Digital Commons Network^™

Salud Es Vida: Development Of A Cervical Cancer Education Curriculum For Promotora Outreach With Latina Farmworkers In Rural Southern Georgia, Kristen J. Wells, John S. Luque, Branko Miladinovic, Natalia Vargas, Yasmin Asvat, Richard G. Roetzheim, Ambuj Kumar

Community Health: Faculty Publications

Methods: A systematic review was conducted to synthesize evidence from all prospective controlled studies on effectiveness of CHW programs in improving screening mammography rates. Studies reported in English and conducted in the United States were included if they: (i) evaluated a CHW intervention designed to increase screening mammography rates in women 40 years of age or older without a history of breast cancer; (ii) were a randomized controlled trial (RCT), case-controlled study, or quasi-experimental study; and (iii) evaluated a CHW intervention outside of a hospital setting.

Results: Participation in a CHW intervention was associated with a statistically significant …

Cerebral Perfusion In Chronic Stroke: Implications For Lesion-Symptom Mapping And Functional Mri, Jessica D. Richardson, Julie M. Baker, Paul S. Morgan, Chris Rorden, L. Bonilha, Julius Fridriksson

Faculty Publications

Lesion-symptom mapping studies are based upon the assumption that behavioral impairments are directly related to structural brain damage. Given what is known about the relationship between perfusion deficits and impairment in acute stroke, attributing specific behavioral impairments to localized brain damage leaves room for speculation, as impairments could also reflect abnormal neurovascular function in brain regions that appear structurally intact on traditional CT and MRI scans. Compared to acute stroke, the understanding of cerebral perfusion in chronic stroke is far less clear. Utilizing arterial spin labeling (ASL) MRI, we examined perfusion in 17 patients with chronic left hemisphere stroke. The …

Prenatal Maternal Stress Programs Infant Stress Regulation, Elyssia Poggi Davis, Laura M. Glynn, Feizal Waffarn, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.

Methods: The study sample comprised 116 women and their full term infants. Maternal plasma cortisol and report of stress, anxiety and depression were assessed at 15, 19, 25, 31 and 36 + weeks' gestational age. Infant cortisol and behavioral responses to the painful stress of a heel-stick blood draw were evaluated at 24 hours after …

The Influence Of Hiv Stigma And Disclosure On Psychosocial Behavior, James Minson

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus (HIV) remains a serious public health issue, and many social factors are involved in virus transmission and treatment. The current conceptualization of how HIV status disclosure and perceived stigma of HIV diagnosis interact is undeveloped. This study was based on social cognitive theory and tested hypothesized positive relations between HIV serostatus disclosure, social support, and self-efficacy. In addition, self-rated HIV stigma was examined as a potential mediating variable. Participants were 109 HIV positive, mostly White gay men recruited via an online bulletin board. They completed the medical outcomes study social support survey, the general self-efficacy scale, the …

Association Between Vegan, Vegetarian, And Omnivorous Diets And Overweight And Obesity, Daniel Sullivan

Walden Dissertations and Doctoral Studies

Overweight and obesity and associated health risks have become epidemic in several regions around the world. Numerous studies have addressed the dietary habits of vegetarians and vegans in terms of disease prevention and nutritional deficiencies but the relationship between overweight and obesity and the demographic, psychosocial, lifestyle, and dietary intake of omnivores, vegetarians, and vegans has received less attention. Guided by the social-ecological model, this study included a cross-sectional, quantitative, anonymous web-based survey to obtain dietary information on omnivores, vegetarians, and vegans. Vegans demonstrated a significantly lower mean and median body mass index ( p=0.00) than omnivores, semi-vegetarians, and vegetarians. …

The Risk Of Pedestrian Injury And Fatality In Collisions With Motor Vehicles: A Social Ecological Study Of State Routes And City Streets In King County, Washington, Anne Vernez Moudon, Lin Lin, Junfeng Jiao, Philip Hurvitz, Paula Reeves

Research Collection College of Integrative Studies

This study examined the correlates of injury severity using police records of pedestrian-motor-vehicle collisions on state routes and city streets in King County, Washington. Levels of influence on collision outcome considered (1) the characteristics of individual pedestrians and drivers and their actions; (2) the road environment; and (3) the neighborhood environment. Binary logistic regressions served to estimate the risk of a pedestrian being severely injured or dying versus suffering minor or no injury. Significant individual-level influences on injury severity were confirmed for both types of roads: pedestrians being older or younger; the vehicle moving straight on the roadway. New variables …

Association Between Fast Food Consumption And Obesity And High Blood Pressure Among Office Workers, Kifle Mihrete

Walden Dissertations and Doctoral Studies

Fast food consumption among office workers is a common phenomenon. Frequent consumption of fast food is linked to cardiovascular risk factors. The pervasiveness of these risk factors has debilitated the office workers' health and contributed to low performance and absenteeism. However, there remains a significant gap in the current literature regarding the health impacts of frequent fast food consumption behavior of office workers. Consuming large portions of fast food has been associated with obesity. The purpose of this correlation study was to investigate the relationship between fast food consumption and obesity and hypertension among office workers. The theoretical foundations for …

The Influence Of Community Support Services In Reducing Potentially Preventable Readmissions, Camille Rose Bash

Walden Dissertations and Doctoral Studies

Recently, the Centers for Medicare and Medicaid Services (CMS) ranked all hospitals based on Medicare readmission rates for heart attacks, heart failure, and pneumonia. CMS offered subsidies to hospitals ranked in the 4th quartile to develop community support services to reduce the problem of potentially preventable readmissions (PPRs). CMS cited 4 of the 5 hospitals in Prince George's County in the 4th quartile. The purpose of this quantitative research study was to investigate the relationship between community support services and the reduction of PPRs in Prince George's County. The Evans and Stoddart field model of health and well-being guided this …

Responses Of Successful Latina Students To Academic Challenges Of Prerequisite Nursing Courses, Julie Wiggins Nadeau

Walden Dissertations and Doctoral Studies

Nursing schools struggle to prepare enough nurses to meet the health care needs of a diverse and aging population in the United States. Many students do not complete their degrees, contributing to the problem. The purpose of this qualitative study was to explore and describe how successful Latina students experience and respond to the academic challenges of prerequisite nursing courses. The nursing shortage; healthcare needs of Hispanic patients; student outcomes; self-efficacy, achievement goal orientation, and academic help-seeking; and Hispanic cultural values framed the study. Using semistructured private interviews, the researcher explored the lived experiences of 6 successful Latina students when …

Predicting Breast Cancer Screening Among African American Lesbians And Bisexual Women, Cheryl B. Fields

Walden Dissertations and Doctoral Studies

In 2009, 713,220 new cases of cancer were diagnosed for women in the United States with more than a quarter million deaths. African American women and lesbians exhibit behavioral risk factors as well as diminished access to and utilization of breast cancer screening that reduces opportunities for early detection. This secondary analysis of a national convenience-based study examined screening compliance among 647 African American lesbian and bisexual women. Barriers to accessing screening represented the theoretical framework for this study. Bivariate chi square analysis was used to assess the association between independent variables: sociodemographic characteristics; participation in wellness activities; sexual orientation/gender …

Patients' Perspectives On Discussing Complementary And Alternative Medicine Therapies With Conventional Doctors, Deborah A. Mcninch

Walden Dissertations and Doctoral Studies

Currently, little is known about patients' perceptions and beliefs in discussing complementary and alternative medicine (CAM) with their conventional medical (CM) doctor. The purpose of this descriptive research was to show whether CAM-using patients have an interest in discussing CAM treatments with their CM doctor for comprehensive care as described by the health belief model (HBM) constructs of perceived susceptibility, perceived seriousness, and perceived benefits of taking action. A sample of 165 participants age 18 or older from 2 chiropractic clinics in the midwestern United States completed a Likert-scaled survey. The data were analyzed using descriptive statistics and multiple regression …

The Relationship Between Overweight And Obesity And Acculturation Of 12- To 19-Year-Old Mexican American Children, Elsa Ramirez-Brisson

Walden Dissertations and Doctoral Studies

Mexican Americans, one of the fastest growing segments of the population, have been identified as having above-average rates of obesity. Yet, among this group, obesity rates seem to differ by immigrant status: recent immigrants, immigrants who have lived in the United States more than 15 years, and U.S.-born Mexican Americans. Guided by the acculturation phenomenon and the social ecological model, the current study assessed all 1,732 Mexican American children 12-19 years old who participated in the National Health and Nutrition Examination Survey between 2003 and 2008 to determine the association between body mass index (BMI) and language, years living in …

The Effects Of An Integrated Health And Physical Education Program On Student Achievement, Myralynn B. Catchings

Walden Dissertations and Doctoral Studies

In recent years, several schools have addressed the No Child Left Behind (NCLB) Act of 2001 by focusing on promoting skill acquisition in reading and math, often overlooking physical education (PE) as a significant part of a child's education. The purpose of this causal-comparative study was to evaluate the effectiveness of an integrated health and physical education (HPE) program on student achievement. This study was grounded in action-based learning theories. The research question examined differences in posttest scores, adjusted for pretest differences, from 204 freshman students enrolled in a Biology-1 class at an urban high school. Students in Group A …

The Relationship Of Provider Cultural Competence And Utilization Of Prenatal Care In The Hmong Of Minnesota, Cynthia J. Larson

Walden Dissertations and Doctoral Studies

Experts suggest that the cultural competence of healthcare providers is a critical factor impacting healthcare services to the ethnically diverse patient populations in the U.S. and that it may play a role in improving outcomes and reducing health disparities; however, the association between cultural competence and health outcomes remains unclear. This study used a cross-sectional quantitative design grounded by cultural competency constructs and the ethnic origins theory to explore the relationships between provider cultural competence, adequacy of prenatal care, and neonatal health outcomes in Hmong women, a population whose cultural beliefs affect their use of early and adequate prenatal care. …

Analysis Of Risk Factors Associated With Asymptomatic Colonization Of Methicillin Resistant Staphylococcus Aureus (Mrsa) Among Community College Students, Marilynn Kish-Molina

Walden Dissertations and Doctoral Studies

The bacterium Staphylococcus aureus has been an important human ailment for centuries, and with the overuse of antibiotics, methicillin resistant Staphylococcus aureus (MRSA) has emerged as a deadly, costly pathogen worldwide. Healthy carriers can become sick or can spread MRSA without symptoms. The amount of asymptomatic colonization among healthy college students and risk factors for colonization by MRSA are not well understood. According to the epidemiologic triangle model, the host (students who take antibiotics or have a history of skin infections), the infectious agent (MRSA) and the environment (direct contact with people, animals, or objects that may harbor MRSA) all …

Factors Affecting Cervical Cancer Screening Among African Women Living In The United States, Mosunmola Adeyemi

Walden Dissertations and Doctoral Studies

More than half of the incidents and mortality rates from cervical cancer occur among minority groups, including immigrant women from continental Africa living in the United States. Although researchers have examined cervical cancer screening practices among minority populations, including Black women in Africa and in the United States, there are few studies on cervical cancer screening and associated risk factors, specifically among African women living in the United States. The purpose of this study was to investigate the association between selected factors and cervical cancer screening practices among African immigrant women living in the United States. Using the behavioral model …

Emotional Support In Managing Cardiovascular Diseases Among Hispanic And Non- Hispanic Menopausal Women, Claudette Andrea

Walden Dissertations and Doctoral Studies

Effective recognition and proper treatment of cardiovascular diseases (CVDs) in Hispanic woman is a public health problem that needs further investigation. Guided by the stress and coping social support theory, the purpose of this cross-sectional survey study was to examine the relationship between attitudes, emotional support, and the perception of success in managing cardiovascular diseases (CVDs) in 335 Hispanic women living in Atlanta, Georgia. Correlations, independent-sample t tests, simple linear regression, and multiple linear regressions showed ethnicity as a moderating variable between the perception of success in handling CVD and emotional support, while emotional support was shown to be a …

Learning Style Needs And Effectiveness Of Adult Health Literacy Education, Leah A. Grebner

Walden Dissertations and Doctoral Studies

Low health literacy impacts an individual's ability to comprehend communication from healthcare providers, reduces access to healthcare, and contributes to increased mortality. The purpose of this study was to evaluate the impact of learning style on adult health literacy education. The health belief model, protection motivation theory, the transtheoretical model, and social cognitive theory were used to analyze the data in this study, and to further develop effective health literacy education. The research questions addressed the effectiveness of educational intervention adjusted to their appropriate learning style in comparison to a standardized health literacy intervention and potential difference, according to type …

The Impact Of Nutrition-Teaching Self-Efficacy On Daily Fruit And Vegetable Intake, Leslie E. Rawls Hoglund

Walden Dissertations and Doctoral Studies

Lack of fruit and vegetable (FV) consumption is directly linked to the prevalence of obesity and chronic disease in the United States. The USDA Fresh Fruit and Vegetable Program (FFVP) offers elementary school teachers access to healthy foods as part of the public school classroom experience. The purpose of this study---which was based on self-efficacy theory and the socio-ecological model---was to examine if an association exists between selected factors: (a) daily fruit and vegetable consumption, training status in the USDA Fresh Fruit and Vegetable Program (FFVP), and an established school nutrition policy and (b) nutrition-teaching self-efficacy (NTSE) among elementary school …

Perspectives Of Women In Nairobi Kenya Toward Malaria Control, Catherine Kisavi-Atatah

Walden Dissertations and Doctoral Studies

Malaria infection has been and continues to be a serious public health concern that has mystified many in the public health care industry. One area in Sub Saharan Africa that continues to feel the devastating effects of malaria is in Nairobi, Kenya. This qualitative research study explored the attitudes of women in Nairobi, Kenya and how they view intervention measures already introduced by public health care experts in fighting malaria. The phenomenological research approach used purposeful sampling to recruit 16 women from Nairobi, Kenya to participate in semi-structured, open-ended interviews. The ecological systems theory was used as a lens of …

Relationships Between Central Obesity, Fructose Intake, And Non-Alcoholic Fatty Liver Disease In Overweight Hispanic Adolescents, Hector Reyes

Open Access Theses & Dissertations

Introduction: The purpose of this study was to evaluate whether central (visceral) fat measured as waist circumference and daily fructose intake were associated with measures of non-alcoholic fatty liver disease (NAFLD) in Hispanic overweight adolescents.

Methodology: Thirty four obese boys (n=15) and girls (n=19) between the ages of 13 and 18 years were measured for body composition, waist circumference, and dietary fructose intake. Fasting alanine (ALT) and aspartate (AST) aminotransferase levels in blood, ALT/AST ratio, and hepatic fat fraction (HFF) by magnetic resonance imaging were measured and used as surrogates for NAFLD. Pearson Product-Moment correlation analyses were used …

Assessment Of Intra-Urban Traffic-Related Air Pollution On Asthmatic Children's Exposure At Schools In The Paso Del Norte Region, Amit Ugamraj Raysoni

Open Access Theses & Dissertations

Traffic-related air pollution can be a major public health concern in any urban area. This problem is compounded in the Paso del Norte region that has experienced rapid economic growth, and a substantial number of people living in close vicinity of major roadways. The desert surroundings, arid weather, frequent temperature inversions, heavy border traffic at the international ports of entry between El Paso and Ciudad Juárez, and poorly maintained vehicle fleet further exacerbates this problem. A growing body of air quality and epidemiologic research has discerned the linkage between traffic emissions and respiratory disorders.

Initial health investigations in the Paso …

Maternal Exposure To The Holocaust And Health Complaints In Offspring, Janine D. Flory, Linda M. Bierer, Rachel Yehuda

Publications and Research

Although the link between chronic stress and the development of cardiovascular and metabolic diseases of adulthood has been known for some time, there is growing recognition that early environmental influences may result in developmental programming via epigenetic mechanisms, thereby affecting the developmental trajectory of disease progression. Previous studies support the idea that offspring of Holocaust survivors may have been subjected to early developmental programming. We evaluated the relationship between parental exposure to the Holocaust and selfreported health ratings and disorders made by their adult offspring (i.e., second generation Holocaust survivors). A total of 137 subjects were evaluated. Regression analyses demonstrated …

Development Of Fetal Movement Between 26 And 36 Weeks’ Gestation In Response To Vibroacoustic Stimulation, Marybeth Grant-Beuttler, Laura M. Glynn, Amy L. Salisbury, Elyssia Poggi Davis, Carol Holliday, Curt A. Sandman

Psychology Faculty Articles and Research

BACKGROUND: Ultrasound observation of fetal movement has documented general trends in motor development and fetal age when motor response to stimulation is observed. Evaluation of fetal movement quality, in addition to specific motor activity, may improve documentation of motor development and highlight specific motor responses to stimulation.

AIM: The aim of this investigation was to assess fetal movement at 26 and 36-weeks gestation during three conditions (baseline, immediate response to vibro-acoustic stimulation (VAS), and post-response).

DESIGN: A prospective, longitudinal design was utilized.

SUBJECTS: Twelve normally developing fetuses, eight females and four males, were examined with continuous ultrasound imaging.

OUTCOME MEASURES: …

The Relationship Of Race And Social Integration On The Health Status Of Older Adults In An Urban City, Thomas T. Jordan

Dissertations, Theses, and Capstone Projects

Durkheim argues that an individual is more vulnerable to self-destruction the more s/he is detached from the collective. This dissertation will explore the relative impact of social integration on older adults who have transitioned into their new roles in the social structure in relationship to their physical (obesity) and psychological (stress) health status. Additionally, the dissertation examines how social integration varies in its impact from one racial group to another, and how such variations influence the health status of the older adults who are members of these groups.

This dissertation employs data from the Brookdale Center for Healthy Aging and …

Creating Persuasive Messages To Promote Abstinence From Alcohol During Pregnancy, Kathryn France

Theses: Doctorates and Masters

While the rates of Fetal Alcohol Spectrum Disorder within Australia are unknown, the rates of alcohol use during pregnancy and at-risk alcohol use by women of childbearing age highlight the need for universal prevention strategies addressing prenatal alcohol exposure. Though many awareness-raising campaigns for alcohol use during pregnancy have been conducted, predominantly in North America, they have rarely been developed using formative research nor have they been comprehensively evaluated (Saskatchewan Prevention Institute, 2009; Elliott et al., 2008). This lack of published information on the development and evaluation of campaigns makes it difficult to determine what communication elements are most credible …

Prostate Cancer Incidence Rates In Africa, Lisa W. Chu, Jamie Ritchey, Susan S. Devesa, Sabah M. Quraishi, Hongmei Zhang, Ann W. Hsing

Faculty Publications

African American men have among the highest prostate cancer incidence rates in the world yet rates among their African counterparts are unclear. In this paper, we compare reported rates among black men of Sub-Saharan African descent using data from the International Agency for Research on Cancer (IARC) and the National Cancer Institute Surveillance, Epidemiology, and End Results Program from 1973-2007. Although population-based data in Africa are quite limited, the available data from IARC showed that rates among blacks were highest in the East (10.7-38.1 per 100,000 man-years, age-adjusted world standard) and lowest in the West (4.7-19.8). These rates were considerably …

Fitness And Adiposity As Predictors Of Functional Limitation In Adults, Andréa L. Maslow, Anna E. Price, Xuemei Sui, Duck-Chul Lee, Ilkka Vuori, Steven N. Blair

Faculty Publications

Background: This study examined the associations of body mass index (BMI), waist circumference (WC), and cardiorespiratory fitness (CRF) with incident functional limitation (IFL) in adults.

Methods: Patients (n = 2400), 30+ years [mean age, 45.2 (SD, 8.3); 12% women], completed a baseline health examination during 1979 to 1995. CRF was quantified by age- and sex-specific thirds for maximal treadmill exercise test duration. Adiposity was assessed by BMI and WC (grouped for analysis according to clinical guidelines). Incident IFL was identified from mail-back surveys during 1995, 1999, and 2004.

Results: After adjusting for potential confounders and either BMI or WC, CRF …

Alcohol Consumption And Risk Of All-Cause And Cardiovascular Disease Mortality In Men, Erin K. Howie, Xuemei Sui, Duck-Chul Lee, Steven P. Hooker, James R. Hébert, Steven N. Blair

Faculty Publications

This study examined the association between consumption of alcoholic beverages and all-cause and cardiovascular disease (CVD) mortality in a cohort of men (n = 31,367). In the Cox proportional hazards model adjusted for age, year of examination, body mass index (BMI), smoking, family history of CVD, and aerobic fitness, there were no significant differences in risk of all-cause mortality across alcohol intake groups. Risk of CVD mortality was reduced 29% in quartile 1 (HR = 0.71, 95% confidence interval (CI): 0.53, 0.95) and 25% in quartile 2 (HR = 0.75, 95% CI: 0.58, 0.98). The amount of alcohol consumed …

Association Between Depression And C-Reactive Protein, Yunsheng Ma, David E. Chiriboga, Sherry L. Pagoto, Milagros C. Rosal, Wenjun Li, Philip A. Merriam, James R. Hébert, Matthew C. Whited, Ira S. Ockene

Faculty Publications

Objective. Depression has been associated with increased cardiovascular disease risk, and a depression-related elevation of high sensitivity C-reactive protein (hs-CRP) has been proposed as a possible mechanism. The objective of this paper is to examine association between depression and high sensitivity C-reactive protein (hs-CRP). Methods. Subjects consisted of 508 healthy adults (mean age 48.5 years; 49% women, 88% white) residing in central Massachusetts. Data were collected at baseline and at quarterly intervals over a one-year period per individual. Multivariable linear mixed models were used to assess the association for the entire sample and by gender. Results. The …