Social and Behavioral Sciences Commons^™

"The Land That Feminism Forgot": Birthzillas, Madwives, And The Politics Of Chilbirth, Amber Vayo

Doctoral Dissertations

“The Land that Feminism Forgot” is an in-depth exploration of the politics of childbirth that draws together qualitative and quantitative evidence to theorize the connections between treatment in childbirth and maternal mortality. Situating the qualitative research in the larger national context, the second chapter offers a State Reproductive Autonomy Index that provides an overview of the reproductive policy landscape at the national level. The dissertation then explores the role of institutionalized childbirth, medical mistrust, and obstetric violence in the U.S.’s longstanding maternal mortality crisis and offers policy suggestions in key public health areas. Through 120 qualitative interviews with people who …

Timing Of Hospital Admission At First Childbirth: A Prospective Cohort Study, Kristen H. Kjerulff, Laura B. Attanasio, Jennifer Vanderlaan, Kristin K. Sznajder

Health Promotion and Policy Faculty Publication Series

Background and aims

It is difficult for women in labor to determine when best to present for hospital admission, particularly at first childbirth. While it is often recommended that women labor at home until their contractions have become regular and ≤ 5-minutes apart, little research has investigated the utility of this recommendation. This study investigated the relationship between timing of hospital admission, in terms of whether women’s labor contractions had become regular and ≤ 5-minutes apart before admission, and labor progress.

Methods

This was a cohort study of 1,656 primiparous women aged 18–35 years with singleton pregnancies who began labor …

Dietary Fat Quality And Serum Androgen Concentrations In Middle-Aged Men, Miika M. Wynne-Ellis, Jaakko J. Mursu, Tomi-Pekka Tuomainen, Elizabeth Bertone-Johnson, Jukka T. Salonen, Jyrki K. Virtanen

Health Promotion and Policy Faculty Publication Series

Average testosterone concentrations in men have declined over the last few decades. The reasons for this are not fully known, but changes in dietary fat quality have been suggested to have a role. This study aimed to investigate the associations of different dietary fatty acids with serum androgen concentrations.

The Effects Of Spoken Self-Disclosure Scripts On Nonaphasic Listeners' Perceptions Of People With Aphasia, Colleen B. Ward

Masters Theses

Purpose: The purpose of this study was to investigate the effects of spoken self-disclosure scripts on nonaphasic listeners’ perceptions of people with aphasia (PWA). Self-disclosure is a tool that PWA can utilize in the event that they want a conversation partner to know of their communication disorder. However, limited research has been conducted on the effects of aphasia self-disclosure or whether it affects perceptions of PWA from neurotypical communication partners. If self-disclosure is determined to make a positive impact on a communicative interaction, it could be grounds for encouraging PWA who are interested to develop a self-disclosure script or use …

Quality Of Life For Women With Chronic Lyme Disease: A Socioeconomic Investigation, Dale M. Jones

Doctoral Dissertations

This is a mixed methods investigation of how chronic Lyme disease, including Lyme-like diseases and co-infections, affects the quality of life of women who have chronic Lyme. Both quantitative and qualitative methods were used during three phases of research: a 91-question survey instrument followed by focus group discussions and written narratives. The research considered the socioeconomic impact on quality of life in five areas: obtaining a diagnosis, relationships and personal support systems, struggles with the medical system, the ability to work, and access to treatment. There were 500 responses to the survey, of which 373 were analyzed; 11 participants in …

Restorative Streetscapes: Promoting Positive Mental Health Outcomes Through Urban Landscape Design In Winooski, Vermont, Sean R. Fitzsimmons

Landscape Architecture & Regional Planning Studio and Student Research and Creative Activity

The global health burden of mental health disorders is immense. The World Health Organization ranks depression as the single largest contributor to global disability; anxiety disorders alone rank sixth. One in four people will have a diagnosable mental illness in their lifetime and mental health conditions are increasing worldwide, rising 13% in the last decade. The economic implications are also immense, costing the global economy US $1 trillion each year. Mental health is more than the absence of disorders or disabilities, however. It is defined by the WHO as “a state of well-being in which an individual realizes his or …

The Massachusetts Public Health Data Warehouse And The Opioid Epidemic: A Qualitative Study Of Perceived Strengths And Limitations For Advancing Research, Elizabeth A. Evans, Elizabeth Delorme, Karl D. Cyr, Kimberly H. Geissler

Health Promotion and Policy Faculty Publication Series

Due to the opioid overdose epidemic, Massachusetts created a Public Health Data Warehouse, encompassing individually-linked administrative data on most of the population as provided by more than 20 systems. As others seek to assemble and mine big data on opioid use, there is a need to consider its research utility. To identify perceived strengths and limitations of administrative big data, we collected qualitative data in 2019 from 39 stakeholders with knowledge of the Massachusetts Public Health Data Warehouse. Perceived strengths included the ability to: (1) detect new and clinically significant relationships; (2) observe treatments and services across institutional boundaries, broadening …

Transitions In Health Insurance During The Perinatal Period Among Patients With Continuous Insurance Coverage, Chanup Jeung, Laura B. Attansio, Kimberly H. Geissler

Health Promotion and Policy Faculty Publication Series

Importance Although health insurance continuity is important during the perinatal period to improve birth outcomes and reduce maternal morbidity and mortality, insurance disruptions are common. However, little is known about insurance transitions among insurance types for individuals who remained insured during the perinatal period.

Objective To examine insurance transitions for birthing individuals with continuous insurance, including those with Medicaid and Medicaid managed care coverage, before, during, and after pregnancy.

Design, Setting, and Participants This cohort study used January 1, 2014 to December 31, 2018 data from the Massachusetts All-Payer Claims Database. The sample included deliveries from January 1, 2015, to …

Accelerometer-Determined Physical Behavior Metrics And Their Associations With Sarcopenia Among Oldest-Old Adults, Eric M. Eberl

Masters Theses

INTRODUCTION: Sarcopenia is a loss of muscle function and muscle mass which frequently occurs among the oldest-old adult population (aged 85+ years). The analysis of accelerometer-determined physical behavior volumes and patterns of oldest-old adults might provide novel insights into the associations with sarcopenia and its components. METHODS: A total of 145 participants in the primary sample and 87 participants in the subsample with a mean age of 88.2 (2.5) years from the Health, Aging, and Body Composition study cohort provided cross-sectional data of handgrip strength, appendicular lean mass, gait speed, and accelerometry. Probable, confirmed, and severe sarcopenia were assessed based …

Policing And Health: Police Encounters As A Fundamental Cause Of Racial Health Disparities, Richard S. Carbonaro

Doctoral Dissertations

Structural racism has taken many forms throughout American history and to this day continues to drive social, economic, and health inequalities. Mass incarceration is a modern tool of social marginalization with well documented and deep-rooted racial inequalities. Research has continually shown that mass incarceration negatively impacts the health of disadvantaged communities. Even police stops, the most common and mundane form of criminal justice contact has been linked with deleterious health outcomes at the individual and community level. In this dissertation, I identify specific social and biological mechanisms connecting encounters with the police and health outcomes. In the first chapter, I …

Evaluating Public Masking Mandates On Covid-19 Growth Rates In U.S. States, Angus K. Wong

Masters Theses

U.S. state governments have implemented numerous policies to help mitigate the spread of COVID-19. While there is strong biological evidence supporting the wearing of face masks or coverings in public spaces, the impact of public masking policies remains unclear. We aimed to evaluate how early versus delayed implementation of state-level public masking orders impacted subsequent COVID-19 growth rates. We defined “early” implementation as having a state-level mandate in place before September 1, 2020, the approximate start of the school-year. We defined COVID-19 growth rates as the relative increase in confirmed cases 7, 14, 21, 30, 45, 60-days after September 1. …

Hospital Assessment And Response To Environmental Pollution As A Population Health Need: Identifying Prevalence And Predictors In Community Benefit Practices, Sarah Valentine

Doctoral Dissertations

Hospitals have a growing role in improving population health. Environmental pollution is an important determinant of health with disproportionate effects on Communities of Color. This warrants hospital action. To advance such action, it is important to take stock of current hospital engagement with environmental pollution and to identify factors associated with such engagement. I investigated the following. To what extent do New York State (NYS) non-profit hospitals assess, identify, and respond to environmental pollutants as part of community benefit practices? Do factors previously reported as associated with hospital engagement of social determinants predict engagement with environmental pollution as a community …

Dental Fluoride Varnish Application During Medical Visits Among Children Who Are Privately Insured, Kimberley H. Geissler Phd, Andrew W. Dick Phd, Sarah L. Goff Phd, Christopher Whaley Phd, Ashley M. Kranz Phd

Health Promotion and Policy Faculty Publication Series

Fluoride varnish is effective at reducing tooth decay, which affects nearly a quarter of US children ages 2 to 5 years and more than half of children ages 6 to 8 years.^1,2 To increase young children’s receipt of preventive oral health services, the US Preventive Services Task Force recommends medical providers apply fluoride varnish to young children’s teeth during well-child visits through 5 years of age.² Offering fluoride varnish in medical settings may increase young children’s receipt of this service because 89% of children younger than 6 years of age had a preventive medical visit in …

Maltreatment And Brain Development: The Effects Of Abuse And Neglect On Longitudinal Trajectories Of Neural Activation During Risk Processing And Cognitive Control, Jungmeen Kim-Spoon, Toria Herd, Alexis Brieant, Kristin Peviani, Kirby Deater-Deckard, Nina Lauharatanahirun, Jacob Lee, Brooks King-Casas

Psychological and Brain Sciences Faculty Publication Series

The profound effects of child maltreatment on brain functioning have been documented. Yet, little is known about whether distinct maltreatment experiences are differentially related to underlying neural processes of risky decision making: valuation and control. Using conditional growth curve modeling, we compared a cumulative approach versus a dimensional approach (relative effects of abuse and neglect) to examine the link between child maltreatment and brain development. The sample included 167 adolescents (13?14 years at Time 1, 53 % male), assessed annually four times. Risk processing was assessed by blood-oxygen-level-dependent responses (BOLD) during a lottery choice task, and cognitive control by BOLD …

Family Support And Readiness To Consider Smoking Cessation Among Chinese And Vietnamese American Male Smokers, Joan A. Daniel, Jin E. Kim-Mozeleski, Krishna C. Poudel, Angela Sun, Nancy J. Burke, Janice Y. Tsoh

Health Promotion and Policy Faculty Publication Series

Introduction. Smoking prevalence is disproportionately high among Asian American immigrant men with limited English proficiency. Understanding the role of family support may provide insights into culturally acceptable strategies to promote smoking cessation. Aims. This study examined how family support was associated with readiness to consider smoking cessation among Chinese and Vietnamese American male daily smokers. Methods. We analyzed baseline data (N = 340) from a cluster randomized trial of a family-based healthy lifestyle intervention. We assessed the frequency of receiving family support in various forms (encouraging use of cessation resources, praising efforts, checking in, and reminding of familial role). Multiple …

Evaluating Epidemic Forecasts In An Interval Format, Johannes Bracher, Evan L. Ray, Tilmann Gneiting, Nicholas G. Reich

Biostatistics and Epidemiology Faculty Publications Series

For practical reasons, many forecasts of case, hospitalization, and death counts in the context of the current Coronavirus Disease 2019 (COVID-19) pandemic are issued in the form of central predictive intervals at various levels. This is also the case for the forecasts collected in the COVID-19 Forecast Hub (https://covid19forecasthub.org/). Forecast evaluation metrics like the logarithmic score, which has been applied in several infectious disease forecasting challenges, are then not available as they require full predictive distributions. This article provides an overview of how established methods for the evaluation of quantile and interval forecasts can be applied to epidemic forecasts in …

Parenting Group For Externalizing Youth With Side Benefits For Parents, Diane Johnson

Doctor of Nursing Practice (DNP) Projects

Abstract

Background/Purpose: Mental health problems in the form of externalizing behaviors in children continues to climb. The financial burden, along and increased risks of long-term adverse effects, are a critical area that are improved with interventions such as parent management training (PMT). PMT is an evidence-based treatment for disruptive and externalizing child behaviors. Even brief interventions can improve parents’ perceptions of challenging behavior and benefit parental well-being through stress reduction and self-efficacy. Purpose: To provide PMT concepts through a group format and improve parental perceptions of externalizing behaviors and stress reduction. Methods: Provide a six-session parent group with discussion, video, …

Processes Linking Socioeconomic Disadvantage And Neural Correlates Of Cognitive Control In Adolescence, Alexis Brieant, Toria Herd, Kirby Deater-Deckard, Jacob Lee, Brooks King-Casas

Psychological and Brain Sciences Faculty Publication Series

Socioeconomic status (SES) is broadly associated with self-regulatory abilities across childhood and adolescence. However, there is limited understanding of the mechanisms underlying this association, especially during adolescence when individuals are particularly sensitive to environmental influences. The current study tested perceived stress, household chaos, parent cognitive control, and parent-adolescent relationship quality as potential proximal mediators of the association between family SES and neural correlates of cognitive control. A sample of 167 adolescents and their primary caregivers participated in a longitudinal study across four years. SES was indexed by caregivers? education and income-to-needs ratio at Time 1. At Time 2, adolescents reported …

Pubertal Development And Risk Of Premenstrual Disorders In Young Adulthood, Donghao Lu, Jurate Alenaviciute, Ragnar Bjarnason, Unnur A. Valdimarsdóttir, Elizabeth R. Bertone-Johnson

Health Promotion and Policy Faculty Publication Series

STUDY QUESTION

Is pubertal timing associated with risk of premenstrual disorders (PMDs) in young adulthood? SUMMARY ANSWER

Late pubertal development is associated with decreased premenstrual symptom burden and risk of PMDs in young adulthood. WHAT IS KNOWN ALREADY

PMDs, including premenstrual syndrome and premenstrual dysphoric disorder, may begin during the teenage years. Few risk factors in early life have been identified for PMD development. STUDY DESIGN, SIZE, DURATION

A prospective cohort study of 6495 female participants during 1996–2013. PARTICIPANTS/MATERIALS, SETTING, METHODS

We included participants from the Growing Up Today Study (GUTS). Pubertal development was indicated by the timing of menarche, …

Older Women’S Experiences Of Intimate Partner Violence: A Phenomenological Study, Lourdes Irene

Doctoral Dissertations

Intimate partner violence (IPV) is a global public health problem, linked to long-term health, social, and economic consequences. Despite the growing number of women over age 60 in Puerto Rico, knowledge is lacking about culturally specific IPV in women of this age group. This lack of knowledge is problematic because women experiencing abuse often do not report it, health professionals are not educated to identify cases of abuse in older women, and researchers often includes IPV with other types of abuse, such as negligence by families. Therefore, the purpose of this study was to explore and describe the experiences and …

Food And/As Communication, Leda M. Cooks

Sustainability Education Resources

This is a two-semester, eight-credit Communication Honors Thesis Seminar focusing on the ways we create and reflect meanings made about food. The seminar delves into the material and social meanings of food and implications for identity, culture and social justice. Students will have the opportunity to research food in the context of the meanings made about it in various institutions, businesses, nonprofit organizations, neighborhoods, cultures and communities. The first semester HONORS 499 CL (Fall 2020) will 1) introduce students to food as a vehicle through which society and social life is communicated; 2) introduce methods and tools for conducting survey …

Shifting To Virtual Cbpr Protocols In The Time Of Corona Virus/Covid-19, Elizabeth Salerno Valdez, Aline Gubrium

Health Promotion and Policy Faculty Publication Series

COVID-19 has upended community based participatory research (CBPR) projects across the United States and globally. COVID-19 disproportionately impacts historically disenfranchised communities and communities of color, the very communities that CBPR is meant to engage, elevate, and support. In-person activities that help develop rapport and research protocols, build capacity, conduct collaborative data collection and analysis, disseminate findings to the community, and engage in sustainability planning are an impossible practice during the COVID-19 pandemic. The purpose of this article is to describe the challenges and facilitators of shifting to a virtual/online CBPR protocol with a Massachusetts community disproportionately affected by COVID19, as …

Improving Alcohol Screening And Brief Intervention In Community Health Settings: Training And Evaluation, Abdonne Mbouadeu

Doctor of Nursing Practice (DNP) Projects

Background: Excessive alcohol use is responsible for 88,000 deaths in the United States each year. Alcohol Screening and Brief Intervention (ASBI) is highly effective for the prevention and treatment of harmful alcohol use in community healthcare settings; however, this intervention is not widely used by healthcare professionals. A structured search of bibliographic databases was conducted to locate evidence-based articles pertaining to barriers to ASBI. Evidence suggests that the lack of knowledge and confidence is responsible for the underutilization of ASBI. Purpose: To assess the impact of ASBI training on nursing staff knowledge, attitude, and confidence and to make ASBI a …

Educating Health Care Providers On The Benefits Of Screening For Adverse Childhood Experiences In Children And Adolescents, Kristen Hickey

Doctor of Nursing Practice (DNP) Projects

Background: Adverse childhood experiences (ACEs) are associated with the development of chronic health problems as well as increased risk for negative mental health outcomes. Research supports the need for health care providers (HCP) to change current practice by adding one of the many types of screening tools for ACEs, such as the ACEs Q, to well-child visits. The information obtained from the assessment leads to early identification of children who are at risk for negative mental health outcomes, allowing HCPs to initiate early interventions potentially decreasing the negative outcomes.

Purpose: The purpose of this quality improvement project was to provide …

Cultural Communication For New Nurse Residents: K.I.N.D Communication Toolkit, Jennifer Caraballo

Doctor of Nursing Practice (DNP) Projects

Background: Microaggressions can create a hostile work environment and decrease rapport and functioning in clinical and personal relationships. Exposure to micro aggression and implicit bias results in micro trauma and possible compassion fatigue by medical staff. Symptoms can include headaches, poor sleep, depressions, and anxiety, similar to compassion fatigue.

Purpose: To develop a toolkit for healthcare staff to use as educational material to facilitate for cultural communication and cultural humility.

Methods: Nurses that were enrolled in a nurse residency program at a level 1 trauma center participated in the education of a communication toolkit related to K.I.N.D …

Food Safety And Risk Of Foodborne Illness At A Food Center Extension: Toolkit For Front-Line Volunteers, Sara Anderson

Doctor of Nursing Practice (DNP) Projects

Background: Foodborne illness is a serious public health issue. One in six Americans has an episode of foodborne illness each year and over 50,000 are hospitalized. Food distribution centers are instrumental in decreasing food insecurity, however, some of the food donated is expired or may be damaged leading to increased risk of foodborne illness.

Purpose: The purpose of this project was to educate front-line volunteers at a local food center regarding food safety.

Methods: A toolkit was developed to teach food safety to the front-line volunteers. Seven classes were given to front-line volunteers including a pre and post intervention …

Adolescent Mental Health Training For Middle School Educators, Sarah Minton

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Adolescent mental health disorders are an increasing concern in the United States. School systems, specifically educators, are in the unique role to aid in early identification of mental health disorders, as well to intervene in mental health distress. However, mental health training for educators is lacking, leaving educators unprepared to manage mental health concerns within their classroom.

Purpose: The purpose was to utilize an evidence-based training, the “Teacher Knowledge Update Guide” from TeenMentalHealth.org to train middle school educators on the signs and symptoms of mental health conditions in the adolescent population with the intent to increase awareness, knowledge, …

Cross-Cutting Narratives Of Opioid Use Disorder Among Pregnant Women And Mothers: Implications For Humanistic Care, Alice Fiddian-Green

Doctoral Dissertations

Opioid-related fatalities in the U.S. have increased drastically. Pregnant women and mothers with opioid use disorders (OUD) are a rapidly growing and vulnerable population. Using a critical narrative approach, this dissertation examines how the syndemic of trauma, substance use, and mental health conditions influences opioid use and treatment trajectories among pregnant women and mothers across the lifecourse. The goal of this dissertation was to examine three discursive resources that shape the social construction of perinatal and maternal opioid use across all strata of social life: macro-level (news media), meso-level (scientific), and micro-level (individual) narratives. Informed by 18-months of ethnographic observation, …

Improving Chinese Mothers’ Health Literacy: A Wechat Intervention, Qiong Chen

Doctoral Dissertations

The health literacy and eHealth literacy of women during the reproductive age is crucial, as it can affect their health and the health of their children. Promoting health literacy is essential to achieve mothers’ empowerment by improving access to and capacity of using health information effectively. However, functional, interactive, and critical health literacy and eHealth literacy have never been assessed among Chinese women. The first study during this dissertation assessed functional, interactive, and critical health literacy and eHealth literacy among 421 of Chinese mothers with children under 3 years old. The results revealed overall less than optimal level of health …

Young Adult Early Childhood Home Visitors’ Perceptions Of Fan (Facilitating Attuned Interactions) And Its Potential Protection To Burnout, Lee Mackinnon

Doctoral Dissertations

ABSTRACT YOUNG ADULT EARLY CHILDHOOD HOME VISITORS’ PERCEPTIONS OF FAN (FACILITATING ATTUNED INTERACTIONS) AND ITS POTENTIAL PROTECTION TO BURNOUT FEBRUARY 2019 LEE MACKINNON, B.A., WILLIAMS COLLEGE Ed.M., HARVARD UNIVERSITY Ph.D., UNIVERSITY OF MASSACHUSETTS AMHERST Directed by: Professor Claire E. Hamilton This qualitative study investigated the experience of young adult early childhood home visitors in the training and implementation of a family engagement tool, Facilitating Attuned Interactions (FAN) (Gilkerson, 2015). Using Interpretative Phenomenological Analysis, the case study explored how 5 home visitors, who were under 30 years of age, viewed their training and use of FAN in three components of their …