Mobility safety, especially fall prevention, plays a significant role in successful aging for older adults. Fall preventive programs aim to reduce risks for mortality from fall-related injuries among older adults. However, the covariation between personal perceptions of falls and factors and confidence of self-management in falls (CSMoF) is still under-studied despite its importance to fall prevention. Using the International Classification of Functioning, Disability, and Health (ICF) model, this dissertation aimed to investigate the relative contribution of CSMoF in relation to fall risk self-perceptions while controlling for demographics and self-reported health and functioning. Participants were 691 older adults recruited from Area Agency on Aging at Arlington, Texas. They completed measures of physical functioning, CSMoF, fall risk perceptions and fear of falls. Regression analyses indicated that fear of falls was the most predictive factor of CSMoF among older persons. Physical function measures of age, chronic illnesses of metabolism, sensory impairment, and health status were also significant predictors of the CSMoF. The interaction of perception of falls and fall experience attenuated CSMoF, with physical functioning limitations. Fear of falls served as a mediator through which demographic predictors influence CSMoF. The joint effects of perception of falls and fear of falls likely explain CSMoF …

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. …

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 …

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 …

Members of Greek Life organizations consume more alcohol and participate in risky drinking behaviors at higher rate than their non-Greek counterparts due to deep rooted social norms within this population. Undergraduate sorority women at college and universities are often overlooked in research regarding trends in alcohol use in Greek Life organizations. However, women between the ages of 18 and 24 are more vulnerable to the consequences of heavy alcohol use compared to men, including liver disease, sexual assault, poor academic outcomes and post-collegiate alcohol use disorders (AUDs). Although higher education institutions are tasked with educating their students about safe alcohol use and protecting students from harm, these interventions are often inadequate in decreasing alcohol related consequences. Among students, sorority women consistently consume higher amounts of alcohol and exhibit higher rates of risky drinking behavior. This thesis aims to examine the unique alcohol-related consequences and risk factors sorority women face. Implications are discussed to guide college administrators, counselors and other supports that are likely to encounter issues associated with alcohol use within this population.

In the US, rural Native American communities (RNACs) experience excess morbidity in mental health disorders and mortality from opioid use disorder (OUD). This study used mixed methods to evaluate and analyze the primary data from 76 healthcare providers (HPs) from 24 states across the US (physicians = 7%), to identify HP knowledge and training regarding available prevention, treatment, and recovery (PTR) programs in treating OUD, assessment and management skills, and networking and collaboration capacity among the RNACs they serve. The HP completed the Opioid Survey for Health Care Providers online. A majority of HPs reported a need for knowledge and training regarding OUD treatments (92%). Less than half of the HPs provide intensive outpatient treatment; 40% contracted out for medication assisted treatment/medications for opioid use disorder (MAT/MOUD) services. Recovery support was low at 33% for adults and 38% for youth. HPs reported use of Narcan to be effective in reversing overdose (87%). Qualitative responses supported survey findings and described barriers, including lack of resources, inadequate staffing, insufficient funding, lack of training and OUD knowledge, stigma, and lack of tribal involvement and support. The study findings indicate HPs' need for information and training about OUD and networking and collaboration of healthcare …