Medicine and Health Sciences Commons^™

Mental Health Service Utilization Among Urban Adolescents: The Roles Of Perceived Mental Health Problems, Attitudes Towards Professional Help, And Stigma, Yi Tak Tsang

Wayne State University Dissertations

Mental health among adolescents is widely acknowledged as a significant concern in the United States. Based on a national survey, Merikangas et al. (2010) found that among 13-17 year olds, 42% to 48% reported experiencing mental health concerns. It is estimated that only half of adolescents with mental health problems utilize mental health services (Costello et al., 2014). An initial study found that caregivers of disadvantaged youth appeared to function as the “gatekeepers” to mental health services (Tsang et al., 2020). Also, the results suggested that positive attitude towards professional psychological help, but not stigma, predicted service enrollment. The current …

Understanding The Utilization Of Community-Based Services In Late Old Age: A Participatory Approach For Connecting Through The Communication Ecology, Carrie Leach

Wayne State University Dissertations

As the pool of eligible recipients continues to grow, understanding service system utilization and barriers can help ensure very old adults can access support from their communities when needed. Mounting research demonstrates that investment in community-based services to ensure seniors remain independent translates to saved government dollars. As a contributing researcher of a multi-year county-wide older adult needs assessment in Monroe County, Michigan, data collected from 1,870 people revealed a communication disjuncture between seniors and service providers. In response, officials convened a post assessment working group that focused on communication and outreach. Along with members of the Community Advisory Group …

Characterizing The Development Of Episodic Memory And Assessing The Reliability Of Fmri Measures, Lingfei Tang

Wayne State University Dissertations

The ability to remember past events is critical for everyday life and showed robust improvement over development from childhood to adulthood. With advances in noninvasive neuroimaging methods such as functional MRI in recent years, research efforts have been focused on identifying neural correlates underpinning developmental gains in memory performance. In my dissertation work, using a widely-validated subsequent memory paradigm, I aim to characterize functional MRI correlates of memory development. Specifically, I focused my investigation on identifying age differences in the functional patterns of two brain regions critical for memory, the prefrontal cortex and the hippocampus. Focusing on the prefrontal cortex …

The Impact Of Neonatal Pain And Reduced Maternal Care On Brain And Behavioral Development, Sean Michael Mooney-Leber

Wayne State University Dissertations

In the neonatal intensive care unit (NICU) preterm infants are exposed to a multitude of stressors, which include both neonatal pain and reduced maternal care. Clinical and preclinical research has demonstrated that exposure to neonatal pain and reduced maternal care has a profound negative impact on brain and behavioral development. Currently, the biological mechanism by which both of these stressors impacts brain and behavioral outcomes remains widely unknown. To uncover a potential biological mechanism, the current dissertation project utilized a preclinical model of repetitive needle pokes and developed a novel model of reduced maternal care through tea-ball encapsulation. Briefly, rat …

Assessing Parent Invovlment In Applied Behavior Analysis Treatment For Children With Autism, Krista Marie Clancy

Wayne State University Dissertations

The purpose of this study was to compare two groups of parents whose children participated in ABA on their levels of stress, self-efficacy, treatment acceptability, and parents’ level of involvement in their children’s treatment, and to assess variables that may explain variance in parent involvement. Parents in the treatment group participated in a voluntary parent training (n=18) and the comparison group were parents who elected not to participate in the voluntary training (n=22). This was a quasi-experimental design study where parents and their therapists completed a survey regarding parents’ involvement in their children’s treatment programs. Additional parent measures collected as …

Measuring The Effectiveness Of Benefit-Provisioning And Cost-Inflicting Mate Retention Tactics Through Relationship Outcomes, Tara Delecce

Wayne State University Dissertations

Mate retention has received much less research attention compared to mate choice and attraction. Even the research that has been done on mate retention often only aims to identify what constitutes as mate retention tactics. In the current studies, the effectiveness of mate retention strategies is explored by measuring relationship outcomes of tactics unlike previous research that measures effectiveness through perceptions of relationship satisfaction. In Study 1, individuals who have experienced a nonmarital breakup reported on their own and their ex-partners’ mate retention tactics before the breakup to see which ones predicted the outcome of relationship dissolution. Tests for moderation …

Rituals Reproducing Race: African American Women's Feminine Hygiene Practices, Shared Experiences, And Power, Angela K. Guy-Lee

Wayne State University Dissertations

This dissertation is an exploration of the role African American women’s feminine hygiene practices, namely vaginal douching, plays in the creation and reproduction of race. Compared to their white and Latina counterparts, African American women are the most likely to engage in this practice. Vaginal douching is associated with myriad reproductive and sexual health problems. These problems include but are not limited to recurrent yeast infections, bacterial vaginosis, disrupting healthy vaginal microbiomes, and spontaneous preterm birth; of which African American women experience disproportionately. Although racial differences in vaginal douching are well documented, little is known about the impetus for African …

Online Health Information Gathering And Health Service Utilization By Emergency Department Patients With Acute, Non-Urgent Illness Symptoms, Joanne Yastik

Wayne State University Dissertations

ABSTRACT

ONLINE HEALTH INFORMATION GATHERING AND HEALTH SERVICE UTILIZATION BY EMERGENCY DEPARTMENT PATIENTS WITH ACUTE, NON-URGENT ILLNESS SYMPTOMS

by

JOANNE M. YASTIK

May 2017

Advisor: Dr. Deborah Schutte

Major: Nursing

Degree: Doctor of Philosophy

Statement of the Problem: The influence of the Internet on our global society cannot be overstated. One of the most utilized areas on the Internet is the quest for health information (Bouche & Migeot, 2008; Goldman & Macpherson, 2006; Warner & Procaccino, 2007, Seckin, 2014). To date, little is known on how this information is being used or whether there is a link between online health …

Change In Processing Speed And Its Associations With Cerebral White Matter Microstructure, Muzamil Arshad

Wayne State University Dissertations

The decline of cognition with age is one of the most feared aspects of aging, while the slowing of responses, or reduced processing speed, is one of the most reliable aspects of aging. Slowing of processing has been hypothesized to affect other domains of cognition as well. Despite the well-known slowing-age relationship and central position processing speed plays in theories of cognitive aging the neurobiological mechanisms which underpin slowing is unclear. If we could identify the biology associated with processing speed we could then attempt to develop interventions to mitigate the effects of age on those variables. In turn we …

Preparing To Parent: Mindfulness In Expectant Parents Exposed To Adversity, Laurel Marie Hicks

Wayne State University Dissertations

Expectant parents who have been exposed to psychosocial risk encounter deleterious psychological (Ashley et al., 2016), and physiological (V. H. Pereira, Campos, & Sousa, 2017) effects. This not only affects the parent-to-be, but also may affect the developing fetus (E. P. Davis et al., 2011) and is linked to poorer infant development (Lefmann & Combs-Orme, 2014). However, not all risk-exposed individuals experience this, many are resilient and still thrive in the face of adversity. Understanding potential risk and resiliency factors in expectant parents is advantageous, so tailored interventions can be devised to improve outcomes. One potential resiliency factor, mindfulness, is …

Essays On Health And Labor Market Outcomes, Maryam Jafari Bidgoli

Wayne State University Dissertations

This dissertation examines the relationship between health and labor market outcomes using the 1996-2010 longitudinal RAND Health and Retirement Study (HRS). First, it estimates the relationship between health and labor supply using a simultaneous equation model, treating health as endogenous. The effect of health may be overestimated because people may adjust their non-employment status by their health conditions (justification hypothesis). By using a full information maximum likelihood method, we can conduct a true test of exogeneity on the health variable, taking into account the correlation between two labor supply and health equations’ time-varying error components (unobserved heterogeneity). The results confirm …

This Is Us Saying Who We Are: Speaking The Rhetoric Of Mental Disability, Renuka Uthappa

Wayne State University Dissertations

People with mental disabilities, or what are sometimes referred to as “mental illnesses,” face stigma when they interact with the public. To fight this stigma, the members of a small, grassroots, advocacy organization known as the Speakers Bureau travel to high school and college classrooms narrating their experiences with mental disability. They do so to replace culturally circulating stereotypes regarding such disability with more accurate and positive images. This dissertation is an auto-ethnographic exploration of the rhetoric of the Speakers Bureau. Through rhetorical analysis of members’ classroom speeches, of interviews with each speaker, and of the speaker’s self- assessment of …

An Examination Of Quality Of Life Of Parents Of Adult Children Diagnosed With Autism Spectrum Disorder, Christina Noel Marsack

Wayne State University Dissertations

Previous research on parental caregivers has focused primarily on caregivers of individuals with intellectual and developmental disabilities, rather than focusing specifically on parents of adult children diagnosed with autism spectrum disorder (ASD). Most research on ASD has centered on parents of young children with this diagnosis, but not on parents of adult children with ASD. Understanding the experiences of parents caring for adult children with ASD is important given the increase in the prevalence of individuals with ASD and the lack of information regarding parents of adult children with ASD. A nonexperimental, quantitative, correlational design was used to examine effects …

The Effects Of Courtship And Pairing Behavior On The Nonapeptide And Noradrenergic Systems Of Adult Male And Female Zebra Finches, Erin Lowrey Ondercin

Wayne State University Dissertations

Social relationships are complex and likely involve the multiple neural circuits, including those involved in learning, memory, motivation, and attention. Two neurotransmitter pathways highly involved in these neural circuits are norepinephrine (NE) and the nonapeptides, vasopressin (AVP) and oxytocin (OT). There is extensive research implicating a role for the nonapeptides in trust, sociality, parental care, and romantic relationships. There is little direct evidence for the role of nonapeptides in monogamous relationships in any species other than the prairie vole (Goodson 2013). However, there is evidence that nonapeptides are important in pair bonding for both male and female zebra finches (Lowrey …

Child Maltreatment, Problem Alcohol Use And Physical Revictimization: Examining Longitudinal Trajectories In A Nationally Representative Sample, Kathryn Mariah Zumberg Smith

Wayne State University Dissertations

Past investigations examining the relationships between child maltreatment, alcohol use and physical revictimization have been limited by their use of cross-sectional designs and their focus on childhood sexual abuse and sexual revictimization. In addition, there is a paucity of epidemiological studies examining child maltreatment, alcohol use, and physical revictimization. The present study sought to address these limitations by examining relationships between child maltreatment, problem alcohol use, and physical revictimization in a nationally representative sample. Data were analyzed from the public-use data set of the National Longitudinal Study of Adolescent to Adult Health (Add health; Harris & Udry, 2014), waves I-IV. …

The Impact Of Age On Workplace Motivation: A Person-Centered Perspective, Keith Lynn Zabel

Wayne State University Dissertations

The present study used the person-centered approach to examine how profiles based upon six different age conceptualizations differentially impact workplace motivation. In the first known study to examine all conceptualizations of age simultaneously, results suggested the age conceptualizations of subjective age and health significantly impact growth motives for older workers, but not social or security motives. Results suggest social motives are influenced more by chronological age as opposed to other conceptualizations of age. Implications for practitioners in designing and implementing HR activities (e.g., succession planning) and researchers in utilizing all the conceptualizations of age and studying workplace interventions are discussed.

The Semantic Memory Imaging In Late Life Pilot Study, Michael Adam Sugarman

Wayne State University Dissertations

Introduction: Several functional magnetic resonance imaging (fMRI) studies have analyzed the famous name discrimination task (FNDT), an uncontrolled semantic memory probe requiring discrimination between famous and unfamiliar individuals. Completion of this simple task recruits a semantic memory network that has shown utility in determining risk for Alzheimer's disease (AD). Specific semantic memory probes using biographical information associated with famous individuals may build on previous findings and yield superior information regarding risk for AD.

Method: Sixteen cognitively intact elders completed the FNDT and two novel tasks during fMRI: Categories (matching famous individuals to occupational categories) and Attributes (matching famous individuals to …

Factors Associated With Primary Care Providers' Willingness To Deliver Routine And Transition Care To Transgender Individuals, Deirdre Aisling Shires

Wayne State University Dissertations

Transgender individuals report being denied healthcare services, but very little is known about primary care providers’ (PCP) willingness to deliver either routine or transition care to the transgender community. The purpose of this study is to examine PCP willingness to deliver routine care, continue a hormone therapy (HT) regimen initiated by another provider, and initiate HT for transgender patients using a theoretical framework informed by the Theory of Planned Behavior and Intergroup Contact Theory. The study sample was all family medicine, internal medicine, and women’s health providers in a large integrated Midwestern health system. Eligible participants were emailed a unique …

The Relationship Between Healthcare Spending And Gross Domestic Product: A Study From A Sample Of African Countries, Steven Harrington Addo

Wayne State University Dissertations

In this essay I estimate the elasticity of total healthcare expenditures with respect to gross domestic product. I also address the stationary properties of total healthcare expenditures and gross domestic product, and whether these measures are cointegrated. The empirical exercise uses a sample of African countries so that the estimates can be compared to those that have been made using data on OECD countries. To address the issue of possible endogeneity of GDP in the healthcare expenditure equation, I assume that total healthcare expenditures and gross domestic product are simultaneously determined, and using structural equations, I identify instrumental variables for …

Essays On Healthy Aging From The Perspective Of A Health Production Function, Nasim Baghban Ferdows

Wayne State University Dissertations

This dissertation examines the determinants of healthy aging among older adults using Grossman’s framework of a health production function. Healthy aging is produced using a variety of inputs, including some determined in early life, such as health and socioeconomic status as a child, others determined in young adulthood, such as education, others determined in mid-life, such as household wealth, and still others determined in later-life, such as current health habits. A production function for healthy aging is estimated using nationally representative data from the 2010 Health and Retirement Study on non-institutionalized seniors, and positing a simultaneous equations mediation model, recognizing …

“I Can See My Values In Places”: Relationships, Place, And Growing Old In Detroit Neighborhoods, Wendy Daniel Bartlo

Wayne State University Dissertations

The central focus of this dissertation is to examine the inextricable link between persons, their social worlds, and their environments. I do this through an ethnographic study of senior members of non-biologically based kinship groups with an affiliation to place. Critical to this examination is the city of Detroit itself, as members of these groups ultimately collectively identify as Detroiters through space and time. It is this collective identity, strengthened mostly through their defense of an outsider deemed unsuccessful city that renders Detroit a good place for the older person to maintain connections, participate socially and civically, and to organize …

An Analysis Of Virtual Place Learning/Navigation In Children And Young Adults Prenatally Exposed To Alcohol, Neil Christopher Dodge

Wayne State University Dissertations

Fetal alcohol spectrum disorder refers to the spectrum of disorders resulting from prenatal alcohol exposure and is the leading cause of preventable mental retardation. Rodent studies have found that prenatal alcohol exposure impairs performance on the Morris water maze. This task requires the rodent to use distal room cues to locate a hidden platform in a pool of opaque water. Successful performance on this task is dependent upon hippocampal function. Rodents prenatally exposed to alcohol are impaired on the Morris water maze and show damage to hippocampal neurons. A human analogue of the Morris water maze, the virtual water maze …

Assessing Patient-Centered Communication In Medical Education: A Crystallized Approach To Understanding The Quality, Nature, And Form Of Feedback By Standardized Patients, Simone Kathe Brennan

Wayne State University Dissertations

Patient-centered Communication (PCC) is the gold standard in effective clinical communication. Feedback from Standardized Patients (SPs) provides one strategy to teach PCC. SP feedback is highly valued, but little is understood about its quality, nature, and the form in which it is actually delivered. Methods: Using the meta-method of crystallization (Ellingson, 2009), I conducted three unique studies, content analysis, iterative thematic analysis, and narrative analysis of SP feedback. These analyses were conducted using transcribed SP feedback from a multi-station, residency-based Objective Structured Clinical Exam (OSCE). SPs in this OSCE were trained using the adapted version of the Kalamazoo Essential Elements …

Cognitive Health And African American Elders Study: Knowledge, Attitudes And Practices, Shelytia Cocroft

Wayne State University Dissertations

A substantial body of literature suggests that cognitive impairment disproportionately affects African Americans. To date, research has uncovered disturbing racial disparities associated with the prevalence of cognitive impairment and dementia and found prevalence rates of Alzheimer’s disease (AD) to be higher among African Americans (Potter et al., 2009). Furthermore, a 2002 report from the Alzheimer’s Association described AD in the African American community as an “emerging public health crisis”. This dissertation examined the impact of socioeconomic status (SES) on knowledge, attitudes, and practices (KAP) associated with the promotion of cognitive health among a sample of 120 African American women aged …

Diabetes Interaction Study: Communicating Understanding And Social Support, Dana K. May

Wayne State University Dissertations

The current study evaluated a brief individualized feedback intervention developed to improve communication style of parents with an adolescent with type 1 diabetes. Seventy-nine parent-adolescent dyads (13-18 years) were randomized to receive a single session of brief feedback to target parental person-centered communication skills (n = 39) or to receive an educational comparison group (n = 40). Families were asked to discuss a diabetes related problem. A clinician concurrently rated the parent’s communication skills to identify communication strengths and weaknesses. Parents in the feedback group received feedback on their use of person-centered communication during the conversation using motivational interviewing techniques. …

Fear Of Alzheimer's Disease And Its Role In Memory Monitoring And Control, Annalise Marie Rahman

Wayne State University Dissertations

Introduction: Fear of Alzheimer’s disease (FAD), or Anticipatory Dementia, is a healthy adult’s misinterpretation of everyday memory failures as indicators of developing dementia. The current study investigated the construct of FAD and aimed to contextualize FAD within the Health Belief Model through development of a new scale, the Anticipatory Dementia Index (ADI). The study also assessed the relationship between FAD and metacognitive monitoring and metacognitive control.

Methods: 94 cognitively-intact community-dwelling older adults with and without a history of family history of AD completed questionnaires regarding their subjective memory complaints, state and trait anxiety, depression, and multiple measures of FAD, including …

Management Safety Climate And Violence Prevention Climate: A Mediational Model For Healthcare Employee Outcomes, Lydia Hamblin Hamblin

Wayne State University Dissertations

Workplace violence is defined as aggressive acts against employees ranging from verbal abuse, threats, and bullying, to physical assault (OSHA, 2002; Jackson, Clare, & Mannix, 2002). The two purposes of this study were (1) to differentiate two specific forms of psychological climate related to workplace violence on a work unit: Violence Prevention Climate (VPC) and Management Safety Climate (MSC), and (2) to test a causal model focusing on the relationship between these climates and their effects on relevant outcomes for at-risk employees in the healthcare industry. MSC was expected to partially mediate the effects of VPC on four outcomes: work …

An Evaluation Of The Factor Structure, Reliability And Construct Validity Of The Male Role Norms Inventory-Revised For African American/Black Men, Wilfred Michael Allen

Wayne State University Dissertations

Background: In the United States, on average, men die nearly five years younger than women. Among men, the life expectancy for African American/Blacks is 72.1 years compared to 76.6 years for White/European Americans. African-American/Black men experience an earlier onset and more severe disease with higher rates of complications than White/European American men. Masculinity ideology has been identified by researchers as having an influence on health behaviors and ultimately health outcomes. Based on prior research literature, higher levels of masculinity ideology have been associated with fewer health promoting behaviors. As such, there is a need for a reliable and valid measure …

What Impacts Life Satisfaction Of Aging Adults Following Stressful Life Events?: An Examination Of The Buffering Effect Of Personal Resources, Cassandra Barragan

Wayne State University Dissertations

Purpose: Existing research has shown that elders experience changes in their life satisfaction following stressful life events. There is an abundance of literature supporting the predictive nature of not only stressful life events on life satisfaction, but social support, autonomy, and financial security. What the literature is lacking, is examination of the buffering effect of social support, autonomy, and financial security on the relationship between stressful life events and life satisfaction. This study hypothesizes that increases in social support, autonomy, and financial security will buffer the impact of SLEs for elders and thus, they will experience increases in their life …

Agency And Resistance Strategies Among Black Primary Care Patients, Janella Nicole Hudson

Wayne State University Dissertations

Research has identified marginalized and minority patients as displaying fewer participatory behaviors during the clinical interaction. Using a culture-centered framework, this study examines the process by which patients with a previous history of discrimination employed agency and resistance strategies in order to influence the outcome of their clinical interactions. This study conducted a secondary analysis of the video taped interactions of 25 black primary care patients in an urban low-income clinic. Using qualitative content analysis, I identified five emergent themes for patient agency: interrupting the physician, stating observations of care, expressing needs and desires, constructing identity, and agenda/goal management. Participants …