PhD, University of Cincinnati, 2022, Education, Criminal Justice, and Human Services: Health Education

Study One Purpose: Latina women face various health disparities and social determinants of health based off their ethnicity, age, sex, and socioeconomic profile. A sample of Latina women between the ages 40 and 65 years old from the 2020 Behavioral Risk Factor Surveillance System (BRFSS) by the Centers for Disease Control and Prevention (CDC) was assessed to measure health status, health care access, and preventive health seeking behaviors (PHSBs). Methods: Secondary data analysis of BRFSS, a system of health-related telephone surveys was conducted with 19 variables. Results: The final sample size was N = 8,621. For questionnaire language 4,714 completed the questionnaire in English and 3,907 in Spanish. Results showed that 74.2% (n = 6,383) rated their health as being good or better. Regarding PHSBs majority of the participants received a mammography exam, a colonoscopy, had a routine check-up and dental visit. As for health care access most reported having health care coverage through an employer or union however, 18.3% (n = 1,569) of participants could not see a doctor because of cost within the past 12 months. Pearson Chi-square revealed statistical associations in reported PHSBs, health status, and health care access factors by demographics and questionnaire language. ANOVA testing revealed statistical significance in total number of PHSBs by demographic characteristics. Those who had reported poor health care access factors had lower mean scores for total PHSBs. Conclusion: Low educational attainment, low income, and lack of insurance are contributing factors for Latinas in receiving the recommended care to enhance their health status and quality of life. Study Two Purpose: Health disparities around sexually transmitted diseases, cervical cancer, and diabetes are prevalent for Latina women. These health disparities can also exist in association with engaging in health risk behaviors. A sample of Latina women between the ages 18 and 40 years old fr (open full item for complete abstract)

Committee: Liliana Rojas-Guyler Ph.D. (Committee Member); Rebecca Vidourek Ph.D. (Committee Member); Amy Bernard Ph.D. (Committee Member) Subjects: Health Education

Psy. D., Antioch University, 2025, Antioch New England: Clinical Psychology

The impact of personal factors on healthcare utilization is an essential area of research to improve overall health outcomes among the population. This study explored the relationship between perceived stigma and healthcare avoidance among men and evaluated the relationship between self-reported body mass index (BMI) and avoidance of healthcare appointments due to weight-related stigma and other reasons. This study found no significant relationship between BMI and avoidance of preventive medical appointments due to perceived stigma. However, men from all weight categories endorsed avoiding preventive healthcare appointments due to weight-related reasons and for other reasons. This study explored the reported reasons for missing preventive medical appointments, such as time constraints, financial concerns, and perceptions of healthcare advice. Additionally, this study emphasized the need for healthcare providers to address weight bias and stigma, as well as other pragmatic obstacles for all categories of weight to reduce patient avoidance and improve patients' experiences at preventive medical appointments. While this study had several limitations, multiple areas for further research are proposed to support providers in decreasing the avoidance of healthcare appointments for men. This dissertation is available in open access at AURA (https:aura.antioch.edu) and OhioLINK ETD Center (https:etd.ohiolink.edu).

Committee: Kathi Borden Ph.D. (Committee Chair); Nancy Ruddy Ph.D. (Committee Member); Elizabeth Dykhouse Ph.D. (Committee Member) Subjects: Health Care; Health Care Management; Psychology; Public Health

PhD, University of Cincinnati, 2024, Education, Criminal Justice, and Human Services: Health Education

Study One Abstract Background: Sexual health behaviors among international students have gained prominence in recent years due to their increasing representation in global educational institutions. Purpose: The present study explored sexual health behaviors in the context of condom usage, partner relationships, and student grade level. Methods: A substantial sample size of international students (N = 13,242) was analyzed using a secondary data analysis of the 2022 American College Health Association's National College Health Assessment (ACHA-NCHA) dataset, revealing noteworthy findings regarding sexual activities and condom usage. Results: The findings indicate that a substantial proportion of international students engage in various sexual behaviors, including oral sex (50.8%), vaginal intercourse (51.3%), and anal intercourse (14.8%). Condom usage during sexual activities, particularly oral sex (4.1%) and anal sex (1.4%), was notably low. A multiple regression analysis rendered significance with sex, grade level, relationship, and number of partners as predictors to sexual health behaviors. Conclusion: The current study significantly contributes to the understanding of sexual health behaviors among international students. It underscores the importance of targeted interventions for promoting safe sex practices, the need for continuous access to sexual health resources, and the imperative for culturally sensitive and inclusive sex education programs on college campuses. Study Two Abstract Background: The influx of international students to the United States has been steadily increasing, with a substantial number of students choosing to pursue their education in this diverse and culturally rich nation. Purpose: The current study delves into the psychological well-being of international students in the US, aiming to uncover the extent of well-being and its relationship with demographics and background characteristics. Methods: A secondary data analysi (open full item for complete abstract)

Committee: Rebecca Vidourek Ph.D. (Committee Chair); Ashley Merianos Ph.D. (Committee Member); Keith King Ph.D. (Committee Member) Subjects: Health Education

Doctor of Philosophy, The Ohio State University, 2023, Public Health

Sleep complaints, such as frequent awakenings or trouble falling asleep, affect between 35-60% of postmenopausal women, yet patterns of sleep duration and insomnia symptoms over the lifespan have not been well characterized in aging women. Sufficient, restorative sleep is critical for the optimal functioning of all body systems given that many health outcomes (e.g., cardiometabolic diseases, cancers) are affected by poor sleep. Sleep problems often begin during menopause and postmenopausal women have the highest rates of sleep disturbances and insomnia complaints. Little research has been conducted longitudinally to understand sleep in postmenopausal women. Since aging is a dynamic process, studying sleep in older individuals at a single time point is likely to be inadequate. The overall objective of this research is to elucidate longitudinal sleep patterns of women as they age. Using the Women's Health Initiative, a long-term national cohort study of health in postmenopausal women, we conducted multiple secondary data analyses using mixed models to assess how insomnia symptoms and sleep duration changed over age among 157,843 women. Participants completed various demographics, health, and lifestyle measures at multiple time points throughout follow-up, with up to 8 assessments of sleep measures. Our first aim was to determine longitudinal changes in self-reported insomnia symptoms and sleep duration over age and to examine which demographic factors are predictive of the change in insomnia symptoms and sleep duration over age. We found that insomnia symptoms, short sleep duration, and long sleep duration all increased with age. Several sociodemographic factors were associated with each sleep outcome, but different racial groups, education, and income levels of the women had the largest impact on sleep changes by age. For insomnia symptoms and short sleep duration, Asian women had the greatest increase in insomnia symptoms and short sleep duration over age co (open full item for complete abstract)

Committee: Electra Paskett (Advisor) Subjects: Epidemiology; Public Health

PhD, University of Cincinnati, 2023, Education, Criminal Justice, and Human Services: Health Education

Study One: Purpose. Describe the sexual behaviors, health seeking behaviors, and substance-related risk behaviors of Black college students, identify differences in sexual and health seeking behaviors of Black college students by demographic factors, and identify the substance-related risk factors associated with the sexual health behaviors of Black college students. Methods. Secondary data analysis of the National College Health Assessment survey conducted by the American College Health Association. Participants were delimited to Black undergraduate college students aged 18 to 24 (n = 2,980). Results. A majority of participants (n = 2,184, 78.4%) had never been tested for HIV and there were a few participants (n = 75, 2.5%) that had reported that they're taking PrEP. Less than one percent of participants (n = 18, 0.6%) had been diagnosed with genital herpes, 0.2% (n = 7) had been diagnosed with Hepatitis B or C, and 0.4% (n = 11) had been diagnosed with HIV/AIDS. Chi-square analysis showed that men were more likely to report having 4 to 10 partners over the past 12 months. Kruskal-Wallis tests showed that 1st year undergraduate students, 18- to 19-year-olds, and participants not in a relationship had a higher average of frequent condom use during vaginal intercourse over the past 30 days. Spearman correlation tests showed negative associations with the last time participants had oral and vaginal intercourse and tobacco and cannabis risk. Conclusions. Additional research that focuses solely on the sexual, health seeking, and substance-related behaviors of Black individuals is needed to better understand the disproportionate rates of STDs and HIV observed. Study Two: Purpose. Describe the overall mental health, substance-related risk factors, and health seeking behaviors of Black college students, identify substance-related risk factors associated with the loneliness and well-being of Black college students, and identify differences in substance-related risk (open full item for complete abstract)

Committee: Liliana Rojas-Guyler Ph.D. (Committee Chair); Rebecca Vidourek Ph.D. (Committee Member); Keith King Ph.D. (Committee Member) Subjects: Public Health Education

Doctor of Philosophy, The Ohio State University, 2022, Public Health

Obesity is the leading preventable cause of cancer. Obesity significantly elevates risk for breast, colorectal, endometrial, liver, pancreas, and nine other cancers. Residents in rural and Appalachian areas are considered underserved populations with lower access and fewer resources to health care, but experience higher rates of obesity, obesity-related comorbidities and mortality, and higher cancer incidence and mortality, compared to residents in urban or non-Appalachian areas. Obesity and poor health behaviors are major contributors to health disparities in rural and Appalachian populations. However, the interaction of rural and Appalachian residency on obesity-related disparities is understudied. Weight loss, physical activity, and healthy diet potentially attenuate the negative effects of obesity and reduce cancer risk and premature mortality. Evidence-based weight loss programs have been implemented in clinical settings and showed various health benefits. However, these programs solely focused on health-promoting resources available in urban areas and are not generalizable to rural and Appalachian populations. Therefore, developing effective strategies to provide weight loss programs for rural and Appalachian populations is an important priority. The first aim of this dissertation examined differences in the prevalence of obesity, obesity-related health behaviors, and health outcomes by rural and Appalachian residency. Data from 2011-2019 Behavioral Risk Factor Surveillance System showed that, among Ohio residents, compared to urban non-Appalachian residents, urban Appalachian and rural Appalachian residents had a higher prevalence of obesity and obesity-related health conditions, and lower rates of healthy behaviors. The association between health behaviors and obesity-related health outcomes differed by rural and Appalachian residency. The second aim examined the role of self-efficacy and social support on behavioral changes and quantified the relationshi (open full item for complete abstract)

Committee: Electra Paskett (Advisor); Brian Focht (Committee Member); Abigail Shoben (Committee Member); Ashley Felix (Committee Member) Subjects: Epidemiology; Public Health

Doctor of Philosophy, The Ohio State University, 2021, Kinesiology

Black women in the United States (U.S.) exhibit higher rates of morbidity and mortality among a multitude of health conditions compared to their White counterparts. Moreover, there are also significant health gaps that exists between various socioeconomic groups of Black women. For example, Black middle-class women are at higher risks for some adverse health outcomes (e.g., poor birth outcomes) compared to their low-income Black and White peers. This is concerning considering that Black middle-class women experience some of the same health disparities and barriers as their lower income counterparts. To date, there is a scarcity of research that addresses Black middle-class women's overall health beliefs, values, and behaviors, and how culture impacts these. The purpose of this study was to explore the health beliefs, values, and behaviors of Black middle-class women, with the intent of understanding and documenting how Black middle-class women define and practice health and wellness. In this study, the researcher also explored the health outcomes most salient and concerning to Black women and the dynamic relationships and influences of culture and the built environment on Black women's health beliefs, values, and behaviors. This study occurred in a metropolitan city in the U.S. Midwest. Study requirements included women who: (a) self-identified as Black, (b) were between 25 and 65 years of age, (c) and self-identified as middle-class. Women who met the criteria were documented as key collaborators and were also invited to identify another Black woman (at least 18 years of age) who held significant social value and importance within their lives and interacted with them regularly (i.e., kin group members).This study was a descriptive qualitative study, grounded in focused ethnography. Data collection occurred during a four-month period and included: (a) individual and small group interviews, (b) wellness inventories, and (c) the examination of health journals and ph (open full item for complete abstract)

Committee: Samuel Hodge (Advisor) Subjects: African Americans; Health; Kinesiology

BS, Kent State University, 2021, College of Public Health

Health inequities in lesbian, gay, bisexual, transgender, queer, and other gender and sexual minorities (LGBTQ+) people are undoubtedly present in various social structures. Researchers have found evidence of increased experiences of perceived discrimination for LGBTQ+ people that lead to increased rates of mental health issues and risky health behaviors. This relationship is best explained by the Framework for Health Equity that identifies "upstream" factors that lead to "downstream" health consequences. It has been hypothesized that sociodemographic factors, including hometown size, household religion, and education level may be predictors of perceived discrimination. However, such little research has been done to concretely identify the upstream factors of perceived discrimination, which is necessary to better understand and address the root causes of the related health inequities. To begin filling in this gap of research, an anonymous online survey was distributed in late 2020 for LGBTQ+ people aged 18 and older that yielded a sample size of 62 adults. The first and novel research question aimed at identifying a relationship between sociodemographic factors and perceived discrimination. If increased perceived discrimination were to be found within certain sociodemographic characteristics, a new and greater understanding of LGBTQ+ health inequities could arise from the findings. Also, to confirm prior findings on perceived discrimination, two research questions were constructed to identify its relationship with depressive symptoms and risky health behaviors, including self-rated health, drug use, and sexual behaviors. These were measured using previously published index scales that assigned scores based on the severity of participant responses. The data reported no significant findings to suggest a relationship between any sociodemographic factors and increased experiences of perceived discrimination. Analyses in perceived discrimination and depressive symp (open full item for complete abstract)

Committee: Abbey Eng PhD (Advisor); Tina Bhargava PhD (Committee Member); Lauren Vachon MFA (Committee Member); Susan Roxburgh PhD (Committee Member) Subjects: Gender Studies; Health; Mental Health; Public Health; Social Research

Doctor of Philosophy, Case Western Reserve University, 2021, Anthropology

In an effort to combat the staggeringly high rates of opioid overdose deaths in the US, Overdose Education and Naloxone Distribution (OEND) clinics were established. This study was a collaborative partnership with a local urban hospital committed to harm reduction through their community-based OEND clinic. This study's purpose was twofold. First, to understand who utilized OEND clinics and the factors affecting their HSB (i.e. number of Naloxone kits). Second, to understand how OEND clients framed their understanding of their SUD and if their model of addiction affected HSB. The study was comprised of three distinct phases. Phase 1 Quantitative assessment examined the demographic characteristics (i.e., gender, race, education, SES, occupation), mental health concerns (i.e., anxiety, depression & general distress), breadth and satisfaction of social support, and addiction beliefs in 235 clients from a local OEND clinic in Cleveland, Ohio. Since all participants in this study were already a part the OEND clinic, the number of naloxone kits will serve as a proxy for HSB. Phase 2 Qualitative Assessment explored how 61 of the enrolled clients framed their understanding of their substance use disorder (SUD). Qualitative interviews were coded for themes related to SUD beliefs, the type of stigma experienced by clients as a function of their drug use, and their motivation behind the decisions to seek out Naloxone. Phase 3 involved informal clinic observations to understand clients' experiences and interactions with OEND clinic staff. Gaining a better understanding of patients' health-seeking behaviors (HSB) at OEND clinics is a critical first step along the road to combatting the opioid epidemic. Phase 1 data revealed that clients who chose to engage in the HSB of OEND clinic were primarily unemployed, Caucasian males who were approximately 38 years of age. They were highly anxious, depressed, and in need of more social support to assist in their recovery. The majorit (open full item for complete abstract)

Committee: Lee Hoffer (Committee Chair); Janet McGrath (Committee Member); Jill Korbin (Committee Member); Brian Gran (Committee Member) Subjects: Behavioral Sciences; Cultural Anthropology; Health; Mental Health; Public Health; Social Research

PhD, University of Cincinnati, 2019, Education, Criminal Justice, and Human Services: Health Education

This dissertation consists of two studies. Study one examined Physical and Mental health related quality of life (HRQOL) based on health behaviors and access to health care among African American adults. Study two examined physical and mental HRQOL based on health behaviors and access to health care among Hispanic/Latino adults. Study One Abstract Introduction: The primary aim of this study was to examine whether physical and mental health-related quality of life (HRQOL) of African American adults differed based on age, sex, income, health behaviors (current exercise, current smoking, recent alcohol use, and recent binge drinking), and access to health care (health care coverage, have a doctor/primary care provider, and physical checkup in last 12 months). Methods: Secondary analysis of the 2014 Behavioral Risk Factor Surveillance System survey was performed. Participants were African American adults (n = 35,493). Results: Results indicated that those reporting the highest physical and mental HRQOL were female, age 65 years or older, with an income of $20,000 or greater and those who had at least one doctor and access to health care. Discussion: The findings of this study can be used by health educators interested in increasing HRQOL among African American adults. Study Two Abstract Introduction: The primary aim of this study was to examine whether physical and mental health-related quality of life (HRQOL) of Hispanic adults differed based on age, sex, income, health behaviors (current exercise, current smoking, recent alcohol use, and recent binge drinking), and access to health care (health care coverage, have a doctor/primary care provider, and physical behaviors (current exercise, current smoking, recent alcohol use, and recent binge drinking), and access to health care (health care coverage, have a doctor/primary care provider, and physical checkup in last 12 months). Methods: Secondary analysis of the 2014 Behavioral Risk Factor Surveillance System survey (open full item for complete abstract)

Committee: Keith King Ph.D. (Committee Chair); Ashley Merianos Ph.D. (Committee Member); Rebecca Vidourek Ph.D. (Committee Member) Subjects: Health Education

Doctor of Philosophy, Case Western Reserve University, 2019, Nursing

The purpose of this study was to examine the extent to which selected population characteristics, and health behaviors influence health outcomes among elderly females aged 65 and above within the context of the Andersen model (1995). The study utilized a secondary data file that was created by the National Center for Health Statistics (NCHS) and the Centers for Disease Control and Prevention (CDC) (NCHS, National Health Interview Survey, 2015). The Andersen model (1995) was used as a theoretical guide to this study. There are four dimensions in the Anderson model (1995). This study focuses on three dimensions from the Andersen's Model, including population characteristics, health behaviors, and outcomes. The data were examined through descriptive analyses, binary logistic regression, and multiple regression. The sample of this study consisted of female older adults aged 65 and older who self-reported perceived emotional problems (depression and anxiety). The results revealed that the majority of the participants in this study were aged 85 years old or above, and were White. Also, they were high school graduates, were not employed, and were widowed. They also had a duration of depression and anxiety for more than one year. The higher number of participants reported a one-time health professional visit. They also indicated that their health status was fair or poor. The significant model in the study examined how the seven study variables including age, race and ethnicity, education level, employment status, marital status, problems paying medical bills, and duration of depression and anxiety, influence health professional visits. The results of the multiple regression equation models showed that all seven predictors explained 12.6% of the variance of the health professional visits. The results indicated that only duration (open full item for complete abstract)

Committee: Faye Gary (Committee Chair); Diana Morris (Committee Member); Matthew Plow (Committee Member); Martha Sajatovic (Committee Member) Subjects: Nursing

Doctor of Psychology (Psy.D.), Xavier University, 2017, Psychology

Obesity in children and adolescents has risen precipitously over the past several decades, especially among underserved populations, due largely to unhealthy diet and insufficient physical activity. Theory and research suggest a link between health beliefs and health behaviors across populations, and current research aims to identify factors that influence and account for this link. The present study explored whether psychological flexibility/inflexibility mediates associations between eating attitudes and both food and physical activity habits in a sample of urban underserved youth. Results indicate that psychological flexibility/inflexibility did not mediate either of the proposed models for the full sample or when sex or age groups were examined separately. Associations were found between eating attitudes and both food habits and physical activity, as well as between psychological flexibility/inflexibility and eating attitudes, food habits, and physical activity, although findings were mixed across the full sample and subsamples examined. It is recommended that future research examine links between psychological flexibility/inflexibility and health beliefs and behaviors more broadly, and that differences by sex and age be more thoroughly studied.

Committee: Abbie Beacham Ph.D. (Committee Chair); Jennifer Gibson Ph.D. (Committee Member); Janet Schultz Ph.D. (Committee Member) Subjects: Psychology; Public Health

MA, University of Cincinnati, 2017, Arts and Sciences: Psychology

Prenatal health behaviors are important factors that protect against or increase the risk of poor pregnancy health and negative birth outcomes (Centers for Disease Control & Prevention, 2016; Lobel et al., 2008). Stress may be an important contributor to prenatal health behaviors, as it has been associated with engagement in negative prenatal health behaviors (Auerbach at al., 2014; Witt et al., 2016). Specifically, research has found that women who experience chronic stress, pregnancy-specific stress, or childhood adversity are more likely to smoke, abuse substances, and have a poor diet (Copper et al., 1996; Lobel et al., 2008; Abel, 2012; Shah, 2010; Chung et al., 2010). Despite the wealth of research about the effects of prenatal health behaviors on pregnancy health and infant outcomes, the influence of psychosocial factors on prenatal health behaviors represents a key gap in the current literature. This is an important area of further study, as the ecobiodevelopmental framework suggests that chronic stress over the lifespan changes the brain's architecture, making it more difficult for individuals to adapt to future adversity in a healthy manner (Shonkoff & Garner, 2012). That is, individuals who experience chronic stress throughout their life adopt unhealthy behaviors as a coping mechanism (Shonkoff & Garner, 2012). However, the existing stress and health behaviors literature does not adequately incorporate the life course perspective. Therefore, the current study aimed to examine the association between prenatal health behaviors and lifetime stress, above and beyond current stress and sociodemographic factors (i.e., education and income). Women (N = 166) who were admitted to the postpartum care unit after delivering an infant were recruited from two large urban hospitals. Results indicated that lifetime stress and the severity of lifetime stress predicts negative prenatal health behaviors, above and beyond relevant sociodemographic factors and current stress (open full item for complete abstract)

Committee: Farrah Jacquez Ph.D. (Committee Chair); Jennifer Malat Ph.D. (Committee Member); Monica Mitchell Ph.D. (Committee Member) Subjects: Clinical Psychology

PhD, University of Cincinnati, 2016, Education, Criminal Justice, and Human Services: Health Education

Background. This study aimed to identify health status, health care access, health behaviors, depression, and neighborhood factors among a sample of older adults who had a diabetes diagnosis. A second aim was to assess if differences existed in perceived positive neighborhood factors and health status, health care, health behaviors, depressive symptoms or demographic factors. Methods. This study was a secondary data analysis of older adults who have a diabetes diagnosis among respondents to the 2013 Greater Cincinnati Health Status Survey (n=478). Selected questions were selected to measure and compare desired variables. Results. A majority of participants were White, lived alone, had a regular source of care, were insured, and reported being in good physical and oral health with few physically and mentally unhealthy days in the prior month. A majority engaged in physical activity in their neighborhoods, few were drinkers or smokers. Nearly two in ten reported being in fair or poor physical health, three in ten reported fair or poor oral health, and nearly two in ten reported being nearly three quarters of the month in physical and mental ill health. Participants reported a number of comorbidities with the average participant having between two and three other diseases besides diabetes. In general participants had Neighborhood Support Scale scores that reflected positive neighborhood factors such as support, dependability and feelings of safety. Neighborhood factors were overall perceived as positive. However, more than one in ten reported low levels of neighborhood support. Several interactions between neighborhood scores, health status, health care access, health behaviors and depressive symptoms were explored. Conclusions. Given the relationship of negative health and lower neighborhood support, it is imperative to conduct further research and health education programs to specifically address issues of community and social support for older adults who have diabet (open full item for complete abstract)

Committee: Liliana Rojas-Guyler Ph.D. (Committee Chair); Amy Bernard Ph.D. (Committee Member); Bradley Wilson Ph.D. (Committee Member) Subjects: Health Education

Master of Arts (MA), Bowling Green State University, 2015, Cross-Cultural, International Education

Research shows that many international students are coming into the United States from countries with high prevalence rates of sexually transmitted diseases, minimal sexual health knowledge, and pre-conceived notions surrounding sexual health. What results from this at colleges across the country is an unavoidable intersection of international students and sexuality, with many administrators of such institutions feeling uncertain or unwilling to include sexual health in their education model. Through my unequivocal belief that resources related to sexual health education are a crucial need on every college campus, for every population, I decided to focus specifically on international students. The overall purpose of this case study is three-fold: (a) to explore the differences in backgrounds in sexual health education and practices for a diverse cross-section of international students studying at BGSU, (b) to investigate whether there is a need for colleges to implement sexual health education for international students in the United States, and (c) to speculate what strategies/curricula could be implemented. Through 24 written, qualitative surveys and 13 follow-up interviews, I sought to answer two research questions, with the first being: From international students' perspectives, how have their social, cultural, familial, and religious backgrounds and practices shaped their home country's stance on sexual health and, subsequently, their own upbringing? My second research question is: From international students' perspectives, what is their perception of the influence of American culture, their perception of access to sexual health information and education programs, level of interest in and preferred format of this kind of education? In an effort to answer these questions, I investigate five major themes in my research that serve as the core foundation of this thesis: (a) prior sexual health knowledge and educational accessibility; (b) cultural ideals about vi (open full item for complete abstract)

Committee: Sherri Horner Ph.D (Advisor); Christopher Frey Ph.D (Committee Member); Mary Krueger Ph.D (Committee Member) Subjects: Comparative; Early Childhood Education; Education; Education Policy; Ethics; Families and Family Life; Gender; Health; Health Education; Higher Education; Multicultural Education; Personal Relationships; Teaching; Womens Studies

PhD, University of Cincinnati, 2015, Education, Criminal Justice, and Human Services: Health Education

Study One Abstract: Background: Steroid use is an increasing health issue among adolescents. Purpose: This study investigated steroid use among 9th through 12th grade students in the Greater Cincinnati area. Methods: A total of 38,414 students completed the PRIDE Questionnaire, which examined steroid use and other drug use. Results: A total of 2.6% of students reported using steroids in the past year. Steroid use (past year) was significantly most common among males, juniors/seniors, African American adolescents, and Hispanic adolescents. Parent and school factors were significantly associated with past year steroid use, while sport participation was not significantly related. Having high levels of parental rule setting regarding substance use were associated with decreased odds for past year steroid use. Similarly, adolescents at schools with clear/consistent rules and enforcement regarding substance use were at decreased odds for past year steroid use. Such findings varied based on sex, grade level, race, and ethnicity. Students who reported that teachers frequently discuss the dangers of substance use were at an increased risk for past year steroid use. Discussion: Several risk and protective factors for steroid use were identified and as such should be addressed in prevention programs. Initiatives to reduce risk of steroid use should incorporate parental and school factors. Special attention is warranted for Hispanic and African American adolescents. Further examination of the potential relationship between context of sport participation and adolescent steroid use is needed. Study Two Abstract: Background: School violence, school victimization and suicidal ideation are serious public health concerns among adolescents. Purpose: The present pilot study investigated the association between adolescent steroid use and school violence, school violent victimization and suicidal ideation. Methods: A secondary data analysis of the 2014 PRIDE Question (open full item for complete abstract)

Committee: Keith King Ph.D. (Committee Chair); Laura Nabors Ph.D. (Committee Member); Rebecca Vidourek Ph.D. (Committee Member) Subjects: Health Education

Doctor of Philosophy, Miami University, 2014, Population and Social Gerontology

This project addresses the causes and consequences of type 2 diabetes among middle-aged and older adults, and the applicability of Western models to different populations. Little attention is given to the occurrence of type 2 diabetes and its correlates in China. This project analyzes data selected from the Chinese Health and Nutrition Surveys (CHNS), 1997-2009, to investigate three research questions: 1) how do unhealthy behaviors affect the occurrence of type 2 diabetes; 2) how is type 2 diabetes diagnosis associated with self-rated health (SRH); and 3) is diabetes self-management (DSM) (i.e., conventional and integrated DSM) associated with SRH among adults aged 45 and older in China. The first inquiry employs a case-control study design and conditional logistic regression, while the second and the third inquiry use binomial logistic regression. The findings reveal that: 1) past and current smoking, high carbohydrate intake, and physical inactivity increase the risks for type 2 diabetes among 45 and older adults in China after controlling for socioeconomic status (SES) and demographic factors; 2) type 2 diabetes diagnosis impairs SRH; and 3) neither conventional DSM nor integrated DSM is associated with SRH among 45 and older Chinese diabetics. Overall, the findings suggest that Western models of type 2 diabetes are partially applicable to a non-Western culture and add new knowledge to the existing literature in understanding diabetes-related consequence on well-being. Furthermore, this project acknowledges the urgency of including sociocultural variations to inform Western research, and provides empirical evidence for further scientific investigation, education, and policy planning on diabetes-related public health outcomes in China.

Committee: Suzanne R. Kunkel (Committee Chair); J. Scott Brown (Committee Co-Chair); Jennifer Kinney (Committee Member); Heidi Harriman Ewen (Committee Member); A. John Bailer (Committee Member) Subjects: Gerontology; Health; Sociology

PhD, University of Cincinnati, 2013, Engineering and Applied Science: Industrial Engineering

The field of Occupational Health and Safety (OHS) is currently facing two main challenges: 1) Increasing awareness and buy-in among stakeholders and 2) Considering differences (cultural, behavioral and anthropometric) in an increasingly diverse and global workforce; work environments and practices designed for one group of workers may not be appropriate for other groups. These challenges are most relevant in the context of worker health and safety in emerging economies; a large and comparatively cheaper workforce is a mainstay of these countries and OHS is an imperative to make their economic growth sustainable. This study addresses needs on two fronts: From a research perspective, there is a dearth of data on contextual and cultural variables in a developing country work environment that impact safety performance; most existing safety research on this topic is Western or developed country centric. From a practitioner perspective, worker health and safety is a relatively nascent field in developing countries; practitioners are struggling to understand safety perceptions and attitudes that can help localize safety practices and enable more effective implementation of safety programs. This empirical study has 3 objectives: 1) Determine if a safety culture is present in a developing country, 2) Understand contextual influences (perceptions, behaviors and cultural context) that affect safety culture, and 3) Demonstrate a positive correlation between improved worker health and safety and key business outcomes; a "business case" for worker health and safety will especially help gain support from management teams in the highly cost competitive business climate in developing countries. For the first two objectives, an empirical study was conducted in India using a sample set of 500 individuals (senior managers/executives, supervisors and workers) derived from 22 organizations across 5 sectors (Infrastructure/Energy, Mining, Biotech, Services/IT and Manufacturing) and (open full item for complete abstract)

Committee: Henry Spitz Ph.D. (Committee Chair); Sundararaman Anand Ph.D. (Committee Member); Thomas Richard Huston Ph.D. (Committee Member); David Thompson Ph.D. (Committee Member) Subjects: Industrial Engineering

Doctor of Philosophy, The Ohio State University, 2012, Sociology

Research demonstrates that both union formation and parenthood have profound influences on health and well-being, in part because these relationships provide social control over health behaviors (Umberson 1987). Despite decades of scholarship concerning the influence of intimate unions and parenthood on health and health behavior, much of this research utilizes non-contemporary data and methods that cannot assess causality. Further, there is a paucity of knowledge on how the influence of intimate social ties on health outcomes differs across socially disadvantaged groups. This is surprising given the core sociological tenet that social stratification fundamentally shapes the nature and consequences of key life course transitions. In this dissertation, I utilize four waves of longitudinal data that are representative of a contemporary adult sample that has transitioned into marriage/cohabitation and parenthood largely in the 21st century and fixed effects analyses to assess whether there is a causal influence of union formation and/or parenthood on body mass index, alcohol consumption, tobacco use, and marijuana use. Further, I examine variations by socioeconomic disadvantage and race/ethnicity in the impact of entry into marriage, cohabitation, and parenthood on these outcomes. My results lead to two central conclusions. First, my results indicate a causal influence of union formation and parenthood on health risk indicators among young men and women in contemporary America. Specifically, I find that transitions into marriage, parenthood, and (to a lesser extent) cohabitation are significantly associated with increases in BMI and reductions in alcohol consumption, tobacco use, and marijuana use. Second, my results indicate that both socioeconomically disadvantaged and black young adults receive substantially fewer benefits from marriage, cohabitation, and parenthood than their nonblack or more advantaged counterparts. For instance, my results indicate that, compared (open full item for complete abstract)

Committee: Kristi Williams (Advisor); Reanne Frank (Committee Member); Kammi Schmeer (Committee Member); Christopher Browning (Committee Member) Subjects: Sociology

Master of Science (MS), Ohio University, 2004, Journalism (Communication)

This secondary analysis examines the influence of purposive and habitual media consumption on Ohioans' knowledge, attitudes and self-perceptions, and behaviors regarding physical activity and health. In all, 2164 individuals from three Appalachian counties and two non-Appalachian counties were interviewed in a telephonic survey conducted in 1999. The study demonstrates that purposive media use is more strongly correlated with respondents' knowledge, attitudes and self-perceptions, and behaviors, than is non-purposive media use. Other findings indicate that the three media investigated (TV, radio and newspapers) seem to have different influences on respondents, depending not only on the type of exposure (purposive or habitual), but also on gender and county. Finally, the study examines the sources of information Ohioans use in their search for physical activity and healthy eating information. It demonstrates that interpersonal sources are preferred to mass media, and that information about healthy eating is sought more intensely than information about physical activity.

Committee: Daniel Riffe (Advisor) Subjects: Journalism