Literature Review Outline
Develop an outline of your planned Concept Review (Chapter 2) content. Review Ch. 7 of James & Slater (2014) for an example, and ensure that your outline adheres to the structure of the Chapter 2 Template found in the College of Doctoral Studies Dissertation Guide in CDS Central. Note: The outline should include all the topics discussed in the Chapter 1 purpose section, research questions, and theoretical/conceptual framework. It is important to ensure the literature review will include sufficient depth and breadth. Keep in mind the completed chapter will need to include at least 30 pages prior to proposal approval, which usually occurs during DOC/741. Here is my Chapter one below: A Modified Delphi Study Examining the Need for a Mental Health Intervention Model in the United States Army Takera Fields Doctor of Health Administration University of Phoenix Precis (Draft of Chapter One) A Modified Delphi Study Examining the Need for a Mental Health Intervention Model in the United States Army This study focuses on investigating the best practice and procedure for mental health services in the United States (U.S.) Army by sharing experience, collaborating ideas, and creating a model that represents adequate mental health. In this study, the model considered will be reviewed by all participants for mutual agreement prior to advertisement. Taking place on an Army base, the study will provide insight on the level of mental health intervention required in this environment to ensure United States Army soldiers are receiving satisfactory care for these conditions. The study will investigate lack of guidance for mental health in the United States Army. Problem Statement Within the United States Army, the state of mental illness often goes unrecognized within the enlisted ranks. Often, mental instability goes unnoticed until a fatality, such as a suicide, occurs. Bachynsk et al. (2012) indicate since the year of 2004, suicides among United States Army soldiers has consistently increased. The problem consists of many potentially interacting risk factors. Mental health issues are at the top of the list as most frequently recorded and broadly researched, which may be relevant to the current rise in suicide rates in the United States Army. Soldiers diagnosed or showing signs of major depressive and bipolar disorder are extremely susceptible to suicidal thoughts and behaviors (Bachynsk et al., 2012). Anxiety, psychotic, personality and narcissistic disorders, alcoholism, and drug addictions, have also been discovered as an association with suicides in the Army along with adjustment and post-traumatic stress disorder known as PTSD (Bachynsk et al., 2012). Zinzow et al. (2017) contended that although mental health is a leading cause of suicides, many soldiers go untreated. Stigma is known to cloud soldiers’ minds against seeking mental health care in the Army. Two identifiable types of mental health stigma are public opinion, which results in unwanted feedback from soldiers alike; and self-stigma, which describes self-blame of identity and undervalue of worthiness (Zinzow et al., 2017). The specific problem remains that, while these issues are recognized, a model of adequate mental health has yet to be established in the U. S. Army. Purpose of the Study The purpose of this qualitative, modified Delphi study is to obtain consensus of opinion on practices and procedures recommended to best support soldiers’ mental health in in the United States Army. Five senior-level enlisted soldiers will be recruited from an Army instillation located in the Southeastern region of the United States. The researcher will engage in a two round iterative process to collect and analyze opinions on the practices and policies needed to support soldiers’ mental health. This study seeks to shed light on the need for better mental health support systems within the U.S. Army and provide a possible model for a future support system. Population and Sample For this study, five senior enlisted soldiers will be recruited from the population of senior enlisted soldiers between the ranks of E-5 and E-8. It is at this level that these personnel can make appropriate decisions regarding policies and procedures related to soldiers’ mental health. Significance of the Study The study of mental health intervention in the Army can be a learning paradigm in the development of a model representation for adequate mental health to enhance the soldiers’ mental agility and ability to adapt and overcome more efficiently. This research is significant to the entire United States Army because inadequate mental health can go unnoticed and some of the suicides that have recently occurred could have been prevented. The contribution of this study will enlighten superiors by offering a solid model for mental health which bridges the gap between mental health issues and suicides. Proposed Research Methodology This research will take a qualitative approach within this study, using a modified Delphi design. Using qualitative strategies best suits this study because of the nature in which inquiry relies on unstructured and non-numerical data. Further, Creswell and Creswell (2018) note the benefits of qualitative research include the ability to analyze multiple sources of data, the ability to build themes through inductive data analysis, and the research collecting data while also being an instruments within the process. Within the modified Delphi design, there will be a two round interactive process to gather data and analyze the senior enlisted soldiers’ opinion on an adequate model for mental health that will benefit the soldiers individually and as a team. The group will come to generate, understand, collaborate, and use concepts, explanations, debates, and facts related to science to develop a model that represents adequate mental health. The first session will consist of five open-ended questions submitted to five senior enlisted soldiers to create a subset of common themes. In the second round the senior enlisted soldiers will rate the themes on a Likert-type scale to identify level of agreement. A qualitative approach is practiced by involving a series of questions to five people, as this study goes in depth about the lack of mental health intervention in the United States Army. Research Questions The potential research questions guiding this study will address the following: R1. What is consensus of opinion from senior enlisted soldiers on adequate mental health for soldiers in the United Stated Army? R2. What are practices and procedures recommended to best support soldiers’ mental health in in the United States Army? Conceptual Framework In this study, the framework used will rely on the self-efficacy theory. The perception of self-efficacy describes a person’s belief in things they are capable of to trigger the motivation, cognitive resources and courses of action needed combined under certain circumstances. According to Gonzalez, Goeppinger, and Lorig (1990), “there are four empirically verified alternatives to enforcing self-efficacy: skills mastery, modeling, reinterpretation of psychological sign and symptoms and persuasion” (p. 2). Out of the four, modeling suits this study best to condition or alter the behavior. When a model is developed, it will provide soldiers attempting to modify their behavior a visual of someone else with similar mental issues, accomplishing the goal to change. Assumptions, Limitations, and Delimitations Assumptions. The assumptions within this study include the belief that participants will answer the interview questions in an honest and candid manner; participants have all experienced the same or similar phenomenon; and participants have a sincere interest in participating in this research. Limitations. Limitations within this study include a small sample size, therefore, findings are not generalizable. As this study only focuses on the United States Army, it may not be applicable to other areas within the overall military. Delimitations. Soldiers will be recruited from the population of senior enlisted soldiers between the ranks of E-5 and E-8, as it is at this level that these personnel can make appropriate decisions regarding policies and procedures related to soldiers’ mental health. This study is also focused on a single Army instillation in the Southeastern area of the United States. Chapter Summary This chapter focused on how the United States Army tends to fall through the cracks regarding mental health intervention. Because of this there are a number of suicides that have taken place. Kathleen E Bachynski et al. (2012), explains in the years between 2007 and 2008, 255 soldiers committed suicide. Factors associated with higher suicide risk included male gender, lower enlisted rank and mental health disorders treated on an outpatient basis, as well as a number of mental health disorders. The recent increase in suicides parallels an increase in the prevalence of mental health issues across the army (Kathleen E Bachynski et al., 2012). Soldiers seeking treatment for mental issues should be a priority for suicide prevention. A mental health intervention model will serve as a vital tool for early stages of mental health issues and appropriate treatment to alleviate added stress while coping and or adapting to military lifestyles. References Bachynsk, K. E., Canham-Chervak, M., & Millikan, A. M. (2012, January). Mental health risk factors for suicides in the US Army. BMJ Journals, 18(6). https://www.researchgate.net/profile/Sandra_Black5/publication/221685000_Men tal_health_risk_factors_for_suicides_in_the_US_Army_2007-8 Bachynski, K.E., Canham-Chervak, M. C., & Black, S. A. B. (2012). Mental health risk factors for suicides in the US Army. Injury Prevention https://apps.dtic.mil/dtic/tr/fulltext/u2/a557649.pdf Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approach. Sage Publications. Gonzalez, V., Goeppinger, J., & Lorig, K. (1990, September). Four psychosocial theories and their application to patient education and clinical practice. Arthiritis Care and Research, 3(3). Zinzow, H.M., Britt, T.W., Pury CL, Jennings, K., Cheung J.H., Raymond, M.A. (2013). Barriers and facilitators of mental health treatment-seeking in U.S. active duty soldiers with sexual assault histories. J Trauma Stress. 2015;28(4):289-297. doi:10.1002/jts.220
