Social and Behavioral Sciences Commons^™

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 …

The Influence Of Patient-Provider Interaction, Self-Concept, And The Socio-Physical Environment On Pelvic Exam Seeking Behavior, Anxiety, And The Health Care Experience, Julie Lasslo

Theses and Dissertations--Education Sciences

Regular gynecological screenings are critical for women in promotion of health and preventing diseases like cervical cancer. Despite the importance of such examinations, many women fail to adhere to recommended screening protocols. As a result, women experience an increased disease risk. The current study examined the relationship between patient-provider communication quality, skill, and empathy on pelvic exam seeking behavior and exam-related anxiety and satisfaction. Additionally, negative self-concept, perceived poor genital self-image, and various elements of the socio-physical clinic environment were explored to better understand their impact on a women’s care seeking behavior.

A total of 350 women 19 through 80 …

Factors That Influence Maternal Feeding Decisions For Toddlers: Extending The Theory Of Planned Behavior, Elizabeth Lucas Combs

Theses and Dissertations--Kinesiology and Health Promotion

Establishing healthy eating behaviors is vital in the early years to help combat the development of obesity and other chronic diseases. Mothers play an invaluable role in shaping their children's eating habits through controlling what and when children eat as well as the overall food environment, which is why a better understanding of what influences mothers’ decisions about these behaviors is important.

The purpose of the dissertation was to gain a better understanding of what impacts maternal feeding decisions regarding toddler nutrition behaviors. This was a two-phased mixed methods study. The aim of the initial study was to explore, using …

A Stress Management App Intervention For Cancer Survivors: Design, Development, And Usability Testing, Elin Børøsund, Jelena Mirkovic, Matthew M. Clark, Shawna L. Ehlers, Michael A. Andrykowski, Anne Bergland, Marianne Westeng, Lise Solberg Nes

Behavioral Science Faculty Publications

Background: Distress is prevalent in cancer survivors. Stress management interventions can reduce distress and improve quality of life for cancer patients, but many people with cancer are unfortunately not offered or able to attend such in-person stress management interventions.

Objective: The objective of this study was to develop an evidence-based stress management intervention for patients living with cancer that can be delivered electronically with wide reach and dissemination. This paper describes the design and development process of a technology-based stress management intervention for cancer survivors, including the exploration phase, intervention content development, iterative software development (including design, development, and formative …

Care Transitions From Patient And Caregiver Perspectives, Suzanne E. Mitchell, Vivian Laurens, Gabriela M. Weigel, Karen B. Hirschman, Allison M. Scott, Huong Q. Nguyen, Jessica Martin Howard, Lance Laird, Carol Levine, Terry C. Davis, Brianna Gass, Elizabeth Shaid, Jing Li, Mark V. Williams, Brian W. Jack

Communication Faculty Publications

PURPOSE: Despite concerted actions to streamline care transitions, the journey from hospital to home remains hazardous for patients and caregivers. Remarkably little is known about the patient and caregiver experience during care transitions, the services they need, or the outcomes they value. The aims of this study were to (1) describe patient and caregiver experiences during care transitions and (2) characterize patient and caregiver desired outcomes of care transitions and the health services associated with them.

METHODS: We interviewed 138 patients and 110 family caregivers recruited from 6 health networks across the United States. We conducted 34 homogenous focus groups …

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 …

Identifying Perceived Risks To Environmental Pollutants And Needs For Risk Communication In A Rural Appalachian Community, Elizabeth H. Travis

Theses and Dissertations--Nutrition and Food Systems

The goal of this study is to determine issues rural Appalachian residents consider most important, their perceived environmental health risk, and how community engagement can potentially improve those issues. The University of Kentucky Superfund Research Center held the Appalachian Community Health and Well-being Forum at the Letcher County Cooperative Extension Office in Eastern Kentucky. A four-member panel consisted of two local health officials, a nutrition expert, and a federal scientist; answered questions from community members. The expert panel and audience members shared concerns, success stories, and highlighted efforts to promote health in the region. Community members completed a questionnaire collecting …

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 …

Reducing Symptom Distress In Patients With Advanced Cancer Using An E-Alert System For Caregivers: Pooled Analysis Of Two Randomized Clinical Trials, David H. Gustafson, Lori L. Dubenske, Amy K. Atwood, Ming-Yuan Chih, Roberta A. Johnson, Fiona Mctavish, Andrew Quanbeck, Roger L. Brown, James F. Cleary, Dhavan Shah

Health and Clinical Sciences Faculty Publications

Background: Symptom distress in patients toward the end of life can change rapidly. Family caregivers have the potential to help patients manage those symptoms, as well as their own stress, if they are equipped with the proper resources. Electronic health (eHealth) systems may be able to provide those resources. Very sick patients may not be able to use such systems themselves to report their symptoms but family caregivers could.

Objective: The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient’s symptoms, as …

Design And Validation Of Patient-Centered Communication Tools (Pact) To Measure Students' Communication Skills, Gloria R. Grice, Nicole M. Gattas, Theresa Prosser, Mychal Voorhees, Clark D. Kebodeaux, Amy Tiemeier, Tricia M. Berry, Alexandria Garavaglia Wilson, Janelle Mann, Paul Juang

Pharmacy Practice and Science Faculty Publications

Objective. To develop a comprehensive instrument specific to student pharmacist-patient communication skills, and to determine face, content, construct, concurrent, and predictive validity and reliability of the instrument.

Methods. A multi-step approach was used to create and validate an instrument, including the use of external experts for face and content validity, students for construct validity, comparisons to other rubrics for concurrent validity, comparisons to other coursework for predictive validity, and extensive reliability and inter-rater reliability testing with trained faculty assessors.

Results. Patient-centered Communication Tools (PaCT) achieved face and content validity and performed well with multiple correlation tests with significant findings for …

Sensemaking, Stakeholder Discord, And Long-Term Risk Communication At A Us Superfund Site, Anna Goodman Hoover

Preventive Medicine and Environmental Health Faculty Publications

Introduction: Risk communication can help reduce exposures to environmental contaminants, mitigate negative health outcomes, and inform community-based decisions about hazardous waste sites. While communication best practices have long guided such efforts, little research has examined unintended consequences arising from such guidelines. As rhetoric informs stakeholder sensemaking, the language used in and reinforced by these guidelines can challenge relationships and exacerbate stakeholder tensions.

Objectives: This study evaluates risk communication at a U.S. Superfund site to identify unintended consequences arising from current risk communication practices.

Methods: This qualitative case study crystallizes data spanning 6 years from three sources: 1) local newspaper coverage …

Perspectives Of Healthcare Practitioners: An Exploration Of Interprofessional Communication Using Electronic Medical Records, Shoshana H. Bardach, Kevin Real, David R. Bardach

Graduate Center for Gerontology Faculty Publications

Contemporary state-of-the-art healthcare facilities are incorporating technology into their building design to improve communication and patient care. However, technological innovations may also have unintended consequences. This study seeks to better understand how technology influences interprofessional communication within a hospital setting based in the United States. Nine focus groups were conducted including a range of healthcare professions. The focus groups explored practitioners’ experiences working on two floors of a newly designed hospital and included questions about the ways in which technology shaped communication with other healthcare professionals. All focus groups were recorded, transcribed, and coded to identify themes. Participant responses focused …

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 …

Understanding And Promoting Parent-Child Sexual Health Communication, Shannon Phelps

Theses and Dissertations--Education Sciences

Parent-child sexual health communication (PCSHC) can have a positive impact on adolescents’ sexual health choices, outcomes, and capabilities for communicating with others about sexual health. Many parents are hesitant and feel unprepared for and uncomfortable with communicating about sexual health with their children. Other parental factors as well as child factors can impact the quality, frequency, coverage, and effectiveness of PCSHC. Some adolescent sexual health outcomes have improved, however, teen birth rates in the United States are elevated compared to other developed countries and half of all sexually transmitted infection (STI) diagnoses are made to adolescents and emerging adults. This …

Offline Social Relationships And Online Cancer Communication: Effects Of Social And Family Support On Online Social Network Building, Namkoong Kang, Dhavan V. Shah, David H. Gustafson

Community & Leadership Development Faculty Publications

This study investigates how social support and family relationship perceptions influence breast cancer patients’ online communication networks in a computer-mediated social support (CMSS) group. To examine social interactions in the CMSS group, we identified two types of online social networks: open and targeted communication networks. The open communication network reflects group communication behaviors (i.e., one-to-many or “broadcast” communication) in which the intended audience is not specified; in contrast, the targeted communication network reflects interpersonal discourses (i.e., one-to-one or directed communication) in which the audience for the message is specified. The communication networks were constructed by tracking CMSS group usage data …

Cognitive Aid Use Improves Transition Of Care By Graduating Medical Students During A Simulated Crisis, Brooke Bauer, Annette Rebel, Amy Dilorenzo, Randall M. Schell, Jeremy S. Dority, Faith Lukens, Paul A. Sloan

Anesthesiology Faculty Publications

Background: Residents are expected to have transition of care (ToC) skills upon entering graduate medical education. It is unclear whether experience and training during medical school is adequate.

Objective: The aim of the project was to assess: 1) graduating medical students' ability to perform ToC in a crisis situation, and 2) whether using a cognitive aid improves the ToC quality.

Methods: The authors developed simulation scenarios for rapid response teams and a cognitive aid to assist in the ToC during crisis situations. Graduating medical students were enrolled and randomly divided into teams of three students, randomly assigned into one …

A Tool To Cost Environmental Health Services In North Carolina Local Health Departments, Nancy L. Winterbauer, Simone Singh, Ashley Tucker, Lisa M. Harrison

Frontiers in Public Health Services and Systems Research

Introduction: The cost of providing a basic set of public health services necessary not been well-described. Recent work suggests public health practitioners are unlikely to have the empirically-based financing information necessary to make informed decisions regarding practice. The purpose of this paper is to describe the development of a costing tool used to collect primary data on the number of services provided, staff employed, and costs incurred for two types of mandated environmental health services: food and lodging inspections and onsite water services.

Methods: The tool was iteratively reviewed, revised, and piloted with local health department (LHD) environmental health and …

Colorectal Cancer Prevention: Perspectives Of Key Players From Social Networks In A Low-Income Rural Us Region, Nancy E. Schoenberg, Kathryn Eddens, Adam Jonas, Claire Snell-Rood, Christina R. Studts, Benjamin Broder-Oldach, Mira L. Katz

Behavioral Science Faculty Publications

Social networks influence health behavior and health status. Within social networks, “key players” often influence those around them, particularly in traditionally underserved areas like the Appalachian region in the USA. From a total sample of 787 Appalachian residents, we identified and interviewed 10 key players in complex networks, asking them what comprises a key player, their role in their network and community, and ideas to overcome and increase colorectal cancer (CRC) screening. Key players emphasized their communication skills, resourcefulness, and special occupational and educational status in the community. Barriers to CRC screening included negative perceptions of the colonoscopy screening procedure, …

Text Messaging Appointment Reminders To Reduce No-Shows: A Pilot Study, Cameron M. Stephenson

DNP Projects

Background: Hospital and outpatient clinic no-show, did not cancel or did not attend rates are a serious problem to organizations across the United States health care system. No-show appointments reduce clinic productivity, wastes clinician time and clinic resources and can be detrimental financially. Bluegrass Pediatrics and Internal Medicine (BPIM) located in Georgetown, KY experiences these problems on a daily basis.

Purpose/Methodology. This quality improvement project consisted of evaluating the effects of text messaging on appointment attendance during 3 clinic weeks of February 2016. The sample was derived from all patients enrolled at BPIM with a scheduled well, established or routine …

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 …

Better Engaging Communities: Moving Beyond Cardinal Rules, Anna G. Hoover

Anna G. Hoover

“Cardinal rules” and best practice approaches have guided governmental risk communication efforts at chronic risk sites for more than two decades, playing an important role in how those most affected by contamination make sense of risk. In addition to providing information, however, communication approaches themselves can affect community perceptions indirectly, through stakeholder interpretations of the processes by which risk information is shared. It is increasingly necessary to evaluate not only whether risk communication approaches have been effective for increasing knowledge but if, in fact, the ways in which information is shared has had unintended consequences that change how stakeholders perceive …

Adolescent Perceptions Of Nutrition: Identifying Memorable Messages, Audrey S. Bachman

Theses and Dissertations--Communication

Research is necessary to uncover ways to improve adolescent nutrition and reduce obesity rates, particularly in the Appalachian region, which has high rates of food insecurity and adolescent obesity. The current study examines rural cultural norms about food, memorable messages adolescents received about nutrition, and the sources of identified memorable messages. Adolescents shared memorable messages during comprehensive, semi-structured, small group interviews in which participants revealed their individual experiences. Thematic framework analysis is used to present the range and nature of memorable messages about nutrition and to develop strategies for future health campaigns and interventions. This qualitative method of sequential inductive …