Publication Date

2025

Document Type

Dissertation/Thesis

First Advisor

Herrmann, Lynn

Degree Name

Ph.D. (Doctor of Philosophy)

Legacy Department

School of Health Studies

Abstract

Background: Despite efforts to increase recruitment and enrollment, the physical therapy profession lacks Black students and clinicians. Racially marginalized students have higher rates of academic difficulty during physical therapy education (PTE) than White students. Mental health and belongingness have been proposed as prerequisites for reaching academic achievement and attaining one’s full potential. Conversely, poor mental health and lack of belongingness during PTE may contribute to the underrepresentation of Black Doctor of Physical Therapy (DPT) students and clinicians. Yet not enough is known about the relationships between mental health, belongingness, and the academic achievement of DPT students. Purpose: This study aimed to investigate the relationships between mental health, belongingness, and academic achievement among DPT students, focusing on the influences of racially marginalized identities and biased experiences. Additionally, the study enhances the understanding of the lived experiences of Black students navigating mental health and belongingness in PTE. Methods: A convergent mixed methods study design generated the rich data necessary to thoroughly explore the problem’s complexity using Strayhorn’s College Student Sense of Belonging Model as a framework. A cross-sectional online survey, including the Depression, Anxiety, and Stress Scale (DASS-21) and belongingness measured by the Program Sense of Belonging Questionnaire (ProSB), was distributed to DPT students enrolled in accredited programs nationwide. Black DPT students were recruited from the online survey to participate in semi-structured focus group interviews. Descriptive statistics were used to examine patterns in mental health and belongingness, while multiple regression analyses were conducted to predict GPA and the sense of belonging constructs, “Value” and “Social Acceptance,” for the entire sample and Black students separately. ANOVA was conducted to determine differences in mental health and belongingness constructs across racial identities. Qualitative data was analyzed with inductive coding and constant comparative methods until the final themes emerged. The quantitative and qualitative results were integrated to explore areas of convergence and divergence. Positionality, reflexivity, and member checking were incorporated to enhance validity and minimize bias. Results: DPT students responding to the survey (N=634) had mean scores on the DASS-21 indicating “mild” levels of stress (mean 17.57, SD 8.61) and depression (mean 12.75, SD 9.89) and “moderate” levels of anxiety (mean 12.59, SD 9.07), and the ProSB mean score was 46.71 (SD 7.76). The study found that Black DPT students experienced significantly higher levels of depression (mean 14.30, SD 9.91, P< .001) and anxiety (mean 13.86, SD 9.45, P=.025) compared to other races, though stress levels and all constructs of belongingness were similar. Black students (N=200) had statistically significantly lower GPAs (mean 3.39, SD 0.35, P< .001) than their White peers. Depression was a negative predictor of perceived “Value” (B= -.07, P < .001) and “Social Acceptance” (B = -.108, P < .001) in Black DPT students and accounted for 2.8% of the variance in perceived “Value” and 5.1% of the variance in “Social Acceptance.” Perceived “Value” was a positive predictor of GPA in Black DPT students, accounting for 2.9% of the variance (B = .016, P= .014). Thematic analysis of qualitative focus group interviews with Black DPT students (N=26) resulted in five themes: Representation Matters, Experiences of Belonging, Threats to Emotional Well-being, Thwarted Belonging, and Coping. The qualitative data supported the quantitative findings that experiences of biased treatment were linked to mental health challenges among Black DPT students. However, qualitative insights further refined the understanding of belongingness, revealing that students often experienced a sense of belonging with Black peers and faculty or White faculty allies but less frequently with White peers. Additionally, socioeconomic status, body size, gender, disability, and sexuality also shaped students’ sense of belonging. Conclusion: This study’s findings highlight the challenges Black DPT students face. Experiencing bias and psychological distress can reduce sense of belonging and academic achievement. Creating a culturally safe and inclusive environment that empowers Black students to reach their full potential may support academic persistence in PTE.

Extent

190 pages

Language

en

Publisher

Northern Illinois University

Rights Statement

In Copyright

Rights Statement 2

NIU theses are protected by copyright. They may be viewed from Huskie Commons for any purpose, but reproduction or distribution in any format is prohibited without the written permission of the authors.

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Text

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