<p>As pedagogical innovations continue to be developed and adopted in engineering education, it is important to understand how these innovations affect the students’ experiences and achievements. A common data analysis practice when evaluating educational innovations is to aggregate the data from all of the students together. However, this data aggregation inherently biases the results toward the characteristics of the dominant student group, leaving the experiences of minority groups largely unexplored. In this dissertation, I investigate the students’ experiences and achievements in an undergraduate dynamics course, and I intentionally use analysis methods that disaggregate the data to better understand the behaviors and performance of smaller subgroups of students, not just the majority.</p> <p> This dissertation presents three studies that examine: 1) the validity, reliability, and fairness of a standardized set of conceptual questions on the final exam, with a focus on gender fairness, 2) how and why the students use the available resources, and 3) how the students’ holistic resource usage patterns relate to their academic achievement. My motivation for choosing these studies was that conceptual assessments and customized resources are two key components of the learning environment for the dynamics course. However, the quality of the conceptual exam questions used for the course had yet to be evaluated. Similarly, the learning environment for the course incorporates many customized resources, including a custom-written “lecturebook” (a hybrid of a textbook and a workbook) and an extensive online library of videos, but little was known about how the students used these resources, or how the students’ pattern of resource usage related to their performance in the course. </p> <p> The first study in this dissertation used multiple-group confirmatory factor analysis to investigate item-level gender bias in a 12-item Abbreviated Dynamics Concept Inventory (aDCI), which was a set of standardized conceptual questions included on the final exam. The results suggested that two items were slightly biased against women, with stereotypically-masculine contexts and content as possible sources of the bias. The bias in the aDCI items likely unfairly lowered some women’s final exam scores, highlighting the need for engineering educators to consider the fairness of their assessments.</p> <p> The second study used a cluster analysis of survey responses to identify nine archetypical patterns of resource usage, all of which differed from the average resource-usage pattern of the aggregated sample. An analysis of forty-four student interviews, organized by resource-usage cluster, determined that students exhibited their resource-usage behaviors largely because of how they perceived the resource’s availability, accessibility, and quality. The results illustrate that there is no “typical” way in which the students used the resources, so it is important for instructors to consider a wide array of usage behaviors when designing a course’s learning environment and resources.</p> <p> The third study utilized a multiple regression analysis to find that <i>on average</i> a student’s resource-usage pattern is not related to their achievement when controlling for many other demographic, cognitive, and non-cognitive factors that can affect resource usage and performance. However, two individual resource-usage patterns were significantly related to achievement. Students who primarily used their lecturebook and their peers for support performed better than their similar peers in other resource-usage clusters. Conversely, students who rarely used their lecturebook had lower course grades than their peers. Drawing from the results of the second study, general study-habit suggestions for the students in the course were extracted from the qualitative themes found in the interviews of the students in these two clusters.</p> <p> Overall, the results of these three studies highlight how the experiences and achievements of smaller groups of students would go unnoticed if analytical methods that only utilized aggregated data were used. While the setting of this research is specific to the assessments and resources of a given dynamics course, the methods used to disaggregate the data to gain insights about different subgroups of students are applicable to many engineering education contexts. My hope is that this work inspires more researchers to consider the experiences of all students, not just those of the majority.</p>

Background. Lung cancer is the leading cause of cancer deaths worldwide. Low survival rates have been attributed to delays to diagnosis, and some patients report having symptoms for several months before presenting to health services. Strategies are needed to encourage timely help-seeking. The Web is increasingly used as a health information source. Aim. The aim of this thesis is to explore whether the Web plays a role in help-seeking behaviour of people with lung cancer prior to diagnosis, and how the Web can be utilised to encourage earlier presentation to health services for symptomatic people. Systematic review. To begin, I carried out a systematic review of the literature (N=34), which highlighted a scarcity of research on Web use for symptom appraisal among cancer populations. Mixed-methods study. I conducted a survey with recently diagnosed (6 months or less) lung cancer patients (N=113). Based on survey responses, I purposively selected a sub-sample of patients and their family/friends ("proxies") for semi-structured interviews (N=33). In the survey, 20.4% of participants reported they or proxies had researched their condition online before the diagnosis. Interview results suggest perceived impacts of online information on symptom appraisal, forming the decision to seek help, and on interactions with healthcare professionals. Intervention development and evaluation. Based on my findings, I developed a Web-based intervention. The intervention provides tailored information about lung cancer, and uses components based on the Theory of Planned Behaviour ("TPB-components") to encourage earlier help-seeking. This intervention was tested in an online feasibility study (N=130), and subsequently in an online randomised controlled trial (N=212) with a factorial design to test main and interaction effects of tailoring and TPB-components. The feasibility study and first trial helped identify methodological issues which were addressed in a second trial with a mixed factorial design. This trial (N=253) indicated that the self-reported likelihood of visiting a doctor increased significantly by 11.8% from before to after viewing study information (p < 0.001), but no effects of tailoring or TPB-components were found. When examining only those aged ≥50 years, who are at highest risk of lung cancer, those receiving tailored information reported an increase of 13.2% in likelihood of seeking help, compared to 3.2% in the untailored group (p=0.01). Participants aged 50+ receiving the TPB-component reported a larger increase (13.8%) than those who did not receive the TPB-component (5.2%), but this did not meet the significance criterion (p=0.054). Conclusions. According to patients' perceptions, the Web can impact on processes in the appraisal, help-seeking and diagnostic interval leading up to diagnosis. Presentation of information about symptoms and risk factors online can produce significant effects on self-reported likelihood of seeking help. These findings indicate that there is potential for the Web to be utlised in the endeavour to educate the public about symptoms and to promote earlier presentation to health services, but due to small effects and differential dropout in this study, further research is required.

Given the increasing number of Chinese international students attending American universities, an important study would be to consider problems arising during these students' initial transition period, as they acculturate into the American culture and educational system. Taking this information into account, university counseling centers, campus services, and those who interact with and support these students would be better able to assist in easing the initial and ongoing stress of living in a foreign country and adapting to a new way of life. Thirteen Chinese international students participated in qualitative interviews conducted in Mandarin Chinese, each participant's native language. Each participant was born and raised in mainland China, had never travelled to the US before studying abroad, had no direct family relative in the US, and had studied at a university in the US for more than two years. In order to gain a better understanding of Chinese international students' initial transition to live and study in the US, a qualitative research design was utilized. This study used a collaborative hermeneutic approach to obtain a valid and common understanding of the meaning of each transcribed interview. Data analysis followed the hermeneutic circle, which emphasizes that the meaning of the text can be better understood through reading individual parts and comparing meanings of parts and whole. These study used a team to analyze data, thus avoiding the narrow reliance on individual interpretations. Based on their personal perspectives, participants reported their experiences encountered during their initial transition into the US. More specifically, information shared during individual interviews with Chinese international students indicated specific experiences in regard to their initial and ongoing adjustment to the U.S. environment, including how they made sense of their experiences and how their ways of thinking and behaving changed as a result of being influenced by their experiences interfacing with U.S. culture. Participants also shared their strategies they perceived as helpful in specific situations. Based on an analysis of participants interviews, themes that arose from the interviews included (a) difficulties and challenges they faced as new immigrants; (b) differences they encountered in respect to their homeland and the new environment, including language/communication, culture, academic study and learning, living in the US, and psychological adjustments; (c) positive growth they acknowledged from facing challenges and adapting to their new environment; and (d) acknowledging the need to accept help and how to more proactively seek and receive help as needed. Implications for more actively assisting and including Chinese international students are discussed.

Evaluating the attitude of African American clergy toward parishioners seeking professional mental health services for mental illness has important treatment implications. Religion and spirituality are equally important determinants of mental health and can affect African American clergy's attitudes toward professional care for mental illness. Utilizing the health belief model (HBM), this quantitative study examined the role of theological beliefs, education, and personal experience with mental illness as they correlated with clergy's attitudes toward seeking professional mental illness services. Approximately 98 African American Protestant Clergy in the states of Georgia and South Carolina participated in this study. Data were collected using self-administered surveys via e-mail and mailings using the religious attitude scale (RAS) and the attitude toward seeking professional psychological help scale (ATSPPHS). A multiple linear regression analysis was used to examine the correlation of independent variables. The results of this study indicated that theological beliefs (p = 0.025) but not education (p = 0.084) or personal experience with mental illness (p = 0.078) had a direct effect on the African American clergy attitudes toward parishioners seeking professional mental health services. This research supports the idea that conservative African American pastors' attitudes toward congregants seeking professional mental health services are positive. The results of this study can influence social change by increasing access through clergy's pivotal role as the gatekeeper for parishioners who seek help for mental illness.

Thesis (M.A. (Clinical Psychology)) --University of Limpopo, 2014 / The aim of the study was to investigate help-seeking pathways that are followed by patients with chronic disease in one rural community in Limpopo Province. Specifically, the objectives of the study were: a). to investigate help-seeking pathways that were followed by patients with chronic diseases before and after they were diagnosed with their condition; b). to explore the treatment modalities that were used by the patients before they started receiving hospital treatment for their chronic conditions; and, c). to determine whether or not the patients received other forms of treatment in addition to their treatment for the chronic diseases. Through snowball sampling, 10 participants (female = 6; male = 4) drawn from Ga-Dikgale community (Limpopo Province) were selected and requested to participate in the present study. The ages of the participants ranged from 42 to 96 years. Data were collected using semi-structured interviews and analyzed using interpretative phenomenological analysis (IPA) The results of the study are presented under the following themes: a). participants‟ understanding of chronic disease; b). participants‟ view or understanding of factors that could have led to their chronic disease ; c). the help-seeking pathways that were followed by patients with chronic diseases before and after they were diagnosed with their condition; d). the treatment modalities that were used by the patients before they started receiving hospital treatment for their chronic conditions; and, e) whether or not the patients received other forms of treatment in addition to their treatment for the chronic diseases. The study found that different treatment agencies are consulted by patients with chronic diseases. These agencies include: spiritual leaders, traditional healers, to mention few. Based on the findings of the present study, it is concluded that help-seeking pathways are mainly determined by the perceived causes of the disease, which are culturally rooted.

Hintergrund und Fragestellung: Weiter steigende Raten des Konsums psychotroper Substanzen und klinisch bedeutsamer Substanzstörungen vor allem bei Jugendlichen und jungen Erwachsenen, veränderte Gebrauchs- und Problemkonstellationen der Konsumentengruppen und die Einführung neuer Therapien und Versorgungsmodelle (Prävention, Frühintervention, Therapie und Rehabilitation) erfordern insbesondere angesichts der begrenzten Finanz- und Versorgungsressourcen neue Bedarfs- und Allokationsmodelle. Diese sollen praxisnah und effizient zu entscheiden helfen wann, bei welchen Rahmenbedingungen, welche Interventionsart und -strategie die individuell erfolgversprechendste ist. Diese Fragen werden in einem Forschungsprojekt des Suchtforschungsverbundes ASAT bearbeitet, das in einer umschriebenen Region mittels schrittweiser, epidemiologisch basierter Bedarfsund Bedürfnisanalysen die Ableitung und Priorisierung von institutionellen und therapeutischen Zuordnungsstrategien untersucht. Methodik: Basierend auf einem prospektiv-epidemiologischen Design wurden (1) bei einer repräsentativen regionalen Bevölkerungsstichprobe (EDSP-Studie) Inzidenzmuster, Spontanverlauf, Risikofaktoren und Konsequenzen des Substanzgebrauchs, -missbrauchs und der -abhängigkeit sowie Inanspruchnahmeverhalten, gedeckter und ungedeckter Bedarf beurteilt. (2) Ergänzt wird diese Erhebung durch eine Gesamterfassung und Evaluation des regionalen Suchthilfesystems. (3) Über statistische Analysen von Verläufen und Suchthilfeangeboten in der Region sollen "natürliche" Allokationsprozesse dargestellt und "outcome"-orientiert bewertet werden. (4) Anhand der dabei sichtbaren Mängel und Defizite können dann zusammen mit den Einrichtungen verbesserte Allokationsrichtlinien für einzelne sowie Gruppen von Patienten abgeleitet werden. Die Ergebnisse sollen in das regionale Suchhilfesystem übertragen werden. Ergebnisse und Diskussion: Erste Ergebnisse des Projekts bestätigen die Möglichkeit, Risikogruppen über spezifische Verlaufsanalysen zu identifizieren (z.B. regelmäßige Cannabiskonsumenten, Mehrfachkonsumenten, mehr weibliche Konsumenten mit einem höherem Abhängigkeitsrisiko). Die Inanspruchnahmemuster deuten in Teilbereichen (Frühintervention) auf ein hohes Ausmaß ungedeckten Bedarfs hin und scheinen neue Allokationsentwürfe zu erfordern. Den Einrichtungsträgern und regional Verantwortlichen der Suchthilfe können nach Auswertung weiterer Daten umfassende Bedarfsabschätzungen und verschiedene alternative Allokationsmodelle basierend auf der Perspektive von KlientInnen/ PatientInnen bereitgestellt werden. / Background and Aims: Increasing rates of substance use and substance use disorders especially in adolescents and young adults, changing patterns of use and associated problems and the introduction of new therapies and programs of care (prevention, early intervention, therapy, rehabilitation) require new need and allocation models especially because of restricted financial and care resources. These models should provide a rational basis for the improvement of allocation processes as well as setting priorities in the provision and restructuring of community and patientoriented interventions. In the present paper, we will present a project of the ASAT research network program which aims at a multi-staged, integrated epidemiology-based need and program evaluation in an area to determine institutional and therapeutical allocation processes. Methods: Based on a prospective epidemiological design, (1) prevalence and incidence, risk factors and course of substance use, abuse and dependence are investigated in a representative sample of the community-based EDSP study. Additionally, helpseeking behaviors, met and unmet need are assessed. (2) The investigation is supplemented by a survey of all substance use services in the area. (3) Course of substance use and service provision of substance use services in the area will be analyzed and reviewed to identify natural allocation processes and to determine the outcome. (4) With the knowledge of deficits and unmet need, improved allocation guidelines for specific groups of clients and patients will be developed. The results will be transferred into the regional health care system. Results and discussion: First results show that the identification of new risk groups with the help of course typologies is possible. The patterns of help-seeking point to a high rate of unmet need, especially with regard to the targeted early intervention, and a need of alternative allocation models. After the assessment and the overall data analyses, need evaluations and several alternative allocation models based on the clients'/patients' perspective will be provided.

Purpose of the study is to examine the relationship of ruminative tendency, internal working models of attachment (Self-Model and Other-Model) and help seeking attitudes (Positive Beliefs and Negative Beliefs) with psychological symptoms among the university students. In scope of the current research, the mediation role of rumination in the relationship between internal model of self and psychological symptoms was examined. By applying convenient sampling procedure, six hundred and ten university students were included into the current study from 9 different state universities in Ankara and Istanbul. Turkish version of Relationship Questionnaire (Bartholomew &amp / Horowitz, 1991), Relationship Scale Questionnaire (Griffin &amp / Bartholomew, 1994), Brief Symptom Inventory (Derogatis, 1992), Ruminative Response Scale (Nolen-Hoeksema &amp / Marrow, 1991) and Attitudes toward Seeking Psychological Help - Shortened (T&uuml / rk&uuml / m, 2001) were delivered to the university students at university campuses. Multiple regression analyses were implemented to evaluate the research hypotheses. The results revealed that rumination, internal model of others, and negative beliefs about psychological help significantly predicted the increase in psychological symptoms of Turkish university students. Positive beliefs about psychological help did not relate to psychological symptoms of university students for the current set of data. In addition to this, rumination mediated the relationship between internal model of self and psychological symptoms of university students. The research findings were discussed by relying on the previous research premises.

Thesis (M.A.)--Kutztown University of Pennsylvania, 2001. / Source: Masters Abstracts International, Volume: 45-06, page: 2775. Typescript. Abstract precedes thesis as preliminary leaf ix. Includes bibliographical references (leaves 32-39).

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

Clinical depression has been prevalent in international health statistics but people are often found to be reluctant to seek help when they encounter depression. This thesis built and evaluated a mental health promotion campaign to encourage help-seeking through first forming a behavioral model to conceptualize the interplays of various factors in shaping one’s help-seeking intention and behavior for depression in Hong Kong. The thesis began with in-depth illness narrative qualitative interviews with 18 participants through purposive sampling from the general public of Hong Kong. Through the interview results and close reference to the theory of planned behavior (TPB), a behavioral model was drafted highlighting impacts of view on depression, help-seeking and other factors had on individual’s help-seeking intention and behavior. Followed by that, 70 quantitative questionnaires completed by members of the general public were then done through snowball sampling to validate the model. 16 items were then retained in the model that uses attitude towards help-seeking, subjective norm and perceived behavioral control to explain individual’s help-seeking intention and behavior. At the same time, the interviews and questionnaires found that participants seem to have a limited view of treatment options and have diverse views of the symptoms of depression, both of which profoundly affect their motivation to seek help. The role of family and friends and a holistic approach to mental health education were found to be particularly important for encouraging help-seeking behavior in future campaigns concerning depression. The content for this mental health promotion campaign was then designed into 4-weeks of email campaign material according to the factors mentioned in the model to encourage help-seeking for depression built and validated in the previous stages. The participant recruitment for the media campaign was done through the social media Facebook through two paid advertisements. A total of 5,405 clicks were gained through the Facebook advertisements and these Facebook users were then directed to a Survey Monkey email registration site to the campaign. 383 people registered their emails in the site with 199 of them completed the pre-test and joined the 4-week campaign. The 199 participants were randomly divided in two groups with one receiving the campaign material and another group receiving information from tradition leaflet issued by the Hospital Authority in Hong Kong. Pre-test and post-test were done before and after the campaign to measure the difference in help-seeking intention after reading the two sets of material respectively. As a result, 116 participants completed the campaign and the post-test. With a post-test only design, no significant change has been found in primary outcomes including attitude, subjective norm and perceived behavioral control, but significant change has been found in secondary outcome, which participants were found to have better mental health literacy after the campaign. This thesis has shown the practicality and effectiveness of using online media and theory-guided material for mental health promotion campaigns. It is important for future studies to take advantage of the popularity of online media and conduct primitive and evaluative research on these campaigns. / published_or_final_version / Journalism and Media Studies Centre / Master / Master of Philosophy