Dissertation Prospectus

This assignment is a continuation of project already started by Catherine Owens, she will gladly continue and has been posted for her.


Assignment Details & Instructions

This assignment needs to be corrected, there are a lot of sections that must be corrected including scientific citations, numerous grammatical errors, some complex sentences that must be broken into smaller and more manageable sentences etc. Please see the attached Prospectus Draft.








Dissertation Prospectus Comment by Astur, Robert: Hi James,Thanks for sharing this. I can see that you have worked hard on this and that you have a passion for this field. We are going to ZOOM tonight, so I want to get you back my first set of comments before we talk. Going forward, you will need to address a number of things:1) It is not clear what the gap is. Why does this research need to be done? What has been done so far and how will this project help to close that gap? You cite one study by Bowdoin which clearly stated that PCMH does not affect expenditures or care. So, how is this a gap?2) You need to provide scientific citations for your statements. You cannot rely on CDC and other websites because they are not peer-reviewed and are less reliable. Offhand, you have very few citations to your work.3) You need to proofread your work or have somebody else proofread it. You have numerous errors throughout, and it is not the role of me or the rest of the committee to fix these for you. They detract from your overall writing.I look forward to learning more from you over our ZOOM.Thanks James!Robert

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






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.








Dissertation Prospectus


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. The UN expressed its uncertainty regarding the extent at which major social determinants of mental disorders is being addressed Worldwide (WHO, 2015). Therefore, it is developing a conceptual framework that will address the social determinants and aligns it with its sustainable development goals so that it can systematically review the evidences about the social determinants and identify potential mechanisms and targets for interventions (Lund, et.al, 2018). Accordingly, the Substance Abuse and Mental Health Services Administration (SAMHSA), the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Justice, every year in this country, millions of people suffer from mental illness. The high numbers necessitate raising public awareness and start campaigning for a much better health care system (Hamilton.et.al, 2016). In 2018, 47.6 million people in the U.S. experienced mental illness which means 1 in every 5 adults. 11.4 million Adults between ages 25 and 35 had an episode of serious mental illness. In 2016, 7.7 million youths aged 6-17 experienced some sort of mental health disorder, while 9.2 million people were reported to have experienced substance use disorder (National Alliance on Mental Illness, 2019). Comment by Astur, Robert: Please can you explain what this means? Comment by Astur, Robert: Please can you break down this complex sentence into smaller and more manageable sentences? Comment by Astur, Robert: You have numerous grammatical errors in your prospectus. Please correct them or have somebody else correct them. It is not my role to do this, but it needs to be done. I will not comment on this each time I see problems though, because there are too many to comment on. Comment by Astur, Robert: Please provide citations for these statistics.

According to Kohn, et. al, (2018), there are emphasis on 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). Comment by Astur, Robert: What does this mean? Comment by Astur, Robert: This details is not necessary here. Perhaps you can use this place to describe what the pressing issue is? Comment by Astur, Robert: I am not sure where you are going with this yet, but you will not be able to use such global stats if you are going to focus on the US. I am sure there are US stats that are more readily available. But, I will read on to see what direction you take this. Comment by Astur, Robert: Please revisit how to cite articles by multiple authors.

Bowdoin, Rodriguez-Monguio, Puleo, Keller, & Roche, (2018) emphasized that patient-centered medical home (PCMH) is a model meant for improving health outcomes while at the same time meant to contain the cost of care. Yet, the evidence is inconclusive. This study aims at studying and examining the links between care provided in consistent with the PCMH and healthcare services utilization as well as expenditures for non-aging citizens who are suffering mental illness in the United States. A survey that was conducted which used self-reported data of 6908 non-aging adults suffering mental illness participated in the 2007-2012 Medical Expenditure Panel Survey. Participants involved in the study on utilization of healthcare services were compared with expenditures on care consistent with the PCMH, other participants include 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 the volunteers who had a non-PCMH USC showed non statistical importance for any healthcare services category. The conclusion demonstrated that there are consistencies in care received with the PCMH was not significantly linked with differences in healthcare services utilization or expenditures when compared to having a non-PCMH USC. Comment by Astur, Robert: Please correct this citation in your REFERENCE section. Comment by Astur, Robert: Why do you say this? The Bowdoin study showed that it did not have any reduction in expenditures? Are there conflicting studies that show that it does reduce expenditures? Comment by Astur, Robert: Which study? Yours ? Or another one? Comment by Astur, Robert: I am not sure how you are interpreting this. Comment by Astur, Robert: What does this mean to you? It means that there are no observable differences between the groups, correct?

This is a research study will examine how mental health providers describe the factors influencing individuals’ decision to utilize mental health services in South Texas. The study is important in understanding the major reasons for utilizing and reasons that limit utilization of mental health services in the State and recommending ways through which the issues can be resolved. Comment by Astur, Robert: At this point, it is unclear why this is important to research – or, put another way, why this is a gap? Comment by Astur, Robert: These are different issues, right? Understanding the reasons is one issues. Recommending resolution is another.


Criteria Learner Self-Evaluation Score


Chair Evaluation Score


Reviewer Score



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.      
2. Provides a summary of results from the prior empirical research on the topic.      
3. Using results, societal needs, recommendations for further study, or needs identified in three to five research studies (primarily from the last three years), the learner identifies the stated need, called a gap      
4. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.      
NOTE: This Introduction section elaborates on the Topic from the 10 Strategic Points This Introduction section provides the foundation for the Introduction section in Chapter 1 of the Proposal.
Reviewer Comments:




Background of the Problem

According to the Centers for Disease Control and Prevention, mental health has become a significant public health issue in the United States that requires immediate attention and must be diagnosed at its early stages. Without an early diagnosis and treatment, children and adolescents may experience problems in the home, at school and among friends including issues with forming friendships (CDC, 2018). Accordingly, researchers have explored some barriers relating to the utilization of mental health service, notwithstanding, there were other factors that may also influence individuals’ decision to not utilize mental health. Comment by Astur, Robert: REF Comment by Astur, Robert: Can you elaborate and with more scientific referencing? Comment by Astur, Robert: REF?

Results indicates that experienced providers who encounter some level of burden may likely utilize mental services than others who do not experience any burden. Providers that experience high level of burden will likely 15 times or more utilize mental health services (OR =13.70; 95% CI 10.58-17.74, p<0.001). Similarly, the caregivers that experience serious signs of depression or anxiety in their child or adolescent (OR=1.55; 95% CI 1.21-1.98; p<0.05) 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 has no influence on need and utilization (Grayson, 2016). Comment by Astur, Robert: REF? Do you mean providers? Or patients? Comment by Astur, Robert: REF.I am going to stop commenting on every sentence that requires scientific citations. In general, if you are making a statement that is not common knowledge, you need to provide a scientific citation. For example, if you are citing stats, or effects, or outcomes, etc. All need a citation. Please try to resolve this for your paper.

Misra, S. M., Guffey, D., Roth, I., & Giardino, A. P. (2017) in their article “Complementary and Alternative Medicine use in Uninsured Children in Texas”, the authors describe the concept relating to the use of complementary and alternative medicine (CAM) for mental health treatment among children in this Southern State County. According to the authors, CAM use among US children stands at 12%. According to the 2012 National Health Interview Study. The research suggests that there are a number of uninsured population due to their limited access to care, which resulted in higher CAM use. A survey of 250 uninsured patients at various pediatric facilities in a free mobile clinic program showed a very high use by Hispanic population, their rate of CAM use in the last 12 months was close to 50% among children and 60% among parents. One Southern State has placed a lot of effort into improving the health care treatment of children; according to that 2012 research report conducted a study National Health Interview Study. Research study suggests that facilities that the services offered are inversely proportional to the allocation provided. Misra and the rest have concluded that this issue has raised a lot of concern since the mental health of the people remain to be very low despite the efforts implanted. Research showed that some institutions have released a lot of funds to run this sector. This research also showed that this Sothern State receive the second largest allocation for mental health. Comment by Astur, Robert: Please revisit how to cite articles. Comment by Astur, Robert: Which? Comment by Astur, Robert: How does this contribute to your story? Comment by Astur, Robert: Why do you use this terminology? Can you just name the state?

Based on the data collected, a gap was identified regarding the factors that affect the utilization of Mental health facilities within the county. Various people within the mental healthcare profession have done research on some factors that may deter people from receiving mental healthcare. The literature on the mental health gap in the county has revealed major reasons as to why the gap exists. Stigmatization and low income are some reasons as to why the gap exists in the county.


Criteria Learner Self-Evaluation Score


Chair or Score


Reviewer Score


Background of the Problem

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 historically into the current problem or opportunity to be addressed by the proposed study (citing seminal and/or current research). 2    
3. ALIGNMENT: The problem statement for the dissertation will be developed from and justified by the “need” or “defined gap” that is described in this section and supported by the empirical research literature published within the past 3-5 years. 2    
4. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format. 2    
NOTE: This Background of the Problem section uses information from the Literature Review in the 10 Strategic Points . This Background of the Problem section becomes the Background of the Study in Note, this section develops the foundation for Chapter 1 in the Proposal. It is then expanded to develop the comprehensive Background to the Problem section and Identification of the GAP sections in Chapter 2 (Literature Review) in the Proposal .
Reviewer Comments:




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

Theoretical literature

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

Literature Themes

Review of the literature review identified the following themes:

· Lack of proper mental health education and infrastructure has been the major factor affecting the utilization of mental health. Goldman Robin & Chester (2018) in his 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, Yeung, Dougher, & Hahm, (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 has left many people without health insurance as they cannot afford. This limits many average and lower-class families from accessing mental illness services (Children at Risk, 2013).

· Poor perception among the community members. Researchers reveals 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 utilization of mental healthcare in the community (Children at Risk, 2013).

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

Major components of the theory in relation to individual behavior change include:

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

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

· Expectations: Determining the outcomes of behavior change.

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

· Self-control: Regulating and monitoring individual behavior.

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

· Reinforcements: Promoting incentives and rewards that encourage behavior change (Eslami, Norozi, Hajihosseini, Ramazani, & Miri, 2018).

Criteria Learner Self-Evaluation Score


Chair or Score


Reviewer Score


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 Foundations section identifies the theory(s), model(s) relevant to the variables (quantitative study) or phenomenon (qualitative study). This section should explain how the study topic or problem coming out of the “need” or “defined gap” in the as described in the Background to the Problem section relates to the theory(s) or model(s) presented in this section. (One paragraph)

2. Review of the Literature Themes section: This section is a bulleted list of the major themes or topics related to the research topic. Each theme or topic should have a one-two sentence summary. 1.5    
3. ALIGNMENT: The Theoretical Foundations models and theories need to be related to and support the problem statement or study topic. The sections in the Review of the Literature are topical areas needed to understand the various aspects of the phenomenon (qualitative) or variables/groups (quantitative) being studied; to select the design needed to address the Problem Statement; to select surveys or instruments to collect information on variables/groups; to define the population and sample for the study; to describe components or factors that comprise the phenomenon; to describe key topics related to the study topic, etc. 1.5    
4. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format. 1.5    
NOTE: The two parts of this section use information about the Literature Review and Theoretical Foundations/Conceptual Framework from the 10 Strategic Points.

This Theoretical Foundations section is expanded upon to become the Theoretical Foundations section in Chapter 2 (Literature Review). The Theoretical Foundations and the Literature Review sections are also used to help create the Advancing Scientific Knowledge / Review of the Literature section in Chapter 2 (Literature Review).

Reviewer Comments:



Problem Statement

It is not known what is influencing individuals’ decision to not utilize mental health in the United States. It is not known how mental health providers describe the factors influencing individuals’ decision to utilize mental health services. While there are increasing mental health cases among the children in the county, the research topics seek to identify the key issues that prevent the people of this county from utilizing the mental health services and facilities.