Medicine and Health Sciences Commons^™

The Political Economy Of Intimate Partner Violence And Crisis Management: An Institutional Ethnography In Rural Vermont, Anna L. Mullany

Doctoral Dissertations

Intimate partner violence (IPV) is a significant public health issue affecting one in four women in the United States. Tasked with addressing IPV, crisis centers can significantly impact women’s health outcomes and approaches to perpetrator accountability and community education. Informed by eight months of field work at a rural crisis center and 40 in-depth interviews, this dissertation investigated how the lives of Vermont women experiencing violence and crisis center work are both shaped by larger social, political, and economic relations within capitalism. Dorothy Smith’s method of institutional ethnography provides an investigative pathway for centering survivor experiences and examining crisis center …

Quality Of Life For Women With Chronic Lyme Disease: A Socioeconomic Investigation, Dale M. Jones

Doctoral Dissertations

This is a mixed methods investigation of how chronic Lyme disease, including Lyme-like diseases and co-infections, affects the quality of life of women who have chronic Lyme. Both quantitative and qualitative methods were used during three phases of research: a 91-question survey instrument followed by focus group discussions and written narratives. The research considered the socioeconomic impact on quality of life in five areas: obtaining a diagnosis, relationships and personal support systems, struggles with the medical system, the ability to work, and access to treatment. There were 500 responses to the survey, of which 373 were analyzed; 11 participants in …

Oxybenzone And The Mammary Gland: Impact Of An Environmental Pollutant On Health, Disease & Ethical Decision-Making, Klara Matouskova

Doctoral Dissertations

The environmental pollutant and common sunscreen compound oxybenzone is a benzophenone type UV light chemical filter used in industrial and consumer goods. This chemical widely contaminates human tissues, non-human species, and environmental matrices. In this dissertation, oxybenzone is investigated for its effects on the mouse mammary gland in the offspring following perinatal exposure; after perinatal and prepubertal exposures as a dual environmental insult during two sensitive times of development; and in adults after exposure during pregnancy & lactation as an environmental factor potentially increasing the tissue susceptibility to mammary tumors. Chapter 1 introduces the mammary gland. Chapter 2 reviews UV …

Consumer Behaviors, Added Sugar Intake, Diet Quality, Inflammation And Metabolic Syndrome Risks Among Adults From The National Health And Nutrition Examination Survey 2007-2010, Shanshan Chen

Doctoral Dissertations

We carried out a secondary data analysis of adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) 2007-2010. All analyses were weighted using NHANES sample weights to account for the complex survey design, survey non-response, and post-stratification. Overall, the majority of our population (60.4%) exceeded the USDA/HHS recommendation on added sugar consumption. In the first study, soft drink availability at home was positively associated with added sugar intake (p In the second study, added sugar intake was negatively associated with diet quality determined by Healthy Eating Index (HEI) 2015, after adjusting for covariates. With regards …

Distributing Condoms And "Hope": Race, Sex, And Science In Youth Sexual Health Promotion, Chris A. Barcelos

Doctoral Dissertations

This project uses discursive, visual, and ethnographic approaches situated in a critical feminist methodology to understand how ways of knowing about youth sexuality and reproduction influence community health work. I understand the “problem” in this inquiry as the discursive contexts that limit critical ways of knowing about young people’s sexual subjectivities and practices and about the design of policies and programs. Although race, class, gender, and sexuality are understood in the public health literature as important social determinants of health, there is a lack of research that applies a critical, feminist lens to these constructs. I draw on three years …

Essays On Household Health Expenditures, National Health Insurance And Universal Access To Health Care In Ghana, Evelyn Kwakye

Doctoral Dissertations

Access to quality health services is essential for maintaining a healthy population and economic development hence the growing global consensus that universal health coverage is necessary. Ghana attempts to expand access by making basic health services free at the point of delivery through its National Health Insurance Scheme (NHIS). Prior studies indicate NHIS increases demand for health services, but questions remain about its impact on out of pocket payments, quality of services, and the financial viability of the program. Hence, this dissertation analyzes the financial risk in health care seeking, the effect of NHIS on out of pocket payments and …

Living With Hypertension: Experiences Of Black Men Related To Their Perceptions Of The Clinical Encounter At Diagnosis, Glenda Mccartney Feild

Doctoral Dissertations

Introduction: In the U.S., hypertension (HTN) is the most common primary diagnosis and HTN related illnesses are the number one cause of death. Being a member of the Black population increases the risk for developing HTN. Black males are reported to develop HTN earlier in life and have a high incidence of undiagnosed, untreated, and uncontrolled HTN. Sociocultural and gender barriers influence this population’s perceptions of medical experiences, which affects their participation in health-promoting behaviors such as eating a healthy diet, engaging in regular physical activity, avoiding tobacco, limiting alcohol consumption, and decreasing stress.

Purpose: The purpose of this study …

Conversations With The Community: An Ethnography Of Two Case Studies Highlighting Community-Research Partnerships In Springfield, Ma, Vanessa Martinez

Doctoral Dissertations

This dissertation is both qualitative and collaborative. It emphasizes the participant observation and ethnographic documentation of two community-researcher partnerships on community-level health interventions in Springfield, MA. Drawing upon critical theories and reflexive methods, I explore and analyze the process of building and sustaining researcher-community partnerships in an era of limited funding. Two Springfield, MA-based projects – one on healthy cooking/eating, and the other on contingency management – serve as case studies to provide a concrete picture of the complex relationships of researcher-community collaborations. I use ethnographic storytelling to provide a multi-dimensional look at two different community-research partnerships on health disparities …

Understanding Health Issues Among Adolescent Females In A Northeast Province Of Afghanistan, Amina Davlatshoeva

Doctoral Dissertations

The purpose of this study is to develop a deeper understanding of the health issues facing adolescent females (ages 18-21) in rural, northeastern Afghanistan. Incorporating participant observations, in-depth interviews, and narrative inquiries, this study seeks to illustrate adolescent females’ perspectives on health issues. To achieve this goal, ten adolescent females were interviewed in rural, northeastern Afghanistan during 2010. The participants were between 18- and 21-years old. The one-on-one interviews were conducted in a multiple-response format and were structured around three research questions:

• How does a young female’s understanding of health issues shape her identity in northeastern Afghanistan?
• In what ways …

Growing Up With Hiv In Kisumu, Kenya: Participatory Action Research With Young People Living With Hiv, Zoe Alexis Hobbs Marinkovich

Doctoral Dissertations

Forty-one percent of new HIV infections are in young people between the ages of 15-24 (Masquillier, et al., 2012). In addition to new infections, advances in medications are now making it possible for children born with HIV to survive into adolescence and adulthood (Bland, 2011; Gray, 2010). Due to the growing population of youth living with HIV, there is an increased need for adolescent-appropriate care and intervention. While many studies have examined the role of education in preventing HIV transmission for HIV-negative youth in the Sub-Saharan context, few have focused on the education and experiences of young people living with …

A Factor Analysis Of The Health, Safety, And Welfare In The Built Environment Toward Interior Design As Perceived By Building Industry Professionals, Dana Marie Moody

Doctoral Dissertations

This research study created, piloted, and field tested a new instrument designed to collect perceptions toward an interior designer’s impact on the health, safety, and welfare of the public. It also established an initial profile of perceptions within building industry professionals, identified the salient factors within those perceptions, and determined the level of these factors through a factor analysis. The Health, Safety, & Welfare in the Built Environment instrument was developed using a Table of Specifications based on the subject content that interior designers must be familiar with in regards to protecting the health, safety, and welfare of the public …

The Relationship Between Self-Directedness And Health Promotion In The Elderly, Barbara L Hulsman

Doctoral Dissertations

With the number of people living longer and with more chronic problems, it is important that health educators examine who they are educating as well as the methods and circumstances of the education. The purpose of this study was to identify the relationship between self-directedness and health promotion in the elderly. A convenience sample of 108 elders who use Senior Centers in rural East Tennessee comprised the study group. The sample was asked to complete the Self-Directed Learning Readiness Scale, the Health Promoting Lifestyle Profile II, and a demographic information survey at a regular meeting of a Senior Center. A …

Unintentional Injury Content Assessment In Undergraduate Personal Health And Wellness Courses, Kiley Elizabeth Winston

Doctoral Dissertations

The purpose of this research study was to describe course content on unintentional injuries in undergraduate personal health and wellness courses at four year public and private colleges and universities identified by the Eta Sigma Gamma directory in the United States. An instrument was created, validated and tested for reliability, and used to assess course content areas related to unintentional injuries in undergraduate personal health and wellness courses. The sample for the study included 106 participants (N=106) from public and private colleges and universities in 36 states. Chi-square analysis, ANOVA, factor analysis, and MANOVA tests were used to determine if …