Theses and Dissertations from UMD
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New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a give thesis/dissertation in DRUM
More information is available at Theses and Dissertations at University of Maryland Libraries.
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Item The "Extra Layer of Things": Everyday Information Management Strategies and Unmet Needs of Moms with ADHD(2024) Walsh, Sheila Ann; St. Jean, Beth; Information Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Mothers with ADHD need to manage their symptoms while balancing parenting responsibilities. Although technology is recommended to people with ADHD, there is limited related research in human-computer interaction (HCI). To help fill this gap, the author interviewed five mothers diagnosed with ADHD. The mothers, whose voices are largely unheard in HCI research, vividly describe their challenges managing everyday information and their attempts to adapt existing systems. The study uncovers a previously unrecognized tendency among moms with ADHD to frequently switch, and sometimes abandon, tools and systems. The study contributes to HCI by linking each finding to a design consideration. The study builds upon previous findings that neurodivergent individuals benefit from externalizing thoughts, providing new insights into how and why this occurs. These findings lay the groundwork for further HCI research and human-centered design initiatives to help parents with ADHD, and their families, thrive.Item "It's Not Like I Can Just Pause Diabetes:" How People Living with Type 1 Diabetes Navigate Relationships, Reproduction, and Parenting(2023) Maietta, Justin T.; Doan, Long; Cohen, Philip N.; Sociology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This dissertation draws on 26 qualitative in-depth interviews to explore how people who live with type 1 diabetes (T1D) navigate three important and intimate areas of life: dating and relationships, reproduction, and parenthood. Applying a sociological disability framework to this research, I explore how participants’ trajectories and outlooks, decisions, and feelings of agency and self-efficacy in these areas of life are influenced biographically, structurally, and culturally on account of living with T1D. Each of the three substantive chapters of this dissertation is an article that examines the relationship between living with T1D and either dating and romantic relationships, reproduction, or parenthood. First, I argue that dating and relationship norms and expectations can be rooted in ableist ideals that marginalize potential partners living with impairment or disability. I also demonstrate the importance of two kinds of support that dating partners offer to participants living with T1D: tangible support and incorporative support. Both kinds of support work against assumptions made about dating and relationships among people living with impairment or disability. I then examine facets of living with T1D occurring at multiple analytical layers (structural and cultural, interactional, self, and body) across the life course and how they influence whether people with T1D feel having children is something they want or need or is within their reach. This article enriches our understanding of disability by demonstrating that individuals with less noticeable or visible disability are subject to similar social imperatives of risk management and moral reproduction as those with more noticeable physical or sensory disabilities. Finally, I discuss how participants think about and practice balancing caring for their T1D and caring for their children, as well as how they reconceptualize “good parenting” within an intensive parenting culture that expects child-centered and self-sacrificing parenting. I also discuss how adults who grew up as children and adolescents with T1D reflect on how they have been and continue to be parented regarding their T1D, leading them to challenge norms of “expert-guided” parenting within an intensive parenting culture. This challenge is made through advocating for more agency, autonomy, and expertise grounded in embodied experience to be afforded to children and young adults with T1D in ways that supersede the expertise of doctors and researchers. Overall, this dissertation illustrates: (1) how experiences, interpretations, and representations of disability at multiple analytical levels have the power to remove some feelings of agency and self-efficacy from disabled people throughout the process of reproduction, in their dating lives and romantic relationships, and in their roles as parents; and (2) the ways that individuals with disability adapt to, challenge, and disrupt the norms, ideologies, and assumptions that marginalize them in these intimate areas of life.Item "I love that they exist, even if imperfectly:" Disability, Music Archives, Descriptive Language, and Symbolic Annihilation(2023) Pineo, Elizabeth; Marsh, Diana E; Library & Information Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Drawing on scholarship that addresses symbolic annihilation, this thesis brings together three related studies to argue that music archivists need to address the symbolic annihilation of Disabled individuals within their materials. It offers an assessment of the current state of representation of Disabled individuals in music and non-music archives (chapter 2) and in Library of Congress Subject Headings (LCSH) (chapter 3). From there, it explores the ways in which music and non-music archives are perceived by Disabled individuals with ties to music (chapter 4). Following the presentation of these three studies, the thesis relates combined implications, considerations for further research, and suggestions for methods archivists might use to combat symbolic annihilation and its underlying causes. The author provides practical steps for combatting symbolic annihilation of Disabled individuals throughout, but the final chapter (chapter 5) focuses exclusively on this topic.Item An Investigation of Factors that Influence Disability Self-Disclosure in Post-Secondary Students(2022) Sullivan, Kathryn E; Wang, Cixin; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)When students with disabilities transition to postsecondary school, they must self-disclose their disability to their institution to receive accommodations. Despite the positive educational outcomes associated with receiving accommodations, many students with disabilities who received accommodations in high school do not go on to self-disclose to receive accommodations in postsecondary school. This study investigated factors that facilitate attitudes towards and the behavior of disability self-disclosure by postsecondary students for accommodations, including quality of transition support, self-determination (self-realization and psychological empowerment), and disability identity. Undergraduate participants were recruited for a survey-based study via university listservs and were included in the study if they had previously received accommodations in high school via an Individualized Education Plan (IEP) or a 504 plan, identified as having a nonapparent diagnosis, disability, or learning difference that impacted them educationally, and had attended college for at least one semester. Within the sample (n=285), 67.6% of the participants had registered with their college or university to receive accommodations. Surprisingly, almost half of the participants in this study (45.6%) did not identify as individuals with a disability despite being legally qualified as students with disabilities in high school. Regressions and path analyses were conducted to determine the factors that significantly predicted self-disclosure attitudes and behaviors (i.e., registering for accommodations). The results indicated that high-quality transition experiences in high school positively predicted attitudes towards requesting accommodations and registering for accommodations. Furthermore, a significant indirect effect was found between the quality of transition support and attitudes toward requesting accommodations via disability identity. Contrary to hypotheses, while quality of transition predicted self-determination factors, self-determination factors did not significantly predict self-disclosure attitudes or registering for accommodations. Further exploring quality of transition factors (i.e., school support, home support, and direct discussions about registering with disability services) as predictors, having direct discussions about registering was found to directly predict self-disclosure attitudes and behaviors. A significant indirect effect was also found between school support and attitudes towards requesting accommodations via disability identity. Results of this study highlight the importance of instilling a positive disability identity to drive the self-disclosure process, as well as having direct discussions with students about the processes and procedures for disability self-disclosure during postsecondary transition. Finally, recommendations for secondary and postsecondary institutions were provided for preparing students with disabilities to navigate postsecondary disability services, and further implications for practice and research were discussed.Item RACIAL AND ETHNIC DISPARITIES IN ADL LIMITATIONS AMONG MEDICARE BENEFICIARIES AND THE EXPERIENCE OF TRANSPORTATION BARRIERS IN THE ADL POPULATION(2022) Saint Dic , Venchele; Boudreaux, Dr. Michel; Health Services Administration; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The study’s aims were to first determine if racial/ethnic disparities in ADL limitations for low-income Medicare beneficiaries. The logistic regression results suggested there is a variance in ADL limitation among Medicare Beneficiaries across race. Then, it tested if low-income elderly Medicare enrollees aged 65 years and older were at a higher risk of experiencing transportation barriers to care. On account of covariates, persons with ADL limitations (OR: 2.47 p<0.001) had higher odds of having transportation barriers compared to those without ADL limitations. Non-Hispanic African Americans had a higher chance of experiencing transportation delays than non-Hispanic Whites (OR 1.76 p<0.001). Finally, the effect size for transportation access barriers did not have a dose-relationship with increasing ADL limitation severity. Though the point estimates suggested that barriers were greatest for those with moderate severity (3-4 ADLs), it failed to find evidence of a statistically significant dose-response relationship between ADL severity and transportation.Item A SEQUENTIAL MIXED METHODS APPROACH TO IDENTIFYING AND UNDERSTANDING MOTIVATIONS FOR LEISURE TIME PHYSICAL ACTIVITY PARTICIPATION AMONG AMPUTEES(2022) Olsen, Sara H; Howard, Donna E; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Physical inactivity contributes to increased risk for hypertension, coronary heart disease, diabetes, various cancers, and depression. Research shows small increases in leisure time physical activity (LTPA) level among the least active populations result in larger improvements in overall health than any increase in LTPA among more active populations. People with disabilities (PwD) are less likely to meet physical activity (PA) guideline recommendations than their counterparts in the general population (39.2% vs 53.8%). People with mobility disabilities, such as those with amputations, are less active than those with other disabilities. Amputees, however, are largely absent from physical activity-related and disability-related research. One step toward improving LTPA participation among amputees is understanding motivations to be active and the experiences influencing those motivations. Using Self-Determination Theory (SDT) as a framework, this dissertation employed a sequential explanatory mixed methods approach to integrate fitness app intervention data with interpretative phenomenological analysis (IPA) findings. The quantitative component evaluated an app-based intervention with a waitlist control experimental design. Outcomes of motivations and PA level (Aim 1) were evaluated using linear mixed effect models. Amotivation, extrinsic motivation, and intrinsic motivation were evaluated as separate outcomes. Changes in amotivation and total activity level were significant during the intervention; there were no significant changes in extrinsic or intrinsic motivation. Amotivation (complete disinterest in LTPA) increased in both groups, but the increase was greater in the waitlist control group, suggesting use of the app staved off amotivation even though it did not contribute to increases in intrinsic motivation. Total activity increased in the waitlist control group only. Moderation was tested using SDT constructs of general causality orientation, a personality trait that represents a person’s belief about behavioral change and reasons to change (Aim 2). Amotivation is moderated by general causality orientation. Results from intervention analyses, including attrition analysis, were used to develop interview guides and participant inclusion criteria for the qualitative phase. In-depth interviews with amputees (Aim 3) explored motivations to be active and embodied PA experiences. IPA resulted in the development of six superordinate themes. Data from both the intervention and interviews were integrated to develop a deeper understanding of amputees’ experiences with motivations to be active (Aim 4). Participants identified barriers and facilitators to PA engagement that were unrelated to and unaffected by motivation to be active. These experiences disrupted the association between motivation and participation which added context to the intervention findings in which changes in intrinsic motivation over time did not parallel changes in PA over the same intervention period. Public health implications and suggestions for future research are discussed.Item Parental Health Literacy, Empowerment, and Advocacy in the Context of Food Allergies Management in Schools(2021) Koo, Laura Warnock; Baur, Cynthia E; Horowitz, Alice M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: Health literacy, empowerment, and advocacy may be important for parents when they communicate with schools related management of their child’s food allergies. Understanding prevention and emergency management of life-threatening food allergies may require high levels of health literacy and may be overwhelming to parents. Yet, parents are often the drivers of school food allergy safety practices. Mixed evidence supports the relationships among communicative health literacy, critical health literacy, and empowerment in chronic disease management. Objective: This cross-sectional study examines the relationships among parental health literacy, particularly communicative and critical health literacy; empowerment; and advocacy in the context of food allergies management in elementary schools. Methods: Parents of children with food allergies were recruited through food allergy organizations to complete an anonymous 20-minute online survey. Measurements of parental health literacy, empowerment, and advocacy were adapted from validated scales or the literature and refined through pre-testing and pilot-testing. Results: Participants (N=313) were predominantly white, college-educated mothers with moderately high food allergy knowledge, health literacy, and empowerment. Their children were allergic to an average of three food allergens and nearly half had asthma. Parents who scored at the highest levels on measures of communicative health literacy, critical health literacy, and empowerment engaged in advocacy behaviors perceived to be more effective than parents who scored at the lowest levels. However, this statistical difference may not represent a clinically significant difference. Communicative and critical health literacy were not more strongly associated with advocacy than functional health literacy. Empowerment and quality of the parents’ relationship with the school were the strongest predictors of the parents’ perceived effectiveness of advocacy efforts. The relationship between parental health literacy and advocacy was mediated by empowerment with a moderate effect size, but reverse causality between health literacy and empowerment could not be completely ruled out. Conclusions: Parental health literacy may impact the effectiveness of advocacy efforts for safe food allergies practices in schools, with parental empowerment possibly mediating the relationship between health literacy and advocacy. Longitudinal studies with diverse samples should verify findings. Health professionals should encourage parents to build good relationships with school personnel and help to empower families when educating them about food allergies management.Item Estimating the Prevalence and Timing of Events Along the Pathway to Identification of Autism in the US 2016–2018(2021) Hanley, Allison; Nguyen, Quyhn; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The prevalence of autism spectrum disorder (ASD) has risen rapidly in the past decade. Estimates on factors associated with developmental screening and the timing of events along the diagnostic pathway can inform early identification efforts. This dissertation uses cross-sectional data from the 2016–2018 National Survey of Children’s Health to achieve 3 aims: 1) evaluate individual- and state-level sources of variance between states in developmental screening rates via multilevel models, 2) evaluate characteristics associated with the ages at which children with ASD are first diagnosed, receive an intervention plan, and begin intervention, and 3) evaluate differences in lengths of time between these events by cohort. Aim 1: The national rate of developmental screening for children ages 9 months to 5 years is 34.4% (95% Confidence Interval (CI), [34.3, 34.4]). Rates varied between states by 38%. Individual-level factors explained 6% of the variance, while income inequality and a state’s choice to track developmental screening did not explain any variance between states. Aim 2: Linear regression models adjusted for individual and household characteristics showed that compared to children aged 3–5 years at the time of the survey, children 6–11 were 18 months older at first services (? =1.49, 95% CI, [1.18, 1.81] and children aged 12–17 were 38 months older at first ASD diagnosis (? =3.16, 95% CI, [2.72, 3.60]. Aim 3: Analyses using identical models showed that compared to children aged 3–5 at the time of the survey, the interval between first plan and first services was 4 months longer for children 6–11 (? =0.34, 95% CI, [0.07, 0.61]; and 8 months longer between first ASD diagnosis and first services for children aged 12–17 (? =0.67, 95% CI, [0.28, 1.06]. Today’s children with autism receive their first diagnosis, intervention plans, and developmental services at younger ages than in the past and are moving between events with less delay compared to older children. However, the low rate of developmental screening nationwide represents missed opportunities for even earlier identification. Research is needed to identify the macro-level factors that explain the variance between states on developmental screening rates.Item Drawn from the Well of the People: The Living Stage Theatre Company and their Groundbreaking Community-Based Practice(2020) Crowley, Patrick Abram; Harding, James M; Theatre; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Drawn from the Well of the People is the first full-length history of the Living Stage Theatre Company. Founded in 1966 by Robert Alexander, Living Stage was the education and outreach arm of Arena Stage in Washington D.C. until their closing in 2002. A multi-racial, improvisational, and community-based company, Living Stage broke ground with many socially engaged theatre practices, and through their process-based approach they created theatrical engagements with, not just for their constituents. Famous for engaging the “forgotten” people of D.C. and beyond, Living Stage worked with young people besieged by poverty and segregation, seniors, the deaf and hard of hearing, disabled students, and inmates at correctional facilities like Lorton Prison and D.C. Jail. This project relies on the Living Stage Records at George Mason University Library’s Special Collections Research Center and is the first major work to do so. Additionally, long-tenured company member Jennifer Nelson donated her personal archive, which was gifted to her by Robert Alexander, to aid in the completion of this project. Oral histories from five company members were collected to supplement and enliven the written records. The dissertation also addresses the work of Haedicke and Biggs, the only extant scholarship on the group. Living Stage’s contributions force us to reconsider the intellectual history of socially engaged theatre in the United States, as they devised similar strategies to those found in Theatre of the Oppressed but did so before Augusto Boal created and published on his system. Similarly, how they obliterated the fourth wall and troubled the hierarchy between artists and audiences by engaging participants as co-creators expands the canon of radical and experimental theatre in the U.S. While their participatory approaches and commitment to marginalized communities radically democratized theatre practice, their institutional practices replicated systems of domination in important ways. For scholars and practitioners alike, Drawn from the Well of the People, offers potent models and philosophies of socially engaged theatre, case studies to illustrate the work in action, and some cautionary tales about failing to apply the ethos of the work to the internal workings of the company.Item Pink Survival Porn and its Malcontents: Visual Breast Cancer Narratives in Contemporary American Media(2020) Flanigan, Lauren Nicole; Walter, Christina; English Language and Literature; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The biggest problem with American depictions of breast cancer survivors in contemporary media is that they’re too pink, i.e. they represent the cheerful image of a white, heteronormative, cis-gendered woman of upper-to-middle-class means who easily overcomes her disease. Such patient depictions in photographic portraits, graphic novels, and television (ad campaigns or fictional episodes) suggest that only women who adhere to white feminine gender codes and sexual aesthetics can achieve survival. Meanwhile, BIPOC, LGBTQIA, and poor patients disproportionately die from breast cancer due to inaccessible or unequal care related to their lack of media representation as bodies that matter. Their truths are glossed over in the fantasy of what I call survival porn, which coopts and genericizes individual cancer experiences into a pink consumer kumbaya that benefits corporations rather than their disease-ridden constituents. This dissertation therefore examines the historical origins of pink ribbon culture, feminist health movements, and their visual entanglement with optimistic, white media metanarratives to determine why and how certain “survivors” become indoctrinated into sheroic narratives of overcoming the disease while “others” are written out of the picture altogether. Successful survivors are shown self-fashioning their personas in accordance with white, heteronormative standards of femininity judged appropriated by patriarchal medicine and cosmetic magnates. Counternarratives focusing on gender-bending these disease expectations, however, begin to chip away at the veneer of aesthetic survival, rescripting illness identities to be more inclusive of those on the fringes, for example: men, lesbians, and women of color; individuals whose inclusion within survival narratives help uncover causal determinants of breast cancer, like environmental toxins. My analysis of these personal, more plural narratives create space in the dominant, pink visual discourse for non-white and gender-fluid folx who likewise deserve to live a considered life, as defined by Audre Lorde in her Cancer Journals. Whether living with or meeting their ends from breast cancer, my academic inquiry into survival ultimately calls for an ethic of pragmatic optimism and authentic corporeal representation to allow patients with various diseases and disabilities, regardless of age, class, gender, race, or sexual orientation, to ensure greater health equity and quality of care in the United States.