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Propensity score analysis, in conjunction with regression analyses, will be used to examine consequences of patterns of incarceration. Finally, qualitative interview data will be coded for common themes and used to further understand and interpret the results found in the quantitative analyses. Products and Reports: The results of this work will be pertinent to public policy, juvenile justice practice, and life course criminology, and will result in at least three manuscripts which will be submitted to high-quality academic journals for publication.

My broad dissemination plan also involves presenting the findings at both academic and practitioner-oriented conferences, dissemination through The Social Development Research Group SDRG newsletter and mailing list, and outreach to the general public through the use of op-eds.

The social work profession emphasizes the importance of strength-based practice, policy, and research. Rather than simply diagnosing problems, social workers came to respect the possibility and capability of individuals to overcome problems and change for the better. Also in research, social work scholars became more interested in understanding individual and environmental strengths that foster healthy development in the face of adversity Benard, In addition to understanding the likelihood of youth exposed to adversities engaging in problem behaviors, studies focused on how youth with adversities develop into successful adults.

In my dissertation, using strength-based framework, I incorporate important elements of prevention science and theory to provide further clarity in defining strengths across youth development — what they are and how they develop. Furthermore, I seek to understand the role of strength in reducing problem behaviors and promoting positive behaviors through a community based prevention strategy.

In doing so, I hope to shed light on how and when these strengths can be targets of interventions to achieve social, emotional, and behavioral health across youth development. Adolescent and young adult sexual behavior is an important health and welfare issue that has the potential to impact the entire life course. Risky sexual behavior can lead to sexually transmitted infections including HW as well as unintended pregnancy.

By understanding the social and cognitive processes that influence sexual behavior choices during adolescence and young adulthood, we will be better able to promote positive sexual health and reduce the potential negative consequences of risky sexual behavior. This sttidy uses data from the Raising Healthy Children study, a longitudinal study of participants from 10 public elementary schools in the Pacific Northwest, to explore the social and cognitive influences on sexual behavior decisions, the patterns of sexual behavior during adolescence and young adulthood, and the predictors and consequences of those sexual behavior patterns.

This dissertation uses the 3 paper option preceded with an introduction and summarized by a conclusion that integrates the findings from the three papers. Paper I examines theory-guided social and cognitive predictors of age of sexual initiation using structural equation modeling. Paper 2 identifies patterns of sexual behavior over time among adolescents and young adults and the predictors of those patterns using latent class analysis.

Paper 3 explores the consequences of the identified sexual behavior patterns and examines gender differences in both the patterns and consequences. Findings from these papers will increase our understanding of the social and cognitive processes during childhood and adolescence that influence sexual decision making. They will provide us with information on the longitudinal patterns of sexual behavior of young people and their predictors, and how these patterns influence later emotional, health, and social outcomes.

These results will provide important information that can be used in developing both sexual risk reduction and sexual health promotion programs. Despite a prolific amount of evidence-based practices EBPs , patients are not receiving these health and mental health interventions as much as they should. Patients relegated to the core safety net, a subset of the health care safety net with a mission or legal mandate to care for uninsured, underinsured, or other vulnerable populations, face even greater obstacles to receiving evidence-based care.

The fundamental research that has shaped current implementation models has been informed by multiple fields, including health and mental health care primarily serving patients with insurance, and fields outside of human services. Therefore, much less is known about the processes and influences unique to implementation of EBPs in settings serving vulnerable patients. Three qualitative studies, using grounded theory methodology, were undertaken to examine the unique processes and contextual influences of implementations of three different EBPs in three different core safety net settings.

Semistructured interviews and focus groups of administrators and front line clinicians participating in the implementations of the EBPs were employed to ascertain their knowledge and experiences. Findings in all three studies revealed interacting beneficial and challenging factors woven together in ways that the fabric of their combinations supported successful implementations, or possessed vulnerabilities that impeded them.

Key findings across all studies were the importance of the following influences: 1- intervention fit with patient characteristics and beliefs, community needs, and organization mission, 2- intervention adaptability, quality, and observability, 3- clinician beliefs and behaviors 4- clinical staffing, training, and education, 5- structural and cultural organizational assets, and 6- ongoing network and system building.

Results from these studies can provide direction for developing implementation frameworks unique to core safety net settings. Members of immigrant communities are at greater risk for mental health disorders, yet are less likely than other groups to access critical health and mental health services Alegria et a!.

One reason for disparities in service utilization may relate to the religious beliefs and practices of immigrants and how these are associated with help-seeking behavior. To address this shortcoming, this study is designed to examine the role of religion in the help-seeking process in order to further understand immigrant mental health service utilization.

To capture the heterogeneity of immigrant experiences with mental health service use, I propose to use Latent Class Analysis with data from the NIMH Collaborative Psychiatric Epidemiology Surveys CPES to determine if subgroups of service users exist based on their religious beliefs and practices. Subsequently, predictors of subgroup membership and their relationship to mental health service use will be tested through regression analyses. Findings will inform interventions for adaptation by health and mental health practitioners in order to improve immigrant wellbeing.

Research has established that adverse experiences during childhood increase the risk of complex sets of long term detrimental effects in adulthood, including poor physical and mental health, as well as functions in multiple social domains. There is a need for a broader discipline wise , yet focused and unified definition of childhood adversity, in order to adequately appreciate its prevalence and long term consequences.

There is also a need to consider a growing evidence in studies of resilience that despite harsh childhood experiences, some achieve a healthy and successful life as adults. This study examined three questions with focus on the long term impacts of childhood adversity: 1 Does childhood adversity as measured by abuse and neglect, poor bonding with parents, poor attachment to neighborhood, family conflict, and poverty impact resilient adult functioning at age 27?

In other words, does childhood adversity predict positive adult outcomes differently across three racial groups? The data in use comes from the Seattle Social Development Project SSDP , a longitudinal study in which children from 18 schools in an urban area in the Pacific Northwest were followed into their adulthood, and regularly interviewed over the last 25 years.

Results of the full sample indicate that adverse childhood experience has a negative impact on resilient adult functioning at age In particular, child maltreatment, poor bonding with parents, and eligibility for free lunch a proxy for poverty showed significantly negative impacts. Identifying as Asian American was also found to positively predict positive adult functioning. Tests of invariance in the regression paths of childhood adversity on positive adult functioning suggests an overall difference in how childhood adversity predicts adult functioning across racial groups.

The differences are tied to how two predictors, specifically child abuse and neglect and poor bonding to parents more strongly predict adult functioning for European Americans. Poor bonding with parents also strongly predicted negative adult functioning for the Asian American group. However, this model did not predict any significant relationships between childhood adversity and positive adult functioning for the African American group.

Examining the moderating effect of high versus low levels of school bonding indicates a non-invariant measurement, which indicates that the measurements are not similar across high and low groups. Results of this analysis suggests that there is not much evidence that bonding to school moderates the relationship between childhood adversities and positive adult functioning as measured in this study.

Community borderlands are spaces that are shifting, polyvocal, and multidimensional; they embody, transform, and resist systems and cultures of oppression, impacting the material realities and lived lives of their occupants and visitors alike. In this dissertation, I applied a borderlands framework to learn about lived experiences in relationship to three central concepts within social work: community, belonging, and wellbeing.

This project integrates elements of transnational feminism, postcolonial studies, and borderland epistemology within a queer framework, employing theoretical pluralism to interpret stories of lived lives, material realities, and perceived wellbeing. Using critical narrative and feminist methodologies, I interviewed 12 adults in the Seattle area who identified in flexible, critical, or ambiguous ways across race, gender, and sexuality; most study participants self-identified as mixed and queer.

I explored articulations and intimations of liminality and belonging used by participants to make meaning of being in community and being well. This dissertation challenges the monolithic assumption that having liminal status is a source of chronic stress and social disconnection that deteriorates wellbeing. Instead, I demonstrate that borderland experiences of community may provide a sense of connectedness that actually enhances perceived and actual wellbeing through increased resources, sense of safety, and belonging.

However, I also highlight the complexity, ambiguity, and discontinuities of these relationships. This study suggests the application of a borderlands framework in social work scholarship, pedagogy, and practice, namely by informing existing and potential collaborative community efforts to address disparities and promote wellbeing. However, many individuals do not have the resources or supports that would enable them to delay adopting one or more of those roles, experiencing an accelerated transition to adulthood.

An accelerated transition can pose more challenges in the form of economic or housing hardships and may hinder the ability of individuals to accumulate additional and necessary human capital. This dissertation applies an institutional lens to the study of the transition to adulthood in order to help illuminate the role of social structures in shaping individual lives during childhood, adolescence, and the transition to adulthood, and consists of three analyses.

Chapter 2 examines the experiences of a general sample of diverse, urban youth, and chapters 3 and 4 focus on foster youth aging out of care. Although the findings indicate that the prosocial socialization process operating in the family and school does not play a role in explaining differences in who experiences an extended or accelerated adulthood, other characteristics of the family play an important role, such as parent school expectations, a family disruption, and immigrant status.

Chapter 3 examines the impact of legal system involvement on foster youth in preparation for the transition to adulthood on criminal activities during the transition to adulthood. The findings indicate that legal system involvement is associated with higher levels of criminal activities at age In addition, legal system involvement initiates a process of social exclusion where youth are less likely to graduate from high school by age 19, and this has an impact on their employment status at age Chapter 4 investigates the impact on arrests of extending foster care support during the transition to adulthood; the findings indicate that extended support in the first year after turning 18 reduces the risk of arrest, but this effect declines after the first year.

Together, this dissertation research finds that during childhood and adolescence, as well as during the transition to adulthood, institutions play an important role in shaping the transition to adulthood. Although South Asians constitute one of the largest, fastest growing Asian groups in the country, there is a paucity of U.

Thirty-one in-depth interviews were conducted with participants of a culturally-specific, community-based performance project, Yoni Ki Baat Talk of the Vagina. Overall, this study demonstrates the utility of narratives and cultural scripts for understanding meaning and self-making processes within diverse communities. Fostering deeper understandings of intersecting oppressions and processes impacting transnational populations in these ways can contribute to more liberatory social work scholarship and practice.

Among LGBTQ youth, queer women, transgender and gender non-conforming youth have been particularly marginalized in both social science research, social service settings, and in the community, where they are especially vulnerable to violence and significantly more likely to become involved with law enforcement.

This is particularly the case for queer young women, transgender and gender non-conforming youth of color and youth or who are low-income. For my dissertation research, I have conducted an oral ethnography with young adults, ages , who have been incarcerated in girls detention facilities in the Juvenile Justice system in New York State.

The study design used the principles of Community Based Participatory Research CBPR and was facilitated by a Community Advisory Board composed of practitioners, legal advocates, researchers, activists, and young people. Moreover, Life History Interviews allowed participants to delve richly into questions of how they negotiate their sexual orientation, gender, gender identity, and race in relation to various contexts, relationships, and systems, over time.

This dissertation research draws upon my direct practice experience with LGBTQ youth in the child welfare system and as a queer activist. To improve services for sexual assault victims, many communities have adopted coordinated models of service delivery, often called Sexual Assault Response Teams SARTs.

Uniting law enforcement officers, rape crisis advocates, and health care professionals, SARTs frequently aim to create a seamless and compassionate experience for victims who engage with formal helping services. There is some indication that the process of implementing SART is contentious. Furthermore, replicating in practice the ideals of SART coordination has proved elusive for some communities.

This research explores the challenges of SART implementation, focusing on why there is sometimes a disconnection between the philosophy of integrated services and the realities of front-line service delivery. Using a qualitative within-case and cross-case method, interviews with 24 SART professionals were analyzed, resulting in three studies of SART functioning. The first study explored the discursive construction of conflict in SARTs.

The second study explored strategies that interviewees used to manage conflict in teams. Four categories were identified including preventative, responsive, unobtrusive, and resignation strategies. All professions were engaged in processes of managing conflict, but advocates talked much more about strategies and were almost exclusively responsible for all discussions of unobtrusive and resignation approaches to managing conflict.

The final study draws on institutional theory to explore how external forces shaped the adoption and operation of SARTs. The analysis revealed two simultaneous processes. The first process illustrated how SART was discursively legitimized, starting with the framing of sexual assault service delivery as a moral imperative for communities and continuing with the identification of coordination as a means of meeting the moral imperative.

Concurrently, a process of decoupling is indicated by the continuing resistance both to the moral imperative and the logic of coordination, as well as by the inconsistent and incomplete implementation of SART. Implications for SART practice and future research are also discussed. Tested and effective approaches are available to prevent mental, emotional, and behavioral problems in youth, but they are underutilized. Communities That Care CTC is a coalition-based strategy that creates a local infrastructure for prevention service delivery that facilitates the community-wide adoption of a scientific approach to preventing these problems.

A community-randomized trial of CTC in 24 communities, matched in pairs and randomly assigned to a control or an intervention condition, has demonstrated that CTC significantly increases the community-wide adoption of a science-based approach to prevention, as reported by community leaders.

For this dissertation, I first examined the extent to which the effect of CTC on the adoption of a community-wide scientific approach to prevention varied significantly across matched community pairs. Results indicated significant and substantial variation in the effect of CTC on the adoption of a scientific approach to prevention across the 12 community pairs.

Next I explored potential sources of the variation across community pairs in community transformation toward a scientific approach to prevention. These sources included five coalition capacities: member knowledge, member acquisition of new skills, member attitudes, organizational linkages, and influence on organizations.

Findings indicated that CTC coalitions successfully built capacities. Results also showed that new skill acquisition by coalition members and the engagement of diverse sectors in coalition work, as reported by coalition members, moderated the relationship between CTC and the community-wide adoption of a science-based approach to prevention.

Finally, I explored whether the internal coalition functioning of CTC coalitions predicted community-wide adoption of a science-based approach to prevention directly or through a coalition culture that builds capacities necessary for coalitions to achieve system transformation. Findings indicate no direct effect of goal-directedness, efficiency, opportunities for participation, or cohesion on community-wide adoption of a science-based approach to prevention, but suggest the possibility of an indirect pathway through building new member skills and external linkages to diverse sectors.

Identification of these malleable coalition processes and capacities, which facilitate the community-wide adoption of a scientific approach to prevention, will be useful for improving the overall effectiveness of community coalitions focused on preventing adolescent mental, emotional, and behavioral problems. In recent decades, there has been an expanded effort to examine the adverse effects of political violence on the health of civilian populations; substantial evidence now points to the effects of political violence on outcomes like PTSD, anxiety, and a variety of physical health symptoms.

Despite the variety of risks inherent within political violence, we know individuals and communities actively cope with the stressors of political violence, exhibiting marked resilience as they function much better than might be expected. Individual and community resilience is generally defined as the successful recovery from or adaptation to stress or adversity through the use of individual or community characteristics, resources, strategies, and processes. While researchers have increasingly focused on political violence in the past few decades, several areas within the field of political violence and global health remain under-explored.

To address these areas, this dissertation explores experiences inherent within the political violence, their effects on health and well-being, and processes of resilience within the experience of political violence. Few studies provide data on the health of self-identified multiracial two or more races Americans.

Subsequently, we know little about this population and existing health disparities. Three areas relevant to multiracial health include health status, health care service utilization, and health related to racial stability over the life course. Although some investigations report the health service use of children and adolescents, almost no studies report the health service use of multiracial young adults. Most studies on multiracial groups are cross-sectional and thus focus on a single time point, so it is difficult to establish how health indicators change for multiracial groups over time.

This dissertation employs epidemiological methods to investigate the health of self-identified multiracial young adults in a series of three linked papers. Using multivariate logistic regression I tested a series of hypotheses for three distinct research questions. In the first paper, I found that there are differences in self-rated health for some multiracial groups. In the second paper, I found that there are differences in the rates of health care service utilization when comparing specific multiracial groups to the monoracial majority.

In the third paper, I found that there are differences in report of self-rated health when comparing monoracial adults with multiracial adults who switch racial categories over time. These findings contribute to the wider understanding of health disparities for vulnerable populations and assist in identifying salient mechanisms of health disparities over the life course.

These results also demonstrate the importance of critically examining changes in categories over time and effects when using quantitative data. This dissertation is a discursive inquiry into the language Horn of Africa HOA youth use as they talk about their experiences. Study participants are 1. Youth in the study participated in three focus groups. The study captures the nuances of HOA youth discourse, moving beyond dichotomous frameworks to more fully acknowledge the complexities for immigrant youth of negotiating inbetween spaces.

These complexities reveal that HOA youth can and do displace discourses that represent them. The study findings challenge theoretical and conceptual frameworks that assume HOA youth have a stable, rational, and unified identity, and assume related ideas about empowerment and change, which can ultimately victimize youth for not fitting into expected norms.

From the perspective of this study, liberation from dominant discourses does not require a stable identity; rather, identities are continuously and complexly produced in and through competing discourses. The research points to the need for youth programs to focus on exploring how cultures and languages represent youth, and their populations, while also questioning what it means to talk across borders, as the youth move beyond conventional discourses of multiculturalism. The study also has the potential to inform host society perceptions of HOA youth in particular and African immigrants in general.

Few legal proceedings in the U. Yet, despite its profound consequences, termination is infrequently addressed in social work scholarship. This dissertation aims to help fill this gap by examining North Carolina judicial opinions, written in , that resolved disputed actions to terminate parental rights. A total of opinions were examined using content analysis. All of the cases involved child neglect. The study focused on neglect because of ongoing difficulty in clearly defining this common form of child maltreatment.

The study yielded a typology of factors appellate courts used to justify their termination decisions. Altogether, 39 factors were identified and organized into 10 different domains: parental conditions, service compliance, home environment, economic conditions, child conditions, bonding, child welfare history, physical abuse, physical presence, and sexual abuse.

These factors are more expansive than the termination criteria listed in the federal Adoption and Safe Families Act as well as North Carolina statutes. Just as important, chi-squared analyses revealed that when courts made their termination decision, they looked to different factors depending upon which parents were involved in the cases mothers, fathers, or both parents. Overall, the study underscores the critically important role the courts play in the child welfare system.

While extensive research has examined associations between marriage, cohabitation and the health of heterosexual adults, it remains unclear whether similar patterns of health are associated with the same-sex partnerships for older adults. The following papers examine how having a same-sex partner may be related to general self-reported health, mental health, and satisfaction with life for older adults. Analyzing survey data collected from lesbian, gay, and bisexual LGB adults 50 years of age and older, the first paper reports findings that those with same-sex partners have significantly better self-reported health, fewer depressive symptoms, less perceived stress, and greater life satisfaction, controlling for gender, age, education, income, sexuality, and relationship duration.

Relationship duration did not significantly impact the association between partnership status and health, nor did gender. The importance of culturally sensitive clinical practice and policies that recognize the role that same-sex partnerships may play in older adult health are discussed along with implications for future research.

The second paper further examines how identifying as married is associated with significantly fewer depressive symptoms and greater life satisfaction compared to those identifying as unmarried partners, but not significantly less perceived stress. Social integration, as reflected in increasing access to and identification with marriage by LGB older adults, is an important area for future research to examine in order to study how changing social acceptance of sexual minorities may impact older adult health.

The final paper reviews the theoretical frameworks that have been employed to study lesbian, gay, and bisexual older adult health. Social determinants of health models are contrasted with social constructionist and post-structural critiques of gender, sexuality, age and health. Future research needs to envision both structural sources of health disparities as well as account for individual agency and the resilient subject as important elements for theorizing the source and meaning of health disparities for lesbian, gay and bisexual older adults.

This dissertation uses a stress and coping resource framework to examine heterogeneity among adolescents and young adults at risk for violence. Three studies are included that build on existing literature concerning risk and protective factors for violence by consideration of etiological differences that bear upon stress exposures and coping capacity. Additional surveys were delivered 5 and 7 years later with satisfactory retention.

Paper 1: Latent Profile Analysis was used to detect four distinct groups with differential risk and protective factor profiles and concomitant problem behavior outcomes, demonstrating important differences for etiological risk of violent behaviors. Paper 2: The sustained impact of adolescent violence histories was established relative to early adulthood psychosocial functioning, across multiple dimensions of risky behaviors and emotional distress.

Paper 3: An assessment of stress and coping resources in early adulthood successfully predicted continuity and discontinuity in violent behaviors from adolescence to young adulthood. Collectively these findings demonstrate the importance of investigating variation among violent youth with respect to stress-related risk, protective factors, and ways in which coping affects development—distinctions that are crucial to insuring interventions are well matched and proportionate to respective risk profiles among youth.

Results strongly bolster arguments concerning the value of preventive and early interventions toward curbing the developmental and transgenerational impacts of violence. Major implications include the need to assess for histories of violence among vulnerable youth, as well as attend to traumatic experiences and emotional distress of youth engaging in violence.

With the projected growth of a diverse older adult population in the U. It is a concern since little is known about what places them at risk and what factors protect them against late-life depression. The primary aim of this dissertation is to address this concern by examining the risk and protective factors associated with depressive symptoms between older black Americans. Data analyzed for all three studies used the National Survey of American Life.

Results indicate that socio-economic status was significant in predicting high depressive symptoms, especially for older African Americans. Results also highlight the fact that greater depressive symptoms are associated with stress in the form of perceived discrimination which poses a risk for late-life depression among both groups of older Black Americans.

In addition, both social support and social connectedness were significant in moderating the effect of stress for both older African Americans and Caribbean blacks. The findings from this study will contribute to the general body of knowledge on black Americans, and more specifically, to the heterogeneity embedded between and within older African Americans and Caribbean Black populations.

Background: Over the last several decades space and place have emerged as important concepts and how they are theorized is beginning to shape many policies and practices that impact the health of indigenous peoples. For indigenous peoples, the ultimate location of space and place is embedded in a profound relationship with the earth.

The earth or land is both literally and figuratively the first and final teacher for understanding our world, communities, families, selves, and bodies. This dissertation articulates an indigenous framework for triangulating the concepts of space and place, historical trauma, and embodiment as they impact health and wellness of indigenous peoples.

Methods: Innovative qualitative methods including narrative analysis of in-depth interviews about traditional and contemporary perceived experiences between land and health from 13 tribal members of a Washington reservation was conducted along with a GPS and photographic survey of food and activity resources on tribal lands.

Data points were mapped onto an interactive web-based map and used to illustrate and deepen individual narratives. Thematic findings were organized into eight primary categories with more nuanced sub-themes articulated within each category. The over-arching themes for how Tulalip tribal members experience the relationship between land and health include: 1 Simultaneous reverence and loss; 2 Close kinship relationship; 3 Respect and reciprocity; 4 Dissonance of historical trauma and cultural strength; 5 Impact of development and western values; 6 Cultural transitions and losses; 7 Contemporary practices and realities and; 8 Cultural revival and regeneration.

Photographs and map illustrate these themes. Conclusions: Using personal narratives to investigate complex environmental conditions helps describe how relationships to historical and contemporary cultural knowledge impacts the health of indigenous community members. There is a clear association between race and health outcomes in the United States. Needed is a systematic examination of the relationship between chronic health and race, ethnicity, nativity, and length of residency.

Further, the role of perceived discrimination and health decline must be explored beyond broad racial categories with the inclusion of Caribbean ethnic subgroups. Logistic regression revealed significant differences in reports of chronic conditions across nine ethnic subgroups.

Logistic regression models reveal significant associations between chronic conditions, and other demographic factors known to influence immigrant health. Chapter 4 explores the relationship between chronic conditions, nativity, perceived discrimination, and length of residency among the three racial and nine ethnic subgroups. Afro-Caribbean subgroups were more likely to report perceived discrimination than Asian and Latino American subgroups were.

Logistic regression analysis was conducted to determine which groups within the model were more likely to report exposure effects. Incarcerated mothers and their babies are invisible to most of us. Little is known about the discourses surrounding women who give birth and begin raising their babies while doing time in prison.

I present just one aspect of our work, namely operationalizing PAR concepts with prisoners, officers, early childhood educators, nurse practitioners, birth attendants, and community members. These stakeholders hold divergent views about incarcerated women and their newborns.

They rarely if ever come to the same table to talk and learn from one another. Stereotyped identities, differences in power, privilege and autonomy, and the divergent missions of their organizations present real challenges to linking research and action on behalf of babies. PAR literature raises questions about the extent to which PAR philosophy can be truly carried out in prisons, when participation is not limited to one or two groups of allied stakeholders.

I explain challenges. I present evidence supporting and contraindicating PAR in settings that mandate limited autonomy and agency for women. I present strategies that led to the emergence of a common discourse. I offer recommendations for future work. This dissertation examines the social context of immigration-related factors as they relate to the health of Asian American immigrants and focuses specifically on age at migration and period of migration as potential explanatory contexts for elucidating the strong relationship between immigration and health.

In the first paper, an historical, social, political and theoretical framework is outlined that argues for the use of expanded contexts when empirically examining Asian American health. This paper provides recommendations as to how such contexts can be brought to bear on Asian American health, such as using model specification techniques used in research on racial health disparities. The second paper is an empirical test of historical context as a way to frame the relationship between Asian American self-rated mental health, age at migration and the historical period of migration.

Specifically, this paper tests the applicability of age at migration as a predictor for self-rated mental health between pre- and post immigrations using model specific path analyses. The third paper also builds on analytical recommendations set forth in the first paper and provides an empirical test of the relationship between suicidal ideation, ethnic density and historical period of migration using multilevel modeling techniques.

In its entirety, this dissertation argues for and provides a more holistic, nuanced approach to examining and explaining the relationship between immigration-related factors and Asian American health. In fact, for many of the youth who experienced prior history of chronic abuse and placement instability, the likelihood of experiencing negative mental health, employment, and education outcomes increase. Due to the fact that research focusing on the experiences of foster care alumni of color is limited, existing interventions to address their negative developmental outcomes may not be effective.

Finally, this dissertation study, from the perspective of front line caseworkers, also examined barriers and challenges Latino children and families experience in the child welfare system. Relying on mixed methods logistic regression, multiple group structural equation modeling, and grounded theory to address these questions, this dissertation study offers valuable contributions by: 1 examining unique predictors of developmental outcomes among foster care alumni of color, 2 highlighting strengths and areas where improvement in child welfare practice is needed to ensure foster care children and adolescents receive evidence based, culturally sensitive services to thrive as adults, and 3 exploring factors that may mitigate negative developmental outcomes and contribute to timely permanency and reunification among Latinos in the child welfare system.

A small but growing body of scholarship that has examined the reasons why women might fail to take advantage of PMTCT services has primarily documented structural and resource factors such as long distance or inability to pay for transportation to a health care facility as key barriers to service uptake.

The influence of service delivery dynamics for example, the nature of provider-patient interactions and the quality of counseling demonstrated in other health literatures to be salient in service utilization is a perspective that is largely ignored in the assessment of PMTCT service use.

Specifically, several patterns of practice elucidated by Lipsky were mapped out in ANC service delivery with pregnant HIV positive women. Insights from this research offer useful directions for modifying care practices to boost facility delivery among HIV positive women. In modern welfare states, teen pregnancy, a social phenomenon that is inextricably linked with poverty, inequality, and race, is considered an indicator of social wellbeing.

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