• The Conceptualization of Race and Racism in the Discourse Addressing Racial and Ethnic Health Inequities

      Vanidestine, Todd J.; Reisch, Michael, 1948- (2015)
      The conceptualization of race, racism, and Whiteness through language and discourse influences policy agendas to eliminate racial and ethnic health disparities/inequities. The manner in which these terms are conceptualized within health promotion agendas also influence the ways social welfare/health professionals take action to address them. The definition of terms like "race," "racism," or "Whiteness" can potentially reinforce or challenge previously held understandings of these concepts. The meaning assigned to racial concepts also reveals who has the resources to interpret, reproduce, and benefit from the sanctioned knowledge. The purpose of the current qualitative study was to explore how policy agendas and social welfare/health professionals conceptualized race, racism, and Whiteness. Additional considerations included the possible influence of those conceptualizations on their actions to address racial and ethnic health disparities/inequities was examined. The primary sources of data were published policy agendas designed to address racial and ethnic health disparities at the city, state, national, and international levels. Furthermore, social welfare/health professionals working in West Baltimore also participated in qualitative interviews as an additional source of information. Grounded theory theme identification (GT; Charmaz, 2014) and critical discourse analysis (CDA; Fairclough, 2009, 2012) provided the methodologies to analyze both sources of data. The city, state, and national policy agendas to eliminate racial health disparities/inequities focused on two complementary discourses, state-sanctioned racial categorizations and racial differences, as the basis for individual-focused interventions. Similarly, the professionals' discourses included skin color identification/categorization and racial [pre]judgments/discrimination. Finally, the common discourses professionals used to describe actions taken to address racial and ethic health disparities were: a) collaboration, engagement, and outreach; b) health provision and promotion; and c) race training, awareness, and diversity. Conversely, the international policy agendas included discourses of government accountability, political context, and theorizing social power. The language and discourse assigned to racial concepts within the professional context can act as barriers or bridges to the formation of comprehensive policies and practices to address the injustice of racialized health outcomes. In turn, the meanings we assign through language and discourse inform the types of analyses and interventions we implement to eliminate racial and ethnic health outcomes.
    • Exploring How Teen Mothers in Foster Care Experience Motherhood: An Interpretative Phenomenological Analysis

      Aparicio, Elizabeth; Pecukonis, Edward Vincent (2014)
      Teen pregnancy in foster care is an issue receiving increasing attention due to high pregnancy rates. Previous literature on both teen motherhood and foster youth is focused on negative outcomes, risk factors, and pathology. Despite this emphasis, a small, but growing body of literature on the experience of motherhood of teen mothers in foster care reflects a perspective that is not simply negative - a lived reality that is characterized by both risk and opportunity. The purpose of the current qualitative study was to explore the meaning and experience of motherhood for teen mothers in foster care. The study involved three in-depth interviews with 6 young women who had become mothers while in care. It employed interpretative phenomenological analysis (IPA; Smith, Flowers, & Larkin, 2009) to elicit, analyze, and re-present a rich account of this experience. Findings suggest the lived experience of motherhood for these young women is an intricate reality that brings past, present, and hoped-for future experiences into seamless unison in the midst of the intensely meaningful experience of becoming a mother. Participants discussed their interpretation of motherhood as offering a sense of hope for new beginnings and doing things differently than what had happened in their own families, yet simultaneously as a time of feeling plagued by the lingering effects of darkness and despair in their childhood and adolescence due to factors such as substance abuse, abuse and neglect, poverty, and the breakdown of family ties. The findings suggest that teen mothers in foster care experience becoming mothers as offering opportunities to change their identities from that of "foster child" to "mother", gain motivation and purpose, receive unconditional love, and work through their views on their own parents in the context of a new role. Implications include the need for comprehensive sexual health, substance abuse, and behavioral health services at all levels for child welfare-involved families and youth that include a significant focus on trauma, grief, loss, and attachment issues; better parenting support for teen mothers in foster care; and meaningful discussions about the unintended effects of child welfare intervention on communities related to teen pregnancy and motherhood.
    • Humor & Opioid Recovery

      Canha, Benjamin; Scrandis, Debra (2019)
      Abstract Background: The prevalence and mortality rates of opioid use disorders (OUD) have drastically increased in recent years in the United States. Narcotics Anonymous (N.A.) is a successful behavioral program supporting recovery for individuals with OUD. Humor may play an important role in maintaining group involvement and continuing support within the culture of the N.A. program. Purpose: The purpose of this study was to understand the ideas, beliefs, attitudes and behaviors of humor in individuals recovering from OUD who are participating in the N.A. program. Design: Qualitative ethnography design was used with three types of complementary data collection methods: observations at meetings and social gatherings, personal interviews, and a focus group session. Results: Instances of humor between N.A. members were noted in observations. Recorded one-on-one interviews with ten members recovering from OUD provided details of various experiences of humor and led to development of five essential themes: Feels Good, Social, Lighten Up, Healing and Alienate. These findings highlight the mostly positive personal and social benefits participants experienced, as well as possible negative effects. A focus group of seven N.A. members provided interactive discussion of humor and discussed the need to become more conscientious of the detrimental effects of humor. Conclusion: The implications of this study suggest the need to explore various humor interventions to assess their relative effectiveness in enhancing recovering, and reducing relapses. Due to the small number of participants, results may not be generalizable to all those with OUD in N.A. or represent the possibly wide range of N.A. meetings. This study added to the depth of knowledge about the effects of humor on this population and their recovery process. The importance of humor and having fun in the recovery of OUD should be more widely recognized by nurses as they help those with OUD, as humor definitely has a role to play in supporting N.A. members’ recovery from OUD.
    • An Intrinsic Case Study of a Domestic Violence Organization's Promotion of Economic Justice for Survivors

      Svoboda, Deborah Vangeison; Harrington, Donna (2012)
      Given the 40 year history of U.S. feminist organizing, domestic violence organizations have a pivotal relationship with survivors, social systems, authorities, and policy makers to operate across multiple domains to address the complexity of intimate partner violence. Since the opening of domestic violence shelters in the mid-1970s, survivors have reported a spectrum of tactics of abuse, including the loss of economic security. Economic coercive and controlling tactics of abusive partners have included limiting access to funds, controlling use of and decisions related to resources in the relationship, stealing their partner's resources, economic exploitation, and sabotaging their partner's capacity to change their economic situation through employment and education. An examination of the efforts by one domestic violence organization to address economic abuse experienced in intimate partner violence expands our understanding of the relationship the organization has with economic justice. Using intersectional feminist theory, an intrinsic case study with embedded units was conducted for the purpose of examining a domestic violence organization's response to economic injustice experienced by survivors of intimate partner violence. The single case selected for this study, the Center, was a confidential East coast nonprofit domestic violence organization serving over 10,000 victims of domestic violence annually. Qualitative methods were used to collect evidence for the case study from four sources including on site participant-observation, interviews with organization members, focus groups with survivors, and archival records. Direct interpretation of the evidence from all sources revealed varying degrees to which the Center responds to the economic abuse experienced by survivors of domestic violence. The evidence demonstrated the Center's response to economic abuse in the following areas of the organization: residential and clinical services, training initiative, legal department, client services program, and housing program. The Center's responses were interpreted to support the economic security and well-being for survivors. A model of economic justice for survivors was used in interviews and focus groups to identify areas for change. Drafted opportunities for reform were recommended to improve the response by systems to survivors, to decrease the impact of economic abuse, and to garner resources in the community for survivors of domestic violence.
    • Rural Veterans: Pathways to Homelessness

      Jorden, Brenda J.; Belcher, John R.; DeForge, Bruce R. (2018)
      Veterans are overrepresented in homeless populations compared to non-veterans (Gamache, Rosenheck, & Tessler, 2001; Perl, 2015). Most homeless individuals live in urban centers and as a result most research studies have focused on urban homelessness leaving the rural homeless less studied and understood (Knopf-Amelung, 2013). The purpose of the current qualitative study was to explore the pathways to homelessness for a sample of rural homeless veterans. Fifteen veterans and 16 staff/administrators were interviewed to determine the causes of homelessness for veterans living in a rural area. A limited grounded theory approach was used to develop themes identified as causing homelessness. The primary pathway according to both groups was chronic substance abuse. Mental health and economic problems, and adverse childhood events were also major factors in veterans experiencing homelessness. Social support appeared to delay the onset of homelessness for some individuals. Not all veterans qualify for VA services, which leaves a segment of the population without access to VA services. Overcoming barriers to substance abuse and mental health services for rural homeless veterans is an area to focus research efforts. Creative ways to provide outreach to the hidden homeless are needed.