Doctor of Psychology (PsyD), Wright State University, 2019, School of Professional Psychology

The purpose of the study is to obtain an improved understanding of behavioral health needs and social determinants of health among the patient population at the safety-net clinic Reach Out of Montgomery County (ROMC). The aims of the study include: 1) identify valid and reliable screening tools that are appropriate for use in primary care to measure behavioral health concerns, 2) identify valid and reliable screening tools that are appropriate for use in primary care to measure social determinants of health, 3) administer the developed survey to a representative sample of patients served by ROMC, 4) conduct statistical analysis of survey findings, and 5) prepare a report with summary of findings and recommendations to address behavioral health concerns and social determinants of health for ROMC. The overall goal of the study is to provide ROMC leadership with data that will inform the development and maintenance of tailored integrated health care services.

Committee: Jeffrey Cigrang Ph.D., ABPP (Committee Chair); Larry James Ph.D., ABPP (Committee Member); Sharon Sherlock RN, DHA (Committee Member) Subjects: Behavioral Psychology; Clinical Psychology; Health Care; Mental Health; Psychology; Public Health

Doctor of Philosophy, The Ohio State University, 2018, Social Work

The emerging adult population, individuals between the ages of 18-29, has grown to 53.7 million in the United States (U.S. Census Bureau, 2017). College students form a significant subset of this population, with 29 percent enrolled at a college or university (National Center for Education Statistics [NCES], 2015). One in three emerging adults will experience some form of mental health disorder (Eisenberg, Hunt, Speer & Zivin, 2011; Lipson, Gaddis, Heinze, Beck & Eisenberg, 2015) and the prevalence of substance use disorders is higher than any other age group (Substance Abuse & Mental Health Services Administration [SAMHSA], 2005). Emerging adult college students with behavioral health concerns face a myriad of challenges that include negative implications for education (Arria et al., 2013; Eisenberg, Golberstein, & Hunt, 2009; Eisenberg, Hunt, Speer, & Zivin, 2011; Sontag-Padilla et al., 2014), long-term health (Eisenberg, Hunt, Speer, & Zivin, 2011), and socioeconomic status (Wang et al., 2007). Despite these challenges, few emerging adults receive help for their behavioral health concerns (Kessler et al., 2007; Lipson, Gaddis, Heinze, Beck, & Eisenberg, 2015; SAMHSA, 2012; Wang et al., 2007). Few researchers have examined this phenomenon, but some evidence shows that institutional and individual-level characteristics may play a role (Cadigan, Lee, & Larimer, 2018; Dunbar, Sontag-Padilla, Ramchand, Seelam, & Stein, 2017; Eisenberg, Hunt, Speer, & Zivin, 2011; Miller et al., 2016). The aims of the Emerging Adult Behavioral Health (EABH) study were to (1) evaluate the association between behavioral health service use and academic outcomes among emerging adult college students; and (2) determine if emerging adult college students' decisions to use or not use behavioral health services are associated with specific student- or institution-level characteristics. Using secondary data from the 2015-2016 Healthy Minds Study (HMS), the EABH study employed a combination a (open full item for complete abstract)

Committee: Audrey Begun (Advisor); Kathryn Maguire-Jack (Committee Member); Joseph Guada (Committee Member) Subjects: Education; Higher Education; Mental Health; Social Work

Doctor of Ministry , Ashland University, 2024, Doctor of Ministry Program

The purpose of this project was to discover the extent to which students in U.S.-based Association for Clinical Pastoral Education (ACPE)-accredited programs had received training in trauma-informed care (TIC) pastoral practices for adolescents. Fifty-two surveys were completed by chaplains within various healthcare settings who had received ACPE training within the previous ten years. The results showed overall disappointment with the amount of TIC training received and a perceived lack of preparedness for providing pastoral care to traumatized adolescents. The results indicate a critical need for more research and training in TIC for this commonly overlooked population.

Committee: Michael Elmore (Advisor) Subjects: Clergy; Pastoral Counseling; Religious Education

Doctor of Education, Ashland University, 2022, College of Education

The importance of school support staff was found to be a critical factor in students' success. However, role ambiguity, bias, and limited quantitative research have caused questions around the impact that support staff have within the school setting. Consequently, this quantitative correlational research study examined the relationship between a higher ratio of support staff per student and student academic, attendance, and behavioral outcomes at the building level. Bronfenbrenner's (1979) ecological systems theory and Getzels' and Guba's (1957) social systems theory frameworks were utilized in this study to increase the understanding of the influence that environmental factors have on child development, and the importance of educational leaders. Data for this study was collected from four large urban school districts located in the Midwest. Two multivariate regressions were run, one to determine the association between the ratio of support staff and all schools K-12 outcomes, the second was to determine the association between the ratio of support staff and elementary only schools outcomes. This study is critical in advancing our understanding of the importance of support staff in the school setting by determining the associations that they have with student outcomes.

Committee: Peter Ghazarian Ed.D. (Committee Chair); Cathryn Chappell Ed.D. (Committee Member); Judy Alston Ph.D. (Committee Member) Subjects: Education; Mental Health; School Administration

Specialist in Education (Ed.S.), University of Dayton, 2021, School Psychology

Anxiety is a normal and appropriate response to a variety of situations. However, long-term effects of anxiety can impede daily life activities and disrupt an individual's overall well-being; this can be amplified when the child is also academically or intellectually gifted. The present study examined the effectiveness of the Brief Coping Cat, implemented in a school setting with three students who were identified gifted and demonstrated elevated levels of anxiety. Students participated in an eight-week intervention designed to increase their understanding of anxiety and teach effective coping skills through cognitive strategies and exposure tasks. Each student completed the Multidimensional Anxiety Scale for Children 2nd Edition Self Report before and after the intervention period and completed a Subject Units of Distress Scale (SUDS) during each session, to measure the efficacy of the intervention. Results indicated that the brief intervention was effective in reducing anxiety for students who were academically and intellectually gifted. Implications for school-based supports for students who are gifted and experience anxiety are discussed.

Committee: Elana Bernstein Ph.D. (Committee Chair); Sawyer Hunley Ph.D. (Committee Member); Layla Kurt Ph.D. (Committee Member) Subjects: Educational Psychology; Mental Health; Psychology; School Counseling

Doctor of Philosophy, The Ohio State University, 2018, Nursing

Background & Purpose: In the United States, asthma affects 6.1 million children and is one of the most common causes of school absenteeism. Asthma is also a major public health issue, accounting for more than $56 billion in annual healthcare costs. Children with asthma are at higher risk of having anxiety/depression and subsequently, higher morbidity and mortality. Few intervention studies have specifically targeted children with asthma and anxiety/depressive symptoms and no scalable school-based interventions are in use. The purpose of this pilot study was to assess the feasibility and acceptability of a school-based, cognitive behavioral skills-building intervention on 8 – 12-year-old children with asthma and anxiety/depression. Methods: A one-group, pre/posttest with a 6-week follow-up post intervention was used to assess the feasibility, acceptability and preliminary effects of Creating Opportunities for Personal Empowerment (COPE) for Asthma on anxiety and depressive symptoms, asthma management self-efficacy, symptom perception, asthma illness representations, controller medication in 8 – 12-year old children with asthma and anxiety/depressive symptoms. Repeated measures ANOVA was used for variables using three time-points, while paired t-tests were used for comparisons using two time-points. Results: Thirty-two children participated in COPE for Asthma. Analyses indicated that COPE for Asthma is feasible for 8 – 12 year-old-children with asthma and anxiety. Significant reductions were found in anxiety, missed doses of the asthma controller medication, and the caregiver completed Pediatric Symptom Checklist, all with moderate to large effect sizes. Significant increases were found in Personal Beliefs, Child-Asthma Self Efficacy, Child Asthma Illness Representations, with moderate to large effect sizes. Conclusions: COPE for Asthma is highly feasible for small groups in the school setting and should be tested in a pilot randomized controlled trial to det (open full item for complete abstract)

Committee: Bernadette Melnyk PhD (Committee Chair); Kimberly Arcoleo PhD (Committee Co-Chair); Barbara Warren PhD (Committee Member); Dawn Anderson-Butcher PhD (Committee Member) Subjects: Behavioral Sciences; Health; Health Sciences; Nursing

PhD, University of Cincinnati, 2024, Education, Criminal Justice, and Human Services: Health Education

Behavioral health disparities in LGBTQ+ youth refer to the differences in mental health and well-being that exist between lesbian, gay, bisexual, transgender, queer and other non-heteronormative or gender-diverse individuals compared to their heterosexual and cisgender counterparts (Szilagyi, 2019). Addressing behavioral health disparities in LGBTQ+ youth require a multi-faceted approach that includes advocacy, education, policy changes, and increased access to affirming mental health and substance use services. The principal investigator's purpose for this research was to follow the Centers for Disease Control and Prevention (CDC) guidelines on using the Youth Risk Behavior Surveillance System (YRBSS) data for her state, to provide information to support policies and new initiatives (CDC, 2023). State, territorial, tribal government, and local agencies and nongovernmental organizations use YRBSS data to set and track progress toward meeting school health and health promotion program goals, support modification of school health curricula or other programs, support new legislation and policies that promote health, and seek funding and other support for new initiatives (CDC, 2023). To determine needs and design behavioral health interventions, information about factors related to suicidality and substance use risks for this vulnerable population will enhance efforts to create gender-affirming environments (McDermott et al., 2021). This dissertation presents information from two studies to illuminate factors related to suicidality and substance use in Ohio's LGBTQ+ youth, and detail is provided in the following abstracts for each study.

Committee: Laura Nabors Ph.D. (Committee Chair); Rachael Nolan Ph.D. M (Committee Member); Amy Bernard Ph.D. (Committee Member) Subjects: Health Education

Doctor of Education (EdD), Wright State University, 2023, Leadership Studies

The state of youth behavioral health in the United States was a public health crisis before the overwhelming challenges presented by the coronavirus disease 19 (COVID-19) pandemic, and now, the situation is even more dire. The impacts of youth behavioral health challenges are pervasive and long-lasting for youth, their families, and the entire community. It is critical to identify innovative ways that youth behavioral health is being addressed in schools and understand how comprehensive school mental health systems including multi-tiered system of support teams are functioning. This comparative case study investigated the functioning of two high school multi-tiered system of support teams in the context of responding to students with behavioral health needs. This study was investigated through the lens of Bronfenbrenner's Bioecological Model of Human Development with a focus on the student, school, and community level. Individual interviews were conducted with nine MTSS team members from two Midwest high schools. One team utilized a traditional school behavioral health model, and the other school had a school navigator. The data were analyzed and organized into 27 different codes, five of which were represented in all participant interviews and were representative of the broader themes: Structure, Division of Labor, Behavioral Health Resources, Barriers, and Student Needs. Structure, division of labor, data and evaluation were identified as key challenges for the functioning of MTSS teams. The utilization of universal behavioral health screening and knowledge of behavioral health resources for students were two of the most critical differences in team functioning. While there were differences that were meaningful to the functioning of the teams, there were more similarities than differences in their functioning. Opportunities to support student mental health, expand the development of comprehensive student behavioral health systems, and further support education pro (open full item for complete abstract)

Committee: Noah Schroeder Ph.D. (Committee Chair); Jennifer Hughes Ph.D. (Committee Member); Josh Francis Ph.D. (Committee Member); Adrianne Johnson Ph.D. (Committee Member) Subjects: Behavioral Sciences; Education; Educational Leadership; Mental Health; Psychology; School Administration; School Counseling; Secondary Education

Master of Arts in Music Therapy, University of Dayton, 2023, Music Therapy

This study sought to identify dimensions of a song that might suggest its clinical relevance to the music therapy method-variation of song discussion as employed with adolescents with behavioral health needs. Additionally, I aimed to explore how those dimensions of a song interact with an individual and their unique clinical profile and thus may contribute to indications and contraindications for the use of this method-variation in treatment. Because much of the published literature on song discussion points to its efficacy, it seemed fitting that the next step would be to detail the various salient aspects of a song that a music therapist must give attention to when evaluating its relevance for a discussion experience. I carefully reviewed the music therapy literature on song discussion, reflected on my own process of choosing songs for discussion in my clinical practice with children and adolescents, and I consulted other music therapy professionals on their process of choosing song material for song discussion and incorporated this information into my considerations. In this report, I outline the 30 relevant dimensions I have identified as crucial to consider when examining a song's potential for use in song discussion. The list of dimensions related to the lyric, musical, and nonmusical aspects of song selection for song discussion is intended to provide a general roadmap for music therapists and is not necessarily the ultimate or only resource that therapists may consult.

Committee: Susan C. Gardstrom, Ph.D., MT-BC (Committee Chair); James Hiller, Ph.D., MT-BC (Committee Member); Bryan Bardine, Ph.D. (Committee Member) Subjects: Alternative Medicine; Behavioral Psychology; Behavioral Sciences; Clinical Psychology; Cognitive Psychology; Cognitive Therapy; Counseling Psychology; Health; Health Care; Mental Health; Music; Therapy; Welfare

Doctor of Healthcare Administration (D.H.A.), Franklin University, 2023, Health Programs

The Crisis Intervention Team (CIT) program is a partnership of law enforcement agencies, the behavioral healthcare system, emergency departments (EDs), advocacy groups, and other stakeholders in a geographic region. People in the community who experience a crisis related to a behavioral health (BH) condition often encounter police officers, and the CIT program offers guidance on the safe handling of those situations that ideally ends with a connection to treatment. In the United States, crisis BH resources are often unavailable, and it is common for officers to resolve the situation by initiating an ED visit, which is not associated with positive health outcomes for the patient. The aim of this study is to test the implications of Structural Functional Theory (SFT) in one CIT program. SFT suggests that imbalanced systems lead to the inappropriate reliance on other systems. The analysis of crisis events may provide insight into potential BH system improvements that align with the goals of the CIT program. One research question aims to find predictors of each disposition option available to LE officers in the CIT program. Findings in this study are drawn from the quantitative analysis of 594 CIT encounters over a 3-year period. The results of the multinomial logistic regression models indicate that adolescents and young adults experience suicide-related crises more often than other types of crises, and the most likely outcome is an ED visit. Findings suggest that the local system could benefit from improvements in BH resources, especially in crisis situations.

Committee: Gail Frankle (Committee Chair); Jesse Florang (Committee Member); Dail Fields (Committee Member) Subjects: Health Care Management

PHD, Kent State University, 2022, College of Public Health

Background: Adolescent depression and suicide risk have steadily increased over the last two decades. With death by suicide being the second leading cause of death among adolescents in the United States, identifying and treating depression is imperative in protecting the lives of our youth. The COVID-19 pandemic emerged in March of 2020 in the United States creating major disruptions to the daily lives of adolescents. School closures and economic shutdowns created a “domino effect” of challenges including but not limited to parental unemployment, food insecurity, social isolation, virtual schooling, and changes in family dynamic. Given these radical changes, how has the COVID-19 pandemic impacted depression and suicide risk among adolescents? Objective: To examine the impact of the COVID-19 pandemic on the severity rates of adolescent depression, suicidal thoughts, and suicide attempts at pre-pandemic (2019), at the onset of the pandemic (2020), and one-year from the start of the pandemic (2021). Methods: The sample population is adolescents 12-17 years of age who completed a PHQ-9 Modified for Teens screening at an annual well child check appointment in one of 30 pediatric primary care clinics across Northeast Ohio. Logistic regression analyses were conducted to evaluate the association between the mental health outcomes (PHQ-9 score, suicidal thoughts, and suicide attempt) and year, adjusting for age, race, gender, ethnicity, and insurance type. Results: Adolescents were 1.36 times more likely to score positive for moderate to severe depression at one year after the onset of the pandemic compared to pre-pandemic (95% CI: 1.25; 1.48). Adolescents were 1.68 times more likely to have had a suicide attempt at one year after the onset of the pandemic compared to pre-pandemic (95% CI: 1.42; 2.00). Female adolescents were more likely to score positive for moderate to severe depression, have suicidal thoughts, and a suicide attempt compared to male adolescents (open full item for complete abstract)

Committee: Bethany Lanese (Committee Chair); Tara Smith (Committee Member); William Lechner (Committee Member); Deric Kenne (Committee Member) Subjects: Health; Health Care; Mental Health; Psychological Tests; Public Health; Public Health Education; Public Policy

Doctor of Philosophy, The Ohio State University, 2021, Psychology

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and repetitive, restricted behaviors, with a current estimated prevalence of 1:54. Individuals with ASD typically benefit from a range of medical, psychological, and other services due to impairments caused by ASD as well as high rates of comorbid conditions. Despite this increased need, individuals with ASD and their families often report significant difficulty accessing services, an issue which is compounded for some groups including minoritized racial groups and people living in rural areas. The current study sought to identify challenges faced by clients with ASD and their families when attempting to access behavioral health services via telehealth within the context of the COVID-19 pandemic. Specific research questions were: (1) What are the most common challenges faced by clients with ASD and their families when attempting to access telehealth services? (2) What are the most problematic barriers (i.e., barriers most associated with being unable to access telehealth) faced by clients with ASD and their families when attempting access telehealth services? and (3) Which demographic groups (e.g., race, age, comorbidities) are least likely to be able to access telehealth? Data were extracted from client records of a multi-site provider of developmental disability (DD) services in Ohio following Institutional Review Board (IRB) approval. Results of our analyses suggest that the most common challenges faced by clients with ASD and their families were issues related to client behavior, including client inattention, client noncompliance, and need for in-person support. In regard to ability versus inability to access telehealth services, need for in-person support was found to be related to decreased likelihood of receiving telehealth services, and client inattention was found to be related to increased likelihood of receiving telehealth services. Demogra (open full item for complete abstract)

Committee: Marc Tasse' (Advisor); Andrea Witwer (Committee Member); Susan Havercamp (Committee Member) Subjects: Psychology

DNP, Kent State University, 2021, College of Nursing

Adverse childhood experiences (ACEs) are traumatic childhood events that alter biopsychological markers of the human body, causing significant damaging lifelong effects. Exposure to ACEs increases health risk behavior, including substance use disorder (SUD). Patients with ACE scores are more likely to struggle with recovery and have a higher incident of relapse. The purpose of this quality improvement project was to screen medication-assisted treatment (MAT) patients for ACEs within a federally qualified healthcare center (FQHC). Knowing and understanding past trauma and its affect on recovery (trauma-informed care) by screening individuals with SUD for childhood trauma is critical to improving patient outcomes. Patients completed the 10-question Kaiser Permanente ACE screening tool on a patient intake handheld tablet. Behavioral health (BH) referral rates were measured pre- and post-ACE screening implementation by utilizing EHR reports. All MAT patients were offered the ACE screen. Age and gender demographics were collected. After three months, an EHR report was obtained to compare post-ACE screening BH referral rates to pre-ACE screening rates the same three months the previous year. Post-ACE screening increased BH referrals by 29.76%. Screening for ACEs in MAT clinics is an effective trauma-informed intervention to increase BH referrals.

Committee: Louise Knox DNP (Committee Chair); Andrea Warner Stidham Ph.D (Committee Member); Lynn Gaddis DNP (Committee Member) Subjects: Nursing

Master of Science, The Ohio State University, 2020, Human Ecology: Human Nutrition

Background: Obesity among children and adults is a persisting national epidemic. Published data demonstrate benefit(s) of healthy family mealtime routines on children's weight status and health. However, there is little research examining the impact on caregivers. Objective: Assess the impact of Simple Suppers, an 8-week evidence-based intervention (EBI) designed to improve family mealtime routines, on caregiver health outcomes. Methods: The study design was a single arm baseline to post-test. The 8-week intervention occurred during the school year at Head Start. Participants were recruited from Head Start family events. Main outcomes included: BMI (kg/m2), waist circumference (cm), blood pressure (mm Hg), and mental health measures (depression (Patient Health Questionnaire-9 (PHQ-9)), stress (Perceived Stress Scale (PSS)), and anxiety (Generalized Anxiety Disorder-7 (GAD-7)). Psychosocial (self-efficacy for healthy family mealtime routines) and social (family functioning (McMaster Family Functioning Scale)) health outcomes were also measured. Paired t-tests were used to determine baseline to post-test change. Results: Twenty-two caregivers enrolled in the study. The sample consisted of 76.20% of households with an annual household income of $44,999 or less and 31.82% with low/very low food security. Caregivers' mean (SD) age was 36.95 (12.75) yr, 95.45% were female, 77.27% were Black, 4.55% were Alaskan/American Indian, and none were Latinx. 77.27% (n=17) of enrollees attended 3 or more sessions and 22.73% (n=5) attended no sessions and were classified as attendees and non-attendees, respectively. Depression and anxiety reflected clinical improvements among enrollees and attendees and blood pressure reflected clinical improvement among non-attendees. Among survey items, significant differences from baseline were observed with: 1) `I can make sure my child has healthy dietary habits' improved within attendees (p=0.0017); 2) `We avoid discussing our fears an (open full item for complete abstract)

Committee: Carolyn Gunther (Advisor); Julie Kennel (Committee Member); Tonya Orchard (Committee Member); Irene Hatsu (Committee Member); Jen D. Wong (Committee Member) Subjects: Families and Family Life; Health Care; Mental Health; Nutrition; Psychology; Public Health

Doctor of Philosophy (PhD), Ohio University, 2019, Counselor Education (Education)

I conducted a qualitative study of burnout among behavioral health providers who are treating opioid use disorders in rural Appalachia. The purpose of this study was to examine the factors contributing to burnout among behavioral health providers of opioid use treatment in rural Appalachia, as well as strategies used by these providers to manage burnout. I used interpretive description, a generic qualitative research approach, to explore burnout among behavioral health providers of opioid use treatment in rural Appalachia. I recruited 11 participants using convenience sampling, purposeful sampling, and snowball sampling strategies. I used semi-structured individual interviews as the primary method of data collection in my study. Guided by my conceptual framework, the multidimensional model of burnout, I used the constant comparative method to analyze my data. Data analysis yielded nine primary categories of factors that contribute to burnout, as well as 16 strategies (both helpful and unhelpful) used to manage burnout, among behavioral health providers of opioid use treatment in rural Appalachia. I discuss the implications of these findings for education and training, clinical practice, clinical supervision, leadership and advocacy, and future research within the behavioral health field.

Committee: Christine Bhat (Advisor); Yegan Pillay (Committee Member); Tamarine Foreman (Committee Member); Dwan Robinson (Committee Member) Subjects: Behavioral Sciences; Counseling Education; Psychology; Social Work

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

This study investigated factors associated with mental health utilization and the role of health insurance in moderating racial/ethnic service utilization disparities, among young adults (aged 18 to 25) with mental illness, as compared with non-elderly adults (aged 26 to 64) with mental illness. Guided by Andersen's Behavioral Model of Health Services Utilization, predictors were grouped into three categories: predisposing, enabling, and need factors. Race/ethnicity and health belief/attitude factors were identified as predisposing variables. Health insurance, family income, geographic regions, structural barriers, and cost/affordability were operationalized as enabling factors. Need factors such as mental illness severity, substance use problems, and self-rated health status — as well as gender, employment status, education, and criminal history — were statistically controlled. Data from the 2014 National Survey on Drug Use and Health (NSDUH) provided a total sample of 543 young adults and 862 non-elderly adults with moderate or serious mental illness. Binary logistic regression models were used for multivariate analyses; interaction effects of age and focal variables on service utilization were also included. Due to the complex sampling design, both weighted & non-weighted analyses were utilized and reported. Results indicated that young adults are significantly less likely to use mental health services than non-elderly adults. Multivariate analyses indicated that for, both, young adults and non-elderly adults with mental illness, identifying as non-Hispanic White, having health insurance, or having serious mental illness are factors that increase one's likelihood to use mental health services. Cost is a significant predictor of mental health service use for non-elderly adults, but not for young adults. Moderating effects of health insurance status and insurance plan type on racial/ethnic disparities in mental health service utilization among young adul (open full item for complete abstract)

Committee: David Biegel (Committee Chair); Hussey David (Committee Member); Meeyoung Min (Committee Member); Patrick Runnels (Committee Member) Subjects: Mental Health; Social Work

MPH, University of Cincinnati, 2017, Medicine: Epidemiology

BACKGROUND: Asthma morbidity is most prevalent among children living in under-resourced, urban environments. Additionally, children living in economically depressed regions tend to experience many barriers to accessing medical care. This study investigates the effects of combining school-based asthma care and health technology to increase access to asthma care among minority students in Cincinnati, Ohio from the perspectives of multiple stakeholders. METHODS: Patients in this study participated in the Asthma Free Schools pilot program (AFS) which engaged youth with poorly controlled asthma in six telehealth appointments with an asthma specialist and six telehealth appointments with an adherence specialist. Descriptive, secondary analysis of inter and post-intervention surveys revealed how well the AFS program met stakeholders' expectations. Survey questions focused on the interaction between participants and the study staff, ease of technology use and participants' opinion of the value of telehealth appointments. RESULTS: Across surveys and stakeholder groups, results revealed high satisfaction with the AFS program. All guardians and nurses believed the telehealth visits met their child's healthcare needs. The AFS program drastically increased access to care among minority youth; 85% (n=11) patients reported that without telehealth, they would not have seen an asthma or adherence specialist. Finally, according to school administrators, participation in the AFS program proved a positive experience for school staff, students and families. DISCUSSION: The AFS program successfully combined school-based healthcare and health technology to increase access to patient-centered, asthma care among patients with uncontrolled asthma living in lower-income, minority communities. All stakeholders were pleased with the intervention, which was likely due to the rapport among researchers, school staff, and families. As school-based health centers become more prevalent, (open full item for complete abstract)

Committee: Liza Murrison Ph.D MPH (Committee Chair); Kevin Hommel Ph.D. (Committee Member); Rachelle Ramsey Ph.D. (Committee Member) Subjects: Public Health

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2015, Media and Communication

This study follows the example of early research in other taboo health topics such as family planning, leprosy, and HIV/AIDS, by first examining baseline Knowledge-Attitude-Practice (KAP) variables to build an initial research base for a menstruation- related health communication study. The primary objective of this study is to explore the relationship among important psychosocial variables pertaining to menstruation and menstrual hygiene; hence, the variables selected include: knowledge of menstruation and menstrual practices, attitude towards menstruation and menstrual practices, cognitive involvement in menstruation and menstrual practices, behavioral involvement in menstruation and menstrual practices, and adoption of menstrual practices. Another objective is to determine which of the above-mentioned factors are predictors of correct and safe hygienic practices in the context of menstruation. A quantitative methodological approach was adopted to conduct the study. A structured questionnaire was used to survey respondents and collect data. Sample size of the study was 475. A probability random sample consisting of both women and men, from Ahmedabad city, India, was selected using multi-stage clustered sampling technique. Descriptive and analytical statistical techniques were employed to analyze the data and prepare the findings. SPSS software was used to conduct appropriate analyses. It was found that knowledge, attitude, and cognitive involvement in menstruation and menstrual practices were high whereas, behavioral involvement in menstruation and menstrual practices were low. Hypothesized relationships between knowledge and attitude towards menstruation among men; knowledge, attitude towards menstrual practices and adoption among women; cognitive involvement and knowledge of menstrual practices in men and women; and behavioral involvement and knowledge of menstrual practices for men and women were statistically significant. Descriptive statistical analyses, (open full item for complete abstract)

Committee: Srinivas Melkote Dr. (Advisor); I-Fen Lin Dr. (Other); Sung-Yeon Park Dr. (Committee Member); Ewart Skinner Dr. (Committee Member) Subjects: Communication; Health; Marketing; Mass Communications; Mass Media

Doctor of Philosophy, The Ohio State University, 2010, EDU Physical Activity and Educational Services

Students served in juvenile correctional school settings often arrive with histories of trauma, aversive educational experiences, low achievement, and other severe risk factors that impeded psychosocial development, educational progress, and occupational outcomes. Schools serving adjudicated youth must address a higher percentage of severe behavioral health and educational needs than schools serving other populations of youth. Rehabilitation and education are essential to mediate the social and financial dilemmas that may result if youth return to communities unprepared to meet basic societal demands. Research demonstrates that lack of essential supports can lead to recidivism. A vast body of literature over the past thirty years has shown self-management procedures to be effective across school settings, grade levels, and disability identifications. Self -management procedures allow students with disabilities to be actively involved in their educational process and these procedures encourage independence by guiding learners away from external control and toward internal control of behavior (Prater, 1994) which is essential for guiding incarcerated students toward governing their lives more constructively (Houchins, 2001). The present study taught high school age girls with disabilities to self-monitoring on-task behavior during independent practice of math calculation skills. Students received daily feedback regarding productivity and accuracy on assignments. Additional components included goal setting and incentives for goal attainment. A single-subject reversal design was used to evaluate effectiveness of the procedure on on-task behavior (time on-task), academic productivity (percentage of problems completed), and academic accuracy (percentage of problems completed correctly). Results indicated that the intervention was very effective for increasing participants' on-task behavior. A modest to moderate impact on academic productivity was noted across participan (open full item for complete abstract)

Committee: Laurice M. Joseph PhD (Advisor); Gwendolyn Cartledge PhD (Committee Member); Moira Konrad PhD (Committee Member) Subjects: Behavioral Sciences; Cognitive Psychology; Education; Educational Evaluation

Master of Arts (MA), Bowling Green State University, 2008, Psychology/Clinical

Involving supportive others in Behavioral Weight Loss Programs (BWLP) is related to improved participant weight loss (e.g., Black, Gleser, & Kooyers, 1990), however little is known of the influence of naturally occurring (external to the intervention situation) support. Similarly overlooked is the role of social support to the numerous behavior changes required for successful weight loss. The current study evaluated the occurrence (i.e., frequency) and experience (i.e., helpfulness appraisal) of naturally occurring support in relation to behavioral and health outcomes. The primary goals were to examine the support – behavior change relationship for evidence of specificity and to evaluate the utility of measuring support appraisals as a tool for identifying resource-need match. Within these objectives, another aim of the study was to identify potentially distinct contributions of different sources of support. Hypothesis testing returned largely null results. Small sample size and low power are important considerations in explaining the null findings. However, attention is also called to other possible factors, including stage of behavior change and the “obesogenicity” of modern environments, which may have contributed to the current null findings and warrant further attention.

Committee: Robert Carels (Advisor) Subjects: