The overall aim of the proposed dissertation is to enhance understanding of the impact of the community and neighborhood in preventing violence against women, and how women who have been displaced from their communities may be at increased risk of violence. This three-paper dissertation utilized secondary data sources from two studies of IPV against women in Uganda: the SASA! Study and the Ugandan Demographic and Health Study (UDHS). The first paper used quantitative data from the baseline of the SASA! study (a cluster randomized controlled trial of a community-based intervention to prevent violence against women and HIV/AIDS, called SASA!), a representative sample of community members in two districts in Kampala. This study hypothesized that women who live in neighborhoods with higher levels of collective efficacy to prevent IPV would be at decreased risk of experiencing male-perpetrated IPV. Using a multi-level logistics model, there was no significant neighborhood effect on intimate partner violence related to collective efficacy or otherwise. However, women with higher levels of self-efficacy to prevent IPV against others were significantly less likely to experience physical IPV themselves. Other fixed effect factors, including younger age, no education, higher number of children, having no electricity, not earning an income, and partner's daily alcohol use significantly predicted women's risk of IPV. Potential research and practice implications will be discussed. The second paper utilized secondary analyses of the impact of displacement on IPV against women from the Demographic and Health Survey, a representative community sample of women throughout Uganda. Using propensity score matching, this study attempts to determine the causal effect of displacement on women's experiences of intimate partner violence. Given that assumptions hold, the results indicate that women who are displaced in northern Uganda are less likely to experience IPV than if they had not been displaced. Potential explanations for these findings, such as the renegotiation of gender during displacement and the impact of the humanitarian Cluster Approach, will be discussed. The third paper is an in-depth qualitative study using secondary analysis of focus groups with community leaders in Kampala Uganda, also from the baseline of the SASA! study. Key findings using framework analysis of focus group discussions with religious leaders, sengas/traditional aunties, health care workers, police and local council leaders suggest a widely held justification for violence against women based on an underlying cultural belief in men's authority over women and expectations on women. The belief in men's power over women manifests in three, interrelated themes: men's authority, blaming women, and controlling women's sexuality. Few dissenting voices argued against violence against women for reasons related to the impact on the children and the need for women and men to live with peace and happiness in the home. Overall, despite numerous justifications for violence against women, community leaders expressed a strong sense of responsibility in responding to violence against women, particularly in life threatening situations. Suggested strategies for intervening in situations of violence against women in the home included recruiting elders, talking to the men about the violence, calling upon help from local council leaders, and reporting to the police. These suggested strategies were not, however, without underlying sentiments of men's authority and associated risks faced by community leaders. Community leaders also expressed a sense of responsibility in helping organize community members for prevention activities, although they did not see their role as leaders or facilitators of these efforts.

This study uses narrative analysis to explore the question: How do forced evictions impact the psychosocial health of displaced women in Phnom Penh, and what sources of risk and resilience frame how they manage the exigencies of displacement? I use Stress and Coping Theory to frame analysis of the narratives of evicted women in order to understand their lived experiences and pathways of adaptation. Analysis of 27 interviews with 22 women demonstrated highly diverse experiences and divergent outcomes. I present a typology of post-eviction socioeconomic pathways because women's coping strategies and adaptation are deeply grounded in the nature and degree of economic harm that they experienced. From this context, I explore how women coped with their displacement. Stress tended to manifest in the form of somatic ailments and rumination. Social support and livelihood capacity emerged as key protective factors. The better-off participants for whom eviction tended to represent harm to assets, community, and aspirations typically exhibited a great deal of anger and/or anxiety, and they experienced forced eviction as a discreet, tragic, and even traumatic event. By contrast, those who lived in poverty tended to manifest depression, hopelessness, and passive resignation. These women spoke of their forced eviction as a terrible but somehow normal event within lives characterized by the exploitation and suffering shouldered by the very poor. I conclude with recommendations for policymakers and social work practitioners.

Productive activity supports successful aging by helping to maintain older adults' cognitive and physical functioning and active engagement in life. This study examines the human, social and cultural resources that contribute to productive activity, specifically formal volunteering, among Early Baby Boomers (EBB) during the transition from mid-life to late life. Four time points across 6 years from a sample of 2,684 EBBs aged 51 and older from the Health and Retirement Study (2004-2010) were analyzed using logistic regression and generalized estimating equations. Baseline and longitudinal human, social and cultural capital factors and demographic variables functioned as predictors of formal volunteer engagement and its intensity. High levels of cultural capital, defined as religiosity, significantly increased the likelihood of both formal volunteer engagement and high intensity volunteering. Greater human capital and some forms of social capital also boosted the probability of volunteer engagement, but higher levels of one component of social capital (paid employment) significantly reduced the likelihood of high intensity volunteering. Volunteer engagement and intensity were stable during the observed period, in spite of the Great Recession during the latter waves of data. Gender appeared to have no effect on the likelihood of volunteer engagement or intensity. The distribution of human, social and cultural resources was associated with differences in mid- to late life productivity among EBBs, and productive activities of formal volunteering and paid employment appear to compete for their time. Exploring the unique contributions of aspects of education and religion to volunteerism in future research may lead to more inclusive public policy and programs that facilitate the participation of individuals from a wider array of backgrounds. Such efforts can increase opportunities for formal volunteering among persons transitioning from mid- to late life.

This study investigates the relationship between Palestinian Women's Movement(s) (PWMs) and the Palestinian Nationalist Movement (PNM). A closer look at the descriptive research about (PWMs) indicates that both movements have generally been perceived as one entity by some Palestinian activists as well as scholars who have explored Palestinian nationalism. Here, we address questions about the nature of women's activism in Palestine and seek to assess to what extent this organizing and mobilization form a social movement, particularly questions that focus on important factors such as faction dynamics, funding dynamics, perceptions and relationships issues, leadership features and religion dynamics. Taking into consideration the specificity of women's movements in a nation that has survived military occupation for over five decades under military occupation, this research draws on a number of theories, including resource mobilization and resource dependence as well as political opportunity theories. The research is rooted in extensive interviews with former and current women activists, in addition to chief executive officers (CEOs) of Palestinian women's movement organizations located in the West Bank, Palestine. Moreover, the researcher utilizes thematic analysis. This study is among very few that seek to shed light on women's activism in Palestine "West Bank and East Jerusalem" through the eyes of a Palestinian-born man who was raised therein and is an integral part of the cultural and academic fabric of that land.

Background: Elder abuse is increasingly recognized as a public health crisis and is associated with significant morbidity and premature mortality. At the foundation of this problem, elder abuse risk factors remain misunderstood. Previous elder abuse risk factor research contains methodological limitations that threaten the validity and reliability of existing knowledge. Further population-based research using standard elder abuse definitional/inclusion parameters and adaptations of established measurement tools is required to advance the literature. A major gap in the elder abuse risk factor literature is consideration of problem severity. Previous studies have focused on dichotomous prevalence/incidence outcomes, yet substantial variation exists in the extent, frequency, and self-perceived seriousness of the problem. Using data from the most methodologically rigorous population-based elder abuse study conducted to date - New York State Elder Abuse Prevalence Study (NYSEAPS) - this dissertation identified candidate risk factors of one-year incidence, objective severity, and subjective severity for elder emotional abuse, physical abuse, and neglect among cognitively intact, community-dwelling older adults. Methods: The NYSEAPS used a random digit-dial sampling strategy to conduct direct telephone interviews with a representative sample (n = 4156) of older adults in New York State. Inclusion criteria captured older adults aged 60 years or above living in the community, cognitively intact, and English/Spanish-speaking. Elder emotional and physical abuse types were assessed using a modified version of the Conflict Tactics Scale. Elder neglect was measured using a modified version of the Duke Older Americans Resources and Services scale. Potential risk factors were examined at several ecological levels of influence, including the individual victim, victim-perpetrator relationship, home living environment, and surrounding socio-cultural context. Multivariate regression modelling was used to identify factors associated with one-year elder abuse incidence in the general population, as well as factors associated with objective and subjective elder abuse severity among mistreated older adults. Results - Incidence: Older adults who were younger, functionally impaired, living in a low-income household, and separated/divorced had significantly higher odds of emotional abuse and physical abuse in the past year. Older adults who were younger, separated/divorced, living below the poverty line, non-Hispanic, and in poor health had significantly higher odds of elder neglect in the past year. Results - Objective Severity: Increasingly severe emotional abuse was predicted by younger age, functional impairment, shared living, Hispanic ethnicity, a spousal/partner perpetrator, and living alone with the perpetrator. Higher levels of physical abuse severity were associated with younger age, a grandchild perpetrator, and living alone with the perpetrator. Increasingly severe neglect was predicted by younger age, functional impairment, and low household income. Results - Subjective Severity: Victims of emotional abuse were more likely to perceive the problem as serious if they were functionally impaired, highly educated, or endured more objectively severe mistreatment; victims were less likely to perceive the emotional abuse as serious if they lived with family or lived with their perpetrator. Physical abuse victims had higher odds of viewing their abuse with greater seriousness if they were a widow, single or experienced more objectively severe mistreatment; victims were less likely to perceive physical abuse as serious if they lived with the perpetrator. Neglect victims reported higher perceptions of problems seriousness if they were functionally impaired, male, had a paid attendant perpetrator, or endured more objectively severe mistreatment; neglect victims had lower perceptions of problem seriousness if their perpetrator was an adult child or when they lived with the perpetrator Implications: Using NYSEAPS data, this dissertation contributes the most valid and reliable elder emotional abuse, physical abuse and neglect risk factor knowledge available to date. It also extends existing risk factor research as the first known study to examine factors predicting elder abuse operationalized along a continuum of severity. Incidence-related risk factor information carries direct implications for policy and interventions aimed at preventing new elder abuse cases. Objective severity risk factor findings inform the development of targeted interventions to alleviate the magnitude of existing elder abuse cases and protect victims from heightened risks of mortality and morbidity. A focus on subjective severity carries indirect implications towards understanding victim help-seeking intentions and protective service utilization.

Background: Integration of social services (e.g., civil registration, community mobilization) with public health and primary care has been recommended as a key strategy by practitioners, researchers and policy-makers to solve the multifactorial determinants of chronic diseases. Despite efforts to increase service integration in the past 50 years, there is limited evidence on effective approaches to integrating myriad services. This study investigated the influence of individual- and organizational-level factors, and job characteristics on service integration using 262 providers from the Estratégia Saúde da Famí­lia teams. Brazil's Sistema Úšnico de Saúde is acknowledged worldwide as a model for studying integration as FHS transdisciplinary teams, which comprise of Community Health Agents (in Portuguese, Agentes Comunitário de Saudi or ACS), nurses, and physicians, are mandated to integrate services. Methods: Cross sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Mesquita and Santa Luzia. Service integration was measured by three services: HIV prevention, community mobilization, and civil registration. HIV prevention refers to biomedical interventions that prevent the spread of HIV by blocking infection (e.g., condoms), decreasing infectiousness (e.g., antiretroviral therapy), or reducing acquisition/infection risk (e.g., medical male circumcision). Community mobilization is the participation of citizens in activities, such as community walks, geared towards understanding their sociopolitical environment. Civil registration is the documentation of deaths, births and household information. Multiple logistic regression analysis and Structural Equation Modeling (SEM) were used to identify salient job characteristics, individual- and organizational-level factors associated with the three measures of service integration and service integration in itself. Individual factors were measured by providers' confidence, knowledge and skills, community familiarity, perseverance, and efficacy of the FHS team. Job characteristics were measured by transdisciplinary collaboration, provider's autonomy in making decisions, skill variety (ability to use a set of diverse skills); and consumer-input. Organizational factors were measured by work conditions and resources. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Of the sample, 82% were females (n =214). The highest proportion of participants identified as pardo (multiracial; n= 123; 46%); 82 (31%) as white; and 54 (21%) as black or Afro-descent. The mean age was 34 (SD = 10); ranging from 20 to 70 years. Results from the multiple logistic regression indicated that pardo providers, ACS, providers with a caseload of more than 500 usuária (service consumers), reported greater perseverance, and less work methods autonomy had greater odds of offering HIV prevention services. Providers with higher levels of knowledge and skills, greater confidence and skill variety had greater odds of engaging in civil registration. Providers who identified as pardo, had less than 5 years or 5 years of work experience with the FHS, reported higher levels of knowledge and skills and greater skill variety had greater odds of mobilizing communities. Providers with experience of 5 years or more reported more service integration. After accounting for all variables, community mobilization, HIV prevention, and civil registration were strongly correlated. The following variables positively influenced service integration: higher levels of knowledge and skills; greater discretion by the job to use a variety of skills, confidence, and perseverance. Greater work-methods autonomy and decision-making autonomy were negatively associated with service integration. No organizational-level factors influenced service integration. Conclusions: This dissertation initiates a conversation in the literature on a framework to studying service integration. Provider trainings globally should incorporate activities that enhance providers' confidence, perseverance, knowledge and skills, and ability to make decisions on the spot use diverse skills while integrating services. While Brazil's FHS program endorses transdisciplinary collaboration as a process for providers to integrate services, transdisciplinary collaboration was not significant predictor. Greater research needs to be designed and implemented in collaboration with providers to assess their perceptions of transdisciplinary collaboration. Research going forward also needs to be conducted on how organizational level factors impact service integration.

For many American adolescents, the decision to delay pregnancy is a manifestation of attitudes and behaviors which increase their ability to avoid unplanned pregnancies. Poor self-perception and external locus of control, in turn, are considered to be major determinants of the quality of decisions that many adolescents make. Research informs us that many factors: family, environmental and psychological, come together to motivate the adolescent's self-perception and perception of the risks of pregnancy and childbearing. To motivate the freshmen at an inner city high school, a three phase program of interventions using professional staff from a nearby hospital was developed. Built into this program was a research component based on the classic experimental design. The sixty students in the experimental group met once weekly for eight weeks in small groups of 10-12 each, to learn social interaction, communication, and decision-making skills as well as family planning and male/female sexual responsibility. Additionally, condoms were distributed free of charge along with encouragement to use them whenever a decision was made to have sex. The six week career mentorship component of the program made it possible for these students to try out a possible life career by spending time with a professional person in a chosen area of health care. The students then returned to their groups for a six week termination phase. Pretesting, based on the Nowicki-Strickland test and the Rosenberg scales showed no differences between the control and experimental groups, and incremental improvement after treatment which was not statistically significant, however, posttests results show a significant increase in the use of contraception amongst sexually active program participants. In addition, frequency of sexual activity decreased by more than one half after treatment. Students who completed the program participated in a graduation ceremony and were given certificates. These young men and women gave very positive evaluations to the program. More significantly, many of them have returned as volunteers and peer mentors to work with a new group who have just started the new program cycle.

This research project was designed to identify variables within the dialysis patients' ecological field associated with behaviors. The import of this study lies in the fact that dialysis patients' health and levels of social functioning are affected by the degree to which they are able to comply with their prescribed medical and dietary regimen. Five measures of compliance were selected as the dependent measures for this study. Serum phosphorous, serum potassium, and between dialysis weight gains constituted three objective measures. An Overall Objective Compliance Index was created by standardizing and summing the patient's scores on the three objective measures.The fifth dependent measure was based upon the patients' self-reports of their compliance. We found this measure to be the least reliable and negatively correlated with the objective measures. Independent variables were grouped into five domains, demographic, intra-personal, inter-personal, health delivery system and environmental factors. A random sample of 60 patients was selected from the 131 patient population at the Brooklyn Kidney Center for this cross-sectional descriptive study. Fifty-five patients were interviewed and five patients refused to be interviewed. The interviewed sample was predominantly male (66%), Black (73%). with less than a high school education (52%), had a mean age of 46 and had been on dialysis an average of four years. A structured interview format was utilized to collect data; information was also abstracted from a review of the medical charts. Each patient was interviewed while they were being dialyzed. Less educated, married, female patients new to dialysis reported experiencing the greatest impact from renal failure and dialysis treatments. However, when we correlated the overall degree of impact of the illness with the five dependent measures, there were no statistically significant associations. In other words, while these patients experienced the greatest impact, there was no relationship between their subjective experience and the compliance measures. The findings between the demographic characteristics and compliance measures indicate that some patients are at higher risk of experiencing social role disruptions. A demographic profile of the patients most at risk in being non-compliant shows that they were older males, with less education, of lower socio-economic status, unemployed, born in the New York City area and new to dialysis. The patients' coping activities and the availability of a neighbor were the only independent variables which emerged as being associated with all four objective measures of compliance. Patients who tended to reach out to others and did not solely rely on themselves and who continued to think about the current crisis were more compliant with respect to all four objective measures. Patients who had a neighbor to call upon when in need of help were also more compliant. Families that lacked organization, internal support, or tended toward either of the extremes of over involvement or disengagement from the patient appeared to increase the likelihood that the patients would have problems with compliance. Patients with lower objective knowledge scores and who experienced barriers to following their medical and dietary instructions such as the lack of cash to purchase medications when needed, feeling depressed, being too busy, etc., were less compliant. Contrary to expectations, patients who reported higher levels of satisfaction with the dialysis staff and quality of care were also less compliant. This was attributed to the patients' use of denial and fear of staff's criticisms. A recommended program for increasing dialysis patients' compliance levels is presented in which more reliance is placed on a comprehensive psychosocial evaluation and the initiation of family and group services. Future research projects are discussed noting the importance of utilizing longitudinal type designs.

This dissertation attempts to learn the amount of satisfaction and comfort single custodial fathers feel in different parenting areas and which variables are most highly associated with the father's satisfaction and comfort. A questionnaire was placed in the May-June, 1982 issue of The Single Parent, the membership magazine for Parents Without Partners. This approach yielded a non-representative sample of 1136 fathers with children 18 years old or younger, approximately 15 to 20 percent of the population that was believed to have qualified for the study. Five different parenting areas were examined. The father must (1) maintain the house and provide child care; (2) feel satisfaction with how the children living with him are progressing; (3) work and balance the demands of child rearing; (4) adjust to being single again; and (5) establish or resolve his relationship with his ex-wife vis-a-vis her involvement with the children. It was hypothesized that the following variables would be associated with either satisfaction or comfort in the five areas: the age, sex, and number of children being raised; the number of years the father had sole custody; the father's income; whether the father sought custody; and the level of involvement of the ex-wife. By using multiple regression, it was found that only one of the seven variables were useful predictors of the father's satisfaction and comfort in the areas. Fathers were more likely to be experiencing satisfaction and comfort if they earned a higher income or if the income earned was felt to be adequate to meet their needs. This variable was also highly associated with the ex-wife's involvement with the children. The father's satisfaction with the child care arrangements made emerged as a significant predictor of their comfort. It was found that fathers feel satisfaction and comfort with running the household and with their children's progress. The areas involving working while raising the children and adjusting to being single proved more problematical. Fathers were mixed as to their satisfaction with their ex-wives' involvement with the children, though fathers who described their ex-wives as being very involved experienced greater satisfaction in some of the areas explored.

Eighty-five sponsors in a Veterans Administration family care program were interviewed for the purpose of ascertaining whether or not the social environment provided a viable alternative to institutional living for the chronic mentally ill. Also, the impact of various descriptive factors of the setting on the social characteristics in the home was estimated. A level of restrictiveness scale (areas in which the freedom of the residents is restricted) and a level of deviation from normative living scale (areas in which residents are excluded from family activities) were utilized to measure the social characteristics of the family care environment. A high degree of each of these factors has been linked with a custodial care type of arrangement and a low degree of these dimensions has been associated' with a rehabilitative type of dwelling. Fifteen per cent of the homes scored above 80% on the level of restrictiveness and only 5% of the residences fell into the same category on the level of deviation from normative living (maximum score 100%), indicating that only a small minority of homes could be placed in a custodial care type category in relation to each of these dimensions. Moreover, a sizeable proportion of homes, approximately 40% of the sample, scored under 50% on the level of deviation from normative living demonstrating that some opportunities are provided for residents to experience different facets of family living. The lack of association found between the level of restrictiveness and degree of deviation from normative living would seem to indicate that the pattern of care is less consistently structured than other dwellings dealing with a similar population. This inconsistency may be the result of a variety of "cross-pressures" on the sponsors related to the decentralized manner in which the program is administered. Sponsors who were previously employed in a custodial care setting scored significantly lower on the level of deviation from normative living scale than sponsors lacking such experience. Sixty-nine per cent of the "trained" sponsors as compared with 39% of the "untrained" sponsors scored below the median on the level of deviation from normative living (p < .01), indicating that the former group may be more involved in "rehabilitative" tasks than the latter group. Younger sponsors appeared to maintain more restrictive homes than older caretakers. Sixty-seven per cent of the caretakers under 40 years of age scored above the median on the level of restrictiveness whereas only 29% of caretakers over 60 years of age scored above the median on the same dimension (p < .12), indicating that there may be more restrictions in homes managed by younger sponsors than in those managed by older ones. Comments obtained from the sponsors seem to suggest that the motivation of the individual for participating in the family care program may play an important role in shaping the structure of the setting. Such individuals as the older person who joins the program for companionship and the former employee of a custodial care facility who desires to take on a broader, more active role with psychiatric patients, may tend to establish settings consistent with these needs. What is noteworthy is the lack of relationship between size of the home and the social dimensions in the environment. This negative finding brings into question a modification in family care programs which has been considered by some or already implemented by others, namely, limiting the number of ex-patients in a home. Based upon the findings different hypotheses were formulated to be tested in future research.