Medicine and Health Sciences Commons^™

Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau

Theses and Dissertations

Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …

The Influence Of Flavor On The Abuse Liability Of A Heated Tobacco Product And Its Feasibility As A Menthol Cigarette Substitute, Augustus White

Theses and Dissertations

Heated Tobacco Products (HTPs) purport to expose people that use cigarettes to fewer of the harmful or potentially harmful constituents of tobacco while still delivering reinforcing amounts of nicotine (Auer, Concha-Lozano et al., 2017). An exemplar of the HTP class, IQOS, and its three varieties of “HeatSticks” have been authorized by the Food and Drug Administration (FDA) as “Modified Risk Tobacco Products” (MRTP). However, as the FDA is planning to ban menthol as a characterizing flavor in cigarettes, questions remain regarding whether characterizing flavors should be permitted in HTPs (FDA, 2022e). New evidence regarding HTP abuse liability (i.e., the likelihood …

Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose

Theses and Dissertations

This study utilized a mixed methods emergent, phenomenological approach to (1) understanding the lived experience of freezing of gait for individuals diagnosed with Parkinson’s Disease and (2) determining the role of anxiety and sleep in freezing of gait outcomes. Participants included 13 adults diagnosed with Parkinson’s Disease (N=14 for qualitative data, N=13 for quantitative data; 23.1% female-identifying, 76.9% male-identifying) who were predominantly white (92.3%) with an average age of 69 years (SD = 6.73 years). Data collection consisted of semi-structured interviews, self-report measures, actigraphic sleep data, and salivary alpha amylase biomarker collection. Results are organized into …

Does What Doesn’T Kill You Make You Stronger? Examining The Effects Of Resilience And Functional Outcomes On Post-Traumatic Growth In Adults With Acquired Disability, Dominique Renee Ghirardi M.S.

Theses and Dissertations

Disabilities acquired in adulthood are often unexpected and disruptive because a loss of functioning can affect one’s ability to maintain employment, pursue their interests, and participate in social activity without assistance or accommodation. This is especially true for those who experience a life-altering injury or develop a chronic health condition between the ages of 18 and 64, as they likely have not planned for the financial and social adjustments that life with a disability involves. However, factors such as post-traumatic growth can reveal the extent to which someone experiences personal growth and improvement in the wake of a traumatic and …

Sun Protection Behaviors And Skin Cancer Risk Among Children Of Color, Williana Magloire

Theses and Dissertations

Sun protection is beneficial for children of color as it decreases the risk for sunburns, hyperpigmentation, and most importantly, skin cancer. Invasive melanoma is commonly seen in children of color due to inadequate sun protection. Parental and caregiver modeling of sun protection behaviors may decrease the likelihood of skin cancer among children of color. The American Academy of Pediatrics (AAP, 2011) has suggested that pediatricians adopt the role of informing parents about the benefits of using sun protection products for their young children. They recommended that providers discuss sun protection behaviors with both the parent/child beginning at the age of …

The Relationship Between Parental Trauma History And Perceptions Regarding Their Child’S Healthcare And Utilization Of Healthcare Services, Krishna Patel

Theses and Dissertations

Abstract

TITLE: The Relationship Between Parental Trauma History and Perceptions Regarding Their Child’s Healthcare and Utilization of Healthcare Services

Adverse child events (ACEs) have been associated with a number of physical and mental health problems and have also been linked to increased health care utilization. While parents who have an ACE history may tend to seek healthcare services for themselves, limited studies have examined the impact of their trauma history on seeking healthcare services for their child. Healthcare utilization may also depend on the parents’ level of health anxiety, as well as their anxiety about their child’s health status. This …

Tailoring Digital Physical Activity Support Messages For Women In Midlife With Elevated Risk For Cardiovascular Disease: A Multicomponent Study, Kiri Baga

Theses and Dissertations

Women in midlife (ages 40-60) are at heightened risk for cardiovascular disease (CVD). Although physical activity (PA) engagement can reduce CVD risk, few women engage in sufficient PA to receive this benefit. They cite lack of social support as a key barrier, but existing interventions that employ social support show limited effectiveness. Digital PA support messages (i.e., brief, text-based messages delivered via smartphone or other device) may be a powerful method to meet social support needs in daily life. However, women’s preferences for and responses to distinct types of messages are not well understood. The aim of this study was …

Awareness, Acceptance, And Equanimity: Relationships Between Trait Mindfulness, Stress, And Blood Pressure, Gabrielle Renee Chin

Theses and Dissertations

Hypertension (HTN) is associated with stress and unhealthy emotion regulation. Mindfulness-based interventions (MBIs) are said to help address stress-related diseases like cardiovascular disease by impacting stress and emotion regulation, yet studies of MBIs on cardiovascular health show inconsistent findings. Limited research has examined the basic links between trait mindfulness and cardiovascular health, leaving the active components of MBIs in this context unclear. Therefore, the current study examined the relationship between trait mindfulness and blood pressure (BP) in individuals with pre-hypertension (pre-HTN). Latent variables representing two conceptualizations of trait mindfulness -Monitor and Accept Theory (MAT) and Equanimity- were calculated using facets …

Using Music To Modify Step-Rate And Running Biomechanics In Healthy Runners, Erin Marie Lally

Theses and Dissertations

Context: Running-related injury (RRI) is a significant public health issue that may be caused by injurious running biomechanics. Increasing step-rate (SR) using gait retraining may prevent and treat RRI. The Optimizing Performance Through Intrinsic Motivation and Attention for Learning (OPTIMAL) theory indicates enhanced expectancies, autonomy, and external focus of attention will optimize motor learning. Music has been shown to create enhanced expectancies, can provide incidental choices (autonomy), directs attention externally, and may increase compliance. No studies have investigated if music can be used to alter SR and running biomechanics or strategies that may improve compliance to gait retraining. Objective: The …

Establishing Validity And Preliminary Clinical Utility Of A Behavioral Economic Measure Of Social Risk Discounting For Health Behaviors, Connor A. Burrows

Theses and Dissertations

The COVID-19 pandemic has been the most profound public health emergency of the past several decades and the United States has faced numerous challenges with the timely adoption of mitigating health behaviors. Sustained ambivalence surrounding perceptions of public health recommendations of social distancing, mask wearing, and timely vaccination remain a barrier to slowing the spread of the virus years after its initial onset. Behavior analysis and behavioral economics offer compelling theoretical and quantitative models for framing the relationship between behaviors that are aversive in the short term but beneficial for individual and public good in the long term. The present …

Assessing The Correlation Between The Socioeconomic Level And Cognitive Function Among Older Adults In Egypt, Macy Abougabal

Theses and Dissertations

The number of older adults is increasing worldwide at an unprecedented rate. Some countries began to understand the challenges of aging, while others are still at the stage of comprehending the true dimensions of the situation. There is a global focus on aging research to appropriately mitigate the negative impact of aging and cognitive decline. Not only that dementia add economic pressure on governments, it also increase the psychological and physical burden of the caregivers. Scholars have previously studied socioeconomic level in three variables, namely work, education, and income, and their relationship with cognitive function. It was concluded that the …

The Impact Of A Parent-Only Pediatric Obesity Intervention Program On Quality Of Life In Racially Diverse Children, Taylor Vashro

Theses and Dissertations

Pediatric obesity has been associated with significant decrements in pediatric quality of life (QOL) comparable with severe pediatric diseases such as cancer. Parenting interventions have yielded health benefits for children with obesity; however, few studies have investigated the impact of parent-focused interventions on QOL in children with overweight and obesity. This study investigated the impact of a 6-week intensive parenting intervention program on the QOL of 5-12 year old, predominantly Black children with overweight and obesity. Parents were randomized into either the parenting intervention (NOURISH+) or a control group, and QOL, as well as variables related to child and parenting …

Addressing Death Distress In Caregivers Of Patients With Malignant Glioma, Kelcie D. Willis

Theses and Dissertations

The field of psychosocial oncology seeks to improve the quality of life of patients and families affected by cancer. This task becomes increasingly important when there are limited, non-curative treatment options, a high probability of recurrence, and rapid functional decline, such as in the case of a malignant glioma (MG). Indeed, the diagnosis of a MG is associated with negative sequalae that often translates to higher caregiver burden. Caregivers—who must manage the functional decline of the patient, changes within the family, and a complicated medical system—often feel overwhelmed, isolated, and ill-equipped to handle these myriad responsibilities. While they also report …

Assessing The Relationships Between Direct And Vicarious Exposure To Healthcare Discrimination And Erasure, Mistrust In Healthcare, And The Healthcare Utilization Behaviors Among Transgender And Gender Independent Individuals, Kyle L. Mason

Theses and Dissertations

Healthcare inaccessibility through direct exposure (i.e., personal) to myriad forms of gender identity-related discrimination and erasure among the Transgender and Gender Independent (TGI) population has been documented by prior studies. The myriad barriers that individuals who embody TGI identities encounter to accessing healthcare are associated with the underutilization of healthcare, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of the harm that direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, their exposure to such harm vicariously (i.e., through observation …

Effectiveness Of Cognitive Behavioral Therapy Versus Therapeutic Play For Hospitalized Children Diagnosed With Cancer: An Integrative Systematic Review, Dianne Kong

Theses and Dissertations

Psychotherapy provides essential coping mechanisms and strategies for children who are diagnosed with cancer, as they experience the extraordinary burden of physical, emotional, and mental strains. While many medical advancements have been made within the past few decades, progress related to psychotherapy for pediatric cancer patients has not been commensurate, evidenced by the limited current literature. Given the sparsity of relevant research, it is presently difficult to compare and evaluate the various psychotherapeutic interventions available for pediatric oncology patients. Additionally, there are significant challenges in providing psychotherapeutic care for patients and their families, including lack of consistency, disruption of care, …

The Heads-Ed: A Psychosocial Screening For Pediatric Patients In Emergency Departments: A Systematic Review, Jessica Burns

Theses and Dissertations

The rates of mental health (MH) conditions among the pediatric population are rising steadily (Abramson, 2022; Clark et al., 2019). Given that MH symptoms and concerns frequently present in the emergency department (ED)-particularly since the onset of the COVID-19 pandemic-the ED setting may be a practical and effective setting to implement screening measures to identify youth at risk for mental illness and suicide (Leeb et al., 2020; Leff et al., 2021). This integrative systematic review examined the extent to which the HEADS-ED, one specific psychosocial screening measure, has been administered in the ED setting with youth and which healthcare professionals …

The Use Of Dance And Movement For The Embodied Healing Of Interpersonal Trauma In Women And Girls: A Systematic Review, Catherine Xinyu Liang

Theses and Dissertations

Interpersonal trauma is a serious and devastating problem for women and girls from all walks of life. Research has shown that there are physiological consequences for experiencing trauma, and as such, treatment for trauma may need to target the body. Dance/Movement Therapy (DMT) has been emerging in the current literature as one body-oriented treatment approach that is effective in helping women and girls heal from interpersonal trauma. This review examines how practitioners are currently using DMT for this population, what treatment outcomes have been observed, and what the racial/ethnic identities and international contexts are for survivors who have benefited from …

Experiences And Perceptions Of Bilingual Spanish-English Latinx Clients And Bilingual Spanish-English Latinx Therapists In Psychotherapy: A Systematic Review, Irvin I. Navarrete

Theses and Dissertations

As the bilingual Spanish-English Latinx population in the United States increases, so will the need for culturally and linguistically competent mental health therapists. While past research has focused on providing culturally competent care, the role of language in the process of psychotherapy has received limited attention. This study aimed to comprehensively analyze the existing literature on bilingual Spanish-English Latinx clients’ and bilingual Spanish-English Latinx therapists’ experiences and perceptions within a bilingual psychotherapy setting and identify recommendations to enhance language proficiency. A systematic review was conducted and identified nine studies for inclusion. Results highlight seven themes focusing on bilingual Spanish-English Latinx …

Impact Of Teacher Cognition On The Implementation Of Social- Emotional Learning Practices For El Students, Madeline Bliske

Theses and Dissertations

There is a well-established achievement and graduation rate gap between English Learner (EL) students and their monolingual English-speaking peers (U.S. Department of Education, 2020). The current study focuses on teacher cognition and characteristics that may impact the likelihood that they will implement culturally and linguistically sustaining (CLS) social-emotional learning (SEL) practices for EL students within their classroom. Specifically, I descriptively analyze whether personal, professional, or school characteristics are associated with teachers’ perception of EL students SEL competencies or implementation of CLS SEL practices. Utilizing the Theory of Planned Behavior (TPB), I evaluate whether teacher cognition (i.e., behavioral attitudes, subjective norms, …

An Interpretative Phenomenological Analysis Of The Lived Experience Of Parental Caregivers For Children With Severe Epidermolysis Bullosa, Michael J. Valentine

Theses and Dissertations

Providing care to child with a chronic, rare diseases has been identified as a major life stressor with a myriad of negative physical and mental health consequences. These stresses have previously been found to create burden that may impair caregiving efforts and increase the risk of mortality for both the caregiver and affected child. Many rare diseases affect children. It is not known how caregiver burden and the source of stress varies by disease. Qualitative methods have been used to understand caregiver experience with the rare disease, epidermolysis bullosa (EB), but no such studies have occurred in the United States. …

Parenthood Orientation Among Young Women: Is It Associated With Pregnancy Intention And Unprotected Intercourse?, Nakeisha Blades

Theses and Dissertations

This study explored relationships between parenthood orientation, pregnancy intention, and unprotected intercourse. Nulligravid, sexually active women aged 18-29 (N = 252) were surveyed on these topics in May 2019. There were significant differences in parenthood orientation by past and current pregnancy intention. Higher scores on parenthood orientation were associated with increased odds of past unprotected intercourse and expecting future unprotected intercourse. Only education and contraceptive self-efficacy retained significance in adjusted models. Study results are consistent with prior work on parenthood orientation and pregnancy intention and point to other factors as stronger correlates of contraceptive use.

Testing Models Of Context-Dependent Outcome Encoding In Reinforcement Learning, William M. Hayes Iv

Theses and Dissertations

Previous studies of reinforcement learning (RL) have established that choice outcomes are encoded in a context-dependent fashion. Several computational models have been proposed to explain context-dependent encoding, including reference point centering and range adaptation models. The former assumes that outcomes are centered around a running estimate of the average reward in each choice context, while the latter assumes that outcomes are compared to the minimum reward and then scaled by an estimate of the range of outcomes in each choice context. However, there are other computational mechanisms that can explain context dependence in RL. In the present study, a frequency …

A Technology-Based, Mixed Methods Approach To Examining The Psychosocial Determinants Of Maternal Health Disparities, Hannah M. Ming

Theses and Dissertations

Background: Exposure to racism and discrimination in the U.S. increases Black women’s risk for experiencing maternal health disparities. Additionally, racism and discrimination affect maternal psychosocial well-being, creating evidence for a biopsychosocial relationship between racism and maternal health outcomes. However, current research does not define the psychosocial Black maternal self well. Given the dynamic relationship between racism, psychosocial well-being, and Black maternal health outcomes, research must comprehensively examine the Black maternal self. The operationalization of a comprehensive construct for Black maternal psychosocial well-being can improve understanding of the relationship between racism, psychosocial well-being, and Black maternal health outcomes.

Purpose: …

Sleep Self-Efficacy, Loneliness, And Physical Activity: Assessing The Pathways Between Sleep Quality And Mental Health Using Structural Equation Modeling, Amber M. Fox

Theses and Dissertations

Although there is robust empirical support that poor sleep contributes to declines in mental health, explanations of this relationship remain unclear. The purpose of the present study was to examine the pattern of associations between sleep quality, sleep self-efficacy, loneliness, physical activity, and mental health among U.S. adults across the lifespan, and whether they differed by gender or age group. A structural equation model with invariance analysis was developed and examined data from 2,300 adults (M_age = 44.1, SD = 16.78) participating in the online study Investigating Sleep Longitudinally Across Normal Development (ISLAND). Sleep quality was measured by …

Treating Gut Feelings: A Systematic Review Of Psychological Treatments For Pediatric Inflammatory Bowel Disease, Venus Mirbod

Theses and Dissertations

Psychological comorbidities and psychosocial challenges are prevalent among children and adolescents with Inflammatory Bowel Disease (IBD). However, a comprehensive review of the availability and effectiveness of psychological treatments for pediatric IBD patients is lacking. This systematic review aimed to determine the availability and efficacy of psychological interventions for children and adolescents with IBD. The systematic review was conducted in accordance with PRISMA guidelines and performed using two electronic databases, PsycINFO and PubMed, from inception until March 2022. Databases were searched for English-language, controlled trials of psychological interventions for children and adolescents with IBD. Outcomes of interest included: depression, anxiety, health-related …

Health Disparities And Psychosocial And Behavioral Interventions For Type 2 Diabetes Within Latinx Communities: A Systematic Review, Elisa Hernandez-Guerrero Smith

Theses and Dissertations

As Hispanic adults are 70% more likely than non-Hispanic White adults to be diagnosed with diabetes (Centers for Disease Control and Prevention, 2022), there is an urgent need to provide culturally appropriate care to the people with diabetes of Latinx heritage. The purpose of this systematic review is to better understand the availability and effectiveness of psychosocial and behavioral interventions for T2DM within the Latinx population. Additional focus was given to the impact of health disparities and complexities within the Latinx population that have been diagnosed with, or are at risk of, T2DM. With a greater understanding of health disparities …

Icu-Related Medical Trauma: A Socioecological Exploration Of Contributing Factors And Experiences Of Traumatic Stress In Adult Icu Survivors, Jacqueline Hanson

Theses and Dissertations

Advances in biomedical technologies and critical care are leading to increased survivorship rates of ICU patients. During critical care, patients confront a variety of stressors that may contribute to adverse psychological outcomes, including posttraumatic stress. The nature of posttraumatic stress in this population differs from that associated with traditional trauma. The phenomenon of medical trauma in ICU survivors is complex: it is highly subjective, exists on a continuum, is cumulative in nature and carries cumulative effects, involves a combination of endogenous and exogenous, physical and emotional stressors that vary in intensity and duration, occurs in an interpersonal context that involves …

Interpersonal Psychotherapy For Depressed Adolescents: A Systematic Review Of Quantitative Studies Exploring Effectiveness, Concomitant Findings, And Mediating And Moderating Variables, Luke Rex

Theses and Dissertations

Depression is one of the leading causes of illness and disability among adolescents. According to the National Institute of Mental Health (2022), almost one-fifth of adolescents ages 12 to 17 years in the United States had at least one major depressive episode in 2020, representing 4.1 million people, and over half did not receive any treatment. An interpersonal approach to therapy for adolescents known as Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), developed by Dr. Laura Mufson, has been regarded as having well-established efficacy in treating depressed adolescents. This systematic review of quantitative studies (without meta-analysis) was conducted to (a) examine …

Systematic Review Regarding The Use Of Mindfulness-Based Mobile Applications To Reduce Psychological Symptoms And Enhance Well-Being Among General And Clinical Population Adults: Benefits, Limitations And Future Directions, Brian Clawson

Theses and Dissertations

Mindfulness is now utilized throughout Western Society and is part of the growing behavioral health, self-help, and wellness movements. Mobile applications have become increasingly popular for a wide variety of uses related to physical health, mental health, and self-improvement. Therefore, mindfulness-based mobile applications have promise both as stand-alone tools for end-users seeking self-help resources and as clinician-recommended adjunctive tools to enhance the process and outcomes of professional therapy. This systematic review identified, reviewed, and synthesized the findings from studies (n = 29) concerning the impact of mindfulness-based mobile applications on specific aspects of psychological functioning in both the general population …

Leaving Part Of Myself Outside The Door: An Exploration Of Pitfalls And Promising Practices For Black Millennial Survivors Of Racism, Sheriece L. Hooks

Theses and Dissertations

Experiences of racism and discrimination are a prominent concern within the Black community and often cause symptoms of stress or trauma for those who endure it. However, there are limited research studies which examine best practices and pitfalls for treating individuals of this population who struggle with race-based stress or trauma. This study uses a phenomenological approach to examine the therapy experiences of six clients, identifying as Black or African American, when discussing stress or trauma related to racism. Results identified several pitfalls, such as experiences of racism, color blindness, inattention, and countertransference, as well as promising practices, such as …