This dissertation contributes to research on social isolation in older adults aged 65 years and above through three essays that expand our understanding of the social determinants of health and identify the social and interpersonal factors that contribute to elderly wellbeing. This dissertation examines the significant factors contributing to the problem of social isolation, and how the availability of interest-based, low-cost engagement resources in the community can alleviate social isolation and foster healthy aging. Essay 1 is a systematic literature review with implications for future research that explores how technological skills and training based on user intention and availability of resources can alleviate social isolation. Essay 2 is a qualitative study that evaluates the effectiveness of a unique community-based senior exercise program in fostering social integration and in reducing social isolation. Essay 3 is a quantitative study that examines the magnitude and direction of the correlated relationships among the determinants of social inclusion and the impact of social and interpersonal processes on senior wellbeing. These three essays provide insight into the social isolation phenomenon that negatively impacts senior wellbeing and recommends solutions derived from a data driven examination of the problem that is especially applicable to economically disadvantaged senior communities. …

Data from this dissertation was obtained from the Texas Behavioral Risk Factor Surveillance System (BRFSS). The Texas BRFSS questionnaire used a cross-sectional retrospective research design while asking questions about individuals' exposure to adverse childhood experiences (ACEs) and included 11 questions. The sample included 9096 individuals over the age of 18 who had exposure to at least one ACE. An ACE score was calculated for all participants and were divided into two groups (less than 4 ACEs and more than 4 ACEs) to compare whether differences in ACE score would impact participating in routine health screening or not. Additionally, whether different kinds of ACEs would impact health screening was also examined. Logistic regression was used to assess whether different kinds of ACEs impact participation in routine health screening. This study found that individuals with a history of childhood adversities including experiencing childhood emotional abuse, living in a dysfunctional household impeded them from participating in routine health screenings. It is recommended that both primary care physicians and mental health providers to use motivational interviewing while interacting with patients with ACE histories. It is also suggested that using trauma-informed care (TIC) in primary care can help patients talk about their abuse histories and …

There remains a dearth of literature that explains with no ambiguity, the complex relationships that exist between adverse childhood experiences (ACEs) and resilience, as well as school engagement and school in individuals with a co-occurring diagnosis of autism spectrum disorder (ASD) and attention deficit hyperactive disorder (ADHD). This study seeks to fill this missing gap in the literature. These research questions were answered using a retrospective cross-sectional study design of national secondary data from the National Survey of Children's Health (NSCH). The findings revealed that the more ACEs an individual had, the less they were likely to engage and succeed in school. A similar finding was obtained for resilience as individuals with more ACEs showed less resilience. However, counterintuitively to the hypothesis of the project, having both ASD and ADHD does not necessarily make these outcomes worse compared to having a singular diagnosis of either ASD or ADHD. The significance of this study is that it informs rehabilitation counselors as well as educators on the need for early identification of individuals with ASD and ADHD with a background of ACEs and commence interventions early enough to ensure they are more resilient and obtain improved success in school-related activities as well …

Mental health is an intrinsic capability that constitute an essential component of healthy aging. Mental health is constituted by positive constructs such as happiness and negative constructs (mental disorders) such as depression. As people grow older, they become more prone to developing mental disorders which are linked to poorer quality of life, increased disability, increased utilization and cost of health services, and higher rates of suicide. This dissertation involved three studies that focused on factors that predict change in mental disorders and happiness of older Americans over a period of five years. Two waves of publicly available national representative data from the National Social Life Health and Aging Project (NSHAP) collected in 2010 and 2015 were used. A total of 2210 older adults within the ages 62-90 years were used in the analyses. Mental health measures were CES-Depression scale, HADS anxiety scale, and self-rated happiness. Essay 1 aimed to identify the important aspects of older adults' interaction with their neighborhood that predict the presence of mental disorder and happiness. Essay 2 evaluated the psychosocial factors that predict change in mental disorder and happiness of older adults, whereas essay 3 investigated the multifactorial determinants of change in mental disorder and happiness …