Objective: To estimate the prevalence of mental health service use among US adults, examine the associations of mental health service use with health insurance coverage, mental health problems and drug use, and detect health disparities. Methods: This was a cross-sectional study with 5,434 adults receiving mental health service out of 37,424 adult respondents from the 2013 National Survey on Drug Use and Health. Weighted univariate and multiple logistic regression analyses were used to estimate the associations of potential factors with mental health service use. Results: The overall prevalence of mental health services use was 14.7%. Our results showed that being female, aging, having a major depressive episode, serious psychological distress, and illicit drug or alcohol abuse/dependence were positively associated with mental health service use; whereas being African American, Asian or Hispanic ethnicity, married, and having any form of insurance were negatively associated with mental health service use. Stratified analysis by insurance types showed that Medicaid/CHIP, CHAMPUS, and other insurance were positively associated with mental health service use. Conclusions: Health insurance coverage, mental health problems, and drug abuse or dependence were associated with mental health service use in US adults. Furthermore, adults with different insurances had disparities in access of mental health service.

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Thesis advisor: Shanta Pandey / A growing body of literature, particularly from low and middle-income countries, has focused on the role of male involvement in maternal care as a crucial strategy to improve maternal and neonatal health outcomes. The purpose of this three-paper dissertation is to add to this evidence base within the context of India, and to gain an in-depth understanding of one aspect of male involvement – that is, male partner attendance in antenatal care. This dissertation utilized data from the National Family Health Survey (NFHS-3, 2005-06 and NFHS-4, 2015-16) and was framed using the Social Ecological Model, Connell’s Theory of Gender and Power and a Gender-Transformative lens. Paper 1 summarized the levels of male partner attendance in antenatal care and assessed changes over time. Further, multivariable logistic regression models were used to examine the factors influencing male partner attendance in antenatal care. The results show an overall increase in male partner attendance in India during the period of 2005-06 to 2015-16, with the Southern region reporting the highest level of male partner attendance in both years. Higher level of education and household wealth, increased knowledge of pregnancy-related complications, older age at marriage, and women’s autonomy were positively associated with male partner attendance in antenatal care. Paper 2 examined the association between male partner attendance in antenatal care and maternal health service utilization. Controlling for all socio-demographic variables and adjusting for report of pregnancy complications, the results showed that women who were accompanied by a male partner for antenatal care reported increased odds of maternal health service utilization (early initiation of antenatal care, frequency of antenatal care contacts and institutional delivery). While the place of residence (rural/urban) did not influence the association between male partner attendance and maternal health service utilization, region had a significant moderating effect. Paper 3 examined the association between antenatal care and infant birth weight, adjusting for gestational age. Further, the analysis also assessed whether the relationship between antenatal care and infant birth weight varied by male partner attendance. Findings indicate that early initiation of antenatal care and maternal immunization was associated with reduced odds of low birth weight among infants. The results showed that male partner attendance in antenatal care did not have a moderating influence. Taken together, the findings of the three papers have implications for policy and practice; further, they provide support for interventions that aim for a more inclusive and gender-transformative approach to maternal and neonatal health. / Thesis (PhD) — Boston College, 2021. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social work.

Indiana University-Purdue University Indianapolis (IUPUI) / The unnecessary medical care causes a heavy financial burden for the patients themselves and the society, and they also negatively impact the quality of medical care. An estimated 13% to 27% of ED visits in the United States could be managed in physician offices, clinics, and urgent care centers, saving $4.4 billion annually, and 26 percent of hospitalizations were potentially avoidable at a cost of $5.6 billion in 2005. If we can help people become more aware of health care services, it could be a potentially effective way to reduce emergency service overuse. we focused on mental health service and social work service as intervention variable, preventable ED visit, preventable ED visit due to mental health problem and hospitalization due to mental health problem as outcomes to determine the impact of specific social service on utilization of specific health care service adjusting for other characteristics of patients (demographic and utilization history information). The data which involved 24074 patients was provided from and managed by the Regenstrief Institute. The date of having the specific service and the frequency of using the specific health care service per year from 2011 to 2014 for each patient was recorded as well as the baseline information including gender, age, race, primary care visit per year before 2011, ACG risk score at 2011, ED visit per year before 2011. For each of preventable ED visit, preventable ED visit due to mental health problem and hospitalization due to mental health problem, we fitted a multiple linear regression model to ascertain the effects of mental health service and social work service adjusted for the baseline information. There was a significant relationship between preventable ED visit & mental health service, hospitalization due to mental health problems & mental health service, as well as hospitalization due to mental health problems & social work service. We found that in most situation, social services were positively associated with health care service. But in the second model which described the impact of mental health service on utilization of hospitalization due to mental health problem, receiving one mental health service can reduce the utilization of hospitalization due to mental health problem, which is as our expectation. According to our study, appropriate amount of services appears helpful on reducing the overuse of ED and hospitalization due to mental health problem. However, people who overused ED or hospitalization in the past were also more likely to be frequent service users, and they tended to continue overuse ED or Incur more hospitalization. There is a group of people who overuse ED or hospitalization without having any service. ED or hospitalization may be their first choice because of their financial condition or other factors, which makes them have no interest to take services.

Despite legal and technological advances, women still face barriers to abortion care in legally restricted or low-resource settings. The advent of medication abortion using misoprostol with or without mifepristone, has enabled women to self-manage their abortions outside of the formal healthcare system. Self-managed abortions are often assisted by telemedicine services, which provide women with evidence-based guidance on managing the abortion process on their own. This thesis explores two separate abortion telemedicine services operating in legally restricted and/or low resource settings – a global online telemedicine service and an abortion support hotline in Venezuela – and evaluates the outcomes associated with each. By interviewing counsellors at a Venezuelan abortion support hotline and the women who used the service, we gained a stronger understanding of the hotline’s successes, barriers, and areas for improvement. We conclude that abortion telemedicine services provide effective and acceptable care, in general, and we recommend greater access to misoprostol in Venezuela.

Magister Public Health - MPH / Disparity in health service delivery between Ghana’s urban and rural areas has been noted to have contributed significantly to the huge gap that exists in health status between the rural and urban areas in the country. Consequently, since the Alma Ata Conference in 1979, Ghana has had a policy of making community-based services available to all, through community-based care and has adopted the Community-based Health Planning and Services (CHPS) Initiative as a national health reforms strategy to mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. The successful implementation of the CHPS initiative rests heavily on the participation and involvement of the communities.

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The purpose of this study is to trace the growth and development of the health service program of the North Texas State Teachers College from 1918-1941 through Campus Chat files, the Minute Book of the Board of Regents of the Teachers College, college records, hospital records, and personal interviews with staff members of North Texas State Teachers college who have been affiliated with the program since its beginning in 1918.

Background Based on the Global Trends report from the United Nations High Commissioner for Refugee, in high-income countries, there are 2.7 refuges per 1,000 national population, girls and women account for nearly 50 percent of this refuge population. In these high-income countries, compared with the general population refuge women have higher prevalence of mental illness. To our knowledge this is the first systematic review that addresses access to mental health services for refugee women in high-income countries. Thus, this review was conducted to examine the barriers to and facilitators of access to mental health services for refugee women in high-income countries for refugee resettlement. Methods MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched for research articles with qualitative component (including mixed-method or multi-method with qualitative component), in order to examine barriers and facilitators related to accessing mental health services. Relevant studies were collected on March 14, 2020 and were extracted and critically appraised by multiple authors. A narrative synthesis was conducted with the included studies to gather key synthesis evidence. Results Of the four databases searched, 1258 studies were identified with 12 meeting the inclusion criteria. The major barriers identified were language barriers, stigmatization, and the need for culturally sensitive practices to encourage accessing mental health care within a religious and cultural context. There were several studies that indicated how gender roles and biological factors played a role in challenges to accessing mental health services. The major facilitators identified were service availability and awareness in resettlement countries, social support and the resilience of refugee women to ease access of mental health services. Conclusion This review revealed socio-economic factors contributed to barriers and facilitators to accessing mental health among women refugees and asylum seekers. Addressing those social determinants of health can reduce barriers and enhance facilitators of access to mental health care for vulnerable populations like refugee women. Although there is a difference in health access policy among the top resettlement courtiers, the review found that there are no significant differences in accessing mental health for refugee and asylum seeker women among leading resettlement countries. The review findings suggest the need for further research on this topic given the potential significance of the findings on refugee and asylum seeker women mental health.