Social and Behavioral Sciences Commons^™

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Device-Based Measures Of Maternal Physical Activity, Pregnancy Nocturnal Glucose, Postpartum Sleep, And Infant Adiposity, Bethany R. Hallenbeck

Doctoral Dissertations

This dissertation presents physical activity, sedentary behavior, and bedrest (sleep estimation) data from ActiGraph devices worn during pregnancy and postpartum. Analyses of these data consider how these behaviors may relate to each other and health outcomes in the mother and child. The research aims to bridge the gap in understanding the intricate relationship between physical activity health behaviors and maternal and infant health metrics during the critical phases of pregnancy and postpartum. For this work, we employed repeated measures mixed modelling and integrated device-based, research-grade, ActiGraph data with clinical measures and survey responses to elucidate the multifaceted dynamics influencing a …

Discriminative Nursing Care Practices Towards Patients With Opioid Use Disorder In The Hospital Setting: How Knowledge And Social Attitudes Impact Care Delivery, Jeanne Adam Bernier

Doctoral Dissertations

Discriminative nursing care (DNC) practices towards patients with opioid use disorder (OUD) is a current phenomenon negatively affecting patient care and patient outcomes. It leads to delays in care, insufficient pain control, and feelings of guilt and shame, and it is linked to self-isolation, social isolation, social rejection, and even unemployment and housing disruption which perpetuate a dangerous cycle of inequity that is hard to overcome. In some cases, OUD stigmatization even increases morbidity and mortality rates. OUD stigmatization and discrimination are real problems in today’s health care climate due to the vast number of people affected by OUD and …

Experiences Of Black American Millennials: A Qualitative Study Of Internalized And Externalized Coping In The Face Of Racial Trauma, Natalia Angelique Giles

Doctoral Dissertations

The experiences Black Americans have faced when standing against racial trauma have impacted the Black community for generations. Though previous generations faced overt styles of racism throughout the eras of slavery and Jim Crow, the invalidation and discrimination have remained consistent within the experiences of the Black American millennial (BAM) generation. Current experiences BAMs face are a combination of both overt and covert styles of racism, which increase mental exhaustion, reduce motivation, and leave the individual psychologically defenseless. The purpose of this qualitative study was to examine the experiences of BAMs in the face of racial trauma. This qualitative research …

Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus

Doctoral Dissertations

This dissertation explored the potential effects of intersections of oppression (i.e., anti-Black racism, diabetes discrimination, and sexism) on mental health and pregnancy experiences among Black women and birthing people with Type 1 diabetes (T1D). Previous studies about pregnancy and T1D have included mainly white, cisgender women. Three participants qualified for inclusion in the present study and participated in semi-structured interviews, which the researcher analyzed using an interpretative phenomenological analysis (IPA) framework. Participants described feeling uncertain about whether aspects of their pregnancy experiences were related to obstetric and/or medical racism. Similarly, participants sometimes seemed uncertain about how racism may affect their …

The Grindr Complex: The Behavioral Health Impact Of Sexual Racism On Latinx Men Who Have Sex With Men, Luisalfredo Plascencia

Doctoral Dissertations

Given the social history surrounding the issue of HIV/AIDS in the LGBTQ+ community and the unique and intersectional experiences that Latinx Men who have Sex Men (MSM) have in their community, this dissertation’s research will contribute to the growing work on sexual racism and how it correlates with various elements of behavioral health. The study investigated the moderation impact of Latinx cultural values of caballerismo and familismo on the relationship between experiences sexual racism to mental health symptoms. The study also examined the moderation of caballerismo and familismo and psychological flexibility on the relationship between experiences of sexual racism to …

Investigating The Transfer Of Learning, Psychological, And Neural Effects In Immersive Virtual Reality, Logan Taylor Markwell

Doctoral Dissertations

Achieving mastery or expertise requires a substantial amount of quality practice. Recent technological developments have introduced a novel approach to practice, virtual reality. Specifically, virtual reality offers a low-cost, customizable opportunity to practice while minimizing the risk of the individual. Given that some types of practice may not lead to the acquisition of a motor skill, or worse, lead to detriments of that skill, understanding the developing science of motor behavior in relation to virtual reality is imperative. The following literature review will begin with a brief historical account of the evolution of virtual reality. Next, some terms of virtual …

Faith Influences On Health Of Rural Appalachian Older Adults In East Tennessee: An Ethnonursing Study, Karina Elizabeth Strange

Doctoral Dissertations

As the U.S. older adult population increases and diversifies, healthcare providers need innovative, cost-effective, and culturally congruent approaches to gerontological nursing care. Decades of multidisciplinary evidence demonstrate that spirituality enhances older adult holistic health. However, although research about spirituality and nursing has become more culturally diverse, little is known about spirituality-health linkages of rural Appalachian older adults (RAOAs). This knowledge gap is significant because Appalachia leads the country in mortality related to chronic comorbidities such as heart disease, cancer, and depression. Given age, poverty, limited transportation, and health provider shortage areas, RAOAs experience severe health disparities. Moreover, spirituality is an …

Sphenoidal Sinuses And Spherical Harmonics: Variation And Covariation Of The Most Morphologically Diverse And Least Understood Paranasal Sinus, Katharine Grace Josephine Ryan

Doctoral Dissertations

Understanding the shape variation of the human sphenoidal sinus is important to several areas of research. This includes clinical investigation (sinus pathology and safe endoscopic endonasal surgical practice) and paranasal sinus evolution (for which there is still no consensus). Yet, the sphenoidal sinus has high morphological variation, prohibiting its quantification through traditional geometric morphometric landmarking methods. The sphenoid body, and thus also the sinus contained within, is located directly at the developmental center of the basicranium in humans, where the three cranial fossae meet at the midline, and adjacent to the three synchondroses which are the sites of cranial base …

Intra-Skeletal Variation In Stable Isotopes Through Non-Destructive Approaches: Applications Of The Patterns Of Skeletal Remodeling To Biological Anthropology, Armando Anzellini

Doctoral Dissertations

Stable isotope analysis is a well-established method in biological anthropology used to deliver data on residence, diet, and life history. Samples for these analyses are often collected from the diaphyses of long bones with an assumption of an expected rate of turnover between five and ten years, depending on the skeletal element. However, the biological foundations of this assumption are still uncertain, especially concerning the intra-skeletal and intra-element variation of isotopic signatures that may relate to patterns of remodeling. Exploring these gaps in intra-element isotopic variation requires fine-grained work using multiple bones from multiple individuals, but such work is limited …

Genealogy Tells: Informing Health And Aging Policies Using East Tennessean Older Women's Family Histories, Perceptions, And Experiences Of Health Inequity, Heather Davis

Doctoral Dissertations

Older women face unique health inequities challenges. This study aims to provide an understanding of older women’s perceptions and situated experiences regarding the gendered health inequities they face and the social determinants (SDH) thereof. It examines how these health inequities are situated in older women’s genealogical (familial) and geographical health and mortality outcomes histories and how their perceptions and experiences of health inequities and their familial mortality outcomes histories are characterized by the geopolitical and social norms in which they live. The purpose of this project is to present policy and decision-makers with insights about and recommendations from older women …

Clinicians' Perspectives On The Effectiveness Of Trauma - Focused Cognitive Behavioral Therapy With African American Children: A Qualitative Study, Jada Carter

Doctoral Dissertations

Literature exploring clinicians' perspectives on the effectiveness of trauma-focused cognitive behavioral therapy with African American children who suffer from trauma-related disorders is very limited. The current study examined clinicians' perspectives on the TF-CBT model when utilized with this population, including their experiences working with African American children and families with observable types of trauma-related disorders. This research study also explored the various facets of trauma that African Americans encounter in childhood and the barriers that prevent them from receiving adequate mental health care. Thematic analysis was utilized to explore themes that emerged when treating African American children with TF-CBT. Five …

Investigating Person-Specific Profiles Of Readiness-To-Exercise: Exploring Associations With Hypothetical Experiential Outcomes And Perceived Relevance, Cory Beaumont

Doctoral Dissertations

Autoregulation is a person-adaptive strategy wherein exercise workloads are adjusted to match one’s readiness (e.g., acute mental, physical, perceptual state). Prior work demonstrated that structural features of readiness profiles (i.e., which factor(s) are most important) differ across individuals. As this work relied on mathematical modeling, research is needed to understand the informational utility of person-specific profiles (PSPs) of readiness. Purpose: Model heterogeneity in PSPs of readiness (Aim 1), explore associations between PSP factor scores and forecasted experiences to hypothetical muscle-strengthening exercise (Aim 2), and explore participants’ perceptions of relevance and utility regarding their PSP (Aim 3). Methods: For …

Design And Development Of The Urban Population Health Observatory To Improve Disease Surveillance And Response, Whitney Brakefield

Doctoral Dissertations

Chronic and infectious diseases have a profound impact on the quality and length of life of populations that suffer from these conditions. Scientists, physicians, and health officials are seeking innovative approaches to decrease the morbidity and mortality of deadly diseases. Incorporating artificial intelligence and data science techniques across the health science domain could improve disease surveillance, intervention planning, and policymaking. In this dissertation, we describe the design and development of the Urban Population Health Observatory (UPHO), an explainable knowledge-based multimodal big data analytics platform. A common challenge for conducting multimodal big data analytics is integrating multidimensional heterogeneous data sources, which …

“In The Skin I’M In…I Represent A Different Version Of What Help Looks Like:” Black Women Sport Psychology Professional’S Experiences In Applied Sport Psychology, Sharon R. Couch

Doctoral Dissertations

Black Feminist Applied Sport Psychology (BFASP) is a culturally inclusive theoretical framework for centering Black women’s experiences in applied sport psychology (Carter et al., 2020; Couch et al., 2022). For the past two decades, (White) Feminist applied sport psychology professionals (FASPPs) described the experiences of Black women as unique but were overlooked in research and participant pools due to the prioritization of White women's and Black male sport experiences. (Carter & Davila, 2017; Carter & Prewitt-White, 2014; Gill, 2020; Hyman et al., 2021). The purpose of this study was to explore the life and work experiences of BASPPs (i.e., faculty, …

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. …

Mental Health Outcomes Of Various Types Of Fear Among University Students Who Have An Undocumented Legal Status During The Donald Trump Presidency, Liliana Campos

Doctoral Dissertations

Having an undocumented legal status is a risk factor for mental health conditions such as depression and anxiety among university students. Much of the literature on the experiences of university students who hold an undocumented legal status has primarily focused on better understanding the educational, social, financial, and legal challenges among undergraduate students. The literature has addressed how some of these difficulties impact components of their social and mental health wellness. Yet, there is still a dearth of research focused on further understanding the experiences of students who hold an undocumented legal status from a psychological perspective, and specifically, with …

The Use Of Mindfulness Meditation To Increase The Efficacy Of Mirror Visual Feedback For Reducing Phantom Limb Pain In Amputees, Nicolas Sebastian Mills

Doctoral Dissertations

Phantom limb pain is a chronic pain condition that negatively impacts the lives of over half of amputees, and results in considerable morbidity. Currently, there is no gold standard for treatment for phantom limb pain. However, a frequently used intervention is the use of mirror visual feedback, in which the amputee watches the reflection of the adjacent non-amputated limb move and exercise. In the last few decades, mindfulness-based interventions have been increasingly used with individuals living with different types of chronic pain. This study attempts to discover if the addition of a mindfulness-based intervention, such as guided meditation, will augment …

Emerging Adults’ Experiences As Receivers Of Sexually Transmitted Infection Disclosures From Sexual Partners: A Three-Part Examination, Kayley D. Mcmahan

Doctoral Dissertations

Each year in the United States, over 20 million cases of sexually transmitted infections (STIs) are diagnosed, mostly among those in the developmental period of emerging adulthood (ages 18-29). Research on STI disclosure to romantic and sexual partners has increased over the last two decades, but this research has (a) generally lacked a developmental and theoretical focus, (b) not examined disclosure recipients, and (c) not been systematically and critically synthesized. To address these limitations, I conducted a three-part examination. First, I systematically reviewed the STI disclosure literature and summarized findings, critical limitations, and future research and intervention directions. Next, I …

Using A Cognitive Behavioral Approach In Individual Counseling With Patients Undergoing Bariatric Surgery, Nina Marie Ditommaso

Doctoral Dissertations

Morbid obesity is linked to physical and psychological well-being. Bariatric surgery has shown tremendous success with rapid weight loss in the patient population with morbid obesity. These patients experience issues with weight regain post-surgery, which can be linked to psychological and social factors. Despite this, mental health counseling is rarely offered in bariatric surgery programs. The primary investigator used a six-session Cognitive Behavioral Therapy (CBT) approach in individual counseling with patients following bariatric surgery. The primary investigator used a single case research design to treat four participants. The primary investigator measured the effectiveness of a six-session CBT treatment, assessing for …

A Collective Metamorphosis Of Breastfeeding Mothers: A Phenomenological Exploration Of A Face-To-Face Healthcare Provider Facilitated Peer Support Group, Emily Alexandria Tucker

Doctoral Dissertations

This research study used phenomenology to examine a face-to-face healthcare facilitated breastfeeding support group. Participant observations and phenomenology were used to address the following research questions: 1) what are the lived experiences of the women participating a breastfeeding support group, 2) how does the group influence their lived experiences, and 3) what were the common experiences of these women? The support group participants were observed while the researcher acted as a participant observer over the course of an eleven-month period. There were a total of seven women interviewed about their lived experiences breastfeeding and attending the support group. Data from …

Examining The Physical Activity Levels Of Youth With Intellectual And Developmental Disabilities During Physical Education And Recess, Vincenzo Nocera

Doctoral Dissertations

Introduction: It is currently believed that children with intellectual and/or developmental disabilities (IDD) are less physically active than their peers. The school setting may offer a promising solution to allow children with and without IDD to engage in physical activity (PA). However, the current school-based PA levels of this population remain unclear. Therefore, the purpose of this investigation was to compare the PA levels and related context of youth with and without IDD during the total school day, physical education, and recess. Methods: A total of 13 children (n = 3 with IDD) enrolled in first- and second grade participated …

Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg

Doctoral Dissertations

For psychotherapists, encountering clients who have experienced sexual trauma or abuse is inevitable, whether or not the abuse is disclosed to the therapist; however, mental health professionals receive extremely limited (if any) training on how to identify or effectively support adult clients who are survivors of childhood sexual abuse (CSA). Many people who experienced CSA, especially those who identify as male, remain isolated and invisible in their suffering as adults even within therapeutic spaces, facing what feel like insurmountable barriers – both internal and external – to getting help. When sexual abuse is intrafamilial, these barriers are both amplified and …

Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott

Doctoral Dissertations

Historically, patients with dual diagnosis have been subjected to ineffective treatment and negative attitudes from healthcare providers. Further, these patients are plagued with myriad afflictions that exist beyond substance abuse and mental illness. The treatments and collateral damage associated with the diagnosis impose excessive healthcare costs and can be of significant detriment to society. Largely, patients suffering from dual diagnosis do not receive adequate treatment. As such, psychiatric emergency services are frequently utilized as an alternate treatment, wherein the main focus of care is on the substance abuse alone. This study argues that solely treating the substance abuse is not …

Evaluating The Effectiveness Of Peer Engagement And Knowledge (Peak): A Community-Based Group Intervention For Youth In Hawai‘I, Jennifer T. T. Ho

Doctoral Dissertations

This study is a program evaluation with a mixed methods design that evaluated the effectiveness of Peer Engagement and Knowledge (PEAK), a six-week community-based group intervention that incorporates mindfulness-based interventions (MBIs) to address multiple health behaviors for multiracial youth in Hilo, Hawai‘i. A total of 51 youth, ages 12-23 years old, participated in this study which included pre-/posttest analyses of health risk factors such as substance use and depression and health promoting factors such as resilience, self-esteem, and mindfulness. Responses from two subsets of participants, who engaged in a focus group (n = 11) and composed gratitude letters ( …

Compassion Fatigue Among Mental Healthcare Providers And The Impact On Overall Wellbeing, Ruchi Patel

Doctoral Dissertations

Compassion, a virtue of the helping profession, can be jeopardized by a provider’s continuous exposure to the trauma experiences of others. The impact of burnout, secondary stress and compassion fatigue on a mental healthcare provider’s work and personal life has been increasingly studied due to negative ramifications on our community healers. The present study used a cross-sectional design to survey mental healthcare providers across specialty and discipline in efforts to gain a better understanding of the relationship between a provider’s degree of compassion fatigue and specific demographic variables, physical health and their spirituality. One hundred and thirty-seven participants across the …

Structurally Rich Movement: Measuring Movement For Empirical Psychology And Examining The Dynamic Complexity Of Affect Regulation In Behavior, Michael Timothy Finn

Doctoral Dissertations

Movement not only permeates human life, but structures dimensions of experience. Phenomenological theory points to the dynamic congruency of movement and emotion, via the body schema, as shaping affectivity. For psychology, this calls for an understanding of behavior beyond being discrete events, but also manifesting kinetic melodies. Yet there is a gap in existing methodology for empirically studying the three-dimensional characteristics of human movement continuously across segments of the body. A potential line of research in this area, implicit affect regulation capacities, was described to inform the selection of instrumentation, measurement, and calculations of dynamic structure that would, theoretically, best …

A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez

Doctoral Dissertations

The current study is a program evaluation at John Muir Behavioral Health, Center for Recovery. The research determined the effectiveness of the program at Center for Recovery that is offered to patients that struggle with substance use disorder and their families. The purpose of this study is to assess patients’ behavioral, cognitive and social/environmental factors as it relates to their commitment to sobriety and examine how the involvement of family members influences the patient’s recovery process. I utilized a mixed methodology of quantitative and qualitative interviews of patients and family members. The findings suggest depressive symptoms were negatively correlated with …

The Impact Of Depressive Symptoms On Cognitive Decline And Risk For Dementia, Katheryn Conde

Doctoral Dissertations

As of 2011, the life expectancy for Latinos in the U.S. was 81.6 years, which is higher compared to non-Hispanic Blacks (75.3 years), non-Hispanic Whites (79 years), and Hispanic Black populations (74.9 years; Arias, 2011; Arias, 2015). Latinos have higher age specific prevalence of dementia, which is higher than African Americans and non-Hispanic Whites (Gurland et al.,1999). Latinos experience Alzheimers disease symptoms 6.8 years earlier, with the average onset of 67.6 years which is younger than non-Hispanic Whites (73.1 years; Clark et al., 2005). Furthermore, older Latinos tend to experience depression at a rate of 13% and 35% with the …

Evaluation Of Increased Targeted Enforcement And Community-Based Outreach And Education Programs To Increase Nighttime Seatbelt Use In East Tennessee, Kwaku Frimpong Boakye

Doctoral Dissertations

According to the National Highway Traffic Safety Administration (NHTSA), motor vehicle crashes are the leading cause of death among people aged 1-54 in the United Sates. In 2015, the number of motor-vehicle deaths on U.S. roadways totaled 35,092, a 7% increase from 2014 (32,744). Though lower gas prices and increased vehicle mileage combined with risky driving behaviors (e.g. speeding, driving while texting) account for the increased fatality rate, seatbelt non-use has been a significant contributory factor. It is estimated that nearly half (48%) of passenger vehicle occupants involved in fatal crashes each year are unrestrained.

In a recent 2014 report …