This study explored the social and cultural factors that impact the mental health and quality of life of Latinx young adults with autism living in the United States. The convergent parallel mixed method design gathered a deeper insight into the participant’s intersectionality of race and disability status within their own social context. Socioecological theory guided the conceptualization of the participants’ experiences with the consideration of their environment. In the U.S., Black Indigenous People of Color (BIPoC) experience discriminatory treatment, when compared to White people, sustained through implicit and explicit systematic processes. Therefore, critical race theory (CRT) was used as a social justice framework to identify those overlapping and interdependent systems disadvantaging racially marginalized people. The framework of intersectionality was also engaged, as it further explicates the experiences of people with multiple oppressed identities. The study created a more nuanced understanding of the experiences of Latinx young adults with autism through qualitative research methods, which conducted semi-structured interviews (n=14) and incorporated knowledge from quantitative data collected through a survey instrument (n=17). Despite the small sample size’s inability to show statistically significant relationships among study variables, some insights can be drawn that help understand how social and cultural factors impact mental health (MH) and quality of life (QoL). The qualitative analysis found three overarching themes emerging from the semi-structured interview data: 1) Inclusion and Belonging, 2) “It Just Doesn’t Work”: Facing Unintended Harms and Encountering Obstacles, and 3) Racism and Ableism. The quantitative and qualitative findings highlight how intersectionality and specifically social oppression, impact Latinx young adults with autism. The experiences shared by the participants indicate the usefulness of the socioecological theory to understand the various systemic impacts that they manage daily. Racism and ableism were constant experiences identified by participants and the consequences of those oppressive experiences often led to negative mental health and quality of life. Overall, this study captures the voices and experiences of young adults on the autism spectrum, contributes knowledge about their lives, and makes practice recommendations on how to better support this community. The findings also inform future research and policy development on how to create more equitable opportunities for all.

Female survivors of intimate partner violence (IPV) are at increased risk for negative sexual health outcomes, such as susceptibility to HIV/AIDS, other sexually transmitted infections, unintended pregnancy, miscarriage, and cervical cancer. Despite this known risk, HIV risk reduction interventions are lacking in IPV content, and little is known about women’s protective sexual health behaviors in this context. The purpose of this dissertation is to gain a deeper understanding of women’s sexual health within the context of a violent intimate relationship. Data were collected through semi-structured, in-person interviews with women who had experienced IPV (N = 28). Service-seeking women were recruited from a domestic violence shelter and a domestic violence counseling program; non-service-seeking women were recruited through a statewide coalition against domestic violence and online advertisements. Interviews were audio-recorded, transcribed, and then analyzed in NVivo Qualitative Software (Version 10). Detailed process notes, analytic memos, peer debriefing, and the use of visual analytic displays were used to increase the trustworthiness of findings. Results are presented in chapters two, three, and four. Chapter two explores women’s experiences of sexual violence in IPV relationships. Women described how their intimate partners used a combination of sexual abuse, sexual coercion, and sexual assault as a unique weapon of power and control. Chapter three examines women’s sexual risks across the levels of their ecological environment using an intersectional feminist framework. Women’s sexual risks went beyond sexual violence and were influenced by subtle yet pervasive cultural gender norms that reduced their power in relation to their male sexual partners. Chapter four focuses on understanding women’s protective sexual health behaviors in order to inform the development of an intervention that follows women’s natural pathway to care as they heal from victimization to surviving to thriving.

A secondary data analysis was conducted to investigate the direct and indirect effects of family traditionalism, family cohesion, and parent involvement on alcohol, cigarette, and marijuana use in a sample of pre-adolescent youth (N = 635) and their parents (N = 462). Aim one hypothesized that family cohesion and family traditionalism would be indicators of a higher order construct, operationalized as familismo. Aims two and three hypothesized that family traditionalism, family cohesion, and parent involvement would be protective against youth substance use. Finally, aim four hypothesized that acculturation would decrease the protective effects of family traditionalism and family cohesion on substance use.

Using second order confirmatory factor analysis, aim one found that family cohesion and family traditionalism were indicators of a second order structure. Regarding aims two and three, a consistent significant association was found between family cohesion and parent involvement across alcohol, cigarette, and marijuana use outcomes. As well, family cohesion was significantly and inversely associated with past 30-day alcohol use amount ( = -.21, p < 0.05), lifetime alcohol use ( = -.19, p < 0.05), and lifetime marijuana use ( = -.31, p < 0.001). Counter to what was hypothesized, a significant positive relationship between family traditionalism and past 30-day alcohol use amount was found. No significant indirect effects were found. Specific to aim four, significant moderation effects were found between family cohesion and acculturation on alcohol and cigarette use. Higher acculturated youth had greater past 30-day alcohol and cigarette use amount compared to low acculturated youth; as family cohesion increased, alcohol and cigarette use for both low and high-acculturated youth decreased.

This study has important implications for social work and future research specific to culture, family, and youth substance use. This study may assist direct social work practitioners, school personnel, and other professionals that work with Latino youth and families in the tailoring of services that are culturally sensitive and relevant to this population and provides further understanding regarding the impact of culture and family on Latino youth substance use. Findings and limitations are discussed specific to social work practice, policy, and research.

Nationally, African Americans suffer disproportionately from diabetes; with 13.2% of African Americans diagnosed with diabetes compared to 7.6% of non-Hispanic whites (CDC, 2014). Nearly one-half of all people with diabetes are non-adherent to their oral medications; adherence to insulin therapy was 60%-80% (Brunton et al., 2011; Cramer, 2004; Rubin, 2005). This study explored the question, "What mechanisms are associated with adherence to diabetes medication, including insulin, for African Americans in the Southwest?" Twenty-three people participated in the study; 17 participated in interviews and six participated in gendered focus groups. A community-based participatory research (CBPR) approach engaged the African American community as partners in research.

Major themes emerging from the data included illness perception, support, and the process of medication adherence. Acceptance of the diabetes diagnosis was imperative for medication adherence. Stigmatization of diabetes was salient in the recruitment process and as it related to mechanisms for adherence. Furthermore, many informants were not aware of a family history of diabetes before their own diagnosis. Four gendered emerging typologies were identified, which further illuminated major themes. Moreover, an eight-step process of medication adherence model is discussed. The researcher was able to identify culturally compatible strategies that may be extended to those struggling with medication adherence. The implications section suggests a set of strategies that healthcare providers can present to people with diabetes in order to increase medication adherence.

This thesis is a qualitative research study that focuses on siblings of children with Autistic Spectrum Disorder (ASD). Even though it is expected that having a child with ASD in the family will influence the whole family including siblings of the child with ASD, the sibling population is rarely included in research related to children with ASD, and there is only limited services available for them. This exploratory study (n=6) is aimed at better understanding the siblings' lives in their family settings in order to identify the siblings' unmet needs and determine how they have been influenced by the child with ASD. This study is also aimed at identifying the most appropriate support for the siblings to help them cope better. The study followed the Resiliency Model of Family Stress, Adjustment, and Adaptation and a narrative theory approach. An in-depth interview with the parents was conducted for the study, so the findings reflect the parents' perception of the siblings. All the themes emerged into two categories: life in the family setting and supports. The findings indicate that the families are striving for balance between the siblings and the children with ASD, but still tend to focus more on the children with ASD. Also, the families tend to have autonomous personal support systems. The parents tend to perceive that these personal support systems are good enough for the siblings; therefore, the parents do not feel that formal support for the siblings was necessary. As a result of the findings, recommendations are made for the organizations that work with individuals with ASD to provide more appropriate services for the families of children with ASD, including siblings. Also, recommendations are made for future studies to clarify more factors related to the siblings due to the limitation of this study; the siblings' lives were reflected vicariously via the parents.

While the suicide rate in Mexico is relatively low when compared to countries throughout the world, it is increasing at an alarming pace. Unfortunately, the amount of suicide research focused on Mexican populations is relatively scarce. Using a sample of high school students living in Guanajuato, Mexico, this study explored the relationship between recent suicidal ideation and three factors that previous research in other countries has connected to suicide: Migration aspirations, religiosity, and sexual behavior. Using multiple and logistic regression, the results indicated the following: 1) Recent suicidal ideation predicted increased migration aspirations, 2) higher levels of external religiosity predicted lower odds of recent suicidal ideation, and 3) stronger parent-child relationships predicted lower odds of recent suicidal ideation. The findings are discussed in light of the Bronfenbrenner's ecological systems theory, Bogenschneider's risk/protection model, and Stark's religious commitment theory.

Dating violence in ethnic minority populations is an understudied phenomenon and little attention has been paid to the experiences of Mexican American youth; less research has been done on how those experiences alter perceptions and acceptance of participation in prevention programs. This study advances knowledge on how Mexican American adolescents view dating violence prevention programs and how cultural beliefs and values may hinder or encourage effective participation. Focus groups (N = 9) were form with Mexican American youth aged 15-17 years separated by gender and acculturation status (Mexican Oriented/Bicultural/Anglo Oriented), as determined previously by acculturation scores measured by the Acculturation Rating Scale for Mexican Americans (ARMSA; 0 or below = Mexican Oriented, 0-1 = Bicultural, 1 or above = Anglo Oriented). Several themes emerged throughout the focus group discussions that were derived from culturally-based needs. Mexican American adolescents made recommendations for program development (e.g., a broad curriculum beyond the topic of dating violence) and delivery (e.g., barriers to participation, the implications of peer involvement) within the context of their cultural values and needs. Low acculturated and bicultural teens identified specific cultural needs and their relevance within a dating violence prevention program. However, across all groups, adolescents felt that the needs of Mexican American youth were similar to other youth in regards to dating violence prevention programs. Implications for how social work can best design and implement prevention programs for Mexican American adolescents are discussed.