Victoria Garcia Wilburn
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Understanding cravings and triggers in adolescents attending a recovery high school in a COVID-19 era
According to the National Center for Drug Abuse Statistics, in 2018 some 863,000 12 to 17-year olds were diagnosed with substance use disorder (SUD). However, only .3% received the treatment necessary to begin the journey of recovery. As SUD symptoms of cravings and triggers in adolescents interfere with healthy adulthood milestone transition, it is increasingly important to investigate the real-life barriers in this unique pandemic time and beyond.
Professor Victoria Garcia Wilburn has partnered with Hope Academy Recovery High School (HARHS) since 2017 to explore the integration of occupational therapy (OT) as part of the core high school recovery team. This most recent project aims to amplify the voice of members directly within the community - the adolescent students – by using real time data collection methods known as Ecological Momentary Assessments (EMAs). Professor Devon Hensel has vast experience in recruiting and retaining large cohorts of participants for clinical and behavioral research and is a leading researcher utilizing EMA as an approach to daily collection of health and behavioral health data.
Such an approach will allow the research team to better comprehend adolescents’ daily lived experience, improve client centered care, and allow for a greater fidelity in capturing the “real life” barriers in SUD. These data will assist in producing interventions that are theory driven and help to lay the necessary groundwork for larger studies to evaluate the effectiveness of function-based interventions in order to establish occupational therapy's distinct role in SUD recovery, ultimately leading to state and national policy change.
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Recent Submissions
Item Considerations for Occupational Therapists in Developing Community-Level Interventions for Youth with High Adverse Childhood Experiences (ACEs)(Western Michigan University, 2022) Wilburn, Victoria G.; Huber, Megan E; Senter, Denise; Stoll, Hannah B.; Occupational Therapy, School of Health and Human SciencesDrug misuse likely contributes to the over 30,000 children in foster care and to the 24.2% of children who have experienced two or more adverse childhood experiences (ACEs). Twenty-five percent of children are living in poverty, with nearly half of those living in single-parent households. Among the national guidelines to preventing ACEs are connecting youth with positive activities and providing family relationship enhancement opportunities. We believe the profession of occupational therapy can help contribute to the mental and behavioral health care workforce in a greater capacity than is currently used. Many children are not afforded the opportunity to engage in novel leisure pursuits that are essential for positive mental health function and well-being. Occupational therapists can assist in creating a culture of health and equity for youth by harnessing the power of play and leisure to promote self-healing communities.Item Adverse Childhood Experiences and Mental Health Conditions Among Multiracial Adolescents(Taylor & Francis, 2021) Weller, Bridget E.; Conrad, Joseph K.; Wilburn, Victoria G.; Ramamonjiarivelo, Jo; Gladden, Jessica; Occupational Therapy, School of Health and Human SciencesThe relationships between adverse childhood experiences (ACEs) and mental health conditions have received much attention in the literature. A particularly well-documented type of ACE is household dysfunction. However, compared to monoracial youth, little is known about the relationship between this type of ACE and mental health outcomes among multiracial adolescents. Objective The objective of this study was to verify the factor structure of the household dysfunction type of ACE using data from the National Survey of Children’s Health (NSCH), and then examine whether household dysfunction (measured as a latent construct) was associated with mental health conditions among multiracial adolescents. Design We used cross-sectional data collected in 2016 from caregivers who completed the NSCH and analyzed data from a subpopulation of adolescents (12–17) who reported more than one race (n = 1,231). Mplus 8.4 was used to conduct confirmatory factor analysis and probit models from a structural equation modeling framework. Results Results from this study indicated that the household dysfunction type of ACE, as a latent construct, had good model fit and was significantly associated with depression [standardized coefficient [B] = .50, 95% confidence interval [CI] .36, .65], anxiety [B = .61, 95% CI .48, .73], behavior problems [B = .58, 95% CI .44, .72], and ADHD [B = .54, 95% CI .38, .69] for multiracial adolescents. Conclusions Household dysfunction may result in adolescents being separated (physically or emotionally) from their caregivers, which may hinder adolescents’ ability to establish or maintain one of the most important relationships needed to promote racial/ethnic identity development and mental health. Implications for advancements in theory and NSCH are presented.Item Utilizing Student Consultation to Promote Incorporation of Occupational Therapy in a Pediatric Behavioral Health Unit(Eastern Kentucky University, 2020) Wilburn, Victoria; Stoll, Hannah; Fodstad, Jill; Chase, Anthony; Douglas, Christina; Occupational Therapy, School of Health and Human SciencesThis advanced graduate elective was designed for second year Master of Occupational Therapy students to provide opportunities for students to act as consultants of the profession and collaborators within the community utilizing community engaged learning methods. This elective helped to detail components of evidence-based practice, primary needs of integration, and future opportunities within an urban pediatric behavioral health unit. The practice area of mental health was chosen specifically as the collaborating site due to the decline of occupational therapist recognition as qualified mental and behavioral health providers. This lack of recognition may limit reimbursement and funding, and decrease employment opportunities, both detriments to practice. However, within the last decade there has been a resurgence in establishing the profession’s roots within mental and behavioral health practice. Several key pieces of federal legislation have recognized occupational therapists' expertise and have cited the profession in several mental and behavioral health initiatives. Many states are seeking recognition of occupational therapists as qualified behavioral health providers (QBHP) or qualified mental health providers (QMHP) and this elective provided the opportunity for didactic instruction to intersect with advocacy and education while producing a rich learning experiences for all involved.Item Comparing Narrative-Informed Occupational Therapy in Adult Outpatient Mental Health to Treatment as Usual: A Quasi-Experimental Feasibility Study with Preliminary Treatment Outcomes(Taylor & Francis, 2021) Wasmuth, Sally; Wilburn, Victoria G.; Hamm, Jay A.; Chase, Anthony; Occupational Therapy, School of Health and Human SciencesThis paper describes implementation of narrative-informed occupation-based service delivery in outpatient community mental health that addresses (1) the need for outcome data on occupational therapy in this setting, (2) an ongoing mental health provider shortage, and (3) a need for innovative approaches to supporting mental health. We found a significant improvement from baseline to post-intervention in occupational participation. Dose of occupational therapy was significantly related to improvements in roles, habits, values, long-term goals, social environment, and readiness for change. This study supports future, larger effectiveness studies of narrative-informed occupation-based intervention delivered by occupational therapists in outpatient community mental health.Item COVID-19 Implications on Student Athletes Occupational Engagement and Mental Health(2021-04-28) DePue, Brianna; Wilburn, Victoria; Pierce, David; Wilburn, Victoria; Department of Occupational Therapy, School of Health and Human Sciences; Wilburn, VictoriaOccupational engagement in preferred activities has been difficult to obtain throughout the Coronavirus-19 (COVID-19) pandemic for high school athletes with the disruption to high school sports. High school athletes utilize sports as a way to interact within their environment and engage in play which is a key factor for facilitating normative development. The purpose of this capstone project is to further understand if associated mental health outcomes exist in high school athletes due to limited occupational engagement within sports through self-reported measurements. This project utilized a cross sectional, mixed methods survey, from a convenience sample of 104 high school athletes in order to obtain student athletes perspectives regarding the impact of COVID-19 on their sport performance, mental health, occupational deprivation, and future collegiate goals/scholarships. This project used a chi square analysis with a linear regression to understand relationships between datasets. Statistically significant (p= .003) relationships were found between grade level and student's self-reported occupational deprivation. This study also found indications of other predictive relationships between factors such as limited playing time or different rules while participating in sports and student's self-reported negative mental health symptoms (r= 2.3). With limited research on COVID-19 in this vulnerable population, this study provides foundational evidence for the need to engage within preferred occupations for normative development in high school athletes and the need to address mental health in this population who undergo feelings of adverse mental health within circumstances out of their control such as the impact of COVID-19.Item Utilizing Student Consultation to Promote Incorporation of Occupational Therapy in a Pediatric Behavioral Health Unit Occupational Therapy in a Pediatric Behavioral Health Unit(Journal of Occupational Therapy Education, 2020) Wilburn, Victoria G.; Stoll, Hannah B.; Fodstad, Jill C.; Chase, Anthony; Douglas, Christina M.This advanced graduate elective was designed for second year Master of Occupational Therapy students to provide opportunities for students to act as consultants of the profession and collaborators within the community utilizing community engaged learning methods. This elective helped to detail components of evidence-based practice, primary needs of integration, and future opportunities within an urban pediatric behavioral health unit. The practice area of mental health was chosen specifically as the collaborating site due to the decline of occupational therapist recognition as qualified mental and behavioral health providers. This lack of recognition may limit reimbursement and funding, and decrease employment opportunities, both detriments to practice. However, within the last decade there has been a resurgence in establishing the profession’s roots within mental and behavioral health practice. Several key pieces of federal legislation have recognized occupational therapists' expertise and have cited the profession in several mental and behavioral health initiatives. Many states are seeking recognition of occupational therapists as qualified behavioral health providers (QBHP) or qualified mental health providers (QMHP) and this elective provided the opportunity for didactic instruction to intersect with advocacy and education while producing a rich learning experiences for all involved.Item The implications of desk arrangement on social interaction in a third grade classroom(Taylor & Francis, 2018) Wilburn, Victoria G.; Wasmuth, Sally; Fehr, Callie; Brokamp, Kristen; Shupe, Mallory; Hursey, Brianna; Ross, Katie; Nelson, Jessica; Occupational Therapy, School of Health and Human SciencesNumerous studies have illustrated that participation in occupations—defined as meaningful life activities—is essential to wellness (AOTA, 2014). Social interaction is an important area of occupational participation for children in their roles as students (AOTA, 2014). Classroom design can impact student social participation; however, there is a lack of current research focused on effects of classroom design on social interaction for all students. Rather, research has examined factors affecting social participation of certain subgroups of students in the classroom, such as those with chronic illness or deafness (Martinez, Carter & Legato, 2011; Martins & Gaudiot, 2012). While literature provides information about various subpopulations, in this paper we emphasize that social participation based on classroom design can facilitate or inhibit overall occupational participation for all children in the role of student.Item Perceptions of Academic Fieldwork Coordinators Regarding the Value of Fieldwork in Emerging Areas of Practice(The Open Journal of Occupational Therapy, 2016-10-01) Wilburn, Victoria G.; DeCleene-Huber, Kate E.; Gahimer, Julie; Beitman, Candace; Moore, Elizabeth S.; Occupational Therapy, School of Health and Rehabilitation SciencesThis study investigated the perceptions of academic fieldwork coordinators (AFWCs) regarding emerging areas of practice as fieldwork experiences for entry-level occupational therapy (OT) students. Further, this study explored several aspects of fieldwork experiences in emerging areas of practice on student personal and professional development, academic curriculum, partnering community agencies, and the profession at large.A survey designed through Qualtrics®, an electronic survey system, was sent to 163 AFWCs of fully accredited master's and doctoral entry-level OT programs. Forty-four participants (27%) completed the 16-question survey. Significance at p< .05 was found in higher levels of Bloom’s taxonomy student performance when compared to traditional areas of practice. Common perceptions found among the AFWCs related to emerging areas of practice fieldwork experiences included: improved student professional and personal skills, increased connections and collaborations across and in health care disciplines, an enhanced ability to define and understand OT. Continued opportunities for fieldwork in emerging areas of practice are essential as the profession contemplates new markets and avenues in a changing health care environment.