WAQP Week 2 Assignment

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

Racial and Ethnic Disparities in Mental Health Care Access and Utilization in the United States Comment by Boone, Leggie: For a qualitative study, the title should emphasize the phenomenon being explored, the participants, and often the qualitative approach rather than implying statistical measurement of disparities. The phrase "racial and ethnic disparities" is often associated with quantitative comparisons, so a qualitative title should focus on experiences, perceptions, barriers, or meanings related to mental health care access and utilization. The current title suggests: Measurement of disparities across groups Statistical comparison of outcomes A quantitative or mixed-methods approach A qualitative study should seek to understand individuals’ experiences, perceptions or how they navigate mental health care access and use.

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 The key words searched and the databases used included racial/ethnic disparities, mental health care access, mental health service utilization, structural barriers, cultural barriers, technological barriers, African American OR Black, Hispanic OR Latino, Asian American, combined with Boolean operators (AND/OR) mental health treatment disparities. Only articles published between 2018 and 2026 that were peer reviewed and empirical were included. PubMed, PsycINFO, Google Scholar, Web of Science and CINAHL were the main databases used for searches. Other searches were made in multi-disciplinary databases, including SAGE Journals and the JSTOR, to find social science views.. Comment by Boone, Leggie: Limit your range to 5 years and include seminal works associated with your theories where needed. Comment by Boone, Leggie: Watch punctuation

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.

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. doi:10.1001/jamanetworkopen.2025.16612 Comment by Boone, Leggie: Watch your spacing. APA formatting requires reference list citations to be organized alphabetically. Number each of them or re-organize your format with indentations to show where one resource ends and another begins. Be consistent with the font and font size throughout.

(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.

Panchal, N., Hill, L., Artiga, S., & Hamel, L. (2024). Racial and ethnic disparities in mental health care: findings from the KFF survey of racism, discrimination and health.  Kaiser Fam Found, 1-13. Comment by Boone, Leggie: Write out the full name of the journal. I was not able to locate this article. Is there a DOI? Verification is needed. Kaiser Family Foundation (KFF) reports are generally respected policy reports but are not typically peer-reviewed journal articles.

(a) Panchal et al. (2024); (b) Analyzed 2023 national survey data on mental health service receipt among adults reporting fair/poor mental health; (c) found White adults (50%) were more likely to receive services than Black (39%) and Hispanic (36%) adults, with additional barriers like stigma, cost, and lack of culturally congruent providers reported by minorities; (d) this is important to my study as it provides current evidence of disparities and identifies structural and cultural factors that my research will explore further.

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) important to my study because they analyzed trends in mental health service use among children using national data; (c) important to my study because they found that disparities in mental health service use among Black youth compared to White youth were increasing while the use of services was decreasing or stagnating for Black youth; (d) important to my study because they highlighted the long-term disparities that are present throughout childhood and into adolescence and the need to address them. Comment by Boone, Leggie: Edit phrasing. The description is too brief and doesn’t identify population, variables, or design. As you described what was found, you share use of service, but this could be more comprehensive. Comment by Boone, Leggie: I added a space to separate the reference grouping

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 populations that are underserved; (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. Comment by Boone, Leggie: Space added

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 Comment by Boone, Leggie: APA formatting. Page numbers and doi URL are not correct

(a) McCleary-Gaddy & James (2024); (b) examined how cultural identity, discrimination, and dehumanization influence mental health treatment-seeking among African American women; (c) mistrust and lack of culturally sensitive environments decrease help-seeking; (d) this is relevant to my study because it highlights cultural barriers central to racial/ethnic disparities. Comment by Boone, Leggie: You summarize the findings but need a little more detail to relate to your study. Added wording would help. For example: The researchers 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 barriers to treatment-seeking.

Choi, S. W., Ramos, C., Kim, K., & Azim, S. F. (2019). The association of racial and ethnic social networks with mental health service utilization across minority groups in the USA.  Journal of Racial and Ethnic Health Disparities,  6(4), 836-850. https://doi.org/10.1007/s40615-019-00583-y

(a) Choi et al. (2019); (b) examined racial/ethnic group social networks and their influence on service use and depression diagnosis; (c) showed variations were associated with service use differences; (d) adds to cultural and community-level factors in research I want to do. Comment by Boone, Leggie: The resource is too old. The description is brief and lacks information about the population and variables examined regarding what was studied. Why the research is important is vaguely noted. Be specific.

Elliott, T. R., Choi, K. R., Elmore, J. G., & Dudovitz, 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) examined inequities in mental health treatment utilization among children; (c) found that significant racial/ethnic disparities exist in access to mental health treatment; (d) general applicability of the issues across the ages. Comment by Boone, Leggie: What was studied needs more detail about the population and focus; what was found is overly general; Why the study is important is vague and does not appropriately respond. Avoid colloquialisms.

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. Comment by Boone, Leggie: Looks good

Breslau, J., Han, B., Levin, J. S., Lai, J., & Yu, H. (2024, March). Are disparities in mental health care for Medicaid beneficiaries lower in managed care?. In  Healthcare (Vol. 12, No. 1, p. 100734). Elsevier. https://doi.org/10.1016/j.hjdsi.2024.100734 Comment by Boone, Leggie: APA formatting needs attention

(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.

Fischer, M., Swint, J., Zhang, W., & Zhang, X. (2024). Mind the gap: Unraveling mental health disparities in America’s diverse landscape.  medRxiv, 2024-07. https://doi.org/10.1101/2024.07.28.24311109 Comment by Boone, Leggie: medRxiv is a preprint repository, not a peer-reviewed journal. Identify a replacement resource.

(a) Fischer et al. (2024); (b) Conducted a systematic review of studies on mental health service utilization across racial/ethnic groups; (c) concluded that African American and Hispanic populations consistently show lower utilization rates due to systemic racism, stigma, and lack of culturally competent care; (d) this research strengthens the justification for my study by synthesizing evidence on the urgency and complexity of these disparities.

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 The problem or question that I would like to address in the literature is the racial/ethnic inequities in access to and utilization of mental health care services in the USA. Although there are similar or higher rates of mental health needs among racial and ethnic minority groups, compared to White individuals, they have very low rates of utilization of mental health services, especially Black, Hispanic, and Asian communities. For example, the percentage of adults who report fair or poor mental health who receive mental health services is significantly higher among White adults (50%) compared with Black (39%) and Hispanic (36%) adults. This inequity is not only seen between age groups but also among adolescents and children despite policy changes that have been instituted, such as the Affordable Care Act and increased insurance coverage. This inequity is due to structural barriers (e.g., cost, lack of insurance, systemic inequities), cultural factors (e.g., stigma, mistrust, and lack of culturally congruent providers), and technological challenges, leading to unmet mental health needs, poorer outcomes, and elevated long-term costs to society. Comment by Boone, Leggie: What Is Missing You should explicitly state: What is known Disparities exist. Structural and cultural barriers have been identified. What is not known How affected individuals perceive these barriers. How barriers influence decisions to seek care. How minority adults navigate mental health systems. Why qualitative inquiry is needed Existing research is largely quantitative. Lived experiences and perceptions remain insufficiently understood. Comment by Boone, Leggie: Consequences including unmet needs, poorer outcomes, and societal costs are identified. Racial and ethnic minority groups are identified, but the specific population for the proposed study is unclear. The statement describes what is known about disparities but does not identify what remains unknown. The focus remains on prevalence and disparities rather than understanding experiences and barriers. The rationale for exploring lived experiences, perceptions, or meanings is not explicitly stated.

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: While many studies have documented racial and ethnic differences in mental health care access and use, few studies have systematically explored the intersectionality of structural, cultural, and technological barriers on a single integrated framework. Comment by Boone, Leggie: The prospectus gap should answer three questions: What is already known? What remains unknown? How will your study address that unknown? A qualitative study should usually explore experiences, perceptions, meanings, or processes. The current gap could be addressed through another quantitative study.

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 research problem that this study will address is the lack of understanding of the role structural, cultural, and technological barriers play in the persistence of racial/ethnic disparities in mental health care access and utilization in the United States. Comment by Boone, Leggie: Your research statement would be stronger if it explicitly emphasized the lack of understanding from the perspective of those experiencing the phenomenon. For a qualitative dissertation, wording that highlights experiences, perceptions, or meanings rather than the "role" of factors is needed.

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 The aim of this qualitative study is to examine the interrelated role of structural, cultural and technological barriers in racial and ethnic inequalities in access to and utilization of mental health care in the U.S. context. Comment by Boone, Leggie: In qualitative research, words such as examine the role can sound more quantitative or explanatory. A qualitative purpose statement typically focuses on understanding experiences, perceptions, meanings, or interpretations. Examine the role" is not strongly qualitative. Racial and ethnic minority adults are not specified. A purpose statement expressing a phenomenological design is strong: Example: The purpose of this qualitative phenomenological study is to explore the lived experiences of racial and ethnic minority adults regarding structural, cultural, and technological barriers that influence access to and utilization of mental health care services in the United States.

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 The theories and/or concepts that underlie this study are Andersen's Behavioral Model of Health Services Use and the intersectionality concept. Comment by Boone, Leggie: Information about the authors of the theories is needed. Andersen's model does not explicitly categorize culture as a predisposing factor or technology as an enabling factor in the way your statement suggests. Rather, the model broadly examines how predisposing, enabling, and need characteristics influence health service utilization. Include appropriate citations. Any author-related resource related to the development of the theories needs to also appear in your literature section with the a, b, c, and d completed. Andersen's Behavioral Model of Health Services Use Original author: Ronald M. Andersen Common citation: Andersen (1995) Intersectionality Original author: Kimberlé Crenshaw Foundational citation: Crenshaw (1989) The phrase: "Intersectionality adds to this model..."would be stronger if it explained that intersectionality helps reveal how multiple social identities and systems of oppression shape experiences of barriers and access.

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 The logical links between the framework presented and the nature of my study are Andersen's Behavioral Model of Health Services Use, which introduces a structure for examining the relationship between the predisposing (cultural), enabling (structural and technological) and need factors that influence the use of mental health services among racial/ethnic minorities. Intersectionality adds to this model by emphasizing the intersectionality of overlapping social identities (race, ethnicity, gender, etc.) aggravating these barriers. These are used in tandem to provide the qualitative look into the interrelated barriers that led to the identified disparities.

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.

What is the impact of the combined effect of structural, cultural and technological barriers on the access to and use of mental health care services for racial/ethnic minority people in the United States? Comment by Boone, Leggie: The research question aligns with the topic and concepts of interest, but it is not aligned with a qualitative study because it asks about the "impact" of barriers, which implies causation or effect and is more consistent with a quantitative design. The purpose is to explore experiences/perceptions. Qualitative research typically asks: How do participants experience...? How do participants perceive...? What are the experiences of...? How do participants describe...? What meanings do participants attribute to...?

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 The specific research design for this qualitative study will be a basic qualitative design with semi-structured interviews to investigate the lived experiences of the participants with structural, cultural and technological barriers to mental health care. Comment by Boone, Leggie: Alignment and methodological issues The phrase "lived experiences" is associated with phenomenology, not a generic/basic qualitative design. Option 1: Basic Qualitative Study Focus on: perceptions perspectives understandings experiences Avoid: lived experiences essence of experience Option 2: Phenomenological Study Focus on: lived experiences essence of the phenomenon phenomenological analysis Currently, your problem, purpose, gap, and research question suggest that either design could work, but your wording is mixing the two approaches.

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

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

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 My proposed research design involves gathering primary qualitative data with semi-structured interviews with adults of racial and ethnic minority backgrounds with barriers to mental health care services. A semi-structured interview guide developed by the researcher will be the main data collection tool.

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

Purposive sampling of adults aged 12–15 of racial and ethnic minority groups (black, Hispanic, and Asian) who have had difficulties accessing and/or using mental health care services will be used as a data source. The data will be gathered using semi-structured interviews with an audio recording. Data analysis will be conducted using the six stages of thematic analysis, which are familiarization with the data, initial coding, searching for themes, reviewing themes, defining themes and reporting. Comment by Boone, Leggie: "adults aged 12–15" This is a contradiction. Individuals aged 12–15 are adolescents/minors, not adults. IRB FLAG Since your purpose statement references racial and ethnic minority adults, your sampling strategy must match.

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.)?

Some challenges faced may include a lack of participants from racial and ethnic minority groups because of mistrust of research and healthcare systems in the past, and the need to maintain confidentiality and avoid emotionally triggering discussions about sensitive mental health experiences. Other factors include obtaining Institutional Review Board (IRB) approval and dealing with the time spent on transcription and thematic analysis. Comment by Boone, Leggie: Specify anticipated sample size (e.g., 10–15 or 12–20 participants)

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 is important in this study to help further understand how the structural, cultural and technological barriers all play a role in racial and ethnic disparities in access and utilization of mental health care. The results can provide information to develop culturally responsive interventions, policies, and practices to address these disparities. The findings of this study can help reduce disparities in access to mental health services and improve the mental health status of racial/ethnic minority groups while promoting positive social change. Comment by Boone, Leggie: You explain why the study is important and address barriers and disparities, but the contribution is implied but not explicitly stated. Be more specific about interventions and policies. The current statement focuses primarily on what the findings might be used for, but it does not clearly state: What new knowledge the study will contribute. How qualitative findings will fill the identified gap. Who specifically may benefit (mental health providers, policymakers, community organizations, minority populations, etc.).

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.

Partner Site Masking Self-Check

Walden capstones typically mask the identity of the partner organization. The methodological and ethical reasons for this practice as well as criteria for exceptions are outlined here (link to posted guidance).

☒ Check here to confirm that you will mask the identity of the organization in the final capstone that you publish in ProQuest.

☐ If you perceive that your partner organization’s identity would be impossible to mask or if there is a strong rationale for naming the organization in your capstone, please check this box so that your Program Director can review your request for an exception. If granted, that exception must be confirmed by the IRB during the ethics review process. The IRB will also ensure that your consent form(s) and/or site agreement(s) permit naming the organization.