Social Work Commons^™

Care Transition Assessment Redesign In The Acute Care Setting, Darla M. Johnston

Electronic Theses and Dissertations

There is a gap in case management professional practice with a lack of consistent, research-based transition evaluation (TE) tools available and used in practice. An evidence-based case management TE is necessary to develop a holistic and comprehensive discharge plan for hospitalized patients. Updating and implementing an evidence-based case management TE would positively impact the transition of care and promote improved health outcomes including a reduction in readmissions. This quality improvement project used a quantitative nonexperimental, interventional pretest-posttest design. Kirkpatrick’s multidimensional knowledge attitudes assessment (KAP) education evaluation model was used to assess (1) the influence an educational offering on evidence-based assessment …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

Electronic Theses and Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

A Life Lived With Schizophrenia: When Mother’S Love Is Kept In The Dark Exploring Maternal Communication And Attachment Organization In Families With Schizophrenia, Myrsini Stefanidou Marini

Electronic Theses and Dissertations

In recent years, research into the transgenerational transmission of attachment styles has shown that a mother’sattachment style often predicts the attachment style of her infant. Fearsome parental behavior has been found to predict disorganized attachment in infants, which is further associated with a range of mental health disturbances in adolescence. Furthermore, regular patterns of disturbed communication between mother and child have also been found to lead to ‘schizophrenic’ thinking and behavior in the child’s life. While acknowledging that genetic and other biological factors contribute to the emergence of schizophrenia, this study focused on disorganized attachment and disturbed communication between mother …

Caregiver-Child Conversations About Sex In African American Women, Hannah King

Electronic Theses and Dissertations

Using grounded theory methods, this study examines the experience of African American women during their caregiver-child conversations about sex and the impacts of the conversations on their sexual attitudes. The process of these conversations begins with an unplanned topic and progresses further to identify six essential themes of these conversations: gender differences, race and religion, protective/emphasis on protection, lack of knowledge, withholding knowledge, and sex negativity/shame. African American women’s description of the process included feelings of shame and negativity towards their sexuality. Caregivers promoted positive messages about sex by having open conversations that advocated for equality between the genders, empower …

The Intersection Of Traumatic Brain Injury And Homelessness, Stephanie A. Chassman

Electronic Theses and Dissertations

The rates of TBI are significantly higher among individuals experiencing homelessness compared to the general population. Up to half of individuals experiencing homelessness may have a TBI. Accurate prevalence rates of TBI among individuals experiencing homelessness are difficult to obtain due to different methods of sampling participants and differing definitions of TBI; therefore, estimates may be underrepresented. Despite past research that has examined the relationship between TBI and homelessness, there are specific gaps in knowledge such as correlates and risk factors of TBI among individuals experiencing homelessness. This three-manuscript dissertation attempts to address these gaps in knowledge.

The first manuscript …

Understanding And Supporting Asian American Youth’S Mental Health Within Cultural And Family Contexts, In Young Park

Electronic Theses and Dissertations

Mental health problems are a major health issue among East Asian American (EAA) youth. Although previous research has explored the risk and protective factors associated with mental health problems of EAA youth, many studies have employed Eurocentric perspectives, thereby excluding their unique cultural backgrounds, beliefs, and values. To better understand mental health needs and support these youth, further research that identifies different factors associated with mental health problems in their cultural context and assesses evidence-supported and culturally responsive interventions is needed.

This three-manuscript dissertation is presented in three papers. The first manuscript presents an integrative conceptual framework that uses two …

Exploring The Relationship Between Historical Redlining And Place-Based Reproductive Health Inequities: A Qualitative Gis Approach, Kristi L. Roybal

Electronic Theses and Dissertations

Individual-level risk factors and characteristics do not fully explain racial, ethnic, and socioeconomic inequities in preterm birth in the United States, and evidence suggests that medical advancements, increased access to prenatal care, and high per-capita spending on health care have done little to reduce these inequities. Health inequities research has shifted its attention from individual-level factors that influence health outcomes to the social determinants of health. Neighborhoods, considered an important upstream social determinant of health, can influence health outcomes through their social, service, and physical environments, and have been consistently linked to birth outcomes. Despite increased attention to neighborhood influences …

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 …

Attrition In A Holistic Job Skills Training Program: A Qualitative Study, Jeaniece Silas

Electronic Theses and Dissertations

Today thousands of individuals and families are unemployed or underemployed and are seeking ways to combat poverty and become employed. One way that individuals seek to gain employment is by attending job skills training and adult education programs. However, there are barriers that hinder those individuals from successfully completing the programs. The purpose of this study is to explore the experience of applicants of a nonprofit job skills training program called FaithWorks and explore the reasons why applicants were not able to continue and, or complete the program. This study was conducted, through qualitative interviewing of four participants (N=4) utilizing …

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

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 …

Evaluation Of A Sexual Health Training For Child Welfare Workers, Katie Massey Comsb

Electronic Theses and Dissertations

Background: Elevated rates of early pregnancy and parenting among youth in foster care (YFC) are well documented. Training child welfare workers to provide sexual health information and resources is stated throughout the extant literature as a pressing need in efforts to prevent unintended pregnancy among YFC. However, few child welfare agencies offer such training to their workers, and little is known about the extent to which conversations about sexual and reproductive health already occur between child welfare workers and youth. Thus, this study aimed to: a) assess baseline attitudes, knowledge, and communication among child welfare workers regarding sexual health of …

Prevention Of Violence Against Children: A Systems Readiness Assessment In Côte D’Ivoire, Marie-Kaye Soletchi Seya-Sery

Electronic Theses and Dissertations

Violence against children (VAC) is a global problem with significant consequences. Recognizing the need to better understand the problem of VAC in Côte d’Ivoire (CI), the government of CI recently completed a survey on violence against children. The recent data will support an evidence-based national action plan for the prevention of VAC. Research shows that initiatives tackling specific problems will only be as successful as the community’s readiness to take action. This study applied the community readiness model to assess the readiness of the multisectoral task force (MSTF) to implement the national action plan in CI. Eight MSTF participants’ interview …

An Exploration Of Dementia Friendly Communities From The Perspective Of Persons Living With Dementia, Catherine Hebert

Electronic Theses and Dissertations

The growing global prevalence of dementia coupled with a shift in public perception from a hopeless disease to the possibility of living well with dementia has led to the formation of dementia friendly communities (DFC). DFCs are a new phenomenon in the United States, with a gap in knowledge on input from people living with dementia (PLWD). This study investigated DFCs from the perspective of PLWD in Western North Carolina, with the following research questions:

1. How are interactions and relationships experienced by persons living with dementia in the community?
2. How is community engagement experienced by PLWD?
3. To what extent and …

Case Study: Healthy Texas Women Program In The Abilene-Taylor County Public Health District, Saul Francisco Delgado

Electronic Theses and Dissertations

The public healthcare system faces continuous transformations and challenges of constant adjustments to the increasing usage of fee for service revenue and the decrease of federal investment to women’s healthcare services and to the safety net healthcare providers (Meit, 2013; Weisman, 1997).

In 2016, the Texas 84^th Legislation Session determined to consolidate two existing women’s healthcare service programs into one a single program: the Healthy Texas Women (HTW) program. The new women’s program is a preventative care program that provides services of family planning and chronic illness care under a complete fee for service reimbursement system as its sourse …

The Effect Of Anxiety And Depression On College Students’ Academic Performance: Exploring Social Support As A Moderator, Katherine H. Bisson

Electronic Theses and Dissertations

The purpose of this study is to explore how social support is related to the overall well-being of college students. Literature suggests social support buffers a negative effect of distress on academic performance. This study attempts to provide practical information for a program called Student Opportunities, Advocacy, and Resources (SOAR) at Abilene Christian University (ACU), which assists students and connects them to resources available to support their path to success. A multiple linear regression was conducted to examine the association between anxiety, depression, social support, and academic performance using a sample of 93 students enrolled in this program in Fall …

Life Balance In Adult Healthy Siblings Of Individuals With Childhood Cancer., Yolanda Williams

Electronic Theses and Dissertations

Siblings of children who were diagnosed with cancer in childhood experience significant stress and psychological difficulties as a result of the cancer. Furthermore, the needs of siblings have often been overlooked in the cancer literature, prompting the need for more studies. The purpose of this dissertation is to examine the life balance and social support outcomes of adults who grew up in the household with a sibling that was diagnosed with cancer. The study sample consisted of 120 adult healthy siblings who grew up in a household with a sibling that was diagnosed with cancer prior to age 19. Participants …

Biopsychosocial Factors Of Resilience In The Medically Indigent Adult Population, Kaitlin E. Puckett

Electronic Theses and Dissertations

The medically indigent adult population continues to struggle with the effects of not having insurance coverage, despite the efforts of the Affordable Care Act to provide more affordable healthcare coverage to the population. Based on the United States Census Bureau’s reported population in 2015, an estimated 45 million Americans are without insurance. This study aims to identify and explore the impacts of the biopsychosocial factors of resilience that enable the population to face adversity, stress, and manage distress in the face of trauma (Masten, Best, & Garmezy, 1990; Rutter, 2006; Zimmerman, 2015). Four hypotheses follow a review of literature and …

The Stigma Effect: The Role Of Internalized Racism And Internalized Homophobia In Risky Sexual Behavior Among Black Gay Men, Darren Lovell Whitfield

Electronic Theses and Dissertations

Black gay, bisexual, queer, and same-gender-loving (GBQSGL) men account for less than 1% of US population, yet account for 36% of all new HIV infections. While, Black GBQSGL men experience higher rates of HIV infection compared to other gay, bisexual, and men who have sex with men (MSM) from other racial groups, they are no more likely to report engaging in condomless anal sex (CAS). These findings suggest that one possible explanation is that the context of sexual behavior for Black GBQSGL men may be riskier because of the prevalence of HIV in the community. Furthermore, research suggests that racism …

A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak

Electronic Theses and Dissertations

The purpose of this study was to understand the phenomenon of how heterosexual Baby Boomers define and understand intimacy, sexual expression, along expectations and desires relating to their respective expressions across the lifespan through their individual experiences and reflections. A set of guiding questions were used in a hermeneutic phenomenological qualitative research design. Data was gathered from thirteen subjects (n=13) using the Rappaport Time Line (RTL) that was used to develop individualized semi-structured interviews and follow-up interviews that were professionally transcribed. These were coded to identify emergent themes. Results of the study provided insight into the phenomenon of how heterosexual …

Adolescent Substance Abuse Treatment: Does Family Systems Therapy Improve Family Functioning And Decrease Drug Use?, Darin J. Wallis

Electronic Theses and Dissertations

Family systems therapy is a way of working with individuals, couples, families, or a group of people that emphasizes relationships and a person's/family's greater "system" as important factors in establishing change and health (Haley, 1976; Minuchin, 1974). Treating adolescent substance abuse with family systems therapy has been demonstrated in the literature as being an effective method of intervention (Coatsworth, Santisteban, McBride, & Szapocznik, 2001; Kumfer & Alvarado, 2003; Leichtling, Gabriel, Lewis & Vander Ley, 2006; Liddle, 2002; Liddle et al., 2001; Rowe & Liddle, 2003), as the various ecological and epidemiological factors associated with adolescent substance abuse can be addressed …

Social Support, Nursing Home Applicants And Their Family Caregivers, Beth Anne Sproat Ternovan

Electronic Theses and Dissertations

The purpose of this qualitative-descriptive study was to evaluate overall social support to elderly applicants and their family caregivers awaiting placement into Windsor-Essex County area nursing homes. The study was executed by means of an exploratory-descriptive interview of the applicants; primary family caregivers. The study focuses on respondents' perceptions regarding three main questions: 1) what the specific needs of the respondents were during the interim waiting period; 2) whether these needs were being met; 3) whether the interface of the formal and informal service systems was adequate in terms of overall social support. Results indicated several common primary needs were …