Syndemic health disparities and resilience processes related to HIV transmission risk among African American/Black men in south Florida

Rates of HIV infection continue to climb among minority populations and men who have sex with men (MSM), with African American/Black MSM being especially impacted. Numerous studies have found HIV transmission risk to be associated with many health and social disparities resulting from larger environmental and structural forces. Using anthropological and social environment-based theories of resilience that focus on individual agency and larger social and environmental structures, this dissertation employed a mixed methods design to investigate resilience processes among African American/Black MSM.^ Quantitative analyses compared African American/Black (N=108) and Caucasian/White (N=250) MSM who participated in a previously conducted randomized controlled trial (RCT) of sexual and substance use risk reduction interventions. At RCT study entry, using past 90 day recall periods, there were no differences in unprotected sex frequency, however African American/Black MSM reported higher frequencies of days high (P<0.000), and drugs and sex used in combination (P<0.000), and substance dependence (P<0.000) and lower levels of social support (P<0.024) compared to Caucasian/White MSM. At 12- month follow-up, multi-level statistical models found that African American/Black MSM reduced their frequencies of days high and unprotected sex at greater rates than Caucasian/White MSM (P<0.001).^ Qualitative data collected among a sub-sample of African American/Black MSM from the RCT (N=21) described the men's experiences of living with multiple health and social disparities and the importance of RCT study assessments in facilitating reductions in risk behaviors. A cross-case analysis showed different resilience processes undertaken by men who experienced low socioeconomic status, little family support, and homophobia (N=16) compared to those who did not (N=5).^ The dissertation concludes that resilience processes to HIV transmission risk and related health and social disparities among African American/Black MSM varies and are dependent on specific social environmental factors, including social relationships, structural homophobia, and access to social, economic, and cultural capital. Men define for themselves what it means to be resilient within their social environment. These conclusions suggest that both individual and structural-level resilience-based HIV prevention interventions are needed.^

Sistematización in Urban Disaster Risk Reduction

Purpose – The purpose of this paper is to provide an analysis of sistematización’s use as a research tool in the operationalization of a “neighborhood approach” to the implementation of disaster risk reduction (DRR) in informal urban settlements. Design/methodology/approach – The first section highlights sistematización’s historical origins in Latin America in the fields of popular adult education, social work, and rural development. The second explains why sistematización was made a required component of project implementation. The third section addresses the approach to sistematización used. The final discusses how this experience both contributes to sistematización’s theoretical development and practical application as a methodology. Findings – The introduction of “sistematización” as a research tool facilitated real-time assessment of project implementation, providing timely information that positively influenced decision-making processes. This on-going feedback, collective learning, and open-exchange of know-how between NGOs and partner institutions allowed for the evaluation of existing practices and development of new ways of collaborating to address disaster risk in complex and dynamic urban environments. Practical implications – Sistematización transcends the narrow focus of traditional monitoring and evaluation on final results, emphasizing a comprehensive understanding of processes and contexts. Originality/value – Its use in the implementation of DRR initiatives in informal urban environments is particularly novel, highlighting the capacity of the methodology to be tailored to a variety of needs, in this case, bridging the gap between NGOs, local governments, and vulnerable communities, as well as between urban, development, and disaster risk management planning.

Syndemic Health Disparities and Resilience Processes Related to HIV Transmission Risk among African American/Black Men in South Florida

Rates of HIV infection continue to climb among minority populations and men who have sex with men (MSM), with African American/Black MSM being especially impacted. Numerous studies have found HIV transmission risk to be associated with many health and social disparities resulting from larger environmental and structural forces. Using anthropological and social environment-based theories of resilience that focus on individual agency and larger social and environmental structures, this dissertation employed a mixed methods design to investigate resilience processes among African American/Black MSM. Quantitative analyses compared African American/Black (N=108) and Caucasian/White (N=250) MSM who participated in a previously conducted randomized controlled trial (RCT) of sexual and substance use risk reduction interventions. At RCT study entry, using past 90 day recall periods, there were no differences in unprotected sex frequency, however African American/Black MSM reported higher frequencies of days high (P Qualitative data collected among a sub-sample of African American/Black MSM from the RCT (N=21) described the men’s experiences of living with multiple health and social disparities and the importance of RCT study assessments in facilitating reductions in risk behaviors. A cross-case analysis showed different resilience processes undertaken by men who experienced low socioeconomic status, little family support, and homophobia (N=16) compared to those who did not (N=5). The dissertation concludes that resilience processes to HIV transmission risk and related health and social disparities among African American/Black MSM varies and are dependent on specific social environmental factors, including social relationships, structural homophobia, and access to social, economic, and cultural capital. Men define for themselves what it means to be resilient within their social environment. These conclusions suggest that both individual and structural-level resilience-based HIV prevention interventions are needed.

Fair price and its effect on willingness to purchase

The purpose of the present research is to demonstrate the influence of a fair price (independent of the subjective evaluation of the price magnitude) on buyers' willingness to purchase. The perceived fairness of a price is conceived to have three components: perceived equity, perceived need, and inferred compliance of the seller to the process rules of pricing. These components reflect the Theories of Distributive Justice (as adjusted for conditions of need) and Procedural Justice.^ The effect of the three components of a fair price on willingness to purchase is depicted in a theoretically causal chain model. Based on the Theories of Dissonance and Attribution, conditions of inequity and need activate concerns for Procedural Justice. Under conditions of inequity and need, buyers tend to infer that the seller has not complied with the generally accepted pricing practices, thus violating the social norms of Procedural justice. Inferred violations of Procedural Justice influence the buyer's attitude toward the seller. As predicted by the Theory of Reasoned Action, attitude is then positively related to willingness to purchase.^ The model was tested with a survey-based experiment conducted with 408 respondents. Two levels of both equity and need were manipulated with scenarios, a common research method in studies of Distributive and Procedural Justice. The data were analyzed with a structural equation model using LISREL. Although the effect of the "need" manipulation was insignificant, the results indicated a good fit of the model (Chi-square = 281, Degrees of Freedom = 104, Goodness of Fit Index =.924). The conclusion is that the fairness of a price does have a significant effect on willingness to purchase, independent of the subjective evaluation of the objective price. ^

Time spent with children and working parents' willingness to medicate ADHD-like behaviors

ADHD, which refers to one of the most common behavioral problems among children, is subject to controversial arguments surrounding its nature and its primary treatment with psychiatric medications. At the heart of the problem are parents, whose responsibility includes providing pivotal information to clinicians for the diagnosis and deciding whether their children will receive medications. This study investigates the relationship between working parents' willingness to medicate ADHD-like behaviors and the time they are able to spend with their children during a regular workday. The importance of time spent with children derives from the observation that it is likely to influence not only parents' judgments of their children's behaviors but the behaviors themselves. The relationship was investigated using a subsample of 551 working parents (452 parents reporting no child with problems and 99 parents reporting child with problems) drawn from a population-based telephone survey of parents in the Miami-Dade and Broward counties of Florida. A series of path analyses, controlling for selected socio-demographic and family variables, showed that spending more time with their children during a regular workday was significantly related to being less willing to medicate ADHD-like behaviors. The association was stronger for parents reporting having a child with emotional and behavioral problems (β = −.20) and faint for other parents (β = −.06). The interpretation of the study findings emphasizes the vagueness surrounding the nature of ADHD and the events and procedures leading to the diagnosing of a child, as well as the delicate situations in which parents find themselves.

Essays in environmental economic valuation and decision making in the presence of an environmental disaster

The first essay developed a respondent model of Bayesian updating for a double-bound dichotomous choice (DB-DC) contingent valuation methodology. I demonstrated by way of data simulations that current DB-DC identifications of true willingness-to-pay (WTP) may often fail given this respondent Bayesian updating context. Further simulations demonstrated that a simple extension of current DB-DC identifications derived explicitly from the Bayesian updating behavioral model can correct for much of the WTP bias. Additional results provided caution to viewing respondents as acting strategically toward the second bid. Finally, an empirical application confirmed the simulation outcomes. The second essay applied a hedonic property value model to a unique water quality (WQ) dataset for a year-round, urban, and coastal housing market in South Florida, and found evidence that various WQ measures affect waterfront housing prices in this setting. However, the results indicated that this relationship is not consistent across any of the six particular WQ variables used, and is furthermore dependent upon the specific descriptive statistic employed to represent the WQ measure in the empirical analysis. These results continue to underscore the need to better understand both the WQ measure and its statistical form homebuyers use in making their purchase decision. The third essay addressed a limitation to existing hurricane evacuation modeling aspects by developing a dynamic model of hurricane evacuation behavior. A household's evacuation decision was framed as an optimal stopping problem where every potential evacuation time period prior to the actual hurricane landfall, the household's optimal choice is to either evacuate, or to wait one more time period for a revised hurricane forecast. A hypothetical two-period model of evacuation and a realistic multi-period model of evacuation that incorporates actual forecast and evacuation cost data for my designated Gulf of Mexico region were developed for the dynamic analysis. Results from the multi-period model were calibrated with existing evacuation timing data from a number of hurricanes. Given the calibrated dynamic framework, a number of policy questions that plausibly affect the timing of household evacuations were analyzed, and a deeper understanding of existing empirical outcomes in regard to the timing of the evacuation decision was achieved.

A Comparative Study of Customer Perceptions Regarding Green Restaurant Practices: Fast Food vs. Upscale Casual

The current exploratory study was designed to determine the impact that green restaurant practices may have on intention to visit a restaurant and willingness to pay more because of those green practices. The study analyzed a convenience sample of 260 surveys from customers in fast food restaurants and 501 surveys from customers in upscale casual restaurants in the Midwestern United States (U.S.) in order to determine if there were differences in the perception of guests regarding these types of restaurants and their green practices. The findings showed that upscale casual restaurant customers believed they are knowledgeable at a higher level than the fast food restaurant customers about green restaurant practices, have a higher mean rating on the importance of environmental record and recycling in restaurants, and believed that restaurants should use local products when they can. In both groups of customers, there was a positive relationship between green practices utilized at home and customers’ willingness to pay more for green restaurant practices as well as their intention to visit the restaurant using green practices. Management implications are discussed.