Recent Dissertation Abstracts

The Irish Republican Army (IRA) serves as the case study for this research which links anthropologically informed methods with a social welfare perspective to explore atypical political culture. The person-environment formulation provides a conceptual orientation to ideology and class consciousness that emphasizes the social ecology of revolutionaries with a focus on the interrelations and processes that shape political culture. Ethnographic methods pay attention to language, meanings, and sentiments whereas political-anthropological theory examines the material basis of life and culture. This framework sensitizes the text to the particulars of the subjective everyday experience of individuals situated in community and wider contexts; the role of language, meaning, and emotions in shaping ideology and class experience; and the material determinations of social relations, context, and agency.
To understand more fully the politic and ideology of modern republicanism this analysis relies on two primary sources of data: a bank of political narratives from prominent IRA agents and deeply immersed community ethnography (embeddedness). The research utilizes an integrative, multi-method qualitative approach, combining analysis of oral narratives from prominent IRA volunteers with embedded ethnography to delve into the narrator’s experiential world in order to understand a distinct form of political culture from the viewpoint of the activist
The distinctiveness of the research stems from its attempt to explore ‘atypical’ political culture, utilizing the voices of revolutionary agents, to bring to light the worldview and critical ideology that shape a revolutionary persona. From this ‘indigenous’ perspective republicanism is a community-based response to social injustices informed by the distinct analysis of individuals who self-identify as political activists adept at community organizing and multiple, simultaneous strategies for change. The study privileges this perspective and the actual lived experience of revolutionary agency as a salient source of knowledge.

In the context of U.S. public policy, battered immigrant (and associated terms battered alien or battered nonimmigrant) signifies a person who is eligible to suspend or amend the conditions of their status under immigration law if they can demonstrate they have suffered domestic violence. Among community organizers, battered immigrant women refers to a broader range of people for whom legal immigration status plays a role in their experience of domestic violence, including options for safety planning, the potential threat of deportation, and eligibility for public benefits. Battered immigrant woman, is also used within women’s rights discourses to call attention to the social political interests of marginalized women. This dissertation focuses on how the difference in signification has direct social and political consequences, with regard to who is recognized by the state and thus may access the benefits and protection offered by the state with regard to legal rights awarded to battered immigrants.
I analyze the production of the battered immigrant in public policy and legal advocacy through the lens of neoliberal governmentality and intersectionality. I call upon conceptualizations of governmentality, introduced by Foucault and taken up in a broad range of studies, to interrogate how the regulatory modes of government extended beyond the state, through social actors at all levels of society (Sharma 2006). Theories of subjectivity and discourse complete my analytic frame in providing theory to explore how subjectivities are produced through legal discourse. When immigration lawyers and domestic violence advocates take up the legal discourse of the “battered immigrant” in their advocacy, they are at once, inheriting the complex tensions and hierarchies within the existing discourse, while participating in its potential transformation.

Persons living in skilled nursing facilities (SNF) have extensive psychosocial needs, yet the services provided to meet those needs appear insufficient. Facility social workers are recognized as the primary providers of psychosocial services in SNFs, but often report barriers interfering with their ability to furnish services to all residents who need them. This study utilizes a three-category quality assessment framework to assess specific factors that either enhance or hinder the provision of effective psychosocial services in Washington State SNFs.
A cross-sectional research design was employed merging two sources of data: an investor-developed questionnaire administered to Social Services Directors (SSDs) in participating SNFs (N = 121) and resident-centered state survey outcomes in psychosocial care-related areas obtained from the Online Survey and Certification Reporting (OSCAR) database. Ordinary least squares regression was utilized to assess the ability of facility structural factors, process factors, and SSD characteristics to predict the frequency of psychosocial services in five diverse service domains: care planning, resource and referral, administration and advocacy, assessment, and intervention. Hierarchical linear regression methods were utilized to assess the ability of structural factors, process factors, and SSD characteristics to predict the scope and severity of survey deficiencies in psychosocial care. Interaction terms were also included in the regression model to determine the potential moderating effect of service delivery on predictive multi-level factors.
Results indicate that structural factors, process factors, and SSD characteristics play only a limited role in predicting service frequency, although the size of the SSD’s caseload is associated with frequency of care planning and intervention services. Four multi-level factors are associated with positive psychosocial care outcomes: low ownership turnover, more years of SSD experience in SNF social services, stronger SSD identification with the helper role, and paradoxically, lower priority attributed to residents’ individualization needs at the facility level. This surprise finding is possibly explained by a stronger focus on assessment services in lieu of intervention services within high individualization priority facilities. An additional finding is that the frequency of assessment services appears to moderate the impact of both ownership turnover and role identification on outcomes in psychosocial care. 

Social Services in Rural Alaska: An Ethnography
of Service Provision in a Yup'ik Eskimo Village

Tracey Burke
2003

This dissertation is an ethnography of the lived experience of contemporary social work in a Yup’ik (Eskimo) village. Despite efforts to increase “cultural competence,” there has been little systematic investigation of the everyday meaning of formal social work/social services in the lives of rural Alaska Natives. This research addresses that gap by examining current service systems and local, culturally-informed perceptions of need and appropriate responses.
I conducted fieldwork in one Bering Sea village. I used participant-observation and multiple conducted ethnographic interviews with various community members, especially the local social service providers and others involved with specific cases. Data consist of field notes, interview transcriptions, and pre-existing documents. I adapted grounded theory and discourse analysis techniques for analysis. I returned to the village to conduct follow-up interviews and to present the initial findings to key informants, and I presented the elaborated findings to the tribal Human Research committee.
I developed a schema of how the community thinks about “social problems” and responses to them, with an emphasis on the roles of formal professional (typically Anglo) and paraprofessional (typically Yup’ik) service providers. I used a composite case study to elaborate the schema and discuss issues of fit between the service systems and local culture; in particular, how responses internal to the village and interventions that require leaving the village are activated and utilized.
Though a white woman reluctant to make declarative statements about what “should” happen with social services practice or organizational policy, I suggest issues worth focused discussion by community members, tribal agency staff, and social work professionals.  

Significant gaps remain in our understanding of the etiology of sexually aggressive behavior among adolescent and young adult men. To speak to these gaps, this dissertation describes results from two analyses of data from the National Longitudinal Study of Adolescent Health, a nationally representative study of U.S. teens. The first analysis examined childhood and adolescent predictors of sexually coercive behavior in early adulthood among males in the sample. A path analysis suggests that experiencing sexual abuse as a child has both a direct effect on sexual aggression in adulthood, and an indirect effect through sexual aggression in mid-adolescence. Perpetration of sexual assault in adolescence, and involvement in delinquent activities are the only two additional significant predictors of later sexually coercive behavior. The second analysis examined social network correlates of sexually aggressive behavior among adolescent boys, and added significant social network factors to the predictors identified in the first analysis. Findings from the full model suggest that having friends who engage in delinquent behavior, perceiving peer pressure to have sex, feeling uncared for by friends, and participating in delinquent conduct are significantly correlated with sexual aggression during adolescence. The final chapter of this document incorporates this evidence of multi-level predictors of sexual aggression with previous research documenting the ecological nature of risk factors for sexual assault perpetration to argue for a renewed focus on using a multi-level approach to conceptualizing and implementing sexual violence preventionprogramming.  

Women’s employment following childbirth depends, in part, on the cost and quality of available child care arrangements. High cost and lower perceived quality may depress employment, particularly for lower-income women, who typically spend a larger proportion of their earnings on child care then do women with higher skills and education. One policy tool, child care subsidies, may shorten the time between the birth of a child and the entry to employment and facilitate family-to-employment balance among low-income mothers by (1) reducing the costs of employment relative to earnings and (2) facilitating stable child care arrangements. However, the child care subsidy system operates within a context of limited funding and local policy discretion. States use various strategies to manage scarcity resulting in regional variation, and these tradeoffs in policy choices that may have unintended, or even offsetting consequences, for subsidy program participation.

Capitalizing on regional policy variation, a set of original policy indicators for state and local welfare and child care subsidy programs are combined with micro data from two waves of the Fragile Families and Child Well-Being Study to (1) characterize child care policy strategies in twenty cities across U.S.; (2) examine the effects of these policies on child care subsidy receipt; and (3) evaluate the role of subsidy receipt in maternal employment and employment-family balance following the birth of a new child. Instrumental variable procedures are used to address concerns of endogeneity and sample selection.

The key findings include: (1) characterization of four different types of policy strategies adopted by the study cities; (2) the important contribution of individual characteristics and Temporary Aid to Need Families (TANF) welfare policies to predicting subsidy receipt among low-income mothers in urban centers; and (3) significant effects of predicted subsidy receipt on several employment outcomes including a positive relationship with breakdowns in child care arrangements and a negative relationship with family-to-employment spillover. A discussion of historical and current relationship among the market, the family and the state frames the research study, and in the conclusion suggestions for addressing enduring legacy of gender and class inequities are presented.

This dissertation examines the role of cultural citizenship in the construction of immigrant community identity. Immigrant cultural citizenship is the process by which immigrant individuals create a legitimized social space for themselves while contesting and negotiating hegemonic discourses that seek to define and limit their subject positions. This study explores immigrant community identity development by examining discursive constructions of the International District (ID) of Seattle, WA. Applying post-structural and post-colonial theoretical frameworks, this study investigates the particular social, political, and historical contexts within which the discourse of a "multi-ethnic Asian American community" arose through an example that is located in specific geographical and historical positions.
This study traces the intertextual chains through which the subject position of the ID was and is produced, deployed, and changed via a critical discourse analysis of mainstream and community newspapers, in-person interviews with community members, community history archives, and government documents. The data illuminate three major challenges that impact the evolving process of community identity development. The population changes, influenced by immigration policy changes, resulted in the influx of new ethnic groups in the ID. The urban development boom in Seattle which swept through many traditionally ethnic communities changed local geographies. Forces of globalization bring increased transnationalism and may alter the ways that capital is invested in the community and used by its members.
The analysis of data suggests that the ID as a subject is produced and sustained not through a consistent and stable articulation of a singular identity but through multiple, contested, and contingent articulation of history, contribution, and change. Similarly, the ID is not produced through unilateral regulatory control of the government or other regimes of a civil society; nor is it completely produced by the inventions of the community members ‘outside’ those controls. Rather, it is constructed through constant processes of engagement, contestation, and negotiation between the community and the various larger social and political structures, as well as among community members themselves. The discursive changes produced by such processes illuminate the possibility that immigrant communities may be able to change the discourses that produce them.

This study utilized an innovative approach to evaluating the responses of community-dwelling frail elders to three different community-based care management models, based on analysis of heterogeneous patterns of long-term care risk, using data from a sample of 540 frail elders living in Southern California. Combining both bio-medical and social care frameworks, long-term care risk in this study was constructed from the baseline data by examining medical risk, physical functioning, caregiving conditions for functioning, and psychological risk prior to the care management interventions taking place. Latent Mixture Modeling Analysis resulted in the identification of 3 risk subgroups. The effects of three different care management models were evaluated through outcome data on functioning, caregiving scores, depression, perceived health and caregiver burden at 12 months past baseline across the three groups. This study demonstrated that it is possible to identify sub-groups within the elderly population with heterogeneous patterns of risk that reliably predict both health related outcomes and varied response to different models of care management. In addition, factors associated with increased risk of nursing home entry in this study were distinctly different from those factors typically addressed by medical and long-term care providers in the community. This suggests that one of the main limitations of current community-based long-term care programs is a failure to match interventions to the specific needs of sub-populations of community dwelling elders. Care management with flexible financing was shown to have significant impacts on increasing caregiving support for functioning and reducing caregiving burden and depression status, particularly for the low-risk subgroup. The approach used here is broadly applicable to other studies attempting to evaluate efforts to match interventions to specific patterns of long-term care risk. This study shows that examining heterogeneous patterns of risk, especially taking social as well as medical-related risk into account, can serve as a basis for efficient targeting of resources. In order to sustain frail elders in the least restrictive environment, the identification of risk-based subgroups and the provision of targeted services should be an integral part of gerontological care management.

Intervention approaches with people with developmental disabilities have moved from a care model which emphasized medical treatment and rehabilitation to a support model that emphasizes consumer self-direction and choice (Mary, 1998). Despite this shift in intervention approach, there has been a lack of theoretically-guided quantitative research on the impact of consumer choice. This dissertation study presents three papers which seek to add both to the conceptual literature and to the empirical literature about the impact of choice on quality of life outcomes for consumers and a final chapter that addresses the practice and policy implications for local agencies. It employs data from Washington State’s involvement in the 2002 National Core Indicators Project consumer survey. The first paper presents a conceptual model to explain the mechanism through which choice predicts outcomes for consumers. The proposed conceptual model draws from an integrative review of the independent living perspective, empowerment theory, and social role valorization to propose an explanation of how choice leads to positive outcomes for consumers. The second paper is a study of heterogeneity in the developmental disability population and the access of sub-groups within the population to community-based, consumer-controlled intervention. This study employs latent profile analysis, a mixture modeling technique, to model sub-groups in the population. Two sub-groups are examined: the first fitting a severe intellectual disability profile (n=101) and the second group fitting mild intellectual disability profile (n=220). Differences between the two groups were examined. Results of this study indicate that individuals with mild intellectual disabilities experience greater participation in services that are community-based and consumer-controlled more frequently than those with severe intellectual disabilities. The third paper presents a study assessing the relationship between choice and quality of life indicators. Using data from the 220 participants who fit the mild intellectual disability profile, structural equation modeling was used to assess the influence of type of living arrangement and choice on quality of life. Results of the study indicate that consumers who lived in the community and made more choices had higher scores on the quality of life indicators.

An understanding of the process of change is important to fulfilling the primary mission of Social Work, as the field aims to attain its mission by changing peoples’ behaviors. However, much research investigating the effectiveness of social work interventions focuses on behavioral outcomes and ignores the exploration of processes by which interventions work. Therefore, the relationship between intervention processes and client cognitive processes operating within the process of change remain unexamined. This dissertation seeks to fill this gap by proposing a model of the process of change within helping relationships that includes intervention processes (i.e., the humanistic environment) and client cognitive processes (i.e., ambivalence, importance, readiness to change, and confidence) and by empirically examining the relationships between these constructs. A well-tested, cognitive-behavioral intervention (Motivational Interviewing; MI), developed in the addictions field, provided the context in which the model was tested. Ninety-three participants of a larger clinical trial, examining the efficacy of MI when implemented with crack cocaine users who were neither in, nor seeking, formal treatment, were included in this study. Using the proposed conceptual model and the Process of Change Tape Rating Measure, intervention sessions were rated in terms of the degree to which clinicians created a humanistic environment, explored ambivalence with clients, and assessed clients’ importance, readiness, and confidence to change their drug use behavior and the degree to which clients perceived and explored these same constructs. Client self-report measures were used in combination with the observational measure to test the predictive nature of model constructs on behavior change. The effects of client characteristics (e.g., severity of dependence, demographics), and clinician characteristics (e.g., the ability to create a humanistic environment) on the model were also examined. Results provided partial support for the model, and some client characteristics were related to the nature of client-clinician interactions. Also, psychometric properties of the Process of Change Tape Rating Scale suggest this measure can be used reliably with multiple raters and over time, though more work is needed to determine the scale’s underlying factor structure and the relationship between observational and self-report measures.

This is a work of discursive history which investigates a particular set of theory-driven questions focused on the representations of immigrants in social work discourse spanning the years 1882 to 1952. The study is founded on a poststructuralist conception of discourse: a contra-modernist, anti-essentialist perspective on language, identity, society, and social practices. Derrida’s perspective on language and text provides the theoretical and analytical tools for the deconstructive textual analysis of the social work discourse on immigrants, and Foucault’s critique of traditional social analysis situates the findings within a broader examination of the constitutive power of a disciplinary discourse. The study examines three publications: The Proceedings of the National Conference of Social Work, The Survey, and the Social Service Review, which recorded the public views of the leaders of the emerging field of social work. They represent an “elite” discourse—authorized and sanctioned texts—which not only held significant sway in the constitution of the mode and the course of social work with immigrants, but upheld and facilitated the larger political and civic discourse on immigration and immigrants. The year 1882 saw the passage of the Chinese Exclusion Act, marking the “beginning” of a period of race-based exclusion, and a general immigration act, which expanded the categories of inadmissible aliens begun in 1875, by adding “persons likely to become a public charge.” The year1952 marked the enactment of an immigration act that “eliminated” race as an exclusionary factor but concretized the “National Origins Quota” restrictions introduced in 1924. Immigrants are problematized in the discourse examined. Whether categorized as the “alien problem,” the “foreign problem,” the “Americanization problem,” the “citizenship problem,” the “racial problem,” the “refugee problem,” the “border problem,” or the more specific “Mexican problem,” and the “oriental problem,” immigrants are consistently conceived as problematic entities whose presence, at best, complicates the smooth operations of the nation-state and, at worst, imperils the physical, material, intellectual, and moral integrity of its society. The cast of characters problematized, the methods of problematization, and the tenor of the voice with which they are problematized change over the years covered, but the fact of the problematization does not.  

The purpose of this dissertation is to re-examine the findings from a research study I conducted in 2001. I examined the recollections of three Somali women—hereafter referred to as F, Z, and S—regarding their experiences of accessing and utilizing prenatal health care services for their most recent live births in the U.S. I used semi-structured in depth interviews to collect and analyze narrative data that yielded valuable information about the participants’ prenatal experiences. However, my analysis led to my discovery of unexpected information that I felt merited further exploration. I re-examined the 2001 study from a critical theoretical perspective within which I used the discourse of multiculturalism as a point of reference. By using multiculturalism in this manner I attended to the range of culturally diverse issues that appear to shape the challenges Somali women experienced within the U.S. perinatal service delivery system. Additionally, using multiculturalism, analyzed in a critical perspective, allowed me to conduct my re-examination keeping in mind that similar challenges continue to be experienced by women from many different cultural backgrounds. My re-examination produced data that led to my discovery that 1) health care representatives often function on the basis of unexamined biomedical assumptions, 2) effective research and clinical practices must include experiential knowledge, and 3) such knowledge comes from an experience of the professional self embodying a critical theoretical stance. My findings do not represent new discoveries in that various scholars have previously discussed similar conclusions in relation to health care issues. However, they are highly relevant to perinatal social work research and practice, and have not been previously applied to widespread efforts to construct and evaluate culturally appropriate perinatal social work and health care practices.  

There is speculation that physician implicit racial bias may contribute to racial/ethnic health care disparities. This dissertation presents three papers that investigate physician implicit and explicit racial bias and the relation of bias to medical care. Paper One presents results from a sample of test takers (n = 21,302) who dropped in to a public web site and took the Race Implicit Association Test (IAT). The data were analyzed by educational attainment, producing a sub sample of MDs. The MD sample (n = 103) showed significant, strong implicit bias favoring White Americans (M = 0.38, SD = 0.44, p = .001, Cohen’s d = 0.88). This result was similar to all other test takers in the sample and is true for a majority of Americans.

Paper two presents findings from an experiment that targeted a physician sample (n = 95) from one department at a large research university. This study aimed to measure pediatricians’ attitudes about race and medical care. Three Implicit Association Tests (IAT) were used; the Race IAT, Race and Patient Behavior IAT and Race and Quality of Care IAT. Sample showed unexpected, weak bias favoring white Americans (M = .18, SD = .44, p = .01) and a moderate association favoring “compliant patient” and white (M = .25, SD = .42, p = .001). The Race and Quality of Medical Care IAT showed an unexpected, association between African Americans and preferred medical care (M = -0.21, SD =0.33,p = .001).

Paper three presents findings from a survey using clinical case vignettes, manipulated by patient race, to assess pediatricians’ treatment recommendations. The relationship between implicit and explicit racial attitudes and treatment was explored. Predicted that if bias exists, would find bias favoring whites and, a relationship between recommendations and implicit and explicit bias. Pediatricians identified optimal treatment recommendation for three of four cases irrespective of patient race. Non-significant differences for optimal recommendations for African American vs. white patients for pain management (56% vs. 39%), management of IV antibiotics (71% vs. 54%) and asthma care (51% vs. 39%). Relationships found between implicit bias scores and medical care.

University-based researchers are required to seek Institutional Review Board (IRB) approval when their project meets the human subjects regulations’ definition of research. The IRB process aims to strengthen the ethical design of research and to assure that study participants are not exploited. The federal regulations guiding this approval process, however, have been critiqued for their use of a clinical or biomedical framework to assess ethical concerns. The intent of this dissertation was to examine whether social science researchers with research and ethical assumptions more similar to the clinical or biomedical model encounter fewer (or different) challenges with the review process as compared to a more alternative methodology.
Interviews were conducted with ten community-based participatory researchers (CBPR) and seven conventional social science researchers (CSSR). Selection of CBPR was primarily in response to the National Bioethics Advisory Commission’s (2001) claim that community-based research presents unique challenges to the regulatory oversight system. CBPR is a participatory research process that often entails building community-university partnerships to address community concerns. CBPR is typically applied to non-clinical questions. CSSR was selected as the comparison group as it represents the social science approach most closely aligned to the human subjects regulations’ clinical emphasis. Grounded Theory (Glaser & Strauss, 1967) was used to analyze the interview data.
In comparison to the CSSR interviewees, the CBPR interviewees’ conceptualizations of research and ethical concerns were less closely aligned with the human subjects regulatory framework. The CBPR and CSSR interviewees, however, shared similar views regarding the benefits and challenges with the IRB process. For example, the CBPR and CSSR interviewees believed that the IRB process encourages researchers to conceptualize their projects, and provides protection for study participants, researchers, and the institution. Shared challenges included problems associated with IRB procedures and problems due to IRB committees not fully understanding either a proposed project’s methodology or relevant risks. Challenges with the IRB were not expressed in terms of differences in ethical assumptions between researchers and the human subjects regulations. The dissertation concludes with reflections on ethical decision-making processes and recommendations to enhance the relevancy of the IRB process for CBPR and CSSR researchers.

Youth in the United States experience problem behaviors such as interpersonal violence, delinquency, substance use, and school failure at high rates. One strategy to address these problems is to reduce their prevalence through the use of prevention programs that have been tested and proven effective. In recent years research has shown that increasing numbers of prevention programs successfully reduce risk factors associated with substance abuse, violence, and delinquency, increase protective factors that buffer exposure to those risks, and reduce the levels of youth problem behaviors. Although numerous interventions that effectively prevent youth problems exist, youth are still more frequently exposed to interventions that are ineffective or untested.
The most common site for implementation of prevention interventions is schools. This dissertation examines the relationships between community and school-level factors and the school-based use of tested, effective prevention programs and effective prevention approaches. One approach to increasing the diffusion of tested and effective prevention programs to schools and other settings is through community-level integration of the findings of prevention science into efforts to support the healthy development of children and youth.
This dissertation research specifically examines whether community-level adoption of a prevention science-based community planning model is associated with increased use of tested, effective prevention programs and increased use of effective prevention approaches in schools. In addition, this dissertation research examines whether school-level factors are associated with increased school-based use of tested, effective prevention programs and effective prevention approaches.
The results of this dissertation research may contribute to more effective efforts to disseminate tested, effective prevention programs to schools. The findings also highlight several important roles that social workers can play in both school and community settings to increase the prevalence of effective school-based prevention efforts.

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