Social Justice Commons^™

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

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 …

Cultural Responsiveness: Examining Assessments Of Therapists For Ethical And Clinical Outcomes (Create Clout), Tsotso T. Ablorh

Graduate Doctoral Dissertations

The Multicultural Counseling Competencies (MCC) and Multicultural and Social Justice Counseling Competencies (MSJCC) are well-researched and supported counseling practices for decreasing microaggressions in therapy and consequent attrition, lack of satisfaction, and maltreatment (Ratts et al., 2016; Sue et al., 1982). However, scholars critique existing methods for measuring therapists’ cultural responsiveness for being disconnected from therapeutic process and outcomes (Hays, 2020; Wilcox et al., 2020). This study examined which MSJCC measures associated with variables clinically and ethically relevant to better treatment outcomes and lower microaggressive, neglectful, and stereotypical treatment for hypothetical Black, female clients by White therapists. 62 White psychologists in …

“When I’M Not Heard, I Feel Like I Don’T Matter”: Advancing Equity In Disability Policy Through Critical Participatory Action Research With People With Intellectual Disability, Cris Marchionne

Student Theses

People with intellectual disability deserve a system that offers flexible, timely, and person-centered support — one that is innovative, sustainable, and holistic in enabling them to live fulfilling lives. This qualitative study, grounded in Critical Participatory Action Research (CPAR), examines how people with intellectual disability experience participation in decision-making within New York State's disability service system. By centering lived experience, the study identifies factors that facilitate or hinder participation in decision-making and examines structural, social, and policy-related barriers that limit agency. Through six focus groups and a Photovoice project with self-advocates receiving OPWDD services, participants described systemic barriers that limited …

Artificial Intelligence And Social Equities: Navigating The Intersectionalities In A Digital Age (Editorial), Daisuke Akiba, Julie Albright

Publications and Research

This editorial article introduces and synthesizes the Special Issue, “Artificial intelligence and social equities: navigating the intersectionalities in a digital age,” which examines how AI systems intersect with race, ethnicity, and interconnected identity dimensions across global contexts. The eight contributions span healthcare, digital media, higher education, organizational communication, and speculative futures, addressing anti-racist psychiatric algorithms, AI-generated visual disinformation, epistemic injustice between the Global North and South, algorithmically mediated rural–urban divides, culturally untranslated technology transfer, accessibility auditing across the AI lifecycle, and the tension between mechanical objectivity and empathic understanding. Read together, they show that AI is neither inherently …

Determinants Of Antenatal Care Utilization: A Community-Based, Cross-Sectional Study In Morang And Sunsari Districts, Eastern Nepal, Sunil Shah, Chandra Jha

Journal of Social, Behavioral, and Health Sciences

This study examined the factors influencing antenatal care (ANC) utilization in the eastern region of Nepal, focusing on the Morang and Sunsari districts, with the aim of identifying key determinants affecting ANC uptake and assessing the extent of ANC service utilization among mothers. Using lot quality assurance sampling, a community-based, descriptive, cross-sectional design was employed, surveying 164 mothers who had given birth within the previous 12 months; data were collected from June through November 2023. Data were collected through a semi-structured questionnaire and analyzed using SPSS, with descriptive statistics, chi-square tests, and logistic regression. Findings revealed that 80.5% of respondents …

Bridging Fiscal Sustainability And Health Equity: A Policy Analysis Of California’S Healthcare Coverage Safeguards, Guadalupe Castaneda Martinez

Master's Projects and Capstones

Without structural policy intervention, approximately 4.6 million Californians remain at risk of being uninsured by 2030, worsening racial and ethnic health disparities and hospital uncompensated care burdens. This policy analysis advocates for a hybrid universal coverage model combining sliding-scale subsidies (California Senate Bill 78) with full-scope Medi-Cal expansion for all income-eligible residents regardless of legal status (California Assembly Bill 133). The framework relies on existing funding mechanisms, including the Managed Care Organization tax and the Health Care Affordability Reserve Fund. Comparative analysis indicates that market-only subsidies leave severe equity gaps, whereas immediate single-payer transitions pose substantial fiscal and administrative risks. …

Ethics Under Siege: The Conflict In Tigray Through The Lens Of Just War Theory, Daniela Widya Purba

Journal of Strategic and Global Studies

This research article explains the ethical principles of the conflict in Tigray based on the Just War Theory. By using the descriptive qualitative methodology, this research article draws data from secondary sources which includes; academic journals, news reports, as well as international legal instruments to analyze the moral trajectory of the conflict. This research begins with jus ad bellum, to assess Ethiopia’s government justification in declaring conflict within Tigray. While the government fulfilled the criteria of just cause and legitimate authority, the question stands on the ambiguous political intentions and the failure to enact peaceful alternatives before resulting in waging …

Oral History With John Barry, Dan Royles

History Faculty Scholarship

Oral history interview with John Barry, who has served as Executive Director of the Southern Tier AIDS Program (STAP) since 2008. He was born in Endicott, New York in 1966, grew up in Vestal, and attended high school at Seton Catholic Central in Binghamton before serving in Germany with the United States Army during the early 1980s. When he returned to Broome County in 1987, some of his friends had been affected by HIV/AIDS and, while earning a degree at SUNY Binghamton, Barry became involved in mutual aid efforts to help people affected by the disease. He went to work …

The Role Of Social Emotional Learning In Utah’S Implementation Of Essa, Sharon Walles

Transforming Communities

The Every Student Succeeds Act (ESSA), as a policy, offers an additional tool to address the escalating adolescent mental health crisis. By acknowledging the critical link between student well-being, academic success, and evidence-based practices, this policy analysis explores how funding from ESSA can be leveraged to integrate Social Emotional Learning (SEL) within Utah’s schools. Experts, educators, and parents can be voices to combat misinformation surrounding the recent politicization of SEL and its implementation. This analysis connects Bronfenbrenner’s Ecological Theory, which highlights the interconnectedness of the environment, with the importance of prioritizing mental health within schools to help adolescents with issues …

Collaboration Is Key: Improving And Increasing Inclusive Programming Through Partnership, Brandy D James, Elizabeth Sparks, Fiona S Davey, Burris Duncan, Nadine Chau

Journal of Extension

Collaborative partnerships between Cooperative Extension offices and the University Centers for Excellence in Developmental Disabilities are a key opportunity to assess and improve accessible, inclusive programming for the communities they serve. This article outlines such a partnership between local Extension, the local UCEDD, and the local Network for Down Syndrome. It reviews their collaborative process and the resulting pilot program—-an inclusive cooking class. Evaluations of the program and collaborative process demonstrate that the partners' collaboration enabled organizational capacity building and improved service provision for persons with Down Syndrome.

Advocating For A Care-Based Ethic: Stories Of Pregnancy And Birth From Caregivers Of Children With Down Syndrome, Lydia Ocasio-Stoutenburg, Nayma Sultana Mim

Developmental Disabilities Network Journal

Down syndrome (DS) impacts about 1 in every 640 childbirths in the United States. While quality of life has improved for people with DS, systemic inequities and deficit-based perceptions have persisted throughout history, with material impacts on people with DS and their caregivers. Researchers have documented how caregivers of children with DS have had negative experiences with healthcare providers and genetic counselors, whose biased views about DS translate into subtle and overt pressures. Few studies explicitly focus on the experiences of Caregivers of Color, multilingual families, as well as families with varying economic experiences who have children with DS. This …

Independent Living Skills For The Aging Population Of Adults With Disabilities, Sara K. Fetter Otd, Otr, Jennifer L. Martin Otd, Otr, Cht, Clt, Michele L. Mccarroll Phd, Faacvpr, Acsm-Ccep, Ccrp, Lssbb

Developmental Disabilities Network Journal

Adults with intellectual disability (ID) are living longer and increasingly outlive family caregivers. Strengthening independent living and vocational skills has therefore become a critical public-health priority. Occupational therapy (OT) can address this need through person-centered, community-based programming. This paper describes the co-design, delivery, and preliminary outcomes of a short occupation-based curriculum intended to enhance autonomy and work readiness in aging adults with ID. In partnership with a Dallas, Texas nonprofit, the authors conducted a needs assessment and created an 8-session course rooted in the Independent Living Model and the Occupational Competence Model. The curriculum addressed four domains (physical health, financial …

Breaking Bread And Barriers: Interprofessional Strategies To Improve Mental And Nutritional Health In Family Caregivers, Candy Ratliff

The Journal of the Research Association of Minority Professors

Family caregivers provide essential unpaid support to individuals with chronic illness, disability, dementia, and age-related decline; however, caregiving responsibilities often place caregivers at increased risk for psychological, physical, nutritional, and social challenges. This literature review examines the mental health and nutritional implications of family caregiving and explores barriers that contribute to declining caregiver wellness. Findings reveal elevated rates of depression, anxiety, emotional exhaustion, social isolation, food insecurity, sleep disturbances, financial strain, and chronic stress among caregivers. The literature further highlights the interconnected relationship between mental health, nutrition, and overall quality of life. Given the multidimensional nature of caregiver burden, interprofessional …

Advancing Culturally Relevant Mindfulness In Public Health, Marcus Johnson, Candy Ratliff

The Journal of the Research Association of Minority Professors

Mindfulness-based interventions (MBIs) have gained significant traction in public health, education, and clinical settings due to their demonstrated benefits for stress reduction and psychological well-being. However, these interventions often originate from Eurocentric frameworks that insufficiently reflect the cultural, historical, and structural contexts of diverse and historically marginalized communities. This commentary proposes a Culturally Relevant Mindfulness (CRM) framework that centers the lived experiences, healing traditions, and epistemologies of underrepresented populations. Drawing on interdisciplinary literature and critiques of conventional mindfulness models, the article articulates four guiding principles of CRM: cultural identity affirmation, historical consciousness, ancestral integration, and community-centered practice. Rather than merely …

Examining Diversity And Cultural Competency Within A Historically Black College And University (Hbcu) Public Health Curriculum, Alyce L. Hays, Yalanda M. Barner, Latarsha Michael

The Journal of the Research Association of Minority Professors

Integrating diversity and cultural competency content into public health curricula is vital in preparing future health professionals to optimize health outcomes of all individuals; however, very few studies have examined whether diversity and cultural competencies are taught in public health curricula. Studies have consistently incorporated diversity, equity, and inclusion in education for healthcare professionals such as nursing, community health workers, health educators, etc. The purpose of this study was to assess the presence of course content diversity, equity, inclusion, cultural competency, or other related topics. A formative assessment approach utilizing a four-step evaluation process was used to review the inclusion …

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 …

Living Through Misinformation: An Autoethnography Of Autism In Chinese Communities, Joy Lu

Ought: The Journal of Autistic Culture

This critical autoethnographic essay examines how misconception, misinformation, and disinformation shape understandings of autism within Chinese communities and produce tangible harm for autistic individuals and their families. Drawing on lived experience, advocacy work, digital observation, and cross-cultural analysis, it explores how language, medical practices, social media, and professional authority sustain persistent misrepresentation.

The essay argues that this misinformation is not merely the result of ignorance, but a socially reinforced and institutionally supported system of knowledge. By situating personal encounters within broader cultural and structural contexts, it highlights the interconnected roles of language, power, and exclusion in shaping autistic lives. It …

Her Fire This Time: Black Women Faculty And The Liberatory Pedagogy That Can't Wait, R. Danielle Scott, Andi Toliver-Smith, Nailah Smith

The Journal of Advancing Education Practice

The purpose of this paper is to document the experiences of Black women faculty sustaining culturally responsive, justice-oriented, liberatory pedagogy in the current sociopolitical climate of higher education. In the context of coordinated attacks on diversity, equity, and inclusion infrastructure, the erasure of culturally responsive accreditation standards in Speech, Language & Hearing Sciences (SLHS), and the unwritten expectation that Black women faculty absorb the weight of equity work that institutions have abandoned, this paper examines the sustaining forces that keep liberatory teaching aflame. Drawing on critical autoethnography and reflective practice, three Black women, two faculty members and one doctoral student …

Physical Therapists' Perspectives Of Implicit Racial And Ethnic Biases And The Influence On Physical Therapy Practice, Michael Blizniak, Mary Shotwell, Cheryl Kerfeld, Shanda Gore

Internet Journal of Allied Health Sciences and Practice

Problem: Physical therapy (PT) outcome disparities exist among racial and ethnic minority groups in the United States. Implicit racial and ethnic biases (IREBs) may contribute to these inequities. Understanding IREBs within PT practice is crucial for addressing disparities and helping physical therapists comply with the American Physical Therapy Association Code of Ethics Principles. Purpose: This study examines the role of IREBs in PT by exploring physical therapists' awareness of them and their potential influence on PT practice. Methods: A virtual explanatory sequential mixed-methods design was employed, integrating quantitative surveys and qualitative interviews. Fifty-one United States physical therapists participated in the …

Diverse Families Navigating Mental Health At The Pediatrician’S Office: A Mixed Methods Exploration Of The Interplay Of Stress, Culture, And Child Mental Health In The Primary Care Setting, Sara B. Budowsky

Dissertations

Low-income and ethnic minority youth experience high psychiatric need but persistently low participation in traditional mental health care. General pediatricians are often the first and only healthcare providers with whom many families engage around their child’s emotional and behavioral development. Using both quantitative analysis of retrospective secondary data and Interpretative Phenomenological Analysis (IPA) of in-depth interviews with diverse caregivers, this project explored influencers of child mental health and family utilization of pediatric primary-care-based mental health services in the context of a uniquely multicultural clinic serving a predominantly Medicaid population. Three key findings include: 1) Caregiver Stress was a highly significant, …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Paving A Path For Equitable And Inclusive Nurse Leadership Within Practice Settings: The Innovative Role Of A Transcultural Equity & Inclusion Nurse Leader, Theresa Reichert

InnovateHER Meeting 2026

Growing cultural diversity in communities and health care practice environments require nurses and nurse leaders to effectively navigate cultural differences and relationships in practice settings (Teixeira et al, 2023)

Recognizing this important shift:

• health care accrediting bodies (such as the Joint Commission)
• professional practice-based nursing organizations (such as the American Nurses Association), and
• professional recognition bodies (such as Magnet)

are incorporating culturally congruent, socially just care within their expectations. The innovative Transcultural Equity & Belonging Nurse role was designed to support nurses and nurse leaders incorporate these expectations within everyday nursing practice.

Thoughts From The Pit: Can Raving Change The World? A Literature Review Exploring Rave Culture As Expressive Arts Healing, Marissa Rose Renella

Expressive Therapies Theses

This literature review examines the structural and philosophical commonalities between expressive arts therapy (EXA) and rave culture. Drawing on scholarship from anthropology, cultural studies, health sciences, transpersonal psychology, neuroscience, and expressive arts therapy, this review identifies five core principles shared between the two fields: transformational experiences, multimodality, entrainment and flow, containment and ritual, and community and social action values. Across each principle, the literature reveals not surface-level similarity but deep convergence — two fields that have, independently and through different lineages, arrived at the same understanding of what human beings need in order to heal, grow, and connect. To the …

Barriers And Bridges: Exploring Factors That Shape Mental Health Service Utilization In Rural America, Margaret Wiwuga

Educational Specialist, 2020-current

Despite disproportionately higher suicide mortality rates and comparable prevalence of mental illness across urban and rural communities in the United States, rural populations across the nation experience significantly lower access to and utilization of mental health services, naturally leading to worse comprehensive outcomes. This literature review examines multifaceted factors shaping mental health service use in rural America, taking note of both barrier and enabling factors that impede or enable these unique populations’ willingness and ability to access and use mental health services. Ten articles published prior to September 9, 2025, were selected from the James Madison University Libraries’ Psychology and …

Black Maternal Mental Health: Counseling Considerations For Prenatal Depression And Anxiety, Morgan Renee Williams

Educational Specialist, 2020-current

The maternal mortality rate of Black women in the United States is four times higher than white women (Centers for Disease Control and Prevention, 2020). The CDC defines a maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy… but not from accidental or incidental causes” (Centers for Disease Control and Prevention, 2024, para. 1). This statistic is a consequence of the inequality within and outside of the American healthcare system (National Academies of Sciences, Engineering, and Medicine, 2020). For the purposes of this research, Black women are defined as any women …

Enhancing Access Through Integrated Behavioral Healthcare: Expanding Counselor Identity And Social Determinants Of Health Competency, Tiffany N. Snow

Dissertations, 2020-current

Abstract

The counseling profession has historically differentiated its identity by emphasizing a wellness-oriented approach. However, this has often led to the exclusion of counselors from integrated behavioral healthcare (IBH). With the 2024 enactment of the Mental Health Access Improvement Act, counselors now have unprecedented opportunities to serve as behavioral health providers in federal medical settings. This three-manuscript dissertation explores the intersection of counselor professional identity, social determinants of health (SDoH) competency, and interprofessional collaboration within IBH.

Manuscript 1 presents a conceptual framework for reconciling traditional counselor identity with the "medical model" of Primary Care Behavioral Health (PCBH), arguing that this …

The Impact Of Trump Administration Immigration Policies On Connecticut Educators And Families, Elena C. Bielesz

Honors Scholar Theses

Anti-immigrant rhetoric, policies, and practices, which have grown increasingly prevalent due to the current national political climate, have adverse effects on the mental health of immigrant families and the teachers that support them in Connecticut. This study seeks to represent the opinions of Connecticut K-12 MLL (Multilingual Learners) Education Teachers and Administrators whose daily lives are impacted by the anti-immigrant and anti-refugee policies and procedures. The study employed a human subjects-based approach supported by a review of related literature. MLL Educators from around the state of Connecticut were interviewed. These interviews found that while immigration-based trauma and stressors are common …

The Legacy Of Lead: Lead Exposure's Harmful Effects And Its Concentration In Poc Communities, Layla Sophronia Barber

Student Theses 2015-Present

This thesis examines the disproportionate burden of lead exposure carried by low income, POC communities. The systemic nature of this problem is a symptom of a longstanding legacy of environmental injustice in the United States. Decades of federal neglect are reflected in the higher statistics of lead exposure and poisoning in predominantly black communities. While it is understood that lead exposure poses a serious threat to physical health and early cognitive development, there is a discouraging lack of urgency to remove the toxin from non-wealthy communities. The material covered by this thesis aims to identify and correct the discriminatory social …

The Ethical Imperative Of Public Health Institutions To Protect The Reproductive Autonomy Of Vulnerable Populations, Kennethea Wilson

Electronic Theses and Dissertations

This dissertation establishes the ethical responsibility of public health institutions to safeguard reproductive autonomy, especially among vulnerable populations. While reproductive decision-making is traditionally framed within individual clinical encounters, this work contends that reproductive autonomy is fundamentally a matter of public health ethics. Socioecological determinants, including social, legal, environmental, and structural factors, often constrain individuals’ ability to make meaningful reproductive choices, leading to preventable harm.

Reproductive autonomy is defined as the capacity to make informed decisions about whether and when to conceive, as well as how to parent. The dissertation critiques the sufficiency of clinical ethics frameworks, such as informed consent …