Social and Behavioral Sciences Commons^™

Neural And Behavioral Associations Of Drinking And Empathic Processing, Charles Samuel Henry Robinson

Psychology ETDs

Alcohol Use Disorder (AUD) is a major health problem, yet most individuals with AUD do not perceive a need for formal treatment and do not receive treatment. The lack of treatment seeking among individuals with AUD may suggest a lack of self-awareness and insight into the seriousness of AUD related problems. Moreover, individuals who have lost or are at risk of losing major relationships are especially likely to perceive the need for help. Thus, it may be the case that awareness of the influence of one’s drinking on social relationships and the feelings of others (i.e., empathy) could improve treatment …

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

Arts & Sciences Electronic Theses and Dissertations

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

Examining Climate Change-Health Nexus In Ghana, Lucia Kafui Hussey

Electronic Thesis and Dissertation Repository

Climate change is one of today’s most pressing global issues with its physical, biological and social impacts widely recognized. One area of concern is its potential health consequences. The postulated health effects from climate change are far-reaching that climate change induced health risks are signaled as the most pressing problems to public health in the 21^st century. Although developing countries such as Ghana had been suggested as a vulnerable hotspot for the health consequences of climate change, there is a paucity of empirical research on climate change and its health linkages in the country.

The purpose of this dissertation …

Hemoglobin A1c Improvements And Better Diabetes-Specific Quality Of Life Among Participants Completing Diabetes Self-Management Programs: A Nested Cohort Study, Abhinav Khanna

Dissertations & Theses (Open Access)

Background: Numerous primary care innovations emphasize patient-centered processes of care. Within the context of these innovations, greater understanding is needed of the relationship between improvements in clinical endpoints and patient-centered outcomes. To address this gap, we evaluated the association between glycosylated hemoglobin (HbA1c) and diabetes-specific quality of life among patients completing diabetes self-management programs.

Methods: We conducted a retrospective cohort study nested within a randomized comparative effectiveness trial of diabetes self-management interventions in 75 diabetic patients. Multiple linear regression models were developed to examine the relationship between change in HbA1c from baseline to one-year follow-up and Diabetes-39 (a diabetes-specific quality …

Sex-Specific Effects And Gene-Sex Interactions In Serum Metabolome Levels: The Atherosclerosis Risk In Communities Study, Zhe Wang

Dissertations & Theses (Open Access)

Metabolomic signatures associated with complex disease have been identified. Metabolomic profiling and the integration of genomic data have proven to be powerful tools to investigate genetic effects underlying intermediate phenotype levels and may facilitate improved understanding of pathophysiologic processes of disease. However, most published studies did not consider sex as an effect modifier, analyze sex-specific effects, nor gene by sex interactions. One reason can be incomplete knowledge of the power of statistical methods used in a given dataset.

I first investigated sex-specific genetic effects by performing sex-stratified exome-wide association studies for 271 chromatography-mass spectrometry measured metabolites in the Atherosclerosis Risk …

Chagas Disease Awareness Amongst Texas Physicians, Gerardo J. Pacheco

Dissertations & Theses (Open Access)

An estimated 300,000 people in the U.S. are living with Chagas Disease (CD), many of whom may not yet know they are infected. Approximately 20% to 30% of individuals with CD are expected to develop clinical symptoms that may manifest as heart disease and result in death if left untreated. The prevalence of CD in humans is not well understood. Given its asymptomatic manifestation and the rarity in cases seen by physicians in general, CD may be under-recognized by physicians.

The purpose of this research was to explore the understanding and knowledge of CD in Texas HCP populations (cardiologists, infectious …

Assessment And Findings Of The Vulnerability Index (Vi-Spdat) Survey Of Individuals Experiencing Homelessness In Travis County, Tx, Benjamin T. King

Dissertations & Theses (Open Access)

Homelessness is a significant barrier to the quality of an individual’s health. Federal housing interventions attempt to eliminate homelessness by providing varying degrees of subsidization, but available units do not currently keep pace with the scale of the problem. Coordinated Assessment is a process requirement put in place by HUD to organize and prioritize the waiting list for housing, based on community priorities. Several tools measuring health and social vulnerability, including the Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT), have become popular options for prioritizing housing resources. Such assessments currently in use are not thoroughly researched and the effects of …

Collateral Benefits Of Diabetes Self-Management Associated With Self-Administered Outpatient Parenteral Antimicrobial Therapy, Anisha P. Ganguly

Dissertations & Theses (Open Access)

Self-administered outpatient parenteral antimicrobial therapy (S-OPAT) is a self-care treatment modality in which patients requiring extended courses of intravenous antibiotics are trained to safely self-administer treatment via an indwelling catheter in their home. Many patients seen in the S-OPAT program have a diagnosis of diabetes and present with infections associated with poor glycemic control, including skin and soft-tissue infections and osteomyelitis. Given the degree of patient activation required to successfully complete the S-OPAT process, we hypothesized that participation in this self-care program may benefit patients in self-management of other chronic health conditions, such as diabetes. The study team included Anisha …

Examining The Effect Of Service Delivery Factors On Timely Initiation Of Tuberculosis Treatment Within Primary Care Settings In Uganda, Michael Juma

Dissertations & Theses (Open Access)

Background: Timeliness of Tuberculosis (TB) treatment is critical to stopping its transmission and preventing disease complications and death. Efficiency in identifying and treating presumptive TB cases is critical to reducing delays.

Aims: We determined the association between health service-related factors and delays in initiating TB treatment within primary care settings in Uganda. Perspectives of healthcare workers on practices underlying healthcare facility level delays were also described.

Methods: A mixed methods study was conducted based on facility-register records of 1199 treated TB cases and key informant interviews with 27 outpatient staffs. Health service-related factors (size, ownership, number of …

Validation Of A Type 2 Diabetes Risk Stratification Tool In A Low Income Hispanic Population, Dara Grieger

Dissertations & Theses (Open Access)

A pilot study was undertaken to evaluate the appropriateness of a previously published diabetes risk stratification tool in a diabetic population. The tool was applied to a sample of 500 prediabetic and diabetic adults receiving primary care services at a Federally Qualified Health Center (FQHC) in Cameron County, Texas. The study population was largely Hispanic and underserved. The National Health and Nutrition Examination Survey (NHANES) 2015-2016 data set was used as a comparison group. The risk assessment tool was applied to separately to the prediabetic and diabetic subset of both study groups. The tool stratified the patients into three risk …

Does Space Matter? An Investigation Of The Spatial Variation In Gestational Weight Gain Associations With Country Of Birth Among Hispanic Women And Access To Care In Texas, Christopher R. Webb

Dissertations & Theses (Open Access)

Inadequate and excess gestational weight gain (GWG) are serious, but potentially preventable adverse pregnancy outcomes which affect as many as two-thirds of pregnant women in the United States. While location and space are associated with a variety of pregnancy outcomes, limited research has investigated potential spatial variation in GWG. The goal of this research is to improve the knowledge of how spatial geography is associated with GWG through secondary analyses of 70,000 to 160,000 birth certificate registry records for Texas mothers with a live birth delivery in 2014. Specifically, this research attempts to assess whether access to obstetrics and gynecologist …

Alternative Tobacco Products & Depressive Symptoms Among Young Adults, David Marsden

Dissertations & Theses (Open Access)

The association between cigarette use and depression has been documented in many studies. Fewer studies have examined other tobacco products such as electronic cigarettes (e-cigarettes) and hookah that are used by young adults. This study examined whether increased frequency of use of these products was associated with depressive symptoms in a cohort of n=5,236 Texas college students followed from 2014 to 2017. A hierarchical model showed that increased frequency of single product use of cigarettes, refillable e-cigarettes and hookah was associated with depressive symptoms. Refillable and disposable e-cigarettes were examined separately and results did not provide evidence of a different …

Investigation Of Hantavirus And Leptospira As Possible Contributing Factors Of The Unexplained Kidney Disease Epidemic In Nicaragua, Nicole J. Delgado

Dissertations & Theses (Open Access)

Throughout Latin America, an epidemic of a kidney disease of an unknown etiology has been occurring since the late 1990s, and this disease is being called “Mesoamerican nephropathy.” Mesoamerican nephropathy predominantly affects male sugarcane workers. In Chichigalpa, Chinandega, Nicaragua, there is sugarcane plantation that is being heavily impacted by the Mesoamerican nephropathy epidemic, and they invited researchers from Baylor College of Medicine to investigate the epidemic. The prospective epidemic investigation began in 2015, and it is an ongoing investigation. Based on the compilation of data collected during the preliminary investigation, our hypothesis is that a possible zoonotic disease, such as …

Hours Of Gaming Or Non-Academic Computer Use, Substance Use, Mental Health Status And School Performance Among Texas Adolescence: Findings From The 2017 Yrbs In Texas, Shanxiazi Gao

Dissertations & Theses (Open Access)

Online gaming activities among adolescents and adults has increased exponentially in the last decade, and mental health issues associated with excessive gaming have drawn attention from health care professionals worldwide (Griffith, 2016). Recognizing this trend, American Psychiatric Association (APA) categorized gaming disorder/addiction as a mental health condition in 2013 in an effort to prevent the expansion of relevant mental health issues (American Psychiatric Association, 2013). Additionally, the World Health Organization (WHO) declared gaming disorder/addiction as a mental health disease, (World Health Organization, 2018). As a result of this declaration, Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has established nine …

Adverse Childhood Experiences, Depression, And Resilience In African-American Adolescents, Jamie C. Freeny

Dissertations & Theses (Open Access)

Research shows that exposure to adverse childhood experiences (ACEs) is common among adolescents; however, no studies have examined the prevalence of ACEs in a racially homogenous sample of African-American adolescents. Thus, the present study examined the cumulative and individual prevalence of ACEs in African-American adolescents. Data were collected from African-American adolescents (n = 241) who attended youth events hosted by churches in Houston, TX. An expanded ACEs tool was used to collect data. ACE scores were summed and dichotomized to 0-3 ACEs versus 4-19 ACEs because a score of four or more indicates a higher risk for adverse mental and …

Development And Usability Testing Of Quit4health, A Smoking Cessation Smartphone App For Young Adults, Katarzyna Czerniak

Dissertations & Theses (Open Access)

Tobacco use is the leading cause of death in the United States. As of 2016, 23.5% of American 18-25 year olds reported having used cigarettes in the last month compared to 20.2% of adults and only 3.4% of adolescents. Due to the efficacy and widespread general use of mobile technology today, mobile-phone health, or mHealth apps, have become increasingly popular methods of delivering smoking cessation programs. However, there is a lack of evidence in regards to the quality and the effectiveness of using mHealth to deliver smoking cessation interventions to young adults. This study aims to fill this gap to …

Sociodemographic Determinants Of Mental Health Outcomes Among Unhealthy Weight Youth In The United States, Chenchita Malolan

Dissertations & Theses (Open Access)

Background

The prevalence of unhealthy weight (defined as a body mass index ≥ 85th %ile for age and sex) among children and adolescents in the United States remains unacceptably high. In parallel, the prevalence of mental health issues in youth is rising as well. Current research shows a strong association between overweight/obesity and poor mental health outcomes. Specifically, youth of unhealthy weight have higher rates of anxiety and depression. The objective of this study is to evaluate the specific the current (2016-17) population-level prevalence of unhealthy weight, mental health issues and the sociodemographic (e.g. sex, age, race, ethnicity, household income) …

A Secondary Data Analysis For The Refinement Of Empirical Modelling For The Estimation Of Environmental Health & Safety Program Resourcing For Colleges And Universities, Seth Michael Parker

Dissertations & Theses (Open Access)

The use of potentially hazardous physical, chemical, biological, and radiological agents is inherent to the teaching, research, and services missions of any university. To manage the risks associated with these agents, it is common for universities to host environmental health & safety (EH&S) programs to protect the safety of the institution’s students, faculty, staff, and visitors. However, since EH&S programs in universities are primarily focused on prevention, it is difficult to estimate the appropriate “industry average” in terms of budget and staffing resources a particular university needs for such programs. Historically, the Campus Safety, Health, and Environmental Management Association (CSHEMA) …

Philosophia Soteria: How Occupational Safety And Health Professionals Influence Decision Makers, Daniel Jay Snyder

Graduate Theses and Dissertations

The purpose of this study was to identify ideas about how occupational safety and health (OSH) professionals influence decision-makers on matters impacting occupational health and safety management systems. A modified nominal group technique was used that involved 67 participants in ten nominal groups and identified the most important ideas about how OSH professionals can influence workplace safety and health decision making. The research produced themes of communication, scientific, professionalism, leadership, adaptability, and business acumen that resulted in six domains of occupational safety and health professional influence.

An Evaluation Of Implementing Trauma-Informed Care Training In Healthcare Settings, Amanda Kis

Capstone Experience

Background: Trauma-informed care (TIC) has recently become a popular topic in medical science. Many patients’ health conditions have been diagnosed and treated purely as medical issues, yet emerging research indicates that trauma is sometimes the source of many physical and mental conditions. Implementing TIC education in healthcare systems may lead to preventing the onset of symptomology related to undiagnosed, chronic trauma experience.

Objectives: The primary goal of this Capstone project was to implement TIC training developed by Trauma Matters Omaha Coalition and assess preliminary evidence for changes in participants’ confidence, clinical knowledge, professional knowledge, self-awareness, and assumptions and biases regarding …

Compassion Fatigue Among Mental Healthcare Providers And The Impact On Overall Wellbeing, Ruchi Patel

Doctoral Dissertations

Compassion, a virtue of the helping profession, can be jeopardized by a provider’s continuous exposure to the trauma experiences of others. The impact of burnout, secondary stress and compassion fatigue on a mental healthcare provider’s work and personal life has been increasingly studied due to negative ramifications on our community healers. The present study used a cross-sectional design to survey mental healthcare providers across specialty and discipline in efforts to gain a better understanding of the relationship between a provider’s degree of compassion fatigue and specific demographic variables, physical health and their spirituality. One hundred and thirty-seven participants across the …

Project Renew Worcester, Danni Yue, Amy Zhang, Jing Han, Omid Ashrafi, Yiming Xu

School of Professional Studies

n The client for this capstone project is RENEW Worcester which is a fledgling solar power project whose main goals are to bring renewable energy in the form of solar power into local, primarily low-income communities and are committed to the mission of making the transition off of fossil fuels to clean, renewable power. Based in Worcester, Massachusetts, they are a local chapter of Co-op Power which is a consumer-owned sustainable energy cooperative (co-op) made up of numerous different local chapters all over the New England area as well as the state of New York. The problem that we will …

Stress Management In The Kitchen, Haley Rosano

Capstone Projects and Master's Theses

Catholic Charities - Diocese of Monterey has implemented Stress Management in the Kitchen though the Family Support Services department of the Seaside office. Stress Management in the Kitchen was implemented to address the knowledge gap between nutrition and healthy living.The purpose of the workshop series was to give clients a fun and digestible way to increase their knowledge on how their health and nutritional habits can or should be applied to how they deal with stress. These workshops were implemented through presentation and a series of activities.The measurement of these workshops will be obtained through an exit survey from participants. …

Bayesian Based Semiparametric Multidimensional Approaches To Analysis Parkinson's Disease, Jun Zhang

Dissertations & Theses (Open Access)

In the slow progression of Parkinson's Disease (PD), impairments arise and affect multiple domains (e.g., motor, cognitive, and behavioral). Mixed types, multivariate longitudinal data are commonly used in PD studies. Challenges exist in assessing PD status and investigating disease progression due to lack of biomarkers and ubiquitous impairment in the disease. We proposed a model framework by combining the semi-parametric approach and multi- dimensional framework, and used the proposed model to investigate the heterogeneous disease development and the non-linear treatment effects in the multiple domains predefined in PD.

Furthermore, we extended the semi-parametric multidimensional approach to the data with multi-types …

Factors Contributing To Lower Cancer Screening Utilization In A Sub-Sample Of United Way 2-1-1 Callers, Jason M. Rhoton

Dissertations & Theses (Open Access)

This dissertation was a secondary analysis of data from a Cancer Prevention Research Institute of Texas (CPRIT)-funded [grant # PP100077 & PP120086] cancer-control intervention with The University of Texas Health Science Center at Houston (UTHealth) School of Public Health and United Way 2-1-1. The aims of the three dissertation papers were addressed by examining a sub-sample of 2-1-1 callers that were drawn from the parent study baseline data. Participants were required to need at least once cancer prevention service to be included in the parent study and dissertation analyses. This dissertation was a cross-sectional analysis of de-identified data examining the …

Observed Cooking Behaviors Of Families With And Without Childhood Cancer Survivors And The Development Of A Healthy Cooking Assessment Tool, Margaret Pleta Raber

Dissertations & Theses (Open Access)

Diet is a modifiable risk factor for several cancers and other chronic diseases. Cooking skills are a target for dietary intervention, with much of the general population reporting infrequent and inadequate home preparation of meals. Childhood cancer survivors (CCS) are a population at high risk of several chronic conditions including secondary cancers that may be influenced by home cooking behaviors. We conducted observations of food preparation practices in 29 parents of healthy school-aged children and 11 parents of CCS. Observations included an audio and video recording of one evening meal per family. Parents were asked to wear a small body …

Impacts Of Cold Weather On Health In Texas, Tsun-Hsuan Chen

Dissertations & Theses (Open Access)

Recent events with recorded low temperature and unusual snow accumulation in the United States and Europe have raised the public awareness of the potential health impacts of extreme winter weather. Excessive cold was the leading cause of weather-related death during 2006-2010 in the U.S., accounting for 63% of weather related deaths. Several studies worldwide have demonstrated that, in general, mortality rates are higher in winter compared to summer. Studies have also shown that the association between cold temperature and death vary across cities, regions and countries and is especially relevant with decreasing latitude or in regions with mild winter climate. …

Relating Rsv Genetic Diversity To Global Transmission Dynamics, Rebecca J. Fisk

Dissertations & Theses (Open Access)

Many studies of Respiratory Syncytial Virus (RSV) have relied on analyses of the Major Surface Glycoprotein G gene (G gene). Global transmission patterns have not been well studied due to lack of systematic global surveillance efforts. This study used phylogenetic analysis of full genome data, categorized by geo-region, to determine the sources of RSV A and B infection in Chile and Houston, Texas. Additionally, disease severity studies have generally focused on outcomes associated with a single genotype. In this study we developed a statistical phylogenetic approach to explore the relationship between tree topology and disease severity. Disease severity data included …

Characterizing Young Adult Exposure And Engagement With Social Media Tobacco And Nicotine Product Marketing And Messaging, Stephanie L. Clendennen

Dissertations & Theses (Open Access)

Tobacco use remains a critical public health issue in the United States. Young adults are disproportionately affected by high rates of tobacco use and heavily targeted by tobacco marketing. Social media has become an important source of exposure to tobacco and nicotine product marketing and messaging for young adults. This dissertation examined the prevalence and socio-environmental characteristics associated with young adults’ exposure to and engagement with tobacco-related social media (paper 1); the prospective associations between young adults’ exposure and engagement and tobacco and nicotine product use (paper 2); and young adults’ experiences with tobacco and nicotine product messaging on social …

Sequential Monitoring Of Adaptive Randomized Clinical Trials With Sample Size Re-Estimation, Jun Yu

Dissertations & Theses (Open Access)

Clinical trials are complicated and involve human beings. Therefore, lots of ethical and efficient objectives are expected to be achieved. These objectives include maximizing the power of detecting the treatment effects, assigning more patients to the better treatments, saving the cost and time, and controlling the type I error rate. A variety of adaptive designs have been proposed to achieve different aims, among which sequential monitoring and sample size re-estimation are very popular in real clinical trials. In addition, adaptive randomization designs sequentially update the allocation probability aiming to target different allocation proportions and achieve different aims. Hu and Rosenberger …