Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Planners Vs. Non-Planners: Do Preterm Births Impact Future Contraceptive Use?, Jessie Moore

NYMC Student Theses and Dissertations

Background: In the United States, 45% of all pregnancies are unintended and occur when contraception is not used or is used inconsistently. Among those pregnancies, 1 in 10 women will experience a preterm birth, which is defined as a birth occurring before 37 weeks gestation. Women who have delivered preterm are at an increased risk for preterm birth in future pregnancies and are encouraged to wait at least 18 months between giving birth and getting pregnant again. Among women who have experienced a preterm birth, the desire to delay future pregnancy or avoiding it all together often becomes a necessity …

The Clinical Healthcare Provided To Homeless Communities Across The United States: A Literature Review, Saylor Sisemore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Homelessness has become a global public health concern as it results in poorer physical and mental health than age-matched people living in permanent housing (Ortiz & Roser, 2017). The area that comprises Northwest Arkansas (NWA), like other areas of the United States experiencing rapid growth, has seen a marked increase in the number of people experiencing homelessness in recent years. The homeless population is one of the most vulnerable and underserved groups of individuals in NWA and beyond. Public health nursing as a discipline is dedicated to providing compassionate care and exceptional service for all members of communities, with special …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Identifying Critical Aging Care Challenges And Opportunities In High-Income Countries: A Cross-Country Comparison Of Denmark, Germany, And The United States, Cassandra Martin

Capstone Collection

Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. …

Eat Well, Be Well: Basic Needs Initiative's Online Hub For Nutrition Education, Misha Moseley

Capstone Projects and Master's Theses

Basic Needs Initiative at California State University, Monterey Bay is a department that provides students with food, housing, and wellness resources. Over half of the university's students experience food insecurity, and over 85% use non-academic resources to learn about nutrition. This project adds a dietary health section to the department’s website to increase students’ access to nutrition education. It addresses the micro-level agency problem that too few students eat a healthy, balanced diet. Unhealthy eating is a risk factor for food insecurity, so the project indirectly addresses the macro-level health problem that too many college students in California experience food …

Emerging Viral Diseases: Generation Z'S Outlook, Ian Mcwhorter

Honors Projects

Generation Z differs notably from previous generations like Baby Boomers or Generation X. In recent years, young adults have been persisting through the COVID-19 pandemic, though not unscathed. This paper seeks to answer the following question: How does Generation Z differ in its outlook on Viral diseases compared to previous generations? Using a series of three surveys conducted on three seperate Viral diseases (HIV, Zika, and COVID 19), it was found that while Generation Z has improved in its ability to combat Viral outbreaks due to factors like high digital literacy, other factors such as poorer mental health show that …

The Relationship Of Child Health And Parenting Stress To Child Neurocognitive Development, Nancy Alise Farrell

Theses and Dissertations (ETD)

Problem. Although the United States rates high in economic resources, the neurocognitive development (NCD) of children falls behind many other developed nations. Levels of parenting stress may be linked to sociodemographic factors such as the high incidence of poverty in children or health disparities in children, which in turn may affect NCD in children. Using the data from an observational, longitudinal cohort study of a diverse population could provide information related to parenting stress, child health, and related factors to guide and support interventions with families and policies to improve child NCD. Aims. The overall aim of this study was …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Exploring The Contextual Factors And Decision-Making Process Of Risky Sexual Behavior Among Homeless Adults In Louisville, Kentucky., Sarah C. Van Heiden

Electronic Theses and Dissertations

Homelessness is a complex public health issue; individuals who experience homelessness are said to engage in risky sexual behaviors at an increased rate and experience a higher prevalence of sexually transmitted infection (STI). While the sexual behaviors of homeless adolescents are commonly studied, little is known about the sexual behaviors of the growing population of older adults, or how they make decisions to engage in sex. Three aims guided this research: 1) to describe the sexual behaviors and sexual decision-making process of homeless older adults, 2) to examine how homeless older adults evaluate the outcomes associated with engaging in risky …

Mental Health Awareness Training Manual: For Faculty To Help Students, Ricardo Vega

Electronic Theses, Projects, and Dissertations

Mental health issues and stigma can affect students in many ways. The teacher-student relationship can be affected by the fear and inconsistent thoughts to be successful in college settings caused by mental health issues. First-generation college students face mental health issues due to support, education degree expectations, inhibition of uncertainty, and resources (Pascarella et al., 2004). This project is about providing communication strategies for faculty to help reduce stigma and provide students with resources to support their mental health.

California's Master Plan For Aging, Health Reimagined: A Case For Seniors To Age-In-Place, Remonia A. Bowie

Master's Projects and Capstones

Abstract

In 2021 Worldwide, communities face a singular yet common challenge; and this is the significant aging of their senior adult populations. Current evidence from the literature suggests that older adults prefer to stay in their homes as they age. However, the facilitators and challenges older people encounter in realizing their aging goals have been inadequately addressed by the current body of literature given the projected increase in the number of older people in the United States preferring to age from their homes. Aging adults are vulnerable to daily frustration, which could negatively impact their aging process. However, knowledge of …

Exploring The Mental Health Experiences Of African, Caribbean, And Black Youth In London, Ontario, Lily Yosieph

Electronic Thesis and Dissertation Repository

This qualitative study explores the mental health experiences of African, Caribbean, and Black (ACB) youth in London, Ontario, investigating how the factors of race, gender, culture, and place have shaped their perceptions and experiences of mental health. The data collection and analysis were conducted using a phenomenological approach and a critical lens informed by feminist, intersectionality, and critical race theories. These data illuminate the ways in which these young people’s attitudes toward mental health and help-seeking strategies are impacted by broader social constructs and community expectations, which they navigate and often resist in their everyday lives. Their insights can provide …

The Role Of Paraprofessionals In The Mental Health Structure Of India, Amy Abraham

Senior Theses

The mental health treatment gap in India is part of a growing public health crisis, with over 95% of those in need of services never receiving them. Over 197 million Indians suffer from at least one diagnosable mental health disorder, and this number continues to grow given the treatment gap. The treatment gap is a result of four major factors: lack of government support, stigma, limited treatment facilities, and the dearth of professionals able to provide treatment. The current study aimed to analyze several factors of paraprofessional led mental health interventions including setting, treatments delivered, treatment models, and client outcomes. …

How Does Access To Healthcare Affect Life Expectancy?, Yara Mahmoud

Senior Honors Projects, 2010-2019

Access to health care is a pressing issue in the United States, whether it be the cost of care or not having enough of it. To emphasize the importance of this topic, this paper assesses the impact of access to health services on life expectancy. A comparison is made between the universal health systems in France and Spain and the mixed system in the United States. Even though the United States spends the most on health care in the world, its statistics fall below those of other developed countries. After addressing other risk factors, it was found that individuals under …

Collection Of Analyzed Data From Health And Human Services Professionals: Stressors And Self-Care Practices, Yesenia Alcala

Capstone Projects and Master's Theses

Alliance on Aging is a nonprofit agency in Salinas, California. It was established in 1970, and they help serve the needs of the senior citizen community by offering multiple services. Working professionals experience high levels of stress in the workplace. Although there are many contributing factors for high stress in the workplace, the main factors at play are the lack of self-care and lack of support Zastrow (pg. 332, 2015). Because working professionally in the human services field experience high stress the consequences they may face are burnout, high turnover rates, and poor overall health. The capstone project will assess …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

A Characterization Of The Medical-Legal Partnership (Mlp) Of Nebraska Medicine, Jordan Pieper

Capstone Experience

This research study was completed at Legal Aid of Nebraska’s Health, Education, and Law Project through the partnership it has formed working with Nebraska Medicine and Iowa Legal Aid. Traditionally, health and disease have always been viewed exclusively as "healthcare" issues. But with healthcare consistently growing towards holistic approaches to help patients, we now know there are deeper, structural conditions of society that can act as strong driving forces of a person's poor daily living conditions that can negatively impact health. The importance of a Medical-Legal Partnership is that it considers a patient's social determinants of health (SDHs). The goal …

Healthcare Utilization For Behavioral Health Disorders: Policy Implications On Nationwide Readmissions, And Outcomes In The States Of Nebraska And New York, Rajvi J. Wani

Theses & Dissertations

The main goal of this dissertation was to estimate national-level inpatient readmissions and state-level hospital-based emergency department (ED) visits with behavioral health (BH) conditions in the states of Nebraska and New York. The dissertation aims to assess the impact of the policy mandates under the Patient Protection and Affordable Care Act on these state and national estimates. The Nationwide Readmissions Database and the State Emergency Department databases maintained by the Healthcare Cost and Utilization Project were used for this dissertation. US Adult population with high-risk of readmissions in the inpatient departments for alcohol-related disorders (ARD) and of visiting ED for …

Identifying The Newly Insurable Medicaid Coverage Gap Population Under The Affordable Care Act: Who They Are And Where They Live, Samuel L. Woodruff

Capstone Experience

The goal of this Capstone Project is to better define and geographically locate the potential distribution of individuals who fall within the current Medicaid Coverage Gap and those populations who would be eligible for Medicaid under the expansion of Medicaid within the state of Nebraska. Using data from multiple United States Census Bureau sources, along with available data from the Health Resources and Services Administration (HRSA), this project looks to also locate populations of these individuals that may live within established Medically Underserved Areas (MUA's) or Health Professional Shortage Areas (HPSA's) within the state. American Community Survey 5-year Public Use …

An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup

Electronic Theses and Dissertations

ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …

Analyzing The Effectiviness Of A Prescription Drug Monitoring Program Targeting At-Risk Opioid Abuse Patients, Treadway Childs

Public Administration ETDs

The effectiveness of a prescription drug monitoring program in coordination with a prescription opioid recidivism program was examined at a semi-rural community hospital. Patients were identified by a multi-disciplinary committee to be at-risk for opioid misuse or abuse, and were denied prescription opioids. Patients were considered eligible for the program if they had over 12 emergency department visits in the previous 12 months, or 6 visits in the previous 6 months, depending on how long the hospital had records on a patient. Patients who were placed in the prescription opioid recidivism program could not receive opioids at this hospital. The …

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

New Outpatient Experience Survey Design: A Quality Improvement Case Study, Nathan Paluso

Muskie School Capstones and Dissertations

The purpose of this capstone project is to evaluate the implementation process for a new survey methodology introduced by Maine Medical Partners (MMP), by following the Plan-Do-Study-Act (PDSA) quality improvement cycle framework. This new survey has been implemented to collect data on patients’ experiences in the MMP outpatient facilities, and is offered to the patients via iPad at check-out after their appointment. Through observation at MMP practices and MMP staff interviews, strengths and weaknesses of the implementation process have been identified. Evidence-based solutions pertaining to the identified weaknesses have been selected through a literature review and are incorporated in recommendations …

Understanding The Processes That Shape Cross Sector Service Provision In The Towards Flourishing Mental Health Promotion Strategy: A Secondary Analysis Utilizing Constructivist Grounded Theory Methodology, Shannon E. Winters

Electronic Thesis and Dissertation Repository

In Canada, many national, provincial, and regional policies indicate that working together within and across sectors in health and social care is necessary and expected but evidence to support this call is lacking. This dissertation study explored the concept of cross sector service provision (CSSP), defined as: independent, yet interconnected sectors working together to better meet the needs of service users and improve the quality and effectiveness of service provision. The intent was to advance our understanding of processes involved in shaping service provision offered by two or more sectors. The thesis contains three studies. A Scoping Review that explored …

Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver

Electronic Theses and Dissertations

Health psychologists with training in integrated care are ideal candidates to work in Federally Qualified Health Centers (FQHCs). However, despite the large documented need for more behavioral health providers in FQHCs, psychologists are underrepresented in this setting compared to other behavioral health professions. The purpose of this study was to: 1) examine the specific beliefs that are most relevant to executives’ intentions to hire psychologists, 2) determine how executives’ perceived control over hiring psychologists varies by several demographic variables, and 3) examine how well the Theory of Planned Behavior (TPB) predicts executives’ intentions to hire psychologists. Method: Executives (N …

Prep Advocacy Project: Increasing The Adoption Of Pre-­Exposure Prophylaxis (Prep) In San Luis Obispo County, Leona Rajaee

Journalism

The following study investigates the need for Pre­exposure Prophylaxis (PrEP) in San Luis Obispo (SLO) County in order to develop an effective health outreach and advocacy program that could increase the adoption of PrEP treatment and in turn decrease new HIV transmissions in the community studied. The sponsor of this study is the Access Support Network (ASN), a non­profit organization that provides supportive services for individuals living with HIV/AIDS. ASN launched this study after observing the effectiveness of PrEP in metropolitan cities. At the same time, ASN also noticed a rise in new HIV transmissions, particularly among injecting drug users …

Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano

Electronic Theses and Dissertations

For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported …

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …