Social and Behavioral Sciences Commons^™

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Comparative Analysis Of Acceptance And Commitment Therapy’S Effectiveness In An Intensive Outpatient Program Setting, Efrain Frank Ellin Iii

Electronic Theses and Dissertations

This thesis presents a comparative analysis of acceptance and commitment therapy (ACT) and treatment as usual (TAU) within an intensive outpatient program setting, evaluating their effectiveness in enhancing various dimensions of psychological well-being. Guided by two main research questions, the study investigates whether ACT demonstrates greater or equal effectiveness compared to TAU and if it provides more immediate effects on psychological well-being within three weeks. Utilizing a quasi-experimental design, the research incorporates a comprehensive array of measurement tools to assess outcomes related to anxiety, depression, stress, psychological flexibility, cognitive flexibility, emotion regulation, mindfulness self-efficacy, and life satisfaction among participants. The …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Social And Structural Determinants Of Health As Predictors Of Covid-19 Vaccine Hesitancy Among Older Adults In The United States, Kingsley Kalu

Electronic Theses and Dissertations

Background: Although vaccination is one of the greatest accomplishments in public health, some people, especially older adults, are reluctant to take vaccines. This study examined the association between the social and structural determinants of health and COVID-19 vaccine hesitancy among older adults in the United States.

Methods: Secondary data from the Health and Retirement Study (HRS) was used. The HRS participants were 65 years and older, and the sample size was 2311. Multinomial multivariable logistic regression models were conducted for this study.

Results: The study shows that social determinants of health (marital status, educational level) and structural determinants of health …

"Shut Down And Closed Off": A Routine Activity Approach To Investigating The Relationship Between Covid-19 School Closures And Child Sexual Abuse Report Characteristics In Georgia, Spencer E. Riner

Electronic Theses and Dissertations

The COVID-19 pandemic of 2020 created a public health crisis that led to an unprecedented number of school closures. A major concern raised by child advocates, law enforcement, and social service providers was the possible increase in undetected child abuse and maltreatment. Undergirding this concern was the belief that this mitigation effort might place child abuse victims and offenders within proximity for extended periods of time. While this was a significant concern, it has rarely been analyzed empirically. To address this gap in the literature, this thesis investigates how school closures impacted the characteristics of child sexual abuse (CSA) reports …

A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon

Electronic Theses and Dissertations

Abstract

Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature …

The Relationship Between Intuitive Eating And Body Mass Index And Diet Quality In College Students, Ashley A. Reynolds

Electronic Theses and Dissertations

Objective

The objective of this research was to explore the influence of intuitive eating (IE) on body mass index (BMI) and diet quality (DQ) among college students.

Methods

A cross-sectional convenience sample of college students completed an online survey consisting of the short-Healthy Eating Index (SHEI) and the Intuitive Eating Scale-2 (23 items). Body mass index was calculated using self-reported height and weight. Descriptive statistics were used to assess group characteristics. A linear regression was used to test if IE scores significantly predicted BMI. An independent t-test was used to compare BMIs of students with IE scores above and below …

Scaling Up The Relevance Of Land-Sea Connections In Coastal Bacteria Pollution Vulnerability, Bea E. Van Dam

Electronic Theses and Dissertations

Bacteria pollution closures of Maine’s coastal shellfish harvest areas have substantial negative consequences for coastal businesses and communities. Sustainability solutions for Maine’s shellfish harvesting areas and businesses require new types of knowledge and information to protect water quality and public health while avoiding unnecessary fishery closures. Coastal management agencies have interests in tools to support science-based management decision-making related to pollution and sustainability solutions for businesses and communities.

Prior research into land-sea connections has demonstrated uses of geographic information and statistical methods to facilitate management and science communication. Research in Maine has focused on identification and comparison of attributes influencing …

A Social And Ecological Approach To Mosquito Species Distribution Across Land Use In Bangor, Maine, Megan L. Schierer

Electronic Theses and Dissertations

Mosquitoes are ubiquitous pests and infectious disease vectors. However, not all mosquito species bite humans, or are competent pathogen vectors between bloodmeal hosts. Along with climatic variables like temperature and rainfall, mosquito species distribution is determined by aquatic habitat availability for juvenile mosquito development, and terrestrial habitat and host availability for adult mosquitoes. There is variation in the preferred aquatic habitat for gravid female oviposition and subsequent larval development. Some mosquito species’ oviposition and development are associated with ephemeral water sources (e.g., floodplains), others prefer more permanent water sources (e.g., bogs or vernal pools). Other mosquitoes have evolved to occupy …

The Effects Of Peers For Young Adults On Anxiety And Quality Of Life For Young Adults With Autism Spectrum Disorder, Alysha Cecile Dagg

Electronic Theses and Dissertations

Social skills deficits as well as comorbid anxiety are two characteristics commonly experienced by people with Autism Spectrum Disorder - Level 1 (ASD-1; American Psychiatric Association, 2013). These characteristics are also both contributors to a lower quality of life for young adults (Smith et al., 2019). The current study aimed to identify how the quality of life and anxiety are affected by social skills intervention, specifically the PEERS® for Young Adults program (Laugeson, 2017). PEERS® for Young Adults is an evidence-based social skills intervention intended to support individuals with ASD-1 (Laugeson, 2017). Prior research has demonstrated its success in both …

Our Story, Our Song: Assessing And Addressing Black Women's Healthcare Experiences., Jason Deakings

Electronic Theses and Dissertations

Despite advancements in medicine and health sciences, health disparities and declining life expectancy persists among Black women in the United States. Researchers and non-traditional healthcare providers suggest alternative healing (e.g., music and Sister Circles) and research methodologies to achieve a culturally conscious, traumainformed, quality, and holistic care and practice. The intersecting identities and cultural responsibility of Black women highly influences the barriers and facilitators on the uptake of healthcare services. Utilizing a community engaged research approach, this qualitative study assessed the healthcare experiences, as well as the role of music in the lived and retold experiences of Black women navigating …

The Impact Of Controlling Language And Source Similarity On Psychological Reactance, Caroline Yarbrough

Electronic Theses and Dissertations

Persuasive health messages are frequently advertised throughout the pandemic to decrease the spread of COVID-19 while increasing the likelihood of immunity. However, research demonstrates that persuasive health messages may be ineffective because they have the potential to elicit psychological reactance. Reactance is characterized by a state of unpleasant motivational arousal and often occurs when individuals experience or perceive threats to their freedom, and it can be evoked through controlling language (Frey et al., 2021; Grandpre et al., 2003). Additionally, research has shown that similarity is associated with liking (Cialdini & Trost 1998) and people are often more inclined to comply …

Medical Providers' Use Of Maternal Mental Health Screening Tools During Prenatal Appointments In Southeast Georgia, Andreka Ewing

Electronic Theses and Dissertations

In the United States, maternal mental health disorders are the most common comorbidities experienced during pregnancy and after childbirth. In particular, the state of Georgia reports that 1 in 7 Georgian mothers experience depression, anxiety, obsessive-compulsive disorders, or psychosis related to these disorders. Research suggests that untreated maternal mental health can have adverse effects on the mother and unborn child. Conditions such as autism, mixed handedness, reduced cognitive ability, and affective disorders can develop while the child is in the womb of a depressed mother. Routine maternal mental health screening using a validated screening tool has been recommended to help …

“My Ob/Gyn Has The Worst Bedside Manner…” A Qualitative Analysis Of Patient-Provider Communication And Mental Health Outcomes Of Women In Rural Georgia, Tobi F. Oloyede

Electronic Theses and Dissertations

Despite technological advances in medicine and public health innovations, maternal mortality in the United States remains significantly higher than in other developed countries. Specifically, Georgia ranks as the second worst place to give birth in the country. Maternal mental health conditions are common, manageable complications that can happen at any point during pregnancy, childbirth, or in the first year following delivery, with 1 in 5 women affected. Unfortunately, 75% of women who experience MMH symptoms are left untreated.

This study focuses on patient-provider communication through the birthing experiences of women who have been pregnant in Georgia to examine how their …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

Electronic Theses and Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

Species Data And Vector Modeling: Evaluating Datasets For Improved Models Of Ixodes Ricinus Tick Distribution In Europe Under A Changing Climate, Steven Jones

Electronic Theses and Dissertations

To increase capacity for monitoring and surveillance of tick-borne diseases, publicly available tick distribution and climate change datasets are required to create accurate predictive distribution models. It is difficult, however, to assess model accuracy and utility when using incomplete datasets.  The more recent development of comprehensive tick databases for Europe and availability of climate change scenarios from multiple IPCC Assessment Reports allows for improved modeling efforts. Multiple tick datasets were combined and three climate change projections were compared by predicting current and future distributions of Ixodes ricinus ticks in Europe using the MaxEnt species distribution model. Overall, much of Europe …

The Correlation Between Transformational Leadership And Mental Health Clinician Burnout, Rebekah E. Shutter

Electronic Theses and Dissertations

Mental health clinicians working in a hospital setting are at a high risk of experiencing burnout due to the stressful demands of their caseloads, compassion fatigue, limited resources, and unsupportive leadership. While there is ample research regarding the cause and effect of burnout on clinicians there is a gap in the literature when it comes to the impact leadership has on mental heath clinician burnout. The purpose of this quantitative, correlational study is to determine if and to what extent there is a correlation between Transformational Leadership and mental health clinician burnout. Participants for this study consisted of 200 mental …

The Purple Heart And Suicidal Behaviors In Post-9/11 U.S. Army Combat Veterans With A Traumatic Brain Injury: A Mixed Methods Study, Jayna Moceri-Brooks

Electronic Theses and Dissertations

Military suicide rates remain high, despite years of targeted efforts to prevent suicide. Specifically, Army Combat Veterans who sustained a traumatic brain injury (TBI) while deployed in support of the Global War on Terrorism are at the highest risk for suicide. This dissertation highlights possible causes for suicidal behaviors within this unique group and provides specific military suicide prevention recommendations. The dissertation is organized into three publishable manuscripts: The first manuscript (Chapter 1) is a mixed-methods dissertation research proposal written according to the National Institute of Health proposal guidelines. The second manuscript (Chapter 2) is an integrative review of the …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Caregiver-Child Conversations About Sex In African American Women, Hannah King

Electronic Theses and Dissertations

Using grounded theory methods, this study examines the experience of African American women during their caregiver-child conversations about sex and the impacts of the conversations on their sexual attitudes. The process of these conversations begins with an unplanned topic and progresses further to identify six essential themes of these conversations: gender differences, race and religion, protective/emphasis on protection, lack of knowledge, withholding knowledge, and sex negativity/shame. African American women’s description of the process included feelings of shame and negativity towards their sexuality. Caregivers promoted positive messages about sex by having open conversations that advocated for equality between the genders, empower …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

Public Health Contagion Of White Supremacy: Examining The Pipeline Of Attitudes About Racism And Racial History Education Among High School Students., Trinidad Jackson

Electronic Theses and Dissertations

We are living in compounded states of upheaval. Violence and exemption from it across socioecological levels have shaped how humans survive, thrive, and die. While different violence typologies exist, the U.S., prioritizes interpersonal violence as its primary target of intervention, often through structural means that foster and reinforce interpersonal violence. The omission of structural and cultural agents and outcomes of violence allows perpetrators to infiltrate and reproduce savage, dehumanizing ideologies in perpetuity. Instead of sustaining societal pillars that oppress and destroy, we must fertilize public health research, practice, and sociopolitical activism with pillars that both inform and activate liberatory consciousness …

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

Exploring The Relationship Between Historical Redlining And Place-Based Reproductive Health Inequities: A Qualitative Gis Approach, Kristi L. Roybal

Electronic Theses and Dissertations

Individual-level risk factors and characteristics do not fully explain racial, ethnic, and socioeconomic inequities in preterm birth in the United States, and evidence suggests that medical advancements, increased access to prenatal care, and high per-capita spending on health care have done little to reduce these inequities. Health inequities research has shifted its attention from individual-level factors that influence health outcomes to the social determinants of health. Neighborhoods, considered an important upstream social determinant of health, can influence health outcomes through their social, service, and physical environments, and have been consistently linked to birth outcomes. Despite increased attention to neighborhood influences …

Factors Associated With Intention To Disclose Concussive Symptoms In Active Duty Soldiers, Carly Beck

Electronic Theses and Dissertations

Background: Concussion disclosure is a heavily researched topic, and while previous literature has explored predictors of concussion disclosure in numerous populations, research within the active duty Soldier population is limited. This study further explored predictors of concussion disclosure to a medical professional or leadership in the active duty Solider population through the lens of the Theory of Planned Behavior. Methods: A cross-sectional electronic survey was distributed to 181 active duty Soldiers. Descriptive statistics were used to report frequency of high intention to disclose concussive symptoms among demographics, and a multivariate regression model was used to assess significant predictors of intention …

Exploring The Contextual Factors And Decision-Making Process Of Risky Sexual Behavior Among Homeless Adults In Louisville, Kentucky., Sarah C. Van Heiden

Electronic Theses and Dissertations

Homelessness is a complex public health issue; individuals who experience homelessness are said to engage in risky sexual behaviors at an increased rate and experience a higher prevalence of sexually transmitted infection (STI). While the sexual behaviors of homeless adolescents are commonly studied, little is known about the sexual behaviors of the growing population of older adults, or how they make decisions to engage in sex. Three aims guided this research: 1) to describe the sexual behaviors and sexual decision-making process of homeless older adults, 2) to examine how homeless older adults evaluate the outcomes associated with engaging in risky …

Exploring Opportunities For Prevention Of Child Sexual Abuse In A Diverse American Muslim Community., Rishtya Meena Kakar

Electronic Theses and Dissertations

Recognizing the significant mental, emotional, developmental and health consequences for victims of child sexual abuse (CSA) and sociopolitical consequences for families and communities in every cultural, ethnic, and religious group around the world, this study sought to determine key opportunities for prevention of CSA in a diverse American Muslim community using a public health socioecological lens, rooted in aspects of critical theory. While there is considerable research on situational and individual-level risk factors related to CSA cases, there is less research on the societal and community-level processes related to the primary prevention of CSA, especially among minoritized communities. Responding to …

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso

Electronic Theses and Dissertations

Legal induced abortion is a safe option for terminating a pregnancy for women of reproductive age in the United States (U.S.), though access has varied since the Roe v. Wade and Doe v. Bolton cases in 1973. Information is lacking on women’s attitudes toward and perceptions of abortion as well as on related constructs such as pregnancy attitudes and contraceptive use. Exploring these constructs is important in that it can provide much needed context to women’s reproductive life planning. This research aimed to explore perceptions of abortion access and safety and examine the potential associations between attitudes toward abortion access …