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Abstract: Background. Higher education transcends academic pursuit; it fosters social community, exploration, exposure to diverse experiences, and career fulfillment. However, Autistic postsecondary students often face barriers that hinder their sense of belonging. Studies indicate 40- 70% of these students struggle with depression and anxiety due to social exclusion and isolation, highlighting the need for inclusive practices in post secondary institutions (McMorris et al., 2019; Cage et al., 2017). Addressing these challenges requires more than just implementing inclusion policies; it necessitates fostering a genuine sense of belonging in their educational journey (Maitland et al., 2021; O’Keeffe, 2013). Objective. This study aims to understand and improve the sense of belonging for Autistic postsecondary students in Canada by reframing an existing model of university belonging through an interactionist approach to disability. Methods. The study involved a qualitative analysis, including surveys with Autistic students across Canadian universities. Participants were selected based on specific eligibility criteria, ensuring a diverse sample. Data was analyzed using both codebook (phase 3) and reflexive (phase 4) thematic analysis to identify patterns and themes related to belonging. Results. Central to this study is the development of the Autism Centred – University Belonging Model (AC-UBM). This model builds on Slaten et al. (2018)’s University Belonging Questionnaire (UBQ) by incorporating specific factors relevant to Autistic students. The ACUBM includes four main pillars: 1. University Support and Acceptance. This pillar emphasizes the importance of addressing sensory needs, providing accessible support and personal growth opportunities, destigmatizing disability, and recognizing contributions. 2. University Affiliation. None of the participant responses in our study aligned with the University Affiliation pillar as defined by Slaten et al. (2018). Therefore, a new pillar (Pillar 4) was created. 3. Faculty and Staff Relations. This pillar highlights the significance of supportive interactions with faculty and staff, adapting instruction to fit learning styles, and maintaining confidentiality regarding autism diagnoses. 4. Peer Relations. This new pillar addresses the impact of external perceptions, the need to mask identity, and the significant role of friendships and social communities in enhancing belonging. The final phase of the analysis identified key factors necessary for Autistic students to experience a sense of belonging, which include (1) addressing sensory needs, (2) providing accessible support and personal growth opportunities, (3) institutional efforts to de-stigmatize disability, (4) recognizing and valuing their contributions, (5) adapting instruction to fit individual learning styles, (6) maintaining confidentiality of diagnoses, (7) having openly neurodivergent staff members, (8) managing external perceptions and the need to mask aspects of their identity, and (8) building and maintaining friendships on campus with both Autistic and non-Autistic peers. Conclusion. The findings emphasize the need for comprehensive strategies to create inclusive environments that support the well-being and academic success of Autistic students. Some recommendations include specialized orientations for Autistic students, Universal Design for Learning principles, support groups, Autistic-led mentorship programs, and integrating neurodiversity into Equity, Diversity, and Inclusion initiatives. By addressing these areas, universities can significantly improve the sense of belonging and overall experience for Autistic students in Canada.

My research inquiry is centered on the larger project of building a transformational, empowerment model of worker voice in workplaces. The purpose of my research is to explore/illuminate the question, “How can I use workers’ stories to center and advance collaborative worker voice on the job through peer-driven training initiatives?” I frame this general research inquiry around two key questions: (a) How do I create authentic spaces for workers’ stories to emerge from the heart? (b) How do I use workers’ stories to create the environment needed for workers to become peer teachers/leaders of their own training initiatives? This study’s intended audience is any practitioner who seeks to center workers’ experiences/stories as the fulcrum for transformational workplace change. My research method is Scholarly Personal Narrative (SPN). SPN is a sustained exploration of one’s own narrative experiences of dealing with a particular question, problem, or dynamic that has broader social significance. It entails analyzing that experience through the lens of relevant research and theory. I have chosen a hybrid video/written format for my SPN, to create a first-person storytelling experience for the viewer/reader that replicates my methodology with workers at their worksites. The video segments of this dissertation can be found at http://debmoy.weebly.com/. My findings document the key elements needed to be an effective change agent supporting organic leadership in organizations through workers’ stories. My dissertation can influence the effectiveness of California Transit Works (CTW), the statewide consortium bringing my approach to scale nationally. My dissertation can bring academic recognition to key roles that third-party neutrals, or “intermediaries,” can play in building worker voice empowerment within labor/management partnerships. Finally, I hope this dissertation inspires and guides workers and change agents to take an holistic view of what it means to have our own voices and be our own best allies in transforming our communities. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu).

Community-based participatory research is an equitable approach to research involving the community in all aspects of the research process to help promote the application of research findings directly to populations. The current study employed a community-based participatory research approach to help identify barriers and facilitators of trust in providers in a collaborative care model of integrated behavioral health at a Federally Qualified Health Center serving mostly Latine children and families called the psychiatry conference. 14 parents and six children were interviewed qualitatively about their experiences with the psychiatry conference and a thematic analysis approach was employed to identify themes related to facilitators of trust in providers. Results found that facilitators of trust included: the primary care provider serving as a bridge to help trusting relationships form between the psychiatrist and families, reciprocal respect between providers and families, and the psychiatrist taking an educational approach. Barriers to trust included: the quality and availability of interpreter services as well as lack of a tailored approach for patients depending on diagnosis. Other factors such as parent-child synchrony and optimism contributed to final reactions to the psychiatry conference as well as retention processes. This study helps to elucidate how to implement a CBPR study in an integrated care setting as well as ways to improve the acceptability of primary care behavioral health services for Latine children and families.

Abstract: This thesis considers the constitution of urban places, futures and belonging through foraging, urban gardening and recipe creation. Adopting a community-based research approach, the research embraces values of inclusion and is an active attempt to diversify the ways in which urban greenspaces are planned and imagined. At the heart of this research is the co-creation of a recipe book by a group of culinarily-inclined English language learners and a Métis instructor from Edmonton who is the author of this thesis. This thesis considered how participation in a community urban agricultural and recipe project could increase belonging as well as aid in building more inclusive futures for its participants and for the City of Edmonton. The recipe book created in this project is the culmination of a year of urban gardening and foraging within the City of Edmonton, Alberta; of experiencing and reflecting upon the ways in which we relate to the land, and our imaginations for our future. Our recipes-as-stories offer a window into who and where we are, and specifically on green and wild city spaces where planning, policies and histories do not always include our voices as women, mothers, immigrants, and Indigenous people. As urban food spaces continue to rise in prominence in cities such as Edmonton, how these spaces are defined, managed, who has access to them, and whose voices and experiences are underrepresented in the planning and use of such spaces are essential questions. Through the narratives, experiences, and reflections that we gathered as we created place-based recipes, we carved out spaces of belonging and agency for ourselves and presented our own imaginary of urban agriculture. This imaginary draws from the magic of the everyday to visualize an inclusive and sustainable future in our City. Our vision and our recipes-as-practice reach beyond the generally understood boundaries of urban agriculture and include not only current and local gardens, but also global places, urban forests and intergenerational connections.

Oneida college lacrosse players have an important perspective on the sacred game of lacrosse that needs to be heard. The Oneida are one of six tribes of the Haudenosaunee, or also known as, the Iroquois. Lacrosse is one of the fastest growing sports in the world and the style played today is most similar to the Haudenosaunee style. Oneidas are traditionally orators and lacrosse players. There is a lack of literature on the Oneida, lacrosse, and education. Oneida college lacrosse players face a problem in attempting to preserve their traditional Indigenous knowledge at their respective university communities, while also seeking the best way to transmit that knowledge. Oneida college lacrosse players are challenged physically, mentally, emotionally, and spiritually when navigating Western education as Native American students. There is a Western educational disparity for Native American people, a distrust of Native Americans towards researchers, and additionally, an emergence of decolonizing ideologies of Indigenous researchers claiming a space in academia. This action research study included monthly talking circles and weekly journaling with 12 Oneida college lacrosse players as collaborators. This dissertation utilized action research and in particular, community-based participatory research, along with principles based on decolonizing practices and the sacred medicine wheel. One interpretation of the sacred medicine wheel is viewing the world through the lens of the physical, mental, emotional, and spiritual, and this was used as a framework for sharing our perceptions’ as collaborators in this dissertation. This dissertation created new knowledge on Oneida college lacrosse players’ perceptions concerning the sacred game of lacrosse. Several themes emerged relating to retaining and transmitting traditional perceptions of the sacred game of lacrosse to participants’ respective university or college communities. Finally, this research created unique and transformative spaces for community healing and growth amongst collaborators.

Abstract: Indigenous peoples in northern Canada are already experiencing significant climate change impacts. Young Indigenous people will inherit serious climate effects that threaten their physical and mental health, as well as ancestral traditions. It is these same young people that live in communities faced with social decay as a result of colonialism. Understanding how climate action can be a mechanism for positive youth development and resilience to environmental and social challenges is important for communities. Many of these same communities continue to be reliant on diesel systems despite the understanding that fossil fuels contribute to climate change. Given the challenges of relying on such an imported, carbon-intensive fuel, communities have expressed interest in renewable energy as a tool to address their energy insecurity. With this context in mind, this thesis explores (1) the benefits of Indigenous youth in climate governance and, (2) Inuvialuit values and decision-making experiences with energy systems in Inuvik and Tuktoyaktuk, NT. This thesis was inspired by principles of decolonized and community-based participatory research which led to collaboration between the student and the research communities at every stage of the research project. Fourteen semi-structured interviews were conducted with Indigenous youth and key informants that participated in a series of culturally appropriate climate action activities. Semi-structured interviews were also conducted with 23 energy stakeholders, including Elders, community members, researchers, and government officials. Both sets of interviews were transcribed and analyzed with a conventional content analysis approach to identify key themes. The research finds that there are significant benefits to including Indigenous peoples in governance processes, including providing opportunities for skill development as well as increasing the likelihood that decisions will reflect the needs of the communities impacted. This thesis contributes to the literature on Indigenous youth in climate action and renewable energy in the Arctic.

This thesis explores the process of facilitating the creation of a community museum in Chiquilá, Quintana Roo, Mexico. The growing presence of tourists travelling to Holbox Island, achieved by going through Chiquilá’s port, makes this project timely. Working with the Proyecto Costa Escondida(PCE), the Chiquilá Community Museum Project (CCMP) aspires to identify the dynamic relationship between the coastal inhabitants and the changing landscape, both past and present, through scientific investigations and local knowledge and make this knowledge accessible to the public. It is the accumulation of information through aforementioned means that allow us to collaborate with the Chiquilá community and other regional stakeholders to create a museum exhibit that aspires to do three things: empower the local population through collaboration, serve the community as a reliable source of information, and provide an adaptable and manageable platform for sustainable development. While this project focuses on the initial stages of this process, it is foundational for the development of the Chiquilá community museum.

The youth of this nation are the individuals that are most effected by educational policy and practices, however their perspectives are often not taken into account when developing programs and services. By including youth’s perspective on their education we can gain a deeper understanding of the intricacies of students experiences, utilizing the information to inform research and implement relevant policies. To engage students regarding their educational experience, the current study utilized a co-researcher model within a larger Community-Based Participatory Research project. Exploring the student identified topics of building positive relationships both among students and between students and teachers, the current project utilized photovoice to capture student’s voice. A participatory method, photovoice allows the students to photograph elements of their lives related to the topic, using those photographs as a catalyst for discussion, which aims to identify root causes and potential action plans. Through conducting photovoice, the students in the current study identified eight themes that were discussed as either a hindrance or as helpful in building relationships. Generally, the themes indicated that a stronger sense of community within the school, paired with spaces for students to practice their autonomy would assist in fostering better relationships both among students and between students and teachers within this setting. The findings support the notion that students are capable of conducting challenging research, and further suggest that students want the space to voice their opinions and make decisions within their school.

The purpose of this study is to identify and understand ways transgender and gender non-conforming people living in Albuquerque, New Mexico are communicating about and understanding their health and wellness needs and the health and wellness needs of their community. Partnering with the Transgender Resource Center of New Mexico, I used a community-based participatory approach to work on a Photovoice project that identified health and wellness related needs as defined by the community. Emergent themes identified by the participants highlighted various challenges and strengths to health and wellness for transgender and gender non-conforming people. I identify five core cultural premises present in the themes identified by participants: (1) transition is a process deserving of chronicling and archiving; (2) trans-stress is persistent throughout the lives of transgender people; (3) bodies are central to transgender experiences but are not the essence of transgender experiences; (4) transition is an ongoing process; and (5) there is no singular transgender experience or narrative. In order to further investigate the dialectical tensions present in these premises, I offer a new framework of TransWellness.

Clinicians in low and middle-income countries (LMIC) face many challenges, including high patient-to-staff ratios, limited resources, and inconsistent access to electricity. This research aimed to improve health outcomes in LMIC through an enlightened understanding of challenges associated with healthcare technology. To understand LMIC barriers to acquiring, maintaining, and repairing medical equipment, a community-based participatory study was conducted at three clinical settings in southern Malawi. Thirty-six clinical staff participated in surveys and focus groups to provide information on medical device challenges. Results from the study emphasize the importance of community-based participatory innovation to improve global health. Many clinical staff expressed frustration regarding inability to prevent patient mortality attributed to equipment failure. Data from the community-based participatory study of medical technology conducted in Malawi revealed key insights for designing for low and middle income countries, and more specifically, for communities in southern Malawi. Specifically, partner communities identified mechanical suction machines as a top priority for design innovation. Working with technical and clinical staff in Malawian communities, a prototype mechanical suction machine was designed and constructed. This work suggests that engineers working in low and middle income countries face a unique sundry of design requirements that require an intimate understanding of the local community, including community leaders, community beliefs and values, and locally available resources. Technology innovation for global health should incorporate community expertise and assets, and health and technical education efforts should be developed to increase working knowledge of medical devices.

In the U.S., diabetes mellitus cases have been increasing, from 25 million in 2010 to 29 million in 2012. Healthy People 2020, the U.S. National Health Agenda, has established specific goals and objectives for diabetes. In the U.S., prevalence of pre-diabetes and diabetes for adult Hispanics was 38% and 12%, respectively, in 2012. The total estimated diabetes cost in the U.S. has been increasing, from $176 billion in 2007 to $245 billion in 2012. The current study had two research hypotheses; the formative phase was expected to demonstrate a need for a community-based Type 2 Diabetes Mellitus (T2DM) self-management intervention for Spanish-speaking Hispanics. Random Control Trial (RTC) was expected to demonstrate the potential impact in preventing and managing T2DM. Methods. A community-based lifestyle education curriculum was translated into Spanish, and adapted to Hispanic culture. This study includes three phases: 1) a formative phase; 2) a two-group pilot RCT with Hispanic Living with Diabetes (HBLD) and a delayed treatment condition; and 3) post-HBLD focus groups held with three participating groups of HBLD. Results. Of 60 participants screened in the formative phase, 62% had A1c > 5.7%, and 75% did not have medical insurance. Of 6 participants who completed the pilot, A1c decreased for all six participants. Of 67 participants screened in phase 2, 61% had A1c > 5.7%. Of 30 HBLD participants in the RCT, baseline versus 3-month mean A1c increased 0.2 for the delayed control group (n = 10) and did not experience any change for the intervention group (n = 11). The difference in A1c change from baseline to follow up between treatment groups was not statistically significant (Kruskal Wallis, p < 0.05). Diabetes knowledge and SCT variables change from baseline to follow-up between groups were not statistically significant. Major themes identified in focus group discussions included barriers to access to health and nutrition services, the value of having a Spanish-speaking Hispanic as a health educator, and barriers to recruiting community members as promotoras. Implications. HBLD has potential to reduce complications of diabetes among Hispanic participants by providing education to those who may not otherwise have access to it.

The purpose of this study was to describe the methods--including practices, policies, and roles--used by public and academic library staff in a Centers for Disease Control and Prevention (CDC) Racial and Ethnic Approach to Community Health (REACH) intervention that proved successful in reducing or eliminating several diabetes-related health disparities in a vulnerable population. An intrinsic case study methodology was used to identify effective services, resources, and practices for library staff. A semi-structured telephone interview was completed by 11 community partners from a successful multi-partnered, community-based, diabetes-related health disparities intervention that included librarians as community partners. Questions included (a) What were some traditional or innovative library roles, services, or resources used in this successful intervention? (b) How was helicopter research avoided? (c) How was trust with the vulnerable community members established and maintained? (d) How were community members with low literacy included? Data were audio-recorded and transcribed. Eight major themes consistent with transformative adult learning theories were identified from the coded transcripts, including (a) autonomy, (b) community-based and community-led, (c) incentives, (d) a new role for professionals, (e) participants realizing success, (f) church participation, (g) transformation, and (h) perspective of the librarians. The insights and guidelines suggested by this research may be helpful when deciding how or when to participate in community-based health disparities interventions for vulnerable populations.

Background: In the United States, women living with HIV/AIDS (WLWHA) face high rates of morbidity and mortality despite the existence of effective antiretroviral therapy. A San Francisco–based arts organization, Cultural Odyssey, in collaboration with the Women’s HIV Program at UCSF, adapted a performance–based empowerment group intervention to include WLWHA. Participants translated personal experiences related to HIV into vignettes that were performed during a theatrical run of eight shows entitled Dancing with the Clown of Love (DCL), which was seen by approximately 1,000 people. The purpose of this study is to describe the impact of the group intervention on WLWHA and compare these findings to the Disclosure Process Model (DPM), a relatively new framework for understanding the process and impact of HIV–disclosure.Methods: In–depth interviews with HIV–positive participants (n=8) were conducted between May and December 2011. A multidisciplinary team transcribed and analyzed data using thematic analysis. All transcripts were double coded. Findings: Participants were primarily African American (62.5%), with the mean age of 48 (range 23–65), and all had earned a high school diploma. All HIV–positive participants disclosed their HIV–status during the performance. Core themes about the impact of the intervention emerged from the data, including: forming relationships, decreasing isolation, normalizing HIV, providing a sense of purpose, and personal transformation. The concept of personal transformation was further analyzed and major sub–themes included: gaining a voice, exploring self–identity, catharsis, gaining a sense of accomplishment, and developing self–esteem. The DPM provides a conceptual framework for understanding the impact of this theatrical performance group on WLWHA and several themes were predicted by the model. Additionally, descriptions of disclosure from this study add depth and complexity to the model. Conclusions: WLWHA are often marginalized and isolated because of continuing HIV–stigma. Women who participated in DCL and publicly disclosed their status reported achieving many aspects of personal empowerment, such as decreased isolation. By participating in a performance group, women found their voice and learned to value their experiences. The findings of this study show that interventions utilizing components from the DPM can have a significant positive impact on the lives of WLWHA.

The Atlanta BeltLine is an innovative redevelopment project re-shaping Atlanta residents’ access to, multi-use trails, parks, public transportation, housing and employment opportunities. The primary purpose of this project was to develop a research proposal to study and analyze the health benefits associated with multi-use trails within BeltLine communities. A secondary purpose of this project was to evaluate the multi-sectoral and multi-institutional partnership that was formed to develop the research proposal and study the influence of the BeltLine on health outcomes. In August 2010 representatives from the Centers for Disease Control and Prevention, Emory University, Georgia Institute of Technology, Georgia State University, the Atlanta BeltLine Inc. and the Atlanta BeltLine Partnership formed the BeltLine Health Proposal Committee. Two online surveys using Survey Monkey were conducted to evaluate how this committee was operating, if roles and responsibilities were clear and to determine if this committee was an effective mechanism to integrate health and the built environment. Findings from the survey indicated that committee members believed this group was a unique partnership comprised of dedicated professionals sharing a common interest. Survey findings indicated there were several challenges that needed attention including improving communication, resolving competing interests, and identifying a lead organization. Findings from this evaluation can help resolve these issues and help the committee transition into a Health Advisory Group. The Health Advisory Group will serve as formal body that will review research proposals, conduct research, leverage funding and disseminate key health findings related to the BeltLine.

Diabetes has become a major public health concern in the United States with over20 million Americans suffering from this chronic disease. It accounts for over 174 billion dollars in healthcare costs annually (American Diabetes Association, 2006, 2007). This study focused on a unique group of diabetics in the United States those who are being served by the Cincinnati Veterans Administration (VA). In 2005, the VA instituted an alternative model for the delivery of healthcare called Advanced Clinical Access or ADA (Schall et. al., 2004, Huey, 2006, Smith 2006). One aspect of ADA is the concept of the Scheduled In Group Medical Appointment or SIGMA. The SIGMA is an organizational paradigm in which 8-12 patients are seen in a two hour window by one primary care provider (Noffsinger, 1999; Noffsinger and Scott, 2000). This study examined the use of the SIGMA as a alternative way to aid in diabetic veteran disease control. Community Based Participatory Research (CBPR) was used as the underlying philosophy for this study. By definition, CBPR is constructed upon the principles of equity, respect for all persons and an ecological belief regarding health (Minkler and Wallerstein, 2003; Israel, et. al., 2005).Two research hypothesis were examined with diabetic veteran participants being served by the Cincinnati Veterans Administration (VA): (1) improvement or lack there of, regarding blood sugar, blood pressure, cholesterol, foot and eye exams, (2) patient perception of the SIGMA. Previous studies demonstrated that group medical appointments may be a viable option for chronically ill outpatients (Scott and Robertson, 1996; Scott et. al, 1998; Scott et. al, 2004) and in particular for diabetic patients (Wagner et. al., 2001; Trento et. al., 2002; Masley et. al. 2007). However, no studies to date have examined the SIGMA in a VA setting.A repeated measures two tailed t-test was used with 33 veteran participants. Outcome measures obtained after an eighteen month period illustrated that group participants had the following: (1) decrease in HbA1c levels of 1.47 (P = .0002), (2) decrease in systolic readings of 3.4 ( P = .3732) and diastolic of 2.6 ( P = .1893) although not significant, (3) decrease in Ldl by 14.5 points ( P = .011), (4) 96.9% comprehensive foot exams maintained and (5) 28% increase in annual eye exams to 96.9% completed. Twelve veterans were interviewed and thematically analyzed. Key themes associated with participation in the SIGMA were the following: a supportive venue; the opportunity to speak; humor; education; knowledge, preventing isolation, Agent Orange and Vietnam Veterans; mental health issues; sexual dysfunction and finally administrative support. Suggested implications from the study included the following: (1) the two theoretical group models may not always meet the needs of a particular SIGMA, (2) poorly controlled diabetic patients may need to participate in a group for several years to obtain maximum benefit, (3) the SIGMA may be a viable option for other diabetic veterans being served by the VA (4) administration may need education to understand the role of the SIGMA.

Many U.S. organizations interested in a renewable and domestic source of energy are considering switching from petroleum diesel to biodiesel blends for transportation and heavy-duty equipment use. Biodiesel is a fuel made from vegetable oils or waste grease. While there is a considerable body of evidence on the negative health effects of petroleum diesel exhaust exposures in occupational and urban settings, there has been little research examining the impact of biodiesel fuel on occupational and environmental exposures. This dissertation combined a collaborative exposure assessment of B20 (20% soy-based biodiesel/80% diesel) at a rural recycling center with a policy intervention to deliberate the results of this analysis and potential policy outcomes. I applied the National Research Council's (1996) analytic-deliberative model to connect the collaborative exposure assessment with a Biodiesel Working Group, which catalyzed policy decisions about the manufacture and use of biodiesel in Keene, NH. Researchers and undergraduate students from Keene State College and employees from the City of Keene Department of Public Works quantitatively estimated diesel and biodiesel exposure profiles for particulate matter (< 2.5 microns diameter), elemental carbon, organic carbon, and nitrogen dioxide using standard occupational and environmental air monitoring methods. I collected qualitative data to examine the genesis, evolution and outcomes of the Biodiesel Working Group. Integrating analysis and deliberation led to a number of positive outcomes related to local use of B20 in nonroad engines. Particulate matter and elemental carbon concentrations were significantly reduced (60% and 22% respectively) during B20 use at the field site. Organic carbon levels were significantly higher (370%) during B20 use. Although NO2 levels were 19% higher, this increase was not statistically significant. Connecting the analysis with deliberation improved the quality of the exposure assessment, increased dissemination of the research results in the local community, and catalyzed novel policy outcomes, including the development of a unique public/private partnership to manufacture biodiesel locally from waste grease.