Public Health Commons^™

Assessing The Social And Ecological Factors That Influence Childhood Overweight And Obesity, Katie Callahan

Electronic Theses and Dissertations

The prevalence of childhood overweight and obesity is increasing at an alarming rate in the United States. Currently more than 1 in 3 children aged 2-19 are overweight or obese. This is of major concern because childhood overweight and obesity leads to chronic conditions such as type II diabetes and tracks into adulthood, where more severe adverse health outcomes arise. In this study I used the premise of the social ecological model (SEM) to analyze the common levels that a child is exposed to daily; the intrapersonal level, the interpersonal level, the school level, and the community level to better …

Collaborative Models Of Care In The Appalachian Region Of Tennessee: Examining Relationships Between Level Of Collaboration, Clinic Characteristics, And Barriers To Collaboration, Jeffrey Ellison

Electronic Theses and Dissertations

Decades of research have shown that there are significant advantages to maintaining close communicative and collaborative relationships between primary care and behavioral health providers. Fiscal, structural, and systemic barriers, however, often restrict the degree to which such interprofessional collaboration can occur. In the present study the authors examined relationships between primary care clinics in the Appalachian region’s characteristics (i.e., clinic type, rurality, and clinic size), barriers (i.e., fiscal, structural, and systemic) reported to using increased collaboration, and the level of collaboration used at a particular clinic.

For the present study 136 surveys were completed by providers working in primary care …

An Examination Of The Relationship Between Sense Of Coherence, Engagement In Health Behaviors, And Individual Coping Style., Dean Todd Misener 1973-

Electronic Theses and Dissertations

Stress is a pervasive issue among traditional college students; affecting their choice in health behaviors, and overall academic performance. What is not clear is why some students, despite the pervasiveness of stressors are able to do well in school and maintain/improve their health, while other students struggle to maintain their health and do poorly in school. Aaron Antonovsky theorized that when confronted with a stressor a person with a high sense of coherence (SOC) will be motivated to cope, believe the challenge is understood and that the necessary resources to cope with the stressor are available. Overall, Antonovsky theorized that …

Maternal Perception Of Child Body Weight And Physical Activity Behavior Patterns: Interactions With Gender And Ethnic Minority Status Of Preschool Children, Kayla F. Brooks

Electronic Theses and Dissertations

Childhood overweight and obesity is a complex disease that requires early identification and intervention. Little research has investigated the influence of maternal perception of child body weight on reported child physical activity behaviors and importance to change these behaviors. Using parent survey and child body mass index (BMI) data, the current study evaluated the difference between maternal perception of child weight status and reported physical activity and sedentary behavior levels amongst preschool-aged children. Reported child physical activity and sedentary behavior levels were not significantly different depending on maternal misperception. A significant interaction, however, between maternal perception of child body weight …

Assessing Health Department Readiness For Public Health Accreditation Through Quality Improvement, Christian L. Williams

Electronic Theses and Dissertations

Engaging in quality improvement (QI) activities can help local and state health departments improve current processes, develop more effective new processes, increase leadership capacity, and prepare for public health accreditation. Public health organizations that have implemented QI processes have seen improvements in health outcome indicators, delivery of the 10 essential services, patient satisfaction, and performance management.

Quality improvement is the foundation of the Public Health Accreditation Board‟s (PHAB) program and further pushes health departments, at both the local and state level, to adopt QI activities within their organizations. There are numerous potential benefits associated with accreditation in public health, one …

Exploring The Role Of Religiosity On Suicidal Ideation: A Study Among A Population-Based Sample Of Adolescents In The United States, Grace E. Tettey

Electronic Theses and Dissertations

Suicide is a major public health issue in the United States. Some studies show decreased suicide rates in religious populations, but it is unclear how religiosity might be linked to suicidal behavior of adolescents emerging into adulthood. To this point few studies have examined the relationship between adolescent suicidal ideation and several risk factors at once and the role of religiosity in these relationships.

Drawing from Waves I-III of the National Longitudinal Survey of Adolescent Health data from 1994 to 2002, I sought to explore the relationship between religiosity (i.e. religious affiliation, service attendance, prayer, perceived importance of religion) and …

Examining The Influence Of Farmers' Market Motivations On Access To Healthful Foods And Business Opportunities For Farms, Rachel K. Ward

Electronic Theses and Dissertations

Farmers’ markets are increasingly promoted as mechanisms for improving access to healthful foods for low-income households, as they are relatively inexpensive to establish and they can provide affordable food for low-income households by offering Supplemental Nutrition Assistance Program Electronic Benefit Transfer (SNAP/EBT). SNAP/EBT at markets also expands revenue opportunities for participating farmers. Market mangers provide a critical role in overseeing SNAP/EBT at markets and influencing business opportunities for farmers. Using a mixed-method approach, this study aimed to evaluate how managers’ motivations influence SNAP/EBT availability and participation at markets and business opportunities for small- and moderate- sized farms.

To develop a …

The Impact Of Preconception Maternal Stress On Fecundability And Adverse Pregnancy Outcomes., Shekufe Akhter

Electronic Theses and Dissertations

It has been commonly hypothesized (and widely believed) that maternal stress either prior to or during pregnancy can adversely affect fertility and pregnancy outcomes. However, surprisingly few epidemiologic studies have rigorously tested these hypotheses. The current study evaluated the effects of pre-conception self-reported stress on fecundability and spontaneous abortion. The study population was derived from the Mount Sinai Study of Woman Office Workers with 487 women included. Women recorded stress (scale from 1 to 4) and covariate information in a daily diary for 12 cycles or until pregnant. Results indicated a significantly increased risk of spontaneous abortion for women with …

Vitamin D Status Of College Students: Implications For Health Leaders, Eileen M. Cress

Electronic Theses and Dissertations

Vitamin D deficiency is considered to be a pandemic with implications for compromised bone health and other chronic diseases. Few studies have examined vitamin D status in college-aged individuals where prevention of future health consequences is still possible. Serum vitamin D 25(OH)D status and vitamin D intake were examined in 98 college students ages 18-29 years during winter. BMI was classified as < 25and 25 or greater. Race was categorized as Caucasian or other. Overall, 69.5% had suboptimal serum vitamin D levels, <30ng/mL. Only 8 students (8.2%) met the EAR (400 IU) per day for vitamin D intake. t tests were used to determine if there were significant differences in serum vitamin D level and dietary intake based on gender, race and BMI. Significant differences were found in serum vitamin D level when compared by gender and race. Females tended to have a higher serum vitamin D level than males. Those representing minorities had lower serum vitamin D levels than Caucasians; One hundred percent of the minority students had suboptimal serum vitamin D levels. Based on these findings, dietitians should increase efforts to target college-aged individuals in educational programming related to factors affecting vitamin D synthesis, vitamin D intake, and health consequences of suboptimal vitamin D status, particularly in winter. Consideration should be given to vitamin D fortification of foods that meet the preferences of today’s consumer.

Evaluation Of Key Components Of Draft Guidelines For The National Weather Service Tsunamireadytm Community Program, Colleen Scott

Electronic Theses and Dissertations

The National Tsunami Hazard Mitigation Program partnered with the National Weather Service (NWS) in 2000 to create the TsunamiReady^TM (TR) Community program. TR is designed to help communities in coastal areas plan and prepare for tsunamis. To achieve TR recognition communities must meet certain criteria including specific emergency planning and management actions within the categories of mitigation, preparedness, response, and recovery.

This study’s purpose was to evaluate the acceptability and usefulness of key components of a proposed revised set of TR Community program guidelines. Research was guided by the Elaboration Likelihood Model (ELM) using Community Based Participatory Research methods …

Markers And Mechanisms Of Metabolic Aging., Peter Dziewornu Ahiawodzi

Electronic Theses and Dissertations

Oxidative stress has been implicated in aging and age-related diseases. Using three distinct studies, this dissertation examines associations between lifestyle factors and oxidative stress, and their effects on advanced glycation end products, telomere length, and type II diabetes. Carboxymethyl-lysine (CML), an advanced glycation end-product, has been linked to oxidative stress, cardiovascular and other age-related diseases. The first study investigates the association between sleep disordered breathing (SDB), a source of oxidative stress, and CML. 1002 participants with sleep data from the Cardiovascular Health Study (CHS) were analyzed. SDB was not significantly associated with CML, but after stratification by gender and hemoglobin …

Cognitive Decline And Polypharmacy In An Elderly Population., Ximena A. Oyarzun Gonzalez

Electronic Theses and Dissertations

Aging is associated with increased risk of chronic disease, comorbidities, and greater medication use. Polypharmacy, the concomitant use of 5 or more medications, has been associated with adverse health effects, and potentially cognitive decline. The proposed hypothesis is that polypharmacy increases the risk of cognitive decline in elderly people. Using longitudinal data from 572 participants from the New Mexico Aging Process Study cohort, the impact of polypharmacy on the Mini Mental State Examination (MMSE) scores and Mild Cognitive Impairment (MCI) was studied. The statistical analyses were performed using mixed linear regression multivariable models and generalized estimating equations, adjusting for important …

Effectiveness Of Chronic Obstructive Pulmonary Disease (Copd) Management Program At The University Of Louisville., Malhar Anantbhai Jhaveri

Electronic Theses and Dissertations

Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease of the respiratory system characterized by airflow limitation that is not completely reversible and is associated with systemic effects especially of the cardiovascular system. COPD is frequently complicated by acute exacerbations that contribute to physical impairment and increased health care use. As COPD is a chronic lung disease with significant systemic manifestations, it is important to have chronic disease management programs specifically targeting individuals with COPD designed to improve their overall quality of life, reduce the burden of disease and decrease the impact of COPD on daily life. Chronic disease …

The Performance Of The K6 Scale In A Large Adolescent Sample., Nicholas Chalmer Peiper 1982-

Electronic Theses and Dissertations

This dissertation is an applied research study to examine the performance of the K6 scale that measures serious emotional disturbance (SED) among adolescents. As the K6 was included in the 2012 administration of the Kentucky Incentives for Prevention Survey (KIP), three specific aims are included: 1) confirm the unidimensional structure of the K6 among adolescents using factor analysis; 2) define the prevalence and correlates of adolescent SED among Kentucky students; and 3) utilize latent class analysis (LCA) to empirically derive clinically relevant subtypes of adolescents with SED. Of the 122,718 students who completed the KIP in 2012, approximately 89% provided …

Coal Ash And Children's Sleep : A Community-Based Study., Clara G. Sears

Electronic Theses and Dissertations

Kentucky is the fifth largest producer of coal ash, a by-product of coal combustion. The small spherical coal ash particles contain heavy metals like arsenic, lead, mercury, and cadmium. Coal ash is currently classified as nonhazardous by the EPA, which allows it to be stored in open-air impoundments near low-income communities. The primary object of the study is to determine the prevalence of sleep disruptive behaviors in children exposed to coal ash, compared to a group of demographically similar non-exposed children. Parents or guardians from five neighborhoods surrounding a coal ash storage facility, and one non-exposed community, participated in a …

Home Care Quality Effects Of Remote Monitoring, Cynthia Williams

Electronic Theses and Dissertations

Despite concerted efforts to decrease costs and increase public health, the embattled U.S. health care system continues to struggle to alleviate these widespread issues. Because the problem of hospital utilizations among patients with heart failure is posited to increase as the population ages, innovative methodologies need to be explored to mitigate adverse events. Remote monitoring harnesses the strength of advanced information and communication technology to affect positive changes in health care quality and cost. By reaching across geographical boundaries, remote monitoring may support increased access to less costly services and improve the quality of home health care. The purpose of …

Zinc Sulfide: Manganese Doped Quantum Rods For Detection Of Metal Ions And A Business Model For Future Sales, Andrew Teblum

Electronic Theses and Dissertations

Hexavalent chromium is an extremely carcinogenic chemical that has been widely produced in the United States. This has led to major waste contamination and pollution throughout the country. According to the Environmental Working Group Hexavalent chromium has been found in 89% of city tap water. Most people believe they are safe using regular home filter systems however that is not true. A more expensive ion exchange water treatment unit is required. Therefore to protect yourselves from this carcinogenic metal a reliable test is required. In this study we have developed a Zinc Sulfide Manganese doped Quantum Rod technology to detect …

Certified Personal Trainers And Physicians: An Evaluation Of Consumer Preference, Influence, And Decision Making On Intent To Use A Weight-Loss Medication, Linda Lemgruber Lobb

Electronic Theses and Dissertations

In health-related behavioral decision-making, the Theory of Planned Behavior (TPB) posits that attitudes toward a behavior are the function of three metrics: beliefs and strengths of beliefs toward the behavior, subjective norms around the behavior and locus of control for the individual (Ajzen, 1988). The purpose of this research was to identify the extent to which consumers would accept the recommendation of taking weight-loss medications, based on the source of the recommendation. Research shows that the source of knowledge for information plays a significant role in health-related decision-making of consumers (Pornpitakpan, 2004). In comparison to traditional weight-loss methods such as …

Cardiovascular Disease Knowledge, Awareness, Perceived Risk, And Hormonal Contraceptive Use Among Female College Students, Amanda Kathryn Hutcheson

Electronic Theses and Dissertations

Cardiovascular disease (CVD) is the leading cause of death for men and women of most racial and ethnic groups in the United States (Centers for Disease Control and Prevention, 2012). Over the past 20 years, women have experienced greater levels of CVD mortality compared to men, and specific risk factors for CVD have been identified that are unique to women, including the use of hormonal contraceptives (Corrao et al., 1990; roger et al., 2011). However, previous research has not addressed knowledge of CVD among college-aged hormonal contraceptive users. Therefore, this cross-sectional study assessed knowledge, awareness, and perceived risk of CVD …

Pilot Study Of Safe Sisters: A Sexual Assault Prevention Program For Sorority Women, Alicia Pugh Cambron

Electronic Theses and Dissertations

Sexual violence is a serious problem that can have lasting, harmful effects on victims and their family, friends, and communities (CDC, 2014). Approximately one in five women will become a victim of sexual violence at some point in their lifetime (RAINN, 2009). College women are at a greater risk for rape and other forms of sexual assault than women in the general population (Fisher, Cullen & Turner, 2000). During an academic school year, approximately three percent of college women became a victim of sexual violence (Tijaden & Thoennes, 1998). Sorority women are four times more likely to experience sexual violence …

The Effects Of Carbonated Soft Drinks On Bone Mineral Density In College Age Women, Tina Irene Bankston

Electronic Theses and Dissertations

Osteoporosis is a fast growing, worldwide public health problem. Also called, 'the silent disease' or 'fragile bone disease', osteoporosis results from low bone mass (Gammage & Klentrou, 2011; NOF, 2013; Swann, 2012). Currently, 44 million Americans have osteoporosis; 80% of which are women (NOF, 2011). Few studies, most implemented in other countries, have been conducted examining the consumption of carbonated soft drinks (CSD) as a risk factor for low bone mineral density (BMD) (Ogur et al., 2007; Hostmark et al., 2011; McGartland et al., 2003). The global consumption of CSDs increased by four percent during 2009 to 2010. Within the …

Development Of A Physical Activity Intervention Targeted At Middle-Aged Males: A Mixed Methods Research Study, Sheryl L. Chatfield

Electronic Theses and Dissertations

No abstract provided.

Preventing Childhood Obesity: A Mixed Methods Study Into The Perceptions Of African Americans In A Rural Community, Dayna S. Alexander

Electronic Theses and Dissertations

Preventing childhood obesity is a global priority due to adverse health risks and financial burdens. With childhood obesity rates stabilizing it is difficult to determine which factors alone (i.e., genetic, environmental, behavioral, or demographic) increase susceptibility to childhood obesity. Parents influence childhood obesity risk factors through their parenting styles and behaviors. Social behavioral theories and public health evidence demonstrate including parents in childhood obesity efforts could assist in reducing childhood obesity rates. The objective of this study was to assess perceptions of childhood obesity among African Americans with children enrolled in a rural elementary school in the Deep South. The …

Exercise Behavior Patterns In Emerging Adulthood: An Exploration Of Predictor Variables From Self-Determination Theory And Transtheoretical Model, Chad R. Johnson

Electronic Theses and Dissertations

During the transition from childhood to adulthood, young people establish patterns of behavior and make lifestyle choices that affect both their current and future health (NCHS, 2010). Emerging adulthood – a new conception of development for the period from the late teens through the twenties – focuses on individuals ages 18-25 who did not have a child, own a home, or have sufficient income to be fully independent (Arnett, 2000). Very little is known about social influence, motivational mediators, and motivation on exercise behavior within this developmental period. Therefore, the purpose of this study was to determine the influence of …

The Determinants Of Physical Activity In Rural Women, Ages 20-44 Years, Dziyana Nazaruk

Electronic Theses and Dissertations

Despite multiple health benefits of exercise, it is reported that only 14.7% of American women engage in the recommended amount of physical activity. Whereas the potential negative consequences of not exercising are well documented, there is a scarcity of literature that investigates the determinants of physical activity in rural women. The purpose of this concurrent transformative mixed method study was to explore the determinants of physical activity in rural women ages 20-44 years. Specific quantitative research questions addressed the relationship between the determinants of physical activity on intra- and interpersonal levels, as well as the current physical activity status of …

Obesity, Food Insecurity And The Impact On Perceptions And Behaviors Toward Dietary Nutrition In Low Income Women In Georgia, Amanda Lowe

Electronic Theses and Dissertations

The purpose of this study was to explore the paradoxical relationship between obesity and food insecurity and the subsequent impact of this relationship on perceptions and behaviors towards diet and nutrition among low-income women in Georgia. Specifically, this study sought to investigate whether factors such as poverty, education, socio-economic status, and participation in food assistance programs influence obesity outcomes among low-income women in Georgia. A sequential exploratory mixed-method research design was conducted for this study. Using qualitative and quantitative measures, the study employed key informant interviews with 16 administrators and staff members from the Women, Infant and Children (WIC) program …