Medicine and Health Sciences Commons^™

Using The Theory Of Planned Behavior To Understand Student Compliance To Tobacco-Free Policies In California Universities, Harit Agroia

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In California, the mortality rate associated with smoking ranks as the sixth highest among all states in the nation (CDPH, 2016). To reduce this rate, many universities in California have adopted tobacco-free policies in recent years (Mamudu, Veeranki, Kioko, Boghozian & Littleton, 2016). Due to the recent adoption of such policies, there is limited research available which aim to assess the effectiveness of these on tobacco use behavior on campus among university students.

Purpose: The purpose of this study was to understand student compliance to tobacco-free policies within select universities in California, specifically those that implemented their …

Acculturation And Cardiovascular Behaviors Among Adult Asian-Americans, Monideepa Bhattacharya Becerra

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The World Health Organization recommends the promotion of positive cardiovascular behaviors (healthy diet and physical activity), while reducing negative ones (tobacco and alcohol abuse) as critical steps in reducing the burden of cardiovascular diseases. Researchers have highlighted the role of acculturation in predicting such behaviors among immigrants, though similar studies among Asian-American subgroups are lacking. This study examines the putative relationship between acculturation and aforementioned cardiovascular behaviors among six Asian-American subgroups.

Methods: A secondary analysis of the California Health Interview Survey 2007, 2009, and 2011 public access data was conducted. Acculturation was assessed utilizing proxy measures of language spoken …

Association Of Dietary Intake Patterns With Emotion Regulation, Megan Holt

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Western dietary patterns, characterized by high intakes of trans fatty acids (TFA’s), are associated with numerous preventable chronic diseases. Conversely, a Mediterranean dietary pattern is known to be favorably associated with health. Recent findings suggest a correlation between Mediterranean dietary patterns and positive affect, and an inverse correlation with negative affect. Trans fatty acid intake is also associated with negative affect. Further, affect disturbances are associated with emotion dysregulation. We have yet to understand the association of diet with emotion regulation after taking affect disturbances into consideration. The purpose of this study was to examine effects of Mediterranean diet …

Perceived Attitudes And Staff Roles Of Community Based Outpatient Clinics In Disaster Management, Pauline Antoinette Hodge-Hilton

Loma Linda University Electronic Theses, Dissertations & Projects

Objective: Natural and manmade disasters have claimed the lives of thousands of individuals in the US and caused billions of dollars in property damage. First responders carry the responsibility of disaster management, leaving other health care professionals such as medical clinic staff underutilized to support the clinic staff. We explored how medical and support staff in Community-based Outpatient VHA Clinics (CBOC) perceive their roles in disaster response, their attitudes about clinic readiness and continuity of care during disasters, and their ability to function in a post disaster environment.

Methods: A mixed method study was conducted to answer questions related to …

The Effects Of Socioeconomic, Built Environment, And Food Environment Factors On Childhood Obesity In Montclair, California, Krystal Redman

Loma Linda University Electronic Theses, Dissertations & Projects

This observational study examines the relationship between socioeconomic status (SES), built environment, and food environment factors and childhood obesity. In this study, the participants were selected from three elementary schools located in the innercity of Montclair, California. Information about each student’s health and family income and was gathered. In addition, the number of parks, fast food restaurants, and grocery stores within the school district border lines were tallied. I also observed the quality of the parks and food sold in the markets, built environment I hypothesized that childhood obesity is associated with SES (i.e., income level and education level), the …

Family Acculturation And Asthma Outcomes In Latino Children, Tania M. Barreno

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Asthma is the primary chronic disease diagnosed in children. California has had some of the highest asthma prevalence rates within the nation. The literature indicates that there is a poor understanding of asthma outcome and management. However, studies exploring the role of acculturation on such outcomes are limited. Thus, the goal of this research was to conduct a secondary analysis of the Child Questionnaire from the California Health Interview Survey (CHIS) 2007 and 2009 cross-sectional data to explore the determinants of asthma outcomes as it relates to family acculturation.

Methodology: The quantitative data were analyzed using Stata. Descriptive statistics, …

The Public Health Impact Of Maternal Smoking Cessation During Pregnancy : The San Bernardino County Experience, Michael Batech

Loma Linda University Electronic Theses, Dissertations & Projects

Most studies of maternal tobacco cessation during pregnancy have estimated measures of effect that can be useful in identifying the exposure as an etiologic risk factor in maternal and child health. However, in the case of maternal tobacco use there is overwhelming evidence for a causal role in adverse infant outcomes, and public health needs to focus on measures of potential impact in order to better prioritize and allocate resources toward interventions. The aims of this dissertation were: 1) to investigate the public health impact of smoking cessation during pregnancy among mothers giving birth in San Bernardino County, California; and …

Maternal Smoking, Weight Status And Preecalmpsia And Eclampsia Risk Among Women Living In San Bernardino County, Fiona Bedelia Lewis

Loma Linda University Electronic Theses, Dissertations & Projects

Preeclampsia is defined as pregnancy-induced hypertension affecting between 2% and 8% of pregnancies and accounting for about 10-15% of maternal deaths worldwide. Eclampsia is defined as the occurrence of one or more episodes of seizures in a pregnant woman related only to a preeclampsia diagnosis. Preeclampsia, if poorly managed, can progress to eclampsia resulting in injury and death to both mother and infant. The etiology of preeclampsia is not completely understood. Oxidative stress leading to abnormal placenta development and endothelial dysfunction are thought to be key components in the biological mechanism of preeclampsia.

Modifiable risk factors include maternal body weight …

Beliefs About Complementary And Alternative Medicine In Hiv-Infected Black Women Using The Theory Of Planned Behavior, Stephanie G. Lino

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Black women make up 12% of the female population in the U.S, yet they account for 66% of new HIV infections. In 2002, AIDS was the most cited reason for death among Black women age 25-34. While prevention remains, a major effort targeting treatment efficacy and modalities for this sub-group need to be better understood.

Purpose. The purpose of this study is to assess whether HIV-positive Black women’s attitudes, subjective norms and perceived behavioral control are related to intention of dietary supplements and spiritual practices use in their HIV treatment.

Method. In phase one, Grounded Theory methods (N= …

The Association Of Diet And Physical Activity With Stroke Mortality Results From The Adventist Health Study-1, Tahereh Zamansani

Loma Linda University Electronic Theses, Dissertations & Projects

Stroke is one of the leading causes of death and disability, with major global public health implications. Stroke ranks No. 4 among all causes of death, behind heart disease, cancer, and chronic lower respiratory disease (CLRD). Stroke accounts for almost 1 of every 18 deaths in the United States. Women accounted for 60.6% of stroke deaths. Death certificate data show that the mean age at stroke death was 79.6 years; males had a younger mean age (76.3) than females.

There is still a great scientific uncertainty among researchers and epidemiologists about the magnitude of any preventive effect, mechanisms of action …

The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HR_{β_biockers}= 0.64, 95% CI 0.26-1.56 and HR_ACEi/ARB=0.50, …

Breastfeeding Attitudes And Intentions Among Middle Eastern Women Living In Southern California, Christina Irsilious Fam

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Breastfeeding is unsurpassed as the preferred method of feeding infants all over the world due to the fact that its benefits far outweigh those of infant formula. Mothers from all cultures prefer breastfeeding, yet with immigration and emigration so widespread from developing countries, women's value systems are changing to adapt to their new surroundings. The United States has experienced a great influx of Middle Easterners; California in particular has a dominant presence of Middle Easterners. Many are faced with obstacles and stresses in acculturation, which may lead to lack of breastfeeding their infants. Few studies are available on Middle …

Effects Of Photovoice On Youth Perceptions Of Healthy Food Access In The Built Environment, Sharlene A. Gozalians

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Minority communities are at a higher risk for chronic diseases related to obesity because they lack access to stores that have affordable, fresh, nutritious foods that are necessary for a healthy diet. Photovoice can serve as a tool to engage youth in positive health behaviors and behavior change. Healthy food access has been analyzed based on nutrition, yet there is a lack of literature as to what factors enable and prevent access to healthy foods.

Methodology. The purpose of this study was to determine if a photovoice intervention would create a difference in perception of food access, empowerment …

The Effect Of Non-Exercise Activity Thermogenesis On Subjects With Metabolic Syndrome, Samer Hammoudeh

Loma Linda University Electronic Theses, Dissertations & Projects

Metabolic syndrome is a cluster of metabolic abnormalities that increases the risk of cardiovascular disease and type 2 diabetes. Several criteria establish the diagnosis of metabolic syndrome, including high waist circumference, low HDL cholesterol, high triglycerides and glucose and above normal blood pressure. The prevalence of metabolic syndrome is on the rise following the rise in obesity across the globe. Qatar, a country in the Arabian Peninsula shares the burden of obesity with recent studies showing prevalences of'---61% among women and —39% among men. These studies found that metabolic syndrome is more common among women. Physical activity helps reduce visceral …

The Efficacy Of An Audio Program And Discussion Guide In Promoting Exclusive Breastfeeding In Cameroon, Africa, Kathryn R. Reinsma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In the Northwest Region of Cameroon, approximately 90% of women initiate breastfeeding; however, only 34% continue exclusive breastfeeding for the recommended six months (Kakute, et al., 2005; WHO, 2008). Entertainment-education is a mass-media communication strategy of placing educational information into media such as television programs, movies, and radio programs (Siegel & Lotenberg, 2007). This form of behavioral change communication has proven effective in addressing health-related issues in developing countries.

Purpose: The aim was to design an audio program and discussion guide to test the hypothesis that an audio program and discussion guide improves exclusive breastfeeding knowledge, beliefs, benefits, self-efficacy, …

Factors Affecting Parents Misperception Of Overweight Or Obesity In Their Children, Carol Barnes Reid

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Treating overweight children may be more difficult when parents themselves do not correctly recognize their child’s weight status (Camell, Edwards, Croker, Boniface, & Wardle, 2005 Boniface, & Wardle, 2005). While it is a commonly held belief in some cultures that overweight children are healthy, incorrectly assessing overweight in very young children results in unfavorable weight development throughout childhood (Kroje, Struthman, & Gunther, 2006). This is due to the increased likelihood that parents may not take the condition of obesity in their child as being serious, or they may fail to seek or accept professional help in correcting the problem …

An Occupational-Based Experimental Study Of Collective Vs. Personal Efficacy To Encourage Sun Protective Behaviors In Head Start Preschool Teachers, Elizabeth A. Holzhauser

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Skin cancer is one of the most common types of cancers in the United States. An analysis of literature shows that skin cancer can be partially mitigated through personal behavior changes (Glanz, Buller, & Saraiya; 2007, Canadian Centre of Occupational Health and Safety [CCOHS], 2010). Currently national sun-safety educational campaigns promote sun-protective behaviors to individuals who receive exposure due to their work environment (Task Force on Community Preventive Services, 2004). Preschool teachers employed with San Bernardino County Head Start are inadvertently exposed to sunlight during mandatory recess periods posing risks to their health.

Purpose. This study evaluated two instructional …

Impact Of An Online Support System On Health Related Quality Of Life Among Men Diagnosed With Prostate Cancer, Daniel K. Osei

Loma Linda University Electronic Theses, Dissertations & Projects

Prostate cancer is a major public health issue worldwide and a significant cause of male cancer death in the USA. Though early screening and treatment has greatly enhanced the outcome, men diagnosed with prostate cancer face problems that compromise quality of life after treatment. Online support for prostate cancer clients is a convenient way to help because it is anonymous, inexpensive, and can be used at clients’ convenience. Yet few studies have explored how these supports impact these clients. This study used a longitudinal randomized experimental design to examine the impact of online services on quality of life of prostate …

The Association Of Religious Coping On Reports Of Low Back Pain And Inflammatory Markers, Jacqueline D. Bougie

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic pain is the most common cause of disability in the United States with depression, anxiety, and stress often occurring co-morbidly. The purpose of the study was to explore how religion may modulate the frequency of back pain, influence inflammatory markers, influence the use of medications, and impact functional ability.

Participants were from the Biological Manifestations of Religion Study (BioMRS; N= 508) and the Psychological Manifestations of Religion Study (PsyMRS; N = 10,988). All participants completed a 20-page questionnaire and BioMRS participants provided blood, salivary, and urine samples, performance tests, and learning tests all collected within 1 week of …

Perceived Barriers And Benefits Of Hiv Voluntary Counseling And Testing Among University Students In Nigeria, Clara Egbealele Omogbai

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Nigeria, the most populous country in Africa is one of the sub- Saharan nations most affected by HIV and AIDS. However, due to stigma most people at risk of infection refuse testing, thereby likely increasing the transmission of HIV. Voluntary counseling and testing (VCT) has been shown to influence behavior change and it is important to explore how to increase rates of VCT in young people who may experiment with sexual activity in this environment that holds increased risks due to nationally elevated rates of HIV.

Purpose. To examine intention to use HIV voluntary counseling and testing (VCT) services …

Child And Family Responses To Weight Management Programs : A Qualitative Investigation, Andra Lynn Fjone

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: The purpose of this study is to explore what happens within families in which a child participates in a pediatric weight management program for the treatment of overweight or obesity and identify strategies and processes for successful weight management.

Method: A qualitative approach was used to collect data from seven families. Individual interviews were conducted with parents, target children, and siblings. Data was analyzed within families and compared between families.

Results: Grounded theory analysis revealed three major essential themes: Shared Burden, Family Congruence, and Collaboration. Descriptive analysis was used to identify recommendations for improving family based weight management programs. …

The Relation Of Fitness Assessment Feedback To Intrinsic Motivation And Physical Activity Among College Students, Laura Chandler

Loma Linda University Electronic Theses, Dissertations & Projects

Physical inactivity is a major public health concern in the United States and is no less of a concern among college students. According to the 2000 National College Health Assessment, as cited by Kilpatrick, Herbert, and Bartholomew (2005), only 38% of college students participate in regular vigorous activity, and only 20% participate in regular moderate activity. This study focused on how fitness assessment results affect intrinsic motivation for physical activity in college students. The specific mechanism examined was that between the constructs of intrinsic motivation, competence and autonomy from the self determination theory (SDT) and cognitive evaluation theory (CET). Approximately …

Predicting Mammography Screening And Breast Self-Examination Among Hispanic And Non-Hispanic White Women In Orange County, California, Sanam Kazemi

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Breast cancer is the second leading cause of cancer deaths among Hispanic/Latina women who are one of the fastest growing ethnic groups in the United States. Although Hispanic women have a lower incidence of breast cancer when compared to non-Hispanic White women, they are more likely to develop breast cancer at an advanced stage. In California, Hispanic women have the lowest rate of insurance coverage compared to other ethnic groups.

Method. The study was a cross-sectional observational study among Hispanic/Latino and non-Hispanic White women, ages 30-64 years. I examined intention to obtain a mammogram or breast self-exam …

Self-Reported Exercise And Risk Of Osteoporosis In Prostate Cancer Patients Receiving Androgen Deprivation Therapy, Lori J. Mennen-Winchell

Loma Linda University Electronic Theses, Dissertations & Projects

Prostate cancer is stimulated to grow in response to testosterone. Androgen deprivation therapy (ADT) leads to chemical castration and suppression of prostate cancer cell production. Testosterone levels less then 300ng/ml decreases bone mineral density and could result in osteoporosis. Studies have shown that during the first year of ADT, fracture risk, mainly in hips and spine increases about 50%. In men, 40% of hip fractures result in death. Exercise may reduce the risk of osteoporosis and thus contribute to the prevention of hip and other fractures. There is limited data regarding whether exercise is associated with a reduced risk of …

Factors That Inhibit Or Enhance Maternal Coping With Stillbirth In Chhattisgarh, India, Lisa R. Roberts

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Over half of the known stillbirths occur in four highly populated countries—India among them. While acknowledged as a significant public health issue in western societies, little is known about maternal coping with stillbirth in developing countries. The purpose of this mixed methods study is to explore how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India.

Methods: In Phase 1 of this mixed methods study, grounded theory methods were used to explore perceptions regarding stillbirth. A de-identified medical records review of 536 deliveries at Christian …

The Association Between Body Mass Index And Dental Caries In Hispanic Elementary School Children, Mary Creske

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Dental caries is the most common chronic disease of children ages 6 to 11. According to the U.S. Department of Health and Human Services, 41% of the children in this age group experience decay in their primary teeth. Since 1980 the number of overweight children ages 6 to 11 has doubled. Childhood obesity is currently the most prevalent nutritional condition of children in the U.S.

Purpose: The purpose of this observational study was to determine if there is an association between childhood dental caries and childhood obesity. The study also explored the effects of diet and other covariates.

Method: …

The Effects Of Consumption Of California Dried Mission Figs On Serum Lipid Concentrations In Hyperlipidemic Adults, Joycelyn M. Peterson

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The National Cholesterol Education Program and American Heart Association have recommended the use of functional or cholesterol-reducing foods, some categories of which include viscous or soluble fibers, soy protein, plant sterols, and nuts, as aids to reduce serum cholesterol concentrations. Figs are a rich source of viscous fiber and antioxidants. Fig consumption has not been studied in regard to effects in reducing serum lipid concentrations. In previous pilot data, increasing fig consumption for six weeks among volunteers was found to be feasible.

Objective: To evaluate the effect of the consumption of California dried mission figs on serum lipid …

Effects Of Acculturation On Hiv/Aids Sexual Risk Behaviors Among Asian And Pacific Islander (Api) Women, Margaret Cabotage Salud

Loma Linda University Electronic Theses, Dissertations & Projects

Background. In the US women are the fastest growing group for sexually transmitted infections (STIs), including HIV and AIDS. In addition, the estimated AIDS cases among female adults and adolescents, aged 13-19, increased from 7% in 1985 to approximately 26% in 2002. Most infections occur by heterosexual transmission with 53% occurring through contact with a high-risk sexual partner. While overall HIV/AIDS rates in the Asian Pacific Islander (API) community remain low, they are rising and HIV testing rates, one of the major prevention strategies for HIV, are lower than that of other populations. Furthermore, very little is known about APIs …

Spirituality, Religiosity, And Weight Management In Black Women, Shené L. Bowie

Loma Linda University Electronic Theses, Dissertations & Projects

Background

Obesity is a major concern in the United States and Black Americans are among those with the highest rates of overweight, obesity, and related co- morbidities. While weight loss among Black women has been studied within the context of a faith-based setting, there is little information about the relationship between spirituality, or relationship with the transcendent, and self-efficacy in the achievement and maintenance of a healthy weight.

Purpose

The purpose of this study was to analyze the relationships among spirituality, self-efficacy for physical activity and healthy eating, and body composition measures among Black women over the period of participation …

The Role Of Unrealistic Optimism In Explaining Preventive Behaviors In High Versus Low Endemic Malaria Settings In Belize, Daniel G. Handysides

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Of all the diseases an individual can encounter in the world, malaria is one of the most destructive. Simple measures like sleeping under a bednet would greatly reduce the burden (Abeku, 2007). When people estimate their risk relative to others, they are most often unrealistically optimistic, which may explain why those at risk often fail to perform behaviors, such as using a bednet that will reduce their risk. However, one study showed that people at high risk for malaria held pessimistic perceptions of their risk for the disease, but the reasons for this finding are unclear (Morrison, Ager, & …