Public Health Commons^™

The Potential Of Mental Health Policy Implementation: Methods And Applications, Meagan Renee Pilar

Arts & Sciences Electronic Theses and Dissertations

Mental illness affects roughly 20% of the world in some capacity and can be debilitating. Though a large emphasis has historically been placed on individual-level interventions (e.g., therapy or medication), mental health policies present an opportunity to intervene on a large scale, with the potential to enhance impact and equity. This dissertation contributes to the mental health policy research literature in three main ways—(1) exploring factors affecting policymakers’ overall support of mental health policies; (2) assessing the use and quality of quantitative and qualitative methods within this field; and (3) exploring implementation determinants and outcomes, as well as strategies used …

A Secondary Data Analysis Of The Prevalence Of Reported Dementia And Subjective Cognitive Decline Across U.S. National Surveys, Matthew C. Picchiello

Arts & Sciences Electronic Theses and Dissertations

Within the United States, many large-scale, nationally representative studies exist with the goal of tracking and monitoring aspects of health. These studies are often used to establish the prevalence of dementia and subjective cognitive decline (SCD) in the population. The goal of the current study is to examine how different population-based studies probe respondents about conditions related to cognitive impairment, and to assess similarities and differences in point estimates. We reviewed eight studies and identified comparable items related to dementia and SCD. We calculated design-appropriate point prevalence estimates and compared weighted estimates across studies, finding a wide range and statistically …

Examining Mental Health In Northern Haiti, Michael Galvin

Arts & Sciences Electronic Theses and Dissertations

Mental health is a severely neglected field in low- and middle-income countries globally. Populations in countries such as Haiti demonstrate a high level of need for mental health services despite a lack of services and trained professionals. In addition to the dearth of biomedical services, local belief systems and explanatory models lead a majority of the population to rely on traditional medicine as their first option for care. The goal of this dissertation is to characterize mental health beliefs, practices, and services in northern Haiti by examining the relationship between traditional beliefs and mental illness, assessing the impact of traumatic …

Sustainable Diets For Planetary Health: A Study Of Indigenous Based Agri-Food Systems In A Community Of The Central Highlands Of Ecuador, Carlos Andres Gallegos-Riofrio

Arts & Sciences Electronic Theses and Dissertations

In order to explore the psychosocial and agroecological dimensions of sustainable diets and their roles in the rural Andean community of Caliata in the Ecuadorian highlands, I conducted a community-centered participatory mixed-methods study. Thirty-nine focus groups and ten key informant interviews were conducted, recorded, translated, transcribed, and analyzed using three-stage coding. The information was triangulated using participant observation, local records, and descriptive statistics from a survey of 57 female household heads, which included a modified 48-hour dietary recall module. Rural appraisal research assessed agroecological dimensions. Ten purposively selected sites were studied alongside local informants in order to obtain diversity indexes …

Pillars Of The Nutrition Transition: The Global Impacts Of Ultra-Processed Foods And Beverages On Overweight And Obesity And National Nutrient Supplies, Jacob Eaton

Arts & Sciences Electronic Theses and Dissertations

Malnutrition in some form impacts nearly one-third of the global population. Across the world, countries are undergoing the Үutrition transitionӠfrom traditional and largely unprocessed diets to Western-style, energy-dense diets. At the same time, rates of overweight and obesity and diet-related chronic diseases continue to climb. Ultra-processed foods (UPF), sugar-sweetened beverages (SSB), and vegetable oils are three of the foods driving the nutrition transition. This dissertation calculates changes in the global food supply between 1961 and 2013 and quantifies the influence of UPF and SSB (as measured through sales) on national nutrient supplies between 2005 and 2013 and trends in adult …

Dismantling Of Obesity-Related Policies, Alexandra Borosova Morshed

Arts & Sciences Electronic Theses and Dissertations

This dissertation fills an important research gap in the study of obesity policymaking by characterizing to what extent the phenomenon of dismantling is happening at the state level for obesity-related policies targeting the context of consumption, identifying determinants, and characterizing actors and processes involved. The five-year rate of dismantling of these policies is close to one-third for any attempts and one-tenth for enacted dismantling. Food and beverage tax policies face a particularly high rate of dismantling. Case studies and news coverage of state- level dismantling identified actors, motivations, and strategies used in the process of dismantling. Review of health-related empirical …

Scaling-Up Child And Youth Mental Health Services: Assessing Coverage Of A County-Wide Initiative, Cole Douglas Hooley

Arts & Sciences Electronic Theses and Dissertations

Over 7 million children and youth have a diagnosable mental illness any given year. There are evidence-based treatments (EBTs) to effectively treat these conditions, but these EBTs reach a very small percentage of their target population with treatment rates between 1-3%.1 We know very little about what influences these coverage rates. Beginning in 2009, the Los Angeles County Mental Health Department (LACDMH) began an ambitious agenda to scale-up the provision of EBTs in child/youth mental health care. The present study seeks to contribute to the scale-up literature by examining three questions based on LACDMH’s initiative: 1) To what extent have …

Understanding Adolescent Physical Activity In The Early Nutrition Transitioning Country Of Haiti, Haley V. Becker

Arts & Sciences Electronic Theses and Dissertations

The nutrition transition is underway in Haiti, giving rise to the dual burden of malnutrition. Physical activity (PA) plays an important role in mitigating the negative health consequences of nutrition transition and the dual burden, but heretofore this data has been unavailable for Haiti. This dissertation undertook an exploratory needs assessment providing baseline PA data for Haitian adolescents. It evaluated two different PA data collection methodologies: a cross-sectional survey adapted from the IPAQ long-form and objectively measured PA via Actigraph GT1M accelerometers. Next, it identified initial covariates of self-reported and objectively-assessed PA behaviors; data was operationalized as meeting the World …

The Intersection Of Intimate Partner Violence Perpetration, Intervention And Faith, Maxine Davis

Arts & Sciences Electronic Theses and Dissertations

In the U.S. most interventions with men who have acted abusively against intimate partners occurs because of a domestic violence conviction and court-mandate to complete treatment. This dissertation examines the intersection of intimate partner violence/abuse (IPV/A), intervention, and faith by investigating a parish-based voluntary partner abuse intervention program known as The Men’s Group (TMG). The function and implementation of TMG is first explored through a case study, laying the groundwork for understanding why men continuously participate in the program. This qualitative study then investigates how group members view the role of religious faith in relationship to IPV/A and how they …

Can We Walk? Environmental Supports For Active Travel In India, Deepti Adlakha

Arts & Sciences Electronic Theses and Dissertations

Background: Rapid rates of increase of obesity, diabetes, and associated chronic and co-morbid non-communicable diseases (e.g., cardiovascular diseases and some cancers) are being documented in India, yet in-country evidence-based research of associated risk factors is lacking. Physical activity has been identified as a preventative factor to counter the risk from obesity-related non-communicable diseases. Built environment supports for physical activity represent promising strategies to curb the rise in non-communicable diseases. Mounting research evidence suggests that the built environment can facilitate or constrain physical activity. However, a majority of this research has been conducted in developed nations. Built environment correlates of physical …

Social Support And Intimate Partnerships In African American Women With Breast Cancer, Tess Thompson

Arts & Sciences Electronic Theses and Dissertations

This mixed methods study investigated social support in African American breast cancer patients in one Midwestern metropolitan area. The study includes a quantitative analysis of social support in 227 African American breast cancer patients participating in a quality of life study, as well as a qualitative component involving a subsample of 15 married participants. In the larger sample, growth curve models were used to assess factors contributing to initial levels of perceived social support and change in social support over time. Interviews with women in the qualitative study allowed an in-depth exploration of how breast cancer affected womens relationships with …

Partnership Development Among Mental Health Organizations, Alicia C. Bunger

Arts & Sciences Electronic Theses and Dissertations

Mental health organizations can play a key role in enhancing youths' access to care by working together to bridge gaps in service delivery systems. This dissertation study examines partnerships among a network of children's behavioral health organizations. The specific aims are to (1) describe and understand the network of partnerships among members of the Children's Services Coalition, (2) assess the capacity of the system to provide coordinated service delivery, and (3) test how patterns of organizational characteristics influence conditions that facilitate and inhibit partnerships among the Children's Service Coalition organizations.

This dissertation is a predominantly quantitative cross-sectional network study of …