Health Psychology Commons^™

Health Equity Through Spatial Justice: A Critical Phenomenology Of Urban Trail Makers, Arvin Simon

Electronic Theses and Dissertations

Research has increasingly demonstrated that race, class and place are powerful predictors of health and social justice. This study was conducted to identify the lived experiences of individuals who were hired and trained as part of a green job program that created trails within a city park in Pittsburgh’s Mount Washington Community. This program has historically hired individuals who were formerly incarcerated, many of whom identify as African American. We explored the personal and social experiences of working in nature to better appreciate the intersections of race, class and environment in an urban community. This current study is based on …

Prenatal Risk For Autism Spectrum Disorder (Asd): Fetal Cortisol Exposure Predicts Child Asd Symptoms, Sheena Ram, Mariann A. Howland, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

The etiology of autism spectrum disorder (ASD) is multifactorial, complex, and likely involves interactions among genetic, epigenetic, and environmental factors. With respect to environmental influences, a growing literature implicates intrauterine experiences in the origin of this pervasive developmental disorder. In this prospective longitudinal study, we examined the hypothesis that fetal exposure to maternal cortisol may confer ASD risk. In addition, because ASD is four times more prevalent in males than in females, and because sexually dimorphic responses to intrauterine experiences are commonly observed, we examined whether or not any associations differ by fetal sex. Maternal plasma cortisol was measured at …

Syndemics Of Severity And Frequency Of Elder Abuse: A Cross-Sectional Study In Mexican Older Females, Mireya Vilar-Compte, Pablo Gaitán-Rossi

Department of Public Health Scholarship and Creative Works

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.

Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.

Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had …

Measuring Hpv Vaccine Worry: Development And Validation Of A Scale In Parents With Hpv Vaccine Eligible Children, Catherine Rochefort

Psychology Theses and Dissertations

Worry is a negatively-valenced emotion associated with risk-related cognitions. In the context of HPV vaccination, it is likely that parents worry about giving their child the vaccine because some vaccine outcomes may be perceived as uncertain. Therefore, worry may be an important factor predicting HPV vaccination outcomes. This study’s purpose was to (1) develop a measure of HPV vaccine worry, (2) examine whether parents worry more about the HPV vaccine than other adolescent vaccines, and (3) determine whether HPV vaccine worry is associated with HPV vaccination intentions. In Study 1, a HPV vaccine worry item pool based on the three-process …

Screen Time, Sleep, And Mental Health: An Investigation Of Electronics Use And Sleep Habits, Robert Nicks

Electronic Theses and Dissertations

Internet addiction (IA) is classified as a compulsive-impulsive behavior disorder involving excessive use of the internet, withdrawal, tolerance, and negative repercussions (Block, 2007). Internet usage is becoming more widespread across all industrialized people, and younger people are using the internet more and more as it becomes more ubiquitous (Rideout, Foehr, & Roberts, 2010). The purpose of the current study is to investigate internet usage habits, sleep disturbance, and IA as it appeared in a national United States sample, and a sample seeking clinical psychological help in the Southwestern United States. The results of the current study suggested that IA predicted …

Maternal Immune Activation (Mia) In Mice: A Study To Phenotype Asd-Related Communication Behaviors And Analyze Maternal Health Outcomes In The Us, Komalpreet Gulati

Honors Scholar Theses

Core symptoms of Autism Spectrum Disorders (ASD) include deficits in social/communicative behaviors, and repetitive/stereotyped behaviors. Mouse models are a highly established paradigm used to study the phenotypic deficits that result from various inducible genotypic or environmental risk factors for ASD. Previous studies have demonstrated a link between maternal immune activation (MIA) and ASD-like behaviors in mouse models. In this model, the maternal immune system is activated during pregnancy by injecting the viral mimic poly(I:C). The resulting offspring are phenotyped and analyzed with regards to their communicative behaviors.

Previous studies have demonstrated that male pups born to dams with immune activation …

The Relationship Between Neuroticism, Self-Esteem, And Disordered Eating Attitudes: Examining The Health At Every Size Theory, Liana Cho

Masters Theses

Background. In the modern day treatment of overweight/obesity, conflicting recommendations regarding treatment have been released by the Academy of Nutrition and Dietetics (AND) and advocates of the Health at Every Size (HAES) movement. While the AND have indicated their support for self-monitoring practices, such as keeping a food diary or tracking calories, HAES advocates have claimed that these restrictive practices may result in increased disordered eating tendencies and poor self-esteem.

Subjects. The participants for this study included 410 students at Grand Valley State University. Almost 80% of participants were female, and just over 85% of participants identified as white. …

Alcohol Expectancies Among Students In The City Of Pokhara, Nepal, Niran Tamrakar

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Alcohol plays a vital role in various aspects of Nepalese society. It also presents public health risks. Though adolescents in Nepal are at high risk for negative consequences from alcohol use, there is limited information available on their alcohol behaviors and beliefs. The present study aims to describe alcohol expectancies among a sample of secondary students in Nepal to identify and understand motivations underlying their alcohol-related behaviors. A self-report survey was administered to 591 students from different Englishmedium schools in the city of Pokhara. This study began with the Chinese Adolescent Alcohol Expectancy Questionnaire (CAAEQ), then used qualitative methods to …

Hemoglobin A1c Improvements And Better Diabetes-Specific Quality Of Life Among Participants Completing Diabetes Self-Management Programs: A Nested Cohort Study, Abhinav Khanna

Dissertations & Theses (Open Access)

Background: Numerous primary care innovations emphasize patient-centered processes of care. Within the context of these innovations, greater understanding is needed of the relationship between improvements in clinical endpoints and patient-centered outcomes. To address this gap, we evaluated the association between glycosylated hemoglobin (HbA1c) and diabetes-specific quality of life among patients completing diabetes self-management programs.

Methods: We conducted a retrospective cohort study nested within a randomized comparative effectiveness trial of diabetes self-management interventions in 75 diabetic patients. Multiple linear regression models were developed to examine the relationship between change in HbA1c from baseline to one-year follow-up and Diabetes-39 (a diabetes-specific quality …

Sex-Specific Effects And Gene-Sex Interactions In Serum Metabolome Levels: The Atherosclerosis Risk In Communities Study, Zhe Wang

Dissertations & Theses (Open Access)

Metabolomic signatures associated with complex disease have been identified. Metabolomic profiling and the integration of genomic data have proven to be powerful tools to investigate genetic effects underlying intermediate phenotype levels and may facilitate improved understanding of pathophysiologic processes of disease. However, most published studies did not consider sex as an effect modifier, analyze sex-specific effects, nor gene by sex interactions. One reason can be incomplete knowledge of the power of statistical methods used in a given dataset.

I first investigated sex-specific genetic effects by performing sex-stratified exome-wide association studies for 271 chromatography-mass spectrometry measured metabolites in the Atherosclerosis Risk …

Impacts Of Cold Weather On Health In Texas, Tsun-Hsuan Chen

Dissertations & Theses (Open Access)

Recent events with recorded low temperature and unusual snow accumulation in the United States and Europe have raised the public awareness of the potential health impacts of extreme winter weather. Excessive cold was the leading cause of weather-related death during 2006-2010 in the U.S., accounting for 63% of weather related deaths. Several studies worldwide have demonstrated that, in general, mortality rates are higher in winter compared to summer. Studies have also shown that the association between cold temperature and death vary across cities, regions and countries and is especially relevant with decreasing latitude or in regions with mild winter climate. …

Chagas Disease Awareness Amongst Texas Physicians, Gerardo J. Pacheco

Dissertations & Theses (Open Access)

An estimated 300,000 people in the U.S. are living with Chagas Disease (CD), many of whom may not yet know they are infected. Approximately 20% to 30% of individuals with CD are expected to develop clinical symptoms that may manifest as heart disease and result in death if left untreated. The prevalence of CD in humans is not well understood. Given its asymptomatic manifestation and the rarity in cases seen by physicians in general, CD may be under-recognized by physicians.

The purpose of this research was to explore the understanding and knowledge of CD in Texas HCP populations (cardiologists, infectious …

Factors Contributing To Lower Cancer Screening Utilization In A Sub-Sample Of United Way 2-1-1 Callers, Jason M. Rhoton

Dissertations & Theses (Open Access)

This dissertation was a secondary analysis of data from a Cancer Prevention Research Institute of Texas (CPRIT)-funded [grant # PP100077 & PP120086] cancer-control intervention with The University of Texas Health Science Center at Houston (UTHealth) School of Public Health and United Way 2-1-1. The aims of the three dissertation papers were addressed by examining a sub-sample of 2-1-1 callers that were drawn from the parent study baseline data. Participants were required to need at least once cancer prevention service to be included in the parent study and dissertation analyses. This dissertation was a cross-sectional analysis of de-identified data examining the …

Assessment And Findings Of The Vulnerability Index (Vi-Spdat) Survey Of Individuals Experiencing Homelessness In Travis County, Tx, Benjamin T. King

Dissertations & Theses (Open Access)

Homelessness is a significant barrier to the quality of an individual’s health. Federal housing interventions attempt to eliminate homelessness by providing varying degrees of subsidization, but available units do not currently keep pace with the scale of the problem. Coordinated Assessment is a process requirement put in place by HUD to organize and prioritize the waiting list for housing, based on community priorities. Several tools measuring health and social vulnerability, including the Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT), have become popular options for prioritizing housing resources. Such assessments currently in use are not thoroughly researched and the effects of …

Bayesian Based Semiparametric Multidimensional Approaches To Analysis Parkinson's Disease, Jun Zhang

Dissertations & Theses (Open Access)

In the slow progression of Parkinson's Disease (PD), impairments arise and affect multiple domains (e.g., motor, cognitive, and behavioral). Mixed types, multivariate longitudinal data are commonly used in PD studies. Challenges exist in assessing PD status and investigating disease progression due to lack of biomarkers and ubiquitous impairment in the disease. We proposed a model framework by combining the semi-parametric approach and multi- dimensional framework, and used the proposed model to investigate the heterogeneous disease development and the non-linear treatment effects in the multiple domains predefined in PD.

Furthermore, we extended the semi-parametric multidimensional approach to the data with multi-types …

Characterizing Young Adult Exposure And Engagement With Social Media Tobacco And Nicotine Product Marketing And Messaging, Stephanie L. Clendennen

Dissertations & Theses (Open Access)

Tobacco use remains a critical public health issue in the United States. Young adults are disproportionately affected by high rates of tobacco use and heavily targeted by tobacco marketing. Social media has become an important source of exposure to tobacco and nicotine product marketing and messaging for young adults. This dissertation examined the prevalence and socio-environmental characteristics associated with young adults’ exposure to and engagement with tobacco-related social media (paper 1); the prospective associations between young adults’ exposure and engagement and tobacco and nicotine product use (paper 2); and young adults’ experiences with tobacco and nicotine product messaging on social …

Censored Count Data Analysis – Statistical Techniques And Applications, Xiao Yu

Dissertations & Theses (Open Access)

Count data are commonly used to report frequency statistics of diverse health outcomes. However, some data are marked intentionally to avoid leaking information that could be used to identify individuals when population sizes are small. The situation hinders the further use from those data in public health research. Thus, an accurate and efficient method for dealing with censored count data is needed.

We developed Integrated Nested Laplace Approximation algorithm to censored Poisson regression model to deal with censored count data and improve the computational efficiency. In addition, we applied three methods to deal with censored count data: 1) multiple imputation …

Collateral Benefits Of Diabetes Self-Management Associated With Self-Administered Outpatient Parenteral Antimicrobial Therapy, Anisha P. Ganguly

Dissertations & Theses (Open Access)

Self-administered outpatient parenteral antimicrobial therapy (S-OPAT) is a self-care treatment modality in which patients requiring extended courses of intravenous antibiotics are trained to safely self-administer treatment via an indwelling catheter in their home. Many patients seen in the S-OPAT program have a diagnosis of diabetes and present with infections associated with poor glycemic control, including skin and soft-tissue infections and osteomyelitis. Given the degree of patient activation required to successfully complete the S-OPAT process, we hypothesized that participation in this self-care program may benefit patients in self-management of other chronic health conditions, such as diabetes. The study team included Anisha …

Observed Cooking Behaviors Of Families With And Without Childhood Cancer Survivors And The Development Of A Healthy Cooking Assessment Tool, Margaret Pleta Raber

Dissertations & Theses (Open Access)

Diet is a modifiable risk factor for several cancers and other chronic diseases. Cooking skills are a target for dietary intervention, with much of the general population reporting infrequent and inadequate home preparation of meals. Childhood cancer survivors (CCS) are a population at high risk of several chronic conditions including secondary cancers that may be influenced by home cooking behaviors. We conducted observations of food preparation practices in 29 parents of healthy school-aged children and 11 parents of CCS. Observations included an audio and video recording of one evening meal per family. Parents were asked to wear a small body …

Examining The Effect Of Service Delivery Factors On Timely Initiation Of Tuberculosis Treatment Within Primary Care Settings In Uganda, Michael Juma

Dissertations & Theses (Open Access)

Background: Timeliness of Tuberculosis (TB) treatment is critical to stopping its transmission and preventing disease complications and death. Efficiency in identifying and treating presumptive TB cases is critical to reducing delays.

Aims: We determined the association between health service-related factors and delays in initiating TB treatment within primary care settings in Uganda. Perspectives of healthcare workers on practices underlying healthcare facility level delays were also described.

Methods: A mixed methods study was conducted based on facility-register records of 1199 treated TB cases and key informant interviews with 27 outpatient staffs. Health service-related factors (size, ownership, number of …

Validation Of A Type 2 Diabetes Risk Stratification Tool In A Low Income Hispanic Population, Dara Grieger

Dissertations & Theses (Open Access)

A pilot study was undertaken to evaluate the appropriateness of a previously published diabetes risk stratification tool in a diabetic population. The tool was applied to a sample of 500 prediabetic and diabetic adults receiving primary care services at a Federally Qualified Health Center (FQHC) in Cameron County, Texas. The study population was largely Hispanic and underserved. The National Health and Nutrition Examination Survey (NHANES) 2015-2016 data set was used as a comparison group. The risk assessment tool was applied to separately to the prediabetic and diabetic subset of both study groups. The tool stratified the patients into three risk …

Does Space Matter? An Investigation Of The Spatial Variation In Gestational Weight Gain Associations With Country Of Birth Among Hispanic Women And Access To Care In Texas, Christopher R. Webb

Dissertations & Theses (Open Access)

Inadequate and excess gestational weight gain (GWG) are serious, but potentially preventable adverse pregnancy outcomes which affect as many as two-thirds of pregnant women in the United States. While location and space are associated with a variety of pregnancy outcomes, limited research has investigated potential spatial variation in GWG. The goal of this research is to improve the knowledge of how spatial geography is associated with GWG through secondary analyses of 70,000 to 160,000 birth certificate registry records for Texas mothers with a live birth delivery in 2014. Specifically, this research attempts to assess whether access to obstetrics and gynecologist …

Alternative Tobacco Products & Depressive Symptoms Among Young Adults, David Marsden

Dissertations & Theses (Open Access)

The association between cigarette use and depression has been documented in many studies. Fewer studies have examined other tobacco products such as electronic cigarettes (e-cigarettes) and hookah that are used by young adults. This study examined whether increased frequency of use of these products was associated with depressive symptoms in a cohort of n=5,236 Texas college students followed from 2014 to 2017. A hierarchical model showed that increased frequency of single product use of cigarettes, refillable e-cigarettes and hookah was associated with depressive symptoms. Refillable and disposable e-cigarettes were examined separately and results did not provide evidence of a different …

Investigation Of Hantavirus And Leptospira As Possible Contributing Factors Of The Unexplained Kidney Disease Epidemic In Nicaragua, Nicole J. Delgado

Dissertations & Theses (Open Access)

Throughout Latin America, an epidemic of a kidney disease of an unknown etiology has been occurring since the late 1990s, and this disease is being called “Mesoamerican nephropathy.” Mesoamerican nephropathy predominantly affects male sugarcane workers. In Chichigalpa, Chinandega, Nicaragua, there is sugarcane plantation that is being heavily impacted by the Mesoamerican nephropathy epidemic, and they invited researchers from Baylor College of Medicine to investigate the epidemic. The prospective epidemic investigation began in 2015, and it is an ongoing investigation. Based on the compilation of data collected during the preliminary investigation, our hypothesis is that a possible zoonotic disease, such as …

Relationship Between Nursing Safety Culture And Patient Perception Of Safety In Inpatient Units Of An Academic Specialty Hospital, Miguel Angel Lozano Garcia

Dissertations & Theses (Open Access)

The objective of this research was to analyze the relationship between nursing safety work culture in inpatient nursing units of a specialty academic hospital and their patients’ perception of safety using quantitative and qualitative methods. The aim of the quantitative study was to quantitatively evaluate whether nursing safety culture, as measured on the Hospital Survey on Patient Safety Culture (HSOPS) safety questions of the institutional employee opinion survey, was associated with patients’ perception of safety during their inpatient care, as measured by responses on the inpatient Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The aim of the …

Exposure To Ambient Air Pollution And Fetal Death In Harris County, Texas, Amal Rammah

Dissertations & Theses (Open Access)

The evidence from studies of maternal ambient air pollutant exposure (including O3, fine particulate matter (PM2.5) and PM2.5 metal constituents) and stillbirth is limited and equivocal. There is also limited evidence of the acute effect of temperature increases in the week preceding delivery and stillbirth. In the first investigation of ambient air pollution, temperature and stillbirth among a large cohort of women in Harris County, Texas, we obtained birth and fetal death records from 2008-2013 and estimated weekly residential levels of apparent temperature and ozone (O3), fine particulate matter (PM2.5), nitrogen dioxide (NO2) and PM2.5 metals from the local monitoring …

Identifying Risk Factors Associated With Cardiovascular Disease Risk In Lesbians, Sofia S. Velazquez

Dissertations & Theses (Open Access)

Cardiovascular disease (CVD) is the leading cause of female deaths in the United States (1). While women, in general, are at risk for CVD, current research indicates that sexual minority women (i.e. lesbians and bisexual women [SMW]) may be at greater risk for CVD than heterosexual women. This heightened risk potentially stems from an increased prevalence of traditional CVD risk factors in SMW, creating health disparities between SMW and their heterosexual counterparts (2). Further research into this high-risk population is needed, in order to minimize these disparities.

The purpose of this study was to establish differences in the prevalence of …

Effects Of Extreme Precipitation On Gastrointesitnal Related Hospital Admissions In Texas, Sharmila Giri

Dissertations & Theses (Open Access)

Extreme precipitation has been implicated in more than 51% of the waterborne disease outbreaks in the United States between 1948-1994. With increased incidence of extreme precipitation projected to be more likely due to ongoing climate change, the burden of waterborne disease is expected to rise even in the United States where drinking water is considered to be one of the safest in the world. In this study we aim to quantify the risk of extreme precipitation on gastrointestinal (GI) related hospital admissions by using meteorological and emergency hospital data from twelve major metropolitan statistical areas (MSA) of Texas from year …

Hours Of Gaming Or Non-Academic Computer Use, Substance Use, Mental Health Status And School Performance Among Texas Adolescence: Findings From The 2017 Yrbs In Texas, Shanxiazi Gao

Dissertations & Theses (Open Access)

Online gaming activities among adolescents and adults has increased exponentially in the last decade, and mental health issues associated with excessive gaming have drawn attention from health care professionals worldwide (Griffith, 2016). Recognizing this trend, American Psychiatric Association (APA) categorized gaming disorder/addiction as a mental health condition in 2013 in an effort to prevent the expansion of relevant mental health issues (American Psychiatric Association, 2013). Additionally, the World Health Organization (WHO) declared gaming disorder/addiction as a mental health disease, (World Health Organization, 2018). As a result of this declaration, Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has established nine …

Quantifying The Impact Of Laboratory And Care Systems On Relinkage To Hiv Care In A Southern, Urban Environment, Kellie L. Watkins

Dissertations & Theses (Open Access)

Background: HIV viral suppression reduces the likelihood of transmission to just 5%,1 demonstrating the critical link between care and prevention, yet only 51% of people living with HIV (PLWH) were retained in care and 46% achieved viral suppression in the Houston area (2012), with the out-of-care (OOC) population increasing between 2008-2011.2,3

Methods: Record-search investigations across HIV surveillance and care data systems determined if potentially OOC persons referred to the Houston Health Department (HHD) from 2013-2015 (N=1287) qualified for public health follow up. A portion were randomized to a non-intervention group (n=200) to assess the program effectiveness. Participants without a disposition …