Master of Science, The Ohio State University, 2021, Kinesiology

Community-based behavioral and exercise interventions with in-person delivery models were challenged to find a new mode of delivery during the COVID-19 pandemic when access to in-person activities were compromised. These interventions are an essential part of chronic disease patients' self-management and health promotion efforts. One particularly prevalent chronic disease, knee osteoarthritis (knee OA), is the leading cause of functional decline in older adults and finding a safe way to deliver the intervention during the COVID-19 pandemic provided an opportunity to explore the feasibility, enablers, and barriers to virtual intervention delivery in this population. Access to community-based intervention settings for patients with knee OA remain limited even though it is well known that exercise combined with weight loss via dietary changes can provide clinically significant improvements to a patient's overall quality of life (QOL). While these meaningful results are well established, further investigation into the delivery of these interventions through online platforms and understanding the patients' perspective is still needed. By qualitatively capturing the experiences from patients who participated in the Collaborative Lifestyle Intervention Program for Knee Osteoarthritis Patients (CLIP-OA), further understanding can be explored about the feasibility and efficacy of this program to be delivered virtually via a video conferencing platform, such as Zoom, versus the established utility of in-person delivery. An especially important outcome to understand is the intervention's ability to educate patients in the application of knowledge and skills from the program and gather information about the patient's confidence to independently maintain the exercise and dietary behavior changes following cessation of the active intervention contacts. As, the pandemic disruption forced both a pause in in-person research activities and subsequent shift to alternate patient (open full item for complete abstract)

Committee: Dr. Sue Sutherland (Committee Member); Dr. Brian Focht (Advisor) Subjects: Behavioral Sciences; Health; Kinesiology

Master of Arts, The Ohio State University, 2016, Sociology

A long-standing body of research shows that the married enjoy better health and health behavior outcomes than the unmarried across many health dimensions, except for BMI. Despite this perplexing aberration, research has yet to establish how eating behavior, a major contributor to BMI, is associated with relationship status. Furthermore, recent research contesting the notion of relationship status as the most salient predictor of health suggests that relationship quality is an additionally formidable health predictor; yet how relationship quality matters for eating behavior has yet to be examined. Data from the NLSY79 reveals that compared to the single, the married engage in significantly less risky eating behavior and there is no significant difference between the cohabiting and single on eating behavior, but only when SES is not accounted for. Additionally, among the married and cohabiting, relationship happiness is a more salient predictor of risky eating behavior than relationship strain, and these effects are similar for the married and cohabiting. Furthermore, SES confounds relationship status findings, but not quality findings. Findings bolster evidence on the declining premium of relationship status and suggest that relationship quality is a formidable predictor of health.

Committee: Corinne Reczek (Advisor); Kristi Williams (Committee Member); Cynthia Colen (Committee Member) Subjects: Sociology

Master of Arts (M.A.), University of Dayton, 2011, Communication

This study examines 161 participants' behavior change in regard to purchasing organic and/or local foods after message exposure. Although much health research and environmental research exist, no research has combined these fields and applied them to behavior change. Participants were exposed to a health message, an environmental message, or a combined health and environmental message. Using the theory of planned behavior as the theoretical foundation, participants' attitudes, subjective norms, perceived behavioral control and behavioral intention were also used as prediction measures for behavior change. Participant cognitions were also coded through a thought-listing measure. The results of this study reveal that participant attitudes, subjective norm and perceived behavioral control all predicted behavioral intention; however, these individual variables did not predict actual behavior. Participant cognitions were found to be reflective of the message type that was read. Additionally, while both political preference and age individually and in interaction with message type influenced behavior, sex individually and in interaction with message type did not.

Committee: Teresa L. Thompson PhD (Advisor); James D. Robinson PhD (Committee Member); Jon A. Hess PhD (Committee Member) Subjects: Agriculture; Behavioral Sciences; Communication; Conservation; Environmental Health; Health; Health Education; Public Health; Public Health Education; Sustainability

PHD, Kent State University, 0, College of Arts and Sciences / Department of Psychological Sciences

This dissertation examined a sample of individuals with endometriosis-consistent symptoms, who have not yet been formally diagnosed. Their views of endometriosis and their symptoms were measured, and the impact of such perceptions on health outcomes including care-seeking intentions, information seeking behaviors, coping strategies, and wellbeing indices, were examined. The Commonsense Model served as the theoretical guide of this work. Illness perceptions emerged as important predictors of health outcomes, explaining between 19.6% and 48% of the variance in outcomes. Notable illness perceptions that significantly predicted outcomes – regardless of their conceptualization as a symptom or endometriosis perception – were concern and control perceptions. Specifically, high concern and control beliefs predicted important outcomes such as care-seeking intentions, learning one's risk, and coping strategies. Interventions that target concern and control beliefs of patients at risk may most profitably foster endometriosis care-seeking behaviors. Such interventions should avoid also raising any of the perceptions identified as threatening in this work (e.g., emotionality). This dissertation lays groundwork for future research to learn more about those at risk of endometriosis and to inform psychological efforts to improve patient health outcomes. Limitations and future directions are discussed.

Committee: John Updegraff (Advisor); Jennifer Taber (Committee Member); Kristen Marcussen (Committee Member); Nichole Egbert (Committee Member); Amy Sato (Committee Member) Subjects: Health; Health Sciences; Psychology; Social Psychology

MA, Kent State University, 2022, College of Arts and Sciences / Department of Psychological Sciences

Prior time perspective research suggests being future-oriented has beneficial health implications. That research has focused primarily on prevention health behaviors and less so on detection health behaviors. Two studies in the context of dental hygiene examined the relationship between time perspective and health outcomes. Messages concerning plaque-preventing and plaque-detecting mouth rinses were designed and individuals were either randomly assigned to (Study 1) or viewed both (Study 2) messages. Time perspective was assessed via temporal orientation (Study 1) and consideration of future consequences (Study 2). Attitudes, intentions, and preferences for the mouth rinses were primary outcomes. Hypothesis 1 predicted time perspective would positively relate to outcomes and both studies provided some support for this hypothesis. Hypothesis 2 explored the interaction between time perspective and behavioral function (prevention vs. detection). A consistent interaction was found in Study 1 showing future-orientation was associated with more positive outcomes with the detective mouth rinse and present-orientation was associated with more positive outcomes with the preventive mouth rinse. Study 2 data did not support this interaction but did find information avoidance mediated the relationship between time perspective and preference between the mouth rinses; future-orientation led to less information avoidance, which in turn led to greater preference for the prevention mouth rinse and immediate-orientation led to greater information avoidance, which in turn led to greater preference for the detection mouth rinse. Inconsistent findings in the present work may be due to measurement differences of time perspective, differences in study designs, or the use of young adult samples. Even so, this work provides initial evidence that time perspective and behavioral function may create an interactive effect on health outcomes, and that information avoidance may explain this relat (open full item for complete abstract)

Committee: John Updegraff (Advisor); Judith Gere (Committee Member); Jennifer Taber (Committee Member) Subjects: Health; Psychology; Social Psychology

Honors Theses, Ohio Dominican University, 2020, Honors Theses

The Ketogenic diet is a low carbohydrate diet that has been shown to have numerous therapeutic effects such as weight- loss intervention, non- pharmaceutical epilepsy treatment, and, more recently, has been shown to have promising results as a supplementary treatment for physical ailments like Type 2 diabetes or Cardiovascular disease. By measuring individuals' success on the Ketogenic diet through physiological and psychological measures, future researchers could be able to use this data in order to form a set of standardized guidelines that will contribute to the most success on the Ketogenic diet, and therefore, show a larger impact from the therapeutic interventions the diet is used for. In order to work towards this research, this study measures success on the Ketogenic diet through two health behavior models, the Health Action Process Approach and the Transtheoretical Model, as well as physiological measures of participants' ketosis levels. The results of this study began to shed light on these guidelines, through measuring aspects of each of the health behavior models with correlational analyses to begin to discover which factors contribute to the most success on the Ketogenic diet.

Committee: Valerie Matthews Ph.D (Advisor); Jessica Hall Ph.D (Committee Member); Brad Nelson Ph.D (Committee Member) Subjects: Biology; Psychology

Doctor of Philosophy, The Ohio State University, 2019, Nursing

Breast cancer survivors are at risk of cancer recurrence and other cancer-related chronic diseases. Lifestyle modification reduces these risks; however, traditional approaches are costly and often lack efficacy. Mobile health (mHealth) interventions may offer advantages over traditional risk-reduction approaches, but limited knowledge about survivors' use of mHealth interventions restricts scientific advancement. The goal of this dissertation research was to develop a substantive theory to understand the process associated with the use of mHealth interventions by breast cancer survivors for lifestyle behavior improvement. Using a grounded theory approach, 16 female breast cancer survivors from central Ohio were enrolled. Each participated in an interview and an interaction with a prototype mHealth intervention. Data were analyzed using constant comparative analysis. The resultant substantive theory describes the synergy between mHealth Engagement and Self-regulation of lifestyle behaviors. The basic process enabling this synergy consists of 5 non-linear phases: adopting, sustaining, habituating, disengaging, and re-adopting. Four main concepts form the basis of this theory and include mHealth Engagement, Self-regulation, Relationships, and Functionality and Features. These findings may inform future mHealth intervention research and development. However, more research is needed to validate and test this new substantive theory.

Committee: Sharon Tucker PhD, RN, FAAN (Committee Chair); Randi Foraker PhD, MA, FAHA (Committee Member); Mary Beth Happ PhD, RN, FAAN, FGSA (Committee Member); Jennifer Kue PhD (Committee Member); Rita Pickler PhD, RN, FAAN (Committee Member); Po-Yin Yen PhD, RN (Committee Member) Subjects: Behavioral Sciences; Behaviorial Sciences; Computer Engineering; Computer Science; Health; Health Care; Health Care Management; Health Education; Information Science; Information Systems; Information Technology; Medicine; Mental Health; Nursing; Organization Theory; Psychology; Public Health; Systems Design; Systems Science; Technology

MA, University of Cincinnati, 2019, Arts and Sciences: Communication

This study analyzes the discourse of community participation within a multi-stakeholder bureaucratic model of public health intervention in West Bengal, India, and highlights the role that vulnerable populations play in the well-meaning participatory health interventions designed for them. A total of 13 individuals (including 5 in-depth interviews and one focus group discussion with 3 community health worker s and 5 affected individuals) were interviewed for the project. Two research questions guide this thesis including: RQ1: How do stakeholders across various agencies construct the discourse of the nature of arsenic problem in West Bengal? and RQ 2: What roles do members from the affected communities play in the current well-meaning participatory processes and with what implications? The dataset revealed stakeholders depended on specific discourses (technical, economic, bureaucratic and moralistic) to discuss the nature of the problem of groundwater arsenic. It also highlighted how marginalization and gender inequalities are played out in the participatory health discourses.

Committee: Shaunak Sastry Ph.D. (Committee Chair); Zhuo Ban Ph.D. (Committee Member); Stephen Depoe Ph.D. (Committee Member); Heather Zoller Ph.D. (Committee Member) Subjects: Communication

MDES, University of Cincinnati, 2019, Design, Architecture, Art and Planning: Design

Chinese international students face high rates of professional mental health (MH) concerns, but they demonstrate less help-seeking behaviors, such as seeking professional counseling. The underutilization of MH resources presents a challenge to colleges and universities. This study is aimed at assessing the perceptions and the barriers of international Chinese graduate students that prevent them from accessing professional MH services at UC. The goal of this study is to create a toolkit that addresses cultural sensitivity to help these students easily conduct self-directed MH care at an early stage. This study uses qualitative research methods to allow participants to extensively express their experiences and perceptions of professional MH services. About 10 in-depth interviews were conducted with graduate Chinese international students at UC, that included but not limited to the College of Design, Architecture, Art, and Planning (DAAP) students. Three significant barriers preventing Chinese graduate students from accessing MH services are lack of mental health resources, concerns of privacy protection, and language interpretation. Additionally, limited knowledge of self-directed care, lack regular treatment time due to busy academic schedules and a shortage of culturally appropriate services pose further difficulties.

Committee: Craig Vogel M.I.D. (Committee Chair); Gerald Michaud M.A. (Committee Member); Danny T. Y. Wu PhD (Committee Member) Subjects: Design

Master of Arts (M.A.), University of Dayton, 2018, Communication

This study examined the potential for concepts within the Health Belief Model to predict Chinese college students' daily brushing, daily flossing, and annual dental check-up behavior. Additionally, dental-related information seeking and scanning were explored. The survey was completed by 150 Chinese college students and found that some components of HBM significantly predict brushing behavior, flossing behavior, and dental check-up behavior. Self- efficacy was the best predictor of brushing and dental check-up behavior, while barriers and dental-related knowledge were the best predictors of flossing behavior. Participants prefer to seeking from social media and with his or her dentist and scan information from social media and mass media. Information seeking and scanning only significantly predicted flossing behavior. Knowledge, seeking and scanning information from a dentist were the best predictor of dental check-up behavior. Future studies could examine more about self-efficacy and dental health behavior in the Chinese cultural context.

Committee: Angeline Sangalang (Advisor); Teri Thompson (Committee Member); James Robinson (Committee Member) Subjects: Communication; Dental Care

Doctor of Philosophy, The Ohio State University, 2018, Human Development and Family Science

Family wellness is defined as the intentional approach of pursuing a healthy state of being for the family, and is linked to children's future health status and health behaviors. In the U.S., racial and ethnic minorities have more negative health outcomes in the areas of chronic diseases or conditions such as cancer, diabetes, obesity, hypertension cardiovascular disease, HIV/AIDS, and infant mortality than their White peers. Literature suggests that African Americans have higher prevalence of hypertension, regardless of sex or educational status, higher hospitalization for strokes, and higher mortality rates from cardiovascular disease at all ages. The purpose of this dissertation is to: (1) use focus groups and quantitative surveys to examine the Family Time Initiative (FTI) program participants' general nutrition knowledge, perceptions and attitudes regarding nutrition, nutritional habits, culture, family relationships, and physical activity; and (2) utilizing that information, identify future policy initiatives to promote health and wellness in predominantly African American communities. FTI is a 10-week wellness intervention program that uses a family systems perspective and health promotion model to engage caregivers and children to participate in healthy culturally relevant activities. Based on the quantitative survey, participants reported a more adverse family environment based on their nutrition and physical activity behaviors, healthy family functioning, and low African self-consciousness. Participants discussed the challenges of scheduling (n=8), lack of adequate time (n=8), competing family members' eating practices, and availability of resources (n=3) for making healthy lifestyle choices (i.e., family meals, food choice, physical activity) for their families. Participants also discussed the shared responsibility of the family, school, and community in developing healthy environments and behaviors for children and families (n=7). Participants suggested (open full item for complete abstract)

Committee: Sarah Schoppe-Sullivan PhD (Advisor); Keeley Pratt PhD (Advisor); Cynthia Tyson PhD, MSW (Committee Member) Subjects: Families and Family Life; Health; Health Education

PhD, University of Cincinnati, 2018, Design, Architecture, Art and Planning: Regional Development Planning

Protecting public health has been an underlying goal of planning since its origin, and planners play a crucial role in creating healthy, sustainable communities by advancing policies that encourage active living and healthy eating. One health issue that has consistently interested planners is obesity. In order to reduce obesity and make our communities healthy, it is necessary to know which factors influence obesity and how planners can have a positive impact on them. There are various social, physical, and behavioral factors (also known as determinants) that affect health. In addition to individual characteristics such as race, income, educational attainment, gender, and age, neighborhood characteristics such as access to healthy food, access to parks, built environment, perceived safety, and social support have also been found to influence health. The primary purpose of this dissertation is to analyze the association between such determinants of health and obesity in Hamilton County, Ohio. Since planners can have a significant impact on the physical environment of a neighborhood, another purpose of this research is to find out if changing the physical environment can change the behavior of people enough to influence health. This work improves on the previous studies as it employs sophisticated and innovative spatial and quantitative analysis to analyze interactions between obesity and its determinants. This study uses three main types of data – qualitative survey data, quantitative data, and spatial data created using Geographical Information System (GIS). After comparing various methodologies and based on the characteristics of the data, log-level regression analysis was used to analyze the weighted data. The raw data was weighted to make it more representative of the Hamilton County population. The results of this research provide an evidence base for directing future planning policy decisions and implementation strategies at local and regional levels. (open full item for complete abstract)

Committee: Christopher Auffrey Ph.D. (Committee Chair); Olivier Parent Ph.D. (Committee Member); Xinhao Wang Ph.D. (Committee Member) Subjects: Urban Planning

PhD, University of Cincinnati, 2017, Education, Criminal Justice, and Human Services: Health Education

Adolescent workers are at increased risk for injury. Health behavior theories provide a roadmap for designing school-based interventions to protect young workers. Pretest and posttest data from 2,503, eighth grade students were collected and structural equation modeling (SEM) was performed to assess the utility of a modified theory of planned behavior (TPB) to examine adolescents' occupational safety and health (OSH) knowledge, attitude, perceived behavioral control (self-efficacy) and behavioral intention. SEM results demonstrated the modified TPB model adequately fit the data. In general, path coefficients were statistically significant in directions consistent with the theory. The latent model constructs explained a higher proportion of variance than results from related adolescent health research. Knowledge had indirect effects to behavioral intention through attitude and self-efficacy. Our study fills a gap in the health behavior research by providing empirical evidence of the indirect role of knowledge acting on other theorized, TPB constructs. The present study is the first to support a modified TPB to examine adolescents' OSH knowledge and perceptions, and it expands the evidence base for measuring and evaluating effective interventions to protect young workers. Evidence about the factors that affect teachers' adoption of occupational safety and health (OSH) interventions, such as the NIOSH Talking Safety curriculum, is sparse. Schools and teachers play an important role in preparing young people to engage in healthy behaviors, including in OSH. For this study, we developed a new measure based on a modified theory of planned behavioral (TPB) model; collected data from a sample of 242 middle school and high school teachers from three large school districts; and conducted factorial analysis of variance (ANOVA) to examine main and interaction effects related to teachers' knowledge, attitude, perceived behavioral control/self-efficacy (PBC/SE), and intention (open full item for complete abstract)

Committee: Liliana Rojas-Guyler Ph.D. (Committee Chair); Amy Bernard Ph.D. (Committee Member); Andrea Okun Ph.D. (Committee Member) Subjects: Behavioral Sciences

Ph.D., Antioch University, 2016, Leadership and Change

Patient-centered care requires robust physician leadership in all aspects of healthcare in order to lead organizations to this ideal. Programs in Graduate Medical Education provide inconsistent and limited exposure to formal leadership development experiences for physicians in their final year of residency training. Literature addressing leadership training for residents focuses on the scarcity of effective programs that deliver adequate training and provide measurable outcomes. The purpose of this study was to explore how chief medical and surgical residents develop leadership awareness and experience training in leadership and engage chief residents, faculty mentors, and program administrators in a collaborative process, developing a leadership training model within an independent (non-academic) residency training program. To understand the residents' and the institutional experience in this realm, focused interviews were conducted with chief residents from Family Medicine and Surgery, faculty mentors, program administrators, and regional subject matter experts. Professional identity development of the residents was investigated and related to their experiences. Action research was the framework for this study due to the iterative and participative nature of the methods. Subsequent to the interviews, outgoing and incoming chief residents engaged in collaborative sessions during which peak leadership experiences were discussed. The outcomes of the sessions and analysis of the interviews were discussed with the program directors for future consideration of curriculum change. The findings indicated a change in leadership awareness among chief residents demonstrating that stimulus and subsequent reflection prompted the residents to review their roles as leaders, seeking opportunities to apply leadership awareness to their daily work. In order to teach and role model leadership, training has to be implemented that interposes the same rigor as in clinical training. Expe (open full item for complete abstract)

Committee: Laura Morgan Roberts PhD (Committee Member); Jon Wergin PhD (Committee Member); Dianne Shumay PhD (Committee Member); Lynn Wooten PhD (Other) Subjects: Adult Education; Behaviorial Sciences; Education; Educational Theory; Health Care; Health Care Management; Health Education; Medicine

Doctor of Philosophy, Case Western Reserve University, 2016, Social Welfare

The first aim of this dissertation was to describe online health information seeking behavior (OHISB) and health information seeking experience (HISE) in elderly cancer survivors using the Internet. The second purpose was to investigate predictors of OHISB and HISE in elderly cancer survivors using the Internet. In this dissertation, OHISB is defined as the behaviors engaged in by individuals to acquire health information via the Internet, while HISE refers to individuals' perceptions and appraisals of not only the quality of information sources and contents, but also experiences and feelings during information seeking. As a theoretical framework, this dissertation adopts the comprehensive model of information seeking (CMIS). The CMIS posits that individuals' health information seeking is affected by various demographic characteristics, health-related experiences, beliefs, salience, and perceptions of information sources. To address these purposes, a sample of 235 elderly cancer survivors was drawn from the 2007 Health Information National Trends Survey (HINTS); data were collected from January 2008 through May 2008 (a cross-sectional cohort survey). For this dissertation, inclusion criteria were individuals who reported they had been diagnosed with cancer at some time in their lives (self-report, not medical records), who used the Internet, and who were aged 60 years or older. A Structural Equation Model (SEM) was used to test the hypothesized structural relationships between predictors and OHISB, and between predictors and HISE. In advance of conducting the structural model, confirmatory factor analysis was used to confirm that each of two multiple-item scales (i.e., unmet health information needs and HISE) adequately fit a single factor model. In this dissertation, the structural model fit the data well. Being male and having higher trust in Internet health information significantly predicted higher OHISB, while higher education, more years since cancer d (open full item for complete abstract)

Committee: Aloen Townsend L. (Advisor); Kathleen Farkas (Committee Member); Elizabeth Tracy (Committee Member); Eva Kahana (Committee Member) Subjects: Behaviorial Sciences; Health Care; Oncology; Social Work

MA, University of Cincinnati, 2016, Arts and Sciences: Psychology

According to the National Health and Nutrition Survey (NHANES; 2009-2010), approximately one in three children are overweight or obese, including 23% of preschool age children (i.e., 2-5 year olds; Ogden, Carroll, Kit, & Flegal, 2014). Emerging literature highlights that the preschool age period is a critical time for establishing healthy behaviors and preventing obesity (Baidal, & Taveras, 2012). There are several child-related contributors to obesity, such as, child consumption and physical activity behaviors (Polacsek et al., 2009). Researchers have also identified parent-related contributors to obesity, parental modeling, reinforcing feeding practices, and foods provided in the home (Haire-Joshu et al., 2008). In addition to these risks, preschool age children from urban environments are often at increased risk for obesity due to environmental barriers, including limited access to healthy food options and low neighborhood safety (Biro & Wien, 2010). The overall aim of this study was to use focus groups and questionnaire data to examine parental perception of (1a) the current state of obesity and health behaviors in urban preschoolers (1b) critical child, parent, and environmental barriers related to obesity and healthy lifestyles; and (1c) what is needed to design and optimize effective healthy lifestyle and obesity interventions and programs.

Committee: Monica Mitchell Ph.D. (Committee Chair); Farrah Jacquez Ph.D. (Committee Member); Bridgette Peteet Ph.D. (Committee Member) Subjects: Public Health

MPH, University of Cincinnati, 2015, Education, Criminal Justice, and Human Services: Public Health - Health Education/Health Promotion

The purpose of this study is to determine if the health belief model predicts childhood obesity prevention behaviors among upper elementary school children in a sample drawn from the Chennai region of southern India. The study reports data about three behaviors: less than two hours of screen time, drinking 6 to 8 cups of water instead of sweetened beverages, and eating five or more cups of fruits and vegetables. The health belief model has offered a practical framework for designing primary prevention interventions to reduce other health problems and continues to do so in the West. This study was designed to examine the extent to which selected health belief model constructs could predict the chosen behaviors among upper elementary school children in India. Data were collected using a 47-item valid and reliable scale administered to the sample population. Regression analyses were run to test for variance in behaviors attributable to each of the independent variables. The final regression model revealed that the health belief model predictors were weak in the current context of study, probably due to cultural differences in India compared to the USA where this model originated. Recommendations have been offered to evolve interventions aimed at predicting obesity associated behaviors in children.

Committee: Bradley Wilson Ph.D. (Committee Chair); Brittany L. Rosen Ph.D. (Committee Member); Manoj Sharma M.B.B.S. Ph.D. (Committee Member); Jun Ying Ph.D. (Committee Member) Subjects: Public Health

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2015, Media and Communication

This study follows the example of early research in other taboo health topics such as family planning, leprosy, and HIV/AIDS, by first examining baseline Knowledge-Attitude-Practice (KAP) variables to build an initial research base for a menstruation- related health communication study. The primary objective of this study is to explore the relationship among important psychosocial variables pertaining to menstruation and menstrual hygiene; hence, the variables selected include: knowledge of menstruation and menstrual practices, attitude towards menstruation and menstrual practices, cognitive involvement in menstruation and menstrual practices, behavioral involvement in menstruation and menstrual practices, and adoption of menstrual practices. Another objective is to determine which of the above-mentioned factors are predictors of correct and safe hygienic practices in the context of menstruation. A quantitative methodological approach was adopted to conduct the study. A structured questionnaire was used to survey respondents and collect data. Sample size of the study was 475. A probability random sample consisting of both women and men, from Ahmedabad city, India, was selected using multi-stage clustered sampling technique. Descriptive and analytical statistical techniques were employed to analyze the data and prepare the findings. SPSS software was used to conduct appropriate analyses. It was found that knowledge, attitude, and cognitive involvement in menstruation and menstrual practices were high whereas, behavioral involvement in menstruation and menstrual practices were low. Hypothesized relationships between knowledge and attitude towards menstruation among men; knowledge, attitude towards menstrual practices and adoption among women; cognitive involvement and knowledge of menstrual practices in men and women; and behavioral involvement and knowledge of menstrual practices for men and women were statistically significant. Descriptive statistical analyses, (open full item for complete abstract)

Committee: Srinivas Melkote Dr. (Advisor); I-Fen Lin Dr. (Other); Sung-Yeon Park Dr. (Committee Member); Ewart Skinner Dr. (Committee Member) Subjects: Communication; Health; Marketing; Mass Communications; Mass Media

Doctor of Philosophy, University of Toledo, 2015, Psychology

People in lower social classes die younger and suffer a greater burden of disease than those in upper social classes. This pattern, referred to as the social gradient, is partly attributable to the fact that people in lower social classes engage in more health risk behavior. The current studies are the first to examine whether perceived risk and expected benefits mediate the relationship between social class and health risk behavior and if the nature of this relationship differs depending upon the category of health risk behavior – those that derive risk from action vs. inaction. In Study 1, adults recruited from Amazon's Mechanical Turk reported how frequently they engage in a variety of health risk behaviors, indicated their perceived risk and expected benefits for each health behavior, and provided socio-demographic information (e.g., social class indicators, sex, and race). Results revealed that people in lower social classes perceived health risk behaviors to be more risky and have fewer benefits than people in upper social classes. Additionally, perceived risk was a stronger predictor of inactive health risk behaviors whereas expected benefits was a stronger predictor of active health risk behaviors. In Study 2, we manipulated participants' perceived social status by shifting the reference point that participants used to make subjective social status judgments and examined whether this manipulation affected perceived risk and expected benefits in a manner similar to that expected in Study 1. Results did not replicate those obtained in Study 1. These findings advance our understanding of the pathways by which social class affects health risk behavior and inform strategies aimed at reducing health risk behavior among lower social classes.

Committee: Jason Rose (Committee Chair); Andrew Geers (Committee Member); John Jasper (Committee Member); John Elhai (Committee Member); Deborah Boardly (Committee Member) Subjects: Psychology; Public Health

Master of Science, The Ohio State University, 2015, Allied Medical Professions

Lifestyle modifications have been shown to improve outcomes for cancer survivors, yet no study has implemented and evaluated e-health coaching (e-HC) to encourage lifestyle modification specific to cancer survivorship. The purpose of this pilot study was to evaluate the feasibility and efficacy of e-HC for survivors harvesting at an urban garden. Twenty-two survivors completed a 4-month experimental pre/post pilot aimed at improving adherence to the evidence-based recommendations for survivorship. A trained dietetic intern provided e¬-HC utilizing motivational interviewing and individual goal¬ setting. Fifteen survivors (68%) utilized e-HC. The majority of e-HC users were female (93%, n= 14), married (60%, n=9), with a mean age of 60. Of those users, (100%, n=15) reported they would utilize health coaching again. Seventy-eight percent of e-HC users (n=7) established and met measurable goals as evidenced by both qualitative (open-ended surveys) and quantitative (anthropometrics and biomarkers) data. In terms of self-efficacy towards adhering to recommendations for healthy survivorship, a 22% improvement was noted in self-efficacy of the goal setting group while a decrease of 4% was documented among those that did not utilize e-HC. A statistically significant increase in the consumption of fruits and vegetables and a statistically significant decrease in the consumption of red and processed meats was observed amongst e-HC users (p = 0.021, p = 0.004, respectively). This pilot established preliminary data to support the feasibility and efficacy of e-HC for cancer survivors. Future large-scale randomized studies with a control group are warranted.

Committee: Colleen Spees (Advisor) Subjects: Health; Nutrition