Social and Behavioral Sciences Commons^™

Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau

Theses and Dissertations

Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …

Department Chairs’ Impact On The Diversity, Equity, And Inclusion Of Their Departments, Nicholas R. Garcia Ii

Theses and Dissertations

Department chairs serve not only as the leaders of their departments but also as middle managers in their schools, colleges, and universities. While many department chairs see their role as having little authority, they still play an integral role in day-to-day campus operations (Hunt & Jones, 2015). As leaders of their departments, chairs can directly influence the department’s organizational culture (Schein, 2010), including the culture of diversity and inclusiveness. Departments nationwide are being held responsible for increasing the diversity of the faculty and responding to students' calls for diversity. Departmental organizational culture and the role of the chairperson are essential …

Children With Special Healthcare Needs: The Cost Of Medical Care, Kasey Dye

Theses and Dissertations

The purpose of this study was to explore factors that impact children with special healthcare needs’ (CSHCN) health insurance coverage and out-of-pocket medical expenses. The Ecological Model for Health Promotion developed by McLeroy et al. (1988) was the guiding theoretical framework for this study. Using data from the 2020 National Survey of Children’s Health, I conducted descriptive statistics, logistic regressions, and multilevel modeling analyses to determine if health insurance coverage and out-of-pocket expenses for CSHCN differed by individual, family, and community, organization, and policy factors. Results indicated that race, gender, disorder category, insurance type, and family’s federal poverty level were …

Underrepresentation Of Black Participants In Drug Court: Reasons Reported For Non-Admission In Six Jurisdictions, Kathryn J. Genthon

Theses and Dissertations

Despite the beneficial impacts of drug court participation, access to these programs may not be equitable across racial groups. The reasons behind racial disparities in access to these programs are not well-documented in the current literature. This study investigates disparities in access to drug court and the possible reasons they occur. Chi-square tests are used to assess for disparities in admissions between Black and White individuals referred to drug court. Additional statistical analyses addressed the association of sex and age with admission to provide a broader picture of the impact of a variety of demographic characteristics on admission to drug …

Motivations And Conflicts In Prison Medical Contracting, Meagan D. Sok

Theses and Dissertations

State correctional departments are responsible for all medical care incarcerated individuals require. Many systems outsource their medical

State correctional departments are responsible for all medical care incarcerated individuals require. Many systems outsource their medical program. Literature indicates that many of these contracts experience significant issues that negatively impact state resources, including both personnel and money.

This dissertation explores the relationship between prison administrators' motivations and the structure, outcomes, efficiencies, and partner conflicts that arise in the contractual process. Using a framework developed from Incomplete Contract Theory, Contracts as Reference Points Theory and the concept of “essential tension,” this dissertation hypothesizes …

Assessing The Relationships Between Direct And Vicarious Exposure To Healthcare Discrimination And Erasure, Mistrust In Healthcare, And The Healthcare Utilization Behaviors Among Transgender And Gender Independent Individuals, Kyle L. Mason

Theses and Dissertations

Healthcare inaccessibility through direct exposure (i.e., personal) to myriad forms of gender identity-related discrimination and erasure among the Transgender and Gender Independent (TGI) population has been documented by prior studies. The myriad barriers that individuals who embody TGI identities encounter to accessing healthcare are associated with the underutilization of healthcare, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of the harm that direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, their exposure to such harm vicariously (i.e., through observation …

The Civil Right To Belong: A Case Study On Immigrant Integration Of Muslim Students In Educational Institutions, Mamoona H. Siddiqui

Theses and Dissertations

Constitutional equal protection values serve as social integration policies for new Americans and generations that follow. They promise equal opportunity, fair treatment, protection from unlawful discrimination, and freedom to preserve cultural identities in their new communities. However, in times of national security crises and political polarization, the disjuncture in the way equal protection doctrines have been historically implemented often reflect deep-rooted inequities that impact underrepresented communities. American Muslims are one such community in which members have experienced anti-Muslim and anti-immigrant sentiment particularly after 9/11 and political polarization on immigration and civil rights policies. The study explores the equal protection doctrine …

Academic Health Science Centers And Health Disparities: A Qualitative Review Of The Intervening Role Of The Electronic Health Record And Social Determinants Of Health, Wies Rafi

Theses and Dissertations

Literature on the magnitude of negative health outcomes from health disparities is voluminous. Defined as the health effects of racism, environmental injustice, forms of discrimination, biases in science, and sociological or socioeconomic predictors across populations, health disparities are part of an ongoing and complicated national problem that health equity programs are specifically designed to address. Academic Health Science Centers (AHC) institutions are a complex and unique educational-healthcare ecosystem that often serves as a safety net for patients in vulnerable and lower-income communities. These institutions are often viewed as one of the most uniquely positioned entities in the U.S. with an …

Tummy Time In Infancy: Real-World Assessments And Associations With Developmental Outcomes In Early Childhood, Ketaki Inamdar

Theses and Dissertations

Tummy time or awake, supervised, prone play is an important developmental play position in infancy. Engaging in more than 15 minutes of tummy time per day is associated with a lower risk of plagiocephaly, lower body mass index, and achievement of higher motor scores in full-term and at-risk preterm infants. However, there are significant gaps in the measurement of tummy time in current literature. Conventionally used subjective parent reports have not been validated against gold standard direct observation, and the feasibility and real-world validity of objective solutions such as wearable sensors has not been examined in full-term and at-risk preterm …

Do Coverage Expansion And Patient-Centeredness Care Delivery Improve Patient Health Outcomes And Care Quality?, Shiva Salehian

Theses and Dissertations

Although correlated, improvement of patient health outcomes and quality of care is a result of health care delivery, performance, and healthcare policies that intend to impact health outcomes (Porter, 2010; AHRQ, 2015). This dissertation focuses on a special model of care delivery (Patient-Centered Medical Homes (PCMH)) and two programs (Addiction and Recovery Treatment Services (ARTS) and Medicaid expansion) to examine the correlation and impact of these programs on cardiovascular-related preventive care, healthcare expenditures, and health behavior hospitalizations as patient outcomes.

Analysis Of Non-Conventional Radiological Terrorism, James N. Padgett

Theses and Dissertations

Nuclear terrorism has been a risk since the dawn of the first atomic bomb. Though state sponsored nuclear weapons development is of concern for countries, non-state sponsored terrorism with radiological material can be of even greater concern. This stems from the fact that the material is under less stringent or no safeguards and can readily change hands between different terrorist groups or innocent civilians may accidently come into contact with the material.

Within this paper an analysis of previous accidents using orphan radiological sources, malicious use of orphan radiological sources, and how these sources could be used by terrorists is …

Examining The Relationship Between Local Governmental Performance In Public Safety And The Growth In Population, Employment, And Per Capita Income For Valley Cities In Arizona, Xin Zhao

Theses and Dissertations

This study focuses on the impact of city performance in public safety on a city’s growth in population, employment, and per capita income. The effectiveness of performance management affects the willingness of governmental agencies to continue using performance management as a tool for day-to-day operations and the improvement of governmental services. The research goal of the study is to discover the relationship between city performance in public safety and the growth of a locality in population, employment, and per capita income. The purpose of the study is to determine if there is a relationship between city performance in public safety …

Evaluating Long-Range Transportation Plans For Mainstreaming Of Climate Adaptation Among Virginia Mpos, Sebastian L. Shetty

Theses and Dissertations

Despite the strides made towards addressing climate change through greenhouse gas (GHG) emissions reduction strategies, it has become increasingly apparent that attempting to mitigate the crisis in such a manner alone is insufficient. This thesis joins a growing body of research on how our societies must adapt to a changing climate, contributing more evidence on common barriers to adaptation and how they might be overcome. Through an attempt to evaluate the progress made towards mainstreaming, or integrating, climate change concerns into five Virginia MPOs’ long-range transportation plans (LRTPs), this study provides support for prior hypotheses around the potential for MPOs …

Threat Assessment Team Activity And Outcomes In K-12 Public Schools: Integrating Methods To Better Understand School Safety, Jessica C. Smith

Theses and Dissertations

The use of threat assessment teams in schools is recommended as a violence prevention measure in K-12 public schools. The present study focused on the threat assessment process in the K-12 environment in Virginia and is the first to examine the association between threat assessment and school safety in tandem over time and the first to incorporate the views of K-12 threat assessment practitioners. Findings from this study demonstrate that while the number of threat assessments has increased overtime, threat assessment practitioners identified numerous concerns regarding threat assessment training, expressed doubts about fidelity to the recommended process, and revealed an …

Associations Between Social Determinants Of Health And Chlamydia Infections Among Georgia Counties, Bre'auna K. Beasley

Theses and Dissertations

Chlamydia is a growing public health concern that disproportionately impacts southern states. While social determinants of health are not direct causes of chlamydia infections, studies have found that these determinants do influence infections by creating environments that promote or hinder health seeking behaviors, as well as exposure to risk factors. Guided by the Social Ecological Model of Public Health and the Healthy People 2030 Social Determinants of Health Conceptual Framework, this dissertation study aimed to examine the associations between social determinants of health and chlamydia infections among Georgia counties. This study employed a correlational research design. Aggregate-level secondary data for …

Preventing Obesity: A Social Ecological Exploration Of Centers For Disease Control Prevention Strategies And Guidance Toward Healthy Eating, Physical Activity, And Communities, Ryan Kelly

Theses and Dissertations

Abstract

Obesity has reached nearly 40% of the adult public in the United States, costing the citizen taxpayer over $200 billion annually in healthcare costs. Those suffering from obesity deal with multiple physical and mental repercussions. Through a content analysis of four Centers for Disease Control (CDC) documents and guided by the conceptual framework of the social ecological model, this research explores the federal approach to preventing obesity. The analysis finds that CDC solutions to obesity involve connecting people to each other and healthier choices, an orientation toward local public administration, and an emphasis on environmental and infrastructure improvements. The …

“Insurance Doesn’T Care About The Patient”: An Institutional Ethnography Of The Influence Of Professional Autonomy On The Provision Care For Medicaid Dental Patients With Disabilities, Stephanie Lau

Theses and Dissertations

In terms of unmet needs for people with disabilities (PWD), dental care is number three behind residential care and employment (Fisher, 2012). Regardless of disability, oral healthcare traverses all disability diagnoses and can be a significant factor in quality of life (Deckler, 2011; Griffin et al., 2007; Norwood & Slayton, 2013). When attempting to secure oral healthcare, people with disabilities face many challenges, including lack of access, lack of provider education on proper care of PWD, and difficulty finding a willing dental provider (Deckler, 2011; Fisher, 2012; Kennedy, 2009).

The purpose of this study was to investigate professional practices and …

Perceived Organizational Support For Women’S Advancement And Turnover Intentions And Career Advancement Aspirations. The Mediating Role Of Job And Employer Satisfaction., Marta Squadrito

Theses and Dissertations

The purpose of this research is to examine whether the lack of organizational support for women’s advancement decreases female supervisors and managers’ aspiration to advance their careers and increases their turnover intentions and, the mediating effect of job satisfaction and employer satisfaction on the relationship between support and advancement aspirations and turnover intentions.

The antecedents of turnover intentions have been widely studied in the literature, while the antecedents of career aspirations, especially women’s, have not been a focus of much scholarly attention. Based on a review of the literature and drawing upon social exchange theory, and social cognitive theory, it …

Cost-Effectiveness Of Interventions Targeting Hard-To-Reach Populations Living With Hiv In Eastern And Southern Africa, Deo Mujwara

Theses and Dissertations

In Eastern and Southern Africa, hard-to-reach populations (e.g., long distance truck drivers and female sex workers), defined as populations that are difficult to interact or engage with due to their unique behaviors and characteristics, are disproportionately affected by the HIV epidemic and are at high-risk of acquiring and transmitting HIV. Further, these populations have substantially low uptake of HIV testing services, and those that have been diagnosed with HIV and on antiretroviral therapy experience high loss-to-follow-up from treatment programs.

Hard-to-reach populations face unique barriers in accessing and utilizing routine HIV care such as provider stigmatization towards sex workers and highly …

Psychological Sense Of Community Among Older Adults In Puerto Rico Two Years After Hurricane María, Thomas D. Buckley

Theses and Dissertations

Hurricane María devastated Puerto Rico in 2017 and resulted in adverse long-term outcomes. Psychological sense of community (PSOC) may serve as a protective factor against the effects of Hurricane María for older adults in Puerto Rico. Using a three-paper format, this dissertation draws on a resilience framework and theories of PSOC and the Ecological Theory of Aging to examine the role of PSOC among older adults in Puerto Rico two years after Hurricane María.

Paper one is a scoping review of the concept of PSOC in research with community dwelling older adults. I begin by presenting findings on study characteristics …

Access To Behavioral Health Services: Supply, Coverage, And Health Insurance Literacy, Heather Saunders

Theses and Dissertations

This dissertation examines policy and individual barriers to behavioral health (BH) service utilization. The full reach of federal policies like the Affordable Care Act (ACA) and the Comprehensive Addiction and Recovery Act (CARA) may be limited by state policies and the supply of the workforce available to deliver these services. Further, individual factors, such as low health insurance literacy, may influence patterns of behavioral healthcare utilization. Despite efforts to increase access to behavioral health services, treatment rates remain low, suggesting that barriers remain. To explore the effectiveness of these policies and examine remaining barriers, this dissertation explores three main research …

First-Year Retention At Virginia Commonwealth University: Understanding Student Departure And The Potential Impact Of Academic Advising, Ben Plache

Theses and Dissertations

This dissertation examines first-year enrollment at Virginia Commonwealth University to determine what factors are associated with an increased likelihood of a student not being retained, and for which of these factors there is evidence that academic advising is an effective intervention. A survey of common retention models identified six factors associated with retention likelihood: student background prior to enrollment (“pre-enrollment factors”), financial support, institutional support, institutional performance, institutional engagement, and student intention. Prior research has shown that academic advising is an effective intervention for two of these factors: institutional performance and institutional support.

The significance of these factors was tested …

Gender Equity Implications Of Nonprofit Youth Programs: Education Outcomes Of Three African American-Led Nonprofits, Yali Pang

Theses and Dissertations

Significant racial and gender differences in school performance have been a great concern in the past decades, and especially the significant differences in education performance between both Black youth and other racial groups and between Black males and Black females. Nonprofit youth programs are increasingly considered a promising intervention that can effectively improve Black youth development and education outcomes. While there is a growing body of literature evaluating the outcomes of nonprofit youth programs, little is known about gender differences in the outcomes, and specifically whether these nonprofit programs are equally effective for both Black males and females. This study …

State Economic Development: Analyzing The Moderating Effects Of Business Climate On Economic Growth, Sean A. Brazier

Theses and Dissertations

States across the country focus intensely on creating jobs, catalyzing capital investment, and stimulating economic output. They pursue different strategies, mixing and matching a variety of tactics in the pursuit of their economic objectives. While scholars have studied the relationship between economic development tactics and economic growth or business climate and economic growth, none to my knowledge have studied the impact of economic development efforts on economic outcomes while accounting for a state’s business climate.

I found economic development spending to be negatively associated with employment growth (other measures, real gross state product and per capita income growth, were not …

The Impact Of Registered Apprenticeships On The Middle-Skills Gap In Virginia, Yolanda Macklin Crewe

Theses and Dissertations

The skills gap debate has raged among scholars and policymakers for the last few decades. The key questions are whether the gap exists, the extent of the gap and how to minimize the gap. Of particular concern is a skills gap for middle-skills occupations. Since 2014, the federal government has invested over $500 million in registered apprenticeships as a strategy to address the skills gap. Likewise, Virginia has invested over $7.5 million and implemented policies such as VA Executive Order 49 (EO49), to expand registered apprenticeships as a workforce strategy to diminish the skills gap.

The goal of this research …

Education Support For Foster Care Youth: The Impact Of Federal Spending On Employment Outcomes, Carlisle C. Bates

Theses and Dissertations

This study examined the extent to which supportive services funded through the federal John H. Chafee Foster Care Independence Program (CFCP) are associated with academic success and employment in foster care youth. Studies suggest that this group experiences poorer employment outcomes (Gypen, Vanderfaeillie, De Maeyer, Belenger, & Van Holen, 2017; Okpych & Courtney, 2014) and earn less money annually (Gypen et al., 2017; Okpych & Courtney, 2014; Pecora, 2012). Despite a 29.4-billion-dollar annual budget for foster care services, individuals with a foster care history struggle after they transition out of care.

The CFCP is intended to help states improve education …

Social Learning Theory And Digital Piracy: Explaining Uploading Behaviors Of Digital Pirates, Cydney J. Lowenstein

Theses and Dissertations

Digital piracy has received significant attention in criminological research but almost no studies have explored illegal uploading and how it may differ from illegal downloading. It is important to examine what theories can explain illegal uploading behaviors and their related factors to develop more effective policies to address digital piracy. This dissertation examined whether Akers’ (1998) social learning theory could explain engagement in digital piracy, both illegal downloading and uploading behavior. Additionally, this research examined the relationship between reciprocity and digital piracy. Questionnaires were administered to 398 university students and 315 visitors to several online communities using a combination of …

Why We Use A New Currency: The Role Of Trust And Control In Explaining The Perception And Usage Of Bitcoin, Joseph B. Walton

Theses and Dissertations

Social media, e-commerce, global peer-to-peer technologies, and the near ubiquity of computers and smartphones allow people to interact, trust, and exchange value across traditional socio-economic control boundaries and over significant distances. Since the creation in 2008 of a new cryptographic currency system called Bitcoin, a financial technology market sector of about 250 billion USD has rapidly emerged, raising questions about the nature of currency in society and whether new types of non-national money are warranted and viable. This debate has pitted heterodox economic interests against orthodox economic interests while it has rekindled interest in theories that view money as a …

Environmental Governance For Whom? Examining The Political, Institutional, Fiscal, And Legal Determinants Of State Environmental Agency Budget Policy In The Us, Andrew R. Duggan

Theses and Dissertations

Budgets are a prospective tool of governance, and appropriations are a planning vehicle reflecting: bureaucracies’ values, complex interactions, collective preferences, political influences, and available resources. Research spanning 30 years finds that environmental pollution is a key determinant of environmental budgets in the US, though myriad factors, actors, and subsystems are important to consider. Due to federalism and devolution of responsibilities and authorities, environmental governance falls largely to the states. While the dynamics that shape state environmental budget policy have received scholarly interest, theoretically-driven examinations of environmental appropriations remain limited within the public budgeting and environmental policy literature.

Using panel data …

Predators And Principles: Think Tank Influence, Media Visibility, And Political Partisanship, Timothy Beryl Bland

Theses and Dissertations

By some measures, the major U.S. political parties have become more extreme in their political positions in recent decades, and scholars have raised concerns about whether the policy expertise provided by today’s think tanks has become similarly partisan and polarized. Furthermore, there is a perception that certain overtly partisan and highly visible think tanks wield considerable and growing influence over the policy platforms of the major U.S. parties, using their media presence to shape public and policymaker views of particular issues. Using publicly accessible tax, media, and congressional data, my proposed study assesses the extent to which media visibility and …