MS, Kent State University, 2016, College of Education, Health and Human Services / School of Health Sciences

PATEL, KRISHNA D., M.S., December 2016 Nutrition KNOWLEDGE, PERCEPTION, AND RISK REDUCING BEHAVIORS OF FEMALE COLLEGE STUDENTS WITH FAMILY HISTORY OF OSTEOPOROSIS (197 pp) Director of Thesis: Eun-Jeong (Angie) Ha, Ph.D. Family history of osteoporosis (FHO) has been recognized as one of the most important risk factors for osteoporosis development (Iqbal, 2000). The amount of bony tissue present at the end of skeletal maturation, known as peak bone mass, has been identified as a crucial component for osteoporosis prevention (Rizzoli, & Bonjour, 1999; Valimaki et al., 1994). The primary objective of this study was to assess knowledge and perception about osteoporosis and risk reducing behaviors of female college students with family history of osteoporosis in comparison with those without FHO. The secondary purpose of this study was to compare modifiable risk factors between the two groups. Inclusion criteria was limited to female college students enrolled at Kent State University in spring 2016 semester ages 18 and older. Family history was determined by self-reported data from participants indicating a FHO or fragility fractures in first- or second-degree relatives. Analysis of the data revealed that 95 students had FHO, making up 16.4% of the sample. Results showed there were significant differences in general knowledge and modifiable risk factors of osteoporosis, and risk perception between female college students with FHO and female college students without FHO (P=0.05). However, no significant differences in perception in risk reducing behaviors and modifiable risk factors were noted between the two groups (P=0.05). Future studies with a more consistent method of recording calcium intake and including calcium/vitamin supplementation questions are needed to reconfirm the findings of this study.

Committee: Eun-Jeong (Angie) Ha (Advisor); Natalie Caine-Bish (Committee Member); Karen Gordon (Committee Member) Subjects: Health Sciences; Nutrition

Doctor of Philosophy, Case Western Reserve University, 2005, Epidemiology and Biostatistics

Background: Recent studies have found that as many as one in three HIV infected persons may continue to engage in unprotected sex, sexual contact often occurring with seronegative or unknown status partners. While the issue of prevention has received greater attention in developed countries, little is known about the extent to which persons living with HIV/AIDS (PLWHA) might continue to engage in high-risk sexual behaviors in sub-Saharan Africa. Objectives: Propose and test a conceptual model explaining sexual-risk behaviors among PLWHA in terms of cognitive and situational factors. Methods: Cross-sectional study conducted in Abidjan, Cote d'Ivoire (West Africa). The study sample consisted of HIV-positive men and women at various stages of their illness and currently attending one of the largest outpatient clinics for HIV patients. All the data were collected through face-to-face structured interviews. Results: Three hundred forty-nine (349) valid questionnaires were completed. Fifty percent (50%) of the study sample reported one regular partner; 10% reported casual partners and 7% reported multiple partners. Over one-third of the respondents had engaged in high-risk sexual behaviors during the previous 6 months. As posited, two cognitive factors (an internal and external) emerged from the factor analysis process. Although only a small to moderate variance was explained by the model, most of the hypothesized effects were statistically significant: the internal cognitive and the situational factors were inversely related to sexual risk behaviors; the internal cognitive factor also partially mediated the relationship between situational factor and sexual risk-taking. The external cognitive had no significant effect on the outcome. Different models were found for the men and women. Conclusions: The present study indicates that the behavior of a sizable number of HIV patients may continue to increase the burden of the disease at the population. Because access to care is (open full item for complete abstract)

Committee: Mendel Singer (Advisor) Subjects:

Master of Science (MS), Ohio University, 2015, Clinical Psychology (Arts and Sciences)

Type 2 Diabetes Mellitus (T2DM) is a lifelong chronic illness influenced by both genetic and behavioral risk factors. Although children of parents with T2DM are at significantly greater risk for developing the disease than age-matched controls (Valdez, Yoon, Liu, & Khoury, 2007), there is a dearth of research examining the factors that influence their perceptions of their own risk for the illness and their likelihood to engage in health risk and protective behaviors. In this descriptive cross-sectional survey study, we recruited university students (N = 197, 86% Caucasian, 66% female, average 19±1.6 years old) to examine factors associated with perceived susceptibility of T2DM and engagement in health protective behaviors in young adult college students with (N = 66) or without a parent/grandparent (N = 131) diagnosed with T2DM. Consistent with hypotheses, individuals with familial risk for T2DM were more likely to report greater own absolute risk and direct comparative risk of developing T2DM than individuals without familial risk for T2DM. However, contrary to hypotheses, no differences in physical activity, healthy diet, and sugar sweetened beverage consumption were found between the two groups. Further, contrary to expectations, both greater own absolute risk of developing T2DM and greater direct comparative risk of developing T2DM were associated with being less likely to have a healthy diet, less likely to engage in regular physical activity, and more likely to consume sugary drinks. Results may provide a better understanding of poor lifestyle choices associated with increased diabetes risk in individuals with familial risk of diabetes and could inform development of interventions targeted towards young adults.

Committee: Julie Suhr Ph.D. (Advisor); Elizabeth Beverly Ph.D. (Committee Member); Stephen Patterson Ph.D. (Committee Member) Subjects: Clinical Psychology

Master of Arts (M.A.), University of Dayton, 2014, Communication

The purpose of this study is to provide a background of alcohol and related risk behaviors, and analyze their portrayal in the popular MTV series Jersey Shore. This study bridges the gap between research conducted in the areas of Reality Television and Health Communication in the media. While previous studies have critically analyzed the genre of Reality Television and the communication of risk related behaviors and Health Communication studies independently, how Reality Television as a genre communicates health related behaviors has yet to be explored. A content analysis was conducted to identify and interpret how physical and communicative behaviors were depicted on MTV's Jersey Shore and categorized how both men and women display and consume, as well as communicate messages, about alcohol. Four frames related to alcohol use were identified: escape, fun, excuse, and problematic/corrective references were used by characters to discuss alcohol use and outcomes. Results indicated high rates of alcohol consumption but minimal depictions of related negative outcomes. In addition, women were shown drinking and intoxicated more often than men, and there were significant differences by sex in terms of communication patterns related to alcohol. Women tended to send more messages that related to potential negative outcomes, and were also more likely to associate alcohol as a means to positive social interaction than their male counterparts. In addition earlier seasons were grouped together and compared to the final season after one character announced an unplanned pregnancy and another underwent substance abuse treatment prior to filming. Although consumption rates did decrease, the communication practices did not change.

Committee: Teresa Thompson Ph.D. (Advisor); Ronda Scantlin Ph.D. (Committee Member); James Robinson Ph.D. (Committee Member) Subjects: Communication

Doctor of Philosophy (PhD), Ohio University, 2010, Psychology (Arts and Sciences)

Sexual risk behaviors, which can lead to a number of negative health consequences, continue to be a problem on college campuses (e.g., Grello, Welsh, & Harper, 2006; Gullette & Lyons, 2006; Ravert et al., 2009). The theory of planned behavior (TPB; Ajzen, 1985; 1991) has been shown to be effective in predicting sexual risk behavior (e.g., Albarracin, Johnson, Fishbein, & Muellerleile, 2001; Godin & Kok, 1996), as well as a range of other behaviors (e.g., Ajzen, 1991; Armitage & Conner, 2001). The predictive validity of the TPB has been shown to increase when other variables are included and therefore an extended version of the TPB was examined in the current study to aid in the prediction of condom use, contraceptive use, dual use (condom use plus another contraceptive method), and casual sex among college students. Structural equation modeling was utilized to test both sufficiency models as predicted by the TPB and extended models where six additional variables were allowed to have direct paths to both intentions and behavior. Specifically, the first goal of the study was to examine both the TPB sufficiency models and the extended TPB models for each of the seven behaviors to determine whether the six added variables (past sexual risk behavior, anticipated affect, moral norms, sexual excitation, sexual inhibition, and sensation seeking) had direct relationships with intentions and/or behavior and to assess which of the two types of models provide a better fit to the data. Given that there is often a discrepancy between intentions and behaviors (e.g., Sheeran, 2002), the current study also sought to further the research on factors that predict intention-behavior consistency by exploring a set of variables that may discriminate between 1) those who intended to engage in safe sex behaviors and did so and 2) those who intended to engage in safe sex behavior and did not engage in such behavior. Specifically, the second goal of the study was to determine if characteristi (open full item for complete abstract)

Committee: Christine Gidycz Ph.D. (Committee Chair); John Garske Ph.D. (Committee Member); Patricia Beamish Ph.D. (Committee Member); Julie Suhr Ph.D. (Committee Member); Benjamin Ogles Ph.D. (Committee Member) Subjects: Psychology; Social Research

Master of Science (MS), Ohio University, 2007, Psychology (Arts and Sciences)

Current measures of sexual risk taking are either too narrowly focused to be used with college students or do not have adequate psychometric properties. The goal of the current study was to develop a broad and psychometrically sound measure of sexual risk taking. Three hundred and ten undergraduate students at a mid-sized Midwestern university were surveyed to develop and gather reliability and validity information on a new measure of sexual risk, the Sexual Risk Survey. Sex differences were also explored throughout the study. The measure was found to be multidimensional with five factors. The measure demonstrated good internal consistency and test-retest reliability as well as convergent, discriminant, and concurrent validity. Although there were no sex differences in total sexual risk taking behaviors reported over the past 6 months, differences emerged in the variables that predicted sexual risk taking. Implications for these findings are discussed.

Committee: John Garske (Advisor) Subjects:

PHD, Kent State University, 2005, College of Arts and Sciences / Department of Psychological Sciences

The current study tested a mediational model of the relationships between childhood physical (CPA) and sexual abuse (CSA) and sexual risk in adulthood. Posttraumatic stress disorder and adult sexual assault were hypothesized to mediate the relationships between childhood abuse and behavioral and relational risk for HIV in adulthood. Participants were 202 young, inner-city women who participated in a large-scale HIV prevention project. Structural equation modeling and a series of regression analyses were used to test the proposed relationships. Results suggested that both CSA and CPA were significantly associated with PTSD and rape in adulthood. CPA was significantly related to an increased number of sexual partners and high-risk sexual relationships in adulthood. In contrast, CSA was not associated with high-risk sexual behaviors or relationships in adulthood. Support was not found for a mediational role of either PTSD or adult rape on behavioral or relational risk. Limitations of the current study and future directions for research are reviewed.

Committee: Stevan Hobfoll (Advisor) Subjects: Psychology, Clinical

Doctor of Philosophy, Case Western Reserve University, 2009, Epidemiology and Biostatistics

Background: Latinos in the United States are at high risk for depression, anxiety, and substance abuse and HIV/AIDS has excessively impacted this community. Individuals with severe mental illness (SMI) are more likely to engage in HIV high-risk behaviors. A range of psychiatric and social factors have been considered as correlates of sexual risk behavior with findings indicating a need for future studies to provide insight into the direction and nature of these associations. Objective: To describe the HIV-risk behaviors of Puerto Rican women with SMI in Cuyahoga County, Ohio using quantitative and qualitative techniques. Aim 1 investigated the association of childhood sexual abuse (CSA) and adult HIV-risk behaviors using a retrospective cohort design. The second aim examined psychiatric and social correlates of HIV sexual risk behavior and aim 3 compared data obtained qualitatively to data obtained quantitatively using criterion validity. Methods: The study sample consisted of 53 Puerto Rican women with SMI recruited between October 2002 and December 2005. Consenting participants participated in a baseline interview, two follow-up, semi-structured interviews, and up to 100 hours of non-continuous participant observation. Descriptive, bivariate, and multivariate analyses were conducted to describe HIV-risk behaviors and assess the efficacy of two data collection methods. Results: The relationship between CSA and HIV-risk may be mediated by partner abuse and mental illness diagnosis. Psychiatric and social factors were differentially associated with sexual risk behaviors and multivariate analysis showed that increased severity of psychiatric symptoms and factors and living below the poverty line are predictive of sexual risk behaviors. The correlations between quantitative and qualitative responses concerning sexual and drug use behaviors revealed agreement in some cases and inconsistencies and contradictions in others. Conclusions: Puerto Rican women with SMI are in (open full item for complete abstract)

Committee: Sana Loue (Committee Chair); Martha Sajatovic (Committee Member); Leslie Heinberg (Committee Member); Daniel Tisch (Committee Member) Subjects: Epidemiology

Psy. D., Antioch University, 2009, Antioch Seattle: Clinical Psychology

This study examined published research on sexual risk behaviors and the people who engage in them. Using current and past literature, an extensive review and analysis of attitudes, beliefs, and causes of sexual risk behaviors was done. Sexual risk behaviors were defined within the following models: medical, alcohol and drug, societal views, self definitions, and cultural definitions. The age groups studied were: adolescence (12-17), young adulthood (18-25), middle adulthood (26-50), and later adulthood (51 and older). Studies of homosexual men and women and heterosexual women and men were reviewed as well as a comparison of gender differences. Studies about religion and culture were reviewed, as well as health, psychological co-morbidity, and substance abuse. And, finally, a review of interventions used was examined. A critical analysis was done of 164 articles to determine themes, which emerged as gender, age, ethnicity, assessments used, procedures used, limitations within the articles, and sexual orientation. Finally, an educational pamphlet was developed to target the largest at-risk group, people between the ages of 18-25 years. Based on sexual risk behavior literature, this study examines the impact that risky sexual behaviors have on a person and society, and it also highlights the importance of accessible education. The electronic version of this dissertation is at OhioLink ETD Center, www.ohiolink.edu/etd.

Committee: Mary Wieneke Ph.D. (Committee Chair); Alex Suarez Ph.D. (Committee Member); Cynde Moya Ph.D. (Committee Member) Subjects: Psychology; Public Health; Sociology

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

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

PhD, University of Cincinnati, 2020, Arts and Sciences: Psychology

Health-risk behaviors (e.g., smoking, poor diet) directly increase the risk for chronic disease and morbidity. There is substantial evidence of a negative association between socioeconomic status (SES) and engagement in health-risk behaviors. However, due to the complexity of SES, researchers have suggested looking beyond this factor to fully understand the mechanisms that underlie engagement in health-risk behaviors. Stress is one plausible mechanism through which SES impacts health-risk behaviors. Currently, it remains unclear how stress occurring across the life course might impact health behaviors and explain the association between SES and these behaviors. To address the gaps in the literature, 172 adults between the ages of 18-49 were surveyed about their lifetime stress exposure, sociodemographic variables, and health-risk behaviors via an online recruitment portal, Prolific. Five major findings emerged from the current study. First, SES was negatively associated with engagement in health-risk behaviors and lifetime stress above and beyond current stress and other relevant demographics. Second, lifetime stress was significantly associated with health-risk behaviors above and beyond current stress and relevant demographic variables. Third, lifetime stress fully mediated the association between SES and health-risk behaviors above and beyond current stress and other demographics. Fourth, the severity of stress experienced emerged as the most significant lifetime stress variable that explains the relation between SES and health-risk behaviors. Fifth and finally, lower SES and experiencing financial and legal/crime stressors increased the likelihood of engaging in health-risk behaviors. The current study results align with previous research and suggest that stress occurring over the lifespan impacts the relation between SES and health-risk behaviors, which are in turn known to impact health outcomes. However, our findings move the current literature forwa (open full item for complete abstract)

Committee: Farrah Jacquez Ph.D. (Committee Chair); Anjali Dutt Ph.D. (Committee Member); Monica Mitchell Ph.D. (Committee Member) Subjects: Psychology

PhD, University of Cincinnati, 2019, Arts and Sciences: Psychology

The prevention of health-risk behaviors during adolescence has been regarded as a nationwide health priority because these are causally associated with chronic illness, disability, and other leading causes of death among adolescents and adults in the U.S. (Kann et al., 2016). To this end, a growing body of research supports a strong link between Adverse Childhood Experiences (ACEs) and health-risk behaviors, such as alcohol and drug use, criminality, self-injury, perpetration of interpersonal violence, and self-injurious behavior (Duke et al., 2009; Layne et al., 2014). However, the behavioral and physiological consequences of being exposed to ACEs have been strikingly understudied among Latino youth. To address the gap in the literature, the purpose of this study was to investigate several mediating (i.e., adrenocortical hormones) and moderating (i.e., family cohesion, community support and social support) variables in the relation between ACEs and health-risk behaviors among Latino youth. Latino youth (N = 72) were recruited from schools and their communities and asked to provide saliva samples and complete questionnaires. Three major findings emerged. First, Traditional ACEs were higher in the current Latino youth sample than the national average but were not directly related to increased health-risk behaviors in this study. However, the prevalence of community-level ACEs was positively associated with alcohol and drug use. Second, both family cohesion and support from friends and adults moderated the association between Traditional ACEs and tobacco use. Third, preliminary empirical evidence is provided to show that exposure to ACEs affect stress hormone production and may be the mechanism by which ACEs relate to health-risk behaviors. Empirical findings such as those from this study highlight the growing need to examine ACEs in more diverse populations. The lack of direct link between ACEs and health-risk behaviors potentially speaks to the resilience, strength (open full item for complete abstract)

Committee: Farrah Jacquez Ph.D. (Committee Chair); Thomas Geracioti M.D. (Committee Member); Bridgette Peteet Ph.D. (Committee Member); Matia Solomon Ph.D. (Committee Member); Lisa Vaughn Ph.D. (Committee Member) Subjects: Psychology

Master of Arts, The Ohio State University, 2019, Psychology

Adverse Childhood Experiences (ACEs) are widespread in the general population and appear to increase vulnerability to adult neuropsychiatric disorders. The biological mechanisms that confer this increased risk are poorly understood. Changes in neuroimmune cell number, phenotype, and activity are observed with stress, depression- and anxiety-like behavior in rodents, and mood disorders; these cells may also program adult behavior following early life stress. In this study, male and female Sprague-Dawley rats were subjected to early deprivation stress or control handling for 4hrs./day from PD2-20. Brains from rats killed at PD21 were processed for counting of mast cells and qPCR analysis of mRNA expression related to microglial phagocytosis, histamine synthesis, and blood-brain barrier proteins in limbic regions. Adult rats were tested for anxiety-like, stress coping, and risk assessment behavior. Stress increased granulated and total mast cell count in the hippocampus, as well as hippocampal expression of genes related to microglial phagocytosis. Stress decreased hippocampal histidine decarboxylase mRNA expression, amygdala cybb mRNA expression, exploratory behavior in the open field test (in males only), risk assessment behaviors, closed arm entries in the elevated plus maze, and time immobile in the forced swim test. When controlling for experimental condition, histidine decarboxylase mRNA expression and phagocytic gene expression were significantly negatively correlated. These experiments suggest potential neuroimmune mechanisms that program maladaptive adult behaviors following early life stress.

Committee: Kathryn Lenz Ph.D. (Advisor); Tamar Gur M.D./Ph.D. (Committee Member); Benedetta Leuner Ph.D. (Committee Member) Subjects: Neurosciences; Psychobiology; Psychology

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

Identity development is a key part of flourishing, but how an at-risk emerging adult student shapes a life project meant for a flourishing life has been understudied. There is a notable gap in current literature examining the effects of capital negotiation (social capital and identity capital) on life project design, and informal educator behaviors on emerging adult student employability and identity capital, which we argue are critical, missing elements of a flourishing life project. Previous research on informal student-faculty interactions has addressed academic/educational outcomes of those interactions, leaving void the potential identity capital development and negotiation also resulting from those same interactions. In the same vein, much research has addressed counseling life designing, some even for vulnerable youth, but little attention has been devoted to informal edu-mentor behaviors regarding the planning of a life project for at-risk emerging adult students across educational settings. This work borrows from othering and literature on under-resourced students to begin to define at-risk, but we concentrate its definition by specifying Adverse Childhood Experiences (ACE). This dissertation's intensive interviews and structural equation modeling investigated behaviors of faculty that foster bonding with students, the consequences of which resulted in student identity capital development. The research offered herein developed from a three-part exploratory sequential mixed methods project addressing how an at-risk emerging adult student negotiates capital in shaping a life project across educational settings. The initial phase leveraged a grounded theory approach to examine the student-teacher relationship from the secondary school teacher's perspective. I investigated the particular behaviors, social and emotional intelligence competencies, and practices that made a teacher good at the facilitation of a relationship with othered students, specifically (open full item for complete abstract)

Committee: Paul Salipante (Committee Chair); Diana Bilimoria (Committee Member); James Gaskin (Committee Member); Kalle Lyytinen (Committee Member) Subjects: Adult Education; Community Colleges; Continuing Education; Education; Education Policy; Educational Evaluation; Educational Leadership; Higher Education; Management; Organizational Behavior; School Administration; Secondary Education; Social Psychology; Social Research; Systems Design; Teacher Education; Teaching

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

Homeless youth frequently engage in high risk sex behaviors putting them at risk for Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs), and unplanned pregnancy (Edidin et al., 2012; Halcon & Lifson, 2004). Previous attempts to intervene have had limited success (Naranbhai et al., 2011). While previous research has documented high prevalence rates and risk factors for engaging in sexual risk behaviors (Halcon & Lifson, 2004; Edidin et al., 2012), less is known about homeless youths' perceptions regarding potential benefits and consequences of their sexual risk behaviors. The current dissertation presents the results of three qualitative studies that explored homeless youths' motivation for engaging in sexual risk behaviors and their perception of the potential risks. The studies used qualitative interviews with 30 substance using homeless youth (ages 14-24). Interviews were coded by three coders using grounded theory methods (Strauss & Corbin, 1998) and NVivo 10 software. The first study explored homeless youths' motivation for engaging in sex and how the potential threat of HIV/STIs impacted their decisions. Youth reported similar emotional and physical benefits of having sex as housed youth. However, the stressful context of experiencing unmet needs appeared to influence youth to make impulsive decisions about sex that were often based on their immediate feelings/needs. Consequently, they rarely considered the threat of HIV/STIs when deciding to have sex. Further, youth were generally unconcerned about their risk of contracting HIV/STI because they either underestimated their level of risk or did not believe they would be significantly impacted by contracting HIV or an STI. The second study examined youths' perception of how substance use influences their decisions to have sex and engage in sex work. Youth differed in whether they believed substance use impacted their decisions. Some youth believed their decisions about sex were not i (open full item for complete abstract)

Committee: Natasha Slesnick (Advisor); Suzanne Bartle-Haring (Committee Member); Keeley Pratt (Committee Member); Irene Hatsu (Committee Member) Subjects: Social Research

PHD, Kent State University, 0, College of Education, Health and Human Services / School of Health Sciences

The purpose of this study was to investigate the risk perceptions and cooking behaviors of Saudi Arabian women in relation to cardiovascular disease (CVD) and intentions to cook low fat meals. Participants were Saudi Arabian women (ages 22-55). Data were collected through self-administered paper-pencil surveys in the summer of 2016. This study was conducted in a primary care clinic's waiting room in a single hospital (King Khalid University Hospital) providing services to patients mainly from the Riyadh district of Saudi Arabia. The Home Cooking and Intentions to Cook Low Fat Meals Survey instrument was used in data collection. Both descriptive and inferential statistical data analyses were conducted using SPSS version 24. The major findings of this study showed a moderate negative correlation between risk perception of CVD and fat-related cooking behavior. Significant positive correlation is seen between risk perception of CVD and intention to cook low fat meals. The participants demonstrated high fat cooking behavior. It is recommended to conduct further research to understand how perceptions are formed among Saudi Arabian women and why they do not practice healthy cooking behaviors to prevent CVD.

Committee: Dianne Kerr (Committee Chair) Subjects: Health Education; Nutrition

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

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2013, Media and Communication

In spite of its prevalence in the contemporary media landscape, the effects of exposure to sexually explicit materials have received relatively little attention from media and communication scholars. From a Social Cognitive Theory (SCT) perspective, the present study investigated whether the consumption of sexually explicit materials predicts the adoption of risk behaviors, particularly sex- and body image-related risk behaviors. In addition, the study focused on the psychological mechanisms - represented by the Sexual Self-Concept (SSC) - that could facilitate the adoption of said risk behaviors. In order to address these issues, quantitative data was collected using a self-administered online survey design. Also, in response to mounting criticism according to which quantitative research methods could offer only truncated snapshots of individuals' interactions with sexually explicit materials, a second, qualitative data set was collected using a self-administered diary design. The analysis of the quantitative data revealed that consumption of sexually explicit media content significantly predicts SSC scores. In turn, SSC was found to be a significant predictor of the adoption of sex-related risk behaviors (sex risk partners and sex risk practices). SSC was found to not be a significant predictor of body image health-related risk behaviors. A path model revealed that the SSC moderates the adoption of risk behaviors, thus supporting the theoretically-driven hypothesis that the SSC functions as a psychological mechanism that could facilitate the adoption of risk behaviors. Also, the path model revealed that age and gender significantly predict the adoption of risk behaviors. Thematic analysis of the qualitative data revealed a complex and nuanced picture of participants' interactions with sexually explicit media content. The underlying assumption of most quantitative studies of pornography is that exposure to pornography is likely to have detrimental effects on (open full item for complete abstract)

Committee: Srinivas Melkote Ph.D. (Advisor); Sandra Faulkner Ph.D. (Committee Member); Michael Horning Ph.D. (Committee Member); Michael Bradie Ph.D. (Committee Member) Subjects: Communication; Mass Media

PhD, University of Cincinnati, 2010, Education : Educational Studies

Despite the increased interest in the social institutional role of the Black Church in the African American community, few scholars have given serious attention to the role (or lack thereof) of the Black Church in addressing the sexual risk-taking behaviors of African American youth. The escalating concern with the increase in STD/STI contraction, unplanned pregnancies, and HIV/AIDS among African American youth has incited interest for expanding systematic research focusing on the African American youth population. The primary purpose of this study is to examine the perceptions of ministerial leaders and sexual health advocates in regards to the sexual risk behaviors of African American youth. This study differs from previous research by focusing specifically on the African American youth population as well as Black Churches within a specific southern geographical location that is traditionally defined as the ‘Bible Belt' region. The specificity of this geographical region is directly related to the disproportionate impact of sexual risk behaviors in that area for African American youth, as reported by the CDC. This study describes the perceptions of Black ministerial leaders and sexual health advocates regarding the relevance and effectiveness of the Black Church as a social and religious institution. More specifically, the research is focused on sex education and faith in the lives of African American youth. In contrast to majority reports this study suggests that the voice of the Black Church is not silent. The voice of Black Church leadership acknowledges HIV/AIDS as a dire health challenge and pandemic in the African American community. More specifically, participants overwhelming agree that the church has a social responsibility to address sexuality issues, including the provision of faith-based sex education for African American youth. While the contention of sexual health advocates indicate that the Black Church has a long way to go in addressing preventive (open full item for complete abstract)

Committee: Vanessa Allen-brown PhD (Committee Chair); Mary Anne Pitman PhD (Committee Member); Roger Collins PhD (Committee Member); Wendy Coleman PhD (Committee Member) Subjects: Religious Education