Doctor of Philosophy, The Ohio State University, 2020, Public Health

The federally-funded health center program aims to deliver high-quality, culturally-competent primary health care services, as well as ancillary health and supportive services, such as care coordination, health education, and oral health care, to all persons regardless of their ability to pay. Federal funding for community health centers (CHCs) has been uncertain for decades. The Affordable Care Act (ACA) Medicaid expansion provided CHCs with new opportunities to expand their patient revenue, broaden their reach, and fulfill their mission. However, relatively little is understood in the scholarly literature about how the ACA Medicaid expansion affected care delivery at CHCs, especially beyond the first few years, post-expansion. In this dissertation, I attempted to examine aspects of health care utilization and quality of care at CHCs following the ACA Medicaid expansion, and in a broader sense, to explore in different ways whether the ACA Medicaid expansion helped facilitate CHCs' pursuit of mission. Chapter 4 examined whether the ACA Medicaid expansion created lasting increases in the percentage of CHC patients covered by Medicaid and lasting decreases in the percentage of uninsured adult CHC patients in expansion-state CHCs, compared to non-expansion-state CHCs. The results of the study showed that, on average, Medicaid expansion increased Medicaid coverage among adult CHC patients in the expansion-state CHCs by 12.0 percentage points and decreased uninsurance among adult CHC patients by 7.7 percentage points by 5-years post-expansion, compared to non-expansion-state CHCs. Moreover, the predicted percentage of expansion-state CHC adults covered by Medicaid increased to a peak at 2-years post-expansion and then slightly decreased and plateaued from 3-to-5-years post-expansion. Expansion-state CHCs retained most expansion-covered patients over time, and greater state-level enrollment efforts were shown to be important for enrolling Medicaid-covered CHC patients. (open full item for complete abstract)

Master of Arts (MA), Ohio University, 2009, International Development Studies (International Studies)

Presently, Ghana is confronted with a health crisis, driven by enormous burden of diseases and poverty. The current health care system, predominantly modern, has proven inept in meeting the needs of Ghanaians as many continually die from preventable diseases. The quality of services available, the geographical access to this care, efficiency of service delivery, and availability of adequate resources to finance and sustain health systems, have placed unnecessary barriers to access available care in Ghana. Continuous decline of health care has consistently failed to compliment the increasing population growth. As a result, the deteriorating healthcare system has forced the majority of the population to seek alternative healthcare services. Traditional health care system, which is the oldest medical system in the country, has once again become the initial avenue of accessing care for about 75% of the population. Traditional health care system is effective, cost-effective, culturally accepted, and have consistently been argued as an effective system that can aid and complement governments's efforts at ensuring equitable health care. Yet, it remains unintegrated into the current health care structure, and hence remains untapped. This study sought to analyze and evaluate the importance of full integration of traditional health system as a way of maximizing health care accesses, use, and availability to the public. The study identifies the historical trends of both health care systems, reviews current health policies and examines the benefits of integrating traditional health care system into the mainstream health care delivery. The method employed in this study was qualitative one, using semi-structured interviews to gather data. Thirty-three respondents consisting of 12 individuals and 2 focus groups (from Tema Municipality), and 8 key informants (government officials and traditional healers), who uses or have knowledge about the traditional health care system, were se (open full item for complete abstract)

Doctor of Healthcare Administration (D.H.A.), Franklin University, 2020, Health Programs

Mental illness is a growing concern among families in the United States, as one in five children between the ages of 13 and 18 suffer from a severe mental illness (National Alliance on Mental Illness, 2013). That means that 20% of children in the country are suffering from an illness whose treatment is difficult to access. Unfortunately, one-fourth of families report problems finding and initiating services for their children, with wait lists that typically start at three months (American Academy of Child and Adolescent Psychiatry, 2013). Even more troubling is the fact that 80% of children with mental illness do not receive any treatment at all (American Academy of Child and Adolescent Psychiatry, 2013). However, to improve access to treatment, organizations need to feel confident that they can open safe, financially sustainable mental health units. The Children's Hospital of Orange County (CHOC) in California recently opened an 18-bed inpatient psychiatric unit that services children ages 3-17 (Perkes, 2016). Many months of thoughtful consideration occurred to develop this elite and cutting-edge model of care. This researcher developed a specific model to approach pediatric mental healthcare through a different lens, called The Core Value Driven Care Model. The model of care is centered around three pillars of focus firmly built on the groundwork of core values. The pillars are representative of People, Place, and Practice, and are anchored in a foundation of empathy, compassion, trust, integrity, dignity, respect, sincerity, unity, honesty, and open-mindedness, as well as trauma-informed thinking. Implementing the Core Value Driven Care Model in a pediatric mental health unit directly impacts the perception of safety and quality of care being provided. The purpose of this study will be to assess the impact the 11 foundational core values have on employee perception of employee safety, patient safety, and quality of care.

Doctor of Nursing Practice , Case Western Reserve University, 2017, School of Nursing

Aims. The purpose of this study to examine certified nurse practitioners' learning needs related to sexual health concerns, to assess frequency of sexual health interventions, and to evaluate the perceived barriers to the application of sexual health interventions in health care. Design. Descriptive study administered via internet-based questionnaire. Methods. A convenience sample of 574 certified nurse practitioners (CNP) was obtained from Ohio Board of Nursing. The Learning Needs for Addressing Patients' Sexual Health Concerns was used to assess knowledge. The Nursing Interventions on Sexual Health Scale was used to assess the frequency of sexual health interventions used in nursing practice. The perceived barriers to the utilization of sexual health interventions among CNPs were assessed using a checklist based on the literature pertaining to sexual health care in nursing. Results. “The influence of treatment on sexuality” was the highest learning need. “Biopsychosocial factors on altered sexual activity” was the lowest learning need. The frequency of nursing intervention in sexual health care among CNPs is average and the behavioral frequency of nursing intervention decreases from the permission level to the specific suggestion level when evaluating care based on the PLISSIT model. Barriers to sexual health care are similar to what is reflected in the literature. Conclusions. While nurse practitioners have the knowledge to manage sexual health concerns, there is a need for further research. CNPs require comprehensive sexual health education and specialized clinical preparation to manage sexual health concerns.

Doctor of Philosophy (PhD), Wright State University, 2012, Engineering PhD

Patient testing is vital for primary care and serves as a gateway to specialty healthcare. Patient safety is worsened when testing orders (e.g., laboratory, imaging orders) are not tracked, results are lost, or abnormal results lack patient notification and follow-up. Non-standardized testing management reduces resilience; affects clinical outcomes; and increases errors, costs, workload, and delays. To address the need for testing management improvements, this research followed four phases in six objectives: (1) In Phase I initial survey, assess perceptions, attitudes, and behaviors of practicing healthcare clinicians and administrators about testing, safety, and technology; (2) In Phase II system design, design a low-cost system prototype that manages primary care testing processes for individual patients, supports safety and resilience, and measures overall clinic testing performance for continuous improvement efforts; (3) In Phase III laboratory experiment, evaluate system prototype for effectiveness in managing testing management processes, including test ordering, results review, notification, and tracking; (4) In Phase III, evaluate effectiveness of technology specifically designed to enforce, support, nurture, and measure safety- including individual safety awareness, attitudes, actions, resilience, and safety culture; (5) In Phase III, evaluate effectiveness of the testing management system prototype for increasing understanding of overall clinic testing performance; (6)In Phase IV clinical review, evaluate a revised prototype with primary care clinicians for its perceived effectiveness and potential for process, safety, and performance improvements. This research resulted in a test management system prototype that was effective in managing and standardizing testing processes; showed effectiveness for some aspects of safety, situation awareness, and resilience; and was effective in developing user understanding of clinic performance in testing processes. Th (open full item for complete abstract)

Doctor of Nursing Practice, Mount St. Joseph University , 2024, Department of Nursing

Care coordination benefits patients and families (Bronstein et al., 2018). HealthVine is a Care management department in a teaching hospital in a Midwestern American City. The department provides care management and care coordination to over 100,000 pediatric patients. However, the department cannot enroll many patients into its care coordination programs. Other care coordination departments also need help with low enrollment rates. To address the low enrollment issue, HealthVine created a project team to test some interventions. The interventions included: • Creating a checklist for HealthVine team members to conduct a targeted chart review, • Creating an elevator pitch for team members to use when calling a family for enrollment and • optimizing EHR for streamlined and practical use. Upon completing the interventions, the project team collected data from a run chart, Survey Monkey, and Microsoft Forms. Enrollment rates increased from 0.72% to 3%, and staff satisfaction increased from 24% to 95%.

Doctor of Nursing Practice Degree Program in Population Health Leadership DNP, Xavier University, 2021, Nursing

Time banditry is defined as the misuse of time doing non-task related activities during paid work; this is also considered to be "stealing time" (Martin et al., 2010). Notably, time banditry may happen in all employment sectors and in various forms. Each time bandit steals time for a marginally diverse reason. Although the motives may be different between individuals, the concept is the same. This DNP project implemented an Electronic Visit Verification (EVV) system to replace the existing time management methods used by organizations. The goal was to facilitate consistency in the duties of CNAs who cared for homebound elderly residents and reduce time banditry. EVV is a computer-based software that enables real-time touchscreen smartphone contact between workers (CNAs) and the managers (nursing supervisor). EVV functions as a medium to monitor home care workers' attendance, current client situation, data entry, and care plan coordinating. CNAs log-in at the time of arrival at the work location indicating the start of work and log out at end of work – completing task. The clients are expected to countersign with the CNAs to confirm agreement with time entry. Findings from the outcome of patient surveys suggests that customers verbalize satisfaction with the EVV use because CNAs are arriving to work on time, staying for the entire scheduled shift, and completing task. Stakeholders state that billing is more accurate and organizational growth becomes promising.

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.

PHD, Kent State University, 2017, College of Public Health

Introduction: Up to 29.5% of U.S. adults are physically inactive. Physical inactivity is associated with excess mortality and morbidity and may contribute an estimated $131 billion in health care expenditures annually. Exercise prescriptions and referrals are an economical solution to physical inactivity, and several health care provider associations and proposed government policy initiatives support adoption of exercise prescriptions. Yet as few as 14% of primary care providers prescribe exercise or make exercise referrals. The purpose of this pilot study is to identify provider characteristics, knowledge, perceived barriers, practices, and needs related to place-based exercise prescription and referral to exercise either at a specific location, or to an exercise professional. Methods: An 88-item questionnaire was developed and administered electronically and in paper format to alumni of a university's nurse practitioner program and two hospital systems' networks of primary care physicians and nurse practitioners. Descriptive statistics were generated regarding clinical practices related to patient exercise and providers' perceived needs related to exercise prescription and referral. Factor analysis was conducted to identify underlying constructs. Bivariate analyses were utilized to identify variables significantly related to exercise prescription and referral. A binomial logistic regression was performed to determine factors related to whether or not providers refer patients to place-based exercise. Results: Responses were received from 166 providers; 61.5% were female, 86.9% were white. Respondents' specialties were: family medicine (20.6%), internal medicine (27.8%), nurse practitioner (29.4%), and other (22.2%). Overall, 14.8% of providers prescribe exercise to at least some of their patients and 54.3% refer patients to specific exercise locations or professionals. Almost 90% ask about patient exercise, 64.3% document patient exercise, and 20.8% assess (open full item for complete abstract)

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2015, American Culture Studies

Offline racial health and health care disparities have been well documented and researched. However there has not been as much research into how these offline disparities have translated into online environments. Specifically, this study examines health websites, with a focus primarily on WebMD.com, that have become ubiquitous to the process of obtaining health information which has become self-propelled by the consumer. The model of health care where by the medical professional serves a patient their knowledge in a one-way model has largely been phased out in favor of a fluid exchange in which patients also bring medical knowledge and information to the table. Overwhelmingly, the information that the patient contributes comes from cyber research from websites such as WebMD.com. The Health 2.0 movement has furthered the expectation of patients to be proactive members of their health care who should research their conditions, symptoms, and treatments in addition to seeking medical professionals advice. Health 2.0 is predicated on users data input into online health care environments. Users interact with each other to exchange information and provide medical support to each other in what seems to be a radical departure from a traditional paternalistic model of health care that helps to reinforce institutional racism that perpetuates racial health and health care disparities. However examining a health website such as WebMD.com reveals that not only has cyberspace not created a radical egalitarian arena for health information exchange, health care websites have largely perpetuated the same model of health care information exchange that information exchange in cyberspace in general and Health 2.0 specifically attempts to circumvent. Using Michel Foucault's idea of the medical gaze, I analyzed WebMD.com as a site in which patients can learn the medical gaze and thus procure medical knowledge the same way that was previously limited to those entering medical school. As su (open full item for complete abstract)

PhD, University of Cincinnati, 2015, Education, Criminal Justice, and Human Services: Health Education

For this dissertation two studies were conducted. The first part of the abstract addresses the manuscript from the first study and the second part addresses the second manuscript from the second study. Manuscript one aimed to explore the relationship between demographic variables, literacy, numeracy, general health status, health care access factors and marketplace utilization among citizens and immigrants in the United States. Manuscript two examined and compared the relationships between immigrants' and citizens' awareness, perceptions, concerns in relation to the Affordable Health Care Act and Marketplace utilization. Manuscript One Abstract Introduction: This study aimed to explore the relationship between demographic variables, literacy, numeracy, general health status, health care access factors and marketplace utilization among citizens and immigrants in the United States. Method: This study was carried out as a secondary data analysis of an internet based survey of U.S. residents who responded to the 2014 fourth quarter Urban Institute's Health Reform Monitoring Survey (HRMS). A subsample of immigrants who participated in the HRMS was selected for secondary data analysis (n= 369). Twenty-one outcomes of interest were selected including demographic characteristics, literacy, numeracy, health status, health care access, and Marketplace utilization. Results: Regression analyses indicated that numeracy and age were predictors of general health status among immigrants. Chi square analyses indicated that age is associated with health care access among this sample of immigrants. A minority of immigrants report utilizing the Marketplace to purchase their health insurance coverage. Discussion: Further research is needed to explore these relationships with a more representative sample of immigrants. Manuscript Two Abstract Introduction: This study examined and compared the relationships between immigrants' and citizens' awareness, perceptions, concerns in relation (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2015, Public Health

Compared to children without special health care needs, children with special health care needs (CSHCN) typically utilize a wider range of health services and a higher quantity of those services due to the health conditions and health-related difficulties that CSHCN experience. CSHCN are also more likely to experience inadequacies in insurance coverage, to delay care, and to have unmet needs. These health services issues can lead to outcomes of care that are worse for CSHCN than for children without special health care needs. The medical home is a model of care delivery that has been promoted as being beneficial for CSHCN, particularly with respect to improving care coordination and providing more comprehensive care. This dissertation involves three distinct, but related studies of health services issues experienced by CSHCN. Study 1 will assess whether particular aspects of a special health condition impact a child's likelihood of having inadequate insurance coverage. Study 2 will examine whether the receipt of coordinated care is associated with reductions in unmet needs for various groups of CSHCN. Lastly, Study 3 will investigate how outcomes of care differ in a medical home versus a traditional setting of care delivery, and whether individual aspects of the medical home are positively associated with outcomes of care for CSHCN. All three studies were based on secondary analysis of data from the 2009/10 National Survey of Children with Special Health Care Needs (NS-CSHCN), which is sponsored by the Maternal and Child Health Bureau, the U.S. Department of Health and Human Services, and the Health Resources and Services Administration.

Master of Arts (MA), Ohio University, 2014, Geography (Arts and Sciences)

The international migration of African health workers has recently received mounting attention from academics and development agencies. While much research exists on push factors of their migration in Africa and the facilitating role played by international recruitment agencies. Little is known about how Africans become health care workers in their new location, how they build and use their job-related networks and how they interact with larger immigrant communities. In an attempt to fill a gap in the literature on the international migration of African health care workers, this thesis has conducted a series of in-depth semi- structured personal interviews and observations of Ghanaian migrants in Columbus, Ohio. This research used a snowball sample method to recruit participants as well as employed a computer-assisted qualitative data analysis. The findings of this research suggest that job related and immigrant community networks play a significant role in the migration of Ghanaian health care workers to the US. Moreover, these networks help to recruit other Ghanaians immigrants who are already in the US to take a career path in the health care sector.

Psy. D., Antioch University, 2014, Antioch New England: Clinical Psychology

In 2009, Gawande published an article in The New Yorker that put the unknown mid-sized South Texas city of McAllen on the map. The article stated that McAllen was one of the most expensive health care markets in the country; it caused such media-frenzy that in a few days President Barack Obama (2009) began citing McAllen in his speeches for health care reform. Gawande concluded that overspending in the area was due to overutilization of medical services. The present study examined whether mental health services are overutilized based on archival data on McAllen's mental health services collected from Medicaid, Tropical Texas Behavioral Health (a McAllen area community mental health center [CMHC]), and The Behavioral Center at Doctors Hospital at Renaissance (a McAllen area private hospital). Findings yielded that diagnostic-related groups significantly impacted the average length of stay, as well as total costs for psychiatric inpatient treatment in McAllen, TX. Schizophrenia spectrum disorders required more days of treatment within the hospital than Bipolar disorders and further more days than Depressive disorders. Correspondingly, inpatient treatment of Schizophrenia spectrum disorders cost an additional $5,554.80 when compared to Bipolar disorders and $9,095.16 more than for Depressive disorders. Additionally, the readmission rate at Doctors Hospital was 26.72%, with nearly 1/4 of patients being readmitted at least once, and nearly 7% had 4 or more psychiatric hospitalizations within a one-year period. This readmission rate was higher than the national average perhaps because of inadequate after-care outpatient treatment in McAllen. Medicaid data showed that Texas consistently failed to contribute any state moneys to mental health spending; and that Massachusetts saw a considerably smaller increase in mental health expenditures over a 10-year period for both inpatient and outpatient services when compared to the United States as a whole (i.e., 26% vs. 260% for (open full item for complete abstract)

Bachelor of Arts, Miami University, 2006, College of Arts and Sciences - Chemistry

Despite its reputation as a leader in groundbreaking biomedical technology and innovative life-extending procedures, the United States today finds itself plagued by a national health care system in dire need of reform. With the number of uninsured Americans burgeoning to over 45 million, policymakers are struggling to ensure wide access, low costs, and first-rate care. With its high level of health care expenditures, the U.S. remains one of the few industrialized states without a universal health care system. The first half of this thesis examines the financing and delivery mechanisms in the health systems of Canada, the Netherlands, France, Germany, and the United Kingdom—with a focus on how they have achieved universal health coverage. The second half of this thesis applies these models in an analysis of how the U.S. can achieve universal health care—with an emphasis on the state-led federalist approach over single-payer, population-based expansions, tax credits, and employer and individual mandate reform pathways.

Master of Technical and Scientific Communication, Miami University, 2010, Technical and Scientific Communication

This report contains four chapters wherein I record my internship experiences as a full-time, paid Community HealthCorps VISTA (Volunteer in Service to America) at the Southeast Health Center. As a VISTA, I expanded and ensured the clinic's capacity to provide quality care to the medically underserved population of Bayview Hunter's Point in San Francisco, California. In Chapter 1, I describe the organizations that sponsored my employment and the nature of my role and VISTA duties. In Chapter 2, I review major projects that I worked on from April 20 to September 15, 2009, the timeframe set aside for my Master of Technical and Scientific Communication internship. In Chapter 3, I describe one major project in detail, the i2iTracks training sessions and tutorials, and I reflect on my internship experiences in Chapter 4.

Master of Science in Pharmaceutical Science (MSP), University of Toledo, 2011, College of Pharmacy

Introduction: Studies have shown that health care disparities continue to persist in the cancer population in the United States. Few studies have been done on disparities in health care resource utilization and expenditures for prostate cancer patients. Examining and reporting potential disparities is important in order to eliminate them. Objectives: To examine possible demographic, socioeconomic and insurance disparities while controlling for self-reported health status and confounding factors, in health care resource utilization & expenditures among prostate cancer patients in the United States using the 2000-2008 Medical Expenditure Panel Survey (MEPS) database. Methods: The MEPS 2000-2008 database was used with a sample of 1018 subjects who had a reported condition of prostate cancer. Logistic and negative binomial survey regression was used to examine differences in utilization. Ordinary least squares survey regression was used to examine differences in expenditures. Medical provider office visits, hospital outpatient visits, hospital inpatient stays and prescribed medicines were separately regressed against race, ethnicity, age, urban/rural location, educational level, poverty status and insurance type, along with controlling for self-reported health status. Results: Black prostate cancer patients had a statistically significantly lower likelihood of having office-based medical provider visits compared to white patients (p = 0.0014), while Hispanic prostate cancer patients had a statistically significantly lower likelihood of having hospital outpatient visits compared to non-Hispanic patients (p = 0.0087). Statistically significant differences in expenditures were also found, where urban prostate cancer patients had statistically significantly higher hospital outpatient visit expenditures compared to rural patients (p < 0.0001). Conclusion: Significant disparities continue to persist in the prostate cancer population, even when controlling for confounding fact (open full item for complete abstract)

Doctor of Philosophy in Urban Studies and Public Affairs, Cleveland State University, 2010, Maxine Goodman Levin College of Urban Affairs

The purpose of this cross-sectional analysis was to determine the importance of spatial accessibility to health care services utilization and to the health status of persons with disabilities. This study utilizes two datasets (Survey of Access to Outpatient Medical Service in the Rural Southeast and Ohio Family Health Survey) to analyze. ArcGIS 9.2 was use to measure spatial accessibility to health care services. Bivariate analysis for health services utilization and health status included t-tests, and Chi-square, as appropriate for the level of measurement. Logistic regression models identified for the three outcomes (health care visit, regular check up visit, and perceived poor health status). The multivariate analyses of "Survey of Access to Outpatient Medical Service in the Rural Southeast" dataset revealed that those residing within an area that had a higher primary physician to population ratio were less likely to have made a health care services visit in the past year. Perceived travel time was significantly associated with poor health status; adults who had to drive longer to access health care services were more likely to perceive themselves to be in poor health compared to adults who were faced with a shorter drive. The analyses of the "Ohio Family Health Survey" dataset indicate that participants of the survey who resided within areas that had a higher primary care physician to population ratio were less likely to perceive themselves to be in poor health. Likewise, those residing in areas that had a hospital located within a 30-minute commute were also less likely to report being in poor health. Further analyses of the Ohio Family Health Survey dataset, which is comprised of data collected from urban and rural areas, revealed that those driving longer to access health care services were more likely to perceive themselves to be in poor health compared to adults who were faced with a shorter drive in urban area. The model of rural areas revealed that those (open full item for complete abstract)

Master of Science, The Ohio State University, 2024, Dentistry

Purpose The goal of this study was to use the secret shopper methodology to better understand the experience of parents of ASHCN when seeking dental care. The aims of this study were as follows: (1) evaluate and quantify the experience for parents of ASHCN in procuring a new patient dental appointment and (2) compare general and pediatric dental office willingness and attitude toward seeing ASHCN. Methods A list of active licensed dentists was obtained from the Ohio State Dental Board which included contact information such as telephone number and address. Only general and pediatric dentists with an Ohio address were eligible for inclusion. A ten percent random sample of 302 dentists was generated and balanced by zip code and specialty. Three members of the research team posed as caregivers calling to make a dental appointment for an ASHCN and each was assigned to one of the three following scripts: A) a 16-year-old patient with no SHCN, B) a 16-year-old patient with SHCN (autism spectrum disorder and ADHD) requiring minor additional supports such as needing headphones or sunglasses during treatment, and C) a 16-year-old with SHCN (cerebral palsy) requiring significant additional supports such as being a wheelchair user. The research team called every selected dental practice with the goal of obtaining a new patient dental appointment for each of the 16-year-old patient scripts. The research team members recorded data directly into REDCap during each phone call. The primary outcomes were the call outcome, the length of the call, and the number of days between when the call was made and when the appointment was offered, if offered. Results The call length and the lead time to first available appointment was significantly longer for Script C. There was a significant difference across scripts with practices increasingly asking for the patient's dental history, behavior history, and insurance status as medical complexity increased. Script C was least likely to be g (open full item for complete abstract)

Doctor of Education, Miami University, 2022, Educational Leadership

This study identifies the assets that principals use to support school based mental health care [SBMH] and makes several recommendations for increasing the efficacy of principals in interacting with SBMH systems and includes their recommendations for improvement in fostering, sustaining, and improving SBMH. Mental health needs are a historically underserved issue that greatly affects the ability of students to learn and flourish. Through a grounded theory analysis within a multiple case study framework, five cases are described and thereafter nine assets were developed as common to the cases informing on the beliefs, competencies, and traits possessed by principals. The identification of these nine assets supports emergent findings of a construct of interactions and describes common factors involved in a principal's support of SBMH.