Preventive Medicine Commons^™

Benefits And Barriers To Hiv Testing In A Population Of Federal Detention Inmates, Nicole A. Knight

Loma Linda University Electronic Theses, Dissertations & Projects

Voluntary HIV testing in combination with early medical intervention has been shown to be effective in reducing the rate of new infections and improving the health and life expectancy of those living with HIV. There are however several high-risk populations in the US that remain largely unreached by HIV testing efforts, some of which could be reached while they spend time in prison or jail. Per current Bureau of Prisons (BOP) policy, HIV testing is routinely offered only to “high risk” pretrial and sentenced inmates. We conducted a cross-sectional study with 721 pretrial and sentenced inmates who entered a large …

Successful Aging And Creativity : An Investigation On Functional Status And Psychological Wellbeing In Older Adults, Mirie E. Levy

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: While the literature supports the maintenance of functional status as integral to successful aging, the relationship of creativity on functional status has received little attention. Creativity has been associated with health and aging in the research but only a small number of studies have examined creativity interventions to enhance functional status and boost psychological wellbeing.

Methods: A pretest-posttest quasi-experimental design was used to investigate an 8-week creativity intervention on functional status and psychological wellbeing in older adults. Sample subjects were 92 men and women all over age 60. A series of two-way mixed ANOVAs measured differences between treatment and …

Effects Of Consuming Beans Before Or With A Meal On Satiety And Gastrointestinal Hormones Concentration In Obese Men And Women, Lisa Delia Griffith

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Consuming beans and staggering meals may control energy intake. We examined the effect of consuming 0.5 cup of beans 15 minutes before a meal on gastrointestinal (GI) peptides concentrations in obese men and women.

Methods: A randomized crossover design was used to measure GI peptides response to two test meals in 28 healthy obese adults. Subjects consumed a standardized breakfast meal on each test day followed by one of two test meals: a meal incorporating 0.5 cup of beans (control bean meal), and an isocaloric meal (staggered bean meal) in which 0.5 cup of beans was consumed 15 minutes …

The Ratio Of Positive To Negative Affect, Flourishing, And Health Behavior, Michael Stuart Leibow

Loma Linda University Electronic Theses, Dissertations & Projects

The ratio between positive and negative affect, known as the positivity ratio (PR) is thought to be associated with flourishing (psychological and social well-being). However, little research has been done on how PR and flourishing relate to specific health behaviors. The relationships between PR and flourishing with health behavior i.e., physical activity, and diet (fruit, leafy green vegetables [LGV] and meat intake) were investigated in this study. We examined whether PR mediated the relationship between flourishing and health behaviors, and whether flourishing mediated the relationship between PR and these behaviors. Gender and ethnic differences for the above associations were examined …

Impact Of A Medically Supervised Weight Management Program On Obese And Morbidly Obese Persons, Gemechu Abraham Kurfessa

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Overweight and obesity represent a major public health problem. While some studies indicate that a clinic-based, healthy-lifestyle program can result in significant weight loss, a systemic review of major commercial weight loss programs concluded that the evidence to support the use of such programs is minimal. While few argue for the need for weight loss in obese individuals it is important to identify factors associated with successful weight loss. These factors could include financial incentives, frequency of intervention sessions, use of adjunctive weight loss medications and supplemental diet products, and availability of group vs. individual therapy sessions. In addition, …

Long Term Weight Variability In Adults Of Adventist Health Study 1 And 2, Namgyal Lhawang Kyulo

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The effect of overweight and obesity on the risk of fatal disease tends to attenuate with age. One plausible explanation is that a proportion of elderly people in the ideal weight category (19 to 25 kg/m ) experienced disease-related weight loss - an effect that will attenuate health risk related to overweight and obesity. One potential approach to controlling for this bias would be to examine fluctuations in weight during the adult lifespan by considering multiple measures of weight or recall of body weight during adulthood. Some of these measures are available in the Adventist Health Study cohorts and …

An Occupational-Based Experimental Study Of Collective Vs. Personal Efficacy To Encourage Sun Protective Behaviors In Head Start Preschool Teachers, Elizabeth A. Holzhauser

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Skin cancer is one of the most common types of cancers in the United States. An analysis of literature shows that skin cancer can be partially mitigated through personal behavior changes (Glanz, Buller, & Saraiya; 2007, Canadian Centre of Occupational Health and Safety [CCOHS], 2010). Currently national sun-safety educational campaigns promote sun-protective behaviors to individuals who receive exposure due to their work environment (Task Force on Community Preventive Services, 2004). Preschool teachers employed with San Bernardino County Head Start are inadvertently exposed to sunlight during mandatory recess periods posing risks to their health.

Purpose. This study evaluated two instructional …

Child And Family Responses To Weight Management Programs : A Qualitative Investigation, Andra Lynn Fjone

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: The purpose of this study is to explore what happens within families in which a child participates in a pediatric weight management program for the treatment of overweight or obesity and identify strategies and processes for successful weight management.

Method: A qualitative approach was used to collect data from seven families. Individual interviews were conducted with parents, target children, and siblings. Data was analyzed within families and compared between families.

Results: Grounded theory analysis revealed three major essential themes: Shared Burden, Family Congruence, and Collaboration. Descriptive analysis was used to identify recommendations for improving family based weight management programs. …

The Association Of Religious Coping On Reports Of Low Back Pain And Inflammatory Markers, Jacqueline D. Bougie

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic pain is the most common cause of disability in the United States with depression, anxiety, and stress often occurring co-morbidly. The purpose of the study was to explore how religion may modulate the frequency of back pain, influence inflammatory markers, influence the use of medications, and impact functional ability.

Participants were from the Biological Manifestations of Religion Study (BioMRS; N= 508) and the Psychological Manifestations of Religion Study (PsyMRS; N = 10,988). All participants completed a 20-page questionnaire and BioMRS participants provided blood, salivary, and urine samples, performance tests, and learning tests all collected within 1 week of …

A High Fiber Diet Versus A Low-Carbohydrate Diet For Weight Loss In Obese Individuals With Or Without Type 2 Diabetes, Neal G. Malik

Loma Linda University Electronic Theses, Dissertations & Projects

In the United States, obesity rates have climbed steadily over the years. Many different diets for weight loss have been proposed and studied, yet no one diet seems to clearly be more beneficial. Among diets that have been promoted are those high in fiber and low in carbohydrates, yet thus far, results of these studies have been mixed.

Using a 2x2 complete factorial design, 173 obese men and women with or without type 2 diabetes were randomized to one of two conditions: (a) a high fiber diet (> 40 grams of fiber per day for women, >50 grams of fiber …

Relationship Of Vitamin D Levels To Blood Pressure In A Biethnic Cohort, Rosario O. Sakamoto

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Serum hydroxyvitamin D [25(OH)D] has been well-accepted as not an ordinary vitamin but a pro-hormone that has many benefits beyond its well-known effects on bone. Cardiovascular risk factors such as hypertension remain a huge health burden and Blacks have been recognized to have higher prevalence of hypertension compared to non-Hispanic Whites. Despite increasing evidence of the benefits of vitamin D on blood pressure control, there is much more to be learned about the relationship of serum 25(OH)D to blood pressure among different ethnicities.

Purpose: The goal of this study was to determine whether vitamin D serum 25(OH)D levels were …

Self-Reported Exercise And Risk Of Osteoporosis In Prostate Cancer Patients Receiving Androgen Deprivation Therapy, Lori J. Mennen-Winchell

Loma Linda University Electronic Theses, Dissertations & Projects

Prostate cancer is stimulated to grow in response to testosterone. Androgen deprivation therapy (ADT) leads to chemical castration and suppression of prostate cancer cell production. Testosterone levels less then 300ng/ml decreases bone mineral density and could result in osteoporosis. Studies have shown that during the first year of ADT, fracture risk, mainly in hips and spine increases about 50%. In men, 40% of hip fractures result in death. Exercise may reduce the risk of osteoporosis and thus contribute to the prevention of hip and other fractures. There is limited data regarding whether exercise is associated with a reduced risk of …

Role Of Breastfeeding And Current Lifestyle On Maternal Long-Term Weight Change, Denise R. Hinds

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Evidence suggests that prolonged and exclusive breastfeeding is associated with health benefits to children and nursing mothers beyond the period of breastfeeding. Studies that support the role of breastfeeding in postpartum weight change primarily focused on short-term weight change (within 12 to 24 months postpartum) (Binns et al. 2003; Lederman 2004; Johnson et al. 2006), while few focused on the association between breastfeeding and long-term weight change (5 years or more postpartum) (Rooney, Schauberger et al. 2005).

Purpose: This study investigated the role of breastfeeding in long-term weight change, specifically 1) whether breastfeeding protects against weight gain, and 2) …

The Effects Of Consumption Of California Dried Mission Figs On Serum Lipid Concentrations In Hyperlipidemic Adults, Joycelyn M. Peterson

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The National Cholesterol Education Program and American Heart Association have recommended the use of functional or cholesterol-reducing foods, some categories of which include viscous or soluble fibers, soy protein, plant sterols, and nuts, as aids to reduce serum cholesterol concentrations. Figs are a rich source of viscous fiber and antioxidants. Fig consumption has not been studied in regard to effects in reducing serum lipid concentrations. In previous pilot data, increasing fig consumption for six weeks among volunteers was found to be feasible.

Objective: To evaluate the effect of the consumption of California dried mission figs on serum lipid …

Preventive Care Utilization Among Black Women : Perceived Beliefs, Benefits And Barriers To Mammography Screening, Rowandalla Y. Dunbar

Loma Linda University Electronic Theses, Dissertations & Projects

Blacks, in comparison to other racial or ethnic groups, suffer higher rates of illness and death from many preventable or treatable diseases. Despite the significantly higher rates of mortality and disease, Blacks are least likely to utilize clinical preventive care services. Black women, who are more likely to have advanced breast cancer at time of diagnosis (Chu, Lamar, & Freeman, 2003) are least likely to seek mammography screening (National Health Interview Study, 2000). Allen, Bastani, Bazargan and Leonard (2002) examined predictors of mammography screening among women 40 years old and older residing in the South Central area of Los Angeles, …

Association Between Obesity, Depression, And Inflammation Among Seventh-Day Adventists In The Biopsychosocial Religion And Health Study, Michael Paalani

Loma Linda University Electronic Theses, Dissertations & Projects

The effects of obesity and depression on morbidity and mortality may be mediated by inflammatory processes. Homeostasis within the immune system depends on a balance of pro-inflammatory and anti-inflammatory cytokine molecules, so chronic inflammatory diseases may result from cytokine dysregulation. The target population consisted of 508 Seventh Day Adventists (SDAs) who participated in the Biopsychosocial Religion and Health Study (BHRS), a sub-study of the Adventist Health Study-2. The study was a cross-sectional analysis of the association between obesity, depression, and inflammation after controlling for demographic, socioeconomic, health behavioral, and health status variables among BHRS participants.

Obesity was assessed by body …

The Effect Of An Educational Intervention On The Sexual Perceptions And Practices Of Adolescents In Trinidad And Tobago, Vanessa Jones

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) is one of the fastest spreading infectious diseases in the Caribbean, and is second only to Sub-Sahara Africa in the prevalence of HIV/AIDS cases. Trinidad and Tobago is the southernmost twin island republic in the Caribbean. In 1999, the 5^th leading cause of death among individuals ages 15-34 in Trinidad and Tobago was HIV/AIDS. According to UNAIDS (2006), the prevalence rate of HIV in Trinidad and Tobago is 2.6%.

Purpose. Currently, there is no standardized HIV/AIDS education program in secondary schools in Trinidad and Tobago. Since HIV/AIDS is …

Effect Of California Mission Fig Consumption On Levels Of C-Reactive Protein And Antioxidant Levels, Rasha Abdrabou

Loma Linda University Electronic Theses, Dissertations & Projects

Polyphenols exert anti-inflammatory and antioxidant effects. We investigated the effect of consumption of polyphenol-rich figs on high sensitivity C-reactive protein (CRP) and antioxidant levels in hyperlipidemic subjects. The purpose of this study was to examine the effect of fig consumption on C-reactive protein and antioxidant levels. Analyses were carried out on collected data from September to December of 2008. Using a crossover design, one hundred and two participants were recruited and randomized into an intervention phase (eating figs) and a control phase (not eating figs) for 5 weeks. Blood samples were drawn from each group at the 4th and 5th …

Quality Of Life And Depression: Outcome Markers For A Weight Management Program, Cecilia Dueñas

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric obesity has become a national epidemic and current trends suggest a continued increase. Obese children have been found to have higher incidences of depression and a lower quality of life (QOL) than children from other often more severe medical populations. As a result, weight management programs are on the increase with the majority measuring outcome success through weight loss and decreased body mass index (BMI). It is evident however, that health factors are not the only factors associated with obesity, and that psychosocial components are important as well. The Loma Linda University Growing Fit Program is unique in that …

Correlates Of Soy Food Consumption In Adventist Health Study-2, Yen Ang

Loma Linda University Electronic Theses, Dissertations & Projects

Much has been discussed about the health benefits and risks of soy consumption but very little is known about who the consumers are. Most of what is known has been observed mainly in Asian populations who consume high levels of soy. Very little is known about soy food intake in the western population who typically has low consumption level. The Seventh-Day Adventist cohort in North America is the only population known in the West with soy food intake that is comparable to the Asian population living in the East.

Soy consumers in a population known for its healthier lifestyle and …

Consider The Source : The Effects Of Adult Sources Of Human Immunodefciency [Sic] Virus And Sexually Transmitted Infection Prevention Information On Teen Risk Behaviors For Sexually Transmitted Infection, Janet E. Flores

Loma Linda University Electronic Theses, Dissertations & Projects

Sexually transmitted infections (STIs), including the Human Immunodeficiency Virus (HIV), are major health problems for adolescents, who represent over 26% of new cases of STIs diagnosed annually in the United States. Half of all HIV cases in people under age 25 result from sexual transmission during adolescence. Adolescent STI prevention is a national priority for the United States, and parents, schools, and medical providers, among others, are expected to have the greatest impact on adolescent STI risk reduction in teens.

This study used secondary Youth Risk Behavior Surveillance Survey (YRBS) data to explore the prevalence of high school students with …

Repeatability Of Serial Carotid Intima Media Thickness Scanning On Individual Subjects, Judi Nightingale

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Heart disease affects millions of Americans each year. In order to improve primary prevention, early risk identification is essential. B-mode ultrasound of the common carotid artery (CCA) intima-media thickness (IMT) assesses risk of a coronary event early in the process of plaque development. Because IMT changes are so small over time, in order to determine clinically significant versus clinically insignificant changes in IMT over a 12 month time period, a protocol is needed which can detect the least significant difference (LSD) of at least 0.030 mm.

Purpose. The purpose of this study was to develop and test a well-defined …

The Association Between Lifestyle Factors And Inflammatory Markers, Kerry Ann Stonebrook

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Cardiovascular disease (CVD) is the leading cause of death for both men and women in the United States. While smoking, high blood pressure, and elevated cholesterol levels are established risk factors for CVD, inflammation is being evaluated as a potential independent risk factor. A key cytokine regulator of the inflammatory response, interleukin-1 (IL-1), has emerged as playing a particularly important role at the genetic level in determining the degree to which the inflammation pathway is turned on. How an individual’s genetic make-up affects inflammation, CVD risk, and response to lifestyle intervention is an area of research that is in …

Predictability Of Cardiovascular Disease Event Rates By Common Carotid Artery Intima-Media Thickness In The Atherosclerosis Risk In Communties (Aric) Study, Mara Hollander

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Carotid artery intima media thickness (IMT) is a non-invasive reliable predictor of the extent and severity of CVD. There is difficulty acquiring all measurements for validated three-site carotid IMT. More accessible one-site common carotid artery (CCA) IMT has not yet been validated with CVD events.

Purpose: This study will evaluate the diagnostic accuracy of one-site CCA IMT compared to three-site IMT in predicting cardiovascular disease (CVD) events. Assessment of whether the association of incremental one-site CCA IMT to a CVD event is significant with and without adjustment for traditional cardiac risk factors was made.

Methodology: Data from The Atherosclerosis …

The Acute Effects Of Nut Ingestion On Plasma Levels Of Polyphenol Compounds, Biomarkers Of Antioxidant Status, And Lipid Peroxidation, Setareh Torabian Esfahani

Loma Linda University Electronic Theses, Dissertations & Projects

Nuts are rich sources of polyphenolic compounds and nutrients, which have antioxidant capacity. To assess the acute effect of treatment diet (75% of energy from nuts (walnut or almond) and control diet (habitual diet with no nut consumption) in healthy subjects on plasma total phenol content, antioxidant capacity and plasma lipid peroxidation. Thirteen subjects participated in the crossover design study. After an overnight fast, walnut, almond and a control diet, in form of smoothies, were consumed by the study subjects. Each subject participated on three occasions one week apart, consuming one of the smoothies each time. Blood samples were obtained …

The Relationship Between High Sensitivity C-Reactive Protein, Metabolic Syndrome And Exercise, Micheline A. Vargas

Loma Linda University Electronic Theses, Dissertations & Projects

Background: It is well known that regular physical activity is associated with lower risk of chronic diseases such as diabetes and cardiovascular disease. Physical activity is also considered an important determinant of metabolic syndrome. All levels of metabolic syndrome, diabetes, and cardiovascular disease are thought to involve inflammation. Physical activity may reduce risk, at least in part, by modifying the inflammatory process. Recent studies have demonstrated an inverse relationship between inflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), and physical activity. Elevated hs-CRP appears to be an independent predictor of both CVD and diabetes. Recent evidence also suggests that …

Using The Outcome Questionnaire 45.2 In Obesity Treatment, Adam L. Arechiga

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to determine if the Outcome Questionnaire 45.2 (OQ-45) can be used in the treatment of obesity to predict participant dropout and initial treatment success, in terms of weight loss (Lambert et. al, 2002a). The OQ-45 has been used with success to predict dropout from psychotherapy in clinical populations. It was hypothesized that higher pretreatment OQ-45 scores would be associated with less program completion and less weight loss by the end of treatment.

Method: The study employed a non-experimental time series design. Seventy-eight participants were recruited from the three local obesity treatment programs, which …

Effects Of Resistance Training Volume And Variety On Dietary Intake And Mood State In Untrained Subject, Suzette K. Smith

Loma Linda University Electronic Theses, Dissertations & Projects

Background: While there is research on the effects of aerobic training on various aspects of mood state and nutrient intake, little is known of the effect of resistance training on these variables.

Purpose: To examine the effects of resistance training (RT) volume and variety on total energy (kcal) and macronutrient intake, and mood states in a healthy, untrained population.

Method:The investigation was part of a prospective experimental study examining the effects of three RT protocols on body composition and strength. An initial 102, healthy, untrained male and female participants, ages 20-40, were recruited, and randomized into one of three …

Psychological Stress And High Sensitivity C-Reactive Protein Levels In Overweight And Obese Men, Olivia L. Moses

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. High sensitivity C-reactive protein (hs-CRP), a measure of inflammatory response, is now considered an independent marker for coronary heart disease. Psychological stress also affects the immune system and influences the inflammatory response. Ladwig, et al (2003) found a significant positive association between hs-CRP levels and depression (F=4.9, p^.008) in 726 obese males, even after adjusting for smoking, high blood pressure and age. This study investigated if there was a similar association between increased hs-CRP levels and psychological stress in overweight and obese males.

Method. Sixty-one overweight (n=28) or obese (n= 33) males, ages 20-35, were recmited …

Predictors Of Intention To Use Contraception, Given Alcohol Consumption, Among Women In Southeast Alaska, Donna Louise Hebbeler

Loma Linda University Electronic Theses, Dissertations & Projects

Fetal alcohol exposure is a serious public health problem and is 100% preventable. Traditionally, FASD prevention programs and research recommendations have targeted peri-conceptual or pregnant women. Another approach to the prevention of FASD involves preventing pregnancy in women who use alcohol. The purpose of this cross sectional study was to identify factors that predicted women’s intention to use contraception using the theory of planned behavior (TPB), to determine if predictors of the theoretical constructs varied in women depending on alcohol use, and to examine interactions between alcohol use and TPB constructs. Qualitative data was gathered to triangulate with the quantitative …