Medicine and Health Sciences Commons^™

Design Thinking For Health Environments: Case Study Research On Innovation, Design Leadership, And Healthcare Complexity, Diana S. Nicholas

Antioch University Dissertations & Theses

As healthcare costs are skyrocketing, of the 6,093 hospitals in America, 53% will lose money in the current year (Coleman-Lochner, 2022). Design health innovation centers (DHICs) are formed in Europe and the United States to create efficiencies in healthcare related to budget challenges. DHICs exist in unique contexts both in America and Europe that are not yet well understood. These efforts are difficult to lead due to the lack of understanding of their worth and how their process is valuable to healthcare settings (Bhattacharyya et al., 2022). The specific problem examined here is that little is known about how DHIC …

Black Birth Work As Radical Praxis: A Hermeneutic Phenomenological Inquiry Of Leadership Among Black Birth Workers, Lesa C. Clark

Antioch University Dissertations & Theses

This hermeneutic phenomenological study explores the leadership experiences of Black birth workers (BBWs), revealing critical insights into leadership dynamics within maternal healthcare. Through a theoretical framework integrating African feminism, Black feminism, and anti-racist feminism, the research examines how BBWs conceptualize and enact leadership through embodied, relational, and liberatory approaches. This study addresses a significant gap in leadership literature, particularly regarding generational knowledge and practices of BBWs, which remain understudied despite their vital role in Black maternal healthcare. This study reveals distinct leadership perspectives and methodologies through in-depth interviews with eight BBWs and a detailed interpretive analysis. The findings contribute to …

Beyond Strong: A Phenomenology Of Women Executives And The Connection Between Leadership And Fitness, Nozomi Bullock

Antioch University Dissertations & Theses

Senior-level executive leaders’ work in a dynamic, competitive, 24/7 business environment can be physically rigorous, mentally demanding, and emotionally isolating. The same holds true for women pursuing senior-level leadership roles in corporate America. Women who achieve and succeed in such roles remain the minority: Outsiders in elite spaces who are held to higher standards and overly scrutinized. Among senior-level executive women leaders, those committed to a fitness and training regimen including weightlifting constitute an even smaller minority. Senior-level executive roles require stamina, resilience, and courage—qualities that make up the foundation of the mindset of fitness and strength training (Foyster et …

Intersectional Opportunities For Drama Therapy And Counseling, Erica Craig-Mann

Antioch University Dissertations & Theses

The purpose of this study was to explore the intersectional possibilities between the fields of drama therapy and mental health counseling through the lens of transformative learning theory. Specifically, the research sought to understand the lived experiences of professionals trained in both disciplines to identify how these fields might mutually inform, strengthen, and enhance one another through collaboration and/or dual training. Data were collected through a qualitative online survey and analyzed using thematic analysis. Five themes emerged: (a) Theoretical and Practical Overlaps and Distinctions; (b) Drama Therapy-Informed Counseling: Embodiment, Creativity, and Experiential Practice; (c) Counseling-Informed Drama Therapy: Frameworks for Practice, …

Outside Of The Counseling Room: Whiteness And Antiracism, Carlee D. Smith

Antioch University Dissertations & Theses

This dissertation explores the lived experiences of white counselors as they integrate antiracism practices into their non-clinical lives. Rooted in the Multicultural and Social Justice Counseling Competencies (MSJCC) framework, this study addresses the gap in literature surrounding how white counselors embody antiracist ideologies outside of the counseling room. Through narrative qualitative methods, the research examines the challenges, strategies, and reflections of white counselors committed to antiracist practices; practical integration into personal life often encounters barriers related to internal biases, social resistance, and limited educational support. Insights from this research highlight the critical need for ongoing self-reflection, community accountability, and structural …

An Examination Of Harm During The Real-Life Experience, Michelle E. Balch

Antioch University Dissertations & Theses

The Real-Life Experience (RLE) has been described as a coercive and arbitrary requirement without evidence of validity or reliability. This can cause more harm than it prevents for a significant subset of transition-seeking transgender clients. For these reasons the RLE was dropped from the WPATH Standards of Care after version six. However, the RLE has been adopted by a number of health insurance companies as a measure of readiness to receive transition services. An Interpretative Phenomenological Analysis (IPA) and semi-structured interviews of five individuals were conducted to evaluate their perceptions of RLE and the meaning they attach to their broader …

Geriatric Care In Corrections: An Exploratory Study Of Cross-Disciplinary Perspectives On The Needs Of An Aging Prison Population, Cynthia A. Scheiderer

Antioch University Dissertations & Theses

The incarcerated population in the United States is aging. The proportion of adults 55 or older in prison rose from 3% in 1993 to 16% at year-end 2022 (Carson & Sabol, 2016; Carson & Kluckow, 2024). Researchers have consistently found evidence that the prevalence of disabilities and functional impairment is higher among older adults who are incarcerated than among those in the community. As the incarcerated population ages, corrections professionals responsible for providing safety, housing, and health care must respond to the needs of the population. In this qualitative study, 21 corrections professionals from the disciplines of custody, classification, medical, …

Childhood Aggression: A New Conceptualization, Hannah G. Harrison

Antioch University Dissertations & Theses

Childhood aggression is a frequently observed behavioral phenomenon, yet lacks a precise
definition in both the DSM-5-TR and current research literature. Definitional ambiguity and
construct enmeshment continue to create construct confusion for researchers, clinicians, and
informants. This empirical review of the current literature and diagnostic criteria examines how
childhood aggression has been historically conceptualized, defined, and described. The primary
aim was to identify and clarify inconsistencies in current definitions and to address knowledge
gaps to improve diagnostic clarity. Through a thematic synthesis of recent literature, several key
issues emerged: the absence of a precise definition of childhood aggression; reliance on …

Embracing The Suck: Overcoming Moral Injury-Related Attachment Trauma Through Outdoor Adventure, Emerald D. Ralston

Antioch University Dissertations & Theses

Moral injury is increasingly recognized as a distinct and debilitating consequence of military service, arising when individuals engage in, witness, or are unable to prevent actions that transgress their deeply held moral beliefs. In this dissertation, I argue that this form of trauma can be experienced as an attachment rupture, particularly when the military—functioning as an institutional attachment figure—betrays the servicemember’s trust. Such experiences compromise internal working models (IWMs) of self, others, and the world, and may result in complex trauma symptoms, including dissociation, depersonalization, and profound relational disconnection. These injuries are frequently stored in the body, rendering traditional cognitive …

Caretaker Of Captors: The Experience Of Role Conflict Among State Correctional Officers, Camille M. Botticelli-Pohl

Antioch University Dissertations & Theses

A variety of policies at the national level over the last 70 years have resulted in the mass incarceration of various marginalized populations, inclusive of individuals with mental health problems or severe mental illness. Although Constitutional mandates require that psychology staff be available at all state and federal facilities, these providers spend a fraction of the time with incarcerated people than correctional officers do. Correctional officers seem to play an important, if often overlooked, supporting role in the management of the day-to-day lives of people in custody, including elements of their mental health care. They are also, theoretically, tasked with …

Nature Interaction Assists With Coping And Resilience: An Interaction Pattern Approach With Adolescents With Histories Of Trauma In A Youth Group Home, Chrystal L. Dunker

Antioch University Dissertations & Theses

Adolescents with histories of trauma often experience disruptions to their emotional, social, and behavioral development. For those living in group home settings, supportive environments can play a key role in fostering healing and resilience. While nature interaction is increasingly recognized as a valuable way to support mental health and resilience, little research has explored its role in these settings. This study introduces an innovative methodology—the Interaction Pattern Approach (IPA)—to examine the role of nature interaction in coping and resilience for 12 adolescents with Adverse Childhood Experiences (ACEs) living in a youth group home. In this design, IPA integrates photovoice data …

Stigma Of Obesity And Healthcare Utilization, Moya A. O'Leary

Antioch University Dissertations & Theses

The impact of personal factors on healthcare utilization is an essential area of research to improve overall health outcomes among the population. This study explored the relationship between perceived stigma and healthcare avoidance among men and evaluated the relationship between self-reported body mass index (BMI) and avoidance of healthcare appointments due to weight-related stigma and other reasons. This study found no significant relationship between BMI and avoidance of preventive medical appointments due to perceived stigma. However, men from all weight categories endorsed avoiding preventive healthcare appointments due to weight-related reasons and for other reasons. This study explored the reported reasons …

Pay Attention! A Comparative Analysis Of Psychological Assessments And Neurological Mechanisms For Adhd Within A Pediatric Population, Kristen E. Newberry

Antioch University Dissertations & Theses

This study evaluated the predictiveness of the WISC-V, NEPSY-II, CPT-3, and CATA when compared to each other in a sample of 272 children aged 8–16. Archival data was analyzed using binary and multinomial logistic regression models to assess concurrent validity of specific subtests and indexes. Participants were grouped by ADHD subtype (inattentive, combined/hyperactive, or no diagnosis), with gender and executive functioning measures included in the models. Findings indicated that lower Cognitive Proficiency Index (CPI) and executive functioning scores (e.g., Animal Sorting, Response Set) predicted any ADHD diagnosis compared to the no diagnosis group, whereas higher CATA scores predicted lower Inattentive …

For Black College Students Who Considered Dropping Out When Grit Wasn’T Enough: A Mixed Methods Study Exploring The Influence Of Family Messaging On Collegiate Outcomes, Dawn M. Wilson

Antioch University Dissertations & Theses

Black college student outcomes are well researched areas in education literature. This dissertation sought to explore the influence of academic and ethnic racial socialization on experiences of shame and guilt and examine the association of those relationships on Black college student retention and persistence. This study employed an explanatory sequential mixed methods design to investigate the socialization experiences of 272 Black college students in the US. Conditional process model analyses revealed that academic socialization is associated with experiences of guilt and shame—guilt predicted improved retention outcomes, while shame predicted lower retention outcomes. The analysis also revealed that while ethnic racial …

How Marriage And Family Therapy Graduate Programs Awaken, Develop, And Teach Clinical Intuition: A Hermeneutic Qualitative Phenomenological Study, Jessica Fountas

Antioch University Dissertations & Theses

This research explored how marriage and family therapy graduate programs awaken, develop, and teach clinical intuition. Using criterion-based sampling and snowball sampling, six licensed marriage and family therapists participated in a two-step hermeneutic phenomenological study consisting of individual semistructured interviews and a follow-up focus group. Requirements for participation were licensed marriage and family therapists who were in clinical practice, had experienced the phenomenon of clinical intuition and awakening of clinical intuition, and used clinical intuition in therapy with clients and in systemic supervision with supervisees. The research findings highlighted 14 themes: Reflection of the Experience of Clinical Intuition; Bodily Knowing, …

A Phenomenological Study Of How Parents Of Lgbtqia+ Youth Experience School-Based Sex Education, Alisha Bachman

Antioch University Dissertations & Theses

Empirical research on LGBTQIA+ youth and Comprehensive Sex Education is scarce and now, due to the current political climate, is under threat. Utilizing an interpretive phenomenological approach applying ecological systems and queer theory, this study explored the lived experiences of how parents of LGBTQIA+ youth perceive school-based comprehensive sex education. By isolating the phenomenon of comprehensive sex education, this study focused on the immediate context of influence that comprehensive sex education makes on LGBTQIA+ youth and families. This research used data collected through semi-structured interviews with nine different parents. Four themes emerged from the data: Communication and Education about Sexuality …

The Importance Of Accessibility, Self-Advocacy, And Affirming Care: An Interpretive Phenomenological Analysis Of Transgender And Gender Diverse Older Adults’ Primary Care Experiences, Jason Vaught

Antioch University Dissertations & Theses

The present study explored the lived experiences of Transgender and Gender Diverse (TGD) older adults when receiving primary care. The methodology utilized for this study was Interpretive Phenomenological Analysis (IPA). Three participants completed individual, semi-structured interviews. The themes that emerged included “Lack of Accessibility to Services,” “Need for Self-Advocacy,” and “Value of Affirming Care from Providers.” These results illustrated the multifarious needs that arise for TGD older adults when accessing primary care. The findings provided recommendations for healthcare organizations, primary care physicians, and other healthcare professionals. Specifically, the recommendations emphasized two key practices for physicians treating TGD older adults: (1) …

Reality Shock And Systemic Strain: Understanding The Lived Experiences Of Pre-Licensed Mental Health Counselors, Sara Al-Khedairy

Antioch University Dissertations & Theses

The counseling profession is struggling to meet the rising demand for mental health care due to a growing workforce shortage driven by burnout, inadequate support, and low compensation—pressures that disproportionately impact pre-licensed clinicians. Despite their critical role in sustaining the field, pre-licensed counselors often face systemic barriers with little structural support. This qualitative study explored the lived experiences of pre-licensed clinical mental health clinicians through social-ecological and reality shock theories. Participants included 14 pre-licensed clinical mental health counselors who had graduated from CACREP-accredited programs within the last five years. Individual interviews were conducted to gain a deeper understanding of participants’ …

Exploring The Lived Experience Of Grief In Adults With Attention Deficit Hyperactivity Disorder, Martina Bauer

Antioch University Dissertations & Theses

The purpose of this phenomenological descriptive-interpretive study was to understand the lived experience of maintaining attention to one’s responsibilities while grieving among adults diagnosed with ADHD who have recently experienced bereavement in the United States. The population for this study included adults aged 18 and over who had experienced the loss of a loved one in the past 5 years and had a current diagnosis of ADHD. Participants were recruited using a sample of convenience via social media, email, and flyers, employing a snowball sampling technique. There were eight participants who met the inclusion criteria and participated in a semi-structured …

Experiences Of Dissertating Students: What Works?, Laura Durkin

Antioch University Dissertations & Theses

This study explores the experiences of doctoral graduates from Council for Accreditation of Counseling and Related Educational Programs (CACREP)-accredited Counselor Education and Supervision (CES) programs. Guided by theoretical frameworks on student attrition and institutional racism, the research investigates three primary questions: (1) What dissertation- specific programmatic factors influence time to completion for CES doctoral students? (2) What interventions most strongly promote a sense of social integration and belonging? and (3) What interventions most strongly promote academic integration and confidence in students’ ability to succeed? Data were collected anonymously through an online survey, which included demographic and open-ended questions. Twelve participants …

Examining The Addictive Qualities Of Smartphone Usage, Daniel J. Pasquini

Antioch University Dissertations & Theses

Individuals in today’s society, both nationally and globally, have become exceedingly reliant on their smartphones, i.e., cellular devices with the ability to perform many tasks similar to a traditional computer, for both recreational and productivity purposes. As smartphones become increasingly accessible and affordable for the general population, smartphone usage will continue to grow exponentially. As a result, a comprehensive investigation into the possible addictive properties of smartphone usage is warranted. The purpose of this study is to examine and highlight any possible addictive qualities of excessive smartphone usage. The research methodology that will be implemented within the study will be …

Journey To Well-Being: An Exploration Of Thrivership Post-Domestic Violence, Kader Gumus

Antioch University Dissertations & Theses

Domestic violence profoundly affects multiple facets of a survivor’s life. While most existing literature on survivorship addresses the immediate aftermath of domestic violence, this study delves into the extended process following the trauma of abuse to attain “thrivership,” a new concept in the scholarly and practice literature that emphasizes enduring well-being and flourishing. This dissertation examines the journeys from surviving to thriving for 13 women who transformed themselves and their lives to achieve well-being after traumatic domestic violence. Bronfenbrenner’s ecological systems theory was applied to examine the multiple layers of environmental influences on an individual’s development, including the micro, meso, …

Medical Students' Attitudes Towards Research Participation After The United States Medical Licensing Examination Step 1 Scoring Change, Danxun Li, Nina Li, Curt Bay, Uzoma Ikonne

Department of Medicine Faculty Publications

Background

The recent transition of scoring for the United States Medical Licensing Examination (USMLE) Step 1 exam from a numerical grading system to pass/fail system has significant implications for residency applicants. It is anticipated that research productivity will gain greater importance in the evaluation process. To understand how medical institutions can best support students, we seek to understand medical students' motivations and experience conducting research in medical school after the USMLE Step 1 scoring change.

Methods

This is a mixed-methods, cross-sectional study that examines the motivations and barriers that medical students face in conducting academic or clinical research. A survey …

Risk And Crisis Communication Research In Singapore, Augustine Pang, Jerena Ng, Jason Shi-Yang Lim

Research Collection Lee Kong Chian School Of Business

This chapter aims to capture the latest insights on the state of risk and crisis communication research in Singapore, examined through the theoretical lens posited by Situational Crisis Communication Theory (SCCT) (Coombs, 2023). This chapter is divided into three sections: the first, consolidates risk and crisis communication research studies, the second examines the state of research, and the third offers a case study on the research conducted. Last but not least, we offer some suggestions on how research can grow. It is hoped that this chapter can offer a comprehensive view of risk and crisis communication research in Singapore and …

Applying The Ecological Model Of Medical Encounters To Understand Patient-Centered Communication For Older Korean Migrants In The U.S., Seulgi Park

Electronic Theses & Dissertations (2024 - present)

Patient-Centered Communication (PCC) is defined as an approach that places patients at the center of communication with healthcare providers. PCC has been recognized as a strategy to address disparities experienced by minority populations. However, despite its associations with positive health outcomes and ethical significance, there has been a paucity of research on PCC in minority populations such as older Korean migrants in the U.S. Understanding PCC within this group may contribute to improving healthcare communication tailored to their needs. This dissertation aimed to (1) explore the expectations of PCC in primary care settings among older Korean migrants in the U.S., …

Investigative Genetic Genealogy Practices Warranting Policy Attention: Results Of A Modified Policy Delphi, Christi J Guerrini, Louiza Kalokairinou, Jill O Robinson, Whitney Bash Brooks, Stephanie M Fullerton, Sara Huston, Jacklyn Dahlquist, Diana Madden, Norah Crossnohere, Nicola Campoamor, John F P Bridges, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

A technique known as investigative genetic genealogy (IGG) was first introduced to criminal investigations in 2018, and it has since been used by U.S. law enforcement to help identify hundreds of criminal perpetrators and unidentified human remains. As expertise in IGG grows, policymakers have shown interest in regulating it. To help inform these efforts and to promote coherence in IGG governance as it expands, we recruited experts representing a spectrum of IGG-relevant professions and perspectives to identify and prioritize IGG practices for policy attention and to develop policy options for addressing them. In two rounds of a modified policy Delphi, …

When Families Bridge The Research-Clinical Divide: An Exploration Of Values Regarding Cascade Screening In Genomic Research, Katherine E Bonini, Lauren R Desrosiers-Battu, Ann Katherine M Foreman, Nuriye N Sahin-Hodoglugil, Mary A Majumder, Candice R Finnila, Stephanie A Kraft, Laura M Amendola, Eimear E Kenny, Stephanie M Fullerton, Sara L Ackerman, Benjamin S Wilfond, Amy L Mcguire, Hadley Stevens Smith

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Genetic results are important for both patients and their biological relatives. However, cascade screening (CS) uptake is low, especially when testing occurs through research programs and not clinical care. Ethical guidance is needed for CS implementation when individuals receive clinical genetic results through research.

Methods: We conducted focus groups with 3 groups of individuals in the Clinical Sequencing Evidence-Generating Research Consortium: clinicians, patient representatives, and scholars of the ethical, legal, and social implications of genomics. We used inductive thematic and comparative analyses to analyze data within and across the groups.

Results: All participants (n = 27) agreed that …

Antibiotic Resistance: The Growing Threats And Potential Solutions, Olisaemeka Zikora Akunne, Blessing Nkechi Emmanuel, Umar Faruk Saidu, Ayobami Sunday Akinnawo, Nasiru Ademola Adeyemi, Livia Chinaza Egoh, Malami Aishatu Muhammad, Olusegun Ayo Ade-Adekunle, Deborah Ahuoyiza Peter, Anne Amina Freitas

Department of Biomedical and Translational Sciences Faculty Publications

Antibiotic resistance (AR) has become a critical global health crisis, threatening the efficacy of antibiotics and increasing healthcare costs, morbidity, and mortality. The One Health approach, which emphasizes the interconnectedness of human, animal, and environmental health, is increasingly recognized as an essential framework for addressing the complex drivers of AR. This review explores the mechanisms of resistance, such as genetic mutations, horizontal gene transfer, and biofilm formation, along with contributing factors such as the overuse of antibiotics in healthcare and agriculture. We assess both traditional and emerging strategies to combat AR, including antimicrobial stewardship, the development of new antibiotics, and …

Unmasking The Nexus Of Race, Ethnicity, And Health: An Intersectional Analysis Of The Epistemology Of Race In Medicine, Medical Curricula, And Health Disparities, Antoinette Leonard-Jean Charles

Antioch University Dissertations & Theses

The persistent health disparities faced by Black, Indigenous, and People of Color (BIPOC) in the United States are deeply rooted in systemic racism embedded within medical education and clinical practice. Historical acceptance of racial supremacy in the United States has shaped both the foundations and continued practices of medical education, leading to entrenched biases that affect healthcare delivery and patient outcomes. This dissertation critically examines the intersection of race, education, and health by analyzing how historical and contemporary understandings of race and ethnicity shape medical curricula, healthcare practices, and patient care. Through the integration of Critical Race Theory (CRT), Social …

Post-Migration Living Distress And Suicidal Behavior In Refugee Populations Resettled In Vermont, Phoebe K. Lewis

Antioch University Dissertations & Theses

The study of refugee psychology and suicidal distress is a comparatively nascent field when compared with the body of research concerning non-refugee populations. Over the past fifty years, however, the post-migration refugee experience has been the subject of growing clinical interest. In particular, the construct of post-migration living distress (PMLD) has been identified as a salient factor contributing to psychological distress in refugee populations. This dissertation explores the relationship between PMLD and suicidality in a sample of refugees resettled in a New England city. Guided by the Interpersonal Theory of Suicide (IPTS), this dissertation considers how elements of the post-migration …