Background and Purpose: Social workers perform important roles within organ transplant services, especially in pediatrics where the parents and extended family are intimately involved. The role of social work in the area of organ transplantation remains underrepresented both within the social work profession and research literature. Research on the psychological and social predictors of medication adherence is critical to the advancement of pretransplant assessments and transplant social work services. Transplant social workers assess the child and family prior to transplantation to determine if the child and family are psychologically and socially prepared to undergo the procedure and care for the child after transplantation, and assist posttransplantation with resources and services. Ultimately, consistency with medication is critical to quality of life and in preventing organ rejection. Methods: The study used hospital-generated data and medical records information to test the association between patient and family psychosocial characteristics and medication adherence outcomes. Data generated from the United Network of Organ Sharing (Department of Health and Human Services) offered medical information and patient and family demographics. The posttransplant data included patients' long-term health, medical outcomes, and adherence to medications. All patients received psychological, psychiatric, or psychosocial assessments prior to being listed for transplantation which included information on the family and patient psychosocial information. Medication adherence was measured using the posttransplant opinion of the physician and standard deviation scores of patients' immunosuppressive medication blood levels. Research on the psychosocial predictors of medication adherence as well as health and medical outcomes are critical to the advancement of pretransplant assessments and transplant social work services. Results: Complete data were collected on 105 pediatric heart and lung transplant recipients and their families. The children were predominantly male (57%), white (65%), heart transplant recipients (78%), and a mean age at transplant of 10.1 years (sd = 6.0). A majority of the parents had an educational level below a four-year college degree (70%), were from a two-parent or blended family home (64%), and had public insurance (70%). In the bivariate analyses, age of the child at transplant, organ type, time of the pretransplant diagnosis, medical status (ICU) at time of listing for transplantation, and patient on life-support predicted standard deviation scores of the medication blood levels. The physician's opinion of the patient's adherence was predicted by age of the child at transplant, child experience of maltreatment, having private insurance, greater parental level of education, having a two-parent home, quality family communication, and patient on life-support. Multivariate, step-wise analyses were conducted with each adherence outcome. The medication blood level standard deviation scores were predicted by age at transplant. The multivariate, step-wise model predicting the opinion of the physician of the patient's adherence included age of the child at transplantation, parental education, two-parent families, other significant psychosocial problems, and the pretransplant life support status of the child. The resulting model explained approximately 39.5% of the variance in the physician opinion of adherence. Conclusions: The ability to assess pediatric patients and their families for risk factors of non-adherence is central to their care both in the pretransplant and posttransplant periods. Efforts to help transplant social workers identify psychological and social aspects of the children and families are important, especially when these characteristics are associated with not taking their medication. The development of standardized and evidence-based pretransplant psychosocial assessments in pediatric populations is suggested, especially those surrounding family factors. Family-centered approaches to the promotion of adherence are suggested during pretransplant and posttransplant periods. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2012. / April 25, 2012. / Adherence, Heart, Lung, Organ Transplantation, Pediatrics, Psychosocial / Includes bibliographical references. / Linda Vinton, Professor Directing Dissertation; Kay Pasley, University Representative; Martell Teasley, Committee Member.

There has been extensive research in the area of childhood sexual abuse in the last several decades. However, the focus has been on symptomology of survivors and the problems they face in adult life. The purpose of this study was to examine the coping strategies childhood sexual abuse survivors use in their daily lives as well as the satisfaction they feel in their current romantic relationship. This study utilized data from Parenting Among Women Sexually Abused in Childhood, 1998, available from the National Center for Child Abuse and Neglect. 265 women answered questions related to current relationship satisfaction as well as strategies they employ to deal with stressful situations. It was found that when women with sexual abuse histories were compared to those women with no sexual abuse history, the women with a sexual abuse history were more likely to use problem avoidance and social withdrawal strategies. No other coping strategies were significantly different. It was also found that there was no relationship between sexual abuse history and current relationship satisfaction. This study discusses implications for these findings for the general public, fellow researchers, and clinicians. / A Dissertation submitted to the Department of Family and Child Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2009. / March 23, 2009. / Sexual Abuse, Coping Strategies, Relationship Satisfaction / Includes bibliographical references. / Thomas Cornille, Professor Directing Dissertation; Nicholas Mazza, Outside Committee Member; Ann Mullis, Committee Member; Marsha Rehm, Committee Member.

This study offers a useful step toward conceptualizing and understanding control-motivated IPV as a device to control partners within specific motivating and facilitating contexts. The research literature suggests that desire for control increases perpetration of intimate partner violence (IPV) against women, that attitudes supporting male dominance and backlash are associated with IPV against women, and that women's status in communities is associated with men's IPV perpetration risk. Recent literature argues that the interpersonal context of coercive control from the victim's perspective is central to understanding IPV. Yet, there are substantial gaps in the literature on how the contextual status of women facilitates IPV and how context might relate to men's attitudes and desire for control. The literature lacks theory to explain how women's contexts influence men to seek control over women and how differences in women's contexts might influence IPV perpetration. To explore these gaps in the knowledge base, this study examines the utility of a multidimensional conceptualization of the macro context of women's controllability in explaining IPV perpetration against women. This study examines how the macro context of women's controllability influences men's control-seeking; the mediating effect of men's attitudes of male dominance and backlash on the relationship between macro context of women's controllability and men's control-seeking; and the effect of macro context of women's controllability on the relationship between men's control-seeking and men's IPV perpetration. Multi-level analyses were conducted linking existing data about the macro context women's controllability in counties to data from 2,920 male undergraduate college students from a state-funded University in Florida. The college student data includes information on psychological and physical IPV perpetration, control-seeking and IPV attributions, and attitudes about male dominance and backlash. Results indicate that control-seeking mediates the relationship between the macro context of women's controllability and IPV. In addition, macro contexts of women's controllability influence men's control-seeking over and above the effects of attitudes supporting male dominance or backlash. Men from counties where women overall had greater controllability were on average more control-seeking. When women had greater power in counties, men were less likely to perpetrate psychological abuse, after taking into account control-seeking. Men with higher levels of control-seeking who were from counties where women shared greater power and independence tended to be less likely to perpetrate physical IPV. The results are promising and underscore the need for further research into macro contextual influences with additional individual level data collected as well as more refined community context delineations. The results are also hopeful for IPV prevention science, especially for community level prevention efforts / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2010. / March 10, 2010. / Prevention, Gender, Multi-level Modeling, Domestic Violence, Intimate Partner Violence, Community Context, Women's Status / Includes bibliographical references. / Dina J. Wilke, Professor Directing Dissertation; Patricia Yancey Martin, University Representative; James E. Hinterlong, Committee Member.

The Trauma Resilience Scale for Children (TRS-C) was created to be a developmentally appropriate, psychometrically valid, reliable and unbiased measure of the major protective factors associated with children's resilience following violence. Extending pilot work with adults, this scale assesses children's perceived presence of ten protective factors following child maltreatment including: physical abuse, sexual abuse, witnessing or experiencing intimate partner violence, and/or witnessing or experiencing a serious threat or injury to life. Empirical and theoretical literature guided subscale and item formulation. Mixed methods design was used for content validation and item refinement with adult trauma experts (n=9) and children in the foster care system (n=9). Refined items were subsequently tested on a larger sample within school and clinical settings (n =208) for scale reliability, validity, factor structure, and differences across demographic characteristics. The scale demonstrated psychometric properties that support its use with children in varied circumstances. The limitations and implications of the scale are discussed, including application within clinical and research settings. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester, 2010. / October 20, 2010. / Positive Adaptation, Protective Factors, Child Maltreatment, Child Abuse, Violence, Scale, Measure, Psychometrics, Children, Resiliency, Resilience, Trauma, Qualitative, Quantitative, Ecological / Includes bibliographical references. / J. Neil Abell, Professor Directing Dissertation; Eric Stewart, University Representative; C. Aaron McNeece, Committee Member.

Florida Self-Directed Care (FloridaSDC) is a state-funded mental health services program for adults diagnosed with a severe and persistent mental illness (SPMI), who rely upon public assistance to access mental health services. Self-directed care (SDC) is a relatively new approach to service delivery in the mental health arena. Modeled after the Cash and Counseling program for individuals with disabilities, SDC differs from traditional community-based mental health services in its "money follows the person" approach. Individuals enrolled in SDC programs control the public dollars allotted for their care, making decisions regarding the types of services and service providers they feel will best assist them in achieving their self-identified recovery goals. Research regarding SDC is limited, particularly with respect to participants and their goals for program success. FloridaSDC presents a unique research opportunity in that it is currently the largest and most established SDC program in the United States. The purpose of this exploratory study is to provide a more holistic, in-depth understanding of FloridaSDC participants than is currently available in the existing literature. This study examines participants' demographic characteristics and mental health, physical health, and substance use histories, as well as their recovery goals, service choices, and outcomes, including goal achievement. Quantitative and qualitative data were collected from the clinical and fiscal records of a purposive sample (n=80) of the FloridaSDC participants (N=264) served during the 2009-2010 fiscal year and still enrolled in the program at the time of this study. The majority of study participants were female (n=49, 61.3%), white (n=61, 76.3%), divorced (n=37, 46.3%) or single (n=34, 42.5%), living alone (n=42, 52.5%), and diagnosed with a mood disorder (n=54, 67.5%). Participants ranged in age from 29 to 70, with a mean age of 51.4 years (SD=9.07). With respect to educational level, 26 (32.5%) participants held a high school diploma, and 21 (26.3%) completed some college. The majority of participants (n=67, 83.8%) reported having an employment history, although 48 (60.0%) were disabled (as opposed to being employed) during the study period. Study participants' had a mean annual family income of $10, 260 (SD=$4,842). A total of 64 (80%) individuals received psychiatric disability income. Key findings suggest that poverty is a major barrier to recovery for FloridaSDC participants, who spent the bulk of their allotted budgets on goods and services to meet their basic needs and maintain independent living. This study also identified an inverse relationship between the severity of participants' symptomology and functioning and their total expenditures, suggesting that those who are the most troubled may be the least likely to make use of FloridaSDC funds to access desired services. Finally, the highly personalized nature of participants' self-reported recovery goals and the degree of consistency between participants' service expenditures and their self-identified barriers to goal achievements reinforce the utility and importance of person-centered planning and individualized budgeting. Additional recommendations for policy, practice, and future research are discussed. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2011. / June 30, 2011. / FloridaSDC, Self-directed care / Includes bibliographical references. / Tomi Gomory, Professor Directing Dissertation; Ann Mullis, University Representative; Nicholas F. Mazza, Committee Member.

This study explored the extent to which differences in social capital among family structures predicted academic improvement in young children using data from the nationally representative Early Childhood Longitudinal Survey, (ECLS) Kindergarten class of 1998-1999, which is administered by the National Center for Educational Statistics (NCES). For all children included in the analyses, parent social and resource capital explained 13% of the variance in reading change scores from kindergarten to fifth grade and 15% of the variance in math change scores from kindergarten to fifth grade. In addition, parent social and resource capital explained 34% of children's reading change scores in stepparent family structures. In light of these findings, implications for policymakers, parents, and scholars are discussed. / A Dissertation submitted to the Department of Family and Child Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester, 2008. / August 26, 2008. / Stepfamilies, ECLS-K, Social Capital Theory / Includes bibliographical references. / Ronald L. Mullis, Professor Directing Dissertation; Patrice Iatarola, Outside Committee Member; Thomas A. Cornille, Committee Member.

Purpose: Decision-making among child welfare professionals is complex, influencing both children and their families. Research has highlighted income and race as factors influencing decisions. However, limited research has focused on family structure issues despite the intersectionality family structure has with income and race. The primary aim of this study is to examine the effects family structure has on the decision-making process using the Florida Safety Decision-making Methodology. Three main research questions are posed: (1) How are removal decisions of case managers affected by family characteristics (family structure and race) for families involved with case management services? (2) How do family characteristics (family structure and race) influence the case managers’ safety assessment of families involved with case management services? And (3) How do family characteristics (family structure and race) influence case managers’ assessment of caregiving protective capacities for families involved with case management services? Methods: This study utilized an experimental 2x2 vignette design, which described a scenario of a family involved with case management services. The child’s family structure served as the independent variable with two levels: (1) two parent family or (2) single parent family. Race served as a moderating variable with two levels: (1) Black or (2) White. Population being studied. The convenience sample included 54 case managers working throughout the state of Florida. Data collection procedures. The study utilized primary data collection procedures, targeting case managers at several case management service agencies throughout Florida by employing a convenience sampling technique. Data collection began November 2016 and ended in March 2017. Data Analysis: Bivariate analyses, regression analyses, and a path analysis were utilized to examine the variables of interest. Results: Several relationships resulted in interesting trends in the data. The relationship between family structure and removal decision had a χ2 = 3.47 (p = .062) with a medium effect size (ϕ = .254). The relationship between the interaction of family structure and race and removal decisions also resulted in interesting data trends, as a higher proportion of case managers recommended out-of-home services to White, single parent families compared to all other family types. The final trend in the data indicate a relationship between the interaction of family structure and race on safety decisions. White single parent families are more likely to have a safety decision of “safe” compared to all other family types, a result contradictory to the findings on family characteristics and removal decisions. Discussion: Overall, family structure is a relevant but often overlooked factor related to decision-making among child welfare professionals. According to the results, family structure has an influence on removal decisions, a previously unexplored factor among decision-making research. Additionally, it is important to examine the full picture of the family to fully understand their multiple layers of discrimination. It is not race alone that biases decisions, it is a combination of factors, which need to be continuously examined to diminish the effects of biases when making decisions that impact families and their children. Limitations: Vignettes have been used as sound methodological approaches in many studies; however, a limitation of this design is that the vignette may not elicit a true response even if the scenario presents a true-to-life situation. Many variables are still uncaptured in these scenarios such as the relationship between the client and case manager, the family’s reaction to the case manager, and the perception the family has of the case manager, which are said to indirectly affect case decisions. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester 2018. / April 17, 2018. / Child Welfare, Decision-making, Family Structure, Family well-being, Vignette Methodology / Includes bibliographical references. / Bruce A. Thyer, Professor Directing Dissertation; Kathryn H. Tillman, University Representative; Lisa Schelbe, Committee Member; James J. Clark, Committee Member.

The decline of outdoor play in children's lives continues to demand investigation with an explicit goal to reveal and understand the child voice. This study aimed to explore children's engagement in outdoor activity as influenced by the perceptions of outdoor activity of parents and teachers. Children were expected to display similar engagement levels as their parent or teacher. Interviews conducted with six children and six adults revealed that outdoor play is held in high regard. However, observational results discovered that children spent 90% of their time indoors due to teacher perception of weather. The predicted levels of engagement, of each parent and their child, revealed evidence to support parental influence on children's engagement during outdoor play. However, the study revealed that children's outdoor play and potential engagement was influenced by the teacher involved in the study and her perceptions of outdoor play. / A Thesis submitted to the Department of Family and Child Sciences in partial fulfillment of the requirements for the degree of Master of Science. / Spring Semester, 2011. / March 21, 2011. / Bronfenbrenner, Early Childhood Education, Early Child Development, Outdoor Play, Child Perception, Parent Perception, Obesity, Engagement, Physical Activity / Includes bibliographical references. / Christine Readdick, Professor Directing Thesis; Ann Mullis, Committee Member; Juliann Woods, Committee Member.

Resilience has been defined to include the recovery from traumatic experiences (Block & Block, 1980, and Bonanno (2005), but this assumption had not been empirically tested until now. By using the Ego-Resiliency Scale (Klohnen, 1996), the Trauma Recovery Scale (Gentry, 2006), part of the Traumagram Questionnaire (Figley, 1989), and the Impact of Events Scale – Revised (Weiss & Marmar, 1997), this idea was tested in a non-clinical sample of 242 social work students from Florida State University. It was found that resilience and symptoms of posttraumatic stress disorder were inversely related as expected, but not significantly. With a Pearson Product correlation coefficient of -.077, it would only be statistically significant at the .268 level. These findings provide evidence that resilience does not mean recovery from traumatic experiences. This new data will require further research exploration to clarify what is meant by resilience. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2010. / April 5, 2010. / Resilience, Resiliency, Ego-Resiliency, Posttraumatic Stress Disorder, PTSD / Includes bibliographical references. / Bruce Thyer, Professor Directing Dissertation; James P. Sampson, Jr., University Representative; Nicholas Mazza, Committee Member.

Based on the family resilience framework, the current study used a longitudinal design to investigate the relationship between youth (depression and trauma) and parent (parental monitoring and parental substance dependence) risk factors and protective factors (caregiver relatedness) for substance use among adolescents involved with the child welfare system that remain living with a biological parent. Overall the hypothesized effects were not significant for youth and parent risk factors. The moderator and interaction effects also failed to support the hypotheses of the study. Two control variables, age and initial levels of substance use, emerged as consistent predictors of future adolescent substance use. Parental monitoring approached significance in both path models suggesting that more parental monitoring among at risk adolescents can reduce future substance use. Post hoc cross-sectional analysis supported the relationship between depression, parental monitoring, and caregiver relatedness with current substance use of at risk adolescents. Based on these results, clinical recommendations include increased training on assessment and early identification of risks for adolescent substance use among child welfare caseworkers and clinicians. Future research should focus on longitudinal analyses using an at risk sample. Finally, significant correlations which were not addressed in the original research questions and hypotheses of the study should be explored. / A Dissertation submitted to the Department of Family and Child Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2010. / March 30, 2010. / Adolescent, Substance Use, Child Welfare System / Includes bibliographical references. / Ann K. Mullis, Professor Directing Dissertation; Ming Cui, Committee Member; Lenore M. McWey, Committee Member.