Medicine and Health Sciences Commons^™

Human Papillomavirus Vaccine Policy In The U.S., Jennifer C. Jarrell

Public Health Theses

HPV vaccine school entry mandates and vaccine funding by state was examined using the Diffusion of Innovations (DOI) theory. The DOI was applied to HPV immunization policy to evaluate the rate of vaccine adoption and to determine whether associations existed between an empirical need for vaccine adoption and action by the states. State-level data on political characteristics, health and policy were collected from several secondary sources. Data analyses were performed utilizing SPSS logistic regression models. Odds rations were used to evaluate the associations between the independent and dependent variables to determine whether there was a statistical significance level of .05. …

Adolescent Knowledge, Attitudes, And Beliefs Toward Vaccination, Richard Brendan Noggle

Public Health Theses

Vaccination, one of public health’s greatest disease prevention tools, is broadening to focus on adolescents. Now that there are more vaccines targeted specifically for adolescents, it is time to give more focus to vaccine delivery in this population. This research will increase the knowledge base to support informed changes in adolescent vaccine delivery by identifying knowledge and attitudes of adolescents toward vaccination within the context of barriers and solutions. Perceived susceptibility to disease, benefits and barriers to vaccination and other constructs were collected through a survey to 1368 high school students. In this population, a scheduled adolescent healthcare visit is …

A Study Of Disaster Preparedness Of Rural Hospitals In The United States, Barbara Cliff

Dissertations

This dissertation examines disaster preparedness in the U.S. and explores the relationships between risk perception, funding from the Health Resources and Services Administration (HRSA), and preparedness. Secondary data analysis was conducted using the National Study of Rural Hospitals from Johns Hopkins University. The study, based on a random sample of rural hospitals, consisted of a mail questionnaire and a follow-up phone interview with the hospital's Chief Executive Officer (n = 134).

A model of disaster preparedness was utilized to examine seven elements of preparedness. Risk perception was examined by seven risk threats, and HRSA funding was examined as a …

Urban Versus Rural Patterns Of Mammography Use: An Analysis Of Two Southeastern States, Valerie Miranda Bycott

Public Health Theses

Mammography is widely recognized as the best method to detect breast cancer. This study examined the screening rate differences among women who live in urban and rural counties in Georgia and North Carolina. Data on the mammography screening rates was obtained from the Behavior Risk Factor Surveillance System (BRFSS) for 2002 and 2004. To assess the availability of mammography facilities, data was obtained from the Mammography Facility Database provided by the FDA. Multivariate logistic regression showed that having a usual source of care in urban counties was a positive predictor of women 40-59 years of age getting screened in both …

Predictors Of Emotional Reactions In Women Treated For Breast Cancer, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer can be a devastating disease that impacts a woman in all spheres of her life (Ingram, 1989). Previous studies have examined the impact of breast cancer on body satisfaction, as well as the impact on emotional well-being. Studies have also examined the role of the coping style that a woman engages in response to the diagnosis and treatment of breast cancer in the woman's psychological adjustment to the disease. However, to date, no research has introduced and tested a multifaceted model.

The purpose of this study was to develop a model predicting psychological maladjustment in women treated for …

Consider The Source : The Effects Of Adult Sources Of Human Immunodefciency [Sic] Virus And Sexually Transmitted Infection Prevention Information On Teen Risk Behaviors For Sexually Transmitted Infection, Janet E. Flores

Loma Linda University Electronic Theses, Dissertations & Projects

Sexually transmitted infections (STIs), including the Human Immunodeficiency Virus (HIV), are major health problems for adolescents, who represent over 26% of new cases of STIs diagnosed annually in the United States. Half of all HIV cases in people under age 25 result from sexual transmission during adolescence. Adolescent STI prevention is a national priority for the United States, and parents, schools, and medical providers, among others, are expected to have the greatest impact on adolescent STI risk reduction in teens.

This study used secondary Youth Risk Behavior Surveillance Survey (YRBS) data to explore the prevalence of high school students with …

Predictors Of Emotional Reactions In Women Treated For Breast Cancer, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer can be a devastating disease that impacts a woman in all spheres of her life (Ingram, 1989). Previous studies have examined the impact of breast cancer on body satisfaction, as well as the impact on emotional well-being. Studies have also examined the role of the coping style that a woman engages in response to the diagnosis and treatment of breast cancer in the woman's psychological adjustment to the disease. However, to date, no research has introduced and tested a multifaceted model.

The purpose of this study was to develop a model predicting psychological maladjustment in women treated for …

Predictors Of Female Sexual Dysfunction, Julie M. Merrell

Loma Linda University Electronic Theses, Dissertations & Projects

Tiefer, Hall, and Tavris (2002) described factors comprising four categories of female sexual dysfunction. They suggested that unique factors need to be examined to understand sexual dysfunction in women. Socio-cultural, political, or economic factors, partner and relationship factors, psychological factors, and medical factors described as aspects of women’s lives that can be the source of sexual dysfunction. The current study examined indicators of the above factors-body shame, relationship satisfaction, sexual self-schema, positive and negative affect, and overall health-as predictors of female sexual dysfunction. The hypotheses were: Body shame and negative affect will be negatively associated with sexual function; and relationship …

A Model For Preventing Anorexia In College Students, Laura Ann Negin

Loma Linda University Electronic Theses, Dissertations & Projects

The prevalence of anorexia nervosa in the general population is relatively low, but anorexia is at the forefront of health concerns because of its seriousness. Unhealthy weight loss has numerous physical, psychological, and social consequences. Most seriously, the mortality rate for people with eating disorders is the highest of all the major psychiatric disorders.

This dissertation presents a model for preventing anorexia nervosa in a population of college students that includes a comprehensive institutional approach, psychoeducational software, a high-risk population, a holistic approach that identifies an individual’s personal risk factors and protective factors, and individual therapy.

The model is built …

The Effectiveness Of A Dynamic Interdisciplinary Food Safety Curriculum Targeted On Middle School Students In Scott County, Sarah M. Johnson

Masters Theses

The focus of this study was to provide a comparison of data collected from seventh grade students on food safety knowledge who have been through USDA’s National Integrated Food Safety Initiative program with those seventh grade students who have had no formal school instruction on this topic. Middle school students were specifically targeted because they are more likely to synthesize this information in a way that will lead to the development of new behaviors.

The population consisted of seventh grade students at Burchfield, Fairview, Huntsville and Oneida Middle Schools. Burchfield and Huntsville were the two schools used as the comparison …

Demographic Factors Associated With Condom Use In 18-24 Year Olds For Two States, 1998 And 2000/2001, Kimberly R. Glenn

Public Health Theses

Despite knowledge about the transmission of HIV and other sexually transmitted diseases (STDs), young adults continue to participate in sexual risk behaviors such as unprotected sexual intercourse. This study examines factors that influence condom use in adults aged 18-24 years in the United States. Using secondary data from the 1998, 2000, and 2001 Behavioral Risk Factor Surveillance System (BRFSS), univariate and multivariate analyses were conducted to assess the factors influencing condom use stratified by gender and study year. A p-value of <0.05 and 95% confidence intervals were used to determine statistical significance throughout all analysis performed. Univariate analysis found that increased age and being male were associated with increased odds of condom use. Multivariate analysis stratified by study year found that in 1998 increased age and unemployment was associated with increased odds of condom use. In 2000/2001, increased age was the only factor associated with increased odds of condom use. Being female was associated with decreased odds of condom use in that study year. When stratified by gender, only increased age was associated with increased condom use. The study results suggest that the factors influencing condom use vary between gender and year. Since different factors impact condom use for each gender, the interventions designed to increase condom use must be centered on those factors. Since age was one of the consistent factors positively associated with condom use, interventions must begin earlier to affect the decision-making processes of young adults.

The Etiology Of Multiple Sclerosis And Correlation Of The Distribution Of The Disease With Migration And Settlement History Of Northern Europeans, Kristin M. Gunderson

Public Health Theses

The geographic disparity of multiple sclerosis has been noted in the literature for well over a century. The frequency of the disease varies significantly both within countries and in different parts of the world. The goal of this project is to give new insight regarding the etiology of multiple sclerosis. Several theories regarding the etiology of the disease have been reviewed, including a geographic theory, a nutritional theory, and a genetic theory. Although the geographic and nutritional theories have been thoroughly investigated by researchers, neither of them provides a conclusive explanation for the etiology of the disease, and there are …

The Effect Of Urinary Cadmium On Cardiovascular Fitness As Measured By Vo2 Max In White, Black And Mexican Americans, Heartley Egwuogu

Public Health Theses

Context: Cadmium is an important predictor of lung function, including forced vital capacity, forced expiratory volume and peak flow. Current evidence supports the notion that cadmium may be an important risk factor for cardiovascular fitness. Objectives: The purpose of this study was to determine the effect of cadmium exposure on cardiovascular fitness in representative sample of US white, blacks and Mexican Americans. The study also sought to determine if the relationship between cadmium and cardiovascular fitness varies by gender and racial/ethnic group. Methods: The data utilized for this study were obtained from National Health and Nutrition Examination Survey (NHANES). One-thousand …

Implications In Using Monte Carlo Simulation In Predicting Cardiovascular Risk Factors Among Overweight Children And Adolescents, Stephen Matthew Heimbigner

Public Health Theses

The prevalence of overweight and obesity among children and adolescents has increased considerably over the last few decades. As a result, increasing numbers of American children are developing multiple risk factors for cardiovascular disease, type II diabetes, hyperinsulinemia, hypertension, dyslipidemia and hepatic steatosis. This thesis examines the use of Monte Carlo computer simulation for understanding risk factors associated with childhood overweight. A computer model is presented for predicting cardiovascular risk factors among overweight children and adolescents based on BMI levels. The computer model utilizes probabilities from the 1999 Bogalusa Heart Study authored by David S. Freedman, William H. Dietz, Sathanur …

Impact Of An Electronic Medical Record Implementation On Drug Allergy Overrides In A Large Southeastern Hmo Setting, Renny Varghese

Public Health Theses

Renny Varghese Impact of an Electronic Medical Record Implementation on Drug Allergy Overrides in a Large Southeastern HMO Setting (Under the direction of Russell Toal, Associate Professor) Electronic medical records (EMRs) have become recognized as an important tool for improving patient safety and quality of care. Decision support tools such as alerting functions for patient medication allergies are a key part of reducing the frequency of serious medication problems. Kaiser Permanente Georgia (KPGA) implemented its EMR system in the primary care departments at Kaiser's twelve facilities in the greater metro Atlanta area over a six month period beginning in June …

Comparison Of Antibiotic Sensitivity Profiles, Molecular Typing Patterns, And Attribution Of Salmonella Enterica Serotype Newport In The U.S., 2003-2006, Nehal Jitendralal Patel

Public Health Theses

Salmonella causes gastrointestinal illness in humans. The purpose of the study was to determine the relative contribution of different food commodities to sporadic cases of salmonellosis (attribution analysis) caused by Salmonella Newport (SN) using Pulsed-Field Gel Electrophoresis (PFGE) patterns and antimicrobial sensitivity (AST) data submitted by public health laboratories and regulatory agencies from 2003 to 2006. The genetic relationship between isolates from non-human (348) and human (10,848) sources was studied by two unique clustering methods: UPGMA and Ward. Results show poultry was the highest contributor of human SN infections, followed by tomatoes and beef. Beef was the largest contributing food …

Examination Of Gender Differences In Baseline Characteristics And 12 Month Death And Rehospitalization Of African American Patients Admitted For Acute Myocardial Infarction, Saadia Khizer

Public Health Theses

Coronary heart disease, including acute myocardial infarction (AMI), is the nation's leading cause of death. This study examined the characteristics and outcomes of 397 African American (AA) patients within one year of hospitalization due to AMI at Grady Memorial Hospital (GMH) in Atlanta. The PREMIER study, a nationwide registry, maintained by John Spertus MD, included data from patient interviews, medical records, and clinical characteristics like diabetes, hypertension, smoking, angina frequency and quality of life was used. Patient characteristics, associated with a major adverse event (MAE) within one-year post AMI were evaluated using SAS. Results showed a trend of higher odds …

Is Knowing Half The Battle? An Examination Of The Relationship Between Folic Acid Knowledge And Awareness And Daily Supplementation With Folic Acid Among 18 To 24 Year Old Women Who Are Not Contemplating Pregnancy, Katie P. Kilker

Public Health Theses

Neural tube defects (NTDs) are serious birth defects that affect 3,000 pregnancies in the United States annually. All women of childbearing age are recommended to consume 400 micrograms of folic acid daily for the prevention of NTDs. Women aged 18 to 24 years have multiple risk factors for having an NTD-affected pregnancy and should be targeted by efforts to promote folic acid consumption. Survey data capturing folic acid awareness, knowledge, and supplementation behavior of women aged 18 to 24 years who are not contemplating pregnancy were examined to identify the relationship of folic acid awareness and knowledge to daily supplementation …

The Prevalence Of Nelson Bay Virus In Humans And Bats And Its Significance Within The Framework Of Conservation Medicine, Jennifer Betts Oliver

Public Health Theses

Public health professionals strive to understand how viruses are distributed in the environment, the factors that facilitate viral transmission, and the diversity of viral agents capable of infecting humans to characterize disease burdens and design effective disease intervention strategies. The public health discipline of conservation medicine supports this endeavor by encouraging researchers to identify previously unknown etiologic agents in wildlife and analyze the ecologic of basis of disease. Within this framework, this research reports the first examination of the prevalence in Southeast Asia of the orthoreovirus Nelson Bay virus in humans and in the Pteropus bat reservoir of the virus. …

Multiple Sclerosis Disease Distribution And Potential Impact Of Environmental Air Pollutants In Georgia, Anthony Charles Gregory

Public Health Theses

This study’s purpose is to examine the potential relationships between MS (Multiple Sclerosis) and environmental outdoor air pollutants in GA (Georgia). We used secondary, cross-sectional data received from the member’s list of the National Multiples Sclerosis Society’s GA chapter (NMSS-GA), the U.S. census, and scorecard.org, a database based on the U.S. Environmental Protection Agency (EPA) Toxic Release Inventory (to 2002) and National Emissions Inventory (1999) data. The study population was 9,072,576 including 6,247 self-reported MS cases from NMSS-GA. Using stepwise multivariate linear regression of census and EPA data, the best predictive model in GA for female or total prevalence rates …

Obesity And The Built Environment In Twenty-Six Rural Georgia Counties: An Analysis Of Physical Activity, Fruit And Vegetable Consumption, And Environmental Factors., Kathleen Elizabeth Sobush

Public Health Theses

This study assesses environmental factors in the exercise and food environment, demographic factors, physical activity behavior, and fruit and vegetable consumption in 26 rural Georgia counties. The purpose of the study is to identify environmental indicators of physical activity and fruit and vegetable consumption; to see what agencies in Georgia, if any, are collecting these types of data systematically throughout the state; and, to analyze potential relationships between environmental factors and health behaviors. Physical activity and fruit and vegetable consumption were derived from the Georgia Behavioral Risk Factor Surveillance System (2001, 2002, 2003, and 2005). Demographic data were from the …

Psychometric Evaluation Of An Instrument For Assessing Policy Outcomes For Families With Children Who Have Severe Developmental Disabilities: The Beach Center Family Quality Of Life Scale, Joni Taylor Mcfelea

Health Services Research Dissertations

The purpose of the study was to evaluate the psychometric properties of the Beach Center Family Quality of Life Scale (BCFQLS) in a sample of families with children who have severe developmental disabilities. The study sought to determine whether or not the scale could be used to measure the quality of life of such families and to differentiate between the quality of life of two family groups—those whose child lives in the family home and those whose child lives outside the family home.

The study used an observational, cross-sectional design and both qualitative and quantitative methods. Self-identified primary caregivers of …

Female Patients’ Perspectives On The Stages Of Eating Disorder Recovery, Cherish C. Knoll

Loma Linda University Electronic Theses, Dissertations & Projects

Eating disorders are severe psychiatric disorders that most commonly begin in the female population during adolescence and across ethnicity (Lucas, 2004). However, the face of eating disorders is changing as they become more apparent across cultures and lifespan, impacting both young and aging women as well as males. In the past few decades progress has been made in the diagnostic, treatment, and recovery phases of eating disorders. These gains have contributed to a better understanding of eating disorders, assisting in the decrease of mortality and morbidity rates seen in eating disorder patients. Nevertheless, there are significant challenges that still remain …

Factors Associated With Aids Risk Behaviors Of African Born Adolescents In Southern California, Dixon Anjejo

Loma Linda University Electronic Theses, Dissertations & Projects

The study was aimed at determining if cultural beliefs are salient factors contributing to the spread of HIV/AIDS among African born adolescents aged 15 to 19 years living in southern California. We used a cross-sectional design and collected data in two phases. The first phase was qualitative and data were collected from 25 participants in focus groups. The second phase utilized a questionnaire which was developed from the results of the focus group, using the theory of planned behavior. One hundred and thirty-five black African born teenagers between the ages of 15-19 years living in southern California completed the questionnaire. …

A Qualitative Study Of Inpatient Rehabilitation Client Perceptions Of The Semi-Fixed Environment, Liane Hewitt

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Literature supports the importance of the environment on promoting or compromising health. However, little is known about how the semi-fixed environment affects client perceptions and recovery from a debilitating condition. The purpose of this study was to investigate beliefs about control within the semi-fixed environment and client perceptions of the rehabilitation process.

Design and Method. This study utilized a basic qualitative research design with 10 rehabilitation clients whose average inpatient length of stay was 14 days. Data were collected in two phases. Phase I included two inpatient visits involving semi-structured interviews on the rehabilitation process and …

Emotional Stroop Effects: Eating Disorders And Obesity, Kristy Anne Kuehfuss

Loma Linda University Electronic Theses, Dissertations & Projects

This study addresses the effects of emotional valence on selective processing of body-shape related words in young women who suffer from anorexia, bulimia, or obesity, and non-clinical controls. Research in the area of emotional Stroop interference has indicated that persons with eating disorders, particularly anorectics, show elevated latencies in naming colors of words related to food or body-shape, in contrast to either neutral words, or to non-clinical control groups. One intriguing issue regarding the emotional Stroop interference among various clinical populations relates to the question of whether the interference is due to the emotionality of the relevant words or to …

Wellness Program Effect On The Health Parameters Of Female Employees Aged 25 To 60 Years Of Age Targeting Physical Activity And Nutrition Therapy., Adrienne J. Poag

Electronic Theses and Dissertations

The purpose of the study was to determine if the health parameters of female employees would improve, as measured in the posttest data, following the completion of a 12-week employee wellness program. The participants included 17 female employees from the Carter County Health Department located in Elizabethton, Tennessee. The principle investigator assessed the changes in the pretests and posttests and analyzed the data using SPSS. The results showed on average an increase in fruit and vegetable consumption and in the number of days exercised per week as well as improved diastolic blood pressure and triglyceride levels. The employees who experienced …

Post Traumatic Stress Symptoms And Critical Incident Stress Debriefing (Cisd) In Emergency Medical Services (Ems) Personnel., Ginger Lee Woods

Electronic Theses and Dissertations

EMS personnel were examined for Post Traumatic Stress symptoms and the usefulness of Critical Incident Stress Debriefing (CISD) using the Los Angeles Symptom Checklist (LASC) and a demographics questionnaire. This study revealed that women in this group show higher PTSD symptoms than male coworkers. Level of Training (LOT) of the EMS provider did not demonstrate a significant difference in whether a provider developed PTSD. EMS personnel receiving debriefing actually suffered greater levels of PTSD than those that did not receive debriefing. And 16% of EMS providers in this study suffered from PTSD, while approximately 20% suffered from partial PTSD or …

Health Barriers, Health Perceptions, And Cardiovascular Risk Factors Of Adolescent Black American Males, Desmarie Jackson Decuir

Theses and Dissertations (ETD)

Area of Investigation: Cardiovascular (CV) diseases are the leading cause of death among Black American adult males. Health behaviors that contribute to CV disease are probably learned during adolescence yet few researchers have studied the factors that influence health promotion behaviors in adolescent Black American males. This study described the health barriers, health perceptions (health self-efficacy and health status), and CV risk factors reported by and the influence of these variables on health promotion behaviors of a sample of Black American adolescent males without known CV disease.

Methods and Procedures: A descriptive correlation study design was used to …

Physical Teen Dating Violence And Risk Behaviors Among Black And Latino Teens, Belsie R. Gonzalez

Public Health Theses

Victims of teen dating violence (TDV) in the United States engage in risk behaviors that increase their vulnerability to ill health. Although teen dating violence affects millions of adolescents of diverse ethnic backgrounds, there is a higher prevalence of TDV among Blacks and Latinos. In order to develop effective interventions for diverse populations, it is critical to understand the risk behaviors associated with different victims of TDV. The purpose of this thesis is to determine whether there is a difference between the risk behaviors (alcohol abuse, illegal drug use and perilous sexual intercourse) engaged in by Black, Latino and White …