Research and Publications - School of Social Work

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    Parenting, privilege, and pandemic: From surviving to thriving as a mother in the academy
    (Sage, 2021) Beech, Haley H.; Sutton, Amber; Cheatham, Leah; University of Alabama Tuscaloosa
    As women who have dual roles as parents and academicians, COVID-19 has presented new challenges and opportunities that have impacted our personal and professional lives. This essay provides insight into unique obstacles from the perspective of mothers, researchers, and social workers and challenges the traditional models of work/life balance as professionals in academics. This reflexive essay provides the narratives and experiences of one assistant professor and two doctoral students who are learning to navigate motherhood and professional responsibilities amidst a global pandemic. The prologue presents a perspective from a current assistant professor and her lived experiences followed by the reflections of two doctoral students on how to navigate the academy as mothers and as women. In addition to our personal stories and narratives, we hope to challenge, inspire, and reimagine how our dual roles can be viewed as an asset, rather than a weakness and encourage others in the academy to rise and support women.
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    Experience of Primary Care among Homeless Individuals with Mental Health Conditions
    (PLOS, 2015) Chrystal, Joya G.; Glover, Dawn L.; Young, Alexander S.; Whelan, Fiona; Austin, Erika L.; Johnson, Nancy K.; Pollio, David E.; Holt, Cheryl L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa A.; Daigle, Shanette G.; Steward, Jocelyn L.; Kertesz, Stefan G.; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Greater Los Angeles Healthcare System; University of California Los Angeles; Veterans Affairs Medical Center - Birmingham; University of Alabama Tuscaloosa; University of Maryland College Park; VA Pittsburgh Healthcare System; University of Pittsburgh; Boston University; University of Alabama Birmingham
    The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.
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    Support groups for Alzheimer's caregivers: Creating our own space in uncertain times
    (Routledge, 2018) Simpson, Gaynell M.; Stansbury, Kim; Wilks, Scott E.; Pressley, Tracy; Parker, Michael; McDougall, Graham J., Jr.; University of Alabama Tuscaloosa; North Carolina State University; Louisiana State University; Florida State University
    Older men are often excluded from family caregiving research despite the steady increase in the number of husbands assuming primary caregiving roles. We explored perceptions of older, male caregivers' experiences with caring for a wife with Alzheimer's Disease (AD) and examined what aspects of the support group were beneficial. Our qualitative research methods invited six caregivers ranging in age from 74 to 85 years to narratively construct their perspectives on caring for their wives with Alzheimer's Disease and benefits of participation in an all-male support group. Thematic analyses revealed caregivers faced several transitions. "Losses related to their personal relationships with their wife, family, and self," captured as loss of golden years. The second area, benefits and improvements of support groups, were captured in the following theme: "creating our own space," which included two sub-themes: "releasing our frustration" and "developing coping strategies." There was also "Gendered experience of caregiving." This study revealed that male caregivers benefited from the support and company of other men in similar caregiving situations. Results from this study have implications for health care professionals for the development of psychosocial educational groups aimed at providing support to male caregivers.
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    A Feasibility Study of Virtual Reality-Based Coping Skills Training for Nicotine Dependence
    (Sage, 2012) Bordnick, Patrick S.; Traylor, Amy C.; Carter, Brian L.; Graap, Ken M.; University of Houston; University of Alabama Tuscaloosa
    Objective: Virtual reality (VR)-based cue reactivity has been successfully used for the assessment of drug craving. Going beyond assessment of cue reactivity, a novel VR-based treatment approach for smoking cessation was developed and tested for feasibility. Method: In a randomized experiment, 10-week treatment feasibility trial, 46 nicotine-dependent adults, completed the 10-week program. Virtual reality skills training (VRST) combined with nicotine replacement therapy (NRT) was compared to NRT alone. Participants were assessed for smoking behavior and coping skills during, at end of treatment, and at posttreatment follow-up. Results: Smoking rates and craving for nicotine were significantly lower for the VRST group compared to NRT-only group at the end of treatment. Self-confidence and coping skills were also significantly higher for the VRST group, and number of cigarettes smoked was significantly lower, compared to the control group at follow-up. Conclusions: Feasibility of VRST was supported in the current study.
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    A Systematic Review of Internet Communication Technology Use by Youth in Foster Care
    (Springer, 2022) Sage, Melanie; Jackson, Sebrena; State University of New York (SUNY) Buffalo; University of Alabama Tuscaloosa
    This systematic narrative review of the literature reports on the experiences of foster youth regarding the use of Internet Communication Technologies (ICTs) such as social media, focusing only on studies that include youth voice. We searched seven databases for articles published internationally from 2010 to 2020 in which foster youth were interviewed regarding their beliefs about ICTs. Youth report benefits of ICTs including to their relationships and identity formation opportunities, and discuss risks of ICTs and how they manage them. ICTs may benefit positive youth development. Stakeholders may consider ways to assess and support healthy ICT use.
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    mSocial Workers as Research Psychotherapists in an Investigation of Cognitive Behavioral Therapy among Rural Older Adults
    (Oxford University Press, 2013) Shah, Avani; Scogin, Forrest; Presnell, Andrew; Morthland, Martin; Kaufman, Allan V.; University of Alabama Tuscaloosa
    This is a report on the treatment fidelity of in-home cognitive-behavioral therapy (CBT) delivered by a sample of clinically trained, master's-level social workers to a group of primarily rural, medically frail older adults as part of the Project to Enhance Aged Rural Living (PEARL) clinical trial. The social workers in this study received brief didactic and experiential CBT training. Audiotaped sessions were randomly selected and evaluated by independent reviewers. Results showed that the social workers adequately delivered CBT as measured by the Cognitive Therapy Scale. Older adult participants also evidenced pre-posttreatment improvements, suggesting that the social workers' delivery of CBT facilitated improvement.
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    Breast cancer literacy and health beliefs related to breast cancer screening among American Indian women
    (Routledge, 2018) Roh, Soonhee; Burnette, Catherine E.; Lee, Yeon-Shim; Jun, Jung Sim; Lee, Hee Yun; Lee, Kyoung Hag; University of South Dakota; Tulane University; San Francisco State University; Wichita State University; University of Alabama Tuscaloosa
    The purpose of this article is to examine the health beliefs and literacy about breast cancer and their relationship with breast cancer screening among American Indian (AI) women. Using the Health Belief Model (HBM) and hierarchical logistic regression with data from a sample of 286 AI female adults residing in the Northern Plains, we found that greater awareness of breast cancer screening was linked to breast cancer screening practices. However, perceived barriers, one of the HBM constructs, prevented such screening practices. This study suggested that culturally relevant HBM factors should be targeted when developing culturally sensitive breast cancer prevention efforts.
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    All I was Thinking About was Shattered: Women's Experiences Transitioning Out of Anti-Trafficking Shelters During the COVID-19 Lockdown in Uganda
    (Sage, 2023) Namy, Sophie; Namakula, Sylvia; Nabachwa, Agnes Grace; Ollerhead, Madeleine; Tsai, Laura Cordisco; Kemitare, Jean; Bolton, Kelly; Nkwanzi, Violet; Carlson, Catherine; Harvard University; University of Alabama Tuscaloosa
    Human trafficking is an egregious violation of fundamental human rights and a global challenge. The long-term harms to survivors' physical, psychological and social wellbeing are profound and well documented, and yet there are few studies exploring how to best promote resilience and holistic healing. This is especially true within shelter programs (where the majority of anti-trafficking services are provided) and during the transition out of residential shelter care, which is often a sensitive and challenging process. The current study begins to address this gap by centering the lived experiences of six women residing in a trafficking-specific shelter in Uganda as they unexpectedly transitioned back to their home communities due to the COVID-19 lockdown. We explore this pivotal moment in participants' post-trafficking journey, focusing on how these women described and interpreted their rapidly changing life circumstances-including leaving the shelter, adjusting back to the community setting, and simultaneously navigating the uncertainties of a global pandemic. Four core themes emerged from the analysis: economic insecurities as a cross-cutting hardship; intensification of emotional and physical symptoms; social disruptions; and sources of hope and resilience. By centering their personal stories of struggle and strength, we hope to elevate survivors' own accounts and draw on their insights to identify actionable considerations for future programming.
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    Worn out: Coping strategies for managing antiretroviral treatment fatigue among urban people of color living with HIV who were recently disengaged from outpatient HIV care
    (Routledge, 2020) Jaiswal, J.; Francis, M. D.; Singer, S. N.; Dunlap, K. B.; Cox, A. B.; Greene, R.; University of Alabama Tuscaloosa; Yale University; Columbia University; New York University; Rutgers State University New Brunswick
    Antiretroviral-related treatment fatigue is inconsistently defined in the literature on barriers to ART adherence. Research suggests that treatment fatigue is a salient challenge for people struggling with antiretroviral therapy adherence, but little is known about how people living with HIV attempt to manage this fatigue. Twenty-seven semi-structured interviews were conducted with low-income people of color living with HIV in NYC that were currently, or recently, disengaged from HIV care. The findings from this exploratory study suggest that treatment fatigue was common and that participants devised personal strategies to overcome it. These strategies included using reminder programs, requesting weekly rather than monthly pill quantities, and taking "pill holidays". The varied nature- and varying levels of effectiveness- of these strategies highlight the need for specific programing to provide tailored support. Future research should examine treatment fatigue as a specific subtype of adherence challenge, and aim to define pill fatigue clearly.
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    Conducting secondary analysis of qualitative data: Should we, can we, and how?
    (Sage, 2019) Ruggiano, Nicole; Perry, Tam E.; University of Alabama Tuscaloosa; Wayne State University
    While secondary data analysis of quantitative data has become commonplace and encouraged across disciplines, the practice of secondary data analysis with qualitative data has met more criticism and concerns regarding potential methodological and ethical problems. Though commentary about qualitative secondary data analysis has increased, little is known about the current state of qualitative secondary data analysis or how researchers are conducting secondary data analysis with qualitative data. This critical interpretive synthesis examined research articles (n = 71) published between 2006 and 2016 that involved qualitative secondary data analysis and assessed the context, purpose, and methodologies that were reported. Implications of findings are discussed, with particular focus on recommended guidelines and best practices of conducting qualitative secondary data analysis.
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    Exploring the Provisions in Medical Social Work Settings for Those Living with Diabetes: A Systematic Review
    (2022) Brunson, Amie; University of Alabama Tuscaloosa
    Diabetes is a public health issue that constantly prompts social work practitioners to examine how to best serve those diagnosed. Social workers and other practitioners unfamiliar with the disease may think of a disease that is easily managed by checking one’s blood sugar and taking medications. Not many people imagine a disease that has the power to inflict extreme damage internally before manifesting in external signs and symptoms. Anyone is susceptible to this disease. Without the knowledge of proper treatment and access to resources on the part of practitioners, devastating consequences can arise for those with diabetes. Nowhere is this issue more prevalent than in communities of color and the underprivileged. Medicaid-eligible patients are particularly at-risk for higher rates of chronic diseases, while communities of color disproportionately suffer from higher rates of poorly controlled diabetes and remain at heightened risk for negative health outcomes. The following systematic review will include a detailed explanation of the disease process along with the devastating effects of untreated diabetes. Care coordination services will be evaluated to determine whether the implementation of those services decrease adverse health outcomes in diabetic patients. By systematically reviewing the literature, this study highlights the crucial need for interventions targeting social determinants of health factors that often affect communities of color and the underprivileged. Without those interventions to address those barriers, the benefits of care coordination services are minimal. are cancelled out. By considering the ways in which the disease has primarily been managed by medical professionals in the past, this will allow for an alternative view of managing the disease in the future.
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    Health Literacy and Frailty in Community-Dwelling Older Adults: Evidence from a Nationwide Cohort Study in South Korea
    (MDPI, 2021) Shin, Hye-Ri; Choi, Eun-Young; Kim, Su-Kyung; Lee, Hee-Yun; Kim, Young-Sun; Kyung Hee University; University of Southern California; University of Alabama Tuscaloosa
    Health literacy is closely associated with poor health outcomes and mortality. However, only a handful of studies have examined the association between health literacy and frailty status. The current study used data from a nationwide sample of Korean adults aged 70-84 collected from 10 cities, each of which represents a different region of South Korea (n = 1521). We used the propensity score matching (PSM) method to minimize the potential selection bias and confounding factors that are present in observational studies. After PSM, demographic and health-related characteristics between the limited health literacy (n = 486) and the nonlimited health literacy (n = 486) groups were not significantly different. Multinomial logistic regression analyses were conducted for the PSM-matched sample to examine the association between health literacy and frailty outcomes, where the robust group was set as a reference. Limited health literacy significantly increased the risk of pre-frailty (RRR = 1.45, p = 0.02) and frailty (RRR = 2.03, p = 0.01) after adjusting for demographic and health-related factors. Our findings underscore the need to foster health literacy programs and provide preliminary evidence to inform tailored intervention programs so that we might attenuate the risk of frailty in the older population.
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    Give Me Proof: A Covert but Coercive Form of Non-partner Sexual Violence Contributing to Teen Pregnancy in Haiti and Opportunities for Biopsychosocial Intervention
    (Routledge, 2020) Rahill, Guitele J.; Joshi, Manisha; Zlotnick, Caron; Lamour, Sabine; Beech, Haley; Sutton, Amber; Burris, Cameron; Paul, Phycien; State University System of Florida; University of South Florida; Brown University; University of Alabama Tuscaloosa
    Adolescent girls in low-resource settings account for over 7.3 million births annually (generally unplanned). Unplanned teen pregnancies are increasing in low-resource settings. As part of a funded Round 20 Grand Challenges Exploration project (Healthy Minds for Adolescent Mothers), we investigated unplanned teen pregnancies in Haiti's Cite Soleil shantytown, teens' biopsychosocial challenges, and desirable interventions. Key stakeholders (N = 23): pregnant teens (13-17-year-olds, n = 8; 18-19-year-olds, n = 8) and health providers (18 or older, n = 7), participated by age group and role in focus groups (FGs). ATLAS.ti facilitated the analysis of transcribed FG audio recordings. Ninety-four percent (n = 15) of teens reported "Banm prev," translated "Give me proof," as a cause of their unplanned pregnancies. Banm prev describes when teens are propositioned by men who demand proof of their unpretentiousness or virginity. A subtle, covert, locally unchallenged phenomenon that is supported by damaging gender norms, Banm prev constitutes an illusionary choice between teens' yielding non-consensual control of their bodies and the tacit alternative of gang rape. Banm prev underscores teens' difficulty discerning consensual from coerced sex. Associated unplanned pregnancies occasion guilt, shame, stigma, depression, anxiety, and trauma in teens. Cite Soleil teens need contextually relevant, community-supported, age-appropriate interventions that challenge existing norms, build on cultural strengths, and include comprehensive sexuality education, including knowledge of reproductive rights. A traditional, contextually familiar, engaging, and humorous story-telling tradition, i.e., krik-krak, packaged in video format, is a useful framework for interventions to reduce depressive symptoms, stress, and anxiety for Cite Soleil teens experiencing unplanned pregnancies.
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    Family Victim Advocates: The Importance of Critical Job Duties
    (2014) Young, Teresa H.; Williams, Javonda D.; Nelson-Gardell, Debra M.; University of Alabama Tuscaloosa
    Child advocacy centers across the United States intervened in more than 250,000 child abuse cases in 2011(National Children’s Alliance, 2012). Understanding the work of family victim advocates is imperative to helping children and families in child abuse cases. In this exploratory study, we surveyed advocates and program directors from child advocacy centers (CACs) across the United States to compare their perceptions of the critical job duties of family victim advocates. Data analysis revealed that CAC directors rated the importance of these duties significantly higher than family victim advocates. Results suggest the need for additional training to ensure that family victim advocates understand the importance of critical job duties to meet the needs of children and families in child abuse cases.