Medicine and Health Sciences Commons^™

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Intention To Breastfeed: Breastfeeding Attitudes, Norms, Self-Efficacy, Social Support Network And Community Resources Of African American, Low-Income, Emerging Adult Women, Pregnant For The First Time, Sara E. Brown

Theses & Dissertations

African American (AA) women continue to have the lowest rates of breastfeeding. This continues to create a health disparity even though breastfeeding is extensively recognized in the scientific and health care communities as the optimal feeding choice for infants. This study examined the relationship between the external variables (social support network and community resources) and the explanatory variables (attitudes, norms, and perceived self-efficacy) and intention to breastfeed, for the AA, first time, low-income, emerging adult pregnant woman. The Integrated Behavior Model (IBM) was used as the theoretical framework to guide this study in better understanding the variables influencing breastfeeding intention. …

Program Development And Evaluation Of A Diabetes Self-Management Education And Support Toolkit On An E-Learning Platform For Young Adults Living With Type 2 Diabetes, Marlene Eicher

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to develop and evaluate the effectiveness of a diabetes education toolkit on an e-learning platform for improving individual self-management and medication knowledge to promote healthy lifestyle behaviors for young adults living with type 2 diabetes mellitus (T2DM).

A descriptive, quasi-experimental design with one-group pretest-posttest was used. Participants were recruited from an independently owned medical clinic. The participants were English-speaking young adults, between ages 18 to 39 with a diagnosis of prediabetes or T2DM. The intervention was a DSMES toolkit with twelve e-learning modules that participants completed over a three-month period. Data collected was age …

Serving Our Students: Evidence-Based Sex Education Policies And Practices Needed In Ohio, Lily Mckenzie Rosenberg

Honors Projects

Ohio has very minimal state-wide sex education laws, requiring only venereal disease education that has many similarities with abstinence-only education. Abstinence-only education has been shown to be ineffective in delaying first sex and lowering teen STDs, pregnancy, and birth rates. When students receive ineffective (or no) sex education it can impact them in many ways, leaving them unprepared for sexual lives as adults. To analyze the state of sex education in Ohio, this paper will look at sex education throughout Ohio both in law and in practice. I will then explore the impact of these minimal sex education laws on …

Associations Between Living On The Texas-Mexico Border, Drug Use, And Sexual Behaviors Among Sexual Minority Men During The First Shelter-In-Place Order Of The Coronavirus Pandemic, Nqobile Nzama

Open Access Theses & Dissertations

Background: There have been changes in drug use and sexual behaviors among sexual minority men since the coronavirus pandemic. At this time, there is not adequate literature focusing on the state of Texas. Aims and Objective: The aims of this secondary data analysis and exploratory study are to determine associations between sociodemographic characteristics and living on the Texas-Mexico border, drug use, sexual behaviors, and use of dating/hook-up apps among sexual minority men who completed the COVID-19 & You Survey conducted between May 1, 2020 to July 31, 2020, during the first shelter-in-place order of the Coronavirus pandemic. Hypotheses: The hypotheses …

Exploring The Contextual Factors And Decision-Making Process Of Risky Sexual Behavior Among Homeless Adults In Louisville, Kentucky., Sarah C. Van Heiden

Electronic Theses and Dissertations

Homelessness is a complex public health issue; individuals who experience homelessness are said to engage in risky sexual behaviors at an increased rate and experience a higher prevalence of sexually transmitted infection (STI). While the sexual behaviors of homeless adolescents are commonly studied, little is known about the sexual behaviors of the growing population of older adults, or how they make decisions to engage in sex. Three aims guided this research: 1) to describe the sexual behaviors and sexual decision-making process of homeless older adults, 2) to examine how homeless older adults evaluate the outcomes associated with engaging in risky …

Understanding Colorectal Cancer: Increasing Screening Rates Amongst Young- And Middle-Aged Adults By Enhancing Prevention Potential, Sarah Agudelo

Nursing | Senior Theses

As nurses, working towards the best health outcomes for our patients is critical to our care. A large aspect of this care includes being knowledgeable of risk factors and precautions to take to avoid conditions and illnesses. Colorectal cancer remains to be a highly preventable disease, yet it is one of the top five leading causes of cancer deaths in the nation. Preventing colorectal cancer requires the efficient use of screening and education, while also addressing barriers of inconvenience and affordability. This senior thesis delves deeper into colorectal cancer prevention by asking the research question: For young and middle-aged adults, …

The Physiological Benefits Of A Plant-Based Diet On Cardiovascular Health, Jenevieve Petray

Nursing | Senior Theses

Cardiovascular disease (CVD) is increasingly more prevalent in today’s society and is attributed to an alarming percentage of American hospitalizations and deaths. Americans are unhealthier than ever before, and the main contributor is the Western diet. Diet is a double-edged sword that can offer benefits or detriments to one’s health. CVD encompasses numerous diagnoses originating from various underlying physiological alterations. These alterations are downstream effects of increased body weight and BMI, increased cholesterol levels, decreased insulin sensitivity and increased arterial plaque buildup. Research shows that a plant-based diet has the potential to manage and reverse all fundamental physiological alterations that …

Substance Use And Psychological Distress Correlates Of Sleep Quality Among College Students, Juanybeth Morales Ortega

Graduate Theses and Dissertations

Poor sleep quality in college students is a major problem associated with adverse health outcomes, cognitive performance, substance use, and psychological distress. Our study explored how substance use and psychological distress are associated with the sleep quality of college students. We analyzed secondary data collected in 2019 using a cross-sectional survey design. Measures included participants’ demographic characteristics, sleep quality using the Pittsburg Sleep Quality Index (PSQI), drug use, depression using the Patient Health Questionnaire-9 (PHQ-9), and suicidality. After excluding participants with missing information for sleep quality, a total of 555 students remained for the analysis. Our bivariate analysis found that …

Effects Of Abstinence-Based Sexual Education Compared To Evidence-Based Sexual Education In K-12 Schools, Lily Probst

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Historically, sexual education in the United States has been abstinence-based (ABSE), meaning that sexual education is centered around encouraging adolescents to abstain from sexual activity outside of wedlock. On the other hand, evidence-based sexual education (EBSE) includes abstinence in its curriculum but does not emphasize it, instead highlighting contraception and prevention strategies. Additionally, EBSE teaches adolescents about healthy relationships, attitudes towards sexuality, gender roles, and provides resources for sexual and reproductive health services. Supplying adolescents in K-12 schools with access to evidence-based sexual education may not only decrease teen pregnancy rates and incidence of sexually transmitted infections (STIs) but …

News Media Trust And Mistrust During The Covid-19 Pandemic, Kaitlyn Seiter

Graduate Theses and Dissertations

With the uncertainty and growing information surrounding the COVID-19 pandemic, news media consumption has increased drastically compared to pre-pandemic consumption. At the start of the pandemic, 94% of Americans reported closely following COVID-19 news, with more than half of Americans spending more than two hours consuming COVID-19 news everyday (SSRS, 2020). With the news media serving as a critical source of information through this public health crisis, the public’s reactions, behaviors, and attitudes to the pandemic stem from the level of trust they have in the news media to share COVID-19 information. Because of this, this study examines trust in …

Falls Screening In Community- Dwelling Older Adults, Hadi Kooshiar

Electronic Thesis and Dissertation Repository

Falls screening can prevent falls and their consequences. The two studies of this thesis aimed to identify the accuracy of falls screening tools and explore patient preferences and empirical validity of the self-rated Falls Risk Questionnaire (FRQ). The first study, Systematic Literature Review, found the Toulouse-St. Louis University Mini Falls Assessment and the Activities-specific Balance Confidence scale Hindi version emerged as accurate tools for predicting falls in the target population. The second study determined most of respondents, 36%, had no preference between Activities Specific Balance Confidence 6 items (ABC-6) or FRQ. The Bland & Altman approach revealed a degree of …

The Development, Short-Term Efficacy, And Pilot Implementation Of An E-Learning Course In Physical Activity And Sedentary Behaviour For Pre-Service Early Childhood Educators, Brianne Bruijns

Electronic Thesis and Dissertation Repository

The overarching purpose of this dissertation was to develop an e-Learning course in physical activity and sedentary behaviour and test its short-term efficacy and implementation among pre- and in-service early childhood educators (ECEs). The Delphi approach was adopted for Study 1, wherein a panel of international experts in physical activity and sedentary behaviour suggested topics for the course and, together with a panel of ECE experts, rated their importance. Study 2 employed a pre-post design to explore the changes in pre- and in-service ECEs’ physical activity and sedentary behaviour-related knowledge, self-efficacy, behavioural intention, and perceived behavioural control following course completion. …

Reddit And Nursing During Covid-19: A Summative Content Analysis, Julia C. Savin

Electronic Thesis and Dissertation Repository

Purpose: The purpose of this thesis was to explore what self-identified nurses discussed on the nursing SubReddit during the Covid-19 pandemic between March 2020 to May 2020.

Methods: The Hsieh and Shannon (2005) summative content analysis with emergent categorical development was used to categorize the naturalistic data.

Findings: Through analysis, six content categories were identified from the nursing SubReddit: (a) employers’ approaches to the pandemic; (b) emergency preparedness in response to the pandemic; (c) shared experiences; (d) nursing students and new graduate nurses; (e) coping; and, (f) gratitude to nurses.

Implications: (a) Leadership that is communication-focused will improve the quality …

Examining Public Health Risk Communication Via Social Media By Provincial And Local Health Authorities In Ontario During The Covid-19 Pandemic, Marc Resendes

Electronic Thesis and Dissertation Repository

Risk communication campaigns are essential during public health crises to inform the public about ways to mitigate, alleviate and manage potential risks. The purpose of this study was to describe risk communication on social media by Ontarian health authorities amid COVID-19, in addition to examining the strategies that guided their social media use. This was completed through (a) a narrative review of risk communication literature; (b) a qualitative content analysis of select health authority Twitter messaging following three major COVID-19 milestones; and (c) key informant interviews with those coordinating social media responses to COVID-19. Information giving and news updates were …

Community Health Workers And Trainers Perspectives On Education And Practice: A Qualitative Case Study In The Context Of Maternal And Child Health In Rwanda, Damilola Toki

Electronic Thesis and Dissertation Repository

Achieving global health-care goals hinges on a health workforce that is available, competent, and productive. Chronic health worker shortages impede the abilities of health systems to provide equitable services, especially in low-resource settings.

Global consensus on bridging health workforce gaps calls for alternatives such as using community health workers (CHWs) to achieve health-care aims. CHWs are laypeople who are closely connected with communities and provide frontline health services. Although CHWs are an integral part of workforces in many countries, with potential to inform global health systems, CHW programs continue to operate on the fringe and are fraught with challenges.

This …

Responding To The Pandemic: A Multicountry Study On Social-Political Factors And Health Outcomes Of Covid-19, Lan Yao

Theses and Dissertations (ETD)

Introduction. Coronavirus Disease 2019 (COVID-19) poses a major global threat to human beings, which has caused devastating consequences of population health, political, and economic crises in many countries. This dissertation was composed of three research activities to study the following aims: (1) review the existing literature focusing on political factors and health outcomes of COVID-19; (2) assess the relationship between democracy and case fatality rate of COVID-19 by controlling for the effect of age, comorbidity, health expenditure, healthcare workforce, and population density; and (3) identify the trajectory pattern cases peak days, deaths peak days, and peak periods.

Methods. We accessed …

Influence Of Political Affiliation, Distrust Of Government And Pharmaceutical Companies On Hpv Vaccination Intentions And Uptake, Alyssa Andrea Martinez

Open Access Theses & Dissertations

Background and Significance: The Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. Currently, approximately 79 million people in the United States are infected with HPV. The CDC estimates that there are nearly 31,500 cases of cancers caused by HPV each year in the United States. Cervical cancer is the most common HPV-related cancer and almost all cervical cancers are caused by a few strains of HPV. Research suggests that Latinx women residing in the U.S.-Mexico border may be at increased risk of contracting HPV types that cause cervical cancer. Although there is no …

A Program Evaluation Of Nutrition-Based Educational Modules Designed For The University Of Windsor Lancers Varsity Athletics, Justine Van Herk

Electronic Theses and Dissertations

The purpose of this program evaluation was to develop nutrition-based educational modules for the coaches and student-athletes at the University of Windsor and to investigate their effectiveness, usefulness, and applicability. The nutrition-based educational modules were a collaborative effort between the Community Health, Environment, and Wellness (CHEW) lab and the Centre for Human Performance and Health (CHPH). Eight teams voluntarily participated in the 6-week implementation period with the nutrition-based educational modules. Following this implementation period, nine participants (n = 2 coaches, n = 7 student-athletes) volunteered to provide feedback during one-on-one semi-structured virtual interviews. The interview guide was divided into …

Pre-Exposure Prophylaxis (Prep) Knowledge, Willingness To Use & Uptake Among Black Heterosexual Men, Akeen Lowell Hamilton

Theses and Dissertations

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP …

Relation Of Breastfeeding Duration With Blood Pressure And Arterial Stiffness, Lohita Kollipara, Abbi Lane-Cordova, Xuewen Wang

Senior Theses

Background: The purpose of this analysis was to investigate the effects of differing breastfeeding duration on vascular function.

Methods: A study was designed to explore the breastfeeding patterns of 79 participants who delivered a singleton fetus 6 months-3 years ago and were aged 18-45 years old. Participant breastfeeding and dietary habits were self-reported using surveys. Breastfeeding groups were established by following the American Association of Pediatric guidelines on breastfeeding duration: Women who did versus did not breastfeeding for 6 months continuously. Blood pressure was measured using a standard oscillometric cuff, while SphygmoCor® technology was used to measure pulse wave velocity. …

Evaluating The Health Impact Of Centeringpregnancy Program Versus Traditional Prenatal Care In Midland Obstetric Clinics And Validating Selected Item On Birth Certificate, Oluwatosin A. Momodu

Theses and Dissertations

The primary focus of this dissertation is to evaluate the health impact of the CenteringPregnancy (CP) program versus traditional prenatal care (TPNC) on important maternal outcomes of pregnancy. This is looked at in two outcomes-gestational weight gain (GWG) and pregnancy induced hypertension (PIH). The specific aims are to examine the: (1) effects of CenteringPregnancy program versus traditional prenatal care on gestational weight gain (GWG); (2) effects of CenteringPregnancy program versus traditional prenatal care on pregnancy induced hypertension (PIH).

Birth certificate (BC) data were linked to hospital discharge records of women who delivered in midland’s obstetric clinics of South Carolina between …

Food Choice Decision-Making Among School-Going Adolescents Amidst The Nutrition Transition In Urban Accra, Ghana, Krystal Krsna Rampalli

Theses and Dissertations

Like many countries of the world, Ghana is experiencing a nutrition transition and rising non-communicable diseases. Adolescents are susceptible to diet-related health risks as they experience significant physical and psychological changes, which are happening in tandem with food environment changes, including widespread proliferation of large portion and package sizes of energy-dense, nutrient-poor foods. Both local and multinational food and beverage companies have encouraged consumption of their products through various marketing tactics targeted directly to adolescents. Some of these tactics include the use of characters or celebrity endorsement, promotional discounts, and appeal to sociocultural values, including messages about body size preferences. …

School-Based Sex Education In The United States And Its Association With Sexual And Reproductive Health Outcomes, 2000-2020, Priscilla M. Lopez

Dissertations and Theses

Background: There are significant sexual and reproductive health disparities in the United States (US). A significant proportion of sexual health disparities among adolescents is likely due in-part to inadequate school-based sex education. Sex education encourages sustainable and informed sexual behavior and has the potential reach adolescents prior to sexual debut and throughout the years at highest risk for adverse sexual health outcomes. However, the way in which sex education is defined and operationalized, as described in the literature, varies substantially, which may lead to wide variation in implementation in schools and this might explain the disparities seen. State-level sex …

A 10-Year Post-Analysis Of The Maya Health Toolkit For Medical Providers, Lorenna Garcia-Bochas

Master of Science in Integrative Biology Theses

Researchers have often overlooked America's Indigenous community when conducting health disparities research. In Central and South America, The World Bank 2015 report identifies 774 indigenous groups living today (Davis-Castro, n.d.). One of the oldest known is the Maya people. The Maya have been through various cultural struggles, from the Spanish conquistadors of the past to current anti-indigenous discrimination, violence, and rhetoric. The historical conflict and prejudice have contributed to why many Maya migrate north to the United States for a better opportunity and a more peaceful life for their families. In doing so, they face many health risks to their …

Focused Ethnography: Storytelling For Hispanics With Low Health Literacy And Diabetes, Virginia H. Cadenhead

Nursing Theses and Dissertations

Background: Storytelling is an intervention for health communication that has many forms, addresses varied health issues, and is suitable for low health-literate populations. Storytelling can impact knowledge, behaviors, attitudes, and health outcomes. Population Focus: Fictional storytelling has not been researched as an educational adaption in diabetes self-management for Hispanics with low health literacy. Forty-one percent of Hispanics in the United States have low health literacy, a contributing factor to poor health outcomes in chronic disease management. The Hispanic population has disproportional rates of diabetes complications. Research Question: How can short, fictional, orally presented stories be developed as culturally-adapted educational tools …

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 …

Guiding Change: A Multidisciplinary Framework For Interventions Addressing Systemic Racism In Healthcare, Lavette D. King

Master's Projects and Capstones

The relationship between systemic and institutional racism in the U.S., and health outcomes in people of the African Diaspora have been well documented (Bailey et al., 2017). Distrust in the healthcare system is the result of generational trauma compounded by an ongoing issue that has yet to be fully addressed (Scharff et al., 2015). For decades people of African descent have expressed concern about negative experiences with the U.S. healthcare system. Often the encounters leave them feeling, mistreated, unheard and or criminalized. These feelings result in trepidation over using the healthcare system which often further compounds health issues (Washington, 2008). …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

Translation And Validation Of The Spanish Version Of The Quality Of Life Inventory For Adolescents (Qolie-Ad-48), Perla Michelle Martinez

Open Access Theses & Dissertations

Background: In 1999, an instrument was developed to assess quality of life (QoL) among adolescences with epilepsy. To our knowledge there is not a validated Spanish version of this questionnaire. There is a gap in the literature about QoL and epilepsy among speaking Spanish populations. Objectives: 1) To conduct an English-Spanish translation of the QOLIE-AD-48; 2) to evaluate the reliability of the Spanish version of the QoLIE-AD-48; and 3) to assess the validity of the Spanish version of the QoLIE-AD-48. Method: Phase 1 translation: Methods followed the published work of Sousa and Rojjanasrirat (2010). Phase 2 Pilot study: the sample …