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- Genre: Doctoral Dissertation
Description
There are federal mandates attached to funding for behavioral health programs that require the use of evidence-based treatments (EBTs) to treat mental health disorders in order to improve clinical outcomes. However, these EBTs have not been constructed with American Indian/Alaskan Native (AI/AN) populations. There are over 340 EBTs, and only two outcome controlled studies have demonstrated effectiveness with AI/AN populations to treat mental health disorders. AI/AN communities often have to select an EBT that is not reflective of their culture, language, and traditions. Although EBTs are frequently used in AI/AN communities, little is known about the adaptation process of these interventions with the AI/AN population. For this study, a qualitative design was used to explore how American Indian behavioral health (AIBH) organizations in the Southwest adapted EBTs for cultural relevancy and cultural appropriateness. One urban and two tribal AIBH programs were recruited for the study. Over a six-week period, 24 respondents (practitioners and cultural experts) participated in a semi-structured interview. Transcripts were analyzed using the constant comparative analysis approach. As a result, four themes emerged: 1) attitudes towards EBTs, 2) how to build culturally competent clinical skills, 3) steps to adapt EBTs, and 4) internal and external organizational factors required to adopt EBTs. The four themes identify how to build a culturally responsive behavioral health program in Indian country and are the purview of this dissertation.
ContributorsPoola, Charlene (Author) / Segal, Elizabeth A. (Thesis advisor) / Mitchell, Felicia M. (Thesis advisor) / Oh, Hyunsung (Committee member) / Arizona State University (Publisher)
Created2020
Description
Intimate Partner Violence (IPV) is a common experience among (lifetime prevalence 16.5% - 54.5%); however, current research, intervention programs, and policies tend to target women of child-bearing age, leaving older adult women feeling unseen and unheard. The purpose of this study was to provide a more accurate picture of violence against women over the life course. Guided by Life Course Theory, the characteristics of trajectories of IPV events and IPV-related help-seeking were assessed among a sample of community-dwelling women aged 60 or older residing in the Southwest United States (n = 52). Semi-structured retrospective interviews were conducted using a Life History Calendar (LHC). The characteristics of trajectories of IPV by type (physical, psychological, sexual) and by frequency (high, low) were examined. The impact of experiencing Adverse Childhood Experiences (ACES) on trajectories of violence were analyzed to account for childhood victimization in the life course. To better understand IPV-related help-seeking behaviors, the characteristics of trajectories of IPV-related help-seeking by age, type of IPV, and frequency of IPV were examined. Generalized linear mixed modeling was used to evaluate whether the probability of experiencing IPV and seeking IPV-related help changed over the life course. Half of the women in the sample experienced IPV at age 45 or later (n = 28; 53.8%), with approximately one-quarter of the women in an intimate relationship reporting IPV at time of interview (n = 6; 27.3%). Findings revealed curvilinear characteristics of IPV experience by type and frequency over the life course, with the probability of IPV events increasing earlier in life then decreasing later in life. Compared to previous studies that report IPV events decreasing in the latter 20s, the probability of experiencing IPV events increased later into adulthood (mid to late thirties among women in the study sample). The probability of seeking IPV-related help increased earlier in the life course and then declined, with the occurrence of IPV of all types significantly affecting trajectories of help-seeking behavior. Findings from this study contribute evidence needed for the recommendation of IPV screening into older adulthood and the adaptation of supportive services for older women seeking IPV-related help.
ContributorsGarbe, Renee Andersen (Author) / Stalker, Katie C (Thesis advisor) / Oh, Hyunsung (Committee member) / Messing, Jill (Committee member) / Arizona State University (Publisher)
Created2021