THE RELATIONSHIP OF SEXUAL AND GENDER-BASED VIOLENCE (SGBV) TO SEXUAL RISK BEHAVIORS AMONG REFUGEE WOMEN IN BOTSWANA: THE MEDIATING ROLE OF DEPRESSION Johannes John-Langba, Ph.D., M.P.H. University of Pittsburgh, 2004 This study investigated the relationships of SGBV, learned helplessness, depression, and sexual-risk behaviors among refugee women in Botswana. It was guided by the reformulated theory of learned helplessness. A cross-sectional research design that was primarily quantitative was utilized to examine the relationship between SGBV and sexual-risk behavior in refugee situations and how depression and learned helplessness affect this relationship. A total of 402 female refugees who were at least 21 years old residing at the Dukwi refugee camp participated in this investigation. This study found that about 75% of participants had experienced some form of SGBV either in their home country, during flight/transit, or in the host country. More than half (56.4%) had experienced SGBV in their home countries, 39.3% reported experiencing SGBV during flight/transit, and about 37% of the participants reported having experienced SGBV while in Botswana. Simultaneous multiple regression analysis showed that overall past SGBV predicts current sexual-risk behavior among refugee women (F = 2.018; p < .011). However, when the standardized regression coefficients of the individual independent variables were examined, only past sexual violence was found to contribute significantly to the prediction of sexual-risk behavior (Beta = .461; p< .024).accounting for 15% of the variance with sexual-risk behavior. Although, the hypothesized mediating roles of learned helplessness and depression on the relationship between past SGBV and current sexual-risk behavior were not supported in this study, more than half of the participants (55%) experienced learned helplessness and about 90% were depressed. The findings of this study provide social work and public health practitioners who are faced with the multi-faceted task of program design and implementation in refugee situations with some vital indicators of the psycho-social and reproductive health needs of refugee women in a camp setting. It also underscores the need to adapt prevention and response measures to suit the different circumstances of the various phases of forced migration.

This dissertation study examined the relationships between intergenerational conflict and ethnic identity, and the negative outcomes of depression and behavioral problems among Korean American adolescents. The study addressed two distinct aspects of the intergenerational conflict - the indigenous aspect and the acculturation aspect. The indigenous aspect referred to the typical intergenerational conflict experienced by American adolescents due to their phase of development. The acculturation aspect examined unique manifestations of conflict related to the acculturation process of immigrant families. This dissertation study attempted to provide a better understanding of how these two specific aspects of intergenerational conflict contribute to depression and behavioral problems among Korean American adolescents. No scale that measured the acculuturation aspect of intergenerational conflict exsited. Thus, a new scale was developed to investigate this unique aspect. The study also investigated the effects of ethnic identity on these problems as a predictor and moderator. The study aimed to assess: (a) the relationship between intergenerational conflict (as affected by the adolescent developmental process and the acculturation process combined, and by each of these processes separately) and depression and behavioral problems; (b) the relationship between intergenerational conflict and ethnic identity; (c) the relationship between ethnic identity and depression and behavioral problems; and (d) the relationship between intergenerational conflict and depression and behavioral problems as moderated by ethnic identity. The study design was cross-sectional, and employed a convenience sampling method. The study participants were Korean American adolescents of junior and senior high school age, 14 to18 years old. The study included a pilot study, administered at two Korean churches in Pittsburgh, Pennsylvania, to clarify any ambiguities or misunderstanding from the questionnaire and to psychometrically evaluate a new scale developed to measure acculturative conflict. The primary study was conducted at eleven Korean churches and one hakwon (private out-of-school studies institute) in Fairfax County, Virginia. The results indicated that two distinct aspects of intergenerational conflict and ethnic identity are important in understanding depression and behavioral problems among Korean American adolescents. This study contributed to our understanding of Korean youth as follow. First, it presented a new scale which measures a unique cultural aspect of intergenerational conflict among Korean American families. Second, the study demonstrated that acculturative conflict had a greater impact on depression and behavioral problems, compared to developmental conflict. Finally, the study provided evidence that ethnic identity moderated the effect of intergenerational conflict on depression. In addition, the results of this study suggest the need for further research in the area of ethnic identity and its unique relationship to psychosocial factors.

There is a need to sustain African people living with HIV/AIDS (PLHAs) in good health for as long as possible, while at the same time preventing further risks of HIV transmission to self and others. Living with a HIV diagnosis creates what I have called HIV status stress. Using a HIV Status Stress Scale and an Adherence to HIV/AIDS Treatment and Prevention Scale that were developed for this investigation, along with two existing measures--the Sources of Social Support Scale and the Multidimensional Health Locus of Control Scale, this study sought to determine adherence to HIV/AIDS treatment and prevention among 212 participants randomly selected from two non-profit organizations in Dar-es-Salaam, Tanzania. Study findings highlight the direct effect of HIV status stress on decreased adherence to treatment and prevention regimes and on increased sexual risk behaviors. Informal social support was found to buffer the impact of HIV status stress on sexual risk. These findings hold important implications for public health and social work practice.

The purpose of this study was to examine the way that Socioeconomic status (SES), social support, and acculturation may influence physical and mental health status of Korean American older adults. It was premised that SES, social support and acculturation are directly and/or indirectly related to the mental and physical health status of Korean American older adults manifested by respective symptoms. The following two objectives were established: 1) Explore the characteristics of Korean American older adults including socioeconomic status, acculturation level, social support, and physical and mental health status. 2) Assess direct and indirect effects of socioeconomic status, acculturation level, and social support on the mental and physical health status of Korean American older adults. Though the social support construct itself did not correlate to the degree of health status in this study, some of observed indicators such as number of network contact, the degree of perceived and actual social support showed significant correlation with the degree of respondent¡¯s perceived physical health status. There was also a significant relationship between the social support indicators and mental health construct. Those who had social support available were less vulnerable to experiencing depressive symptoms. In addition, it was shown that some of socioeconomic and demographic characteristics of respondents were directly related to the mental health status of Korean American older adults. Mental and physical health and the aging process of Korean American older adults appeared to be complicated with many factors. First of all they were old immigrants who came to the United States relatively recently to unite with their adult children. The majority of them were living apart from their children. Their sense of self and satisfaction was greatly influenced by the quality of their relationship with their children. Secondly, Korean American older adults were living in a culturally and physically different environment with a number of barriers, such as language, transportation, isolation, and loneliness. And finally, they lacked appropriate socioeconomic resources and support systems.

The purpose of this study was to investigate the influence of perception of social support, privacy preference and level of depression on marital adjustment for couples presenting for infertility treatment. Data was obtained from three infertility clinics in Louisiana from January 1, 2001 through October 1, 2001. Forty-seven couples presenting for infertility treatment completed four questionnaires measuring marital adjustment, perception of social support, privacy preference and level of depression. Demographic and descriptive information was gathered from an information sheet completed by the subjects. Multiple regression analysis was used to determine which, if any, of the independent variables predicted the dependent variable of marital adjustment for couples, husbands and wives. Results indicated that when using couples scores, perception of social support from significant other and privacy reference for solitude explained a significant amount of the variance in couple marital adjustment; when using husbands and wives scores, husbands perception of social support from significant other and privacy preference for solitude contributed significantly to the explained variance in couples marital adjustment. When predicting husbands marital adjustment, only couples perception of social support from significant other and husbands perception of social support from significant other were significant contributors to the explained variance. Privacy preference for solitude and perception of social support from significant other contributed significantly to the explained variance in wives marital adjustment when using couples scores. The strongest model was found when using husbands and wives scores to predict wives marital adjustment. Wives privacy preference for solitude, level of depression, perception of social support from significant other and from friends and husbands privacy preference for solitude combined to predict a significant amount of variance for wives marital adjustment. Findings from this study have implications for social work practice. As the prevalence of infertility rises, social workers who may be in a position to assist couples in coping with the experience of infertility can use these findings to help address the special issues involved and possible risks to marital adjustment for couples presenting for infertility treatment.

This study examines the historical coping and survival strategies of African American women - as reflected through the works of Nannie Helen Burroughs- that can be integrated into current social work practice. This research is important because is describes, explores and analyzes culturally relevant helping traditions, among African American women that have historically promoted their emotional and psychological well-being. An analysis of methods used by Burroughs was derived from articles, letters, speeches and minutes from various convention meetings. Also, a variety of secondary sources were also used during the research process. Results from the study are important in that they support the impact of Black women's experiences as a central component to their psychological health particularly in four distinct areas: understanding and appreciation historical oppression in reform efforts; developing and exploring critical awareness/critical consciousness; promoting collective resistance through faith and demonstrating group problem solving through community art and dialogue. Recommendations from this study include the need for social work profession to validate and disseminate the importance of using non-traditional practice methods when working with oppressed groups. This also includes the professions' employment of Black religious practice/Black church institutions in promoting social and economic reform.

This study examined variables associated with the use of corporal punishment (CP) by parents who hold attitudes that do not support CP, via secondary analysis of an existing nationally representative data set, obtained by the Gallup organization. A cross-sectional telephone survey design was used. The sample consisted of 318 parents, with at least one child between birth and 17 in the home. Independent variables included demographic characteristics, childhood experiences with CP and family violence, contemporaneous household stressors, and parental anger responses. Parents use of CP in the past year was the dependent variable. Results indicated that among parents who do not support CP, those parents who used it were significantly more likely to have been female, single, African American, and younger. They more likely had less than a college education, an annual income of less than $15,000, and younger children. More likely they reported having received corporal punishment at about age 13, having been exposed to parental spousal violence as a teenager, having experienced spousal violence in the past year, and having administered unjustified punishment to the child out of anger. Results of discriminant analysis identified a five variable model that correctly classified 77.5% of the cases (p < .001). The order of the five variables entering the model were: age of child, reporting of anger responses, having received CP when about age 13, race, and having been physically abused as a child. Having younger children, reporting anger responses, having received CP at age 13, and being African American were associated with an increased likelihood of using CP. Having been physically abused as a child was associated with a decreased likelihood of using CP. Findings imply that social work assessments, interventions, and policy initiatives need to utilize the biopsychosocial perspective, with an emphasis on early intervention. Future research recommendations include: analyses of interaction effects among independent variables identified in the present study; additional research on the use of CP by females and African Americans, and on the nature of parental anger and the use of CP; focus on behavioral intention; and qualitative approaches that seek additional variables for consideration.

This study shows the existence of Black Indians in Louisiana and investigates whether differences exist between Black Indians who are members of officially recognized tribes and those who do not have any type of recognition. The study examined if a relationship exist between tribal recognition and ethnic identity, subjective well-being, and social support. A cross-sectional survey design was used. Semi-structured interviews were conducted to obtain qualitative data. The sample consisted of 60 participants. 30 were from recognized tribal groups and 30 were from non-recognized tribal communities. The study specifically examined variables related to the perceptions of Black Indians in Louisiana to see if this group perceives themselves to be Black, Indian, or both. The independent variable included demographic characteristics and tribal designation. The dependent variables were ethnic identity, subjective well-being and social support. Results showed that Black Indians in recognized groups had higher levels of Native American identity when compared to their levels of African American identity (p< .01). There were no significant differences in the levels of Native American identity when compared with the African American identity among the non-recognized samples (p< .342). Differences did emerge with respect to income, age, and tribal designation. Results indicated that those Black Indians in recognized tribes were significantly more likely to be younger with higher annual incomes than those Black Indians in non-recognized groups (p < .01). There were no significant differences between the two groups for the variables social support and subjective well-being. Findings imply that race, as a social construct, is designed by arbitrary categories that are inconsistent with ethnic heritage or cultural identity development.

The increasing number of uninsured Americans is a crucial policy issue for the United States; however, there is a paucity of empirical social science research on the uninsured with which to guide the development of policy. Previous research indicates that when insurance is voluntary, whether offered through a state-initiated reform to reduce uninsurance or offered through an employer as a benefit, some people choose to remain uninsured. The literature calls for research to increase understanding of the factors that affect whether people offered insurance accept or decline that insurance. Research on the uninsured is lacking a theoretical framework to help researchers and policymakers understand, predict, and explain why some people decline insurance and remain uninsured. Previous research suggests that while cost is a primary factor, there are other, unknown factors that contribute to uninsurance. The current research seeks to fill the gaps in the literature by using the Health Belief Model as a framework to explore relationships between insurance status and beliefs about insurance. Five constructs are of focus in the Health Belief Model: susceptibility, severity, benefits, barriers, and cues to action. This study, employing cross-sectional survey methods, is an observational, descriptive, and exploratory study seeking to establish relationships between demographic characteristics, health beliefs, and insurance status. The population under study is insurance-eligible, insured and uninsured employees of a large, state university, where 24% of insurance-eligible employees decline to participate in employer-offered voluntary health insurance benefits. Data were collected through a telephone survey of employees (n=140) selected through a stratified random sample. A Pearsons correlation coefficient was calculated to examine the relationship between insurance status and various dimensions of beliefs as framed by the health belief model. Findings show a significant positive correlation between insurance status and cues to action and significant negative relationships between insurance status and barriers and insurance status and benefits. This study provides insights into the social barriers to health insurance participation. The results of this study suggest that the Health Belief Model is a useful framework with which to study the uninsured.

The ecomap, developed in 1975, is a tool used in social work practice to measure social support (Hartman, 1995). Although the ecomap is widely utilized, due in part to its ease of administration, it has not been validated in the literature as a reliable and valid tool in the measure of social support. This study aims to quantify the ecomap, explore its psychometric soundness, and begin the process of validation using two empirically validated social support measurement tools, the Multidimensional Scale of Perceived Social Support (MSPSS) (Zimet, Dahlem, Zimet, & Farley, 1988) and the Young Adult Social Support Inventory (YA-SSI) (McCubbin & Thompson, 1991). These efforts are expected to contribute to evidence-based practice in social work.