Health Psychology Commons^™

Implementing Integrated Care In Family Medicine: Description And Outcomes In An Underserved Population, Zach Radcliff

Theses and Dissertations

Introduction: Family physicians provide access to medical and behavioral healthcare for many underserved populations. Integrating behavioral health clinicians into primary care practices has been proposed as one of the most effective ways to increase access to necessary behavioral health services for many Americans. Integrated behavioral healthcare (IBHC) has begun to be implemented in family medicine practices but there is limited research examining the impact for patients and clinic staff. This study begins to fill this gap in the literature by examining the effects of implementing integrated behavioral healthcare in an urban family medicine clinic in a medically underserved area.

Objective: …

The Role Of Afrocentric Features In Mental Healthcare Utilization And Counselor Preferences In Black College Students, Randl B. Dent

Theses and Dissertations

Though mental health issues are prevalent in Black young adults, they underutilize mental healthcare services. This research examined the role of feature-based discrimination in mental healthcare (under)utilization. Study 1, a secondary analysis of the National Longitudinal Study of Adolescent to Adult Health, provided no evidence supporting a link between skin tone and mental healthcare utilization, when controlling for depression diagnosis. However, when controlling for depression symptoms, there was a trend such that Black young adults with darker, as opposed to lighter, skin tone utilized healthcare less. Study 2, an experimental study with 33 Black college students, showed 73% of the …

Non-Medical Use Of Prescription Drugs, Stress, Cultural Orientation, Utilization Of Healthcare, And Protective Factors Among College Students In China, Cheuk Chi Tam

Theses and Dissertations

Background: Non-medical use of prescription drugs (NMUPD) refers to the use of prescription drugs which are traditionally utilized to manage pain or treat psychiatric problems but without a doctor’s prescription. In 2010, an investigation by the Substance Use and Mental Health Services Administration (SAMHSA) revealed that 5.3% of young adults (18 to 25-year-olds) in the United States reported past-month NMUPD. NMUPD has become a growing concern owing to associations with consequences such as college dropout, poor academic achievement, and health jeopardizing behaviors. College students' NMUPD has been well documented in the United States. Limited studies, however, have been conducted among …

Examining Health Behaviors In College Students With And Without Chronic Conditions, Duc-Thi J. Barsell

Theses and Dissertations

Many college students are in a developmental period in which they are transitioning from pediatric to adult health care. This time period can be challenging for all college students and especially for students with a chronic condition. The current study investigated the association between various health-related factors (health locus of control [HLOC], health literacy, health self-efficacy, and health-related quality of life [HRQOL]) and health behaviors in college students, as well as the moderating effect of having a chronic condition on those associations. These health behaviors were further operationalized as healthy lifestyle behaviors (preventative and wellness behaviors, dietary behaviors, physical activity) …

An Integrated Behavioral Model Of Healthcare Utilization Among Transgender And Gender-Nonconforming Adults, Megan Elizabeth Sutter

Theses and Dissertations

Transgender and gender-nonconforming (TGNC) individuals in the United States experience significant marginalization due to stigma enacted at the structural, interpersonal, and individual levels. As a result, this population has reported increased behavioral and physical health needs, as well as unique barriers to healthcare. Moreover, TGNC individuals have reported greater experiences of childhood abuse compared to cisgender individuals. The cumulative experiences of stigma-related stressors and adverse childhood experiences put this population at risk for the development of mental and physical health problems, increasing need for health services. However, TGNC individuals have reported being denied medical care and postponing seeking care due …

Sustainable Adapted Treatments For Eating Disorders: The Role Of Cultural Adaptation In Prevention, Sarah J. Javier

Theses and Dissertations

Despite demonstrating eating disorder rates equivalent to White women, African American and Asian American women are less likely to seek treatment and are more likely to terminate treatment prematurely. One of the most successful programs for eating disorder prevention has only focused on surface-level cultural adaptations. Prevention literature maintains that deep-structure cultural adaptation (e.g., integrating cultural values and beliefs) can enhance outcomes for ethnic minorities. This dissertation examined the feasibility of Sustainable Adapted Treatments for Eating Disorders (SATED), a pilot intervention that included a culturally- targeted pre-treatment to an eating disorder dissonance-based intervention. A sample of 72 women (ages 18-30) …

Protective Factors In The Association Between Child Sexual Abuse And Telomere Length In Adults, David Sosnowski

Theses and Dissertations

The purpose of the present study was to examine if childhood sexual abuse (CSA) was associated with decreases in mean telomere length (TL), and if social support and/or optimism moderated this association. The study included 99 Caucasian female monozygotic twins, ranging in age from 19-48 (M_age = 30.5, SD = 7.8) at Time 1. Linear mixed effects models were employed to test study hypotheses. Analyses with all participants did not detect an effect of CSA exposure or severity on mean TL, nor were there effects with optimism. However, in analyses that only included women exposed to abuse, increases …

Psychological Consequences Of Genetic Testing, Jack Allen

Cal Poly Humboldt theses and projects

Direct-to-consumer genetic testing describes genetic testing which is done using online or mail in services, without the direct supervision of a counselor or physician. Individuals can order information about their ancestry, trait information, and even disease risk information. Online testing services have previously been prevented from offering certain types of genetic self-knowledge to consumers due to government regulation, however, there is little information available about how genetic self-knowledge may affect consumers. The present study evaluated whether simply believing oneself to be genetically disadvantaged could cause an individual to perform poorly on a working memory task.

University students participated in a …

Measuring Chocolate Craving In Adults, Haley M. Whitham

Cal Poly Humboldt theses and projects

Present research finds that the experience of chocolate craving is unique from other foods (Bruinsma & Taren, 1999). Only two measures on chocolate craving exist, the Attitudes to Chocolate Questionnaire (ACQ; Benton et al., 1998) and the Orientation to Chocolate Questionnaire (OCQ; Cartwright et al., 2007). Both measures theoretically vary and include subscales that measure other eating components, such as guilt-driven restrictive eating. A need for a measure that focuses on the characteristics of chocolate craving and consumption exists. Thus, the Chocolate Craving Inventory (CCI; Whitham & Reynolds, 2014) was created. The purpose of the present study was to examine …

Double Whammy: Interpretive Phenomenological Analysis Of Older African Americans Experiencing Hiv & Age Related Comorbidities, James W. Chavers

Antioch University Dissertations & Theses

HIV among older African Americans represents one of the fastest and largest growing populations of infected groups in America (CDC, 2008). With the availability of anti-retrovirals (ARV), or AIDS cocktail drugs, HIV has become a chronic illness. As African Americans are living longer with HIV, they are encountering the diseases that are consonant with aging. The effect of aging with HIV and an age-related comorbid condition can be physically and emotionally debilitating. Many of these older adults are also dealing with poverty, stigma, poor healthcare access, and limited social support. The purpose of this study was to explore how these …

The Effect Of Social Influence On Perception Of Tornado Warnings, Jason A. Parker

College of Graduate Studies: Theses & Dissertations

Tornado activity annually results in many deaths throughout the U.S. As a result, the emergency alert system (including tornado warnings) has made considerable advancements throughout the past few decades. However, continued improvements could be made to warning content that aid to facilitate adaptive decision-making by increasing individuals’ motivation to respond. One method that could increase adaptive responses to warnings is by including the modality of descriptive social information within the warning. Research suggests that normative social influence acts as a powerful motivator for individuals to conform toward the witnessed or perceived behaviors of others. The current study examined the impact …

Differentiating The Effects Of Animal-Assisted Versus Equine Facilitated Psychotherapy On Positive Psychological Outcomes Through A Stress Induction Context, Catherine J.V. Jones

College of Graduate Studies: Theses & Dissertations

The unique benefits of Equine Facilitated Psychotherapy (EFP) such as the human-horse bond, a non-traditional therapy setting, and performing altruistic acts are thought to facilitate positive change in humans. One mechanism by which positive changes occur is through improved coping and resilience in the face of stress. To date, only a handful of correlational studies speak to the potential effects of EFP on resilience-based outcomes. Thus, this study sought to address this gap in the literature by exploring the benefits of EFP compared to traditional Animal Assisted Therapy (AAT) in an experimental context. Specifically, we examined the effects of different …

Exploring The Role Of Motivational Interviewing In Adolescent Patient-Provider Communication About Type 1 Diabetes, Laura J. Caccavale

Theses and Dissertations

Type 1 diabetes (T1D) is one of the most common pediatric chronic illnesses. Glycemic control among patients with T1D often deteriorates during adolescence; yet little is known about the most effective way for providers to communicate with adolescents to prevent this decline. Given the importance of effective communication, examination of effective patient-provider communication strategies is needed. The current investigation used Motivational Interviewing (MI) as a framework to help characterize naturally-occurring adolescent patient-provider communication in medical encounters and examined the relations between provider communication and T1D self-management and control.

Participants were five pediatric endocrine providers and 55 adolescents with T1D (49% …

Mechanisms Of Motivational Interviewing In A Parent-Focused Pediatric Obesity Intervention, Nadia Islam

Theses and Dissertations

Pediatric obesity is a major public health epidemic with serious physical and psychological consequences. Difficulty engaging families in treatment is a significant obstacle in addressing pediatric obesity, especially among underserved populations. Motivational interviewing (MI) is a collaborative, person-centered communication style that has been shown to reduce attrition, increase attendance, and improve patient treatment adherence; however, little is known about the process of MI and how it improves treatment engagement. This study examined clinician and parent language in a pre-treatment MI session that increased initial engagement in a parent- focused pediatric obesity intervention (N= 81). Results showed that increased parent change …

Racial And Ethnic Differences In Smoking Changes After Chronic Disease Diagnosis Among Middle-Aged And Older Adults In The United States, Ana R. Quinones, Corey L. Nagel, Jason T. Newsom, Nathalie Huguet, Paige Sheridan, Stephen M. Thielke

Psychology Faculty Publications and Presentations

Background

Middle-aged and older Americans from underrepresented racial and ethnic backgrounds are at risk for greater chronic disease morbidity than their white counterparts. Cigarette smoking increases the severity of chronic illness, worsens physical functioning, and impairs the successful management of symptoms. As a result, it is important to understand whether smoking behaviors change after the onset of a chronic condition. We assessed the racial/ethnic differences in smoking behavior change after onset of chronic diseases among middle-aged and older adults in the US.

Methods

We use longitudinal data from the Health and Retirement Study (HRS 1992–2010) to examine changes in smoking …

What Is The Key To Culturally Competent Care: Reducing Bias Or Cultural Tailoring?, Adolfo Gabriel Cuevas, Kerth O'Brien, Somnath Saha

Psychology Faculty Publications and Presentations

Objective: To gain a better understanding as to whether disparities in patient– provider relationships arise from ethnic minority patients being treated differently than European American patients while they would prefer to be treated the same, or whether disparities arise when ethnic minority patients are treated the same as European American patients while they would prefer to be treated differently.

Method: African-American, Latina/Latino and European American community members were recruited to participate in one of 27 focus group discussions. Topics included what made a good or bad relationship with a doctor and what led one to trust a doctor. A thematic …

Vital Exhaustion, Burnout, And Other Avatars Of Depression, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In our view, there is a worrying tendency in psychology and medicine to let proliferate “depression-like” constructs—a transgression of the scientific canon of parsimony. The problem is not limited to vital exhaustion (VE). Burnout, a condition akin to VE, has been shown to problematically overlap with depression. Compassion fatigue, a condition that shows particularly blurred definitional contours, is also uncomfortably close to depressive symptomatology. The construct of neurasthenia may be part of this confusing trend as well, although neurasthenia has been elevated to the status of nosological category in the ICD. Construct proliferation jeopardizes knowledge growth by undermining theory building …

‘Burnout Syndrome’: From Nosological Indeterminacy To Epidemiological Nonsense, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

All in all, Imo’s review is undermined by the very research it relies on. We recommend that researchers interested in burnout begin at the beginning, that is to say, by establishing a reasoned, clinically-founded (differential) diagnosis for their entity of interest. As long as investigators do not complete the required groundwork for establishing a diagnosis and remain unable to distinguish a case of burnout from either a noncase or an existing disorder, conclusions regarding the prevalence of burnout will be nonsense. To close this comment, we note that an immediately available solution for effectively monitoring and protecting physicians’ occupational health …

Consequences Of Job Stress For The Psychological Well-Being Of Teachers, Irvin Sam Schonfeld, Renzo Bianchi, Peter Luehring-Jones

Publications and Research

This chapter examines research on the relationship between job stressors and mental health (depressive symptoms, burnout, and mental disorders such as depression) in teachers. Teachers are exposed daily to job stressors (e.g., student disruptiveness) that have been linked to adverse mental health effects. Epidemiologic research indicates that when compared to members of other groups, teachers experience higher rates of mental disorder, although some studies question that conclusion. Large-scale studies indicate when compared to members of other occupational groups, teachers are at higher risk for exposure to workplace violence, with its adverse mental health consequences. Longitudinal research has linked teaching-related stressors …

Predictors Of Substance Use, Relationship Arrangements And Intimacy Expectancies Among Gay Couples And Associations To Erikson Intimacy Development, Jonathan Lopez Matos

Theses and Dissertations

This study explored relationship arrangements, intimacy expectancies of substance use and the potential role of Eriksonian intimacy development on drug use among gay and bisexual men. Data were collected from 339 partnered gay/bisexual men across the United States. Measures addressed arrangement type, intimacy expectancies, Eriksonian intimacy and drug use.