School of Public Health

Permanent URI for this communityhttp://hdl.handle.net/1903/1633

The collections in this community comprise faculty research works, as well as graduate theses and dissertations.

Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.

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Author: search.filters.author.King-Marshall, Evelyn

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Now showing 1 - 5 of 5
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    LGBTQ+ cultural-competence training effectiveness: Mental health organization and therapist survey outcome results from a pilot randomized controlled trial
    (Wiley, 2023-08-25) Boekeloo, Bradley; Fish, Jessica; Turpin, Rodman; Aparicio, Elizabeth M.; Shin, Richard; Vigorito, Michael A.; Lare, Sean M.; McGraw, James S.; King-Marshall, Evelyn
    Lesbian, gay, bisexual, transgender, queer/questioning and other sexual and gender diverse (LGBTQ+) persons frequently lack access to mental health service organizations (MHOs) and therapists who are competent with LGBTQ+ clients. Existing continuing education programmes to better equip therapists to work with LGBTQ+ clients are often not widely accessible or skills focused, evaluated for effectiveness and inclusive of MHO administrators who can address the organizational climate needed for therapist effectiveness. A virtual, face-to-face, multi-level (administrators and therapists) and multi-strategy (technical assistance, workshop and clinical consultations) LGBTQ+ cultural competence training—the Sexual and Gender Diversity Learning Community (SGDLC)—was tested in a pilot randomized controlled trial. Ten organizations were randomly assigned to the intervention (SGDLC plus free online videos) or control (free online videos only) group. Pretest/posttest Organization LGBTQ+ Climate Surveys (n = 10 MHOs) and pretest/posttest Therapist LGBTQ+ Competence Self-Assessments (n = 48 therapists) were administered. Results showed that at pretest, average ratings across organization LGBTQ+ climate survey items were low; twice as many items improved on average in the intervention (10/18 items) than control (5/18 items) group organizations. At pretest, therapist average scores (range 0–1) were highest for knowledge (0.88), followed by affirmative attitudes (0.81), practice self-efficacy (0.81), affirmative practices (0.75) and commitment to continued learning (0.69). Pretest/posttest change scores were higher for the intervention relative to the control group regarding therapist self-reported affirmative attitudes (cumulative ordinal ratio [OR] = 3.29; 95% confidence interval [CI] = 1.73, 6.26), practice self-efficacy (OR = 5.28, 95% CI = 2.00, 13.93) and affirmative practices (OR = 3.12, 95% CI = 1.18, 8.25). Average therapist and administrator satisfaction scores were high for the SGDLC. These findings suggest the SGDLC training can affect organizational- and therapist-level changes that may benefit LGBTQ+ clients.
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    Technical Assistance: An Overview of a Product from the Sexual & Gender Diversity Learning Community Program
    (2024) Aparicio, Elizabeth M.; Gazit-Rosenthal, Shachar; Lare, Sean; Vigorito, Michael; Thomas, Shanéa; King-Marshall, Evelyn; Fish, Jessica N.; Boekeloo, Bradley O.; UMD-PRC Community Advisory Board
    Reflecting on your mental health organization’s structure and integrating LGBTQ+ affirming policies and procedures can be helpful in increasing your organization’s competency in supporting LGBTQ+ people. This guide includes statements and questions to help you individually or in a group setting to reflect upon, discuss, and apply key concepts to your practice.
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    Clinical Consultations: An Overview of a Product from the Sexual & Gender Diversity Learning Community Program
    (2024) Aparicio, Elizabeth M.; Gazit-Rosenthal, Shachar; Lare, Sean; Vigorito, Michael; Thomas, Shanéa; King-Marshall, Evelyn; Boekeloo, Bradley O.; Fish, Jessica N.; UMD-PRC Community Advisory Board
    Reflecting on your practice in consultation with other clinicians can improve your comfort and confidence in providing mental health care to LGBTQ+ clients. This guide includes self-reflection questions to consider on your own or bring to clinical consultation meetings.
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    Sexual and Gender Diversity Learning Community (SGDLC) Workshop Study Guide
    (2024) Aparicio, Elizabeth M.; Gazit-Rosenthal, Shachar; Lare, Sean; Vigorito, Michael; Thomas, Shanéa; King-Marshall, Evelyn; Fish, Jessica N.; Boekleoo, Bradley O.; UMD-PRC Community Advisory Board
    This guide introduces concepts from the Sexual and Gender Diversity Learning Community (SGDLC) workshop: a 7-hour training for mental health providers and administrators on LGBTQ+ affirming mental health care. The objective of this guide is to provide ways to improve mental health providers’ and administrators’ comfort, knowledge, and skill with LGBTQ+ affirmative mental health care.
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    Evaluating preferences for colorectal cancer screening in individuals under age 50 using the Analytic Hierarchy Process
    (Springer Nature, 2021-07-29) Hyams, Travis; Golden, Bruce; Sammarco, John; Sultan, Shahnaz; King-Marshall, Evelyn; Wang, Min Qi; Curbow, Barbara
    In 2021, the United States Preventive Services Task Force updated their recommendation, stating that individuals ages 45-49 should initiate screening for colorectal cancer. Since several screening strategies are recommended, making a shared decision involves including an individual’s preferences. Few studies have included individuals under age 50. In this study, we use a multicriteria decision analysis technique called the Analytic Hierarchy Process to explore preferences for screening strategies and evaluate whether preferences vary by age. Participants evaluated a hierarchy with 3 decision alternatives (colonoscopy, fecal immunochemical test, and computed tomography colonography), 3 criteria (test effectiveness, the screening plan, and features of the test) and 7 sub-criteria. We used the linear fit method to calculate consistency ratios and the eigenvector method for group preferences. We conducted sensitivity analysis to assess whether results are robust to change and tested differences in preferences by participant variables using chi-square and analysis of variance. Of the 579 individuals surveyed, 556 (96%) provided complete responses to the AHP portion of the survey. Of these, 247 participants gave responses consistent enough (CR < 0.18) to be included in the final analysis. Participants that were either white or have lower health literacy were more likely to be excluded due to inconsistency. Colonoscopy was the preferred strategy in those < 50 and fecal immunochemical test was preferred by those over age 50 (p = 0.002). These results were consistent when we restricted analysis to individuals ages 45-55 (p = 0.011). Participants rated test effectiveness as the most important criteria for making their decision (weight = 0.555). Sensitivity analysis showed our results were robust to shifts in criteria and sub-criteria weights. We reveal potential differences in preferences for screening strategies by age that could influence the adoption of screening programs to include individuals under age 50. Researchers and practitioners should consider at-home interventions using the Analytic Hierarchy Process to assist with the formulation of preferences that are key to shared decision-making. The costs associated with different preferences for screening strategies should be explored further if limited resources must be allocated to screen individuals ages 45-49.