Doctor of Philosophy, The Ohio State University, 2024, Public Health

Introduction: Human milk is the recommended infant food for the first six months of life. Despite recommendations and known health benefits for infants and lactating parents, only a quarter of the infants in the United States meet the recommended human milk feeding goals. While human milk feeding is often a personal decision, engaging in this health behavior may be shaped by neighborhood- and systemic-level factors. Aims: This dissertation aimed to evaluate the association between human milk feeding behaviors and three factors: (1) neighborhood-level social determinants of health, (2) caregiver-reported social needs, and (3) neighborhood-level food access. Methods: I performed secondary analyses of electronic health record data from infants born from April 2019 through July 2022 who attended a well-child visit at Nationwide Children's Hospital (NCH) primary care clinics during the neonatal period. Infant records were linked to Ohio birth certificate data to obtain maternal demographic information and hospital breastfeeding data. During well-child visits at NCH, caregivers are asked about infant food intake. At each visit where feeding data was recorded in the first two years of life, I categorized an infant's human milk consumption as exclusive, mixed, or none. In Aim 1, neighborhood-level social determinants of health were measured using the Child Opportunity Index (COI) 2.0 and the Area Deprivation Index (ADI). In Aim 2, caregiver-reported social needs were assessed using data from routinely administered social needs screenings performed at NCH. In Aim 3, neighborhood-level food access was assessed using the Food Access Research Atlas. Multivariable interval-censored accelerated failure time modeling was used to evaluate the time to cessation of (1) exclusive human milk feeding and (2) any human milk feeding. In secondary analyses, multivariable logistic regression modeling was used to evaluate the odds of (1) breastfeeding initiation and (2) exclusive b (open full item for complete abstract)

Committee: Maria Gallo (Committee Chair); Fernanda Schumacher (Committee Member); Sarah Keim (Committee Member); Deena Chisolm (Advisor) Subjects: Epidemiology; Public Health

Doctor of Education (Ed.D.), University of Findlay, 2023, Education

The goal of this research was to determine how two well-known theories, Bandura's triadic reciprocal causation model and Maslow's hierarchy of needs, align to the five competencies in Ohio's social and emotional learning standards document. More specifically, to determine if Ohio has integrated core components of researched-based theories within the SEL standards. Ohio's social and emotional learning standards provide a developmental progression across ages and grades from kindergarten to grade 12. This study used a qualitative research approach in which a document analysis was used to look for alignment of the TRC model and hierarchy of needs pyramid. The analysis included examining the content of Ohio's social and emotional learning standards in order to determine the presence of certain words, themes, or concepts derived from both theories. This was performed using manual coding. The results indicated that all three elements (personal, behavior and environment) of Bandura's TRC model align across all of the five competencies. However, not all five levels of Maslow's hierarchy of needs (physiological, safety, love and belonging, esteem and self-actualization) aligned across the five SEL competencies. The implications of this research study may impact the future implementation of Ohio's SEL standards in a positive way. The in-depth analysis of two important theories within educational psychology and their degree of alignment to the Ohio's SEL standards confirms that Ohio has a good foundational framework that now holds some merit and may encourage administrators within Ohio to make the decision to move ahead with SEL standards application.

Committee: Gwynne Rife (Committee Chair); Kara Parker (Committee Member); Amanda Ochsner (Committee Member) Subjects: Early Childhood Education; Education; Elementary Education; Secondary Education

Doctor of Philosophy, Case Western Reserve University, 2023, Clinical Translational Science

Despite growing priority for social risk screening and intervention in pediatric care settings, little attention has been paid to the challenges of these processes in practice. Recent guidance from professional organizations and funders encourages the implementation of Social Determinants of Health (SDoH) intervention in healthcare settings, despite limited evidence regarding which patients are most likely to make use of SDoH intervention services or how engagement with SDoH intervention services influences subsequent healthcare utilization, health outcomes, and experience of care. To address these open questions, this program of research aimed to determine whether greater engagement by families with SDoH intervention services related to stronger connections with the medical home, focusing on an embedded SDoH program's interactions from April 2020 through October 2022 with children obtaining care in an academic pediatric practice serving a population of predominantly urban-dwelling, Black children with public insurance. First, SDoH program data were interrogated to characterize the factors influencing program reach at each stage (screening, intake, and follow up). Second, program data were connected to medical records data to assess the effectiveness of social needs screening and intervention in promoting subsequent adherence to other aspects of preventive care. Finally, longitudinal parent-reported survey data explored how social needs intervention services influenced their relationship with the practice. Review of SDoH program data found that family-reported urgency of needs and activation for social care assistance most strongly predicted subsequent engagement with the SDoH navigation team. Evidence for beneficial impact of that engagement on health care use and health outcomes was mixed, with increased health services use (both preventive and acute) observed among children with positive screens, but gaps in routine immunizations persisted. There was no evi (open full item for complete abstract)

Committee: Mary Dolansky (Committee Chair); Kurt Stange (Advisor); James Spilsbury (Committee Member); Marlene Miller (Committee Member) Subjects: Health Care

Doctor of Philosophy, The Ohio State University, 2020, Environment and Natural Resources

Policy makers, farm family advocates, and researchers have overall focused on resolving issues connected to the farm operation such as access to land or farm transition. The consideration of household level issues, such as difficulties paying for health insurance or saving for retirement, has however been inadequate despite the evidence that these difficulties can negatively impact the development and viability of the farm operation. To work towards a greater understanding of the factors that shape and support family farms, I explore the links between farm household social needs, social policy, and farm persistence in three stand-alone, yet, connected research articles. The farm persistence literature, a body of work with a long tradition of studying how family farms adapt to on-going changes, provides the theoretical foundation of this dissertation. My methodological approach is based on a mix of qualitative and quantitative data and a comparative approach. In the first article, I broadly consider the role of social policy in the farm sector and propose a research framework to integrate social policy into the international family farm research agenda. Then, I focus on health policy, a large component of social policy in Western industrialized countries, and health needs, a major social need, for U.S. farm households as an empirical case. In particular, I assess U.S. farm households' access to health insurance and health care along the life course in the second article and I assess their medical economic vulnerability in the third article. Taken together, my findings point to difficulties accessing and paying for health insurance and health care and a general sense of vulnerability. Farm households of all ages juggle trade-offs between household consumption, savings, and on-farm investments but it is the younger households that are the most vulnerable despite being in better health. Meanwhile, the eligibility for old-age universal coverage (i.e. Medicare) does no (open full item for complete abstract)

Committee: Shoshanah Inwood Dr. (Advisor); Linda Lobao Dr. (Committee Member); Douglas Jackson-Smith Dr. (Committee Member); Jill Clark Dr. (Committee Member) Subjects: Agriculture; Families and Family Life; Health; Social Research; Sociology; Welfare

Master of Arts (MA), Bowling Green State University, 2024, Cross-Cultural, International Education

This research study focuses on exploring the parental struggles that parents of children with disabilities go through when trying to access special education for their children in the educational system of Kenya. The study documents the perspectives of parents through analysis of data anchored within their struggles and experiences as they navigate the system of education to access quality education for their children with disabilities. Based on a phenomenological approach, the study focuses on a sample of eight parents of children with disabilities. Hogan's (2019) Social Model of Disability and Medical Model of Disability help frame the study within the discussion of the experiences of parents of children with disabilities. The findings of this study are presented through specific themes, describing the personal challenges and experiences of these parents followed by an analysis of the same themes. These findings underscore systemic challenges in special education, cultural and societal attitudes and educational outcome and well-being issues faced by parents and their children with disabilities.

Committee: Audrey Roberts Ph.D. (Committee Chair); Chris Willis Ed.D. (Committee Member); Christy Horner Ph.D. (Committee Member) Subjects: Education; Educational Leadership; Special Education

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2024, Psychology

Previous research has found that some motives have a significant relationship with problematic gaming, likely influenced or moderated by other factors. Self-Determination Theory suggests that people are intrinsically motivated to grow and develop themselves under assumption that basic psychological needs (BPN) are met. The basic psychological need sub theory posits that people desire to satisfy needs for competence, autonomy, and relatedness. The gaming motives of socialization and skill development overlap with the relatedness and competence BPNs respectively, and likely play a role in the desire of satisfying BPNs and the relationship between gaming motives and problematic gaming. The current work sought to examine how BPNs relate to both gaming motives and gaming outcomes, and test whether BPN fulfillment would moderate links between specific gaming motives (socialization and skill development motives) and problematic gaming. Results revealed multiple significant correlations between satisfaction of BPNs and symptoms of gaming disorder. The satisfaction and frustration of BPNs were significant moderators of the relationship between socialization/skill building motives, and symptoms of gaming disorder. Findings suggest that the satisfaction and frustration of BPNs should be considered and addressed when observing gaming disorder symptoms, as having methods to satisfy frustrated BPNs aside from gaming alone would likely reduce gaming disorder symptoms.

Committee: Joshua Grubbs Ph.D. (Advisor); Joshua Grubbs Ph.D. (Committee Chair); Eric Dubow Ph.D. (Committee Member); Doug Ewing Ph.D. (Committee Member); Meagan Docherty Ph.D. (Committee Member) Subjects: Clinical Psychology; Psychology

Master of Arts, The Ohio State University, 2022, Medical Humanities and Social Sciences

The classical social model of disability, though it has improved the lives of disabled people, implies that there is a distinct binary between abled and disabled people. Disabilities, however, will affect all living people through birth, accident, illness, or aging. As demonstrated here, it is necessary to look beyond the current models of disability in favor of a new model that indicates that all people, regardless of disability or ability, can reach their fullest potential. A revision of Abraham Maslow's hierarchy of needs provides such a model, effacing the binary of abled and disabled.

Committee: Amy Shuman (Committee Member); Jim Phelan (Advisor) Subjects: Ethics; Literature; Medical Ethics

Doctor of Philosophy, The Ohio State University, 2020, Communication

While obesity is an important public health issue, media use can be a useful way for prevention and intervention. This study takes an ecologically valid, longitudinal, dynamic systems approach to understand the common motivations driving media use and diet in daily life, and their dynamic fluctuations so as to further understand how media use moderates the influence of emotional needs, social needs, and/or mood on caloric intake for consumers with emotional eating tendencies. Building upon prior work (Hedstrom, 2014), two studies further tested and extends the model developed in the prior work to better predict food consumption from media use in daily life. First, a more nuanced operationalization of the main input of emotional needs is introduced to differentiate arousing and relaxing emotional needs, and to identify their different effects on media use and diet. Second, the model includes social needs to investigate the interaction of social and emotional needs along with mood fluctuations to better understand how they impact media use and diet. These additional differentiation and interactions are found to be important for understanding media use and diet.

Committee: Zheng (Joyce) Wang (Advisor); Joseph Bayer (Committee Member); Hyunyi Cho (Committee Member); Shelly Hovick (Committee Member) Subjects: Communication

Specialist in Education (Ed.S.), University of Dayton, 2018, School Psychology

The present study evaluated the effectiveness of a school-based program, known as The Sparkle Effect, that establishes school-based cheerleading and dance teams to unite students with special needs with their typically developing peers. The program aims to build student leaders, promote inclusion in schools, and build students' self-esteem and social relationships through the use of mentoring and physical activity. A specific Sparkle Program in a public school district in southeastern Indiana was evaluated in the present study, using a qualitative design. Observations and semi-structured interviews were conducted to evaluate the effectiveness of the program. Participants reported that participating in the program built student leadership skills, promoted inclusion and understanding, and created a familial connection among students and their peers. Suggestions are made for future research and recommendations for school-based professionals who work with students with special needs are also discussed.

Committee: Elana Bernstein PhD (Committee Chair); Susan Davies Ed.D (Committee Member); Katie Weber Ed.S. (Committee Member) Subjects: Education; Psychology; Special Education

MA, Kent State University, 2017, College of Education, Health and Human Services / School of Lifespan Development and Educational Sciences

The purpose of this study was to gain a deeper understanding of the instrumental support received by parents of children with special health care needs (CSHCN) throughout the life course. The study sample included 489 parents of CSHCN obtained from the Wave III sample and the Refresher sample of the Midlife Development in the United States (MIDUS) survey. The study provided a description of the sources of unpaid assistance for the parents of CSHCN and yielded significant findings regarding variations in support receipt associated with life course variables. Parents receive significantly more instrumental support from informal sources than from formal sources at each stage of the family life cycle. Additionally, a significant positive relationship exists between the amount of support received from formal sources and the amount of support received from informal sources. The receipt of support from various specific sources also demonstrates a relationship with the receipt of support from other specific sources. Finally, life course variables including religious participation and gender were associated with the receipt of support from formal sources, whereas family life cycle stage was associated with the receipt of support from informal sources. Parents from families with young children reported receiving significantly more unpaid assistance from informal sources than parents from families at all other life cycle stages. These findings help inform service providers as to parents who may potentially need assistance securing instrumental support as well as point to potential areas for future research.

Committee: Kelly Cichy PhD (Advisor); Maureen Blankemeyer PhD (Committee Member); Rhonda Richardson PhD (Committee Member) Subjects: Families and Family Life; Health Care; Social Research; Social Work

Doctor of Philosophy (PhD), Ohio University, 2017, Speech-Language Pathology (Health Sciences and Professions)

Adaptive sport and recreational programs provide rich opportunities for communication and participation while also providing enjoyable and meaningful experiences for people with significant physical and communication disabilities. Programs rely on the skills, support, and dedication from community-based volunteers. Active recreation typically occurs in natural outdoor settings which can provide ideal contexts for capturing photos and videos that may be shared with others. The research project employed a distance training called the CAPTURE & Share program. The program provided instruction to volunteers about how to support people with disabilities to effectively collect and share digital artifacts (e.g., photos, videos) during an adaptive sport activity (i.e., kayaking). The first objective was to implement and evaluate the effectiveness of the distance training program for the volunteers. The second objective was to gather the perspectives of volunteers, participants with complex communication needs (CCN), and their caregivers before and after implementation of the CAPTURE & Share program. The project was divided into two studies: (a) implementation of the distance training program; and (b) use and application of the program during a series of recreational activities. An experimental single-subject research design with multiple baselines was used to investigate the training program in study 1 and Participatory Action Research (PAR) provided a framework for the application phase in study 2. During a series of three kayaking lessons, the volunteers implemented their plans and had an opportunity to engage in feedback sessions to share ideas, reflect, and revise their plans. Caregivers and participants with CCN provided their perspectives before and after lessons to better understand their activity patterns relative to capturing and sharing digital media. Results indicated that all volunteers were successful in learning the program as they effectively demonstrated thei (open full item for complete abstract)

Committee: John McCarthy (Advisor) Subjects: Communication; Education; Educational Technology; Recreation; Speech Therapy; Teaching

PhD, University of Cincinnati, 2016, Arts and Sciences: Psychology

The symptomatology and negative outcomes commonly associated with Attention-Deficit/Hyperactivity Disorder (ADHD) have been shown to cause a significant amount of caregiver strain. Social support has been identified as a possible buffer to caregiver strain. Although the benefits of increasing social support for parents of children with ADHD have been noted, the type of social support most needed has yet to be identified. The study has three aims: 1) to further specify the relation between parent reports of caregiver strain and their perceived ADHD-specific social support, 2) to investigate the types of social support parents of children with ADHD report they need given their level of caregiver strain and current level of perceived ADHD specific social support, and 3) to explore parents' interest in using a web-based social support intervention based on their level of caregiver strain. Fifty-one parents (Mage=38.98 years old, SD = 9.51; 94.1% female) completed self-report measures of caregiver strain, perceived ADHD specific support, needs for social support, an item to measure the intent to use the social networking platform, a demographic form, and measures of their child's symptomology and impairment. Our findings indicated that parents with more perceived ADHD specific social support experience less strain. The amount of social support parents reported needing was correlated with the child's symptomology, the amount of caregiver strain, and the level of perceived ADHD support. Parents reported needing a listening ear, information, and parental counseling for their child's ADHD the most, and a majority of the parents (62.75%) reported a strong intent to use the social networking platform if added to the ADHD portal. Therefore, the results of this study suggest that increasing social support interventions for parents would be beneficial to reducing their strain, and introduces the creation of a portal-based platform as one possible approach.

Committee: Farrah Jacquez Ph.D. (Committee Chair); Jeffery Epstein Ph.D. (Committee Member); Monica Mitchell Ph.D. (Committee Member) Subjects: Psychology

Doctor of Philosophy, University of Toledo, 2015, Curriculum and Instruction

Being a gifted high school student means far more than taking hard classes and getting good grades. Gifted high school students have specific social, emotional, and academic needs that make them different than non-gifted students. It was my intent with this phenomenological case study to describe the essence of being a gifted high school student. After studying the lived experiences of gifted high school juniors and seniors in two suburban school districts, I was able to uncover what makes gifted students tick. I learned what the participants viewed as the advantages and disadvantages of being a gifted high school student and what educators can do to help ensure that these students' needs are being met. The three research questions that drove the study were as follows: How do gifted high school students describe what it is like to be identified as gifted? How do gifted students describe the extent to which their needs are being met or are not being met in schools? What are similarities and differences in gifted high school students' experiences in schools that provide their students with Written Education Plans (WEPs) and those schools that do not provide WEPs? A participant survey, classroom observation, and semi-structured interviews were the data collection methods that were used in order to capture the participants' lived experiences. The results of this study revealed that while gifted high school students may be sufficiently challenged through Advanced Placement (AP) classes, their social and emotional needs are often overlooked in schools. Just because a school used WEPs for its gifted students does not mean students' needs are being met. Teachers, counselors, and administrators do not necessarily understand the obstacles that gifted high school students incur daily, such as battling perfectionism and dealing with pressure and competition. Schools and districts need programs in place that will ensure gifted students' social, emotional, and academic ne (open full item for complete abstract)

Committee: Leigh Chiarelott Dr. (Committee Chair); Mary Ellen Edwards Dr. (Committee Member); Lisa Huelskamp Dr. (Committee Member); Marcella Kehus Dr. (Committee Member) Subjects: Education; Gifted Education

PhD, University of Cincinnati, 2001, Arts and Sciences : Psychology

Although participating in mental health case management services has been linked with positive outcomes for individuals with serious mental illnesses, a significant proportion of these consumers drop out of treatment within the first six months. This study evaluated the system's effectiveness in maintaining consumers in services for six months, and assessed consumer outcome after six months. One hundred sixteen individuals with serious mental illnesses served as the participants in the study. They were interviewed at two points in time, once following their diagnostic interview for entry into the case management system, and once after six months had elapsed. Sixty-nine of the participants completed the follow up portion of the study (60%). Participants completed self report measures of quality of life, symptoms, social support, empowerment, service needs and case manager alliance (Time 2 only). At both Time 1 and Time 2 unmet service needs were significantly positively correlated with symptoms and were significantly negatively correlated with quality of life, empowerment, social support, and case manager alliance. A reduction in unmet needs from Time 1 to Time 2 was positively associated with quality of life and social support and negatively correlated with symptoms. Reduction in unmet needs was not related to empowerment or case manager alliance. Individuals who remained in services for six months had significantly fewer symptoms and unmet service needs. However, they did not have significantly higher quality of life, social support, or empowerment at Time 2. No demographic predictors of treatment drop out were found. However, those who dropped out of services had significantly lower quality of life and less social support at intake than those who remained in services for six months. More specifically, those who treatment had less family support. The results indicate that evaluating and addressing consumers self-defined needs is important because it is highly relat (open full item for complete abstract)

Committee: Steffen John (Advisor) Subjects: Psychology, Clinical

Master of Social Work, The Ohio State University, 2010, Social Work

Memory loss disorders, such as Alzheimer's disease and other dementias, are difficult to diagnose and individuals and families can wait years to receive a definitive diagnosis. Without a diagnosis, questions arise as to when these individuals will be provided information about their condition and whether they will have access to disease-specific resources, such as those offered through the Alzheimer's Association. The majority of the existing research that has been conducted on the diagnostic process for dementia has focused specifically on exploring physician attitudes and practices. As such, little is known regarding the needs of individuals with dementia and their family caregivers following this often devastating diagnosis. In this study, the researchers examined caregivers' experiences with the diagnostic process and with accessing information and community resources. A convenience sample was drawn from caregivers identified through the Alzheimer's Association (N=106). Participants completed either a 25-item written or online version of the questionnaire. A cross-sectional survey design was utilized to investigate the experiences of families during and following the diagnostic process for dementia. Survey items focused on the following: demographic and contextual variables; characteristics surrounding the diagnosis including the type of diagnosis, support service knowledge and use of community resources; and the caregiving role. The results of this study indicated that the majority of individuals were receiving diagnoses within one year of pursuing a memory loss diagnosis; however, caregivers felt they were not adequately supported at the time of diagnosis, nor up to one year following diagnosis. Caregivers stated that they were not provided enough information at the time of diagnosis about the disease or how to provide care for an individual with memory loss. A year following diagnosis, the majority of caregivers still felt they did not understand the disease (open full item for complete abstract)

Committee: Keith Anderson A (Advisor); Holly Dabelko-Schoeny (Committee Member) Subjects: Social Work

Doctor of Philosophy, The Ohio State University, 2006, Social Work

This multi-method research study had three goals that were quantified into the six research questions. The first goal of this study was to identify the concrete, work-related needs of social workers in Ohio and if those work-related needs are being met. Level of met-need was examined to determine its relationship to job satisfaction and worker burnout. The second goal of this research was to learn what factors are associated with a social worker joining and remaining a member of the professional association, N.A.S.W. The final goal of this research was to investigate if membership in N.A.S.W. is associated with having a higher level of work-related needs met or moderates job satisfaction and/or anticipated tenure in the profession. This survey quantified the work-related needs of Ohio social workers into the motivational categories classified by Knoke (1988) and most recently tested by Chen (2004) and then rated the specific needs by importance to the worker. The highest category of work-related needs cited were in the informative category followed by solidary needs. Findings indicate that social workers value informative and solidary work- related items and having those needs met increases job satisfaction. Having material needs met does not increase job satisfaction. Having an adequate salary is important but not as important as these other items. Factors positively associated to projected long-term tenure in the social work field revolve around the issues of being valued, feeling safe and being treated fairly. Working more hours than being paid for was negatively associated with projected long-term tenure. Feeling taken advantage of is correlated with a lower level of job satisfaction but is not correlated with intention to leave the social work field. Having opportunities for leadership was associated with longer projected tenure in the field. Being a member of N.A.S.W. was not correlated with having higher met-need.

Committee: Keith Warren (Advisor) Subjects: Sociology, Public and Social Welfare

Doctor of Philosophy, The Ohio State University, 2006, Teaching and Learning

The purpose of this investigation was to explore Latino students' perceptions of the US History curriculum at one high school in the Eastern United States. The ultimate objective was to understand if the US History classes are serving the perceived needs of Latino students. Data were collected for six months. Data sources included observation notes, interview transcripts from students, teachers, administrators, and a State Board of Education member, the researcher's journal, and document analysis of the State Social Studies Standards and a practice version of the State Graduation Test. This study was influenced by Latino Critical Theory. LatCrit builds on the five themes of Critical Race Theory while adding perspectives unique to Latino experiences in the United States such as language acquisition, cultural background, gender, ethnicity, immigration status, and colonial experience. A major finding of this study was that the US History curriculum is or is not meeting student participants' needs in different ways. The students in Group One stressed the basic need to learn English. Group Two student-participants wanted their culture to be present so that White students would learn about them. Group Three students wanted to learn in more interactive ways, with groups and flashy videos. Students at Crawford did not have an adequate framework around which to make sense of race, racism, and racial tensions. The presence of how race was talked about, and the absence of how race was not talked about, led to negative stereotypes against Latinos based upon ethnicity, immigration status, and native language. The student-participants in all Groups wanted to talk about race. They wanted to talk about their “positive invisibility” at Crawford—that is, the absence of affirmative constructions around their ethnicity, country of origin, and language. The findings suggest that there is a need for more studies with Latino students that focus on the aspects of Latino Critical Theory.

Committee: Steven Miller (Advisor) Subjects: