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Health Disparities Among LGB Women From Experiences With Their Healthcare Providers

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This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball

This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball sampling. Interviews were conducted inquiring about their health history and their experiences within the healthcare system in the context of their sexual orientation. The data collected from these interviews was used to create an analysis of the healthcare experiences of those who identify as queer. Although the original intention of the project was to chronicle the experiences of LGB women specifically, there were four non-binary gender respondents who contributed interviews. In an effort to not privilege any orientation over another, the respondents were collectively referred to as queer, given the inclusive and an encompassing nature of the term. The general conclusion of this study is that respondents most often experienced heterosexism rather than outright homophobia when accessing healthcare. If heterosexism was present within the healthcare setting, it made respondents feel uncomfortable with their providers and less likely to inform them of their sexuality even if it was medically relevant to their health outcomes. Gender, race, and,socioeconomic differences also had an effect on the patient-provider relationship. Non-binary respondents acknowledged the need for inclusion of more gender options outside of male or female on the reporting forms often seen in medical offices. By doing so, medical professionals are acknowledging their awareness and knowledge of people outside of the binary gender system, thus improving the experience of these patients. While race and socioeconomic status were less relevant to the context of this study, it was found that these factors have an affect on the patient-provider relationship. There are many suggestions for providers to improve the experiences of queer patients within the healthcare setting. This includes nonverbal indications of acknowledgement and acceptance, such as signs in the office that indicate it to be a queer friendly space. This will help in eliminating the fear and miscommunication that can often happen when a queer patient sees a practitioner for the first time. In addition, better education on medically relevant topics to queer patients, is necessary in order to eliminate disparities in health outcomes. This is particularly evident in trans health, where specialized education is necessary in order to decrease poor health outcomes in trans patients. Future directions of this study necessitate a closer look on how race and socioeconomic status have an effect on a queer patient's relationship with their provider.

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2016-05

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An Examination of Dimensions of Social Support and Their Associations with Mexican-Origin Adolescent Mothers' Mental Health

Description

Social support for Mexican-origin adolescent mothers can benefit mental health. Currently, there is little research on specific dimensions of social support and how they change during the beginning years of parenthood, and even less focusing on the influence each dimension

Social support for Mexican-origin adolescent mothers can benefit mental health. Currently, there is little research on specific dimensions of social support and how they change during the beginning years of parenthood, and even less focusing on the influence each dimension has on adolescent mothers' mental health. This study sought to fill such gaps through the analysis of data from the Supporting MAMI Project at Arizona State University. First, the current study assessed perceptions of emotional, instrumental, and companionship support received from mother figures by Mexican-origin adolescent mothers (N = 204; Mean age at Wave 1 = 16.24, SD = .99) across five years through descriptive statistics and univariate latent growth models. Second, the study assessed the strength of the impact that each dimension of social support had on mental health across six years via conditional growth models. Findings indicated that each dimension of social support shifted in a bi-linear spline shape from Wave 1 to Wave 6, with growth parameters' significance varying for each dimension of support. Each dimension of support was significantly related to depressive symptoms at Wave 6, with varying degrees of influence across growth parameters. Implications for future research and practice are discussed.

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2016-05

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Mental Health Training: Pathway to Early Mental Health Intervention

Description

There is an increase in the prevalence of mental health problems in the United States. Healthy People 2020’s leading mental health indicator is to increase the delivery of care to those with mental health issues and lower the number of

There is an increase in the prevalence of mental health problems in the United States. Healthy People 2020’s leading mental health indicator is to increase the delivery of care to those with mental health issues and lower the number of youth who experience a major depressive disorder. Teachers and non-teaching staff are well placed in the community to identify youth undergoing emotional distress and facilitate early interventions, yet do not receive adequate training in mental health.

A project was undertaken to determine if a mental health training intervention affected the community youth mentors knowledge, attitude and self-efficacy towards helping youth with mental health issues. Three instruments with good validity and reliability namely Mental Health Literacy Scale (MHLS), Attitudes to Severe Mental Illness (ASMI) scale, and Gatekeeper Behavior Scale were used in pre intervention, immediately post intervention and two weeks post intervention questionnaires. The Wilcoxon Signed Ranks test indicated changes in the pre and post intervention scores as significant in knowledge, and attitude between pre intervention and immediately post intervention time periods. Cohen’s effect size value suggested large, medium, small, and minimum clinical significance in the variables over period of time.

Mental health literacy narrows the gap between symptom onset and intervention. Numerous mental health trainings are currently available worldwide. Schools and after school clubs in collaboration with hospital mental health and other community agencies are better equipped to bridge the gap. School staff report better confidence in addressing mental health and behavioral health issues among youth when equipped with additional resources within the school in the form of psychologists, social workers, and counselors.

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2020-05-03

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Screening for Posttraumatic Stress Disorder in Behavioral Health

Description

Background: Non-Veteran Affair (VA) mental health care facilities are admitting increased numbers of military affiliated members due to recent changes, allowing veterans to outsource healthcare at civilian treatment centers. The VA reports less than 9 million veterans enrolled in VA

Background: Non-Veteran Affair (VA) mental health care facilities are admitting increased numbers of military affiliated members due to recent changes, allowing veterans to outsource healthcare at civilian treatment centers. The VA reports less than 9 million veterans enrolled in VA services, leaving over 50% seeking treatment from civilian providers. Given the high prevalence of Posttraumatic Stress Disorder (PTSD) in the military population, it is imperative to implement a valid and reliable screening tool at primary care facilities to ensure timely and accurate diagnosis and treatment.

Method: This project aimed to provide an evidence-based education for intake nurses to understand prevalence of PTSD and to use a screening tool Primary Care PTSD for DSM-5 (PC-PTSD-5) in a non-VA behavioral health facility.

Setting: The project site was a civilian behavioral health facility located in West Phoenix Metropolitan area. The behavioral health facility serves mental health and substance abuse needs. Project implementation focused on the intake department.

Measures: Sociodemographic data, PTSD diagnosis criteria, prevalence and PC-PTDSD-5 screening tool knowledge collected from pre and posttest evaluation. Patients’ charts for those admitted 6-week before and 6-week after the education to calculate numbers of screening tools completed by nurses at intake assessment.

Data analysis: Descriptive statistics was used to describe the sample and key measures; the Wilcoxon Signed Rank Test was used to examine differences between pre-test and post-test scores. Cohen’s effect size was used to estimate clinical significance.

Results: A total of 23 intake nurses (87.0% female, 65.2% 20-39 years old, 52.2% Caucasian, 95.6% reported having 0-10 years of experience, 56.5% completed Associate’s degree) received the education. For PTSD-related knowledge, the pre-test score (Mdn = 6.00) was significantly lower than the post-test score (Mdn = 10.00; Z= -4.23, p < .001), suggesting an increase of PTSD knowledge among nurses after the education. Regarding the diagnosis, the percentage of patients who were diagnosed with PTSD increased from (0.02% to 20% after the education).

Discussion: An evidence-based education aimed at enhancing intake nurses’ knowledge, confidence and skills implementing a brief and no-cost PTSD screening tool showed positive results, including an increase of PTSD diagnosis. The implementation of this screening tool in a civilian primary mental health care facility was feasible and helped patients connect to PTSD treatment in a timely fashion. Continued use of paper version of screening tool will be maintained at facility as an intermediary solution until final approval through parent company is received to implement into electronic medical records.

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2020-05-06

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Mental Health Application in Anxiety

Description

Background: The shortage of providers, therapists, and long waiting times for appointments in the United States is growing. Mental health technology applications (apps) expand the strategies available to people with mental health conditions to achieve their goals for well being

Background: The shortage of providers, therapists, and long waiting times for appointments in the United States is growing. Mental health technology applications (apps) expand the strategies available to people with mental health conditions to achieve their goals for well being through self-management of symptoms.

Methods: A project was undertaken at an outpatient behavioral setting in urban Arizona to determine the use and effectiveness of a mental health app called insight timer to reduce anxiety symptoms. Adult clients with anxiety symptoms were provided with the insight timer app to use over a period of eight weeks. Anxiety was evaluated with the GAD-7 scale initially and after the eight weeks of app use. Usability and the quality of the app were assessed with an app rating scale at the end of the eight weeks.

Results: Findings of the Wilcoxon Signed Ranks test indicated changes in pre and posttest assessment scores as significant (p = .028), which is a significant reduction in anxiety among seven clients who completed the 8-week intervention. the mean TI score was 15.57 (SD = 4.9), and the mean T2 score was 7.71 (SD = 5.7). Besides, Cohen's effect size value (d = 1.465) suggested large clinical significance for GAD7 in pre and posttest.

Discussion: Evidence suggests that the use of an evidence-based app can effectively reduce anxiety symptoms and improve the quality of life. The use of mental health apps like insight timer could reduce health care costs associated with unnecessary hospital admissions as well as re-hospitalizations. The routine use of apps such as the insight timer may also be beneficial to all the clients who have anxiety symptoms in outpatient as well as inpatient settings.

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2020-05-06

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Health & Wealthness Podcast

Description

Health and Wealthness is a podcast where your hosts, Emily Weigel and Hanaa Khan discuss pressing and trending topics about health and wealth that everyone should know about. Our first four episodes focus on the opioid crisis. Both the science

Health and Wealthness is a podcast where your hosts, Emily Weigel and Hanaa Khan discuss pressing and trending topics about health and wealth that everyone should know about. Our first four episodes focus on the opioid crisis. Both the science and healthcare sides. We then go on to talk about burnout and mental health in a conversational episode.

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2021-05

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An Examination of Chronic Pain and Opioid Use Among Veterans with and without Alcohol Use Disorder

Description

Chronic pain is devastating and highly prevalent among Veterans in the United States (Johnson, Levesque, Broderick, Bailey & Kerns, 2017). While there are various treatment options for chronic pain, opioids remain high in popularity. Although opioids are fast-acting and effective,

Chronic pain is devastating and highly prevalent among Veterans in the United States (Johnson, Levesque, Broderick, Bailey & Kerns, 2017). While there are various treatment options for chronic pain, opioids remain high in popularity. Although opioids are fast-acting and effective, potential consequences range from unpleasant side effects to dependence and fatal overdose (Baldini, Korff & Lin, 2012; Park et al., 2015; Kaur, 2007). The effects of opioid treatment can be further complicated by a history of alcohol abuse. Past alcohol abuse is a risk factor for opioid misuse (McCabe et al., 2008). One alternative to opioid medication is Cognitive Behavioral Therapy for Chronic Pain (CBT-CP). CBT-CP has shown small to moderate effects on chronic pain after the end of treatment (Naylor, Keefe, Brigidi, Naud & Helzer, 2008). The current study examined the effect of CBT-CP on opioid prescriptions, as well as the role of past alcohol abuse in CBT-CP efficacy, through an archival data analysis of Veterans Affairs patient charts. In order to determine the effect of CBT-CP on opioid prescriptions, an opioid change score was calculated from treatment start date to twelve months post-treatment. An analysis of 106 patient charts demonstrated no statistically significant difference in opioid prescriptions between Veterans who were referred and attended treatment (n = 24) and those who were referred but did not attend (n = 82). Veterans from both groups showed a reduction in prescribed opioids during a 12-month period. Furthermore, there was no statistically significant difference between Veterans with versus without a history of alcohol abuse in terms of the change in opioid prescriptions over a 12-month period (both groups showed reductions). This research suggests that opioid prescriptions may decrease over time among Veterans referred for CBT-CP, even among those who do not participate in the groups. More work is needed to understand the relationship between opioid prescriptions and actual opioid use over time among Veterans who do and do not choose to participate in CBT-CP. Continuing to address poly-substance use in chronic pain patients also is critical to ensure that Veterans suffering from chronic pain receive appropriate intervention.

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Date Created
2019-05

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Shared Parenting: From Practice to Policy

Description

This study examines how a 2013 Arizona law on shared parenting would affect living arrangements, and thus mental health measures. There were two hypotheses. According to the Law Change Hypothesis, it was hypothesized that parenting time in Arizona would be

This study examines how a 2013 Arizona law on shared parenting would affect living arrangements, and thus mental health measures. There were two hypotheses. According to the Law Change Hypothesis, it was hypothesized that parenting time in Arizona would be more equal following the 2013 Arizona law change while there would be no change in parenting time in other states following the 2013 Arizona law change. It was further hypothesized that child mental health would be better after the law change in Arizona with no change being seen in other states. Results of this study were almost completely inconsistent with the hypothesis. According to the Law Reflect Hypothesis, the law is actually reflecting the behavior of the community and their thoughts on equal parenting time becoming more favorable, and therefore a change towards more equal parenting time would be found prior to 2013 in Arizona with no change seen in other states. Furthermore, as the Arizona community’s behavior changed, child mental health would be better with no change being seen in other states. Regressions found that a small change toward more equal parenting and closeness with father was prior to 2013 for Arizona students, compared to out-of-state students, although it did not find that the year of divorce resulted in less anxiety, stress, and depression. This partially agrees with past research that the 2013 law is working as intended, even if it started working earlier than we thought. This does not agree with previous research stating there is a connection between equal parenting and better mental health. This is important because this study questions the efficacy of an important and controversial policy. If future studies are consistent with this one, the effectiveness of the Arizona 2013 law change on mental health will need to be further evaluated.

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2021-05

Sammie's Self: A Response to Transgender Issues in Contemporary Society

Description

This honors thesis is a combination of analytical and creative endeavors. The research portion of the project examines contemporary transgender issues, including social, emotional, and cultural concerns. Most notably, the research focuses on the relationship between social support and mental

This honors thesis is a combination of analytical and creative endeavors. The research portion of the project examines contemporary transgender issues, including social, emotional, and cultural concerns. Most notably, the research focuses on the relationship between social support and mental health. These findings suggest that children who fail to receive adequate support are liable to face severe developmental and emotional consequences. The accumulation of this research ultimately serves as the foundation and justification for the creative work, which is presented as a children's book directed at transgender and gender non-confirming youths.

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2016-12

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Exposing Women's Experiences with Von Willebrand Disease: A Case Study of Online Support Groups

Description

This research explores the unique and complicated experiences of women living with Von Willebrand Disease (VWD). VWD occurs with quantitative or qualitative deficiencies in Von Willebrand Factor—a key protein involved in blood clotting. While VWD affects men and women, women

This research explores the unique and complicated experiences of women living with Von Willebrand Disease (VWD). VWD occurs with quantitative or qualitative deficiencies in Von Willebrand Factor—a key protein involved in blood clotting. While VWD affects men and women, women often suffer harsher complications because of menstruation, childbirth, and other women’s health issues. Using online VWD support groups, this research recognizes and attempts to understand the common experiences of women with VWD. Availability of Care, Motherhood, Community and Sisterhood, Girlhood, Sexual Health and Reproductive Health, and Stigma were the six common themes found within these online support groups. Women in these groups corroborate the current understandings of women-specific experiences with VWD: particularly, heavy menstruation, postpartum hemorrhaging, diagnostic difficulties, treatment complications, and implications of an overall lower quality of life. However, these women also report VWD-induced complications with sexual health, mental health, care when trying to conceive, misinterpretations of bruising, constraints on healthcare availability, and the stigma associated with heavy menstruation. These findings address gaps in the literature and identify new areas for further research. Ideally, these conclusions will provide educational materials for healthcare professionals, government legislatures, and families to better support women and girls with VWD.
Keywords: Von Willebrand disease, women’s health, sexual health, mental health, reproductive health, phenomenology, and stigma

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2016-12