Medicine and Health Commons^™

“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 …

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 …

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 …

Strategies For Improving Preventive Health Outcomes In Long-Term Care Case Management At Molina Healthcare Of Wisconsin, William W. Feilbach Jr.

M.S. in Human Services Administration

This research evaluates strategies to improve preventive health outcomes in long-term care case management at Molina Healthcare of Wisconsin, with a specific focus on improving participation in annual wellness visits.  Increasing health care costs and gaps in preventive care engagement among Medicare and Medicaid populations underscore the need for effective interventions. A systematic literature review of recent peer-reviewed and governmental sources was conducted to examine the relationship between preventive care, health outcomes, and cost containment. Findings show that greater engagement in preventive services, including annual wellness visits and screenings, supports early detection, reduces high-cost service utilization, and improves overall health …

Hiv And Sti Testing Service Utilization Among Youth Experiencing Homelessness: A Multi-Method Inquiry, Alexander A. Ochs

Electronic Theses and Dissertations

Youth experiencing homelessness (YEH) face disproportionately high risk for HIV and sexually transmitted infections (STIs), yet rates of testing remain low. This dissertation examines the individual and social network level factors that influence HIV/STI testing behaviors among YEH. Guided by insights from multiple theoretical frameworks, this three-paper dissertation integrates quantitative and qualitative approaches to better understand how personal relationships and social context shape HIV/STI testing decisions in this population.

Paper 1 presents a secondary data analysis of the Homeless Youth Risk and Resilience Survey (HYRRS), which includes 1,426 YEH across seven U.S. cities. Logistic regression models identified geographic variation in …

Planning And Facilitating Hybrid Meetings To Support Relationality During Coalition Building, Luettamae Lawrence, Maureen Boyle, Moira Ross

Utah Conference on Community Engagement

Hybrid events where communities are connected through both in person and online spaces have simultaneously grown in popularity and gotten a bad reputation. While hybrid events have been around for decades, they gained significant traction with the onset of the COVID-19 pandemic to increase accessibility for attendees to accommodate diverse needs. Although hybrid events can be beneficial to many, they are not simple to execute. With the increase in hybrid events has come frustration with the low quality interactions between in person and online attendees leading to isolation, technology challenges, and low productivity. We argue the positive affordances of hybrid …

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

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 …

Learning To Be An Autistic Therapist: Personal Steps Towards An Autism-Affirming Psychotherapy, Sasha D. Strong

Ought: The Journal of Autistic Culture

How can Autistic therapists understand and support themselves, and how can this help them support their clients? In this paper, I recount my personal journey of healing and growth as an Autistic psychotherapist, 16 months after self-identification. Here is an overview of conceptual frameworks from #actuallyautistic authors, critical theory, queer theory, and social justice that I have found helpful. I also share some of the therapeutic and wellness approaches that have been important to me, including mindfulness and bodyfulness. Organic knowing has been pivotal for me in discerning between masking and aliveness, and regaining a choice around masking behaviors. This …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Exploring The Effects Of Mindful Nature Walks On College Student Anxiety, Grace Young

Graduate Theses and Dissertations

Individuals pursuing a degree in higher education face challenges that lead to greater levels of anxiety than that of the general U.S. adult population. This disparity, further heightened by the COVID-19 pandemic, presents a need for higher education institutions to search for ways to address this spike in student anxiety and other mental health concerns. This mixed-methods study explored mindful nature walks as a low-cost and easily accessible way for college students to reduce levels of experienced anxiety. Using validated quantitative measures, this study examined the impact of three weekly, consecutive 30-minute mindful nature walks on state and general anxiety …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Implementing Social Determinants Of Health Data Collection In A Large Urban Pediatric Hospital Setting, Stormee Williams, Kristina Hill, Barry Owen, Forest Melton

Research

No abstract provided.

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

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, East Africa

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 …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

College of Graduate Studies: Theses & Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Integrating Feminist Approaches In Counseling Work With Adult Women, Kristen M. Toole

Adultspan Journal

The scope of ‘women’s issues’ in counseling is an ever-evolving landscape. Recent events such as the reversal of Roe v. Wade and the disproportionate impact of COVID-19 on women serve as powerful reminders of the necessity of this focus while underscoring a deep-rooted history of oppressive patriarchal structures. Therefore, counselors must remain informed of the unique considerations surrounding adult women in counseling and acquire proficiency in versatile techniques to meet this population’s nuanced needs. This article examines the complexity of contemporary womanhood and explores the fundamentals of Feminist Counseling Theory (FCT), a holistic, multiculturally conscious, social justice theory in counseling. …

Examining Effective And Realized Healthcare Access In The West South Central Division., Katherine Cameron

Electronic Theses and Dissertations

This study explores realized and effective access domains outlined by Andersen’s Behavioral Model of Health Services Use. Exploring other domains of access is critical to understanding how the healthcare system functions (Kirby & Yabroff, 2020). This study evaluates rural-urban and racial/ethnic differences in access to care using two underresearched domains of healthcare access. It also allows for exploring access disparities within rural communities amongst minority populations. This dissertation is divided into five chapters. Chapter One provides an overview of health disparities and inequities and a brief overview of the study. Chapter Two details a high-level history of racism and its …

Effect Of Covid-19 Pandemic On Volunteerism And Fundraising Management Strategies In Nonprofits And Rebuilding Tactics Of Ronald Mcdonald House Charities Of Chicagoland And Northwest Indiana (Rmhc-Cni), Humza Wolf

Nonprofit and NGO Studies Student Projects

The financial sustainability of nonprofits depends highly on volunteerism and funding strategies which got impacted during Coronavirus 2019 (COVID-19) Pandemic. This capstone study explores to what extent nonprofits got affected and evaluates the efforts of Ronald McDonald House Charities of Chicagoland & Northwest Indiana (RMHC-CNI) to improve the provision of support for underprivileged families of critically ill children. The continual efforts to overcome financial hurdles escalated in pandemic. Mixed method research design was used to collect, analyze, and triangulate both quantitative and qualitative research methods in this single study to understand the research problem. Interpretive approach encompassed the complexities of …

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 …

The Long-Term Health And Developmental Impacts Of Children Born At Low Birth Weight, Kathryn Grace Kelly

Honors Theses

The state of Mississippi currently has the highest incidence of low birth weight (LBW) births in the United States. LBW is a negative birth outcome which can lead to suboptimal pediatric health and development. The primary goals of this thesis are to identify the long-term outcomes associated with LBW and to present potential interventions to address LBW. A combination of literature review and quantitative data analysis were used to inform the objective of this thesis. A variety of physical health, behavioral health, and other long-term issues were found associated with LBW. The consequences of LBW place LBW children at a …

Pornography: Social, Emotional And Mental Implications Among Adolescents, William K. Canady

National Youth Advocacy & Resilience Conference

This presentation will explain the historical development of pornography. It will highlight four segments: 1- Porn’s impact on brain development of reward pathways, ultimately increasing the appetite for more porn. 2- Porn can be a false substitute for real intimacy, resulting in decreased sexual satisfaction with a real person and increased verbal and physical aggression. 3- Porn promotes sex trafficking, promotes multiple sex partners and reduced STD prevention. 4- A review of interventions available to assist clients in navigating a lifestyle away from pornography.

“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 …

The Intersection Of Traumatic Brain Injury And Homelessness, Stephanie A. Chassman

Electronic Theses and Dissertations

The rates of TBI are significantly higher among individuals experiencing homelessness compared to the general population. Up to half of individuals experiencing homelessness may have a TBI. Accurate prevalence rates of TBI among individuals experiencing homelessness are difficult to obtain due to different methods of sampling participants and differing definitions of TBI; therefore, estimates may be underrepresented. Despite past research that has examined the relationship between TBI and homelessness, there are specific gaps in knowledge such as correlates and risk factors of TBI among individuals experiencing homelessness. This three-manuscript dissertation attempts to address these gaps in knowledge.

The first manuscript …

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …