Behavioral & Community Health
Permanent URI for this communityhttp://hdl.handle.net/1903/2271
Prior to January 24, 2011, this unit was named the Department of Public & Community Health.
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Item Exploring Young Bi+ Women's Intersecting Mental Health and Sexual and Reproductive Health Experiences in Context: A Multi-Analytic Method Qualitative Study(2023) Robinson, Jennifer Lynn; Aparicio, Elizabeth M; Butler, James; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Young bi+ women report worse mental health and sexual and reproductive health (SRH) outcomes compared to gay, lesbian, and straight young adults. They experience intersecting threats to their health and well-being due to their sexuality, gender, and stage of development. There is a lack of research on bi+ women’s unique mental health and SRH experiences, and often bi+ women are overlooked due to bi-erasure and biphobia. Regressive policies related to LGBTQ+ and women’s rights, including increased restrictions to reproductive healthcare after the Dobbs v. Jackson Women’s Health Organization decision overturning abortion protections, further threaten bisexual women’s health. This dissertation used a multi-analytic method qualitative approach to explore the intersecting mental health and SRH experiences of young bisexual women in the current socio-political context. Semi-structured in-depth interviews were conducted over Zoom with 16 young bi+ women from across the U.S. A narrative inquiry approach was used to explore young bi+ women’s mental health experiences and coping strategies. In addition, thematic analysis was used to investigate how young bi+ women describe their mental health as intersecting with their SRH in the current socio-political context. The study yielded rich and nuanced information about challenges these young bi+ women experienced throughout their lives that affected their mental health and SRH. Experiencing trauma had far-reaching negative effects on their mental health. Participants discussed the challenges of forming their identity within the social context, particularly as bi+ women in a society that often invalidates bisexual identities and subjugates women. They also discussed the joys along with difficulties of navigating young adulthood. They further described coping with challenges in a variety of adaptive (e.g., therapy, exercise) and maladaptive (e.g., substance use, self-injury) ways. They discussed relying on social support such as partners, friends, family, therapists, and teachers. Participants desired more support with sexuality-related issues, particularly in early adolescence. These bi+ women described their mental health and SRH as intertwined and discussed how bodily autonomy and agency were essential to their well-being. The socio-political context, including social norms, rhetoric, and federal- and state-level policies, influenced participants’ well-being. The current study shows that young bi+ women face unique threats to their mental health and SRH. Practice implications include improving access to affordable and LGBTQ+-affirming healthcare and developing interventions attuned to the needs of young bi+ women. Policies are needed that uphold the choice and agency of young women in their reproductive health decision-making. Future research should continue to explore the needs and experiences of young bi+ women concerning their mental health and SRH including demographic differences along with potential mechanisms resulting in poorer health.Item WHAT HAPPENS WHEN STUDENTS KNUCK AND BUCK SYSTEMS OF INJUSTICE? A MULTIMETHOD STUDY EXPLORING THE RELATIONSHIP BETWEEN STUDENT ACTIVISM AND EMOTIONAL WELL-BEING(2022) Smith, Samantha Alyce; Arria, Amelia M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)In recent years, college students' declining mental health status has garnered the attention of public health and educational professionals. Mental health is a complex construct influenced by biological, behavioral, social, and environmental factors. One critical dimension of mental health is emotional well-being, representing the positive and negative emotions one experiences. Little research exists regarding the relationship between activism, a possible social influence, and mental health. This multimethod dissertation study focuses on the relationship between college student participation in activism and contemporary social movements, including the Black Lives Matter movement, and different dimensions of emotional well-being, including depressive and anxiety symptoms, level of optimism, and sense of belonging. Framed by the Transactional Theory of Stress and Coping, the qualitative portion of the research involved in-depth interviews among 18 students aged 18-25 who participated in 2020 Black Lives Matter protests. The purpose of these interviews was to examine the short-term impact of protest participation on student emotional well-being and how activism was related to coping. Findings revealed that the sociopolitical climate negatively impacted student emotional well-being, and those associated negative emotions acted as a motivator to participate in protests. Conversely, participating in protests garnered sense of belonging and empowerment. Protest participation appeared to serve as an emotion-focused coping strategy among these students. The quantitative analyses conducted in this dissertation utilized secondary data from the 2019 Wake Forest Well-being Assessment to investigate the motivators (Aim 2) and emotional well-being correlates (Aim 3) of activism participation. For both analyses, two forms of activism were studied – disruptive (e.g., protests) and persuasive tactics (e.g., digital activism). Civic morals identity centrality and discrimination were examined as possible motivators. Multivariate and multinomial logistic regression models developed for Aim 2 held constant other potential confounding variables (i.e., gender, sexual orientation, parental education and race/ethnicity) and revealed positive associations between discrimination experiences and civic moral identity centrality and disruptive activism (p<.001) and persuasive tactics (p<.001). Regression models for Aim 3 that examined the relationship between activism participation and emotional well-being revealed that disruptive activism tactics were positively associated with depressive symptoms (p<.001), anxiety symptoms (p<.001), and sense of belonging (p<.05). A negative association was observed between disruptive activism and optimism (p<.05). All of these associations were robust to the inclusion of demographic covariates. Coping did not appear to moderate any of the relationships observed. Taken together these finding begin to elucidate the nuanced and complex relationship between activism and emotional well-being. Given that a significant proportion of college students studied participated in some form of activism, our understanding of the impact of activism on student emotional well-being is an important area that warrants additional investigation in future studies. The findings of this study can be used to support ongoing intervention development that addresses the mental health needs of college students, specifically those engaged in activism work. Additionally, these findings can be used to support mitigating health disparities that are the result from sociopolitical factors such as racism and discrimination.Item YO SOY PAZ (I AM PEACE): PILOT STUDY OF A TRAUMA-INFORMED, COMMUNITY AND MINDFULNESS-BASED PROGRAM FOR LATINO IMMIGRANTS IN MARYLAND.(2022) Munoz, Juliana; Green, Kerry M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: One in three Latinos in the US is an immigrant. Immigrants face particular stressors that are heightened by previous traumatic experiences before, during, and after migration. Latino populations report the highest level of stress of all racial/ethnic groups in the US and the second-highest prevalence of mental health illness. Mindfulness-Based Interventions (MBIs) have shown to be successful at reducing stress and strengthening mental health in diverse populations, yet little is known about the effects of these interventions on this particular population.Methods: The pilot study tested the Yo Soy Paz (I am Peace) online synchronous program, an evidence and trauma-informed mindfulness-based intervention that was adapted for immigrant Latina mothers and the community staff members that work with them in a community setting. The eight session pilot intervention was delivered to three cohorts for a total of 41 participants, including staff and parents of youth receiving services at a local community-based organization that serves Latino immigrants. The study used the Consolidated Framework for Implementation Research (CFIR) to examine the feasibility, acceptability, appropriateness, and fidelity of the Yo Soy Paz online program. The study also examined the initial effects of the program on stress, mindfulness, mind-body connection, and subjective well-being. Qualitative and quantitative data were collected through self-reported pre-post questionnaire, fidelity checklists, and focus groups with parents and staff. Results: Acceptability, feasibility, fidelity and appropriateness scored high on the quantitative measures. Inner compatibility with the organization’s mission and vision, clients’ needs and the organization’s receptivity to implement the intervention scored in the medium range. Mothers’ and promotoras’ self-reported mean scores for subjective wellbeing and perceived physical and mental health increased significantly from baseline- to post-test. No significant changes were observed in surveys completed by the staff, even though focus group participants reported meaningful improvement. Discussion: Overall the pilot feasibility study was well received and relevant for the organization and the population they serve. MBIs for Latino immigrants and the staff that works with them have the potential to improve well-being and overall mental and physical health. The study’s findings provide guidance to others in implementing online mindfulness practices with Latino immigrants and the staff that works with them.Item PREDICTORS OF RESILIENCE AMONG COMMISSIONED OFFICERS IN THE UNITED STATES PUBLIC HEALTH SERVICE(2012) Peat, Raquel Antonia; Desmond, Sharon M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The purpose of this cross-sectional study was to examine the predictors of resilience and mental health among United States Public Health Service (USPHS) commissioned officers who have deployed. The study employed the Transactional Model of Stress and Coping (Antonovsky and Kats, 1967; Cohen, 1984; Lazarus and Cohen, 1977) to aid in evaluation of the above factors. Relatively few research studies have examined the concept of resilience, and to date, no study has systematically examined risk, social support, mental health and resilience in USPHS commissioned officers. A pilot study (N = 11) was conducted to determine acceptability of the survey items and assess time needed to complete the questionnaire. The final 94-item on-line survey was completed over a two month time period by a convenience sample of 534 USPHS commissioned officers. Univariate analyses demonstrated that when entered individually, team support, post-deployment social support and mental health (protective factors) and the covariates, gender and relationship status were significantly (p<0.05) associated with resilience, while predeployment affectivity (risk factor) was not. When all risk and protective factors were entered into the multivariate logistic regression model, team support, post-deployment social support, mental health, gender and being divorced as compared to being separated, widowed or living with a partner were found to be significantly associated with resilience (p<0.05). Also, both team support and resilience were negatively associated with mental illness measured using depression, anxiety and post-traumatic stress disorder subscales (p<0.05). Those USPHS commissioned officers who reported mental illness were less likely to be resilient. This study provides new data that may help improve our understanding of the resilience and mental health of USPHS commissioned officers, before and after deployment. Findings can be used to inform education and training programs for USPHS commissioned officers (e.g. coping skills training techniques) to help increase their ability to thrive despite adversity before and after deployment.Item THE EASE PROGRAM: THE DEVELOPMENT OF A DISTRESS TOLERANCE INTERVENTION FOR MIDDLE SCHOOL ADOLESCENTS(2012) La Touche-Howard, Sylvette Antonia; Daughters, Stacey B.; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Although many middle school adolescents consider the middle school grades to be an exhilarating time of momentous change in their lives, others struggle not only with academic challenges but also with the inability to handle negative emotional states. Middle school adolescents often seek ways to cope with the distress they experience. Evidence indicates that adolescents are rarely adequately equipped with the necessary skills to deal with these stressful situations. Moreover, studies indicate that their distress tolerance, defined as the ability to persist in goal directed activity while experiencing emotional distress, is associated with increased risk behavior. Given preliminary evidence that low distress tolerance is associated with risky health behavior amongst adolescents, the overall goal of this study was to develop an adolescent appropriate intervention for improving distress tolerance skills, drawing on techniques from Dialectical Behavior therapy, with four main objectives: (1) to enable adolescents to understand the relationship between their emotions and behavior; (2) to educate adolescents on how to identify and label their emotions; (3) to teach skills to adolescents that will enable them to cope with their difficult emotions; and (4) to provide adolescents with skills that will enable them to avoid engaging in later risk behavior. To aide in the development of this intervention, a multi-method approach was employed using focus groups (n=20), in depth interviews (n=15) and a 3 round Delphi method (n=12). Results from this study were used to develop, modify and finalize a distress tolerance intervention (EASE- Empowering Adolescents to deal with Stress and Emotions) for middle school adolescents.