Social Policy Commons^™

Cost Analysis Of Integrated Genderaffirming And Sexual Health Services For Transgender Women In Thailand: Evidence From The Tangerine Clinic, Braprut Sawatwipachai, Kunncadah Anuwong, Nittaya Phanuphak, Rena Janamnuaysook, Kritima Samitpol, Sujin Nitadpakorn

The Thai Journal of Pharmaceutical Sciences

Background: Transgender women experience a disproportionate burden of human immunodeficiency virus (HIV) globally and in Thailand. Integrating gender-affirming care into sexual health services may improve uptake of HIV and sexually transmitted infections (STIs) testing, treatment, and prevention. Cost data are essential to inform program planning and policy decisions regarding inclusion of such services within Thailand’s Universal Health Coverage (UHC) system.
Objectives: To estimate the full and unit costs of trans-led, integrated gender-affirming and sexual health services along the HIV care cascade.
Methods: Costs of Tangerine Clinic services in 2021 were assessed from the provider perspective, using standard and activity-based costing …

From Structure To Experiences: How Facility Capacity And Staffing Shape The Adoption And Impact Of Lgbt-Affirming Policies In Long-Term Care, Andrew Alberth

Graduate Doctoral Dissertations

Long-term care (LTC) settings – including nursing homes (NHs) and assisted living facilities (ALFs) – provide necessary care for individuals with extreme health and functioning limitations. Sexual and gender minority (LGBT) older adults report challenges receiving effective, person-centered care LTC. Some LGBT older adults may hide their sexual orientation and gender identity when entering LTC settings or delay seeking needed LTC fearing discrimination from staff and other residents. Furthermore, staff in LTC settings indicate little awareness of LGBT-residents and possess inadequate LGBT-cultural competency necessary for providing person-centered care. Therefore, LGBT-residents LTC experiences remain underexplored in the broader research. Adopting LGBT-affirming …

Vietnamese Grandparents' Caregiving Experiences For Grandchildren Impacted By Hiv/Aids: An Ethnographic Study, Lesley M. Harris, Nguyen D. Thang, Linh Thuy Nguyen

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This ethnographic study explores the caregiving experiences of grandparents in northern Vietnam who are raising grandchildren impacted by HIV/AIDS. Specifically, what is the process of skipped-generation caregiving in families affected by HIV/AIDS in Vietnam? Data were collected between 2009 and 2011 through participant observation and in-depth interviews with 26 grandparent caregivers and eight key informants. Informed by the Caregiving Career framework as a sensitizing concept and using constructivist grounded theory analytic strategies, the study identifies four interconnected caregiving phases shaped by cultural expectations, stigma, and intergenerational disruption. Through fieldwork and analysis, we found that grandparents drew from previous and current …

Screening And Treatment Protocols Used In Nicus Across Minnesota For Perinatal Mood & Anxiety Disorders (Pmads), Rachael Witt

Journal of Justice-Informed Social Work Practice and Research

Parents of infants with prolonged neonatal intensive care unit (NICU) hospitalizations are a population that is overlooked in recommended routine screening for perinatal mood and anxiety disorders (PMADs), yet this population is at greater risk for developing diagnosable mental health disorders. Previous research shows that across the US, PMAD screening and treatment practices vary widely, with many NICUs not providing any routine PMAD screening, psychoeducation, or treatment options to parents. The objective of this study was to explore the current mental health screening and treatment protocols used in NICUs across the state of Minnesota to learn if there are areas …

The Growing Needs For Young Adults’ Behavioral Health Services In Oregon And Pathways For Sustainable Service Deliveries, Anis Zaman

Hatfield Graduate Journal of Public Affairs

Recent OHA data indicate a significant surge in behavioral health cases among young adults ages 17-26 across Oregon. Every year in Oregon, the total number of young adults receiving medical treatment includes a significant number of them who have behavioral health challenges. This large group of young adults with mental health conditions is vulnerable to suicidal ideation and substance overdose. Despite sincere efforts by the Oregon Health Authority (OHA), the young adult mental health state of Oregon remains a concern. Therefore, there is a need for a comprehensive action plan for the sustainable delivery of mental health services to young …

Governing Algorithmic Attention: Attention Safeguard Models And The Cognitive Attentional Standard As System Level Interventions In Human Computer Interaction, Behavioral Economics, And Artificial Intelligence, Delante Clark

Graduate Scholarship and Creative Works

Algorithmic recommendation systems and interface designs shape attention by combining visually salient cues with uncertain reward timing and low friction interaction. These conditions can sustain anticipatory checking, extend time on task, and reduce natural disengagement points through patterns such as infinite scrolling and autoplay. This paper synthesizes research across neuroscience, human computer interaction, behavioral economics, and artificial intelligence to argue that attention capture is a predictable outcome of incentive driven design rather than an individual failure of self regulation. It advances the Attention Safeguard Models and the Cognitive Attentional Standard as system level interventions that regulate exposure conditions, pacing, and …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

The Capital Gap: Mitigating Banking Barriers For Nonprofit Providers In Mental Health And Educational Systems, Jinhee Lee, Josefina Martinez

Pepperdine Policy Review

Nonprofit organizations are vital contributors to public welfare, yet they are systematically excluded from conventional banking systems, creating a liquidity crisis that undermines their capacity to deliver essential services. This paper discusses the structural issues of the banking sector that hinder nonprofits in acquiring credit and explains how this problem can be solved. Specifically, it aims at investigating liquidity constraints faced by schools providing mental health services and education programs. With the help of information asymmetry and relationship lending theories, the paper explains why traditional credit approaches cannot work, considering the distinctive features of the financial model of mission-oriented institutions. …

Complex Systems Mapping Of Fiscal Growth Dynamics At Strategic Maritime Chokepoints Using Time-Series Slopes, Rahul Balamurugan, Preethi Nanjundan, Avichal Sharma

Northeast Journal of Complex Systems (NEJCS)

This study examines how maritime and trading states allocate public resources between defence, health, and economic growth around three strategic chokepoints the Strait of Malacca, the Strait of Hormuz, and the Suez Canal. The analysis extends the classic “guns versus butter” framing by treating defence and health spending as co-evolving components of an interconnected fiscal-growth system. Using World Development Indicators data (1999-2024), trend slopes are estimated for military spending (% of GDP), healthcare spending (% of GDP), and GDP growth (annual %). Two derived indicators are computed, a defence-to-health slope ratio (military slope/health slope) and a fiscal-balance proxy (health slope …

Physical And Behavioral Health Diagnoses And Comorbidities Associated With Transition From Military Health System To Veterans Health Care Among Post-­ 9/11 Veterans, Nikki R. Wooten, Megan E. Amaun, Madeline Meyers, Prince Nii Ossah Addo, Jeffery Bowers, Felicia R. Carey, Rudolph P. Rull, Edward J. Boyko, Nathaniel Bell, Ana Defede-Lopéz, Mary Jo V. Pugh

Faculty and Staff Publications

Objective

To identify factors associated with transitioning from Military Health System (MHS) to Veterans Health Administration (VHA) care in post-9/11 veterans.

Study Setting and Design

Retrospective cohort study from the Long-Term Impact of Military-Relevant Brain Injury Consortium Phenotype Study.

Data Sources and Analytic Sample

Population-level data were analyzed from MHS and VHA electronic health data (FY2000-2020). Participants received ≥ 3 years of MHS care and separated from the military before October 1, 2016. The primary outcome was transition from MHS to VHA care after military separation. Covariates included demographic, military, and deployment characteristics at military separation; physical, mental, and substance …

Call To Action Against Sex Trafficking Of Black Women And Girls, Stephany Powell, Tracey Sylvester, Brenda Myers-Powell, Audrey Morrissey, Melanie Thompson

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Improving Maternal Health: Investigating The Early Impacts Of Medicaid Coverage Of Doulas In Oregon, Miriam Akhmetshin

Scripps Senior Theses

While the U.S. spends more per-capita than any country on healthcare, we experience the worst maternal health outcomes of high-income nations. In addition to hefty healthcare bills, an overwhelming majority of mothers experience pregnancy-related health issues that decrease productivity and utility. Thus, it is critical to research cost-effective solutions that can improve maternal health and promote equitable outcomes. Doulas are trained non-medical professionals who support mothers and families before, during and after birth. As a growing body of medical literature points to the role of doulas in decreasing costly medical interventions, insurance companies have begun covering their services. In 2014, …

Food Stamp Participation And Health Outcomes In Ca Immigrants, Esther Kang

Scripps Senior Theses

The U.S. social welfare system includes programs aiming to increase access to nutritious food to reduce nutrition insecurity. However, studies suggest that immigrants continue to face disproportionate risks of nutrition insecurity and may face barriers to enrollment due to legal status. This study, using secondary data from the 2023 California Health Interview Survey, examines the associations between food stamp participation, food insecurity, and clinical diagnosis of diabetes among adult U.S.-born, naturalized, and non-citizen adults in California. The findings suggest that those enrolled in food stamps are more likely to report food insecurity than those who are not enrolled, and that …

The Attention Safeguard Models: Governing Digital Harm Without Restricting Lawful Speech, Delante Clark

Graduate Scholarship and Creative Works

Digital platforms increasingly govern contemporary social, civic, and psychological life through systems optimized for attention capture, amplification, and monetization. While lawful expression remains protected under the First Amendment, the infrastructural mechanisms that determine how speech circulates have produced a range of attention‑based harms, including cyberbullying, engagement farming, compulsive doom scrolling, emotional dysregulation, and civic polarization. This research paper introduces the Attentional Safeguards Model (ASM), coined and formalized by Delante Clark, as a novel governance framework that mitigates such harms by regulating systems of amplification rather than restricting expression itself. Building on attention economy theory, technological mediation, constitutional free‑speech doctrine, …

Defining The European Union’S Top Public Health Priorities: What Can Be Gleaned From Its Multi-State Interdisciplinary Systems?, Mattie Frascella, Thierry Leger

Symposium of Student Scholars

Delineation of the European Union’s (EU) contemporary public health agenda is examined within the evolving architecture of a ‘European Health Union.’ Five interdependent domains are synthesized: climate and planetary health, digital transformation, resilient systems and workforce development, non-communicable disease (NCD) prevention, and cross-sectoral and global leadership. Mutual reinforcement is essential for achieving equitable outcomes. The climate pillar reframes environmental disruption as a public health emergency, embedding adaptation, mitigation, and Planetary/One Health approaches across EU initiatives. The digital pillar examines the European Health Data Space and adjacent tools (telemedicine, e-prescribing, mobile health) as infrastructure for secure interoperability, research, and quality improvement. …

Investigating The Relationship Between Noun Classes And Plant Folk Taxonomy In Chasu Language Of Kilimanjaro Region In Tanzania, Peter Rabson Mziray

Journal of Humanities and Social Sciences

The current study investigates the relationship between noun classes and plant folk taxonomy in Chasu (G 22). The study focuses on two objectives: the first objective is to describe the plant folk taxonomy in Chasu and the second objective is to determine the relationship between noun classes and plant folk taxonomy in Chasu. Data were collected from rural villages in Same and Mwanga districts by using free listing, field interviews (jungle-walk-and-identify), and written texts containing Chasu plant names. The findings reveal that Chasu folk taxonomy reflects different ethnobotanical categories; including a unique beginner which is mmea/mimea ‘plant(s)’, and three life …

Adapting To Inflationary Pressures: Household Coping Strategies In Urban Egypt (2016– 2025), Mohamed Mohamed Ashraf Kamal

Theses and Dissertations

Over the past decade, Egypt has faced persistent economic challenges including repeated currency devaluations, high inflation rates, subsidy reforms such as the gradual reduction of food and energy subsidies, and the ripple effects of global crises that have significantly impacted household well-being, especially in urban areas. These pressures have eroded purchasing power and heightened food insecurity, especially among low- and middle-income families. Although substantial attention has been paid to macroeconomic indicators, there remains a critical gap in understanding how households adapt on a daily basis to manage financial stress and sustain their livelihoods. This inquiry is especially timely, as household …

Graduate Student Paper: Aging In A Changing Japan: Gendered Adaptation To Changing Family Structure, Miki Izu, Clayton Chalmers

Asia Pacific Perspectives

Although Japanese seniors are very healthy, research shows that they are not very happy. Compared to seniors in other developed countries, Japanese elders have lower ratings of subjective well-being and are increasingly alone. This paper argues that changes to Japanese family life help explain why Japanese elders are struggling with low subjective well-being. Specifically, declining marriage rates and declining rates of elders living with their children (co-residency) have made it harder for elders to get the support they need. Moreover, the effect and the adaptations to these changes are not equal between men and women. While elderly Japanese men are …

'There Is That Of God In All Of Us': Church, State, And Restrictive Abortion Policies, Kimsey J. Stewart

LSU Master's Theses

Unsafe abortion affects millions of women around the globe every year. Unsafe abortions are more likely to occur in countries with restrictive abortion policies. Yet, these policies persist, and the worldwide trend of liberalization of abortion laws is at risk of reversal. There is a disconcerting lack of research regarding what factors cause governments to enact, retain, and enforce restrictive abortion policies. This paper is an attempt to fill in such a gap. I theorize that countries in which the government has closer ties with religious organizations will have more restrictive abortion policies. My results indicate that this is likely …

The Social Standing Versus The Mind Standing Of Older Adults In Egypt: Cross-Sectional Analysis Of The Relationship Between Social Capital And Cognitive Functions, Shaza H. Shinaishen Dr

Theses and Dissertations

Introduction: Egypt's population, much like that of other countries, is expected to age considerably over the course of the coming decades. Although biological and socioeconomic predictors of cognitive function have been studied widely, personal level social capital remains unexplored, especially in LMICs.

Purpose: This study primarily investigates the relationship between individual social capital and cognitive functioning among older adults aged 65 years and older in Egypt using the structural and cognitive components of social capital, including group membership, civic engagements, and caregiving roles.

Methods: A cross-sectional survey on 363 older individuals in different geographical and demographic segments of Egypt using …

Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano

Psychology Division Scholarship

Repeated eras of mass incarceration, criminalization of marginalized communities, and substance use policies have created a revolving door of justice involved populations. The ever-increasing prison population has repeatedly become the largest contingency of mental health clientele for an overburdened mental health system. Those who work with formerly incarcerated individuals in the community often don’t know the unique set of challenges faced by practitioners within the system. Increased understanding and coordination of care can offer opportunities for sustained recovery and reduced levels of recidivism. In this presentation participants will learn about the unique insights on mental health treatment that can be …

Covid Cover-Up: Secrecy, Censorship And Suppression During The Pandemic, Brian Martin

Secrecy and Society

During the height of the COVID-19 pandemic, most health authorities, governments, and mass media organizations presented a single official view concerning lockdowns, masking, distancing, and vaccines. The methods used against contrary views can be classified into four types: flooding, ignoring, censoring, and attacking. The method of information flooding involves presenting dominant views in a unified front, overwhelming contrary views by volume and consistency. The method of ignoring includes the absence of research on alternative approaches, failure to report on research contrary to orthodoxy, and not mentioning challenging views. Censoring involves active measures to prevent the circulation of contrary information and …

Social Determinants Of Health And Aging In Africa: Structural Inequality, Vulnerability, And The Future Of Care, Aremu Umor Lukman, Sunkanmi Folorunsho, Abdulrauf Olaitan Taofeeq

Department of Sociology: Faculty Publications

Population aging is accelerating across Africa yet remains underrepresented in research, policy, and public health planning. This review critically examines how social determinants shape aging experiences across the continent, focusing on health, care systems, and structural inequalities. While traditional African societies have historically valued older adults, modernization, migration, and economic hardship have eroded support systems, leaving many to face old age with limited resources. Older Africans, particularly women and rural residents, contend with lifelong disadvantages including low education, informal labor, poverty, and gendered caregiving roles that contribute to poor health and social vulnerability. Health systems remain poorly equipped to address …

Examining Drug Policy In Portugal And Greece, Collin Fernandes

Dissertations and Theses

This thesis examines the divergent drug policies implemented in Portugal and Greece, analyzing why Portugal's comprehensive decriminalization model has been more successful than Greece's partial approach. Since 2001, Portugal has pioneered a drug policy that decriminalizes all drugs for personal use while investing in harm reduction services, rehabilitation, and social reintegration. In contrast, Greece maintained criminalization while implementing more limited harm reduction measures, particularly through OKANA (the Organization Against Drugs). The research highlights how economic factors, particularly the 2008 financial crisis and austerity measures, negatively affected both countries' programs but hit Greece's initiatives with greater severity. Portugal's programs have remained …

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, …

The Affordable Care Act And The For-Profit Congregate Care Industry: How Good Policy Intent Turned A Fringe Industry Into A Taxpayer-Funded Multi Billion Dollar Industry, Erin Viehmann

College of Graduate Studies: Theses & Dissertations

The Affordable Care Act significantly transformed the for-profit congregate care (FPCC) industry, which provides residential treatment for adolescents with behavioral and mental health issues. This study analyzes financial records from Universal Health Services (UHS), the largest provider in the industry, to examine how healthcare policy changes and economic conditions affected the industry's growth and funding structure. Through analysis of SEC Form 10-K filings from 2006-2016, the research documents how the ACA's mental health coverage mandates created new revenue streams that enabled dramatic industry expansion. Findings show that following ACA passage in 2010, UHS more than doubled its behavioral health capacity …

How White Supremacy Travels Through Time: Anti-Literacy Laws, Dei Bans, And The Issue Of Black Self-Determination In Public Health., Nicole V. Ford

Electronic Theses and Dissertations

This dissertation used a qualitative policy content analysis (PCA) of historical anti-literacy laws and modern DEI bans to answer two research questions: What is the connection between anti-literacy laws and DEI bans? How do anti-literacy laws and DEI bans create an environment that maintains white supremacy? A PCA exercise informed the analysis of historical anti-literacy laws in South Carolina (1834), Georgia (1829), North Carolina (1830), Louisiana (1830), Virginia (1831), and Alabama (1833) and modern DEI bans in Texas (2023), Alabama (2024), and Florida (2023) to find the connection between the laws. Findings from this dissertation illustrate how white supremacy operates …

Impacting Community Well-Being Through Effective Engagement Using The Seed Method, Carlin Rafie, Emily B. Zimmerman, Angelina Hargrove, Theodora Biney Amissah, Samantha Lee

Journal of Extension

Cooperative Extension can make a significant impact on health in the United States through effective community engagement that focuses on the complex socio-ecological factors that impact health. The Stakeholder Engagement in Question Development Method (SEED Method) employs community based participatory research principles to engage communities in research, problem-solving, and action planning. Projects employing the SEED Method engage community members from diverse backgrounds, create community capacity, result in tangible outcomes, and foment inter-organizational trust and networking. A SEED Toolkit is available on the Extension Foundation Campus site and provides implementation instructions, tools and timelines, and potential applications within Extension.

Which Way? Experiences Of Aboriginal And Torres Strait Islander People Who Are Deaf Or Hard Of Hearing Attaining Supports To Meet Their Interwoven Socio-Cultural, Health And Disability-Related Needs And Aspirations Within The Context Of Australia’S National Disability Insurance Scheme, Jody Barney, Alexandra Devine, Damien Howard, Marie Huska, Hannah Lack, Yeokyung Kim, Yi Yang, George Disney, Peter Summers, Ashley Mcallister

Journal of the Australian Indigenous HealthInfoNet

The life experiences of Aboriginal and Torres Strait Islander people who are Deaf or Hard of Hearing are often more complex than for Aboriginal and Torres Strait Islander people who are hearing, or non-Aboriginal Australians who are Deaf or Hard of Hearing. In turn, this can make engaging with and benefiting from policies and programs such as Australia’s National Disability Insurance Scheme (NDIS) more complex, particularly for individuals living in remote settings. To understand more about these complexities, yarnings were held with 15 Aboriginal and Torres Strait Islander NDIS participants who are Deaf or Hard of Hearing living in rural …

Selected U.S. Government Statistical Agencies And Their Data, Bert Chapman

Libraries Faculty and Staff Presentations

Provides introductory and detailed overview of U.S. Government agencies statistics. Includes examples of how an individual U.S. law authorizes government agencies to compile statistics for particular congressional committees and the general public. Statistics cover topics such as demography, defense, foreign assistance, economic growth, criminal justice, energy, Social Security, and Medicare.