The continuum of care framework posits that individuals move from one level to the next in seeking resources for help ranging from first using informal support to finally using formal services. Yet, the literature is mostly focused on formal services. It is well-known in the literature that existing formal services are underutilized by the Asian American population. If that is also the case in nontraditional settlement cities like Richmond, Virginia, the continuum of care framework and existing literature suggest that Asian Americans are turning to their informal support networks to meet their needs. Thus far, the literature on informal support networks is very limited and a focus on Asian American communities is nonexistent. Furthermore, there is not an adequate theory to explain and predict this phenomenon. This study uses a grounded theory design to develop a testable theory that could further the understanding of informal support networks in the Asian American community. The theory posits that the Asian culture and community influence how individuals within the community seek help in times of need and, in turn, the helping process developed within the informal support network is a reinforcement of the Asian culture and community. When individuals have needs, they look to the informal support network and the network is developed in response to those needs. However, the informal support network is not able to meet all the needs of the Asian American community. At times, though infrequent, when the informal support network cannot meet the need, individuals are referred to mainstream services. Therefore, the informal support network serves as a gatekeeper to mainstream services. In addition, needs are rarely successfully met directly by mainstream services because of inaccessibility. Consequently, mainstream services provide infrequent help in meeting the needs of the Asian American community. It is important to comprehend how these developing communities in the new South are responding to their own needs. This understanding will allow mainstream services to extend formal systems of care and better partner with existing resources to effectively serve the increasing Asian American population in the South.

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.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-03-28T12:58:59Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Carla Patrícia Pereira Gonçalves Fernandes_Dissertação_050820162301.pdf: 1508954 bytes, checksum: 9136bb28456e805922c2017ddd6b54f3 (MD5) / Made available in DSpace on 2017-03-28T12:58:59Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Carla Patrícia Pereira Gonçalves Fernandes_Dissertação_050820162301.pdf: 1508954 bytes, checksum: 9136bb28456e805922c2017ddd6b54f3 (MD5) Previous issue date: 2016-02-15 / Percebeu-se através da literatura a necessidade e carência de estudos sobre anarquia e gerenciamento de projetos. Esta dissertação de mestrado tem por objetivo investigar como os conceitos da anarquia - apoio mútuo, coletivismo e autogestão - relacionam-se com os processos de gerenciamento de projetos, baseados no Guia Project Management Body of Knowledge (PMBOK), presentes no dia-a-dia dos profissionais da área de projetos. Portanto, foi conduzida uma revisão bibliográfica e um survey para atingir esse objetivo. A pesquisa inquiriu profissionais atuantes na área de gestão de projetos, em organizações de software e serviços de tecnologia da informação. Para tanto, o estudo foi desenvolvido de forma exploratória, dado que existia pouco conhecimento acumulado e sistematizado a respeito deste tema. A análise dos dados recolhidos na pesquisa conclui que tanto a pesquisa bibliográfica quanto o survey confirmam que há uma relação positiva significativa entre a anarquia e os processos de gerenciamento de projetos estudados. Almeja-se que o presente estudo possa servir de elemento prospectivo para outras pesquisas na área de gerenciamento de projetos, fomentando a realização de trabalhos e publicações científicas. Por fim, o trabalho propõe contribuir com a academia, gerando nova literatura com informações relacionadas ao tema. / It was realized through literature the need and the lack of studies on anarchy and project management. This master thesis aims to investigate how the concepts of anarchy - mutual support, collectivism and self-management - are related to the project management processes, based on Project Management Body of Knowledge (PMBOK), present in the day-to-day professional project. Thus, we conducted a literature review and a survey to achieve this goal. The survey asked professionals working in project management area, in software organizations and information technology services. Therefore, the study was developed in an exploratory way, since there was little accumulated and systematized knowledge about this topic. The analysis of the data collected in the survey concludes that both the literature and the survey confirm that there is a significant relationship between anarchy and the studied processes for project management. One hopes that this study can serve as a prospective element to further research in the project management area, fostering the realization of scientific works and publications. Finally, the work proposes to contribute to the area, creating new literature with information related to the topic.

The study investigates the depression in a group 55 adults (14 women and 41 men) who live with VJH, between 18 and 58 years, oflow and medium low socioeconomic leve! which attend public health centers, NGO and mutual support groups (MSG) of Lima. The Beck Depression Inventory was used to study the level of depression, as well as the five factors found in this population.The descriptive results were correlated with the following demographic variables: age,sex, time of diagnosis, the presence or absence of symptoms associated to VIH, the participationor not in a MSG, sexual orientation and sex. Results indicated that depression varies depending on whether the person belongs or not to a MSG, sex and sexual orientation. / El estudio investiga la depresión en un grupo 55 adultos (14 mujeres y 41 hombres) que viven con VIH, entre 18 y 58 años, de nivel socio económico bajo y medio bajo que acuden a centros de salud estatales, ONG y grupos de ayuda mutua (GAM) de Lima. Se uso el Inventario de Depresión de Beck para estudiar el nivel de depresión. así como los cinco factores encontrados en esta población. Se correlacionaron los resultados descriptivos con las siguientes variables demográficas: edad, sexo, tiempo de diagnóstico, presencia o no de síntomas asociados al VIH, participación o no en un GAM, orientación sexual y sexo. Los resultados indicaron que la depresión varía según la persona pertenezca o no a un GAM, el sexo y la orientación sexual.

This research studies the social support in a group of adult persons with HIV: 14 women and 41 men between 18 and 58 years of age, from medium- low social economic status that appeal to state health centers, non government entities and mutual support groups of Lima. The resultsof perceived social support, effective social support, social support satisfaction and social support need ha ve been correlated with variables age, sex, diagnostic time, presence of symptoms associated lo H!V, participation in a mutual support group, sex and sexual orientation(heterosexual males, men that have sex with other men and heterosexual women).The results showed that the social support indexes behaved differently according to weather they participated in a mutual support group or not, according to sex, according to sex and sexual orientation. Also, the need for social support rate varies according to diagnostic time. / Se investiga el soporte social en un grupo de adultos con V!H: catorce mujeres y cuarenta y un hombres. de entre 18 y 58 años. de estrato socioeconómico bajo y medio bajo que acuden a centros de salud estatales, organismos no gubernamentales y grupos de ayuda mutua (GAM) de Lima. Se correlacionaron los resultados descriptivos de los índices soporte social percibido, soporte social efectivo, satisfacción con el soporte y necesidad de soporte con las variables edad, sexo, tiempo de diagnóstico, presencia o no de síntomas asociados al VIH, participación o no en un GAM y orientación sexual (hombres heterosexuales, hombres que tienen sexo ton otros hombres (HSH) y mujeres heterosexuales). Se encontró que los índices del soporte social se comportan diferente según se pertenezca a un GAM o no, según el sexo, según la orientación sexualy el sexo. Asimismo, el índice necesidad de soporte varía según el tiempo de diagnóstico.

The policy of Separate Development and its forceful implementation by the Nationalist Government from the !960's and into the 1980's resulted in the resettlement of thousands of Africans in the 'homeland' Ciskei in the Eastern Cape. All these changes had a profound and very often a disruptive influence on the lives of those involved. People's ability to survive amidst these circumstances, was tested to the limit. This study looks at the role of the local Christian faith community in supporting its members during these rapid and disruptive socioeconomic and political changes. The study is confined to two congregations of the Uniting Reformed Church in Southern Africa in Ilitha and Ndevana in the Eastern Cape. Following an introductory chapter, Chapter 2 gives a historical outline of developments in the broader Ciskei. Attention is also given to demographic, social and economic conditions. Chapter 3 describes the culture and feeling of despair, powerlessness and mistrust that is deeply entrenched in the minds of many people in the community due to depressive socio-economic situations. Chapter 4 gives an overview of the churches in the area and describes the supportive structures and actions of two churches in the Ilitha-Ndevana area. No instant solutions are offered to members but through mutual support they find a sense of belonging and encouragement in the midst of their hardship. In Chapter 5 a model for the mission of the local church in a context of social and economic change and disruption, is presented. It is shown how the image of Christianity and the Gospel have been distorted and misused in the past through the entanglement of mission and colonialism, a negative attitude towards African culture, and by contributing to the subordination of women in society. A vision that people in Africa can have peace and dignity and become self-reliant is proposed. Within the local faith community this vision is built on an understanding of God as the weak and suffering Lord, on fellowship and mutual support, a new reading of the Bible, a practical community based spirituality, and an emphasis on healing. / Die daarstelling en .kragdadige toepassing van die beleid van Afsonderlike Ontwikkeling vanaf die 1960's tot·die 1980's het tot gevolg_gehad dat duisende Swart Suid-AftilCaners hervestig is in die Ciskei-tuisland in die Oos-Kaap. Al hierdie veranderinge het verreikende en baie dikwels ontwrigtende gevolge op die betrokkenes gehad. Mense se vermoens om binne hierdie omstandighede te oorlee:t: is tot die uiterste beproef. Hierdie studie kyk na die rol van die plaaslike · Cbristelike. geloofsgemeenskap in die ondersteuning van sy lede tydens snelle en ontwrigtende sosiale, ekonomiese en politieke veranderinge. Die studie is beperk tot twee gemeentes van die Verenigende Gereformeerde Kerk in Suider-Aftika in Ilitha en Ndevana in die Oos-Kaap. Na 'n inleidende hoofstuk, gee hoofstuk 2 'n historiese oorsig van ontwikkelinge in die breere Ciskei-gebied. Aandag word ook gegee aan demografriese, sosiale en ekonomiese toestande. Hoofstuk 3 beskryf 'n kultuur en gevoel van moedeloosheid, magteloosheid en wantroue wat, as gevolg van neerdrukkende sosiaal-ekonomiese toestande, diep in menige mense se gemoedere vasgele is. Hoofstuk 4 gee 'n oorsig oor die kerke in die gebied en beskryf die ondersteunende strukture en optrede in twee gemeentes in die Ilitha-Ndevana area. Geen kitsoplossings word aan lede aangebied nie, maar deur onderlinge steun vind hulle geborgenheid en bemoediging te midde van swaarkry. In hoofstuk 5 word 'n model aangebied vir die missie van die plaaslike kerk te midde van sosiale en ekonomiese veranderinge en ontwrigting. Daar word aangetoon hoe die beeld van die Christendom in die verlede verwring en misbruik is deur: die verstrengeling van sending en kolonialisasie; 'n negatiewe houding teenoor kultuur in Afrika; en deur by te dra tot die ondergeskikte posisie van vroue in die samelewing. 'n Visie dat die mense van Afrika vrede en menswaardigheid kan geniet en self onderhoudend kan raak, word voorgestel. Binne die plaaslike geloofsgemeenskap word aan hierdie visie gebou deur 'n begrip van God as die magtelose en lydende Here, deur onderlinge gemeenskap en ondersteuning, 'n nuwe lees en begrip van die Bybel, 'n praktiese gemeenskaps-gerigte spiritualiteit en 'n beklemtoning van heling en herstel. / Christian Spirituality, Church History and Missiology / D.Th. (Missiology)

The policy of Separate Development and its forceful implementation by the Nationalist Government from the !960's and into the 1980's resulted in the resettlement of thousands of Africans in the 'homeland' Ciskei in the Eastern Cape. All these changes had a profound and very often a disruptive influence on the lives of those involved. People's ability to survive amidst these circumstances, was tested to the limit. This study looks at the role of the local Christian faith community in supporting its members during these rapid and disruptive socioeconomic and political changes. The study is confined to two congregations of the Uniting Reformed Church in Southern Africa in Ilitha and Ndevana in the Eastern Cape. Following an introductory chapter, Chapter 2 gives a historical outline of developments in the broader Ciskei. Attention is also given to demographic, social and economic conditions. Chapter 3 describes the culture and feeling of despair, powerlessness and mistrust that is deeply entrenched in the minds of many people in the community due to depressive socio-economic situations. Chapter 4 gives an overview of the churches in the area and describes the supportive structures and actions of two churches in the Ilitha-Ndevana area. No instant solutions are offered to members but through mutual support they find a sense of belonging and encouragement in the midst of their hardship. In Chapter 5 a model for the mission of the local church in a context of social and economic change and disruption, is presented. It is shown how the image of Christianity and the Gospel have been distorted and misused in the past through the entanglement of mission and colonialism, a negative attitude towards African culture, and by contributing to the subordination of women in society. A vision that people in Africa can have peace and dignity and become self-reliant is proposed. Within the local faith community this vision is built on an understanding of God as the weak and suffering Lord, on fellowship and mutual support, a new reading of the Bible, a practical community based spirituality, and an emphasis on healing. / Die daarstelling en .kragdadige toepassing van die beleid van Afsonderlike Ontwikkeling vanaf die 1960's tot·die 1980's het tot gevolg_gehad dat duisende Swart Suid-AftilCaners hervestig is in die Ciskei-tuisland in die Oos-Kaap. Al hierdie veranderinge het verreikende en baie dikwels ontwrigtende gevolge op die betrokkenes gehad. Mense se vermoens om binne hierdie omstandighede te oorlee:t: is tot die uiterste beproef. Hierdie studie kyk na die rol van die plaaslike · Cbristelike. geloofsgemeenskap in die ondersteuning van sy lede tydens snelle en ontwrigtende sosiale, ekonomiese en politieke veranderinge. Die studie is beperk tot twee gemeentes van die Verenigende Gereformeerde Kerk in Suider-Aftika in Ilitha en Ndevana in die Oos-Kaap. Na 'n inleidende hoofstuk, gee hoofstuk 2 'n historiese oorsig van ontwikkelinge in die breere Ciskei-gebied. Aandag word ook gegee aan demografriese, sosiale en ekonomiese toestande. Hoofstuk 3 beskryf 'n kultuur en gevoel van moedeloosheid, magteloosheid en wantroue wat, as gevolg van neerdrukkende sosiaal-ekonomiese toestande, diep in menige mense se gemoedere vasgele is. Hoofstuk 4 gee 'n oorsig oor die kerke in die gebied en beskryf die ondersteunende strukture en optrede in twee gemeentes in die Ilitha-Ndevana area. Geen kitsoplossings word aan lede aangebied nie, maar deur onderlinge steun vind hulle geborgenheid en bemoediging te midde van swaarkry. In hoofstuk 5 word 'n model aangebied vir die missie van die plaaslike kerk te midde van sosiale en ekonomiese veranderinge en ontwrigting. Daar word aangetoon hoe die beeld van die Christendom in die verlede verwring en misbruik is deur: die verstrengeling van sending en kolonialisasie; 'n negatiewe houding teenoor kultuur in Afrika; en deur by te dra tot die ondergeskikte posisie van vroue in die samelewing. 'n Visie dat die mense van Afrika vrede en menswaardigheid kan geniet en self onderhoudend kan raak, word voorgestel. Binne die plaaslike geloofsgemeenskap word aan hierdie visie gebou deur 'n begrip van God as die magtelose en lydende Here, deur onderlinge gemeenskap en ondersteuning, 'n nuwe lees en begrip van die Bybel, 'n praktiese gemeenskaps-gerigte spiritualiteit en 'n beklemtoning van heling en herstel. / Christian Spirituality, Church History and Missiology / D.Th. (Missiology)