Medicine and Health Commons^™

Recovery Capital In A Justice-Involved Population: An Asset-Based Approach To Recovery And Community Reentry, Evan Joseph Batty

Theses and Dissertations--Sociology

The burden of the opioid epidemic demands further efforts to facilitate recovery, particularly for disadvantaged populations and those recently released from prison. After community reentry, individuals face a period of vulnerability as they adjust to new roles and responsibilities to meet their basic needs. Prison-based substance use disorder treatment (SUD Tx) programs provide support to help prepare individuals with SUD for their release and facilitate successful recovery goals after community reentry. This dissertation has three aims: (1) further the understanding of potential barriers and facilitators of recovery after community reentry, (2) assess how prison-levels of recovery capital influence recovery outcomes …

An Examination Of Three Transitional Events In The Substance Misuse Trajectories Of Women With Criminal Legal System Involvement, Martha Tillson

Theses and Dissertations--Sociology

Research has consistently demonstrated that criminal legal system (CLS)-involved women are distinct from men in initiation and course of drug use, with important differences on biological, environmental, and sociocultural levels. Thus, the unique pathways and transitions into and out of drug use for women with CLS involvement are critical to consider from a research perspective, but also from a need to develop and support evidence-based, women-centered services in correctional contexts. This dissertation project uses a three-paper format to investigate three aims: (1) to understand CLS-involved women’s initiations to injection drug use and their experiences providing injection initiation assistance (IIA) to …

Social And Biological Determinants Of Pregnancy-Related Mortality And Morbidity In A Rural, Underserved Population, Anna Hansen

Theses and Dissertations--Sociology

Cases of severe maternal morbidity (SMM) and pregnancy-related mortality (PRM) are increasing in the US. Research concerning SMM and PRM has neglected women in Central Appalachia; a largely rural, health-disparate population. The aims of this study are two-fold: (1) Examine patient-level and place-based predictors of SMM/PRM via hierarchical logistic regression modeling, and (2) Elucidate Appalachian healthcare patients’ and providers’ experiences with SMM/PRM, perceptions of contributing factors, and insights on points of intervention.

This study uses a mixed methods approach guided by the WHO’s conceptual framework for action on social determinants of health to identify determinants of SMM and PRM among …

Other People’S Families: How Social Ties Shape Entrance Into The Medical Profession, Lillian Sims

Theses and Dissertations--Educational Policy Studies and Evaluation

Not enough members of low-income, rural, and minoritized populations are successfully prepared for and recruited into medical school, exacerbating issues of unequal access to healthcare and limiting access to the profession. While a multitude of factors contribute to this problem, early social exposure to others in a field can act as a key contributor to career interest and a key advantage for entering the profession. Meanwhile, students without early social exposure to healthcare may take unconventional paths to medical school or may struggle to fit into the unique culture of medicine when they do enter training, especially if they belong …

Is Secondhand Discrimination Harmful For The Mental Health Of Black Americans? Findings From A Community Epidemiological Study, Myles Moody

Theses and Dissertations--Sociology

In recent years, there has been a growing concern about not only the deleterious health effects of direct experiences of racism, but also how individuals are affected by others’ experiences of racism. It has been firmly established that direct exposure to discrimination can negatively impact the mental health of Black Americans and other minorities. But there is a dearth of empirical evidence that may answer the question of how indirect experiences of racism affects health. The purpose of this study is threefold: 1) to examine the social distribution of personal and vicarious experiences of discrimination among Black adults, 2) to …

Consuming Appalachia: An Archaeology Of Company Coal Towns, Zada Komara

Theses and Dissertations--Anthropology

Material culture is an understudied aspect of social life in Appalachian Studies, the multi- disciplinary investigation of social life in the Appalachian region. Historically, material culture in the region has been largely studied for its semiotic properties, decoded as a tangible symbol of “a region apart,” lagging behind the rest of America in terms of moral, mental, economic, and social development. Critical material studies from archaeology and other disciplines paint a different picture, however, and construct a region as American as any other. This study utilizes discourse analysis of material rhetoric about Appalachia and archaeological and oral historical data from …

Gay Men And Satisfaction With Health Care Interactions, Michael Huggins

Theses and Dissertations--Nursing

The purpose of this research was to determine relationships among depression, anxiety, self-rated physical and mental health, self-advocacy, internalized homophobia, and quality of patient-provider communication to satisfaction with health care interactions. These were measured while controlling for select demographic variables: age; ethnicity; urban or rural domicile; relationship status; household income; highest educational attainment; health insurance; disclosure to health care provider as a gay man; reason for last healthcare visit; and, general health self-rating. The specific aims of this study were to: 1) identify general characteristics of gay men in this sample; 2) examine how levels of satisfaction with health care …

Maternal Relationships, Bullying, And Deviance: A Comparison Of Adolescents With And Without Medical Conditions, Kristina M. Hayes

Theses and Dissertations--Family Sciences

The purpose of the current study was to examine and compare the quality of the mother-adolescent relationship, the prevalence of bullying and cyberbullying perpetration and victimization, and the prevalence of externalizing behaviors, as well as the relationship among these constructs, in a clinical and a nonclinical sample of adolescents. It tested a series of hypotheses focused on group differences in the mother-adolescent relationship, peer victimization, and externalizing behaviors (i.e. deviant behaviors and bullying perpetration) for the clinical and nonclinical samples. It also tested the relationships between the mother-adolescent relationship and peer victimization, deviant behaviors, and bullying perpetration, and whether these …

Making Health A Priority: Constrained Choices At The Grocery Store, Christy F. Brady

Theses and Dissertations--Sociology

Mounting evidence of the deleterious health effects of poor diet, obesity, and correlated conditions underscore the need to understand how social factors influence food choices. A variety of factors contribute to the diets that Americans consume including limited time, limited income, lack of cooking skills, food deserts, and cheap, convenient foods in abundant portions in grocery stores and restaurants. These contextual factors serve as constraints that impact an individual’s ability to prioritize health when shopping for food. Using the three paper dissertation format, this project will utilize a Constrained Choice Theory (CCT) framework to investigate sociodemographic trends in priorities in …

The “Weight” Of Socio-Economic Status, Race/Ethnicity, And Gender: A Systematic Examination Of Obesity And Its Co-Morbidities, Gabriele Ciciurkaite

Theses and Dissertations--Sociology

Although extensive research exists on the association between SES and obesity and its patterning across separate gender and racial/ethnic groups, critical gaps remain. In particular, the majority of studies on the SES-BMI association have examined it in additive models without simultaneously considering the influence of gender and race/ethnicity. An additional limitation of the current obesity scholarship concerns the lack of scholarship addressing the interplay between social factors, such as SES, race/ethnicity, gender, and proximate health risk factors, such as BMI, in shaping obesity-related chronic health outcomes, especially considering that health outcomes may vary in the extent to which they may …

Social Networks, Drug Use, And Drug Abuse Help-Seeking: A Test Of The Network Episode Model Among African American Women, Erin L. Pullen

Theses and Dissertations--Sociology

Untreated substance use disorders are a major public health concern that has costly consequences at both the societal and individual level. Identifying the characteristics and resources of those who seek help for substance abuse problems in order to inform more effective intervention and treatment techniques is therefore an important research objective. Using the Network Episode Model (NEM) as a theoretical framework, this dissertation examines both substance abuse help-seeking (i.e. inpatient/outpatient treatment and 12-Step meeting attendance) and patterns of drug use over time among low-income African American women, with a special focus on the role of the social network system in …

Untangling Neoliberalism’S Gordian Knot: Cancer Prevention And Control Services For Rural Appalachian Populations, George F. Bills

Theses and Dissertations--Sociology

In eastern Kentucky, as in much of central Appalachia, current local storylines narrate the frictions and contradictions involved in the structural transition from a post-WWII Fordist industrial economy and a Keynesian welfare state to a Post-Fordist service economy and Neoliberal hollow state, starving for energy to sustain consumer indulgence (Jessop, 1993; Harvey, 2003; 2005). Neoliberalism is the ideological force redefining the “societal infrastructure of language” that legitimates this transition, in part by redefining the key terms of democracy and citizenship, as well as valorizing the market, the individual, and technocratic innovation (Chouliaraki & Fairclough, 1999; Harvey, 2005). This project develops …

Applying Specific Arts Activities To Improve The Quality Of Life For Individuals With Alzheimer’S Disease And Dementia, Ann Christianson Tietyen

Theses and Dissertations--Art and Visual Studies

This study examined the effectiveness of a combination of seven different visual art activities, hat decoration, collage, embossing, painting, ceramics, photography, and printmaking, on quality of life for eight veterans with Alzheimer’s disease and dementia. The eight veterans were selected from the population of residents at the Thomson‐ Hood Veterans facility in Wilmore, Kentucky. These veterans were administered the seven art activities mentioned above, which ranged from less difficult to increasing difficulty. Three standard self‐reporting instruments, the Quality of Life‐AD, the Rosenberg Self‐Esteem Scale, and the Smiley‐Face Mood Assessment, as well as systematic observation and surveys were used to explore …

Making Boundaries And Linking Globally: “Material Politics” Of Phytosanitary Regulation On Mexican Mangos, Kiyohiko Sakamoto

Theses and Dissertations--Sociology

This dissertation illuminates how phytosanitary (PS) regulations enable mango exportation from Mexico to the United States. PS regulations are technical and legal measures to prevent plant pests from proliferating or being transported to other places and are important regulatory mechanisms enabling the globalization of agriculture. My case study investigates how PS regulations enable Mexican mango exportation as an aspect of the globalization of agriculture, illustrating the consequences of PS regulations to humans and non-humans. More specifically, three research questions are posed: (1) How does the PS regulation network operate to draw distinctions between pest/non-pest, thereby enabling the export of Mexican …

Kentucky Wic Participants’ Knowledge, Attitudes, And Beliefs Regarding Grains, Dustin Tyler Reed

Theses and Dissertations--Nutrition and Food Systems

Obesity, diabetes, cardiovascular disease, and poor dietary habits are major healthcare problems in the United States. These issues are especially prevalent in the state of Kentucky and among at-risk populations such as Women, Infants, and Children (WIC) participants. Studies have found that whole grains play a role in weight maintenance, protection against type 2 diabetes, and lowering cholesterol. Interventions aimed at improving WIC participant dietary behavior and intake has been successful as well. This study assessed Kentucky WIC participants’ knowledge of the benefits of consuming grains, attitudes and beliefs regarding food purchasing and grains, and identified grains consumed in a …

Breast Cancer Trends Among Kentucky Women, 2004-2007, Kara Ann Hagan

Theses and Dissertations--Nutrition and Food Systems

The purpose of this study is to investigate the discrepancies of female breast cancer mortality between the Appalachian and Non-Appalachian regions of Kentucky using data from the Kentucky Cancer Registry. This study identified subtype, reproductive, and regional differences in women with breast cancer in Kentucky. Among women with breast cancer living in Kentucky from 2004 to 2007, one and three live births significantly increased a woman’s risk of breast cancer mortality by 91% and 58% respectively, compared to a woman with zero live births. Progesterone receptornegative tumor status significantly increased a woman’s risk of breast cancer mortality by 64% compared …