Public Health Commons^™

Understanding The Role Of Political Commitment And Coherence Across Sectors And Across National And Sub-National Levels In Enabling Improvements In Nutrition In Rwanda, Elyse Iruhiriye

Theses and Dissertations

Reducing undernutrition is on the political agendas of many low- and middle-income countries. There is general consensus that to improve nutritional outcomes involves actions across the different sectors that influence both the immediate and underlying determinants of optimal nutrition and an enabling environment to support the political and policy processes. Despite renewed attention over the last 15 years, addressing nutrition in a multisectoral way was previously promoted in the 1970’s but failed to have sustained political commitment due to its organizational complexities to plan and implement strategies across sectors.

We conducted an in-depth retrospective case study to understand how Rwanda, …

Determinants Of Nutrition Agenda Setting In The Context Of The Double Burden Of Malnutrition In Tamil Nadu, India, Shilpa Vimalananda Constantinides

Theses and Dissertations

The double burden of malnutrition is increasing in low- and middleincome countries, with economic, social, and health consequences. Policies and programs to address malnutrition at the national and subnational levels reflect the priorities and framing of the problem by the stakeholder community. Previous studies have examined if and how nutrition-related NCDs have been included into national nutrition policy agendas that have historically focused on reduction of undernutrition, but little is known about if or how this process occurs at the subnational level where policies are translated and implemented according to local contexts, priorities, and frames of nutrition-related NCDs.

We aimed …

Examining The Organizational Capacity Of Public Libraries That Offer Obesity Prevention Programs, Olivia Whitt

Theses and Dissertations

Supplemental Nutrition Assistance Program Education (SNAP-Ed) is a federally funded grant program that helps SNAP-eligible populations make healthy choices, like those outlined by the Dietary Guidelines for Americans and the Physical Activity Guidelines for Americans. Together with implementation agencies (IAs) and local sites, SNAP-Ed provides direct nutrition education and facilitates policy, systems, and environmental strategies (PSEs) such as farmers markets and community gardens. This qualitative research investigated two specific aims: 1.) Understand the elements of organization capacity that influence a public library’s ability to implement obesity prevention programs and 2.) Evaluate the need for library staff public health knowledge …

Rethinking The Customer Experience: An Empirical Comparison Of Airbnb And Hotels, Jing Li

Theses and Dissertations

Experience is at the heart of the tourism and hospitality industry. One of the fundamental objectives of this sector is to create memorable customer experiences. For years, the sharing economy has been an essential industry phenomenon. Distinct from the traditional sector, Airbnb emerged as a disruptive innovation and a dominant online sharing-economy platform and has had a significant impact on the traditional industry. Despite growing interest in customers’ experiences in tourism and hospitality, limited research has provided insight into what constitutes the customer experience with Airbnb, how it can be conceptualized, and how it should be measured. In addition, Airbnb …

Social Networks, The Local Food Environment, And Maternal Food Choice For Children Ages 1 To 5 Years Old In Rural Mexico, Ligia Ivette Reyes

Theses and Dissertations

Children’s nutrition is largely determined by the food choices their primary caregivers make. Food choice for children has important implications for nutrition, development, and the dietary habits and preferences that are formed during early life food exposure. Little is known about the food environments in which food choices are made and the role of social networks in maternal food choice during habit- and preference-forming years in contexts undergoing nutrition transitions and facing the double burden of malnutrition. The overall objective of this study was to gain an indepth understanding about how mothers, as primary caregivers, make food choices for their …

Influences On Parents’ Food Shopping For Children’S Consumption In South Carolina, Nazratun Nayeem Monalisa

Theses and Dissertations

Background: The diets of children in the United States typically do not meet dietary guidelines. Energy-dense nutrient-poor (EDNP) foods dominate children’s diets, contributing excessive energy, sugar, sodium, and fat intake. Home is the major source of children’s energy intake. Parents oversee household food purchases including foods for children.

Objectives: This research aimed to 1) identify parents’ food and beverage purchases for their household and for 6-11-year old children; 2) understand how parents made food purchase decisions by adjudicating among different values; 3) understand children’s food choice construction, strategies to influence parents for desired items, and extent of children’s influence.

Methods: …

A Qualitative Study Of The Genesis Of A Community Food Pantry For Students Of Higher Education, Elizabeth Fast

Theses and Dissertations

Objective: The purpose of this case study was to understand the development of a food pantry for students of higher education at a Midwestern university.

Methods: The researchers recruited 11 individuals on the food pantry’s board using a snowball sampling method to participate in a 30-minute interview about the food pantry’s development from conception to implementation. The interviews were transcribed and then qualitatively analyzed by two researchers. The researchers coded interviews separately to identify frequent commonalities between participant responses. The researchers then organized the codes into themes, which were then summarized in the results of this study.

Results: The first …

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 …

Doctor-Patient Communication: The Experiences Of Black Caribbean Women Patients With Diabetes, Rosanne Paul-Bruno

Theses and Dissertations

This applied dissertation was designed to examine the verbal and non-verbal communication experiences of Black Caribbean diabetic women patients with their doctors, in order to provide a better understanding of the essential aspects of doctor- patient communication and their experiences as they managed their condition. Black Caribbean women have been disproportionately impacted by medical conditions such as diabetes. It has been a documented fact that minorities experience disparities in the health care system at different levels and doctor-patient communication is no exception. Poor doctor-patient communication has been known to hinder patients’ health outcomes, and therefore warrants such studies to increase …

Women’S Socio-Economic Empowerment And Uptake Of Hiv Testing In Ethiopia, Dawit Alemu

Theses and Dissertations

Introduction: Sub-Sahran Africa constitute two-thirds of all people living with HIV in the world. HIV infection rate is high in the continent with women comprising 56% of new HIV infections among adults 15 and older. Women 15 to 24 are the most affected constituting 66 % of new infections occurring among this age group. The purpose of this study was to examine how gender power relations between men and women affect health seeking behavior, particularly HIV testing, among Ethiopian women age15 to 49.

Methods: The Ethiopian Demographic and Health Survey (EDHS) from 2016 served as the data source for …

Experience Of Persistent Pain Among Military Service Members Participating In An Interdisciplinary Intensive Outpatient Program, Barbara Katarzyna Bujak

Theses and Dissertations

Persistent pain is one of today’s most complex issues in healthcare. In the U.S. military, persistent pain affects close to half of the service members who have deployed overseas and up to 73.2% of service members and veterans experiencing persistent pain. Interdisciplinary pain management, considered one of the most effective ways to manage persistent pain, utilizes the biopsychosocial model that illustrates the dynamic interaction between the physiological, psychological and social factors involved in the experience of persistent pain. Effective interdisciplinary programs address all components of the model and result in better coping skills to self-manage persistent pain, decreased fear of …

Pre-Exposure Prophylaxis (Prep) For Hiv Prevention: A Mixed-Methods Study Of Sexual Risks And Knowledge, Perceptions, And Willingness Of Prep Use Among African American Women In The South, Jamie Troutman

Theses and Dissertations

There are approximately 1.1 million people living with HIV in United States, with nearly 40,000 new diagnoses annually. Significant regional and racial disparities are associated with HIV diagnoses — with the South experiencing the greatest burden of HIV and African American women accounting for 60% of new diagnoses among women. Pre-exposure prophylaxis (PrEP) has been designated as an effective tool to prevent HIV transmission among individuals who may be at risk of HIV infection. Earlier PrEP research has focused mainly on at-risk groups such as men who have sex with men (MSM). Previous PrEP research involving African American women included …

Evaluating Impacts Of A Multilevel Resilience-Based Psychosocial Intervention On Mental Health Of Children Affected By Parental Hiv In China, Yanping Jiang

Theses and Dissertations

Background: Children affected by parental HIV are commonly exposed to multiple risk factors, including parental illness and death, other traumatic life events, HIV stigma, and poverty, all of which in turn put them at elevated risk of experiencing poor mental health outcomes. Previous research has suggested the promise of psychosocial interventions in improving mental health for children affected by parental HIV through an integrated and multilevel resilience-based approach. However, there are few multilevel resilience-based interventions for this group, and the efficacy of such interventions on mental health outcomes has not been fully examined. Furthermore, very few studies have examined whether …

The Plant-Based And Soul-Full Study (Pass): Examining How Owners Of Local Vegan Soul Food Restaurants Promote The Consumption Of Vegan Foods In The African American Community, Anthony Crimarco

Theses and Dissertations

Background: Obesity remains a prevalent public health epidemic and African American (AA) adults are disproportionately affected by obesity more than any other ethnic group. There are also disparities in obesity by location, with the South having the highest rates compared to other geographic regions in the United States. Addressing poor dietary habits is important for improving obesity rates among AAs, but there has been limited research that has focused on specifically developing culturally-tailored interventions. With a recent number of soul food restaurants serving exclusively vegan meals opening up across the country to appeal to AAs and others interested in eating …

Social Networks, Social Support, And Contextual Factors That Affect Blood Glucose Control Among Individuals With Type 2 Diabetes Mellitus In Urban Ghana, Marian O. Botchway

Theses and Dissertations

This study used primary data from Kumasi, Ghana, to examine whether social networks, social support, diabetes-related stigma, religion, and traditional medicine affected blood glucose (HbA1c) control among adults with type 2 diabetes mellitus (T2DM). First, the study evaluated whether three social network characteristics (kin composition, household composition, and network density) were directly or indirectly (via social support) associated with HbA1c. Kin composition and household composition were significantly associated with social support. Neither network characteristics nor social support were associated with HbA1c, which suggests that social network characteristics may operate through mechanisms other than social support to affect HbA1c among study …

Sociocultural Factors Influencing Cervical Cancer Prevention And Control Behaviors In Cusco, Peru, Venice Elizabeth Haynes

Theses and Dissertations

Cervical cancer is one of the most preventable types of cancer; however, it continues to pose significant health challenges for women in low and middle-income countries (LMICs), particularly in Peru. Studies previously conducted in Peru have examined factors associated with cervical cancer screening, screening access, availability, and geographical determinants on cervical cancer incidence and mortality. These studies have suggested the need to explore sociocultural factors and the roles of men and women in screening decisions associated with excessive cervical cancer burden and low rates of screening among Peruvian women. The goal of the dissertation research was to explore influences of …

Beyond The Sentimental Cliche: How Local Communities Impact Residents And Shape Public Opinion, Kate Brunk

Theses and Dissertations

The Trump administration has recently established a rule that will prohibit abortion services providers from receiving Title X funds for the non-abortion family planning services they provide. Little public opinion research has focused on family planning and reproductive health topics outside of abortion. I find statistically significant experimental evidence that increasing perceptions of local need for a local reproductive health clinic caused subjects to be more supportive of federal reproductive health funding for local clinics. I did not find statistically significant correlational evidence that objective measures of poor reproductive health at the county level influence public opinion on federal reproductive …

Role Of Resources For Care In Improving Care Behaviors, Children’S Nutritional Status And Early Childhood Development In Low- And Middle-Income Countries, Sulochana Basnet

Theses and Dissertations

Poor child growth and suboptimal early childhood development are global health problems. Provision of appropriate care may help to achieve optimum child growth and development. Maternal resources for care such as education, knowledge, health, autonomy, reasonable workload, and social support may be needed to provide appropriate care behaviors, and improve children’s nutritional status, and early childhood development. The overall goal of this research was to understand the role of resources for care in improving care behaviors, child nutritional status, and early childhood development. The baseline Alive & Thrive household surveys from Bangladesh, Vietnam, and Ethiopia were used. We examined the …

Parenting And Child Self-Regulation As Mechanisms For The Relationship Of Household Food Insecurity With Child Dietary Behavior, Hoa Thi Mai Nguyen

Theses and Dissertations

Background: Food insecurity is both a nutritional problem and a stressful life experience of adults and children in households dealing with food shortage. Potential mechanisms of the associations between food insecurity and adverse outcomes in children’s health and development are through parenting and child self-regulation.

Objectives: We investigated parenting and child self-regulation as potential mechanisms for the relationship of food insecurity with child dietary behaviors with two specific aims. Specific aim 1 was to understand how food insecurity and its change over time relate to parenting in early childhood. Specific aim 2 was to understand the relationship of parenting in …

Social Emotional Learning Through Depression Education In A High School Setting, Antonette Minniti

Theses and Dissertations

Education on depression is an important part of social emotional learning. Lacking emotion regulation skills tend to lead to larger problems, such as academic struggles, disconnect from peers, strife at home and trouble in interpersonal relationships. Research in depression education or educational programs connected to mental health literacy are minimal, especially at the high school level. The purpose of this research will focus on examining the impact of one depression education program, John Hopkins Hospital’s Adolescent Depression Awareness Program (ADAP). ADAP is a three-day program that informs students about the facts of depression, how it is treated, and what to …

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 …

Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus

Theses and Dissertations

Hospital readmissions are a major burden for patients with end stage renal disease (ESRD). On average, one in three hospital discharges among patients with ESRD are followed by a readmission within 30 days. Currently, dialysis facilities are held accountable for readmissions via the ESRD Quality Incentive Program standardized readmission ratio (SRR) clinical measure. However, little is known about facility-level factors associated with readmission. Additionally, unlike other standardized measures of quality in the dialysis setting, incident patients within their first 90-days of dialysis are included in the performance calculation. This study analyzed CMS Dialysis Facility Report data from 2013 to 2016 …

Illumination Of The Golgi Apparatus Of Pathogenic And Nonpathogenic Naegleria Species, Tyler M. Poe

Theses and Dissertations

In this study, Naegleria fowleri, a pathogenic amoeba and the causative agent of Primary Amebic Meningoencephalitis (PAM), was utilized to determine the presence or absence of classically conserved Golgi molecules featured in the expression of a Golgi apparatus. Previous studies concluded no Golgi expression via light microscopy and transmission electron microscopy, but a recent report on Naegleria gruberi indicated the presence of dispersed Golgi tubules. Non-pathogenic species of the Naegleria genus such as Naegleria gruberi 30540 and Naegleria lovaniensis 30569 were utilized in Western immunoblot analysis compared to reduced whole-cell lysate proteins of two strains of N. fowleri and …

What's So Bad About Hooking Up? : Factors Predictive Of More Positive Perceptions Following A Hookup, Jade A. M. Spaulding

Theses and Dissertations

The purpose of the study was to examine factors predictive of a more positive perceptions following a hookup. The participants included 188 students from Illinois State University. Participants completed a demographics questionnaire, the Hookup Scale, the Rosenberg Self-Esteem Scale, the Sexual Self-Esteem Inventory, religiosity questions, attitudes toward hooking up questionnaire, emotional reactions to hooking up questionnaire, and the Social Academic, Romantic, and Sexual Hooking Up Reactions Scale. The current study found that participants who reported high global self-esteem, high sexual self-esteem, and positive attitudes toward hooking up reported less regret, more positive reactions, and fewer negative reactions following a hookup.

Framed Text Messages As A Nutrition Education Intervention, Michael James O'Halloran

Theses and Dissertations

A youth’s college years is a critical period in health behavior formation, during which body mass index (BMI) and other health behaviors such as diet and physical activity are strong predictors of adult health status. Text messaging is prominent in the lives of most college-age adults. Despite this, relatively few studies have investigated the potential of utilizing a text message-based intervention to target fruit and vegetable consumption, a measure for weight management behaviors. Additionally, few studies utilizing a text message-based intervention have utilized a theory specific to the creation of behavior-motivating text messages. The gain-framed health behavior messages of Prospect …

Adult Nursing Students’ Perceptions Of Social Presence In Facilitator-Created Subject- Specific Videos In An Online Nursing Course, Jamie Anne Marcus

Theses and Dissertations

The literature established that online instruction consists of cognitive, teaching, and social presence. Studies on the element of social presence linked text-based delivery of instruction with learners’ feelings of isolation and disengagement. This research findings prompted this facilitator creation of five-to-seven-minute companion videos that aligned and complemented weekly text-based learning modules to ascertain students’ perceptions of these videos as a medium for channeling social presence.

Post-video viewing surveys yielded responses to pragmatic and emotional questions. Pragmatic questions were aimed at the visual impact of professor’s delivery of information. Emotional questions gauged the students’ feelings of connectivity with the facilitator. Triangulated …

Motivators Impacting Employment After Disability Due To Injury Or Chronic Illness, Damion B. Jackson

Theses and Dissertations

Unemployment caused by the need to treat and recover from a disability due to injury or chronic illness is a common phenomenon. Research illustrates that absence from work damages organizational growth, employers, and employees. Employees often experience problems with their mental and physical health that affect their social identity and function. In the context of the recognized value of employment for human health and well being, policy-makers have implemented various programs and approaches to encourage re-employment of those unemployed due to required treatment and rehabilitation. Many of the approaches are driven by financial incentives to encourage individuals to rejoin the …

The Effect Of Neighborhood Characteristics And Acculturation On Vegetable Intake Among U.S. Hispanics, Anna Victoria Mesa

Theses and Dissertations

The growing prevalence of chronic disease among the U.S. Hispanic population has drawn increasing attention to modifiable behaviors such as diet in an effort to curb the burden of disease among this population. While factors affecting dietary intake among U.S. Hispanics have been largely studied, this study broadens the scope of existing analyses from examining the role of individual-level factors, including acculturation, to also include environmental factors such as neighborhood ethnic composition. Multilevel mixed modeling was employed to test the interaction of individual acculturation with neighborhood ethnic composition to predict vegetable intake among a sample of U.S. Hispanics. Individuals who …

Body Mass Index Trajectories And The Relationship Between Stressful Life Changes And Nutrition-Related Health Outcomes Among United States Army Soldiers, Julianna Marie Jayne

Theses and Dissertations

Body mass index (BMI) has risen among members of the military, though to a lesser degree than in civilian populations. BMI as an anthropometric tool has been essential for population surveillance and documenting the obesity epidemic and its health consequences. One use for BMI in population surveillance is to model the BMI trajectories of a population over time. Many studies are available on the BMI trajectories and determinants of BMI in civilians, but few studies of this nature in military populations exist. Establishing the shape and determinants of BMI trajectories among Soldiers is critical given the importance of weight management …

A Qualitative Exploration Of Experiences And Motivations For Diabetes Self-Management In African American Men Between The Ages Of 40-85 With Type 2 Diabetes, Anthony Q. Walker

Theses and Dissertations

Diabetes is a devastating disease that can affect an individual’s health and quality of life, but if managed properly, individuals with diabetes can have a good quality of life. Diabetes strikes African American men at a high rate. This study used a qualitative design to explore African American men between the ages of 40-85 with type 2 diabetes (T2DM) and their definition of diabetes and motivation, their experience of living with diabetes, their self-management behaviors, their motivations for managing diabetes, and what they and healthcare providers believe motivates them to self-manage diabetes and to attend diabetes self-management education (DSME) programs. …