자료유형  

 학위논문

Control Number  

0016935841

International Standard Book Number  

9798380596626

Dewey Decimal Classification Number  

614

Main Entry-Personal Name  

Coxe Hyzak, Kathryn A.

Publication, Distribution, etc. (Imprint  

[S.l.] : The Ohio State University., 2023

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2023

Physical Description  

1 online resource(242 p.)

General Note  

Source: Dissertations Abstracts International, Volume: 85-04, Section: B.

General Note  

Advisor: Bunger, Alicia C.

Dissertation Note  

Thesis (Ph.D.)--The Ohio State University, 2023.

Restrictions on Access Note  

This item must not be sold to any third party vendors.

Summary, Etc.  

요약Background: Approximately 50% of individuals seeking treatment for substance use and mental health conditions in behavioral healthcare settings have a lifetime history of TBI affecting their ability to engage in behavioral health treatment. Identifying lifetime history of TBI using validated screening methods can optimize interventions for these individuals, however, TBI screening adoption has failed in these settings. Drawing on the Theory of Planned Behavior and Diffusion of Innovations Theory, this explanatory sequential mixed methods study aimed to improve our understanding about how provider characteristics (attitudes, subjective norms, perceived behavioral control (PBC), intentions), innovation-level factors (acceptability, feasibility, appropriateness), and contextual determinants affect TBI screening adoption in behavioral healthcare settings.Methods: In Phase I, 215 behavioral health providers in the United States completed a training introducing the OSU TBI-ID, followed by a web-based survey assessing attitudes, PBC, subjective norms, and intentions to screen for TBI (Time 1). After one-month, providers completed a second survey assessing the number of TBI screens conducted, and the acceptability, feasibility, and appropriateness of TBI screening (Time 2). Data were analyzed using structural equation modelling with logistic regressions (SEM) and logistic regression with moderation effects. Results informed development of a qualitative interview guide. In Phase II, 20 providers from Phase I participated in interviews to build upon the quantitative results. Data were analyzed thematically and integrated with the quantitative results. Barriers to adoption were also identified and linked to constructs from the Consolidated Framework for Implementation Research (CFIR).Results: Approximately 25% of providers adopted TBI screening, which was driven by motivations to trial the innovation. SEM demonstrated that more favorable attitudes toward TBI screening were associated with an increased odds of screening intentions and adoption, which providers expanded upon in interviews, explaining advantages in guiding diagnostic assessments. Greater subjective norms also demonstrated increased odds of intentions to screen for TBI and adoption. However, providers reported lack of external pressures from state governing boards and internal pressures from leadership to adopt TBI screening. Although PBC was not associated with TBI screening adoption in SEM, providers reported the desire for additional training and education to improve self-efficacy in administering TBI screening. Furthermore, although no interaction effects were found between characteristics of providers and innovationlevel factors, descriptive ratings and qualitative appraisals of the acceptability feasibility, and appropriateness of TBI screening were high. Providers confirmed in qualitative interviews that the OSU TBI-ID is helpful in guiding clinical decisions, easy to use, and relevant to clinical practice. However, 10 barriers were identified to affect adoption, which linked to CFIR's Inner-Setting, Outer-Setting, Individual Characteristics, and Process.

Subject Added Entry-Topical Term  

Public health.

Subject Added Entry-Topical Term  

Social work.

Subject Added Entry-Topical Term  

Behavioral sciences.

Subject Added Entry-Topical Term  

Health care management.

Subject Added Entry-Topical Term  

Social research.

Index Term-Uncontrolled  

Traumatic brain injury

Index Term-Uncontrolled  

Implementation science

Index Term-Uncontrolled  

Mixed methods

Index Term-Uncontrolled  

Structural equation modeling

Index Term-Uncontrolled  

Theory of Planned Behavior

Index Term-Uncontrolled  

Diffusion of Innovation Theory

Added Entry-Corporate Name  

The Ohio State University Social Work

Host Item Entry  

Dissertations Abstracts International. 85-04B.

Host Item Entry  

Dissertation Abstract International

Electronic Location and Access  

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Control Number  

joongbu:642540