Public Health Commons^™

Inorganic Nanoparticle And Nanoplastic Transformations And The Impact On Biouptake By Freshwater Algal Cells Using Single Cell And Single Particle Inductively Coupled Plasma Mass Spectrometry, Elizabeth Carey Bair

Theses and Dissertations

The ubiquitous presence of nanoparticles (NPs) and nanoplastics (NPPs) and their effects on environmental and human health is a significant concern. They are used in every aspect of our lives, and while they offer many benefits, there are concerns about their impacts on ecosystems and human health. The primary aim of this dissertation is to quantify NP and NPP transformations in the presence of algae and determine how those transformations influence bioavailability. The methodology involves two complementary analytical techniques: single particle (SP) and single cell (SC) inductively coupled plasma mass spectrometry (ICP-MS). These techniques are tested and applied to two …

Medicaid Managed Care Organization Service Coverage And Diagnosis And Treatment Of Opioid Use Disorder: Evidence From Quasi-Random Auto-Assignment In Kentucky, Shelby R. Steuart, Miguel Antonio G Estrada, Christina Andrews Ph.D., Colleen M. Grogan, Olivia M. Hinds, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Melissa A. Westlake, Coady Wing, Amanda J. Abraham

Faculty Publications

Introduction

Opioid-related mortality continues to claim tens of thousands of American lives annually. Medicaid plays an outsized role in financing opioid use disorder (OUD) treatment, paying for almost 40% of all Americans who received OUD treatment in 2017. Methods

Using Medicaid T-MSIS Analytic Files data and a novel data set of Medicaid managed care organization (MCO) plan coverage, we examined the relationship between comprehensiveness of benefits for OUD treatment provided by Medicaid MCO plans and the likelihood of OUD diagnosis and medications for OUD (MOUD) receipt among newly enrolled Medicaid beneficiaries in Kentucky. We use two stage least squares to …

Functional Time Transformation Model With Applications To Digital Health, Rahul Ghosal Ph.D., Marcos Matabuena, Sujit K. Ghosh

Faculty Publications

The advent of wearable and sensor technologies now leads to functional predictors which are intrinsically infinite dimensional. While the existing approaches for functional data and survival outcomes lean on the well-established Cox model, the proportional hazard (PH) assumption might not always be suitable in real-world applications. Motivated by physiological signals encountered in digital medicine, we develop a more general and flexible functional time-transformation model for estimating the conditional survival function with both functional and scalar covariates. A partially functional regression model is used to directly model the survival time on the covariates through an unknown monotone transformation and …

The Influence Of Sex Education On Sexual Behaviors From Adolescence To Young Adulthood In South Carolina, Megan Elizabeth Austin

Theses and Dissertations

Sex education in South Carolina (SC) is known to be limited, which may influence adolescent sexual behaviors, leading to a higher likelihood of lower ages of sexual initiation, more sexual partners, and more experiences of sexual violence. These behaviors are associated with many negative health outcomes.

A political content analysis of bills, laws, and educational standards provides insight to changes in political discourse around sex education from when the Comprehensive Health Education Act (CHEA) was passed in 1988 until 2024. A variable created through this analysis is used along with SC Youth Risk Behavior Survey data to assess changes in …

Aggressive, Adaptive, And Underestimated: From Allergy To Arboviruses, The Rise Of The Lone Star Tick, Emily Ellen Owens Pickle

Theses and Dissertations

Once considered a nuisance with little medical importance, the lone star tick (Amblyomma americanum, Acari:Ixodidae) has emerged as a formidable vector driving a new era of public health threats across the United States of America. This dissertation traces the rise of the lone star tick from obscurity to infamy, exploring its expanding geographic range, unique immunologic impacts on humans, and role in the transmission of emerging tickborne viruses. Through a series of integrated studies, this work characterizes the epidemiology, immunology, and ecological context of tick-borne diseases in the southeastern U.S., with a particular focus on α-Gal syndrome (AGS), …

Hypertensive Disorders Of Pregnancy And Perinatal Outcomes: Two Prospective Cohort Studies Of Nulliparous Women In India And Tanzania, Andrea B. Pembe, Pratibha Dwarkanath, Amani Kikula, John Michael Raj, Nandita Perumal Phd, Heavenlight A. Paulo, Rajalakshmi M, Christopher P. Duggan, Honorati M. Masanja, Nandini Chopra, Mary M. Sando, Tinku Thomas, Cara A. Yelverton, Alfa Muhihi, Anura V. Kurpad, Wafaie E. Fawzi, Blair J. Wylie, Christopher R. Sudfeld

Faculty Publications

Introduction Hypertensive disorders of pregnancy (HDP) have been linked with increased risk for maternal and offspring complications in high-income settings. However, in resource-limited settings, studies with robust measurement of HDP, including severity and timing, and perinatal outcomes are limited.

Methods We analysed data from two prospective cohorts of nulliparous women in India (n=10 570 pregnancies) and Tanzania (n=10 299 pregnancies) who were enrolled in calcium supplementation trials and had blood pressure and proteinuria assessments throughout pregnancy and at the time of labour and delivery. Generalised estimating equations were used to assess the relationship between HDP severity categories (gestational hypertension, preeclampsia …

Association Between Dietary Inflammatory And Antioxidant Potential And Systemic Inflammatory And Oxidative Status With The Risk And Severity Of Coronary Artery Disease, Zahara Namkhah, Elham Alipoor, Manhnaz Salmani, Negar Ebrahimi, Monireh Ahmadpanahi, Ali Vasheghani-Farahani, Mehdi Yaseri, Michael David Wirth, Longgang Zhao, James Hébert Scd, Javad Hosseinzadeh-Attar

Faculty Publications

Background and aims

Unhealthy diets have pro-inflammatory properties that have been shown to contribute to coronary artery disease (CAD). The dietary inflammatory index (DII®) and the dietary antioxidant quality score (DAQS) quantify the anti-/pro-inflammatory and antioxidant potential of a diet. This study aims to investigate the association between the energy-adjusted DII (E-DIITM), DAQS, oxidant/anti-oxidant biomarkers, and CAD risk and severity.

Methods and results

This cross-sectional study investigated 158 participants for the presence and severity of CAD based on coronary angiography. E-DII and DAQS scores, malondialdehyde (MDA), total oxidant status (TOS), glutathione peroxidase (GPX) activity, total antioxidant capacity (TAC) and conventional …

Relocation Post-Dobbs Among Clinicians Providing Abortions, Dana Howard, Marta Bornstein Phd, Mph, Jocelyn Wascher, Alison H. Norris, Katherine Rivlin

Faculty Publications

Introduction

Intensifying state-level abortion restrictions following the Dobbs v Jackson Women’s Health Organization (2022) decision could lead clinicians to leave states that ban abortion.¹ While large-scale changes are not yet apparent among obstetrician-gynecologists, the abortion care workforce may be uniquely at risk.² We examined the proportion of abortion-providing clinicians who changed primary state of practice, comparing those who left states that banned abortion with those who left states that did not ban abortion after Dobbs, and the ban status of the states to which they relocated.

Methods

This survey study was approved by The Ohio State University …

Prevalence And Predictors Of Intimate Partner Violence Against Men In Kisumu Slums, Kenya, Elizabeth Akello Odemba, Edward A. Frongillo Jr. Ph.D., Sheri D. Weiser

Faculty Publications

Background

Men in sub-Saharan Africa experience intimate partner violence, with few reporting their cases to the legal authorities or coming out for assistance. Consequently, data on the prevalence and drivers of intimate partner violence in different parts of sub-Saharan Africa are inadequate. Therefore, this study was designed to investigate the prevalence and predictors of intimate partner violence against men in Kisumu slums, Kenya.

Methods

This retrospective cross-sectional study included 398 randomly selected men in intimate relationships aged 18–54 years and residing in Kisumu slums. The sampling frame used was from Community Health Volunteers covering the area of study. Data collection …

Telehealth And In-Person Hiv Care During The Covid-19 Pandemic At A Large Academic Medical Center In North Carolina, Valerie Yelverton, Jan Ostermann Ph.D., Michael E. Yarrington, Andrew K. Weinhold, Nabil Natafgi, Bankole Olatosi, Sharon Weissman, Nathan M. Thielman

Faculty Publications

Background

To maintain HIV care during the COVID-19 pandemic, many HIV clinics across the United States adopted telehealth. However, not everyone participated in telehealth equally. This study assessed the use and disparities in telehealth and in-person HIV care at a large academic medical center in North Carolina (NC) relative to the COVID-19 pandemic.

Methods

Data from the Duke University Infectious Disease clinic in NC were extracted from electronic health records (EHR), aggregated across persons with HIV (PWH) by calendar month, visit type (in-person vs. telehealth HIV care), and by key sociodemographic and clinical characteristics. Variation in HIV care over time …

Social Exclusion And Mental Health Of Youths Affected By Parental Hiv/Aids In China: Based On A Serial Mediating Model, Jiaojiao Wan, Lili Ji, Zheqian Wang, Junfeng Zhao, Xiaoming Li

Faculty Publications

The mental health of youth living with patients with HIV needs focused attention. The primary source of psychological distress they experience may stem from social exclusion. Therefore, the current study was designed to explore the relationship between social exclusion and mental health among youths affected by parental HIV/AIDS in rural China.

Methods

297 youths affected by parental HIV/AIDS were recruited to completed questionnaires of social exclusion, perceived stress, future orientation and mental health. The bootstrap method was used to examine the mediation effects.

Results

It showed that: (1) the social exclusion (M = 32.48, SD = 15.25) significantly and …

What, When, And How Food And Beverage Are Advertised On Ghanian Television, Morgan Boncyk, Krystal K. Rampalli, Marian N. Winters, Muskaan K. Makkar, Silver Nanema, Gideon S. Amevinya, Amos Laar, Edward A. Frongillo Ph.D., Christine E. Blake

Faculty Publications

Food marketing has increased volume, precision, and reach to influence viewers’ food attitudes, beliefs, and eating behaviors. What and how much people eat has implications for health. While many countries regulate food advertising to protect consumers and encourage healthy eating, Ghana has none. Understanding the content and framing of food and beverage advertisements can inform the development of effective policies and practices that encourage healthier diets. This content analysis examines the foods and beverages advertised, their timing, and marketing techniques on Ghanaian television. From February to May 2020, 486 hours of advertisements were recorded. Advertisements with ≥1 actors were coded …

High Prevalence Of Diabetes Mellitus Among Patients With Fabry Disease In Taiwan: A Cross-Sectional Study, Shih Han Hung, Sudha Xirasagar Mbbs., Ph.D, Yen Fu Cheng, Herng Ching Lin, Chin Shyan Chen

Publications

Objectives This study aimed to investigate the prevalence of diabetes mellitus in patients with Fabry disease using a nationwide population-based dataset. We hypothesised that patients with Fabry disease would have a higher prevalence of diabetes mellitus compared with the general population. Design A cross-sectional study. Setting Taiwan. Participants We identified a study sample from Taiwan's LHID2010 Database. There were 9408 sampled patients in this study, 2352 study patients with Fabry disease and 7056 propensity-score-matched comparison patients. Primary outcome measures Multiple logistic regression analyses were conducted to explore the association between diabetes mellitus and Fabry disease after taking the variables of …

Implementation Outcomes And Associated Constructs From The Consolidated Framework For Implementation Research Among Churches Trained Online To Implement Faith, Activity, And Nutrition In A National Implementation Study, Sara Wilcox Phd, Ruth P. Saunders Phd, Andrew T. Kaczynski Ph.D., Caroline Rudisill Ph.D., Msc, Ye Sil Kim Phd, Jasmin Parker-Brown, Kelsey R. Day

Faculty Publications

Churches hold promise for reaching populations with high rates of chronic disease, yet few faith-based large-scale implementation studies exist. The study purpose was to examine 12-month implementation outcomes and associated Consolidated Framework for Implementation Research (CFIR) constructs after converting in-person training to online for an evidence-based intervention designed to improve church organizational practices related to physical activity (PA) and healthy eating (HE). US churches recruited from 2020 to 2022 participated in eight online lessons prior to implementation. Each church’s coordinator completed an online baseline and 12-month survey assessing church practices for PA/HE components targeted in the Faith, Activity, and Nutrition …

Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan

Faculty Publications

Background

Bangladesh faces one of the highest global burdens of maternal and newborn deaths, primarily caused by hemorrhage and eclampsia/preeclampsia. Despite reducing maternal mortality by 40%, comprehensive medical interventions remain insufficient in health facilities.

Objectives

This study assessed the readiness of sub-district hospitals in Bangladesh to provide Emergency Obstetric and Newborn Care (EmONC) and analyzed the association between facility readiness and delivery rates.

Methods

Using Health Facility Assessment Survey data from 140 hospitals in 2014 and 141 in 2017, facility readiness was measured based on nine signal functions: administering antibiotics, oxytocin, and anticonvulsants; providing blood transfusions; performing cesarean and assisted …

Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan

Faculty Publications

Background

Bangladesh faces one of the highest global burdens of maternal and newborn deaths, primarily caused by hemorrhage and eclampsia/preeclampsia. Despite reducing maternal mortality by 40%, comprehensive medical interventions remain insufficient in health facilities.

Objectives

This study assessed the readiness of sub-district hospitals in Bangladesh to provide Emergency Obstetric and Newborn Care (EmONC) and analyzed the association between facility readiness and delivery rates.

Methods

Using Health Facility Assessment Survey data from 140 hospitals in 2014 and 141 in 2017, facility readiness was measured based on nine signal functions: administering antibiotics, oxytocin, and anticonvulsants; providing blood transfusions; performing cesarean and assisted …

Generative Ai For Thematic Analysis In A Maternal Health Study: Coding Semistructured Interviews Using Large Language Models, Shan Qiao, Xingyu Fang, Junbo Wang, Ran Zhang, Xiaoming Li, Yuhao Kang

Faculty Publications

Study Objectives: The coding of semistructured interview transcripts is a critical step for thematic analysis of qualitative data. However, the coding process is often labor-intensive and time-consuming. The emergence of generative artificial intelligence (GenAI) presents new opportunities to enhance the efficiency of qualitative coding. This study proposed a computational pipeline using GenAI to automatically extract themes from interview transcripts. Methods: Using transcripts from interviews conducted with maternity care providers in South Carolina, we leveraged ChatGPT for inductive coding to generate codes from interview transcripts without a predetermined coding scheme. Structured prompts were designed to instruct ChatGPT to generate and summarize …

Podcasts In Mental, Physical, Or Combined Health Interventions For Adults: Scoping Review, Elizabeth M. Dascombe, Philip J. Morgan, Ryan J. Drew, Casey P. Regan, Gabrielle Turner-Mcgrievy, Myles D. Young

Faculty Publications

Background:

The increasing prevalence of poor mental and physical health in adults is a global health concern. Given the scope of this problem, scalable and effective treatment interventions are needed. While podcasts (online digital audio files) are becoming more popular, the extent of podcast use in mental, physical, or combined health interventions has not been reviewed.

Objective:

This scoping review primarily aims to summarize the available evidence regarding the use of podcasts in health promotion interventions. A series of 5 research questions was designed to systematically review and accurately represent podcast use in current research interventions.

Methods:

We conducted a …

Investigating The Suitability Of Dichotomous Responses For The Water Insecurity Experiences (Wise) Scales Using Nationally Representative Data From 39 Countries, Indira Bose, Joshua D. Miller, Hilary J. Bethancourt, Olga P. García, Hugo R. Melgar-Quiñonez, Rosana Salles-Costa, Mauro E. Delgrossi, Scott M. Miller, Tessa L. Durham, Teresa Shamah-Levy, Pablo Gaitán-Rossi, Sera L. Young, Edward A. Frongillo Jr. Ph.D.

Faculty Publications

The Water Insecurity Experiences (WISE) Scales have been validated to comparably measure water insecurity globally. The scales consist of 12 items that can be administered in approximately 3 minutes. There is interest in developing more rapid versions of the tools for when time is limited. One alternative is to use a subset of 4 items, which has been validated, but has some drawbacks. Here we investigate another alternative: dichotomous (yes/no) response options instead of the original four levels of frequency-based (polytomous) responses. We used nationally representative data from 39 countries to simulate dichotomized responses by collapsing the four levels of …

Sexually Transmitted Infection (Sti) Incidence And Risk Factors Among People With Hiv (Pwh): Insights From A 13-Year Cohort Study In South Carolina, Salome-Joelle Gass, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi

Faculty Publications

The Ending the HIV Epidemic (EHE) initiative aims to reduce new HIV infections by 90% by 2030 in the United States (US). However, rising sexually transmitted infection (STI) rates exacerbate the bidirectional infection risk between HIV and STIs. Most research on STIs among people with HIV (PWH) has focused on high-risk groups, resulting in limited data on broader populations. This study addresses that gap by examining the incidence and risk factors for gonorrhea, chlamydia, and syphilis in a statewide cohort of PWH in South Carolina. Data from South Carolina’s HIV and STI surveillance systems were linked, and all PWH aged …

Environmental Risk And Alpha-Gal Syndrome (Ags) In The Mid-Atlantic United States, Brandon D. Hollingsworth Ph.D., Margaret Wiener, Dana A. Giandimenico, Scott P. Commins, Ross M. Boyce

Faculty Publications

Alpha-gal syndrome (AGS), commonly referred to as the tick bite red meat allergy, has been reported worldwide with the number of suspected cases in the United States increasing from 24 in 2009 to over 34,000 in 2019. Within the US, AGS is associated with the bite of two tick species, Amblyomma americanum and Ixodes scapularis, and has particularly high incidence rates in the mid-Atlantic region. Because AGS is associated with tick bites, the risk of developing AGS is affected by the environment individuals visit. Despite this, as well as the numerous studies associating the environment with Am. americanum, …

Human Capital And Lifetime Income Gains Of Scaling-Up Small-Quantity Lipid Nutrient Supplements Among Children Under 2 Years: A Modelling Analysis, Nandita Perumal Phd, Goodrarz Danaei, Günther Fink, Mark Lambiris, Christopher R. Sudfeld

Faculty Publications

Undernutrition in early childhood is associated with adverse health and developmental outcomes later in life and remains a persistent global public health problem. Providing small-quantity lipid nutrient supplements (SQ-LNS) to children aged 6-24 months improves child growth and neurodevelopmental outcomes, but the potential long-term benefits to human capital have not been previously estimated. We estimated the potential returns to schooling and lifetime income attributable to increasing coverage of SQ-LNS for children < 2 years of age from 0% to 50% or 90% per five-year birth cohort in five countries (Bangladesh, Burkina Faso, Ethiopia, Pakistan, and Uganda) with a high burden of undernutrition. Random-effects meta-analyses were used to estimate the effect of SQ-LNS on child development using evidence from randomized controlled trials, and to estimate the returns to lifetime income as a function of change in development based on a de novo meta-analysis of observational economic studies. Gains in school years attributable to scaling-up SQ-LNS to 90% coverage ranged from 0.14 million school years (95% uncertainty interval [UI]: 0.064, …

Revitalizing Passenger Rail: A Sustainable Solution To Environmental And Public Health Challenges In South Carolina, Benjamin Cochran

Theses and Dissertations

South Carolina, a historic leader in passenger rail, has become a heavily vehicle-dependent state. As the population rapidly grows, so does the number of vehicles, vehicle miles traveled, and vehicle emissions, including the greenhouse gas pollutants carbon dioxide (CO2), nitrous oxide (N2O), and particulate matter (PM2.5), significantly contributing to air pollution and deteriorating health and environmental outcomes. Despite this, mass transit is nonexistent for the three largest cities in South Carolina, Charleston, Columbia, and Greenville, forcing residents and travelers to drive. This study evaluates the feasibility and the environmental, public health, environmental justice, and economic implications of a passenger rail …

Tobacco Package Health Warnings About Product Manipulations: An Experimental Study Among Australian Adults Who Smoke, Emily Brennan, Claudia Gascoyne, Kimberley Dunstone, Amanda Vittiglia, Gayathri Srinivasan, Jim Thrasher Ph.D., Ma, Ms, Janet Hoek, Melanie Wakefield, Sarah Durkin

Faculty Publications

The tobacco industry manipulates cigarettes to provide sensory cues that mislead people who smoke. We assessed the effectiveness of health warnings (HWs) focussed on the impact of misleading product attributes, including filter ventilation, menthol, and roll-your-own tobacco, which were called Product Attribute HWs. Australian adults who smoke (n = 2544) were randomly assigned to view: control medication warnings; new Standard HWs with smoking harm images; Product Attribute HWs; or Product Attribute HWs plus a video. At baseline, participants were exposed to seven condition-specific warnings (+ video for those in the Product Attribute HWs + Video condition), then they were …

Research Priorities For Drivers Of Food Choice For Food System Transformation In South Asia: Proceedings Of A Collaborative Workshop, Christine E. Blake Ph.D., Rd, Sunny S. Kim, Edward A. Frongillo Ph.D., Purnima Menon

Faculty Publications

Agrifood systems in South Asia are highly productive, but substantial challenges including poverty, climate change, and environmental degradation complicate progress toward achieving sustainable healthy diets for all. The dynamics of food systems and the consequence of their rapid transformation for food choice behaviors that contribute to healthy and unhealthy diets are not well understood. Food choice is defined as a decision-making process through which individuals and households consider, acquire, prepare, distribute, and consume foods and beverages. Understanding drivers of food choice (DFC) is important for achieving sustainable healthy diets, but evidence is lacking. This article outlines collectively derived priorities for …

Telehealth Or In-Person Hiv Care? Qualitative Study Findings On Decision-Making From People With Hiv And Hiv Care Providers In South Carolina During The Covid-19 Pandemic, Valerie Yelverton, Salome Joelle Gass, Daniel Amoatika, Christopher Cooke, Jan Ostermann, Nabil Natafgi, Nicole L. Hair Ph.D., Bankole Olatosi Ph.D., Otis L. Owens, Shan Qiao Ph.D., Xiaoming Li Ph.D., Caroline Derrick, Sharon Weissman, Helmut Albrecht

Faculty Publications

The COVID-19 pandemic disrupted HIV care services across the United States. Telehealth was rapidly implemented to ensure HIV care continuity. Despite the evidence of unequal telehealth uptake among some people with HIV (PWH), the decision-making processes to determine who received telehealth or in-person care are under-researched. This study assessed which decision criteria and processes determined which HIV care visit type was used by PWH and HIV care providers during the COVID-19 pandemic. Qualitative in-depth interviews with 18 PWH and 10 HIV care providers from South Carolina assessed PWHs’ and HIV care providers’ decision-making criteria and processes for telehealth HIV care …

Adolescent Sleep Health, Mental Health, And Cardiovascular Disease Risk In Adulthood, Prince Nii Ossah Addo

Theses and Dissertations

Background: Insufficient sleep and poor sleep quality are major public health issues among adolescents in the United States (U.S.). Mental health and substance use challenges are also common among adolescents, particularly those with sleep problems. Although exposures in adolescence have been evidenced to significantly impact future health, little is known about how adolescent sleep health, mental health, and substance use influence future cardiovascular disease (CVD) risk. We, therefore, examined the association between sleep health in adolescence and CVD risk in adulthood and assessed whether the association is mediated by depressive symptoms and substance use in adolescents. Further, we explored the …

Delta-8 Tetrahydrocannabinol Policy And Related Health Impact Among College-Aged Individuals In South Carolina: A Scoping Review, Emily K. Luoma

Senior Theses

After the 2018 Farm Bill passed, loopholes were quickly found that led to the popularization of delta-8 THC, a derivative of delta-9 THC, more commonly known as marijuana. Use of this substance became particularly high in states that criminalized marijuana, such as South Carolina. This scoping review aimed to assess South Carolina’s current delta-8 policies in the context of health-related impacts among college-aged students. Comprehensively analyzing the results of relevant studies, it was determined that there are three commonly observed threats to public health that are direct outcomes of existing policies: 1) a lack of quality control standards; 2) misleading …

The Stigma Surrounding Sex And Sexuality In American Culture, Sophia L. Pollock

Senior Theses

An important question to examine is the origin and implications of the taboo against sex and sexuality. The stigma against these topics encourages negative public health implications like poor sex education, high rates of sexually transmitted infections, and teen pregnancy. History of sexual stigma was examined through physical media and digital articles from the Thomas Cooper Library databases. The background and global perspective of these stigmas are covered, examining how past and distant cultures deal with sex. How sex is portrayed in the media, why a healthy sex life is important, and the subject of sex education are also addressed. …

Understanding The Factors Influencing Movement Behaviors Among Dog Owners, Katherine Eileen Devivo

Theses and Dissertations

This dissertation investigates two key objectives: 1) to understand influences of physical activity among dog owners, and 2) to determine if there were differences in objectively measured physical activity levels and/or affect at times when dog owners are with their dogs compared to times when they are not with their dogs. To address the first objective, a qualitative study was conducted with 20 dog owners using semi-structured interviews, constant comparative methodology, grounded theory, and open coding. The findings revealed several key barriers to physical activity and dog walking such as physical health, seasons/weather, time/schedules, and dog specific limitations. Key facilitators …