, Erin Elizabeth Stack

Dissertations and Theses

Community-based participatory research (CBPR) is a research approach that benefits from the expertise of community members being involved in the research along all stages of a project (Israel et al., 2003). CBPR is often utilized with marginalized populations in order to amplify a community's voice on important issues in their lives (Bastida, Tseng, McKeever, & Jack, 2010; Minkler & Wallerstein, 2008). In the past, persons with disability have been excluded from research in order to protect them from exploitation. This practice of exclusion undermines opportunities for persons with disabilities to be independent and make decisions that are important for themselves …

Risk Factors For Homelessness Among Community Mental Health Patients With Severe Mental Illness, Rupert Talmage Van Wormer

Dissertations and Theses

The purpose of this study was to identify risk factors associated with homelessness, assess the relationship between housing status and consumption of costly publicly funded resources, to identify characteristics associated with service retention, and to evaluate whether length of treatment is associated with better outcomes. The target population was homeless and formerly homeless adults with SMI enrolled in community mental health services at the Downtown Emergency Service Center SAGE mental health program located in Seattle. The sample consisted of 380 SAGE patients who had continuous enrollment in 2005. These patients formed the cohort for the study. Agency records for these …

Comparison Of Cardiovascular Disease Risk In Japanese Natives And Japanese Americans, Mayumi Takeda

Dissertations and Theses

This research examined potential differences in cardiovascular disease risk (CVR) in two groups: Japanese Natives living in Saga, Japan and Japanese Americans living in or near Portland, Oregon. It explored data gathered in an effort to build a theoretical framework for future studies. Environmental, nutritional, and lifestyle differences were also examined to compare the health status of Japanese residents in the two countries. The history of Japan from World War II to present, and the history of Japanese Americans both first and second generation, are discussed in the literature review.

Accelerated plethysmography (APG) is a technique which presumably allows the …

Evaluation Of The Role Of Neighborhood Health Coordinators In A Comprehensive Neighborhood Health Services Project, Sharron Faye Easley, John Collins Flanagan, Janet Fredricksen, Linda Janice Johnson, Beatrice Hays Young

Dissertations and Theses

This study evaluates the role of the Neighborhood Health Coordinators (NHC's) within Kaiser Foundation's Comprehensive Neighborhood Health Services (CNHS) Project. This project was established in September 1967, under the provisions of the 1966 amendments to the Economic Opportunity Act, to provide and make readily available comprehensive medical care to low-income persons. In compliance with the stipulations of this Act, persons who reside in target areas, designated as depressed neighborhoods, were hired to serve as NHC's. These indigenous non-professionals serve as links or "gatekeepers" between the low-income persons enrolled in this program, and the Kaiser medical care facilities which include the …