Public Health Education and Promotion Commons^™

Primary Prevention Healthcare Among Black American Men: Social Ecological Factors Predictive Of Prostate Cancer Early Detection Access, Virginia Diane Bush Agbonkhese Woods

Loma Linda University Electronic Theses, Dissertations & Projects

Access to healthcare requires individuals to have a place to go, a healthcare provider to see them, resources to obtain proper care, and the appropriate health services given in an appropriate timeframe. Non-Hispanic Black American men have the highest incidence rate of prostate cancer in the world, 180.6 per 100,000 (NCI, 2004). It is not clear as to why high rates persist, but higher death rates are associated with late detection. This mixed-methods ecological study was to investigate physician and Black male perceptions and practices regarding prostate cancer early detection with prostate specific antigen (PSA) blood test, and the digital …

Predictors Of Intention To Use Contraception, Given Alcohol Consumption, Among Women In Southeast Alaska, Donna Louise Hebbeler

Loma Linda University Electronic Theses, Dissertations & Projects

Fetal alcohol exposure is a serious public health problem and is 100% preventable. Traditionally, FASD prevention programs and research recommendations have targeted peri-conceptual or pregnant women. Another approach to the prevention of FASD involves preventing pregnancy in women who use alcohol. The purpose of this cross sectional study was to identify factors that predicted women’s intention to use contraception using the theory of planned behavior (TPB), to determine if predictors of the theoretical constructs varied in women depending on alcohol use, and to examine interactions between alcohol use and TPB constructs. Qualitative data was gathered to triangulate with the quantitative …

Social Welfare Systems And Their Effects On Adolescent Violence, Injecting Drug Use, And Negative Health Behaviors, Elvin A. Hernandez

Loma Linda University Electronic Theses, Dissertations & Projects

Youth and young adults who are injection drug users (IDU’s) often live and survive in physical and emotional environments that are associated with negative behaviors and outcomes. Past environmental and social factors, such as participation in social welfare systems or institutionalization in foster care or juvenile hall, have been found to be associated with IDU-involved young adults’ health behaviors when they become older. Social networks, which include drug, sex, or hangout networks, may influence their health outcomes and behaviors. The goals of this dissertation include an investigation of how reported past social welfare participation and institutionalization is associated with IDU-involved …

The Effects Of Long Term Walnut Consumption On Levels Of Plasma Tocopherols And Inflammatory Mediators, Suwimol Sapwarobol

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine the effects of long term walnut consumption on plasma levels of tocopherols and the inflammatory mediators interleukin-1β (IL-1β ), interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a) and Creactive protein (CRP) in healthy participants. Ninety participants were recruited into a 12-month randomized crossover intervention study, which consisted of two phases, the walnut supplemented diet and the habitual diet. Participants were randomly assigned to either of these two phases for six months and then switched to the other phase for the second six months. During the walnut supplemented diet phase, participants incorporated walnuts (28-56 g/d) …

Correlates Of In-Home Smoking Behavior Of Parents With Newborns, James Kyung Jo

Loma Linda University Electronic Theses, Dissertations & Projects

Secondhand smoke has been shown to have adverse health effects on young children. It is associated with various health effects such as respiratory infections, Sudden Infant Death Syndrome (SIDS), and asthma. Because of the dangers secondhand smoke poses to young children, there is a need for educating parents about the dangers of secondhand smoke as well as determining factors associated with secondhand smoke exposure among children. Understanding these factors may be first step toward developing strategies to reduce ETS exposure.

The study examined correlates of in-home smoking behavior of parents with newborns by analyzing 657 respondents who filled out the …

Motivated Breast Cancer Screening Behavior And Its Cultural Antecedents, Patricia M. Flynn

Loma Linda University Electronic Theses, Dissertations & Projects

Discrepancies in breast cancer screening behavior exist among various ethnic groups in the United States (Jacobs & Lauderdale, 2001), with Latino American women reporting particularly low screening rates in comparison to Anglo American women (ACS, 2002). Research indicates that behavior is in part influenced by aspects of culture and relevant psychological processes (Betancourt & Lopez, 1993; Betancourt & Fuentes, 2001). This study was designed to investigate the relations among cultural values, attributions regarding the causes for not screening, related emotions, expectancy that screening leads to early detection and value incentive of early detection as determinants of breast cancer screening intention …

A Study Of Pediatric Heart Transplant Patients In Relationship To Post Transplant Coronary Artery Disease, Mark Randall

Loma Linda University Electronic Theses, Dissertations & Projects

Post transplant coronary artery disease influences short and long-term survival of pediatric heart transplant recipients. Associated cardiovascular disease risk factors among non-heart transplant adult and pediatric heart populations for development of coronary artery disease have been documented. Little is known about these typical cardiovascular disease risk factors as well as other possible risk factors in the development of post transplant coronary artery disease. Objective: The purpose of this research was to examine children/adolescents (n=194), 5-18 years old, at least one-year post heart transplant. This study also investigated if there were physiological and psychological/behavioral differences between recipients with (n = 28) …

Assessment Of A Body Composition-Focused Approach To Obesity Treatment, Beverly D. Hall

Loma Linda University Electronic Theses, Dissertations & Projects

Obesity is a significant United States’ public health concern. However, high relapse rates continue to be a problem for obesity treatment programs while the focus remains on weight loss, not body composition change. This study examined whether a clinic-based obesity treatment program, focused on body composition change through resistance training, lead to improved body composition, exercise behaviors, and attitude change from focus on weight loss to body composition change. Improvements in self efficacy, outcome expectations and stages of change were also examined. Forty-eight physician-referred overweight or obese adult women (mean body fat 41%, SD = 6.65%), completed assessments and questionnaires …

Cultural Value Orientations, Attributions, And Breast Cancer Screening Behaviors, Patricia M. Flynn

Loma Linda University Electronic Theses, Dissertations & Projects

Discrepancies in breast cancer screening behavior exist among various ethnic groups in the United States (Jacobs & Lauderdale, 2001), with Latino American women reporting particularly low screening rates in comparison to Anglo American women (ACS, 2002). Research indicates that behavior is in part influenced by aspects of culture and relevant psychological processes (Betancourt & Lopez, 1993; Betancourt & Fuentes, 2001). This study was designed to investigate the relations among cultural values, attributional processes, and breast cancer screening behavior among Anglo and Latino women. This study also investigated the influence of acculturation among Latino women in relation to the other study …

Pediatric Obesity: Intervention Outcomes, Kristy Anne Kuehfuss

Loma Linda University Electronic Theses, Dissertations & Projects

Childhood obesity is a national epidemic with serious medical and psychological implications. Almost one-fourth of children in the United States are overweight. Children do not typically grow out of obesity and without intervention the majority of overweight children become overweight adults. Further, childhood obesity results in numerous chronic medical conditions. Thus, the prevention and treatment of childhood obesity are paramount to the avoidance of resultant physical and psychological risk factors. Loma Linda University’s Growing Fit Program seeks to serve the critical and urgent needs of the ever-increasing population of obese children with a multi-disciplinary approach to pediatric weight management. Evaluating …

The Association Of Blood Type On The Five Factors Of Personality In Chinese Adolescents, Kunher Wu

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the number of personality factors in Chinese adolescents using the Chinese Revised NEO Personality Inventory (NEO-PI-R) and to determine whether blood type is associated with personality. It is widely accepted by psychologists that the five-factor model can provide an adequate representation of adult personality dimensions, but there is less agreement on the number of factors observable in adolescence. A total of 3,396 11^th graders from the city of Kaohsiung, Taiwan completed the Chinese NEO-PI-R. Principle component analysis with varimax rotation showed five factors of personality in these Taiwanese adolescents, which clearly …

Attitudes Of Preventive Care Specialists And Registered Dietitians Toward Their Obese Patients, Maryanna Gabriel

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to compare preventive care specialists and registered dietitians regarding attitudes toward obese patients, to compare both groups with Canadian and American nurses previously studied, and to determine whether relationships exist between personal characteristics and attitudes toward obese patients. Questionnaires were sent to members of the American Preventive Care Association and 1,000 randomly selected members of the California Dietetic Association. Sixty-seven preventive care specialists and 579 registered dietitians participated in the study. A modified version of the Attitudes Toward Obesity scale, developed by Bagley, et al. was used to measure attitudes. Preventive care specialists and …

Characteristics Of Help-Seeking Among First-Year Community College Students, Patricia A. Smith

Loma Linda University Electronic Theses, Dissertations & Projects

Health trends among freshmen entering college indicate that 2-year college students are especially vulnerable to engaging in risky health behaviors, yet many do not seek help. There was a need to more directly assess those who use college health services and factors that enable them to seek help when others do not.

The purpose of this study was to examine factors associated with help-seeking among two groups of first-year community college students: those who utilized the student health center and those who had not.

This study used a cross-sectional study design to examine differences between first year community college students …

The Role Of Health Promotion In Physical Therapy, Brenda L. Rea

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to investigate physical therapy practice patterns in four focus areas of Healthy People 2010 (focus area #6, disability and secondary conditions by looking at psychological well-being; focus area #19, nutrition and overweight; focus area #22, physical fitness and activity; focus area #27, tobacco use) and identify self-efficacy and outcome expectations related to those practice patterns across California, New York and Tennessee using Bandura’s Social Cognitive Theory as a framework. It was hypothesized that physical therapists’ self-efficacy and outcome expectations in the four focus areas of Healthy People 2010 would be significantly associated with …

Spiritual Function And Its Relationship To Health-Related Quality Of Life In A Population With Chronic Illness, Holly B. Orozco

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine the association between different aspects of spiritual function (intra- and interpersonal relationships, connectedness to God, and practices) and health-related quality of life, and to determine if perceived spirituality and perceived religiosity were significantly related to spiritual function and health-related quality of life. The study analyzed secondary data collected in the third year of a three year (1997-1999) Ambulatory Care Quality Improvement Project (ACQUIP) of the Veteran's Administration. A sample of 500 male veterans were randomly selected from a larger sub- sample of six Veterans Hospital Administration facilities across the U.S., having one …

Peer Nutrition Education: A Model For Nutrition Education Among Spanish-Language Participants Of The Special Supplemental Nutrition Program For Women, Infants And Children (Wic), Maximino Alfredo Mejía

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the steady improvement in the health status of Americans, Hispanics are a minority in the United States with greater prevalence of several infectious and chronic diseases and less health knowledge than the average citizen. Nearly half of the Hispanics living in this country die of preventable nutrition-related conditions, with heart disease and cancer being the leading causes. Since this minority has limited access to health care and preventive services, there is a need for an inexpensive, viable model of health education for this underserved segment of the population in order to lower the excess of preventable diseases. We trained …

The Role Of Diet And Physical Activity For Ovarian Cancer Results From The Adventist Health Study, Fatemeh Kiani

Loma Linda University Electronic Theses, Dissertations & Projects

A few aspects of the epidemiology of ovarian cancer are well understood, such as the inverse relationship with parity and oral contraceptive (OC) use. The role of other factors such as the potential influence of diet or physical activity is far from being established. A few studies, however, have been able to identify dietary risk factors for ovarian cancer. In this dissertation, I have conducted two studies that investigate the relationship between dietary factors and physical activity and the three endpoints: 1) nonfatal ovarian cancer (1976-1982; time to diagnosis), 2) fatal ovarian cancer (1976-1988; time to death), and 3) total …

A Model For Hiv/Aids Risk Behaviors Of Students In Armenia, Talin Babikian

Loma Linda University Electronic Theses, Dissertations & Projects

Without a cure in now its third decade, AIDS is a concern for both the medical and social science disciplines. Most at risk for a nationwide AIDS epidemic are developing countries, which often lack the necessary resources and knowledge to minimize the spread of the disease. There are an estimated 1500 HIV cases in Armenia, 81.5% of which occur in the 20-39 age group. Armenia’s current economic and political instability, increase in sexually transmitted infections (STI), prostitution, and injecting drug use, and the alarming incidence rates in neighboring countries amplify its risk for a national epidemic.

The goals of this …

Hand Intensive Leisure Activities And Repetitive Motion Injuries Of The Distal Upper Extremities, Marilyn Colvin Wright

Loma Linda University Electronic Theses, Dissertations & Projects

Background. The work-relatedness of repetitive motion injuries to the distal upper extremities (RMI-DUEs) has been well documented; however, human occupation extends beyond the job to include self-care and leisure activities. The effects of hand intensive leisure activities (HILAs) such as home computer use and needlework on RMI-DUEs have not been explored. These HILAs require hand usage similar to known work-related risk factors. Additionally, sedentary leisure contributes to obesity thereby increasing the disease burden of women. Health beliefs regarding leisure and fitness among women employed in hand intensive sedentary jobs have not been explored.

Purpose. The purpose of this study was …

How Peruvian Mothers Appraise Pneumonia And The Predictors Of Their Intention To Seek Medical Care When Their Children Have Signs Of Pneumonia, César Augusto Gálvez

Loma Linda University Electronic Theses, Dissertations & Projects

Pneumonia ranks first in health problems demanding attention, and second in the cause of mortality for children under five years old in Peru (Toledo, & Minaya, 1999). Studies about behavioral determinants that influence mothers to seek medical help for their child with signs of pneumonia do not focus on the contribution of the behavioral determinants to intention of seeking medical help.

Using the Theory of Planned Behavior (TPB) and a cross-sectional design, the objectives of this study were to know first, Peruvian mothers' perceptions about knowledge and recognition of pneumonia, and about the government pneumonia campaign (GPC). Second, mothers' attitudes, …

Effects Of High Fruit Intake On Systematic Blood Pressure In African Americans, Leonard L. Gibbons

Loma Linda University Electronic Theses, Dissertations & Projects

This randomized dietary intervention trial examined the effects of a high fruit diet on systemic BP in African-Americans. Thirty-eight free-living subjects with systolic BPs between 130-159 mm Hg and diastolic BPs between 85-99 mm Hg, were enrolled for a six week period. The cases were given daily supplements of potassium rich foods: bananas, orange juice and raisins, while no dietary advice or food was given to the controls.

After six weeks, the means systolic BP was 5.79 mm Hg ( p=.009) lower in the cases than the controls. The mean diastolic BP at week six was 3.76 mm Hg (p=.047) …

Client-Centered Versus Traditional-Directive Educational Approach: A Randomized Study Of Exercises And Perceived Control Among Patients With Type 2 Diabetes, Melissa D. Olfert

Loma Linda University Electronic Theses, Dissertations & Projects

A patient’s adherence to self-management therapies in diabetes strongly influences health outcomes, health care utilization, and ultimately health care costs. Engaging in regular exercise therapy reduces risk factors associated with type 2 diabetes. The purpose of this randomized prospective study was to determine if a client-centered approach (CCA) toward diabetes education, verses a traditional-directive approach (TDA), would improve exercise participation, perceived control, intention to exercise, and glycemic control in patients with type 2 diabetes.

Fifty-nine type 2 patients were randomized into two groups: CCA and TDA. Diabetes education in the CCA group provided empowerment toward acquiring knowledge, skills, and responsibility …

Predicting Milk And Soft Drink Consumption Among Female Adolescents Using The Theory Of Planned Behavior, Nada Osman Kassem

Loma Linda University Electronic Theses, Dissertations & Projects

A total of 756 female adolescents, aged 13 to 18 years, from five public high schools in Antelope Valley Union High School District located in North Los Angeles County participated in this study between February 1999 and March 1999. The ethnic composition was 53.3% White/Anglo Americans, 19.3% Hispanics or Latinos and 10.2% Black/African Americans. The constructs of the Theory of Planned Behavior (attitude, subjective norm, and perceived behavioral control and their underlying beliefs) were assessed to determine the predictors of low-fat milk and regular soda consumption. A cross-sectional design with group-administered questionnaires was utilized.

Most participants (89.6%, n = 636) …

Recidivism Among Jamaican Teenage Mothers : A Historical Cohort Study 1995-1998, Vonna Lou Caleb Drayton

Loma Linda University Electronic Theses, Dissertations & Projects

Pregnancy is the single most important reason why girls fail to complete secondary school in the Caribbean. The Women's Centre of Jamaica Foundation (WCJF) Program was established in 1978 to enable adolescent mothers 16 years and under to return to school, and to delay second pregnancies until completion of their education.

This historical cohort study assessed the effect of the WCJF Program on the incidence of repeat pregnancies over the period 1995-1998, and on the educational attainment of program participants. A random sample (n=260) of primiparous Jamaican adolescent mothers 12-16 years who gave birth in 1994 in the parishes of …

The Association Of Fluid Intake With Total Natural-Cause Mortality, Coronary Heart Disease And Fatal Stroke, Jacqueline Chung Lun Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Hypohydration may be more widespread than realized since it does not always arouse a sense of thirst. When thirst is felt, it is often ignored, or satisfied before euhydration is achieved. There is growing evidence indicating that hypohydration contributes to acute and chronic illnesses, and to rheological factors associated with coronary heart disease (CHD) and stroke. Therefore the relationship of fluid intake with risk of total natural-cause mortality, CHD and stroke death was examined using data on 34,192 white, non-Hispanic participants in the Adventist Health Study.

Among the 27,342 reporting no CHD, stroke or diabetes at baseline, during six years …

A Cross-Sectional Study Examining Lifestyle And Rheumatoid Arthritis, Leslie Nazaroff

Loma Linda University Electronic Theses, Dissertations & Projects

Objective. Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects the synovial joints. RA affects 0.5-2% of the population. Though it is predominantly a progressive disease, adjunct therapy may slow the destructive pathway or alleviate affiliated symptoms. This study examined the effects of lifestyle (diet and exercise) and self-efficacy on symptoms of RA as measured by disease activity and health satisfaction.

Methods. Seventy-five RA patients (77% female) from the Loma Linda University Faculty Medical Offices, Rheumatology Department completed self-assessment surveys on their lifestyle practices and RA affliction. Disease symptoms and activity were assessed with the Arthritis Impact Measurement …

The Influence Of Low Dietary Fat Intake On Incidence And Severity Of Migraine Headache, Zuzana Bic

Loma Linda University Electronic Theses, Dissertations & Projects

Migraine headaches are a common and debilitating syndrome causing untold suffering and loss of productivity. A review of the literature indicates that there are two primary factors involved in triggering these headaches: high levels of blood lipids and high levels of free fatty acids. Under these conditions platelet aggregability is increased, which is associated with decreases in serotonin and heightened prostaglandins levels. These conditions may produce vasodilation, the most immediate precursor to migraine headache. A high fat diet is one factor that may directly affect this process. This study was undertaken to evaluate the impact of dietary fat intake on …

Negotiating The Healthy Self: A Theory Of Health Behavior In Older Adults, Barbara Schwitz White

Loma Linda University Electronic Theses, Dissertations & Projects

Researchers have identified discrete behaviors of older persons to maintain or improve health and prevent or treat illness. Few have developed theories of health behavior specific to this population. The purpose of this study was to develop a substantive theory to explain how health and illness are integrated into and influence behaviors in the daily lives of community-residing older persons. Using grounded theory design and analysis, 26 participant observations involving 186 individual encounters, and seven semistructured [sic] one-on-one interviews were conducted at two senior centers in urban southern California, between 1992 and 1994.

Informants defined health in terms of physiologic …

The Effects Of Lowering Cholesterol On Vasodilation, Maria Christi Hardt

Loma Linda University Electronic Theses, Dissertations & Projects

Endothelial dysfunction has been found prior to any signs of atherosclerotic plaque formation in patients with a variety of risk factors for atherosclerosis. Elevated serum cholesterol has repeatedly been associated with endothelial dysfunction as demonstrated by impaired vasoreactivity to vasodilating stimuli.

The aim of this research was to determine whether short term lowering of serum cholesterol levels by life style changes or by cholesterol lowering medication could reverse or reduce the endothelial dysfunction. The brachial artery diameter was measured by high-resolution ultrasound at rest and during reactive hyperemia pre and postintervention. Fifty-three subjects with cholesterol levels above 240 mg/dl were …

Prevalence Of Fatty Liver In Japanese Children Ages 4 To 12 Years Old : Relationship To Obesity : An Epidemiological Ultrasonographic Survey, Kunihiko Tominaga

Loma Linda University Electronic Theses, Dissertations & Projects

The prevalence of fatty liver disease in children is not well established and its relationship to childhood obesity is poorly defined. The present study of 810 northern Japanese school-aged children (4-12 years old), determined the prevalence of fatty liver and its relationship to gender and degree of obesity. Diagnosis of fatty liver was assessed by real-time ultrasonography.

RESULTS: 1. The overall prevalence of fatty liver is 2.6 %. 2. Fatty liver prevalence is higher for boys (3.4 %) than for girls (1.8 %), although not statistically significant (P = 0.15). 3. Fatty liver occurs in children as young as 6 …