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Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health. Depression is a prevalent mental health disorder in the US linked to increased risk of mortality. Literature suggests depression screening

Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health. Depression is a prevalent mental health disorder in the US linked to increased risk of mortality. Literature suggests depression screening can identify high-risk individuals with using the patient health questionnaire (PHQ-9).

The objective of this project is to determine if screening identifies depression in the homeless and how it impacts healthcare access. Setting is a local organization in Phoenix offering shelter to homeless individuals. An evidence-based project was implemented over two months in 2019 using convenience sampling. Intervention included depression screening using the PHQ-9, referring to primary care and tracking appointment times. IRB approval obtained from Arizona State University, privacy discussed, and consent obtained prior to data collection. Participants were assigned a random number to protect privacy.

A chart audit tool was used to obtain sociodemographics and insurance status. Descriptive statistics used and analyzed using Intellectus. Sample size was (n = 18), age (M = 35) most were White-non-Hispanic, 44% had a high school diploma and 78% were insured. Mean score was 7.72, three were previously diagnosed and not referred. Three were referred with a turnaround appointment time of one, two and seven days respectively. No significant correlation found between age and depression severity. A significant correlation found between previous diagnosis and depression severity. Attention to PHQ-9 varied among providers and not always addressed. Future projects should focus on improving collaboration between this facility and providers, increasing screening and ensuring adequate follow up and treatment.

ContributorsParamo, Cinthia Arredondo (Author) / Thrall, Charlotte (Thesis advisor)
Created2020-05-04
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Description
Despite the growing numbers of foreign-born Latina young adult immigrants in the United States, this population is underrepresented in psychological science. Building upon previous literature, this study examines the moderating effect of acculturation and enculturation on the relationship between depression and alcohol use quantity and frequency among 530 young Latina

Despite the growing numbers of foreign-born Latina young adult immigrants in the United States, this population is underrepresented in psychological science. Building upon previous literature, this study examines the moderating effect of acculturation and enculturation on the relationship between depression and alcohol use quantity and frequency among 530 young Latina women (ages 18-23 years) who recently immigrated to the United States (i.e., approximately 12 months prior to assessment). Acculturation (i.e., the process of immersion into

another culture) lessened the positive link between depression and alcohol use quantity and frequency. Those with higher levels of acculturation reported less symptoms of depression and alcohol use. Enculturation (i.e., the process of immersion to one’s own ethnic culture) increased the positive link between depression and alcohol quantity and frequency. Implications for culturally competent counseling for this underserved and understudied population are discussed.
ContributorsWinn, Larren (Author) / Dillon, Frank (Thesis advisor) / Pereira, Jennifer (Committee member) / Capielo-Rosario, Cristalís (Committee member) / Arizona State University (Publisher)
Created2020
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Description
Over 25% of children in the United States suffer from a chronic illness, and close to 70% of all childhood deaths are due to chronic illness. Prevalence of childhood chronic illness continues to increase, and as a result, the pervasiveness of parents faced with stress associated with caregiving for their

Over 25% of children in the United States suffer from a chronic illness, and close to 70% of all childhood deaths are due to chronic illness. Prevalence of childhood chronic illness continues to increase, and as a result, the pervasiveness of parents faced with stress associated with caregiving for their child with a chronic illness is also rising. The Stress Process Model (SPM) conceptualizes the caregiving experience as a multidimensional process influenced by the caregiving context, primary and secondary stressors, resources, and caregiver outcomes. Utilizing the SPM, the goals of this study were to examine the relations between caregiving stress (role overload and role strain) and resources (instrumental support, social support, and positive attitudes) and psychological outcomes (depression and anxiety) to determine whether resources moderated the associations between caregiving stress and psychological outcomes.

Participants included 200 parent caregivers of a child with a chronic illness. Participants responded to an online survey that measured demographics, role overload (Role Overload scale), role strain (The Revised Caregiver Burden Measure), instrumental support and social support (Medical Outcomes Survey), positive attitudes about caregiving (Brief Assessment Scale for Caregivers), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder scale-7). Pearson correlations and six hierarchical regression models were tested to examine caregiving stress, resources, and psychological outcomes.

Consistent with the study hypotheses, positive correlations between caregiving stress (role overload and role strain) and depression and anxiety were found. Negative correlations were found between resources (instrumental support, social support, positive attitudes) and depression and anxiety. Both instrumental support and social support had negative moderating effects on the relations between role overload and psychological outcomes (depression and anxiety). Positive attitudes also negatively moderated the relations between role strain and psychological outcomes. Thus, when participants reported high instrumental and social support, they also reported low depression and anxiety, even when role overload was high. Participants also reported low anxiety and depression when they reported high positive attitudes, even when role strain was high. Implications of these findings are discussed.
ContributorsJohnson, Courtney Kerber (Author) / Kurpius, Sharon (Thesis advisor) / Dillon, Frank (Committee member) / Tracey, Terence (Committee member) / Arizona State University (Publisher)
Created2020
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Description
Adolescent substance use is a complex and significant public health concern that has received considerable attention among researchers and practitioners (Gray & Squeglia, 2018). The purpose of this dissertation was to examine factors associated with substance use intervention effects and to develop subgroups of risk factors for Mexican adolescents. This

Adolescent substance use is a complex and significant public health concern that has received considerable attention among researchers and practitioners (Gray & Squeglia, 2018). The purpose of this dissertation was to examine factors associated with substance use intervention effects and to develop subgroups of risk factors for Mexican adolescents. This dissertation utilizes secondary data from a randomized controlled trial of the school-based substance use universal prevention program, keepin’ it REAL (kiR). The dissertation included two studies. Study 1: This study tested a model on the efficacy of the school-based substance use universal prevention program, keepin’ it REAL, among a sample of Mexican adolescents (N = 3,742, 11-17 years old). Study 1 analysis included Structural Equation Modeling and results demonstrated that participation in kiR positively predicted alcohol resistance strategies and those alcohol resistance strategies were negatively and significantly associated with alcohol use. Further, depressive symptomology was a moderator of intervention effects as the effects of kiR on resistance strategies increased as the level of depressive symptomology increased. Study 2: this study explored subgroups (classes) of Mexican adolescents (N = 5,520, 11-14 years old) based on their experiences with violence (witnessing, victimization, and perpetration), depressive symptomology, and substance use (alcohol, tobacco, and marijuana). Using Latent Class Analysis (LCA) four empirically, well-differentiated classes emerged representing adolescents various risk typologies (Moderate Risk-Violence at 55% of the sample, Low Risk at 35%, High Risk at ~8%; and Moderate Risk-Substance Use at ~2%) Implications for research and practice are discussed across both studies.
ContributorsArévalo Avalos, Marvyn R (Author) / Spanierman, Lisa (Thesis advisor) / Dillon, Frank (Committee member) / Marsiglia, Flavio (Committee member) / Arizona State University (Publisher)
Created2021
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Description
The Latinx population in the United States is projected to increase exponentially in upcoming years. Latina women in particular are put at disproportionate risk of experiencing psychological distress after immigrating to the US. Separation from family upon immigration introduces more difficulty to the immigration experience. Yet protective factors such as

The Latinx population in the United States is projected to increase exponentially in upcoming years. Latina women in particular are put at disproportionate risk of experiencing psychological distress after immigrating to the US. Separation from family upon immigration introduces more difficulty to the immigration experience. Yet protective factors such as family cohesion may buffer potential psychological distress. The present study will examine the two following research questions. First, is there a difference in psychological distress experienced by Latina young women who report separating from their family in comparison to those who did not experience familial separation at immigration. Second, does a potentially deleterious effect of immigration on familial attachment underlie or mediate the hypothesized positive association between separation at immigration and psychological distress. Participants were Latina young women who ranged from 18-23 years-old, were unmarried, and had to have resided in the US for 36 months or less. I used structural path analysis to examine hypothesized associations among separation status, attachment to family, and psychological distress. Findings aim to inform mental health interventions for Latina young adults who immigrate to the US without family.
ContributorsRomero, Abigail (Author) / Dillon, Frank (Thesis advisor) / Pereira, Jennifer (Committee member) / Buckman, Lindsey (Committee member) / Arizona State University (Publisher)
Created2021