Social Work Commons^™

Mothers Get Really Exhausted!” The Lived Experience Of Pregnancy In Extreme Heat: Qualitative Findings From Kilifi, Kenya, Fiona Scorgie, Adelaide Lusambili, S. Luchters, Peter. Khaemba, Veronique Filippi, B. Nakstad, Jeremy Hess, Cathryn Birch, S. Kovats, M.F. Chersich

Institute for Human Development

Background: Palliative care (PC) can reduce symptom distress and improve quality of life for patients and their families experiencing life-threatening illness. While the need for PC in Kenya is high, PC service delivery and research is limited. Qualitative research is needed to explore potential areas for PC research and support needed to enable that research. This insight is critical for informing a national PC research agenda and mobilizing limited resources for conducting rigorous PC research in Kenya.

Objectives: To explore perceptions of priority areas for PC research and support needed to facilitate rigorous research from the perspective of Kenyan PC …

A Call To Action: Person-Centered Care Aligned With Reproductive Justice For Incarcerated Pregnant People With Substance Use Disorder, Essence Hairston, Aunchalee El Palmquist, Andrea K. Knittel, Kevin Mensah-Biney, Crystal M. Hayes, Amelia Mack, Hendrée E. Jones

School of Social Work Faculty Publications

Although research has proven that jails and prisons are ineffective in preventing or reducing substance use among pregnant people, the USA continues to rely heavily on the criminal legal system as its intervention. Pregnant people with an opioid use disorder are more likely to experience incarceration than pregnant people without an opioid use disorder. In some states, pregnant people are transported from jail to prison through the process of safekeeping in order to receive physical or mental health care that the jail does not provide, despite conviction status. When pregnant and postpartum safekeepers with an opioid use disorder experience incarceration, …

The State Of Transgender And Kinnar Communities In Delhi: Case Studies Connecting Socioeconomic Factors To Health, Ray Craig

Independent Study Project (ISP) Collection

The paper seeks to draw connections between socioeconomic barriers faced by the transgender (trans) community in Delhi, India and the healthcare that the community receives. It primarily discusses transgender people who are not part of the kinnar population, with as much consideration to the experiences of the kinnar community as possible, given limited access to their circles. Five transgender individuals and two cisgender individuals who have worked with trans communities participated in semi-structured qualitative interviews to understand various factors that affect trans people’s daily lives and their healthcare experiences in Delhi. Interviews were transcribed and coded, finding common themes of …

The Relationship Between Religion, Substance Misuse, And Mental Health Among Black Youth, Dexter R. Voisin

Faculty Scholarship

Studies suggest that religion is a protective factor for substance misuse and mental health concerns among Black/African American youth despite reported declines in their religious involvement. However, few studies have investigated the associations among religion, substance misuse, and mental health among Black youth. Informed by Critical Race Theory, we evaluated the correlations between gender, depression, substance misuse, and unprotected sex on mental health. Using multiple linear regression, we assessed self-reported measures of drug use and sex, condom use, belief in God, and religiosity on mental health among a sample of Black youth (N = 638) living in a large midwestern …

The Longitudinal Relationship Between Broken Windows And Sexual Behaviors Among African American Girls In Juvenile Detention: The Moderating Effects Of Sexual Sensation Seeking And Parental Monitoring, Dexter R. Voisin

Faculty Scholarship

Objective: Broken windows theory has been applied in public health to understand how neighborhood disadvantage contributes to health risk and disparities. This longitudinal study examined the relationship between a broken windows index (i.e., a proxy for neighborhood disadvantage) and sexual behaviors and whether sexual sensation-seeking behaviors and parental monitoring moderated that relationship. Method: Participants were 188 African American adolescent girls incarcerated in a short-term detention facility in Atlanta, GA. Participants completed audio computer-assisted self-interviews at baseline, 3, and 6 months; interviews assessed neighborhood disadvantage, sexual risk behaviors, sexual sensation seeking, parental monitoring, and demographics. Results: Longitudinal findings indicate that the …

“We Are Doing The Absolute Most That We Can, And No One Is Listening”: Barriers And Facilitators To Health Literacy Within Transgender And Nonbinary Communities, C. Riley Hostetter, Jarrod Call, Donald R. Gerke, Brendon T. Holloway, N. Eugene Walls, Jennifer C. Greenfield

Graduate School of Social Work: Faculty Scholarship

Transgender and nonbinary (TNB) individuals face disparities in nearly every aspect of health. One factor associated with poor health outcomes in other marginalized populations is health literacy, yet no identified studies examine health literacy in TNB samples. Moreover, most health literacy frameworks focus primarily on the capacities of individual patients to understand and use healthcare information, with little attention given to provider literacy and environmental factors. In partnership with a statewide LGBTQ advocacy organization, we recruited 46 transgender and nonbinary individuals to participate in seven focus groups conducted in urban, suburban, and rural locations throughout Colorado. TNB participants consistently engaged …

Exploring The Experiences Of Transgender And Gender Diverse Adults In Accessing A Trans Knowledgeable Primary Care Physician, Shanna K. Kattari, Jarrod Call, Brendon Holloway, Leonardo Kattari, Kristie L. Seelman

SW Publications

Transgender and gender diverse individuals face a variety of barriers when attempting to access healthcare, from discrimination to lack of access to lack of knowledgeable providers. Using data from the 2015 United States Trans Survey (N = 27,715), this study looks at the differences within the TGD population regarding having seen a doctor in the past year, having a primary care provider, and having a primary care provider who is knowledgeable about trans health. Logistic regressions indicate that even within an all transgender and gender diverse sample, a variety of identities and experiences are related to increased or decreased likelihood …

Right! From The Start: Improving Maternal-Child Health In The Mississippi Delta, John J. Green, Elizabeth Young Sweeney

Delta Directions: Publications

Right! From the Start (R!FTS) was created nearly ten years ago as a collaborative effort between Women and Children Health Initiatives, Inc. and the Community Foundation of Northwest Mississippi with support from the W.K. Kellogg Foundation (WKKF). The immediate goal of the initiative was to raise breastfeeding rates for mothers and babies in vulnerable families, especially those with preterm and low weight births. A long-term goal was improvement of maternal and child health outcomes in a region plagued by socioeconomic and racial disparities, the Mississippi Delta. R!FTS has gone through three distinct phases of development, which are detailed in this …

Examining The Causal Impact Of Prenatal Home Visiting On Birth Outcomes: A Propensity Score Analysis, Elizabeth R. Anthony, Robert L. Fischer

Faculty Scholarship

Objectives: In Ohio, African American babies die at 2.5–3 times the rate of White babies. Preterm birth and low birth weight are the leading causes of infant mortality. Home visiting is an evidence-based strategy for serving low-income pregnant women; however, there are relatively few rigorous studies examining its effect on birth outcomes. Methods: This study uses a propensity score technique to estimate the causal effect of participation in home visiting on prematurity and low birth weight among a low-income, predominantly African American sample (N = 26,814). Results: We found that participation in home visiting significantly reduced the odds of experiencing …

Correlates Of Depression Among Black Girls Exposed To Violence, Dexter R. Voisin

Faculty Scholarship

Depression rates for youth remanded to juvenile detention is double that of the general population and Black girls are especially vulnerable. A dearth of literature analyzes the factors that are correlated with depression among system-involved Black girls, ages 12–17 years old. We utilized personal agency to examine the relationship between risk factors (i.e., abuse history, and fear of condom negotiation) and protective factors (i.e., condom self-efficacy, and perceived social support) that might correlate with depression among Black girls exposed to violence. Findings indicate that fear of condom negotiation, abuse history and low condom self-efficacy are correlated with depressive symptomology while …

Trans Men’S Access To Knowledgeable Providers And Their Experiences In Health Care Settings: Differences By Demographics, Mental Health, And Degree Of Being “Out” To Providers, Kristie L. Seelman, Shanna K. Kattari, Penny Harvey, Matthew Bakko

SW Publications

Transgender adults face a health care system rife with stigma, including a lack of culturally responsive providers and high likelihood of discrimination and mistreatment. However, there is a gap in knowledge about trans men—those assigned a female sex at birth who identify as men or as transmasculine—including subgroups, such as trans men of color. Using data from the U.S. Transgender Survey, the largest transgender survey conducted in the United States, this study analyzes whether trans men’s access to knowledgeable providers and their experiences of mistreatment in health care were related to demographic and mental health characteristics and degree of being …

Conceptualizing The Effects Of Continuous Traumatic Violence On Hiv Continuum Of Care Outcomes For Young Black Men Who Have Sex With Men In The United States, Dexter R. Voisin

Faculty Scholarship

The United States (US) is on track to achieve the 90-90-90 targets set forth by UNAIDS and the National HIV/AIDS strategy, yet significant racial disparities in HIV care outcomes remain, particularly for young Black men who have sex with men (YBMSM). Research has demonstrated that various types of violence are key aspects of syndemics that contribute to disparities in HIV risk. However, little research has looked collectively at cumulative violent experiences and how those might affect HIV treatment and care outcomes. Drawing on extant literature and theoretical underpinnings of syndemics, we provide a conceptual model that highlights how continuous traumatic …

Racial And Ethnic Comparison Of Ecological Risk Factors And Youth Outcomes: A Test Of The Desensitization Hypothesis, Dexter R. Voisin

Faculty Scholarship

Minority youth, because of structural, ecological, and societal inequalities, are at heightened risk of reporting depression and experiencing negative sanctions associated with delinquency. Sociological theories suggest that greater exposure to ecological risk factors at the peer, family, school and community levels are associated with elevated rates of youth depression and delinquency. Desensitization theory posits that repeated exposures to ongoing stressors result in a numbing of psychological and behavioral responses. Thus, it remains unclear whether racial/ethnic differences exist with regards to how contextual stressors correlate with depression and delinquency. Using a sample of 616 Black, 687 Latinx, and 1,318 White youth, …

Art Adherence Among Men Who Have Sex With Men Living With Hiv: Key Challenges And Opportunities, Dexter R. Voisin

Faculty Scholarship

Purpose of Review: In the USA, gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. High levels of adherence to antiretroviral therapy (ART) can dramatically improve outcomes for persons living with HIV and reduce the risk of HIV transmission to others. Yet, there are numerous individual, social, and structural barriers to optimal ART adherence. Many of these factors disproportionately impact Black MSM and may contribute to their poorer rates of ART adherence. This review synthesizes the key challenges and intervention opportunities to improve ART adherence among MSM in the USA. Recent Findings: Key …

Peer Victimization And Illicit Drug Use Among African American Adolescents In Chicago: The Moderating Effects Of Religious Affiliation, Dexter R. Voisin

Faculty Scholarship

Objective: Investigators have examined the moderating effects of young people’s relationships with parents, teachers, and peers on victimization and on adverse outcomes such as drug use. However, the moderating influence of religious affiliation on the association between peer victimization and illicit drug use, the focus of this paper, has seldom been examined. Method: Participants were 638 low-income African American youth ages 12–22 (mean age = 15.8; 54% female and 46% male) in Chicago, IL. We conducted hierarchical logistic regression analyses to examine the moderating effect of religious affiliation on the relationship between peer victimization and illicit drug use. Results: Youths …

Social Networks Moderate The Syndemic Effect Of Psychosocial And Structural Factors On Hiv Risk Among Young Black Transgender Women And Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

The interaction between the cumulative effect of psychosocial and structural factors (i.e. syndemic effect) and social networks among young Black transgender women and men who have sex with men (YBTM) remains understudied. A representative cohort of 16–29 year-old YBTM (n = 618) was assessed for syndemic factors [i.e. substance use; community violence; depression; poverty; justice system involvement (JSI)], social network characteristics, condomless anal sex (CAS), group sex (GS), and HIV-infection. The syndemic index significantly increased the odds of CAS, GS, and HIV-infection, and these effects were moderated by network characteristics. Network JSI buffered the effect on CAS, romantic network members …

Social Support And Discrimination: The Experiences Of Recovering Heroin Addicts In Kunming, China, Phoebe Li

Independent Study Project (ISP) Collection

Opioids have had a long, complex position in Chinese society, dating all the way back to the Ming dynasty. In 1949, 5% of the overall Chinese population and 25% of the population in Yunnan smoked opium regularly, which led to societal collapse and economic downturn. Since then, the Chinese government has used many different methods to attempt to control drug use and trafficking, including registering all users, executing traffickers, and using Compulsory Rehabilitation Centers. Starting in 2008, the government switched to a harm reduction approach and began to invest in methadone clinics, community support groups, and needle exchange programs. Because …

Exposure To Community Violence And Substance Use Among Black Men Who Have Sex With Men: Examining The Role Of Psychological Distress And Criminal Justice Involvement, Dexter R. Voisin

Faculty Scholarship

Young Black MSM (YBMSM) are disproportionately affected by violence, criminal justice involvement, and other structural factors that also increase vulnerability to HIV. This study examined associations between exposure to community violence (ECV) and substance use, psychological distress, and criminal justice involvement (CJI) among YBMSM in Chicago, IL. Respondent driven sampling was used to recruit a sample of 618 YBMSM (aged 16–29) from the South Side of Chicago between June 2013 and July 2014. Weighted logistic regression assessed the direct effects of ECV, CJI, and psychological distress on substance use outcomes. Indirect effects were assessed via path analysis with mean and …

A Longitudinal Examination Of Factors Associated With Network Bridging Among Ymsm: Implications For Hiv Prevention, Dexter R. Voisin

Faculty Scholarship

Social-environmental factors may be associated with social network stability, which has implications for HIV acquisition. However, the link between social-environmental factors, network composition and HIV risk has not been examined previously among a city-population based sample of young Black men who have sex with Men (YBMSM). Respondent driven sampling was used to recruit a cohort of 618 YMBSM. Respondents were evaluated at baseline, 9 and 18 months beginning June 2013. A logistic regression model was used to assess the relationship between bridging (i.e. having non-redundant contacts in one’s network, indicating network instability) and social-environmental factors and HIV risk factors between …

Chinese Enclave Protections Among Married Chinese American Women: Exploratory Secondary Analysis Of Colon Cancer Survival, Luisa Kcomt, Kevin Gorey

Social Work Publications

Objective: Like the barrio advantage theory related to Mexican Americans, a theory about the protective effects of Chinese American enclaves is developing. Such protections were examined among socioeconomically vulnerable people with colon cancer.

Design: A colon cancer cohort established in California between 1995 and 2000, and followed until the enactment of the Affordable Care Act was utilized in this study. Secondary analysis was conducted on the 5-year survival among 127 Chinese Americans and 4524 other Americans (3810 non-Hispanic white and 714 Hispanic people). A third of the original cohort was selected from high poverty neighborhoods. Chinese American enclaves were neighborhoods …

Identifying Validity In Qualitative Research: A Literature Review, Fitzroy R. Gordon

Faculty Publications and Presentations

This paper explores multiple articles relating to qualitative research. Qualitative research has seen several transformation that aim to support contributions for this research development. As research, using a qualitative methodology rises to prevalence, this paper explores industry and academia use of this methodology. The paper review research based in the field of healthcare and social work. After analysis, the review of literature shows that a majority qualitative research are within the field healthcare (Johnson, 1999). The research conducted embraces a diverse collection of approaches to inquiry intended to generate knowledge actually grounded in human experience. The literature review also addressed …

Family Impact Seminar 2018: The Kids Are Not All Right: Policy Options To Address Youth Trauma In Massachusetts, Denise Hines, Laurie Ross Ph.D, Marianne Sarkis Ph.D

Mosakowski Institute for Public Enterprise

Family Impact Seminars are a series of annual seminars, briefing reports, and discussion sessions that provide up-to-date, solution-oriented research on current issues for state legislators and their aides. The seminars provide objective, nonpartisan research on current issues and do not lobby for particular policies. Seminar participants discuss policy options and identify common ground where it exists.

The Kids are NOT All Right: Policy Options to Address Youth Trauma in Massachusetts is the ninth Massachusetts Family Impact Seminar. Today’s seminar is designed to emphasize a family perspective in policymaking on issues related to early intervention in childhood trauma, sex trafficking and …

The Summit Ambulatory‑Icu Primary Care Model For Medically And Socially Complex Patients In An Urban Federally Qualified Health Center: Study Design And Rationale, Brian Chan, Samuel T. Edwards, Meg Devoe, Richard Gil, Matthew Mitchell, Honora Englander, Christina Nicolaidis, Multiple Additional Authors

School of Social Work Faculty Publications and Presentations

Background: Medically complex urban patients experiencing homelessness comprise a disproportionate number of high-cost, high-need patients. There are few studies of interventions to improve care for these populations; their social complexity makes them difficult to study and requires clinical and research collaboration. We present a protocol for a trial of the streamlined unified meaningfully managed interdisciplinary team (SUMMIT) team, an ambulatory ICU (A-ICU) intervention to improve utilization and patient experience that uses control populations to address limitations of prior research.

Methods/design: Participants are patients at a Federally Qualified Health Center in Portland, Oregon that serves patients experiencing homelessness or …

The Relationship Between Black And Gay Community Involvement And Hiv-Related Risk Behaviors Among Black Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

Black gay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their White male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV-related risk and protective behaviors. Data were drawn from uConnect, a population-based cohort study of young Black men who have sex with men (YBMSM) on Chicago's South Side. The sample consists of 618 Black MSM ranging in age from 16 to 29. Cross-sectional measures for this study include Black and …

Pathways To Delinquency And Substance Use Among African American Youth: Does Future Orientation Mediate The Effects Of Peer Norms And Parental Monitoring?, Dexter R. Voisin

Faculty Scholarship

The following study assessed whether future orientation mediated the effects of peer norms and parental monitoring on delinquency and substance use among 549 African American adolescents. Structural equation modeling computed direct and indirect (meditational) relationships between parental monitoring and peer norms through future orientation. Parental monitoring significantly correlated with lower delinquency through future orientation (B = −.05, standard deviation =.01, p <.01). Future orientation mediated more than quarter (27.70%) of the total effect of parental monitoring on delinquency. Overall findings underscore the importance of strengthening resilience factors for African American youth, especially those who live in low-income communities.

Project Ngage: Results Of A Randomized Controlled Trial Of A Dyadic Network Support Intervention To Retain Young Black Men Who Have Sex With Men In Hiv Care, Dexter R. Voisin

Faculty Scholarship

HIV-positive young black MSM (YBMSM) experience poor outcomes along the HIV care continuum, yet few interventions have been developed expressly for YBMSM retention in care. Project nGage was a randomized controlled trial conducted across five Chicago clinics with 98 HIV-positive YBMSM aged 16–29 between 2012 and 2015. The intervention used a social network elicitation approach with index YBMSM (n = 45) to identify and recruit a support confidant (SC) to the study. Each index-SC dyad met with a social worker to improve HIV-care knowledge, activate dyadic social support, and develop a retention in care plan. Each index and SC also …

Older Adults And Mobile Technology: Factors That Enhance And Inhibit Utilization In The Context Of Behavioral Health, Alexis Kuerbis, Adina Mulliken, Frederick Muench, Alison A. Moore, Daniel Gardner

Publications and Research

While numbers and proportions of older adults with behavioral health issues are expected to substantially increase, there is also a widening gap in available services for older adults. Mobile health interventions (mhealth) are a way to address existing barriers to treatment, provide frontline assessment and increase access to services for older adults. Due to perpetuated stereotypes, many assume that older adults do not utilize mobile technology nor will they accept a mHealth intervention. The purpose of this paper is to synthesize contemporary literature from information technology and healthcare regarding: (1) current mobile technology utilization by older adults, particularly in regards …

A Longitudinal Analysis Of Antiretroviral Adherence Among Young Black Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

Purpose: Young black men who have sex with men (YBMSM) experience poorer antiretroviral therapy (ART) medication adherence relative to their white counterparts. However, few studies have longitudinally examined factors that may correlate with various classifications of ART adherence among this population, which was the primary aim of this study. Methods: Project nGage was a randomized controlled trial conducted across five Chicago clinics from 2012 to 2015. Survey and medical records data were collected at baseline and 3- and 12-month periods to assess whether psychological distress, HIV stigma, substance use, family acceptance, social support, and self-efficacy predicted ART medication adherence among …

Creating Healthy Communities Across Minnesota: Investing In Integrated Health Care, Leah Jacobson, Nicole Lidstrom, Jenna Lipovetz, Jamie Schuller

Master of Social Work Student Policy Advocacy Briefs

In Minnesota, behavioral health homes have become an efficient resource for individu­als on Medical Assistance to receive integrated behavioral and primary health care under the Patient Protection and Affordable Care Act. The rising popularity of behav­ioral health homes in Minnesota introduced the concept of integrated medical care with a patient's primary care physician as the "home-base". Figure 1 illustrates the inte­grated approach that supports the patient and their family, provides care that covers an entire continuum of care with a comprehensive care team focused on the whole person, is accessible with short waiting times, and is committed to quality and …

Time To Stand Up For Female Vets: Improving Access To Vegerans Administration Health Services For Female Veterans Who Experience Military Sexual Trauma, Rhonda Haugstad, Dana Miller, Michelle Remold

Master of Social Work Student Policy Advocacy Briefs

Military Sexual Trauma (MST), is defined as sexual assault and/or sexual harassment experienced while serving in the United States military. The process of obtaining Department of Veterans Affairs (VA) benefits are difficult for individuals that suffer from MST. MST survivors are faced with delays and numerous barriers in accessing services, including discrimination in seeking compensation. Statistical data from the Department of Defense (DOD) is reviewed highlighting the high rates of sexual assault in the military and addresses concerns about the long-term implications for survivors of MST.

Many female veteran survivors of MST are struggling to access needed services covered by …