Social and Behavioral Sciences Commons^™

And The Survey Says ... A Qualitative Exploration Of Structurational Divergence From The Perspectives Of Nurse Managers Who Are Accountable For Patient Experience Measures, Lisa Carpenter Huddleston

Theses and Dissertations--Communication

For more than a decade, hospital leaders have focused on boosting patient experience scores as part of the federal government’s value-based purchasing (VBP) program. Hospitals that receive federal financial assistance (such as Medicare) are mandated to participate in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a standardized survey that measures patients’ perceptions of their care. Results are publicly reported, and hospitals may be penalized on their reimbursements if they do not reach established benchmarks for patient experience. However, much debate has occurred about whether VBP has increased the quality of healthcare and whether the HCAHPS is an …

Paper Gowns, Cold Hands, Or Something Else? Black Women's Barriers To Gynecologic Screening, Nadia Ayesha Sesay

Theses and Dissertations--Communication

Cervical cancer mortality burden is carried disproportionately by African American women. Early indicators of cervical cancer are identified through prevention screening, a procedure typically performed by a gynecologist. Ideally, the patient group with the most severe mortality would likewise be the group with the most robust communication exchange with their physician to prevent cervical cancer incidence. However, a slew of factors contributes to continued mortalities among Black women. This study uses semi-structured interviews (n=10) and the health belief model to examine one barrier to Black women’s prosocial behaviors regarding routine gynecologic care—awkwardness, which here is conceptualized as social anxiety. The …

Applying The Causal Network Model To Advance Care Planning Messages, Katherine Leigh Harville

Theses and Dissertations--Communication

The process of advance care planning often involves conversations that focus on worst case scenarios and discussions of end-of-life, which makes the topic a daunting one. Most of these conversations occur with older adults or individuals who are seriously ill. However, advance care planning is of importance to those who are healthy, young adults as well. Narrative messages could help simplify the process of approaching such conversations and provide tools for conducting them in a more effective manner.

The proposed study makes use of the causal network model, a model that proposes that the location of information within narratives impacts …

Predictors And Outcomes Of The Occurrence And Valence Of Campaign-Related Talk: The Interplay Between New Media Use, Conversations, And Vicarious Learning In The Context Of Reproductive Health, Carina Mazariegos Zelaya

Theses and Dissertations--Communication

Study 1 explored the dominant or deciding barriers and facilitators, beyond environmental and systemic factors, influencing women’s LARC uptake (RQ1, RQ2). Moreover, it examined pregnancy ambivalence and motivation to prevent unintended pregnancy as distal variables to LARC information seeking and uptake (H1, H3). Additionally, it examined embodied experience as an important source of information about contraception (H4). Furthermore, it explored how informal and formal sources support reproductive health decision-making, specifically focusing on social networks as sources of information, knowledge (RQ3, H2), and norms regarding LARC uptake (RQ4, RQ4a, RQ5). Study 2 examined the influence of social learning and LARC knowledge …

A Content Analysis Of Reddit Comments Discussing Fibroadenoma Appraisal And Decision Making, Hayley Marie Kay Stahl

Theses and Dissertations--Communication

Though fibroadenomas are clinically benign in most cases, clinical research suggests that these lesions can cause diagnosis-related physical health complications and psychological distress. However, this research is limited and should be investigated further. Thus, this study aimed to explore how patients appraise their fibroadenoma diagnosis uncertainty. Additionally, this study sought to determine if a correlation existed between appraisal and decision making as well as identify the factors that influence the most common treatment decision: removal. Data was retrieved from Reddit discussions for a content analysis. These discussions were then qualitatively analyzed using codebooks associated with this study’s research questions. Findings …

Is This Going To Be The End? Understanding Problematic Integration Among Appalachian Patients In Colorectal Cancer Screening Navigation, Audrey Smith Bachman

Theses and Dissertations--Communication

Colorectal cancer (CRC) is preventable through regular screening; however, incidence and mortality rates in Appalachia are among the highest in the United States. Public health programs and interventions meant to mitigate the higher CRC burden and increase screening rates are ongoing in the U.S. and Appalachia. In continuing the efforts to reduce the burden of CRC in Appalachian communities, this dissertation uses a two-part study to investigate communication practices relative to problematic integration and health beliefs in CRC screening conversations from the perspective of both patients and patient navigators in the region. As part of efforts directed by the Rural …

Coordinating Boundaries And Negotiating Mental Health Diagnoses And Disclosure: An Exploration Of Stigma And Communication Privacy Management, Paige Anne Von Feldt

Theses and Dissertations--Communication

For quite some time, researchers have tried to reduce stigma and misconceptions about individuals diagnosed with a mental illness. Researchers have examined stigma towards individuals diagnosed with a mental illness, and the internalized stigma that can result. Additionally, researchers have analyzed the dialectical push and pull that occurs between privacy and confidentiality for self-disclosures. Past research has explored disclosure of a mental illness in the context of family members, psychiatrists, employers, friends, and in academic settings. However, there is a lack of research examining how risk perceptions are affected by internalized stigma, thus impacting young adults’ intentions to disclose their …

Turning The Tides: An Inoculation Theory And Theory Of Planned Behavior Approach To Developing Mental Health Help-Seeking Interventions For Gen Z, Sarah Ann Geegan

Theses and Dissertations--Communication

Extensive research, predating and during the COVID-19 pandemic, demonstrates the rising prevalence of anxiety and depression among Gen Z college students in the United States—findings which are accompanied by rising rates of suicide, the second leading cause of death among people aged 15-24. Although college campuses often offer mental health resources, the number of college students utilizing them is significantly less than the number of students reporting mental health challenges. A dearth of empirical evidence, focused on Gen Z specifically, exists as a basis for developing interventions to address this issue. This investigation addressed this gap through two component studies. …

Communication Strategies To Intervene In Intimate Partner Violence Among Young Adult Couples, Kaylee Marie Lukacena

Theses and Dissertations--Communication

Intimate partner violence (IPV) is a social and behavioral health issue of importance among the young adult population (Cupp et al., 2015). IPV includes acts of physical violence, sexual violence, psychological aggression, and stalking enacted by an intimate partner (Smith, Zhang, Basile, Merrick, Wang, Kresnow, & Chen, 2018). In the United States., approximately one in three women and one in ten men experience IPV during their lifetime (Smith et al., 2018). Furthermore, over more than 70% of women who experience indicate that the first act occurred before the age of 25. One approach to preemptively address IPV on college campuses …

A Multiple Goals Perspective On Burnout Disclosure And Support Among Attending Physicians, Alison N. Buckley

Theses and Dissertations--Communication

Burnout is a common experience among physicians and has been identified as a precursor to substance abuse and suicide ideation. When not addressed, burnout can have many negative personal, relational and professional consequences. Research about the burnout experience is limited due to the taboo nature of the topic. The present study used a multiple goals theoretical perspective to examine how physicians disclose burnout in order to access social support. Attending physicians from various specialties (N = 30) participated in one-on-one interviews and were asked to discuss their burnout experience, conversational goals during burnout disclosure, catalysts and barriers for disclosure, and …

An Examination Of Communication Sequencing In Enacted Support Interactions For People With Major Depressive Disorder, Madison Adams

Theses and Dissertations--Communication

Social support is integral to helping one manage Major Depressive Disorder [MDD], but enacted social support, or the supportive behavior itself, is not always beneficial. Using a normative theoretical perspective on social support and theory related to sequencing as guiding frameworks, in this thesis I examined common sequential patterns of enacted support between support providers and individuals with MDD. Moreover, I investigated how individuals with MDD evaluated the helpfulness of each of the different sequential patterns. To examine the sequential patterns and how individuals with MDD evaluated their helpfulness, I interviewed 20 participants who had been diagnosed with MDD. The …

Exploring Health And Risk Information Seeking In The Context Of Covid-19: Testing The Comprehensive Model Of Information Seeking And Risk Information Seeking And Processing Model As Competing Explanatory Models, Xianlin Jin

Theses and Dissertations--Communication

Facing a pandemic caused by a novel coronavirus (COVID-19), the public feels uncertainty and fear. To cope with the pandemic and reduce uncertainty, the public needs accurate and prompt information. By theoretically and empirically comparing the Comprehensive Model of Information Seeking (CMIS) and the Risk Information Seeking and Processing Model (RISP), this dissertation aims to unpack the core mechanism of health and risk information seeking. Built on the two models, the author proposed an Integrated Model and explored which variables are the significant predictors of health and risk information seeking.

The author recruited 729 adult participants and analyzed 394 completed …

Conversation Goals, Communication Satisfaction, And Relational Dynamics While Navigating Alzheimer’S Disease: A Pre- And Post-Diagnosis Dyadic Examination Of Family Communication, Elizabeth A. Spencer

Theses and Dissertations--Communication

Currently there are more than 16 million unpaid Alzheimer’s disease and dementia caregivers in the United States. These caregivers are often family members of the person living with dementia, and as they navigate the process of giving care to the patient, they must also maintain relationships with each other. Families enter the dementia experience with a history of their relational experiences, and their relational experiences potentially change as they navigate family experiences after the dementia diagnosis. Much existing scholarship examining family communication in the context of progressive Alzheimer’s disease and other related dementias has focused on the perspectives of one …

Encouraging Healthy Eating Among Older Adults Using The Transtheoretical Model: An Evaluation Of A Pilot Intervention, Lauren Brinkman Roberson

Theses and Dissertations--Communication

Older adults, defined as those age 60 and above, are at an increased risk for many health-related complications that are directly related to nutrition (Centers for Disease Control and Prevention, 2015). This study highlights the lack of nutrition education material developed for older adults in Kentucky. Such material has great potential to influence the health of older adults (Chernoff, 2001). This study evaluated an intervention developed, by means of formative research, to teach older adults nutrition basics. Both direct and indirect measures related to stages of change for healthy eating behaviors were collected six weeks pre-intervention and then immediately post-intervention. …

Analysis Of Information Value Chains For Gout Self-Care Management, Maranda Russell

Theses and Dissertations--Communication

This value chain analysis study sought to identify information needed by gout patients to successfully manage their disease, leading to a model for information extraction from patient health records. A scoping review was conducted to identify the types of information needed by gout patients. The findings of each included study were divided and analyzed according to the stages of the care delivery value chain. The results of the review were then used to create a gout information value chain as criteria for annotating the information deemed important for gout patients contained in publicly available patient education materials according to the …

Boundaries And Infomediaries: A Qualitative Study Of The Information Practices Of Community Health Workers, Robert M. Shapiro Ii

Theses and Dissertations--Communication

Despite successful efforts to treat and manage diseases, public health officials have recently begun a campaign to refocus efforts toward initiatives to alleviate the pressures that are often referred to as social determinants of health. In eastern Kentucky, and in other geographical regions labeled as health professional shortage areas or medically underserved areas, issues stemming from social determinants are compounded with health care systems that are often lacking the human resources to meet basic medical needs. One strategy has been to utilize volunteers and paraprofessionals such as community health workers to lessen the burden on the primary care and hospital …

Navigating The Michelle P. Waiver: A Narrative Examination Of The Impact Of Parent Caregiver-Related Uncertainty And Decision Making For Children With Disabilities, Whittney H. Darnell

Theses and Dissertations--Communication

The Michelle P. Waiver (MPW) is the primary means of health insurance for more than 10,000 people in the state of Kentucky. The waiver is especially popular among families with young children with disabilities because it is robust in its benefit offerings and also one of the few Medicaid resources that does not include parental income as a qualifying factor in eligibility. Through the waiver, children receive a medical card as well as additional coverage for medical expenses that fall beyond the scope of traditional health insurance. For these young children to gain access to the comprehensive offerings of the …

A Descriptive Analysis Of Health Influencer Videos On Youtube In The Ostomy Community, Sarah Irenke Sophia Bell

Theses and Dissertations--Communication

The expansion of YouTube into the mainstream media and its place as the second most-used website in the world makes it a prime place for health information seeking. However, content can be created and uploaded by anyone and thus, the threat of misinformation on YouTube is high. Medical researchers have established that videos created by health professionals on YouTube promote accurate information whereas videos by non-professionals promote generally inaccurate or misleading information. Yet, videos created by non-professionals have more views and higher relevance rankings on YouTube. To begin to understand this phenomenon, a descriptive study is used to lay a …

“It’S Hard To Get Your Head Around Something Like This”: Figurative And Intense Language For Sensegiving During Severe Weather Coverage, Robert W. Prestley

Theses and Dissertations--Communication

During high-impact weather events like Hurricane Harvey, broadcast meteorologists take on the role of sensegiver, as they develop frameworks to help their viewers make sense of the storm. These frameworks are communicated through rhetorical choices evident in the language the meteorologists use to describe the storm’s threat and impact. This study investigates the rhetorical choices of KHOU broadcast meteorologists during Hurricane Harvey in order to make sense of the disaster, using an inductive thematic analysis. The results indicate that the KHOU broadcasters framed Harvey figuratively as an all-encompassing monster and a heat-seeking machine. The meteorologists used emotionally intense language to …

“Standing On The Front Lines And Down In The Trenches With Her”: An Exploration Of The Dialectical Tensions And Competing Goals Of Adult Children Of Mentally Ill Parents, Kelley Hodgson

Theses and Dissertations--Communication

Mental illness is a pervasive health epidemic in the United States and worldwide, and available data suggest that mentally ill adults are statistically more likely to be parents than non-parents. The prevalence and continued growth of parental mental illness means that millions of children in the United States have a parent with some form of mental health issues.

This dissertation contributes to and extends existing literature on children of mentally ill parents by exploring 15 adult children’s subjective perspectives on how they navigate the tension-wrought experience of having a mentally ill parent, and how this has implications for the management …

“I Want To Feel What They Feel”: Evaluating The Effectiveness Of Emotional Flow In Narrative Health Blogs, Sarah Elizabeth Sheff

Theses and Dissertations--Communication

Emotion has long been implemented in persuasive messages and campaigns to influence attitudes and health behavior. Research demonstrates that messages often evoke more than one emotion during and after exposure, and this was previously viewed as an undesirable outcome; however, the literature suggests that the intentional inclusion of multiple emotions, or emotional flow, could positively impact persuasive outcomes, such as attitudes and behavioral intention.

The proposed study employs the concept of emotional flow, the intentional inclusion of more than one discrete emotion, in the context of narrative health blogs addressing mental health topics relevant to college students. The study specifically …

Using The Integrative Model Of Behavioral Prediction To Understand Gay Men’S Beliefs, Intention, And Behavior On Prep Uptake, Minhao Dai

Theses and Dissertations--Communication

Antiretroviral treatment pre-exposure prophylaxis (PrEP) is an effective daily prevention medicine to reduce risks of HIV infections in high-risk populations. The current study examined PrEP uptake among gay men using the integrative model of behavioral prediction (IMBP) as the theoretical framework. Briefly, the IMBP states that attitude, norms, and behavioral control predict intention, which then predicts behavior. The intention-behavior relationship is moderated by actual control variables: skills and environmental constraints. To examine how IMBP variables affect PrEP uptake among gay men, I first conducted formative elicitation interviews with gay men; then I used the results from the interviews to construct …

Quitting Together: Formative Research To Develop A Social Marketing Plan For Smoking Cessation Among Women In A Residential Treatment Facility For Substance Abuse Recovery, August D. Anderson

Theses and Dissertations--Communication

Both smoking addiction and illicit substance abuse are prevalent issues in the United States today. Furthermore, these are issues that have significant impact on women’s health and mental state. Despite research that shows that smoking cessation coupled with substance abuse recovery can decrease likelihood of relapse post-recovery, few substance abuse recovery facilities today offer smoking cessation programming options. To address the issue of smoking addiction on top of substance abuse recovery, formative research was conducted through this study to determine the underlying causes of smoking habits coupled with recovery efforts and the attitudes. Through focus group sessions with women in …

Not Your Grandma’S Iud: Identifying Memorable Messages About Larcs, Carina Mazariegos Zelaya

Theses and Dissertations--Communication

Reducing the percentage of unwanted pregnancies has been one of the top objectives of the national health promotion "Healthy People" since the early 1980s. As the increase of unwanted pregnancies continues, research is necessary to uncover factors that influence the decisions women make about their contraceptive methods. The current study examines the topics and the sources of memorable messages regarding LARCs. To address the research questions, this study will analyze interviews conducted with young women about memorable messages regarding LARC methods. This study is a formative research of memorable messages in the context of contraceptive methods, specifically long-acting reversible contraceptives …

Message Effects And The Communication Theory Of Identity: Does Making Message Recipients Mindful Of Identity Gaps Influence Their Health Behavior Decisions?, Jacob J. Matig

Theses and Dissertations--Communication

Situated within the context of college students’ excessive drinking behaviors, the current study drew from dissonance theory, self-consistency theory, and hypocrisy induction methodology to evaluate the utility of the Communication Theory of Identity within persuasive health message design. Specifically, it examined whether hypocrisy induction manipulations that focused participants on salient identity layers made them mindful of corresponding identity gaps, which in turn caused them to experience cognitive dissonance that they sought to resolve by reporting intentions to change their excessive drinking behavior.

Participants (N = 279) completed an online experiment in which they were randomly assigned either to one …

A Beacon Of Hope: Inoculating Against Relapse, Allison F. Thieneman

Theses and Dissertations--Communication

Inoculation is a robust theory applied to a variety of health behaviors. Social marketing is designed to change behavior by applying marketing tactics in the context of social change. This study combines inoculation theory with social marketing in the context of substance abuse disorders to promote long-term recovery. This is a pilot project that specifically focuses on the Beacon House, a residential recovery treatment center in Louisville, Kentucky. With the growing drug problem in America, it is necessary to implement effective recovery strategies in treatment programs. The social marketing plan focuses on the target audience to outline potential barriers, motivators, …

Using Social Cognitive Theory To Understand Child And Adolescent Psychiatrists’ Discussions Of Substance Abuse With Their Patients, Kevin A. Wombacher

Theses and Dissertations--Communication

This study investigates factors that influence the conversations that child and adolescent psychiatrists have with their patients about substance use. The goal of the study is to gain a better understanding of salient psychological and communication constructs in this context using social cognitive theory as a guide. The study consisted of a national online survey of child and adolescent psychiatrists (n = 170) focused on understanding factors that affect self-efficacy and communication competence related to discussing substance use with adolescent patients. Results show that communication apprehension has a strong negative association with perceptions of self-efficacy. Results also show that …

Managing Multiple Goals In Opioid Prescription Communication: Perspectives From Trauma Physicians, Elizabeth T. Adams

Theses and Dissertations--Communication

Prescription opioids and heroin account for more than half of all drug overdose fatalities, claiming an estimated 91 American lives every day (Rudd, Seth, David, & Scholl, 2016). The ongoing opioid epidemic represents a tremendous burden to the national economy and healthcare system (Rudd, Aleshire, Zibbell, & Gladden, 2016). In 2016, the Centers for Disease Control and Prevention and the White House Office of National Drug Control Policy proposed action to train prescribers on the proper dispensing of opioids, which are indispensable pharmacologic resources for treating acute pain resulting from trauma or surgery. This study examines the prescribing practices of …

Black Women’S Perspectives On Breast Cancer Detection Messaging, Denise M. Damron

Theses and Dissertations--Communication

A qualitative approach was used to explore the influence of mass media campaigns on Black women’s perceptions of breast cancer. The primary purpose of this study was to address the high breast cancer mortality rate among young Black women, thus informing strategies to increase awareness of risk and encourage prevention activities. Black women have higher incidence rates before age 45 and are more likely to die from breast cancer at every age. Although the breast cancer mortality variance has been linked to socioeconomic status, studies have shown that differences in cancer knowledge and beliefs persist even when educational and socioeconomic …

Using Social Networking Sites During Public Health Crises: Theorizing The Diffusion Of Effective Messages, Sarah Vos

Theses and Dissertations--Communication

During a public health crisis, officials need to communicate with the public quickly and accurately. Social networking sites (SNS) have been identified as an appropriate channel for this type of communication; however, few studies have examined what makes SNS messages effective. Further limiting research in this area is a lack of attention to theoretical constructs that may explain message effectiveness in SNS.

In this dissertation, I propose that diffusion of innovations (DOI) be used to understand SNS and message success on SNS. In doing so, I compare traditional message success (persuasion) to message success on SNS platforms (amplification) and provide …