Dissertation Defense Announcements

This study examined horizontal fiscal equity in North Carolina’s public school funding system from 2012 to 2022, expanding on previous research by Rolle et al. (2008) for the 1996–2006 decade. The research assessed whether the state’s school funding mechanism aligns with its constitutional obligation to provide a "sound basic education" for all students, as established in Leandro v. State (1997). Using statistical measures of horizontal fiscal equity, this study evaluates per-pupil expenditures at the local, state, and federal levels, providing a longitudinal comparison of funding disparities over time.
Findings indicated persistent and, in some cases, worsening inequities in school funding across North Carolina districts. Local per-pupil expenditures exhibited stagnation and decline in real-dollar terms, particularly during the COVID-19 pandemic, contributing to increasing disparities. While state per-pupil expenditures grew moderately, measures such as the range, standard deviation, and coefficient of variation suggest that funding inequities persisted and, in some cases, expanded. The analysis of combined local and state per-pupil expenditures revealed continued funding increases, yet disparities remained evident, particularly in lower-wealth districts. Total per-pupil expenditures, including federal funding, showed modest increases, yet gaps between high- and low-poverty districts persisted, reinforcing concerns regarding the adequacy and fairness of North Carolina’s school finance system.
Despite legal mandates and increased investment, North Carolina’s school finance system continues to exhibit inequities, particularly for districts with high concentrations of economically disadvantaged students. While some progress has been made in funding distribution, challenges in ensuring equitable access to resources remain. The findings underscored the need for policy reforms aimed at revising the state’s funding model, increasing targeted investments in high-needs student populations, and improving the overall efficiency of resource allocation. Future research should explore broader fiscal capacity, revenue equalization, and policy impact assessments to further understand and address systemic inequities in school funding.

This project educated nurses on trauma-informed care (TIC) principles to build their perceived confidence and ability to apply TIC practices in clinical settings. The goal was to increase knowledge, affective commitment, beliefs, and self-efficacy with TIC through an educational intervention. Trauma significantly impacts well-being, leading to chronic health issues, substance abuse, and mental health problems. Nurses can also experience trauma, such as vicarious or secondary trauma. TIC focuses on identifying the impact of trauma and preventing re-traumatization within the healthcare setting. The project was conducted to enhance TIC behaviors in nurses using an interactive educational intervention. The project used a pre-post survey design with validated assessment tools to measure knowledge, affective commitment, self-efficacy, and beliefs about trauma. An interactive session included a didactic presentation, case studies, and open discussion. Data analysis used paired t-tests and descriptive statistics. Participants (N=44) achieved a 100% post-survey response rate. Although improvements in knowledge scores were not statistically significant (p < .077), affective commitment, self-efficacy, and beliefs showed significant improvements (p < 0.001). Evaluation surveys revealed that 91% indicated they gained knowledge, and 89% would apply their knowledge to practice. The project is replicable and scalable, promoting enhanced safety and wellness for patients and nurses.

Preconception care is designed to ensure that women begin pregnancy at optimal health by having received proper chronic and sexual transmitted infection screenings, provider counseling about necessary health improvements, and treatment for conditions or illnesses that may impact the likelihood of a healthy pregnancy or childbirth. This type of care is especially important for Black women who continue to face disproportionate risk of pregnancy-related death in the United States. Due to the higher maternal mortality rates among Black women, a more targeted investigation and implementation of consistent care prior to pregnancy is needed.

My dissertation thematically examines the trends, knowledge, and experiences of preconception care among Black women who reside in the United States. I investigated the offer, reception, and administration of preconception care services using a mixed methodology approach. First, I analyzed preconception care reception among Black women using 2016-2021 PRAMS (Pregnancy Risk Assessment Monitoring System) data. This secondary analysis concluded that hypertensive Black women had 21% decreased odds of receiving preconception care, compared to their non-hypertensive counterparts despite their diagnosis of hypertension. Second, I developed and preliminarily validated the Preconception Care Health Knowledge Scale, which was designed to assess a woman’s knowledge level of the preconception care services needed for a healthy pregnancy. By community validation, psychometric validation, and content validation, I established that the instrument, once revised, will be suitable for assessing the knowledge of preconception care among Black women in the US. Third, I conducted a qualitative study that analyzed the healthcare experiences of Black women who began pregnancy with hypertension. Through semi-structured interviews, the participants identified Health Literacy and Knowledge, Provider Counseling, Provider Interaction, and Provider Race/Ethnicity as the most impactful themes related to their overall healthcare. The participants were knowledgeable about their hypertensive condition and expected their healthcare providers to inform them about the risks associated with beginning pregnancy with hypertension. However, several participants reported not being properly diagnosed with hypertension prior to pregnancy, which resulted in delayed treatment and increased the potential for adverse outcomes stemming from pregnancy-related hypertensive disorders.

My findings address critical gaps in the literature on the use of preconception care as a method to prevent maternal morbidity and mortality among Black women. I found Black women’s preconception care treatment to be inconsistent, especially among women who were hypertensive. These findings inform the development of frameworks, interventions, and policy to reduce the disproportionate and unnecessary maternal morbidity and mortality among Black women in the United States.

This dissertation explores elementary educators' perceptions of trauma-informed practices (TIPs) in schools. It examines how teachers develop knowledge of childhood trauma, its classroom manifestations, and implementation of TIPs. The study investigates challenges in identifying trauma-related behaviors and educators' preparedness, aiming to improve teacher training and school-wide TIP implementation.