Doctor of Philosophy, The Ohio State University, 2021, Human Ecology: Human Development and Family Science

Research consistently shows that maternal substance use can have lasting, detrimental effects on the parent-child relationship and on child outcomes over time. These children are also at higher risk for developing a substance use disorder themselves. However, less is known about the communication patterns of mothers who use substances and their children, or how these patterns are related to substance use. The present study examined how dyadic communication patterns change over time, and how these changes are related to maternal substance use, as well as risk and protective factors for adolescent substance use. Additionally, this study tested the impact of family therapy on mother-child communication patterns over an 18-month period. The current study consisted of 49 dyads of mothers who had a substance use disorder (alcohol or illicit drug use) and their 8- to 16-year-old children who completed a communication task at baseline, 6 months, and 18 months. Mothers were randomized to receive family therapy or an individual attention control. The verbal content of the communication task was coded using the Living in Familial Environments coding system (LIFE; Hops et al., 1990). Behavioral tendencies and conditional probabilities for the sequence of mother-child interactions were generated using the Generalized Sequential Querier Program (GSEQ version 5.1.23; Bakeman & Quera, 2016). It was hypothesized that mothers and children of mothers who identified alcohol as their primary substance of choice would have higher levels of positive verbalizations compared to dyads whose mothers identified an illicit drug as their primary substance of choice at baseline. It was also expected that increases in positive communication over time would be related to increases in protective factors and decreases in risk factors for adolescent substance use. Finally, it was expected that dyads who received family therapy would show greater improvements in communication over time. T-tests, re (open full item for complete abstract)

Ph.D., Antioch University, 2019, Leadership and Change

The purpose of this study was to unearth how adolescents with substance use disorders achieve the task of identity formation and the construction of self-concept in the midst of the drug culture and society that exists. It sought to uncover the social constructs designed to ignore and/or remove human complexities and allow an intersectional approach to be brought to a study on this population. Historically, there has been a failure to investigate the underlying social attitudes and behaviors that impact the very delicate and vulnerable process of finding self. Psychosocial and relational adjustment are strongly influenced by the extent to which adolescents successfully develop a coherent and structured sense of identity. One's life pathways and decisions are guided by a consolidated sense of self. An understanding of key identity literature led to a methodological design using both Grounded Theory Methodology and Situational Analysis to provide a thorough description and understanding of the entire situation around identity development for adolescents with substance use disorders. The detailed analysis of the interviews provided by 20 adolescent females served as the basis for the development of a theoretical model depicting the findings from both the dimensional analysis and situational analysis. The research provided empirical evidence that adolescents in this situation form a pseudo-identity to achieve a sense of belonging that has pervaded their existence due to familial, social, and cultural factors. This pseudo-identity is reinforced by acceptance into drug-seeking and substance-using groups, as well as by leadership and practices in treatment, therapy, healthcare, criminal justice, and other macro forces. The research provides practical implications for prevention and intervention practices, as well as leadership practice. Recommendations for future research invite further exploration into whether the situation for the participants in this study hold true acr (open full item for complete abstract)

Doctor of Philosophy, Case Western Reserve University, 2017, Social Welfare

Although research has investigated both risks and protective factors associated with risky teen health behaviors, an examination of these factors simultaneously and with regard to gender differences has not been studied comprehensively or in teens known to be at elevated risk for early substance use and sexual risk taking. This study examined relationships between gender, risk and protective factors at age 12 and risky health behaviors (RHB) (alcohol, tobacco, marijuana use and sexual intercourse at age 15) in a sample of low socio-economic status, primarily African American, prenatally poly-substance exposed youth. This study utilized secondary longitudinal data from Project Newborn-Next Steps, a National Institutes on Drug Abuse (NIDA) funded longitudinal study of prenatally cocaine-exposed children and their mothers/caregivers, (NIDA RO1 07957), from 265 prenatally substance exposed adolescents. The Developmental Assets Profile, ALEXSA substance use risk scales (permissive attitude, perceived substance access) at age 12 and substance use and sexual risk behavior (YRBSS and biologic samples) at age 15 were used to assess the primary predictor variables and outcomes. Hierarchical logistic regression analysis was used to determine if a permissive attitude to toward substance use, perceived access and number of developmental assets are associated with RHB, whether these risk and protective factors interact to affect RHB and how gender influences these associations while controlling for covariates. For males, more developmental assets were a predictor of marijuana use, tobacco use, and sexual intercourse; externalizing behavior was a predictor of tobacco use, and violence exposure was a predictor of sexual intercourse. For females, perceived access to substances was a predicator of marijuana use, and tobacco use; and externalizing behavior was a predictor of sexual intercourse. Developmental assets did not moderate the relationship between risk factors and RHB. Increa (open full item for complete abstract)

Master of Science, The Ohio State University, 2008, Hospitality Management

Previously, most substance use research on workplace alcohol and drug problems have focused on four aspects: social control, norm, availability and stress. Due to the prevalence of substance use problem in the food service industry, this study investigates food service employee involvement with alcohol, marijuana, and other illicit drug using the National Longitudinal Survey of Youth 97 cohort. Self-selection is first examined using a multinomial logistic regression model. Then availability theory, norm theory, and stress theory are extended and tested by a number of job-related risk factors to predict employee substance use, using OLS models. Results show some evidence of self-selection: previous binge alcohol users and marijuana users had a greater likelihood to work in the food service industry. After controlling for previous substance use and individual backgrounds, bartending, tip earning, and holding multiple jobs were the major risk factors for employee alcohol or illicit drug use in the food service industry. Implications for practitioners are discussed and future research opportunities are then presented.

PhD, University of Cincinnati, 2023, Arts and Sciences: Psychology

Background: In 2020, 16.1 million individuals ages 12 and over endorsed past-year prescription drug misuse (PDM); opioids were the most misused prescription drug class (i.e., 9.3 million people). According to the Center for Disease Control and Prevention, prescription opioid misuse resulted in an average of 38 deaths per day in 2019, making pain relievers responsible for 28% of all opioid-related fatalities. The “opioid epidemic” was declared a public health emergency due to the widespread impact of drug overdose deaths in rural and suburban communities across the United States. This epidemic has traditionally been depicted as a crisis devastating non-Hispanic White populations, however, as opioid overdose deaths decrease within these communities, deaths among African Americans have increased over time. The prevalence and correlates associated with misusing prescription drugs have been outlined in the extant literature and the deleterious effects of PDM in the African American community have been observed, yet research investigating misuse among this population remains limited. A primary aim of this study was to examine the psychosocial factors (i.e., mental health, substance use) that increase the risk of PDM among African Americans. PDM trends were also analyzed to evaluate misuse over time. Method: Using pooled cross-sectional data (2015-2019) from the National Survey on Drug Use and Health (NSDUH), this study examined trends and correlates (i.e., mental health [major depressive episode, suicidal ideation, serious psychological distress], substance use [alcohol, marijuana, tobacco, illicit substances]) of PDM among African American adults (ages 18 and older) who endorsed lifetime misuse of prescription drugs. Results: Trend analyses revealed that lifetime PDM among African Americans was significantly lower in 2017 and 2018, relative to 2015. A similar relationship was observed for past 12-month PDM with significant differences indicating lower prev (open full item for complete abstract)

Doctor of Psychology (Psy.D.), Xavier University, 2020, Psychology

Research on emotion regulation while in residential substance abuse treatment is scarce, and even more so within the veteran population. This present data analysis examined the relation between emotion regulation and various aspects of residential substance abuse treatment. First, it was found that difficulties with emotion regulation significantly decreased from admission to post-completion of a veteran residential substance abuse program. In addition, treatment persistence, or the act of remaining in treatment for the recommended duration, was examined. This data analysis tested the hypothesis that fewer difficulties regulating emotions would increase the chances veterans would remain in the 21-day program. This hypothesis, however, was not supported. In addition to veterans voluntarily leaving the program earlier than recommended, some veterans are involuntarily asked to leave due to violating program rules. As such, it was hypothesized that fewer emotion regulation difficulties upon admission would lessen the likelihood of committing rule infractions; this hypothesis was not supported. Lastly, it was found that the greater the change in DERS scores from admission to discharge, the lower the likelihood of returning to aftercare treatment (e.g., outpatient follow-up appointments); these results were contrary to what was hypothesized. Although emotion regulation difficulties can significantly decrease after a 21-day program, further research is needed to determine variables associated with remaining in treatment, following program rules, and attending recommended follow-up care.

MA, University of Cincinnati, 2020, Arts and Sciences: Psychology

In the U.S., approximately 2.3 million individuals ages 16-24 have not attained a high school diploma (National Center for Education Statistics [NCES], 2017). Those who drop out are three times more likely to be unemployed and earn incomes 27% less than those who graduate (Bureau of Labor Statistics [BLS], 2018, 2019). Academic failure is associated with higher rates of substance abuse (Trenz, Harrell, Scherer, Mancha, & Latimer, 2012), which can have a causal effect on academic performance. Prescription drug misuse (PDM), or taking drugs that are not prescribed to you or as intended, is the second most commonly abused drug class among teens after marijuana (excluding alcohol/cigarettes; NIDA, 2018). Nearly a quarter (23%) of adolescents report a lifetime history of PDM (MetLife Foundation, 2013). The current study evaluated the lifetime misuse of four different drug classes (i.e., sedatives, stimulants, tranquilizers, opioids) to understand the prevalence and correlates of PDM among this at-risk group. Results revealed that lifetime PDM among adolescents was at 8%, with the highest rates of use found among White youth, females, and individuals with family incomes at or above $75,000. Age and alcohol use were both significantly associated with lifetime PDM among youth. The odds of PDM were highest among 13-year-olds (B = .30, p = .05, OR = 1.36 [95% CI: 1.01, 1.83), indicating an increase in risk for this age group. There were decreased odds of PDM for youth engaging in alcohol use (B = -.28, p<.05, OR = .75 [95% CI: .69, 1.23). In terms of academic performance, youth who earned a D or less than D average had the highest odds of PDM (B = .52, p< .05, OR = 1.70 [95% CI: 1.16, 2.45]). Findings suggest that early adolescence and academic failure increase the risk for lifetime PDM among youth.

Doctor of Philosophy, The Ohio State University, 2019, Human Ecology: Human Development and Family Science

Women engaged in prostitution report high rates of substance use, HIV risk, victimization, mental health and physical health problems (Dalla, Xia, & Kennedy, 2003; Love, 2015). These women typically have children in their care who also contend with high rates of adverse outcomes (Dalla, 2004; Sloss, 2002). Prostitution and substance use are intrinsically linked (Gilchrist et al., 2005; National Institute of Justice, 1998; Nuttbrock et al., 2004). In fact, many women identify substance use as a significant barrier to exiting prostitution (Dalla, 2004). As a result, it has been posited that interventions for this population must address problematic substance use and underlying problems associated with substance use (Dalla, 2002). However, very few studies have tested interventions with this vulnerable population. Among these previous studies, findings suggest limitations of traditional treatment modalities. Using a Grounded Theory approach, the proposed study seeks to recruit mothers who have engaged in prostitution (n=15) to participate in qualitative interviews exploring their experiences and treatment needs as well as those of their children. An inductive content analysis will then be utilized to interpret the data and identify themes regarding intervention targets that are salient and require attention. This study will serve as a necessary first step towards understanding the treatment needs and experiences of these extremely vulnerable mother-child dyads. Current findings will offer meaningful new insights that will inform the development and adaptation of maximally effective, feasible, and acceptable interventions for this high-risk population.

Psy. D., Antioch University, 2019, Antioch Santa Barbara: Clinical Psychology

While psychiatric medications have been categorized as the same as substances of abuse in Alcoholics Anonymous (AA), medications for common medical disorders were not affected by this disapproval of medication. It may be time for a new dialogue (Woody, 2015). According to Gjersing and Bretteville (2018), there has been a concerning increase in overdose deaths in the last decade. This includes a threefold increase in overdose deaths from prescription narcotics and six-fold increase in overdose deaths from heroin in the United States. When prescription opioid users find difficulty in obtaining pills, they may move on to heroin, which is much more readily available on the streets, in an effort to avoid painful opioid withdrawal. For this study, individuals who had previously achieved long-term abstinence from alcohol or substance use but relapsed after a significant amount of time sober were interviewed in order to better understand their experience with relapse as well as their experience returning to at least partial remission. Thematic analysis was conducted on interview data. The results from this phenomenological analysis of interviews with eight participants identified several themes regarding the experience of being a long-timer, relapsing after a substantial amount of time abstinent, and challenges to as well as factors in returning to AA. These themes are organized as long-term recovery, relapse, and a new beginning. Long-term recovery is further explored as acute treatment only, treatment did not utilize evidence-based interventions, treatment did not address emotional issues, contact with mental health, long-timer, and complacency and drifting. Relapse is further explored as medical issues, new trauma, and justification of the use of medication or marijuana. A new beginning is further explored as recovery challenges such as feelings of ostracism, age-related issues, and shame as well as recovery factors such as finding acceptance and love within the fellowsh (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2009, ED Physical Activities and Educational Services

The increasing prevalence of substance use among adolescents is a growing concern across the United States today. Previous researchers have identified risk factors for substance use in the individual, peer, family, school, and community domains. With respect to the individual domain, mental health problems and problem behaviors have been postulated as explanatory variables in adolescent substance use. Although problem behaviors have been consistently identified as powerful explanatory variables in adolescent substance use, research assessing the influence of mental health problems has been equivocal. Investigators have further cited high comorbidity rates between mental health problems and problem behaviors. Therefore, researchers have recently examined the interaction effect between mental health problems and problem behaviors in relation to substance use; however, the findings have produced mixed results. With respect to the etiology of adolescent substance use, researchers have typically investigated risk and protective factors in isolation, which has led to conflicting results over the salience of risk factors in the individual, peer, family, school, and community domains. Thus, a composite risk and protective factor approach has been proposed for investigating the etiology of substance use. The primary purpose of the present study was to examine the explanatory power of mental health problems and problem behaviors in adolescent substance use and to explore the interaction effect between mental health problems and problem behaviors. A secondary aim of the study was to identify risk and protective factors of adolescent substance use, as measured by the Primary Prevention, Awareness, Attitude, and Use Survey (PPAAUS). In addition, protective factors were examined as moderators in the relationship between risk factors and adolescent substance use. Data used for this study came from a triennial survey completed in 2006 by the Franklin County's Safe and Drug Free Sc (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2004, Physical Activity and Educational Services

The focus of this study was to report and analyze the responses of students, grades 6 - 12, who had Specific Learning Disabilities (SLD) and attended schools in 17 public school districts and 12 parochial and private schools in and surrounding a major Midwestern city. The data were collected through the Primary Prevention, Attitude and Use Survey (PPAAUS, 2000) that was administered every 3 years to all students in Grades 6 - 12 in these schools. A random sample of 470 students with SLD, selected from a database of approximately 3,760 students, reported that they participate in classes for students with SLD. The independent variables established were Gender (Male and Female) and Grade Level (Middle School and High School), and the dependent variables were the responses to the items of Feelings; Perceptions of School Climate; Willingness to Use Alcohol, Tobacco, and Other Drugs; Frequency of Use; Age of First Use; and Location of Use. The results of the Feelings items indicated that Middle School students reported feeling more stressed and anxious about their school work than did High School students. Males reported being more sad and depressed, more angry, and more nervous and anxious than did females. Males also reported that they felt worse about their schoolwork. Middle School students with SLD had more positive perceptions of school climate than did High School students, and there was no difference between males and females and their reported perceptions of school climate. There was no difference between males and females and their reported use of alcohol, tobacco, and other drugs. High School students reported more actively using alcohol, tobacco, and other drugs than did Middle School students. No differences were found by Gender or Grade Level for locations of substance use. An examination of the age of first substance use indicated that students with SLD who used generally began using substances between the ages of 12 to 15 years. Recommendations for program (open full item for complete abstract)

Master of Science (MS), Ohio University, 2011, Clinical Psychology (Arts and Sciences)

Using the Circumplex Model of Family Systems (Olson, 1989; 2000; Olson & Gorall, 2006), this study sought to conceptualize family functioning patterns and examine the relationship between family functioning and substance use severity in adolescents admitted to a residential substance use treatment center. More problematic family functioning (i.e., greater family disengagement, rigidly, enmeshment and chaos) and less healthy family functioning (i.e., lower balanced cohesion and lower balanced flexibility) was observed in the current sample compared to a non-clinical comparison sample. Substance use severity was operationalized using the Substance Abuse Subtle Screening Inventory-Adolescent-2 (SASSI-A2) and three groups of substance users were established (Low Severity, Moderate Severity, and High Severity; Miller & Lazowski, 2001). After controlling for family member substance abuse, peer substance use and the impact of trauma, family cohesion level was significantly related to substance use severity group. Study findings suggest that family based interventions need to incorporate a wide range of problematic patterns and family cohesion, in particular, is an important family functioning pattern that should be addressed in interventions for adolescents in residential substance use treatment settings.

Master of Science (MS), Ohio University, 2009, Psychology (Arts and Sciences)

The current study examined predictors of Substance Abuse Severity in a sample of adolescents entering treatment for substance use disorders. Specific daily hassles and types of social support were assessed at treatment admission. Participants included 72 adolescents: 76.4% male, 91.7% Caucasian, and ranging in age from 13 to 18 years old (Mean=16.3 years). When daily hassles correlated with Substance Abuse Severity were forced entered into block 2 of a hierarchical regression, after gender was entered in block 1, the set of predictor variables explained a marginally significant proportion of variance in Substance Abuse Severity (R2=.29, Adjusted R2=.14, F(10,47)=1.96, p=.060, f2=.416), and no individual daily hassle accounted for a significant amount of unique variance. When provisions of social support correlated with Substance Abuse Severity were forced entered into a multiple regression, the set of predictor variables explained a marginally significant proportion of variance in Substance Abuse Severity (Adjusted R2=.09, F(2,57)=2.66, p=.078), and no individual provision of social support accounted for a significant amount of unique variance. Subsequent moderator analyses performed for each type of social support revealed a significant interaction between Reassurance of Worth and Total Stress. These results suggest that adaptive management of daily stressors should be addressed in youth substance use interventions. Additionally, there may be an important protective function in helping to increase adolescents' feelings of competence/ability.

Doctor of Philosophy, Case Western Reserve University, 2007, Social Welfare

This study examined the predictive role of social networks and substance use and mental health disorders on perceived barriers to treatment services and treatment motivation. The research objectives of this study were to identify and to gain a further understanding of the barriers and motivators women experience in accessing services in substance abuse treatment and/or mental health disorders treatment programs. The sample consisted of 245 women: 86 recruited from community based substance abuse treatment facilities and 159 recruited from an ongoing study of cocaine exposed infants and their mothers. The measures included: the Diagnostic Interview Schedule to determine substance use and mental health disorders, Allen Barriers Scale to measure perceived barriers to substance use and mental health disorders treatment, Treatment Motivation Scale to measure Problem Recognition, Desire for Help and Treatment Readiness and Social Network Map to collect information on the composition of and support provided by the social network. Multiple regressions examined the contributions of social network characteristics, substance use and mental health disorders, current participation in treatment, age of women, and the number of children to barriers to treatment and treatment motivation. Overall, few social network variables accounted for barriers to treatment. Informational support and lack of sobriety support from friends were statistically significant predictors of treatment barriers. Several social network variables were found to be predictive of treatment motivation, although not always in the direction expected. Informational support was the only positive support predictive in the expected direction. Dual disorder status was a significant predictor of both treatment barriers and treatment motivation. The study did not show the age of the woman as a significant predictor of barriers but did show age as a significant predictor for treatment motivation. The number of children wa (open full item for complete abstract)

Doctor of Philosophy, University of Akron, 2008, Urban Studies and Public Affairs

Adolescent use of alcohol, tobacco, and other drugs (ATOD) is a continuing public health problem in the United States. The single largest source of funds for substance use prevention from the federal government is provided through the Safe and Drug- Free Schools and Communities Act (SDFSCA); administered by the United States Department of Education. In 1998, the Department introduced a planning framework, the Principles of Effectiveness, to guide school districts in establishing effective prevention programs. Those four Principles were: conduct needs assessment, establishment of measurable goals and objectives, selection of appropriate evidence-based prevention programs, and evaluate the impact of the program. This research study explored the degree to which the Principles of Effectiveness were implemented in Ohio public school districts. Data for the study were collected from prevention coordinators utilizing a web based survey. The survey collected information on the implementation of the four Principles and on organizational characteristics drawn from the theory of innovation that were hypothesized to be related to such implementation. In addition, the respondents were asked to identify obstacles and resources needed that influence the implementation of effective prevention programs. The results of this study indicate that the role of the prevention coordinator is significantly related to the implementation of the Principles of Effectiveness. More importantly, the tenure of the coordinator is an attribute that strongly points to the value of experience in the implementation process. Finally, limited funds and time demands were mentioned as the greatest obstacles that impede the implementation of the Principles of Effectiveness.

Psy. D., Antioch University, 2024, Antioch Seattle: Clinical Psychology

This qualitative study explored the lived experience of addiction counselors in their work with clients who have a primary diagnosis of methamphetamine (MA) use disorder. Interpretative phenomenological analysis was used as the methodology for this study. A total of seven participants were recruited and met inclusion criteria. Participants engaged in individual, semi-structured interviews. The primary themes that emerged included “Flexibility,” “Understanding,” “Self-Reflection,” “Demanding,” “Encountering Resistance,” “Hope,” “Developing an Individualized Understanding of MAUD,” and “Essentials of Treatment Success.” The findings of the study demonstrate the usefulness of qualitative inquiry to examine the lived experience of addiction counselors in their work with an MA-dependent population and provide guidance on the clinical application of the findings.

Master of Arts in Psychology, Cleveland State University, 2023, College of Sciences and Health Professions

The COVID-19 pandemic is a collective trauma that caused profound disruptions in day-to-day life and negatively impacted the psychological well-being of many emerging adults. Existing research shows that experiencing quarantine due to disease exposure or illness exacerbates psychological distress, particularly among people with existing symptoms of posttraumatic stress disorder (Solomon et al., 2021). Research points to problematic alcohol and other substance use as a mechanism in the development and maintenance of PTSD (Tripp et al., 2020). However, alcohol and other substance use has yet to be implicated in the exacerbation of PTSD symptoms among emerging adults in the context of the COVID-19 pandemic. The present study attempts to address these gaps in the scientific literature. It was hypothesized that A) pre-pandemic PTSD symptoms will positively associate with PTSD symptoms measured during the pandemic, B) problematic alcohol and other substance use will mediate the relationship between pre-pandemic PTSD symptoms and PTSD symptoms during the pandemic, and C) emerging adults who experience quarantine due to COVID-19 exposure or illness will report elevated symptoms of PTSD relative to those who did not. Participants (N=39) from the first wave of the study completed measures for the second wave of the study via an online survey between December 2021 and March 2022. Participants reported on their symptoms of psychological distress, use of alcohol and other substances, and quarantine experience. As expected, symptoms of PTSD at wave 1 predicted symptoms of PTSD at wave 2. However, no mediating effects of problematic alcohol or other substance use on the association between PTSD symptoms at waves 1 and 2 were detected. Similarly, quarantine experience was not found to moderate the relationship between PTSD symptoms at waves 1 and 2. These results suggest that symptoms of PTSD among young adults worsened under the conditions of the COVID-19 pandemic, but there was n (open full item for complete abstract)

MA, University of Cincinnati, 2023, Education, Criminal Justice, and Human Services: Counseling, Mental Health

The consumption of alcohol in social settings is common and research has linked drinking to unrestricted sociosexuality (i.e., more positive attitude toward, greater desire for, and higher frequency of casual sex). While alcohol consumption has been tied to unrestricted sociosexuality, the nature of the causal effects underlying this association in naturalistic settings is unclear. Thus, the goal of the current study is to use a repeated measures design that controls time-stable confounders to better determine the effects linking unrestricted sociosexuality to alcohol use. Using cross-cultural data (n=764) collected from two time points one year apart, I tested whether participants who displayed higher alcohol consumption at baseline displayed greater increases in unrestricted sociosexual attitude, desire, and behavior one year later. Further, I tested whether participants who scored higher on components of unrestricted sociosexuality at baseline displayed greater increases in alcohol consumption. Results indicated that baseline unrestricted sociosexuality did not forecast changes in alcohol use from time one to time two. Baseline alcohol use helped to explain increases in unrestricted sociosexual behavior but not unrestricted sociosexual desire or attitude over time. These findings suggest alcohol use prevention could have long-term effects on the incidence of unsafe sex; moreover, casual sex could receive attention as a potential component of drinking motives in substance use disorder counseling. Additional work could also be done to moderate the effects of alcohol use on risky sexual behavior, particularly in environments where alcohol is heavily used (bars, parties, etc.).

Doctor of Nursing Practice, Mount St. Joseph University , 2023, Department of Nursing

Historically, a visit to the medical director was not consistently provided to each new patient at the TriHealth Outpatient Alcohol Drug Treatment Program (TOADTP). This resulted in patients being dispossessed of access to care such as evaluation and comprehensive treatment of co-occurring mental health diagnoses, the initiation of pharmacotherapy, and initiation of medication-assisted treatment for persons living with substance use disorders. This project centered on development and implementation of a standardized intake process for TOADTP patients with the goal of increasing referrals to the medical director to expand access to these lifesaving interventions. Over an eight-week period, pre-intervention data were collected. During this pre-intervention period, only one of the 12 new patients was referred to the medical director. Development, education, and mobilization of the new standardized intake process included: analyzing the old intake process for variances, educating the direct care team about the benefits of practicing from an evidence-based platform, developing a new intake process that included a hard stop in the electronic health record, and educating the TOADTP team about it. The process then was mobilized. Post-intervention outcome measures were collected over an 8-week period. These measures revealed that 17 out the 24 new patients were referred to the medical director. In sum, the implementation of a standardized referral process to the medical director increased referrals from 8.4% to 70.8%, thus expanding access to life-saving evidence-based care for people living with substance use disorders.

MA, Kent State University, 2023, College of Arts and Sciences / Department of Sociology and Criminology

Poly-victimization refers to the experience of multiple victimizations of different kinds, such as bullying, sexual or physical assault, physically abusive punishment, and intimate partner violence, among others. Much attention has been given to the relationship between poly-victimization and adolescent outcomes, especially substance use, but little research attention has been given to the relationship between poly-victimization and adult substance use. This relationship, along with social support as a potential moderator, is important to explore for the sake of implementing non-punitive interventions and reducing our reliance on incarceration. The present study examines the relationship between adolescent poly-victimization and subsequent substance use in adulthood, as well as the potential moderating effect of social support. Publicly available data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) are used to assess the impact of multiple measures of violent victimization, as well as multiple measures of social support, such as religiosity and school and parental support, on adult substance use. Past-year marijuana and hard drug use are assessed as outcome variables. Findings suggest that adolescent poly-victimization is positively associated with the odds of using marijuana and hard drugs during adulthood, while higher levels of social support are negatively associated with the odds of using these substances during adulthood. Avenues for future research and policy implications are discussed.