Medicine and Health Sciences Commons^™

The Long-Term Consequences Of Adolescents' Comparative Economic Position In School, Kiwoong Park

Legacy Theses & Dissertations (2009 - 2024)

The goal of this dissertation project is to investigate how adolescents’ comparative socioeconomic positions within their schools shape their short- and long-term outcomes, including later health, educational expectations and attainment, and the risk of having a nonmarital first birth. Although social comparison theory posits that individual well-being depends on the standings of others with whom one compares oneself, as well as on one’s own absolute standing, the empirical evidence of the theory has been mixed and controversial. This project argues that inconsistent findings may arise from difficulty in measuring reference groups, temporal ambiguity between exposures and outcomes, and methodological limitations.

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Kenya, Charlotte E. Warren, Pooja Sripad, Charity Ndwiga

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically disadvantage women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. In …

Reference Guide: Factorial Focus Group Analysis Methods For Studying Social Norm Change, Bettina Shell-Duncan, Amadou Moreau, Katherine Wander, Sarah Smith

Reproductive Health

The factorial focus group methodology described in this guide provides a powerful means of illuminating the social norms that uphold female genital mutilation/cutting (FGM/C), and the ways in which meanings have at times become contested or rejected. The methods described here can be applied to the study of a wide range of behaviors influenced by social norms, such as early marriage, adoption of contraception, and more.

« More Than Brides Alliance (Mtba) » : Rapport D’Évaluation À Mi-Parcours Au Mali Et Au Niger, Andrea J. Melnikas, Grace Saul, Mouhamadou Gueye, Aissa Diarra, Sajeda Amin

Poverty, Gender, and Youth

L’Alliance « Plus qu’une épouse » (More Than Brides Alliance—MTBA) a été formée, rassemblant les forces d’une équipe diversifiée, compétente pour la mise en œuvre et la recherche de programmes destinés aux adolescents. Le volet recherche de l’Alliance MTBA vise à fournir des preuves et des connaissances sur ce qui fonctionne pour retarder le mariage des enfants en Inde, au Malawi, au Mali, au Niger et au Pakistan en évaluant le programme d’intervention de l’Alliance MTBA et en examinant les facteurs spécifiques du mariage des enfants dans chaque contexte. Dans ce rapport, nous visons à évaluer les succès du programme …

The Girl Roster: A Practical Tool For Strengthening Girl-Centered Programming, Population Council

Poverty, Gender, and Youth

This brief describes the Girl Roster^TM, a practical tool designed by the Population Council to help practitioners understand their program areas and elicit foundational information to intentionally link girls—especially highly marginalized adolescent girls—to the vital resources, facilities, and services to which they are entitled but often have limited or no access. The tool is a user-friendly, efficient, and cost-effective way to collect program-relevant information about girls in a community, using a mobile phone–based questionnaire (or, where resources do not permit, paper and pencil). The tool enables users to see a fuller view of girls’ lived realities in defined …

Examining Early Marriage In India: Qualitative Findings, Neelanjana Pandey, Komal Saxena, Andrea J. Melnikas

Poverty, Gender, and Youth

The More Than Brides Alliance (MTBA) implements the “Marriage: No Child’s Play” program (2016–20) in India, Malawi, Mali, Niger, and Pakistan. The MTBA is a holistic program that addresses early marriage through multiple strategies, including: sexual and reproductive health and rights, livelihoods, education, and prevalent community social norms around marriage. Furthermore, the program operates at multiple levels (girl, family, community, block, and district) to address individual, familial, and structural barriers to reducing child marriage in these communities. This report first looks at the legal environment in which programs operate by examining participants’ awareness of laws, acts, and programs related to …

Media Exposure And Community Perception Of Alcoholism Among Female Adolescents In South-West Nigeria, Rowland Edet, Julianah Babajide

Department of Sociology: Faculty Publications

Purpose - The purpose of this paper is to investigate the influence of alcohol adverts on female adolescents as well as the perception of the community on alcohol consumption among female adolescents. The authors analyzed respondents’ opinions towards media portrayal of alcoholic beverages. Design/

Methodology/ Approach - The study adopted a descriptive cross-sectional survey. The methodology based upon semi-structured questionnaire among 500 female adolescents and a qualitative methodology using in-depth interviews with parents and alcoholic beverage sellers.

Findings - The study reveals that television was the major source of information on alcoholic beverages among female adolescents in both rural (36.4%) …

Sexual Behaviours Of Adolescents In Creek Town, Cross River State, Nigeria, Kabiru K. Salami, Rowland E. Edet

Department of Sociology: Faculty Publications

Risky sexual behaviors of adolescents in Creek Town have not been fully profiled. This study investigated the sexual behaviors of adolescents and their various dimensions in Creek Town, in Cross River State, Nigeria. This cross-sectional survey design adopted multi-stage sampling procedure to administer a 112-items questionnaire to 422 adolescents, to elicit information on their sexual behaviors and practices. Four focus group discussion sessions were also conducted with in-school and out-of-school adolescents. The mean age of adolescents was 17 years. Majority (65.4%) of the adolescents were sexually active. The mean age at sexual debut was 15 years for both male and …

Data Note: Social Security Administration Data Show A Record Low Level Of Pass Usage Among Ssi Recipients, Daria Domin, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Social Security Administration (SSA) offers a set of work incentives for Supplemental Security income (SSI) beneficiaries. Work incentive employment supports help SSI recipients go to work by minimizing the risk of losing their SSI or Medicaid benefits (Social Security Administration, 2018). One such incentive, the Plan to Achieve Self-Support (PASS), allows approved individuals to set aside earned or unearned income and resources to achieve an employment goal. The money or resources set aside are excluded from SSI income and resource tests and can be used to pay for goods or services needed to reach the goal, such as education, …

Service Provider Promising Practice - Penn-Mar Human Services: Creating Their “2020 Strategic Plan”, Esther Kamau, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

At the beginning of the transformation process, Penn-Mar recognized the importance of robust strategic planning to understand what the organization needed to do differently to transform. Therefore, Penn-Mar created the 2020 Strategic Plan, a 5-year plan to help focus the organization, and to strategize about how to achieve their objectives. The 2020 Strategic Plan outlines Penn-Mar’s goal to close its sheltered workshop, with a set of action steps for achievement. The plan set a specific date for closure, as Penn-Mar staff argued that without it, the transformation process would “linger forever.” Penn-Mar established a task force to support the development …

Service Provider Promising Practice - The Arc Of Westchester: Creative Partnership With Mercy College, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Arc of Westchester benefits from an agency culture that values innovative partnerships. In fact, an agency leader explained that the organization “will work with anybody who is willing to sit and talk.” This collaborative spirit led to a creative endeavor with Mercy College, a four-year school offering degrees in Business, Education, Liberal Arts, Health and Natural Sciences, and Social and Behavioral Sciences. Within Health and Natural Sciences are departments such as nursing, speech therapy, occupational therapy, physical therapy, and nutrition. The Arc of Westchester partnered with these departments to form a mutually beneficial relationship, creating opportunities for both college …

Service Provider Promising Practice - Arc Of Westchester: Annual Employer Appreciation Breakfast, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Arc of Westchester was established in in New York State in 1949 as a day school for children with developmental disabilities. It has since grown to over 800 hundred employees serving over 2000 individuals throughout Westchester county supporting children, teens, and adults with intellectual and developmental disabilities. The organization’s vision is a world where the population that they serve enjoy fulfilled lives and an inspired future while the mission focuses on strengthening families and encouraging personal choices, abilities and interests. The programs focus on the individual, helping them discover their interests, develop their talents and prepare for meaningful careers. …

Service Provider Promising Practice - Atwork!: Creating A Robust Investment In Staff Professional Development, Esther Kamau, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

At the beginning of their transformation process, AtWork! did not have a training structure in place. Recognizing that job development required a different skill set for their staff, AtWork! made a commitment to invest in training, which they saw as “a key ingredient” to successful transformation. Investing in the development of staff skills and competencies to support the transformation process is essential. Without that investment, as one agency leader put it, “every provider is going to continue to spin their wheels with people in, people out, retraining, all those type of things.” Consequently, AtWork! invested in training its staff through …

Service Provider Promising Practice - Work Inc.: Developing A Community Liaison Program To Address Holistic Needs, Esther Kamau, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Leadership at Work Inc., a provider in the Boston area, thought about the holistic approach to providing individual supports even before their agency’s transformation began. Work Inc. designed its community liaisons program to have three components: volunteerism, with the intention of identifying employment opportunities and contributing to the community; recreation, “because everyone wants to have fun”; and instruction, with a focus on skill-building and identifying interests and talents. In designing and implementing the program, Work Inc. staff considered each person’s interests, and turned former workshop staff into “community liaisons.”

Deputizing Family: Loved Ones As A Regulatory Tool In The “Drug War” And Beyond, Matthew B. Lawrence

Faculty Articles

Many laws use family members as a regulatory tool to influence the decisions or behavior of their loved ones, i.e., they deputize family. Involuntary treatment laws for substance use disorder are a clear example; such laws empower family members to use information shared by their loved ones to petition to force their loved ones into treatment without consent. Whether such deputization is helpful or harmful for a patient’s health is a crucial and dubious question discussed in existing literature, but use of family members as a regulatory tool implicates important considerations beyond direct medical impacts that have not been as …

Put Your Money Where Your Mouth Is: Reforming Organized Dentistry To Address Persistent Oral Health Disparities In The U.S., Aparna Chintapalli

Pomona Senior Theses

The importance of oral health has been largely neglected from the conventional standards of healthcare in terms of public understanding & prioritization, the industrial infrastructure, and the scope of prevention & early-intervention services. Its adjunctive locus to the field of medicine has lead to the bifurcation of the oral cavity from the rest of the human body. As a result of this divide, there have been multiple factors that have allowed socially stratified oral health outcomes to manifest. This thesis examines the determinants of oral health disparities through a multidisciplinary lens (i.e. biology, public policy, infrastructure), and offers evidence of …

Effects Of International Service Learning On Development Of Intercultural Competence, Sharon M. Mccloskey

Occupational Therapy Faculty Publications

As the United States becomes an increasingly multicultural society (Colby & Ortman, 2014; Perez & Hirschman, 2009), there are greater opportunities for cross-culture interactions, especially in settings for healthcare practitioners. The profession of occupational therapy demands future practitioners understand culture and become skilled in the delivery of culturally competent care (AOTA, 2014). The purpose of this study was to examine the effects of international service learning (ISL) on the development of intercultural competence in graduate occupational therapy students. Inquiry for this research followed a mixed-methods explanatory sequential design. Study participants were graduate occupational therapy students who engaged in an international …

A Comparison Of Motivational Differences Among Older Marathon Runners And Their Injury Status, Marsha Renee Kaufman

Walden Dissertations and Doctoral Studies

Despite the high occurrence of running-related injuries, master level runners, those aged 40 years and older, account for 50% of all marathon finishers. What is not known is the common motive sustaining participation, especially among this age demographic. The self-determination theory was the theoretical framework to support how behavior is regulated by the individual. The purpose of this quantitative research was to identify a difference in the motives (psychological, physical, social, and achievement) and their subcategorical motives (health orientation, weight concern, affiliation, recognition, psychological coping, life meaning, self-esteem, competition, and personal goals) via the Motivations of Marathoners Scales by master …

Education Program For Critical Care Nurses On Preventing Catheter-Associated Urinary Tract Infections, Olatunde Olatunji

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTIs) are the most frequently reported hospital-acquired condition, affecting more than 560,000 patients each year. CAUTIs prolong hospital stays and increase health care costs, and they can result in patient morbidity and mortality. Nurses can be empowered by receiving education and knowledge to manage and identify urinary catheters that are not clinically indicated. The purpose of this project was to develop an education program on CAUTI prevention for critical care nurses using the teach-back method. The conceptual framework that guided this project was Knowles's adult learning theory. The theoretical model was based on 4 fundamental assumptions …

Exploring The Challenges Non-Clinical Departments Encounter During Eden Alternative Implementation, Keith George

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services recommends new guidelines that shift healthcare delivery in nursing homes and long-term care facilities from an institutional model to a person-centered care model. Although clinical outcomes are measured and tracked, there was limited literature about the challenges non-clinical departments face in a nursing facility during implementation of a person-centered model. The purpose of this qualitative study was to explore the challenges non-clinical staff experience while transitioning to an Eden Alternative philosophy, a person-centered care model. The theoretical foundation of this study relied upon Bressers' Contextual Interaction Theory. The research questions for this study …

Gay Men And Satisfaction With Health Care Interactions, Michael Huggins

Theses and Dissertations--Nursing

The purpose of this research was to determine relationships among depression, anxiety, self-rated physical and mental health, self-advocacy, internalized homophobia, and quality of patient-provider communication to satisfaction with health care interactions. These were measured while controlling for select demographic variables: age; ethnicity; urban or rural domicile; relationship status; household income; highest educational attainment; health insurance; disclosure to health care provider as a gay man; reason for last healthcare visit; and, general health self-rating. The specific aims of this study were to: 1) identify general characteristics of gay men in this sample; 2) examine how levels of satisfaction with health care …

Demography, Risk, And Power: An Examination Of The Deceased Patient Population At The Hastings State Hospital, 1900-1978, Dawn T. Whitney

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this research is to investigate the Hastings State Hospital (HSH) and its cemetery (HSHC) within a multidisciplinary framework, invoking discourse analysis, demography, and critical race theory to examine how power and risk factors impact the treatment and disposal of the body at death. It incorporates perspectives from both anthropology and sociology to interpret the data, relying heavily on the ideas of Michel Foucault. Integrating these diverse analytical tools is important to this research because social and structural forces all intersect in the creation of identity, power, and inequality.

All data in this study represent patients that have …

Associations Between Income, Acculturation, Country Of Origin, And Type Ii Diabetes Among African Immigrants To Ontario, Canada, Girma Aman Goshe

Walden Dissertations and Doctoral Studies

Diabetes has become a longstanding public health challenge around the world. Over the last 3 decades, the number of people with Type II diabetes (T2DM) has grown to an epidemic level in Canada. Prior research indicated African immigrants residing in Ontario, Canada experienced a 2-4 times higher prevalence of T2DM than Canadian-born individuals. The social determinants of health theoretical framework guided this study assessing the relationship of the risk factors with T2DM. A quantitative, cross-sectional design was employed using the 2007-2014 Canadian Community Health Survey data. The random sample included 1,526 African immigrants residing in Ontario, Canada. Descriptive, bivariate, and …

Participant Experiences In Christian-Based Recovery, Joshua Mjolsness

Walden Dissertations and Doctoral Studies

Health care leaders are challenged with addressing addiction and the treatment of addiction. Many studies have been conducted around addiction treatment; however, no studies have been conducted on Christian-based recovery programs that use the same approach regardless of the addiction. The purpose of this phenomenological study was to explore the experiences of participants in a Christian-based recovery program that uses the same approach for all addictions. The social learning theory provided the framework for this study. Data were collected by interviewing participants of the Christian-based recovery program Free Grace Recovery (FGR). Eight participants selected had a variety of reasons for …

Survey Of U.S. Undergraduate Self-Reported Opioid Diversion And Heroin Use, Motives, Sources, And Collective Efficacy As Mediating Factors, Mark Francis Plaushin

Walden Dissertations and Doctoral Studies

Epic morbidity and mortality, and intractability make prescription opioid diversion a wicked problem. Meanwhile, college undergraduates are vulnerable to opioid misuse and its consequences. The purpose of this quantitative study was to assess U.S. undergraduate students' opioid misuse and the relationship between mediating factors. The study's theoretical framework rested on Wakeland's et al. opioid system model and Shaw and McKay's social disorganization theory. This study bridged the gap, measuring collective efficacy and testing its relationship to undergraduate decisions to regulate misuse. Thus, research questions focused on gauging the problem's scope and assessing relationships between factors that drive or potentially regulate …

A Qualitative Case Study Exploring Hand-Hygiene Standards In An Intensive Care Unit, Lyndon Augustine, Walter Mccollum, Richard Brown, Phoenix Mourning-Star

International Journal of Applied Management and Technology

Healthcare-associated infections (HAIs) are infections that occur in patients during their time of care in a hospital. Considerable emphasis is currently placed on reducing HAIs through improving hand-hygiene (HH) compliance among healthcare professionals because HAIs are a critical challenge to public health in the United States. By focusing on meeting Centers for Disease Control and Prevention HH standards, the purpose of this qualitative research was to explore how noncompliance with these standards and lack of technology usage affect HAIs in the intensive care unit. Additionally, the goal of this research was to explore behavioral factors and best practices that influence …

Accelerating Action To End Child Marriage In Bangladesh—Project Brief, Population Council

Poverty, Gender, and Youth

Bangladesh ranks among the five countries with the highest rate of child marriage in the world. Community norms and values are among the underlying factors that support the practice of child marriage in Bangladesh. The Population Council is partnering with the Ministry of Women and Children Affairs to delay marriage as part of the UNFPA-UNICEF Global Program to Accelerate Action to End Child Marriage. This program is being implemented to generate evidence on reduction of child marriage through an adolescent skills-building program. The project works to empower girls with life-skills and livelihood and gender-awareness trainings, as well as engaging communities …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Spanish], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

La Caja de herramientas: Fortalecimiento de habilidades del Population Council ayuda a los profesionales, los encargados de formular políticas y los defensores a crear contenido personalizado, significativo y positivo para ayudar a subpoblaciones específicas de niñas. La caja de herramientas guía a los profesionales a través de una serie de pasos que deben tomarse para definir objetivos de sentido común: qué información, habilidad o activo físico (como una tarjeta de identificación) debe tener una niña en un entorno particular para una edad en particular. Este documento consta de las tarjetas de activos que forman parte de la Caja de herramientas: …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Swahili], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

[In Swahili] The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls.

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The …

Um Só Currículo: Actividades Para Uma Educação Integrada Em Sexualidade, Género, Hiv E Direitos Humanos, International Sexuality And Hiv Curriculum Working Group, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

Education on sexuality and HIV can help adolescents develop the capacity for healthy, respectful relationships and protect themselves from unwanted and unsafe sex, unintended pregnancy, and sexually transmitted infections. A 2015 Population Council study found that sexuality and HIV education programs that address gender and power in intimate relationships are five times more likely to be effective than programs that do not. However, most curricula still do not address these issues. "It’s All One Curriculum" provides a rationale, content, and sample activities for placing gender and rights at the center of sexuality and HIV curricula—both as stand-alone modules and integrated …