Public Health Education and Promotion Commons^™

Examining Crowdsourced Social Media Platforms And Their Association With College Students' Alcohol Consumption, Perceived Risk, And Behaviors, Danielle Gentile

Theses and Dissertations

Introduction: High-risk alcohol use by U.S. college students remains a significant threat to individual health and community well-being. Newly-emerging social media platforms and apps which relay information about alcohol-related law enforcement serve as an intriguing addition to college alcohol-use environments. The purpose of this study was to examine the information delivered to users by the local social media platform @Drinking Ticket (DT), determine which types of information were then relayed to others, and clarify how this information influences alcohol use, perceived risk, and alcohol-related risk behaviors among college students. Methods: One year of DT tweets (n=854 tweets) were qualitatively coded …

Conversations About Sexuality On A Public University Campus: Exploring Perspectives From Campus Ministry Leaders And Students, Charis Rebecca Davidson

Theses and Dissertations

Since the 1800s, religious organizations have been a presence on public universities. However, there is limited research on the influence these organizations may have on student health communication and behaviors. Prior research on campus ministries has focused primarily on the culture of individual organizations. In this study, researchers explored the goals and experiences of USC leaders related to communication around sexuality with their students, as well as student perceptions of these messages, and how students incorporate religious messages about sexuality into their lives. The present study had four aims:

1. Assess whether students participating in campus ministries at USC differ …

Exposure To Mass Media And Interpersonal Counseling Has Additive Effects On Exclusive Breastfeeding And Its Psychosocial Determinants Among Vietnamese Mothers, Phuong H. Nguyen, Sunny S. Kim, Tuan T. Nguyen, Nemat Hajeebhoy, Lan M. Tran, Silvia Alayon, Marie T. Ruel, Rahul Rawat, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

The pathways through which behavior change interventions impact breastfeeding practices have not been well studied. This study aimed to examine: (1) the effects of exposure to mass media and interpersonal counseling on exclusive breastfeeding (EBF) and hypothesized psychosocial determinants (i.e. knowledge, intention, beliefs, social norms, and self-efficacy); and (2) the pathways through which exposure to mass media and interpersonal counseling are associated with EBF. We used survey data from mothers with children< 2 year (n = 2045) from the 2013 process evaluation of Alive & Thrive’s program in Viet Nam. Multiple linear regression analyses and structural equation modeling were used to estimate effects. Exposure to mass media only, interpersonal counseling only, both or neither was 51%, 5%, 19% and 25%, respectively. Exposure to both mass media and interpersonal counseling had additive effects on EBF as well as on related psychosocial factors, compared with no exposure. For example, EBF prevalence was 26.1 percentage points (pp) higher in the group that received interpersonal counseling only, 3.9 pp higher in the mass media group and 31.8 pp higher in the group that received both interventions. As hypothesized, more than 90% of the total effect of the two interventions on EBF was explained by the psychosocial factors measured. Our findings suggest that combining different behavior change interventions leads to greater changes in psychosocial factors, which in turn positively affects breastfeeding behaviors.

A Technology-Mediated Behavioral Weight Gain Prevention Intervention For College Students: Controlled, Quasi-Experimental Study, Delia Smith West, Courtney M. Monroe, Gabrielle Turner-Mcgrievy, Beth Sundstrom, Chelsea Larsen, Karen Magradey, Sara Wilcox, Heather M. Brandt

Faculty Publications

BACKGROUND: Both men and women are vulnerable to weight gain during the college years, and this phenomenon is linked to an increased risk of several chronic diseases and mortality. Technology represents an attractive medium for the delivery of weight control interventions focused on college students, given its reach and appeal among this population. However, few technology-mediated weight gain prevention interventions have been evaluated for college students. OBJECTIVE: This study examined a new technology-based, social media-facilitated weight gain prevention intervention for college students. METHODS: Undergraduates (n =58) in two sections of a public university course were allocated to either a behavioral …

Progress In Improving Provincial Plans For Nutrition Through Targeted Technical Assistance And Local Advocacy In Vietnam, Jody Harris, Phuong H. Nguyen, Quyen To, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained …

Syrian Refugees And Digital Health In Lebanon: Opportunities For Improving Antenatal Health, Reem Talhouk, Sandra Mesmar, Anja Thieme, Madeline Balaam, Patrick Oliver, Chaza Akik, Hala Ghattas Ph.D.

Faculty Publications

There are currently over 1.1 million Syrian refugees in need of healthcare services from an already overstretched Lebanese healthcare system. Access to antenatal care (ANC) services presents a particular challenge. We conducted focus groups with 59 refugees in rural Lebanon to identify contextual and cultural factors that can inform the design of digital technologies to support refugee ANC. Previously identified high utilization of smartphones by the refugee population offers a particular opportunity for using digital technology to support access to ANC as well as health advocacy. Our findings revealed a number of considerations that should be taken into account in …

Syrian Refugees And Digital Health In Lebanon: Opportunities For Improving Antenatal Health, Reem Talhouk, Sandra Mesmar, Anja Thieme, Madeline Balaam, Patrick Olivier, Chaza Akik, Hala Ghattas Ph.D

Faculty Publications

There are currently over 1.1 million Syrian refugees in need of healthcare services from an already overstretched Lebanese healthcare system. Access to antenatal care (ANC) services presents a particular challenge. We conducted focus groups with 59 refugees in rural Lebanon to identify contextual and cultural factors that can inform the design of digital technologies to support refugee ANC. Previously identified high utilization of smartphones by the refugee population offers a particular opportunity for using digital technology to support access to ANC as well as health advocacy. Our findings revealed a number of considerations that should be taken into account in …

Perceptions And Experiences Of Human Papillomavirus (Hpv) Infection And Testing Among Low-Income Mexican Women, Leith León-Maldonado, Emily Wentzell, Brandon Brown, Betania Allen-Leigh, Leticia Torres-Ibarra, Jorge Salmerón, Deborah L. Billings, Jim Thrasher, Eduardo Lazcano-Ponce

Faculty Publications

Background

HPV infection causes cervical cancer, a major contributor to morbidity and mortality among low-income Mexican women. Human papillomavirus (HPV) DNA testing is now a primary screening strategy in Mexico’s early cervical cancer detection program (ECDP). Research on Mexican women’s perceptions of HPV and testing is necessary for establishing culturally appropriate protocols and educational materials. Here, we explore perceptions about HPV and HPV-related risk factors among low-income Mexican ECDP participants.

Methods

We conducted semi-structured interviews with 24 ECDP participants from two primary care health clinics in Michoacán state, Mexico. Interviews addressed women’s understandings of and experiences with HPV and HPV …

Stigma Against People Living With Hiv/Aids In China: Does The Route Of Infection Matter?, Chen Zhang, Xiaoming Li Ph.D., Yu Liu, Shan Qiao Ph.D., Liying Zhang, Yuejiao Zhou, Zhenzhu Tang, Zhiyong Shen, Yi Chen

Faculty Publications

In the current study, we tested the hypothesis that people who contracted HIV from “blameless” routes (e.g., blood transfusion, sex with stable partners) are less stigmatized compared to people who contracted HIV from “blamable” routes (e.g., injection drug use, sex with sex workers). A cross-sectional study was conducted among 2,987 participants in Guangxi province, China, between 2012 and 2013. We employed both explanatory and predictive modeling strategy by using multivariate linear regression models. In the explanatory models, we assessed the association between routes of infection and three types of stigma (perceived, internalized, and enacted). From identified routes of infection that …

Supply- And Demand-Side Factors Influencing Utilization Of Infant And Young Child Feeding Counselling Services In Viet Nam, Phuong H. Nguyen, Sunny S. Kim, Tuan T. Nguyen, Lan M. Tran, Nemat Hajeebhoy, Edward A. Frongillo Jr., Marie T. Ruel, Rahul Rawat, Purnima Menon

Faculty Publications

Adequate utilization of services is critical to maximize the impact of counselling on infant and young child feeding (IYCF), but little is known about factors affecting utilization. Our study examined supply- and demand-side factors associated with the utilization of IYCF counselling services in Viet Nam. We used survey data from mothers with children <2y >(n = 1,008) and health staff (n = 60) from the evaluation of a program that embedded IYCF counseling into the existing government health system. The frequency of never users, one-time users, repeat users, and achievers of the recommended minimum number of visits at health facilities were …

An Increasing Trend Of Illicit Drug Use Among Romanian University Students From 1999 To 2011, Lucia Maria Lotrean, Edna Arillo Santillan, Jim Thrasher, Valeria Laza

Faculty Publications

Aim

The present study investigates the evolution of illicit drug use among Romanian university students from 1999 to 2011.

Methods

The study was performed in Cluj-Napoca, Romania, in three phases: in 1999 (T1), in 2003 (T2) and in 2011 (T3).The study was carried out by means of anonymous questionnaires among university students aged 19-24.

Results

The results show that among girls the lifetime illicit drugs use increased statistically significantly from 2.5% in 1999 to 7.5% in 2003 and to 15% in 2011. Among boys the trend was also increasing, the prevalence of illicit drug use was 14.2% at T1, 18.1% …

Waterpipe Tobacco Smoking And Susceptibility To Cigarette Smoking Among Young Adults In The United States, 2012–2013, Ramzi G. Salloum, M. Rifat Haider, Tracey E. Barnett, Yi Guo, Kayla R. Getz, Jim Thrasher, Wasim Maziak

Faculty Publications

INTRODUCTION:

Waterpipe tobacco smoking, also known as hookah and shisha, has surged in popularity among young people in the United States. Waterpipe is also increasingly becoming the first tobacco product that young people try. Given the limited access to and limited portability of waterpipes, waterpipe smokers who become more nicotine dependent over time may be more likely to turn to cigarettes. This study examined the relationship between waterpipe tobacco smoking and susceptibility to cigarette smoking among young adults in the United States.

METHODS:

Using data from the 2012-2013 National Adult Tobacco Survey, a nationally representative sample of US adults, we …

Surgical Complications And Their Impact On Patients’ Psychosocial Well-Being: A Systematic Review And Meta-Analysis, Anna Pinto, Omar Faiz, Rachel E. Davis, Alex Almoudaris, Charles Vincent

Faculty Publications

Objective Surgical complications may affect patients psychologically due to challenges such as prolonged recovery or long-lasting disability. Psychological distress could further delay patients’ recovery as stress delays wound healing and compromises immunity. This review investigates whether surgical complications adversely affect patients’ postoperative well-being and the duration of this impact.

Methods The primary data sources were ‘PsychINFO’, ‘EMBASE’ and ‘MEDLINE’ through OvidSP (year 2000 to May 2012). The reference lists of eligible articles were also reviewed. Studies were eligible if they measured the association of complications after major surgery from 4 surgical specialties (ie, cardiac, thoracic, gastrointestinal and vascular) with adult …

Estimates Of The Quality Of Complementary Feeding Amongvietnamese Infants Aged 6-23months Varied By Howcommercial Baby Cereals Were Classified In 24-H Recalls, Nguyen T. Tuan, Mellissa Withers, Edward A. Frongillo Jr., Nemat Hajeebhoy

Faculty Publications

The World Health Organization's (WHO) standardized questionnaire for assessing infant and young child feeding practices does not include commercial baby cereals (CBC), which are derived from several food groups and are fortified with micronutrients. We examined how different scenarios for classifying CBC affect estimates of the quality of complementary feeding in children ages 6−23 months in Vietnam in 2014 (n = 4811). In addition to the WHO standardized 24‐h recall questionnaire for infant and young child feeding, we asked mothers about the consumption of CBC. The five resulting scenarios were S1 – omitted CBC; S2 – CBC classified as grains; …

Attention And Recall Of Point-Of-Sale Tobacco Marketing: A Mobile Eye-Tracking Pilot Study, Maansi Bansal-Travers, Sarah E. Adkison, Richard J. O’Connor, Jim Thrasher

Faculty Publications

Introduction: As tobacco advertising restrictions have increased, the retail ‘power wall’ behind the counter is increasingly invaluable for marketing tobacco products.

Objective: The primary objectives of this pilot study were 3-fold: (1) evaluate the attention paid/fixations on the area behind the cash register where tobacco advertising is concentrated and tobacco products are displayed in a real-world setting, (2) evaluate the duration (dwell-time) of these fixations, and (3) evaluate the recall of advertising displayed on the tobacco power wall.

Methods: Data from 13 Smokers (S) and 12 Susceptible or non-daily Smokers (SS) aged 180–30 from a mobile eye-tracking study. Mobile-eye tracking …

Clinically Relevant Behavioral Endpoints In A Recurrent Nitroglycerin Migraine Model In Rats, Kenneth J. Sufka, Stephanie M. Staszko, Ainslee P. Johnson, Morgan E. Davis, Rachel E. Davis, Todd A. Smitherman

Faculty Publications

BACKGROUND: This research sought to further validate the rat nitroglycerin (NTG) migraine model by comparing the effects of single versus recurrent NTG episodes on behavioral endpoints that mirror ICHD-3 diagnostic criteria for migraine, and to determine if the altered behavioral endpoints are reduced after administration of sumatriptan. METHODS: Separate cohorts of rats were administered NTG (10 mg/kg/2 ml) or saline (Experiment 1: single injection; Experiment 2: repeated injections; Experiment 3: repeated injections with sumatriptan [0.0, 0.3 and 1.0 mg/kg/ml] rescue. Behavioral endpoints were assessed 2 h after final NTG administration and included time in light/dark chambers for photophobia and activity, …

Enhancing Parent-Child Communication And Promoting Physical Activity And Healthy Eating Through Mobile Technology: A Randomized Trial, Danielle E. Schoffman

Theses and Dissertations

Background

Although rates of pediatric and adult obesity remain high in the U.S., finding scalable and engaging ways to disseminate obesity prevention and treatment for families has been challenging. The purpose of the Motivating Families with Interactive Technology (mFIT) study was to test the feasibility, acceptability, and effectiveness of two remotely-delivered family-based health promotion programs for improvements physical activity (PA), healthy eating, and parent-child communication and relationship quality.

Methods

Parent-child (child age 9-12 years) dyads enrolled in a 12-week mobile intervention to increase physical activity and healthy eating, which included weekly email newsletters and the use of pedometers. Dyads were …

Social Capital And Social Networks: The Importance Of Social Ties For Health Among Residents Of Disadvantaged Communities, Stephanie Child

Theses and Dissertations

Access to social capital via social networks is important for health and may be linked with chronic disease, including obesity and hypertension. Socioeconomic status (SES) may influence access to social capital and social network characteristics, and may also moderate the relationship between social capital, social networks, and health. Yet few studies have explored relationships between social capital, social networks, and chronic disease among resource poor individuals.

Respondent-driven sampling was employed to recruit participants (n=430) from low-income communities in the US South for a household survey as part of the Greenville Healthy Neighborhoods Project. The survey collected information about participants’ SES …

Quality Over Quantity: Positive Interactions During Family Meals In Food-Insecure Households Compensate For The Negative Impacts Of Household Chaos On Child Emotional Well-Being, But Not Diet Quality, Tiara Nicόl Rosemond

Theses and Dissertations

Family meals are important family activities that have many positive nutritional and emotional benefits for children. Positive family meal experiences may provide opportunities for children to strengthen emotional bonds, leading to a sense of security and, fostering improved children’s self-regulation of healthier food intake and emotional well-being. Unfortunately, children in food insecure households experience higher amounts of chaos, lower diet quality, and worry about having enough to eat compared to children in food-secure households, all of which may affect both family meal frequency and interpersonal quality. Yet, the relationships between food insecurity, household chaos, and family meal frequency and interpersonal …

A Qualitative Study Of How Communities Think About And Act Upon Hunger In The Presence Of A Food Banking System, Eliza Miriam Fishbein

Theses and Dissertations

Hunger is often addressed by providing food directly to those experiencing symptoms of food insecurity and hunger. Even with the availability of government food assistance programs, food insecurity and hunger rates continue to rise. Many local community organizations (e.g., small food banks, faith-based organizations, schools) across the country have come together to create and implement a variety of nongovernment food programs. Although there is no evidence these programs lower food insecurity and hunger rates, community organizations appear to be strongly committed to sustaining these programs. Little is known about the basis for this commitment, i.e., “ the will to act …

Implementation Processes And Impacts Of School Store Policies In South Korea, Seul Ki Choi

Theses and Dissertations

With the concern of unhealthy school food environments, the South Korean government enacted two school nutrition policies to reduce unhealthy foods in school stores. The first policy banned on soft drinks sales in school stores enacted in 2007. The second policy restricted energy-dense nutrient-poor (EDNP) food sales in school stores enacted in 2009. This study aims to examine the changes in adolescents’ food intake and foods sold in school stores due to the two policies and to understand the policy implementation processes.

The Korea National Health and Nutrition Examination Surveys were used to examine trends in adolescents’ energy intake from …

The Roots Of Perspective In The American Context: News Media Discourse And Stakeholder Perspectives About The Supplemental Nutrition Assistance Program, Nicholas Younginer

Theses and Dissertations

The Supplemental Nutrition Assistance Program serves 46 million people but is controversial. The media is positioned to influence political and public opinions about SNAP policy. This study identifies the SNAP media discourse and investigates perspectives of SNAP participants and frontline workers about the program.

I employed a mixed-methods design with two aims. Aim 1 gathered 295 articles across six news outlets, semi-inductively coding the articles for characters, assignment of responsibility, and framing of the article. I then ran chi-square tests for difference between employed frame and responsibility and employed frame and political ideology.

Aim 2 collected a sample of 20 …

Sustainability Of Food And Nutrition Security Policies During Presidential Transitions: Integrating Socio-Political And Nutritional Sciences, Jessica Liana Escobar-Alegría

Theses and Dissertations

Presidential transitions are uncertain periods in which relationships among power, accountability, and electoral support of a democratic process do not hold. Transitions challenge collaboration towards implementing policies contributing to food and nutrition security (FNSP). Sustaining these policies during transitions is critical for reaching long-term goals. Knowledge gaps remain on how to perform strategic multisectoral work during transitions to maximize FNSP sustainability.

This study aimed to examine what determines FNSP sustainability during presidential transitions and responded to the questions: How do policy actors define sustainability? What are the mechanisms determining policy sustainability? What are the implications of terminal logic behavior (TLB) …

Contextualizing Multilayered Sexual Subjectivities Of Heterosexual Black Female Undergraduate Students At A Predominantly White Institution In The South, Amarachi Rossana Anakaraonye

Theses and Dissertations

This study uses an intersectional theoretical framework to examine Black college women’s sexual health by focusing on how they engage in sexual decision making within their social contexts. This qualitative study analyzed 20 individual in-depth interviews of Black female undergraduate students, ages 18-22, who attend a predominantly white institution (PWI) in the Southeastern United States. The themes that emerged from qualitative data analysis include Black female undergraduate students’ perceptions of the sexual culture of their campus and the protective strategies they employ to navigate the sexual culture in order to achieve and/or maintain physical, emotional, and social well-being. Key findings …

Filter Presence And Tipping Paper Color Influence Consumer Perceptions Of Cigarettes, Richard J. O’Connor, Maansi Bansal-Travers, K. Michael Cummings, David Hammond, Jim Thrasher, Cindy Tworek

Faculty Publications

Background: Cigarettes are marketed in a wide array of packaging and product configurations, and these may impact consumers’ perceptions of product health effects and attractiveness. Filtered cigarettes are typically perceived as less hazardous and white tipping paper (as opposed to cork) often conveys ‘lightness’.

Methods: This study examined cigarette-related perceptions among 1220 young adult (age 18-35) current, ever, and never smokers recruited from three eastern U.S. cities (Buffalo NY, Columbia SC, Morgantown WV). Participants rated three cigarette sticks: two filtered cigarettes 85 mm in length, differing only in tipping paper color (cork versus white), and an unfiltered 70 mm cigarette. …

Refinement And Pilot Testing Social Networks For Encouraging Healthy Behaviors: The Social Pounds Off Digitally (Social Pod) Study, Sarah B. Hales

Theses and Dissertations

Currently about 71% of adults in the US are considered overweight or obese. Overweight and obesity are associated with higher risk of developing many chronic diseases; however, health risks associated with overweight and obesity can be reduced by as little as a 3% to 5% reduction in weight. Mobile health (mHealth) has shown promise as a way to deliver weight loss interventions, yet maintaining participant engagement over time has been a challenge. The purpose of this study was to develop, refine, and pilot test the Social Pounds Off Digitally (POD) Android app for personalized health monitoring and interaction; revise the …

Framing Risk, Responsibility, And Resolution: A Mixed-Methods Study Exploring Traditional And Social Media Coverage Of The 2014 Elk River Chemical Spill, Tracey Thomas

Theses and Dissertations

Background: The 2014 Elk River Chemical Spill raised policy questions concerning chemical safety and revealed an immediate need for improved emergency communication. This two-phase study explored how media presented causes of and longterm solutions to the spill through an examination of media frames. The study also explored how health risks were communicated through traditional and social media. The specific aims of Phase I were to examine media coverage in the days following the spill and compare coverage across media channels. The specific aims of Phase II were to understand how public health stakeholders perceived coverage of the spill and how …

Post-Fall Decision Making Among Older Women Living In Continuing Care Retirement Communities: A Mixed Methods Study, Caroline D. Bergeron

Theses and Dissertations

Introduction: One in every three adults over the age of 65 experiences a fall every year, with women experiencing more falls than men. Falls can affect how older women perceive themselves and their independence. The purpose of this study was to examine older women's health decision making after experiencing a fall. Methods: I conducted semi-structured interviews with 17 older women living independently in continuing care retirement communities (CCRCs) who had experienced a fall within the previous six months and 11 individuals the women identified as being involved in their post-fall decision making. I also conducted an exploratory survey on post-fall …

A Qualitative Study Of The Massage Therapy Foundation's Best Practices Symposium: Clarifying Definitions And Creating A Framework For Practice, Ann Blair Kennedy

Theses and Dissertations

Large numbers of individuals seek massage therapy for wellness/disease prevention purposes and research supports consumer reported benefits including physical and psychological improvements. However, challenges within the profession may be hindering the advancement of the field. To better understand the process and outcomes and ultimately develop best practices for massage therapy as well as better inform education, policy and research, it is necessary to investigate how massage and/or massage therapy are defined and operationalized in practice. This study entailed qualitative analysis of cross-sectional data using a grounded theory approach to examine the data gathered from a two-day symposium held in 2010 …

Support For Comprehensive Sexuality Education And Adolescent Access To Condoms And Contraceptions In South Carolina, Sarah H. Kershner

Theses and Dissertations

A statewide random-digit dialed telephone survey was administered to residents of a historically conservative southern state to 1) assess the level of support for comprehensive sexuality education (CSE) in public schools, 2) assess the support for availability to condoms and contraception as an effective strategy for reducing unintended pregnancies and sexually transmitted (STIs) among adolescents and 3) assess the perceived view of reproductive health as a moral or public health issue. Survey data were obtained from 841 South Carolina residents May through June 2013. Findings from the study revealed that the majority (90%) of South Carolina residents support CSE in …