University of Alabama Repository :: Browsing by Author "Albright, David L."

Browsing by Author "Albright, David L."

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Attitudes and opinions toward stress-related support services among police in a southern state: a qualitative study
(University of Alabama Libraries, 2020) Barber, Brad W.; Albright, David L.; University of Alabama Tuscaloosa
Police work is considered one of the most stressful occupations in the world and the high levels of stress associated with police work place officers at high risk for developing mental and physical health problems. Police officers also pose a threat to themselves, their families, and the general public when work-related stress is unresolved; high levels of stress among police can manifest into self-destructive, violent, and deviant behavior. Although stress management interventions have been available to police since the 1940s, the health and behavioral problems associated with unresolved stress have not shown any signs of improvement. The purpose of this study was to explore and identify (1) how police officers appraise stress-related support services, (2) suggestions they have regarding ways to improve these services, and (3) recommendations for new support services that would help to reduce and better manage work related stress. A pragmatic qualitative research approach was used to guide this study. Individual semi-structured interviews were conducted with a purposeful sample of 20 patrol officers with at least two years of police experience. Findings showed that overall attitudes toward support services were positive, but two external factors were identified as major barriers to using services. Distrust toward confidentiality protections with intervention workers resulted in a perceived threat of being deemed unfit for duty by supervisors for using a support service. Similarly, a fear of appearing weak to other officers keeps officers from seeking needed services. However, participants recommended several feasible implications for lowering these barriers and to increasing officers’ willingness to using support services if needed. Most participants endorsed mandatory counseling after a critical incident because a standardized policy would reduce the fear of looking weak and the threat of being deemed unfit for duty. Suggestions for increasing trust in confidentiality protections included allowing police to meet counselors at private and discrete locations, giving officers the option of choosing their own counselor rather than assigning them one, and requiring external intervention workers to conduct “ride alongs” to build rapport with officers and better understand the unique stress associated with police work.
Attorney Interpretations of Law and Policy Regarding Military Families with Dependents Experiencing Disabilities
(University of Alabama Libraries, 2024) Meadows, James Thomas; Cheatham, Leah P.
Within the United States Armed Forces, support of families is seen as a service that is critical to the success of the military mission. Due to the armed forces being an all-volunteer force, families of all demographics need to be served, including families where a dependent has a disability. Policies and practices influence how these families experience their lives in the armed forces. When those policies and practices conflict, they are often interpreted through court cases. This study analyzed interviews with attorneys familiar with military and/or disability-related issues to describe how these policies and practices are being interpreted in relation to military families where a family member experiences a disability. Interviews and qualitative analyses were guided by ecological systems and intersectionality theories. Participant attorneys reported that these families are typically enrolled in the Exceptional Family Member Program. Findings suggest that while policies as written do not appear to be in conflict, the applications of policies based on discretionary authority and cultural norms do appear to cause distress for these families. Particular concerns identified include resolving service interruptions after relocation, mitigating career influences, and addressing issues of appropriate representation. Recommendations for research, policy and advocacy, and practice are identified.
Delivering problem-solving therapy to family caregivers of people with cancer: A feasibility study in outpatient palliative care
(Wiley, 2018) Washington, Karla T.; Demiris, George; Oliver, Debra Parker; Albright, David L.; Craig, Kevin W.; Tatum, Paul; University of Missouri Columbia; University of Pennsylvania; University of Alabama Tuscaloosa
Objective: In response to the well-documented need for evidence-based cancer caregiver support, we examined the feasibility of problem-solving therapy for family caregivers of cancer patients receiving outpatient palliative care and investigated the impact of problem-solving therapy on family caregivers' anxiety, depression, and quality of life. Methods: We conducted a feasibility study of a structured problem-solving therapy intervention delivered to family caregivers of cancer patients receiving outpatient palliative care from an academic health center in the Midwestern United States. Participants (N = 83) were randomly assigned to receive usual care or usual care plus a problem-solving therapy intervention, which was delivered over three sessions via web-based videoconferencing or telephone. Descriptive statistics were used to determine feasibility relative to recruitment, retention, and fidelity to core intervention components. Outcome data were analyzed using ordinary least squares multiple regression. Results: Problem-solving therapy for family caregivers of patients with cancer was found to be highly feasible in the outpatient palliative care setting. Caregivers who received problem-solving therapy reported less anxiety than those who received only usual care (P = 0.03). No statistically significant differences were observed for caregiver depression (P = 0.07) or quality of life (P = 0.06). Conclusions: Problem-solving therapy is a feasible and promising approach to reducing cancer family caregivers' anxiety in the outpatient palliative care setting. Further testing in multiple sites is recommended.
Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans
(BMC, 2018) Johnson, Rebecca A.; Albright, David L.; Marzolf, James R.; Bibbo, Jessica L.; Yaglom, Hayley D.; Crowder, Sandra M.; Carlisle, Gretchen K.; Willard, Amy; Russell, Cynthia L.; Grindler, Karen; Osterlind, Steven; Wassman, Marita; Harms, Nathan; University of Missouri Columbia; US Department of Veterans Affairs; Veterans Health Administration (VHA); Harry S. Truman Memorial Veterans' Hospital; University of Alabama Tuscaloosa; Purdue University; Purdue University West Lafayette Campus; University of Missouri Kansas City
Background: Large numbers of post-deployment U.S. veterans are diagnosed with post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI), leading to an urgent need for effective interventions to reduce symptoms and increase veterans' coping. PTSD includes anxiety, flashbacks, and emotional numbing. The symptoms increase health care costs for stress-related illnesses and can make veterans' civilian life difficult. Methods: We used a randomized wait-list controlled design with repeated measures of U.S. military veterans to address our specific aim to test the efficacy of a 6-week therapeutic horseback riding (THR) program for decreasing PTSD symptoms and increasing coping self-efficacy, emotion regulation, social and emotional loneliness. Fifty-seven participants were recruited and 29 enrolled in the randomized trial. They were randomly assigned to either the horse riding group (n = 15) or a wait-list control group (n = 14). The wait-list control group experienced a 6-week waiting period, while the horse riding group began THR. The wait-list control group began riding after 6 weeks of participating in the control group. Demographic and health history information was obtained from all the participants. PTSD symptoms were measured using the standardized PTSD Checklist-Military Version (PCL-M). The PCL-M as well as other instruments including, The Coping Self Efficacy Scale (CSES), The Difficulties in Emotion Regulation Scale (DERS) and The Social and Emotional Loneliness Scale for Adults-short version (SELSA) were used to access different aspects of individual well-being and the PTSD symptoms. Results: Participants had a statistically significant decrease in PTSD scores after 3 weeks of THR (P <= 0.01) as well as a statistically and clinically significant decrease after 6 weeks of THR (P <= 0.01). Logistic regression showed that participants had a 66.7% likelihood of having lower PTSD scores at 3 weeks and 87.5% likelihood at 6 weeks. Under the generalized linear model(GLM), our ANOVA findings for the coping self-efficacy, emotion regulation, and social and emotional loneliness did not reach statistical significance. The results for coping self-efficacy and emotion regulation trended in the predicted direction. Results for emotional loneliness were opposite the predicted direction. Logistic regression provided validation that outcome effects were caused by riding longer. Conclusion: The findings suggest that THR may be a clinically effective intervention for alleviating PTSD symptoms in military veterans.
Gender Differences in Caregiving at End of Life: Implications for Hospice Teams
(Mary Ann Liebert, 2015) Washington, Karla T.; Pike, Kenneth C.; Demiris, George; Oliver, Debra Parker; Albright, David L.; Lewis, Alexandria M.; University of Missouri Columbia; University of Washington; University of Washington Seattle; University of Alabama Tuscaloosa
Background: Researchers have identified important gender differences in the experience of caring for a family member or friend living with advanced disease; however, trends suggest that these differences may be diminishing over time in response to changing gender roles. In addition, while many studies have found caregiving experiences and outcomes to be poorer among female caregivers, noteworthy exceptions exist. Objective: The primary aim of this exploratory study was to determine how, if at all, current day caregiving at end of life varies by gender. Methods: We conducted a secondary analysis of data from a multisite randomized controlled trial of a family caregiving intervention performed between 2010 and 2014. We compared female and male hospice family caregivers on baseline variables using (2) tests for association of categorical variables and t-tests for continuous variables. Our sample included 289 family caregivers of individuals receiving services from one of two hospice agencies located in the northwestern United States. Demographic data and other categorical variables of interest were provided via caregiver self-report using an instrument created specifically for this study. Reaction to caregiving and caregiving burden were measured using the Caregiver Reaction Assessment (CRA). Results: As it related to caregiving, females had significantly lower self-esteem and more negative impact on their schedule, health, and family support than males. No gender differences were detected with regard to the impact of caregiving on individuals' finances. Conclusions: Despite changing social expectations, pronounced gender differences persist in caregiving at the end of life.
A multimethod analysis of shared decision-making in hospice interdisciplinary team meetings including family caregivers
(Sage, 2016) Washington, Karla T.; Oliver, Debra Parker; Gage, L. Ashley; Albright, David L.; Demiris, George; University of Missouri Columbia; University Nebraska Kearney; University of Alabama Tuscaloosa; University of Washington; University of Washington Seattle
Background: Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. Aim: We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. Design: We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n=100), individual interviews of family caregivers (n=73) and hospice staff members (n=78), and research field notes. Setting/participants: Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. Results: Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in healthcare delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. Conclusion: The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers.
Psychological Resilience and Cognitive Function Among Older Military Veterans
(Sage, 2022) McDaniel, Justin T.; Hascup, Erin R.; Hascup, Kevin N.; Trivedi, Mehul; Henson, Harvey; Rados, Robert; York, Mary; Albright, David L.; Weatherly, Taryn; Frick, Kaitlyn; Southern Illinois University; University of Alabama Tuscaloosa
The purpose of this study was to explore the association between psychological resilience and cognitive function in military veterans. We obtained public-use data from the Health and Retirement Study (HRS) for this cross-sectional study of military veterans aged 52 to 101 years (n = 150). We estimated a multivariable linear regression model in which cognitive function served as the dependent variable and psychological resilience served as the independent variable. After controlling for demographics, health conditions, and health behaviors, veterans who had higher psychological resilience scores had better cognitive function (b = 0.22, p = 0.03). Our findings suggest that psychological resilience may be associated with cognitive function among veterans. These findings highlight the importance of assessing psychological resilience in gerontological social work practice.
Psychosocial Needs of US Active Duty Military Service Members and Spouses with Cancer: a Qualitative Study
(University of Alabama Libraries, 2021) Godfrey, Kelli; Albright, David L.; Csikai, Ellen L.; University of Alabama Tuscaloosa
Current United States active duty military (AD) service members and spouses are at an increased risk of developing various types of cancer at a higher rate reported than their military predecessors (Defense Health Research Programs, 2017; Zhu et al., 2009; Steinmaus, Lu, Todd, & Smith, 2004). Active duty service members and spouses also face challenges not faced by their civilian counterparts because of the military lifestyle and “mission first” culture. These challenges can include being geographically separated from families, friends, and other support systems, along with deployments, frequent moves, and the lack of consistent support systems. Therefore, when AD service members and spouses are diagnosed with cancer psychosocial needs may not be met. The research and literature surrounding the psychosocial needs of AD military service members and spouses with cancer are limited as the current research focuses mainly on non-military affiliated groups or veterans. The purpose of this qualitative research was to understand the psychosocial needs of US AD service members and spouses diagnosed with cancer. Data from semi-structured interviews provided insight that facilitated understanding these psychosocial needs. Participants discussed support systems, relationships, psychological and emotional responses, and ways the military environment both supported and lacked support during their cancer journey. Participants further noted that some of the barriers included not knowing what support systems were available and availability depended upon geographic location and how “close” the community was; not having to pay any out-of-pocket costs; and that chains of command inconsistently supported their service members and families. The results of this study have implications for social workers who work within the military structure as well as civilian providers. Ensuring that AD service members and spouses know the available resources, both through the military and in the civilian community, is one area that can improve the psychosocial outcomes of AD service members and spouses with cancer. The results also show the importance in understanding the stressors that cause additional mental and physical barriers, unique to the military environment, during treatment and into survivorship. Participants were eager to have their voices heard and wanted to ensure that fellow AD service members and spouses with cancer have improved experiences with health care systems and support.
Relationships between social sector spending, public healthcare spending, and mental health service use
(University of Alabama Libraries, 2018) McKinney, Robert Earl; MacNeil, Gordon; Albright, David L.; University of Alabama Tuscaloosa
Recent research suggests that increased governmental social sector spending, those monies allocated for such diverse things as transportation infrastructure, parks, police and fire protection, education, and income support, is positively related to improved health. This study, expanding upon the work of Elizabeth Bradley and Lauren Taylor, was intended to determine if there is a similar relationship between components of social sector spending and mental health indicators. The study uses mental health indicator data that are drawn from the National Survey on Drug Use and Health (SAMHSA) and spending data that are drawn from the US Census Bureau and the Centers for Medicare and Medicaid. My regression analyses suggest that, for two of the three identified mental health indicators, there is a relationship between social sector spending and mental health indicators. These findings of the descriptive study are considered in the context of Gelberg’s Behavioral Model for Vulnerable Populations. Although the data for the dependent variables (mental health indicators) are longitudinal for a 12-year period, they were reported in 2-year panels, thus limiting the study to six observations over 12 years. This has negative implications for the power of the study. Additionally, the data for the independent variable captured spending at the state level, with no analysis of particular programs or activities.
The Social Convoy for Family Caregivers Over the Course of Hospice
(Elsevier, 2016) Albright, David L.; Washington, Karla; Parker-Oliver, Debra; Lewis, Alexandria; Kruse, Robin L.; Demiris, George; University of Alabama Tuscaloosa; University of Missouri Columbia; University of Washington; University of Washington Seattle
Context. Family caregivers play a central role in the care of those in hospice care. Little is known about the social support networks for those providing this day-to-day care without training. Objectives. The purpose of this study was to explore changes in family and friend social networks among hospice caregivers over the course of the hospice stay. Methods. Data on social support networks were collected as part of a multisite randomized controlled trial and analyzed using structural equation modeling. Results. A statistically significant decline in the caregivers' family network subscale score was found over the four week period during which they received hospice services, reflecting a possible weakening of their family networks. Conclusion. This result illustrates the potential importance of ongoing comprehensive assessment of caregiver networks and attention to interventions that may assist in capitalizing on both the quantity of support (numbers of individuals asked to help) and the quality of social support (attending to issues of support burden). (C) 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Browsing by Author "Albright, David L."

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