Health Psychology Commons^™

Numerical Study For Seamless Clinical Trials With Covariate Adaptive Randomization, Mengxi Wang

Dissertations and Theses (Open Access)

One important goal of the pharmaceutical industry is to evaluate new therapies in a time-sensitive and cost-effective manner without undermining the integrity and validity of clinical trials. Adaptive seamless phase II/III designs (ASD) have gained popularity for accelerating the drug development process and reducing cost. Covariate adaptive randomization (CAR) is the most popular design in randomized controlled trials to ensure valid treatment comparisons by balancing the prognostic characteristics of patients among treatment groups. Although adaptive seamless clinical trials with CAR have been implemented in practice1, the theoretical understanding of such designs is limited. In addition, current approaches to control the …

Long-Term Outcomes After Endovascular Stent Placement For Long-Segment Superficial Femoral Artery Lesions, Nader Zamani

Dissertations and Theses (Open Access)

Objective: Endovascular intervention is commonly pursued as first-line management of symptomatic, long-segment superficial femoral artery (SFA) disease. The relative effectiveness and comparative long-term outcomes among bare metal stents (BMSs), covered stents (CSs), and drug-eluting stents (DESs) for long-segment SFA lesions remain uncertain.

Methods: A retrospective cohort study identified patients with symptomatic SFA lesions measuring at least 15cm who successfully received an endovascular stent (BMS, CS, or DES). The outcomes were patency, patient presentation upon stent occlusion, amputation free survival (AFS), and all-cause mortality. Proportional hazards regressions and a multinomial logistic regression model were used to control for significant confounders.

Results: …

Lymphocyte-Specific Tyrosine Kinase Expression In Ovarian Cancer: A Valuable Prognostic Indicator, Emily Moss Hinchcliff

Dissertations and Theses (Open Access)

Cellular immune response, specifically tumor infiltrating lymphocytes (TILs), has been correlated to survival in epithelial ovarian cancer; however, specific gene expression patterns for this response remain poorly understood. The objective of this research was to investigate the prognostic and biologic significance of immune-related gene expression in high grade serous ovarian cancer (HGSOC). To do so, a panel of immune related gene expression was evaluated in HGSOC utilizing The Cancer Genome Atlas (TCGA) and validated in an independent cohort of ovarian tumors. Based on the strong association with survival, the cohort was grouped into LCK (lymphocyte specific tyrosine kinase) high and …

Clinical Diagnostic Whole Exome Sequencing For Infants In Intensive Care Settings: Outcomes Analysis And Economic Evaluation, Hadley Stevens Smith

Dissertations and Theses (Open Access)

Whole exome sequencing (ES) is an extensive form of genetic testing and increasingly used as a diagnostic tool. Clinical uptake of genome-scale sequencing occurred without clear guidelines for application or robust information regarding potential impact on patient health outcomes or cost of care. For infants in intensive care with suspected genetic conditions, ES can be especially powerful to identify a specific diagnosis and inform crucial decisions about medical care. However, little is known about the cost-effectiveness of ES compared to other diagnostic strategies. This project first assessed the literature on pediatric clinical ES. Then, using electronic medical record, diagnostic laboratory, …

Fire Department Support And Physical Activity Of Volunteer Firefighters: A Cross-Sectional Examination, Sarah Wagner

Dissertations and Theses (Open Access)

Greater health and fitness of volunteer firefighters protects them from cardiovascular disease-related deaths, reduces risk of injury, and improves job performance, which subsequently provides better protection for the majority of the U.S. population who is served by volunteers. Given the strong social support system characteristic of the U.S. fire service, there seems to be potential opportunity to influence the behaviors of firefighters by creating a culture that promotes healthy habits rather than unhealthy. Objective: Determine the association between fire department culture’s encouragement of physical activity and volunteer firefighters’ moderate- to vigorous-intensity aerobic activity. Methods: A cross sectional analysis was performed …

Evaluating The Impact Of Early Initiation Of Antiretroviral Therapy (Art) On Patient Outcomes Among Hiv-Infected Adolescents And Young Adults In Uganda, Hilda Sekabira Nakalema

Dissertations and Theses (Open Access)

Introduction: Since the introduction of anti-retroviral therapy (ART), treatment initiation criteria have continually been revised to start these lifesaving drugs before onset of advanced disease and optimize ART benefits for people living with HIV. However, little is known about the effect of these changes on treatment outcomes among young people. We evaluated the effect of such a policy change on long term adherence and treatment outcomes among young people, aged 15-24 years.

Methods: We conducted a retrospective cohort analysis of young people, 15-24years old, who started ART from January 2012 – December 2016. We used administrative data from the District …

Ends Device Types And Subsequent Use Of Combustible Tobacco Products Among Texas Youth, Aslesha Sumbe

Dissertations and Theses (Open Access)

The aims of the study were to determine whether ENDS device types (i.e., disposable devices, replaceable cartridges, and refillables) at initial, or first ENDS use is longitudinally associated with subsequent initiation of combustible tobacco products (cigarettes, hookah, cigars) and continued, past 30-day use of combustible and ENDS products. This study is a secondary analysis of data from the Texas Adolescent Tobacco and Marketing Surveillance system (TATAMS) study, a longitudinal cohort study of students who were in the 6th, 8th, and 10th grades (n = 3907) during the 2014-2015 academic year. Data were collected every 6 months, from 2014-2018. Using data …

Dynamic Competing Risk Model For Multi-Type Recurrent Events With Dependent Termination, Alokananda Ghosh

Dissertations and Theses (Open Access)

Cardiovascular disease (CVD), defined by the World Health Organization (WHO) as diseases that involve the heart and/or blood vessels is the number one cause of morbidity and mortality worldwide. In the United States more health care dollars are spent managing and treating CVD and/or its complications than any other disease process. Coronary heart disease (CHD) is the leading cause of deaths (43.8%) attributable to CVD, followed by stroke (16.8%), hypertension (9.4%) and heart failure (HF) (9%). CVD-related deaths and attendant morbidities, which include lifelong disability are in many cases preventable. This research proposes a dynamic risk model that handles multi-type …

Assessing Hospitalizations Due To Assaults At Dell Seton Medical Center (2015-2018), Stephani L. Curry

Dissertations and Theses (Open Access)

Physical assaults are a major public health concern in the United States, with rates being on the rise during the last couple of years (WISQARS Nonfatal Injury Reports, n.d.). In Austin at the Dell Seton Medical Center [DSMC], physical assaults are a main reason for hospitalization, making up nearly 10% of their hospitalizations, with around 250 patients per year. No subgroup of the population is risk free from physical assaults; however, national data suggest some sociodemographic groups are at higher risk than others (“Injury and Violence Prevention”, n.d.). Given the diversity of Austin, TX, it was unclear whether local sociodemographic …

The Association Of Cell Phones With Adolescents' Academic Performance, Sleep, Time Spent With Friends, And Cyberbullying Exposure, Johanna E. Peyton

Dissertations and Theses (Open Access)

This study examined the association between owning or having access to a cell phone with/without internet access and adolescent academic performance, whether they met the guidelines for recommended nightly sleep, the amount of time spent with friends outside of school and the presence and frequency of cyberbullying experienced by 8th and 11th grade participants in the 2015-2016 SPAN study in Texas. This study also examined the association between gender of the adolescent and the above-mentioned outcomes.

The study group consisted of 5,421 adolescents from 8th grade and 3,635 from 11th grade. The 8th grade sample contained 51.48% males(48.6% females) and …

Exploring Prenatal Risk Factors Among Hispanic Children With Autism Spectrum Disorders. – A Pilot Study In The Rio Grande Valley, Lauren Tien

Dissertations and Theses (Open Access)

Background: Peer-reviewed studies suggest that a hostile gestational environment is associated with delayed neurological development in infants. Autism spectrum disorder (ASD) is estimated to affect 1 in 59 children in the United States; however, few studies have specifically investigated risk factors for autism in Hispanic children. Purpose: The University of Texas RGV Hispanic Autism Research Center (HARC) studied Hispanic children with ASD and their biological mothers to identify potential environmental exposures and prenatal risk factors that could impact the risk for ASD through preliminary research in the Rio Grande Valley. Methods: This pilot study recruited 25 Hispanic mothers and their …

Alcohol Use, Dietary, And Exercise Behaviors: A Latent Profile Analysis Of Young Adult Lifestyle Behaviors, Ryan Wesley Grant

Graduate Theses and Dissertations

As individuals enter adulthood, their lifestyles and lifestyle behaviors begin to change drastically. These lifestyle behavior changes in emerging adulthood provide a foundation for future health behaviors that often persist through all of adulthood. The aim of this study was to use Latent profile analyses (LPA) to discover distinct profiles of homogenous groups of young adults based on alcohol, diet, and exercise behaviors. Overall, five distinct profiles for both males and females were identified: Moderates, Unhealthy Eaters, Medium Drinkers, Healthier Eaters and Exercisers, and Heavy Drinkers. Heavy Drinkers and Unhealthy Eaters were the highest risk groups and reported the highest …

Reducing The Risk: Psychological And Technological Approaches For Improving Handwashing Practices In The Foodservice Industry, Jeffrey Allan Clark

Graduate Theses and Dissertations

As Americans are spending greater portions of their dollar on food consumed outside the home, the foodservice industry plays more of an integral part of daily existence compared to previous generations. Given the numerous annual foodborne illness outbreaks that threaten human lives while undermining confidence in the food supply, food safety is a pertinent issue for industry stakeholders, government regulators, and consumers. Food worker handwashing reduces the risk of foodborne illness transmission, yet compliance with this simple behavior is a complex problem. This dissertation addresses, predominantly, the issue of sub-optimal handwashing practices through applying psychology and technology, including wearable computers …

Patient Participation In Medical Consultations: The Experience Of Patients From Various Ethnolinguistic Backgrounds, Rhéa Rocque, Annabel Levesque, Yvan Leanza

Patient Experience Journal

Patient participation in health care is a priority. Yet, patients’ perspective with regards to their experiences of participation is not well understood. Moreover, few studies have attempted to explore the perspective of ethnolinguistic minority patients. The objectives of this study, to explore 1) patients’ experiences of participation in medical consultations with physicians, and 2) potential variations in these experiences based on participants’ ethnolinguistic status. Using a qualitative design, 60 participants, from various ethnolinguistic background, took part in individual semi-structured interviews. A content analysis was performed to identify emerging themes. The results, five themes emerged in response to the first objective …

Delay Discount Rate Moderates A Physical Activity Intervention Testing Immediate Rewards, Christine B. Phillips, Jane C. Hurley, Siddhartha S. Angadi, Michael Todd, Vincent Berardi, Melbourne Hovell, Marc A. Adams

Psychology Faculty Articles and Research

Financial incentives can increase physical activity (PA), but differences in the immediacy of reward delivery and individual differences in delay discount rates (i.e., higher discount values associated with less tolerance for delayed rewards) may explain differential responding. The current study tested whether delay discount rate moderated the relative effectiveness of immediate financial rewards on increasing daily PA. Inactive, overweight adults (ages 18–60, N = 96) were randomized to receive either smaller, immediate goal-contingent rewards or larger, delayed rewards for participation. Delay discount rates were derived for those who completed the Monetary Choice Questionnaire (N = 85). Linear mixed models tested …

The Impact Of The Aca Cost-Sharing Elimination Provision On The Utilization Of Breast, Cervical, And Colorectal Cancer Screening Services Among Insured Individuals In The United States, Sara Salah Atallah

Dissertations and Theses (Open Access)

Preventive cancer screenings are essential to early detect cancer and subsequently save lives. However, out-of-pocket expenditures for cancer screening services deter individuals from obtaining them. In an effort to improve the utilization of cancer screening, the Affordable Care Act (ACA) implemented a cost-sharing elimination provision that removes all forms of cost sharing including copayments, co-insurance and deductibles from certain preventive care services that are recommended by widely known scientific figures such as the United States Preventive Services Task Force (USPSTF). This study evaluated the impact of the ACA cost-sharing elimination provision for preventive care services from 2008 through 2016 using …

Spatial Analysis Of Exposure To Soil Heavy Metals, Oral Bioaccessibility And Risk Assessment In Houston, Texas, Tsai Shu Chu

Dissertations and Theses (Open Access)

Chronic exposure to heavy metals could lead to adverse health effects such as cancer, neurological development diseases and immunological diseases. The ingestion pathway has been considered the major exposure route for heavy metal contaminated soils. Heavy metals may be proportionally bioaccessible for the human body to absorb. There are no risk assessment studies done in Houston to evaluate health risks from exposure to heavy metals and no spatial analysis done yet. The aims of this dissertation are (1) to characterize 13 heavy metals: magnesium (Mg), vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), nickel (Ni), copper (Cu), zinc …

Stochastic Search Variable Selection Applied To A Bayesian Hierarchical Generalized Linear Model For Dyads, Adriana Lopez Ordonez

Dissertations and Theses (Open Access)

In behavioral science research, many outcomes of interest can be influenced by interpersonal relationships (Gyarmathy & Neaigus, 2007). To assess such outcomes, data can be collected using dyads. Each dyad has two elements, an actor, who responds to a stimulus and a partner, who can potentially influence the actor (Kenny, Kashy, & Cook, 2006). One popular model for analyzing dyadic data is the Actor Partner Interdependence model (APIM). In this study, we proposed a variable selection method applied to a probit Bayesian Hierarchical Generalized Linear Model (Bayesian HGLM) to fit the APIM to dyadic data. The proposed method used stochastic …

Kolmogorov-Smirnov Type Tests Under Spatial Correlations, Wenjun Zheng

Dissertations and Theses (Open Access)

Kolmogorov-Smirnov test is a non-parametric hypothesis test that measures the probability of deviations, that the interested univariate random variable is drawn from a pre-specified distribution (one-sample KS) or has the same distribution as a second random variable (twosample KS). The test is based on the measure of the supremum (greatest) distance between an empirical distribution function (EDF) and a pre-specified cumulative distribution function (CDF) or the largest distance between two EDFs. KS test has been widely adopted in statistical analysis due to its virtue of more general assumptions compared to parametric test like t-test. In addition, the p-value derived from …

Z4, A Slow Puncture: An Autoethnographic Exploration Of Language, Embodiment, And Meaning-Making, Charlotte Rose Samuels

Independent Study Project (ISP) Collection

In my ISP, I explored language as it relates to the ways in which people living in Cato Manor make sense of HIV/AIDS in their community. With 7.1-7.2 million people living with HIV (PLWHIV) in South Africa, individuals across the country are either infected or affected by illness. KwaZulu-Natal (KZN), the province with the highest rate of HIV, is also the province that was surveyed with the disproportionately highest internal stigma rates for PLWHIV. High prevalence of HIV, particularly in KZN, calls for a constant contextualization of life in the presence of illness.

Throughout the world, metaphor and symbolism is …

Redefining Burnout: Exploring Common Conceptualizations And The Neurophysiology Of Chronic Stress To Establish An Integrated Allostatic Model, Danny A. Guzzi

Dissertations

Burnout is a widely researched stress-related phenomenon associated with numerous adverse outcomes for employees and organizations. Unfortunately, burnout is not well understood and research to this point has been flawed due to a lack of consensus on the definition, dimensionality, and context of the construct. Prevalent conceptualizations of burnout have been criticized for being arbitrarily developed without solid theoretical foundation and for failing to clearly distinguish burnout from depression or other work-related conditions such as compassion fatigue, secondary traumatization, and vicarious traumatization. The current project first examines relevant literature to identify commonalities among prevalent burnout conceptualizations. Then relevant stress research …

Dynamic Prediction Of Survival Data Using Single Or Multiple Longitudinal Markers, Xuehan Ren

Dissertations and Theses (Open Access)

Recurrent events and time-to-event data occur frequently in longitudinal studies. In large clinical trials with survival endpoints, researchers collect a multitude of longitudinal markers. There is a growing need to utilize these rich longitudinal information to build prediction models and assess their prognostic performance. In this dissertation research, I propose a novel approach of integrating longitudinal markers in modeling the recurrent event or terminal event data, and conduct dynamic prediction of event risks. Under joint a model framework, I jointly model a longitudinal outcome and a recurrent event process with the two process correlated via shared latent function. The probability …

Cancer Blog Narratives: The Experience Of Under-Fifty Women With Breast Cancer During Different Times After Diagnosis, Maria Luisa Martino, Anna Gargiulo, Daniela Lemmo, Giorgia Margherita

The Qualitative Report

The recent literature shows an increase of breast cancer in women under 50, however still few are the studies which analyse the impact of the disease in this specific target age. This study aims at exploring the most prevalent topics in Italian cancer blogs of women who have received a breast cancer diagnosis before the age of 50, in order to understand their experience of illness and the characteristics of women’s narrations at different times after diagnosis (1 year, 2 years, 3 years). We collected the textual corpus of 4 Italian breast cancer blogs and performed a thematic analysis. Five …

An Evaluation Of Differences In Motivations To Receive Cervical Cancer Screening And Follow-Up Care Between Black And White Women, Ashlee Sawyer

Theses and Dissertations

Background: Cervical cancer among Black women is a major individual and public health concern. Despite advancements in medical technology and policy, disparities in cervical cancer diagnosis and mortality still exist between White and Black women, with Black women having higher rates of diagnosis (10.0 vs 7.1 per 100,000) and mortality (4.1 vs 2.0 per 100,000). Previous studies have focused heavily on barriers to obtaining cervical cancer screening among Black women and efforts to improve screening rates. Despite speculation by researchers that gaps in receipt of quality follow-up care may contribute to disparities, its role in disparate mortality rates between Black …

Developing An Evidence-Based Hiv Testing Message For Young African American Women, Melanie P. Moore

Theses and Dissertations

African American women have the highest rates of HIV infection among women of all racial/ethnic groups in the United States, and over 50% of HIV infected young adults are unaware of their infection. HIV testing is a cost-effective mechanism for reducing HIV transmission. Despite this, limited research has been devoted to developing interventions specifically promoting HIV testing. This two-part study proposed to address this gap through developing a culturally tailored HIV testing message aimed at increasing HIV test intentions among young African American women. Study 1 was a quantitative study that examined predictors of HIV testing history and future HIV …

A Program Of Research On Burnout-Depression Overlap, Irvin Sam Schonfeld

Publications and Research

The article describes a program of research aimed at unraveling the nature of the relationship of job-related burnout to depression. The research tends to show that burnout symptoms are depressive symptoms and what is termed a state of burnout often reflects an episode of depression.

From Sunrise To Sunset: A Lifespan Approach To Understanding The Mental Health Of A Subset Of American Farmers, Janna L. Imel

Theses and Dissertations

Prior research has indicated higher risk of suicide for farmers and identified depression and anxiety as mental health concerns, though the majority of research was conducted in the 1980s-1990s. In today’s economic, social, and political climate, farmers are exposed to situations and stressors reminiscent of the 1980s Farm Crisis. An added risk is the aging workforce of farmers, as age-related conditions can make farming even riskier. This study investigated the mental health of a subset of American farmers by exploring farm-related stressors, coping mechanisms, and mental health outcomes. Dispositional mindfulness was explored as a specific coping mechanism. Participants (N …

Locus Of Control And Health Promotion For Marginalized Populations, Cara Stephenson-Hunter, Kathryn L. Dardeck

Journal of Social, Behavioral, and Health Sciences

Socioeconomic health disparities in the United States have remained largely unchanged for decades. This remains the case even for preventable illness and disease. Current health behavior theories and interventions rely on the perception of control over one’s fate to achieve desired behavior. In low-income and other marginalized populations, however, hopelessness and the perception of having limited control may make interventions less effective. The purpose of this quantitative study was to examine the role of the locus of control (LOC) as defined by the degree to which one believes outcomes are determined by external forces such as chance or authority figures …

Are Chronic Inflammatory Diseases Associated With Trauma Exposure And Gender? An Empirical Analysis Of Self-Reported Trauma And Health Histories Of Men And Women, Meghan Lacienski

College of Graduate Studies: Theses & Dissertations

A growing body of research indicates an association between trauma, inflammation, and chronic inflammatory disease; however, the mechanisms of this relationship are not fully understood, and the salience of potential risk factors, such as cumulative effects of trauma, trauma type, and gender, remain unclear. Trauma is associated with poor mental and physical health, such as PTSD, depression, and chronic inflammatory conditions, and this association may be stronger when certain risk factors are considered (Brody, Pratt, & Hughes, 2018; Groer, Kane, Williams, & Duffy, 2014; Husky, Mazure, & Kovess-Masfety, 2018; Kilpatrick et al., 2013). For example, sexual trauma and multiple traumatic …

Construction And Validation Of A Non-Medical Use Of Prescription Opioids Outcome Expectancies Scale Among College Students In China, Cheuk Chi Tam

Theses and Dissertations

Background:Non-medical use of prescription opioids (NMUPO) has become a clear threat to public health. Young adults (aged 18 to 25) have a high risk of NMUPO. My prior work on Chinese undergraduates indicates a high prevalence of lifetime NMUPO (49.2%). Health behavior theories propose that outcome expectancies are robust psychosocial determinants of substance use. Literature has identified the influence of outcome expectancies on alcohol and drug use. However, the role of outcome expectancies in NMUPO in China is unknown, and a scarcity of a valid measures for NMUPO outcome expectancies may be a barrier. Our previous research also found …