Digital Commons Network^™

Putative Mechanisms Of Personality Change In Treatment, Hannah Croom

Theses and Dissertations--Psychology

BPD Compass was designed to engage the BPD-relevant traits from the Alternative Model of Personality Disorders in the DSM-5 by targeting putative mechanisms associated with these personality domains: aversive reactivity to engage negative affectivity, attachment insecurity to engage antagonism, and self-efficacy to engage disinhibition. The goal of the present study was to test the associations between putative mechanisms and respective personality traits. We used multilevel structural equation modeling to test if personality domains and putative mechanisms changed in treatment, if changes in putative mechanism were associated with changes in respective personality domain, and if within-person changes in putative mechanisms predicted …

Why Are Women Tired? Examining Sex-Dependent Effects Of Behavioral Rhythms On Perceived Sleepiness, Maricel Schuler

Theses and Dissertations--Psychology

Sleep complaints in women emerge at menarche and coincide with reproductive hormonal fluctuations throughout the monthly menstrual cycle. To our knowledge, we are the first study (N = 44) to utilize a validated algorithm that uses actigraphy-derived light and activity data in a novel approach to estimate circadian phase, referred here as the photobehavioral phase. We hypothesize that women will have earlier photobehavioral phases, larger phase angles, poorer perceived sleep quality, and greater sleepiness compared to men. In addition, we hypothesize that the perimenstrual phase will be associated with poorer sleep within a subsample of women (N = 15). Contrary …

Free Food And The Fabric Of Need: Moralized And Institutionalized Care Within Kentucky Charitable Food Programs, Alisha D. Mays

Theses and Dissertations--Anthropology

This dissertation offers a critical ethnographic examination of hunger and charitable food programs (CFPs) in rural Eastern Kentucky, situated within the broader political economy of welfare retrenchment and neoliberal governance in the United States. Through multi-sited fieldwork spanning food pantries, mutual aid networks, state and federal partner agencies, and the regional food bank system, I analyze how hunger is experienced, managed, and framed by clients, volunteers, and organizational staff.

This work uses qualitative methods to weave the lived experiences across intersecting charitable food systems; this dissertation contributes to economic anthropology by illuminating the relational and political dimensions of hunger in …

Community Health Worker-Delivered Tobacco Cessation In A Small Rural County, Ellen J. Hahn, Amanda Bucher, Amanda T. Wiggins, Kathy Rademacher, Whitney Beckett, Leeann Taylor, Audrey Darville, Jean Edward

BREATHE Faculty Publications

Purpose: We evaluated a Community Health Worker (CHW)-Tobacco Treatment Specialist (TTS) model for delivering tailored tobacco treatment counseling and support in a rural, low-resourced county.

Methods: This was an exploratory, prospective study of people 18 years or older who used any tobacco product including e-cigarettes or vapes in the past 30 days. The CHW assessed tobacco use, secondhand smoke exposure, and quit history; and collected an expired breath carbon monoxide sample and a brief health history before providing 4–6 in-person or phone-based sessions involving tailored tobacco treatment counseling and support. The CHW connected participants to a prescriber at a federally …

Implementing And Evaluating A Pilot Interprofessional Training Program To Engage Health Care Teams In Cost Of Care Conversations, Jean Edward, Kimberly D. Northrip, Mary Kay Rayens, Julia Costich, Andrea Welker, Rachel O’Farrell, John A. D'Orazio

Nursing Faculty Publications

Introduction: This study evaluated the impact of Financial and Insurance Navigation Assistance-Training – a pilot interprofessional training program to facilitate cost of care (CoC) conversations and address health-harming social determinants of health in a pediatric hematology–oncology clinic.

Methods: A pre–post study design was used to evaluate the impact of Financial and Insurance Navigation Assistance-Training on an interprofessional health care team's (clinicians, social workers, financial navigator, and legal advocates) knowledge, attitudes, and behaviors related to CoC conversations and screening, referring, and collaborating with interprofessional team members. Data were collected …

Diet Quality Mediates The Relationship Between Chronic Stress And Inflammation In Patients With Metabolic Syndrome, Junghee Kang, Debra K. Moser, Terry A. Lennie, Misook L. Chung, D. Travis Thomas, Martha J. Biddle

Nursing Faculty Publications

Background 

Chronic stress is associated with promotion of inflammation and development of metabolic syndrome, as well as deterioration of diet quality. Inflammation can be modified by changes in dietary intake.

Objective 

The aim of this study was to test the hypothesis that diet quality mediates the relationship of chronic stress with inflammation in patients with metabolic syndrome.

Methods 

Participants with metabolic syndrome (n = 73, 62 ± 12 years old, 71% female) completed questionnaires on chronic stress (Perceived Stress Scale-10) and diet quality (Healthy Eating Index-2020). The Perceived Stress Scale-10 was dichotomized. The Healthy Eating Index-2020 score was used as …

Championing Reproductive And Perinatal Health With The Recovery Community: Improving Access To Healthcare And Health Promotion Resources To Support Recovery, Hartley C. Feld, Alex Elswick, Jeremy Byard, Whitney Beckett, Amanda Fallin-Bennett

Nursing Faculty Publications

Peer recovery support services are instrumental in the promotion of long-term recovery primarily by focusing on building the recovery capital of people with substance use disorders. Women may have specific health-related needs that are not generally part of recovery support staff training. Our team co-created a model by training people with lived experience as coaches to promote the health of women with SUD during the critical period of their reproductive years when mortality from overdose risk is high and can be compounded by issues surrounding pregnancy. We explored the outcomes of a small pilot test of this model to promote …

Degree Of Rurality Moderates The Association Of Sedentary Time With Cognitive Function In Rural Patients With Cardiac Diseases And Depressive Symptoms, Chin-Yen Lin, Jia-Rong Wu, Geunyeong Cha, Junghee Kang, Martha J. Biddle, Misook L. Chung, Ashmita Thapa, Mary Kay Rayens, Linda Gibson-Young, Debra K. Moser

Nursing Faculty Publications

Background: Prolonged sedentary time has been linked to impaired cognitive outcomes. However, the impact of sedentary time on cognitive function at different degrees of rurality is not yet well understood in patients with cardiac diseases and depressive symptoms.

Purpose: To determine whether degree of rurality moderates the relationship between sedentary time and cognitive function.

Methods: This study includes 135 coronary heart disease or heart failure patients, primarily residing in rural Kentucky, including Appalachian areas, United States. Sedentary time was measured by the average daily sedentary time (in minutes) using accelerometry (ActiGraph). Cognitive function was assessed using the Montreal Cognitive Assessment-Blind. …

Challenges And Lessons Learned While Conducting A Diabetes Prevention Program Among Black Churches During The Covid-19 Pandemic, Erika R. Karle, Destiny Cozart, Bassema Abu Farsakh, Victor Afolayan, Treasure Ebikwo, Maranda Brooks, Lovoria B. Williams

Nursing Faculty Publications

We share our experiences conducting a 5-year randomized controlled diabetes prevention project among 20 Black churches in central Kentucky during the COVID-19 pandemic and offer strategies to inform future church-based interventions. Researchers have long recognized the potential to reach Black adults in church settings for health promotion interventions and have implemented trials within this socially rich setting. However, there is a dearth of literature that describes the challenges and lessons learned while conducting these trials. We describe the challenges we experienced and the strategies we used to overcome them to successfully conduct the trial. During the study, we maintained detailed …

Hpv Self-Sampling Promotion Among African American (Aa) And Sub-Saharan African (Sai) Immigrant Women: Adaptation And Usability Testing, Adebola Adegboyega, Gia Mudd-Martin, Nancy Schoenberg, Mark Dignan

Nursing Faculty Publications

Background: Cervical cancer (CC) rates have declined nationally but rates remain high in Black women with most cases occurring among unscreened and under-screened women. This paper describes the adaptation, acceptability, and useability of an education intervention, “Health is Wealth: A Cervical Health Intervention”, to promote cervical screening and reduce perceived barriers to CC screening among two subgroups of Black women: African American (AA) and sub-Saharan African immigrant (SAI) women.

Methods: In this paper, we describe the process of adapting the Health is Wealth intervention using the Barrera and Castro adaptation framework. The iterative adaptation process included formative focus groups (n …

Improving Lung Cancer Education And Screening Navigation Skills Among Hbcu Health Trainees: A Pilot Study Of Program Connect, Shanada Monestime, Erika L. Thompson, Monica Wilson, Tamara Mccants, Lovoria B. Williams

Nursing Faculty Publications

Lung cancer is the leading cause of cancer death, disproportionately affecting Black communities due to delayed diagnoses and low screening rates. While these disparities persist, few educational interventions aim to equip health professional trainees—particularly those at Historically Black Colleges and Universities (HBCUs)—with the knowledge and confidence to address them. Empowering providers early in their training through culturally tailored education may help build a more prepared, equity-focused workforce. The purpose of this project was to evaluate a culturally tailored lung cancer education program, Program CONNECT, for health professional trainees at HBCUs. Program CONNECT was implemented in regions where lung cancer mortality …

How To Eat Right And Why We Ask That Question, Heather N. Carpenter

Theses and Dissertations--Gender and Women's Studies

What does it mean to “eat right?” The notion is, of course, culturally, historically, nationally, politically, ethnically, and class determined. For the purposes of this project, however, I am particularly interested in changing notions of what it means to “eat right” within the post-World War II to the early new millennium American context, as such notions are represented within the prescriptions of popular culture. I turn to popular culture because this is the commons of the hegemonic call to “normalcy”—this is where we all learn to imitate, aspire, or rebel against a generic American consumer-self in conformity with the biases, …

Psychometric Properties Of The Gad-7 Among College Students: Reliability, Validity, Factor Structure, And Measurement Invariance, Agnes E. White, Justin E. Karr

Psychology Faculty Publications

The GAD-7 (seven-item Generalized Anxiety Disorder Scale) is a brief, freely available questionnaire measuring anxiety, which is a common mental health problem among college students. The current study examined the psychometric properties of the GAD-7 among undergraduate students from a public midwestern university (n = 582; M = 19.0 +/- 1.0 years old; 79.4% women; 81.6% White) who completed the GAD-7, State-Trait Anxiety Inventory-Trait subscale (STAI-T), and Behavioral Inhibition and Activation Scale-Reward subscale (BIAS-R). The psychometric properties of two GAD-7 models were examined: a one-factor model, equivalent to a single total score, and a two-factor model, including cognitive-emotional and somatic …

Appalachian Primary Care Patients’ Quit Readiness And Tobacco Treatment Receipt, Jessica L. Burris, Abigayle R. Feather, Asal Pilehvari, Sarah Cooper, Amie M. Ashcraft, Roger Anderson, Amy K. Ferketich

Psychology Faculty Publications

Introduction: Healthcare providers should facilitate smoking cessation, and primary care is an ideal setting for delivering this evidence-based care. This study’s objective was to describe readiness to quit smoking combustible cigarettes among adult Appalachian primary care patients and determine their providers’ implementation of an established tobacco treatment model.

Methods: As part of a randomized clinical trial, 298 providers in 10 health systems across 4 states received tobacco treatment training. Periodically between January 2022 and June 2023, anonymous surveys were distributed to patients after primary care visits. The survey included questions about demographics, visit type, smoking status, readiness to quit, and …

Climate Anxiety Impairs Sustained Attention, Ekaterina Denkova, Taylor K. Tardibuono, Jason S. Tsukahara, Anthony P. Zanesco, Amishi P. Jha

Psychology Faculty Publications

Introduction: As climate anxiety rises globally, it may influence how individuals cognitively engage with the climate crisis. Although cognitive functioning is a key component of climate anxiety, its association with objectively measurable cognitive performance impairment remains unclear. This study examines whether individual differences in climate anxiety correspond with performance on a task measuring sustained attention. Methods: A total of 182 undergraduate students completed self-report measures of climate anxiety, personal climate change experience, and general anxiety and depression. In addition, they completed the Sustained Attention to Response Task (SART), which measures attentional performance through accuracy and response time variability. Results: Greater …

Cognitive Weaknesses Or Impairments On The Nih Toolbox Cognition Battery In Children And Adolescents, Nathan E. Cook, Grant L. Iverson, Justin E. Karr

Psychology Faculty Publications

Introduction: The National Institutes of Health Toolbox for Assessment of Neurological and Behavioral Function Cognition Battery (NIHTB-CB) is a brief neuropsychological battery for the assessment of crystalized (i.e., vocabulary and word reading) and fluid cognition (i.e., working memory, visual episodic memory, processing speed, and executive functions). This study examined the frequency of low NIHTB-CB scores and proposes flexible algorithms for identifying cognitive weaknesses and impairment among youth. Methods: Participants were 1,269 youth from the NIHTB-CB normative sample who did not have a neurodevelopmental, psychiatric, or medical problem that might be associated with cognitive difficulties (53% boys and 47% girls; M …

Development Of A Mobile App To Support Head And Neck Cancer Caregiving, Katherine Sterba, Evan Graboyes, Jessica Burris, Megan Scallion, Hannah Kinder, Jama Olsen, Benjamin Toll, Kent Armeson, Terry Day, Bhishamjit Chera, Kenneth Ruggiero

Psychology Faculty Publications

Background: Survivors with head and neck cancer (HNC) face challenging treatment consequences that can lead to severe disruptions in swallowing and result in weight loss, malnutrition, and feeding tube dependence. Caregivers (family or friends who provide support), therefore, often encounter distressing nutritional caregiving burdens and feel unprepared to provide adequate support at home. Objective: The purpose of this mixed methods study was to develop a mobile support app to support HNC caregiving with an emphasis on nutritional support following treatment. Methods: We assessed perspectives on nutritional recovery challenges and mobile support app preferences in (1) a national panel of oncology …

Examining Cognition In Action, Anthony P. Zanesco, Ekaterina Denkova, Jordan Barry, Costanza Alessio, Amishi P. Jha

Psychology Faculty Publications

Introduction: There is growing interest in understanding how individual differences in cognitive abilities contribute to military performance. Laboratory-based cognitive tasks, which are well-suited for assessing specific cognitive capacities, offer a controlled and efficient approach for evaluating these differences. If performance on such tasks corresponds with operationally relevant performance, these measures could serve as valuable tools for evaluation, selection, and targeted training interventions to enhance military readiness. Here, we examined associations between performance on laboratory tasks of attentional control and operationally relevant tasks in an augmented reality military training environment. Methods: Across two study rounds, 45 squads of active-duty U.S. Army …

Examining The Association Between Vigilance And Mind Wandering, Brooke Schwartzman, Anthony P. Zanesco, Ekaterina Denkova, Jason S. Tsukahara, Amishi P. Jha

Psychology Faculty Publications

There has been a growing interest in the relationship between the vigilance decrement, characterized by performance decline with greater time-on-task, and the occurrence of mind wandering—task-unrelated thought. Recent evidence from a large-scale military sample suggests a link between performance declines and increased mind wandering over a 20-min Sustained Attention to Response Task. Herein, we examined if similar patterns are present when the task duration is shorter and delivered online to college students who rely on sustained attention for academic success. Specifically, we explored the relationship between the vigilance decrement and mind wandering in undergraduates (N = 310) completing a 10-min …

Oura Ring Behavioral Feedback Intervention For Alcohol Reduction In Young Adults, Frances J. Griffith, Oksana K. Ellison, Sahiti Kunchay, Madilyn Augustine, Kelly S. Demartini, Michael Fatigate, Leah Latimer, Stephanie S. O'Malley, Nancy S. Redeker, Garrett I. Ash, Lisa M. Fucito

Psychology Faculty Publications

Background: Wearable fitness technologies, like the Oura Ring (Oura Health Oy), provide physiological metrics, like sleep and heart rate data, to a growing user base of young adults. However, these technologies and connected mobile apps do not measure young adults’ alcohol use that contributes to these metrics. Personalized feedback on the impact of alcohol on sleep and heart rate may boost motivation to reduce drinking among young adults. Objective: For this pilot randomized controlled trial, we evaluated the acceptability, feasibility, and perceived effectiveness of a wearable personalized feedback intervention for alcohol reduction in young adults that integrated physiological and behavioral …

What Do Parents Want? Relevant Content And Formats For Resources To Address Issues Of Racism, Antiracism, And Xenophobia With Youth, Deborah Rivas-Drake, Victoria Vezaldenos, Gabriela Livas Stein, Dawn P. Witherspoon, Laura Ann Jacobs, Tiffany Yip, Christia Spears Brown, Enrique Neblett

Psychology Faculty Publications

Diverse U.S. parents seek to engage in conversations about racism and immigration injustices with their children. To inform the design of a free resource hub and curriculum, we interviewed 62 parents of 3–17 year olds across 6 demographic categories (Asian/Asian American, Black, Latinx, Multiracial, Native American, White). We explored the question: “What content (substance and format) would be useful for parents in addressing issues of race, racism, and immigration with their children?” Analyses yielded multiple cross-cutting themes addressing both the substance and format of resources parents viewed as important for addressing these topics. Four content themes include: (a) Desire for …

Proximity And Density Of Tobacco Retail Locations To Kentucky Schools And The Relationship To Youth Perceptions Of Harm And Susceptibility To E-Cigarette Use, Hannah Cardona

Theses and Dissertations--Kinesiology and Health Promotion

Purpose: To explore the potential relationship between tobacco retailer proximity/density around Kentucky elementary, middle, and high schools, and students’ perceptions, perceived norms, susceptibility to, and use of e-cigarettes. Design: A mixed-methods analysis of youth’s self-reported survey results and geographical data. Setting: 106 Kentucky elementary, middle, and high schools which participated in #iCANendthetrend’s tobacco education program between September 2023 and May 2024. Subjects: Convenience sample of students from Ky schools (N = 7,823) Measures: Items assessing e-cigarette use, susceptibility, perceptions, and perceived norms. Analysis: ANOVA tests used to compare responses of elementary, middle, and high school students. Chi-squared tests were used …

Exploring College Students’ Motivation For Physical Activity: Applications Of Self-Determination Theory And The Role Of Health And Wellness Education, Anne Russell Blevins

Theses and Dissertations--Kinesiology and Health Promotion

This dissertation includes three pieces of writing that aim to show the importance of physical activity for all ages but specifically college-aged students. The first piece of writing (Chapter 2) includes a teaching tip written for the Journal of Physical Education, Recreation, and Dance. Research has shown that dance was a subject of the past and many teachers did not feel comfortable teaching it. This practical piece was written to help show K-12 physical education teachers effective ways to involve students in physical activity specifically through teaching dance, mainly through using the “Teaching Dance for Understanding” model.

The second section …

The Effects Habitual Training Shoe Use Has On Running Economy When Transitioning To High Performance Running Shoes, Dalton C. Harris

Theses and Dissertations--Kinesiology and Health Promotion

Background: The recent increase in popularity of minimal shoes in endurance running is linked to potential improvements in running economy and reduced injury risk. However, high performance running shoes, specifically designed to improve running economy remain the fastest shoe to wear when racing. Purpose: Knowing this, the aim of this paper is to examine whether or not the habitual use of minimal shoes increases the benefits of the high performance shoes. This will guide practitioners and athletes when establishing shoe rotations and training plans during race preparation. Methods: The study consisted of 4 sessions: Sessions 1 and 2 were maximal …

Reevaluating The Opportunity For Wind Energy In Kentucky: Advancing Technology, Changing Economics, And Generation Complementarity, Lawrence E. Holloway, Aron Patrick, Dan M. Ionel

Electrical and Computer Engineering Faculty Publications

Recent developments in wind turbine technology, new wind resource data, and new federal tax credits for renewable energy are increasing the suitability of wind electricity generation in Kentucky. In 2022, Kentucky had 68% of its electricity from coal and in 2023 was one of eight U.S. states with no utility-scale wind generation. In the past, the state has been viewed as being generally unsuitable for wind power generation. While wind is not the most economic resource in Kentucky, all states bordering the Commonwealth have wind power. Wind power generation in Kentucky appears increasingly likely in the coming decades to play …

A Review Of The Association Between Dietary Intake And Brain Iron Levels In Older Adults: Preliminary Findings And Future Directions., Valentinos Zachariou, Christopher E. Bauer, Colleen A. Pappas, Brian T. Gold

Behavioral Science Faculty Publications

Background/Objectives: Non-heme iron is essential for critical neuronal functions such as ATP generation, synaptogenesis, neurotransmitter synthesis, and myelin formation. However, as non-heme iron accumulates with age, excessive levels can contribute to oxidative stress, potentially disrupting neuronal integrity and contributing to cognitive decline. Despite growing evidence linking high brain iron with poorer cognitive performance, there are currently no proven methods to reduce brain iron accumulation in aging or to protect cognitive function from iron’s negative effects. Recent studies suggest that nutrition may influence brain iron levels, though the evidence remains limited and mixed. Methods: In this review, we explore recent findings, …

Differential Infiltration Of Key Immune T-Cell Populations Across Malignancies Varying By Immunogenic Potential And The Likelihood Of Response To Immunotherapy., Islam Eljilany, Sam Coleman, Aik Choon Tan, Martin D. Mccarter, John Carpten, Howard Colman, Abdul Rafeh Naqash, Igor Puzanov, Susanne Arnold, Michelle L. Churchman, Daniel Spakowicz, Bodour Salhia, Julian Marin, Shridar Ganesan, Aakrosh Ratan, Craig Shriver, Patrick Hwu, William S. Dalton, George J. Weiner, Jose R. Conejo-Garcia, Paulo Rodriguez, Ahmad A. Tarhini

Markey Cancer Center Faculty Publications

Background: Solid tumors vary by the immunogenic potential of the tumor microenvironment (TME) and the likelihood of response to immunotherapy. The emerging literature has identified key immune cell populations that significantly impact immune activation or suppression within the TME. This study investigated candidate T-cell populations and their differential infiltration within different tumor types as estimated from mRNA co-expression levels of the corresponding cellular markers.

Methods: We analyzed the mRNA co-expression levels of cellular biomarkers that define stem-like tumor-infiltrating lymphocytes (TILs), tissue-resident memory T-cells (TRM), early dysfunctional T-cells, late dysfunctional T-cells, activated-potentially anti-tumor (APA) T-cells and Butyrophilin 3A (BTN3A) isoforms, utilizing …

Population-Based Cross-Sectional Analysis Of Cannabis Use Among Kentucky Adults, 2020– 21, Sydney Shafer, Gunnar Kennedy, W. Jay Christian

UK CARES Faculty Publications

Purpose We conducted this study to assess cannabis use rates in the state of Kentucky relative to socioeconomic, demographic, and geographic factors, as well as reasons for use and modes of use, before the legal medical marijuana market commences in 2025.

Methods We pooled Kentucky Behavioral Risk Factor Surveillance System (BRFSS) data for 2020–2021 and used weighted responses for all analyses. We estimated current cannabis use (at least once in the past 30 days), and heavy use (at least 20 of the past 30 days) prevalence rates for Appalachian, Delta, and Central geographic regions of Ken- tucky. We tabulated descriptive …

Students Participating As Ambassadors For Research In Kentucky (Spark): A Health Equity Undergraduate Research Training Program, Ariel A. Arthur, Rebecca L. Delacerda Allen, Fidelis Y. Sesenu, Maxwell A. Groznik, Carrie B. Oser, Madeline Dunfee, Philip A. Kern, Nancy Schoenberg

UK CARES Faculty Publications

The Students Participating as Ambassadors for Research in Kentucky (SPARK) program provides novel health equity research training and targeted mentorship for undergraduates, particularly those from groups underrepresented in the biomedical and behavioral research and workforce. SPARK aims to address inadequate diversity in the medical and scientific research fields by providing comprehensive research mentorship and skill-building. Unlike most existing research training programs that are brief, focus on laboratory research, or are limited to graduate students and junior faculty, SPARK delivers a 16-month intensive behavioral and population health science training, equipping students with needed tools to conceptualize, plan, execute, and analyze their …

Myosin Xva Isoforms Participate In The Mechanotransduction-Dependent Remodeling Of The Actin Cytoskeleton In Auditory Stereocilia, Ana I. López-Porras, Ava M. Kruse, Mark T. Mcclendon, A. Catalina Vélez-Ortega

Neurology Faculty Publications

Auditory hair cells form precise and sensitive staircase-like actin protrusions known as stereocilia. These specialized microvilli detect deflections induced by sound through the activation of mechano-electrical transduction (MET) channels located at their tips. At rest, a small MET channel current results in a constant calcium influx which regulates the morphology of the actin cytoskeleton in the shorter ‘transducing’ stereocilia. However, the molecular mechanisms involved in this novel type of activity-driven plasticity in the stereocilium cytoskeleton are currently unknown. Here, we tested the contribution of myosin XVA (MYO15A) isoforms, given their known roles in the regulation of stereocilia dimensions during hair …