Medicine and Health Sciences Commons^™

The Impact Of A Parent-Only Pediatric Obesity Intervention Program On Quality Of Life In Racially Diverse Children, Taylor Vashro

Theses and Dissertations

Pediatric obesity has been associated with significant decrements in pediatric quality of life (QOL) comparable with severe pediatric diseases such as cancer. Parenting interventions have yielded health benefits for children with obesity; however, few studies have investigated the impact of parent-focused interventions on QOL in children with overweight and obesity. This study investigated the impact of a 6-week intensive parenting intervention program on the QOL of 5-12 year old, predominantly Black children with overweight and obesity. Parents were randomized into either the parenting intervention (NOURISH+) or a control group, and QOL, as well as variables related to child and parenting …

Access To Hiv Prevention, Care, And Treatment Services In The Us: The Role Of Primary Care, Jessica S. Kiernan

Theses and Dissertations

This dissertation examines the role of access to primary care in benefitting HIV outcomes through increased access to HIV prevention, care, and treatment services, among populations disproportionately affected by HIV in the US. Over 30,000 individuals are newly diagnosed with HIV annually in the US and diagnoses are concentrated in specific populations. At an individual-level, ~ 70% of new diagnoses are among gay and bisexual men and of those diagnoses, 70% are among Non-Hispanic Black and Hispanic gay and bisexual men. At a community-level, over 50% of new HIV diagnoses occur in less than 2% of US counties (48), Washington, …

Mathematical Models Of Infection Prevention Programs In Hospital Settings, Kelly A. Reagan

Theses and Dissertations

Hospitals play a vital role in providing for the healthcare needs of a community. Patients can develop hospital-acquired infections (HAIs) during their hospitalization due to exposure to foreign bacteria, viruses, and fungi. Infection prevention programs target and reduce HAIs, but implementing the infection prevention programs often comes with a cost. The goal of my research is to use mathematical models to quantify the impact of infection prevention programs on cases of HAIs and total healthcare costs. First, I use a Markov chain model to quantify how one infection prevention program reduces general HAIs in the hospital. Then, I calculate the …

A Novel Approach To Reducing Adiposity Among Young Men, Jean M. Reading

Theses and Dissertations

Background

Lifestyle intervention is the first line treatment for obesity. Yet, young men are underrepresented in lifestyle interventions, which is posited to be the result of unmet needs and overall low concern for weight management. The aims of this dissertation are to:

Papers 1 and 2: Test the preliminary efficacy, feasibility, and acceptability of a self-guided lifestyle intervention for young men.

Paper 3: Explore the behavioral and physiological factors associated with changes in adiposity among young men and women enrolled in a more intensive lifestyle intervention.

Results

Papers 1 and 2: The self-guided intervention produced modest weight …

Pharmacists' Role In Opioid Use Disorder And Overdose Prevention And Treatment And Their Attitudes And Perceptions Towards Distributing Naloxone Under A Standing Order, Stephen C. Ijioma

Theses and Dissertations

Background: Opioids are a class of drugs that bind to opioid receptors (mu, delta, and kappa), located in the central and peripheral nervous systems, to exert responses such as analgesia, respiratory depression, euphoria, and miosis. The opioid epidemic is characterized in large part by an increase in opioid overdose deaths. Community pharmacists are one of the most accessible healthcare professionals who frequently interact with patients and can implement OUD and opioid overdose prevention strategies. Treatment for opioid overdose and OUD include naloxone for overdose deaths as well as medication-assisted treatment for OUD.

Objective: The specific aims of this thesis include …

A Qualitative Analysis Of Caregiver Goals For Urban Children With And Without Asthma, Megan M. Carlson

Theses and Dissertations

Pediatric asthma is a major public health concern that disproportionately affects children of color and youth living in low-income, urban areas. The implications for public health, child health, and family functioning necessitates our understanding and addressing experiences by families who are facing barriers within their socio-demographic context in addition to the stressors associated with managing pediatric asthma. The current study applied qualitative methods to interviews with caregivers of children with and without asthma in an effort to more deeply connect with caregivers’ experiences and yield richer information about the intersection of identities as Black caregivers living in an urban setting …

Predictors Of Experimental And Control Group Attendance: Findings From An Hiv/Std Prevention Rct With Pregnant Women At Risk For Substance Use, Jaclyn S. Sadicario

Theses and Dissertations

Efforts to improve inclusion in research have included mandating the recruitment of ethnic minorities and women into NIH funded studies. However, little research has been completed on who attends such interventions. This is particularly worrisome in populations for which attendance to interventions can have dire consequences. HIV is a public health concern for pregnant women in substance using communities, as pregnant women are much less likely to use condoms during intercourse to prevent HIV. Group modular HIV prevention interventions have long been the standard for HIV prevention. However, little attention in research on HIV prevention interventions RCTs has been focused …

Recovery From Design, Cassandra J. Ellison

Theses and Dissertations

Through research, inquiry, and an evaluation of Recovery By Design, a ‘design therapy’ program that serves people with mental illness, substance use disorders, and developmental disabilities, it is my assertion that the practice of design has therapeutic potential and can aid in the process of recovery. To the novice, the practices of conception, shaping form, and praxis have empowering benefit especially when guided by Conditional and Transformation Design methods together with an emphasis on materiality and vernacular form.

Exploring The Role Of Intersectionality On Cardiovascular Disease Risk In Sexual Minorities, Leia Harper

Theses and Dissertations

Background: Previous research has shown that sexual minority individuals (SM) are twice as likely to smoke, twice as likely to be overweight or obese, and less likely to be physically active than heterosexual persons; all of which place SMs at an increased risk for cardiovascular disease (CVD). While information on CVD risk by race/ethnicity and socioeconomic status is well documented, there is scant literature examining race, gender, and the potential CVD risk in SMs. The purpose of this study was to examine CVD risk in sexual minorities.

Method: The current study used data from the National Longitudinal Study of Adolescent …

An Exploration Of Factors Influencing Attrition From A Pediatric Weight Management Intervention, Melissa Ann Kwitowski

Theses and Dissertations

Childhood obesity is a serious health problem in the United States. Numerous weight management programs attempt to address this issue. However, attrition poses significant treatment efficacy challenges. Understanding attendance and attrition from childhood obesity programs is crucial for effective and appropriate resource utilization. NOURISH+ is a community-based treatment program for parents of overweight and obese children (age 5–11 years, BMI ≥ 85th percentile). The current study investigated attrition from NOURISH+ to enhance understanding of pediatric obesity treatment retention factors. NOURISH+ participants (n=70) completed a questionnaire assessing barriers to adherence and general program feedback. Data were analyzed using frequencies, …

Factors That Influence Breast Cancer Diagnoses In Virginia Women 40-64 Years Old Who Utlized The Every Woman’S Life Program 1998-2012, Melanie C. Dempsey

Theses and Dissertations

This dissertation examines sociodemographic determinants and preventive health behaviors among women 40-64 years of age who participated in the Virginia Department of Health’s Every Woman’s Life breast cancer screening program. Utilizing secondary data, this research sought to explore patterns of breast cancer incidence, mammography screening utilization and sources of health information among low-income women.

The Virginia Department of Health provided a large sample size (N=34,942) on which to perform binary logistic regression analyses. Sociodemographic determinants and preventive health behaviors were analyzed as potential influencing factors in the diagnosis of breast cancer, the stage at the time of diagnosis and source …

Toothbrushing, Flossing, And Preventive Dental Visits By Richmond-Area Residents In Relation To Demographic And Socioeconomic Factors, Kim T. Isringhausen

Theses and Dissertations

Purpose. This study was conducted to identify factors that influence preventive dental behaviors and, from the results, target groups for intervention.Methods. Data were collected using the 1997 Behavioral Risk Factor Surveillance System (BRFSS) resulting in a probability sample of 399 dentate adults living in Richmond City, Henrico, Chesterfield and Hanover Counties in Virginia. All analyses were performed using the statistical software program STATA. Initial hypothesis testing was performed using univariate logistic regression models. Multivariate logistic regression models were used to test the significance of independent variables while controlling for other possible predictors of behavior.Results. Females were more likely than males …

Effect Of Repeated Dosing Of Delta 9-Tetrahydrocannabinol, The Major Psychoactive Ingredient Of Marijuana, On Memory In Mice, Floride Niyuhire

Theses and Dissertations

Purpose: Marijuana is the most widely used illicit drug in the United States. However, marijuana and cannabinoid derivatives have potential therapeutic uses. Studies in cannabis users have yielded contradictory results with regard to long-term effects on cognitive functions. There is no prospective study assessing this issue, and such studies may raise ethical issues in humans, whereas mice have been shown to exhibit similar cannabinoid-mediated behaviors as humans. The purpose of this study was to assess the consequences of chronic administration of Δ9-THC, the major psychoactive component of marijuana, in a mouse memory model. Methods: In Experiment 1, the dose-response relationship …

Rabies In Virginia, 1989-2003: With Particular Attention To Animals, Geographic Distribution, And Virus Variant, William Andrew Holzgrefe

Theses and Dissertations

Objectives: The description of the raccoon rabies epizootic in Virginia over fifteen years (1989-2003). Methods: Using simple statistical methods and a geographic information system (GIS)-based approach, and fifteen years worth of animal surveillance data, the progress of this epizootic has been charted in terms of the geographic spread of the disease, the major animal species affected by the disease and its spread, and the exposure and risk to humans and livestock animals presented by the expansion of the geographic range. Results: The resulting descriptive study illustrates the eastward expansion of the epizootic, the mushrooming of the disease in the northern …

Targeting The Male In Teen Pregnancy Prevention, Terri Burgan

Theses and Dissertations

Study Objectives: To examine demographic characteristics and contraceptive habits of young men.Methods: A descriptive study was conducted utilizing data analyzed from three waves of the National Survey of the Adolescent Male (NSAM) administered in 1988, 1991, and 1995. The first wave consisted of 1,880, never-married, noninstitutionalized 15-19 year old men living in the United States. The second wave consisted of 1,676 re-interviewed respondents who were 17-22 years old. The third wave consisted of 1,377 re-interviewed respondents who were 22-27 years old. Descriptive statistics were used to compare personal and demographic characteristics across each year group. Odds ratios, and their corresponding …

Antioxidants As Risk Factors For Gingival Bleeding, Hee-Jeong Bahng

Theses and Dissertations

Background: Studies of gingival bleeding and the effects of antioxidants on extracellular matrix and immunologic and inflammatory responses provide a rationale for hypothesizing that antioxidants reduce the risk for gingival bleeding.Methods: This study evaluated the role of antioxidants as contributing risk factors for gingival bleeding utilizing the Third National Health and Nutrition Examination Survey (NAHNES III). A sample of 18,825 adults (20 to ≥ 90 years of age), with dental measurement and assessment of serum levels of antioxidants were included in the study. Gingival bleeding was defined as those who had more than 30 percent of gingival bleeding in 28 …

Determinants Of Prenatal Care And Supplement Use: The Case Of Honduras, Catherine E. Henze

Theses and Dissertations

Context: Literature suggests that prenatal care and prenatal supplement use improves pregnancy outcomes. However, we do not know the factors associated with prenatal care and supplement use in Honduras.Objective: To identify characteristics of Honduran women who are the least and most likely to use prenatal care and supplements.Methods: Data from a 2001 Honduras cross-sectional survey of women was used to assess their use of prenatal care and supplements. All data was weighted, resulting in a sample size of n = 5647 women who had a live birth since January 1996. Bivariate and multivariate analyses were used to examine factors associated …

Association Between The Frequency Of Physical Education Classes And The Prevalence Of Overweight/Obesity In Adolescents, Collin N. Rice

Theses and Dissertations

Background/Objective: Overweight and obesity has been steadily on the rise in the United States for all groups. The prevalence of obesity for adolescents has tripled since 1980. The purpose of this study is to determine an association between the frequency of physical education classes and the prevalence of overweight/obesity in adolescents in the United States.Methods: This was a cross-sectional study that used the 2001 Youth Risk Behavior Survey (YRBS) of the Center for Disease Control. The outcome variable for the study was Body Mass Index (BMI). A BMI of 25 or greater was considered overweight or obese. The main independent …

Evaluation Of The Hayes E. Willis Health Center In South Richmond -- Has It Served Its Targeted Population?, Shannon Nicole Shaw

Theses and Dissertations

Objective: The Hayes E. Willis Health Center (HWHC) was opened in a neighborhood of South Richmond in October 1993 to remove the barriers that prevented South Richmond residents from accessing primary healthcare services. The major objective of this study was to determine the effectiveness of the HWHC in providing primary care to the South Richmond Community deemed to be in need. An additional objective was to describe the changes in characteristics of clinic users and illnesses seen over time.Methods: Patient data was compared from the HWHC�s first full year of operation in which patient data was collected (1995) to the …

Is Number Of Pregnancies A Risk Factor For Heart Attack In Women?, Pavan Kumar Irukulla

Theses and Dissertations

Background: Studies regarding number of pregnancies and coronary heart disease have shown inconsistent results. In the present study, we assessed the association between number of pregnancies and heart attack (HA) in women.Methods: Using data from NHANES III a cross sectional data analysis of 10634 women aged 17 and above was conducted. We considered socio-demographic factors and other potential risk factors including physical activity, smoking, alcohol, diabetes, hypertension, hypercholesterolemia, BMI, age, and family history of heart attack. We conducted Bivariate analysis to determine prevalence and crude odds ratios. Multivariate logistic regression analysis was used to adjust for confounding variables using SPSS. …