Public Health Commons^™

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 …

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 …

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.

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: …

“Is Therapy For Me?” Perceptions Of Therapy Inclusivity And Willingness To Seek Help Among Black Emerging Adults, Randl B. Dent

Theses and Dissertations

Mental health issues are prevalent among Black emerging adults; however, they tend to underutilize mental healthcare services. The goals of the current study were to examine whether: (1) perceived therapy inclusivity would predict willingness to utilize mental healthcare services and (2) the relationship between perceived therapy inclusivity and willingness would be moderated by two indices of racial identity (i.e., centrality and private regard). Results provide evidence that greater perceptions of therapy inclusivity are associated with greater willingness to seek mental health services even after controlling for factors, such as gender, self-stigma, and previous mental healthcare utilization. Additionally, there was no …

The Intersection Of Social Stress, Mental Well-Being, And Sexual Health Among Black Women In Emerging Adulthood, Brandi Galloway

Theses and Dissertations

With an estimated 37,000 new HIV infections each year, HIV continues to be a major public health concern. HIV affects some populations more than others. Young Black women, in particular, are disproportionately affected by HIV. While being a woman does not typically increase a person’s HIV risk, being Black and being a woman does.

Data indicate that individual-level factors do not fully address the differences in HIV and STIs between Black emerging adult women and their White counterparts. Thus, it is critical to better understand contextual factors such as social stress and mental-wellbeing which might better account for these disparities. …

Swipe Right For Condoms And Testing: Differences In High-Risk Sexual Behavior And Sexual Health Beliefs Among Dating App Users Compared To Non-App Users, Shelby A. Smout

Theses and Dissertations

Millions of Americans are currently using smartphone dating applications (apps) to socialize and meet with others. In some cases, app-based conversations lead to sexual interactions. Previous research examining the relationship between the use of dating apps and sexual behaviors has found that individuals who use dating apps and meet with partners from the app are more likely to engage in high-risk sexual behaviors such as having multiple partners and inconsistent condom use. Individuals between the ages of 18 and 24 are the group most likely to be using dating apps compared to other age groups and are a high-risk group …

The Correlation Between Maternal Postpartum Depression And Child Psychopathology, T'Keyah I. Vaughan

Theses and Dissertations

Background: Postpartum depression (PPD) is a phenomenon that affects nearly 10-15% of pregnancies in the US. It is characterized by depressed mood or anhedonia and lasting for more than 2 weeks. PPD changes how moms interact with family members and child-rearing behavior. Depression is a phenomenon that is also known to affect the psychopathology of children. However, the specifics of how postpartum depression impacts children remains controversial. Many studies do not control for major depressive disorder which makes it difficult to disentangle the impact depression has within the first year of life. Furthermore, other PPD risk factors may be confounding …

A Qualitative Analysis Of Caregiver Goals For Urban Children With And Without Asthma, Megan M. Carlson

Theses and Dissertations

Pediatric asthma is a major public health concern that disproportionately affects children of color and youth living in low-income, urban areas. The implications for public health, child health, and family functioning necessitates our understanding and addressing experiences by families who are facing barriers within their socio-demographic context in addition to the stressors associated with managing pediatric asthma. The current study applied qualitative methods to interviews with caregivers of children with and without asthma in an effort to more deeply connect with caregivers’ experiences and yield richer information about the intersection of identities as Black caregivers living in an urban setting …

From Sunrise To Sunset: A Lifespan Approach To Understanding The Mental Health Of A Subset Of American Farmers, Janna L. Imel

Theses and Dissertations

Prior research has indicated higher risk of suicide for farmers and identified depression and anxiety as mental health concerns, though the majority of research was conducted in the 1980s-1990s. In today’s economic, social, and political climate, farmers are exposed to situations and stressors reminiscent of the 1980s Farm Crisis. An added risk is the aging workforce of farmers, as age-related conditions can make farming even riskier. This study investigated the mental health of a subset of American farmers by exploring farm-related stressors, coping mechanisms, and mental health outcomes. Dispositional mindfulness was explored as a specific coping mechanism. Participants (N …

Construction And Validation Of A Non-Medical Use Of Prescription Opioids Outcome Expectancies Scale Among College Students In China, Cheuk Chi Tam

Theses and Dissertations

Background:Non-medical use of prescription opioids (NMUPO) has become a clear threat to public health. Young adults (aged 18 to 25) have a high risk of NMUPO. My prior work on Chinese undergraduates indicates a high prevalence of lifetime NMUPO (49.2%). Health behavior theories propose that outcome expectancies are robust psychosocial determinants of substance use. Literature has identified the influence of outcome expectancies on alcohol and drug use. However, the role of outcome expectancies in NMUPO in China is unknown, and a scarcity of a valid measures for NMUPO outcome expectancies may be a barrier. Our previous research also found …

An Evaluation Of Differences In Motivations To Receive Cervical Cancer Screening And Follow-Up Care Between Black And White Women, Ashlee Sawyer

Theses and Dissertations

Background: Cervical cancer among Black women is a major individual and public health concern. Despite advancements in medical technology and policy, disparities in cervical cancer diagnosis and mortality still exist between White and Black women, with Black women having higher rates of diagnosis (10.0 vs 7.1 per 100,000) and mortality (4.1 vs 2.0 per 100,000). Previous studies have focused heavily on barriers to obtaining cervical cancer screening among Black women and efforts to improve screening rates. Despite speculation by researchers that gaps in receipt of quality follow-up care may contribute to disparities, its role in disparate mortality rates between Black …

Developing An Evidence-Based Hiv Testing Message For Young African American Women, Melanie P. Moore

Theses and Dissertations

African American women have the highest rates of HIV infection among women of all racial/ethnic groups in the United States, and over 50% of HIV infected young adults are unaware of their infection. HIV testing is a cost-effective mechanism for reducing HIV transmission. Despite this, limited research has been devoted to developing interventions specifically promoting HIV testing. This two-part study proposed to address this gap through developing a culturally tailored HIV testing message aimed at increasing HIV test intentions among young African American women. Study 1 was a quantitative study that examined predictors of HIV testing history and future HIV …

Queer Health Equity And Cervical Cancer: Identifying Social Determinants Of Papanicolaou Test Uptake In A Sample Of Sexual Minority Women And Gender Nonbinary Individuals, Ariella R. Tabaac

Theses and Dissertations

Sexual minority women (SMW) demonstrate lower rates of cervical cancer screening than heterosexual women. This is concerning as lesbian and bisexual women tend to engage in higher rates of substance-related cancer risk behaviors, unprotected sex, and tend to have higher body mass indices, all of which are risk factors for cancer development. Another major risk factor, screening avoidance, places SMW at increased risk for the development of high grade cervical lesions in the absence of early detection practices, which is likely to impact overall cervical cancer morbidity in this population. The aim of the present study was to utilize the …

A Stakeholder Examination Of Gestational Weight Gain Guidelines, Melissa Kwitowski

Theses and Dissertations

Obesity is a significant health concern for women of childbearing age. More than 40% of women have a Body Mass Index (BMI) in the overweight or obese ranges at the time they conceive, posing significant health risks for both mother and child. Excessive weight gain during pregnancy is common and associated with numerous deleterious complications. The Institute of Medicine published gestational weight gain (GWG) guidelines based on prepregnancy BMI. However, more than 50% of women gain in excess of these recommendations. Further, many women report receiving minimal guidance from their healthcare providers regarding weight gain, nutrition, and physical activity during …

Non-Medical Use Of Prescription Drugs, Stress, Cultural Orientation, Utilization Of Healthcare, And Protective Factors Among College Students In China, Cheuk Chi Tam

Theses and Dissertations

Background: Non-medical use of prescription drugs (NMUPD) refers to the use of prescription drugs which are traditionally utilized to manage pain or treat psychiatric problems but without a doctor’s prescription. In 2010, an investigation by the Substance Use and Mental Health Services Administration (SAMHSA) revealed that 5.3% of young adults (18 to 25-year-olds) in the United States reported past-month NMUPD. NMUPD has become a growing concern owing to associations with consequences such as college dropout, poor academic achievement, and health jeopardizing behaviors. College students' NMUPD has been well documented in the United States. Limited studies, however, have been conducted among …

Sustainable Adapted Treatments For Eating Disorders: The Role Of Cultural Adaptation In Prevention, Sarah J. Javier

Theses and Dissertations

Despite demonstrating eating disorder rates equivalent to White women, African American and Asian American women are less likely to seek treatment and are more likely to terminate treatment prematurely. One of the most successful programs for eating disorder prevention has only focused on surface-level cultural adaptations. Prevention literature maintains that deep-structure cultural adaptation (e.g., integrating cultural values and beliefs) can enhance outcomes for ethnic minorities. This dissertation examined the feasibility of Sustainable Adapted Treatments for Eating Disorders (SATED), a pilot intervention that included a culturally- targeted pre-treatment to an eating disorder dissonance-based intervention. A sample of 72 women (ages 18-30) …

The Role Of Afrocentric Features In Mental Healthcare Utilization And Counselor Preferences In Black College Students, Randl B. Dent

Theses and Dissertations

Though mental health issues are prevalent in Black young adults, they underutilize mental healthcare services. This research examined the role of feature-based discrimination in mental healthcare (under)utilization. Study 1, a secondary analysis of the National Longitudinal Study of Adolescent to Adult Health, provided no evidence supporting a link between skin tone and mental healthcare utilization, when controlling for depression diagnosis. However, when controlling for depression symptoms, there was a trend such that Black young adults with darker, as opposed to lighter, skin tone utilized healthcare less. Study 2, an experimental study with 33 Black college students, showed 73% of the …

Exploring The Role Of Intersectionality On Cardiovascular Disease Risk In Sexual Minorities, Leia Harper

Theses and Dissertations

Background: Previous research has shown that sexual minority individuals (SM) are twice as likely to smoke, twice as likely to be overweight or obese, and less likely to be physically active than heterosexual persons; all of which place SMs at an increased risk for cardiovascular disease (CVD). While information on CVD risk by race/ethnicity and socioeconomic status is well documented, there is scant literature examining race, gender, and the potential CVD risk in SMs. The purpose of this study was to examine CVD risk in sexual minorities.

Method: The current study used data from the National Longitudinal Study of Adolescent …

Chronic Pain Causal Attributions In An Interdisciplinary Primary Care Clinic: Patient-Provider And Provider-Provider Discrepancies, Bryan Jensen

Theses and Dissertations

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed …

Gender And Sexual Health: Applying Gender Role Theory To Men And Women’S Intention To Engage In Sexual Health Information Seeking Behaviors, Ariella R. Tabaac

Theses and Dissertations

The purpose of the present study is to examine the pathways between gender and behavioral intention to engage in sexual HISB through application of the Theory of Planned Behavior (TPB). It was found that feminine and masculine gender role stress differentially influence perceived behavioral control and behavioral attitudes, and that intention to engage in HISB was higher among women than men. Attitudes and PBC significantly predicted behavioral intention in this model. Further, women in the sample were more likely to search for sexual health information, with online sources being the most frequently reported resource. Additionally, past HISB was a significant …

An Exploration Of Factors Influencing Attrition From A Pediatric Weight Management Intervention, Melissa Ann Kwitowski

Theses and Dissertations

Childhood obesity is a serious health problem in the United States. Numerous weight management programs attempt to address this issue. However, attrition poses significant treatment efficacy challenges. Understanding attendance and attrition from childhood obesity programs is crucial for effective and appropriate resource utilization. NOURISH+ is a community-based treatment program for parents of overweight and obese children (age 5–11 years, BMI ≥ 85th percentile). The current study investigated attrition from NOURISH+ to enhance understanding of pediatric obesity treatment retention factors. NOURISH+ participants (n=70) completed a questionnaire assessing barriers to adherence and general program feedback. Data were analyzed using frequencies, …

Examining The Effect Of Race On The Relationship Between Posttraumatic Stress Disorder And Metabolic Syndrome In Women, Leia Harper

Theses and Dissertations

Posttraumatic stress disorder (PTSD) is a psychiatric condition affecting approximately 8% of the adult U.S. population with rates twice as high in women than men. Increasingly, evidence has suggested a close relationship between PTSD and increased risk of metabolic diseases. However, the literature on PTSD and metabolic disease risk factors has been limited by the lack of investigation of the potential influence of race on this relation. The current study examined the possible effect of race on the relation between PTSD and metabolic risk. Data for this study were provided from sample of that included 50 African American women and …