DR 9000

Rubric Standard | Complete > Does the prospectus contain all the required elements? Refer to the annotated outline to see the required parts of the Dissertation Prospectus document.

Note. Please complete following the directions provided, using the stem sentences, and referring to the examples in the appendix.

Title

Prison Stakeholder Perspectives On Mental Health Care Among Racial And Ethnic Minority Adults

Supporting Literature

The first step in developing your prospectus is to search the literature related to the general area you want to investigate (see social problem below). In your review of recent, empirical literature, what keywords did you search and in what databases?

The keywords and databases searched included Racial/Ethnic disparities, mental health care access, mental health care services, structural, cultural, technological, African American OR Black, Hispanic OR Latino, Asian American, and mental health treatment disparities, combined with Boolean operators (AND/OR). Previously reported databases included PubMed, PsycINFO, Google Scholar, Web of Science, CINAHL, SAGE Journals, and JSTOR. To align the literature review with the revised participant population, we will extend the search using prison OR correctional facility, incarcerated adults, correctional mental health, prison wardens, mental health counselors, prison volunteers, stakeholder perspectives, culturally responsive care, language access, and telehealth. We will prioritize recent empirical literature specific to adult prisons and stakeholder perspectives. Foundational framework and methodological sources will be retained where relevant.

Provide at least 10 brief summaries of recent, scholarly (peer-reviewed) articles that support/justify a current and relevant problem in your discipline or professional field. Source(s) supporting your framework should be included. Include the complete, APA reference entry, followed by (a) an in-text citation; (b) what was studied; (c) what was found; and (d) why this research is important in relation to your study. This evidence provides the justification for your research problem.

Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1–10. This foundational model will organize consideration of predisposing, enabling, and need factors in participants’ descriptions of care access and utilization.

Breslau, J., Han, B., Levin, J. S., Lai, J., & Yu, H. (2024). Are disparities in mental health care for Medicaid beneficiaries lower in managed care?  Healthcare,  12(1), 100734.  https://doi.org/10.1016/j.hjdsi.2024.100734

(a) Breslau et al. (2024); (b) used Medicaid claims data to evaluate the trends of racial/ethnic disparities in mental health service use; (c) identified large and persistent disparities among Black and Hispanic beneficiaries despite insurance coverage, highlighting structural and cultural barriers; (d) relevant to my study because they found that disparities in mental health care access persist despite insurance coverage, which emphasizes structural and cultural barriers.

Cook, B. L., Rastegar, J., & Patel, N. (2024). Social risk factors and racial and ethnic disparities in health care resource utilization among Medicare Advantage beneficiaries with psychiatric disorders.  Medical Care Research and Review,  81(3), 209-222. https://doi.org/10.1177/10775587231222583

(a) Cook et al. (2024); (b) This study examined the intersection of social risk factors (e.g., housing instability, food insecurity) and racial/ethnic disparities in mental health service utilization using large-scale claims and survey data; (c) found that even after accounting for social risks, Black and Hispanic adults had significantly lower utilization rates than White adults; (d) this research is important to my study because it highlights how structural social determinants compound racial/ethnic disparities, supporting the need to examine multifaceted barriers.

Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 1989(1), 139–167. This foundational framework will inform interpretation of intersecting identities and institutional conditions in stakeholder accounts.

Elliott, T. R., Choi, K. R., Elmore, J. G., & Dudoit, R. (2024). Racial and ethnic disparities in receipt of pediatric mental health care.  Academic Pediatrics,  24(6), 987-994. https://doi.org/10.1016/j.acap.2024.01.024

(a) Elliott et al. (2024); (b) This study examined racial and ethnic disparities in the receipt of mental health services among a nationally representative sample of U.S. children aged 5 to 17 years using data from the National Health Interview Survey; (c) found that Black and Hispanic children were significantly less likely to receive mental health treatment compared to White children, even after controlling for socioeconomic and health-related factors; (d) this research is important to my study because it demonstrates the persistence of racial and ethnic disparities in pediatric mental health care access, thereby supporting the need for qualitative exploration of the structural, cultural, and technological barriers experienced by racial and ethnic minority populations across age groups.

Green, J. G., McLaughlin, K. A., Fillbrunn, M., Fukuda, M., Jackson, J. S., Kessler, R. C., Sadikova, E., Sampson, N. A., Vilsaint, C., Williams, D. R., Cruz-Gonzalez, M., & Alegría, M. (2020). Barriers to mental health service use and predictors of treatment dropout: Racial/Ethnic variation in a population-based study.  Administration and Policy in Mental Health and Mental Health Services Research,  47(4), 606-616.  https://doi.org/10.1007/s10488-020-01021-6

(a) Green et al. (2020) b) Studied nationally representative survey data from the United States related to adults with mental illnesses and explored the factors of perceived need, barriers to treatment and dropout; c) Discovered that racial and ethnic minorities had lower chances of recognizing their need for treatment or accessing services and higher rates of dropout in comparison to white adults, with different kinds of barriers involved (structural, attitudinal, cultural, etc.); d) Relevant to my paper since it presents information about structural, cultural and other barriers causing disparities in mental healthcare utilization by racial and ethnic minorities.

Koroma, M. I., Inungu, J. N., Adu-Serwaah, M., Sultana, S., Younis, M. Z., & Iheduru-Anderson, K. (2025). Disparities in adult mental health service utilization in the United States: A cross-sectional study.  Electronic Journal of General Medicine,  22(5). https://doi.org/10.29333/ejgm/16747

(a) Koroma (2025); (b) This cross-sectional study examined factors associated with mental health service utilization among U.S. adults using national survey data; (c) found that White adults had the highest service utilization rate (28.3%), compared to Black (17.6%), Hispanic (16.1%), and Asian (10.3%) adults, with significant racial/ethnic disparities persisting even after controlling for predisposing, enabling, and need-based factors; (d) this research strengthens the justification for my study by providing recent evidence of the ongoing racial and ethnic disparities in mental health service utilization and highlighting the need to qualitatively explore the structural, cultural, and technological barriers contributing to these inequities

Ma, Y., Ramos, C., Wen, H., & Cummings, J. R. (2025). Racial and ethnic differences in mental health service use among adolescents.  JAMA Network Open,  8(6), e2516612. https://doi:10.1001/jamanetworkopen.2025.16612

(a) Ma et al. (2025); (b) This cross-sectional study examined racial/ethnic differences in mental health service utilization (visits, medications, telemental health) among 23,541 U.S. adolescents using national survey data; (c) found that racial/ethnic minority adolescents (Black, Hispanic, Asian) were significantly less likely to receive any mental health visits, outpatient care, or telemental health services compared to White adolescents; (d) this research is important to my study because it documents persistent post-pandemic disparities in access and utilization among youth, highlighting the need to examine structural, cultural, and technological barriers affecting minority populations.

McCleary-Gaddy, A. T., & James, D. (2024). Dehumanization, attitudes toward seeking professional psychological care, and mental health among African American women.  Cultural Diversity & Ethnic Minority Psychology,  30(1), 166. https://psycnet.apa.org/doi/10.1037/cdp0000554

(a) McCleary-Gaddy & James (2024); (b) This study examined how cultural identity, discrimination, and dehumanization influence mental health treatment-seeking behaviors among African American women; (c) found that experiences of dehumanization and discrimination were associated with less favorable attitudes toward seeking professional psychological care, while mistrust of providers and the lack of culturally responsive mental health environments served as significant barriers to treatment-seeking; (d) This is relevant to my study because it highlights cultural barriers central to racial/ethnic disparities in mental health care access and utilization.

Pervez, R., & Anjum, N. (2023). Systemic barriers and interventions in healthcare for underserved communities: An exploration of health disparities.  Insights-Journal of Life and Social Sciences,  1(2), 19-24. https://orcid.org/0009-0004-0747-3369

(a) Pervez & Anjum (2023); (b) looked at the structural and institutional barriers that impact access to healthcare for underserved populations; (c) found that logistical, institutional, and systemic inequities are significant factors that contribute to interrupted care; (d) relevant because this gives evidence for the structural inequities that I will examine in the mental health context.

Rodgers, C. R., Flores, M. W., Bassey, O., Augenblick, J. M., & Lê Cook, B. (2022). Racial/ethnic disparity trends in children’s mental health care access and expenditures from 2010-2017: Disparities remain despite sweeping policy reform.  Journal of the American Academy of Child & Adolescent Psychiatry,  61(7), 915-925. https://doi.org/10.1016/j.jaac.2021.09.420

(a) Rodgers et al. (2022); (b) This study analyzed national trends in children’s mental health care access and expenditures using data from the Medical Expenditure Panel Survey (MEPS) from 2010 to 2017; (c) found that despite national policy reforms, disparities persisted and widened for Black youth compared to White youth, with Black children showing decreasing or stagnant mental health service use and lower expenditures over time; (d) this research is important to my study because it highlights the persistence of long-term racial/ethnic disparities in mental health care access from childhood into adolescence, underscoring the need to examine underlying structural, cultural, and technological barriers.

Van Doren, N., Zhu, Y., Vázquez, M. M., Shah, J., Grammer, A. C., Fitzsimmons-Craft, E. E., Eisenberg, D., Wilfley, D. E., Taylor, C. B., & Newman, M. G. (2024). Racial and Ethnic Disparities in Barriers to Mental Health Treatment Among U.S. College Students.  Psychiatric Services,  75(9), 839-846.  https://doi.org/10.1176/appi.ps.20230185

Van Doren et al. (2024); (b) This study examined racial and ethnic differences in barriers to mental health treatment using a national sample of U.S. college students who were not currently in psychotherapy; (c) found significant disparities, with Black and Hispanic/Latina students reporting more financial and time-related barriers, while also showing greater willingness to seek treatment compared to White students; (d) this research is important to my study because it highlights structural and cultural barriers to mental health care access among racial and ethnic minority young adults and underscores the need for qualitative exploration of lived experiences with these interconnected barriers.

Rubric Standard | Justified > Is evidence presented that this problem is significant to the discipline and/or professional field? The prospectus should provide relevant statistics and evidence, documentable discrepancies, and other scholarly facts that point to the significance and urgency of the problem.

Problem

What was the social problem that prompted you to search the literature to find out more? Write in complete sentences using a scholarly tone.

The situation or issue that prompted me to search the literature is Unequal access to mental health care services among racial and ethnic minority adults, with a particular interest in adult prison settings. The literature summarized below describes disparities in several populations (e.g., Green et al., 2020; Koroma et al., 2025); those findings provide broader context rather than direct evidence about prisons.

This study will focus on how prison wardens, prison mental health counselors, and prison volunteers describe institutional processes, service availability, language access, cultural responsiveness, trust, and technology in relation to care for racial and ethnic minority incarcerated adults. These accounts may reveal opportunities to improve correctional mental health care services.

Now that you have read and summarized some of the recent literature to understand your problem, and given what other researchers are exploring, what meaningful gap have you identified that your study will address? (What have others not yet explored about this problem that you will contribute with your study?)

Although researchers have investigated this issue, the topic has not been explored in this way: The proposed gap concerns how wardens, prison mental health counselors, and prison volunteers describe the interaction of structural, cultural, and technological factors in adult prison settings. Existing summaries mainly address broader community, youth, college, or insured populations and do not establish this prison-specific gap on their own. The study will review additional recent empirical correctional literature to substantiate and refine the gap. The study will seek complementary administrative, clinical, and volunteer perspectives on access, including accounts of facilitating conditions and variation across roles.

Based on all of the above information (social problem, literature review, gap), in one sentence, what is your research problem ?

The specific research problem that will be addressed through this study is The limited understanding of how prison wardens, prison mental health counselors, and prison volunteers perceive the structural, cultural, and technological factors affecting mental health care access among racial and ethnic minority incarcerated adults in U.S. prisons.

Rubric Standard | Meaningful > Has a meaningful problem and gap in the research literature been identified? In other words, is addressing this problem the logical next step, given the previous exploratory and confirmatory research (or lack thereof) on this topic? It is not acceptable to simply replicate previous research for a Ph.D. degree.

Rubric Standard | Original > Does this project have potential to make an original contribution? The problem must be an authentic "puzzle" that needs solving, not merely a topic that the researcher finds interesting. Addressing the problem should result in an original contribution to the field or discipline.

Purpose

To address your stated research problem, what is the purpose of your study? Will you describe, compare, explore, examine, etc.? Complete the purpose sentence below and be sure to clarify your variables/concepts of interest.

The purpose of this Qualitative study is to Explore prison wardens’, prison mental health counselors’, and prison volunteers’ perspectives on structural, cultural, and technological factors affecting mental health care access among racial and ethnic minority incarcerated adults in U.S. prisons.

The interview participants will be members of these three stakeholder groups. Racial and ethnic minority incarcerated adults are the population whose access to care is discussed; they will not be recruited or interviewed. The findings will reflect stakeholder accounts and will not present firsthand accounts of incarcerated adults’ experiences.

Framework (Conceptual or Theoretical)

What theory(ies) and/or concept(s) support (frame) your study and who are the original authors? Provide an in-text citation with your response, and the complete APA reference entry with summary in the Supporting Literature section.

The theories and/or concepts that ground this study include Include intersectionality (Crenshaw, 1989) as the primary conceptual lens and Andersen’s Behavioral Model of Health Services Use (Andersen, 1995) as a complementary organizing model. Intersectionality will guide attention to how stakeholder accounts discuss race, ethnicity, incarceration, socioeconomic position, and other relevant social conditions. Andersen’s model will guide consideration of predisposing, enabling, and need factors related to access. These frameworks will interpret reported perceptions rather than infer individual experiences or causal relationships.

Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1–10

Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 1989(1), 139–167.

How do these theories and/or concepts relate to your research problem, purpose, and the nature of your study?

The logical connections between the framework presented and the nature of my study include Using intersectionality to consider how stakeholder accounts describe overlapping social identities and institutional conditions, and Andersen’s model to examine perceived predisposing, enabling, and need factors. Semi-structured questions will address institutional procedures, staffing, trust, stigma, cultural responsiveness, language access, and technology where participants have relevant knowledge. Open-ended questioning and thematic analysis will allow participants to identify additional factors or report that an anticipated barrier is absent. The framework supports interpreting professional and volunteer perspectives without substituting them for incarcerated adults’ own voices.

Rubric Standard | Grounded > Is the problem framed to enable the researcher to either build upon or counter the previously published findings on the topic? For most fields, grounding involves articulating the problem within the context of a theoretical base or conceptual framework. Although many approaches can ground a study in the scientific literature, the essential requirement is that the problem is framed such that the new findings will have implications for the previous findings.

Research Question(s) and Hypotheses (if applicable)

List the question(s) that you plan to use to address the research problem. Your question(s) must align with your study purpose and include the variables and/or concepts and how they will be examined.

How do prison wardens, prison mental health counselors, and prison volunteers describe structural, cultural, and technological factors affecting mental health care access among racial and ethnic minority incarcerated adults in U.S. prisons? This overarching research question will guide all three role-specific interview guides. Follow-up probes will reflect each role’s knowledge and responsibilities. This qualitative study proposes no hypothesis.

Nature of the Study

What systematic approach/method and research design do you plan to use to address your research question(s)?

To address the research questions in this Qualitative study, the specific research design will include A basic qualitative approach. The study will explore how prison stakeholders interpret and describe factors affecting mental health service access among racial and ethnic minority incarcerated adults. A basic qualitative design is appropriate for examining these perspectives without claiming to capture incarcerated adults' lived experiences (Tisdell et al., 2025). The study will conduct individual semi-structured interviews with wardens, prison mental health counselors, and prison volunteers using separate researcher-developed guides aligned with the same research question. With permission, we will record and transcribe interviews verbatim; the revised protocol will specify the interview format and duration. We will use thematic analysis following Braun and Clarke (2022). We will not recruit or interview incarcerated individuals, and we will not collect individual clinical or correctional records.

Reference entry for the work on which this research design is based:

Braun, V., & Clarke, V. (2022). Thematic analysis: A practical guide. SAGE Publications.

Tisdell, E. J., Merriam, S. B., & Stuckey-Peyrot, H. L. (2025).  Qualitative research: A guide to design and implementation. John Wiley & Sons. https://doi.org/10.1177/07417136251356470

For your planned research design, what type of data will you need and what data collection instruments will provide it?

For my planned research design, I will need Primary qualitative data will be collected from individual semi-structured interviews with prison wardens, prison mental health counselors, and prison volunteers. Three researcher-developed, role-specific interview guides will explore access procedures; institutional and cultural factors; language access; trust; technology (where applicable); and recommendations for improvement. The guides will be checked for alignment with the overarching research question and for neutral wording. Participants will be asked to distinguish direct observations from secondhand information and to avoid identifying incarcerated individuals. Brief role and experience information, along with researcher reflexive notes, will provide context for interpretation.

What data sources and analysis do you plan to use to answer your research question(s)?

For this research design, we will use the following data sources. We will purposively recruit approximately 12–15 participants across three groups: prison wardens, prison mental health counselors, and prison volunteers. Eligible participants will be adults aged 18 or older who currently serve, or have served, in one of these roles in a U.S. adult prison and have direct professional or volunteer experience relevant to mental health service access among racial and ethnic minority incarcerated adults. Participants will not be required to belong to a particular racial or ethnic group. Recruitment will seek representation from each role through approved organizational contacts, professional networks, and volunteer organizations. Invitations will permit private, voluntary responses to the researcher. The final sample and role distribution will depend on recruitment feasibility and the depth and relevance of the data. Interview transcripts will be analyzed using Braun and Clarke’s (2022) six-phase thematic analysis: familiarization, coding, generating initial themes, developing and reviewing themes, refining and naming themes, and writing the analysis. Coding will attend to participants’ accounts and unexpected findings, with the conceptual framework informing interpretation rather than imposing predetermined conclusions. Themes will be examined across the full dataset and by participant role, while preserving differences and contradictory accounts. Reflexive journaling and an audit trail will document analytic decisions. Reference

Braun, V., & Clarke, V. (2022). Thematic analysis: A practical guide. SAGE Publications.

What limitations, challenges, and/or barriers might you need to address while conducting this study (e.g., access to participants, access to data, requirements for storing data, separation of roles or other ethical considerations, instrumentation fees, etc.)?

This study will face limitations associated with purposive recruitment, a small sample, and unequal representation across participant roles or institutions. Institutional loyalty, social desirability, recall, or limited knowledge of clinical services may influence participants' accounts. Volunteers may have less access to service information than counselors or wardens. Questions will allow participants to say they do not know, and analysis will preserve these differences. Findings will provide contextual understanding rather than statistical generalization. A central limitation is that stakeholder perceptions cannot establish incarcerated adults’ own experiences, preferences, or prevalence. The analysis and conclusions will explicitly maintain this distinction. Recruitment may require organizational permission, and employees or volunteers may worry about professional consequences. Participation will be voluntary, with private recruitment responses and attention to avoid supervisory pressure. Consent materials will explain confidentiality and its limits. Participants will be instructed not to disclose names, case details, or other identifying information about incarcerated individuals; inadvertent identifiers will be removed from transcripts. We will report role and facility information cautiously to reduce identification risks. Data access, secure storage, retention, and deletion procedures will follow the institution’s approved protocol. We will submit the revised population, recruitment procedures, and instruments through the applicable university review process before data collection.

Rubric Standard | Feasible > Can a systematic method of inquiry be used to address the problem; and does the approach have the potential to address the problem while considering potential risks and burdens placed on research participants? The tentative methodology demonstrates that the researcher has considered the options for inquiry and has selected an approach that has potential to address the problem.

Significance

How will your study address the meaningful, discipline-specific issue that you identified and therefore contribute to your field, discipline, professional practice, etc. contributing to positive social change?

This study is significant in that It may contribute to forensic psychology and correctional mental health practice by clarifying how administrative, clinical, and volunteer stakeholders perceive the impact on mental health care access among racial and ethnic minority incarcerated adults. The study may identify institutional processes, culturally responsive practices, language support, and service coordination issues that warrant further attention. Differences across roles may also reveal areas in which stakeholders have different information or priorities. Intersectionality and Andersen’s Behavioral Model will help interpret how social and institutional conditions relate to access. Findings may inform discussion of policies, staff education, volunteer coordination, and service delivery. These potential contributions will be framed as implications of stakeholder accounts, without claiming demonstrated effects on care outcomes or recidivism. The study may support positive social change by identifying opportunities to make correctional mental health care more equitable.

Rubric Standard | Impact > Does this project have potential to affect positive social change? As described in the Significance section, the anticipated findings have potential to support the mission of Walden University to promote positive social change.

Rubric Standard | Objective > Is the topic approached in an objective manner? The framing of the problem should not reveal bias or present a foregone conclusion. Even if the researcher has a strong opinion on the expected findings, the researcher must maximize scholarly objectivity by framing the problem in the context of a systematic inquiry that permits multiple possible conclusions.

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