Social determinants of health present significant barriers to utilization of maternal health services in transitional countries. This dissertation study examined associations between household autonomy and utilization of prenatal services among women of reproductive age in Armenia and Azerbaijan. Using nationally representative survey data, this study explored if household autonomy of women positively influenced the timing of the first prenatal visit, the number of prenatal care visits, and the content of care during visits. Results showed that household autonomy was positively associated with the timing of the first visit for prenatal care and the number of prenatal care visits. The content of care was negatively associated with the autonomy of women. Findings also pointed to an endogenous influence of a woman's position in the household structure. Additionally, this study analyzed associations between women's reproductive history and utilization, and economic disparities in utilization of prenatal care. The findings demonstrated that a history of complications during pregnancy and stillbirths were positively associated with utilization of prenatal care. Economic disparities in utilization of care were identified. Future interventions to increase utilization of maternal health services should account for traditional household structures in transitional countries. Women from poor families should receive support from social assistance and the health sector in accessing services pertaining to their health and well-being.

This research examined the perceptions of refugees towards social entrepreneurship in Arizona through focus group discussions with 77 members of the refugee communities that have been organized under nine groups. Business experience, problem solving experience, conception of social entrepreneurship, examples, opportunities, support, and needs emerged as the themes of the study. Available opportunities as well as barriers for refugee social entrepreneurship based on the views of refugees in Arizona were explained. The difference between commercial entrepreneurship and social entrepreneurship was highlighted and some examples of refugee social entrepreneurship described. Qualitative data analysis revealed that refugees in Arizona have entrepreneurial characteristics such as risk taking, hardworking, problem solving, and determination. They also have a good understanding of commercial entrepreneurship but very little understanding of social entrepreneurship. The findings underlined that social entrepreneurship can be used as a helpful strategy for self-sufficiency of refugees residing in Arizona. Given their life trajectories, refugees in Arizona have high potential to be social entrepreneurs with the right exposure and training. If supported adequately and planned appropriately, the refugee social entrepreneurship project can lead to self-sufficiency and faster integration of participating individuals to the mainstream society. The findings may spark interest among practitioners, policy makers, and scholars. It may redefine refugee social work practices as the passion of enterprising empowers refugees and helps them to discover self-confidence and rebrand their image. Policy makers may consider incorporating refugee social entrepreneurship in to the current self-sufficiency plan for refugee resettlement. Future research needs to investigate how refugee social entrepreneurs can be successful and focus on the measurement of their success.

Much of the current literature regarding the well being of children of incarcerated

parents has focused largely on the trauma that results from losing a parent to incarceration. Little research has been dedicated to examining the pre-existing trauma and negative life experiences these children are exposed to prior to parental incarceration. Using cross-sectional data on children (N = 1,221) from a representative study of Arizona Department of Corrections inmates, the present study examines the relationships among children who have contact with Child Protective Services (CPS) prior to parental incarceration and: (1) parental substance abuse, (2) exposure to violence and (3) parental mental illness. Nearly a quarter of all children whose inmate parents were interviewed were contacted by CPS before experiencing parental incarceration. Children whose inmate parents reported being unemployed or less involved in the lives of their children and children who were reportedly exposed to violence were significantly more likely to have been contacted by CPS prior to experiencing parental incarceration as were younger children. The children of incarcerated mothers were more likely to have been contacted by CPS than were the children of incarcerated fathers. This effect remained even after controlling for additional parent, child and family risk factors for CPS contact such as prior history of incarceration and race.

Families with intellectually disabled caregivers are more likely than families without intellectually disabled caregivers to experience poor child welfare outcomes, including high rates of substantiation. However, little research has examined child maltreatment re-reports among this population. The objectives of this study were to begin to address this gap by examining maltreatment re-report rates, and factors associated with maltreatment re-reports, among child welfare-involved families with intellectually disabled caregivers. Survival analysis was conducted using restricted release data from the National Survey of Child and Adolescent Well-Being (NSCAW) to examine the hazard rate and survival rate of maltreatment re-reports for cases with, and without, intellectually disabled caregivers. Multivariate discrete-time hazard models were run using logistic regression to examine the relationship between various predictors and the hazard of maltreatment re-reports. Results revealed that child protection cases involving caregivers with intellectual disabilities were no more likely than cases without intellectually disabled caregivers to experience maltreatment re-reports. Predictors of maltreatment re-reports varied based on whether or not a case involved a caregiver with an intellectual disability. Child gender, child disability, and child race/ethnicity were significant predictors for cases involving caregivers with intellectual disabilities, whereas prior involvement with CPS, caretaker drug problems, and initial allegation substantiation were significant predictors for cases not involving caregivers with intellectual disabilities. These preliminary findings suggest that prevention, screening, and intervention strategies should consider variability of predictive factors based on caregiver intellectual disability status.

ABSTRACT Research suggests that there are benefits of early intervention and in focusing on mental health for infants and toddlers who have been maltreated. Court Teams for Infants and Toddlers is a model program designed to improve developmental outcomes using a systemic change approach. Multi-system collaboration between the courts, child welfare, health professionals, child advocates, and community partners are promoted to increase awareness and improve outcomes for infants and toddlers who have been removed from their parents. The Court Teams model in Arizona is known as Best for Babies. This study looks at implementation efforts of Best for Babies in two counties, Yavapai and Pima, and the unique perspectives of foster parents and attorneys representing the infants and toddlers while in the foster care system. It is important for purposes of effective program implementation to understand whether the Best for Babies program has impacted how these stakeholders address the unique needs of infants and toddlers. Findings reveal that most foster parents in this study were not familiar with the Best for Babies program; however, many of the comments shared are aligned with the values of the program. For example, all participants commented that collaboration among various stakeholders is necessary. Areas of opportunity were also illustrated in the findings regarding Best for Babies program implementation. For instance, the study found that even those foster parents familiar with the program could not attribute an impact on their care of infants and toddlers specifically to Best for Babies.

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.

Children removed from methamphetamine laboratories are a severely understudied population despite the widespread deprivation parental methamphetamine abuse has on children, particularly in homes where methamphetamine is produced. Arizona's children are uniquely affected by the use and manufacturing of methamphetamine due to the geographic location and landscape of the state. A sample of 144 children removed from their homes during the seizure of methamphetamine laboratories, as part of the Arizona Drug Endangered Children program between 1999 and 2003, was investigated. Results indicate that younger children were more likely to be reported by Child Protective Services as high or moderate risk of further abuse, test positive for methamphetamine, and have maternal alleged perpetrators of abuse. Older children were more likely to be reported as low risk for further abuse, test negative for methamphetamine, and have paternal alleged perpetrators of abuse. Results also show that children initially placed in foster care were more likely to remain in foster care at the final assessment than to be living with a parent or kin. These findings have implications for individuals working with children removed from methamphetamine laboratories, including Child Protective Services case workers, medical personnel, temporary and permanent child caregivers (i.e., foster care, kin care, adoptive parents, and shelters), and community members (i.e., teachers). Recommendations based on study findings are offered to child and family advocates and interventionists.

This study examines the differences in demographic and life characteristics between transgender and female prostitutes in a prostitution diversion program and identifies specialized treatment and exiting strategies for transgender prostitutes. The purpose of this study was to develop a better understanding of the transgender experience in prostitution and to contribute to the descriptive literature. Participants were 465 individuals who were arrested for prostitution and attended a prostitution-focused diversion program. Differences found to be significant between transgender and female prostitutes included demographic characteristics, history of childhood sexual abuse, and experience of violence in prostitution. Implications for treatment, exiting strategies and future research are discussed.

The purpose of this study was to explore the relationship between childhood maltreatment and juvenile homicide offending. Specifically, this study compared a sample of maltreated male juvenile homicide offenders (N = 51) with non-maltreated male juvenile homicide offenders (N = 364) among the following areas: familial dysfunction and disorganization, mental health issues, academic functioning, prior delinquency, substance abuse and homicide-related crime characteristics. Data was obtained from the following aggregate sources: Supervision Risk Classification Instrument (SRCI), the State Attorney's Recommendation form (SAR), the Predisposition Report (PR), and the Massachusetts Juveniles Screening Instrument 2 (MAYSI-2). Chi square and t-tests were then utilized to compare the two groups and preform analyses. Maltreated male juvenile homicide offenders significantly differed from non-maltreated male juvenile homicide offenders in terms of familial dysfunction and disorganization, academic functioning, prior delinquency and homicide-related crime characteristics. As a result of these significant differences, tailored prevention and treatment efforts were discussed.

Legal narratives obtained from forensic interviews of twenty sexually abused children were analyzed concerning gender differences in disclosure patterns and narrative elaboration. Quantitative analysis of the children's disclosure of sexual abuse revealed that boys made prompted disclosures to caretakers, primarily mothers. Girls more often made purposeful disclosures, and revealed the abuse to caretakers as well as other supportive individuals. Quantitative analysis of the children's forensic interviews revealed that girls provided more coherent, elaborate, structured, and contextually detailed narratives than boys did. Children's accounts of their disclosures were qualitatively analyzed. Results indicated that fear was the primary reason children delayed abuse disclosure. Qualitative analysis also found that the children's narratives revealed several common themes including themes of force and resistance. Implications for legal interventions on behalf of children and the effectiveness of abuse prevention programs were discussed.