Medicine and Health Sciences Commons^™

Exploring Contextual Differences In Environment And Policy Strategies To Promote Physical Activity In Disadvantaged Communities, Natalicio Hector Serrano

Arts & Sciences Electronic Theses and Dissertations

The benefits of physical activity for health are far reaching, including the reduced risk of several chronic diseases. However, only about 24% of US adults meet recommended guidelines of physical activity, with traditionally disadvantaged populations such as rural residents and persons of color facing even lower rates. Ecological models of health behavior help to understand correlates of physical activity that impact population health, but may not be as useful in disadvantaged populations where the evidence base is either lacking or not as rigorous. Furthermore, measures and methods may be underdeveloped in disadvantaged populations and there is a lack of understanding …

Gut Reactions: Quantitative Predictions Of The Responses Of Human Gut Microbiota To Medical Interventions, Amy Elizabeth Langdon

Arts & Sciences Electronic Theses and Dissertations

The collection of microbes known as the human microbiome perform vital functions for their host, and when this community becomes unhealthy, its dysbiosis is implicated in a myriad of diseases. The gut microbiota in particular are known to suppress colonization of opportunistic pathogens, regulate the immune system, aid in nutrient breakdown, produce vitamins, and a growing number of other functions. In order to intervene in a dysbiotic microbial ecology, we can try to remove unwanted microbes or try to recolonize the gut with microbes expected to be beneficial. This dissertation provides an overview of the state of medical interventions for …

Examining Mental Health In Northern Haiti, Michael Galvin

Arts & Sciences Electronic Theses and Dissertations

Mental health is a severely neglected field in low- and middle-income countries globally. Populations in countries such as Haiti demonstrate a high level of need for mental health services despite a lack of services and trained professionals. In addition to the dearth of biomedical services, local belief systems and explanatory models lead a majority of the population to rely on traditional medicine as their first option for care. The goal of this dissertation is to characterize mental health beliefs, practices, and services in northern Haiti by examining the relationship between traditional beliefs and mental illness, assessing the impact of traumatic …

Sustainable Diets For Planetary Health: A Study Of Indigenous Based Agri-Food Systems In A Community Of The Central Highlands Of Ecuador, Carlos Andres Gallegos-Riofrio

Arts & Sciences Electronic Theses and Dissertations

In order to explore the psychosocial and agroecological dimensions of sustainable diets and their roles in the rural Andean community of Caliata in the Ecuadorian highlands, I conducted a community-centered participatory mixed-methods study. Thirty-nine focus groups and ten key informant interviews were conducted, recorded, translated, transcribed, and analyzed using three-stage coding. The information was triangulated using participant observation, local records, and descriptive statistics from a survey of 57 female household heads, which included a modified 48-hour dietary recall module. Rural appraisal research assessed agroecological dimensions. Ten purposively selected sites were studied alongside local informants in order to obtain diversity indexes …

A Public Health Examination Of The Discipline Gap, Karishma Furtado

Arts & Sciences Electronic Theses and Dissertations

Education is often positioned as the great equalizer in the United Statesѡ cure all for many social ills, from poverty, to family instability, to exposure to violence. However, disadvantaged students tend, on average, to get a lower quality education. One example of a barrier that impedes educational equity is the discipline gap, or the disproportionate rate of exclusionary discipline like suspension and expulsion experienced by students with disabilities and those from historically disadvantaged racial, ethnic, and gender subgroups. Removing a student from class for punitive reasons puts them at greater risk of academic disengagement, a diminished sense of belonging and …

Pillars Of The Nutrition Transition: The Global Impacts Of Ultra-Processed Foods And Beverages On Overweight And Obesity And National Nutrient Supplies, Jacob Eaton

Arts & Sciences Electronic Theses and Dissertations

Malnutrition in some form impacts nearly one-third of the global population. Across the world, countries are undergoing the Үutrition transitionӠfrom traditional and largely unprocessed diets to Western-style, energy-dense diets. At the same time, rates of overweight and obesity and diet-related chronic diseases continue to climb. Ultra-processed foods (UPF), sugar-sweetened beverages (SSB), and vegetable oils are three of the foods driving the nutrition transition. This dissertation calculates changes in the global food supply between 1961 and 2013 and quantifies the influence of UPF and SSB (as measured through sales) on national nutrient supplies between 2005 and 2013 and trends in adult …

Investigating The Role Of Genetic Variants And Environmental Factors In The Trajectory Of Substance Use Disorders, Linda Johnson

Arts & Sciences Electronic Theses and Dissertations

Substance use disorders are a serious threat to public health with devastating social, economic, and health impacts on affected individuals and their families. This dissertation aims to improve understanding of substance use disorders in three parts: first, an epidemiological project examining smoking cessation and e-cigarette use at a population level; second, a genetic project examining the role of genetic variants on tobacco, alcohol, cannabis, and cocaine use; and finally, a review of the utility of polygenic risk scores in predicting risk of substance use behaviors. Cigarette smoking is a leading cause of preventable death, accounting for over 480,000 deaths in …

Dismantling Of Obesity-Related Policies, Alexandra Borosova Morshed

Arts & Sciences Electronic Theses and Dissertations

This dissertation fills an important research gap in the study of obesity policymaking by characterizing to what extent the phenomenon of dismantling is happening at the state level for obesity-related policies targeting the context of consumption, identifying determinants, and characterizing actors and processes involved. The five-year rate of dismantling of these policies is close to one-third for any attempts and one-tenth for enacted dismantling. Food and beverage tax policies face a particularly high rate of dismantling. Case studies and news coverage of state- level dismantling identified actors, motivations, and strategies used in the process of dismantling. Review of health-related empirical …

Scaling-Up Child And Youth Mental Health Services: Assessing Coverage Of A County-Wide Initiative, Cole Douglas Hooley

Arts & Sciences Electronic Theses and Dissertations

Over 7 million children and youth have a diagnosable mental illness any given year. There are evidence-based treatments (EBTs) to effectively treat these conditions, but these EBTs reach a very small percentage of their target population with treatment rates between 1-3%.1 We know very little about what influences these coverage rates. Beginning in 2009, the Los Angeles County Mental Health Department (LACDMH) began an ambitious agenda to scale-up the provision of EBTs in child/youth mental health care. The present study seeks to contribute to the scale-up literature by examining three questions based on LACDMH’s initiative: 1) To what extent have …

Understanding Adolescent Physical Activity In The Early Nutrition Transitioning Country Of Haiti, Haley V. Becker

Arts & Sciences Electronic Theses and Dissertations

The nutrition transition is underway in Haiti, giving rise to the dual burden of malnutrition. Physical activity (PA) plays an important role in mitigating the negative health consequences of nutrition transition and the dual burden, but heretofore this data has been unavailable for Haiti. This dissertation undertook an exploratory needs assessment providing baseline PA data for Haitian adolescents. It evaluated two different PA data collection methodologies: a cross-sectional survey adapted from the IPAQ long-form and objectively measured PA via Actigraph GT1M accelerometers. Next, it identified initial covariates of self-reported and objectively-assessed PA behaviors; data was operationalized as meeting the World …

The Intersection Of Intimate Partner Violence Perpetration, Intervention And Faith, Maxine Davis

Arts & Sciences Electronic Theses and Dissertations

In the U.S. most interventions with men who have acted abusively against intimate partners occurs because of a domestic violence conviction and court-mandate to complete treatment. This dissertation examines the intersection of intimate partner violence/abuse (IPV/A), intervention, and faith by investigating a parish-based voluntary partner abuse intervention program known as The Men’s Group (TMG). The function and implementation of TMG is first explored through a case study, laying the groundwork for understanding why men continuously participate in the program. This qualitative study then investigates how group members view the role of religious faith in relationship to IPV/A and how they …

Studies On Health, Place, And Education, Kelly Mcclelland Harris

Arts & Sciences Electronic Theses and Dissertations

Good health is positively associated with education outcomes, and likewise higher education-related achievement is positively associated with good health. Similarly, social disadvantage follows a cyclical pattern. It is cumulative; both accruing over the life course and across generations. Moreover, this relationship disproportionately impacts our most vulnerable populations, including both minorities and children living in or near poverty. For example, since the 1990s asthma, the most common chronic illness among youth, has seen the greatest increases in urban environments, and among racial and ethnic minorities in or near poverty. Still, consideration of the interdependence between health, place, and education remains underdeveloped …

The Role Of Physical Activity Enjoyment In The Pathways From Social And Physical Environments To Physical Activity Of Early Adolescent Girls, Elizabeth Lauren Budd

Arts & Sciences Electronic Theses and Dissertations

In 2013, only 27.1 % of adolescents (age 10-19) met the daily physical activity (PA) recommendations of 60 minutes of PA a day. 1 Inactivity is highly prevalent among youth and especially prevalent among adolescents. This inactivity can have harmful and costly, immediate and long-term repercussions on physical, mental, and social health.28 Health behaviors throughout childhood, including PA, are predictive of health behaviors throughout adulthood.9 Girls experience the steepest decline in PA in early adolescence compared to boys and any other age group, which positions them on a lifelong trajectory of inactivity and increased risk for disease.2,4 Among early adolescent …

Refining Associations Between Targeted Genes And The Development Of Substance Use Disorders, Emily Olfson

Arts & Sciences Electronic Theses and Dissertations

Recent genome-wide association studies (GWAS) provide strong evidence for the contribution of a few specific genes to alcohol and nicotine dependence. Chapter 2 explores numerous previously identified candidate genes for alcohol dependence using a publicly available GWAS. I found that many candidate loci do not replicate, highlighting the utility of GWAS for focusing on disease associated genes. Chapters 3-5 dissect associations between three genome-wide significant genes and substance use disorders. Chapter 3 focuses on a functional variant in alcohol dehydrogenase (ADH) 1B. Through examining 1,550 adolescent drinkers in the Collaborative Study on the Genetics of Alcoholism (COGA), I extended adult …

Social Support And Intimate Partnerships In African American Women With Breast Cancer, Tess Thompson

Arts & Sciences Electronic Theses and Dissertations

This mixed methods study investigated social support in African American breast cancer patients in one Midwestern metropolitan area. The study includes a quantitative analysis of social support in 227 African American breast cancer patients participating in a quality of life study, as well as a qualitative component involving a subsample of 15 married participants. In the larger sample, growth curve models were used to assess factors contributing to initial levels of perceived social support and change in social support over time. Interviews with women in the qualitative study allowed an in-depth exploration of how breast cancer affected womens relationships with …

Can We Walk? Environmental Supports For Active Travel In India, Deepti Adlakha

Arts & Sciences Electronic Theses and Dissertations

Background: Rapid rates of increase of obesity, diabetes, and associated chronic and co-morbid non-communicable diseases (e.g., cardiovascular diseases and some cancers) are being documented in India, yet in-country evidence-based research of associated risk factors is lacking. Physical activity has been identified as a preventative factor to counter the risk from obesity-related non-communicable diseases. Built environment supports for physical activity represent promising strategies to curb the rise in non-communicable diseases. Mounting research evidence suggests that the built environment can facilitate or constrain physical activity. However, a majority of this research has been conducted in developed nations. Built environment correlates of physical …

A Social Network Analysis Of Active Transportation Policy Networks, Marissa Zwald

Arts & Sciences Electronic Theses and Dissertations

Background: In an effort to increase physical activity, communities are recognizing the importance of policy and environmental changes to facilitate active transportation. However, evidence on the policy partnerships and processes to achieve such policy and environmental changes, particularly in non-health sectors, is lacking.

Methods: An online social network survey was administered in Fall 2015 to organizations engaged in active transportation policies in six cities across the United States. In addition to individual and organizational characteristics, relationships between organizations were assessed, including: level of collaboration around active transportation policies, frequency of contact, resource sharing to support active transportation, and perceived decisional …