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Frailty, Home Accessibility, and Falls in Later Life
No full textAs more people remain in their homes as they age, the risk of living at home with frailty and reduced function increases, which may also increase the risk for falls in the home. The scientific literature shows that frail people are more likely to experience falls, which leads to many negative outcomes, such as hospitalization, placement in a skilled nursing facility, and even death. The preference to age-in-place (AIP) is more likely to be met if older people live in accessible housing. Accessible homes may mitigate the risk for falls and promote AIP, especially among frail older people.
While there has been research on the association between frailty and falls, we do not yet know the potential significance of home accessibility as a moderator within longitudinal frameworks, nor do we know much about the trajectories of frailty and falls in the context of the accessibility of the home over time. Falls in the home could be due, in part, to a non-accessible home environment. Misalignment between internal competence, represented by frailty, and environmental press, as measured by home accessibility, may offer insights into in-home falls over time for community-dwelling older people.
The study sample for this dissertation included all National Health and Aging Trends Study respondents who were residing in their homes at the time of the 2011 interview. Subsequent rounds of observations from this cohort, from 2012 through 2020, were merged to create a respondent-round dataset. This allowed a trajectory analysis tracking the same individuals over time. The main analytic strategy included testing hypotheses using weighted logistic regression models in a multilevel modeling framework.
Hypothesis 1 tested the association between frailty and falling in the home, and this hypothesis was supported by the current study. There results showed that as compared to respondents with no frailty, respondents with more frailty had higher odds ratios of experiencing a fall in the next year. When this growth trajectory is graphed, we can also see that as age increases, the risk of falling increases, and it is consistently higher as levels of frailty increase. Hypothesis 2 tested the association between accessibility of the home and falling in the home and this hypothesis was not supported in the current study. The third hypothesis tested whether home accessibility moderated the relationship between frailty and experiencing a future fall. In other words, this study addressed the question of whether there was positive relationship between frailty and a future in-home fall higher for older people with higher levels of frailty living in less accessible homes as compared to those living in more accessible homes. This hypothesis was somewhat supported in that some of the interaction terms were significant.
The main practice and policy implications from the study findings are related to the first hypothesis. As age increased, the risk of frailty and falls increased. These findings supported clinical frailty assessments using the physical frailty phenotype. In clinical assessments, if an older person scores in the prefrail or frail category, they should be referred by health care providers to a falls risk reduction program, such as Medicaid’s CAPABLE or other programs that aim to reduce falls hazards
#Inmyhealingera: Black Women Creating New Narratives and Representations of Their Identities and Womanhood on Instagram
No full textThe global representation of Black women in media has historically centered trauma and has been shaped by controlling images and harmful stereotypes. With the emergence of Instagram over a decade ago, however, Black women have increasingly used digital platforms as sites of self-definition, healing, and resistance. Within this digital landscape, hashtags such as #InMyHealingEra have been widely adopted and repurposed by Black women to articulate narratives of self-transformation and healing. Social media has thus become a space where marginalized communities share vulnerable stories that address embodied and generational trauma. For Black women, these narratives are grounded in an intersectional framework that recognizes how race, gender, culture, immigration, sexuality, and spirituality shape experiences of both oppression and healing. This study centers intersectional and embodied understandings of trauma by examining how Black women content creators engage holistic healing practices that attend to mental, emotional, physical, and spiritual well-being. The research draws on digital narratives curated by African American and Haitian women creators, acknowledging cultural and national differences while recognizing their shared racialization and exposure to the burdens of Black womanhood. Through intentional digital storytelling practices, including photos, videos, text, and audio, these content creators create new narratives of identity and womanhood that challenge dominant stereotypes such as the strong Black woman and poto mitan archetypes. Their stories operate as decolonial interventions, emphasizing that Black women are not monolithic and can be vulnerable, joyful, soft, and deserving of support and care. Grounded in digital Black feminist theory and praxis, this research explores how Black women use digital storytelling to disrupt stereotypes, address embodied and generational trauma, and mobilize collective healing. It argues that Black women’s vulnerability on social media is not merely a personal act of self-care but a political practice that reclaims narrative power and reshapes dominant understandings of Black womanhood
“TAG, YOU’RE IT!”: Catalyzing Latino Success Through a Latino-Centered College Access Program in Boston
No full textThis mixed-methods case study examined the impact on Latino students of a Latino-centered college access program, the Talented and Gifted (TAG) Latino Program, based at Boston’s only public university (the University of Massachusetts Boston). Centering on the experiences of predominantly—but not exclusively—Latino alumni, the study triangulated quantitative survey data from 127 participants, qualitative data from 27 “Cafecito focus groups involving a total of 120 alumni, and content analysis of 27 documents developed collaboratively during Cafecitos. Through this approach, the study amplified alumni voices to define the TAG program’s impact on their academic, social, personal, and professional advancement, illuminating the characteristics and conditions that catalyzed Latino success. Findings revealed that TAG alumni attributed their success to the program’s use of culturally sustaining pedagogy, intergenerational mentorship, identity affirmation, strong community-rooted networks, and holistic programming that cultivated a college-going culture and academic identity. The Cafecito process modeled a participatory and culturally resonant method of alumni engagement, yielding rich community-authored insights into long-term impact. These findings underscore the transformational power of targeted Latino-centered programs and call for sustained public investment in community-rooted, identity-affirming models of college access—especially as TAG’s continued operation remains at risk. As a blueprint for educational equity, TAG demonstrates what is possible when Latino communities design the solutions that serve them
ECONOMIC STATECRAFT AS GRAND STRATEGY: STATE CONTROL, NATIONAL SECURITY ANXIETY, AND THE INSTRUMENTALIZATION OF THE CHINESE FIRM IN THE CRITICAL AND EMERGING TECHNOLOGY ERA
No full textSince 2005, China has spent nearly $2.4 trillion in foreign direct investment (FDI), in addition to another trillion dollars, since 2013, through the ambitious Belt and Road Initiative (BRI). These capital flows have helped open new global markets for Chinese companies, redrew trade routes, tapped into intellectual property, allowed for opportunities in industrial espionage, reshaped supply chains, and combined with significant investment in human capital by the Chinese government, allowed for technological breakthroughs in genomics, quantum computing, and artificial intelligence that are re-imagining the world. China’s emergence as a global technological powerhouse has, in turn, set it not only as a strategic competitor to the United States, but also, increasingly, as a challenger to US unipolarity. This dissertation project explores how, and to what extent, is Chinese FDI triggering American national security anxieties. More specifically, this research project examines (if and) how the Chinese state instrumentalizes Chinese firms, through FDI, to advance its foreign policy and national security goals. By understanding the means of state control, its extent, and the sites of linkages between firms and the state, we gain clearer understanding of the magnitude of Beijing’s influence over the decision making, operations, and behavior of Chinese firms in the international market; and by extension, the reach of China’s economic statecraft. Academic literature on the role of commercial actions in relation of FDI and state power takes an explicitly state-centric approach, that uses the state as the unit of analysis, not the firm. This dissertation has been a distinct departure from that tradition in the scholarship, by centering commercial actors as the unit of analysis of the extent of state power. This dissertation uncovers and examines these relationships in two ways: firstly, by analyzing legal and legislative provisions compelling Chinese firms to abide by state interests and/or directives; and secondly, by analyzing the nature of incorporation and ownership of Chinese firms undertaking FDI. Based on these findings, this dissertation developed and proposes a national security codebook comprising 25 concrete decision rules for what criteria and parameters represent national security red flags from FDI threatening American interests and competitiveness. Effectively, this national security rules codebook aims to bolster the Committee on Foreign Investment in the United States’ (CFIUS) ability to flag national security concerns, in an astute, precise, strategic, and especially, pre-emptive manner. While the theoretical grounding and empirical evidence weaned from this dissertation’s research and analysis underscore the structuralist viewpoint of inherent security competition, it does, however, challenge the paradigm of a zero-sum game in the context of a rising China
FOSTERING COLLABORATION BETWEEN MOBILE CRISIS INTERVENTION TEAMS AND SCHOOL TEAMS
No full textABSTRACT
FOSTERING COLLABORATION BETWEEN MOBILE CRISIS INTERVENTION TEAMS AND SCHOOL TEAMS
August 2025
Talia Berkman, B.A., Mount Holyoke College
M.Ed., University of Massachusetts, Boston
Ph.D., University of Massachusetts, Boston
Directed by Professor Melissa Pearrow
With the goal of strengthening partnerships between Mobile Crisis Intervention (MCI) and school teams to improve behavioral health crisis response for youth and families, the current project reflects the initial implementation and evaluation of a toolkit based on a comprehensive needs assessment in Massachusetts (MA). The work is grounded in Interconnected Systems Framework (ISF), an organizing framework for synthesizing education and mental health care, and implementation science, which provides a staged approach to the uptake of new practices. The current project is based upon needs identified in a nationwide review of MCI programs and an in-depth needs assessment in MA. The needs identified then informed the development of the toolkit.
In this study, a process evaluation was conducted with the goals of observing and evaluating how providers implemented the toolkit, to what extent collaboration was evident, and investigating providers’ responses to the toolkit. Over the course of one school year, 3 school teams and 2 regionally affiliated MCI teams (16 providers total) worked to strengthen their inter-agency collaboration through use of the Behavioral Integrated Resources for Children (BIRCh) Toolkit to Foster Mobile Crisis Intervention (MCI), School, and Caregiver Collaboration. Data included descriptive observations and field notes, review of records, fidelity monitoring, a brief self-reported repeated descriptive measure of strategies used following each encounter between MCI and the school, an informal pre-post knowledge and attitudes measure of MCI and school staff, and focus groups following implementation.
Qualitative data was analyzed for themes using Framework Analysis. Framework Analysis is a technique used often in applied research that provides a step-by-step process for analyzing qualitative data thematically, comparing findings from different participant groups, and presenting information in a matrix format to be applied in practice. Major themes that emerged in the focus groups included discussion of solutions to mitigate resource challenges, such as geographic context, funding, and workforce capacity. Participants also discussed their experience with the work of collaboration itself, such as edits to the written toolkit, teaming, formal partnership, crisis practices, and building their knowledge base. Finally, their experiences relating to the impact of their efforts included strengthening personal relationships, improving quality of services, and encouraging appropriate utilization of services.
The goal is that this study will provide the groundwork for future evaluation of the effectiveness of this toolkit. Ultimately, upon refining the toolkit based on findings from this study, this toolkit will be a free resource for all Massachusetts MCI and school-based providers for the benefit of all
Living in Action: A Critical Phenomenological Study of School-Based Mental Health Counselors’ Engagement in Social Justice Practices
Get PDFThis study argues that a problem facing school-based mental health counselors is that neither traditional counseling psychology practices nor the public educational system in the United States were designed to meet the needs of students experiencing intersectional oppression. This study therefore described and compared traditional counseling psychology theory and practices with that of liberation psychology, and outlined social justice frameworks that are applicable to school-based mental health counselors. The overarching research question for this study then asked, “What are the experiences of social justice-oriented mental health counselors who work within public schools in Massachusetts?” To answer this question, a critical phenomenological research design was used to study the experiences of 14 school-based mental health counselors working in public schools in Massachusetts via open-ended, semi-structured interviews. Textural findings described the experiences of participants within four main themes: 1) witnessing the oppression and marginalization of students, 2) engagement in social justice action at various socio-ecological levels, 3) holding privilege while being marginalized, and 4) conflicting internal experiences and actions. Structural findings described the contexts within which participants described these experiences to occur under four main themes: 1) leadership structures, 2) access to resources, 3) school environment, and 4) staff culture. The political and practical implications of these findings include strengthening federal and local anti-discrimination policies, spreading power in schools by way of shared leadership, providing comprehensive social justice education to educators and mental health counselors, and increasing funding for public education and mental health care
TAN OVA DEH SUH: QUEERIBEAN FEMINISM, HUMAN SECURITY, AND THE DYNAMICS OF EXCLUSION IN JAMAICA AND TRINIDAD & TOBAGO
No full textLaws criminalizing LGBTQ sexuality have been entrenched in Anglophone Caribbean states since the 1600s, persisting through colonial rule and independence via savings law clauses that shield them from legal challenges. This study examines these laws in Jamaica and Trinidad & Tobago (T&T), exploring how colonial legacies inherited from Britain continue to shape contemporary legal, political, and social attitudes toward LGBTQ communities. The project introduces the reader to Queeribean feminism, a lens that incorporates Queer, Black, Caribbean, intersectional, and postcolonial feminism. Subsequently, the research reframes theorizing about the Women, Peace, and Security (WPS) and human security frameworks in the Caribbean region.
The study investigates why some Anglophone Caribbean nations have moved toward decriminalization while others maintain anti-LGBTQ laws. A secondary inquiry examines why postcolonial states like Jamaica and T&T have retained colonial-era legislation despite Britain’s repeal. The research draws on archival materials, media, legislative debates, and constitutional documents using a paired comparative case study approach. It also incorporates interviews with advocacy groups, government officials, religious figures, and legal experts, alongside focus groups and participant observations.
Through critical discourse, content, and document analysis, the study identifies factors hindering decriminalization, particularly human security concerns, gendered power dynamics, and morally exclusive language embedded in legal and social institutions. These structures marginalize LGBTQ citizens, undermining their human security and reinforcing systemic exclusion that fosters a culture of Tan Ova Deh Suh (Stay Over There).
By reconceptualizing critical feminist theories, the study highlights how LGBTQ criminalization operates in postcolonial societies through the lens of Queeribean Feminism. Findings reveal the intersection of heteronormativity, hegemonic patriarchy, and colonial legacy in shaping exclusionary policies. Additionally, the resilience of LGBTQ activists navigating legal barriers provides insight into grassroots efforts for rights recognition. Ultimately, the research provided a deeper understanding of the factors influencing both the persistence and dismantling of anti-LGBTQ laws in the Anglophone Caribbean
Latinos in Massachusetts: Dominicans
Get PDFThe Gastón Institute’s 2024 Latinos in Massachusetts series includes this statewide report on the Dominican population in Massachusetts. This report analyzes Public Use Microdata Sample (PUMS) data from the 2022 American Community Survey (ACS) conducted by the U.S. Census Bureau. Our descriptive analysis uses both household- and individual-level data to estimate population size and percentages and to compare Dominicans to Other Latinos and Non-Latinos in the state
Editor\u27s Note
Get PDFThis issue of the New England Journal of Public Policy, again with Lord John Alderdice as guest editor, examined how wars end. The articles complement those in the previous issue on the Changing Character of War and Peacemaking
Charles Coughlin: Conspiratorial Radicalization and the Making of a Fascist
Get PDFThis paper traces the radicalization of Father Charles Coughlin, a radio populist radio preacher from the 1930s who is most well known today for the extreme anti-Semitism and fascist tendencies which defined the later parts of his career. It seeks to determine why Father Coughlin became a fascist, as well as examining how much of his fascism was evident in his earlier years. Major areas of focus include: 1) A conspiratorial anti-Communist worldview that would align Coughlin with right-wing authoritarianism and was present from his early days. 2) His ascent to becoming a national figure as a populist radio preacher in the first half of the 1930s. 3) His removal from the political mainstream as the result of a falling out with President Franklin Roosevelt and his failed attempt at creating the Union Party in 1936. 4) The fallout of the Union Party’s failure and Coughlin’s resentment of democracy as a system of government. And 5) Coughlin’s extreme fascist turn around 1938, resulting from a combination of the above factors, an increasing obsession with “atheistic Jews” as the villains of his conspiratorial worldview, and an affection for Fascist Catholic dictator Francisco Franco. The paper makes the case that there were always aspects of Coughlin’s politics that would draw him towards fascism, but that the above mentioned factors were what actually cemented that turn, showing how someone with conspiratorial and authoritarian tendencies can be made to become a full-blown fascist