Medicine and Health Sciences Commons^™

Outcomes Of Prediabetes And Diabetes Education Programs Tailored For Vulnerable Popuations, Diana Al Sayed Hassan

Dissertations

Diabetes is a debilitating disease and if not managed properly it can lead to multiple complications and even premature death. Diabetes continues to disproportionately affect vulnerable populations. The purpose of this three-paper method dissertation was to examine the implementation of a prediabetes and diabetes programs in a community setting to serve vulnerable populations in addition to understanding future diabetes-related educational needs.

The first paper is an evaluation of a shortened five-week diabetes prevention program for older adults with prediabetes or at a high risk for developing type 2 diabetes mellitus (T2DM). Chang in nutrition knowledge, eating and physical activity behaviors, …

Flow Experiences Among Individuals With Aphasia, Thomas W. Sather

Dissertations

Flow has been described as positive experiences of intense concentration, distorted time passage, and loss of self-consciousness. While flow has been reported for multiple populations in various settings, it has not been studied among individuals with aphasia. The purpose of this three paper dissertation is to examine flow experiences among individuals with mild aphasia, including environmental and personal factors associated with flow. Advocates of life participation approaches to aphasia stress the importance of interventions that support full engagement in life. Research on flow experiences and related environmental and personal factors may foster improved service delivery and outcomes for this population. …

Co-Construction Of Personal Narratives In Supporting Identity And Communication In Adults With Aphasia: The ‘My Story’ Project, Katie A. Strong

Dissertations

Stroke and subsequent aphasia can impact a person’s identity negatively, interfering with quality of life. Co-constructing personal narratives about stroke and other aspects of a person’s life is a promising intervention for addressing identity issues. This series of three dissertation studies explored key aspects related to identity, personal narratives, and the perceived impact of telling one’s story.

Study 1 involved a survey examining whether speech-language pathologists view themselves as having a role in supporting the reconstruction of self-identity in adults with aphasia through the use of personal narratives. Results revealed that, whereas the majority of respondents viewed themselves as having …

The Effects Of Schedule Density Of Reinforcement For Alternative Behavior On Resurgence, Kathryn M. Kestner

Dissertations

Resurgence is the reemergence of a previously extinguished response when an alternative response no longer produces reinforcement. Although returning to previously successful methods for obtaining reinforcement is likely advantageous, resurgence also occurs in the form of treatment relapse. An individual may return to problematic behavior (e.g., aggression, self-injury, drug use) when an alternative behavior (e.g., communication response, coping skill, social behavior, etc.) is no longer successful at producing a reinforcer. Behavior analysts rely on treatments based on differential reinforcement of alternative behavior, and resurgence has been demonstrated following changes to reinforcement schedules due to errors in treatment integrity or intentional …

Functional Analysis Of Gambling, Mack S. Costello

Dissertations

Given high rates of gambling and the growing population of disordered gamblers, there is a need to develop assessment strategies with improved treatment validity. More specifically, assessment strategies are needed that identify the controlling variables for disordered gambling and, thus, provide guidance in the selection of treatment and prevention strategies. This study sought to develop a functional analysis for gambling by utilizing a simulated gambling environment in which contextual variables hypothesized to be causally linked to disordered gambling could be systematically manipulated. Seven experienced gamblers participated in the multi-element, single-subject experimental study. Participants who endorsed at least some problems from …

Preferences For Evidence-Based Depression Treatments: An Emphasis On Patient-Focused Care, Lauren A. Frye

Dissertations

Research indicates most depressed patients in the general U.S. adult population seek depression treatment in primary care settings where the prevailing method of treatment is antidepressant medication. Although primary care physicians regard this approach as a preferable first line method of depression treatment, studies indicate many patients do not. Several studies have found depressed patients in these settings prefer psychotherapy or counseling over anti-depressant medication. Many advocate patient preferences should be integral to the treatment decision making process. There is a demonstrated propensity towards psychotherapy or counseling over antidepressant medication among depression patients. However, it is unclear which psychological depression …

Increasing Physical Activity In Young Adults With Autism Spectrum Disorder, Katherine B. Lalonde

Dissertations

Experts recommend that individuals walk 10,000 steps or more per day and doing so has been shown to have several health benefits. Unfortunately, many people fall short of 10,000 steps per day. Exercise levels are characteristically lower in people with Autism Spectrum Disorders (ASD) than in people without ASD. The present study comprised two experiments that used goal setting and reinforcement to increase physical activity in young adults with ASD. The first study employed a multiple-baseline-across-participants design in combination with a reversal design to determine the effects of a treatment package on the number of daily steps taken by young …

Choices Related To Maximizing Quality Of Life At End Of Life, Theresa Lynn

Dissertations

Humans, including those residing in the United States, can live in denial of their own mortality. Because of this, futile care is sometimes provided, often at great monetary expense and for little or no return in terms of quality or length of life. At least two opportunities exist for making choices regarding care at the end of life in the U.S.: completing advance directives and choosing hospice care. This dissertation consists of three studies related to this topic. The first is a quantitative study about advance directives and attitude toward death. The advance directive completion rate among adults in the …

An Evaluation Of The Primary Care Providers’ Perspective Of The Effects Of Moderate Alcohol Consumption On Health, Gisele Tchamba

Dissertations

The complexity of health benefits of moderate alcohol consumption (MAC) is well documented. From the World Health Organization recent report, impact of harm from alcohol consumption was 3.3 million deaths or 5.9 percent of all global deaths (WHO, 2014).

Yet, the benefits of MAC for better health and longer life expectancy compared with abstinence are advocated in numerous studies (Nova, Baccan, Zapatera and Marcos, 2012). However, the nature of alcohol, its role on human sufferings has generated disagreements in the scientific community. Analysis of the results of early studies advocating better health for moderate drinkers, reveal discrepancies regarding the influence …