Preventive Medicine Commons^™

The Application Of The Transtheoretical Model Of Change To Self-Care Behaviors In Type 2 Diabetics, Heather N. Mercer

Loma Linda University Electronic Theses, Dissertations & Projects

Background. The Transtheoretical Model of Change (TTM) has been investigated as a model of health behavior change; however, it has only begun to gain recognition in the diabetic population, and has not yet been investigated as it relates to the full-spectrum of diabetes self-care behaviors.

Purpose. The purpose of this study was to compare the pattern of stages of change across four self-care behaviors between intervention and control groups, and examine psychosocial and health outcome variables.

Method. In a cross-sectional design, a sample of 132 adult subjects with type 2 diabetes completed surveys. The survey assessed stages of change among …

Attributional Styles Of Women Who Quit Or Reduce Smoking In The Antepartum, Patricia T. Alpert

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Researchers in the field of smoking have sought to identify variables that predict whether or not pregnant smokers stop or continue to smoke. Most variables examined are demographic in nature and little is known about psychological variables associated with those who quit or reduce smoking while pregnant.

Purpose: To analyze attributional style and locus of control to determine which factors alone, or in combination, are associated with quitting versus reduced smoking among pregnant smokers.

Methodology: Pregnant smokers who quit (n = 66) or reduced their smoking (n = 43) were identified by the nursing staff at a women’s county …

A Study Of Pediatric Heart Transplant Patients In Relationship To Post Transplant Coronary Artery Disease, Mark Randall

Loma Linda University Electronic Theses, Dissertations & Projects

Post transplant coronary artery disease influences short and long-term survival of pediatric heart transplant recipients. Associated cardiovascular disease risk factors among non-heart transplant adult and pediatric heart populations for development of coronary artery disease have been documented. Little is known about these typical cardiovascular disease risk factors as well as other possible risk factors in the development of post transplant coronary artery disease. Objective: The purpose of this research was to examine children/adolescents (n=194), 5-18 years old, at least one-year post heart transplant. This study also investigated if there were physiological and psychological/behavioral differences between recipients with (n = 28) …

Assessment Of A Body Composition-Focused Approach To Obesity Treatment, Beverly D. Hall

Loma Linda University Electronic Theses, Dissertations & Projects

Obesity is a significant United States’ public health concern. However, high relapse rates continue to be a problem for obesity treatment programs while the focus remains on weight loss, not body composition change. This study examined whether a clinic-based obesity treatment program, focused on body composition change through resistance training, lead to improved body composition, exercise behaviors, and attitude change from focus on weight loss to body composition change. Improvements in self efficacy, outcome expectations and stages of change were also examined. Forty-eight physician-referred overweight or obese adult women (mean body fat 41%, SD = 6.65%), completed assessments and questionnaires …

Attitudes Of Preventive Care Specialists And Registered Dietitians Toward Their Obese Patients, Maryanna Gabriel

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to compare preventive care specialists and registered dietitians regarding attitudes toward obese patients, to compare both groups with Canadian and American nurses previously studied, and to determine whether relationships exist between personal characteristics and attitudes toward obese patients. Questionnaires were sent to members of the American Preventive Care Association and 1,000 randomly selected members of the California Dietetic Association. Sixty-seven preventive care specialists and 579 registered dietitians participated in the study. A modified version of the Attitudes Toward Obesity scale, developed by Bagley, et al. was used to measure attitudes. Preventive care specialists and …

Prediction Of 1976 Diabetes Incidence From 1960 Animal Product Consumption Among California Seventh-Day Adventists, Arnold Vang

Loma Linda University Electronic Theses, Dissertations & Projects

The prevalence of diagnosed and undiagnosed diabetes in the US has been estimated at more than 16 million individuals (King, 1998). This has led to research into lifestyle practices (Astrup, 2001; Touomilehto, 2001), which has identified several of primary prevention. High fat diet and type 2 diabetes has been attributed to the wellareas known mechanisms of hyperglycemia, hyperinsulinaemia and insulin resistance (Ferrannini, 1999; Reaven, 1988).

We examined the association between all animal product consumption, specific animal product consumption and diabetes incidence among California Seventh-day Adventists who were cohort members of the Adventist Mortality Study (Kahn, 1984) and the Adventist Health …

The Role Of Health Promotion In Physical Therapy, Brenda L. Rea

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to investigate physical therapy practice patterns in four focus areas of Healthy People 2010 (focus area #6, disability and secondary conditions by looking at psychological well-being; focus area #19, nutrition and overweight; focus area #22, physical fitness and activity; focus area #27, tobacco use) and identify self-efficacy and outcome expectations related to those practice patterns across California, New York and Tennessee using Bandura’s Social Cognitive Theory as a framework. It was hypothesized that physical therapists’ self-efficacy and outcome expectations in the four focus areas of Healthy People 2010 would be significantly associated with …

Are Antinuclear Antibodies And Rheumatiod Factor Positivity More Prevalent In Apparently Healthy Smokers Compared To Ex-Smokers And Never Smokers?, Susan Nyanzi

Loma Linda University Electronic Theses, Dissertations & Projects

Context: There is now consistent evidence from population and epidemiological studies that cigarette smoking is an independent risk factor for Rheumatoid Arthritis (RA), via Rheumatoid Factor (RF) production (Deighton, 1997; Saag, 1997; Silman, 1996; Uhlig, 1999; Wolfe, 2000). Antinuclear Antibodies (ANA) are another collection of autoantibodies that are being associated with smoking and RA initiation. To our knowledge, no studies have examined the effects of smoking on both ANA and RF simultaneously in healthy subjects.

Objectives: To determine whether cigarette smoking has an effect on ANA and RF positivity in healthy blood donors.

Design, Setting, Participants: This was a cross-sectional, …

A Correlational Analysis Of Anthropometric Measures And Selected Blood, Immune And Endocrine Indices In Adult Males, Janet Tracey Peterson

Loma Linda University Electronic Theses, Dissertations & Projects

Over the past few decades it has become apparent that increased body weight, specifically body fat, coupled with a sedentary lifestyle is associated with an increased risk for chronic disorders such as cardiovascular disease and diabetes. Researchers are now re-directing their focus on determining the cause of these relationships from an epidemiological view to a more biological or physiological standpoint. The purpose of this cross sectional study was to examine associations among obesity, physical activity and select immune, endocrine and metabolic parameters identified as risk factors for several chronic conditions. Ninety-one healthy males between the ages of 19 and 45 …

Effects Of High Fruit Intake On Systematic Blood Pressure In African Americans, Leonard L. Gibbons

Loma Linda University Electronic Theses, Dissertations & Projects

This randomized dietary intervention trial examined the effects of a high fruit diet on systemic BP in African-Americans. Thirty-eight free-living subjects with systolic BPs between 130-159 mm Hg and diastolic BPs between 85-99 mm Hg, were enrolled for a six week period. The cases were given daily supplements of potassium rich foods: bananas, orange juice and raisins, while no dietary advice or food was given to the controls.

After six weeks, the means systolic BP was 5.79 mm Hg ( p=.009) lower in the cases than the controls. The mean diastolic BP at week six was 3.76 mm Hg (p=.047) …

Factors Associated With Healthy Eating: Attitudes, Cultural Adherence, And Snacking Behavior Among Korean-American Adolescents, Kyoung Eun Oh

Loma Linda University Electronic Theses, Dissertations & Projects

Adolescents have increased nutrition needs and report frequent meal skipping and snacking, but there are few studies that examine the determinants of unhealthy eating, especially among ethnic minority groups. This study investigated dietary intake and snacking behavior among Korean-American adolescents in the Los Angeles area. We determined the relationship between dietary fat intake and overall quality of the diet as assessed by two healthy eating indices: the Healthy Eating Index (HEl) and Mean Nutrient Adequacy Ratio (MNAR). HEl assessed degree of compliance to Food Guide Pyramid and Dietary Guidelines for Americans while MNAR assessed nutrient consumption compared to Recommended Dietary …

Client-Centered Versus Traditional-Directive Educational Approach: A Randomized Study Of Exercises And Perceived Control Among Patients With Type 2 Diabetes, Melissa D. Olfert

Loma Linda University Electronic Theses, Dissertations & Projects

A patient’s adherence to self-management therapies in diabetes strongly influences health outcomes, health care utilization, and ultimately health care costs. Engaging in regular exercise therapy reduces risk factors associated with type 2 diabetes. The purpose of this randomized prospective study was to determine if a client-centered approach (CCA) toward diabetes education, verses a traditional-directive approach (TDA), would improve exercise participation, perceived control, intention to exercise, and glycemic control in patients with type 2 diabetes.

Fifty-nine type 2 patients were randomized into two groups: CCA and TDA. Diabetes education in the CCA group provided empowerment toward acquiring knowledge, skills, and responsibility …

The Association Of Fluid Intake With Total Natural-Cause Mortality, Coronary Heart Disease And Fatal Stroke, Jacqueline Chung Lun Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Hypohydration may be more widespread than realized since it does not always arouse a sense of thirst. When thirst is felt, it is often ignored, or satisfied before euhydration is achieved. There is growing evidence indicating that hypohydration contributes to acute and chronic illnesses, and to rheological factors associated with coronary heart disease (CHD) and stroke. Therefore the relationship of fluid intake with risk of total natural-cause mortality, CHD and stroke death was examined using data on 34,192 white, non-Hispanic participants in the Adventist Health Study.

Among the 27,342 reporting no CHD, stroke or diabetes at baseline, during six years …

A Cross-Sectional Study Examining Lifestyle And Rheumatoid Arthritis, Leslie Nazaroff

Loma Linda University Electronic Theses, Dissertations & Projects

Objective. Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects the synovial joints. RA affects 0.5-2% of the population. Though it is predominantly a progressive disease, adjunct therapy may slow the destructive pathway or alleviate affiliated symptoms. This study examined the effects of lifestyle (diet and exercise) and self-efficacy on symptoms of RA as measured by disease activity and health satisfaction.

Methods. Seventy-five RA patients (77% female) from the Loma Linda University Faculty Medical Offices, Rheumatology Department completed self-assessment surveys on their lifestyle practices and RA affliction. Disease symptoms and activity were assessed with the Arthritis Impact Measurement …

The Relation Of Weight Loss And Improved Fitness To Survival In Healthy Males, Joanna Lynn Bokovoy

Loma Linda University Electronic Theses, Dissertations & Projects

Obesity is a critical public health problem because of its prevalence, medical and psychosocial effects, and resistance to intervention. Weight loss in overweight individuals has been encouraged by the United States Public Health Service and by the medical community as a means for improving health. However, recent studies have suggested either positive or negative effects of weight loss on survival. It is possible that physical fitness may have a confounding effect, or be an effect modifier on survival in weight loss studies.

This study used Cox Regression analysis to address the separate and combined association of weight loss and improved …

Cardiorespiratory Fitness And Cardiovascular Disease Risk Factors In Postmenopausal Women, Bryan L. Haddock

Loma Linda University Electronic Theses, Dissertations & Projects

In spite of the reductions in cardiovascular disease mortality over the last several years, cardiovascular disease remains the number one cause of death in the U.S. Prior to menopause, women have approximately 2.5-4.5 times lower risk of cardiovascular disease than do men of a similar age. Within about 10 years following menopause, however, the rate in women becomes similar to that seen in men. Increased cardiorespiratory fitness and use of hormone replacement have been suggested as ways to improve the cardiovascular disease (CVD) risk profile. Unfortunately, very little is known about the effect of cardiorespiratory fitness on the CVD risk …

The Influence Of Low Dietary Fat Intake On Incidence And Severity Of Migraine Headache, Zuzana Bic

Loma Linda University Electronic Theses, Dissertations & Projects

Migraine headaches are a common and debilitating syndrome causing untold suffering and loss of productivity. A review of the literature indicates that there are two primary factors involved in triggering these headaches: high levels of blood lipids and high levels of free fatty acids. Under these conditions platelet aggregability is increased, which is associated with decreases in serotonin and heightened prostaglandins levels. These conditions may produce vasodilation, the most immediate precursor to migraine headache. A high fat diet is one factor that may directly affect this process. This study was undertaken to evaluate the impact of dietary fat intake on …

The Effects Of Lowering Cholesterol On Vasodilation, Maria Christi Hardt

Loma Linda University Electronic Theses, Dissertations & Projects

Endothelial dysfunction has been found prior to any signs of atherosclerotic plaque formation in patients with a variety of risk factors for atherosclerosis. Elevated serum cholesterol has repeatedly been associated with endothelial dysfunction as demonstrated by impaired vasoreactivity to vasodilating stimuli.

The aim of this research was to determine whether short term lowering of serum cholesterol levels by life style changes or by cholesterol lowering medication could reverse or reduce the endothelial dysfunction. The brachial artery diameter was measured by high-resolution ultrasound at rest and during reactive hyperemia pre and postintervention. Fifty-three subjects with cholesterol levels above 240 mg/dl were …

Predicting Intentions Of Physical Therapy Students To Practice Primary Prevention, Sharon Potter Anderson

Loma Linda University Electronic Theses, Dissertations & Projects

Physical therapy (PT) has traditionally been a hands-on, tertiary-care field. Although the American Physical Therapy Association has mandated a broader perspective, little primary prevention is yet being reported in the U. S. An attitude change toward prevention must occur if physical therapists can be expected to become involved in preventive physical therapy. The purpose of this project was to determine predictors of physical therapy student intention to perform primary prevention with a questionnaire based on Ajzen's Theory of Planned Behavior. The theory uses attitude, subjective norm and perceived control to predict intention based on beliefs and strength of beliefs in …

The Effect Of The Cooper Wellness Program In Promoting Long- Term Lifestyle Behavior Changes, Ernesto P. S. Medina Jr.

Loma Linda University Electronic Theses, Dissertations & Projects

Most research on health behavior change programs examines their effectiveness in producing initial behavior changes, but fails to evaluate long-term maintenance of those changes. This study examined the effectiveness of the Cooper Wellness Program (CWP) in Dallas, Texas, in promoting maintenance of lifestyle behavior changes for one year or longer in the areas of diet, exercise, and stress management.

The CWP offers an intensive live-in lifestyle behavior modification program in four-, seven-, or 13-day formats. Data were collected from 223 individuals who attended the CWP between January, 1989, to February, 1992. The study addressed the following areas: 1) long-term maintenance …

Self-Efficacy And Self-Care In The Hypertensive Female Patient, Robert Davis Lutz

Loma Linda University Electronic Theses, Dissertations & Projects

This study focused upon physician/patient interaction as it pertains to patient involvement in personal health-care planning decision making, and self-care. The study was a multi-intervention trial that allowed for testing the effectiveness of two instruments used separately or simultaneously, in combination. Participants were 73 female patients, ages 41 to 76, diagnosed with essential hypertension and requiring medication for control.

Patients were randomly assigned to four groups: 1) a control group that was given no intervention, 2) a Pre-Knowledge Intervention (PKI) group that was given an interactive treatment plan with foreknowledge of what their physicians would probably do at their next …

The Development And Application Of A Multiple Regression Equation That Predicts The Sum Of Triceps And Subscapular Skinfolds In Children Ages 10-18, Pamela Luna-Raffy

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to develop a tool to predict the sum of triceps and subscapular skinfolds in children ages 10-18. In addition, school-based weight management programs were reviewed.

Skinfold calipers are often used to assess body fat percentage, particularly in non-clinical settings, test sites recommended by researchers are the triceps and The subscapular skinfolds. Recently, however, educators have reported two concerns about using skinfold calipers in the schools: (1) Specialized training and equipment are required, and (2) individuals must remove their clothing from selected test sites.

For schools where the use of calipers present problems, it seemed …

Motivating Factors In Completing Tetanus Immunization, Eva Mae Krohn Leech

Loma Linda University Electronic Theses, Dissertations & Projects

It was the problem of this study to find out the number of people who were given tetanus antitoxin who did and did not initiate and complete tetanus immunization and to find out why they did or did not do so. The subjects were patients from two hospitals who had been given tetanus antitoxin sometime between January 1, 1963, and October 15, 1963. These subjects were contacted through the use of a questionnaire. The 75 who returned the questionnaire were considered respondents of the study.

This sample was composed primarily of men who were married and were members of the …