Browsing by Author "Parrish, Danielle E."
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Item A Mixed Methods Investigation of the Impact of Neurocognition, Gender Role Conflict and Self-Identity on Psychosocial Adjustment to Traumatic Brain Injury(2014-05) Pappadis, Monique Renae; Leung, Patrick; Epstein, Maxine W.; Parrish, Danielle E.; Sander, Angelle M.Many persons with traumatic brain injury (TBI) experience substantial emotional distress and psychosocial adjustment difficulties. The contribution of alterations in gender roles and self-identity to psychosocial adjustment has been hypothesized, but not empirically investigated. To address this gap in the research, the current study: (1) assessed experiences of gender role conflict and changes in sense of self after TBI, (2) assessed gender and racial/ethnic differences on gender role conflict and changes in sense of self (3) investigated the mediation effects of cognitive functioning and avoidant coping, and (4) tested a moderated-mediation model of psychosocial adjustment by gender and race/ethnicity. Using an equal-status, concurrent mixed-method approach, 60 persons with TBI, who were at least 3 months post injury, participated in a semi-structured interview regarding the gender role conflict and self-identity after TBI, brief neuropsychological assessments of cognitive functioning, and self-report measures on gender roles, gender role conflict, sense of self, coping, acceptance of disability, anxiety, and depression. Using quota sampling of men and women, forty-eight of the sixty participants completed qualitative interviews based on their racial make-up and stage of recovery. An overall model using structural regression modeling was utilized to test meditational and moderated mediation effects of factors influencing psychosocial adjustment to TBI. Persons with TBI reported gender role conflict and changes in sense of self, which impacted their adjustment to TBI. Avoidant coping fully mediated the relationship between self-identity and psychosocial adjustment. A theory of Reconstructing Identity after TBI emerged from the data, which has implications for clinical practice, service delivery and identifying key factors associated with psychosocial adjustment of a diverse sample of persons with TBI.Item Advancing the Integration of Religion and Spirituality in Mental Health Care: Measurement and Current Implementation(2014-05) Oxhandler, Holly Kay; Parrish, Danielle E.; Achenbaum, W. Andrew; Pargament, Kenneth I.; Torres, Luis R.Research on religion, spirituality, and health indicates that assessing and discussing clients’ religion and spirituality (R/S) in practice can improve client outcomes, and that clients prefer such integration. However, few social workers have received this specialized training. This dissertation is the first study to holistically understand social workers’ orientation toward religious/spiritually integrated evidence-based practice, including their attitudes, behaviors, perceived feasibility, and self-efficacy. Consisting of three manuscripts, this dissertation includes: 1) a literature review on social work practitioners’ integration of R/S; 2) the results from the validation of the Religious/Spiritually Integrated Practice Assessment Scale; and 3) a description of the views and behaviors concerning the integration of clients’ R/S among a national sample of LCSWs. Findings highlight a need to expand training for social workers and allied fields on the use of ethical and effective integration of clients’ R/S into treatment. Implications for social work education, practice, and research are provided.Item Behavioral Health Risk Assessment and Estimation: Validating an Integrated, Multi-Risk Factor Approach aided by Technology(2017-12) Putnam, Kathleen D.; Leung, Patrick; Parrish, Danielle E.; Robichaux, René J.High rates of behavioral health problems in the U.S. require integrated, multi-dimensional approaches. The study of behavioral health risk assessment and estimation aided by technology has the potential to inform assessment and management of behavioral health problems toward the goal of reducing adverse outcomes. The objective of this study is to inform evidence-based behavioral health risk assessment and estimation. This research examines the U.S. Army Medical Command data within the Behavioral Health Risk Management module (BHRM) to explore behavioral health risk assessment and estimation aided by technology. Analyses are conducted on BHRM data from the records of 30,263 U.S. Army active duty, Guard and Reserve service members assigned to military medical units (U.S. Army Warrior Transition Units) between September 1, 2009 and November 12, 2013. To test risk assessment, responses on the BHRM intake tool (Behavioral Health Risk Assessment-Questionnaire / BHRA-Q) are used to test prevalence, associations, internal reliability and questionnaire’s factor group structure. To examine risk estimation, statistical tests are completed on the prevalence and correlations of risk estimates by the BHRM and clinical providers as well as the predictive properties of demographic variables toward risk estimation. Hypotheses are supported for significant relationships among behavioral health risk variables (r = .40); good fit of the data to the eight-factor group structure of the BHRA-Q (Comparative Fit Index = 0.969; Tucker-Lewis Fit Index = 0.967; Root Mean Square Error of Approximation = .029 [90% Confidence Interval 0.029 - 0.030]); significant correlations among BHRM and provider risk estimates (large or medium effect size of BHRM on provider estimates); and three significant demographic predictors of risk estimation (race, religion and military service component). Internal reliability of BHRA-Q is supported (Cronbach’s α = .897). This study tests data related to an integrated, multi-risk factor behavioral health risk assessment questionnaire (BHRA-Q) and risk estimation aided by technology (BHRM). Findings support behavioral health risk assessment and estimation using evidence-based / informed multi-risk factor assessment, aided by technology, to inform clinical decision making. Although demographic variables are not strong predictors of risk estimation, as grouped and tested, further study is recommended.Item Condom Use Among U.S. Young Adult Black Women: An Integrated Cognitive Approach(2012-05) Loudd, Grace 1980-; Epstein, Maxine W.; Leung, Patrick; Parrish, Danielle E.; Buzi, RuthThis study examines how cognitive influences such as sexual self-schema, HIV-related stigma, perception of HIV risk and condom sexual self-efficacy influence condom use at last sex among young adult Black women. An integrated theoretical framework consisting of The Health Belief Model, Social Cognitive Theory and Intersectionality Theory were presented to explore how these cognitive influences impact condom use at last sex among young adult Black women. The present study was based on a secondary data analysis collected by the Baylor College of Medicine Teen Clinic located in Houston, TX. Young adult Black women with high condom sexual self-efficacy are 33.2% more likely to report an increase in condom use at last sex after controlling for sexual self-schema, HIV-related stigma, and perception of HIV risk.Item Efficacy of an Integrated Sleep and Anxiety Intervention for Anxious Children: A Pilot Randomized Controlled Trial(2018-05) Clementi, Michelle A.; Alfano, Candice A.; Viana, Andres G.; Lu, Qian; Parrish, Danielle E.Less than optimal response rates and long-term outcomes following treatment for child anxiety disorders suggest that interventions may need to target more precise underlying mechanisms that maintain anxiety in order to improve treatment outcomes. Children with anxiety disorders report high rates of sleep-related problems and evidence suggests that sleep may impact exposure-based treatment outcomes given the role of sleep in facilitating extinction learning. Thus, addressing sleep as part of anxiety-focused interventions may produce superior outcomes in terms of both anxiety and sleep. Although three studies have shown purely anxiety-focused interventions improve sleep-related problems, wide developmental ranges, lack of control groups, and a proxy measure for sleep are notable limitations. Preliminary findings support the efficacy of Targeted Behavioral Therapy (TBT), an integrated intervention that targets sleep problems and anxiety in children with generalized anxiety disorder (GAD). The current pilot study used a randomized, controlled design to examine the efficacy of TBT compared to ‘gold standard’ cognitive-behavioral therapy (CBT) for anxiety among 20 children (ages 6-12) with primary GAD. Assessments were conducted at baseline, post-treatment, and 6-month follow-up, which included diagnostic interviews, multi-informant measures, and objective sleep monitoring (i.e., actigraphy). Sleep-related questions were also collected on a weekly basis, as well as more comprehensive assessment of sleep and anxiety at mid-treatment. Results indicate that sleep, anxiety, and global functioning significantly improved across both groups from baseline to post-treatment, and improvements were maintained at 6-month follow-up based on moderate to very large effect sizes. Objective sleep onset latency also decreased marginally for both groups at post-treatment. The TBT group demonstrated a significant decrease in child-reported anxiety from mid-treatment to post-treatment (i.e., after the sleep intervention) that was not observed in the CBT group. A linear decrease in weekly bedtime problems was observed for nearly twice as many TBT participants compared to CBT participants, suggesting progressive improvement in bedtime problems across 16-weeks of treatment with TBT. Findings demonstrate the potential utility of anxiety interventions for improving some sleep-related problems, but raise questions about the nature of sleep disturbances in anxious youth and specific aspects of sleep to be targeted during intervention. Future directions and limitations are discussed.Item Exploring the Interrelationships Among College Students' Attachment Orientations, Sexual Motives, and Sexual Risk-Taking(2018-08) Powell, Elisabeth; Lopez, Frederick G.; Smith, Nathan Grant; Wiesner, Margit F.; Frankel, Leslie A.; Parrish, Danielle E.Background: The sexual risk taking behaviors and attitudes of college students are important phenomena to examine due to the potential for negative outcomes, including contraction of STIs or unintended pregnancy. Purpose: As most of the current research on college students’ sexual behaviors has been descriptive and atheoretical, this investigation conducted an attachment theory-guided study of the interrelationships among their adult attachment orientations (i.e., relative levels of attachment avoidance and attachment anxiety), sociosexual orientation (i.e., domain-specific perspectives on uncommitted sex, which varies from restricted to unrestricted), sexual motives, and their sexual risk behaviors (e.g., frequency of condomless sex and casual sex). Methods: Six-hundred and thirty undergraduate students between the ages of 18 to 24 at the University of Houston participated in this study by completing online measures assessing adult attachment, sociosexual orientation, sexual motives, and sexual risk behaviors. Results: Findings indicated that insecure attachment (i.e., high levels of attachment avoidance and attachment anxiety) was related to some, but not all, aspects of sexual risk-taking behaviors, and also related to a less restricted sociosexual orientation in some domains. Additionally, there was evidence of an indirect effect of adult attachment orientations on sexual risk behaviors and attitudes through theoretically-expected sexual motives. Lastly, participants’ gender moderated the indirect effects of sexual motives in explaining the relationship between attachment anxiety and one sexual risk behavior (i.e., use of alcohol prior to sex). Conclusion: Adult attachment orientation influences motives for engaging in sex, attitudes towards sex, and participation in sexual risk behaviors. Several important implications of these findings for future research and clinical practice are discussed.Item Health, Wellness, and Quality of Life Satisfaction among Persons Receiving Medication-Assisted Treatment(2018-05) Patrick, Rhonda G.; Robbins, Susan P.; Rubin, Allen; Parrish, Danielle E.Purpose This study explores the health, wellness, and quality of life (QoL) of opiate-dependent individuals who are receiving medication-assisted treatment for opioid use disorder. The study assesses longitudinal improvement of QoL and the influence of demographic, psychosocial, drug, and health-related variables on individuals' QoL. Methods This is a quantitative longitudinal study of adult patients enrolled in two outpatient opioid treatment programs (OTP) located in Texas. The patients were receiving medication-assisted treatment for opioid use disorder. The study includes analysis of patient psychosocial and demographic information collected at the time of the patient’s initial enrollment in the program and analysis of QoL assessments collected from patients annually in 2013, 2015, 2016, and 2017. Results Although there were some small long-term changes in the six dimensions of the patients’ QoL, these changes appeared to have limited practical or clinical significance. Several psychosocial stressors, including anxiety, alcohol use, non-prescribed opioid use, being physically abused as a child, and childhood exposure to substance use had statistically significant effects on patient QoL, however, these effects appeared to have limited practical or clinical significance. Conclusions Ultimately, this study has revealed that individuals receiving medication-assisted treatment (MAT) for opioid use disorder need psychosocial supports throughout the entirety of their treatment, regardless of the length of the episode. A satisfactory QoL is mediated by psychological well-being. Consequently, a more holistic approach to MAT is recommended, which goes beyond pharmaceutical maintenance and medical care to include special attention for psychological complaints and trauma.Item IDENTIFYING THE LEGACY IN PATIENTS WITH CO-OCCURRING DISORDERS AND EXAMINING CHANGES IN LIFE SATISFACTION AND SELF-EFFICACY(2012-12) Franklin, Felina 1983-; Cheung, Monit; Epstein, Maxine W.; Parrish, Danielle E.Roughly 50 percent of individuals diagnosed with severe mental disorders are affected by substance abuse, with 29 percent abusing alcohol or drugs. Social isolation, discrimination, physical illness, and financial worries place adults at risk for addiction and mental illness, and interventions focused on legacy with adults with co-occurring disorders may help to alleviate these concerns. The word legacy as related to this study means a set of past glories and memories that can be explicitly passed to a person’s next generations including genetics, materials, values, culture, and life stories. Published literature on legacy of adults with co-occurring disorders is nonexistent. The purpose of this study was to uncover the legacy adults with co-occurring disorders possess to manage life stresses. A framework utilizing existential, gestalt, and narrative theory will serve to discuss the theoretical importance of legacy. An experimental study was conducted to test a Legacy intervention’s impact on life satisfaction and self-efficacy. Seventy patients with co-occurring disorders were randomly selected into two groups: ordinary partial hospital program (PHP) intervention or Legacy intervention (which combines PHP with Legacy intervention). Both interventions included 10 sessions over 5 weeks and were offered for three cohorts (about 10-15 patients each). The outcome measures included: sense of legacy, life satisfaction and self-efficacy. The legacy definition for the intervention subsample was consistent with existing literature; however, several unique themes were also identified within this population. Life satisfaction and self-efficacy scores increased overtime and were statistically significant within the experimental group; however, not significantly different statistically when compared to the control group changes over time.Item Impact of Experimental Sleep Extension on Adolescent Social Emotion Regulation(2017-08) Reynolds, Katharine C.; Alfano, Candice A.; Viana, Andres G.; Derrick, Jaye L.; Parrish, Danielle E.Approximately 80% of adolescents do not receive adequate sleep. Sleep loss is particularly detrimental to emotional functioning, yet examination of the protective qualities of increased sleep are lacking. The current study sought to expand existing knowledge in this area by comparing teens assigned to either sleep extension (SE) or typical sleep (TS) conditions on multimodal measures of mood, emotional reactivity, and emotion regulation within a social context. A total of 30 adolescents were enrolled. Baseline measures of psychological symptoms, sleep problems/disorders, and mood were completed prior to 7 nights of at-home, typical sleep (Phase 1; baseline phase). Participants were then randomized to either SE (n = 20; required to sleep additional 30 minutes) or TS (n = 10; no sleep directions given) for 5 nights (Phase 2; experimental phase). A total of 10 participants randomized to SE were excluded due to non-compliance with sleep manipulation, resulting in a final sample of n=20 adolescents. Participants returned to the lab following Phase 2 for an assessment of emotional reactivity and emotion regulation via a computerized task (frustrating computer game) and two computerized social interactions (naturalistic and manipulated interactions) designed with specific emotional goals. Both subjective and objective measures of emotion were collected. Results indicated that participants in the SE group displayed greater (i.e., more appropriate) negative facial expression (large effect size) during the frustrating computer game. More effective emotion regulation was also detected in the SE group, demonstrated by an increase in subjective ratings of valence and arousal and objective language (word count) during a goal directed social interaction relative to a naturalistic interaction task (medium effect sizes), even after engaging in a frustrating computer game. These patterns were not observed in the TS group. Together, results suggest that an additional 30 minutes of sleep for 5 nights assisted adolescents in up-regulating positive affect in order to meet social interaction goals. These findings may have meaningful implications for adaptive peer functioning and reduced affective risk during the vulnerable socio-emotional period of adolescence. Although findings need to be replicated in larger samples, preliminary results suggest that an additional 30 minutes of sleep may improve emotion regulation skills in healthy adolescents.Item Legal Decision-Making in Child Sexual Abuse Investigations: Factors That Influence Prosecution(2014-05) Duron, Jacquelynn; Cheung, Monit; Parrish, Danielle E.; Sampson, McClain M.This mixed-method, multiphase study explored factors associated with child sexual abuse cases that are accepted for prosecution. Prosecution of child sexual abuse is the most consequential approach communities have for addressing perpetrators, yet as many as 72% of perpetrators evade prosecution despite evidence of the crime (Cross, Walsh, Simone, & Jones, 2003). In order to explore the decision to prosecute, quantitative and qualitative data were sequentially integrated across three phases of study. This research incorporated prosecutor perceptions surrounding influential factors to analyze 100 child sexual abuse case records and forensic interviews for children who provided a disclosure through a Children’s Advocacy Center. This exploration concluded with prosecutor reviews of 10 prosecuted cases. Analytic methods included logistic regression modeling to determine predictive factors associated with a decision to prosecute and framework analysis to further confirm and expand upon the factors found to influence prosecution. Findings across all phases of study indicate that prosecution is most strongly predicted by caregiver support, the availability of other evidence, and family engagement in services. Additionally, emergent themes indicate that the decision to prosecute requires an ongoing evaluation of the evidence and a balanced approach. These findings present opportunities for multidisciplinary teams of professionals to provide assistance to families who are likely to interface with legal proceedings. Findings support prosecution of sexual abuse when appropriate as one component in a system wide approach to child sexual abuse prevention.Item Longitudinal Relations between Infant Temperament and Child Internalizing and Externalizing Symptoms: The Role of Parental Conflict Tactics and Intimate Partner Violence(2018-12) Hanna, Abigail Elizabeth; Viana, Andres G.; Alfano, Candice A.; Parrish, Danielle E.Background: The present longitudinal investigation examined direct and indirect effects of parental conflict tactics and intimate partner violence (IPV) in the relation between infant temperament and internalizing and externalizing (I/E) symptom trajectories in a diverse sample of children at risk for maltreatment. Method: Participants included 499 mother (36.1% White; 44.3% single; 34.1% employed) and child (51.1% female; 31.7% White) dyads from the LONGitudinal Studies of Child Abuse and Neglect (LONGSCAN; Runyan et al., 1998) dataset. Mothers completed a measure of child temperament between infancy and the child’s fourth birthday and a checklist of I/E symptoms when the child was 6, 8, 10, and 12 years old, respectively. Children completed a self-report measure of IPV exposure at age 6, and mothers reported on parental use of aggressive conflict tactics when the child was 8 years old. Results: Multi-level modeling revealed a significant main effect of temperament on the cubic trajectory of internalizing symptoms. Post-hoc slope probing revealed that children with higher levels of difficult temperament evinced a sharper growth in internalizing symptoms during the study period. Finally, multilevel modeling of externalizing (but not internalizing) symptoms revealed a significant temperament*IPV*linear time interaction, such that low difficult temperament/high IPV children evinced the most pronounced growth in externalizing symptoms over the course of the investigation. Surprisingly, both the high difficult temperament/high IPV and high difficult temperament/low IPV groups experienced sharp decreases in externalizing symptoms over the study period. Conclusion: Findings underscore the role of difficult temperament and IPV on the trajectory of I/E symptoms, yet also highlight the need for a more comprehensive assessment of temperament and a multimethod approach to IPV to more clearly delineate the specific role of these variables above and beyond relevant covariates.Item Patient Access to Medical Information: A Multi-Perspecitive Study(2014-05) Giardina, Traber Davis; Parrish, Danielle E.; Achenbaum, W. Andrew; Sittig, Dean F.Recent U.S health care policy emphasizes increased patient access to medical information to empower patients and improve quality of care. However, little is known about what access should consist of, how these systems will impact patients and physicians, and whether their use leads to better outcomes. Furthermore, the discrepancy between the 85 percent of Americans who use the internet and the 10 percent who access a patient portal is striking, suggesting a need to better understand barriers and facilitators concerning the use of patient portals. This three article dissertation builds upon existing research by: 1) providing a systematic review of the literature to determine the impact of patient-accessible records on quality of care; 2) identifying physician perceptions of patients’ access to test results; and 3) exploring patients’ experiences using portal-based test result notification. Despite a lack of evidence in the literature, psychological harm to patients is a major concern for both physicians and patients, especially as it relates to the release of sensitive test results. As portals continue to evolve, it is important to address both patient and physician concerns to facilitate acceptance and use, and to ensure that patients understand the medical information they are accessing. These findings suggest important considerations for health professionals, including medical social workers, who may be able to leverage this technology to engage patients in their care.Item PREDICTORS OF PHYSICAL ACTIVITY DURING PREGNANCY IN OVERWEIGHT AND OBESE WOMEN(2014-12) Saher, Najmus; Ledoux, Tracey A.; Hernandez, Daphne C.; Parrish, Danielle E.Background: Obesity is a nationwide problem. More and more women are overweight/obese during pregnancy. It is important to target behavioral interventions during pregnancy as women are more motivated to make behavioral changes, for the wellbeing of themselves and their baby. Physical activity is well established intervention to fight the problem of obesity. The purpose of this study is to find predictors of physical activity during pregnancy among overweight/obese women using the health belief model (HBM). The proposed predictors knowledge of risks of obesity during pregnancy, perceived susceptibility, and pre-pregnancy BMI measured the three constructs of the HBM, perceived severity, perceived susceptibility and perceived barriers respectively. Method: Secondary data analysis was performed on data collected from a previous study. Only overweight/obese pregnant women (N=164) from the sample were included in the study. The variables from the study were taken from the items on a questionnaire that the women completed in the original study. Descriptive analyses were performed to determine participant characteristics. Univariable analyses (t-tests and chi square tests) were performed to find any covariates from the demographic variables. Logistic regression was performed to determine if the independent variables, knowledge of obesity risk in pregnancy, perceived susceptibility to risk and pre-pregnancy BMI are the predictors of physical activity during pregnancy, controlling for any covariates. Results: Our results indicate that none of the proposed predictors have a significant relationship with the dependent variable. Discussion: Identifying predictors of physical activity (PA) during pregnancy can lead to informed behavioral interventions. This study uses only three constructs of the HBM to predict PA during pregnancy. Future studies should aim for a better design and reliable measures to find predictors of PA during pregnancy and should include variables that measure all constructs of the HBM.Item Reintegration into Civilian Life among Returning Veterans: The Roles of Posttraumatic Stress Disorder and Traumatic Stressor Exposure(2017-12) Ma, Kit Ying; Cheung, Monit; Parrish, Danielle E.; Sampson, McClain M.This study examined the roles of posttraumatic stress disorder (PTSD) and cumulative exposure to pre-deployment physical and/or sexual trauma and combat trauma in predicting reintegration difficulties faced by a sample of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. Schlossberg’s Transition Model was used as the conceptual framework to support the study on seven outcomes in four functional domains: (a) interpersonal functioning in terms of post-deployment social support, (b) vocational functioning in terms of difficulty obtaining employment, job loss, and current employment status, (c) current legal problems, (d) current substance use in terms of alcohol use and cannabis use. Following approval from Institutional Review Boards and permission from the Veterans Affairs Principal Investigator, this study analyzed pertinent data from the Deployment Risk and Resilience Inventory Dataset that was created via medical record review of 1,740 OEF/OIF veterans. Hierarchical multiple and logistic regression analyses were conducted to test two hypotheses. Results on the entire sample (N = 1,198), firstly, indicated that PTSD was significantly associated with lower post-deployment social support and a greater likelihood of job loss, current legal problems, and current alcohol use, even after statistically controlling for age, gender, and depressive disorders. Second, cumulative exposure to pre-deployment physical and/or sexual trauma and combat trauma did not predict any of the functional outcomes among veterans with PTSD (n = 322), after statistically controlling for age, gender, and depressive disorders. Implications for research, practice, and policy as well as limitations of the study are discussed. Recommendations are also provided.Item STRESS AND COPING: FACTORS THAT INFLUENCE THE HEALTH STATUS OF BLACK MEN(2012-05) Cummings, Tawana; Williams Jennings, Sheara; Parrish, Danielle E.; Saint Onge, Jarron; Hill, CarlStudies have shown that there is a direct relationship between socioeconomic status (SES) and health status, but the health status of Black men does not improve at the same rate as their White counterparts with increases in SES. There is minimal literature on factors that influence the health status of Black men from improving with SES. The purpose of this study is to explore both stress and coping as possible factors that influence this population’s health status. The theories of fundamental social causes, stress and coping, and self-efficacy were used to inform the relationship between SES, stress, coping, and health status for Black males. The research questions include: 1) Is higher SES associated with a better health status for Black males?, 2) What is the relationship between SES and perceived stress for Black males?, 3) What is the relationship between SES and coping for Black males?, and 4) Do perceived stress and coping mediate the relationship between SES and health status for Black males?. The study included a convenience sample of 251 Black males between the ages of 25 and 45, recruited from two locations, a health clinic and a graduate level Black fraternity in a large metropolitan city. The data from four instruments were analyzed using SPSSv18 to answer the study questions using bivariate correlations and multivariate regression analyses. Data analysis interpretation indicated that there was a positive relationship between both SES and health status and SES and coping. There also was a negative relationship between SES and perceived stress. Several regression analyses were conducted to determine that coping was a mediator between SES and mental health status of Black men. Stress was only a mediator between SES and mental health status of Black men when coping was also included as a mediator. Stress and coping were not identified as significant predictors of physical health status of Black men. These findings suggest salient factors that may influence the health status of Black men, and have implications for social work practitioners and researchers working to improve the health status of this population.Item The Needs and Experiences of Justice-Involved Young Women(2021-05) Menon, Sujeeta Elizabeth; Robbins, Susan P.; Lea, Charles H., III; Parrish, Danielle E.The dissertation includes three studies with a focused analysis on the needs and experiences of Justice-Involved Young Women (JIYW). The first two studies utilize a cross sectional data collected from the Positive Achievement Change Tool (PACT) (n=365). The first study, “How are they different? An exploration of family and school factors among post-adjudicated young women” explores the associations between family and school factors, and their relationship to criminal risk among JIYW using multiple regression analyses. After controlling for age, the model (Family incarceration history, Running away from home, School suspension or expulsion, Abuse, Neglect and a Special learning need) emerged as significant predictors of criminal risk (p= <.001). However, only family incarceration and special education needs (learning, behavioral or ADHD/ADD) were predictive of higher levels of criminal risk for Black JIYW, while running away from home was predictive for Hispanic JIYW. The second study, “Risk and protective factors among post-adjudicated young women with high criminal risk: An exploratory cross-sectional analysis” explores the risk and protective correlates of criminal risk among JIYW with high risk using an exploratory model building method with logistic regression analyses. The results revealed that young women with high criminal risk were more likely to have had a history of mental health problems, a history of running away from home, and were younger in age, based on the best model selected (χ2 = 51.904, df = 8, p<.001). The third study, “They see me as a bad kid”: Public School and Correctional Educational Experiences on the Self-perception of Justice-Involved Young Women” utilized a secondary dataset (n=14) to examine the self-perceptions of a sample of 10 JIYW, two probation officers and two correctional teachers from a youth correctional facility. A qualitative thematic analysis using Symbolic Interactionism and Institutional Embeddedness revealed three themes, (1) " I would pay attention and I would still get them wrong and feel stupid ", (2) I'm making straight As for the first time", and (3) "They see us as bad kids". All three studies elucidate unique experiences, across risk level and race/ethnicity, which calls for gender-specific, culturally sensitive and trauma-informed intervention for JIYW.Item The patient portal and abnormal test results: An exploratory study of patient experiences(Patient Experience Journal, 2015-04) Giardina, Traber Davis; Modi, Varsha; Parrish, Danielle E.; Singh, HardeepMany health care institutions are implementing patient portals that allow patients to track and maintain their personal health information, mostly in response to the Health Information Technology for Economic and Clinical Health Act requirements. Test results review is an area of high interest to patients and provides an opportunity to foster their involvement in preventing abnormal test results from being overlooked, a common patient safety concern. However, little is known about how patients engage with portals to review abnormal results and which strategies could facilitate that interaction in order to ensure safe follow-up on abnormalities. The objective of this qualitative study was to explore patientsÍ experiences related to abnormal test result notifications through patient portals. The authors conducted semi-structured telephone interviews with 13 participants, patients and primary caregivers, between February 2014 and October 2014. Using content analysis, the authors explored patient experiences accessing abnormal test results through their portals. Respondents strongly favored access to all types of abnormal test results, but they raised several concerns including need for more timely notification and not being able to interpret the exact relevance of the result. RespondentsÍ personal experiences with physicians, test result notification, and the portal heavily influenced respondentsÍ notification preferences. Patient experiences with portals could be improved by development of strategies to help patients understand and manage the information received. These findings suggest important considerations for health professionals and institutions aiming to better engage patients in follow-up of their test results.Item The Role of Paternal Self-Efficacy in Father Involvement(2015-05) Trahan, Mark Herrick; Cheung, Monit; Parrish, Danielle E.; Sampson, McClain M.This research study sought to understand the associations between father involvement and paternal self-efficacy, partner support, co-parenting alliance, and relationship satisfaction. Recognizing that fathering occurs in a complex system of relationships and influences, this research sought to examine the association between father involvement and other factors that measure fathering behaviors in a co-parenting relationship. The study is a cross sectional research design using a snowball sampling method for surveying fathers and mothers about their perceptions of fathering factors. Data from a sample of 191 electronic surveys were collected from February 2014 to June 2014. The survey consisted of five previously validated scales measuring variables of co-parenting alliance, father involvement, partner support for parenting, relationship satisfaction, and paternal self-efficacy. Findings indicate consistent parental role expectations for father involvement, report of actual involvement, and report of paternal self-efficacy. The discrepancy between paternal expectations and reported father involvement was related to paternal self-efficacy: Fathers who reported high levels of involvement were three times more likely to have high paternal self-efficacy than fathers with lower levels of involvement. Among all other relationship factors, paternal self-efficacy was the strongest factor related to father involvement. A father with strong paternal self-efficacy was 1.5 times more likely to be involved. Other factors influencing father involvement included co-parenting alliance and income earner status.Item Virtual Patient Simulation Training for Clinical Social Work Diagnostic Assessment and Skills Evaluation(2015-08) Washburn, Micki; Bordnick, Patrick S.; Parrish, Danielle E.; Torres, Luis R.Despite successful completion of advanced clinical training and professional licensure, many clinicians lack adequately developed clinical assessment skills, resulting in misdiagnosis of mental health issues. Skill deficits may result from systemic factors associated with current clinical training programs including the widespread use of passive/observational learning and limited experiential learning opportunities, inadequate practice with live clients in field placements, and unstandardized assessment measures. This study evaluates standardized virtual patient simulation to determine the impact of these simulations on students’ self-efficacy, diagnostic accuracy and clinical interviewing skills. This project also compares students’ performance on Objective Clinical Structured Examinations (OSCEs) using both standard actor patients and virtual patients.Item Virtual patient simulations for brief assessment of mental health disorders in integrated care settings(Social Work in Mental Health, 5/1/2017) Washburn, Micki; Parrish, Danielle E.; Bordnick, Patrick S.This mixed methods pilot investigation evaluated the use of virtual patient simulations for increasing self-efficacy and diagnostic accuracy for common behavioral health concerns within an integrated care setting. A two by three factorial design was employed to evaluate three different simulated training conditions with a sample of 22 Masters level behavioral health students. Results support engagement in virtual patient simulation training to increase studentsÍ self-efficacy in brief clinical assessment, and support the use of virtual patient simulations to improve diagnostic accuracy. Results further indicate that virtual patient simulations have sufficient levels of usability and acceptability as a tool for developing brief clinical interviewing skills, and that participants found this method of instruction to be a valuable adjunct to traditional classroom or field based training. Future directions and next steps for the integration of technology enhanced simulations in clinical social services education are explored.