Medicine and Health Sciences Commons^™

Healthcare Access And Utilization By Transgender Populations: A United States Transgender Survey Study, Axenya Kachen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Transgender communities in the United States are highly marginalized and have been systematically and infrastructurally ignored due to the widespread fundamental belief that gender exists as a binary classification. The dichotomous theoretical framework of sex and gender prevented public recognition of this community as a population of interest for public health research and targeted intervention. Sexual and gender minority (SGM) populations have fought for basic human rights, including access to affordable healthcare. The National Center for Transgender Equality (NCTE) was founded in 2003 to advocate for the advancement of equality for transgender people. In 2015, the NCTE conducted the United …

The Medicalization Of Sleeplessness: Results Of U.S. Office Visit Outcomes, 2008-2015, Mairead Eastin Moloney, Gabriele Ciciurkaite, Robyn Lewis Brown

Sociology Faculty Publications

Previous analysis of U.S. physician office visits (1993–2007) indicated that the medicalization of sleeplessness was on the rise and had potentially negative implications for population health. Our study asks if the medicalization of sleeplessness at the level of patient-physician interaction has persisted over time. Using the most recent years available (2008–2015) of the National Ambulatory Medical Care Survey we calculated nationally representative estimates for four sleeplessness-related outcomes of physician office visits: sleeplessness complaint, insomnia diagnosis, and prescription of benzodiazepine and non-benzodiazepine sedative-hypnotics (NBSH). To test for the significance of the linear trajectory, we ran a series of bivariate linear models. …

Older Adults’ Expectations, And Knowledge Of Oral Health Issues: A Study Of Arkansas Seniors, Virginia Marie Hardgraves

Graduate Theses and Dissertations

The life expectancy of the U. S. population is increasing. The advantages of fluoridated water, dental insurance, greater awareness of preventive oral healthcare measures, and more restorative dental services, have helped this generation of adults maintain their teeth into their advanced years. The demand for oral health care services will be greater and more complex that of previous generations. Challenges for the older adult, and the healthcare system providing for them, are complex. Increasing evidence of a link between oral health and overall health underscores the need to promote public health awareness of the need for dental care to be …

Implicit Bias And The Boundaries Of Belief: A Single-Representational Dual-Attitude Account Of Implicit Attitudes, Austin Dakota Synoground

Graduate Theses and Dissertations

Since their inception, implicit attitudes have been defined as associative mental states, separate from beliefs, which are considered to be propositional in nature. Recently, several philosophers have challenged this distinction, arguing that implicit attitudes are actually unconscious beliefs. In turn, I argue that the attitudes detected by current experimental paradigms are blind to distinctions between implicit attitudes, which I define as the products of an associative learning mechanism, and unconscious beliefs, which are the products of a propositional learning mechanism. Specifically, I argue for a single-representational dual-attitude account of implicit bias.

Por Ahí Dicen: Sexual Health Promotion Campaign In A Puerto Rican Community, Isabella M. Antenucci, Yessica Guzman, Phillip Granberry, Maria Idali Torres

Gastón Institute Publications

The purpose of this study was to assess Puerto Rican mother’s levels of exposure to the Spanish media campaign launched by Por Ahi Dicen, and to assess the identification mothers had with these stories. The methodology consisted of in-person survey interviews of 210 Puerto Rican mothers residing in the city of Springfield, Massachusetts. The study used a sub-set of data taken from these interviews and analyzed using Microsoft Excel and Stata15. The major finding of this study showed that the mothers who regularly watched television in the 90-day campaign time frame were more exposed to the campaign than they were …

How Does Alcohol Intoxication Impair Risk Detection Of Sexual Assault? Testing An Integration Of Alcohol Myopia And Social Information Processing Theories, Alexander James Melkonian

Graduate Theses and Dissertations

Sexual assault among young adults is a highly prevalent public health concern. Alcohol is often implicated as a risk factor for sexual assault through its impairing effects on an individual’s ability to process and respond to social cues in the environment. The effect of alcohol myopia can result in greater focus of attention on salient environmental cues. The relationship between alcohol intoxication and resulting behavior may depend on what type of information is most salient. The current study examined the effects of alcohol on social information processing as it relates to sexual assault risk detection. Method: Participants were 48 young …

Childhood Sexual Abuse: The Truth Behind The Trauma, Alexandra Punch

Population Health Research Brief Series

There are many misconceptions about coping behaviors, laws, and regulations that make coming forward difficult and painful. This issue brief discusses the hurdles for child victims of sexual assault and the initiatives taking place across the country to combat stereotypes and bring justice to children and their families.

Same-Sex Sexual Coercion Among Women: The Impact Of Minority Stress On Perpetration And Victimization Experiences Of Women Of Diverse Sexual Identities, Allison Kirschbaum

Dissertations

The purpose of the current study was to investigate women’s experiences with same-sex sexual coercion perpetration and victimization. Specifically, I sought to explore the role that the stress of living as a sexual minority plays in these experiences as well as to determine whether the psychological variables of perceived powerlessness, psychological distress, social support, and alcohol use mediate the relationship between minority stress and perpetration and victimization experiences. Data were collected online from self-identified women and individuals assigned female at birth who reported experiencing genital sexual contact with another woman (N=339). Of the cisgender women in the sample, 31.6% reported …

An Interpretative Phenomenological Analysis Investigating Uk Female Experiences Of Psychosocial Adjustment Following Bariatric Surgery, Mark J. Maxwell

The Qualitative Report

The psychosocial impact of bariatric surgery has not been studied as diligently as the physical impact, particularly within the first 6 months following surgery. The aim of the present study was to explore psychosocial adjustment in UK bariatric candidates within this time-scale. Six female participants were purposively recruited to complete a semi-structured interview, and Interpretative Phenomenological Analysis was used to analyse their experiences. Four super-ordinate themes emerged from the interview data which were: (1) "It was me but it wasn’t me": pre-surgery identity, (2) "I don’t see myself as this fat blob of a person anymore": transforming identity, (3) "No …

Black Women’S Wellbeing: The Intersections Of Race, Immigrant Status, And Mental Health Among African Diasporan Women In Houston, Texas, Sianneh Vesslee

African American and Africana Studies Summer Fellows

My central research question is: how has white supremacy impacted African Diaspora women’s mental health, access to mental healthcare, and identities as mental health patients in the United States as discernible in advertisements and state policies for psychological wellness? More specifically, I will investigate whether and/or how white supremacy shapes the ways in which advertising and state policies for mental healthcare address the particular needs of black women who immigrate to Houston, Texas from Lagos, Nigeria and Coahuila, Mexico. I choose those geographies because Houston is a U.S. city with one of the highest populations of black immigrants from Nigeria …

Understanding Opioid Users’ Views On Fentanyl Could Help Reduce Overdoses, Kate Mclean, Shannon M. Monnat, Khary Rigg, Glenn Sterner, Ashton Verdery

Population Health Research Brief Series

The opioid overdose crisis is a national public health emergency, made much worse in recent years by the widespread emergence of fentanyl – a highly potent synthetic opioid. This research brief summarizes the findings from their research conducted in southwestern Pennsylvania in 2017 and 2018. Results show that the majority of interviewees who use opioids are fearful of and want to avoid fentanyl and would utilize harm reduction strategies such as fentanyl test strips if they were made more widely available.

Structural Racism And Odds For Infant Mortality Among Infants Born In The United States 2010, Roman Pabayo, Amy Ehntholt, Kara L. Davis, Sze Yan Liu, Peter Muening, Daniel Cook

Department of Public Health Scholarship and Creative Works

Abstract

OBJECTIVES:

While ecological studies indicate that high levels of structural racism within US states are associated with elevated infant mortality rates, studies using individual-level data are needed. To determine whether indicators of structural racism are associated with the individual odds for infant mortality among white and black infants in the US.

METHODS:

We used data on 2,163,096 white and 590,081 black infants from the 2010 US Cohort Linked Birth/Infant Death Data Files. Structural racism indicators were ratios of relative proportions of blacks to whites for these domains: electoral (registered to vote and voted; state legislature representation), employment (civilian labor …

Getting Change-Space: A Grounded Theory Study Of Automated Ehealth Therapy, Marianne T. S. Holter, Ottar Ness, Ayna Johansen, Håvar Brendryen

The Qualitative Report

A promising tool for bettering people’s health is eHealth (or “mHealth”) programs: fully automated, web-based health interventions. However, we know surprisingly little about eHealth’s working mechanisms. One possible working mechanism is that program users benefit from a collaborative “relationship”—a “working alliance”—with the program. Although evidence support the existence of a person-to-program alliance it is unclear if and how it influences change. Therefore, we conducted a grounded theory study of how relating to an eHealth program for quitting smoking influenced the participants’ change processes. The ensuing model focuses on how participants got change-space—feeling free from social forcing and able to work …

A Legacy Of Disease, Arthur L. Frank

Journal of Appalachian Health

In Appalachia, like much of America, there are important health issues that have not always been appropriately predicted or dealt with when they occur. Lifestyle issues in Appalachia lead to obesity and heart disease, not surprisingly due to extensive use of sugary drinks. The current opioid crisis could have been better predicted given the trauma of mining and the past abuse of less-potent narcotics. A continuing major problem in the whole country is inadequate support for preventive health activities.

Using Mini-Grants To Build Multi-Sector Partnerships In Rural Tennessee, Ginny Kidwell, Kristine Bowers, Taylor M. Dula, Randolph F. Wykoff

Journal of Appalachian Health

Rural counties in Tennessee, including those located in Appalachia, face some of the greatest health challenges in the nation. Unpublished data collated by the East Tennessee State University College of Public Health (ETSU) show that Tennessee’s 52 Appalachian counties vary dramatically from its 43 non-Appalachian counties in virtually all socioeconomic, behavioral, and health outcome metrics. Since 2011, the Tennessee Institute of Public Health (TNIPH) has actively encouraged local communities to address behavior change, enhance educational achievement, and improve economic conditions as essential components for improving health and well-being in rural Tennessee.

Improving Access To Addiction Recovery Care In Central Appalachia Through Organizational Collaboration, Katy Stigers

Journal of Appalachian Health

Fahe, a Network of 50+ members throughout Appalachia based in Berea KY, has brought together a coalition to finance, build, and manage several addiction recovery care centers across Kentucky and West Virginia, increase access to employment, and deploy vouchers for supportive services.

Disparities In Quality Of Life By Appalachian-Designation Among Women With Breast Cancer, Robin C. Vanderpool, Ann L. Coker, Heather M. Bush, Sarah E. Cprek

Journal of Appalachian Health

Introduction: Few studies have examined the association of geography and quality of life (QOL) among breast cancer patients, particularly differences between Appalachian and non-Appalachian Kentucky women, which is important given the cancer and socioeconomic disparities present in Appalachia.

Purpose: The purpose of this study was to determine whether women with breast cancer residing in Appalachian Kentucky experience poorer health outcomes in regards to depression, stress, QOL, and spiritual wellbeing, relative to those living in non-Appalachian Kentucky after adjusting for demographic, socioeconomic, and health-related factors.

Methods: Women, aged 18–79, recruited from the Kentucky Cancer Registry between 2009 and 2013 with an …

West Virginia’S Sugary Drink Tax: Examining Print Media Frames In Local News Sources, Lauri Andress, Ogaga Urhie, Christine Compton

Journal of Appalachian Health

Introduction: Framing is an important aspect of the policy process that helps the public and decision makers sort through and resolve highly charged claims about an issue. Through slight changes in the presentation of issues, a framing effect may alter public support. The way a proposed sugary drink tax is discussed in public discourse and by the media significantly influences policy acceptance. Given the public health significance of obesity and diabetes in West Virginia (WV) the study of media frames employed to represent a sugary drink tax policy is useful.

Methods: Using quantitative content analysis, this study assessed news articles—published …

Investigating The Impact Of The Diseases Of Despair In Appalachia, Michael Meit, Megan Heffernan, Erin Tanenbaum

Journal of Appalachian Health

Introduction: Appalachia is one of the regions most significantly impacted by the opioid crisis. This study investigated mortality due to diseases of despair within the Appalachian Region, with an additional focus on deaths attributable to opioid overdose.

Methods: Diseases of despair include: alcohol, prescription drug and illegal drug overdose, suicide, and alcoholic liver disease/cirrhosis of the liver. Mortality data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) Multiple Cause of Death database were analyzed for this study, focusing on individuals aged 15–64.

Results: Over the past two decades, the mortality rate due to diseases of …

Root Causes Of Appalachia’S Deaths Of Despair, F. Douglas Scutchfield Md

Journal of Appalachian Health

The U.S. is experiencing a decline in life expectancy, particularly among rural white males in their most productive years. Appalachia is disproportionally represented in mortality rates, accounting for 30% of the U.S. population, but 50% of the excess mortality attributed to the “deaths of despair”: drug overdose, suicide, and alcoholic cirrhosis. A substantial proportion of that excess mortality is related to the current opioid crisis we are experiencing. We have data on evidence-based solutions to the treatment of addiction, but little information on prevention of addiction as well as the other deaths of despair, likely with the same etiologic agent. …

Widow Narratives On Film And In Memoirs: Exploring Formula Stories Of Grief And Loss Of Older Women After The Death Of A Spouse, Jennifer R. Bender

USF Tampa Graduate Theses and Dissertations

This dissertation analyzes narratives (written and mediated) about widows’ post-loss experiences—specifically the ways in which these women embody and adjust/adhere to their post-loss widow identities—and whether or not the canonical/formula stories about widows reflect current experiences of widowhood. I look at older widowed women—both those in well-read widow memoirs and also in media portrayals of widows on film. The canonical view of widows as not attractive, not useful, and not interesting needs to be reexamined in light of changing ideas about gender roles and increased longevity. Surely older women have experiences, desires, and goals that encompass more than being socially …

Ua35/8 Reveille, Vol. 27, No. 1, Wku Veterans Upward Bound

WKU Administration Documents

Newsletter created by and about WKU Veterans Upward Bound.

• Veterans Administration Community Suicide-Prevention Challenge
• RallyPoint
• PsychArmor Institute
• Explore VA.gov to Learn About Your Benefits
• Stone, Davy. The Director's Desk - Michelle Shutt

What Parents Value Matters: Examining The Association Between Cultural Values, Parenting Styles/Practices, And Child Outcomes, Chen-Yun Wang

Theses and Dissertations

Researchers have identified significant relationships between parenting styles and child outcomes. However, these associations might vary in different cultures because parenting behaviors could link to cultural values. Additionally, understanding the cultural values of parents would help researchers better understand the reasons of parents’ behaviors. Therefore, the purpose of this study was to examine the relationships between parental Asian values, parenting styles, parenting practices, and child outcomes. Parents of preschool-age children (N = 273) from Taiwan completed a series of parenting values and parenting behaviors questionnaires. Teachers rated child prosocial behaviors, modesty, sociability, and impulse control. Results revealed that some domains …

Racial And Ethnic Disparities In Stroke Outcomes: A Scoping Review Of Post-Stroke Disability Assessment Tools, Suzanne Perea Burns, Brandi M. White, Gayenell Magwood, Charles Ellis, Ayaba Logan, Joy N. Jones Buie, Robert J. Adams

Health and Clinical Sciences Faculty Publications

Purpose: To identify how post-stroke disability outcomes are assessed in studies that examine racial/ethnic disparities and to map the identified assessment content to the International Classification of Functioning, Disability, and Health (ICF) across the time course of stroke recovery.

Methods: We conducted a scoping review of the literature. Articles published between January 2001 and July 2017 were identified through Scopus, PubMed, CINAHL, and PsycINFO according to predefined inclusion and exclusion criteria.

Results: We identified 1791 articles through database and hand-searching strategies. Of the articles, 194 met inclusion criteria for full-text review, and 41 met inclusion criteria for study inclusion. The …

The Mother Domain: A Mediated Model Of Maternal Gatekeepers And Depressed Fathers Among Newlyweds With Children, Clare R. Thomas

Theses and Dissertations

Paternal depression is an understudied topic and research connecting it to maternal gatekeeping is still in its infancy. Research has found that the marriage relationship can be associated with both depression and maternal gatekeeping. This study focuses on how these three areas are related. A subsample of the CREATE project was used including 216 couples, or 432 married parents. Two separate SEM mediational models were tested to examine father depression as a predictor of maternal gatekeeping, with marital instability as the mediator in one model and partner connectedness as the mediator in the other model. Both parent reports were used …

Coding Rupture Indicators In Couple Therapy (Crict): An Observational Coding Scheme, Annalisa Ward Carr

Theses and Dissertations

The therapeutic alliance, a construct representing agreement and collaboration on therapy goals, therapy tasks, and the emotional bond between client(s) and therapist, is a robust predictor of therapy outcomes in individual, couple, and family therapy. One way to track the therapeutic alliance is through ruptures and repairs. Ruptures are breaks, tensions, or tears in the therapeutic alliance. Ruptures and repairs influence the therapeutic alliance and consequently therapeutic outcomes. Currently, there is a lack of research addressing ruptures and repairs in couple therapy. The first step in researching alliance ruptures is to have a reliable way to assess alliance ruptures. This …

Social Withdrawal And Indices Of Adjustment And Maladjustment In Adolescence: Does Parent Warmth And Extraversion Matter?, Mallory Abigail Millett

Theses and Dissertations

Social withdrawal is often associated with a number of indices of adjustment and maladjustment, but little research exists that attempts to uncover potential protective factors. This study longitudinally examined the moderating role of parent extraversion and parent warmth on the association between two types of social withdrawal (shyness and unsociability) and later indices of adjustment and maladjustment. Participants were 463 families from the flourishing families project. Results showed no longitudinal associations between social withdrawal and later indices of adjustment or maladjustment. However, when parent extraversion was added as a moderator, shyness was positively associated with prosocial behavior for those with …

Prevalence And Correlates Of Diagnosed And Undiagnosed Hypertension In The Indigenous Kuna Population Of Panamá, Daniel R. Hanna, Rebekah J. Walker, Brittany L. Smalls, Jennifer A. Campbell, Aprill Z. Dawson, Leonard E. Egede

Center for Health Services Research Faculty Publications

Background: To determine the prevalence of hypertension and investigate sociodemographic correlates in an indigenous Kuna community living on the San Blas islands of Panama.

Methods: Data was collected from adults using a paper-based survey using a cross sectional study design. Blood pressure was measured, and hypertension defined at two cut-points: 130/80 mmHg and 140/90 mmHg. Individuals with undiagnosed hypertension had a blood pressure measurement that indicated hypertension, however, the individual had not been told by a doctor they had hypertension. Whereas individuals with diagnosed hypertension had been told by a healthcare provider that they had hypertension. Univariate tests compared diagnosed …

Is Intimate Partner Violence A Risk Factor For Cardiovascular Disease In Women? A Review Of The Preponderance Of The Evidence, Rose Eva Constantino, Alona D. Angosta, Andrew Thomas Reyes, Brayden Kameg, Linden Wu, Jordan Cobb, Vivian Hui, Daisy Palompon, Reema Safadi, Mayada Daibes, Elizabeth Schlenk

Nursing Faculty Research

This paper examines the relationship between intimate partner violence (IPV) experience in women and cardiovascular disease (CVD), and determines if there is a preponderance of literature evidence. Research is reviewed dealing with the different biopsychosocial factors affecting the relationship between IPV and CVD. As a result of our review, we propose a framework on the biopsychosocial pathway of IPV as a risk factor of CVD of women. Our proposed framework portrays how IPV experiences contribute to long-term biopsychosocial changes that increase the risk of CVD among female victims of IPV. These biopsychosocial changes include chronic inflammation and hypothalamus-pituitary-adrenal axis dysfunction, …

There Are Multiple And Geographically Distinct Opioid Crises In The U.S., Shannon M. Monnat

Population Health Research Brief Series

Rates of fatal drug overdose increased 250% in the U.S. between 1999 and 2017, due in large part to a massive surge in overdoses involving opioids. However, there is substantial geographic variation in fatal opioid overdoses, and prescription opioids, heroin, and fentanyl are differentially responsible for high overdose rates across different parts of the U.S. This research brief summarizes the findings from a study just published in the American Journal of Public Health. The study shows that there are at least four geographically distinct opioid overdose crises in the U.S.