Social and Behavioral Sciences Commons^™

Spillover Theory: Unintended Consequences Of Provisions In The Affordable Care Act, Robert T. Braun

Theses and Dissertations

Objective: To examine spillovers from a federal policy, managed care market, and community perspective.

Data Sources/Study Setting: We studied spillovers from a federal policy and managed care market perspective using the Health Care Utilization Project’s (HCUP) State Inpatient Database (SID). American Hospital Association (AHA) data, Interstudy Commercial Managed Care, and Area Health Resource File (AHRF). Medicare Advantage county-level payment schedules originate from CMS. We examined community uninsurance spillovers using 2011-2015 Medical Expenditure Panel Survey (MEPS), the Area Health Resource File (AHRF), and the Small Area Health Insurance Estimator (SAHIE).

Study Design: Ordinary Least Squares (OLS) and difference-in-difference regression analyses were …

Investigating Racial Bias In Perceptions Of Free Will, Courtney J. Alderson

Theses and Dissertations

The overarching goal of this study was to examine whether perceptions of others’ free will would differ depending on perceiver race as well as target race. The current study proposed that such a racial bias may be one mechanism by which racial disparities in medical treatment recommendations arise. By bridging findings from four different lines of research (i.e., the literatures on racial health and medical treatment disparities, racial bias, free will beliefs, and social identity), it was hypothesized that: (1) participants would perceive greater amounts of free will for a hypothetical racial ingroup patient than an outgroup patient; (2) such …

Why Local Governments Collaborate: Perspectives From Elected Officials And Local Government Managers On Regional Collaboration, Stephanie D. Davis

Theses and Dissertations

This study examined the factors that influence a local government’s decision to engage in regional collaborations. Analysis of 7 local government managers and eleven elected officials revealed that the decision to engage in regional collaboration was influenced by external factors, organizational factors, and internal motivations. Elected officials and local government managers identified a disaster occurrence, fiscal stress, outside agencies, jurisdictional benefit, and communication as key factors. Further, this research highlights the importance of the role of the elected official in intergovernmental arrangements, the role of the local government manager as the policy entrepreneur, and the influence of shared norms and …

Differences In Spatial Visualization Ability And Vividness Of Spatial Imagery Between People With And Without Aphantasia, Anita Crowder

Theses and Dissertations

Mathematics education researchers have examined the relationship between visualization and mathematics for decades (e.g., Arcavi, 2003; Bishop, 1991; Duval, 1999; Fennema & Tartre, 1985; Presmeg, 1986). Studies have linked spatial visualization ability, such as measured in mental rotation tasks, directly to mathematics self-efficacy (Pajares & Kranzler, 1995; Weckbacher & Okamoto, 2014), which in turn influences mathematics achievement (Casey, Nuttall, & Pezaris, 1997). With the important role that spatial visualization plays in learning mathematics, the recent identification of congenital aphantasia (Zeman, Dewar, & Della Sala, 2015), which is the lack of mental imagery ability, has raised new questions for mathematics education …

Prosecution As The "Soul Crushing Job:" Complexities Of Campus Sexual Assault Cases, Tammi L. Slovinsky

Theses and Dissertations

On April 4, 2011, the U.S. Department of Education issued a Dear Colleague Letter on campus sexual assault reaffirming the intent of Title IX, the 1972 law that prohibits discrimination sex-based under any education program or activity receiving federal financial assistance. In response to growing concern over due process rights for defendants, in September 2017 the guidance was rescinded. Public policy continues to evolve, leading to potentially lasting institutional changes on many college campuses. These developments include the formalization of campus investigations and adjudications, the development of campus coordinating committees and expanded support mechanisms for victims. In Virginia, laws passed …

Communicating Colorectal Cancer Risk To Average Risk Adults: Examining The Impact On Risk Perceptions And Health Behavior Intentions, Carrie A. Miller

Theses and Dissertations

Background. CRC risk can be reduced though lifestyle modification and regular screenings. Providing CRC risk feedback that promotes preventive behaviors to those at average risk has the potential to significantly reduce CRC morbidity and mortality.

Purpose. The purpose of this dissertation was to examine the impact of CRC risk assessment feedback among adults aged 50-75 with no personal or family history of the disease. The specific aims were to: (1a) test personalized (vs. generic) risk assessment feedback on individuals’ risk perceptions and intentions to engage in three risk-reducing behaviors (e.g., physical activity, diet, and screening); (1b) determine if the provision …

Validation Of Virginia's Juvenile Risk Assessment Instrument, Jessica P. Schneider

Theses and Dissertations

Utilizing a validated risk assessment tool to predict future offending is recommended as best practices in corrections by a number of professional organizations (Latessa & Lovins, 2010). Guided by the risk-needs-responsivity model, risk assessment tools have evolved to help inform criminal justice practitioners by identifying offenders most in need of intervention or supervision, guiding the case plan to optimize outcomes (Bonta & Andrews, 2007). The Virginia Department of Juvenile Justice (DJJ) utilizes the Youth Assessment and Screening Instrument (YASI) at all stages of contact with youthful offenders, including intake, probation, commitment, and parole (DJJ, 2016). However, risk assessment instruments do …

The Experiences That Promote Success For Students With Intellectual Disability In Postsecondary Education, Kimberly S. Handsome

Theses and Dissertations

This in-depth qualitative, phenomenological (Smith & Fowler, 2009) research study attempted to understand the experiences of young adults with intellectual disability who had completed a 2-year, inclusive postsecondary education program. 13 participants (4 former students with ID, 5 parents, and 4 Postsecondary Education staff members) participated in semi-structured interviews. Interviews were coded to provide themes amongst each individual group of participants. A document review was also conducted to better understand the program components and add validity to self-reports from interviews. Results were analyzed and used to provide implications for future research and program development.

Police Officer Perceptions Of Organizational Justice And Body-Worn Cameras: A Civilizing Effect?, Carolyn Naoroz Ph.D.

Theses and Dissertations

This research sought to understand the potential association between officer perceptions of organizational justiceand officer perceptions of body-worn cameras (BWCs). A questionnaire was administered to a convenience sample of 362 officersfrom the 750 sworn personnel from the Richmond Police Department in Richmond, VA, yielding a response rate of 91% and representing 44% of the Richmond Police Department’s sworn employees. This study extends prior work by partially replicating a previous BWC survey conducted by leading body-worn camera scholars, utilizing a large sample from an urban mid-Atlantic police department. This study also extends prior work on officer perceptions of organizational justice …

A Practice Elements-Based Approach To Adherence Measurement, Stephanie Violante

Theses and Dissertations

The measurement of treatment adherence (i.e., the frequency and thoroughness with which a therapist delivers a treatment as designed) is critical to the field of implementation science, as adherence is often considered an indicator of successful implementation. Most existing instruments of treatment adherence are treatment protocol specific; however, this approach is costly, inefficient, and disallows cross-treatment and cross-study comparisons. Thus, there is a need for adherence instruments that can be used across treatment protocols. It has been suggested that an instrument that captures adherence at the practice element level would meet this need, as it would have utility across protocols …

Tommi's Place: An Adaptation And Commentary On Uncle Tom's Cabin, Vanessa L. Jackson

Theses and Dissertations

Harriet Beecher Stowe penned Uncle Tom’s Cabin which was published in 1852. This book exposed and condemned the atrocities of slavery. Her book became a bestseller and is said to be one of the primary reasons why slavery was eventually abolished. Though slavery has been dismantled the system of oppression which allowed the marginalization of others to thrive has never been eliminated. This system established a dominant culture; one which oppresses those of African descent and has endured for centuries. Tommi’s Place retells Uncle Tom’s Cabin in contemporary corporate America. Tommi’s Place reflects that this system of oppression is still …

Structured Poetic Expressions For Emerging Adults Experiencing Bereavement, Kelcie D. Willis

Theses and Dissertations

Previous research has produced heterogeneous findings regarding the effectiveness of expressive writing in reducing grief symptomatology among the bereaved (e.g., Collison, 2016; Lichtenthal & Cruess, 2010; Stroebe et al., 2006). The purpose of this study was to address these mixed results by exploring the effects and linguistic characteristics of a novel writing task (i.e., the acrostic poem) among bereaved undergraduates, using an innovative data analysis technique (i.e., Linguistic Inquiry and Word Count). The current study recruited 68 undergraduates who had lost a loved one. Participants were randomly assigned to write over multiple days using the acrostic poem, emotional disclosure prompt, …

Evaluating And Reducing The Effects Of Misclassification In A Sequential Multiple Assignment Randomized Trial (Smart), Jun He

Theses and Dissertations

SMART designs tailor individual treatment by re-randomizing patients to subsequent therapies based on their response to initial treatment. However, the classification of patients being responders/non-responders could be inaccurate and thus lead to inappropriate treatment assignment. In a two-step SMART design, by assuming equal randomization, and equal variances of misclassified patients and correctly classified patients, we evaluated misclassification effects on mean, variance, and type I error/ power of single sequential treatment outcome (SST), dynamic treatment outcome (DTRs), and overall outcome. The results showed that misclassification could introduce bias to estimates of treatment effect in all types of outcome. Though the magnitude …

Critical Consciousness, Racial Identity, And Appropriated Racial Oppression In Black Emerging Adults, Keyona Allen

Theses and Dissertations

The present study explored private regard and public regard, two subcomponents of racial identity, as mediators of the association between critical consciousness and appropriated racial oppression. In a sample of 75 Black emerging adults, ages 18-25, the current study examined (1) the relationships between critical consciousness, racial identity, and appropriated racial oppression and (2) whether racial identity mediates the relationship between critical consciousness and appropriated racial oppression. Relationships in the expected direction were evident between private regard and both critical consciousness and appropriated racial oppression. Relationships in the expected direction were evident between public regard and critical consciousness. Further, mediation …

Relationships Among Parenting Stress, Parenting Practices, And Conduct Problems In African American Mothers Of Children With And Without Adhd, Amanda Parks

Theses and Dissertations

Parents of children with attention-deficit/hyperactivity disorder (ADHD) endorse increased levels of parenting stress and subsequently employ ineffective parenting practices. For children with comorbid conduct problems, mothers report more parenting stress than mothers of children with ADHD alone. I investigated the relationships among child ADHD diagnostic status, parenting stress, parenting behaviors (i.e., involvement and positive parenting) and child conduct problems in 78 African American mothers of children with and without ADHD. Mothers completed a demographic questionnaire, a semi-structured clinical interview, the ADHD Rating scale (also completed by teachers), the Impairment Rating Scale, the Parenting Stress Index – Short Form, and the …

Effects Of A 2-Week Exercise Intervention On Heart Rate Variability In Individuals With Low And High Anxiety Sensitivity, Hannah M. Kotarski

Theses and Dissertations

Anxiety Sensitivity (AS), the belief that anxiety-related sensations may have harmful implications, can alter autonomic nervous system (ANS) function. Exercise has previously been shown to reduce AS; however, the effects of an exercise intervention on heart rate variability (HRV), a measure of ANS function, has not been evaluated in individuals with high AS. This study sought to 1) compare resting HRV in individuals with either low (LAS) or high AS (HAS) and 2) evaluate the effects of a 2-week exercise intervention on HRV and AS. Using the Anxiety Sensitivity Index (ASI-3), participants were identified as LAS (n=9; ASI-3=5.89±1.39) or HAS …

Culture And Colonial Legacy: Evidence From Public Goods Games, Latika Chaudhary, Jared Rubin, Sriya Iyer, Anand Shrivastava

ESI Working Papers

We conduct a public goods game in three small towns in the Indian state of Rajasthan. Due to historical military conquest, until 1947 these towns were on (barely) opposite sides of a colonial border separating British India from the Princely States. Our research design offers a treatment comparison between the towns of (British) Kekri and (Princely) Sarwar, and a control comparison between (Princely) Sarwar and (Princely) Shahpura. We find no significant difference in contributions to home town groups, but a significant difference in contributions to mixed town groups. Participants in (British) Kekri are more co-operative (i.e., contribute more) in mixed …

Trust In Humans And Robots: Economically Similar But Emotionally Different, Eric Schniter, Timothy W. Shields, Daniel Sznycer

ESI Working Papers

Trust-based interactions with robots are increasingly common in the marketplace, workplace, on the road, and in the home. However, a looming concern is that people may not trust robots as they do humans. While trust in fellow humans has been studied extensively, little is known about how people extend trust to robots. Here we compare trust-based investments and emotions from across three nearly identical economic games: human-human trust games, human-robot trust games, and human-robot trust games where the robot decision impacts another human. Robots in our experiment mimic humans: they are programmed to make reciprocity decisions based on previously observed …

Bed And Breakfast: The Role Of Sleep And Affect In Breakfast Intake, Ashley R. Macpherson

Theses and Dissertations

Breakfast intake is associated with numerous positive physical and mental health outcomes, yet breakfast skipping remains common in adults. Chronotype and sleep show potential as predictors of breakfast intake; however the existing literature has methodological limitations and fails to examine how psychological mechanisms might explain the relation between sleep and breakfast. The current investigation explored the association of means and variability of sleep behaviors (bedtime, midsleep, sleep duration) as predictors of breakfast intake frequency and high-protein breakfast intake frequency. Additionally, the role of positive and negative affect as mediators in the sleep—breakfast association was examined. Hierarchical regressions and PROCESS parallel …

A Stakeholder Examination Of Gestational Weight Gain Guidelines, Melissa Kwitowski

Theses and Dissertations

Obesity is a significant health concern for women of childbearing age. More than 40% of women have a Body Mass Index (BMI) in the overweight or obese ranges at the time they conceive, posing significant health risks for both mother and child. Excessive weight gain during pregnancy is common and associated with numerous deleterious complications. The Institute of Medicine published gestational weight gain (GWG) guidelines based on prepregnancy BMI. However, more than 50% of women gain in excess of these recommendations. Further, many women report receiving minimal guidance from their healthcare providers regarding weight gain, nutrition, and physical activity during …

Mental Health Difficulties And Service Use Of Incarcerated Women: The Influence Of Violence Perpetration And Victimization, Rachel C. Casey

Theses and Dissertations

The present study aimed to expand the knowledge base regarding incarcerated women’s experiences with violence and their mental health with the goal of identifying avenues for more tailored, compassionate responses to their mental health difficulties in both macro and direct practice contexts. To achieve this aim, a secondary data analysis was performed using data from the Survey of Inmates in State Correctional Facilities (SISCF) completed by the Bureau of Justice Statistics (BJS) in 2004. Six research questions pertaining to women’s experiences with violence and their mental health difficulties and service utilization guided the inquiry, which involved univariate, bivariate, and multivariate …

Longitudinal Relations Between Adhd Symptoms And Substance Use Across The Transition To College And Evaluation Of Promotive And Protective Factors, Melissa R. Dvorsky

Theses and Dissertations

The prevalence of substance use and related problems increases during adolescence and peaks in young adulthood with substantial increases during the transition from high school to college (Johnston et al., 2018). However, these increases are not universal for all students (White et al., 2006), and there is substantial variation in rates of substance use during the first year of college (Borasri et al., 2007; Frisher et al., 2007). It is important to identify the individual and environmental factors that serve as risk factors for substance use as well as factors that may promote or protect against use during the high …

Investigating The Presence And Correlates Of Anti-Thin Bias In Adults, Alexandria Davies

Theses and Dissertations

Weight stigma is associated with negative health outcomes across the BMI continuum. However, few studies have examined weight discrimination targeting people with low body weights. This investigation explored the presence of anti-thin bias, defined as the belief that people with low BMIs have undesirable personality characteristics. Participants were randomly assigned to read one of six vignettes about women that differed by race (White and Black) and weight status (slightly underweight, normal weight, and slightly overweight). Negative personality characteristics were more likely to be ascribed to both underweight and overweight women, compared with normal weight women. Furthermore, participants were significantly more …

Strengthening Social Networks Of Youth Aging Out Of Foster Care: Promoting Positive Adult Outcomes, Rachel D. Rosenberg

Theses and Dissertations

During the transition to adulthood, youth often rely on the people in their life for support. However, for transition-aged foster youth, these supports may not be available or may look different than supports available to youth in the general population. Relationships with supportive adults have been found to help former foster youth transition to adulthood, but little is known about the adults youth have in their network. Foster youth who report increased levels of social capital have been shown to experience higher levels of success in young adulthood. However, as former foster youth transition to adulthood, a lack of in-depth …

Does Emotion Regulation Moderate The Association Between Impairment And Depression In Adolescents With Adhd?, Laura D. Eddy

Theses and Dissertations

In comparison with their peers, adolescents with ADHD are at increased risk for developing depression, with prevalence estimates for comorbid depression ranging from 14% to 20%. Youth with comorbid ADHD and depression are at greater risk for multiple negative outcomes compared to youth with ADHD alone, including suspension from school, failing a grade, or difficulties in peer relationships. Identifying risk factors for depression among adolescents with ADHD is important for facilitating early identification and treatment efforts. Research completed to date indicates that interpersonal impairment and emotion regulation may mediate the relationship between ADHD and depression. However, a comprehensive longitudinal model …

Loyalty Program Effectiveness: An Examination Of Mainstream And Niche Sport Fan-Team Relationships, Lisa S. Rufer

Theses and Dissertations

The purpose of this study was to explore the efficacy of using loyalty programs on sport fans’ relationship quality and fan engagement toward sport organizations. This study also sought to explore which relationship quality and fan engagement factors potentially differed as a result of using loyalty programs. Since there are two major defined sport levels, differences were explored across niche and mainstream sport organizations. Using relationship marketing as the theoretical framework, participants (n = 678) were administered a 55-item instrument that included revised relationship quality and fan engagement scales. Quantitative data were used to run confirmatory factor analyses, analyses of …

Queer Health Equity And Cervical Cancer: Identifying Social Determinants Of Papanicolaou Test Uptake In A Sample Of Sexual Minority Women And Gender Nonbinary Individuals, Ariella R. Tabaac

Theses and Dissertations

Sexual minority women (SMW) demonstrate lower rates of cervical cancer screening than heterosexual women. This is concerning as lesbian and bisexual women tend to engage in higher rates of substance-related cancer risk behaviors, unprotected sex, and tend to have higher body mass indices, all of which are risk factors for cancer development. Another major risk factor, screening avoidance, places SMW at increased risk for the development of high grade cervical lesions in the absence of early detection practices, which is likely to impact overall cervical cancer morbidity in this population. The aim of the present study was to utilize the …

Predictors Of Resilient Outcomes Among Juvenile Offenders, Kristina A. Mcguire

Theses and Dissertations

Research on resilience has almost completely bypassed the juvenile justice literature. Using data on 1,354 youth from the Pathways to Desistance study, the present study examined associations between individual, community, and familial risk and promotive factors and resilient outcomes, specifically gainful activity, in juvenile offenders. Results of both logistic and hierarchical regression models indicated significant associations between resilient outcomes in each domain: specifically individual (age at first arrest, motivation to succeed), community (geographic location, exposure to violence), and family (socioeconomic status, parental monitoring) predictors. Finally, this paper discusses reasons for non-significant findings and directions for future research on resilience among …

Orthodontists’ And Patients’ Preferences In Website Design In The Selection Of An Orthodontic Practice: A Comparative Study, Taylor R. Brown

Theses and Dissertations

Objective: To determine which website characteristics are preferred by orthodontists, adult patients, and parents of patients.

Materials and Methods: 1,000 active members of the American Association of Orthodontists and 750 active orthodontic patients/parents were sampled. Participants rated the importance of website characteristics, indicated presence of those characteristics on the current website, and ranked sample website images. Preferences were compared between orthodontist and the patient/parent group using t-tests and sample websites were compared using ANOVA models and Tukey’s adjusted post-hoc tests. Significance level was set at 0.05.

Results: 11 of the 16 website features showed significant differences between patients/parents and orthodontists. …

A Laboratory Study Of Stress Reactions To Witnessing A Police Killing Of An Unarmed Black Man: Discrimination, Distress Tolerance, Ethnic Identity, And Risk-Taking, Michael A. Trujillo

Theses and Dissertations

Black individuals have been disproportionately targeted by law enforcement, most notably in shooting deaths at the hands of police, and has contributed to a general distrust of law enforcement. A rise in citizen journalism has helped document excessive use of force by police on video; however, little is known how individuals respond to viewing this type of media. A history of race-based stress is likely to contribute to an expectation of racism and may impact how individuals respond to videos of the treatment of unarmed Black men at the hands of police, with some evidence suggesting ethnic identity may moderate …