32Dissertation ProspectusFactors Influenci.docx

32
Dissertation Prospectus
Factors Influencing Individuals' Decision to Utilize Mental
Health in South Texas
Submitted by:
James Dada
April 5, 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.
Score
Assessment
0
Item Not Present
1
Item 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.
2
Item 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.
3
Item Exceeds Expectations. No Revisions Required. Component

is addressed clearly and comprehensively. No gaps are present
that leave the reader with questions. No changes required.
Introduction
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 utilize or
reject mental health services in the state. Researchers (AUTH
YEAR) have expressed a need for further research on the
reasons why people decide to utilize or reject mental health
services. In South Texas this research is needed because
XXXXXXX. There is a high need as this region receives the

second-largest allocation for mental health in the country (Mista
et al. 2017). Interestingly, Misra et al. (2017) describe the use
of complementary and alternative medicine (CAM) for mental
health treatment among children in Southern Texas. Despite all
these efforts, there still exists a gap between the treatment of
mental health disorders in the US. This research on reasons why
people use or reject mental health treatment is needed because
mental health is such a prevalent problem. Indeed, mental
health service use is an international problem. Comment by
Dr. Seymour: This is the “gap” statement for further research
that we discussed.
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 There is a need to identify the social
determinants of mental disorders, 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). Part of this effort is to determine why
people choose to get mental health support or not. Comment by
Dr. Seymour: Provides a summary of results from the prior
empirical research on the topic.This is really not meeting this
item. Instead it is part of the reason why the study is needed
from the first rubric item.
Mental health is a national problem as well. 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),
47.6 million people in the U.S. experienced signs of a mental
illness in 2018. This amounts to one in every five adults.
Roughly 11.4 million Adults between the ages of 25 and 35 had
an episode of serious mental illness that same year. In 2016, 7.7
million young people between the ages of 6 and 17 experienced
some sort of mental health disorder, while 9.2 million people
were reported to have experienced a substance use disorder
(National Alliance on Mental Illness, 2019). The high numbers
necessitate raising public awareness and campaigning for a
better health care system (Hamilton.et al. 2016). Part of this
effort is identifying the reasons why people choose to utilize or
reject mental health support.
Results from previous studies on the topic of use of mental
health services indicate that there is a gap between the people
who need treatment and the people who get treatment.
According to Kohn, et al. (2018), there is an emphasis on the a
gap in mental health treatment in America when examined
through the prevalence of mental health disorders, the lack of
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 in formulating this conclusion. While 42.6% of
children and adolescents in the US suffered mental illness, the
treatment gap in this group was 64%. This issues of addressing
a lack of mental health services has not been given enough
attention, thus resulting in a wide gap in treatment(REF).
Comment by Dr. Seymour: Provides a summary of results
from the prior empirical research on the topic. Comment by Dr.
Seymour: How it is about America when the data is
international? Focus on US.
Other studies have found that there are programs that help
support the use of mental health services. According to
Bowdoin et al. (2018), a patient-centered medical home

(PCMH) model This designed to improve certain mental health
outcomes, while at the same time proving effective as cost-
containment. A total 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.
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
Given these needs in the mental health around the world, in the
US and in South Texas this study will examine the gap: there is
a need to understand why people choose to utilize or reject
mental health services. This is recommended by researchers
including xxxx who stated “ xxxx” (p. 202).
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, which allows them to persist to
the point that it is dangerous (Kohn et al. 2018).
According to Bowdoin et al. (2018), a patient-centered medical
home (PCMH) model is designed to improve certain mental
health outcomes, while at the same time proving effective as
cost-containment.
This proposed study will examine the links between care
provided that is 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. Comment by Dr. Seymour: This seems too
complicated. You don’t want to do this for your study I don’t
think. You would need a pcmh system. Do you have one? You’d
have to compare it to non pcmh.
A total 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 utilize or regject
mental health services in the state.
Criteria
Learner Self-Evaluation Score
(0-3)
Chair Evaluation Score
(0-3)
Reviewer Score
(0-3)
Introduction
This 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.
1.5
2. Provides a summary of results from the prior empirical
research on the topic.
1
3. Using results, societal needs, recommendations for further
.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: 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.

There is a gap in the research regarding the reasons people
utilize or reject mental health treatment according to Authors
(years). The research has documented this gap. This includes
REFS REFS REFS. Comment by Dr. Seymour: Includes a brief
discussion demonstrating how literature has established the gap
and a clear statement informing the reader of the gap.
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).
Early research on use of mental health services found xxxxxx.
Later research on use of mental health services found xxxxxx.
Current research on use of mental health services found xxxxxx.
There is the need to understand the consequences of both
effective utilization and non-utilization of mental health as it
has 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 a decrease in the number of insurance policies
offering individuals 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).

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). Comment by Dr. Seymour: This is research
on what people have already found on your research question. It
answers your research question instead of indicating that there
is a need for research on it. It might be useful in the literature
review.
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%. South Texas has begun to put forth 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
more funding to operate this sector and that this region receives
the second-largest allocation for mental health in the country
(Mista et al. 2017). Despite all these efforts, there still exists a
gap between the treatment of mental health disorders in the US.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)

This 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
.5
2. Discusses how the “need” or “defined gap” has evolved
research).
2
0
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
????
APA format.
2
1

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
The theoretical model for this research gap is Albert Bandura’s
Social Cognitive Theory. The Social Cognitive Theory can be
applied to the context of mental health promotion and
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
psychologist Albert Bandura (Morin, 2019). It is important to
determine the limiting factors behind individuals and families
not currently getting the mental health services that they need.
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.
· Expectancy: 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).

Theoretical literature
2013).
Literature Themes
Review of the literature review identified the following themes:
Comment by Dr. Seymour: 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.
· Research documenting Mental Health Need
· Research Documenting the lack of use of mental health
services
· Reasons for Lack of Use of Mental Health Services
· Lack of proper mental health education and infrastructure has
been the major factor affecting the utilization of mental health
(REF) .
· 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).
· Reasons for Use of Mental Health Services
· 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. What happens to these women as a result of
these lack of services needs to be further extrapolated by further
research. This demonstrates a current gap in existing literature.
· This is another gap in existing literature. It is important to
ascertain the reality that living in poverty face and how a lack
of services prevents them from being able to be class mobile in
terms of future career opportunities.
· 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
psychologists Albert Bandura (Morin, 2019). It is important to

Many do no seek help due to social stigmatization, while others
simply lack any type of access in the first place. Due to a lack
of promotion in this area, many do not know where to turn and
this is causing the problem to be compounded in society from
one generation to the next.
change include:
perform a behavior.
change.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Theoretical Foundations and/or Conceptual Framework
This 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/Themes
This 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 Foundationssection 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
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
1
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
????
APA format.
1.5
1
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
The problem is that individuals across South Texas are do not
make use of the mental health services that are offered to them.
It is not known how mental health providers describe the factors
influencing individual decisions to utilize mental health
services. Comment by Dr. Seymour: Need evidence of this .
references.

Describes the population of interest affected by the problem.
The general population refers to all individuals that could be
affected by the study problem
For qualitative studies this describes how the phenomenon will
be studied. This can be individuals, group, or organization
under study.
Discusses the importance, scope, or opportunity for the problem
and the importance of addressing the problem
There are increasing mental health cases among the children in
the country, indicating that much improvement in this area is
needed. This research seeks to identify the key issues that
prevent the people of this part of the state from utilizing its
mental health services and facilities. Comment by Dr.
Seymour: Are you going to focus on children?Is there a
recommendation in the literature for this?Is there a need in
South Texas for this in particular? Is there a reason to focus on
this and not look at it in general? Are you going to be able to
get enough pediatric mental health people to participate???
They are few and stressed.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Problem Statement
This 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
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
0
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
0
Discusses the importance, scope, or opportunity for the problem
and the importance of addressing the problem.
1.5
0
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
1
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. Comment by Dr. Seymour: Begins with one sentence
that identifies the research methodology and design, target
population, variables (quantitative) or phenomena (qualitative)
to be studied and geographic location.OkBut we will have to do
an alignment activity to make sure all the gap, problem,,
purpose, theory, research questions align. We can discuss it. We
basically copy and paste them onto one page and then
manipulate them until they are aligned.
Describes the nature of the phenomena to be explored.
The study aims to come with the factors that either positively
influence or deter the people in the StateSouth Texas 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. This study will make a recommendation on how to

improve the mental health accessibility in the State. It will
identify multiple factors that are associated with both the
utilization and under-utilization of specialty mental health
services among the people living in South Texas, 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. Comment by Dr. Seymour: This is all
methods.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
PURPOSE OF THE STUDY
This section reflects what the study is about, connecting the
problem statement, methodology & research design, target
population, variables/phenomena, and geographic location.
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
2
Quantitative Studies: Defines the variables and relationship of
variables.
Qualitative Studies: Describes the nature of the phenomena to
be explored.
1.5
0

format.
1.5
1
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: What do mental health providers identify as reasons
patients do NOT seek mental health services?
· RQ 2: What do mental health providers recommend to solve
the problems?
· RQ3: What do mental health providers identify as reasons
patients DO seek mental health services?
· RQ 4: What do mental health providers recommend to promote
seeking mental health services?
·
·
· RQ5: Do mental health providers believe self-efficacy is
related to patients seeking or not seeking mental health
services?
· RQz: Do mental health providers believe expectations is
related to patients seeking or not seeking mental health
services?
·

·
·
·
·
· 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.
of behavioral capacity on individuals' decision to utilize mental
health services?
· H2: Behavioral capacity influences individuals' decision to
utilize mental health services.
of expectations on individuals' decisions to utilize mental health
services?
·
· H3: Expectations influence individuals' decisions to utilize
mental health services.
Criteria
(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
1
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
?????
format.
2
1
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
xx Comment by Dr. Seymour: Clearly identifies the “gap” or
“need” in the literature that was used to define the problem
statement and develop the research questions. (citations
required)
The gap in the literature is xxxx (REFS). The gap was used
to define the problem statement which is COPY PASTE. The
gap and the problem led to the research questions which address
xxxx.
xx This study will address the gap of xxxxx and this will add to
the literature base. The current literature has identified
xxxxxxxx REF REF REF. This study would extend beyond that
to identify xxxxxx. The current literature has also identified
xxxxxxx REF REF REF. This study would expand on this to
include xxxxx. The literature has identified that stigma is
preventing seeking mental health treatment (Morin & Cherry,
2019). This study may document that stigma is a problem in
South Texas and what practitioners recommend doing to combat
stigma. Summary sentence NEEDED. Comment by Dr.
Seymour: 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)
The results of this research will add considerably to the
conclusions already reached by 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 and focus
efforts on reducing the stigma that is associated with mental
health problems in the minds of most people (Morin and Cherry,
2019).

In addition, 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 prevent people from getting the
public services they need and thus help them be more
responsive to the services that are available to them.
Comment by Dr. Seymour: Describes the potential
practical applications from the research. (citations required)
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 exists or develops 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. Comment by Dr. Seymour: Not the theory you
said you were using. Social cognitive theory is different. Which
one are you using? How is all of this related to your
study???What will this study to do extend the theory? Bring it
into this new area where it might be helpful? Have others used
it to describe seeking mental health treatment?
Criteria
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ADVANCING SCIENTIFIC KNOWLEDGE and
SIGNIFICANCE OF THE STUDY

This 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
0
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
.5
Describes the potential practical applications from the research.
(citations required)
2
.5
Identifies and connects the theory(ies) or model(s) that provide
the theoretical foundations or conceptual frameworks for the
study. (citations required)
2
.5
format.
2

1
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
Qualitative methodology (Colorafi and Evans, 2016) will be
used in this study. Qualitative methodology is Thethe most
appropriate methodology that will be used in for answering the
research questions of this study which ask xxxxx. Qualiative
methods are appropriate because xxxxxx. , Comment by Dr.
Seymour: 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.You
have to explain and justify this. You can’t just state it as fact.
Why is it appropriate?
and which will also address the problem statement is a
qualitative methodology (Colorafi and Evans, 2016). Why?
The qualitative approach is very effective when a phenomenon
that is being queried is properly and effectively defined. It is
appropriate for this study because the phenomena is clearly
defined as the factors that mental health professionals identify
as reasons people utilize or reject mental heath services. , and
this study has distinctly defined the phenomena of factors
influencing the behavior Comment by Dr. Seymour: Justify in
terms of problem statement and phenomenon.
and choices of people in a natural environment to utilize or not
utilize Mental Health.

The methodology is preferred as it can document a first hand
account about the lack of mental health services being taken
advantage of by marginalized members of society. This will
support existing research in this area and aim to fill in certain
gaps that currently exist in literature. This methodology was
adopted because it will help to provide real-life evidence from
the interview with participants in terms of how the problem is
impacting them. The literature has determined the causes of the
low utilization of mental health in a certain area of Texas to
include limitations to accessing health care. It has 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 Texas
Conclusions will be extrapolated based on existing literature
and the information shared by participants during the interviews
Criteria
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Chair or Score
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Rationale for Methodology
The 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.

1. Identifies the specific research methodology for the study.
2
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
.5
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
2
format.
2
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 across Texas, which is aimed at identifying the
specific issues that are deterring the utilization of mental
healthcare facilities in a certain area of the state. This
qualitative descriptive design is the most appropriate design
For the problem statement of COPYPASTE because xxxx.
For the research questions about xxxx because xxxx.
selected because it helps to connect how mental health
providers and mental health professionals combine to influence
an individual’s decision to utilize mental health services (Kim
et al., 2017). This method is also justified as it applies the
description of the factors affecting the problem and how they
ultimately determine the outcome. According to Kim et al
(2017), qualitative-descriptive research helpful in so far as it
explains why a natural phenomenon exists and how it impacts a
given population. This method is suitable for research
purposesthe phenomena as it will allow mental health
practictioners to describe factors limiting the utilization of
mental healthcare throughout a particular county inSouth
Texas. Comment by Dr. Seymour: Justifies why the selected
design addresses the problem statement and research questions.
Comment by Dr. Seymour: Why? Comment by Dr.
Seymour: good
Literature also supports the fact that issues resulting in
underutilized mental health resources and non-institutionalized
adults create a behavioral risk factor in the state (Hamilton et
al, 2016). Comment by Dr. Seymour: doesn’t go here but seems
like an important point. Maybe literature review
The population for this study is all the mental health providers
in South Texas. This would include XX clinics and
approximately xx providers. The study populationfor the
research will be caregivers, psychiatrists, therapy offices, and
counseling facilities located within the State.

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)
After analyzing members of the population group, 12 Mental
Health Providers were determined to suffice as a sample group
because they would provide xx potential participants. This
number provides the researcher with a representative sample of
the entire state. The respondents will be chosen volunteer to
participate from among the mental health providers that current
members 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, therapy offices, and counseling
facilities located within the State. Mental health providers with
at least five years of experience in the field and who have
current membership in a mental health association will be the
main participants in the study. Participation is entirely
voluntary, and participants can choose to be withdrawn from the
study at any time. Providers will be selected to complete a
questionnaire that will include basic demographic questionnaire.
The responses will be used to verify eligibility to participate in
this study. Comment by Dr. Seymour: Briefly describes the
target population and sample for the study. Comment by Dr.
Seymour: But South Texas???
A structured system of interviews with a minimum of 120
questionnaires administered to 40 different mental health
providers, will be used as the primary source of data. The data
will be collected within three weeks with each respondent given
30 minutes 1 hour for the interview and to fill out the

questionnaire. Data will be collected for the study using this
system of interviews and questionnaires . Notes will be taken,
while interviews will be tape-recorded and properly
documented. Comment by Dr. Seymour: This is not a
quantitative study
Mental health providers with at least five years of experience in
the field and who have current membership in a mental health
association will be the main participants in the study.
Participation is entirely voluntary, and participants can choose
to be withdrawn from the study at any time. Providers will be
selected to complete a questionnaire that will include basic
demographic questionnaire. The responses will be used to verify
eligibility to participate in this study.
A consent form will be sent using DocuSign 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/participant names will be removed from all collected
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 Score
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Chair or Score
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Reviewer Score
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Nature of the Research Design for the Study
This 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.
paragraphs and must address each criterion.
1. Identifies and describes the selected design for the study.
2
1
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
0
Briefly describes the target population and sample for the study.
2
1
Identifies the sources and instruments that will be used to
collect data needed to answer the research questions.
1
.5
Briefly describes data collection procedures to collect data on
the sample.
2
1

format.
2
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, structured face-face interviews will be conducted with
open-ended questions that require participants to elaborate on
the causes that keep people from properly utilizing mental
health services. Responses should also lead to the development
of a conclusion as to why qualifying individuals are hesitant to
receive the mental health treatment that they need. 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)
Selected providers will be selected to complete a basic
questionnaire that details certain demographic information and
confirms experience in the field. 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 make note of the factors that providers think can improve
mental health accessibility throughout the state.
Criterion Score

(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
RESEARCH MATERIALS, INSTRUMENTATION, OR
SOURCES OF DATA
This 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.).
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
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
1

format.
1
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 have
acknowledged and DocuSign signed the consent form.
Furthermore, the dissertation will collect information from a
selected group of providers to provide primary data.
· The researcher will communicate with the sample group and
allocate everyone a 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, properly fill out, and
return the questionnaire to the researcher within a specified
period of time.
· The research will be conducted 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 Texas.
· Respondents will respond to both interviews and the
questionnaires.
· Manual coding will be conducted on all collected data.
· Data will be checked for any errors by both parties before
further processing.
· Data will be entered into SciLab MaxQDA for analysis.
Criteria
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Chair or Score
(0-3)
Reviewer Score
(0-3)
DATA COLLECTION AND MANAGEMENT
This 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 situations

Qualitative 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
1
Describes the procedures for obtaining participant informed
consent and for protecting the rights and well-being of the study
sample participants.
2
1
format.
2
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
Upon completion of the interviews, each one will be transcribed
from the audio that has been recorded. Descriptive statistical
analysis will then began based on the results from the interview
and focus group sessions. Collected data will first be manually

coded for inductive codes that emerge from the data. Common
codes across participants will be determined as themes. with the
themes of the study. The coded themes will then be analyzed
and explanations assigned. The overall aim of the analysis will
be to find a certain level of consensus relating to the factors
that influence an individual’s decision to not utilize existing
mental health services offered throughout the county. During
this initial 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
become intimately familiar with it. This will allow the
researcher to be able to identify the answers to the research
questions forming the basis for this study, as well as identify
any themes that the participants seem to agree on repeatedly
adddress. The researcher will use the two theories selected to
see if the themes from the interviews align with the theoretical
framework. Comment by Dr. Seymour: Zoom transcripts,
cleaned up Comment by Dr. Seymour: ?? what two? Only
use one. We should DISCUSS
· Data will be collected and analyzed for the study.
· Descriptive statistics will be used to summarize the acquired
data.
· Coding will be used to address the questions posed.
· A narrative summary will be developed.
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. Comment by Dr. Seymour: GOOD!!!!
· Stage 1: Become familiar with the data: the researcher is
expected to already be familiar with the contents of the research
and have a better understanding of it. This is because the
researcher is the individual who will collect the data.
· Stage 2: Generate first codes regarding the significant ideas
discovered in the data. Pertinent data relating to each code
should be combined together.

· Stage 3: This stage allows the researcher to start the search for
themes via analysis and a review of the codes. This stage is also
designed to better understand those responses 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, a detailed description of the
phenomenon from the synthesis of the data will be developed.
Criteria
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DATA ANALYSIS PROCEDURES
This section provides detailed steps for the analytic procedures
to be used to conduct data analysis.
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

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
1
Why: Provides the justification for each of the (statistical and
non-statistical) data analysis procedures used in the study.
2
0
Show Steps that Support Evidence
Quantitative 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
2
format.
2
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, authorization from all
the relevant bodies including the IRB will be sought for
approval. The site authorization will be obtained from XXX ,
XXX, and xXXX to contact their mental health professionals
regarding participation in the study. Participants will be
recruited by asking the staff secretaries to forward an email
from me to the staff. The email will include an invitation to
participate and the informed consent documentation.
Participants will contact the researcher through email or phone
call to participate. The participants will use DocuSign to sign
the informed consent. Zoom or phone interviews will be

conducted with the participants. The research will also seek
authority from the University Board to conduct the research.
Comment by Dr. Seymour: Describes site authorization
process, subject recruiting, and informed consent processes.
All collected data will be used purely for research purposes and
remain confidential. Respondents can freely withdraw from the
study, and they will be continually reminded of this at every
state. No personal name or organizational names that may bring
conflict of interest in the research will be included. Fake names
will be assigned to each participant and will be the only names
used throughout the study. The DocuSign informed consent will
be saved in a password protected folder on my personal
computer and a password protected thumb drive in a locked
drawer in my home office. The research will remain property of
the University will all rights reserved. Additionally, only
relevant data that covers the specific scope of this study will be
collected by the researcher. The researcher will steer clear of
any bias, perceived or otherwise, and remain subjective as the
data is analyzed so as to further prevent any harm on the part of
the participants. Comment by Dr. Seymour: Describes how
the identities of the participants in the study and data will be
protected. Comment by Dr. Seymour: Discusses potential ethical
concerns that might occur during the data collection process.
During the data collection, ethical concerns that might occur
include….
Criteria
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Chair or Score
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Ethical Considerations
This 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.
1. Describes site authorization process, subject recruiting, and
informed consent processes.
2
2
2. Describes how the identities of the participants in the study
and data will be protected.
2
2
3. Discusses potential ethical concerns that might occur during
the data collection process.
2
0
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
???
format.
2
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 research, 15(1),
542.
https://bmchealthservres.biomedcentral.com/articles/10.1186/s1
2913-015-1191-7
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.2015.3
02981
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 journal, 52(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 Medicine, 23(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 A
10 Strategic Points
My Degree: Ph.D.
Program Emphasis: Industrial & Organizational Psychology
Ten Strategic Points
Comments or Feedback
Broad Topic Area Final Topic

Factors Affecting Utilization of Mental Health in Southern
Texas
Lit Review
(Theoretical Framework (Theory)
Gaps
Themes
All Citations
Gaps
A. 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.co

m/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 Foundation
The 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 Review
A. 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 Statement
It is not known how mental health providers describe the factors
influencing individuals' decision to utilize mental health
services
Research Questions
RQ1: How do mental health providers describe the influence of
self-efficacy on individuals’ decision to utilize mental health
services?
behavioral capacity on individuals’ decision to utilize mental
health services?
expectations on individuals’ decision to utilize mental health
services?
Population
Target Population
Sample
· Location – Southern, Texas. USA
· Target Population:
· Mental Health providers with membership of Mental Health
Association in South Texas
· Behavioral Hospitals
· Psychiatrists
· Therapists
Sample:

· 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 services
Methodology & Design
Qualitative Descriptive Study
Purpose Statement
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
Data Collection Approach
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
· 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 Approach
Descriptive Statistics
demographic information
years of experience
According 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 C
Demographics of the participants
Sample Population
12 Mental Health Providers in United States
Questionnaire
Minimum of 120
Interviews
Minimum of 40 Mental Health providers in the South

32
Submitted by:
James Dada
April 5, 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.
Score
Assessment
0
Item Not Present
1
Item 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.
2
Item 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.

3
Item Exceeds Expectations. No Revisions Required. Component
is addressed clearly and comprehensively. No gaps are present
that leave the reader with questions. No changes required.
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), 47.6 million
people in the U.S. experienced signs of a mental illness in 2018.
This amounts to one in every five adults. Roughly 11.4 million
Adults between the ages of 25 and 35 had an episode of serious
mental illness that same year. In 2016, 7.7 million young people
between the ages of 6 and 17 experienced some sort of mental
health disorder, while 9.2 million people were reported to have
experienced a 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 in formulating this conclusion. While 42.6% of
children and adolescents in the US suffered mental illness, the
treatment gap in this group was 64%. This issues of addressing
a lack of mental health services has not been given enough
attention, thus resulting in a 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, which allows them to persist to the point
that it is dangerous (Kohn et al. 2018).
According to Bowdoin et al. (2018), a patient-centered medical
home (PCMH) model is designed to improve certain mental
health outcomes, while at the same time proving effective as
cost-containment. This proposed study will examine the links
between care provided that is 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. A total 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 utilize or regject
mental health services in the state.
Criteria
(0-3)
Chair Evaluation Score
(0-3)
Reviewer Score
(0-3)
Introduction
This section briefly overviews the research focus or problem,
why this study is worth conducting, and how this study will be
completed.
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
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:
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%. South Texas has begun to put forth 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
more funding to operate this sector and that this region receives
the second-largest allocation for mental health in the country
(Mista et al. 2017). Despite all these efforts, there still exists a
gap between the treatment of mental health disorders in the US.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
This 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
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
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
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. What happens to these women as a result of
these lack of services needs to be further extrapolated by further
research. This demonstrates a current gap in existing literature.
· 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). This is another gap in
existing literature. It is important to ascertain the reality that
living in poverty face and how a lack of services prevents them
from being able to be class mobile in terms of future career
opportunities.
· 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).
Again, further research must be conducted to determine how
these attitudes can shift so that socio-economically
disadvantaged families can get their children access to the
critical mental health services that they need.
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
psychologists Albert Bandura (Morin, 2019). It is important to
Many do no seek help due to social stigmatization, while others
simply lack any type of access in the first place. Due to a lack
of promotion in this area, many do not know where to turn and
this is causing the problem to be compounded in society from
one generation to the next.
change include:
perform a behavior.

change.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Theoretical Foundations and/or Conceptual Framework
This 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/Themes
This 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 Foundationssection 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

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
The problem is that individuals across South Texas are not make
use of the mental health services that are offered to them. It is
not known how mental health providers describe the factors
influencing individual decisions to utilize mental health
services. There are increasing mental health cases among the
children in the country, indicating that much improvement in
this area is needed. This research seeks to identify the key
issues that prevent the people of this part of the state from
utilizing its mental health services and facilities.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Problem Statement

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