Health Psychology Commons^™

Family- And Cultural-Level Influences For Latine Adolescent Nicotine Use: A Qualitative Study Informing Prevention, Cindy M. Hernandez Castro

Theses and Dissertations

Early tobacco use among Latine adolescents represents a critical public health concern, with 23.8% reporting current use and exceeding rates among other racial/ethnic groups (Birdsey et al., 2023; Gaddy et al., 2022). This early initiation elevates risks for nicotine dependence and related morbidity in adulthood (Tsao et al., 2023). Guided by Structural Ecosystems Theory (Szapocznik & Coatsworth, 1999) and contemporary grounded theory analysis (Braun & Clarke, 2006; Charmaz, 2006; Noble & Mitchell, 2016), this study examined multilevel influences on nicotine-related attitudes among Latine youth, including: (1) familial factors (i.e., parental monitoring, caregiver-youth communication), (2) cultural dynamics (i.e., cultural values and …

Internalizing Symptoms In Lgbtq+ Young Adults: Understanding The Roles Of Social Support And Resilience To Social Stigma, Chloe M. Sobolewski

Theses and Dissertations

LGBTQ+ young adults are at increased risk of adverse mental health outcomes including internalizing symptoms. The current study seeks to better incorporate strengths when modeling internalizing symptoms outcomes in LGBTQ+ young adults. The present study is secondary analysis of data collected as part of a three-wave longitudinal study. LGBTQ+ young adults (N = 250) completed baseline questionnaires assessing resilience to social stigma, types of perceived social support (i.e., family, friend, significant other), and internalizing symptoms. Moderation models were not practically or statistically significant; however, covariates (i.e., age, socioeconomic standing, and childhood basic needs) stood out in their significant contribution in …

What’S Sleep Got To Do With It? A Mixed Methods Exploration Of The Feasibility, Acceptability, And Initial Outcomes Of Group Cbt For Insomnia In Parkinson’S Disease, Claire M. Williams

Theses and Dissertations

Parkinson’s disease is a progressive neurodegenerative disease that is commonly associated with sleep disturbances, affecting up to 80 percent of individuals with Parkinson’s. Effective and accessible treatments for sleep problems in Parkinson’s disease remain limited. Cognitive Behavioral Therapy for Insomnia (CBTi) is a well-established, non-pharmacological treatment for insomnia but has been minimally studied in Parkinson’s populations. This study evaluated the feasibility, acceptability, and preliminary outcomes of a group-based CBTi intervention adapted for individuals with Parkinson’s disease. Participants engaged in a six-week group intervention that incorporated Parkinson’s-specific adaptations. Preliminary findings indicated that the adapted group CBTi intervention was generally feasible and …

Assessing Electronic Nicotine Delivery System Abuse Liability Among People Who Smoke Cigarettes: Impact Of Device Characteristics, Nicotine Flux, And Flavor, Elizabeth Oluwapelumi Ogunleye

Theses and Dissertations

This clinical laboratory study utilizes subjective and behavioral economic measures to assess the abuse liability of own-brand cigarettes and six currently authorized ENDS products, examining how device characteristics, nicotine flux, and liquid flavor influence outcomes among adults who smoke cigarettes. Using a Latin-square-ordered, within-subject design, adults who smoke cigarettes (N = 30; N = 20 preferred menthol cigarettes) attended four clinical sessions: one to evaluate their own-brand cigarette and three to assess six NJOY ENDS products: 2.4% nicotine pods (~58 µg/s; tobacco and menthol flavor), 6% nicotine disposable products (~61-65 µg/s; tobacco and menthol flavor), and 5% nicotine pods (~118-123 …

Examining Multiple Stakeholder Perspectives On The Acceptability Of Pain-Mitigation As A Tool To Manage Needle Fear, Sarah C M Morton

Theses and Dissertations

Needle fear affects up to 63% of the global adult population and is associated with significant fear-based medical care avoidance (e.g., blood donation refusal, vaccine hesitancy, insulin injection adherence). Current behavioral treatments have low acceptance in this population, and often fail to address the experience of pain associated with needle procedures. Despite the existence of evidence-based pain-mitigation for needle procedures, these interventions are not commonly used in clinical settings. The current study used qualitative methods to examine patient and provider perceptions of: 1) current methods of needle fear management, and 2) the acceptability of pain-mitigation as an effective tool to …

Acute Effects Of Electronic Nicotine Delivery System Liquid Nicotine Form And Sweetener Among People Who Use Inhaled Tobacco Products, Mary A. Carrico

Theses and Dissertations

Research on tobacco product standards to limit the abuse liability of electronic nicotine delivery systems (ENDS) has primarily focused on nicotine concentration and flavor. Other liquid characteristics, such as protonated nicotine ratio and sweetener additives, are less understood but may serve as regulatory targets. This clinical laboratory study examined the effects of ENDS protonated nicotine ratio and sweetener presence on nicotine delivery, use behavior, and subjective effects.

Thirteen participants completed four sessions that varied by protonated nicotine ratio (0:100 vs. 40:60 freebase to monoprotonated nicotine) and sweetener status (sweetened with 3 mg/mL ethyl maltol vs. unsweetened). Each session included a …

Improving Telehealth Education And Training: A Needs Assessment Of Healthcare Providers And Trainees, Conor Duffy

Theses and Dissertations

Telehealth utilization has increased dramatically since the start of the COVID-19 pandemic. There are many positive impacts of this shift to telehealth, including increasing access to care and reducing patient burden. However, healthcare providers report several consistent challenges that limit their ability to deliver telehealth, such as effective communication, technological difficulties, and difficulty performing physical examinations. To address these concerns, it is necessary to integrate telehealth education and training into healthcare professional training programs and healthcare systems. While many institutions have implemented telehealth education and training since the start of the pandemic, there is little consistency in the content, duration, …

Identification Of Mechanisms Associated With Electronic Nicotine Delivery System Use For Weight Control In Young Adults, Gabrielle Maldonado

Theses and Dissertations

Electronic nicotine delivery system (ENDS) use continues to rise among young adults in the United States, raising public health concerns as the harmful effects of ENDS continue to rise while tailored cessation programs lag. Weight control motives may drive ENDS initiation and frequent use, particularly among sexual and gender minority (SGM) populations, who report higher ENDS use, body dissatisfaction, and disordered eating behaviors than those who identify as heterosexual and cisgender. Understanding these behaviors, their mechanisms, and at-risk populations is critical for improving public health. Seven hundred and eight young adults (ages 18–30; M = 26, SD = 3.3) reporting …

Cannabis Use Among Cancer Survivors And The Impact On Cancer-Related Pain, Tiffanie A. Vargas

Theses and Dissertations

With a growing population of older adult cancer survivors—many of whom experience cancer-related pain—interest in medical cannabis as a pain management strategy has increased. This secondary analysis used data from the 2022 U.S. Behavioral Risk Factor Surveillance System (BRFSS) to examine cannabis use behaviors among cancer survivors and assess associations with cancer-related pain. The study had three aims: (1) to describe 30-day cannabis use (prevalence, intensity, and administration routes) by chronic health condition and cancer diagnosis, focusing on non-melanoma skin cancer, melanoma, and other cancers; (2) to compare demographics, health characteristics, and tobacco use by cannabis use status among cancer …

Social Support, Tobacco Attitudes/Perceptions Of Harm, And Asthma Status As Moderators In The Association Between Tobacco Exposure And Cotinine Levels, Rachel L. Pitts

Theses and Dissertations

Tobacco use and exposure are linked to adverse health outcomes (e.g., respiratory conditions) and increased healthcare utilization (e.g., emergency room visits). This study examined the moderating role of social support, tobacco attitudes/perceptions of harm, and asthma status on associations between tobacco use (e.g., combustible product use) and exposure (e.g., secondhand smoke) and cotinine levels among individuals in Richmond, Virginia. We also explored differences in tobacco-related variables by asthma status and associations among tobacco use, secondhand smoke exposure, cotinine levels, and asthma control. Youth (n = 201) and adults (n = 209) (95.7% Black/African American; 60.6% female; 65.8% non-tobacco users; 21% …

Therapy In The Age Of Ai: How Young Adults Seek Help, Support, And Solutions, Faith Maeba, Isabella Quilon, Abigail Adade

UROP Posters

Therapy has long been a foundational approach for addressing mental health, but advances in digital technology have led many young adults, especially Generation Z, to increasingly turn to AI tools for support. Rising costs, limited access to providers, and long wait times have further boosted the appeal of AI-based mental-health solutions. Despite this growing interest, the use of AI for emotional and psychological support raises important questions about trust, empathy, safety, and the ethical responsibilities of mental-health providers and developers. We conducted a brief scoping review of research on AI-based mental-health tools and student help-seeking behaviors. Searches were performed on …

From Trans Health To Vaccines: A Theoretically Driven Model Exploring Factors Related To Susceptibility To Medical Misinformation, Catherine Wall

Theses and Dissertations

Medical misinformation represents a significant threat to both individual and public health. While some consequences of this form of misinformation are relatively benign, there can be serious consequences ranging from a decreased trust in healthcare systems to an increased likelihood of epidemic outbreak and death. One such consequence can be seen in the recent legislative actions taken regarding access to transgender healthcare in the United States. Gender affirming care has been shown to benefit the mental well-being of transgender youth and adults; however, the demonstrably false information that underlies these legislative efforts can and has yielded significant harm. But what …

Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau

Theses and Dissertations

Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …

Evaluating The Role Of Interoceptive Awareness In Insomnia And Across The Sleep Health Spectrum, Lara Lobrutto

Theses and Dissertations

Interoceptive awareness, characterized by a non-judgmental and trusting attitude towards body sensations, is an understudied construct that is implicated in sleep and health outcomes. Interoceptive awareness is cultivated via contemplative and mindfulness-based practices. Given that it may be utilized to reduce pre-sleep arousal, which is a key mechanism in insomnia, interoceptive awareness is posited to be a protective factor for sleep health. A cross-sectional study was conducted among undergraduate university students (N = 420) in the Mid-Atlantic region of the United States to assess the association between interoceptive awareness and sleep outcomes. Participants received a survey link and completed …

Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose

Theses and Dissertations

This study utilized a mixed methods emergent, phenomenological approach to (1) understanding the lived experience of freezing of gait for individuals diagnosed with Parkinson’s Disease and (2) determining the role of anxiety and sleep in freezing of gait outcomes. Participants included 13 adults diagnosed with Parkinson’s Disease (N=14 for qualitative data, N=13 for quantitative data; 23.1% female-identifying, 76.9% male-identifying) who were predominantly white (92.3%) with an average age of 69 years (SD = 6.73 years). Data collection consisted of semi-structured interviews, self-report measures, actigraphic sleep data, and salivary alpha amylase biomarker collection. Results are organized into …

The Role Of Sleep And Social-Ecological Supports In The Association Between Racial Discrimination And Cardiometabolic Risk In Black Youth, Jelaina R. Shipman-Lacewell

Theses and Dissertations

Black youth are at an increased risk for poor short and long-term cardiometabolic health, including obesity, hypertension, and type 2 diabetes. Racial discrimination and poor sleep are theorized as key factors contributing to cardiometabolic health. While adult studies support sleep as a pathway through which discrimination is associated with health, there is a critical gap in our knowledge of this pathway in youth. Socio-ecological supports may protect Black youth against stressors, including racism. However, studies of the protective nature of these factors in Black youth have primarily focused on psychological and behavioral outcomes. Thus, the current study built upon previous …

Investigating Black Emerging Adult Health And Model Of Care Choices, Alexandra Wynn

Theses and Dissertations

This mixed methods study aimed to analyze the health profiles of Black emerging adults (who do not seek medical care for chronic condition management) college students to identify factors influencing their use of preventive services and their choices in healthcare plans. The study revealed distinct profiles of Black emerging adults based on patterns of factors related to their engagement with healthcare, such as barriers to care, insurance access, usual source of care, self-rated health, intention to seek care, discrimination, trust in physician, medical mistrust, and sex-assigned at birth. Interviews were conducted to investigate the similarities and differences among all participants …

Disparities Between Native Americans And White Individuals In Trajectories Of Community Participation Over The 5 Years After Traumatic Brain Injury, Jack Watson

Theses and Dissertations

Traumatic brain injury (TBI) disproportionately affects minoritized populations within the U.S., especially Native Americans who are more likely to experience a more severe or fatal TBI than White individuals. The current study used a subsample of 63 Native Americans with TBI from the TBI Model Systems (TBIMS) database matched by age, sex, and injury severity to 63 White individuals to examine disparities in community participation, as measured by the Participation Assessment with Recombined Tools—Objective (PART-O), over the five years following TBI. Analysis of variance (ANOVA) and chi-square tests revealed Native Americans were less likely to be employed prior to injury, …

Acute Effects Of An Oral Nicotine Pouch In People Who Use Smokeless Tobacco, Alisha Eversole

Theses and Dissertations

People who use smokeless tobacco (SLT) are exposed to a variety of carcinogenic toxicants, yet, despite health risks, nearly 6 million people in the US use SLT. SLT contains and delivers nicotine, a psychostimulant that causes dependence and hinders cessation efforts. An orally-administered nicotine pouch marketed as “tobacco-free” recently has become available for purchase in the US. However, there are very few non-industry-sponsored studies regarding the effects of these oral nicotine pouches.

The current study used clinical laboratory methods to determine the acute effects of an oral nicotine pouch in people who use SLT. Participants completed four sessions (within subjects, …

The Many Impacts Of The Covid-19 Pandemic On Latinx College Students’ Mental Health: Exploring The Role Of Sleep, Social Support, And Familismo, Mayra S. Ramos

Theses and Dissertations

College students experienced a multitude of disruptions to their daily life, and changes to their physical (i.e., sleep quality) and mental health (e.g., anxiety and depressive symptoms) because of the COVID-19 pandemic. Though the field has identified the factors that have contributed to negative physical and mental health changes, there remains much to be known about social and cultural protective factors that could buffer the negative role of the COVID-19 pandemic on Latinx college students. The current study contributed to the literature on the mental health outcomes of Latinx college students by identifying a possible mediator and moderators between the …

Life After Discharge: Predicting Longitudinal Trajectories Of Community Integration And Global Functioning In Black Individual With Traumatic Brain Injury, Chimdindu Ohayagha

Theses and Dissertations

The onset of traumatic brain injury (TBI) begins a chronic health pathway that contributes to various impairments and comorbidities across the lifespan. Common consequences of TBI include mental health issues, cognitive impairments, and reduced functional independence, all of which impact how an individual integrates into their community. Community integration is a primary goal for rehabilitation after TBI. Studies show that racially/ethnically minoritized individuals have a higher incidence of TBI, higher rates of mortality, and report poorer functional and community integration outcomes. Limited studies have explored longitudinal outcomes of community integration in a Black-only sample of individuals with TBI. Additionally, no …

Correlates Of Coffee And Energy Drink Use Among Individuals With Severe Alcohol Use Disorder, Enkelejda Ngjelina

Theses and Dissertations

Research on caffeine consumption among college students and young adults has primarily focused on caffeinated energy drinks (EDs) and their combination with alcohol, demonstrating a strong association with heavy and problematic alcohol use. However, little attention has been directed toward older adults. Furthermore, studies have shown that regular ED consumers are more likely to meet the criteria for alcohol dependence compared to their peers. Despite this association, little is known about ED consumption among individuals with Alcohol Use Disorder (AUD), particularly those undergoing treatment, and even less is understood about other caffeine sources such as coffee. This study aimed to …

The Ritual Of Therapeutic Artmaking In Long-Term Care, Melinda Heinz Dr., Elissa Wenthe, Alexis Schramel

International Journal of Lifelong Learning in Art Education

The transition to long-term care settings can be difficult for residents and feelings of loneliness, depression, and anxiety are not uncommon in these environments. However, participating in therapeutic artmaking rituals creates opportunities for residents to process their feelings, experience states of flow and mindfulness, engage with others, and focus on their own psychological growth. In long-term care, the physical needs of residents are often prioritized, but psychosocial needs also require attention. For this project, therapeutic artmaking rituals were created at a long-term care facility in three levels of care over 12 months. Older adults engaged with clay, paint, raw fiber, …

“Trans Broken Arm Syndrome”: Examining Causal Antecedents Of Gender-Related Medical Misattribution And Invasive Questioning In An Analogous Healthcare Setting Through The Lens Of Person Perception, Catherine Wall

Theses and Dissertations

Transgender individuals face particular challenges when interacting with a cisgender focused medical system. Gender-related medical misattribution and invasive questioning (GRMMIQ), colloquially known by the tongue-in-cheek named “trans broken arm syndrome,” is a form of medical discrimination wherein a healthcare provider assumes that a transgender patient’s medical complaints, regardless of origin, result from their gender identity or medical transition. Previous research has suggested that this, and other forms of identity-related discrimination both in and outside of healthcare, might be understood either using a top-down approach focused on stereotypes founded in schema, or a bottom-up approach examining perceived typicality. One additional theory, …

Sleep And Health Behaviors In A Safety-Net Primary Care Setting, Sahar Sabet

Theses and Dissertations

Nearly half of all premature deaths in the United States are attributable to preventable and modifiable health risk behaviors. For decades, the leading behavioral health contributors to morbidity and mortality are tobacco use, physical inactivity, and alcohol consumption. Medication adherence is a relatively less studied yet critical interrelated health behavior that is tied to health and treatment outcomes. Sleep, an important pillar of health, is a daily and modifiable behavior that shows promise as a health behavior facilitator. Better understanding the dynamics of these modifiable health behaviors is essential for the improvement of health promotion, particularly among underserved populations (e.g., …

Addressing Death Distress In Caregivers Of Patients With Malignant Glioma, Kelcie D. Willis

Theses and Dissertations

The field of psychosocial oncology seeks to improve the quality of life of patients and families affected by cancer. This task becomes increasingly important when there are limited, non-curative treatment options, a high probability of recurrence, and rapid functional decline, such as in the case of a malignant glioma (MG). Indeed, the diagnosis of a MG is associated with negative sequalae that often translates to higher caregiver burden. Caregivers—who must manage the functional decline of the patient, changes within the family, and a complicated medical system—often feel overwhelmed, isolated, and ill-equipped to handle these myriad responsibilities. While they also report …

The Impact Of A Parent-Only Pediatric Obesity Intervention Program On Quality Of Life In Racially Diverse Children, Taylor Vashro

Theses and Dissertations

Pediatric obesity has been associated with significant decrements in pediatric quality of life (QOL) comparable with severe pediatric diseases such as cancer. Parenting interventions have yielded health benefits for children with obesity; however, few studies have investigated the impact of parent-focused interventions on QOL in children with overweight and obesity. This study investigated the impact of a 6-week intensive parenting intervention program on the QOL of 5-12 year old, predominantly Black children with overweight and obesity. Parents were randomized into either the parenting intervention (NOURISH+) or a control group, and QOL, as well as variables related to child and parenting …

Profiles Of Family Functioning In Pediatric Hematology-Oncology Patients: Longitudinal Associations With Child Well-Being, Sydney Sumrall

Theses and Dissertations

This study aims to assess 1) patterns of family functioning and 2) longitudinal associations between family functioning patterns and well-being in a vulnerable cohort of children with chronic illness. Caregivers of hematology (16.4%) and oncology (83.6%) patients ages 7-20 (N=55; M_age = 13.3 [SD = 2.7]; 52.7% female; 45.5% non-Latinx White, 38.2% Black or African American, 12.7% Latinx, 1.8% Asian, and 1.8% multi-racial,) reported on family functioning via the Family Assessment Device. Cluster analyses identified three mutually exclusive clusters: one high adaptive group, one moderate adaptive group, and one maladaptive group. Group membership was not significantly …

Correlates Of Current Tobacco Use Among Cancer Survivors: Examining The Role Of Posttraumatic Growth And Family Conflict, Kendall Fugate-Laus

Theses and Dissertations

Cancer survivors who use tobacco are at a greater risk of death and poor health outcomes. Although tobacco use during cancer survivorship is associated with poor psychosocial functioning, it is relatively unknown how tobacco use is associated with other variables important to cancer survivorship, such as family functioning and posttraumatic growth. Thus, the current study aims to contribute to this gap within the literature by investigating the association between family conflict, posttraumatic growth, and current tobacco use status among cancer survivors. Participants were recruited from Virginia Commonwealth University’s Massey Comprehensive Cancer Center and eligible to participate if they received any …

Examining Allostatic Load As A Biological Mechanism Linking Childhood Adversity And Pediatric Pain, Angela Pascale

Theses and Dissertations

Despite a strong literature base relating childhood adversity to pain, the biological mechanisms underlying these associations remain unclear. Theoretical and preliminary empirical evidence supports allostatic load as a potential biological mechanism, though prior studies investigating associations between childhood adversity and elevated allostatic load and/or between elevated allostatic load and poorer pain outcomes have primarily focused on adult populations and individual allostatic load indicators rather than a comprehensive index. Thus, the current study built upon prior literature by testing longitudinal relationships between childhood adversity and multiple biological indicators spanning across physiological systems (i.e., comprehensive allostatic load index) and pediatric pain outcomes …