Medicine and Health Commons^™

Project Ngage: Network Supported Hiv Care Engagement For Younger Black Men Who Have Sex With Men And Transgender Persons, Dexter R. Voisin

Faculty Scholarship

Background: Young Black men who have sex with men and transgender persons (YBMSMT) aged 13-29 carry the nation's highest burden of new HIV infections. Studies indicate that YBMSMT have poor retention in care, which is associated with reduced medication adherence and increased virologic failure. Objective: Project nGage is a randomized controlled (RCT) trial evaluating the feasibility and preliminary efficacy of a brief, dyadic intervention designed to promote adherence to HIV primary care in safety-net clinics. Network visualization is used to identify and engage a support confidant (SC) from participants' social networks. A social work interventionist then meets with the SC …

A Longitudinal Examination Of Risk And Protective Factors Associated With Drug Use And Unsafe Sex Among Young African American Females, Dexter R. Voisin

Faculty Scholarship

This study prospectively examined associations among multiple theoretically informed risk (e.g., depression, sexual sensation seeking, and risky peers norms) and protective factors (e.g., social support, STI knowledge, and refusal to have sex self efficacy) on unsafe sex among 715 African American adolescent females aged 15-21 who participated in an STI/HIV prevention intervention. Generalized estimating equation models were used to assess associations between baseline characteristics and sexual risk over a 12-month follow-up period. Overall risk in this population was high: at baseline, nearly a third of women reported sex under the influence of alcohol or substances; ≥ 2 partners for vaginal …

Public Opinion And The Oregon Death With Dignity Act, Peggy Jo Ann Sandeen

Dissertations and Theses

Oregon voters legalized physician-assisted death in 1997 by passing the Oregon Death with Dignity Act. This law allowed terminally ill, mentally competent adult residents of the state to legally obtain a physician's prescription to hasten death under narrow sets of circumstances. The purpose of this study was twofold: to examine contemporary patterns of support for the law in Oregon and to explore how opinions have changed over time on the issue. This study examined patterns of public support among a random sample of registered Oregon voters for the state's death with dignity law, using a mixed mode (mail, online, and …

Medicalization Of Mental Disorders: 1970- To The Present, W. Joseph Wyatt

Psychology Faculty Research

A thirty-five year escalation of emphasis on biological causation has rendered, for many, medications as the treatment of choice for mental disorders. Non-drug treatment may be cast aside, as a result.

The Social And Health Service Needs Of Aboriginal Peoples In Smaller Urban Centers In Southern Ontario: A Synthesis Paper For Service Agencies, Martin Cooke, Julia Woodhall, Jennifer Mcwhirter

Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series/ Un Réseau stratégique de connaissances Changements de population et parcours de vie Document de travail

The disproportionate needs of urban Aboriginal people make it important for urban social and health service providers to understand the conditions faced by this population. This synthesis paper reviews recent literature on urban Aboriginal populations in order to identify their characteristics and main areas of need. It is meant to inform those who work in health and social service planning and delivery in smaller urban centers, particularly non-Aboriginal service agencies in Southern Ontario.

The existing research shows that urbanized First Nations, Métis and Inuit have greater needs for specific health, cultural, justice, financial, and educational services. Furthermore, the literature indicates …

A Longitudinal Examination Of The Relationship Between Sexual Sensation Seeking And Sti-Related Risk Factors Among African American Females, Dexter R. Voisin

Faculty Scholarship

Sexual sensation seeking has been correlated with STI-related risk factors in numerous cross sectional studies. However, no current studies have examined whether sexual sensation seeking is longitudinally related to a broad spectrum of STI-related factors such as consistent condom use, number of sexual partners, frequency of partner sexual communication, self-efficacy to refuse sex, and fear of condom negotiation. We explored these relationships over a 12-month period among a sample of 715 African American females attending three STI clinics in Georgia that were recruited into a larger randomized clinic intervention study. Utilizing A-CASI technology to assess all self-reported measures and employing …

Exposure To Verbal Parental Aggression And Sexual Activity Among Low Income African American Youth, Dexter R. Voisin

Faculty Scholarship

The study examined whether witnessing verbal parental aggression (VPA) was related to sexual activity among mostly low income African American youth, and whether psychological symptoms mediated this relationship. Five hundred and sixty-three African American high school adolescents (ages 13-19) completed self-administered questionnaires, which assessed demographics, psychological problems (e.g., depression, anxiety, aggression and posttraumatic stress disorder symptoms), witnessing VPA, and sexual activity. Participants who witnessed high versus no VPA were 2 times more likely to report sexual activity. This relationship was mediated by aggression for males and females, and posttraumatic stress disorder symptoms for females only. Youth service providers should be …

Sexual Sensation Seeking, Drug Use And Risky Sex Among Detained Youth, Dexter R. Voisin

Faculty Scholarship

Sexual sensation seeking has been correlated with drug use and risky sex in a number of populations. However, these relationships have had limited examination among adolescents, and to date, have not been explored among detained youth, a group with some of the highest rates of illicit drug use and STIs. To better understand these relationships we utilized A-CASI to collect data on sociodemographics, sexual sensation seeking, drug use and risky sexual behaviors among a sample of 550 detained youth. A series of multivariable regression models controlling for age, gender, race/ethnicity, socioeconomic status and risky peer networks indicated that sexual sensation …

The Relationship Between Ethnic Identity And Chlamydia And Gonorrhea Infections Among Low-Income Detained African American Adolescent Females, Dexter R. Voisin

Faculty Scholarship

This study explored the relationship between ethnic identity and Chlamydia and Gonorrhea infections among detained African American female adolescents. A cross-sectional survey was conducted among 123 African American female adolescents within eight detention facilities in Georgia. Using audio-computer assisted self-interviewing technology, data were collected on demographics, ethnic identity, laboratory-confirmed Chlamydia and Gonorrhea, and other known correlates for sexually transmitted infections (STIs), such as socioeconomic status, parental monitoring, and risky sexual behaviors. Rates of Chlamydia and Gonorrhea testing yielded incidence rates of 22.6% and 4.3%, respectively. Findings indicated that, controlling for STI correlates, participants who indicated high ethnic identity were 4.3 …

Correlates Of Sexually Transmitted Infection Prevention Knowledge Among African American Girls, Dexter R. Voisin

Faculty Scholarship

Purpose: To identify significant factors that distinguish African American girls who have high sexually transmitted infection (STI) prevention knowledge from those lacking such knowledge. Methods: We recruited a sample of 715 African American girls from three public health clinics in downtown Atlanta. Using audio computer-assisted self-interviewing (A-CASI) technology, we assessed for age, self-mastery, employment status, attendance at sex education classes, socioeconomic status, and STI prevention knowledge. Results: Slightly more than one-third of the girls did not know that females are more susceptible to STI infections than males; and that having an STI increases the risk of contracting HIV. Almost half …

Independent Living Program Evaluation For Rebuilding All Goals Efficiently, Patricia Armour, Debra Moulton, Araceli Pruett

UNLV Theses, Dissertations, Professional Papers, and Capstones

This paper evaluates the outcome of independent living (IL) services provided to clients with Spinal Cord Injuries (SCI) by a local non-profit organization, Rebuilding All Goals Efficiently (RAGE). Agency services are directed at increasing client self-sufficiency, self-advocacy, and maintenance of least restrictive living environment. Secondary data provided by RAGE for 22 SCI clients who received services in FY10 was used in the evaluation. Outcomes were measured for living arrangement at case closure, impact of services on client’s life, and cost effectiveness of services provided. Descriptive statistical analysis of the data revealed successful outcomes for all 22 SCI clients. All clients …

Toward A Conceptual Model Linking Community Violence Exposure To Hiv-Related Risk Behaviors Among Adolescents: Directions For Research, Dexter R. Voisin

Faculty Scholarship

Purpose: To present a conceptual framework which accounts for the relationship between community violence exposures (CVEs) and youth HIV risk behaviors. Methods: This article provides an overview of existing research on the links between CVE and HIV risk for youth and offers a conceptual framework for clarifying how CVE might contribute to HIV sexual risk behaviors. Results: Increasing empirical findings substantiate that the links between CVE and HIV risk behaviors among youth are mediated by psychological problem behaviors, low school success rates, and negative peer influences. Conclusions: Researchers have identified the behaviors that place teens at risk for becoming infected …

Community Violence And Health Risk Factors Among Adolescents On Chicago's Southside: Does Gender Matter?, Dexter R. Voisin

Faculty Scholarship

We assessed community violence, school engagement, negative peer influences, mental health problems, and human immunodeficiency virus risk among 563 black adolescents. Boys reported higher rates of community violence exposures and gang involvement, while girls reported higher mental health distress. In the presence of multiple risk factors, negative peer norms were the strongest correlate of human immunodeficiency virus risk behaviors.

Scaling Up, Lourdes Hernández-Cordero, Susan P. Sturm, Kathleen Klink, Allan J. Formicola

Faculty Scholarship

Moments of crisis require big, bold ideas. In this chapter we will zoom out of our close examination of the Northern Manhattan Community Voices Collaborative experience to propose ways to scale up the things that worked for us in order to make them applicable at a national level. With this chapter we honor the intent of the W. K. Kellogg Foundation in its support of learning laboratories across the nation. Our goal is to contribute to the collective dialogue on how to improve the health care system. Specifically, we propose that making a healthier nation and reducing health care costs …

Children's Health Insurance Program: The Dynamics Of Federalism And Health Care Policy, Erik White

Political Science Theses and Capstones

On February 4^th, 2009, President Obama signed into law the reauthorization of the Children Health Insurance Program. The federal government will now spend 30 billion dollars towards the goal of ensuring that more children in the United States are insured. I investigate this particular health care policy and look at the different dynamics that affect the ultimate goal of universal health insurance for children. Because this program allows for state flexibility under broad federal guidelines, one is able to look at individual states, and their particular actions and characteristics, to determine the best approach to insuring the most …

Pathways To Drug And Sexual Risk Behaviors Among Detained Adolescents, Dexter R. Voisin

Faculty Scholarship

This study recruited 559 youths from detention centers (mean age was 15.4 years; 50.1% of detainees were girls) to investigate pathways that link witnessing community violence in the 12 months before detainment to drug and sexual risk behaviors in the two months preceding detainment. Through the use of audio-computer-assisted technology, data were collected on demographics, family factors, peer influences, religiosity, witnessing community violence, and drug and sexual risk behaviors. When controlling for demographics and family variables, the authors found positive associations between witnessing community violence and drug and sexual risk behaviors. Witnessing community violence was directly linked to sexual risk …

Assessment Of Maine's Long-Term Care Needs Baseline Report: Demographics And Use Of Long Term Care Services In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Karen Mauney, Catherine Mcguire Bs, Louise Olsen, Jasper Ziller

Disability & Aging

In 2006, the Office of Elder Services requested the assistance of the Muskie School in developing an assessment of long term care service use in Maine. This report provides baseline information on the demographic characteristics, participant characteristics and service use trends for people accessing long term care services in this State.

For purposes of this report, we have excluded people with MR/DD. Long term care services do not include community support services for people with mental illness.

In this report, long term care services include:

• Nursing Facility Services
• Private Non-medical Institutions
• Consumer Directed Attendant Services
• Day Health Services
• Elder and …

Measuring The Effect Of Intimate Partner Violence On Health-Related Quality Of Life: A Qualitative Focus Group Study, Eve Wittenberg, Manisha Joshi, Kristie A. Thomas, Laura A. Mccloskey

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Health related quality of life (HRQOL) can be measured by a wide range of instruments, many of which have been designed for specific conditions or uses. "Preference-based" measures assess the value individuals place on health, and are included in economic evaluations of treatments and interventions (such as cost effectiveness analysis). As economic evaluation becomes more common, it is important to assess the applicability of preference-based health related quality of life (HRQOL) measures to public health issues. This study investigated the usefulness of such instruments in the context of intimate partner violence (IPV), a public health concern that that …

Chaotic Patterns Of Restraining Power: The Dynamics Of Personal Decision Making In A Long-Term Care Facility, Sandra Loucks Campbell

Theses and Dissertations (Comprehensive)

This is a study of personal decision-making dynamics at multiple levels in an Ontario Home for the Aged, including managers, staff leaders, direct care workers, non-direct care workers and residents. Personnel dyadic units of differential decision-making power were postulated: managers/staff leaders, staff leaders/direct care workers and direct care workers/residents. Weber's bureaucracy, other organizational power literature and chaos theory provide the theoretical frame. Staff completed a self administered questionnaire package which included variants of the Staff Involvement in Decision Making scale (Kruzich, 1989), open-ended and demographic questions. Residents were assisted in completing a similar, but shorter, questionnaire. Cognitively impaired residents' decision …

The Sun Always Comes Out After It Rains: Exploring The Experience Of Aids Caregivers (Immune Deficiency), Susan Cadell

Theses and Dissertations (Comprehensive)

This research was designed to explore the growth of people who have cared for or about someone who has died of Acquired Immune Deficiency Syndrome (AIDS)-related illnesses or complications related to Human Immunodeficiency Virus (HIV) disease. It consists of a cross-sectional study of 176 bereaved caregivers of people with HIV disease, some of whom themselves are HIV-positive. Measures were selected to assess demographics, creativity, spirituality/religiosity, social support, depression, traumatic symptomatology and posttraumatic growth. A research model is tested which examines the relationship of psychosocial resources and stressors to the post-traumatic growth of the bereaved participants. In addition, seven caregivers participated …

The Challenge Of Adolescent Health: Views From Catholic Social Teaching And The Social And Medical Sciences, Brenda Wixson Donnelly, Dennis M. Doyle, Una M. Cadegan, Teresa L. Thompson, Patricia Voydanoff, Joan Mcguinness Wagner

History Faculty Publications

This book provides a multidisciplinary examination of the complex social issues surrounding adolescent health and health care delivery. It draws specifically on the resources of Catholic social teaching, presents an overview of the medical problems common among young people, and explores the social and familial contexts in which these problems arise. It provides a framework within which to view the conditions limiting the health and well-being of adolescents and to understand the resultant deterioration of the physical and mental health of adolescents in this country.

The insights gained from Catholic moral teaching are included with those of social science and …

Coping And Support Needs Of Family Caregivers Of Older Adults With A Developmental Disability, Caroline Cochrane

Theses and Dissertations (Comprehensive)

Due to the policy of deinstitutionalization there is a population of adults with a developmental disability who are aging in the community and who are living with their aging parents as caregivers. This study used a phenomenological, qualitative approach to gain an in-depth understanding of the experiences of these aging family caregivers of aging adults with a developmental disability. A literature review indicated that some sources of support and service needs have been identified for this population of caregivers, and that planning for the future of their adult child with a developmental disability was important to these caregivers. Six caregivers, …

The Biographic Impact Of An Hiv Diagnosis (Immune Deficiency), Leanne Carol Baird

Theses and Dissertations (Comprehensive)

No abstract provided.

The Young Adult Substance Abuse Clinic. A Program Evaluation: Process And Immediate Output, Kimberly Calderwood

Theses and Dissertations (Comprehensive)

ln this program evaluation, I present the demographic characteristics and underlying problems of YASAC’s clientele. The clients’ level of satisfaction regarding the services provided is also examined. A comparison of the results with YASAC's implementation objectives as well as its current goals and objectives helps to determine some of the clinic’s strengths and weaknesses. An extensive literature review provides the basis for six hypotheses used to address the following three questions: (1) whether clients involved with probation and parole differ from other clients in terms of successful completion of the program, (2) whether clients’ attitudes toward their alcohol and drug …

Southeast Asian Refugees In Canada: Gender Differences In Adaptation And Mental Health, Roger Gary Edwards

Theses and Dissertations (Comprehensive)

This thesis involves secondary analysis of epidemiological data concerning a large cohort of Southeast Asian refugees resettled in British Columbia, Canada, who were surveyed three times over a ten year period. Male-female differences in the mental health impact of adaptational demands, such as the acquisition of host language skills and securing employment were the focus for the thesis. The psychometric properties of the mental health scales used in the study demonstrated high internal consistencies and construct validity in both male and female samples. There was evidence to suggest that the external validity of the study was somewhat compromised by the …

Benefits For The Disabled: How Beneficial For Women?, Elizabeth Ann Kutza

The Journal of Sociology & Social Welfare

The social and economic consequence of disability is of increasing interest in American society today. The numbers of persons reporting disabling conditions is rising, as is the number of persons qualifying for public disability benefits. This article examines the impact of current United States disability policy on disabled women, and concludes that the major programs -- disability insurance, supplemental security income, workers' compensation, vocational rehabilitation -- because of their relationship to labor market participation, disadvantage women. Women not only receive fewer, but less generous benefits. Explanations of this outcome, and implications for future policy are addressed.

Dayas In Urban Health Care: Activities, Problems, And Prospects For The Future, Dagmar Simon

Archived Theses and Dissertations

No abstract provided.

Quality Of Life Assessment Of Chronic Hemodialysis Patients At The Artificial Kidney Unit Of Good Samaritan Hospital And Medical Center, Karen Jones Whittle, Michael Tripp, Bruce De Young

Dissertations and Theses

The purpose of this study was to evaluate certain factors that affect the quality of life experienced by the chronic hemodialysis patient population served by the Artificial Kidney Unit at Good Samaritan Hospital and Medical Center, Portland, Oregon. The intent of the study was to discover if there was a significant difference in quality of life between patients who dialyzed at home and patients at the Artificial Kidney Unit (center patients).

For the purposes of this study, House, Livingston and Swinburn’s definition of quality of life was used. Their definition states that quality of life is a function of the …

Social Work Intervention And Patients' Utilization Of The Kaiser Health Care System, Pegi Sten, Liz Swint Young

Dissertations and Theses

This study was an analysis of social work practice in a medical setting: analyzing the work of a medical social worker in an outpatient clinic located in a metropolitan area. The primary purpose of this descriptive study was to evaluate the performance of a medical social worker in a Kaiser-Permanente outpatient clinic and to determine if there were possible associations between social work intervention and patient utilization of existing services offered by the Kaiser Health Care system, also referred to herein as Kaiser. Specifically, the study attempted to determine if there were quantitative changes in patient contacts, and utilization of …

Motivational Factors Behind Repetitive Abortions, Kelly Osmont, Ellen Wolfford

Dissertations and Theses

This practicum intends to explore the motivational factors behind repeat abortions. The underlying assumptions of this study include: (1) women have abortions; (2) women have repeat abortions. Based on these assumptions, the two research questions are (1) are there significant factors in the causation of repeat abortions, and (2) what are the implications regarding the lack of information and service to women which have a direct relationship to repeat abortions.