SOLUTION: Walden University Social & Health Care Concepts & Definitions Paper

SOLUTION: Walden University Social & Health Care Concepts & Definitions Paper.

Definition Section Examples
Deployment Practices – Officers are assigned to patrol according to their racial
backgrounds and with conscious regard to the racial and gender composition of the places
being patrolled (Mbuba, 2018, p.96).
Disproportionate Minority Contact – Refers to the disproportionate number of
minority youth who encounter the juvenile system (Hanes, 2012, p.1).
Intergroup Threat – Is experienced when members of one group perceive that another
group is able to cause them harm (Stephans, Ybarra & Morrison, 2009, pp.44).
Institutional Practice – A commonly structured police practice that, while not
required by any specific official policy, is supported and legitimated by rules, training, and
law and has spread widely to become a commonly accepted activity (Epp, Moody, & Markel,
2017, p. 170).
Organizational Socialization – Defined as a learning and adjustment process that
enables an individual to assume an organizational role that fits both organizational and
individual needs (Chao, 2018, pp.).
Police Socialization – The organizations everyday behavior that serves as the
foundation of a culture (Conti & Doreian, 2014, p. 415).
Racial Disparity – The proportion of racial /ethnic groups within the control of the
system is greater than the proportion of such groups in the general population (Schrantz &
McElroy, 2000).
Racial Profiling – Primarily used to denote police bias and stereotypes in its law
enforcement practices on the basis of racial and ethnic consideration; the disparate and
disproportionate targeting of racial minorities for traffic stops, searches, arrests, detention,
and charges (Kamalu, 2016, p.191).
Racial Threat Theory – Racialized competition whereby race, and ethnic groups are in
constant struggles over valued resources (Dollar, 2014, p.2).
Social Identity Theory – In groups members tend to look for negative aspects in outgroups, thereby improving their self-esteem (McLeod, 2019; Tajfel, 1979)
Symbolic Threat – Racialized threats in social conduct and to the social order (Mowatt, 2017,
Administration: Principal, assistant principal, dean, education administrator, provost,
assistant superintendent, and superintendent (West, Day, Somers, & Baroni, 2014).
Constriction: Pulling away from others and not being able to form relationships (Zaleski
et al., 2016).
Hyperarousal: A person always feeling as though they are in state fight or flight (Zaleski
et al., 2016).
Intrusion: Reliving the event even though the person may not realize that is what is
happening (Zaleski et al., 2016).
Mental health worker: Any professional who plays a role in the care of an individual with
mental health concerns (Damian, Gallo, & Mendelson, 2018).
Resilience-based programs: Sessions in which the promotion of social and emotional
learning is included (Coleman, 2015).
Restorative justice: Empowers students to be active participants in conflict resolution
(Ehrenhalt, 2016).
Trauma: An identified event that can be acute or chronic; the event is physically or
emotionally damaging to the individual, and there is a lasting effect that interferes with an
individual’s quality of life (Plumb et al., 2016).
Trauma-informed care (TIC): Situation in which individuals in an organization are
trained to understand the importance of a connection, providing protection, respect, and
reinforcing skill-building (Plumb et al., 2016).
Trauma intervention: The implementation of a practice that promotes a safe environment,
the processing of unresolved memories pertaining to the trauma, and making connections
with others (Plumb et al., 2016).
Chapter 1: Introduction to the Study
Drug and alcohol addiction as a major health problem throughout the world (Miller,
2013). The World Health Organization (WHO; 2014) indicated that worldwide, 5.5% of the
world’s population suffer from drug or alcohol addictions. The National Survey on Drug Use
and Health (NSDUH) showed that slightly less than 11% of Americans with substance use
disorder (SUD, which can include drugs or alcohol) were able to receive treatment at a facility
(Center for Behavioral Health Statistics and Quality, 2016). Some of those suffering from
addictions are not able to or choose not to get help with their substance use disorders (Cook, et
al., 2013).
Different definitions exist for the term recovery. One definition is generalized as a
journey a person takes over time, including multiple stages throughout the process (Substance
Abuse and Mental Health Service Administration, 2012). These stages can be seen as early
recovery, sustained recovery, and stable recovery (Betty Ford, 2007). Neale (2014) discussed
recovery as abstinence, or reduction in use of substances, that results in better living situations,
better health, employment, or some positive outcome. Recovery from dependence on a
substance is seen as a voluntary act, maintained by change in lifestyle to include sobriety
(abstinence) health, and community involvement (Betty Ford, 2007).
In 1991, The U.S. Department of Health and Human Services developed an office to
focus on the health and wellness of women (National Institute Drug Addiction, 2018). The
National Institute of Drug Addiction (NIDA) focused on studies in women as the biological
differences between men and women became more prominent in addictions to drugs and alcohol
(NIDA, 2018). An entire department titled the Office of Research on Women’s Health is
dedicated to determining the differences between the genders on health-related topics (NIDA,
2018). Women face unique challenges surrounding substance and alcohol abuse that are also
impacted by culture and geography (Wilsnack, 2013). A few of these challenges facing women
entering recovery include problems with domestic violence, victimization, sexual assault and
trauma (Evans, Padwa, Li, Lin & Hser, 2015). These instances can lead to co-occurring
disorders in women to include depression, anxiety, and low self-esteem (Evans et al., 2015).
The following articles form the background to this research.
1. Benavides-Vaello, Strode and Sheeran (2013) discussed the use of technology for treating
persons with substance abuse to reduce disparities. .
2. Dixon and Chartier (2016) presented that alcohol is the most abused drug in the rural
areas within the United States.
3. Edmond, Aletraris and Roman (2015) showed the fundamental and quality difference that
exists between the rural and the urban treatment centers.
4. Ghia, C. J., Patil, A. S., Ved, J. K., & Jha, R. K. (2013) acknowledged that telemedicine
is increasingly becoming a widely recognized concept globally.
5. Hickson, Talbert, Thornbury, Perin, and Goodin (2015) discussed online technologies,
and how there is a more efficient and better care system.
6. Melemis (2015) acknowledged that four primary ideas exist for relapse prevention.
7. Pullen and Oser (2014) highlighted substance abuse as a major concern in both urban and
rural areas, with more focus on the rural areas.
8. Sigmon (2014) focused on the access to treatment for those who are in rural America.
The specific target treatment for the study is on opioid dependence.
9. Wang, Becker and Fiellin (2013) is premised on the fact that rural areas in the United
States have shown an increase in overdose deaths due to the nonmedical use of
prescription opioids.
10. Zanaboni, Knarvik and Wootton (2014) explored the state of application of routine
telemedicine with specific reference to Norway
Problem Statement
Substance abuse is a steadily growing concern (Pullen & Oser, 2014) in rural America
(Sigmon, 2014). According to the U.S. Census Bureau (2016), a rural area is defined as areas of
population not classified as urban. Areas of urban populations are denser, with more developed
territories, leaving areas farther away from city centers to be classified as rural (U.S. Census
Bureau, 2016). In general, rural areas lack easy access to quality healthcare (Pullen & Oser,
2014). Throughout the United States, rural areas report physician shortages, travel difficulties,
and lack of specialized treatment options (Warren & Smalley, 2014).
Alcohol and substance abuse in Georgia is a social problem that has caused a significant
level of social and economic problems (SAMHSA, 2016). In a paper, “Gender Impact
Assessment of Georgia’s Drug Reform”, the Gender Equality Council of the Parliament of
Georgia (GECPG) indicates that there are over 45,000 substance abuse cases in Georgia. Out of
this number, 10% are women (Gender Equality Council of the Parliament of Georgia, 2017).
Even though lack of rehabilitation is a threat to individual health and well-being, there remain
significant hindrances to the treatment of abusers of substances (Pullen & Oser, 2014). One of
the primary challenges to the treatment of substance abuse is the availability of resources in
communities (Edmond, Aletraris & Roman, 2015), while marginalization and stigmatization are
other devastating challenges. One proposed way to overcome the obstacles in addiction recovery
in rural areas is the use of online systems.
One such option for rehabilitation from substance use disorder is that of
telerehabilitation, a sub-discipline of telemedicine. Telemedicine is one of the most recent
improvements in the provision of medical services (Mid-Atlantic Telehealth Resource Center,
2016). It allows medical practitioners to provide medical services to patients without ever
meeting them. It refers to the use of various forms of technologies and communication systems
to offer rehabilitation services and assist the affected persons to start living independently (MidAtlantic Telehealth Resource Center, 2016).
A study of online substance abuse recovery was completed in the United Kingdom in
2015, comprising of smart phone apps, online groups, and websites (Graham, Irving, Cano, &
Edwards, 2018). This study revealed a strong correlation between those in established and stable
recovery and the usage of some type of virtual recovery tool. Established or stable recovery is a
period of sobriety of more than 5 years (Betty Ford, 2007). The study did not reveal if online
services for those beginning recovery, or those in early recovery, which is a period of time less
than 1 year, were used, which suggests further research is needed to understand recovery change
via online sources with a focus on gender (Graham et al., 2018).
Best et al. (2016) describes the amount of judgment from outsiders women receive in
comparison to men when dealing with substance use disorders. According to the Federal Center
for Substance Abuse Prevention (2017), about 2.7 million women in the United States abuse
drugs or alcohol. Some women may know that they are struggling and will take pills or alcohol
while hiding whereas other women will view it as a social activity and will not agree to see it as
a problem (Bepko, 2014). Women face pressure to have everything together, meaning a perfect
balance between work, raising kids and other social activities. It is for this reason that once a
woman gets addicted, accepting that they are addicted is quite hard and seeking treatment is even
harder (Bepko, 2014).
Although the aforementioned research regarding deliveries of rehabilitation services for
women suffering from substance abuse and alcohol addiction illuminates important findings, I
have found no research that has examined how women located in rural areas who suffer from
addiction use telerehabilitation as a primary recovery option.
Purpose of the Study.
The purpose of this general qualitative study is to gain deeper understanding of the
experiences of recovery from substance abuse disorders among women in rural North Georgia
who are limited in access to in-person treatment options and rely on online rehabilitation
services. The research will explore the experience of recovery stabilization from substance abuse
and related diseases. Focus will be limited to women clients of recovery treatments living in
North Georgia. The online treatment platform provides a private and convenient option for drug
and alcohol addiction recovery (Griffiths, 2015).
Health related outcomes have been studied from the social media platform of recovery,
showing positive benefits, with little negative impacts (Merolli, Gray, & Martin-Sanchez, 2013).
Highly trained medical experts can provide therapeutic intervention via the internet. This
platform offers numerous benefits in addition to the traditional recovery approach. Differing
interactions via online such as counseling, peer groups, and other tools for successful recovery
are available. More engagement online will positively influence the results of addiction
treatment for women clients in rural areas.
Utilizing the online tools, the women of North Georgia will benefit from full flexible
schedules 24/7, therapeutic support, and continual progression in counseling. Connection is a
strong part of recovery, and through online applications, women can stay connected to
counselors and set up appointments as needed. Length of online meetings and sessions will vary,
but the nature of interaction will depend entirely on the woman and her desire for support
(Griffiths, 2015).
Research Question
What are the experiences of recovery from substance abuse disorders among women in
rural north Georgia who are limited in access to in-person treatment and who rely on online
rehabilitation services?
Theoretical Foundation
The self-regulation theory will serve as the theoretical framework for this study. The selfregulation theory developed by Baumeister and Bandura (1989) is a self-directed management
system that involves guiding one’s thoughts, feelings and behaviors towards the attainment of
certain goals (Baumeister & Vonascha, 2015). It involves what we feel, think, say or do that
helps in controlling our urges, emotions and behaviors (Baumeister, 1994). This theory is
effectively used for impulse control, illusion control, goal attainment and management of
sickness behavior making it eligible for this study (Baumeister & Vonascha, 2015).
Bandura claimed that humans control behaviors through self-regulation and the behaviors
associated with the social cognitive theory and social learning theory (Baumeister, Bratslavsky &
Muraven, 2018). Schunk and Zimmerman reviewed the theory and came up with particular
strategies that contribute to an individual’s learning process that leads to self-regulation (as cited
in Panadero, 2017). Baumeister designed four components of self-regulation to be the standard
of behaviors that are desired, the motivation to meet the standards, analyzing and evaluating
situations and ideas and the willpower to control urges (Baumeister, Bratslavsky & Muraven,
Individuals engage in their own learning in three stages: planning, monitoring and
reflection (Panadero, 2017). The individual lays out strategies to tackle the tasks, monitors their
performance and reflects on the outcome (Panadero, 2017). In monitoring of health-related
issues, the self-regulatory model may be used. It describes the stimulus, cognitive and emotional
responses, the coping responses and evaluation of the coping responses and health outcomes
(Baumeister & Vonascha, 2015). Patients are guided in identifying their health problems, the
risks and issues involved and an action plan to handle the problem (Panadero, 2017). The selfregulation theory is applied by an individual who takes control and evaluates his/her behaviors to
attain satisfaction trough life experience.
The nature of this study will be qualitative inquiry with a general approach that will focus
on the lived experiences of women living in rural north Georgia who utilize online treatment for
recovery from substance use disorder. According to van Manen (2014), the heart of human
experiences presented to the researcher has meaning to the participants through their surroundings,
and how their meaning influences behaviors. Purposeful sampling will align with the purpose of
this qualitative study. Sampling will allow for selection of participants to meet the requirements
needed to further the study (Suri, 2011). Individual interviews will be conducted, utilizing semi-
structured questions. A total sampling of between 12 to 15 women will be selected on a voluntary
basis, ensuring anonymity through only voice recording. Women will be a minimum of eighteen
years old, with no age limit. Some will have entered into recovery on their own decision and some
may have been assigned to it through court ordered processes. The location of the participants will
be in Northern Cherokee County in the state of Georgia. Selection will be from more rural areas,
with a minimum of 20 mile drive to the closest treatment option for addiction recovery. Participant
pool will lead to a better understanding of the experiences of women entering into recovery from
substance use disorders.
Scope and Delimitations
In this study, the focus is on the analysis of the experiences in stable recovery for women
living in rural north Georgia who treat substance use disorders through online rehabilitation
services. The deeper understanding under investigation may accrue a qualitative attachment to
the research methodology investigated. Hence, it is imperative to focus not on outside events, but
on the experiences being presented. Following a thorough analysis of women seeking online
treatment on drug abuse online, there has existed a limited scope and need to research the
particular field to find out the motivation behind the action (Matua & Van Der Wal, 2015). The
motivation behind the whole concept points to the fact that there are gaps within community
centers charged with engaging the society in containing substance abuse amongst women in the
Georgian community. From a sample of women, it was agreed that drug and substance abuse
problems had online choices and should be expanded to other territories for better service (Van
Manen, 2014).
Of specific interest is:
a) The experiences in stable recovery for women living in rural north Georgia; and
b) The treatment of disorders through online rehabilitation services.
Data will be analyzed through thematic content analysis. Through this technique, the
common patterns across a data set will be established. During the analysis of collected data,
individuals will read and re-read data, then label and code for broad patterns of meaning. The
themes will be reviewed to ensure that the data will correlate (Braun & Clarke, 2014). Themes
will be named and then defined appropriately. Write up will include quotes from the interviews.
The method to be used, semi-structured interviews has its shortcomings. First, the method
can be time-consuming and utilizes many resources. Additionally, the technique requires
confidentiality which has to be assured and if not, the participants may feel hesitant to share
information. The skills to analyze the data can be a problem as there are chances of construing so
much (Van Teijlingen, 2014). A main limitation may be achieving the correct sample size.
According to Babione (2015), saturation is the point in a qualitative research where new
data and analysis only confirm previous conclusions. Consequently, it determines when to stop
data collection and analysis. At the saturation point, the theory appears clear and is easy to
construct since there are no gaps of unexplained phenomena. Sirakaya-Turk et al. (2017)
considers saturation to be reached when no new concepts can emerge and the data cannot
contribute any further to theoretical development. Data repetition and redundancy begins to
appear and further collection is unproductive since it yields no new information. According to
Phillips (2014), any additional information after saturation becomes redundant because the
purpose of qualitative research is to discover the context and diversity rather than a large number
of participants with the same experience.
The failure to achieve saturation has a negative impact on the research quality and the
validity of the results (Fusch & Ness, 2015). Further, there is no universal data collection method
for attaining data saturation. According to Fusch & Ness 2015, some methods have a high
probability of reaching saturation than others. Data collection approaches depend on the study
design and hence researchers should select a study design that is explicit about reaching data
saturation (Fusch & Ness, 2015). Saturation should be operationalized in a method consistent
with the theoretical position, study questions, and the adopted analytical context (Saunders et al.,
Ethical Procedures
One of the things that will be ensured in the study is research confidentiality. The consent
of the interviewees will also be sought before carrying out the study. The research aim and
objectives will be made known to the researchers as well. A steady focus to keep and remove any
bias of the researcher will be maintained, after using any experiences necessary to gain complete
confidence from participants.
Overdose deaths increased at a more rapid rate in the state of Georgia than the national
average last year (CDC, 2018). In 2016, 928 Georgia residents died in the circumstances related
to substance use disorder (Cupit, 2018). During 2017, the number of overdose deaths reached
1,035 people living in Georgia (Cupit, 2018). The mortality rate in Georgia is now considered
an epidemic crisis. Deaths relating to drug abuse in Georgia for 2018 reached 2000 people. This
study will provide useful information benefitting women living in rural North Georgia battling
substance abuse issues. The results from this study will provide a contribution to the literature
on understanding addictions in women with less access to treatment (King et al., 2018).
Significance will be seen through a reduction of barriers to treatment and recovery by improving
the online ability to treat substance use disorders.
The results gathered from this research will contribute to literature by revealing depths of
substance abuse in women. Knowledge obtained from this study could promote social change
through recommendations from collected information towards policy makers in rural areas (King
et al., 2018) to increase availability of services for those suffering substance use disorders. The
ripple effect of this information will reduce deaths in the community from addiction because
more availability to recovery help will be available. Policy makers within the state of Georgia
will be involved in positive changes for availability of treatment for women suffering from
substance use disorder. This study will be fundamental in importance by reducing the number of
deaths in the area thru online recovery options.

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