What is the correct response towards the world being set on fire? Climate change is a global emergency that can cause many emotions within people, including climate anxiety and ecological grief. While both of these emotions are valid responses to the global emergency humanity is facing, it is essential that environmentalists and humanitarians throughout the world hold on to hope when addressing this crisis. It is also essential that they tend to their mental health as they work to tend to the world. My thesis describes my journey in working to promote hope in the environmental movement and the framework for a global mental health study I am conducting on environmentalists. Inner sustainability (the practice of taking care of one's mental health) and outer sustainability (the practice of taking care of the world) need to coexist in order for any movement to truly be sustainable.

With the accelerated emergence of telehealth systems being deployed with promises to access unreachable populations in today’s socially distant environment, it is increasingly important to understand the barriers that underprivileged populations face when trying to access healthcare through digital platforms. This research investigates the use of telehealth in social and cultural sub-populations, focusing on how the diverse student population at Arizona State University (ASU) use the recently-launched ASU Telehealth system. Statistical analysis of demographic factors spanning the five categories of social determinants of health were coupled with population studies of the ASU student body to evaluate the reach of services and patient diversity across telehealth and in person health platforms. Results show that insurance, racial and international student identity influence the percentage of students within these demographic categories Also, though the ASU Telehealth patient body reflects ASU’s general student population, the platform did not increase the reach of Health Services and the magnitude of students served. using ASU Telehealth. Due to the COVID-19 pandemic, it is difficult to determine the validity and reliability of these findings. However, the findings and background research point to targeted marketing campaigns, intentional policy decision-making, post-pandemic telehealth resilience, and the continuation of quantitative and qualitative data collection as means to expand the impact and equity of ASU Telehealth into future iterations of the platform. Outputs of this study include web communication materials and qualitative data collection mechanisms for future use and implementation by ASU Health Services.

Background: Exercise is Medicine (EIM) is a health promotion strategy for addressing physical inactivity in healthcare. However, it is unknown how to successfully implement the processes.

Purpose: The purpose of this study was to understand how implementing EIM influenced provider behaviors in a university-based healthcare system, using a process evaluation.

Methods: A multiple baseline, time series design was used. Providers were allocated to three groups. Group 1 (n=11) was exposed to an electronic medical record (EMR) systems change, EIM-related resources, and EIM training session. Group 2 (n=5) received the EMR change and resources but no training. Group 3 (n=6) was only exposed to the systems change. The study was conducted across three phases. Outcomes included asking about patient physical activity (PA) as a vital sign (PAVS), prescribing PA (ExRx), and providing PA resources or referrals. Patient surveys and EMR data were examined. Time series analysis, chi-square, and logistic regression were used.

Results: Patient survey data revealed the systems change increased patient reports of being asked about PA, χ2(4) = 95.47, p < .001 for all groups. There was a significant effect of training and resource dissemination on patients receiving PA advice, χ2(4) = 36.25, p < .001. Patients receiving PA advice was greater during phase 2 (OR = 4.7, 95% CI = 2.0-11.0) and phase 3 (OR = 2.9, 95% CI = 1.2-7.4). Increases were also observed in EMR data for PAVS, χ2(2) = 29.27, p <. 001 during implementation for all groups. Increases in PA advice χ2(2) = 140.90, p < .001 occurred among trained providers only. No statistically significant change was observed for ExRx, PA resources or PA referrals. However, visual analysis showed an upwards trend among trained providers.

Conclusions: An EMR systems change is effective for increasing the collection of the PAVS. Training and resources may influence provider behavior but training alone increased provider documentation. The low levels of documented outcomes for PA advice, ExRx, resources, or referrals may be due to the limitations of the EMR system. This approach was effective for examining the EIM Solution and scaled-up, longer trials may yield more robust results.

How does a university create a culture of affinity where students seek and maintain life-long connections to the institution? The purpose of this action research study was to examine how affinity increased or developed for undergraduate students at the Arizona State University Polytechnic campus through meaningful student-centric activities. Three theoretical frameworks guided the study including the work of Baumeister and Leary, Kuh, and Ajzen.

In this mixed method study, quantitative data about affinity, attitude, toward Arizona State University was collected using pre- and post-intervention surveys and qualitative data were gathered through individual semi-structured interviews at the conclusion of the study. Study participants were degree-seeking, undergraduate students whose degree programs were affiliated with the Polytechnic campus. The study was conducted during the first semester for first-year students. The intervention was implemented over a four-week period and consisted of providing information and opportunities to students to initiate connecting to the institution.

Quantitative data exhibited slight upward changes or slight to modest decreases in the dependent variables between pre- and post-intervention assessments. Qualitative data provided a content-rich explanation that helped in understanding the quantitative results. For example, students indicated high behavioral beliefs, attitudes toward involvement, and intentions. Moreover, they demonstrated high levels of connectedness and loyalty to the institution. Discussion focused on describing the complementarity of the data, explaining outcomes relative to the theoretical frameworks, limitations, implications for practice and future research, and lessons learned.

This action research dissertation study was undertaken to establish the foundation of a comprehensive evaluation component for the Turn-It-Around (TIA) workshop intervention program at Arizona State University (ASU), and was delivered in the form of a program development consultation. The study's intent was to enhance the ASU Counseling Service's departmental capacity to evaluate one of its important clinical services. The outcomes of this study included multiple assessments of TIA's evaluability and the fidelity of its implementation to its program design. The study products include a well-articulated program theory comprised of program goals, learning objectives, a detailed description of program activities, a logic model, and theoretical construct checklist documents articulating the behavioral science theory underlying the TIA intervention. In addition, instruments tailored to the Turn-It-Around intervention that are suitable for assessing program outcomes were developed and are implementation ready. TIA's clinical stakeholders were interviewed following the generation and delivery of the products and instruments mentioned above to determine whether they found the study's processes and products to be worthwhile and useful. In general, the clinicians reported that they were very satisfied with the benefits and outcomes of the program development consultation. As an action research dissertation, this study generated useful and usable collateral materials in the form of reports, documents, and models. These products are now at the disposal of TIA's institutional stakeholders for use in day-to-day business activities such as training new facilitators and liaisons, and giving presentations that describe the usefulness of TIA as an intervention. Beyond the documents generated to form a program evaluation infrastructure for Turn-It-Around, the processes involved in crafting the documents served to engage relevant stakeholders in a cycle of action research that enriched and solidified their understandings of TIA and furnished them with insight into their counterparts' thinking about the intervention and its potential to benefit the college students they are responsible for helping. Consistent with the intent of action research, the processes involved in accomplishing the objectives of this study surfaced new topics and questions that will be useful in subsequent cycles of program improvement.