Child abuse and neglect is a devastating yet preventable social problem. Currently, early childhood home visitation services are the primary approach to preventing maltreatment and improving child well-being in the United States. However, existing literature suggests that improvement is needed regarding how home visitation professionals identify and respond to risk factors for child abuse and neglect. Although there is substantial multidisciplinary literature that investigates the utility of standardized measures to determine future risk for maltreatment, there has been minimal inquiry into the validity of early childhood home visitation assessment instruments to accurately identify and classify children and their families by their risk for future maltreatment. In response to the dearth in the literature, the purpose of this dissertation was to examine the utility of the Healthy Families Parenting Inventory (HFPI) to predict a family’s risk for future maltreatment. Families enrolled in Healthy Families Arizona, a child abuse and neglect prevention program, were followed for 12 months after the completion of the baseline HFPI to measure if the family had received an investigation of maltreatment from the public child welfare system. Bivariate results indicated that the generated risk classifications of the HFPI and the overall total composite score were related to the occurrence of a future maltreatment investigation. Specifically, the results from the binary logistic regression models provided evidence that as a family’s score increased on the inventory, the likelihood of receiving an investigation of maltreatment decreased. Further, significant relationships were found between a family’s score on several individual items of the HFPI and the occurrence of a maltreatment investigation. This dissertation concludes with a discussion of potential avenues of research on the topic of risk assessment in prevention programs serving at-risk families.

Health care in the United States has been undergoing significant changes since the 2010 passage of the Patient Protection and Affordable Care Act. One of the outcomes of this policy was an attempt to bring physical health care and behavioral health care together in an effort to provide more coordinated care for patients. This change created an opportunity to improve the quality of care for patients, and as a result reduce high cost emergency service that could be prevented through better maintenance of chronic conditions. Three studies were conducted to examine challenges behavioral health agencies face in implementing two models of coordinated care (co-located and fully integrated), staff and organization capacity and needs, and patient service utilization by model of care coordination. The first study used site visits and interviews to capture the challenges faced by agencies. Results from this study indicated that behavioral health agencies faced a number of challenges in providing coordinated care including financial barriers, regulations, information sharing, inadequate technology, and provider training needs. The second study used a staff survey to assess agency and staff capacity and needs in providing coordinated care. The results from this study found differences in capacity based on model of coordination in multiple dimensions related to inter-agency coordination and communication, role clarity, and team cohesion. The third study examined patient service utilization for outpatient visits, inpatient visits, and emergency visits. The results indicated that patients receiving care from co-located agencies were more likely to have at least one encounter in each of the three service utilization categories compared to patients at fully integrated agencies. Overall, the three studies suggest that agencies that have or will implement models of coordinated care face significant barriers that may impact the sustainability or feasibility of such care. Given the findings on patient service utilization, it seems that coordinated care has great potential for patient level outcomes which makes addressing agency barriers even more critical.

LGBTQI people are often victimized by law enforcement and these victimizations often are related to victimizations of domestic violence and hate violence. Because reporting a victimization to the police leads to contact with police, a part of the research question involved herein looked at whether or not reporting a victimization to the police also increases the rate of police violence. Through secondary data analysis, this study investigated the correlation between reporting domestic violence and hate violence to the police, and subsequent victimizations by the police in the form of police violence. Additionally through secondary data analysis, this study investigated whether or not this correlation is stronger with transgender women and people of color. All data analyzed in this study was collected in Tucson, Arizona through the Wingspan Anti-Violence Project (WAVP). All data was analyzed with the permission of the data owner, the National Coalition of Anti-Violence Programs (NCAVP) (see Appendix IV), and with IRB approval from the Arizona State University Office of Research Integrity and Assurance (see Appendix III). The findings demonstrated a positive correlation between the rate of LGBTQI people reporting violent crimes to the police and the rate of police violence against LGBTQI survivors of domestic violence and hate violence. The results further demonstrated the rate of police violence associated with reporting domestic violence or hate violence is greatest for transgender women and people of color.

ABSTRACT The experience of grief and loss is a process that can be extremely distressing to anyone, regardless of age. This may be especially true for youth. This study was designed and conducted to determine the effects of a therapy dog as a therapeutic adjunct in Child Life interventions with adolescents experiencing grief and loss. Subjects were randomly assigned to one of two groups. The intervention consisted of 3 sessions with a Certified Child Life Specialist (CCLS) to address grief. Group 1 (N=14) was the control group, meeting only with the CCLS. Group 2 (N=13) was the experimental group and met with the CCLS with a therapy dog present during the sessions. Participants completed a pre-test and post-test of the Children's Mood Questionnaire. At the end of each session, subjects completed a Therapeutic Engagement Questionnaire. The pet therapy group experienced a significant improvement in mood scores on the Children's Mood Questionnaire following the intervention. However, there were no significant differences between groups on the Therapeutic Engagement Questionnaire during any of the 3 sessions. The data collected from this study indicate that the addition of a therapy dog in grief interventions with adolescents may improve mood outcomes.

This study utilized ecological theory and social exchange theory to examine how father involvement effects the human capital accumulation of young mothers. This study used data from a sub-sample of young mothers taken from the Healthy Families Arizona longitudinal evaluation (N = 84). The participants in the sub-sample were between 13 and 21 years of age. Using a random effects regression model, it was found that father involvement negatively affects a young mother's school attendance over time. The probability of a mother attending school when the father is involved decreases by 12%. It was also found that for the average age mother (19 years of age), the probability of attending school decreases by 59% every additional year. Furthermore, for a mother with an average number of children (one child), every additional child she has decreases the probability of attending school by 24%. In addition it was found that for the average age mother (19 years of age) every additional year, the likelihood of being employed increases 2.9 times, and for a mother with an average number of children (one child) every additional child decreases the likelihood of employment by .88 times.