Thesis advisor: Jane Flanagan / Background: Over the past decade, increasing numbers of emerging adults, defined as ages 18 to 22, have journeyed to the United States (US) from Guatemala, Honduras and El Salvador. Upon arrival to the US, many experience inequities in health and healthcare access. The inequities are shaped by US political practices and choices attributed to broad structural and systemic-level barriers within planetary, social, economic and necropolitical forces. Applying a critical framework of antiracism, anti-oppression and anticolonialism, nurses and other healthcare providers must seek to understand the health patterning and life experiences of emerging adult im/migrants from Guatemala, Honduras, and El Salvador so that their health and healthcare needs may be supported. Approach: This qualitative research project aimed to explore health patterning of emerging adult immigrants from Guatemala, Honduras, and El Salvador using the nursing specific research praxis of Health as Expanding Consciousness (HEC). The second aim explored themes across the group. Critical posthuman, feminist, and new materialist assumptions also informed the approach to the study. Between June 2021 to November 2022 thirteen emerging adult participants from Guatemala and Honduras were interviewed twice. Enrollment occurred through community-based recruitment and snowball sampling methods. Each person’s individual story was explored using the HEC praxis method. Results: Participants’ stories uncovered unique profiles with situated, context-specific individual health patterning. Four themes were identified across stories using the qualitative analytic method of Sort and Sift, Think and Shift: Family is Fundamental, The Journey Holds Meaning, Opportunities Exist Amidst Constraints, and Movement and Art are Healing. Conclusions: The discussion section reviews main implications for building critical nursing praxis; understanding intersections of health, nursing care and human mobility; advancing nursing policy for people excluded from care; advancing research using HEC praxis as a caring act of accompaniment; and transforming nursing education for social justice and radical possibility. Im/migration and asylum-seeking were viewed as fundamental human rights including critically advancing the right to health and safety for people in mobility contexts. / Thesis (PhD) — Boston College, 2022. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

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Bakgrund: Diabetes typ 1 är en kronisk autoimmun sjukdom som orsakar att personen behöver regelbunden behandling. Det påverkar deras vardag och kan orsaka både kort- och långsiktiga komplikationer. Livet som ung vuxen kan vara utmanande och att samtidigt leva med kronisk sjukdom kan skapa svårigheter, i en redan komplex period i livet. Utökad kunskap om detta är därför viktigt för hälso- och sjukvårdspersonal. Syfte: Att beskriva unga vuxnas upplevelser av att leva med diabetes typ 1. Metod: Litteraturstudien baseras på kvalitativa studier och analyserades med kvalitativ manifest innehållsanalys med induktiv ansats. Resultat: Data resulterade i 7 slutkategorier: Stöttande omgivning är betydelsefullt och ger trygghet, Svårighet att hitta balans mellan diabeteshanteringen och livet, Det ökade ansvaret är betungande men leder även till personlig utveckling, Önskan att passa in och inte stigmatiseras, Behov av frihet och kontroll kan påverka diabeteshanteringen, Att det finns barriärer inom hälso- och sjukvården, Rädsla över komplikationer och graviditet. Slutsatser: Upplevelser av att leva med diabetes typ 1 varierade mellan de unga vuxna. Det fanns en gemensam önskan över ökad kunskap och förståelse i samhället och hos hälso- och sjukvårdspersonal för att de ska kunna tillgodose individuella behov och en personcentrerad vård.

It is crucial to understand how patient portals are used and adopted among different population groups. This dissertation follows a traditional 5-chapter format that includes three studies with the results of each study presented in an essay format. The first essay provides a systematic literature review of existing research on patient portal adoption, barriers, and predictors. This review reveals a gap in knowledge regarding emerging adults who are transitioning from adult care to self-care settings. The second essay presents an emerging adult patient portal behavioral model, which identifies the factors that impact patient portal usage. Finally, the third essay focuses on patient's trust in providers in secure messaging, which is one of the features available through patient portals. The results of Essay 1 revealed gaps in the literature, highlighting the need for understanding the perceptions of different subgroups of the population towards patient portals to promote their meaningful use. The findings from Essay 2 show that perceived risk and perceived usefulness are significant determinants affecting the behavioral intentions of emerging adults toward the usage of patient portals. Essay 3 describes how information reliability, structural assurance, persuasiveness, perceived ease-of-use, and patients' trusting beliefs in providers are related to the patient's intentions to use secure messaging and patient portals. In addition to addressing existing research gaps, the results of the research in this dissertation inform healthcare providers and developers on how to improve patient portal adoption. By identifying the factors that impact patient portal usage, healthcare providers can optimize the benefits of patient portals for patients and healthcare organizations. Additionally, understanding patients' trust in providers in secure messaging can help improve communication and further lead to better health outcomes.

The impacts of emerging adults' social media use have been shown as generally negative, especially in decreasing their self-esteem and self-concept and increasing anxiety, depression, and more. Although there is research on social media's impact on various communities of adolescents and young adults, limited research has focused on this effect for young adults with mental health diagnoses or served under IDEA's emotional disturbance eligibility criteria. Additionally, no research has studied this topic during the COVID-19 pandemic. Therefore, the purpose of the current study is to examine how various types of social media use impact young adults' self-esteem, including those who are psychologically vulnerable. Participants included 119 individuals, 18 to 19-years of age, with and without mental health diagnoses or Emotional Disturbance special education eligibility recruited utilizing social media pages and social media hashtags. Participating individuals answered demographic and social media use questions and completed the Rosenberg Self-Esteem Scale to provide information about self-esteem. Additionally, participants responded to questions regarding what role they feel social media use has had on their mental health, including contribution to or exacerbating their symptoms. Univariate statistics were run to control demographic factors and determine the percentage of participants who believe social media has negatively affected their mental health. Multiple regression analyzed if time spent on social media or specific social media platform or activities were predictive of participant self-esteem. Limitations and implications are discussed.

This study was informed by a phenomenon observed by a variety of members from the multidisciplinary team at an acute psychiatric facility, where the researcher works daily. It appeared to clinicians as if the individual between the ages of 18 and 25 years was reluctant to engage in therapeutic intervention. The researcher considered current literature and discovered that this phenomenon seems to be globally relevant and an issue in the field of mental health. Emerging adulthood is the developmental phase that occupies the transitional period between adolescence and adulthood. The life phase is an essential developmental phase where an identity is established and skills are acquired to equip the individual through his/her life process. Emerging adulthood is predominantly defined by the individual’s progress to independence and autonomy and the establishment of a personal and societal identity. Developmental tasks include taking responsibility for him/herself, deciding on future career paths and re-evaluating introjected values to form an independent belief system. Literature indicates that emerging adults’ life phase can cause severe distress due to a variety of social and personal stressors. Emerging adults who are enrolled in university often face additional stressors with regards to adapting to campus life, academic pressure and a need to establish themselves within their new environments. A high prevalence and onset of mental health disorders is noted not only in the general emerging adult population, but also in the population of emerging adults who attend university. Despite the increase in stressful experiences the percentage of emerging adults who experience distress is not reflected in the percentage of emerging adults who actually seek and receive therapeutic intervention as a means to manage their distress. As therapeutic intervention is seen as an effective tool in managing distress, the fact that emerging adults negate the help is a clear area of concern. This urged the researcher to closely consider which factors might lead to negation of therapeutic services by the emerging adult. The study was performed at a South African university where students residing in campus residences where approached to volunteer their participation. In total fifteen participants participated in one of three focus groups with the focus on understanding which factors contribute to the negation of therapeutic services by emerging adults. The data crystallised into eleven main themes with different subthemes to support and describe the relevant main theme. The themes clearly emphasised the lack of awareness, pervasiveness of stigmatisation and the internalised beliefs emerging adults have about themselves and therapy that induce help negation. In addressing the issue of help negation in emerging adults this study suggests solutions and actions to the role players involved in the therapeutic intervention of emerging adults that would support the promotion of mental wellbeing and mental health awareness. / MA (Psychology), North-West University, Potchefstroom Campus, 2014

This study was informed by a phenomenon observed by a variety of members from the multidisciplinary team at an acute psychiatric facility, where the researcher works daily. It appeared to clinicians as if the individual between the ages of 18 and 25 years was reluctant to engage in therapeutic intervention. The researcher considered current literature and discovered that this phenomenon seems to be globally relevant and an issue in the field of mental health. Emerging adulthood is the developmental phase that occupies the transitional period between adolescence and adulthood. The life phase is an essential developmental phase where an identity is established and skills are acquired to equip the individual through his/her life process. Emerging adulthood is predominantly defined by the individual’s progress to independence and autonomy and the establishment of a personal and societal identity. Developmental tasks include taking responsibility for him/herself, deciding on future career paths and re-evaluating introjected values to form an independent belief system. Literature indicates that emerging adults’ life phase can cause severe distress due to a variety of social and personal stressors. Emerging adults who are enrolled in university often face additional stressors with regards to adapting to campus life, academic pressure and a need to establish themselves within their new environments. A high prevalence and onset of mental health disorders is noted not only in the general emerging adult population, but also in the population of emerging adults who attend university. Despite the increase in stressful experiences the percentage of emerging adults who experience distress is not reflected in the percentage of emerging adults who actually seek and receive therapeutic intervention as a means to manage their distress. As therapeutic intervention is seen as an effective tool in managing distress, the fact that emerging adults negate the help is a clear area of concern. This urged the researcher to closely consider which factors might lead to negation of therapeutic services by the emerging adult. The study was performed at a South African university where students residing in campus residences where approached to volunteer their participation. In total fifteen participants participated in one of three focus groups with the focus on understanding which factors contribute to the negation of therapeutic services by emerging adults. The data crystallised into eleven main themes with different subthemes to support and describe the relevant main theme. The themes clearly emphasised the lack of awareness, pervasiveness of stigmatisation and the internalised beliefs emerging adults have about themselves and therapy that induce help negation. In addressing the issue of help negation in emerging adults this study suggests solutions and actions to the role players involved in the therapeutic intervention of emerging adults that would support the promotion of mental wellbeing and mental health awareness. / MA (Psychology), North-West University, Potchefstroom Campus, 2014

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Money attitudes modeled in the home are an important part of a child's economic socialization. Although not always labeled as such, earlier literature clearly addressed this type of child learning through observation, interaction, and direct familial involvement (Rettig, 1986). Families operate as one of society's most salient economic socializing agents as they provide environments conducive to human development, information networks, role models, and grants and exchanges (Rettig, 1983). The research reported here addresses the economic socialization of children and their money attitudes as emerging adults. The current study investigated the role of money attitudes (power, anxiety, and distrust) by examining their contribution to impulsive buying among college students. Building on the groundbreaking work of Roberts and Jones (2001), this research also examined credit use and debt avoidance as potential moderators between money attitudes and impulsive buying. Contrary to the way money attitudes have been modeled in previous research, this study found support indicating that the anxiety attitude scale was not an antecedent to impulsive buying. Instead the scale as originally created (Yamauchi & Templar, 1982) was found to consist of two highly correlated subscales, one conceptualized as an antecedent to impulsive buying and the other may be more appropriately modeled as a result of it. Secondly, when tested as moderators, although some of the interaction terms between the money attitudes and behaviors were significant, neither credit use nor debt avoidance was found to be a significant moderator. This indicates a potential need for further research on the relationship between this measure and impulsive buying. Clarification made in the research reported here between anxiety and compulsive buying provides an insight that money attitudes are not all the same. Evidence suggests that some attitudes are precursors to behavior while other attitudes may be the result of behavior. With the passage of time, the drive to seek anxiety relief through impulsive buying may unwittingly fold back to greater rather than less anxiety. Impulsive buying based on anxiety then becomes a belief in relief that is not real. The proposed new attitude-behavioral model acknowledges the difference in money attitudes, that some are best conceptualized as predictors of impulsive buying while others are better conceptualized as a by-product of the behavior. Using this model in future research will acknowledge the potential of a circular relationship between attitude-behaviors and attendant implications for helping individuals and families. For this study, data was collected from students attending ten universities, located mostly in the state of Utah. There were 709 respondents used in this study, substantially more than have been used in similar studies. Demographically, there was a representative mix of male and female respondents and a balanced mix of age groups with a slight shift toward older students. Demographic information also includes respondent's reported race, home state, age, year in school, and family income. In accordance with the research of Roberts and Jones (2001), using ordinary least squares regression, the unconstrained traditional model was tested. Regression analysis of impulsive buying was preformed on money attitudes (anxiety, power, and distrust), controlling for age, gender and income. Following the procedure that Aiken, West, Cohen and Cohen (2003) and Baron and Kenny (1986) outlined, the attitude-behavior relationships between money attitudes and impulsive buying for the potential effects of the two moderating variables-credit use and debt avoidance were also examined. In those models where a significant interaction effect was found, post-hoc analysis was used interpret the significant slope differences in the independent variables.

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