Public Health Education and Promotion Commons^™

Stressors And Coping Mechanisms Of Married Female Physicians : A Qualitative Review, Eva Marie Starner

Loma Linda University Electronic Theses, Dissertations & Projects

Female physicians live and work in a very complex world fraught with professional demands and personal challenges. Twenty-seven married female physicians were interviewed for this study to assess demands and stressors endemic to them and to determine how they manage them. The breadth of this study looked at the demands and stressors of the female physician from the perspective of her work environment, home and family responsibilities, parenting responsibilities, and self-imposed demands in her perceived roles as a working wife and mother. Two main categories emerged during the development of grounded theory: System Challenge and System Adaptation. Additionally, work demands, …

Psychosocial Factors Associated With Nicotine Dependence Among College Students : Are There Differences Between Social And Regular Smokers?, Devan Rae Romero

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Cigarette smoking, the primary source of tobacco used by adults 18-25, has remained stable, at around 21-25%, in the college population since 2003. Many college students report their smoking as primarily a “social” behavior, which may reflect an emerging type of smoker. Ambiguity exists in defining and categorizing smokers in the college population.

Purpose. The purpose of this study was to examine psychosocial perceptions related to smoking among college students who currently smoke and those who do not smoke, and among different types of smokers. In addition, validation of self-reported smoking behavior with saliva cotinine was conducted in …

Patient/Physician Communication In Type 2 Diabetes-Related Health Behavior Change, Barbara Marie Thomas

Loma Linda University Electronic Theses, Dissertations & Projects

Adult type 2 diabetes is an increasing problem in the United States and affected over 16 million Americans in 2004. Most patients are treated in primary care settings and managed medically, but controlling insulin resistance through activity and diet is considered the greatest challenge for the next 30 years (Katen, et al., 2007). Understanding how physicians and patients communicate about health behaviors is necessary for developing the most effective strategies for facilitating health behavior change in this population. In the current study, adults with type 2 diabetes (n= 87) from the Loma Linda University Diabetes Treatment Center (LLUDTC), …

The Effect Of An Educational Intervention On The Sexual Perceptions And Practices Of Adolescents In Trinidad And Tobago, Vanessa Jones

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) is one of the fastest spreading infectious diseases in the Caribbean, and is second only to Sub-Sahara Africa in the prevalence of HIV/AIDS cases. Trinidad and Tobago is the southernmost twin island republic in the Caribbean. In 1999, the 5^th leading cause of death among individuals ages 15-34 in Trinidad and Tobago was HIV/AIDS. According to UNAIDS (2006), the prevalence rate of HIV in Trinidad and Tobago is 2.6%.

Purpose. Currently, there is no standardized HIV/AIDS education program in secondary schools in Trinidad and Tobago. Since HIV/AIDS is …

Predicting Intention To Wean From The Bottle Among Hispanic Mothers, Elaine K. Fleming

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Hispanic children carry a disproportionate burden of prolonged bottle use and associated disease. Children in low-income households who use the bottle beyond age 12 months are at risk for iron deficiency anemia, obesity, and early childhood dental caries.

Purpose. The purpose of this study was to identify predictors of intention to wean from the bottle among low-income Hispanic mothers of infants enrolled in the Special Supplemental Food Program for Women, Infants and Children (WIC).

Method. A convenience sample of 266 low-income Hispanic mothers of infants age 5 to 14 months old were categorized into four groups by experience …

Attitudes And Beliefs That Predict Taiwanese Older Adults' Intentions To Attend Strength And Balance Training Programs, Shih-Fan Lin

Loma Linda University Electronic Theses, Dissertations & Projects

The rate of participation in the strength and balance training (SBT) program, an effective fall prevention intervention, is very low among older adults. To increase older adults' participations in SBT programs, this study involved an observational and cross-sectional study design to understand factors that affect Taiwanese older adults' intention to attend SBT programs utilizing the theory of planned behavior. Questionnaires that measured constructs of the theory of planned behavior (attitude, subjective norm, perceived behavioral control, and behavioral, normative, and control beliefs) were collected from 221 community-dwelling Taiwanese elderly women between the age of 55 and 94. Simple correlations and multiple …

Body Weight Perceptions And Weight Control Behavior Among Adult Bermudians, Kyla J. Raynor

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Overweight and obesity is a serious public health concern that has major consequences on health and quality of life. As of 2006, 64% of adults in Bermuda were overweight or obese. There remains a gap in the literature related to how adult Bermudians perceive their body weight and body image, and if perceptions of being overweight or obese are associated with weight control behaviors.

Purpose. This study was undertaken to develop a better understanding of the perceptions of ideal body weight, level of overweight, body image and weight control behavior in adult Bermudians.

Methodology. This was a cross-sectional observational …

Tuberculosis In San Bernardino County, 1993-2004 : Lifestyle And Environmental Factors, Anuj Bhatia

Loma Linda University Electronic Theses, Dissertations & Projects

An observational retrospective study was conducted for tuberculosis (TB) cases between San Bernardino County (SBC), Riverside County, and the state of California from 1996 to 2004. A univariate comparison between San Bernardino County and California indicated a higher proportion of U.S. born cases in SBC. Additionally, it was found that San Bernardino had a higher proportion of non-injection drug using TB cases, compared with California in 1996. Further comparisons were made along country of birth between TB cases in San Bernardino County from 1993 to 2004. Notable differences were observed for injection drug use, non injection drug use, alcohol abuse, …

The Prevalence And Determinants Of Health Risk Behaviors Among High School Students In Mexico, Nellie León

Loma Linda University Electronic Theses, Dissertations & Projects

The Centers for Disease Control and Prevention report that despite health promotion efforts, adolescents continue to engage in behaviors that put them at risk for morbidity and mortality. Alcohol consumption, illicit drug use, smoking, and risky sexual behaviors are among the behaviors that contribute to leading causes of morbidity and mortality in youth; these four behaviors were explored in this study. An observational cross-sectional design was utilized. The Youth Risk Behavior Survey from the Centers for Disease Control and Prevention was utilized to assess the prevalence of the four risk behaviors among high school students in Jalisco, Mexico. Items constructed …

The Influence Of Familism On Descriptive And Injunctive Norms In Predicting The Intention To Eat A Vegetarian Diet Among Chinese Seventh-Day Adventists, See Wei Toh

Loma Linda University Electronic Theses, Dissertations & Projects

According to the theory of planned behavior (TpB), one determinant of intention to engage in a behavior is the subjective norm. Various studies have found that subjective norm is often the weaker predictor of intention compared to perceived behavioral control and attitude. This study examined whether familism (emphasis on the family rather than the individual) would contribute positively to the predictive power of the TpB model through interactions with the family portion of descriptive and injunctive norms. Descriptive and injunctive norms are component variables of the subjective norm. A sample of 284 adult Chinese Seventh-day Adventists 18 years and older …

Look Beyond And Rejoice : A Spiritual Intervention For Patients With Life-Threatening Illness Or Chronic Pain, Jung H. Park

Loma Linda University Electronic Theses, Dissertations & Projects

Recently, the study of religious coping has increased dramatically. Researchers have recognized that cognitive-behavioral interventions imbued with spiritual dimensions may have greater impact when they incorporate a persons’ belief system. Based on scientific literature and Christian coping methods in the Bible, the Look Beyond & Rejoice [LB&R] Healing Model was developed to provide a theoretical framework for an intervention aimed at improving spiritual, mental, and physical health. The model includes: (a) positive reframing of illness that may change a patient’s perception from a threat to challenge and hope, and (b) daily transcendent visualization and verbalization, through looking beyond adversity and …

The Association Of Maternal Intention To Breastfeed, Early Skin-To-Skin Mother/Infant Contact, And Exclusive Breastfeeding During The Maternity Hospital Stay, Leslie Mary Bramson

Loma Linda University Electronic Theses, Dissertations & Projects

Breastfeeding is the optimal method to nourish and nurture an infant. Exclusive breastfeeding rates in the United States have reached the goal of Healthy People 2010 that 75% of mother's breastfeed in the immediate postpartum period. Yet, less than 35% of San Bernardino county mothers and 47.7% of Riverside county mothers are exclusively breastfeeding during their maternity hospital stays, with as many as 50% of the infants being weaned from the breast in the first 14 days of life.

This prospective study examined archived data collected by Perinatal Services Network (PSN) of Loma Linda University Medical Center/Children's Hospital for the …

Knowledge, Perceptions, Beliefs And Behaviors Related To The Prevention Of Hypertension Among Black Seventh-Day Adventists Living In London, Maxine A. Newell

Loma Linda University Electronic Theses, Dissertations & Projects

This study was a cross-sectional survey of the hypertension (HTN) knowledge and risk behaviors of Black Seventh-day Adventists (SDA) in London. Recruitment took take place in 17 predominantly Black SDA churches in London. A questionnaire assessed knowledge and lay-beliefs about HTN and perceptions towards HTN using the health belief model (HBM) constructs of susceptibility, severity, benefits, barriers, and self-efficacy. Cohen’s Perceived Stress Scale was incorporated into the questionnaire. Blood pressure, height, weight and waist circumference were and current lifestyles practices were evaluated for the presence of HTN risk factors.

Of the 312 volunteers, ages 25 to 79, 55% were born …

Psychosocial Support, Newborn Readmissions, And Postpartum Follow-Up, Dora Barilla

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Women and their infants are being discharged as soon as 24 hours after giving birth without proper follow-up care. The Maternity Department at San Antonio Community Hospital established the Family Care Center (HBFCC) in November 2000 in response to a higher than expected newborn readmission rate, shorter maternity hospitalizations, and a lack of postpartum follow-up. A comprehensive program was offered to support new families in the form of developmental assessment and intervention, breastfeeding, infant and toddler nutrition, health promotion and education, and referrals to appropriate agencies when indicated. In 2004, due to inadequate funding, the hospital reduced the intervention …

Hiv Risk Among Nursing Students In Rwanda : Self-Efficacy, Knowledge And Attitudes, Jacqueline Wosinski

Loma Linda University Electronic Theses, Dissertations & Projects

Acquired immune deficiency syndrome (AIDS) is the leading cause of death in sub-Saharan Africa. With a prevalence rate of 3.1% in 2006, Rwanda is one of the hardest hit countries. Nurses are often the leading health professionals in rural communities and at the forefront of the fight against the HIV pandemic. Little has been written on how nurses are prepared to intervene successfully along the continuum of HIV prevention and care. A mixed-methods sequential exploratory approach was used to explore this question.

In the first phase, cognitive, socio-psychological, and environmental factors of nursing education in Rwanda in regard to HIV …

Partner Communication And Factors Associated With The Decision To Obtain An Hiv Test Among Chinese/Chinese American Community College Students In Northern California, Sang Leng Trieu

Loma Linda University Electronic Theses, Dissertations & Projects

HIV testing and counseling is considered the cornerstone of a comprehensive approach to HIV prevention and education. Little is known, however, about HIV prevention, including HIV testing rates for Asian Pacific Islander (API) women, because data for this ethnic group is aggregated, thus limiting specific data for Chinese/Chinese American population or other API subgroups. This dissertation research examined factors associated with the decision to obtain an HIV test among Chinese/Chinese American community college women and explored the association among relationship status, partnership communication, and discussions of HIV testing.

Using constructs of the health belief model, an online and paper-pencil, crosssectional …

Application Of The Asset Mapping Model To Church Based Hiv/Aids Prevention And Control In Aba, Abia State, Nigeria, Godwin Nwadibia Aja

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined whether HIV/AIDS activities were more frequent among churches with needs and assets for HIV/AIDS prevention and control in Aba, Nigeria and whether this connection was mediated by collective efficacy. A cross-sectional design was used to obtain data in two phases. First, a three-step forum focus group discussion (FFGD) method was used to obtain data from 32 representatives of five denominations. Second, a quantitative survey questionnaire was constructed based on the result of the FFGD and the collective efficacy model. This questionnaire was administered to 830 members aged 18 years and above from 83 churches that had operated …

Infant Feeding Decisions Among Pregnant Black Wic Participants And The Role Of Peer Support, Astrid D. Mickens

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the important factors that impact infant feeding decisions among Black women, and to determine whether peer support influences the relationship among theoretical constructs of the social learning theory. A convenience sample of 110 Black pregnant women, ages 18-45, attending Women, Infant and Children (WIC) clinics throughout Riverside and San Bernardino Counties were recruited to participate in the study through the Nutrition Services Department. Eligible participants included pregnant Black WIC clients in any stage of pregnancy.

The survey questions contained information about perceived support, cognitive knowledge, abilities and beliefs regarding breastfeeding. The goal …

A Model For Preventing Anorexia In College Students, Laura Ann Negin

Loma Linda University Electronic Theses, Dissertations & Projects

The prevalence of anorexia nervosa in the general population is relatively low, but anorexia is at the forefront of health concerns because of its seriousness. Unhealthy weight loss has numerous physical, psychological, and social consequences. Most seriously, the mortality rate for people with eating disorders is the highest of all the major psychiatric disorders.

This dissertation presents a model for preventing anorexia nervosa in a population of college students that includes a comprehensive institutional approach, psychoeducational software, a high-risk population, a holistic approach that identifies an individual’s personal risk factors and protective factors, and individual therapy.

The model is built …

Consider The Source : The Effects Of Adult Sources Of Human Immunodefciency [Sic] Virus And Sexually Transmitted Infection Prevention Information On Teen Risk Behaviors For Sexually Transmitted Infection, Janet E. Flores

Loma Linda University Electronic Theses, Dissertations & Projects

Sexually transmitted infections (STIs), including the Human Immunodeficiency Virus (HIV), are major health problems for adolescents, who represent over 26% of new cases of STIs diagnosed annually in the United States. Half of all HIV cases in people under age 25 result from sexual transmission during adolescence. Adolescent STI prevention is a national priority for the United States, and parents, schools, and medical providers, among others, are expected to have the greatest impact on adolescent STI risk reduction in teens.

This study used secondary Youth Risk Behavior Surveillance Survey (YRBS) data to explore the prevalence of high school students with …

A Qualitative Study Of Inpatient Rehabilitation Client Perceptions Of The Semi-Fixed Environment, Liane Hewitt

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Literature supports the importance of the environment on promoting or compromising health. However, little is known about how the semi-fixed environment affects client perceptions and recovery from a debilitating condition. The purpose of this study was to investigate beliefs about control within the semi-fixed environment and client perceptions of the rehabilitation process.

Design and Method. This study utilized a basic qualitative research design with 10 rehabilitation clients whose average inpatient length of stay was 14 days. Data were collected in two phases. Phase I included two inpatient visits involving semi-structured interviews on the rehabilitation process and …

Factors Associated With Aids Risk Behaviors Of African Born Adolescents In Southern California, Dixon Anjejo

Loma Linda University Electronic Theses, Dissertations & Projects

The study was aimed at determining if cultural beliefs are salient factors contributing to the spread of HIV/AIDS among African born adolescents aged 15 to 19 years living in southern California. We used a cross-sectional design and collected data in two phases. The first phase was qualitative and data were collected from 25 participants in focus groups. The second phase utilized a questionnaire which was developed from the results of the focus group, using the theory of planned behavior. One hundred and thirty-five black African born teenagers between the ages of 15-19 years living in southern California completed the questionnaire. …

Repeatability Of Serial Carotid Intima Media Thickness Scanning On Individual Subjects, Judi Nightingale

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Heart disease affects millions of Americans each year. In order to improve primary prevention, early risk identification is essential. B-mode ultrasound of the common carotid artery (CCA) intima-media thickness (IMT) assesses risk of a coronary event early in the process of plaque development. Because IMT changes are so small over time, in order to determine clinically significant versus clinically insignificant changes in IMT over a 12 month time period, a protocol is needed which can detect the least significant difference (LSD) of at least 0.030 mm.

Purpose. The purpose of this study was to develop and test a well-defined …

Predictability Of Cardiovascular Disease Event Rates By Common Carotid Artery Intima-Media Thickness In The Atherosclerosis Risk In Communties (Aric) Study, Mara Hollander

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Carotid artery intima media thickness (IMT) is a non-invasive reliable predictor of the extent and severity of CVD. There is difficulty acquiring all measurements for validated three-site carotid IMT. More accessible one-site common carotid artery (CCA) IMT has not yet been validated with CVD events.

Purpose: This study will evaluate the diagnostic accuracy of one-site CCA IMT compared to three-site IMT in predicting cardiovascular disease (CVD) events. Assessment of whether the association of incremental one-site CCA IMT to a CVD event is significant with and without adjustment for traditional cardiac risk factors was made.

Methodology: Data from The Atherosclerosis …

The Latino Caregiver Experience Among Dementia And Non-Dementia Caregivers : Can Community Based Care Management Improve Caregiver Health?, Catherine Oliveros

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: This study provides an analysis of the Latino caregiving community in Southeast Texas and the role community based care management plays in influencing caregiver physical and emotional well-being. Design and Methods: A non-random sample of 63 Latino caregivers was interviewed by phone. Caregiver physical and emotional well-being was studied through burden, depression, perceived health status, and resourcefulness. Regression, correlation, and comparison analysis was performed with key variables. Results: Acculturation was positively correlated with care management use. In comparing dementia and non-dementia caregivers both groups had similar levels of depression and burden, however, the dementia group had significantly lower levels …

Determinants Of Long-Term Care Service Utilization By Mexican-American Family Caregivers, Angelica P. Herrera

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: Participation in long-term care services may prevent the deterioration of family caregivers' mental and physical health, yet research suggests that Latino caregivers may forego using long-term care services in the absence of other barriers to long-term care use (e.g., lack of insurance).

Methods: An adapted version of the Andersen Model of Health Care Service Utilization served as a framework for examining familism, acculturation, gender roles, religiosity, and knowledge and perceptions about long-term care, as potential determinants of long-term care service use, alongside other factors known for their association with long-term care use (e.g. functional status of care recipient, caregiver …

The Relationship Between High Sensitivity C-Reactive Protein, Metabolic Syndrome And Exercise, Micheline A. Vargas

Loma Linda University Electronic Theses, Dissertations & Projects

Background: It is well known that regular physical activity is associated with lower risk of chronic diseases such as diabetes and cardiovascular disease. Physical activity is also considered an important determinant of metabolic syndrome. All levels of metabolic syndrome, diabetes, and cardiovascular disease are thought to involve inflammation. Physical activity may reduce risk, at least in part, by modifying the inflammatory process. Recent studies have demonstrated an inverse relationship between inflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), and physical activity. Elevated hs-CRP appears to be an independent predictor of both CVD and diabetes. Recent evidence also suggests that …

Eating Behavior And Obesity Risk Of Youth Living In The City Of San Bernardino, California, Carolyn A. Corder

Loma Linda University Electronic Theses, Dissertations & Projects

Adolescents living in the City of San Bernardino, California, are susceptible to health risks due to high rates of violence, suicide, teen pregnancy, and poverty, which place them among the most vulnerable in the Nation to disability, early death, unhealthy offspring, illiteracy, economic disadvantage, and chronic disease. This study analyzed data from the Youth Risk Behavior (YRBS) and local surveys conducted in the City’s Unified School District from 1999 through 2001. The investigators focused on the relationship, if any, of dietary and anthropometric factors to the priority adolescent behaviors targeted for intervention by the Healthy People 2010 objectives: accidental injuries …

Factors Related To Delayed Time For Hiv Care Among Youth Living With Hiv: A Cross-Sectional Analysis Of Social Support Networks And Access To Care, Patricia L. Jones

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: This research explored the pattern of influence social support networks had on delayed time between diagnosis and first doctor’s visit after diagnosis of HIV in youth. Results showed that factors related to receiving a referral were prosocial peer behaviors and excessive fibbing in the past 6 months. The study identified sources of social support and described the relationship between the source of support and time of first doctor’s visit after HIV diagnosis. Both descriptive and multivariate analyses were performed on all youth (N=347) and specifically on those seeking care. Methodology: Historical data were extracted from the baseline dataset of …

Effects Of Resistance Training Volume And Variety On Dietary Intake And Mood State In Untrained Subject, Suzette K. Smith

Loma Linda University Electronic Theses, Dissertations & Projects

Background: While there is research on the effects of aerobic training on various aspects of mood state and nutrient intake, little is known of the effect of resistance training on these variables.

Purpose: To examine the effects of resistance training (RT) volume and variety on total energy (kcal) and macronutrient intake, and mood states in a healthy, untrained population.

Method:The investigation was part of a prospective experimental study examining the effects of three RT protocols on body composition and strength. An initial 102, healthy, untrained male and female participants, ages 20-40, were recruited, and randomized into one of three …