Dissertation Prospectus

Factors Influencing Individuals’ Decision to Utilize Mental Health in South Texas

Grand Canyon University

Submitted by:

James Dada

March 7, 2020

The Prospectus Overview and Instructions

Prospectus Instructions:1. Read the entire Prospectus Template to understand the requirements for writing your prospectus. Each section contains a narrative overview of what should be included in the section and a table with required criteria for each section. WRITE TO THE CRITERIA, as they will be used to assess the prospectus for overall quality and feasibility of your proposed research study.2. As you draft each section, delete the narrative instructions and insert your work related to that section. Use the criterion table for each section to ensure that you address the requirements for that particular section. Do not delete/remove the criterion table as this is used by you and your committee to evaluate your prospectus.3. Prior to submitting your prospectus for review by your chair or methodologist, use the criteria table for each section to complete a realistic self-evaluation, inserting what you believe is your score for each listed criterion into the Learner Self-Evaluation column. This is an exercise in self-evaluation and critical reflection, and to ensure that you completed all sections, addressing all required criteria for that section.4. The scoring for the criteria ranges from a 0-3 as defined below. Complete a realistic and thoughtful evaluation of your work. Your chair and methodologist will also use the criterion tables to evaluate your work.5. Your Prospectus should be no longer than 6-10 pages when the tables are deleted.
ScoreAssessment
0Item Not Present
1Item is Present. Does Not Meet Expectations. Revisions are Required: Not all components are present. Large gaps are present in the components that leave the reader with significant questions. All items scored at 1 must be addressed by learner per reviewer comments.
2Item is Acceptable. Meets Expectations. Some Revisions May Be Required Now or in the Future. Component is present and adequate. Small gaps are present that leave the reader with questions. Any item scored at 2 must be addressed by the learner per the reviewer comments.
3Item Exceeds Expectations. No Revisions Required. Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions. No changes required.

Dissertation Prospectus

Introduction

Mental health is a major issue around the World. The United Nations (UN, 2015), has identified the issue as one of its Sustainable Development Goals. These are a collection of goals designed globally that aim to achieve a sustainable future for all. The UN expressed its uncertainty regarding the extent to which major social determinants of mental disorders are being addressed worldwide (WHO, 2015). Developing a conceptual framework will address the social determinants and align it with its sustainable development goals. This way it can systematically review the pieces of evidence about the social determinants and identify potential mechanisms and targets for interventions (Lund, et.al, 2018). According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Justice, millions of people suffer from mental illness in this country. The high numbers necessitate raising public awareness and start campaigning for a much better health care system (Hamilton.et.al, 2016). According to the National Alliance on Mental Health (2019), in 2018, 47.6 million people in the U.S. experienced mental illness which means 1 in every 5 adults. 11.4 million Adults between ages 25 and 35 had an episode of serious mental illness in the same year. In 2016, 7.7 million youths aged 6-17 experienced some sort of mental health disorder, while 9.2 million people were reported to have experienced substance use disorder (National Alliance on Mental Illness, 2019).

According to Kohn, et al (2018), there is an emphasis on the gap in mental health treatment in America when examined through the prevalence of mental health disorders, the use of mental health services, and the global burden of disease. Statistical data from community-based surveys of mental disorders in the various countries in America including Argentina, Brazil, Canada, Chile, and the United States, etc. were utilized. While 42.6% of children and adolescents in the US suffered mental illness, the treatment gap in this group was 64%. The need to address the issue of mental health has not been given enough attention resulting in the wide gap in treatment. Mental disorders in children can be corrected if detected early enough. Unfortunately, most of the caregivers do not have the skills to detect these disorders causing them to advance (Kohn et al, 2018).

According to Bowdoin et al (2018), a patient-centered medical home (PCMH) is a model meant for improving health outcomes while at the same time meant to contain the cost of care. In this study, I will examine the links between care provided inconsistent with the PCMH and healthcare services utilization as well as expenditures for non-aging citizens who are suffering from mental illness in the United States. 6908 non-aging adults suffering from mental illness participated in the 2007-2012 Medical Expenditure Panel Survey. Utilization of healthcare services was compared with expenditures on care consistent with the PCMH, other participants include a non-PCMH, usual source of care (USC), and participants without a USC. The outcome showed differences in utilization and expenditures between participants who were provided with care consistent with the PCMH and those who had a non-PCMH. USC showed no statistical importance for any healthcare services category. This research study will examine the factors according to mental health providers that influence an individuals’ decision to utilize mental health services in South Texas. This research will help us understand why individuals choose to or not to utilize mental health services in the state.

CriteriaLearner Self-Evaluation Score(0-3)Chair Evaluation Score(0-3)Reviewer Score(0-3)
IntroductionThis section briefly overviews the research focus or problem, why this study is worth conducting, and how this study will be completed.The recommended length for this section is two to three paragraphs.
1. Dissertation topic is introduced along with why the study is needed.
2. Provides a summary of results from the prior empirical research on the topic.
3. Using results, societal needs, recommendations for further study, or needs identified in three to five research studies (primarily from the last three years), the learner identifies the stated need, called a gap
4. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.
NOTE: This Introduction section elaborates on the Topic from the 10 Strategic Points This Introduction section provides the foundation for the Introduction section in Chapter 1 of the Proposal.
Reviewer Comments:

Background of the Problem

According to the Centers for Disease Control and Prevention (2018), mental health has become a significant public health issue in the United States that requires immediate attention. A mental disorder must be diagnosed at its early stages to avoid the advance effects of it progressing into adolescence (Kohn et al, 2018). According to Grayson (2018), there has been a notable difference in how patients utilize mental health services with patients that experience a high level of burden more likely to utilize mental health services. Similarly, the caregivers that experience serious signs of depression or anxiety in their child or adolescent will tend to use the services more than the caregivers who experience mild or no sign of depression or anxiety. The mental health status of the caregiver is of no significance and does not influence need and utilization (Grayson, 2016).

Misra et al (2017) in their article describe the concept relating to the use of complementary and alternative medicine (CAM) for mental health treatment among children in the Southern State Region. According to the authors, CAM use among US children stands at 12%. The Southern State Region has placed a lot of effort into improving the health care treatment of children. The services offered are directly proportional to the allocation provided. Research showed that some institutions have released a lot of funds to run this sector and that the Sothern State Region receives the second-largest allocation for mental health (Mista et al, 2017). Despite all these efforts, there still exists a gap between the treatment of mental health disorders in the US.

CriteriaLearner Self-Evaluation Score(0-3)Chair or Score(0-3)Reviewer Score(0-3)
Background of the ProblemThis section uses the literature to provide the reader with a definition and statement of the research gap and problem the study will address. This section further presents a brief historical perspective of when the problem started and how it has evolved over time.The recommended length for this section is two-three paragraphs.
1. Includes a brief discussion demonstrating how literature has established the gap and a clear statement informing the reader of the gap.2
2. Discusses how the “need” or “defined gap” has evolved historically into the current problem or opportunity to be addressed by the proposed study (citing seminal and/or current research).2
3. ALIGNMENT: The problem statement for the dissertation will be developed from and justified by the “need” or “defined gap” that is described in this section and supported by the empirical research literature published within the past 3-5 years.2
4. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.2
NOTE: This Background of the Problem section uses information from the Literature Review in the 10 Strategic Points . This Background of the Problem section becomes the Background of the Study in Note, this section develops the foundation for Chapter 1 in the Proposal. It is then expanded to develop the comprehensive Background to the Problem section and Identification of the GAP sections in Chapter 2 (Literature Review) in the Proposal .
Reviewer Comments:

Theoretical Foundations/Conceptual Framework and Review of the Literature/Themes

Theoretical literature

There is the need to understand the consequences of both effective utilization and non-utilization of mental health as it evolved historically. Mental health services in this Southern State have faced several challenges. Texas (2017) asserts that people suffering from mental illness still face problems despite the huge costs that are directed towards healthcare. Schwartz, (2017) in support of the Southern State Region argues that the increased growth-rate of populations in one specific county located in a Southern State has impacted the health sector at large. The high population together with economic constrains has led to few medical insurances which limit access to health. The access to and utilization of mental health care for the populations living in this county has created a gap within the State (Children at Risk, 2013).

Literature Themes

Review of the literature review identified the following themes:

· Lack of proper mental health education and infrastructure has been the major factor affecting the utilization of mental health. Goldman et al (2018) in their research found out that women who had been exposed to sexual abuse and drug abuse formed the high numbers of people who utilize mental health services among the Hispanic and non-white people in the county. Augsberger et al (2015) in support of this research argued that mental health services had been underutilized by Asian women living in this county, as a result of both cultural needs and mismatch of the services offered in the health facilities in this Southern State.

· Lack of medical insurance. Research has shown that many people due to poor economic status have left many people without health insurance as they cannot afford it. This limits many average and lower-class families from accessing mental illness services (Children at Risk, 2013).

· The poor perception among the community members. Researchers reveal that many people who live in this county perceive child mental illness as a mere sign of hunger besides poor diets. This has left many people neglecting the utilization of mental healthcare in the community (Children at Risk, 2013).

The theoretical model for this research gap is the Albert Bandura, Social Cognitive Theory. The Social Cognitive Theory: Examines the context of health promotion and disease prevention. It helps to describe how motivations in health and behaviors are influenced by the interaction of people’s beliefs, environment, and behaviors. It was advocated by famous psychologists Albert Bandura (Morin, 2019).

Major components of the theory concerning individual behavior change include:

· Self-efficacy: The belief that an individual has control over and can execute a behavior.

· Behavioral capability: Understanding and having the skill to perform a behavior.

· Expectations: Determining the outcomes of behavior change.

· Expectancies: Assigning a value to the outcomes of behavior change.

· Self-control: Regulating and monitoring individual behavior.

· Observational learning: Watching/observing outcomes of others’ performance or modeled behavior.

· Reinforcements: Promoting incentives and rewards that encourage behavior change (Eslami et al, 2018).

CriteriaLearner Self-Evaluation Score(0-3)Chair or Score(0-3)Reviewer Score(0-3)
Theoretical Foundations and/or Conceptual FrameworkThis section identifies the theory(s) or model(s) that provide the foundation for the research. This section should present the theory(s) or models(s) and explain how the problem under investigation relates to the theory or model. The theory(s) or models(s) guide the research questions and justify what is being measured (variables) as well as how those variables are related (quantitative) or the phenomena being investigated (qualitative).Review of the Literature/ThemesThis section provides a broad, balanced overview of the existing literature related to the proposed research topic. It describes the literature in related topic areas and its relevance to the proposed research topic findings, providing a short 3-4 sentence description of each theme and identifies its relevance to the research problem supporting it with at least two citations from the empirical literature from the past 3-5 years.The recommended length for this section is 1 paragraph for Theoretical Foundations and a bulleted list for Literature Themes section.
1. Theoretical Foundations section identifies the theory(s), model(s) relevant to the variables (quantitative study) or phenomenon (qualitative study). This section should explain how the study topic or problem coming out of the “need” or “defined gap” in the as described in the Background to the Problem section relates to the theory(s) or model(s) presented in this section. (One paragraph)1.5
2. Review of the Literature Themes section: This section is a bulleted list of the major themes or topics related to the research topic. Each theme or topic should have a one-two sentence summary.1.5
3. ALIGNMENT: The Theoretical Foundations models and theories need to be related to and support the problem statement or study topic. The sections in the Review of the Literature are topical areas needed to understand the various aspects of the phenomenon (qualitative) or variables/groups (quantitative) being studied; to select the design needed to address the Problem Statement; to select surveys or instruments to collect information on variables/groups; to define the population and sample for the study; to describe components or factors that comprise the phenomenon; to describe key topics related to the study topic, etc.1.5
4. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.1.5
NOTE: The two parts of this section use information about the Literature Review and Theoretical Foundations/Conceptual Framework from the 10 Strategic Points.This Theoretical Foundations section is expanded upon to become the Theoretical Foundations section in Chapter 2 (Literature Review). The Theoretical Foundations and the Literature Review sections are also used to help create the Advancing Scientific Knowledge / Review of the Literature section in Chapter 2 (Literature Review).
Reviewer Comments:

Problem Statement

It is not known what influences an individual’s decision to or not to utilize mental health services in the United States. It is not known how mental health providers describe the factors influencing individuals’ decision to utilize mental health services. There are increasing mental health cases among the children in the country, this research seeks to identify the key issues that prevent the people of this country from utilizing the mental health services and facilities.

CriteriaLearner Self-Evaluation Score(0-3)Chair or Score(0-3)Reviewer Score(0-3)
Problem StatementThis section includes the problem statement, the population affected, and how the study will contribute to solving the problem.The recommended length for this section is one paragraph.
1. States the specific problem proposed for research with a clear declarative statement.1.5
Describes the population of interest affected by the problem. The general population refers to all individuals that could be affected by the study problem.1.5
Describes the unit of analysis.For qualitative studies this describes how the phenomenon will be studied. This can be individuals, group, or organization under study.For quantitative studies, the unit of analysis needs to be defined in terms of the variable structure (conceptual, operational, and measurement).1.5
Discusses the importance, scope, or opportunity for the problem and the importance of addressing the problem.1.5
The problem statement is developed based on the need or gap defined in the Background to the Study section.2
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.1.5
NOTE: This section elaborates on the Problem Statement from the 10 Strategic Points. This section becomes the foundation for the Problem Statement section in Chapter 1 and other Chapters where appropriate in the Proposal.
Reviewer Comments:

Purpose of the Study

The purpose of this qualitative descriptive study is to examine how mental health providers describe the factors influencing individuals’ decision to utilize mental health services in South Texas. The study aims to come with the factors that either influence or deter the people in the State from accessing much-needed mental healthcare. The study will employ a qualitative study that will target mental health providers within the State who are service providers that care for the mentally challenged and compare factors impacting utilization and non-utilization of mental services available in the State. The study will make a recommendation on how to improve the mental health accessibility in the State. It identified multiple factors that are associated with both the utilization and under-utilization of specialty mental health services among the people living in the State such as delays in observing and recognizing the symptoms and how to seek help, the absence of appropriate mental health providers, and lack of health insurance.

CriteriaLearner Self-Evaluation Score(0-3)Chair or Score(0-3)Reviewer Score(0-3)
PURPOSE OF THE STUDYThis section reflects what the study is about, connecting the problem statement, methodology & research design, target population, variables/phenomena, and geographic location.The recommended length for this section is one paragraph.
1. Begins with one sentence that identifies the research methodology and design, target population, variables (quantitative) or phenomena (qualitative) to be studied and geographic location.1.5
Quantitative Studies: Defines the variables and relationship of variables.Qualitative Studies: Describes the nature of the phenomena to be explored.1.5
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.1.5
NOTE: This section elaborates on information in the Purpose Statement from the 10 Strategic Points. This section becomes the foundation for the Purpose of the Study section in Chapter 1 and other Chapters where appropriate in the Proposal.
Reviewer Comments:

Research Questions

The following research questions will help to guide this qualitative study:

· RQ1: How do mental health providers describe the influence of self-efficacy on individuals’ decisions to utilize mental health services?

· H1: Self-efficacy influences individuals’ decision to utilize mental health services.

· RQ2: How do mental health providers describe the influence of behavioral capacity on individuals’ decision to utilize mental health services?

· H2: Behavioral capacity influences individuals’ decision to utilize mental health services.

· RQ3: How do mental health providers describe the influence of expectations on individuals’ decisions to utilize mental health services?

· H3: Expectations influence individuals’ decisions to utilize mental health services.

CriteriaLearner Self-Evaluation Score(0-3)Chair Score(0-3)Reviewer Score(0-3)
Research Question(s) and/or Hypotheses· The recommendation is a minimum of two research questions along with related hypotheses and variables is required for a quantitative study.· Also recommended is a minimum of two research questions along with the phenomenon description is required for a qualitative study.· Put the Research Questions in the appropriate Table in Appendix B based on whether the study is qualitative or quantitative.The recommended length for this section is a list of research questions and associated hypotheses (quantitative)
1. Qualitative Studies: States the research question(s) the study will answer and describes the phenomenon to be studied.Quantitative Studies: States the research questions the study will answer, identifies and describes the variables, and states the hypotheses (predictive statements) using the format appropriate for the specific design and statistical analysis.2
Alignment: The research questions are based on both the Problem Statement and Theoretical Foundation model(s) or theory(s). There should be no research questions that are not clearly aligned to the Problem Statement.2
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.2
NOTE: This section elaborates on the information about Research Questions) Hypothesis/variables or Phenomena from the 10 Strategic Points . This section becomes the foundation for the Research Question(s) and/or Hypotheses section in Chapter 1 in the Proposal .
Reviewer Comments:

Advancing Scientific Knowledge and Significance of the Study

The results of this research will add considerably to the results of other studies as it provides means by which prevention and intervention efforts will help to raise mental health awareness and the importance of utilizing mental health services among Americans as well as offer culturally sensitive services. The result would direct efforts and focus on reducing the stigma that is associated with mental health problems in the minds of most people (Morin and Cherry, 2019). Besides, the results will help, and be of value to practitioners in determining the necessary strategies to be used to allow more individuals to receive the necessary health care services that they require. It will also help in eliminating the individualized beliefs that tie people from getting the public services they ought to and thus help them be more responsive to the services which are available to them.

Similarly, the result will enhance knowledge of social learning theory through observation and modeling as they both play significant and primary roles in this process, which moves far and beyond Albert Bandura’s behavioral theory, which suggests that all behaviors can or are learned through conditioning, and cognitive theories. Bandura’s social learning theory also proposed that learning also exist or develop simply by observing the actions of others (Morin and Cherry, 2019). Therefore, a learning condition like this may be used in explaining different behaviors, including those factors influencing individuals’ decision to either utilize or not utilize mental health.

CriteriaLearner Self-Evaluation Score(0-3)Chair Score(0-3)Reviewer Score(0-3)
ADVANCING SCIENTIFIC KNOWLEDGE and SIGNIFICANCE OF THE STUDYThis section reiterates the gap or need in the literature and states how the study will address the gap or need and how the research will contribute to the literature, practical implications to the community of interest, and alignment with the program of study.The recommended length for this section is one to two paragraphs, providing a brief synopsis of each criteria listed below which will be expanded in the proposal.
1. Clearly identifies the “gap” or “need” in the literature that was used to define the problem statement and develop the research questions. (citations required)2
Describes how the study will address the “gap” or “identified need” defined in the literature and contribute to /advance the body of literature. (citations required)2
Describes the potential practical applications from the research. (citations required)2
Identifies and connects the theory(ies) or model(s) that provide the theoretical foundations or conceptual frameworks for the study. (citations required)2
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.2
NOTE: This section builds on information about the Literature review and Theoretical Foundations sections in the 10 Strategic Points. This section becomes the foundation for the Theoretical Foundations section in Chapter 2
Reviewer Comments:

Rationale for Methodology

The most appropriate methodology that will be used in answering the research questions, and which will also address the problem statement is a qualitative methodology (Colorafi and Evans, 2016). The qualitative approach is very effective when a phenomenon that is being queried is properly and effectively defined, and this study has distinctly defined the phenomena of factors influencing the behavior and choices of people in a natural environment to utilize or not utilize Mental Health. The methodology is preferred as it is flexible when researching health science topics to support various medical theories. This will support the research in finding and filling the gap in the study. This methodology was adopted because it will help to provide real-life pieces of evidence from the interview with participants. The literature has determined the causes of the low utilization of mental health in the South to include limitations to accessing health care. It also identified other barriers to specialty mental health care utilization (Augsberger et al, 2015).

· Interviews and Questionnaires will be used to gather accurate information

· Data will be obtained to determine the health-seeking behavior and mental health patients/services in the State

CriteriaLearner Self-Evaluation Score(0-3)Chair or Score(0-3)Reviewer Score(0-3)
Rationale for MethodologyThe Rationale for Methodology section clearly justifies the methodology the researcher plans to use for conducting the study. It argues how the methodological choice (quantitative or qualitative) is the best approach to answer the research questions and address the problem statement. Finally, it contains citations from textbooks and articles on research methodology and/or articles on related studies to provide evidence to support the argument for the selected methodology.The recommended length for this section is one paragraph.
1. Identifies the specific research methodology for the study.2
Justifies the methodology to be used for the study by discussing why it is an appropriate approach for answering the research question(s) and addressing the problem statement.Quantitative Studies: Justify in terms of problem statement and the variables for which data will be collected.Qualitative Studies: Justify in terms of problem statement and phenomenon.2
Uses citations from seminal (authoritative) sources (textbooks and/or empirical research literature) to justify the selected methodology. Note: Introductory or survey research textbooks (such as Creswell) are not considered seminal sources.2
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.2
NOTE: This section elaborates on the Methodology and Design in the 10 Strategic Points. This section becomes the foundation for the Research Methodology in Chapter 1 of the Proposal and the basis for developing Chapter 3, Research Methodology.
Reviewer Comments:

Nature of the Research Design for the Study

The design for this piece of research work will be a qualitative descriptive study that will collect information from service providers in the State, which is aimed at identifying the specific issues that are deterring the utilization of mental healthcare facilities in this South. Qualitative descriptive is the most appropriate design selected because it helps to describe how mental health providers and mental health professionals the factors influencing individuals’ decision to utilize mental health services. (Kim et al., 2017) This method is also justified as it applies the description of the factors in play and how they affect the outcome. According to Kim et al (2017), qualitative-descriptive research is descriptive and helps in describing a natural phenomenon. This method is suitable in research as it will describe factors limiting the utilization of mental healthcare in the county. Literature also supports the fact that issues of underutilized mental health resources and non-institutionalized adults are a behavioral risk factor in the South (Hamilton et al, 2016).

After analysis of the population group, 12 Mental Health Providers were determined to suffice as a sample group. The respondents will be chosen among the mental health providers with a membership of the Mental Health Association in South Texas, which will include focus groups of service providers’ that will form the sample population. The study area for the research will be caregivers, psychiatrists, and therapists’ offices, and counseling facilities within the State. A structured system of interviews with a minimum of 120 questionnaires and 40 mental health providers, will be used as the primary source of data. The data will be collected in three weeks with each respondent given 30 minutes for the interview and filing the questionnaire. Data will be collected for the study using interviews and questionnaires. Notes will be taken; interviews will be tape-recorded and documented properly. Mental health providers with membership in Mental Health Associations will be the main participants in the study based on 5 years’ experience and the willingness to be interviewed. Providers would be selected to complete questionnaire forms that will include basic demographic questionnaire, which will be used based on their experiences.

A consent form will be sent and obtained with signatures. The selected participants will submit the consent forms and complete the interview using Zoom. Data will be collected using a Google Form. Mental health providers/participants’ names will be removed from the data. Descriptive statistics will be used in summarizing the acquired data. Coding will be used to address questions posed and the transcribed interviews and coded data will also be stored on a backup USB thumb drive. Data will remain stored on the researcher’s computer with the password encrypted.

Criterion ScoreLearner Self-Evaluation Score(0-3)Chair or Score(0-3)Reviewer Score(0-3)
Nature of the Research Design for the StudyThis section describes the specific research design to answer the research questions and why this approach was selected. Here, the learner discusses why the selected design is the best design to address the problem statement and research questions as compared to other designs. This section contains a description of the research sample being studied, as well as, the process that will be used to collect the data on the sample.The recommended length for this section is two to three paragraphs and must address each criterion.
1. Identifies and describes the selected design for the study.2
Justifies why the selected design addresses the problem statement and research questions.Quantitative Studies: Justifies the selected design based on the appropriateness of the design to address the research questions and data for each variable.Qualitative Studies: Justifies the selected design based on appropriateness of design to address research questions and study the phenomenon.1
Briefly describes the target population and sample for the study.2
Identifies the sources and instruments that will be used to collect data needed to answer the research questions.1
Briefly describes data collection procedures to collect data on the sample.2
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.2
NOTE: This section also elaborates on the Design portion of the Methodology and Design section in the 10 Strategic Points This section provides the foundation for Nature of the Research Design for the Study in Chapter 1.
Reviewer Comments:

Sources of Data

The interview will utilize structured questionnaires developed by the researcher to uncover the phenomena at hand in addition to face-face interviews for the research that will be structured with questions that require answers on the reasons that causes people to utilize mental health services as well as the hesitation in receiving treatment among the individuals who require mental health treatment. The initial collection of data would involve getting a list of mental health providers who are members of Mental Health Organizations including:

· Mental Health America (MHA)

· National Institute of Mental Health (NIMH)

· National Alliance on Mental Health (NAMI)

· National Institute of Environmental Health Sciences (NIEHS)

Providers would be selected to complete questionnaire forms that include basic demographic questionnaire, which will be based on their experiences. Tools will be used in collecting primary data, while the selected group will be composed of service providers. A tape-recorded analysis will also be used within the focus groups. Furthermore, the research will take note of the factors that providers think can improve the mental health accessibility in the State.

Criterion ScoreLearner Self-Evaluation Score(0-3)Chair or Score(0-3)Reviewer Score(0-3)
RESEARCH MATERIALS, INSTRUMENTATION, OR SOURCES OF DATAThis section identifies and describes the types of data that will be collected, as well as the specific research materials, instruments, and sources used to collect those data (tests, surveys, validated instruments, questionnaires, interview protocols, databases, media, etc.).The recommended length for this section is one to two paragraphs. Note: this section can be set up as a bulleted list.
Quantitative- Instruments/Research Materials:Provides a bulleted list of the instrumentation and/or materials for data collection.Describes the survey instruments or equipment/materials used (experimental research) and specifies the type and level of data collected with each instrument.Includes citations from original publications by instrument developers (and subsequent users as appropriate) or related studies.1
Qualitative – Sources of Data:Describes the structure of each data collection instrument and data sources (tests, questionnaires, interview protocols, observations databases, media, etc.).1
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.1
NOTE: This section elaborates on the Data Collection from the 10 Strategic Points.This information is summarized high level in Chapter 1 in the Proposal in the Nature of the Research Design for the Study section. This section provides the foundation for Research Materials, Instrumentation (quantitative) or Sources of Data (qualitative) section in Chapter 3.
Reviewer Comments:

Data Collection

The data collection process will be as follows:

· The process will begin by writing a letter to the dean to get permission.

· After the IRB committee gives its approval for the project to begin, participants will be selected. The study sample is set to include caregivers, service providers, psychiatrists, therapists, school counselors and members of the community.

· Data collection will only start after candidates must have acknowledged and signed the consent form. Furthermore, the dissertation will collect information from a selected group of providers to provide primary data.

· We will communicate with the sample group and allocate everyone specified time that they are free and then will follow up to ensure that all the sample members are included. Moreover, the researcher will ensure that the providers who are to receive questionnaires are directly contacted to make sure that they receive and fill out the questionnaire then send them back.

· It will be collected systematically in a way that begins with interviewing the service providers. The process will be as follows:

· Respondents will be 12 mental health providers given questionnaires to fill.

· Interviews will involve 12 respondents from within the State.

· Respondents will respond to both interviews and the questionnaires.

· Manual coding will be done to all collected data.

· Data will be checked for any errors by both parties before further processing.

· Data will be entered into SciLab for analysis.

CriteriaLearner Self-Evaluation Score(0-3)Chair or Score(0-3)Reviewer Score(0-3)
DATA COLLECTION AND MANAGEMENTThis section details the data collection process and procedures so that another researcher could conduct or replicate the study. It includes authorizations and detailed steps.The recommended length for this section is a bullet or numbered list of data collection steps that should not exceed one page.
Quantitative Studies: Lists steps for the actual data collection that would allow replication of the study by another researcher, including how each instrument or data source was used, how and where data were collected, and recorded. Includes a linear sequence of actions or step-by-step of procedures used to carry out all the major steps for data collection. Includes a workflow and corresponding timeline, presenting a logical, sequential, and transparent protocol for data collection that would allow another researcher to replicate the study.Data from different sources may have to be collected in parallel (e.g., paper-and-pen surveys for teachers, corresponding students, and their parents AND retrieval of archival data from the school district). A flow chart is ok—”linear” may not apply to all situationsQualitative Studies: Provides detailed description of data collection process, including all sources of data and methods used, such as interviews, member checking, observations, surveys, field tests, and expert panel review. Note: The collected data must be sufficient in breadth and depth to answer the research question(s) and interpreted and presented correctly, by theme, research question, and/or source of data.2
Describes the procedures for obtaining participant informed consent and for protecting the rights and well-being of the study sample participants.2
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.2
NOTE:This section elaborates on the Sample and Location and Data Collection in the 10 Strategic Points This section provides the foundation for the Data Collection Procedures section in Chapter 3 in the Proposal. And it is summarized high level in Chapter 1 in Nature of the Research Design for the Study in the Proposal.
Reviewer Comments:

Data Analysis Procedures

Data analysis will be conducted using descriptive statistics, followed by its transcription from the tape recorder, then the analysis will be performed based on interviews and focus groups. Data collected will first be manually coded with the themes of the study. The coded themes will then be analyzed, and explanations are given. The overall aim of the analysis will be to find factors influencing individuals’ decision to not utilize Mental Health in one Southern State County. At the initial starting stage, individual interviews will be conducted, recorded and transcribed verbatim. This will be followed by the researcher repeatedly reading and listening to the content to get familiarized with it. As such, the researcher will be able to gain deeper and better familiarization with the contents; he or she will also identify the answers to those questions asked as well as identify the themes. The researcher will use the two theories selected to see if the themes from the interviews align with the theoretical framework.

· Data will be collected and analyzed for the study.

· Descriptive statistics will be used in summarizing the acquired data.

· Coding will be used to address the questions posed.

· A narrative summary will be developed.

Descriptive Statistics

· demographic information

· years of experience

Thematic Analysis

The researcher may choose to adopt the process notes and MAXDQA in organizing and visualizing data. According to Braun and Clarke (2006), the following six-step thematic analysis process is effective in identifying the relevant patterns in data.

· Stage 1: Get familiarized with the data: the researcher is expected to already get familiarized with the contents of the research and have a better understanding of it. This is because the researcher is the individual that will collect the data.

· Stage 2: Generate first codes regarding the significant ideas discovered in the data. Identifications of data and combining pertinent data relating to each code

· Stage 3: This stage allows the researcher to start the search for themes through analysis and a review of the codes and to understand those that can be developed into acceptable themes.

· Stage 4: Reviewing and refining the themes and determining if there are any of them that need to be removed, combined, or if they can be broken down into additional themes.

· Stage 5: Define and name the themes after refining them.

· Phase 6: Generate the final report by the researcher.

Once the researcher is familiar with the data by reading through the data and looking for patterns, he will develop a detailed description of the phenomenon from the synthesis of the data

CriteriaLearner Self-Evaluation Score(0-3)Chair or Score(0-3)Reviewer Score(0-3)
DATA ANALYSIS PROCEDURESThis section provides detailed steps for the analytic procedures to be used to conduct data analysis.The recommended length for this section is one to two paragraphs, can also be presented in bulleted format.
Describes in detail the relevant data collected for each stated research question and/or each variable within each hypothesis (if applicable).Quantitative Studies: “In detail” means scales (and subscales) of specified instruments AND type of data for each variable of interest. IMPORTANT: For (quasi) experimental studies, provide detailed description of all treatment materials per treatment condition, as part of the description of the independent variable corresponding to the experimental manipulation.2
What: Describes, in detail, statistical and non-statistical analysis to be used and procedures used to conduct the data analysis.Quantitative Studies: (1) describe data file preparation (descriptive statistics used to check completeness and accuracy; for files from different sources, possibly aggregating data to obtain a common unit of analysis in all files, necessarily merging files (using the key variable defining the unit of analysis); (2) computation of statistics for the sample profile; (3) computation of (subscales and) scales; (4) reliability analysis for all scales and subscales; (5) computation of descriptive statistics for all variables of interest in the study (except those already presented in the sample profile); (6) state and justify all statistical procedures (“tests”) needed to generate the information to answer all research questions; and (7) state assumptions checks for all those statistical procedures (including the tests and / or charts to be computed).Qualitative Studies: This section begins by identifying and discussing the specific analysis approach or strategy, followed by a discussion of coding procedures to be used. Note: coding procedures may be different for Thematic Analysis, Narrative Analysis, Phenomenological Analysis, or Grounded Theory Analysis.2
Why: Provides the justification for each of the (statistical and non-statistical) data analysis procedures used in the study.2
Show Steps that Support EvidenceQuantitative Analysis – states the level of statistical significance for each test as appropriate and describes tests of assumptions for each statistical test.Qualitative Analysis – evidence of qualitative analysis approach, such as coding and theming process, must be completely described and included the analysis /interpretation process. Clear evidence from how codes moved to themes must be presented.2
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.2
NOTE: This section elaborates on the Data Analysis from the 10 Strategic Points . This section provides the foundation for Data Analysis Procedures section in Chapter 3 in the Proposal.
Reviewer Comments:

Ethical Considerations

Before the commencement of the study, I will seek authorization from all the relevant bodies including the IRB for approval. The research will also seek authority from the University board for conducting the research. All the data collected will be purely used for research purposes and remain confidential. The data will remain free to withdraw from respondents from the study. No personal name or organizational names that may bring conflict of interest in the research will be included. The research will remain in the custody of the University will all rights reserved. Additionally, only relevant data will be collected by the researcher, solely for the study. He or she must stay clear of any subjectivity in analyzing the data and must also be proactive at preventing anything that will be harmful to the participants.

CriteriaLearner Self-Evaluation Score(0-3)Chair or Score(0-3)Reviewer Score(0-3)
Ethical ConsiderationsThis section discusses the potential ethical issues surrounding the research, as well as how human subjects and data will be protected. It identifies how any potential ethical issues will be addressed.The recommended length for this section is one paragraph.
1. Describes site authorization process, subject recruiting, and informed consent processes.2
2. Describes how the identities of the participants in the study and data will be protected.2
3. Discusses potential ethical concerns that might occur during the data collection process.2
4. ALIGNMENT: Ethical considerations are clearly aligned with and relate directly to the specific Data Collection Procedures. This section also identifies ethical considerations related to the target population being researched and organization or location as described in the Purpose Statement section.2
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.2
NOTE: This section does not include information from any of the 10 Strategic Points .This section provides the foundation for Ethical Considerations section in Chapter 3 in the Proposal.
Reviewer Comments:

References

Augsberger, A., Yeung, A., Dougher, M., & Hahm, H. C. (2015). Factors influencing the underutilization of mental health services among Asian American women with a history of depression and suicide. BMC health services research15(1), 542. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-1191-7

Blosnich, J. R., Marsiglio, M. C., Gao, S., Gordon, A. J., Shipherd, J. C., Kauth, M., … & Fine, M. J. (2016). Mental health of transgender veterans in US states with and without discrimination and hate crime legal protection. American journal of public health, 106(3), 534-540. https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.302981

Bowdoin, J. J., Rodriguez-Monguio, R., Puleo, E., Keller, D., & Roche, J. (2018). The patient-centered medical home model: Healthcare services utilization and cost for non-elderly adults with mental illness. Oxfordshire,: Routledge. doi:10.1080/09638237.2017.1385744

Centers for Disease Control and Prevention (2018). Mental health: Data and Publications. Retrieved from https://www.cdc.gov/mentalhealth/data_publications/index.htm

Children at Risk (2013), Fort Bend County Assessment, A Report on the Needs of the Community’s Children, The George Foundation and The Fort Bend Chamber of Commerce, pp. 23.

Children at Risk: The Future of Fort-Bend’s Children 2012-2014. Retrieved from http://www.thegeorgefoundation.org/media/resources/future-of-fort-bends-children-report-2014.pdf

Colorafi, K. J., & Evans, B. (2016). Qualitative descriptive methods in health science research. HERD: Health Environments Research & Design Journal, 9(4), 16-25.

De Luca, S. M., Blosnich, J. R., Hentschel, E. A., King, E., & Amen, S. (2016). Mental health care utilization: How race, ethnicity and veteran status are associated with seeking help. Community mental health journal52(2), 174-179. https://link.springer.com/article/10.1007/s10597-015-9964-3

Eslami, A. A., Norozi, E., Hajihosseini, M., Ramazani, A. A., & Miri, M. R. (2018). Social cognitive theory as a theoretical framework to predict sustained abstinence 6 months after substance use treatment. Philadelphia, Pennsylvania: Taylor & Francis Ltd. doi:10.1080/14659891.2017.1394382

Grayson, H. C. (2016). Caregiver impact on the relationship between need and utilization for child and adolescent mental health: An examination of factors influencing utilization of mental health services Available from ProQuest Central Student. Retrieved from https://search.proquest.com/docview/1840134079

Hamilton, J. E., Desai, P. V., Hoot, N. R., Gearing, R. E., Jeong, S., Meyer, T. D., … & Begley, C. E. (2016). Factors associated with the likelihood of hospitalization following emergency department visits for behavioral health conditions. Academic Emergency Medicine23(11), 1257-1266. https://onlinelibrary.wiley.com/doi/full/10.1111/acem.13044

Kim, Sefcik, & Bradway (2017): Staying focused on non-treatment seekers) Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6552680/

Kohn, R., Ali, A. A., Puac-Polanco, V., Figueroa, C., López-Soto, V., Morgan, K., . . . Vicente, B. (2018). Mental health in the Americas: An overview of the treatment gap. Revista Panamericana De Salud Publica = Pan American Journal of Public Health, 42, e165. doi:10.26633/RPSP.2018.165

Lund, C., Brooke-Sumner, C., Baingana, F., Baron, E. C., Breuer, E., Chandra, P., . . . Saxena, S. (2018). Social determinants of mental disorders and the sustainable development goals: A systematic review of reviews. The Lancet Psychiatry, 5(4), 357-369. doi:10.1016/S2215-0366(18)30060-9

Mental Health America (2020). The U.S. Mental Health History. Retrieved from https://www.mhanational.org/our-history

Morin, A. & Cherry, K. (2019). How Social Learning Theory Works. Retrieved from https://www.verywellmind.com/social-learning-theory-2795074

Schwartz, A. (2017). A report on the demographic changes and changing needs of fort bend county University

Wang, N., & Xie, X. (2019). Associations of health insurance coverage, mental health problems, and drug use with mental health service use in US adults: An analysis of 2013 national survey on drug use and health. Oxfordshire, : Routledge. doi:10.1080/13607863.2018.1441262

Appendix A10 Strategic PointsMy Degree: Ph.D.Program Emphasis: Industrial & Organizational PsychologyTen Strategic PointsComments or FeedbackBroad Topic Area Final TopicFactors Affecting Utilization of Mental Health in Southern TexasFactors Influencing Individuals’ Decision to Utilize Mental Health in South TexasLit Review(Theoretical Framework (Theory)GapsThemesAll CitationsGapsA. De Luca, Blosnich, Hentschel, King, & Amen (2016). The authors indicate that mental health has emerged as one of the critical areas of focus in recent times, and for a long time, it had been sidelined. However, with the realization that most health conditions are related in one way or another to a mental disorder, this area is now been studied extensively, and more attention has been given to patients.B. Mental health professionals point to insufficient mental healthcare resources in the United States as one of the major factors contributing to the rising suicide rate in the country. Nevertheless, these professionals noted that emergency providers paly major role at forefront of the problem and may also play significant role in its prevention. The experts reiterated the necessity for providers to possess the skills required for managing patients at lower suicide risk levels, especially in settings in which such patients do not enough access to behavioral healthcare providers and that the providers need to be accustomed to suicide risk, especially when there are widely publicized high-profile instances of suicide.https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=131266532&site=eds-live&scope=site.C. According to Kohn, et. al, (2018), emphasize the gap in mental health treatment in the American Region when examined through the prevalence of mental health disorders, use of mental health services, and the global burden of disease. Statistical data from community-based surveys of mental disorders in the various countries in America including Argentina, Brazil, Canada, Chile, and the United States etc. were utilized. The World Mental Health Survey published data were used in estimating professional the treatment gap. For Canada, Chile, and Guatemala, the treatment gap was calculated from data files. The mean, median, and weighted treatment gap, and the 12-month prevalence by severity and category of mental disorder were estimated for the general adult, child-adolescent, and indigenous populations. Disability-adjusted Life Years and Years Lived with Disability were calculated from the Global Burden of Disease study. Mental and substance use disorders accounted for 10.5% of the global burden of disease in the Americas (Kohn, Ali, Puac-Polanco, Figueroa, López-Soto, Morgan, & Vicente, 2018).D. Wang, & Xie, (2019) Emphasizes the need to eliminate the prevalence of mental health service utilization among many adults in the United States. The authors examined the links between mental health service utilization, health insurance coverage, mental health problems and drug abuse, and the health disparities among communities. In 2013. the authors in conjunction with the National Survey on Drug Use and Health performed a research with 37,424 adults’ respondents, with the outcome that only 5,434 adults were receiving mental health services. The outcome of the research indicated statistics of overall prevalence of mental health services utilization to be around 15%, with the female and the aging population experiencing major depressive episodes, serious psychological distress, and illicit drug or alcohol abuse/dependence were positively associated with mental health service use. Insured African Americans, Asians and Hispanics, and married were negatively associated with mental health service utilization. Adults with varying types of insurances having disparities in accessing mental health services. (Wang, & Xie, 2019).Theoretical FoundationThe theoretical framework for this research study is the Albert Bandura’s Social Cognitive Theory, which examines the context of health promotion and disease prevention. It helps to describe how motivations in health and behaviors are influenced by the interaction of people’s beliefs, environment, and behaviors (Morin, 2019).Literature ReviewA. Empathic Approach: Emphasized the issues of utilized and underutilized mental health resources and non-institutionalized adults as behavioral risk factors in Southern Texas. Mental health professionals point to insufficient mental healthcare resources in the United States as one of the major factors contributing to the rising suicide rate in the country. Nevertheless, these professionals noted that emergency providers play major roles at the forefront of the problem and may also play significant roles in its prevention. The experts reiterated the necessity for providers to possess the skills required for managing patients at lower suicide risk levels, especially in settings in which such patients do not enough access to behavioral healthcare providers and that the providers need to be accustomed to suicide risk, especially when there are widely publicized high-profile instances of suicide. (Morrisville, North Carolina: AHC Media LLC, 2018).Professional Development:Job Satisfaction: Mental health has recently emerged as a critical area of interest as it had been sidelined for years. Due to this realization, the illness is now been studied extensively, and more attention has been given to patients. It has been suggested that most of the chronic conditions and terminal illnesses lead to mental disorders in patients. For many reasons, mental health is now among the priorities of medical practice (De Luca et.al. 2016).Problem StatementIt is not known how mental health providers describe the factors influencing individuals’ decision to utilize mental health servicesResearch QuestionsRQ1: How do mental health providers describe the influence of self-efficacy on individuals’ decision to utilize mental health services?RQ2: How do mental health providers describe the influence of behavioral capacity on individuals’ decision to utilize mental health services?RQ3: How do mental health providers describe the influence of expectations on individuals’ decision to utilize mental health services?PopulationTarget PopulationSample· Location – Southern, Texas. USA· Target Population:· Mental Health providers with membership of Mental Health Association in South Texas· Behavioral Hospitals· Psychiatrists· TherapistsSample:· The sample will be in South Texas of the United States· Out of a population of 12 Mental Health Providers· Questionnaire: Minimum of 120· Interviews: Minimum of 40 Mental Health providers.Describe Phenomena (qualitative) or Define Variables/Hypotheses (quantitative)To understand why the people living in Southern Texas are not effectively utilizing mental health services· There is a high rate of mental health conditions in Southern Texas· Individuals living in South Texas utilizes very low budget allocation on funding of mental health care· Cost is a factor impacting the population’s utilization of mental health servicesMethodology & DesignQualitative Descriptive StudyPurpose StatementThe purpose of this qualitative descriptive study is to examine how mental health providers describe the factors influencing individuals’ decision to utilize mental health services in South TexasData Collection ApproachMental health providers with membership in Mental Health Associations will be the main participants in the study based on 5 years’ experience and the willingness to be interviewed· Visits to mental health providers· Informed & signed consent will be obtained from participants· Interview with mental health providers recorded on tape· Sampling Method: Purposeful Sampling· Sources: Interviews & Questionnaires: Notes will be taken; interviews will be tape recorded and documented properly· Data will be Collected using a Google form· Mental health providers/participants names will be removed from the data· Data will remain stored on the researcher’s computer with password encrypted.Data Analysis ApproachDescriptive Statisticsdemographic informationyears of experienceAccording to Braun and Clarke (2006), the following procedures are recommended for thematic analysis:· Ensure that researcher is familiar with the data by reading through the data and looking for patterns· Followed by the researcher beginning coding through identifications of the data and combining pertinent data that relates to each code· Data will be collected and analyzed for the study.· Descriptive statistics will be used in summarizing acquired data.· Coding will be used to address questions asked and the transcribed interviews and coded data will be stored on a backup USB thumb drive· A narrative summary will be developed.Appendix CDemographics of the participantsSample Population12 Mental Health Providers in United StatesQuestionnaireMinimum of 120InterviewsMinimum of 40 Mental Health providers in the South