Browsing by Author "Oruche, Ukamaka"

Now showing 1 - 4 of 4
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    Activation in Persons with Opioid Use Disorders in Intenstive Outpatient Treatment
    (2021-12) Keen, Alyson Yvonne; Lu, Yvonne; Draucker, Claire Burke; Oruche, Ukamaka; Mazurenko, Olena
    Persons with opioid use disorder (OUD) often receive intensive outpatient treatment (IOT) but these programs are associated with low rates of completion and high rates of relapse. Enhancing patient activation - taking an active role in one’s healthcare - would likely improve outcomes for persons with OUD in IOT. The overarching purpose of this dissertation is to describe how persons with OUD experience IOT, especially regarding activation. The dissertation includes three components. The first is an integrative review of 29 studies of activation in persons with mental health disorders generally. Results revealed that activation was related to several heath and treatment-related factors and some interventions, most notably educational programs, increased activation. The second and third components were based on interviews with 14 persons who had been enrolled in an IOT program in academic health centers. The second component was a constructivist grounded theory study conducted to describe the process people undergo as they participate in an IOT program. Participants described a process of connecting and disconnecting that included eight stages: (1) connecting with drugs, (2) disconnecting from everyday life, (3) connecting with the IOT program, (4) connecting with others in the IOT program, (5) disconnecting from drugs, (6) reconnecting with others, (7) reconnecting with self, and (8) disconnecting from the IOT program. The third component was a qualitative descriptive study conducted to describe types of instances in which persons play an active role in their IOT (activation). Participants described six types of instances: (1) making and enacting one’s own treatment decisions, (2) actively engaging in treatment planning with staff, (3) choosing to actively engage in groups, (4) making a commitment to treatment, (5) taking responsibility for one’s own recovery, and (6) taking actions to avoid relapse. The results of this dissertation will inform the development of strategies to enhance activation among persons with OUD in IOT with the goal of improving engagement and program outcomes.
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    Data Mining Teen Narratives on Reddit: Revealing Insights in Cyber Victimization Experiences
    (2024-07) Antisdel, J'Andra Lashay; Miller, Wendy Trueblood; Ellis, Rebecca Bartlett; Jones, Josette; Carter, Gregory A.; Oruche, Ukamaka
    As teens increasingly turn to the internet and social media for entertainment and social connection, they are faced with increasingly dangerous situations as technology advances and aggressors seek to harm and exploit victims online. This qualitative study used data mining and Word Adjacency Graphing (WAG), a type of computational analysis, with the aim of analyzing how teens on Reddit describe and discuss their experiences of cyber victimization. WAG modeling allowed for an examination of public, unsolicited teen narratives revealing patterns and alarming insights that were identified in six themes, including psychological impact, coping and healing, protecting yourself online, protecting yourself offline, victimization across various settings, and seeking meaning and understanding. These themes encompassed the impact of cyber victimization and its profound effects on the mental and emotional well-being of teens, emphasizing the importance of updated assessment methods and a trauma-informed approach in healthcare settings. In addition, the trauma expressed by teens highlighted the importance of recognizing cyber victimization as a serious adverse event impacting mental health. This approach would encourage open discussions, validate teens’ experiences, and focus on understanding and responding to the impact of trauma. The findings call for comprehensive strategies in healthcare to screen and assess for cyber victimization effectively, thereby supporting and empowering teens in overcoming these traumatic experiences.
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    The processes of disease management in African American adolescents with depression
    (2016-05-05) Al-Khattab, Halima Abdur-Rahman; Draucker, Claire Burke; Oruche, Ukamaka; Perkins, Danielle; Pescosolido, Bernice
    Depression in African American (AA) adolescents is a prevalent mental health problem, can result in serious concurrent and long-term effects, and is associated with health disparities due to underutilization of mental health services. Initiatives to reduce disparities among depressed AA adolescents require a greater understanding of the experience of depression from their own point of view. The purpose of this dissertation was to generate a comprehensive theoretical framework that describes how AA adolescents experience depression throughout adolescence. The information gained about how AA adolescents understand and manage depressive symptoms, and in some cases seek and use mental health services will contribute to initiatives to reduce behavioral health disparities. This dissertation project was composed of two components. The first component was an integrative review of studies that explored associations between adolescent coping responses and depression. The integrative review summarized and integrated research from the past ten years that examined coping techniques of depressed adolescents. It revealed that the use of active coping strategies plays an important role in recovery from depression. The second component was a grounded theory study which included a sample of 22 community-based AA young adults (ages 18-21) and 5 clinic-based AA adolescents (ages 13-17). During semi-structured interviews, participants described their experiences with depression as adolescents. In addition, a timeline was constructed that included major events related to the unfolding of depression, including treatment seeking, which occurred during adolescence. Data generated from the grounded theory study were analyzed and resulted in two qualitatively derived products. The first is a typology titled Being With Others that depicts interaction patterns of depressed AA adolescents with people in their lives. The five categories in the typology are keeping others at bay, striking out at others, seeking help from others, joining in with others, and having others reach out. The second product is a theoretical framework titled Weathering through the Storm that describes how depression in AA adolescents unfolds over time. The five phases of the framework are labeled enduring stormy weather, braving the storm alone, struggling with the storm, finding shelter in the storm, and moving out of the storm.
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    The unfolding depressive symptoms, disease self-management, and treatment utilization for Latina adolescents
    (2018-06-18) Stafford, Allison McCord; Draucker, Claire Burke; Aalsma, Matthew C.; Bigatti, Silvia M.; Oruche, Ukamaka
    Latina adolescents are more likely to suffer from depressive symptoms and less likely to receive mental health services for depression than their White peers, and this mental health disparity is poorly understood. The purpose of this dissertation study is to describe how Latina adolescents experience and seek mental health services for their depressive symptoms. The dissertation includes three components. The first is an integrative literature review to determine which cultural stressors are associated with depressive symptoms among Latino/a youth. The results indicate that discrimination, family culture conflict, acculturative and bicultural stress, intragroup rejection, immigration stress, and context of reception are associated with depressive symptoms in this population. The second and third components were based on interviews with 25 Latinas (ages 13-20) who experienced depressive symptoms during adolescence. In the second component, a content analysis was conducted to determine cultural stressors experienced by contemporary Latinas living in a tumultuous sociopolitical climate in the United States. The stressors included (a) pressure to succeed, (b) parental oversight, (c) being treated differently, and (d) fears of deportation. In the third component, grounded theory methods were used to develop a theoretical framework to describe the process by which Latina adolescents self-managed and sought treatment for depressive symptoms. In this framework, participants shared a psychosocial problem labeled Being Overburdened and Becoming Depressed. They responded to this problem through the psychosocial process labeled Getting a Grip on My Depression, which consisted of five phases: 1) hiding my depression, 2) keeping my depression under control, 3) having my depression revealed, 4) skirting treatment for my depression, and 5) deciding to move on from depression. The Latino family, peer groups, and mainstream authorities influenced the participants’ experiences. The process of experiencing, self-managing, and seeking treatment for depressive symptoms for Latina adolescents is both similar to and unique from the processes by which other groups of adolescents experience depressive symptoms. These results will contribute to the development of culturally-sensitive strategies to prevent, identify, and treat depressive symptoms in Latina adolescents.