This paper originated as a result of one of the stated objectives of the Salem Primary Prevention Project. That project, operating jointly with Marion County Community Mental Health, Salem School District 24J and the City of Salem’s Community Development Department, has had as one of its stated objectives, the development of a mechanism to review the impact of planned change at the local level. For several years both the staff and Advisory Committee for the Primary Prevention Program had wrestled with the complexity of developing such a review or assessment mechanism. Existing literature on social impact assessment appeared to deal primarily with rather large physical impacts upon local areas. Projects such as multiple-use reservoirs and inter-state highways that came under the constructions auspices of the federal government are examples. This, then was the background for beginning the search to develop the social impact assessment tool in January of this year. It shall be the purpose of this paper to construct both a rationale and a method for assessment of planned changes from local units of government upon neighborhoods under their jurisdiction.

Supports to improve self-care or self-management are beneficial for many people living with health issues, especially chronic conditions. Yet, socioeconomically marginalized groups have often been neglected from self-management initiatives, despite experiencing an increased prevalence of chronicity and multimorbidity. To this end, there are several established critiques within the self-management literature that are addressed through this dissertation. First, limited attention has been given to equity considerations within self-management, thus there remain gaps in the evidence base around disadvantaged groups. Second, there is a lack of understanding about the mechanisms that make self-management supports work, as well as little evidence to explain the wide extent of non-participation, including understanding the impact of structural barriers. Third, the social embeddedness of self-care has received little attention, despite people highlighting social roles as important concerns within self-care. In addition, the grassroots history of self-care has been neglected, which has resulted in minimal recognition of the role of mutual aid/self-help groups. This dissertation includes two exploratory, qualitative studies that attend to these knowledge gaps: the first explored self-care experiences among people who use drugs with chronic health issues, and the second explored mutual support among people experiencing homelessness within the context of encampments during the COVID-19 pandemic. The study findings are also contextualized by worsening overdose and housing crises. I employed community-based participatory research methods and the transformative framework to contend with social injustice and power imbalance and amplify the worldviews of marginalized groups. We conducted in-depth interviews and reflexive thematic analysis to analyze data. Overarching findings demonstrate the importance of agency in shaping how marginalized groups manage their health and social needs, the critical structural limitations they face in doing so, and the substantial influence of their formal and informal social supports. Thus, findings show the importance of recognizing these groups’ alternative and holistic practices of care, the need to address structural and systemic barriers that inhibit their capacity for care, and the immense value of harnessing social support networks to meet care needs. Programs intended to support self-care among marginalized communities would benefit from incorporating a relational autonomy lens and community-centered approach.

Older adults, especially those who are of low socioeconomic status, experience higher rates of mortality and chronic disease. As a result, older adults are frequent users of emergency medical service (EMS), comprising approximately 38-48% of all EMS calls. In response to higher EMS demands, community paramedicine has recently emerged as a non-traditional model whereby paramedics provide care in a community- based setting. CP@clinic is a community paramedicine programme that focuses on disease prevention and health promotion with the goal of reducing EMS demand. Given the knowledge that older adults who live in subsidized housing have poorer health outcomes, CP@clinic has been implemented in several subsidized housing building across Ontario. A program evaluation of CP@clinic is currently underway to make recommendations to paramedic partner stakeholders regarding program delivery. As part of this evaluation, I sought to understand the association of the number of CP@clinic sessions held per month and EMS calls per apartment unit. De-identified EMS call data were collated from 9 paramedic services across Ontario from February 2015 to December 2019. I conducted a three-level multilevel regression analysis, with EMS calls per apartment unit as the outcome. The primary analysis found that a one-session increase in the number of sessions held per month was associated with an average 2.4% higher incident rate of EMS calls, adjusted for building size. A secondary analysis, with the number of sessions per month as a categorical variable, revealed that two CP@clinic sessions per month had the smallest association with EMS calls, adjusted for building size. Based on these results, it is recommended that paramedic services offer two or more CP@clinic sessions per month. Future research should investigate the factors that impact each services’ ability to offer the CP@clinic programme. / Thesis / Master of Science (MSc) / Older adults experience high rates of chronic diseases, especially older adults living in subsidized housing. Community paramedicine has recently emerged as a way of addressing the healthcare needs of older adults living in subsidized housing, while simultaneously decreasing the burden on EMS. CP@clinic is a community paramedicine programme aimed at improving the health of older adults and reducing the demand on EMS. To make recommendations to the paramedic services operating CP@clinic, I sought to understand the association between the frequency of CP@clinic sessions and the number of EMS calls per apartment unit in Ontario. Based on the results, CP@clinic sessions were associated with higher incident rate of EMS calls, after accounting for building size, reflecting the trend of rising EMS calls in Ontario. Overall, paramedic services may see improved EMS call outcomes with two or more CP@clinic sessions per month but should offer the programme according to their organizational capacity.

The most common goal of professional sociology is to describe and or explain the social world. However, recognizing the performative aspects of science, and in keeping with Burawoy’s (2005) emphasis on “organic public sociology,” I ague that there is latitude within the discipline to design research with the aim of linking knowledge production and social change. I also argue that the discipline’s understanding of effecting change need not be limited to outcomes such as teaching, publication, or the creation of policy; the research process itself has social effects (Hesse-Biber, Leavy, and Yaiser 2004). Importing a performative research design from human geography (Community Economies Collective 2001, Cameron and Gibson 2001, 2005, Gibson-Graham 2006b), I co-designed a participatory action research (PAR) project with a graduate student in Geography. We hired 23 artists and artisans from Franklin County, Massachusetts forming a research team. Our goal was to act on the world in real-time through the use of peer-to-peer interviewing. In this paper I explore the outcomes, including the challenges, of researching from this approach. The research design and the ensuing process—training members of the research team, conducting interviews, and collaborating on projects—is the focus of my analysis. I discuss how aiming for transformation shaped our research decisions. Through my analysis of the research process, and in contrast to decision-making processes from a common sense epistemology, I argue that the interactions and connections engendered by the process itself matter just as much as the ensuing sociological understanding.

This research project is a study of 227 Christian Churches (Disciples of Christ) in Indiana. These 227 churches were identified by the Regional Office of the Christian Church (Disciples of Christ) in Indiana as being fully cooperative with the work within the Region. The project was conducted in two parts or phases. Phase 1 was a study of the churches based upon statistical data which the churches reported to the Yearbook. Phase 2 was a study of the attitudes of selected leaders within these 227 churches. It should be noted in the beginning that this study does not tell the complete story of the Christian Church (Disciples of Christ) in Indiana. Any such attempt to tell all the story must take into account the churches which have withdrawn from the relationship with the Regional and National ministry. This study concerns only the 227 churches currently involved and seeks to tell the story of these churches. This report seeks to be descriptive in character. One section in Chapter 2 dealing with anomia is analytical. The funds for this project were made available by Christian Theological Seminary with money provided by the Lilly Endowment, Inc. 1

No description available.

Survey instruments have been developed to measure whether someone claims to be religious but do not address the degree to which someone is satisfied with their religious commitment. The Religious Surrender and Attendance Satisfaction Scale (RSASS) was revised to measure both a person's level of religious commitment and satisfaction with level of religious commitment. This study was conducted to determine initial validity for the satisfaction portion of the RSASS. Construct validity measures provided initial confirmation of the utility of RSASS as a measure of satisfaction with religious commitment, that can be used by nurses in practice and research.

Recognizing and understanding the potentially powerful roles that religiousness and spirituality (RS) may serve in the prevention and amelioration of disease, as well as symptom management and health related quality of life, significantly enhances research and clinical efforts across many areas of behavioral medicine. This article examines the knowledge established to date and suggests advances that remain to be made. We begin with a brief summary of the current knowledge regarding RS as related to three exemplary health conditions: (a) cardiovascular disease; (b) cancer; and, (c) substance abuse. We then focus on particular concerns for future investigations, emphasizing conceptual issues, possible mediators and moderators of relationships or effects, and methodology. Our discussion is framed by a conceptual model that may serve to guide and organize future investigations. This model highlights a number of important issues regarding the study of links between RS and health: (a) RS comprise many diverse constructs, (b) the mechanisms through which RS may influence health outcomes are quite diverse, and (c) a range of different types of health and health relevant outcomes may be influenced by RS. The multidimensional nature of RS and the complexity of related associations with different types of health relevant outcomes present formidable challenges to empirical study in behavioral medicine. These issues are referred to throughout our review and we suggest several solutions to the presented challenges in our summary. We end with a presentation of barriers to be overcome, along with strategies for doing so, and concluding thoughts.

Pender’s health promotion model guided this descriptive/correlational study exploring the relationship between religiosity and health-promoting behaviors of pregnant women at Pregnancy Resource Centers (PRCs). A consecutive sample included women who knew they were pregnant at least 2 months, could read/write English, and visited PRCs in eastern Pennsylvania. Participants completed self-report surveys that examined religiosity, demographics, pregnancy-related variables, services received at PRCs, and health-promoting behaviors. Women reported they “sometimes” or “often” engaged in health-promoting behaviors, Hispanic women reported fewer health-promoting behaviors than non-Hispanic women, and women who attended classes at the centers reported more frequent health-promoting behaviors than those who did not attend classes. In separate multiple linear regressions, organized, non-organized, and intrinsic religiosity and satisfaction with surrender to God explained additional variance in health-promoting behaviors above and beyond what Hispanic ethnicity and attending classes at the PRCs explained in pregnant women at PRCs.

Salivary cortisol has been measured extensively in developmental research over the last three decades. The purpose of this article is to summarize the contributions to and limitations of salivary cortisol measurement in developmental research and propose future directions for research that includes salivary cortisol measurement. The properties of cortisol, the history of its burgeoning popularity, and the utility and limitations of (a) cortisol as a biological indicator, (b) saliva as a source of cortisol, and (c) various saliva collection methodologies are described. The current state of understanding about what is and is not reliably predictable from cortisol is summarized and the value of salivary cortisol measurement in developmental research is discussed, addressing whether methodology could be driving research design. Recommendations are made for streamlining study design and reporting within developmental research.