Health Psychology Commons^™

Area-Level Landfill Density And Asthma Prevalence In Urban Texas Areas, Jessica Meighan Herrin

Dissertations and Theses (Open Access)

Environmental exposures, especially air pollutants, pose a threat for an increase in asthma prevalence. In particular, hydrogen sulfide (H2S) gas can cause severe health effects closely resembling asthmatic symptoms. Ambient concentrations of H2S gas correlates with the amount of solid waste found in landfills. The potential for adverse health risks associated with H2S emitted from landfills is of concern for those populations living in close proximity to landfills. Asthma is one of the adverse health effects that can occur due to H2S exposure. However, there is a lack of detailed studies characterizing possible associations between the density of landfills and …

Impact Of Substance Use In Social Networks On Antiretroviral Therapy Adherence For Hiv-Positive Younger Men Who Have Sex With Men, Natascha Del Vecchio

Dissertations and Theses (Open Access)

The community of young men who have sex with men (YMSM) has higher rates of substance use than the general population and the use of alcohol, cannabis, and illicit drugs has been shown to have a negative impact on the HIV care continuum. Our first aim was to understand the prevalence of substance use in the community through the use of self-reported, RDS-II, and RDS-SS estimates. We used multivariable logistic and negative binomial GEE with QIC selection to determine the factors important to having a prescription and staying adherent, respectively. Selected variables were included with a subset of substance use …

Effect Of The Expanded Prospective Payment System On Dialysis Initiation, The Usage Of Erythropoiesis-Stimulating Agents, And Medicare Expenditures, Lu Zhang

Dissertations and Theses (Open Access)

In January 2011, the U.S. Centers for Medicare & Medicaid Services (CMS) implemented the expanded prospective payment system (PPS) for financing the management of end-stage renal disease (ESRD). Expanded PPS may not only change healthcare providers’ decisions about patient care by removing the financial incentives associated with the previous composite rate payment methodology, but also change the Medicare expenditures associated with various treatment patterns by using a constant base rate for all dialysis modalities. This study aimed to examine the effect of the expanded PPS on providers’ decisions on timing of dialysis initiation and ESA utilizations in ESRD patients as …

Hospital Market Analysis Using A Cohort Of Privately Insured Patients With Total Hip And Knee Replacement Procedures, Elifnur Yay Donderici

Dissertations and Theses (Open Access)

Background: Several recent studies have analyzed the contribution of hospital inpatient prices and utilization to variation in medical spending. However, it is still unknown how the drivers of spending for specific procedures differ within privately insured patients. Next, the market concentration of hospitals has been a matter of concern for several decades. However, researchers usually calculate Herfindahl-Hirschman index (HHI) as a measure of market concentration or power, but there is a drawback of using this measure. Hospitals sell differentiated products, and the HHI measure does not take this differentiation into account in its formulation (Gaynor and Town, 2011). Objective: First …

The Multilevel Factors Facilitating Or Impeding Healthcare Access Among Refugees Residing In Bexar County Texas, Howaida Werfelli

Dissertations and Theses (Open Access)

The goal of this study was to increase understanding of healthcare access among refugees by investigating the multilevel factors that facilitate or impede healthcare access among refugees who have resettled in Bexar County, Texas. The multilevel factors facilitating or impeding access to healthcare for refugees resettled in Bexar County were identified as follows: health literacy, level of educational attainment, proficiency (reading, writing and, speaking) in English, proficiency (reading, writing and speaking) in native language, translation services, public transportation, income level, a shortage of healthcare providers, navigation of the healthcare system, the fragmentation of the healthcare system, insurance status, staff shortages …

Health Disparities Across Funcitonal Disability Groups, Katherine Sanches

Dissertations and Theses (Open Access)

Background: People with disabilities experience higher rates of chronic disease and poor health status compared to those without disability. People with disabilities do not participate in community health programs to the same degree as those without disability due to social, programmatic, and environmental barriers. The Community Health Inclusion Index (CHII) is a community health assessment tool which evaluates the degree to which community-level health promoting opportunities to promote nutrition and physical activity are inclusive and accessible to people with disabilities. The CHII assess barriers to inclusion across five domains: build environment, equipment, program/services, staff, and policies. Objective: The purpose of …

A Daily Diary Examination Of Microaggressions And Alcohol Use Among Emerging Adult Bisexual Women: The Role Of Alcohol Demand, Sarah J. Ehlke

Psychology Theses & Dissertations

Bisexual women are at far greater risk for alcohol use, alcohol-related negative consequences, and alcohol use disorder than heterosexual or lesbian women. However, research on sexual minority women often combines lesbian and bisexual women into a single group. One possible explanation for the increased alcohol use and associated consequences among bisexual women relates to their experiences of discrimination or microaggressions that are daily insults and comments, intentional or unintentional, about their sexuality from both the heterosexual and sexual minority communities. Thus, it is possible that bisexual women drink to cope with microaggressions. Specifically, bisexual women may drink more and have …

Thwarted Interpersonal Needs, Depression, And Sleep Disturbances In Primary Care: Does Gratitude Help You Sleep?, Heather R. Altier

Electronic Theses and Dissertations

Sleep disturbances are prevalent in primary care patients and can be exacerbated by interpersonal dysfunction and depression. As well, thwarted interpersonal needs (TIN), including thwarted belongingness and perceived burdensomeness, contribute to depression. However, the presence of gratitude, a cognitive-emotional protective factor, may improve symptoms. We longitudinally examined the mediating role of depressive symptoms on the relation between TIN and sleep disturbances, and the moderating role of gratitude on the TIN-sleep disturbances and depression-sleep disturbances linkages. Our primary care patient sample (N = 223) completed self-report surveys at baseline (T1) and at a one-year follow-up (T2; n = 97). Patients …

The Mediating Effects Of Drinking Refusal Self-Efficacy On The Associations Between Alcohol Protective Behavioral Strategies And Alcohol Use Outcomes, Kray Scully

Dissertations

Alcohol use continues to pose a serious public health problem at universities across the U.S., largely due to the extent of consumption and frequency of negative consequences experienced among college students. Alcohol protective behavioral strategies (PBS-A) are an empirically supported repertoire of safe drinking behaviors college students can use to monitor and control their alcohol consumption as well as limit harm while drinking. However, there remains a need to better understand how cognitive mechanisms, such as drinking refusal self-efficacy (DRSE), help explain college student safe alcohol use behaviors to enhance evidenced-based intervention and prevention efforts. Recently, studies that examined the …

Exploring How Communal Motivations And Gender Norms Predict Sexual Health Practices, Courtney Olds

PANDION: The Osprey Journal of Research and Ideas

In the U.S., one in four women under 20 will experience unwanted pregnancy (NCPTU, 2017). Additionally, young adults (15-24) account for half of the new STI’s (CDC, 2017). Previous research has found that gender norms can have detrimental impacts on factors related to safe sex practices (e.g., condom use) such as perceptions of responsibility, self-efficacy and partner communication (Bertens, et al., 2008; Fantasia, et al., 2014; French & Holland, 2013; Huber & Eresek, 2011; Impett, et al., 2006; Noar, et. al, 2002). Conversely, findings have shown that communal (other-oriented) motivations is a predictor of condom use intentions, however, it has …

Feasibility And Validity Of Asking Patients To Define Individual Levels Of Meaningful Change On Patient-Reported Outcomes, Salene M.W. Jones, Yuxian Du, Ari Bell-Brown, Kaylin Bolt, Joseph M. Unger

Journal of Patient-Centered Research and Reviews

Purpose: Patient-reported outcomes (PROs) are frequently used in clinical care to monitor treatment response. However, most guidelines on PRO use treat all patients the same. This study tested the feasibility and validity of a method for determining individually meaningful change in PRO measures.

Methods: Participants (n = 398) completed 12 pain and distress questions to define individually meaningful change. This mixed-methods study used both quantitative and qualitative analyses, including descriptive statistics, inferential statistics, and content analysis.

Results: Two-thirds (67%) of the sample reported at least one medical condition, including depression and back pain. Most participants (70%–90%) were able to answer …

Hiv Preexposure Prophylaxis And Treatment As Prevention — Beliefs And Access Barriers In Men Who Have Sex With Men (Msm) And Transgender Women: A Systematic Review, Joshua J. Matacotta, Francisco J. Rosales-Perez, Christian M. Carrillo

Journal of Patient-Centered Research and Reviews

Purpose: While the annual rate of new HIV infections and diagnoses has remained stable for most groups, troubling increases are seen in transgender women and racial/ethnic-minority men who have sex with men (MSM), groups that are disproportionately affected by HIV. The primary purpose of this systematic review is to examine factors that impact attitudes and beliefs about preexposure prophylaxis (PrEP) and treatment as prevention (TasP) and to explore barriers to PrEP uptake in MSM and transgender women.

Methods: Using MeSH terms and relevant keywords, we conducted a systematic review of studies published between 2010 and 2019. We searched 4 literature …

The Relationship Between Organizational Trauma-Informed Care And Secondary Trauma Symptoms In Staff Members Of Kentucky Domestic Violence Programs, Mary Ellen Foley

Dissertations

This study evaluated secondary traumatic stress (STS) levels in 89 employees from Kentucky’s 15 regional domestic crisis programs to determine whether certain demographic variables predicted STS levels (as measured by the Secondary Traumatic Stress Scale©) and whether employee perception of organizational trauma-informed care practices (as measured by the Ticometer©) reduced levels of STS. Results of a multiple regression analysis indicated that personal trauma history severity did significantly impact STS levels. In this way, the current study rejected the null hypothesis. Results also indicated that the more the employee perceived the organization to adopt and execute trauma-informed care practices, the lower …

Impact Of Covid-19 On Psychology Training In Egypt, Jamie E. Mendoza, Yasmine Saleh

Faculty Journal Articles

In the immediate phase of the rapid shift, our role as supervisors evolved from pre-planned educators to crisis managers and mentors. While the shift was overwhelming, we found comfort through consultation and collaboration with each other to make the most of an unparalleled situation. Our interactions role-modelled effective partnership and joint decision-making. We prepared several of our classes together, and when needed, brought all of the interns together so that our message and approach would be unified. Our discussions shifted from an individual mentality to a collective one. This gave the interns an opportunity to see their supervisors discussing ethical, …

Using Spatial Methods To Better Understand Food Insecurity And Snap Under-Participation In Texas, Ryan Ramphul

Dissertations and Theses (Open Access)

The overall objective of this research is to use spatial methods to better understand food insecurity and SNAP under-participation in Texas. Paper 1 assesses whether a sample of community dwelling Medicare and Medicaid beneficiaries, who screen positive for food insecurity at healthcare locations in Harris County, exhibit a spatial pattern in terms of where they live. In other words, it tests whether or not there are statistically significant neighborhood hot spots or cold spots of food insecurity against a null hypothesis of complete spatial randomness. This approach is novel because it uses address-level data on patients who report being food …

Physician Burnout: Slowing The Burn Through Positive Deviance Strategies, Swapna Reddy

Dissertations and Theses (Open Access)

Introduction: Affecting 42% of physicians in the United States, “physician burnout” is considered a public health crisis with adverse impacts for personal providers, patients and organizations. Though much research has been devoted to the existence and causes of burnout, to date few studies have been conducted to identify factors associated with physician fulfillment. Aims: This dissertation research was intended to increase and improve knowledge of factors effective in contributing to physician professional fulfillment utilizing a Positive Deviance based approach. To that end, two studies were conducted: the first, a narrative review of the literature to identify specific correlates of physician …

Bayesian Modeling Of Censored Data With Application To Meta-Analysis Of Immunotherapy Trials, Xinyue Qi

Dissertations and Theses (Open Access)

My dissertation builds on a systematic review of 125 clinical trials reporting on treatment-related adverse events (AEs) associated with PD-1/PD-L1 inhibitors published from 2010 to 2018. The motivating dataset contained the following study-level components extracted from each publication: trial name, number of treated patients, selected immunotherapy drug, dosing schedule, cancer type, number of AEs within each category, and the pre-specified criteria for AE reporting. The number of AEs were reported based upon all-grade (Grade 1-5) and Grade 3 or higher (Grade 3-5) severity. My overall objective was to increase our understanding of the toxicity profiles of five most common cancer …

From "Hooah" To "Om": Mindfulness Practices For A Military Population, Kimberlee B. Bonura, Dawn M. Fountain

Journal of Social, Behavioral, and Health Sciences

Mindfulness practices, in general, have a growing body of evidence of effectiveness for improving both physical health and mental health. Further, these practices are showing promise when implemented with military populations for mental health issues such as PTSD. Challenges arise for practitioners in understanding the military's cultural differences and the functional aspects of mindfulness that may be specifically useful to military members. We outline strategies for referring military members to quality services and instruction, as well as best practices for connecting with military clients. Recommendations are made for further research with female service members and using single case design.

Sense Of Purpose In Life And Five Health Behaviors In Older Adults, Eric S. Kim, Koichiro Shiba, Julia K. Boehm, Laura D. Kubzansky

Psychology Faculty Articles and Research

Accumulating evidence shows that a higher sense of purpose in life is associated with lower risk of chronic conditions and premature mortality. Health behaviors might partially explain these findings, however, the prospective association between sense of purpose and health behaviors is understudied. We tested whether a higher sense of purpose at baseline was associated with lower likelihood of developing unhealthy behaviors over time. Prospective data were from the Health and Retirement Study, a national sample of U.S. older adults. Our sample included 13,770 adults assessed up to five times across eight years. Among people who met recommended guidelines for a …

Womanism & Wellbeing: A Manuscript Dissertation Exploring The Effects Of Shame, Loss And Gender Issues, Christy Angelle-Vidrine Bauman

Education Dissertations

The purpose of this study is to contribute to the research on gender issues and psychological well-being across the adult lifespan utilizing qualitative research examining factors (e.g., societal influences, sexual objectification, shame, loss, meaning-making, and internal identity) in developing resilience and mitigating mental health issues. This paper discusses the importance of addressing well-being through expression of loss, meaning-making, and social impact. This manuscript style dissertation will review publications in such areas as sexuality, spirituality, grief, shame, intimacy, social, and interpersonal relationships. The exploration of biopsychosocial impacts as it relates to meaning-making, resilience, and communal involvement. The three publications will be …